Jeanelle de Gruchy: Should David Bowie have spoken out about the cause of his cancer?

jeanelledegruchy2David Bowie has died. From cancer. So much outpouring of grief. And yes I participated, posting #RIPBowie tweets and reminiscing about seeing him in concert in Montreal as an 18 year old with all who would listen, shedding a tear listening to the day long radio tributes as I felt my youth slipping away with his passing. And yet everything I watched, on TV, on YouTube, on Facebook and in the many pictures, there it was, revelling in its strong silent presence and mocking us for our complicity, the killer that took him away from us aged only 69. The swell of adulation for one of the greatest musicians, pop stars, cultural icons, and boundary pushers was wonderful; the lack of comment on what killed him prematurely was pitifully duplicitous.

I normally hold my tobacco industry genocide outrage in check in social settings…until my friend said what a wonderful, quiet, dignified death he had had. Actually no I opined, not acceptable—why did he go quietly, why didn’t he use his celebrity status to speak out about the epidemic caused by smoking? I questioned how, when well-known people have died from AIDS, this is foregrounded, and if they had spoken out about the epidemic, we were pleased, and if they denied they had it, we disapproved. Yes Bowie stopped smoking some years ago, but those who were HIV positive are likely to have changed their behaviour too. For them both, the extra bullets had already been loaded in the gun for the Russian roulette of diseases that would kill them.

We know that Bowie died from cancer. There is a small amount of online speculation about whether it was liver cancer—primary, or perhaps secondary to lung cancer; we know that smoking is a major risk factor for cancer. Given that previously he has been open about his struggle with alcohol and drug misuse, it seems odd that Bowie and his family have been so guarded about the details of his death. And the mainstream media appear silent on making a connection between his smoking and death from cancer. According to the internet chats I looked at, it’s felt to be insensitive and counter productive to focus on the cancer and his history of smoking.

It reminds me of how, as a medical student, I was fascinated by Susan Sontag’s 1977, Illness as metaphor, and the sequel a decade later: AIDS and its metaphors. In both, she explores the taboo of illnesses, the myths and stigma surrounding consumption (TB) and cancer and subsequently HIV. In the later book, she wrote that cancer was no longer swathed in secrecy and shame. As we become clearer about what causes cancer, maybe this just isn’t true anymore? Or maybe smoking isn’t seen as noteworthy as alcohol and drugs abuse, and this was just about Bowie simply wanting people to focus on his art right up until the end.

Yet, the tobacco industry did very well from their product placement through Bowie—even more so following the wide coverage of his death and surge in viewing of Bowie smoking footage. It makes me angry, angry that he died so young—and angry that no one is lamenting this, as if death from cancer is random and unpredictable, and no-one is responsible. It makes me angry that my hero has allowed this to happen, to influence so many more to start or continue smoking, and to die quietly, without speaking out in rage about this needless, profit-making killer.

I feel lucky I can do my bit to reduce tobacco use through my work. For social occasions however, I think I’m going to have to tone the old outrage down, and turn Bowie up.

Jeanelle de Gruchy, Director of Public Health, London Borough of Haringey. 

No competing interests.

  • Steve Malen

    I’m sorry I don’t agree at all. Smoking is not a major cause of all cancers. However even if David did have lung cancer there is nothing wrong with his family and him keeping that private. Obviously he had a fatal disease and it is understandable for him not to have wanted to exactly go on an anti-smoking campaign while dying. Also it’s 2016, not the 70s, a much smaller percentage of the population smoke and people are already aware of the dangers of smoking.
    What’s interesting now is the switch many people are making for vaporizers and research needs to be done to find any link to cancer. Many people assume it’s no cancer risk but you never know. I would assume because of much less tar, hot smoke, other chemicals that risk is much lower but like I said, you never know.
    Back to Bowie, may he rest in peace and I don’t blame him for keeping his fatal disease a private matter.

  • Mark Magenis

    Ecigs have been tested, extensively, no link has been found to any disease. Indeed public health England have reviewed over 185 studies and concluded they are a minimum of 95% safer. Further they found zero evidence of gateway effect for non smokers and no measurable metabolic effect on bystanders, so no secondhand vaper to worry about. What they did find is that over a million smokers have fully switched to ecigs and another 1.5million are undergoing transition.

  • OfJamaicensis

    I do find it strange that you wrote this when all you have is a “small amount of online speculation”. You seem to have no idea if tobacco, drugs, alcohol, bad diet or just natural causes contributed to his death. Yet the opportunity seemed too good for you miss blaming tobacco. As a Director of Public Health I would have expected a higher standard.

  • susanne stevens

    totally agree with Steve Malen…….Bowie has a right to have his medical condition kept private and not to have anybody snooping around in his life.

  • Allan Reid

    “those who were HIV positive are likely to have changed their behaviour too. For them both, the extra bullets had already been loaded in the gun for the Russian roulette of diseases that would kill them”
    ooooh, what a completely unwise and sweepingly judgemental statement to make…are you a Director of Public Health, or an African Anglican bishop?

  • Gerry Stimson

    Directors of Public Health shouldn’t exploit celebrity deaths. You have no idea what Bowie died from, and what views he had about his life. I went to the same youth club as him in 1966 – I don’t think he would care for your views. Celebrate a life well led.

  • Vinny Gracchus

    More antismoking propaganda. Smoking is not the cause of all cancers. It may be a risk factor for some; but it is an outright exaggeration to claim smoking causes all cancers is an outright lie.

  • Daniel Hammond

    7 October, the COT meeting on 26 October and the COC meeting on 18
    November 2004.

    “5. The Committees commented that tobacco smoke was a highly complex chemical mixture and that the causative agents for smoke induced diseases (such as cardiovascular disease, cancer, effects on reproduction and on offspring) was unknown. The mechanisms by which tobacco induced adverse effects were not established. The best information related to tobacco smoke – induced lung cancer, but even in this instance a detailed mechanism was not available. The Committees therefore agreed that on the basis of current knowledge it would be very difficult to identify a toxicological testing strategy or a biomonitoring approach for use in volunteer studies with smokers where the end-points determined or biomarkers measured were predictive of the overall burden of tobacco-induced adverse disease.”

    In other words … our first hand smoke theory is so lame we can’t even design a bogus lab experiment to prove it. In fact … we don’t even know how tobacco does all of the magical things we claim it does.

    The greatest threat to the second hand theory is the weakness of the first hand theory.

  • Daniel Hammond

    …World Atlas: More People Smoking Cigarettes than Ever

    There are more people smoking now than ever before, despite health warnings and the rising price of cigarettes. In 1980, 4,453 billion cigarettes went up in smoke, which increased to 6,319 billion in 2010. By 2020, you can expect to find nearly seven billion cigarette ends littering the world.

    Top of the charts in terms of nicotine addiction are Asia and Australia, which is where 57 percent of cigarettes are smoked today.

  • Sam Kusmeti

    David Bowie quit smoking over 12 years before his death from stomach cancer (generally not related to smoking) so this is a pretty big reach

  • CyZane

    So what kiind of lesson does the author of this article want never smoker celebrities who die young to give to their fans? ”Kids, don’t do like I did, I got sick from not smoking” maybe? Please stop exploiting every opportunity no matter how tasteless, to gain cheap points for your anti-smoking advocacy. It’s low and has absolutely no class.

  • Robert Ward

    Strange you blame cigarettes for his death, i am a cancer nurse, and many, many of my patients, have never ever smoked in their lives and still get horrendous cancers. It is impossible to quantify oh yes smoking caused this. Yes smoking increases ones risk of cancer, but so do a whole lot of other stuff to. Get off your soap box and stop blaming smoking on all of life’s ills. If people want to smoke, drink eat too much, it is our job as health professional to coach and educate, not dictate from some make believe superior elevated position!

  • Mag01

    A question for Jeanelle. What should people be dying of? Or
    does Jeanelle believe that leading the “Public Health approved lifestyle” will lead to immortality?

    A questionable adage is “only the good die young”. Contemporary Public Health, long hijacked by spittle-flicking, finger-wagging, moralizing zealots, has inverted the saying into the equally questionable “only the good die very, very, very old”.

    Let anyone die, particularly those engaged in “unapproved”
    behaviors, and the moralizing vultures begin to circle, reducing the life of the recently departed to the disease they died from, seizing the opportunity to deliver another spittle-saturated “sermon” on how people should be living according to the church of Public Health.

    You Public Health guys are worse than the Temperance lobby
    of a century ago.

  • Mag01

    Jeanelle de Gruchy, Director of Public Health, London Borough of Haringey.
    No competing interests.

    Jeanelle (and all of those in Public Health) is a prohibitionist who would like to see tobacco use eradicated. As such, Jeanelle is ideologically compromised. That is a competing interest in the interpretation of data, in the dissemination of information, and in commentaries/opinions such as above.

  • “Liver cancer” just means cancer in the liver. Hepatocellular carcinoma is the cancer actually arising from the liver cells (hepatocytes). The most common cause is hepatitis c. Primary lung cancer often spreads (metastasizes) to liver. In both cases, the patient can be stated to have cancer in the liver, which a lay person could call “liver cancer.”

    If a smoker developes “liver cancer,” it is statistically much more likely to be primary lung cancer metastatic to the liver, as opposed to hepatocellular carcinoma. Half of all lung cancers have liver metastases, and fatal lung cancer is ten times as prevalent as fatal primary liver cancer. In smokers, the ratio is even more lopsided.

    With regard to Bowie’s smoking discontinuation, lung cancer doesn’t become clinically evident for many years after it starts. It takes nearly 20 years after smoking discontinuation until the risk of lung cancer for a former smoker falls to the range of a never smoker.

    From a bit of Internet searching, I was unable to find an authoritative statement concerning whether Bowie’s “liver cancer” was primary liver cancer or primary lung cancer, metastatic to the liver. Statistically, it was much more likely to be the latter.

    There is absolutely no doubt that smoking is the number one cause of avoidable deaths. The average non smoker lives more than ten years longer than the average smoker.

    – Larry Weisenthal / Huntington Beach CA USA