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Thank You for Smoking

by Drew J Jones Thu Jan 25th, 2007 at 06:20:21 AM EST

Yesterday Mark Thoma's Economist's Voice included a diary on NHS doctors and trusts debating whether to treat smokers -- a question that I find absolutely horrifying, not because I'm a smoker, but because of the absolutely disgusting degree to which smokers have become targets in this day and age.  The argument is fairly straightforward: Smoking increases costs.  Smokers are more likely to suffer complications, such as failure of tissue to heal quickly and infection.  Thus, argue proponents, finite resources should be concentrated on those who are least likely to suffer such complications.

It is, as one of the opponents points out, the accepted norm to preach discrimination against smokers in western societies.  Smokers in Nottingham fork over £5.40 for a twenty-pack of Marlboros -- fully three times the cost of the same pack in Atlanta.  (And, yes, you can pay less if you want to smoke the stale European garbage, but even that will run you £4.25.)  In San Francisco, last I heard, smokers were banned from lighting up in the streets.  Across America and Europe, smoking is being banned from bars and restaurants.  And now, finally, we have discrimination in the world of medicine.

But, as is always the case, no such discrimination exists against (say) the morbidly obese, who enjoy greater influence due to their larger numbers -- and who, I'll bet, cost society far more than smokers could ever dream.  Presumably these are not life or death surgeries, but, if we are to begin discriminating based upon cost considerations, then socialized medicine in Britain has rendered itself no more a moral beacon than its privatized counterpart in America.  And it is made worse by the fact that smokers in Britain are already paying taxes for the NHS, in addition to the insane "sin taxes" they pay at the supermarket.  It is, in other words, organized theft.


As I have pointed out in the past, I am, while leaning to the supportive side, very suspicious of universal medicine because of the political football I knew our habits would inevitably become.  (My habit has long become one, of course, but putting medicine in the political arena would, without question in America, open the door to full-scale totalitarianism, as far as habits are concerned.)  I despise, knowing that I am more intelligent than most of them could ever dream, politicians who pretend to know what is best for me, and who pretend to know what is, or is not, harming society to one degree or another.  As a fairly militant cultural libertarian, I'm of the opinion that we all have our bad habits (smoking, poor eating, drugs, booze, dangerous sexual behavior, etc), and that our habits should be off limits to our potential tyranny of the majority.  I don't begrudge people these choices, and I expect the same treatment.

Now the argument will, of course, be made that smokers chose to adopt their destructive habit, and this is unquestionably true.  Most, if not all, destructive habits are a matter of choice.  But allow me to ask: Are smokers going to be given a corresponding discount in their tax rates?  The fact remains that smokers pay for the NHS just as nonsmokers do, and even more at a given income because of the previously-mentioned sin taxes, as well as the taxes they pay, in America, for programs like Social Security and Medicare that they are less likely to receive back upon retirement given their lower life expectancies.

And this is to say nothing of my bet that the tax revenue generated by cigarettes in England likely exceeds -- and by an obscene amount -- the difference in cost associated with treating smokers as opposed to nonsmokers.

It's easy to hate on smokers -- to blame them for the problems of society associated with higher medical costs while ignoring the ever-growing number of Jabba-the-Hutt-like beings that make up our populations.  (And, by the way, I don't see any discussion of all the expensive drugs advertised on American television dealing with illnesses associated with obesity.  I wonder how that impacts our public spending and insurance premiums....)  The smokers have paid amounts exceeding their fair share without bitching, yet still the social engineers want more.  This obsession with controlling one's fellow human beings is despicable, and it is dangerous.  Nonsmokers have been given everything they wanted on a silver platter: Smokeless bars, smokeless streets, high taxes, and on and on.  They spent years whining and got their way, so now, please, leave us the hell alone.

Or, if they're truly going to insist on denying treatment, then give us back our fucking tax money.

Display:
I hate smoking. Let's get that straight. I can't stand the smell, most smokers I've enountered in E London seem to think it's okay to smoke in no-smoking areas cos non-smokers are all politically correct wankers who need taking down a peg or two.

Having an entire table light up in the non-smoking restaurant section of a busy pub next to where I'm trying to eat is to confront smoking in its vast aggressive overpowering awfulness.

So believe me. I hate the filthy habit. I hate stinking of their habit when I get home from the pub, I hate the sore throat from inhaling their habit.

However, this is a step too far. We can do our best to discourage people from smoking, and I do agree with banning it from pubs and restaurants whilst thinking that banning it in the open air is taking anti-smoking zealotry to Godwin-esque lengths.

But a case in point. I am on a very high dose of oestrogen every day. A dose that gives me a form of natural high. However, I am under firm instructions that 10 weeks prior or 6 weeks after any planned surgery I must cease medication as the chances of me dying on the operating table are unacceptably high.
Smokers are told that their recovery is impaired if they smoke, their chances of succesful outcomes are impaired if they smoke. If they're going for surgery, they should give themselves the best chance of recovery possible. I can understand the medical community's reluctance to expend scarce resources on those who are being perversely suicidal.

However, as Drew asks, why not the obese ? Why not the drinkers ? (thinking selfishly) The inevitable end of this is requiring us to live on a diet of fish, fresh vegetables and boiled chicken whilst drinking green tea (uurghhh!!!). Now I like sushi, but I'm not sure the oceans could cope with such a change of global diet. So we enter the idea of rationing healthcare according to our purity. Who amongst us could cast the first stone ? Eek and yuk. One can imagine a modern day Pastor Niemoller intoning "First they denied the smokers, but I did not raise my voice. I was not a smoker"

It's not really about a problem of socialised medicine as Drew would suggest. I'm quite sure that US insurers would discriminate against smokers (and anybody else they can) if they were able to, but the smoking lobby is still powerful in DC.

But this isn't really about smoking, or even about rationing healthcare. This is about Government abdicating responsibility for setting national guidelines. What this is about is that healthcare is becoming increasingly expensive and resources are increasingly stretched. It is quite obvious that healthcare, at least in the UK, cannot much longer support the "anything goes" model.

But this is not an issue for local helathcare trusts, this is an issue for government to determine what should is the level of care that can be consistently considered. Funding models must be re-visited, the NHS model was the first; better ones exist.

Sadly it won't happen. Politicians are particularly cowardly in this regard. Hazel Blears, the labour party chair, deomnstrated this perfectly when she campaigned against the closure of a hospital, a direct result of policies she'd fought hard to push through parliament.

keep to the Fen Causeway

by Helen (lareinagal at yahoo dot co dot uk) on Thu Jan 25th, 2007 at 09:54:53 AM EST
on individual policies now.

It's one of the questions they ask when deciding to take you on.  

by HiD on Fri Jan 26th, 2007 at 01:59:22 AM EST
[ Parent ]
Which only proves my point. This is not an issue of socialised medicine.

keep to the Fen Causeway
by Helen (lareinagal at yahoo dot co dot uk) on Fri Jan 26th, 2007 at 06:58:44 AM EST
[ Parent ]

Nonsmokers have been given everything they wanted on a silver platter: Smokeless bars, smokeless streets, high taxes, and on and on.  They spent years whining and got their way, so now, please, leave us the hell alone.

This deserves only one answer, which includes a sexually oriented expletive, and a second person pronoun, but being polite, I'll desist.

Smoking stinks. Smokers (in general, there are honorable exceptions, but they are a minority) have NEVER EVER shown ANY respect to non-smokers unless forced to. Smokers have always behaved as if they had the absolute right to smoke whenever and wherever they wanted, and they whine whenever they are prevented from lighting up for a minute.

Not smoking for an hour does not make you a non-smoker. Being in the presence of a smoker for a minute destroys my being a non-smoker and annihilates the concept of "non-smokers". Get that fucking assymetry in you selfish little head and stop the fucking whining.

You deserve all the opporbrium you get, because you (smokers as a group) never made any effort. It's like corporations: self-regulation DOES NOR WORK. Regulation, and enforcement are what it takes.

But I'll be happy to pay for your healthcare, because smokers save us lots of pension payments.

In the long run, we're all dead. John Maynard Keynes

by Jerome a Paris (etg@eurotrib.com) on Thu Jan 25th, 2007 at 10:28:12 AM EST
Doesn't your wife smoke?  Do you consider yourself a forced smoker?

And in all fairness, I know a lot of smokers who have made an effort.  It is an addiction, and it really a struggle to quit. Though it is possible, it takes more discipline than never smoking at all and sitting around judging people.

Frankly both sides of this debate are whining.  

All that said, the diarist is quite wrong about anything being handed to us on a silver platter.  Basic rights are fought for tooth and nail.  Gah! indeed.

Those who can make you believe absurdities can make you commit atrocities. -Voltaire

by p------- on Thu Jan 25th, 2007 at 06:29:49 PM EST
[ Parent ]
Smoking under a no-smoking sign is not an example of failing to kick the addiction.

*Lunatic*, n.
One whose delusions are out of fashion.
by DoDo on Thu Jan 25th, 2007 at 06:53:42 PM EST
[ Parent ]
And she's respectful. At home, she does it at the window, in the kitchen (and that's at most once or twice a day). And that's okay, for the most part. Some compromises, when both sides show tolerance, can be acceptable, you know.

There are friends that do smoke in my presence (for instance, over coffee after lunch), because they don't ever try to smoke without asking, and they never complain if I say no - and it works.

In the long run, we're all dead. John Maynard Keynes

by Jerome a Paris (etg@eurotrib.com) on Fri Jan 26th, 2007 at 04:20:12 AM EST
[ Parent ]
The correct solution to the smoking problem was to adopt a program back in the 1950's, when it was shown to be a health hazard, that would have phased out tobacco.

Notice that when a product like Vioxx is shown to have a 20% greater risk of damage than a similar product it is quickly removed from the market, but when cigarettes are shown to be much more harmful they continue to remain legal.

The answer is simple: follow the money. The (primarily US) tobacco companies have been able to buy politicians and push through legislation that has protected their interests. Even as restrictions have been imposed on promotion in the US they have been expanding into other regions of the world. The penalties and taxes that have been imposed are having a slight affect on usage.

False libertarian arguments about freedom of action are inappropriate. It is the role of government to protect its citizens from known harmful conditions as has been demonstrated in the Vioxx and similar cases.

Tobacco use could be phased out by imposing grandfathering clauses on use, for example. This means that existing smokers could continue to buy the product, but it would become increasingly difficult for youngsters to pick up the habit. Would this work perfectly? Of course not, but a black market distribution system would never be able to fill the gap. After a certain period (say 25 years) growing tobacco would become illegal. This would give plenty of time for farmers to adapt and for smokers to quit.

Those who are so addicted that even after this long transition period they cannot stop would be supplied with cigarettes under conditions similar to those on methadone maintenance programs.

Policies not Politics
---- Daily Landscape

by rdf (robert.feinman@gmail.com) on Thu Jan 25th, 2007 at 10:37:14 AM EST
No, I absolutely resist the prohibition stance. I think it's about time we learnt that every time we make a "pleasure" illegal we simply create an area of well-rewarded economic opportunity and a new gateway into illegality and contempt of law for users.

And the economic activity, beng illegal, simply invites other criminalities alongside it. Addiction to heroin may be unpleasant outsdie of the healthcare-managed arena, but the criminality associated with its illegaility is far far worse. Heroin costs each country far more than its legailty would. Drugs hsould be elgalised for this reason alone.

Tobacco would be a stupid addition to the list.

keep to the Fen Causeway

by Helen (lareinagal at yahoo dot co dot uk) on Thu Jan 25th, 2007 at 10:46:46 AM EST
[ Parent ]
Most of the world got along without tobacco up until about 300 years ago. Promoting tobacco was fostered solely by economic concerns - starting with the British cultivation in the American colonies.

There may be some slight psychophysical response to tobacco as there is to coffee, but the primary reason tobacco is "pleasurable" is because it satisfies the nicotine addiction. This is different that other substances like alcohol and marijuana which have an effect independent of addiction.

The world gets rid of harmful materials all the time. The determination is sometimes made rationally but too frequently powerful money interests override good public policy. Study the issue of Phen-fen to see how bad things have to get before governments will act when there is a lot of money to be made.

I think some version of my phased disuse would require the least impact on present addicts.

Policies not Politics
---- Daily Landscape

by rdf (robert.feinman@gmail.com) on Thu Jan 25th, 2007 at 11:11:52 AM EST
[ Parent ]
No. Nicotine directly interacts with the brain's pleasure receptors. The physical addiction is annoying, but getting rid of it is no worse than a moderately bad cold lasting a few weeks. The problem is that you'll still crave the pleasure long after the physical withdrawal is gone. Nicotine also creates a positive reinforcement effect of the pleasure caused by alcohol and caffeine The big difference between substances like alcohol or marijuana and nicotine or caffeine is that the pleasure effect comes combined with mental disorientation which may or may not be pleasurable depending on ones tastes, but clearly interferes with normal day to day functioning in a way that nicotine and caffeine don't.
by MarekNYC on Thu Jan 25th, 2007 at 12:04:19 PM EST
[ Parent ]
I don't smoke, and I think that those who do need to be mindful that they are imposing on others with their habit when they smoke.  Your right to do whatever the hell you want ends at my lungs.  That their actions may negatively affect the lives of others, and that they have no right to impose on others in this manner seems lost to the liberatarians. My niece had heart surgery when she was less than a year old, and is extremely sensitive to smoke.  When smokers light up in a confined public space, they seem to miss that there are people out there who can end up in the hospital because they've decided to do so.

That said, I think that a prohibition is a bad idea.  Is it a tobacco problem that we have, or a cigarette problem that drives consumption far beyond reason.  We not ban the cigarette, and force the loose leaf sale of tobacco products.  If the smoker has to make each and every cigarette they smoke, this quickly ends chain smoking. When people primarily smoked cigars or pipes, they smoked far less.  Something like the equivalent of a cigarette a day.  Smoking is an impluse driven habit, why not increase the personal effort cost of each and every smoke to reduce consumption?

And I'll give my consent to any government that does not deny a man a living wage-Billy Bragg

by ManfromMiddletown (manfrommiddletown at lycos dot com) on Thu Jan 25th, 2007 at 05:13:40 PM EST
[ Parent ]
If the smoker has to make each and every cigarette they smoke, this quickly ends chain smoking.

I know a living disproof of your more.

*Lunatic*, n.
One whose delusions are out of fashion.

by DoDo on Thu Jan 25th, 2007 at 05:59:19 PM EST
[ Parent ]
I'm confused what you're saying.

My point is that even if it doesn't stop smoking, it slows it down.

The only people I know who like to roll with paper aren't smoking tobacco.

And I'll give my consent to any government that does not deny a man a living wage-Billy Bragg

by ManfromMiddletown (manfrommiddletown at lycos dot com) on Thu Jan 25th, 2007 at 06:03:43 PM EST
[ Parent ]
What I meant is that I know someone who prefers to roll it himself (and that because it's unfiltered), and does so one after another. With his routine, rolling takes less than a minute, and he can do it without looking...

*Lunatic*, n.
One whose delusions are out of fashion.
by DoDo on Thu Jan 25th, 2007 at 06:17:32 PM EST
[ Parent ]
Must be a cultural thing.

It's extremely rare to find a tobacco smoker who rolls their own here in the US. In the US filted cigarettes own about 97% of the market.  I suspect the numbers are similar in most of Western Europe. Scandinavia is a bit different in that they seem to like chewing tobacco (I think its called snoose, a much more socially responsible way to use tobacco in my mind), and Central (Eastern) Europe is pretty much a mystery to me.

And I'll give my consent to any government that does not deny a man a living wage-Billy Bragg

by ManfromMiddletown (manfrommiddletown at lycos dot com) on Thu Jan 25th, 2007 at 06:24:00 PM EST
[ Parent ]
Said person resides in the Netherlands. This stidy claims that the roll-your-own percentage is lvery low in the US and 28.4%(!) in Britain. The study also reinforces my (unstated) hunch that one rolled cigarette generally provides more of both tar and nicotine than a pre-manufactured cigarette. This article claims "almost half" of Dutch smokers smoke hand-rolled tobacco.

*Lunatic*, n.
One whose delusions are out of fashion.
by DoDo on Thu Jan 25th, 2007 at 06:45:54 PM EST
[ Parent ]
one rolled cigarette generally provides more of both tar and nicotine than a pre-manufactured cigarette

Further evidence in this 1996 report to the EU Commission.

*Lunatic*, n.
One whose delusions are out of fashion.

by DoDo on Thu Jan 25th, 2007 at 07:00:35 PM EST
[ Parent ]
Much of this growth is based on value for money and the fact that the ritual of rolling your own has become simpler with the arrival of easy to use cigarette rolling machines.

Why must they make an idiocy out of a reaction to a plant?

Don't fight forces, use them R. Buckminster Fuller.

by rg (leopold dot lepster at google mail dot com) on Thu Jan 25th, 2007 at 08:01:33 PM EST
[ Parent ]
BTW, that 97% figure is only of manufactured cigarettes. Check the accompanying tables referenced by the text you linked.

*Lunatic*, n.
One whose delusions are out of fashion.
by DoDo on Thu Jan 25th, 2007 at 06:54:41 PM EST
[ Parent ]
Rolling one's one cigarettes is way cheaper in this land of the 5€ pack... 40g of tobacco are as expensive as a 20 cigarettes pack, but will let you roll about 50 cigarettes ; for young and poor people, halving the cost of addiction is an easy computation...

Un roi sans divertissement est un homme plein de misères
by linca (antonin POINT lucas AROBASE gmail.com) on Thu Jan 25th, 2007 at 07:05:29 PM EST
[ Parent ]
Wow, really !! Most smokers I know use roll-ups now and again, and given the cost here, about $7 a pack (is that right Drew ?), many do so exclusively.

Really glad I gave up 25 years ago

keep to the Fen Causeway

by Helen (lareinagal at yahoo dot co dot uk) on Fri Jan 26th, 2007 at 07:03:48 AM EST
[ Parent ]
I'm not sure how the cost of rolling one's own cigs runs, honestly.  Buying packs runs about £5.50 ($11.00), but I'm a Marlboro smoker, so mine cost a bit more.  I'm, I think, smart enough to know that my own clumsiness -- and believe me when i say that I am astonishingly clumsy -- dictates that attempting to  roll my own cigs would only result in a lot of tobacco being spilled onto the ground.

Be nice to America. Or we'll bring democracy to your country.
by Drew J Jones (pedobear@pennstatefootball.com) on Sun Jan 28th, 2007 at 05:24:07 AM EST
[ Parent ]
Via Google news:

Aftenposten: Snuff use explodes (15 Jan 2007)

Increasing numbers of Norwegians are walking around with a rather thick upper lip. Under it is a pouch of tobacco, known as "snuff" or snus in the local language, and its popularity has skyrocketed after the country invoked strict anti-smoking laws.

Some are calling it a "snuff epidemic," and it's infected young men especially. Even in Aftenposten's own newsroom, colleagues share the small round boxes of the stuff that older colleagues remember their grandfathers using.

Snuff has suddenly become trendy. "It's good," Anders Stikbøkken, age 21, told newspaper Aften in Oslo. "I think it's great to sit down and relax with a cup of coffee and some snuff. It's become a habit."

There was a similar report the other day in one of the free commuter newspapers about snuff use being on the rise in London after the introduction of the smoking ban.

Bye, bye, lung cancer, hello tongue cancer.

"It's the statue, man, The Statue."

by Migeru (migeru at eurotrib dot com) on Fri Jan 26th, 2007 at 07:45:12 AM EST
[ Parent ]
And you are the same guy who wrote this?????
by someone (s0me1smail(a)gmail(d)com) on Thu Jan 25th, 2007 at 11:04:14 AM EST
[ Parent ]
I don't think my position is inconsistent. On the one hand I'm talking about criminalizing certain behavior and on the other I'm talking about a public health threat.

Prosecution of "sin" is usually motivated by some underlying religious/moral stance that wants to impose values on others. Getting rid of deadly products in the marketplace is motivated by an entirely different set of concerns.

Policies not Politics
---- Daily Landscape

by rdf (robert.feinman@gmail.com) on Thu Jan 25th, 2007 at 11:15:31 AM EST
[ Parent ]
I generally agree with the principle you are espousing here, and there are clearly anti-social behaviors worthy of such treatment.

This being said, in my view (and I am not a smoker) is that smoking tobacco, like drinking alcohol, ingesting caffeine, eating saturated fat, getting endorphins from chocolate, getting ones jollies from consensual sex, enjoying a little hashisch or and numbing ones mind with television, does not rise to the level of noxiousness at which banning would be in order.

All the above activities, while certainly carrying certain properties which in some circumstances can be described as anti-social, are not in reasonable, usual circumstances, necessarily harmful either to those who engage in them, or even those around them if properly legislated and proscribed. (And those circumstances where these things cross over into the anti-social can be legislated as circumstances warrant, thus laws against smoking in public places, or gay sex in front of elementary schools, or driving while intoxicated and so forth.)

We should be conscious of the social costs of all behaviors - this is a rightful attitude to assume. But we should also be tolerant, open to behaviors inimical to our own values, and mindful of the pitfalls of tyrannies by majority rule. Anti-social behaviors are rightfully proscribed when on balance they do more more harm than good, and we should be mindful that it is not simply for the majority to determine what is harmful, what is good, and how each should be evaluated and measured. Minority rights are important on many levels, and this is one of them.

100% in agreement with you on the "libertarian" dodge though.

The Hun is always either at your throat or at your feet. Winston Churchill

by r------ on Thu Jan 25th, 2007 at 12:56:34 PM EST
[ Parent ]
Anti-social behaviors are rightfully proscribed when on balance they do more more harm than good, and we should be mindful that it is not simply for the majority to determine what is harmful, what is good, and how each should be evaluated and measured. Minority rights are important on many levels, and this is one of them.

If it is not for the majority to determine what is harmful than who is do this? Who also determines where the "balance" lies?

This illustrates one of the contradictions of democracy - the tyranny of the majority. The best scheme we have come up (so far) is to try to minimize the infringement of minority rights, but this also depends upon the willingness of the majority. When the majority decides that something is to be done that the minority disagrees with it's just too bad, but that's how things work. If the minority has a strong enough case and feels passionate about the issue they can campaign (democratically or otherwise) to get things changed.

This is how the US got rid of slavery, women got the vote and senators became directly elected. The problem arises when a minority manages to push through a policy which is not supported by the majority. This is either done by getting control of the levers of power, but misrepresenting the issues or by subverting democracy altogether.

Examples include passage of the Abolition amendment, the present minority regime in Washington, and the rise of the Nazis.

We establish government organizations with guidelines based upon general philosophical principles. After a long period of consumer abuse a number of agencies were created at the beginning of the 20th Century to create and enforce safety and efficacy standards. These included the FDA and later the EPA. By all logic cigarettes should have been covered by the rules of the FDA but a lobbying effort on congress explicitly exempted tobacco from regulation. A similar thing happened a few years ago with dietary "supplements" and various herbal preparations.

This is not democracy or letting people do their own thing, but a corruption of the democratic process - which is why my comment is labeled "follow the money". There is no rational reason to continue to allow new people to become addicted to tobacco and vaguely libertarian arguments about freedom of choice are insufficient. In the battle for hearts and minds the tobacco industry uses propaganda, bribery (of legislators and consumers), deceit, and manipulation of the product to hook consumers. Everyone likes to think that they are able to evaluate all the options and make rational decisions, but if this were actually true than most advertising wouldn't exist.  

Policies not Politics
---- Daily Landscape

by rdf (robert.feinman@gmail.com) on Thu Jan 25th, 2007 at 01:26:12 PM EST
[ Parent ]
If it is not for the majority to determine what is harmful than who is do this?

There's a bit more to it that this, as I suspect you know. For one thing, determination of harm needs to have a proper basis in fact. Lots of religious Americans will tell you sex outside of marriage, or even certain sex acts inside of marriage (even if consensual) are sins and harmful to the soul. And so, they have, via their majorities, made these things illegal.

I hope you are not arguing that this is right, proper and as it should be?

The first line of defence should be science (by which I mean, of course, good science, peer-reviewed and held as acceptable by the bulk of trained scientists in the field). Is there harm? What is the nature of the harm? Can it be measured? How?

Conversely, are there any benefits? Measurements?

And within these data, are there minority populations who are significantly different from the population in aggregate, and if so, how do the data relate to them?

You could ignore the wishes of minority populations, but doing so has historically proven counterproductive (eg various prohibition regimes surrounding alcohol, sex and cannibis) or intensely and violently repressive (eg the sorts of extreme measures favored by, say, Mao in dealing with opium addicts).

I don't know what the rule of thumb should be for at what proportion you simply ignore the preferences of behavioral minorities, but given cannibis use in the US is around 20% of the active 15-34 population, and anti-cannibis laws are largely ineffective, I'd say the threshold is at least as low as 20%, and probably less than half that. (And as an aside, despite the repressive laws in most US states, not to mention the feds, on cannibis, the usage rates in the US are roughly double those in the EU, where cannibis is relatively more tolerated).

Who also determines where the "balance" lies?
Again, this gets left initially to the experts, after whose evaluation, and giving due deference to minority populations and their rights, the political process can be joined (democratic or otherwise). That's my preference anyhow.

When the majority decides that something is to be done that the minority disagrees with it's just too bad, but that's how things work.

And when it comes to legislating behaviors, the disagreeing minority tends to ignore the majority and do their own thing.

I think fellatio is still illegal in Georgia, and dancing in a poorly-lit dance hall in Minnesota is too. Doesn't stop too many people, though.

And if you start enforcing all those silly laws, just watch what happens. (Ditto if you go ahead and outlaw all use of tobacco...)

You cannot, repeat, cannot legislate virtue. You can only legislate against truly anti-social behavior, and even that's hard. Expand the field of behaviors liable to prosecution overmuch and you undermine the legitimacy of law in the first place.

And, in watching how America has recently gone about attempting to legislate virtue, I note that the poor increasingly get screwed so that middle class folks can feel they are doing their part to make society better. Taxes on cigarettes? Regressive as hell, the SES of the average smoker is lower than average. Emissions testing on automobiles? Surprise surprise if it isn't overwhelmingly the cars of the working poor which can't pass the inspection. But of course, there's no decent public transportation in most of the US, and access to health-care for the working poor? Fuggedaboutit.

You want to go after the truly anti-social, destructive behaviors that do immense harm to others lives, you might consider legislating for socio-economic justice first before going after the average middle-class to-do list of do-goodisms. Give me a living wage, health care coverage for all, decent public transportation, fund schools for the poor as well as those of the middle-class and rich, quit gutting retiree pensions and maybe top that off with guaranteed housing for every family who needs it, then maybe we can talk about going after the small stuff.

Because that's what cigarette smoking is - the small stuff.

The Hun is always either at your throat or at your feet. Winston Churchill

by r------ on Thu Jan 25th, 2007 at 06:28:29 PM EST
[ Parent ]
Because that's what cigarette smoking is - the small stuff.

From the CDC (not the latest figures, but good enough):
http://www.cdc.gov/MMWR/preview/mmwrhtml/mm5114a2.htm


Results show that during 1995--1999, smoking caused approximately 440,000 premature deaths in the United States annually and approximately $157 billion in annual health-related economic losses.

The economic costs of smoking totaled $3,391 per smoker per year.

Even by your somewhat ambiguous standards I think smoking qualifies to be a banned product. As I said the reason it isn't has more to do with institutionalized bribery that public health concerns.

Policies not Politics
---- Daily Landscape

by rdf (robert.feinman@gmail.com) on Thu Jan 25th, 2007 at 07:30:07 PM EST
[ Parent ]
Provided you think US government-supplied figures are intellectually honest.

Needless to say, I think we have ample evidence to the contrary. And this topic is no different (please refer to Jerome's post above about retirement savings for further fleshing out...)

The Hun is always either at your throat or at your feet. Winston Churchill

by r------ on Thu Jan 25th, 2007 at 09:13:53 PM EST
[ Parent ]
What would be the benefit to the government (in this case the independent agency CDC) to exaggerate the negative impact of smoking?

It is the government that is supporting the tobacco industry.

Policies not Politics
---- Daily Landscape

by rdf (robert.feinman@gmail.com) on Fri Jan 26th, 2007 at 09:20:52 AM EST
[ Parent ]
The benefit is indirect. Sins of omission in this case which absolve the government of responsibility for far greater sins than tolerance of false advertizing by the tobacco industry and subsidization of tobacco farmers.

Why is the CDC document silly? Well, beyond the points they themselves make about the imperfections in their analysis, I'd point out three larger points that are ignored altogether.

  1. Definition of "pre-mature death". Seems to me this is quite important in such an analysis and yet, I can't figure exactly what they mean, so really I don't know how to make sense of their assertion that tobacco is the leading cause of premature death in the US. Do they mean in raw numbers of people? In years lost? Or some other measure (ie, certain years - say in the prime of a taxpayers' life are worth more than other years)?

  2. What are the cost savings from "pre-mature" deaths? Seems to me, retirement benefits, including those that the US government actually supplies (one of the few things it does well) owuld see a net saving to the public treasury. Why doesn't the CDC evaluate this?

  3. Further to point one, surely they must be joking if they think smoking causes more deaths than systematic neglect of health care, especially of the poor. Take a look at child mortality rates in the US and compare them to developed countries the US is so proud of being, and then revisit CDC's assertions about smoking being the leading cause of premature death. I mean, c'mon, an American child is 60% more likely to die before the age of 5 than a French or German child and yet the CDC thinks smoking is the leading cause of premature deaths?

I guess societal neglect is not considered a cause in the US. I bet firearms aren't, either. Or suburban sprawl and the attendant automobile traffic accidents and smog which accompany it.

Well, at any rate, that's why I take what the US government says, at many different levels, with a large grain of salt. It is the expression of two classes warring for control - the upper middle and the welathy classes. What comes out is the expression of the interests of those two classes in alternance.

And smoking eradication if on one of the "do goody" lists the American middle-class has set out for itself. Along with getting the right car seat in the cars of the poor (without, of course, funding them), television sex and violence or other similar well-meaning but not exactly well-targeted social engineering experiments the Democratic party has increasingly limited itself to achieiving anything legislatively.

Too bad proper pre- and neo-natal care and early pediatric cancer detection for the poor aren't also on that list.

The Hun is always either at your throat or at your feet. Winston Churchill

by r------ on Fri Jan 26th, 2007 at 12:34:32 PM EST
[ Parent ]
You are, of course, free to believe whatever you wish. But why anyone else should consider your opinion on the studies of the harmful effects of tobacco as authoritative is another question.

There have been hundreds of studies done by thousands of scientists and social scientists over 60 years which document the relationship of tobacco usage to public health. Even the cigarette companies found such links back in the 1950's and suppressed them as came out later in a variety of government probes and law suits. This cover up is one of the reason they ended up being fined hundreds of billions of dollars.

When debating scientific data one has to use the tools of science not rhetoric (although one wouldn't know this looking at the behavior of the Bush regime). Study up and get back to us when you are a recognized world authority on the subject.


Policies not Politics
---- Daily Landscape

by rdf (robert.feinman@gmail.com) on Fri Jan 26th, 2007 at 02:42:27 PM EST
[ Parent ]
Right. But I'm not contesting the fact that cigarette smoking is bad for people.

What I am contesting is the importance folks like you give to cigarette smoking, especially those of you who would have that we move to declare it a controlled substance altogether (which is what you are in fact proposing here). I note that while true that tobacco use is undoubtedly harmful, I note also that there are far more harmful things on this world that somehow escapes the notice of the US CDC towards whom you are so deferential.

I note that children die in the US (and children don't generally smoke or otherwise ingest tobacco) at rates far outstripping those of other Western countries, and I blame the US healthcare system for this.

I also note that US occupation of Iraq kills far more innocent Arabs in any given recent year than die in the US of self-inflicted wounds related to tobacco use.

And, of course, in both cases, the average age of premature death is far lower than for those of cigarette smokers.

Given these facts, I wonder about the wisdom of fighting for a deeply unpopular cause you seem to espouse (ie, adding tobacco to the list of controlled substances in the US) when there are far more important fish to fry. Namely, getting equitable access to healthcare in America, and getting America's ass out of the parts of the world where it is currently killing people.

Now, you can say that my holding this opinion proves I don't know shit about science, and therefore my opinion is irrelevant, and that's your right. But of course, I am within my rights to think you greatly mistaken and, what's more, a bourgeois crank.

Instead of moving into the sort of ad hom you profess to eschew in other fora, why don't you limit yourself to the criticism I level to the statistics I cite, starting with the data from the World Health Organization, on child mortality in the US?

The Hun is always either at your throat or at your feet. Winston Churchill

by r------ on Fri Jan 26th, 2007 at 04:27:41 PM EST
[ Parent ]
Sorry, Very So.

Very good analysis, Red Star, last two comments.

You hit the nail right on the fugging head.

Democrats and the goody left are amazing in their innovative incrementalism. Paying for it all largely is regressive, and then the left wonders why it is mocked and not taken  " seriously" in American politics.

"When the abyss stares at me, it wets its pants." Brian Hopkins

by EricC on Fri Jan 26th, 2007 at 04:37:52 PM EST
[ Parent ]
In the 50's people would have laughed at you much the same as talking about peak oil in 1960.  Sure we could have done something, but the majority weren't interested.

It is the role of government to protect its citizens from known harmful conditions as has been demonstrated in the Vioxx and similar cases

what a silly analogy.  Drug safety is long way from regulating personal habits.  There shouldn't be anyone left out there that doesn't know smoking is harmful.  What people didn't know was that Vioxx had harmful side effects that outweighted its benefits.  Many drugs with potentially harmful side effects are still used.  They are just labeled properly so that doctors and patients can decide.  That route is still open to Vioxx.  It's just since it really doesn't provide much in the way of real benefit over it's competitors, it won't sell.

by HiD on Fri Jan 26th, 2007 at 02:11:13 AM EST
[ Parent ]
by afew (afew(a in a circle)eurotrib_dot_com) on Thu Jan 25th, 2007 at 10:54:47 AM EST
I like grinding up the meat to make a satisfying meat pie. Unfortunately it's hard to find Grade A smug.

Be nice it were open  season on sanctimonious nonsmokers, and all the rest of the smug set.

Somebody would probably make it a felony though.<sigh>

"When the abyss stares at me, it wets its pants." Brian Hopkins

by EricC on Thu Jan 25th, 2007 at 10:01:05 PM EST
[ Parent ]
Sorry, I retract the statement.

I was thinking of smut above, I guess.

Smug is actually a gas:

http://www.southparkstudios.com/show/display_episode.php?season=10&id1=1002&id2=145

Long download,but one of the funniest things I have seen recently.

"When the abyss stares at me, it wets its pants." Brian Hopkins

by EricC on Thu Jan 25th, 2007 at 10:49:45 PM EST
[ Parent ]
Across America and Europe, smoking is being banned from bars and restaurants.

I have all but stopped going to restaurants. The cost of my inhaling the smokers' poison was more than the pleasure of good food.
Now that it'll be forbidden to smoke in public places, I just may dine out again.

PS : Thanks, afew, this urbandictionnary.com is a real time sink !

by balbuz on Thu Jan 25th, 2007 at 11:31:50 AM EST
I'll support libertarian plans not to limit what people do at home as soon as smokers learn to smoke at home and nowhere else.

I agree with Helen that the NHS proposals are a step too far. (Assuming anyone is taking them seriously in the first place, which I suspect isn't the case.)

But there is no justification for someone forcing their habit onto unwilling non-participants. Which is exactly what smokers do now.

And obesity will be next. The UK is already making noises about trying to deal with it. The problems is that it's much harder to regulate food consumption, especially among kids, because - unlike tobacco and booze - food is sourced in too many different ways.

But 10-15 years from now, don't be surprised if obesity is starting to gain the same pariah status that smoking has today.

by ThatBritGuy (thatbritguy (at) googlemail.com) on Thu Jan 25th, 2007 at 01:17:01 PM EST
And obesity will be next

Oh, no it won't.  It's right up there alongside smoking now, which is why claiming smokers are being singled out is fallacious from the outset.

Obese patients denied hip replacements

Call to deny obese fertility treatment

One difference is that many of the obese tend towards being 'suitably' ashamed of themselves and therefore aren't as assertive (or noisy, aggressive and full of self-justification) as the smoking lobby.

But the greatest difference is that I'm not aware of any roving packs of the overweight claiming the right to force lard down the throats of strangers in public places.

by Sassafras on Thu Jan 25th, 2007 at 01:53:56 PM EST
[ Parent ]
why put the money into hip replacements for people so heavy that they will likely fail?  Start with whatever it takes to help them get their weight down right through gastric bypass first.  There really have to be some limits on public health care expense.  Medicare spending $100K on heart bypasses for my grandfather at 80+, long after his diabetes was destroying him from the inside, was just crazy.  Not to mention fatal.

But the greatest difference is that I'm not aware of any roving packs of the overweight claiming the right to force lard down the throats of strangers in public places.

bravo.

i always loved George Carlin's take

"mind if I smoke?"  "no, mind if I fart?"

by HiD on Fri Jan 26th, 2007 at 02:22:06 AM EST
[ Parent ]

"mind if I smoke?"  "no, mind if I fart?"

... or

«a non smoking area in a restaurant is like a no pissing area in a swimming pool»

In the long run, we're all dead. John Maynard Keynes

by Jerome a Paris (etg@eurotrib.com) on Fri Jan 26th, 2007 at 03:13:03 AM EST
[ Parent ]
no smoking is like pissing in someones coffee.

If you get to put toxins in my body, shouldn't I get to return the favor?

And I'll give my consent to any government that does not deny a man a living wage-Billy Bragg

by ManfromMiddletown (manfrommiddletown at lycos dot com) on Fri Jan 26th, 2007 at 06:09:39 AM EST
[ Parent ]
Considering that tobacco smoke contains Polonium 210, putting it in the coffee is like what they did to Litvinenko.

"It's the statue, man, The Statue."
by Migeru (migeru at eurotrib dot com) on Fri Jan 26th, 2007 at 06:11:20 AM EST
[ Parent ]
no smoking is like pissing in someones coffee.

And then on your clothes, for good measure.

*Lunatic*, n.
One whose delusions are out of fashion.

by DoDo on Fri Jan 26th, 2007 at 06:21:09 AM EST
[ Parent ]
Don't doctors have to take the Hippocratic Oath or make some pledge to not deny treament unless treatment could actually make things worse for the patient?

Let's say you are running and not paying attention to where you are going and you fall and sprain your ankle.  A doctor is not going to deny treatment simply because you should have known better.  Should we deny treatment to people who have Aids as a result of unprotected sex or needle use?  Of course we have a responsibility to do everything we can to prevent illness, but when something has not been prevented, we also have the responsibility to reduce pain and suffering and try to make people well again.

Don't they also have drug treatment and rehabilitation programs?  Yes, people should know not to shoot up and it sucks we have to pay to treat them, but to deny treatment is almost a form of torture.  It is a form of torture.  Does NHS perform abortions?  You could argue those patients should know better too.  Type 2 diabetes?  Totally preventable.  The list is endless.  Treatment should include education about prevention and healthy lifestyles.  But that idea that taxpayers can decide who deserves medical treatment is appalling.

And I'd like to know who will explain to the child why his father was left to die of lung cancer...

Those who can make you believe absurdities can make you commit atrocities. -Voltaire

by p------- on Thu Jan 25th, 2007 at 01:27:24 PM EST
You wouldn't advocate putting new livers into raging alcoholics would you?

someone spraining their ankle is hardly a good analogy for someone choosing to continue a dangerous habit long after the risks are known.

by HiD on Fri Jan 26th, 2007 at 02:24:19 AM EST
[ Parent ]
Something to inspire future policy at the NHS:

Scientists studying stroke patients are reporting that an injury to a specific part of the brain, near the ear, can instantly and permanently break a smoking habit, effectively erasing the most stubborn of addictions. People with the injury who stopped smoking found that their bodies, as one man put it, "forgot the urge to smoke."

Scientists Tie Part of Brain to Urge to Smoke

by MarekNYC on Thu Jan 25th, 2007 at 04:07:10 PM EST
you mean if I whack a smoker upside the head with a 2x4 it can cure his addiction?

[sorry, that was an uncharacteristically brutal image for yr humble correspondent, but I'm getting over a rotten little cold and feeling particularly angry with smokers at the allegedly smokefree bus stops whose pet poison aggravates what is left of my sore throat.  sometimes sharing is just not the right thing to do.]

as to nicotine, the cat was out of the bag long ago that the cig companies boost the nicotine content to hook smokers good and proper.

all that said...
the issue of health care denial is a slippery slope indeed.  there's a lot of waste, abuse, and fraud we could eliminate from our medical systems before we turn to denying services for autopathic conditions, and a lot of corporate undermining of public health we could critique and curtail before we start pointing fingers at individual behaviours.  should we deny health care to habitual motorists because they don't walk enough?  to eaters of red meat and rich dairy foods (their poor arteries)?  caffeine addicts?

disease and suffering -- and being forced into a state of medical dependency -- seem like punishment enough for "bad behaviours".

there are deeper issues here wrt medicine and society -- iatrogenic pathology seems to me at least as serious a problem as autopathy, but this darker side of modern medicine is seldom on the radar.

as to the "obesity epidemic" I tend to agree with Campos that there's more heat than light being generated by this new fuss.  it generates a very satisfactory bunch of Untouchables to insult and deride -- if we aren't allowed to tell N*gg*r jokes we can tell Fat jokes -- and builds a new and miserable marketing demographic to consume quack remedies and bogus 'diet programs'... but is it any more reality-based than BushCo's GWOT and other modern 'madnesses of the crowd'?  gotta wonder.  I'm still reading and pondering.

The difference between theory and practise in practise ...

by DeAnander (de_at_daclarke_dot_org) on Thu Jan 25th, 2007 at 08:43:21 PM EST
[ Parent ]
On the fat panic it seems that the real health 'risk' to being overweight in and of itself is non existent. However, poor dietary and exercize habits are health risks and they in turn correlate well with obesity. When they control those habits out there's no statistically significant health risk associated with weight. But then obesity in turn also seems to be partly a biological thing - some people will be more likely to gain weight than others with the same lifestyle. I should know, I'm the living proof. I eat masses of cream, butter and cheese, and while my weight range has gone up quite a bit since I was in my early twenties, it's still relatively low for my height - 160 at 6'2.

I also smoke. A couple years ago a girlfriend did slam me upside the head with a golf club - it did nothing either for my nicotine habit nor did I suddenly discover the charms of golf as she intended. I'm not volunteering for any repeat experiments.

by MarekNYC on Fri Jan 26th, 2007 at 01:07:45 AM EST
[ Parent ]
having 10-15 extra lbs on board is actually life extending once you are past a certain age.  I'm just a little early.

6-2, 160 -- don't go out in high winds!

by HiD on Fri Jan 26th, 2007 at 02:27:15 AM EST
[ Parent ]
For the past year, I was put in the same room with a heavy smoker at the office, who retired a month ago. That I don't just dislike (like 75% of non-smokers) but will protest (like 15% of non-smokers) and leave the room if my protest is ignored (like 5% of non-smokers) was already well-known, so he was nice and offered in advance to go to another room or the gangway. At first he'd do it every 10-15 minute, later maybe once an hour.

3-4 months ago, he gave up smoking. At retirement age.

Lately he told me how awful it was when he returned home from some party, and all his clothes stank. I asked yeah, aren't you used to that? Then he proudly told that his sense of smell is back, and it feels good.

*Lunatic*, n.
One whose delusions are out of fashion.

by DoDo on Thu Jan 25th, 2007 at 06:13:56 PM EST
I am not sure I get your point. What I understand from your post is that cohabitation is possible without having to ban smoking.
by Deni on Sat Jan 27th, 2007 at 06:50:50 PM EST
[ Parent ]

Nonsmokers have been given everything they wanted on a silver platter: Smokeless bars, smokeless streets, high taxes, and on and on.  They spent years whining and got their way, so now, please, leave us the hell alone

We withstood generations of second hand smoke harming us.  And it took a lot of fighting to keep your poison out of my lungs unless I refused to go out in public.  Silver platter my ass.

I don't think all medical treatment should be withheld from smokers, but in some areas I can see it.  We don't give liver transplants to active alcoholics.  I don't see any point in lung transplants for smokers .  But for most any other health issue, doesn't seem fair to single out smokers unless you are going to apply the same standards to the obese etc.

by HiD on Fri Jan 26th, 2007 at 01:57:37 AM EST
but, if we are to begin discriminating based upon cost considerations, then socialized medicine in Britain has rendered itself no more a moral beacon than its privatized counterpart in America.
Socialized medicine a moral beacon?  My recollection is that the UK heavily rationed treatment for kidney failure patients in the early '80's. Treatment was readily available for the insured in the US in the early '70's, and in the mid-'70's became covered for everyone under a government funded program.  I don't have time to research research thoroughly, but a Google search turned this up quickly:
Paradoxically, the most effective covert rationing was achieved under the British NHS which ostensibly provides free care for all, while the uncentralised market system in the US gave way, on this issue, to almost universal state-subsidised provision. Under the British system, the most cost-effective options for renal care tended to flourish, but some patients were turned away. Physicians have been held responsible for complying with covert rationing: this paper suggests that early gearing towards socially-useful survival filtered back to selection at primary level, possibly continuing long after specialists wished to expand. Public outcry, though muted, reached parliament and caused minor shifts in policy; the main aim of the voluntary pressure campaign, to release more organs for transplant through 'opt-out', remained unrealised in the UK.
"but some patients were turned away", a euphimism for they died, fairly quickly and not very pleasently,,,,,,and this
Abstract

This paper describes how the structure and operational policies of the British National Health Service (NHS) affect the allocation of high cost medical technology. An exploratory case study of the technologies of dialysis and kidney transplantation provides the research focus. When relevant, the British and American experiences with these technologies are contrasted. In the U.K., intensive interviews were conducted with 43 medical and administrative personnel primarily in London. The study suggests that a fixed-budget system within a centralized NHS structure in an environment of scarce resources will be associated with shortages, less utilization of expensive technological options in treatment, greater ability of the government to change health priorities and ration care, conflict among interest groups, conflict among and within bureaucratic levels, and more effective cost-control.

I didn't want to buy the paper, but you can if you want at the link.

I liked some of the aspects of socialized healthcare when I lived in the UK, but absolutely hated others--mainly in the area of them being far behind the new technologies.  Needing to go through a "gatekeeper" GP before you could see a specialist was another.  

by wchurchill on Fri Jan 26th, 2007 at 03:55:44 AM EST
The early 80s were Thatcher's heyday, and since she hated poor people and especially having to share her hard-earned money with them, Thatcher-style NHS policies are hardly representative of the original ideals of the NHS.
by ThatBritGuy (thatbritguy (at) googlemail.com) on Fri Jan 26th, 2007 at 08:38:00 AM EST
[ Parent ]
see here
Kidney dialysis was first developed by a Dutch physician, Willem Kolff, M.D., Ph.D. In the early 1940s, he began searching for a way to use dialysis, the process by which particles pass through a membrane, to treat patients with kidney failure. A sever shortage of materials due to the war forced Kolff to improvise, especially when it came to a suitable membrane, the key component to the filtering process.
 This had absolutely nothing to do with Thatcher.  Kidney machines were available in the '60's, and treatments could have started then--way, way before Thatcher and the problems she issued in.  
by wchurchill on Fri Jan 26th, 2007 at 01:22:52 PM EST
[ Parent ]
You said kidney treatment was heavily rationed in the early eighties. Unless your claim is that that practice was continuous since the sixties, your above argument doesn't make the slightest sense.

*Lunatic*, n.
One whose delusions are out of fashion.
by DoDo on Fri Jan 26th, 2007 at 01:30:48 PM EST
[ Parent ]
just check it out dodo.  I know facts are difficult for you,,, but give it a try.
by wchurchill on Sat Jan 27th, 2007 at 04:44:07 AM EST
[ Parent ]
yes of course it was rationed from the beginning.  probably made sense in the beginning being new technology and high cost, but certainly not in the mid seventies.
by wchurchill on Sat Jan 27th, 2007 at 05:29:14 PM EST
[ Parent ]
happened under Thatcher, now that I think of it.  Treatment rates started going up dramatically in the early '80's and by the mid '80's new techniques had been introduced, CAPD, to expand care, and hemodialysis was expanded.  Blaming it on a person, despite her many other flaws, is just not even close to accurate.
by wchurchill on Fri Jan 26th, 2007 at 01:29:59 PM EST
[ Parent ]
That person was a head of government, and her anti-public-services, including anti-NHS policies are well known, so even if it would be a wrong assumption to blame the kidney treatment issue on these policies, don't act like it's an ad hominem.

*Lunatic*, n.
One whose delusions are out of fashion.
by DoDo on Fri Jan 26th, 2007 at 01:33:52 PM EST
[ Parent ]
I simply corrected a factual mis-statement.  It's fine that you don't admire or agree with Thatcher policies.  My original point had nothing to do with Thatcher.  But the statement I responded to was simply historically inaccurate.  
by wchurchill on Fri Jan 26th, 2007 at 11:20:11 PM EST
[ Parent ]
Little niceties such as that never stops anyone here.

"When the abyss stares at me, it wets its pants." Brian Hopkins
by EricC on Fri Jan 26th, 2007 at 11:57:56 PM EST
[ Parent ]
Your original post gave a specific time point. I queried it, and DoDo queried it. You then ignored the query and tried to change the subject.

If you're implying that the increase of availability of dialysis was a direct result of our former beloved leader-ette's enlightened and generous policies, that's nonsense - of course.

In the 70s the technology was relatively new, and very expensive. By the 80s it had developed into increasingly affordable variants.

by ThatBritGuy (thatbritguy (at) googlemail.com) on Sat Jan 27th, 2007 at 08:05:35 AM EST
[ Parent ]
Wow, economists who smoke are even better than other economists at the game consisting of totally ignoring reality and building theocracy.

I deconstructed a french economist-blogger post that was insane, irrational and as far from reality you can possibly go, see on my blog a few monthes ago.

The comparison of smoking with obesity is just insane, I won't repeat the argument since you're obviously unable to face reality.

Disclaimer: I'm an obese non-smoker. My mother does smoke but in thirty years she didn't light up a cigaret inside a room while me or my sister were there (or nearby) and she doesn't smoke in restaurants and public places anyway.

And as far as obesity-related health is concerned, public policy to curb "free market practices" are effective as usual, see wikipedia:


According to Steen Stender of Gentoffe University Hospital in Copenhagen, Denmark has seen a 20% drop in deaths from heart disease since the country's 2003 ban. Another study considered deaths due to CHD, with consumption of trans fats being linked to an increase in mortality, and consumption of polyunsaturated fats being linked to a decrease in mortality

That doesn't preclude personnal responsability, but I don't know how this issue rates amongst all behaviour related health problems (including cancer caused by chemicals from the "free market" again).

by Laurent GUERBY on Fri Jan 26th, 2007 at 07:08:26 AM EST
For those so eager to ban smoking outright, think of the wonderful social side effects of similar bans on other addictive pleasure bringing drugs. Just raising doubling the price from roughly 3.50 to 7.00 here in NYC changed the jingle of my local corner dealers from 'smoke, coke' to 'smoke, coke, Marlboro, Newport'.
by MarekNYC on Fri Jan 26th, 2007 at 03:42:14 PM EST
to the fact that if you let restaurants  choose whether to be smoking or non-smoking, they will inevitably be smoking (or both, which means the same thing in most places) because restaurant managers do not see able to imagine a world where non smokers have dinner out?

I'm serious. I'd love it if there were both smoking and non smoking restaurants, bars, night clubs - hell, even cinemas, theaters or trains) - everybody is happy and no side effects. But how do you get it to happen in practice?

As to taxing cigarettes, it should be done at the manufacturing plant (or the import terminal), not at the retail outlet. Malboro and co are known to have been heavily involved in the various contraband circuits that exist in countries with high taxes, by providing large volumes to nearby lowtax countries - much beyond local demand. Punish the hell out of that.

In the long run, we're all dead. John Maynard Keynes

by Jerome a Paris (etg@eurotrib.com) on Fri Jan 26th, 2007 at 06:42:57 PM EST
[ Parent ]
That's the way it should be in restaurants, same way in bars.

Could be done. No one is imaginative.

"Malboro and co are known to have been heavily involved in the various contraband circuits that exist in countries with high taxes, by providing large volumes to nearby lowtax countries - much beyond local demand. Punish the hell out of that."

Did anyone actually prove this in a court of law?

It would kick the crap out of whatever credibility RJR has.

Lot of illegal smuggling arbitrage going on over here state to state, with some "organized crime" involvement. Lot of little old ladies from Maryland buying $400 worth of cigarettes here, too.

For the sake of the little old ladies, hope each cigarette isn't a RICO count charge.

"When the abyss stares at me, it wets its pants." Brian Hopkins

by EricC on Fri Jan 26th, 2007 at 07:06:30 PM EST
[ Parent ]
"Malboro and co are known to have been heavily involved in the various contraband circuits that exist in countries with high taxes, by providing large volumes to nearby lowtax countries - much beyond local demand. Punish the hell out of that."

Did anyone actually prove this in a court of law?

I don't know how the case concluded, but there's this:

NYT: EUROPEANS SUING BIG TOBACCO IN U.S. (November 7, 2000)

European Commission files civil racketeering lawsuit in US against Philip Morris Company and R J Reynolds Tobacco Company, seeking damages for alleged involvement with organized crime in smuggling cigarettes into Europe; accuses companies of engaging in money laundering and wire fraud in pursuit of smuggling activities; is seeking financial compensation for tax losses, estimated by experts at about $1.5 billion per year, that European governments reportedly suffer; is also seeking injunctive relief to halt alleged practice; budget commissioner, Michaele Schreyer, says suit under US racketeering laws represents new strategy to fight fraud and financial irregularities; companies deny allegations and question why suit is being filed in US; case is only latest sign of frustration among government officials in Europe who believe they are losing billions of dollars because of illicit sales of American cigarettes with help from manufacturers; investigation of British American Tobacco by British government noted; issue is also subject of US Justice Dept probe; North Carolina federal grand jury is investigating allegations that tobacco companies are knowingly selling to dealers who resell American cigarettes to smugglers that infiltrate European countries; American companies, faced with little or no domestic growth, have aggressively expanded overseas sales and marketing; smugglers are increasingly avoiding high import duties and taxes on American brands by illegally bringing cigarettes into markets like Spain and Italy and selling them for 20 to 30 percent less than legal price.


"It's the statue, man, The Statue."
by Migeru (migeru at eurotrib dot com) on Fri Jan 26th, 2007 at 07:17:05 PM EST
[ Parent ]
You Goggle and find things well.

I'd love to see the resolution on this one.

"When the abyss stares at me, it wets its pants." Brian Hopkins

by EricC on Fri Jan 26th, 2007 at 07:38:30 PM EST
[ Parent ]
Well, I googled for another minute or so, and found this:
On September 12, 2006, the European Court of Justice (ECJ) sanctioned the decision of the European Community (EC) and member states to bring actions for damages against certain cigarette manufacturers in United States courts.  The decision grew out of the companies' unsuccessful attempt to have the European Court of First Instance preclude any such lawsuits.  In connection with its efforts to stem cigarette smuggling into the EC, the European Commission (the Commission) filed two unsuccessful actions in a U.S. federal court in late 2000 against  R.J. Reynolds Tobacco Holdings, RJR Acquisition Corporation, R.J. Reynolds Tobacco Company, R.J. Reynolds Tobacco International, Japan Tobacco, and Philip Morris International (the Companies) for compensation resulting from losses allegedly related to cigarette smuggling, specifically in the form of lost customs duties and value added taxes (VAT).  As an EC appeal of the federal court's dismissal of the case remained pending, the Companies sought review in the EC judiciary of the Commission's decision to file the lawsuits in the first place.
Here is an overview of a number of other cases...
There are five cases underway. These are described in the five sections below:
  1. European Union
  2. Colombian governors
  3. Canada (stopped by US supreme Court)
  4. Ecuador (current status unknown)
  5. Honduras and Belize (current status unknown)
Regarding the EU case,
Philip Morris indicated in April 2004 that it is willing to settle the lawsuit b offering to pay $1bn to the EU over 12 years. The offer is under consideration by the European Commission and by the 10 EU member states which brought the legal action.
And here's an advocacy site
Philip Morris International (PMI), the worlds biggest tobacco manufacturer, agreed to pay the European Commission a billion dollars in compensation as part of a landmark deal to combat smuggling of tobacco on Friday 9th July 2004.

In the past tobacco industry representatives have denied they have aided smuggling activity or could have done anything to prevent it.

But the European Respiratory Society (ERS), an EPHA member, believes that the new agreement casts major doubts over this.

So, did Phillip Morris settle out of court so as to be able to say thay the allegations haven't been proven in a court?

"It's the statue, man, The Statue."
by Migeru (migeru at eurotrib dot com) on Sat Jan 27th, 2007 at 06:31:54 AM EST
[ Parent ]
I'll read these summaries with great interest tonight.

"So, did Phillip Morris settle out of court so as to be able to say thay the allegations haven't been proven in a court?"

PM might say that, but all the little Horace Rupoles in America would be sniggering a bit and blowing Chateau Thames Embankment out their noses as they read the press release.

"When the abyss stares at me, it wets its pants." Brian Hopkins

by EricC on Sat Jan 27th, 2007 at 12:41:04 PM EST
[ Parent ]
I am happy you have raised this point, as I would be very curious if you have an explication to this mystery. For even if a majority of the population is non-smoking (I think) and even if a majority (though not the same) hates smoke in bars, some even so ... passionately as you do, they are very few, or none, non-smoking bars. It cannot be that all the managers are so idiots as to not see this huge customer base.

This question is also addressed to Mr. balbuz, who had a similar post above.

by Deni on Sat Jan 27th, 2007 at 07:18:29 PM EST
[ Parent ]
No one I know is suggesting a full smoking ban.

It's clear that lots of smoker have hallucinations about seeing people suggesting a full smoking ban everywhere they look, it's probably nicotine.

We're talking about a smoking ban on public closed areas and may be a limited few open areas as well.

Smokers are still free to smoke on at least 99.999% of earth surface.

by Laurent GUERBY on Sat Jan 27th, 2007 at 06:41:34 PM EST
[ Parent ]
Let me summarize:
The critics:

  1. Tobacco is recognized as a harmful substance by all those not paid to ignore this fact.
  2. The degree of harm is under dispute, especially by those not having created or evaluated the statistics.
  3. There are other bad things in the world (some even worse) so why not deal with those instead?
  4. Banning pleasurable intoxicants doesn't work.

Me (I don't seem to have many allies):

  1. Every advanced country has now acknowledged this as well as some less advanced ones.

  2. I don't have to defend the statistics or the methodology. Those who find fault have to show where the errors arise. The scientific community has reviewed the data and has allowed for publication using the usual mechanisms (peer review, multiple studies, etc) to ensure the results are as accurate as possible.

  3. If we were to pursue making things better only one at a time it would be a long day until things improved. Society can go after more than one problem at at time. If you feel that some important area is not getting remedied fast enough then use the usual mechanisms available in a democracy to effect change. That is speak up, protest, run for office, support candidates that espouse your position, and give money to causes you favor.

  4. I have already argued against legislating against "sin" and against punitive drug laws. However, it makes a difference what tack government takes towards various harmful substances. The drugs which persist in spite of attempts to ban them are all fairly powerful: alcohol, marijuana, and opiates. Cigarettes don't fall into this class. They are a mild stimulant like coffee with a highly addictive side affect. What people take as pleasure is mostly a result of satisfying the addictive need. The side effects are also much more severe. Try this chart:
http://www.drugwarfacts.org/causes.htm

Tobacco kills five times as many people as alcohol.

It is the (assigned, by the voters) duty of government to protect people from harmful substances. This is why we have laws about selling harmful medical products. The fact that these have been compromised of late is a result of a failure of government to fulfill its role, not a change in what has been mandated.

I have not recommended "banning" tobacco, but phasing it out. It is the most harmful substance in general use in the world at present. A policy of making it harder to obtain, restricting the availability to prevent new users, making growing tobacco less economically rewarding to farmers and various educational policies could achieve most of these aims within 25-50 years. The known dangers of tobacco have existed for this period of time and if these efforts had been started after the original Surgeon General's report we wouldn't be having this discussion today.

Banning alcohol didn't work because it was an idea of a minority imposed on a majority by misrepresentation and deceit. Controlling harmful drugs by means of an enlightened policy as in the Netherlands does work (pretty well) and is a sharp contrast to the stupid policies in the US.

Libertarian arguments about freedom of choice I've already discussed before. Society sometimes has to save people from themselves. They are not able to make wise decisions for a variety of reasons including ignorance and being fed false information by those with a hidden agenda.

That there are some on this forum (and elsewhere) that have so little faith in parts of government that they see reports as misleading propaganda shows how far our elected governments have drifted from representing the interests of the people. How to evaluate information is such a polarized environment is a question for another day.  

Policies not Politics
---- Daily Landscape

by rdf (robert.feinman@gmail.com) on Fri Jan 26th, 2007 at 05:09:46 PM EST
You summary reminds me of something Carrie Nation might have written in the 19th century.

I will leave it at that.

"When the abyss stares at me, it wets its pants." Brian Hopkins

by EricC on Fri Jan 26th, 2007 at 05:59:13 PM EST
[ Parent ]
I don't know who you are, but so far your recent comments haven't added anything of substance to discussions.

You can disagree all you like, but snide remarks usually denote an absence of anything meaningful to contribute.

This site attracts its share of libertarians, some of whom think they can hold their own in discussions, but when they have to resort to ad hominem attacks they quickly find themselves ignored.

Carry Nation is exactly the type of person that I claim produced counter-productive results. She appealed to theocratic beliefs about "demon rum" and drummed up enough outrage to get a badly considered amendment passed. I already criticized Prohibition, perhaps you should try following the thread more closely.


Policies not Politics
---- Daily Landscape

by rdf (robert.feinman@gmail.com) on Fri Jan 26th, 2007 at 07:12:39 PM EST
[ Parent ]
"I don't know who you are, but so far your recent comments haven't added anything of substance to discussions.

You can disagree all you like, but snide remarks usually denote an absence of anything meaningful to contribute.

This site attracts its share of libertarians, some of whom think they can hold their own in discussions, but when they have to resort to ad hominem attacks they quickly find themselves ignored."

Ah, yes, the old ad hominem, libertarian, no contribution troll meme.

Amusing.

In the real world of the American Left, excluding San Fran Bay Area, Cambridge Mass, and Upper East Side of NY(5%), I imagine that I come in at about 20 percentile, in the real American left.

Doubt you and some other purists here would be interested in hearing from the other 32-odd% of us, who did achieve a small election victory.

Whatever.

Statements stand.

"When the abyss stares at me, it wets its pants." Brian Hopkins

by EricC on Fri Jan 26th, 2007 at 07:56:41 PM EST
[ Parent ]
I support your summary and your recommendations.

In the long run, we're all dead. John Maynard Keynes
by Jerome a Paris (etg@eurotrib.com) on Fri Jan 26th, 2007 at 06:43:35 PM EST
[ Parent ]
puritanism is "the haunting fear that someone somewhere may be happy."

Obviously I'm quoting this because, at least on this diary, most of you are coming across as the most insufferable puritanical prigs. But I'm also hoping -- because I'm not a puritan -- that you may one day, when Europe catches up with California and New York, experience at least a moment of contentment, if not real bliss, enjoying smoke-free bars, restaurants, public transport, offices, hotels, building entrances, bus stops, lines (queues), parties, concerts, hospitals, etc., etc., etc. Soon, like most New Yorkers, you'll have only the vaguest of memories of what it was like to smell smoke in an enclosed space. And you'll live happily ever after on your brave new nicotine-free continent.

Or not. Based on my experiences with New Yorkers, five long and dreary years after smoking was essentially banned here, many of you, I am truly sorry to say, will continue to be miserably unhappy just at the thought  that someone, somewhere might be actually enjoying, yes, enjoying, a cigarette. The nerve! Don't they know that the only permissible pleasure in life is a little cube of tofu, washed down with a moderate sip of room-temperature water?

I know this will never happen but I can dream that once you don't have smokers to scorn and despise, you'll redirect your venom at people who really are  threatening your very survival between now and 2050. Of course, I'm talking about car drivers, frequent flyers and owners of big, earth-hostile homes. Just imagine, if you did something about them, you might actually live long enough to revel -- but with sober moderation, of course! -- in a smoke-free old age!              

by Matt in NYC on Sat Jan 27th, 2007 at 03:48:32 AM EST
who smokes a few cigarettes per week.

For addicts who get angry if you dare tell them anything, I seriously doubt it's a pleasure. It looks like a chore from the outside - which is why it's so annoying for them to be called on it - it's already disgusting enough on its own without it being flagged by others.


In the long run, we're all dead. John Maynard Keynes

by Jerome a Paris (etg@eurotrib.com) on Sat Jan 27th, 2007 at 08:15:14 AM EST
[ Parent ]
Anti-smoking smokers are the biggest pain of all. If you're going to do it, at least have the indecency to enjoy it!

I have a good friend who started smoking twotwo two cigarettes a day after she finished chemotherapy for a form of cancer that is over 95% fatal. Thirty years later she's alive, kicking and one of the very few truly happy sixty-somethings I know.

by Matt in NYC on Sat Jan 27th, 2007 at 02:18:26 PM EST
[ Parent ]
Literally 100% of smokers I know tell such anecdotal stories to each other and to non-smokers (and to themselves). This included my former work roommate, who was also very proud of his own health despite smoking; and also the son of that Dutch relative of mine; both of whom ultimately ditched the habit.

*Lunatic*, n.
One whose delusions are out of fashion.
by DoDo on Sat Jan 27th, 2007 at 04:11:21 PM EST
[ Parent ]
somewhere might be actually enjoying, yes, enjoying, a cigarette

"I enjoy smoking! cough cough <rubs swollen eyes>"

*Lunatic*, n.
One whose delusions are out of fashion.

by DoDo on Sat Jan 27th, 2007 at 12:09:51 PM EST
[ Parent ]
   I very much agree with your post, except for the last part. One of the things that bothers me most in the anti-smoking campaign is the crusading spirit behind it. The smokers are not presented like normal people stupid or careless enough to have a pleasurable (at least for some) but dangerous habit, but like despicable people, like heathens that have to be converted. Somehow the first crusaders manage to get most people to adopt their view, and it can easily get to the point where you will be treated like scum for the simple reason that you are a smoker. If I may quote bruno-ken from a comment of this diary :


When I lived in California, it was my impression that many smokers felt shamed into giving up, or at least hiding and denying, their smoking habit.  I remember seeing one woman smoking by a fountain once, and instantly feeling disgusted and offended by her "behavior" (and then being startled by own indignation -- she was the first person I saw smoking outside in many months.)

   Ok, I might have exaggerated more than a bit, but I think that most people are in favor of a ban because they consider smoking "bad" or "disgusting" more then  because they feel it is dangerous for they health.
   Anyway, my point was that making people to hate something is relatively easy and may be effective but is a very blunt and dangerous weapon. Think only at what will happen if the anti-obesity campaign will get to be an anti-obese people campaign, like the anti-smoking/smokers campaign we have now.

by Deni on Sat Jan 27th, 2007 at 08:03:13 PM EST
[ Parent ]
Very well said.

This thread is very Menckean, and very amusing.

I'm still wondering who gets the money when Drew pays $10.58 for a pack of Marlboros.

I admire Europeans who shiver in their hovels and pay $4-5 an imperial gallon for gas or diesel. And ride bicycles.What does it cost to land diesel or gas from the Me in Europe? Anybody know?

Hope you are really getting a sufficient bang for your tax dollars at work.

Off now to turn up the thermostat to 80, and bask in warmth.

We thank you, for your sacrifice.

Never thought Europeans were the ultimate in gullible, until I thought it all through.

Thought Americans, at first were rube naifs and Europeans were worldly cynical.

Got it all really wrong.

TEHE!

"When the abyss stares at me, it wets its pants." Brian Hopkins

by EricC on Sat Jan 27th, 2007 at 09:35:27 PM EST
[ Parent ]
You have a point, there, and it is that it's not like tobacco is not heavily taxed in the first place. If the tobacco tax revenue is not high enough to cover the cost of the additional risk of disiease for smokers and passive smokers, then maybe it should be raised.

I think it is appalling that the NHS would seriously consider denying treatment to people based on their behavioural risk factors.

The only possible justification for these suggestions is that the NHS cannot cope with the health care needs of the population, and so doctors are forced to engage in a sort of triage, that is, rationing of medical care. Now, if you have 10 lung cancer patients and you can only treat 5, how do you choose which ones to treat?

  • first come, first served
  • earliest diagnosed first
  • those with the least risk of remission
  • those with the least risk factors
  • those who can't afford to pay for private treatment
Maybe a combination of all these five factors, as well as others, is the right thing to do. But the point is that the 3rd and 4rd factors put smokers at a disadvantage because of a behavioural choice.
Now, if it is an outrage that patients need to go untreated unless they can afford private care, maybe as a society we need to realise that the NHS needs to be funded adequately and that that means (gasp) higher taxes, especially on the wealthy [and here I'm talking about wealth, not income].

"It's the statue, man, The Statue."
by Migeru (migeru at eurotrib dot com) on Sat Jan 27th, 2007 at 07:02:31 AM EST
Now, if you have 10 lung cancer patients and you can only treat 5, how do you choose which ones to treat?

I knew someone who had a good friend who got cancer about 30 (I no longer remember what kind of cancer). His doctors faced the above problem. Their strategy was "youngest first". This guy around 30 knew that, and told my acquaintance he knew he will die...

*Lunatic*, n.
One whose delusions are out of fashion.

by DoDo on Sat Jan 27th, 2007 at 12:15:12 PM EST
[ Parent ]
Do you mean that even 30 was too old for your health services? (So they refused him treatment) Or that he was certain that he would die no matter how much treatment he got?
by Matt in NYC on Sat Jan 27th, 2007 at 02:23:01 PM EST
[ Parent ]
Even 30 too old to concentrate resources on him. (There was no such thing as refusal of treatment.)

*Lunatic*, n.
One whose delusions are out of fashion.
by DoDo on Sat Jan 27th, 2007 at 04:07:42 PM EST
[ Parent ]


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