Novel way to curb Smoking Public Health Cost

i wish our lawmakers would stop kowtowing to big tobacco

 

I'd have to admit there's been a lot of progress,

As recently as when I started grad school, you could end up reeking of secondhand smoke after walking across campus. Outdoors.

 

I wonder how well it will work, especially after seeing the "success" of other drug prohibitions, including ethanol.

 

About public health tobacco, drugs, and poor foods:

1. prohibition - leads to expensive, draconian enforcement and black markets.
2. education - spotty as too often ineffective means (aka., "your brain on drugs").
3. treatment - some percentage of afflicted can returned to useful lives.
4. regulated market - delay and reduce the afflicted percentage.

Bob Wilson

 

It's been all over the news here, as you'd expect since they're next door.

I think the thing to bear in mind with comparisons to prohibition is that where it's failed - such as the US in the 1920s - it's been the prohibition of something that people were already accustomed / addicted to (choose your own word there). But where there's a long-lasting ban - like, say Iran or Saudi Arabia for alcohol, while there is a black market, it remains small, and levels of addiction are limited.

A full smoking ban in NZ would inevitably lead to the same problems as we saw with US alcohol prohibition, because a lot of people are extremely addicted to nicotine. The key here is that tobacco will still be available for those existing addicts, so there isn't much money in a black market. Instead, you're stopping the next generation from getting addicted. That, to me, seems like an excellent idea.

Here in Australia, we have very strict rules around advertising and branding for tobacco, making it very hard to make tobacco appeal to young people. There is no cigarette advertising. Packets have to have the brand name in, I think, Times New Roman 10 point, and all packaging must be olive green, with really gruesome anti-smoking adverts covering about 70-80% of the packet. Cigarettes are also expensive - around US$30-40, I think, for a pack of 20. Smoking is very rare here, in large part as a result of that. But we have seen an upsurge in young people vaping recently, which is a problem.

Anyway, I think the NZ rule is a good idea. I don't know whether it applies to vaping: I hope it does.

 

Don't stop with just alcohol prohibition. We prohibited a lot more than that. The comparison also includes marijuana, heroine, cocaine, amphetamines, LSD, meth, fentanyl, PCP, ecstacy, ...

 

Indeed. But the comparison with alcohol is relevant because it was legal and widely used before it was prohibited, as is the case with NZ's tobacco. And the difference is that the NZ smoking prohibition only applies to people who should never have had the chance to smoke.

With the other substances you mention, though, use is nowhere near as widespread as it would be if these products were legal. Whether prohibition the best approach is open to question - Portugal's decriminalisation of heroin (and of course actions by many US states on marijuana) certainly cast doubt on that.

 

people will find a way in a 'free' society. it's always worth a try though

 

If you count only the number of users, that point works.

But when considering the amount of criminality associated with efforts of addicts to acquire and pay for their drugs, and the illegal smuggling and frequently violent supply chains for those products, I believe it falls apart. The cost of that criminal activity is a very large multiplier, and it gets spread out to a lot more people than just the addicts themselves.

While the jury is still out on these issues, I do believe that decriminalization looks promising. We can tolerate a larger number of addicts when they don't have to hide it, go underground, and steal and rob to feed their habit. A large majority of them can remain productive community members.

As for smoking, changes in smoker behavior since my early adulthood have essentially eliminated my exposure to the unwanted toxic smoke. About the only significant non-consensual second-hand smoke issues remaining are pregnant women still smoking, and parents smoking in the lung space of their children.

As for public health costs, a true accounting should include the saved pension costs of smokers who don't live long enough to collect the benefits they paid for. A very few studies have included this, but the topic is so non-PC that later studies just left it out.

 

I remember when keyboards were filthy from smokers.

Bob Wilson

 

we've definitely cut smoking out of many situations, but how much has smoking actually dropped?

i live across the street from an elementary school, can't smoke on the grounds.

so all the smokers finish there butts in front of our house and toss them overboard before heading in.

met a guy in a boston bar/restaurant from north carolina a number of years back. he was just nonplussed that you couldn't smoke inside

 

In the U.S., a lot:

If the last such person you encountered was only from a tobacco state, and was years back, then we have made great progress.

 

Yes, that's certainly true. I honestly have no idea how relevant this is to tobacco: I have no idea whether people would be prepared to go to the same lengths to feed their addiction, or to get into the addiction in the first place.

That's certainly true too. Even when it is criminalised, those with the resources can remain productive members of society: I know people with good jobs who retained those jobs and continued functioning even when addicted to heroin.

Yes. Smoking is similarly rare here: here's the Australian equivalent of the graph you posted.




I must say I'm surprised by how similar our most recent numbers are to yours, given that my understanding is that our rules on packaging and advertising are, I think, stricter than yours, and I think our tobacco taxes are higher. Perhaps this shows that there's a point at which people are addicted no matter what, and no amount of regulation is going to change this beyond that point. Or not. I don't know.

An excellent point.

 

I have a friend who is very poor. He has just given up smoking after many years. He and his wife are on a combined income of less than US$40,000: they do live in a part of Australia where housing is cheap, but still, that is really low by Australian standards. They worked out that they were spending almost US$20,000 a year on smoking. Stopping smoking (which they managed with an enormous amount of help from the healthcare system) has made a huge difference to their otherwise-disposable income. But it was hard for them to give up, even with the help they got.

This, I think, ties in to the thinking behind the NZ plan. As I said in my reply at 15, it may be that taxation works to a certain point, causing people to stop or cut back on smoking because of the expense, but that after that point the remaining smokers are so addicted that they're not going to give up. And a lot of those people are in lower socioeconomic groups. At that point, you're not stopping people from smoking; you're just hitting their income, possibly causing them to cut back on spending on essentials. I think the point of the NZ plan is to try - to the extent that it's possible - to stop people from ever getting to that level of addiction.

 

I think we should get serious about peoples bad habits. Its not 1955 anymore. Everybody knows what time it is.

You wont take your covid shots cause your a nut job Trumper good for you but sorry we cant help you at the hospital without your covid shot card and proof of vaccination. Hey you don't believe in vaccinations I guess you don't believe in hospital care. GTFO.

Oh You now have COPD after a lifetime of cigarette smoking good for you your on your own.

I guess its all a moot point anyway as the american health care system is about to collapse anyway with all the vaccination nonsense.
All local hospitals are full with flu and so are the primary docs.

I'm 67. When I was a child I remember in 3rd or may have been 4th grade the teacher said ok everybody line up in the hallway.
Why?.....shut up line up. Here comes the nurse we all get a shot. I remember the 4 prong TB shot and another shot too. Same with polio in earlier generations. No parents ok no nothing here's your shot.

If the Polio vaccine was needed now there would be a polio epidemic. The stupidity is epidemic .

Now Fox news now is pushing lets indict Dr Fauci. Really not much hope here....

 

Where does that end, though? Is there a cut-off on weight or BMI? What about people who do sport - cycling might make them fitter, but it also makes them more likely to get hit by a car: should we refuse to treat those cyclists because they chose to put themselves in a position where they were at risk of getting injured? What about parachutists? Climbers? People who have a shower over the bath instead of a walk-in shower? People in houses with stairs? Firefighters? People who drive cars that don't have a five-star safety rating?

How about people who eat meat and leave themselves open to greater cancer risk? People who don't eat meat and have shortfalls in protein or iron?

We all do stuff that increases the risk to our health. Of course in the US system I suppose you can make insurance more expensive for certain groups, but in the rest of the world that's not an option.

 

Pretty sure that guy couldn't smoke inside in his home state these days.

 

much to his chagrin