Do people really make an informed choice to smoke?

[Gadarene]

This Pit thread about some yahoo suing McDonald’s because their food is fatty and sugar-ridden quickly turned into a broadside against what many people see as the abdication of individual responsibility.

ivylass, for example, posted that:

Only in America can you be awarded millions of dollars for being stupid.

“Oh, I didn’t know cigarettes were dangerous, even though the warnings are all over the packs.”

“Oh, I didn’t know if I spilled the coffee in my lap it would burn me.”

“Oh, I didn’t know eating Big Macs four times a week would make me fat.”

A bit later, yosemitebabe followed up by accurately observing that warnings on the danger of tobacco have been prevalent for quite some time. She then concluded that:

Anyone who started smoking within the last 40 years has made an informed choice about its health risks.

Based on what I’ve learned the last couple of years about behavioral law and economics, I took issue with this statement:

Wellll…yes and no. I honestly believe that given human cognitive biases and heuristics, we’re not very capable of making informed choices about matters in which the consequences (positive or negative) occur far in the future. As much as we may understand that cigarettes a) are addictive and b) cause cancer, we make our decisions based on the immediate costs and benefits of an action, and not on the likelihood of dying a gruesome, painful death forty years from now. Only if there were some way of viscerally demonstrating to people the tangible long-term consequences of smoking would I call someone’s choice to smoke truly “informed.”

If it were up to me, liability regarding nicotine addiction would be based not on the initial choice of the twenty-year-old smoker, but on whether (and how much) the sixty-year smoker with emphysema regrets her choice to start smoking forty years before.

Rhum Runner, quite rightly, asked me to clarify the last part of my post. I did:

I mean that unless we can show that a smoker in making their choice fully understands the consequences of their actions–which to me, at least in part, means that they would make the same choice in hindsight once those consequences occur–then “informed” consent is a total non-starter as a defense against liability.

That is–and I phrased it unclearly–to the extent that cigarette companies knowingly produced an addictive product, the risks of which were systematically downplayed, liability should accrue regardless of whether individual smokers, in choosing to start smoking, had some vague awareness that sometime in the future cigarettes were likely to accelerate their death in a variety of nasty ways.

Since this is all more suited for GD than the Pit (and off-topic in the original thread besides), I decided to move the discussion here. What do y’all think? Is it a valid defense of the tobacco industry to say that people who start smoking are making an informed choice to do so? I maintain that the disconnect between the act and its consequences, time-wise, makes this different from other libertarian issues like, say, not wearing a seatbelt or a motorcycle helmet. I say that most people who knew what it felt like to get cancer would not choose to engage in a carcinogenic activity.

There are at least two possible objections here. First, it doesn’t matter whether the person really gets the consequences of her actions; she’s making a choice that values the pleasure of smoking for the next fifty years over the adverse effects that will occur in fifty years, and this ordering of preferences would stay the same no matter what the likely consequences were fifty years from now. Second (and somewhat different), the person is knowingly accepting a risk: that is, she is sufficiently informed about the precise incidence of cancer or other respiratory ailments stemming from smoking that she is taking the chance that it won’t happen to her. I don’t know that I buy that the typical decision-making process actually factors either of these into account, but I’ll throw it out there for the rest of you–what do you say?

[gazpacho]

My father grew up in a small town in the forties. He says that back then it was generally known that smoking was not good for you. Certainly when I was growing up we were told in school, on TV etc. that smoking was bad for us. So smoking is one of the decisions that I think we have some of the best information on. If we are not informed about smoking then the whole idea of informed decision has to be pretty much thrown out.

With things like diet and exercise the generally excepted advice has changed even in my relatively short life time.

[Gadarene]

So smoking is one of the decisions that I think we have some of the best information on. If we are not informed about smoking then the whole idea of informed decision has to be pretty much thrown out.

Not necessarily. Like I said, the fact that decades often pass before the adverse effects of smoking happen arguably distances the perceived costs of smoking from the perceived benefits. I think this should be taken into account.

[Rhum_Runner]

Thanks for the clarrification. I think the main problem with assessing conset or full disclosure retroactively is that in the event of any negative outcome the subject person is likely to claim that they would have made a different decision.

Say you buy a lottery ticket, which is what smoking is in a way, and then you don’t win. If I ask you, after you don’t win, would you have bought this ticket if you had known you were going to loose, I would be surprised if you said yes! If I ask the person with lung cancer, would you have started smoking all those years ago if you had known this is where you would end up most would also say no. (I don’t have a cite for that, but my gut tells me most people would not trade a lifetime of smoking for the pain of a slow death from cancer) However, that doesn’t mean that the person who buys the lottery ticket, or the person who starts smoking is unaware of the risk, and it seems unfair to allow them to claim that they weren’t informed after the outcome has been determined. Perhaps I am not phrasing this correctly, if it is unclear let me know and I will try again!

I honestly believe that given human cognitive biases and heuristics, we’re not very capable of making informed choices about matters in which the consequences (positive or negative) occur far in the future.

Here I must disagree with you. I am only 24 years old, yet I have an IRA account. I can not use that money for 40+ years, and yet I opened the account anyway. I am well aware that there is a chance I might die before I get to use that money, and that if I do die before I use it that I will have missed out on some of the things I could have used that money for while I was alive. (Instead of having a couple grand in the bank I could go on big vacation for example) But, having weighed the options, I choose to forego the vacation today in favor of the possibility of having more money when I retire. Isn’t this a prime example of someone looking down the road and making an informed decision?

If I die when I am 35, and St. Peter were to ask me, “Rhum old boy, knowing what you know now, would you have taken that vacation to Tahiti?” I would say yes, if I had known I was going to die at 35, when I was 24 I would have gone to Tahiti.

[Gadarene]

Let me put it another way. Four scenarios:

1. A man comes up and offers you a fifty dollar bill. He tells you that if you accept it, there’ll be a five percent chance every day of the month of December, 2022, that you’ll fall down dead.

2. A man comes up and offers you a fifty dollar bill. He tells you that if you accept it, there’ll be a five percent chance every day for a month, starting tomorrow, that you’ll fall down dead.

3. A man comes up and tells you that he’ll give you a fifty dollar bill on December 1, 2022, but you must decide whether or not to accept it right now. If you do, there’ll be a five percent chance every day of the month of December, 2022, that you’ll fall down dead.

4. A man comes up and tells you that he’ll give you a fifty dollar bill on December 1, 2022, but you must decide whether or not to accept it right now. If you do, there’ll be a five percent chance every day for a month, starting tomorrow, that you’ll fall down dead.

Of these, which would you be likely to agree to? Which wouldn’t you? Why?

[gazpacho]

Yes the benefits of not smoking may really only be seen many years later. However you had to be willfully ignoring information told to you in school if you are under 50 years old. I certainly had to look at the gross pictures of diseased lungs in health class. We had see stories about very sick people that started smoking when they were our age. How much more informed can we be.

I really don’t see you point about the effects coming late in life. We can only be informed about things that will happen soon?

[DocCathode]

In second grade, my class was shown actual lungs set in urethane. One was normal. The other lung was that of a smoker. This was in 1982.

If you can’t make an informed decision after that, I’m more worried about the fact that you may be voting than that you may be smoking.

[Gadarene]

Simulpost; that wasn’t in response to you, Rhum. (Oh, and assume that the fifty dollar bill you get in twenty years is worth whatever it’d be worth today.)

Say you buy a lottery ticket, which is what smoking is in a way, and then you don’t win. If I ask you, after you don’t win, would you have bought this ticket if you had known you were going to loose, I would be surprised if you said yes! If I ask the person with lung cancer, would you have started smoking all those years ago if you had known this is where you would end up most would also say no. (I don’t have a cite for that, but my gut tells me most people would not trade a lifetime of smoking for the pain of a slow death from cancer) However, that doesn’t mean that the person who buys the lottery ticket, or the person who starts smoking is unaware of the risk, and it seems unfair to allow them to claim that they weren’t informed after the outcome has been determined.

So you’re propounding the second objection I laid out in my OP; that the person who chooses to smoke is taking an informed risk that they won’t get cancer. You think, then, that if cigarettes were one hundred percent guaranteed to cause cancer eventually–and their packages reflected that fact–that the incidence of people starting to smoke would decline precipitously?

Anyway, the retroactivity isn’t the essential part of it: what if, every time someone was making the decision to start smoking, they were subjected to five seconds–only five seconds–of what it feels like to have, say, emphysema and mesothelioma. Do you think the same number of people would then take up smoking?

Here I must disagree with you. I am only 24 years old, yet I have an IRA account. I can not use that money for 40+ years, and yet I opened the account anyway. I am well aware that there is a chance I might die before I get to use that money, and that if I do die before I use it that I will have missed out on some of the things I could have used that money for while I was alive. (Instead of having a couple grand in the bank I could go on big vacation for example) But, having weighed the options, I choose to forego the vacation today in favor of the possibility of having more money when I retire. Isn’t this a prime example of someone looking down the road and making an informed decision?

Yeah, definitely. And you’ll note that I said that we’re “not very capable” of making such decisions, not that we’re incapable. I’d also argue that “some cost now for significant benefit later,” as with the IRA account, is more easily assimilated than “some benefit now for significant cost later.”

[Gadarene]

In second grade, my class was shown actual lungs set in urethane. One was normal. The other lung was that of a smoker. This was in 1982.

If you can’t make an informed decision after that, I’m more worried about the fact that you may be voting than that you may be smoking.

Looking at a picture of a diseased lung isn’t the same as knowing how it feels to have a diseased lung. That’s the distinction I’m making.

[Gadarene]

(Sorry…in your example it wasn’t a picture, but an actual lung. It doesn’t change my response, but I apologize for the inaccuracy.)

[gazpacho]

Looking at a picture of a diseased lung isn’t the same as knowing how it feels to have a diseased lung. That’s the distinction I’m making.

Then I am not sure that we can be informed about any thing. Being told that we can save money using coupons is not the same as actually have a little extra money. We are not informed about coupons?

[xcheopis]

I think a lot also has to do with what age at which someone begins to smoke. I started on my 11th birthday and most certainly not making an informed decision.

The warnings against cigarette smoking weren’t all that blatant in 1975, at least not at the level for 6th graders. Smoking was still very much socially acceptable and most of the parents were smokers, therefore it was a cool grown-up thing to do.

[Gadarene]

Like I said, gazpacho, I’m singling smoking out because the potential consequences are so far-ranging, negative, and severe, and because they are not likely to occur for many years after the initial choice to smoke. If people were presented with a sheet of ten coupons, each of which would save ten cents off some grocery item a year from now, I doubt that most people would still have the sheet in a year in order to redeem the savings.

[Gadarene]

Does anyone care to tackle those scenarios I set out, by the way?

[Rhum_Runner]

*Originally posted by Gadarene *
Simulpost; that wasn’t in response to you, Rhum. (Oh, and assume that the fifty dollar bill you get in twenty years is worth whatever it’d be worth today.)

I think the problem with the four senarios is that the $50/5% ratio is way out of wack. What is the going rate in a tobacco case these days? $3-8 million, (I’m not talking about the punitives, just straight out compensatory damages, but if we take that as a number that is somehow related to the value of a life) If you said, for a 5% chance of you dropping dead in the next month I’ll give you $3 million in 2022 I am not sure what I would say…

[quote]

So you’re propounding the second objection I laid out in my OP; that the person who chooses to smoke is taking an informed risk that they won’t get cancer. You think, then, that if cigarettes were one hundred percent guaranteed to cause cancer eventually–and their packages reflected that fact–that the incidence of people starting to smoke would decline precipitously?

[quote]

I think it is certainly in part an informed risk, but I wouldn’t limit it to just, either I will get cancer or won’t get cancer. I think there could be many senarios, either I will take my chances and hope I don’t get cancer, or that I will die before I get cancer, or I will get cancer anyway, so I might as well smoke, or everyone has to die someday, I might as well die from cancer etc.

Anyway, the retroactivity isn’t the essential part of it: what if, every time someone was making the decision to start smoking, they were subjected to five seconds–only five seconds–of what it feels like to have, say, emphysema and mesothelioma. Do you think the same number of people would then take up smoking?

Probably. What if everyone had to feel five seconds of what it is like to be in a car accident before they could drive? Would people still drive? Sure.

Yeah, definitely. And you’ll note that I said that we’re “not very capable” of making such decisions, not that we’re incapable. I’d also argue that “some cost now for significant benefit later,” as with the IRA account, is more easily assimilated than “some benefit now for significant cost later.” **

I still disagree. What about AIDS for example? Many people still have casual sex ala the 60s and 70s, but many people who probably would have been into casual sex twenty five years ago are more careful now. They recognize that the pleasure of sex tonight does not justify the risk of AIDS tomorrow. Interestingly, as AIDS treatments get better and better there seems to be an upswing in sexual activity. Isn’t this a sighn that people are performing fairly complicated analysis of the risks inherent in their behavior? (I don’t have a cite for this, but I will try to google one up for you if you disagree with the general idea)

[gazpacho]

*Originally posted by Gadarene *
**Like I said, gazpacho, I’m singling smoking out because the potential consequences are so far-ranging, negative, and severe, and because they are not likely to occur for many years after the initial choice to smoke. If people were presented with a sheet of ten coupons, each of which would save ten cents off some grocery item a year from now, I doubt that most people would still have the sheet in a year in order to redeem the savings. **

But we would still be informed about the sheet of paper. It seems to me that the evidence for your argument is that many people have made what you think are bad choices and you have decided that the reason that people made the choices is that they were not informed. I don’t find this argument convincing.]

[DocCathode]

*Originally posted by Gadarene *
**Looking at a picture of a diseased lung isn’t the same as knowing how it feels to have a diseased lung. That’s the distinction I’m making. **

Not having the had the experience, we are not capable of making a decision to have or not have it.

Going by that reasoning, no human is capable of making an informed decision about anything.

[Rhum_Runner]

Eh gads, apologies for the coding, spelling and general malaise of that last post. :rolleyes:

[yosemite]

The warnings against cigarette smoking weren’t all that blatant in 1975

Didn’t they remove all cigarette-related ads from TV in the early '70s or late '60s? How can anyone not know that the danger was there? Shouldn’t have such a sweeping regulation (banning smoking ads on TV) been yet another nail in the coffin of the “I didn’t know it was bad for me” lame excuse? How much information and how many warnings does it have to take before people finally admit that they just decided to ignore the warnings?

And while I do have sympathy for a kid who is encouraged at age 11 to smoke, it still doesn’t mean that the kid was unaware that it was a bad idea. Hell, the fact that smoking is illegal for minors should have been an incentive to not start smoking. And even if the kid’s peers or family members told the kid to ignore the health warnings, who is to blame for that? The kid breaks the law and smokes while underage, and ignores the health warnings that are emblazoned on each package…and yet some of them still want to be able to claim victim status? I don’t see why.

I am no fan of the tobacco companies, (I think they are evil) but if the labels, banning TV ads, and other warnings of the perils of smoking weren’t enough, what will be?

[The_Font_of_all_Wisdom]

I started smoking when I was 10 years old. I quit when I was 28 (12 years ago!). I couldn’t pronouce Marlboro when I first smoked so I bought Winston’s instead. Can any 10 year old make an informed choice?

The choice to keep on smoking is based on several things. Inerita, addiction, and the belief there is always a tomorrow. Right now my Father is fighting lung cancer. He also started smoking as a child.