http://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748884.html
From health care alone, yeah it saves money. But you also have to factor in social security, someone who dies at 77 collects 7 years less in social security payments than someone who lives to 84.
Not necessarily. It depends how much medical care they need before they do die, among many other factors. Some of the studies quoted are just medical costs. But things like opioid abuse (which was mentioned in response) often drastically reduce or cut short working lives. So those working age people aren’t helping pay the cost (via taxes) of eg. retired people’s benefits. And they might become dependent on the state themselves more or sooner than they otherwise would, without necessarily dying. Same with their distraction of family members from being more productive The same would be true of smokers to some degree though the health effects tend to hit later in life than drug abuse.
If a medico-social problem made people drop dead immediately and no medical care could do anything to help or delay it, then the economic equation would simplify to lost taxes v savings in medical costs. And in theory (subject to real world cultural/political limitations) the tax loss could be made up by immigrants. But real world medico-social problems tend to make people (including those who don’t directly suffer from the illness) less productive and more expensive to others while they are still alive. So while you can’t necessarily ‘make the data say anything you want it to’, it’s not easy to figure out the real net impact.
No, amazing as it seems, even the tobacco companies were too embarassed to make much of claim about that. But it was pretty much well known by everbody I knew, except, oddly enough, the girl who worked for the anti-smoking council 
(but she wasn’t a medical or finance person).
The effect it did have was that it wasn’t possible for the anti-smoking lobby to add
“and it’s more expensive for society” to all the other arguments. And it would have been a powerful argument. There is a lot of health and welfare stuff that is driven by econmics at one point or another.
Note also that it’s a general average effect. The effect on specific families (small children, father dies of lung cancer at 34) can be financially devestating on top of the personal loss.
I’ve occasionally heard people jokingly suggest that certain applicants for disability benefits ought to be awarded benefits as a cost savings measure, as they would use those benefits to eat, smoke, and drink themselves into an early grave. No idea of objective data, but is is frustrating to see so much resources spent on (at least largely) self-inflicted illnesses.
Thanks for all your responses. This was an issue in public policy some 25-30 years ago; some (I remember reading about it in the ‘New Republic’) speculated that smoking saved the government, adding up Social Security benefits forgone, total Medicaid and Medicare costs. I thought that was a clever thing to think so used it in my arguments. I thought I read an article by Mr Adams debunking it; I asked here in hope that I would get an ‘official’ answer, after searching the site’s archives didn’t turn it up.
On the turn this thread has taken, I propose that we take prescription opioids off-prescription, sell them OTC. First, it would divert users from heroin, which is often tainted with more-powerful opioids such as fentanyl and carfentanil and may be unsanitary, funds criminals who commit other crimes, is expensive, and results in more users shooting up.
OTC it would be a $1 or so a pill; no user would have to commit a crime to get his/her fix.
Opiated people who have no trouble getting their opioids don’t do anything else; if a lot of them are malcontents, sedating them into inactivity would benefit the rest of us.
I suspect it may be the cure for alcoholism - assuming, as I do, that we redefine opioidism as a non-disease, overdoses as positive outcomes: tickets to junkie heaven. It may also be an effective cure for people who are trying to smoke and eat themselves to death: if their underlying disease is fugue, opioids are the most-effective agent.
Similar to arguments made in support of full legalization. No clear downsides, so long as you are willing to lose some who overindulge.
Re: smoking costs, are the environmental effects of cigarette butts being taken into account here? It seems like increasing the supply of nicotine in the environment has to be a net negative.
That is, of course, a Straw Man argument. But an arguable suggestion is to to relax the prescription restrictions from opioids, so that anybody with a stable lifestyle and a suitable income could be a user.
That would be more restrictive than the rules for alchohol, which is still arguable. The next suggestion would be to make the rules the same as alcohol - over 18/21, heavily taxed, restricted outlets.
Both of those suggestions imply that prescription opiods are not more dangerous than alcohol, which is an arguable point.
The counter example is imperial China, when free availability of opioids was enforced by European powers. (Again arguably), opiods had a massivly destrctive effect on the society. According to one theory, the backwardness of pre-republican China was do to the effects of wide-spread opium addiction. (The counter-counter example is England before the restrictions and taxes on distilled spirits, where distilled spirits had a massively destructive effect on the society.)
In my uneducated opinion, real benefit would flow from legalization and regulation of the drug Ecstasy. In my city (Melbourne), criminalization and policing of E led to the strong resurgence of Alcohol as a party drug, leading to a massive increase in Crime, Injury and Deaths.
I guess it depends on how you look at the problem. If you have a business that makes money out of selling tobacco products, you look at the world very differently from a politician responsible for expensive healthcare programmes. For a consumer, their perspective is also different. They just want to get high for the least personal cost.
Human beings seem to have a tendency towards stimulants that can be highly addictive and have severe effects on public health. Nicotine, Alcohol and a range of legal and illegal drugs. We are also addicted to some refined foods based on sugar, fat and meat products that cause dental problems and obesity.
From a public health perspective, all of these have a cost in that they create avoidable medical conditions that are expensive to treat and render the individual incapacitated and far less capable of productive work. Sufferers may also get themselves into a state where they lie, cheat and steal, beat their partners, abuse their neighbours and colleagues and generally make other people’s lives a misery. There are secondary negative effects that are a great cost to society.
Now if there was a stimulant that gave addicts the hit the are looking for, did not cause serious health problems and had no serious secondary effects on society and was also cheap to produce…send suggestions on a postcard to the politician of your choice.
Producers of these stimulants have a vested interest in promoting arguments their products are, in some way, a benefit either to the individual or society. Most of these are the fallacious result of marketing to gullible consumers and political campaigning to tweak laws and policies in favour of their business. They want a lot of consumers prepared to pay for their product.
Anyone responsible for the health and economic productivity of a nation has a broader perspective. A nation ravaged by addictive illnesses is a serious liability. Reports like this are intended to give some semblance of reason to policies that favour, in this case, the tobacco lobby. Usually, they leave out important factors that, when included, make a nonsense of the conclusion. They have usually been debunked long ago.
I would like to see some reason applied to the problem of addiction and public health policy instead of it being swayed by self-interested lobby groups selling diabolical weed or powder.
Unfortunately, the regulation of addictive substances is a political battleground and few countries have evidence-based policies that reconcile concerns for the health of the nation, the concerns of the individual looking for stimulation and the purveyors of highs of one sort or another, legal or illegal.
Governments have a quite an appalling record managing drug and alcohol regulation, the moral crusades of the prohibition era empowered mafias and organised crime. The ‘War on Drugs’ wasted billions unsuccessfully trying to stifle the supply and distribution of narcotics and so provided a profitable revenue stream for insurgencies in politically unstable countries. Meanwhile, the mismanagement of prescription drugs has now emerged as a gateway to opioid addiction. The latest trend seems to be an explosion in the variety and potency of analogs of popular illegal drugs have many times the addictive potency and no laws covering these new formulations - legal highs.
If only there were drugs designed be non-addictive or have some antidote, yet were able to provide the stimulation that users seek without the destroying their health or their mind. Drugs and other stimulants can be managed and regulated to minimise their negative health effects and there are ways of controlling and moderating addiction.
If it was seen as a simple public health issue, existing addictions could be dealt with in a pragmatic way that minimises the negative consequences.
There are some indications that this is happening, legislation regarding smoking has certainly seen a marked decline in the number of smokers and smoking-related deaths.
Oddly, one “argument” made by Smokers in denial is “*So, who cares if it takes ten years off my life? Those last ten years are when I am feeble and sick, fine with me.” *However, this is false as it take ten good years off you life, you just get feeble and sick earlier. Your skin also looks ten years older.
I’m having trouble understanding why smokers would get better rates for life insurance. Here in the US, the more likely it is that you’ll die soon, the higher your premiums are. A healthy 30 year old would pay much less for a $10,000 life insurance policy than an 80 year old with heart disease.
Cite?
As our table shows, a non-smoking male aged 39 requiring £100,000 of level term assurance for 20 years would pay £16.50 a month for cover from Halifax Life but, if he smoked, would pay more than twice this - £39.48 a month.
The crucial aspect of smoking here is that it’s a cumulative effect on mortality and hits after many years. Virtually no one is dying of smoking-related disease at 45. But many people are dying at 60+.
The fundamental point is that everyone dies once and only once. So what matters is 1) whether whatever kills the person is an expensive way to die versus a cheap one, and 2) what the ratio of productive/working years its victims have as compared to the general population. I’m not sure what the answer is to the first question. But apparently smoking changes the ratio of working/non-working years to be very “favorable”, so that overall it saves society a lot of money.
Someone observed that cigarettes themselves cost a lot of money. But that’s not a valid point. Firstly, most of the cost of cigarettes is in the form of taxes and the like. Beyond that, any consumer good costs money. People pay to enjoy themselves. The cost of cigarettes is not different than the cost of clothing or entertainment or anything else in that regard.
There was a time, just after WW2, when about 82% of the male population smoked and cigarette brands were recommended by doctors. The prevailing wisdom was that smoking was a sign of a robust constitution. Even if you did not smoke, you were certainly exposed to it. It is now down to 19%. Times have changed and the air is a lot cleaner.
I agree the original statement could not have been true, unless at one time UK ins co’s thought smoking actually increased life expectancy. Otherwise the lower the life expectancy, the fewer payments the insured makes to the insurance company before the insurance co must make a big payment to the beneficiaries. No way would that lower the premiums.
What could result in better rates for smoker is an annuity sold by a life insurance co. There it’s the other way around: the smoker will collect fewer payments on average so the annuity is more profitable to the insurance co if they require the same upfront payment as for a non-smoker. However in practice I don’t think ins co’s offer a discount like that. For one thing they can’t verify that you smoke and moreover that you have smoked as long as you say you have and will continue. So annuities are just a worse deal for a smokers. Life insurance might be an equal deal for smokers and non-smokers because the higher price for smokers might be fully justified by the life expectancy difference. Besides being bummed out thinking about it, it’s not necessarily a bad deal to pay more for life insurance if in fact your life expectancy is shorter.
This was an interesting stat.
Low-Income Smokers in New York Spend 25% of Their Income on Cigarettes
As I recall, virtually no one is dying at 45. But of those that do, smoking-related disease is / was a notable fraction.
Yes, you are more likely to die old than to die young, but the cancer wards always had a few young men among the many old men.