It may have been semantics in our last discussion but I don’t think it is with this OP.
Yup. From a public health standpoint, the primary goal is to reduce deaths and severe illness and resource-intensive treatment of severe illness. Since smoking puts individuals at higher risk for all those things, it makes statistical sense to prioritize the vaccination of smokers along with other high-risk individuals.
It may not seem fair at the individual level, but pandemics don’t care about fairness, sorry.
Sure. But they are a limited tool for now, so we have to triage them.
No way should smokers get ahead in line. That is just wrong.
Smokers murder 50000 American every year.
Yes. We’re triaging them on the basis of what will produce the most harm reduction overall. Not on the basis of which individuals are most personally deserving of protection from harm.
But I dont see how putting them forward in line does this.
Sure if you have COPD or something from smoking, fine.
sigh
I don’t have any defense of smoking, or people who will not take the effort to stop smoking, but that isn’t the point, here. The point is that smoking is correlated with severe illness that requires ICU hospitalization, so including it as a risk factor in evaluating priority for vaccination in terms of overall benefit to public health, e.g. preventing the health system from being overwhelmed. You don’t have to have any sympathy for smokers to appreciate the benefit in not subjecting medical workers and first responders to more risk, exhaustion and burnout, and trauma from having to work at an over-capacity state for weeks or months on end.
As a separate effort, this administration should work on reducing smoking and offering assistance with smoking cessation as a public health mandate, because this is also a public behavioral health epidemic. But that is distinct from the immediate threat of the infectious pandemic that needs to be addressed promptly in order to deal with all of the other challenges (unemployment, GDP reduction, housing crisis, food instability, et cetera) we are also facing.
Stranger
Note that word “correlated”. Scientists dont like that word much, correlation is not causation.
In any case, this means all ya gotta do is say “Yep, I am a smoker” and get a bump up.
It is ethically wrong.
It’s like throwing yourself on the mercy of the court for being a orphan after murdering your parents.
It’s just a statistical assessment. Smokers on average are at higher risk for COVID death and severe illness (and all the societal costs associated with coping with those) than non-smokers are. Therefore, prioritizing smokers over non-smokers for COVID vaccinations will on average reduce total COVID harm.
Public health is all about statistical averages, not about individual worthiness or risk levels.
Again, how do you confirm they are a smoker? I had to confirm my age.
Not ethically right, and subject to abuse.
You are quite wrong in all accounts. Scientists are fine with correlation as a test of the null hypothesis. Correlation does not necessarily mean that the hypothesis is correct, but a lack of correlation to a specified level of statistical significance indicates that it is wrong. It is rare in public health or social sciences to actually have a first principles causal mechanism that is definitive and completely exclusionary, so correlation and falsification are the toolbox by which those fields make evaluations. Saying “correlation is not causation” without any context is a meaningless counterargument.
It is also not true that you just claim to be a smoker and you get “a bump up” to the front of the line. Smoking is one of several factors considered. And this is not an issue of the ethics of poor health choices. Certainly smoking is a bad choice for the individual and also has manifest impacts upon society, but in this situation, the primary ethical concern is in protecting the general public, and specifically health care workers and first responders.
Stranger
They’ve started vaccinations for “essentials workers” in Illinois which as far as I know requires no real confirmation. At some point we have to get to things that aren’t easily verifiable.
This sounds like you’re introducing the additional issue of perverse incentives motivating people to lie about whether they smoke. I haven’t seen any evidence that this is a genuine problem in vaccine allocation, though.
Do you mean that lying about one’s smoking habits for the sake of vaccination prioritization is ethically wrong (which, yeah, nobody’s disagreeing), or that prioritizing smokers for vaccination is ethically wrong because unfair?
If the latter, see my above point about pandemics not caring about fairness.
No, it’s not at all like that. Because the point of the court trial in that situation is to judge and punish you for murdering your parents. The point of a COVID vaccination is not to judge and punish you for smoking.
Speaking as a non-smoker, and a math professor, can I just say how glad I am that your emotionally righteous but non-pragmatic perspective is not what’s determining public-health policy about vaccine distribution? We’ve got a fucking pandemic to fix here, folks. We need to focus on maximizing overall harm reduction, not on moralistic criteria about individual deservingness.
(Besides, your punitive project of afflicting smokers with physical ill-health for their irresponsible destructive behavior may be safely left in the nicotine-stained hands of the smokers themselves. I really don’t think you need to worry about most smokers benefiting from unfairly excessive amounts of healthiness.)
Looking at MA’s phases, smokers (without another health issue) are behind:
Early education/daycare, K-12, transit, grocery, utility, food and agriculture, restaurant and cafe workers;
Employees across the food, beverages, agriculture, consumer goods, retail, and foodservice sectors;
Meatpackers;
Sanitation, public works and public health workers;
Vaccine development workers;
Food pantry workers and volunteers;
Transit/transportation: Uber/Lyft/ride share services/pharmacy delivery drivers, workers in the passenger ground transportation industry (e.g. paratransit for people with disabilities, food delivery, non-urgent medical transport), Massport workers other than police, airline workers;
Convenience store workers (under grocery workers);
Water and wastewater utility staff
Court system workers (judges, prosecutors, defense attorneys, clerks), other than court officers who are listed under first responders
Medical supply chain workers
Workers at manufacturers (including biotechnology companies and those companies that have shifted production to medical supplies), materials and parts suppliers, technicians, logistics and warehouse operators, printers, packagers, distributors of medical products and equipment (including third party logistics providers, and those who test and repair), personal protective equipment (PPE), isolation barriers, medical gases, pharmaceuticals (including materials used in radioactive drugs), dietary supplements, commercial health products, blood and blood products, vaccines, testing materials, laboratory supplies, cleaning, sanitizing, disinfecting or sterilization supplies (including dispensers), sanitary goods, personal care products, pest control products, and tissue and paper towel products.
Funeral directors and funeral workers
Shipping port and terminal workers
Are there still health insurance payment aspects to being a smoker? I thought at one time it meant you or your company had to pay higher insurance rates. I suppose it’s possible for a fake smoker to inadvertently bump themselves up into the smoker premium on health insurance by declaring themselves a smoker.
Most plans I’ve seen still charge more for smokers.
I have been part of a longitudinal study on smoking since I was 14 years old. Every time I filled out a questionnaire, which I did twice a year through high school, and once a year in college-- now they come in the mail about every four years-- I had to submit a spit sample to check for nicotine to see whether I was telling the truth about being a smoker.
And, if smokers catch the virus more readily, and are sicker longer, then they are more likely to be spreaders, and to spread for a longer amount of time. So it’s not just a question of protecting the smokers-- it’s a question of protecting the people they come into contact with, who may not be smokers, but may get a high “dose” of exposure by living with a smoker, working with one in an environment where distance working doesn’t fly, or being the person who has to police up the butts they throw all over the ground. Which is a disgusting behavior I’d love to punish them for, but with fines for littering, not by withholding a vaccine, which hurts their children, their co-workers, and the guy who has to police up their goddam virus-laden butts.
My car insurance asked if I was a smoker (I’m not, and never have been). I asked why, and was told it’s now considered a form of distracted driving. I have State Farm.
Here in CA you have to show company ID. Or at least are supposed to.
This entire argument demonstrates why universal health insurance can be a hard sell. UHC works when all it is about it health care, and only about health care.
But if the government can take lifestyle/ethics/moral choices into account in allocating health care, people won’t support it, because they see that as government getting to judge whether someone is worthy enough to get health care.
These two seem to not be in correlation.