There follows a guest post by John Staddon, Professor of Psychology, and Professor of Biology and Neurobiology, Emeritus at Duke University, which is an extract from Chapter 4 of his book Unlucky Strike: Private Health and the Science, Law and Politics of Smoking.
I have discussed the morality of smoking, its supposed lethality, its addictiveness and its effects on nonsmokers. The evidence shows that if smoking is a sin it is a pretty venial one; nor is smoking as lethal as its critics charge and many smokers imagine. The health effects of passive smoke are almost impossible to measure. The best attempts have failed to find significant effects.
This chapter deals with the most serious policy-related charge against smoking: that it costs non-smokers money – smoking has a Public Cost. Smoking-related disease is “a profound burden on our national health care system”, wrote Judge Kessler. As we’ve seen, the National Socialists agreed (all those lost Volkswagens). “Smoking imposes a huge economic burden on society – currently up to 15% of total healthcare costs in developed countries,” says an article in the BMJ in 2004. The case seems unarguable. A substantial fraction of smokers die of smoking-related illnesses. Treating illness, especially if the treatment is protracted and often ineffective, as it is with COPD and many cancers, is always expensive.
But “obvious” is not always “correct.” The smoking-costs-us folk seem to forget (brace yourself!) that we all die, even non-smokers. As the bumper sticker reminds us: “Eat right, exercise – die anyway.” The facts about the health-care cost of smoking are in fact the opposite of the common preconception. For the 24-50 age range, smokers cost a bit more, thereafter they cost quite a bit less because smokers die a bit earlier than non-smokers. Overall “smoking actually saved the Medicare program money, $2,800 per male smoker aged 24 and $600 per female”, concluded Sloan and colleagues from a database up to 2002. Data gathered since, which I discuss at more length in a moment, confirm this conclusion: smokers save society on health-care costs. Silberberg, using a different set of data, concludes similarly in the Appendix.