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Why do we still permit tobacco use? (2015)

85 points| LaFolle | 4 years ago |ncbi.nlm.nih.gov

227 comments

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Barrin92|4 years ago

Simple answer, because we live in a free society and the consideration for what is outlawed isn't how beneficial an activity is for the person who engages in it but how dangerous it is to others.

And so while I'm okay with banning smoking from places where others are affected, tobacco consumption in private or voluntary settings shouldn't really be an issue.

Also interesting angle in the piece to declare that tobacco has 'no benefits'. Is the author the enjoyment police? First thing that comes to mind for me is, I have a lot of Arab and Turkish friends and there's a strong cafe and smoking culture within those communities that's an important part of social gatherings.

In the world of health professionals which appear to attempt to pathologize everything this apparently doesn't hold a lot of value but for most people it does.

Volundr|4 years ago

> Simple answer, because we live in a free society and the consideration for what is outlawed isn't how beneficial an activity is for the person who engages in it but how dangerous it is to others.

To be honest, I don't see how you can look at American drug laws and come to this conclusion. It's certainly what we say we do, but when you actually look at the laws it place, be it drugs, gambling, marriage or any number of other things it becomes obvious that our "free society" only extends as far as the freedom to do those things the powers that be approve of.

kube-system|4 years ago

> the consideration for what is outlawed isn't how beneficial an activity is for the person who engages in it but how dangerous it is to others.

We aren’t consistent in that regard, or at least, we often consider that someone who sells a harmful substance is harming another person.

Our laws often prohibit Pfizer from selling dangerous drugs, as well as your local street drugs dealer.

These decisions are always a tradeoff between cultural expectations and harm. There’s no hard and fast rule.

randombits0|4 years ago

If a cigarette was considered an occasional treat rather than a 20x a day ritual, it wouldn’t be a big deal. That’s my present take. I was a long time smoker that eventually quit, more from physical symptoms than anything else.

But an occasional smoke is no biggie. Six cigarettes a year has little affect. Some can’t walk that without relapse, of course. It’s different for everyone.

ryrymcfly|4 years ago

I feel like the substance should be permitted, but companies profiting from it's industrialized production should be taxed into oblivion.

wolverine876|4 years ago

> In the world of health professionals which appear to attempt to pathologize everything

What does that refer to? That's not my experience.

willcipriano|4 years ago

> However, there is no moderation in tobacco. There is no level at which tobacco smoke is safe for the consumer or the people around them or, as we are seeing, even those who are exposed in a tertiary environment.

I've used tobacco products perhaps from 0 - 5 times a year from adulthood on. While not "safe", pretty low risk. I have the same relationship with caffeine and alcohol. Nothing can be all that enjoyable if you do it everyday.

I've often thought of a sort of "vice license", at the age of authority you can apply for a license that you need to buy things like alcohol and tobacco. Everybody gets one that applies and is of age. Then you can voluntarily choose to limit access to a particular vice, and if you are a danger to others a court could limit your access as well.

Casinos already have this model, it's called self-exclusion[0]. It seems like the most humane solution that allows people to still be adults.

[0]https://gamban.com/blog/ban-yourself-from-online-gambling

__MatrixMan__|4 years ago

It looks like you have good dopamine hygiene. You can probably also trust yourself moderate other dangerous things like World of Warcraft, Twitter, or cocaine--if for some reason you wanted to. Keep it up.

For me the real question is: can people who have unhealthy dopamine habits heavily etched into their neural pathways be taught to change that about themselves, or is replacing unhealthy addictions with healthier ones (i.e. exercise) the best that they can do?

I wish policy would focus less on specific vices and more on helping people along such a path (if it exists). Such a license would be a good way to explore that possibility.

Ideally it would be part of something broader though. You can get a commercial endorsement on your regular driver's license, why not a "drinks-responsibly" endorsement too? While we're at it we can have "can use the 3d printers at the library without supervision" endorsement and a "licensed realtor" endorsement. You can imagine all kinds of badges people might want to collect.

jawns|4 years ago

This presumes that vices have no effects on anyone but the person partaking. Think about the secondary effects of smoking on those around you, or the societal effects of the opioid crisis, or even the effects on rescue workers who need to scoop up what remains of a person riding a motorcycle without safety gear.

5e92cb50239222b|4 years ago

I believe Japan has something similar to what you describe.

https://en.wikipedia.org/wiki/Taspo

If you want to buy cigarettes from vending machines, you have to get this card first.

Just start requiring it in regular convenience stores (or stop selling tobacco there altogether), and you're done.

nemo44x|4 years ago

I would love to acquire power and label a bunch of things I dislike as “vices” so I can control opposition.

Posting too much on social media is a vice. It releases dopamine according to my experts and can be harmful to others. It shouldn’t be done often. So now your “vice license” needs to have this “badge”.

I don’t want any part of the nanny state you describe.

captn3m0|4 years ago

The state of Maharashtra in India has a personal drinking license (min age 21 for Beer/Wine and 25 for the rest) that’s needed for drinking privately. I have never heard of it being enforced - I think it is a colonial-era leftover but I might be wrong.

A friend of mine spent some effort acquiring one , and shows it off very enthusiastically :)

https://www.wikihow.com/Obtain-an-Alcohol-Permit-in-Maharash...

ravi-delia|4 years ago

You know what, that's the first good plan I've seen for handling the issue.

sidpatil|4 years ago

The country of Oman has something like this. If you are not Muslim, you can apply for a permit which will allow you to purchase alcohol in restaurants and state-owned liquor shops.

osigurdson|4 years ago

I don't think such an idea would have any practical benefit. A vanishingly small percentage of people would voluntarily limit access and even fewer would end up in courts. Motivated addicts would simply find workarounds to the system while non-addicts and suppliers would be burdened with additional regulation.

BrS96bVxXBLzf5B|4 years ago

> Tobacco smoking has no health benefits. None. It can be argued that nicotine, one of the thousands of compounds in tobacco smoke, can have positive effects on some cognitive functions and may even confer some neuroprotection (1), but getting nicotine from tobacco products may be likened to sucking on a tail pipe to get oxygen – it’s there but it’s not going to do you any good.

I'm sorry for their personal experience but leading with "there are zero health benefits", immediately following up with "there might be benefits" and then continuing completely disregarding that point is irresponsible.

Without interjecting my own opinion, two points I feel are underdiscussed regarding this issue:

- as the author mentions there are studies on the cognitive benefits, many mental health patients self-medicate with tobacco including 80% of those diagnosed with schizophrenia

- overshadowed cultural aspects. Millennia of pre-20th century tobacco use, its role and impact (positive and negative) in societies, religion, and spirituality is much different than we've experienced over the last hundred years

wildrhythms|4 years ago

The quote says "Tobacco smoking has no health benefits." It goes on to make a distinction between tobacco smoking and nicotine.

Zababa|4 years ago

You're mixing tobacco and nicotine. There are ways to get nicotine in you without consuming tobacco. I know at least of nicotine gums and nicotine patches.

JoeyBananas|4 years ago

> I'm sorry for their personal experience but leading with "there are zero health benefits", immediately following up with "there might be benefits" and then continuing completely disregarding that point is irresponsible.

Ridiculous. What the author wrote about the health benefits of tobacco makes perfect sense. What would really be beyond irresponsible is any argument that tobacco use has health benefits. You have to ignore the mountain of evidence suggesting that tobacco use causes all sorts of major health problems.

tedajax|4 years ago

Smoking is bad but prohibition is worse. Being subjected to the carcercal system is worse for your health than smoking.

gpm|4 years ago

Or phrased differently, "we don't know how to stop it without causing something worse".

Outright prohibition is massively expensive (prisons, police, loss of taxes), is a gift to criminals who will grow/import it illegally and sell it, and has outsized negative consequences on the people who use it anyways.

Partial prohibition (under X years of age), taxes, and public education work to reduce the amount of it, without most of the negative side effects, so we did those. If you could point at other measures that would further reduce the usage, which didn't come with huge drawbacks, I'm pretty sure we would jump on that as well. Unfortunately, it's not clear any such measures exist.

throwawaygh|4 years ago

This, to me, is the only compelling reason. Prohibition is almost always worse. Even just prohibition of production -- not use -- has substantial negative externalities.

Almost every other argument is absurd on-face. Even base appeals to "freedom" fall flat given the significant secondary and tertiary effects of smoke exposure, as well as the huge cost imposed on society by smoking.

WastingMyTime89|4 years ago

The issue was prohibition in the USA was that it indiscriminately criminalised selling, transporting, owning and consuming alcohol. With tobacco, modern countries could simply ban selling while allowing consumption. The risk is that the black market would flourish. I think the current policy of constantly hiking the price is a compromise: it restricts availability while limiting the development of parallel sell channels.

woodruffw|4 years ago

Being subjected to the carceral system is indeed bad for your health, but there's a gap here: you haven't explained why banning smoking means we have to put people in prison.

I would have thought to just fine them, or tax purchases out of existence. No need for shackles.

rzimmerman|4 years ago

Prohibition has clearly been worse in the case of alcohol and marijuana. You might be right, but I’m not convinced a prohibition on production and sale would produce the same black market for tobacco. Maybe it’s my own bias, but I like to think that most people that smoke don’t really want to. It’s driven by addiction and ease of access. Cravings are ephemeral and it’s not like buying a 6 pack or some pot to have a good time later. There’s a spectrum where prohibition works. The best example I can think of (at the extreme) is plastic bags at supermarkets in California - no black market for that, vs marijuana where it clearly a failure.

yalogin|4 years ago

I think there can be a place in between allowing it and incarcerating people. Make it illegal to sell and may be heavy fines for getting caught smoking?

Sure, there will be a black market for it but a lot of the low effort entrants to the market and many new entrants will be discouraged. Overall there will be less people using it.

I generally understand that prohibiting something with the threat of incarceration is wrong, but without some legal interference smoking is not going to go away.

kzrdude|4 years ago

What about the current system, where it's not prohibited but people tell you it's bad all the time, where does it fall on the scale? Is it the best solution?

kadoban|4 years ago

Does this apply to other drugs as well?

cmrdporcupine|4 years ago

I enjoy the plant. I grow it in my garden for the beautiful scented flowers, and then I dry it or buy higher quality pipe tobacco and smoke it in my pipe in the summer and fall. Or a nice cigar when I'm on vacation in a warm place.

The industrial cigarette product.. yeah that's something else. Gross.

But I don't see how the two can be reasonably separated from each other, though, and how you can realistically police cigarette consumption. You'll just end up with a black market.

Seems like the current approach in western countries of high taxation and intensive education and regulation is (slowly) working.

ivanhoe|4 years ago

In many countries it's illegal to grow tobacco on your own, while it's perfectly legal to buy the industrial product - because government wants their tax money - and I think that's also the reason why the tobacco industry is not more regulated. It's still a huge money not just for the manufactures, but also for governments, and you don't kill the goose that lays the golden eggs.

63|4 years ago

You've hit upon the article's exact thesis.

elephanlemon|4 years ago

As a cigar smoker I really hate articles like this. Not everyone that uses tobacco smokes 20 cigarettes per day. Cigar smoking in moderation (all the way up to one cigar per day) has been shown to be a fairly minimal risk multiplier for cancer. And many cigar smokers such as myself smoke much less than this.

Same goes for some other types of tobacco usage as well. Last I checked, the correlation between cancer and nasal snuff usage among non-smokers is extremely limited. Here’s a fun remark from one study:

“ The last reported case of nasal snuff causing cancer of the nose was described by John Hill in 1761. We describe here a case of a 69-year-old woman who developed a nasal vestibular malignancy after 30 years of snuff usage, and this, we believe, is the only reported case of nasal snuff causing cancer in the last 2 centuries.”

As far as “no health benefit” goes, I would disagree. Smoking a cigar is a highly relaxing activity that I very much enjoy. I am sure that it is good for my mental health.

nmpennypacker|4 years ago

I'm a cigar smoker as well and I think it's unfortunate that cigars are often lumped in with other tobacco products.

jrlocke|4 years ago

> Cigar smoking in moderation (all the way up to one cigar per day) has been shown to be a fairly minimal risk multiplier for cancer

Honestly curious about this one, do you have a source?

air7|4 years ago

This is one of my favorite questions in the area of social/moral governance.

Put more generally: How much should we protect people from themselves?

In the not-so-distant past, I'm guessing, the answer to that for most people was: Very little. After all, adults are capable and expected to make rational choices and do so every day; for themselves, and the people they cate about. So giving them more options is just helpful...

But the past few decades have perhaps opened our eyes. From Kahneman & Tversky, behavioral economics and cognitive biases, to the smartphone (and other screens) epidemic that rages everywhere the device is in use.

It's become extremely clear that "adults" are not very good at being rational and self-controling. At least when they are put up aginst corporations who employe armies of professional mind hackers whos sole job is to make them lose the battle.

So the debate isn't really Control vs. Freedom anymore. Its more like Protection vs. Jungle Law.

And still, though we've realized the stakes are higher than we first thought, the right moral choice is unclear. Perhaps the idea of protecting ourselves from commercial predetors should be seen as childishly quixotic as the idea of protecting Deer from lions. Especially since the "Lions" are us too. We (though in smaller numbers) are also the benefactors of these questionable actions.

But then again, no one likes to be prohibited from doing what they want, and that's a great, and fairly new, right that we have (with restrictions of course). We should be quick to hamper it.

Good question...

akira2501|4 years ago

> From Kahneman & Tversky, behavioral economics and cognitive biases, to the smartphone (and other screens) epidemic that rages everywhere the device is in use.

That new inventions often have a negative impact shouldn't be surprising, but I think it's worthwhile to try to set this against all the positive aspects. I remember life before mobile phones, and from my perspective, they have provided far greater benefits than harms. Wide access to GPS and maps, instant access to emergency communications, and many applications that improve productivity and quality of life are far better explanations of why these devices have become so prevalent.

> It's become extremely clear that "adults" are not very good at being rational and self-controling.

Has it? I feel that this is a refelction of them not very good at "following the agenda of the elites," but that's hardly the same thing as not being rational. As a counter example, there are more guns than people in the United States, yet there are only around 12,000 murders per year. From that view, we're exceptionally good at being rational and exhibiting self control.

Likewise, we travel trillions of miles on our roads, and they're not the complete disaster that you would expect from a population that's largely unable to self-regulate. Similarly, general aviation is a thing that exists, and while it may seem largely regulated you would be surprised to learn exactly how much latitude a GA pilot has in operating their aircraft.

> So the debate isn't really Control vs. Freedom anymore. Its more like Protection vs. Jungle Law.

If that's the case.. why wouldn't you punish the abusers, rather than preempt the freedom of individuals? One is definitely a problem, the other _might_ be a problem. It seems like putting the cart before the horse to approach the problem in this way.

SuoDuanDao|4 years ago

One thing that occurs to me is that the 'jungle law' is fairly one-sided in who can predate upon whom. We all laughed at the lady who won a big settlment for being burnt by coffee she spilled, or the people sueing Mcdonald's because they were overweight. But maybe those were opening salvos in a war that currently has the megacorps winning more ground than they should. Perhaps the parents of the next radicalised young person should sue Meta, and perhaps the jury should help take them to the cleaners. It seems to be working against Monsanto. Perhaps we need to recognise that we don't care nearly as much about how protective the megacorps are as we care about our ability to turn the tables now and then.

throwawayboise|4 years ago

> It's become extremely clear that "adults" are not very good at being rational and self-controling.

Consequence of several generations of "self-esteem-oriented" child rearing. If people are not taught self-control when they are young, why will they suddenly exhibit it when they are adults?

beloch|4 years ago

"Our governments collect $2.81 billion in tobacco sales taxes federally (2), which is >1% of all federal government spending in 2013 (3) ... However, the direct and indirect cost of lung cancer, asthma and chronic obstructive pulmonary disease in Canada is $12.0 billion (2012 figure), of which smoking is considered to be the number one cause (4). That’s not a good trade-off, even if you only consider it economically."

Tobacco sales taxes show up in the current fiscal year, while chronic respiratory health costs show up decades down the road. Governments tend to be better than corporations at prioritizing long-term concerns over short-term accounting. However, there is substantial demographic that opposes regulations on narcotics. Specific ones, at least.

Look at how popular legalizing cannabis was in Canada over the last decade. Smoking pot is the most popular form of delivery for that narcotic and it's likely going to prove to have many of the same long-term consequences as smoking tobacco. Nonetheless, Canada legalized it. Doctors raised concerns and were ignored. The public willed it, and politicians don't stay politicians by ignoring the public's will.

Why do we still permit tobacco use? Because politicians have the power to prohibit it, not doctors.

Perhaps the doctors espousing prohibition don't have the right of it either. Narcotics have been a part of human existence across the globe for all of recorded history. Although many people successfully abstain from them, narcotics seem to fill a basic human need.

Research on safe, enjoyable recreational drugs is virtually nonexistent. Perhaps we should focus on filling that human need while minimizing the side-effects. To put it another way, with all the medical and pharmacological advances we've made in the last century, does it really make sense that people are still sucking on burning leaves to get high?

retrac|4 years ago

> The public willed it [...] because politicians have the power to prohibit it, not doctors

At face value you seem to be arguing for a medical technocracy to replace democracy.

Pre-legalization I expected the government to strongly discourage /smoking/ cannabis. Edibles and sprays and non-combusting vapes would be emphasized. But nope, my local cannabis shop prominently sells rolling papers and bongs. You can buy pre-rolled joints ready to go from the government distributor directly.

I feel this aspect of legalization was handled poorly. The public wanted legal cannabis. Our politicians should have done so while emphasizing harm reduction. They talked about it but perhaps unsurprisingly it didn't really materialize.

k12sosse|4 years ago

The prohibition of the sale of cigarettes, ready to smoke, would be a good start. Treat it like weed, buy it loose-leaf, roll your own.

That way people still have their freedom and it's not so easy to "just have another one" when you're a kid.

Also since legalization, I've eaten more weed than I smoke, the freedom to grow means I have surplus to bake with and experiment with. My inhalation is near 0. (Smoked weed and cigarettes for 18 years).

Stopped smoking cigarettes thanks to "vaping" and weed thanks to "baking".

Just because people are allowed to have it doesn't mean we should let them buy 25-packs, ready to go.

chernevik|4 years ago

Because some people enjoy it, and it's a free country. Why is this even a question?

63|4 years ago

The article is specifically speaking about Canada. I suppose Canada is a free country too, though.

throwawaygh|4 years ago

> Why is this even a question?

Again, the article explains:

"I can vividly recall in the first couple of weeks into my first clinical rotation watching an elderly man with end-stage emphysema literally suffocate and die on my shift wearing just a venti mask. It was a clarion moment for me as a young health care professional even though I never smoked."

__turbobrew__|4 years ago

In Canada (where the article is authored) there is universal healthcare. The health effects of smoking burden the healthcare system and therefore other Canadian citizens.

In the US healthcare system I have less a problem with smoking since you will have to pay for the healthcare on your own.

CaptArmchair|4 years ago

Because tobacco use is deeply engrained in culture, economy, politics, etc. There are tons of social and economical interests tied into all of that.

Tobacco use has a long history. Archeological finds indicate that humans in the Americas began using tobacco as far back as 12,300 years ago, thousands of years earlier than previously documented.

https://en.wikipedia.org/wiki/History_of_tobacco

Also, society doesn't consist of people who all share the same mindset or the same faculties to come to a particular notion. There's a wild amount of diversity which defines people's identity. It is said that you can't reason someone out of a position they haven't reasoned themselves into. If you were raised in an environment with tobacco use, there's a high likelihood you're going to be a smoker from a young age as well.

Wholesale prohibiting tobacco use sounds like an easy fix. But it really isn't. Prohibitionism as a legal philosophy has its fair share of criticism as well:

https://en.wikipedia.org/wiki/Prohibitionism

Consider the complex history of Prohibition in the U.S. during the 1920s:

https://en.wikipedia.org/wiki/Prohibition_in_the_United_Stat...

That doesn't mean tobacco, alcohol or any other drug consumption is problematic. It very much is, and it comes with immense suffering and a massive societal cost which shouldn't be ignored. But instead of approaching consumption as a singular law enforcement issue, the bigger challenge is to approach the education, healthcare, social, culture and economical issues that lead to the promotion of such consumption.

Even then, it's a pipedream to assume that the entirety of humanity will ever stop using tobacco. Or other substances for that matter.

lunias|4 years ago

Prohibition to the rescue! We all know prohibition has the consumer at heart. I'm sure smoking tobacco post-prohibition will be much safer and more equitable for everyone!

rwmj|4 years ago

It'll certainly be a lot more profitable!

cproctor|4 years ago

Well this thread finally convinced me to set showdead=no in my profile. It's scary to see how much damage a few accounts can do to the erosion of discourse on this site, and especially to think I'm reasonable in worrying that some of them are state or corporate sock puppets. I am grateful to the site moderators and to other community members (in downvoting bad-faith comments) for asserting our shared valuation of this discourse space.

JohnHaugeland|4 years ago

I have never smoked a cigarette in my life.

As a pothead, I find this line of reasoning offensive.

As a scientist, I'd like to observe that their opening claim that tobacco has no medical benefits is hard-false; it's by far the most effective known medication for schizophrenia, by example, helps with crohn's, helps with IBS, et cetera.

Alcohol is far worse for us than tobacco. So is white sugar.

This person is just plying a grudge.

tptacek|4 years ago

You could construct an equivalent argument about bacon.

andybak|4 years ago

Anyone can throw in a silly comparison but it doesn't really help. I'm fairy certain you're smart enough to reflect on the nuance that this topic deserves. Some bad things are legal. Some bad things aren't. It's a complex thing for society to weigh up and the linked article attempts to contribute to that discussion.

paulryanrogers|4 years ago

It would be weaker though. Second hand bacon is not a thing. Unless one is a fecal transplant donor.

11235813213455|4 years ago

That's also what I sometimes say to smokers "it has no benefit at all, only drawbacks, it's just an addiction and you can decide to stop if you understand it's damaging" (my mother died at 63 from lung cancer), and there are many subjects here in France. It's also quite annoying to breath that smoke anywhere outside. That's one of the things I hope will change, along with noise (cars, motorcycles as someone living near a street, and using a bicycle) and pollution, and overconsumerism

Zigurd|4 years ago

The numbers here do not add up. Here (https://www.cdc.gov/tobacco/data_statistics/index.htm) CDC says the US spends $225 billion/year on treating tobacco related disease.

In the article the authors claim US tobacco tax revenue is $2.81 billion. But here )https://www.taxpolicycenter.org/fiscal-fact/federal-tobacco-...) the number is about $12 billion.

Nevertheless, tobacco is a very large, very bad problem, but it also seems like patches and vapes for delivering nicotine could put a big dent in tobacco use, and cut a lot of the ill effects, maybe in the amount of tens of billions each year. I would guess if there was a reduced harm form of alcohol health experts would be all over it. Yet I see no PSAs that overtly tell smokers to vape or use nicotine gum. Such a message could be placed on every pack of cigarettes.

Because there is a low cost alternative to cigarettes, why not tax cigarettes even more than they are taxed now, offer vapes as an alternative, and see how much progress can be made using simple, obvious measures.

ThinkBeat|4 years ago

One can make much the same argument regarding alcohol. It is a potent neurotoxin.

Drink too much of it, you die. (Alcohol Poisoning / OD)

Drink it too often the liver will have issues.

For one Alcohol metabolizes into Acetaldehyde which is an even more potent poison. Usually, the liver takes care of it, but if there is too much and too often the liver can't deal with it all. Acetaldehyde is said to damage the DNA.

It is also linked to developing cancer.

There are many studies that claim drinking in moderation is healthy for you. Mostly that deals with chemicals contained for instance in wine but not related to the Alcohol

All that is something that happens to your body. Whilst smoking annoys everyone who must smell it.

However, the overall cost of the abuse of alcohol to society is enormous. Aside from the physical damage it does, it is a huge contributing factor to sexual harassment, rape, domestic abuse, violence, child abuse (in so many ways), car crashes, homicide, impaired judgement.

An argument can be made that the impact of alcohol on society is much worse than tobacco.

Still alcohol is a popular poison. The last time the US tried to ban it, it didn't work out too well. It is ingrained in culture in many places and many ways.

Personally, I think weed is much safer than alcohol. I do prefer people have it in ways that do not impact others. Walking around smelling weed smoke is not that great.

I have always said that people should be allowed more of a choice in how to get high/drunk/euphoric/relax. Now we have weed so that gives people a choice. I think MDMA and LSD should also be legal. (But made legally in safe and pure forms)

jmclnx|4 years ago

Well, one thing to consider, seems these days, it is OK to smoke marijuana but not tobacco.

So, I believe until it is illegal to put 'smoke' into your lungs, anything goes. But, as some US businesses are doing, increase Medical Costs for people who smoke anything. Hard to verify since I know of a few people who lie about smoking to avoid the increased rates. At least that is a start.

klarstrup|4 years ago

What are some examples/places you've seen that have simultaneously allowed marijuana smokeing but discouraged tobacco smoking? In my country the signs are just "no smoking" they don't say what

scythe|4 years ago

Does freedom have inherent value, or does it have to lead to something else in order to be valuable? This editorial seems to assume the latter.

For example, it suggests that the sole justification for alcohol legality is that it can have benefits in moderation. Notwithstanding the dubiousness of this claim, does anyone really believe that is why alcohol is legal?

js8|4 years ago

> Does freedom have inherent value, or does it have to lead to something else in order to be valuable?

If you assume the first then you're a fundamentalist. In order to compare different moral values, we need to look at what they lead to in practice, and weigh that. So the abstract "freedom" doesn't cut it, you need to be able to say, what is the practical benefit of such freedom? So that we could compare it with practical disadvantages of the freedom, in case of smoking, things like people getting addicted and less healthy, and Philip Morris shares decreasing in value.

sponaugle|4 years ago

And this is why we can't have nice things... because "we" don't "permit it". How does someone even write this sentence? Did they glance over at their crown, which says "King We", and think "thou shall not smoke!"?

andybak|4 years ago

Well. There's plenty of things that are illegal. How far down the libertarian rabbit hole are you prepared to go?

throwaway984393|4 years ago

Tobacco has been grown and used both socially and ceremonially by native American cultures for thousands of years. I get that generally we white western Americans don't give a shit about native cultures, but it would be nice to at least acknowledge the indigenous heritage that literally all tobacco comes from and is still used in today.

Personally I like cigars and hookah. I smoke maybe once a year. I'm not saying millions of people should die just so I can smoke, but I'd be fine with chewing tobacco and cigarettes being banned, while indigenous and more ceremonial / social forms of tobacco are kept.

codr7|4 years ago

Why should anything be banned?

If it's ok to smoke once a year using whatever kind of delivery method, it's going to have to be ok to do whatever the hell you feel like with it.

Banning people from growing/harvesting/consuming plants is just silly, it's one of many ideas we will eventually have to let go of, because it makes no sense.

dionidium|4 years ago

> There is no level at which tobacco smoke is safe for the consumer or the people around them or, as we are seeing, even those who are exposed in a tertiary environment (5).

This framing drives me nuts. It's the same claim the CDC makes on their website:

> There is no safe level of smoking.

> Each cigarette you smoke damages your lungs, your blood vessels, and cells throughout your body. Even occasional smoking is harmful, and the best option for any smoker is to quit completely. The more years you smoke, the more you damage your body. Quitting at any age has benefits.

Source: https://www.cdc.gov/vitalsigns/adultsmoking/index.html

First of all, it's absurd. If you smoke, let's just say, I dunno, one puff off a cigarette once a year I am certain there is no measurable health effect. So the claim is wrong.

But more important, this kind of argument could be applied to all kinds of things. In a technical sense, there is no safe amount of air travel, for example. You are exposed to background radiation at measurably higher levels every time you fly and this has measurable impacts on longterm health (pilots and other flight staff have measurably higher rates of cancer). But does the CDC say, "there's no safe amount of air travel?" Do they point out that every flight does some amount of damage to the cells in your body? Do they warn you that the more you do it, the more harmful it is? Do they tell you that quitting is the only way to be sure you're doing no damage?

No! They give actual figures, explain that the risk of infrequent exposure is relatively low, and then provide a simple point of reference to help the public contextualize the risk:

> We are exposed to low levels of radiation when we fly. You would be exposed to about 0.035 mSv (3.5 mrem) of cosmic radiation if you were to fly within the United States from the east coast to the west coast. This amount of radiation is less than the amount of radiation we receive from one chest x-ray.

Source: https://www.cdc.gov/nceh/radiation/air_travel.html

temp8964|4 years ago

Is "Canadian Journal of Respiratory Therapy" a legit academic journal? This paper sounds more like a rant to be posted on reddit than a scholar paper to be published on a legit journal.

The author jumped from "Tobacco smoking has no health benefits" to "tobacco has no benefit". Seriously, this shouldn't even get passed for a high school writing class.

Scoundreller|4 years ago

Seems to be the journal for the Canadian respiratory therapists’ national association.

So I wouldn’t call it illegitimate, but it’s a small field in a small country that’s largely bedside rather than academic, so filling the pages may be a struggle.

giantg2|4 years ago

"Why do we still permit tobacco use?"

Because society chooses to. That's the case for most things. Why should I want to control what others do if it doesn't directly affect me? If we look hard enough, chances are there is one activity or another that we each engage in that could also be eliminated or highly regulated on this same basis.

wolverine876|4 years ago

I don't see limiting people's freedom to do things harmless to others, except in extreme situations. But what about limiting the production and sale of a poisonous, addictive substance?

At least it should be regulated to remove the addictive properties. Why hasn't that been done? Is it technically conceivable?

2-718-281-828|4 years ago

> These other ‘sins’, however, have at least some benefit. ..., alcohol in moderation has benefits and gambling in moderation is entertaining for some.

The author is an idiot ... what is this "rethoric" manipulation called btw? I bet it has a Wikipedia article.

klarstrup|4 years ago

Yeah it's weird how there seems to be so little institutional support for regulating low-risk psychoactive substances like nicotine(and caffeine). Stimulants that increase alertness and enhances concentration, very useful for productivity.

throwaway_2009|4 years ago

Is universal healthcare important enough to cede control over what we put into our own bodies?

That's the only important question. As far as I'm concerned the answer is definitionally no, and I live in the UK where we arguably have it.

It's an endless rabbit hole of authoritarianism. Ban cigarettes, ban sugar in high concentration, ban fast food, mandate vaccines. If we find out that taking an aspirin a day improves health outcomes - mandate that too. Ban unprotected sex - just use phone cameras to enforce it or whatever.

There is literally no end to it because if we only take into account the one metric "does this thing affect aggregate health outcomes" you can justify banning anything.

I'm sure someone will read this and get grumpy that I've mentioned vaccination. I have three, they're ace.

The idea of authoritarian policy is that you don't have a choice; your opinion is truly irrelevant. I don't think its' proponents often hold that in the forefront of their mind, they only focus on "well, right now I'm on the popular side" or whatever.

riffic|4 years ago

so I just watched the Get Back documentary and one of the thoughts I had is that the amount of cigarettes smoked in the production of a Beatles album likely had an effect on the band's creative output (spoilers - there was a lot of smoking, lol).

I'm not saying that I would want to be exposed to any of that second hand smoke myself or that I would want to get addicted to the substance, but there's something that was part of that magic formula that affects the mindset of an artist.

rapsacnz|4 years ago

New Zealand has just banned it using a rolling age locked technique - starting from next year. This means that anyone 14 and under in NZ will never be legally able to by tobacco.

SMAAART|4 years ago

As an ex-smoker at times I wonder the same, but I know the answer: governments the world over are addicted to the tax revenue from tobacco production and consumption.

retrac|4 years ago

In 1994, the Canadian federal government reduced its tobacco excise tax. Quite a lot too, nearly 50%. It wasn't a libertarian whim, or the desperate power grab of a cigar-lover. The black market was rampant. About 30% nationally approaching nearly 100% in some communities. (Clever: you can measure the rate by collecting butts from public ashtrays and the street.)

Prohibition doesn't eliminate demand. And in the Canadian context, with a border with the USA and with some indigenous communities being exempt from federal excise taxes and who use tobacco in religious ceremonies, effectively prohibiting the black market trade seems daunting, both pragmatically and politically. It also raises the old question: are the harms of the substance or the harms of prohibition worse?

gimmeThaBeet|4 years ago

I don't know if there's provincial taxes or anything, but a similar dynamic happens in the US, there's arbitrage smuggling between states with different taxes. A bit dated, in the link the negative states are one where cigarettes are net flowing out of the state, so you can see where they are going and coming from.

At first, I was going to state that it would be interesting to compare organized crime trafficking tobacco to other drugs where there is no long running commercial history. But then I saw the southern border states are theorized high in importing smuggled cigarettes. So either wyoming, idaho, and nevada are supporting the whole western US, or some of it's coming up from mexico.

2012 https://taxfoundation.org/cigarette-taxes-and-cigarette-smug...

2017 paper arguing tax increases do not exacerbate this https://tobacconomics.org/uploads/misc/2017/11/2017-generic-...

throwawayboise|4 years ago

It's a plant; it's not going away. Some people like to dry the leaves and smoke it. If those people are adults, leave them alone.

jhallenworld|4 years ago

We should ban US companies from marketing cigarettes to people (kids) in other countries. They are doing it right now in Africa.

tim333|4 years ago

It'll be interesting to see how New Zealand's experiment with getting rid of it goes.

Ekaros|4 years ago

Why do we still permit ethanol use?

ufo|4 years ago

The article does address this question.

jppope|4 years ago

Totalitarians are creeping into academia more and more. Little to no nuance in their understanding of human behavior or what allows free societies to function. We all maybe cracking jokes and pointing out flaws in the argument... but the real problem here is that this is a real paper, and a real view being given real consideration

rubyist5eva|4 years ago

Because outlawing it will simply allow a black market to flourish, which is worse.

EamonnMR|4 years ago

Because laws match social rules, not the other way around?

chrisgd|4 years ago

Alcohol seems a bigger problem

JRGC1|4 years ago

simpler answer: look what happens when you ban things

imwillofficial|4 years ago

“Why do we still permit McDonalds use?”

sebow|4 years ago

As it says there, nicotine is not that harmful, at all.It's mostly the vast majority of other sh*t that makes up a cigarette that makes "tobacco"[whatever the hell you understand by tobacco actually] harmful.Cigs/Cigars don't have this problem, granted you usually don't inhale them in lungs, or at least you're not supposed to.

Just because it's mainstream and overall damaging to the health over long periods of time doesn't mean we should ban or restrict it's use.No, not even in public spaces.Maybe if there were a referendum then yes, but usually people won't really ban something if it's really a problem or danger to society. Tobacco is a problem/danger to the individual and not to society at large.I can't say that it was ever addictive to me ever for a number of reasons: usually expensive, they make things smell, and it's not really something that you enjoy most of the time,especially alone.

But the biggest thing that made me "quit" smoking(or at least dropped it significantly for me, to a lower level than "socially smoking") is when i first started going to the gym more seriously.You notice how your energy level drop and other things aswell(greasy skin,lower fertility,etc).Why not promote sports more actively?It will have more effect than these restrictive initiatives, to a degree that smoking is not even than harming when you do sports.Do you need to ban it because it can become a vice and lower lifespan?No, that's stupid(besides the fact that it erodes responsability in society).Tobacco is a decent substance that can be consumed socially, compared to others. The nicotine itself actually relaxes you and 90% of the time people smoke is to forget the stress of the moment.Also the damage to the lungs is vastly overblown. Lungs recover pretty fast actually if you don't "burn" them with smoke.If i recall it was one week of smoking is recovered somewhere between a month and 3 months, with obvious factors: air quality, degree of smoking,etc.

Here's a better idea than this "karen" mentality: improve the quality of tobacco: focus on the nicotine,you have to keep the smoke(you really can't get rid of the aspect, people have been inhaling for thousands if not tens of thousands of years, and it won't go away: it's a very direct path to the brain chemistry) and finally,obviously: get rid of the bad substances.

novosel|4 years ago

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throwawaygh|4 years ago

Because we need oxygen to live. A less absurd question might be "why do we still permit gambling and alcohol", which the article addresses:

> One of the main arguments for the continuance of tobacco sales is that the government should not dictate what vices the public engages in. This is a valid point. Alcohol and gambling are restricted but not prohibited; fast food is unrestricted (although New York City [USA] attempted the restriction of soft drink sizes but failed miserably); and, although government intervention is on the rise, few are protesting access to these products. These other ‘sins’, however, have at least some benefit. We need gasoline, we need to eat even if we occasionally do so at fast food restaurants, alcohol in moderation has benefits and gambling in moderation is entertaining for some. However, there is no moderation in tobacco. There is no level at which tobacco smoke is safe for the consumer or the people around them or, as we are seeing, even those who are exposed in a tertiary environment

(I'm not expressing agreement or disagreement with the article, but I'm not sure how parent comment contributes anything to this post.)

SuoDuanDao|4 years ago

Why do we still permit busybody bureaucrats to receive public funds?

Bureaucrats like the NIH have no societal benefits. None. It can be argued that public goods, one of the thousands of effects bureaucrats have, can have positive effects on some aspects of society, but getting public goods from an unelected bureaucratic institution may be likened to sucking on a tail pipe to get oxygen – it’s there but it’s not going to do you any good. /s