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.
> 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.
It's what people say for their own vices and faults, freedom! Other people's vices should be banned.
That's why freedom isn't meaningful when we talk about ourselves. Everyone thinks themself should be free; it's freedom for others, especially those we don't like, that is significant.
Not really. Most narcotics lead to serious drug problems that definitely put a strain on others. I wouldn't say our drug laws are perfect, but they are aimed at reducing dangers to others, and to a reasonable degree, it accomplishes that.
Sure, if only narcotics were all we were controlling. But there are plenty of other schedule 1 drugs (marijuana being the most popular) that don't have this issue, yet remain illegal. Meanwhile alcohol use most certainly has a devastating impact on others, both in terms of drunk drivers, and alcoholics committing crimes to buy more alcohol. The difference being alcohol is considered "acceptable" by the powers that be, while marijuana is not.
It all boils down to them enforcing their morality on the rest of us.
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.
> 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.
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.
I think the trick is to savor the experience and to seek novelty. When I drink coffee, it has an almost uncomfortable effect, but it really wakes me up and the feeling is sort of fun. However if I drink it the next day, the effect will be greatly reduced. If I drink it for a week, I'll start to become dependent and feel less awake than when I started without it.
Coffee isn't really the enemy here, it's your own biology.
That said, I feel like you need enough dopamine to make it though the week and sometimes people get trapped by life circumstances. I'm luckily enough to have a beautiful wife, if I had to sleep alone in a cold bed and go out into the world, I might be the kind of guy who needs to cup of coffee in the morning to remain sane.
So in short I think you need to start with a life that is fulfilling enough that you can endure the slings and arrows of the world on a day to day basis. If you don't have that, it's going to be very difficult to not fall into the embrace of temptations that you'd rather avoid.
I'm reminded of the https://en.wikipedia.org/wiki/Rat_Park experiments, which (to me) imply that addictive behavior is an indicator of problems elsewhere, rather than a problem to be solved directly. And by all means, we should work at addressing root causes. But I think there's also room for improvement re: how we respond to bad situations.
> you need enough dopamine to make it though the week
I think this is part of the story, but not all dopamine is created equal. Or rather, it's all created equal, but it ends up motivating different things. I don't have any studies to back this up, but I like to think in terms of fast-vs-slow dopamine. Fast dopamine motivates you to do something arbitrary in search of more dopamine, slow dopamine motivates you to do something that you also have other reasons for wanting to do.
I'm in the middle of fixing a fence that blew down in a recent storm. There will be some slow dopamine involved at gazing upon the finished product. I think it can count towards my enough-to-make-it-through-the-week allotment. But that's easy for me to say--I don't generally have problems with addictive behavior. I'm just interested because I'd like to find a way to share that quality with my friends who do.
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.
This could also be said for alcohol though. Alcohol is associated with higher levels of motoring accidents, assaults, and chronic disease.
The externalities of alcohol consumption can be largely mitigated by drinking in moderation.
The primary externality of smoking, secondhand smoke, can be mitigate by having people smoke outdoors, which most countries already require in public spaces.
The main secondary externality of smoking, increased strain on the healthcare system, is more complex. Smoking is more addictive than alcohol, so moderate consumption is less possible. Therefore, smokers are more likely to experience an illness directly related to their consumption than alcohol consumers.
In America, I'd suggest this externality could be addressed by removing the cap on the smoking health insurance surcharge (it's currently 50%). In countries with socialised medicine, this could be better addressed by adjusting cigarette taxes to fully reflect the average lifetime cost of treating smoking related illnesses.
There's no "secondhand" alcohol drinking like there is secondhand smoking - while the effects afterwards (if someone chooses to be irresponsible after becoming inebriated) can be severe, they are mitigated by choosing safer practices such as having a ride, drinking at home, and knowing to limit oneself if they exhibit behavior that is negative toward others. With smoking, this isn't a possibility.
> rescue workers who need to scoop up what remains of a person riding a motorcycle without safety gear
If it is an obvious death, it is a crime scene until proven otherwise. The police and coroner take care of things in this case. The ambulance is usually not involved after the declaration of death.
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.
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 :)
Speaking in terms of tech addiction, there are tools and strategies out there to manage. Anti-engagement tools you might call them. The "Digital Wellbeing" app on Android can be used to limit certain apps, such as to one hour per day. The unhook.app extension neuters YouTube's engagement by disabling things like suggested videos. I have also set a Windows Task Scheduler task to run shutdown /s /hybrid /t 60 in the evening. Having a reminder of goals to curb irresponsible behavior can often be enough to curb them.
In a perfect world I'd be able to set a weekly calorie limit. Charge me double the cost and send the overage to the charity of my choice for any food over the limit.
A government body limiting who can buy food isn't really a good idea, so it only works in utopia. It could work for non-essentials though.
I order from a service that provides me nutritionist-built meals every day; in the morning, I get exactly 2000kcal spread out across 3 meals and 1 snack. I also drink protein yogurt reaching around 2350kcal so that's my daily intake (and I guess calorie limit) with balanced macro and micronutrients.
What this means is that I am aware that anything above these meals is too much for me. Do I still do it? Yes, but I have an unhealthy relationship with food.
What if you could opt for a custodian, and the designation can't change very often (like open enrollment)?
Give a trusted friend the right to set your calorie limit, and if it doesn't work out, try a different friend next week--but you can only change it between 10AM and 2PM on Mondays.
Yeah I could see maybe a credit card sort of offering with these rules. I don't think credit cards get that granular level of data however. Then I would only have to commit to only carrying around that card.
Yeah, let's not hand that sort of data to the credit card companies. It might be a good use case for homomorphic encryption--where the transaction processor computes a go/no-go result without knowing why (and then you scan a QR code and decrypt on your device).
I was thinking of having it decoupled from payments, sort of a more customizable replacement for the ID-checks that we currently do when buying alcohol. I think you could do zero-knowledge trickery to avoid the privacy problems.
But then again, an API for a third party to cut off your access to resources might be too juicy of an abuse-enabler to be worth building.
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.
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.
> 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
I think also that developing software has no health benefits, none, but only as a counterpoint I do not wish to argue. The better argument is that something is deadly, not that something has no health benefits.
What I do wish to argue is that the author failed to recognize the difference between tobacco, and what is in nearly all manufactured cigarettes, that is killing people. What is killing people is that most smokers are not smoking tobacco, but half-tobacco, half recorrugated garbage off the floor made into a paper before shredding and infused with additives like 300 carcinogenic chemicals intended to increase the addictiveness of nicotine and smoking.
Pipe tobacco is just plain old tobacco, with no additives but water. Pipe smokers don't seem to suffer the fates of cigarette smokers.
Death rates for current pipe smokers were little if at all higher than for non-smokers, even with men smoking 10 pipefuls per day and with men who had smoked pipes for more than 30 years. [1]
Among the pipe smokers.... The US mortality ratios are 0.8 for non-inhalers and 1.0 for inhalers. [2]
This means pipe smokers who inhale live as long as nonsmokers, and pipe smokers that don’t inhale live longer than non-smokers.
I don't really want to criticize the author, who is merely expressing frustration and compassion and attempting to persuade smokers to quit and non-smokers to never start. But his beef is not really with natural tobacco. Big Tobacco (with their chemical death sticks) is the enemy here.
"Even if you don't inhale, you can get cancer from smoking pipes and cigars. People who smoke cigars regularly are 4 to 10 times more likely than nonsmokers to die from cancers of the mouth, larynx, and esophagus." [1]
"Between pipe and cigarette smokers, no or only minor differences were found in mortality from any cause and the specified smoking-related diseases. Pipe smoking is not safer than cigarette smoking." [2]
Not sure if pipe smoking is a better alternative. Would love to hear your thoughts on what I've shared.
The trouble here is that I can't see actual paper in [2], cigars don't enter into it, and that the study I referenced, and subsequent studies, show that what causes cancer is carcinogens, which are intentionally addrd by Big Tobacco to increase addictiveness. The fact is everyone has cancer, but we're not all sick because we naturally slough off cancer cells. Is anyone particularly aware of cancer rates in Native Americans from the 1300s to the 1940s? Why aren't we? Probably because they were low enough to be noise against the natural occurrences of cancer.
Smoking anything can cause emphysema, and I wasn't ever making a claim that smoking is healthy or safe, so there are some straw man fallacies present in your reply. What I was drawing attention to is that cigarettes are not tobacco, and that due to the intentional infusion of 300+ known carcinogens [1], it is no wonder it kills so many people every year. I don't have any references, but I expect before the chemical revolution in the 1950's, smoking cigarettes didn't kill remotely as many people.
> Pipe smokers don't seem to suffer the fates of cigarette smokers.
Oh yes they do. See eg [1]. Also logically, both are inhaling smoke from burning organic matter. There is no way it is not going to be very unhealthy, once you look at the chemical composition of the smoke.
[1] Between pipe and cigarette smokers, no or only minor differences were found in mortality from any cause and the specified smoking-related diseases. Pipe smoking is not safer than cigarette smoking.
https://pubmed.ncbi.nlm.nih.gov/20952559/
According to the US Surgeon General report I cited, my statement is true.
> Also logically, both are inhaling smoke from burning organic matter.
No, that is my point. At least half of what is in national brand cigarettes is not organic. [1]
> There is no way it is not going to be very unhealthy, once you look at the chemical composition of the smoke.
Since I made no mention of health, this is a straw man. Please take better note of what my claim is, which concerns mortality, not health. But yes, the chemical composition of cigarette smoke is terrifying, though there is confusion here. Cigarettes are not tobacco, and what is in (nearly all) cigarettes is not natural tobacco.
Regarding your endnote, what you are (effectively) claiming is that the infusion of 300+ known carcinogens in cigarette tobacco has no effect on mortality, which is absurd on its face. Also, it is possible to likely that popular pipe tobaccos have in the last 45 years changed to include these carcinogens. If so, these participants were not smoking natural tobacco, and the study says nothing whatsoever about smoking natural tobacco.
So please produce a study showing the differences in mortality rates between smokers of national brand cigarettes (which since the 1950's chemical revolution or thereabouts have intentionally added carcinogens [1]) compared to mortality rates of smokers of unadulterated natural tobacco, as in tobacco that is merely grown, dried and smoked without any processing.
> what you are (effectively) claiming is that the infusion of 300+ known carcinogens in cigarette tobacco has no effect on mortality, which is absurd on its face
It's not absurd once you account for the already present carcinogens from burned plant material. And even smokeless tobacco (chewing etc) causes oral, oesophagus, and pancreas cancer.
What is in national brand cigarettes is not tobacco, but a product made from tobacco that is almost entirely unlike tobacco. Tobacco is put in a vat, the nicotine is extracted, a mash is made into which nicotine is infused at higher levels than in natural tobacco, and 300+ known carcinogens are added called additives, from the mash a paper is made, the paper is sliced into little pieces, this is mixed with cut stems, whatever fell on the floor, and previous recycled product that was never sold, all stuffed into paper.
Natural tobacco, on the other hand, is grown, dried, and sold. Sometimes water is added.
Your claim is both products are equally lethal. If smoking pipe tobacco (which as I have always seen it sold, is natural tobacco, easy to tell by looking at it) is just as bad as smoking cigarettes, then adding 300+ carcinogens to cigarettes has no ill effects. This is what is absurd, because, of course adding 300+ carcinogens is going to make the product more lethal. The 300+ carcinogens is the reason why 400K Americans die every year do to smoking-related illness. Prior to the 1950's chemical revolution, the mortality rate of smokers did not even begin to approach this number. Beginning in the 1950's is when smokers started dying en mass every year.
There is a massive difference between natural tobacco and what is in cigarettes. The latter is lethal, the sole cause of the high mortality rates of smokers. The former is merely unhealthy. Pipe smokers that inhale live as long as non-smokers, and pipe smokers that do not inhale live longer than non-smokers. That's what the US Surgeon General report says.
I don't care about some chemicals that go into American cigarettes. I am not American and I don't smoke. I only know people died from lung and other cancers or copd on a massive scale long before anything was added to tobacco. I objected to your claim that
"Pipe smokers don't seem to suffer the fates of cigarette smokers", because of course they do. One of my uncles died of aggressive lung cancer and he smoked natural tobacco from a pipe. Smoking tobacco will not be healthy even if it is the most bio organic tobacco available.
The years of life expectancy a typical cigarette smoker loses is 25, so the life expectancy for a typical cigarette smoker is roughly 55.
My grandparents smoked, presumably for 50 years before they passed in their mid-70's. They could have lived past 100, because my grandmother's sister lived to 103. But she also smoked for 80 years. My mother points out that unlike my grandparents, my great aunt was an avid walker, walked a few miles every day religiously. So she makes a fair point, because inactivity and sedentary lifestyles also are cut short. My mother's sister smoked intermittently, but ultimately had quit for 10 years before dying relatively young (58) from breast cancer. My aunt made the observation that cigarettes stink, but insisted that they did not used to stink, claiming that when she was young her parents smoked in the car with her and her siblings, and it never occurred to her to open a window, because the second hand smoke back then was not irritating in the least. Her brother, my uncle, smoked cigars, basically chain smoked them, died at 67. My mother smoked, but quit for decades, then started again and smoked for another 15 years before quitting again only a year ago. She's 79. Then there's George Burns, who started smoking when he was 14 years old and lived to 100 after smoking an estimated 300,000 cigars. See Ecc. 9:11.
Very sorry to hear about your uncle. How old was your uncle when he passed? What did he do for a living? Was he a veteran? How much did he weigh? Is there any history of cancer in the family?
> I only know people died from lung and other cancers or copd on a massive scale long before anything was added to tobacco.
If you could share any reference links to any study performed before the 1950's, then we could all know this.
Some believe that this is why replacements that contain only nicotine (e.g. nicotine gum and patches) aren't really all that effective as smoking cessation aids.
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.
Nicotine is fairly non-addictive (in gum and patch form. Vapes, may be slightly more addictive due to oral fixation -- but still nothing compared to actual tobacco).
Benefits are mostly in appetite suppression (if one is prone to overeating/unhealthy binging), mental stamina (usually due to the aforementioned appetite suppression), emotional anti-lability, and greatly improved saliva production (from nicotine gum, ergo oral hygiene).
Tobacco itself contains a lot more psychoactive chemicals (MAOIs, and such), and are definitely more useful in the emotional-regulation department. If you're going through severe, inescapable emotional and physical hardship, tobacco generally keeps you from losing your mind and having a breakdown. And generally, I believe this is the most addictive quality: it keeps the stress to a manageable level (that becomes unmanageable once you stop tobacco, but don't do anything to change your environment).
One cigarette/cigarillo every few days is nothing in the grand scheme of things. It becomes a serious problem when you're smoking a pack a day, every day, without giving your lungs any time to heal and clear out (i.e. once the sharp perma-cough comes in, it's time for a break). Even having a cigar once a month (and even inhaling it), it is basically nothing, if you're perfectly healthy otherwise.
For what its worth, if the U.S. stopped selling tobacco completely, the economy would fall apart. No one would work all of the absolute dogshit jobs that "underpin" everything else (see: low-skilled, manual labor, etc.); and weed would not be able to fill the void.
It seems as though the beginning argument is incorrect - [0] seems to state that nicotine itself is in fact addictive. While there may be pseudo-benefits to both tobacco and nicotine, the overuse does indeed negate said effects as you've mentioned, though.
The FDA doesn't source those claims. It seems more political, than empirical.
Having used nicotine, tobacco, and been around people that have used nicotine and tobacco, there is little observational evidence that is addictive, relative to every other drug out there (including caffeine).
From my experience, the effects of nicotine are exceptionally mild compared to caffeine. The most serious is usually severe nausea/vertigo/lightheadedness if you dose too high.
Vapes are a different beast, though. You can easily get the same effects as a whippit by chain-vaping 50mg salt nic. However, I would still put whippits as vastly more dangerous long-term (the cause of effect for whippits is oxygen deprivation, including cell death in the brain, whereas for nicotine it's neuronal in nature; but I'm having a hard time finding actual research on the pathways involved, due to the politicized nature of this drug).
I'm not going to condone abusing Whippets, but it takes an awful large amount of long term repeated abuse of Nitrous Oxide to have adverse effects, which I believe are neuronal... losing feeling in the legs is one symptom I've heard. But it is well known among all the substances that are abused to be the least harmful. Even so, Nitrous Oxide abuse is no laughing matter.
Every so often you hear about asphyxiation deaths from nitrous oxide abuse because it is being used in an enclosed space, such as a vehicle with the windows closed because it is heavier than air, it displaces the air, thus there is a danger of asphyxiation. But you probably won't get hepatitis or AIDS from sharing a cream dispenser, nor develop lung cancer or emphysema, nor will it make your heart explode or cause heart disease. But tinnitus is probably maddening, as well as the realization one has caused their own chronic symptoms due to poor judgement. But N2O is of vital importance to medicine as the most harmless and effective anesthetic known when properly administered with proper amounts of O2.
Nicotine is addictive. Patches and gum contain extended release nicotine which might be why you think it isn’t addictive. Zyn pouches are a freebase nicotine product that the user puts in their gum like tobacco chew and is an addictive product.
I've done free base nic, salt nic, and nic polacrilex. Salt nic would be, in my opinion, the most habit-forming (but not addictive), due to a quick and high "peak," and quicker clearance -- leading to a need to re-dose more often. That's also granted that the route of administration (vaping) allows for an insane amount of nicotine to be absorbed, much more than you can ever get with pouches, gums, and patches.
As well, I'm not certain, but I believe Zyn uses salt nic, and not free base.
I've done snuff as well, and it's similar to nicotine gum (except being more of a nuisance).
I haven't seen evidence for basic nicotine products being addictive. I have little comprehension how something so mild can become addictive. Habit-forming? Yes. Full-blown addiction? No.
Cigarettes are different. They're a cocktail of various psychoactive chemicals that get dumped straight into the bloodstream in large amounts. I understand how they can become addictive. I have first-hand experience of all the necessary things that must come together for the "addiction" switch to come on.
In my experience, nicotine alone is not enough for that switch to be flipped.
This reads like a thinly-veiled marketing piece for Nicorette (now owned by J&J and GSK) via lobbying -- four years after nicotine gum receives FDA approval in the U.S.
I have yet to see any actual research on isolating nicotine as the addictive component in tobacco products.
> Nicotine is fairly non-addictive (in gum and patch form. Vapes, may be slightly more addictive due to oral fixation -- but still nothing compared to actual tobacco).
You are somewhat mistaken. Natural tobacco is fairly non-addicting because it doesn't contain nearly the amount of nicotine than what is in cigarettes, and what is in cigarettes is not natural tobacco. Nicotine, itself, is highly addictive, and there are myriad reference of studies to back this up. The addictiveness of nicotine is often compared to that of heroin. Vaping with nicotine is most likely just as addictive as smoking national brand cigarettes only due to the amount of nicotine present, thus natural tobacco is most likely not as addictive as vaping nicotine. Nicotine gum, due to the difference in delivery system, is likely just as addicting as chewing tobacco (which is also not natural tobacco but highly manipulated tobacco product to increase addictiveness). But nicotine, itself, beyond it's addictiveness, is not all that bad to consume, it won't kill you (below the lethal dose of 30-60mg), thus, vaping nicotine or nicotine gum is not all that bad, maybe not bad at all (but, again, addiction is bad in and of itself, not due to killing you, but due to messing with your free will, making you a slave to the addiction).
The only justifications I've come across are a matter of post-hoc rationalization ("because nicotine is addictive, X, Y, and Z"; but no "nicotine is addictive, because A, B, C"), and taking it as granted.
I have yet to see anything explaining why nicotine is addictive (not merely, how it could be addictive, but the evidence behind why this statement is just taken as fact).
Everything being written about it just flies in the face of my experience with nicotine/tobacco, and what I've seen from talking first-hand with smokers, vapers, and other types of users. It's like I'm listening to a bunch of upper middle class people talk about what it's like to be homeless: completely detached from reality -- and simply repeating a bunch of thoughts and ideas that they've seen somewhere else.
Even Cochrane's, a gold standard in this field, Tobacco Addiction Group just takes it at face value that nicotine is addictive. Where is the evidence? Where is the paper trail? Who has decided this? When and why? Why cannot I find any high-impact, high-citation count research that explains and justifies why nicotine is addictive?
"It was not until the 1988 report that the Surgeon General declared that cigarettes are addicting, similar to heroin and cocaine, and that nicotine is the primary agent of addiction (USDHHS 1988)."
Four years after nicotine replacement therapy via nicotine gum is introduced, the Surgeon General declares cigarettes to be addicting, in the same vein as cocaine and heroin (no it's not what was actually said, but it is implied), and that nicotine is the cause of addiction. I'm going to have to read the original 1988 report, but I'm not convinced that this is anything but political (when is it not?), rather than actual.
I'm more liable to agree with (same page):
"Additionally, throughout the 1960s and 1970s, the general understanding of smoking behavior and nicotine addiction was very limited. At the time, health scientists viewed smoking as primarily psychological and social, rather than pharmacological or biological. The 1964 report concluded that tobacco dependence should be characterized as a form of habituation rather than addiction (USDHEW 1964), drawing on a distinction established by WHO in 1957. That definition emphasized the physical effects of the drug, the compulsion to obtain it at any cost, and the habit’s detrimental effects on the individual and society (WHO 1957). The WHO Expert Committee on Addiction-Producing Drugs
observed that for cigarette smoking, evidence was lacking at the time for a typical abstinence syndrome. “In contrast to drugs of addiction, withdrawal from tobacco never constitutes a threat to life,” they wrote. “These facts indicate clearly the absence of physical dependence” (USDHEW 1964, p. 352)."
I keep seeing things just claimed as fact, without a single shred of evidence, besides "we've all agreed upon it. There are WMDs in Iran."
Apologies for the hyperbole and hysterics, but this is just maddening. Who gets addicted to nicotine? Who is actually physically and mentally dependent on nicotine products (excluding tobacco)? Where are these people?
The only people I've met who have issues with nicotine products are smokers -- including those that are trying (always unsuccessfully) to quit via nicotine replacement therapy. I'm more convinced nic gum manufactures lobbied the Surgeon General, under some plausibly deniable pretenses, than I am to believe nicotine, a chemical weaker than caffeine, is addictive.
I understand the low-level pharmacodynamics (but these are seldom useful when talking about high-level, system-wide, and complex effects).
BUT, this portion https://en.wikipedia.org/wiki/Nicotine#Reinforcement_disorde... has a few interesting tid-bits, especially the article on DeltaFosB/"as a critical factor in the development of virtually all forms of behavioral and drug addictions." (https://en.wikipedia.org/wiki/FOSB#Delta_FosB) As well as, "Based upon the accumulated evidence, a medical review from late 2014 argued that accumbal ΔFosB expression can be used as an addiction biomarker and that the degree of accumbal ΔFosB induction by a drug is a metric for how addictive it is relative to others."
Fascinating stuff -- and exactly what I was complaining about.
BUT, so many things cause DeltaFosB expression (e.g. sugar, exercise, drugs, etc.), that we need to establish how significant of an effect nicotine has compared to everything else. Fortunately, we do have one study comparing caffeine's and nicotine's DeltaFosB expression: https://sci-hub.se/10.1016/j.jchemneu.2017.10.005
Results (page 9; "number of DeltaFosB-immunoreactive nuclei per 1 mm^2" in the nucleus accumbunus):
To me, that looks like a similar addiction-profile. Granted, DeltaFosB is probably not the be-all end-all, but a small piece in untangling why and how nicotine (and other drugs) may or may not be addictive.
It would be even better, if we could put these two side-by-side with other drugs, notably cocaine and heroin, to see if the effect expression is logarithmic (and DeltaFosB over-expression is similar across-the-board for all drugs considered addictive).
On the first point, yes, health benefits may be mostly related to nicotine, but you wouldn't declare an apple useless just because other sources have the fiber and vitamins without the excess sugar.
> 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.
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.
“Suppose, for example, that a legislator should feel himself authorized to undertake the extirpation of drunkenness and fornication by direct laws. He would have to begin by a multitude of regulations. The first inconvenience would therefore be a complexity of laws. The easier it is to conceal these vices, the more necessary it would be to resort to severity of punishment, in order to destroy by the terror of examples the constantly recurring hope of impunity. This excessive rigour of laws forms a second inconvenience not less grave than the first. The difficulty of procuring proofs would be such that it would be necessary to encourage informers, and to entertain an army of spies. This necessity forms a third inconvenience, greater than either of the others.
“Let us compare the results of good and evil. Offenses of this nature, if that name can be properly given to imprudences, produces no alarm; but the pretended remedy would spread a universal terror. Innocent or guilty, everyone would fear for himself or his connections; suspicions and accusations would render society dangerous; we should fly from it, we should involve ourselves in mystery and concealment, we should shun all the disclosures of confidence. Instead of suppressing one vice, the laws would produce other vices, new and more dangerous.”
That will be an interesting experiment to watch in the years to come.
I have my doubts that it will work, or at least that it would work here (in Canada). When I was in high school I knew too many people who were smoking illegally for me to think that you could just slowly creep the law up the age groups and not end up with a thriving black market. Hopefully I will be proven wrong though!
To describe why I think this is unlikely to work in another way, I think banning it for young people is really only effective because they have almost no money, and the illegal sales to supply them mostly aren't done through criminal gangs using it to fund terrible things, but slightly older people who are just using it to earn a little extra money. Both of those break down once you start banning it for older people, even if it's always been illegal for them.
That is making the same mistake of many here and the author of the linked article, which is equating smoking cigarettes to smoking tobacco. Smoking tobacco may not be healthy, but it is not nearly as lethal as smoking (national brand and major brand) cigarettes, because cigarettes include a lot of extra stuff that is not tobacco, namely, an infusion of 300+ known carcinogens in order to increase addictiveness.
What should be banned and made illegal is the method Big Tobacco uses to process tobacco into such a lethal product [1]. If we banned this process, but permitted manufacture, sale and consumption of smoking products containing only unadulterated natural (i.e. no additives except water) tobacco, within 10-20 years, the mortality rates of smokers would plummet and return to what they were prior to the chemical revolution of the 1950s, which is probably far less though we don't know by how much because the studies only appeared after the chemical revolution.
Do like the state of Hawaii was going to do, and just gradually increase the minimum age to purchase, until it's up to 100. If you live to 100 and still want to smoke, go for it.
IMO, the principle is sound, but you could certainly argue about the rate at which the age should increase. 1 year per year seems like it would do the least harm overall.
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.
On your last point, from what I've seen smoking saves society money because it kills people at much younger ages so governments don't have to pay for their health care for nearly as long.
I think if the op was talking about non-monetary costs.
But if we're limiting this to monetary costs only, I believe you're right. I saw a similar study from the UK circa ~2008ish that compared long term smoker/obese/healthy medical costs, and healthy people are indeed the most expensive (mostly because of tremendous end of life care costs).
Edit: I dug around a bit and found the study I was thinking of. It was actually a study on obesity (also not done by the UK), but used (non-obese) smokers as a group for comparison.
Surely most living people are worth more than the economic cost of keeping them alive. They don't seem to even mention the economic value of a living person, other than to say that they didn't take into account the difference in productivity between obese and non-obese people.
Given that most smokers/obese people tend to die right around retirement age, we probably aren't leaving much on the table (from a purely economic perspective). Smokers probably aren't missing enough days of work to cancel out the $60k they save the system by smoking (not to mention all the extra taxes they pay).
But there's more value to human beings than their economic value, hence my talk about non-monetary costs. There's very real suffering that happens, and I'm not sure that's something you can put down in a spreadsheet somewhere.
Lots of tremendously valuable labor is done by people who don't pull down a wage. I.e., retired people who volunteer and watch the grand kids. Many people -- perhaps most -- contribute more value to society in retirement than in their wage labor years.
I mostly just disagree with the framing of the question. But, yes, I reckon the average retired person contributes as much/more to the GDP of the country than the typical wage-earning person.
There's no reasonable way to choose between the two framings. They are both obviously important. An accurate and purely quantitative utilitarian conversion of human suffering into USD is obviously beyond any reasonable assumption on the bounds of human rationality. A purely non-economic assessment ignores the possibility of real zero-sum tradeoffs caused by hard bounds on productive capacity.
Almost all economic activity is not zero-sum. Contrary to the intuitions of household budgets, at the scale of an economy operating over the timeframe of a generation, spending a dollar on X probably doesn't actually mean taking a dollar away from Y, especially if the productive/extractive inputs to X and Y are very different.
Therefore, it's more about finding a (necessarily vague & qualitative) exchange rate between the two. But at the order of $60K/yr in costs, I think that conversation is moot. Let's say retirees produce half of that value -- a grossly conservative estimate. That means we value "all the rest" at $30K/yr, which is prime facie absurdly low (what does a new SUV cost these days? How many "SUV new car feel vs. Corolla new car feel" units of happines equals the units of unhappiness caused by lung cancer? You get the point.).
If the number were $6M or even possibly $600K then the resource allocation question becomes more reasonable because there we approach the realm of starting to consider real zero-sum tradeoffs in what is possible. But at $60K with 50% to >100% offset, the number becomes too small to worry about the exchange rate. At most, in a pathologically broken system, we might, possibly, be discussing what we choose to do (not what is actually possible at minimal sacrifice). But it's not even clear to me that this is true in the US!
So, the framing seems silly, because once you do the work to figure out how to properly compare two radically different things you arrive at the conclusion that $60K is an order of magnitude away from forcing any sort of actual zero-sum resource allocation decisions.
This has never made sense to me. I'd be interested to know if there are numbers to back it up. You still have your most expensive years (the ones that come before death), they just come much sooner and are much more likely to involve expensive debilitating disease. In any case, the expense of old age mostly comes from pills and surgery which are artificially expensive due to our shit healthcare system. And I doubt we accurately measure the economic benefit of having the elderly around to help with young families, provide wisdom and experience, etc.
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.
That hasn’t worked well with cannabis. If the price is too high, that allows the black market to thrive. There are three dispensaries on my street. Yet there’s still street-level drug dealers selling illegal cannabis.
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.
The enforcement of that fining system will put thousands of people in prison, since fining use necessarily means prohibiting sale (or, fining retail sale necessarily prohibits wholesale, etc). This is a thing people already go to prison for, simply because the licensing fees annoy people.
NYPD officers approached Garner on July 17 on suspicion of selling single cigarettes from packs without tax stamps. After Garner told the police that he was tired of being harassed and that he was not selling cigarettes, the officers attempted to arrest Garner. When Pantaleo placed his hands on Garner, Garner pulled his arms away. Pantaleo then placed his arm around Garner's neck and wrestled him to the ground. With multiple officers pinning him down, Garner repeated the words "I can't breathe" 11 times while lying face down on the sidewalk. After Garner lost consciousness, he remained lying on the sidewalk for seven minutes while the officers waited for an ambulance to arrive. Garner was pronounced dead at an area hospital approximately one hour later.
How do people pay fines? If they are unable to pay what are the penalties? You also just created a black market for people who still want to smoke and that'll produce all kinds of fun.
There's already a massive black market for people who want to smoke in the form of tax stamp fraud. It used to be even bigger than it currently is, but there are two forces working against it: the overall decline of organized crime starting in the 1980s, and the overall decline in the number of smokers.
Black markets are a reality under current economic conditions, and they're a reality even in completely legal markets (there's always someone willing to pay XX% less in exchange for YY% more legal risk). Putting extreme taxes and/or fines on smoking might pour gas on that market, but long-term trends just don't support its survival.
And as for fines: we already have a legal structure for that[1].
I think they can be, although I'd like to see specific numbers on that. Killing roughly half a million Americans a year is a high bar to clear in terms of harmful social policy changes.
But there's also a trend against long term damage here: smoking rates have been declining for decades, and the evidence overwhelmingly suggests that higher taxes and civil penalties (like fines for smoking in parks) do reduce smoking across all ages and demographics. Fewer people smoking overall means fewer people who are subject to any sort of systemic abuse. That feels like a decent tradeoff to me, especially when we consider the knock-on effects of smoking itself (individual and community health, pollution, dental outcomes, &c).
You can't tax purchases out of existence. That creates a black market. Indeed, countries that have raised taxes to astronomical levels have significant illegal markets for tobacco.
What happens when they don't pay their fines? There has to be some backup plan and it's usually jail. You could keep increasing the fine for as long as they don't pay, but they you end up with loads of bankrupt people.
> or tax purchases out of existence
That creates a black market. In the UK, where tobacco taxes are high, it's quite easy to find small shops and individuals who will sell illegally imported cigarettes at a fraction of the price.
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.
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.
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?
Not all tobacco products are equal because not all tobacco products are intended to be inhaled. Cigars and Pipe tobacco aren't intended to be inhaled and most people will not find them addictive.
But there's no nuance regarding them in discussion of tobacco. They do likely have negative issues in terms of potential mouth cancer, but they're way less dangerous than cigarettes.
I was responding to somebody who lumped all 'drugs' into a single category. Talk to them about a lack of nuance. FWIW, I'm all about safe, regulated supply and harm reduction -- nicotine products included.
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.
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.
Not really, I read the article and saw the thesis, and I took exception to the "tobacco has no benefit", hence what I was saying about the beauty of the plant and the pleasure of some of the product. Many things have no benefit when taken from that same angle of medical analysis. The tobacco plant has benefits like many other pleasures, and a long social history on this continent of North America and in this region, among the people who were here before my people.
Despite people's dubious health claims about anti-oxidants and resveratrol, wine also has "no benefit" when taken from this angle. Alcohol generally, beyond its anti-septic/cleansing properties. But it has at least a 10,000 year history of pleasurable and social use, like tobacco.
It just has to be taken in the right context and the culture around it one of education and management of risks and context.
>"So there is the conundrum: tobacco has no benefit, yet it can’t be outlawed. So, as a society, and as health care professionals specifically, we are driven to what remains for us to use as tools for smoking cessation: rational or emotional arguments, structured cessation programs, drugs, patches, e-cigarettes and gum, among others. And these are working, albeit slowly."
>"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."
The above conclusion in the article and your conclusion in your comment are identical was all I meant.
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.
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.
> 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.
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.
> 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?
"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?
> 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.
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.
Honestly, you might be right. The way that pre-Colombian societies used it was totally different than the methods Europeans adopted upon introduction. And this is kinda interesting because the native cultures had thousands of years of experience with this stuff, and Europeans, even now, have about 500. Now as for scientific rationalism being applied in those communities, nobody can really say, so an argument positing that they did some actuarial science over the subject in such a long trial may or may not be spurious, but the long-range experiment being conducted may well have yielded plain and visible results. Maybe there was a reason they hadn't adopted alternative methods.
"Everything from effigy pipes topped by exquisite animal carvings (used to smoke a variety of tobacco strong enough to induce trance-like states"
Graeber, via Goodman et. al - Consuming habits: drugs in history and anthropology
Evidently the Amerindians smoked high doses from pipes, enough to induce a trance-like state. Having made use of pre-rolled filtered Tobacco extensively, I'd surmise they were either using it infrequently, or making themselves use it infrequently. In the first case, they show enough self-restraint to forego daily use, which allowed them to remain sensitive to the drug. In the latter case, they frequently poisoned themselves by indulging in a very high level of consumption - I suspect this would discourage frequent use as the side effect tends to be nausea and sudden onset anxiety. Of course, my perspective on this is limited, as my exposure is largely (near-exclusively) that of commercially treated tobacco with its various additives and mode of transport - paper. They were smoking I imagine largely unprocessed tobacco out of pipes.
Altering the cultural fabric of smoking itself might actually yield better outcomes. I'm not so interested in the topic as to find statistical demonstrations, but I suspect at least a portion of the damage that smokers can be directly attributed to the physical characteristics of the smoke, and the frequency of use. Cooler smoke inhaled through a pipe constructed with a conductive material like ceramic or stone done for ritual purposes might well yield a better social outcome than what our current smoking modality does without infringing on human rights and wholly eschewing the use of tobacco and all of its cultural complement.
Somewhat less free than the US. They do have government healthcare. That means unhealthy habits are a drain on government. To cut cost it is natural to look at high cost of care conditions that could be prevented. The government has to increase taxes or make things illegal to control cost.
I see that as a problem with government healthcare. It will always result in either higher taxes or a restriction on behavior.
"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."
Elderly man -- had possibly lived a good life. Why is this even a question. People can do what they want. In every other western country outside of the US, you might be able to argue that since Medicare is provided free by the state that it is an unfair load on the system -- but in the US -- you absolutely don't have that argument available in your pocket. Sorry. So -- to each his own.
Smoking doesn't only impact the smoker. Second hand smoke is dangerous too. That's why there is regulation on where it's permitted.
Costs to health care system also impact everyone. Though in the USA private insurers are starting to pass on some of the costs to smokers. And it could be argued that smokers often die young enough to offset health care costs of later life.
This is why we've banned smoking in restaurants and have designated areas. That's enough Government intervention although my personal take on this would be to leave it up to restaurants to manage this decision. If they don't want smokers in their restaurants, they can choose to ban them. If you don't like smoke in restaurants, don't go to ones that allow indoor smoking. This is a bilateral choice for a non-essential service (restaurants). But, we've handed over the power to Gov in this case. Too late. I would be OK for Gov to mandate a sign outside the restaurant that informs customers if it is smoking/non-smoking as it would be horrible if you sit down for a meal and all of a sudden someone next to you just lights a Cigarette.
>If you don't like smoke in restaurants, don't go to ones that allow indoor smoking.
I remember living in the 90s where every restaurant allowed smoking indoors; smoking section or not, the stench and irritability of the smoke permeated the entire space. It was impossible to get away from, other than simply not patronizing restaurants. To this day, I experience an immediate headache when cigarette smoke wafts in my direction.
The question is: Why does somebody's unhealthy habit get to travel with them and affect people around them everywhere they go?
Yeah, I have the same problem with Marijuana. Our apartment complex has a courtyard which has been destroyed by the stench of Marijuana. It permeates every corner, it doesn’t go away.
I have no problem with people smoking Marijuana but people need to be more considerate.
Unless you can prove that my actions are directly harming you, you have no claim to control over what I do. My skin demarks the beginning of a sovereign dictatorship ruled by me. Your rules and desires do not apply here.
I like this straightforward argument and an honest stance. I think it is OK for Gov to provide warnings to people. Put nutrition labels. Even Tax things to a certain degree (need to put limits on how much). But, prohibiting access is crossing the line.
I think many people would like to see their loved ones live longer, healthier lives and die with relative comfort. That doesn't require being denial about their mortality.
I don't disagree. But it's also not clear why the government should incentivize individually cheap, collectively expensive personal decisions like current smoking patterns.
Which doesn't, in itself, justify a particularly nasty form of death for hundreds of thousands of people. Why let the perfect be the enemy of the good?
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.
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.
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:
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.
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!
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.
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.
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.
I'm not being glib. This article is premised on the idea that because there are no health benefits to tobacco (none.), it has no value whatsoever. But it clearly does have value: it is a source of pleasure for a large number of people. Pleasure has value. People shouldn't smoke, it makes perfect sense to vice-tax it to offset the externalities, and nobody should valorize the companies profiting from those externalities. But the reason we "permit" it is because we have no business not permitting it: we have centuries of experience showing that, unlike opiates and methamphetamine, there is no risk of tobacco destabilizing society.
It's a comically weak argument. It could, as I just said, be applied just as readily to bacon.
Here you're picked the extremes to make your point stronger. There's plenty of prohibited substances and behaviours that are much closer to the gray area that this article is pondering on.
I don't have a clear view on this topic myself - but there's too many people in this thread claiming that it's absurd to even have the discussion - which I think is lazy and disingenuous.
Name a prohibited substance that (1) poses no threat of destabilizing society or the health care system, (2) has centuries of cultural context, and (3) isn't on the verge of being legalized right now, like cannabis and psilocybin.
The imminent legalization of psilocybin makes my argument for me. It was an argument isomorphic to the one this anti-smoking piece made that banned it in the first place. And as a society, we're charting a course in the opposite direction of that argument, because, it turns out, that argument was dumb.
The one-liner topic do not permit tobacco use. Not in the unconditional way that we permit bacon use. We permit tobacco use at the legislative level only in the sense that it's not criminalized.
Smoking is widely banned in workplaces and public spaces in many countries. I can bring a bacon lunch to work and nobody will even know. A five-year-old sent on a shopping errand can buy bacon.
Smoking is a nuisance and a harm to people around the smoker in ways that bacon isn't.
I've not read reports of bacon being addictive; that someone has to have more and more strips of bacon everyday, and has severe withdrawal symptoms when he or she tries to quit.
Therefore, no, it doesn't seem that we can take a "why do we still permit tobacoo" lament and transliterate it to bacon such that it makes sense.
Moreover, if we could do the substitution so that it makes sense, that wouldn't necessarily make the argumentation false. Presumably, the point of the substitution would be to try to discredit the argument due to it being self-evident that bacon is good and must continue to mass-produced and freely available.
The production of bacon is a nuisance and harm to people in ways that tobacco farms are not, so I don't think you've exsanguinated my analogy as completely as you appear to think you have. :)
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
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.
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)
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.
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
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?
> 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.
> Apparently your opinion is that I should be dismissed out of hand as a "fundamentalist".
I don't know, do you hold the position that abstract freedom is valuable, regardless of the real-world consequences? In any case, I think giving you an option to change your mind is not a dismissal. :-)
I don't think anything is valuable in itself, without a real-world context. The story of Midas' gold illustrates that.
And when we think about the practical context, we find that lots of freedoms (for starters, the ones in EU Charter of Fundamental Rights) are actually valuable in most circumstances. But that doesn't mean we can generalize it to freedom to do anything is valuable in all contexts, which I think is a logical consequence of attributing value to freedom in the abstract.
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!"?
Things that don't endanger other people or their property should never be illegal in the first place. Your body is your property and yours only. You should be able to do with it whatever the hell you please. The only open question here is who pays for any healthcare needs resulting from any self-inflicted damage to one's health.
It's only an open question because the government has inserted itself into the healthcare delivery business. If "we" were not paying for other people's health care, "we" would not need to care what they did or didn't do with regards to their own bodies.
You don't even need to go that deep. Does tobacco hurt others? Except for smokers costing the state more on average, which should never be a crime by itself, not really. I don't like cigarette smoke and think we should take obnoxious smells more seriously, but the logical conclusion is not banning tobacco use.
Agreed. The idea that the 'concept of banning' is a rabbit hole should not prevent actually talking about the concepts. To say something should be banned with such unsubstantiated arguments and complete disregard to the actual outcome is ridiculous.
I agree completely. I do find some of the cherry picking from right-libertarians can make my head spin sometimes but left-libertarians can be just as guilty of that.
And as much as I find full-on anarcho-utopianism charming, I can't see it as much more than a fairy tale that ignores much of history and human nature.
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.
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.
> 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.
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.
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.
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.
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.
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?
> 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.
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.
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.
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.
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.
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.
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?
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.
Oh yes. there's absolutely analogies to that here. It's more common with liquor. Quebec has substantially lower taxes than Ontario and there's a major city straddling the border. Both ordinary individuals and bar owners do routine runs to Quebec to stock up. This is illegal, but given the unrestricted internal border, is about as likely to be caught as interstate smuggling in the USA.
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
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.
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.)
> These other ‘sins’, however, have at least some benefit.
Yes, that is a distinction that is true, but that is not why alcohol and gambling are permitted. It seems to me like the author is trying to brush this question aside rather than really engaging with it.
(Agreed that the oxygen comment isn't very helpful, and just responding to the part you quoted.)
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
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.