Smoking and socioeconomic class

[Ser Scot A Ellison]

2 hours ago, Luzifer's right hand said:

Well duh it is a drug. As long as alcohol is allowed and legal talking about other drugs is just pointless hypocrisy to me. 

The mere consumption of Alcohol has no negative impacts upon those around the direct consumer.  Unlike smoking and vaping.

[Fez]

3 minutes ago, Ser Scot A Ellison said:

The mere consumption of Alcohol has no negative impacts upon those around the direct consumer.  Unlike smoking and vaping.

Well, responsible consumption of alcohol isn't. But alcohol consumption overall is pretty heavily associated with increased rates of traffic fatalities, traffic accidents, homicide, domestic violence, assault, work-related accidents, and suicide. And there's a few other negative externalities I'm blanking on right now.

In fact, while I haven't seen recent research on it, I suspect that alcohol has a greater impact on those around the user than smoking or vaping now, because there is such greater awareness of the dangers of second hand smoke.

On the other hand, while alcohol can cause cirrhosis and liver disease, smoking and vaping do seem to harm users quite a bit more. And those health related costs dwarf pretty much anything else. 

[Luzifer's right hand]

1 hour ago, Fez said:

Hard disagree. Not all drugs are equally bad.

Now, funnily enough, alcohol is actually a pretty bad one (though I sure do enjoy it); worse than marijuana and maybe vaping. It may be worse than cigarettes even, depending on if we're looking at the impact it has on the user or the people around them. However, cocaine, methamphetamines, opioids, and various designer drugs are far worse than alcohol.

None of these drugs are worse than alcohol and most are pretty safe if you get good quality. It is the non-GMP production and distribution that makes them really dangerous but even in that case adulterated alcohol is usually far more dangerous.

[Martell Spy]

1 hour ago, Fez said:

Hard disagree. Not all drugs are equally bad.

Now, funnily enough, alcohol is actually a pretty bad one (though I sure do enjoy it); worse than marijuana and maybe vaping. It may be worse than cigarettes even, depending on if we're looking at the impact it has on the user or the people around them. However, cocaine, methamphetamines, opioids, and various designer drugs are far worse than alcohol.

Coffee, the friendliest of all drugs. It has the same sound it sounds like cigarettes have, where it just gets you to zero. On the rare days I don't drink coffee, usually in the hospital, I mainly get a splitting headache from not drinking it.

Cigarettes will absolutely take you from the Earth faster than most drugs, definitely more than pot and alcohol. Decades earlier, likely. And the addiction gets an iron grip. 

Alcohol is pretty bad though. It also depends on the amount you take though and how often. I think it's far easier to reduce or go without though. I'm not a smoker, but I do drink and have experience changing amounts and going cold turkey. It's at least possible to do so. And frankly from what I've heard and seen of cigarette addiction I strongly suspect if I started I'd never quit.

Alcohol absolutely has a favored political status in America, however. It's pretty ridiculous. The weight gain alone is a really bad effect of alcohol.

[Ser Scot A Ellison]

3 hours ago, Fez said:

Well, responsible consumption of alcohol isn't. But alcohol consumption overall is pretty heavily associated with increased rates of traffic fatalities, traffic accidents, homicide, domestic violence, assault, work-related accidents, and suicide. And there's a few other negative externalities I'm blanking on right now.

In fact, while I haven't seen recent research on it, I suspect that alcohol has a greater impact on those around the user than smoking or vaping now, because there is such greater awareness of the dangers of second hand smoke.

On the other hand, while alcohol can cause cirrhosis and liver disease, smoking and vaping do seem to harm users quite a bit more. And those health related costs dwarf pretty much anything else. 

That's why I said "mere consumption".  If someone is driving after drinking the results can be horrifying.

[DMC]

8 hours ago, Jen'ari said:

So as a smoker it feels quite calming?, ok I can get that, I’m guessing you’d have to smoke for a while first for it to have that effect?.

Yeah pretty much.  Like I said, it becomes part of your life.  When I wake up like everybody else one of my first thoughts is "I need to shower," but before that I've already grabbed a pack, lighter and keys to head down for a smoke.  I think a good comparison would be you know those glasses that say "drink to remember," "drink to forget," etc.?  There's similarly always a reason to smoke - if you're stressed, if you're celebrating, if you're bored, etc.

6 hours ago, Ser Scot A Ellison said:

The mere consumption of Alcohol has no negative impacts upon those around the direct consumer.  Unlike smoking and vaping.

Heh.  This reminds of a thread I made on another forum literally 20 years ago called "pot vs. alcohol."  I understand you're just talking about actual act, to be clear I'm not arguing with you.  Second-hand smoke is something any responsible smoker should work to avoid - it's why I already "social distanced" when going out to the parking lot to smoke back when corona was just a beer.  But if we're looking at it from a utilitarian perspective, alcohol inflicts tons more societal harm than smoking weed or tobacco ever could.

[Ser Scot A Ellison]

13 minutes ago, DMC said:

Yeah pretty much.  Like I said, it becomes part of your life.  When I wake up like everybody else one of my first thoughts is "I need to shower," but before that I've already grabbed a pack, lighter and keys to head down for a smoke.  I think a good comparison would be you know those glasses that say "drink to remember," "drink to forget," etc.?  There's similarly always a reason to smoke - if you're stressed, if you're celebrating, if you're bored, etc.

Heh.  This reminds of a thread I made on another forum literally 20 years ago called "pot vs. alcohol."  I understand you're just talking about actual act, to be clear I'm not arguing with you.  Second-hand smoke is something any responsible smoker should work to avoid - it's why I already "social distanced" when going out to the parking lot to smoke back when corona was just a beer.  But if we're looking at it from a utilitarian perspective, alcohol inflicts tons more societal harm than smoking weed or tobacco ever could.

I do see your point.

[OldGimletEye]

1 hour ago, DMC said:

alcohol inflicts tons more societal harm than smoking weed or tobacco ever could.

I like to buy my alcohol with firearms. What could possibly go wrong?

[DMC]

3 minutes ago, OldGimletEye said:

I like to buy my alcohol with firearms. What could possibly go wrong?

It's an American's god-given right to be able to carry guns in bars!

[A True Kaniggit]

40 minutes ago, OldGimletEye said:

I like to buy my alcohol with firearms. What could possibly go wrong?

Just make sure you have another gun in case someone tries to steal the alcohol and gun you just bought.

[OldGimletEye]

14 minutes ago, A True Kaniggit said:

Just make sure you have another gun in case someone tries to steal the alcohol and gun you just bought.

Never leave home without a firearm. It's extremely important that I let everyone know I'm a gun owner, even if I don't use it for anything.

[A True Kaniggit]

58 minutes ago, OldGimletEye said:

Never leave home without a firearm. It's extremely important that I let everyone know I'm a gun owner, even if I don't use it for anything.

Why am I trying to give you advice?

You obviously know what you’re doing. 

[DireWolfSpirit]

On 5/16/2020 at 11:00 AM, Martell Spy said:

Cigarettes will absolutely take you from the Earth faster than most drugs, definitely more than pot and alcohol. Decades earlier, likely. And the addiction gets an iron grip. 

Smokers have lower "end of life" healthcare costs associated with them than the majority of people who are living into their 80's and 90's. That savings on healthcare expenses needs to be backed out of the equation for us to truly attribute the costs of smoking on healthcare. Problem is that never is accounted for and smokers get blamed for more than their true share of healthcare costs.

One should look at the entirety of lifetime costs "paid in/ paid out" of patients. 

The hard cold truth is that by paying in over entire careers, while dying early, avoids all those very expensive "end of life" healthcare costs in a high percentage of the smokers.

I don't want anything being done to stop smokers, they help keep costs down overall

[Rippounet]

4 hours ago, DireWolfSpirit said:

The hard cold truth is that by paying in over entire careers, while dying early, avoids all those very expensive "end of life" healthcare costs in a high percentage of the smokers.

Erm... you have some data to back this up? Because I can see several problems with that assertion. In fact, IIRC studies on this have pretty much always found that smoking drives healthcare costs up, certainly not down. I can see at least two reasons for this: i) being sick doesn't necessarily mean you die early and ii) dying early doesn't mean healthcare is going to be cheap, or even cheaper than what it would be if you died later.
But I'm not a healthcare professional and what I read about this could be outdated, so if this isn't just dark humor I'll be kinda curious to know more.

[Fury Resurrected]

My grandfather died early of smoking related illness (he had emphysema and lung cancer both)- I can assure you that him dying earlier than my nonsmoking grandparents in no way made it cheaper to deal with his care than theirs.

[Alarich II]

On 5/16/2020 at 4:25 AM, OldGimletEye said:

My grandmother smoked Pall Mall unfiltereds for over 50 years and there wasn't anything that was going to stop her.

So did mine and what stopped her was having a string several strokes and being physically unable to pick up a cigarette until she died about two years later. We had her for those last two years in domestic care at our home (I was about 15 when she came to live with us) and that was more effective than any non-smoking ad.

What I find interesting is the comparison of smoking to obesity - my guess would be, that many of the social ills of lower socio-economic classes (higher cancer-rate, physical and mental illness, shorter overall life-span etc) are also correlated to obesity and I wonder if there is a connection between the sinking rates of smokers and the rising obesity (which is on the rise almost everywhere in the western world).

[Alarich II]

12 hours ago, DireWolfSpirit said:

Smokers have lower "end of life" healthcare costs associated with them than the majority of people who are living into their 80's and 90's.

I don't think it works that way. What drives the "end of life" healthcare costs are mostly costs around very expensive therapies and the fact that smokers have higher cancer rates for example is a driver for increased "end of life" healthcare costs not lower costs. The problem is exacerbated by smokers being relatively speaking younger when they need treatment, thus reducing the total amount they can pay into the healthcare insurance and/or taxes.

[DireWolfSpirit]

8 hours ago, Rippounet said:

Erm... you have some data to back this up? Because I can see several problems with that assertion. In fact, IIRC studies on this have pretty much always found that smoking drives healthcare costs up, certainly not down. I can see at least two reasons for this: i) being sick doesn't necessarily mean you die early and ii) dying early doesn't mean healthcare is going to be cheap, or even cheaper than what it would be if you died later.
But I'm not a healthcare professional and what I read about this could be outdated, so if this isn't just dark humor I'll be kinda curious to know more.

I can find studies arguing either way.

This is from The New England Journal of Medicine.

https://www.nejm.org/doi/full/10.1056/NEJM199710093371506

In our study, lifetime costs for smokers can be calculated as $72,700 among men and $94,700 among women, and lifetime costs among nonsmokers can be calculated as $83,400 and $111,000, respectively. This amounts to lifetime costs for nonsmokers that are higher by 15 percent among men and 18 percent among women.Oct 9, 1997

https://www.nejm.org › doi › full

The Health Care Costs of Smoking | NEJM

 

There are many competing studies that you could make various arguments though.

There's this one-

JOURNAL ARTICLE

Cigarette Smoking and Lifetime Medical Expenditures

Thomas A. Hodgson

 

Which concluded that lifetime expenditures were higher for smokers than nonsmokers by close to a third for males and around 20 percent higher for females. However interestingly enough Hodgson did conclude that lifetime Medicare costs were actually lower for female smokers than female non smokers.

Hodgkin also mentions a Swiss study that argued lifetime healthcare costs were lower for Swiss males.

[DireWolfSpirit]

9 hours ago, Fury Resurrected said:

My grandfather died early of smoking related illness (he had emphysema and lung cancer both)- I can assure you that him dying earlier than my nonsmoking grandparents in no way made it cheaper to deal with his care than theirs.

Sure, the earlier life illness are far more burdensome on "out of pocket" and private insurance expenses. While later "end of life" expenses are largely borne by Medicaid. Those earlier expenses may be concentrated over shorter duration, but it's a terrible impact to households I'm sure.

I'm reminded of a workmate who smoked and we just lost at 56. He worked and paid into our insurance fund for decades. Very fit guy, he was a competitive softball player, never sick or missed work. And within just a few short months he was diagnosed with advanced lung cancer and was gone. Very sad, great guy liked by all, he only made it 2-3 months from his last day on the job, r.i.p.

This is not an isolated story, I've seen it with others over the years and I venture others could tell of similar stories. The point is that while dying early is surely tragic, it also means they are not going to be long term users of the insurance. Their lifetime costs are finished, and they will have never even made it to Medicare or nursing homes or any other future healthcare costs that would be used in the equation of what ones lifetime healthcare costs would be. Those end of life healthcare costs are quite costly as well.

[A wilding]

As I understand it, that is the consensus in the UK.

Most of the medical costs for a person (still typically paid by the state in the UK) are incurred in the last year or so of their life. These costs are generally comparable for smokers and non-smokers. However as the smokers die younger, the state needs to spend less money on their pensions (also still at least partly paid by the state) and on the infrastructure needed to support elderly people.

So it is to the credit of UK governments over the last generation or so that they have generally tried to persuade people to give up smoking anyway.