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1 in 5 Americans choose slow death over long life

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January 20-26 is National Non-Smoking Week, an annual public health education effort in Canada, established by the Canadian Council for Tobacco Control. The goal of this is to educate people about the dangers of smoking, to help people quit smoking, and generally to attain a smoke-free society across Canada. This includes the stated aim of “de-normalizing” the tobacco industry (i.e., to turn public discourse about all things tobacco so that they are seen, by default, to be negative) and to advance one’s right to breath air without cigarette smoke in it (i.e., sequester smokers into designated areas where they can’t bother anybody with their smoking).

Now, I don’t know of too many folks (except those who work for tobacco companies) who are willing to argue that cigarettes don’t pose a pretty substantial health risk. But I do know a few civil libertarians who would grind under the notion of demonizing tobacco just to get people to stop using it, as well as creating little internment camps for people who want to smoke in public. I get where they are coming from. But I don’t care.

In the United States today, when the health risks of smoking are clear to all, when smoking itself is listed by the Centers for Disease Control as the number one form of preventable deaths each year, one in five Americans are still willing to smoke. One in five! Coincidentally, those CDC stats also notes that one in five deaths in the U.S. each year—about 443,000, total—occur from smoking. That is a handy coincidence, if ever I saw one.

In 1965, smoking rates were close to 45 percent, and have gone downhill steadily since then for adults, down to about 20 percent today. We have to thank for this awareness campaigns and a greater aversion to giving oneself heart disease and cancer than to enjoy a puff. For teenagers, the CDC began keeping figures around 1992, and there was a weird spike in teenage smoking, up to about 35 percent by 1998, but that, too, has fallen to about 20 percent in the years following. Still, the rate is not yet zero, which it really ought to be for any number of reasons. Reducing the overall health care cost burden is just one of the more obvious ones.

Personally, I would be fine if we just outlawed tobacco entirely. We outlaw heroin because it is patently harmful and addictive, qualifications tobacco use surely fits as well. War on terror? Smoking kills a high multiple of the people lost in 9/11 each and every year. We ought to declare a war on tobacco in general and on smoking in particular.

But a much more meaningful solution, really, would be to get smokers to quit voluntarily, as a dear friend of mine did recently. After smoking for some 25 years, he simply decided he wanted to not smoke more than he wanted to smoke, and he quit and stayed quit. Not everybody has such willpower, so any help would be appreciated. What would be great is if the health insurance community unified in a serious effort to get folks to stop using tobacco. It, along with various business groups, rallied most impressively to oppose health care reform, often on the plank that PPACA did not address the real issue of health care costs. By dissuading people from smoking, the industry would have succeeded where the federal government has failed.

Life insurance could also help by cranking premiums for smokers, and perhaps lending some of their lobbying muscle to help their compatriots in the health insurance world get whatever leeway they need from Washington to be able to price health care accordingly for anybody who smokes. After all, if you put down as an interest on your life insurance application that you play Russian roulette, usually after meals or when out with friends, you’d never get any coverage. Surely we can ask smokers, who are already so willing to treat their own lives with disregard, to pay accordingly when they ask others to insure something already being harmed.