Smoking: More than just a vice

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Something Not Unlike Research” is a health care blog I recently came across written by two university professors. One of them, Bill Gardner, wrote this week in defense of employers choosing not to hire smokers. He concluding by noting that “Smoking is a vice that benefits no one.” I took him to task for this last line on Twitter:

“Smoking is a vice that benefits no one.” — @Bill_Gardner Oh please. I like it. It benefits me! Arrogant assumption.

To my surprise, he responded in a new post:

My point is that I do not see a compelling argument against employers choosing not to hire them. By extension, we should have no public policies protecting access to employment for smokers (or bone lugers). This is, I believe, consistent with Mill’s view that

The only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not sufficient warrant.

I do want to see smoking go away, and I think social pressure is what makes that happen. (“Social pressure” is not, I think what Mill means by “exercising power”.) To that end, I think it is legitimate to ban smoking in public places, and for employers to refuse to hire smokers if they judge that to be in the interest of their firms.

Having conceded that smoking may benefit Jacob’s subjective well-being, can I still say that “smoking is a vice that benefits no one”? I certainly can, if it’s understood that benefit refers to the long-term well-being of smokers, and those who depend upon them, rather than immediate subjective well-being. In that sense of benefit, there is nothing to be said for smoking or binge drinking.

(NB: The binge drinking reference is about the bone luge, which happened to be the top post on my site when he visited. The photo definitely makes his post more awesome but I’ll stick to the smoking discussion!)

I’ll elaborate in more than the 140 characters allowed by Twitter. To start, I agree with Bill that smokers shouldn’t be a protected class of worker. I think refusing to hire smokers is generally a silly policy but that’s something the market can sort out. Where we disagree is in our assessment of smoking. He says that smoking is “a vice that benefits no one” in the long term, that “there is nothing to be said for smoking,” and that “I do want to see smoking go away.”

I know where he’s coming from because I used to make the same assumptions. I grew up believing everything bad about smoking and made it through high school and college without taking a single puff from a cigarette. My interest in tobacco began shortly after I started working as a barista. In conversation with a cigar-smoking friend, I realized that he talked about his stogies the same way I talked about coffee. The varietal of the plant and the origin of the leaf mattered, a Cameroon wrapper tasting differently than one from Nicaragua. Flavors ranged from light sun-grown tobacco to deep, dark maduro, much as coffee roasts came on a spectrum from light to dark. And he suggested that there was just as much difference between the hand-rolled cigars he was smoking and the mass produced cigarettes of Big Tobacco as there was between Folgers and the small batch beans I brewed.

Perhaps, I thought, there was more to tobacco than I realized. When I eventually tried a cigar for the first time I took to it at once. Doing that required getting over my own prejudices that had led to me viewing smoking as pure vice, an unhealthy and addictive habit without redeeming qualities.

I am not addicted to tobacco. I go weeks and months without it. Of the three mood-enhancing drugs I enjoy — caffeine, alcohol, and nicotine — the last would be by far the easiest to never again partake of. It’s unlikely that my occasional indulgence in a cigar will have any significant effects on my health, though there is a small chance that it will. In exchange cigars have given me wonderful experiences, both in taste and in the friendships that have deepened over contemplative, smoke-fueled conversations. I expect that cigars are a net benefit in my life on both the short and the long view. Perhaps additional evidence could persuade me otherwise, but it can’t simply be assumed that I’m mistaken.

Admittedly I don’t fit the median profile of a smoker. However the value that smokers get out of smoking is almost never acknowledged by anti-smoking activists, who treat smoking as inherently wrong. Unlike them, and perhaps unlike Bill, I don’t want to see a completely smoke-free America. I want to see smoking substantially reduced. I’d like for people to smoke less and smoke better, using products other than cigarettes, which seem to be the most dangerous form of tobacco. (It’s also worth noting that the employment policies that inspired these posts are enforced via urine tests for nicotine, which wouldn’t discriminate between pack-a-day smokers and those who smoke rarely or those who are trying to quit with the aid of nicotine patches or gums.)

Semantics aside, activists’ unwillingness to consider the benefits of smoking leads to excessively restrictive policies. Let’s take smoking bans for example. Consider two businesses:

Business 1 is a tobacco shop with an attached lounge that offers beer and wine. Customers are allowed to smoke there. It’s a freestanding building with no immediate neighbors, so no one except customers and employees is affected by the smoking. Four people are employed serving drinks in the lounge. A smoking ban passes that forces the business to eliminate drink service. The day the ban takes effect those four employees lose their jobs.

Business 2 is a restaurant that serves Dungeness crab caught in the Pacific Northwest. Commercial fishing has one of the highest fatality rates of any occupation and crabbing in this region is often the highest of all. For comparison, the average annual fatality rate for all occupations is 4 per 100,000 workers. For fishing as a whole the rate is 115/100,000. For Dungeness crab fishermen in the Pacific Northwest the rate is 463/100,000. (Source here.) There are no proposals to forbid restaurants from serving Dungeness crab.

The comparison might seem silly, but why? Dungeness crab is delicious but it’s hardly a staple in the food supply. Fishermen are literally dying to put it on our plates. Though the level of risk associated with secondhand smoke exposure is in dispute, it would be astonishing if the danger of pouring beer in a smoky room was at all comparable to crabbing on a stormy ocean. So again, why the disparity in how we treat these workers?

The number of actual deaths resulting from Dungeness crabbing is low since it’s a small industry, but it provides a model for how we normally regulate occupational risk. We don’t ban dangerous jobs, we try to discover reasonable rules to make them safer. Safety regulations have apparently been successful in reducing the fatality rate among Alaskan Dungeness fishermen.

Let’s accept for the sake of argument that banning smoking in some places to protect patrons and employees is justified under Mill’s proviso. It’s much harder to argue that smoke-friendly businesses should be banned entirely. Our normal approach to worker safety would allow people to work in smoking venues, subject to reasonable rules about ventilation to minimize risk.

Yet exceptions to smoking bans are often unreasonably narrow, preventing consenting adults from making free exchanges with each other. This is because policy makers view smoking as inherently without value. The thought process goes something like this:

1) Smoking has no value.

2) Protecting workers has value.

3) Therefore it’s OK to ban smoking everywhere without worrying about smokers’ preferences.

This is why I vehemently object to statements such as Bill’s. They create an environment in which the rights of smokers, business owners, and workers are too easily violated. I’ve seen too many of my favorite places completely altered by smoking bans, to the dismay of owners, patrons, and employees. See my ode to one of them, the Horse Brass, in DoubleThink magazine. Business 1 above is another example; it’s an actual establishment outside of Portland.

In sketch form, here are two other arguments for how ignoring the benefits of smoking skews our thinking and leads to bad policy.

Electronic cigarettes — The view of many in tobacco control is that tobacco is inherently bad and that quitting should be smokers’ only goal. It would undeniably be a good thing if more smokers quit, but the obvious truth is that quitting is difficult and relapse is frequent. A new study concludes that even with increased use of nicotine replacement therapy and quitlines, the rate of successful cessation has remained unchanged.

E-cigarettes are a promising alternative for smokers who find it difficult to quit. They are undoubtedly safer than actual cigarettes and offer a substantial opportunity for harm reduction, whether used to quit entirely or just to reduce use of real tobacco. Their popularity is likely due in part to their similarity to cigarettes: their appearance, the ritual of lighting them up, the ability to manage nicotine levels through their use. They deliver many of the same benefits smokers’ get from cigarettes at a fraction of the health cost. Yet precisely for this reason they are treated with outright hostility by many in tobacco control, who blind themselves to e-cigarettes’ potential because of their puritanical view of smoking — including acts that mimic smoking — as inherently bad.

Flavored cigarettes — The legislation giving the FDA regulatory authority over tobacco included a ban on all flavorings except for menthol. The reprieve for menthol may only be temporary. Flavors are treated as dangerous additives but they’re essentially being banned because they make smoking more appealing and enjoyable. This is pure paternalism. If a consenting adult wants to have a clove cigarette, he should be allowed to buy a clove cigarette.

The preferences of smokers were never given a voice in this debate. Because smoking was simply assumed to have no value, smokers were dismissed as addicts who could only benefit from this legislation. Perversely, those of us who support consumer choice on menthol are accused of racism since menthol cigarettes are popular among African-Americans. It’s unclear at this point how FDA regulation may affect more artisanal forms of tobacco, but the industry is understandably worried: If the agency views tobacco as inherently bad, it’s unlikely to pass regulations in the interest of pipe and cigar consumers.

The costs of smoking are undeniably high, yet smoking has persisted even in the face of penalties as harsh as death. The habit is here to stay. Unfortunately, smoking has become synonymous with Big Tobacco and the lowly, lethal cigarette. There is much more to it than that, and more to say on its half behalf. But that will have to wait for a future post.

Comments

  1. Mag says:

    The idea that “smoking has no value” is as old as antismoking, i.e., the last 400 years. A more recent addition is the idea of nicotine “addiction”. The argument goes…. If smoking has no benefits, then why do people continue to smoke? Because they’re “addicted”; addicted to what? Well….. um…. nicotine.

    In America, this “argument” was peddled by the Temperance (questionable religious leanings) Movement since the mid-1800s. It was then picked up by a more dangerous group from the late-1800s – the Eugenics (physician led) Movement.

    What can be said of the TM and EM is that they represented the most dangerous type of fanatic – the “world-fixer” fanatic. All sorts of baseless, inflammatory claims were made about tobacco (and alcohol). Seeing themselves as “world fixers”, the fanatics’ goal is to coerce/terrorize/terrify the public into conformity, usually through progressively more absurd lies.

    Here’s some background on antismoking in early-1900s America, all of it pre-dating the more recent concoction of secondhand smoke “danger”.
    http://www.americanheritage.com/content/thank-you-not-smoking
    http://www.historylink.org/index.cfm?DisplayPage=output.cfm&File_Id=5339

    The current antismoking crusade had its formal beginnings in the mid-1970s.
    See Godber Blueprint http://www.rampant–antismoking.com

    The crusade begins with a throwback to a century-old “definitions”. It also involved the standard eugenics personnel – physicians, biologists, statisticians, behaviorists (although they don’t refer any longer to the social-engineering mentality as eugenics). The crusade also has the same social-engineering extermination goal reminiscent of the eugenics mentality. It also uses the same vulgar denormalization/propaganda methodology.

    Never referring to anything positive and only referring to negatives (often contrived) is part of the denormalization process. Physicalists are only obsessed with the physical. They have no grasp of any other dimension (e.g., psychological, social). In fact, they have such a blatant disregard for anything other than their deranged world view and social-engineering goals, that they will bulldoze their way through all else. That’s what makes them dangerous. The incessant inflammatory propaganda unfortunately produces a neurosis/bigotry bandwagon effect that many, including politicians, are happy to unquestioningly jump on – just like early last century. And much multi-dimensional damage is done.

  2. Tob says:

    I am offended by people in government who think that it’s their job to use television and the print media to tell me not to smoke. I have read the Constitution, and I cannot find authorization for government to hector us and pester us on issues of private conduct.

    It’s not as if people don’t know that smoking entails some health risks. The term “coffin nail” was coined in the 19th century. People know that smoking carries risks. Those risks are not news to anyone, so I really can’t see a case for government’s hectoring us about it. I’m especially offended that kids are hounded in school from a very young age to take pledges that they won’t smoke, to go home and bug their parents about smoking, and to report their parents’ smoking and drinking habits to the social welfare agents who go to schools to talk to the kids. Government paternalism permeates society more than nicotine does, and it’s much more toxic, much more pernicious.

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