Smoking Risks and Resistance

Smokers shorten their lives by an average of seven years, according to insurance actuarial tables (one of humanity's greatest inventions and a model for rational calculation that the rest of the culture would do well to imitate). At least, seven years is what studies suggest is the handicap insurance companies are putting on smoking. Insurance companies normally don't officially open their actuarial tables to outside inspection, since those numbers are the basis of all the gambling-like choices the companies make about who to charge how much, the odds of having to pay out, and so forth. Insurance companies' habit of treating smokers as a separate, unique category of human being on questionnaires should give you some hint how much worse a hand the house thinks you're playing if you're a smoker.

An argumentative libertarian, irked by my anti-smoking comments, told me that the actuarial tables only show only a three-year deficit for smokers, but it appears he was wrong. Much like a portly libertarian from the same organization who asserted that fat is not per se a health risk, the smoking defender was probably not so much interested in quibbling with my numbers as in implying that statistics are, as a general rule, fairly useless and that individuals should therefore do whatever they like and worry less about risks. Frightened, highly risk-averse people are more likely to file lawsuits and demand regulations over minor harms, which is no doubt why libertarians tend to like rugged individualist daredevils.

But at the, uh, risk of sounding like a party-pooper, I have to defend those dry actuarial tables and statistics in general even if I share the aversion to all those lawsuits and regulations. Individual safety circumstances may vary, but that is not the same as saying that no general patterns of safety and danger exist. Similarly, subjective risk preferences (one's willingness to face danger) may vary, but that doesn't mean the actual underlying risks necessarily vary in a way that is correlated to one's subjective preferences. In other words, you may be the sort of person who scoffs at wearing a motorcycle helmet, but that doesn't mean you're more likely to survive an accident than the next person, nor that statistics showing higher death and injury rates for helmetless riders are somehow fraudulent.

You can ignore numbers, but you can't wish them away and people of all political stripes should be wary of any temptation to do so. Facts should never be reshaped to fit a political agenda, whether authoritarian or individualist.

Now, don't get me wrong: I like daredevils. In fact, two friends of mine have just written a book called Invisible Frontier about their unusually risky hobby of climbing tall buildings, decaying ruins, and bridges for fun "urban exploration," they call it, and they do it all without equipment or significant preparation. And, as the book makes clear, they do indeed see their hobby as embodying a spirit of boldness similar to that of our explorer and pioneer ancestors, as well as the individualism inherent in America's founding. But they also admit that they're a bit nuts, and they don't go around stubbornly claiming that a tangle of girders four hundred feet up the side of Manhattan's George Washington Bridge in the middle of the night is a safe place to be. And I would worry about them more if they did make such assertions.

In general, it seems that intelligent individualists should worry less about whether people are risk-takers that's a matter of personal preference, after all and more about whether they are deluded or misinformed about the relevant risks (or are deluding and misinforming others). To sum up:

(1) There's nothing wrong with having a positive, optimistic attitude. Check out Happy & Healthy in a Chemical World by W. Alan Sweeney, for example, if you want a book that allays fears by putting the minute risks from chemical exposure into proper perspective.

(2) And, yes, fear often brings out humans' most irrational impulses. I recently read of a nine-year-old girl in India who was ritually married to a dog because it was seen as the only way to ward off the bad luck that would otherwise have resulted from one of her teeth growing in improperly. This is fear-induced supernatural thinking at its most obvious.

(3) But caution is not always misplaced. In fact, an eighty-year-old pedestrian was run over and killed by a delivery van across the street from ACSH's offices just a few weeks ago, a tragic reminder that the modern world fosters longevity but still carries risks.

(4) So we shouldn't let our attitudes, whether optimistic or pessimistic, get in the way of a cold, clinical assessment of the facts, even the grim and scary ones.

warning Toward that end, I think it would behoove anyone who is considering taking up smoking, is considering quitting smoking, merely has his or her head deeply in the sand about just how dangerous the habit is, or perhaps worst of all is prone to shooting his or her mouth off about how hip and rebellious and fun it is to smoke (in a way that might encourage others to take up the habit) to read ACSH's newly-revised book, Cigarettes: What the Warning Label Doesn't Tell You. As the book makes clear, cigarettes increase the odds of numerous ailments, even for those who do not die from lung cancer, emphysema, and heart disease. Some smokers, in a fighting mood, say they or fellow smokers get enough pleasure out of cigarettes to justify losing those seven years of life (sometimes less, of course, but sometimes far more the odds are good that if you hear about someone dying of cancer at a young age and the type of cancer is not specified, you're mourning a smoker). Are they laughing in the face of the Grim Reaper, like my skyscraper-scaling daredevil friends, living life on the edge, or are they making excuses because they don't want to think about the mistake they've made or face the withdrawal symptoms that may come with trying to quit?

Some people reading this article right now may be thinking that the last thing they want to read is a book about the dangers they're facing by smoking since they don't think they could summon the strength to quit. But facing the facts can be calming and empowering, like knowing exactly what sort of discomfort you're likely to face if you receive a dental procedure and what problems perhaps far more severe you may face if you don't (and the fact that few dental problems can kill probably means this book should come before the illustrated history of teeth in your pile of things to read). At the very least, this book should prevent people from cavalierly assuming smoking is just one more little risk among many (skateboarding, fatty foods, etc., etc.). Cigarettes are very special.

smoking Best of all, though, ACSH will not leave you hanging if you read Cigarettes and decide that you or someone you care about needs some way to kick the habit. We've also just released Kicking Butts in the Twenty-First Century: What Modern Science Has Learned About Smoking Cessation. Quitting isn't easy, but people become more likely to succeed with each successive attempt, and using certain quit methods in combination sometimes works better than using one alone. This book is not a how-to guide for quitting but an overview of the options available to someone looking to quit.

Just knowing you've got options should be inspiring, and the actuarial tables suggest that sometimes people need inspiration of that sort, since being a daredevil, pioneer, or mountain climber doesn't solve all of life's problems.


NOTE: My aforementioned daredevil friends, and their club called the Jinx Society, will host a debate on Wednesday, August 6, 2003 at 8pm in the basement of Manhattan's Lolita Bar, at the corner of Broome St. and Allen, in which I will defend the resolution that "Humanity Will Be Extinct Within One Hundred Years." I could be wrong, but if things work out that way, it would certainly solve a lot of health problems.

[UPDATE: You will all be relieved to know I lost the debate, though some people -- me included -- would have been more easily convinced if the resolution had said "Within One Thousand Years" and if "Extinct" were interpreted to mean "transformed into various subspecies." That makes two Jinx debates I've lost -- the other to Jinx co-leader LB Deyo, who argued that morality is subjective -- and one I've won, in an admittedly hair-splitting debate with Prof. Jacob Levy over how to balance tradition and individualism. First Wednesday of every month at 8pm, see what ideas survive the Lolita Bar crucible, as announced at http://JinxMagazine.com.]