Sunday, November 12, 2006

Passive smoking causes harm

Most people know that smoking is the largest preventable cause of death in the world today. Smoking is the only legal product which kills people when it is consumed as intended. A recent report claims smoking kills half the people who regularly smoke.

Defenders of smoking and opponents of smoking bans however claim that, if smokers internalize the risks of smoking, and are fully informed of its effects, that it unnecessary to target smoking with public policy. They argue the externalities caused by the effects of secondary smoke are so small that they can be ignored. The specific claim is that only 1% of the toxins in cigarette smoke are inhaled by passive smokers an amount so small that it is irrelevant.

But there are plenty of US studies that refute this optimistic picture. Indeed the earliest study (in 1981) of Japanese non-smoking women married to smokers found their lung cancer risks were raised 20-30% and their risk of heart disease by 23%. Recently, I found this interesting excerpt from a recent ABS publication. It further buries the myth that passive smoking is a beat-up by the moral police:

  • The breathing in of tobacco smoke by non-smokers can lead to harmful health effects in the unborn child, and middle ear infections and bronchitis, pneumonia, asthma and other chest conditions in children. It is also linked to sudden infant death syndrome (SIDS).
  • In adults, passive smoking can increase the risk of heart disease, lung cancer and other chronic lung diseases (Queensland Health 2006).
  • 37% of children aged 0-14 years live in households with one or more regular smokers, while 10% of children 0-14 years live in households where there is at least one regular smoker who smokes indoors.
The Queensland Health report cited is of interest. It states that passive smoking is a proven health hazard. Over 600 medical reports have been published linking passive smoking to diseases. In 1999-2001, in Queensland, exposure to passive smoking caused an estimated 21 deaths per year in children aged newborn to 4 years.

Libertarians who see smoking only as a ‘freedom of choice’ issue and who suppress the role of smoking’s health costs on both smokers and non-smokers alike are missing these points. There are significant external costs of smoking that need to be considered by those adopting the daft position of supporting smoking on the grounds that people have the right to kill themselves.

If you do choose to kill yourself you probably do have that right - though the death will inflict misery on your friends and family. But you definitely have no right to inflict smoke-induced health costs on co-workers, bar attendants and your children. As high taxes on cigarettes are regressive in their income-distributional impact, have low impacts on those hhighly addicted and because most people initiate smoking as immature youth, smoking bans as well as high cigarette taxes make good sense.

Non-smoking wives of smokers can of course walk-out of the marriage or force their spouse to smoke outside and should be encouraged to do so should they value their health.

But a good question is how to stop parents breathing carcinogens over 'their' children. Do they have the 'right' to do this in their 'own home' or their 'own car'? Smoking could be made illegal in cars with non-smoking passengers with hefty fines on those offending but in the home I can't think of a practical policy for limiting smoking that goes beyond providing information about its health consequences. The hope then is that idiot parents will act with consideration towards other non-smoking residents. Of course in schools children should be warned at a young age against inhaling secondary cigarette smoke, to encourage parents who must smoke to do so in a way that prevents secondary smoke from being inhaled by them. The suggestion of giving children the right to sue parents for health damages that can be attributed to passive smoking is an inviting one but there are manifest practical issues of establishing causation.

The main secondary consequence of being a child in a family that does smoke is that there is an increased probability of acquiring the smoking habit yourself.


Damien Eldridge said...

The health effects of passive smoking are not the only potentioal externality from smoking. There is also the disgusting smell of cigarrette smoke that you have to put up with if you are stuck down wind of a smoker.

hc said...

I have a lot of sympathy for this but in many such situations you can choose to move away. Often I choose not to move away because I might attach other values (friendship, commercial) in pursuing the proximity. But in other cases you can avoid situations where there are many smokers - choosing non-smoking bars etc.

But kids in the home or in the family car have no such choices and yet medical science suggests this group is most at risk. I am thinking of policies to address the latter problem.

Damien Eldridge said...

Actually, in most cases where it matters, you can't. For example, you might be stuck on a railway platform or a crowded footpath by a busy road. Furthermore, even if you can move away, the other persons smoking has still imposed costs on you. You have to use a sub-optimal route to wherever you are going.

A problem with Coasian type arguments is that they require low transactions costs, no market power and, in their strong form, no wealth effects. Low transactions costs implies that there are likely to be few people affected. But this means that market power is likely to be a problem.

Indeed, one could make an argument that passive smoking by strangers is more likely to be a problem than passive smoking by family members. Parents who smoke probably care more about their children than they do the average person on the street. As such, they are more likely to be influenced by the adverse impacts of passive smoking on their children than they are by the impacts opf passive smoking by strangers.

Sinclair Davidson said...

'Smoking is the only legal product which kills people when it is consumed as intended.'

Maybe. Alcohol also imposes high 'externalities' - these don't always result in death, but I suspect there is over-reporting on tobacco and under-reporting on alcohol societal costs (to the extent these costs exist and call for a policy response).

Anonymous said...

You're regurgitating WHO propaganda verbatim and trying to sound smart.

Some are paid to lie about smoking; some do it for the fun of it. Which are you?

Perry said...

If all the evidence of the adverse effects of tobacco were true, any responsble Government, state or federal, would immediately ban it's sale across it's jurisdiction. Ergo, tobacco smoke is as harmless to all as a sea breeze, unless the various governments are as addicted the smokers taxes, as the smokers are to tobacco. Ironically, the taxes governments collect from tobacco is probably are far less than the cost of treating people with tobacco related diseases.

conrad said...

I'm not sure why you think smoking is the only legal product that kills people: try alcohol (undoubtedly increases cancer) and hydrogenated fats (now known as trans fats -- increases heart disease) which most people didn't even know about until recently and probably still don't.

I agree the issue of children/parents passive smoking is an interesting one (and I guess children/parents and food is similar). It will be interesting to see if children start suing their parents.

hc said...

Anonymous, I don't lie - may be mistaken but I don't tell known falsehoods ever. And no I am not paid either or doing this for fun.

Anonymity is allowed on this blog but these types of outrageous claims push things to the limit.

In fact my motivation for the post was my recent attendance at the ADSAD Conference where I was reminded of the terrible consequences of cigarette smoking.

Perry, Revenues collected from excises on tobacco substantially exceed health costs of smoking. Viscusi for the US estimates by a facrtor of 5X.

Damien Eldridge said...

There have been some Australian studies of tobacco taxation as well. Two such studies are:

Albon, R (1998), "Efficient tobacco taxation: Ramsey and Pigouvian considerations", mimeo The Australian National University, Canberra; and

Gabbitas, O and D Eldridge (1998), Directiomns for State stax reform, Productivity Commission Staff Research Paper, Ausinfo, Canberra, May.

Disclosure: I was one of the co-authors of Gabbitas and Eldridge (1998).

hc said...

Damien, I've been collecting Australian refs and missed both these. I'd like to get copies.

Sam Ward said...

And no I am not paid either or doing this for fun.

This is a bald-faced lie harry.

You are paid to research addictions. If you came out and said "smoking is great everyone should do it", you would lose your funding.

But you definitely have no right to inflict smoke-induced health costs on co-workers, bar attendants and your children.

Also untrue. If I own a house I am free to smoke in it whenever I choose. Even if I have a maid or an au pair.

If they don't like the job they are free to leave.

It is THEM that have no right to say what I can and can not do on my own property.

Bars and restaurants are no different. They are not a public service, they are private property and those owners (should) have the right to set their own smoking policies. Any bartender who doesn't like it is not forced to work there, there are plenty of other jobs available.

hc said...

Sam, My funding is in no way conditional on my conclusions. It is given in advance of the work I do. Indeed cigarette smoking was not even a topic covered in the terms of the ARC grant I hold. "Bald-faced lie' is strong even for the Yobbo. Prominent researchers in the tobacco area (e.g. Kip Viscusi) have appeared in court cases for the tobacco companies.

Children cannot leave parents who smoke though I agree low-income bar workers can go on the dole or perhaps find other work.

I know you are a smoker Sam but for the life of me isn't this issue a bit more than just about 'rights to smoke'? That is an aspect of this issue but there is also the fact that smoking is such a disasterously dangerous habit both for the smoker and those around him or her. Does this consideration carry no weight at all to the monofocused?

Sam Ward said...

"I know you are a smoker Sam but for the life of me isn't this issue a bit more than just about 'rights to smoke'?"

This issue isn't about "right to smoke" Harry. It is about private property rights.

The people most hurt by this legislation are bar and restaurant owners themselves, who may or not be smokers themselves but are nevertheless seeing their livelihoods destroyed by this legislation.

That is an aspect of this issue but there is also the fact that smoking is such a disasterously dangerous habit both for the smoker and those around him or her.

Another lie Harry. Cigarette smoking is not "disasterously dangerous" to those around smokers, in fact there is no proof that it is dangerous AT ALL, which you know very well.

People don't like passive smoke because it smells bad and can cause allergic irritations. If passive smoking actually caused serious health problems then smoking would already be banned throughout the world. As one commentator has already pointed out, that is not the case.

hc said...

No Sam the evidence is that passive smoking is harmful. It isn't 'another' lie because neither my earlier or latter statements are 'lies'.

On lyingI often stuff up and get things wrong and I may even delude myself but I don't lie. Moreover, I am not claiming my stance is particularly moral - the world is complicated enough for me to try to assess in terms of truths to bother lying. There is no payoff to me in lying.

Your last statement is obviously incorrect - damage to non-smokers from smokers can be denied (as you do) and it won't be banned.

Sam Ward said...

Your last statement is obviously incorrect - damage to non-smokers from smokers can be denied (as you do) and it won't be banned.

That's rubbish Harry. If Health Nazis could produce just one victim of passive smoking they would, but they can't.

You can't deny the facts. The problem for the Health Nazis is that their claim that "passive smoking is harmful" is make-believe. If they could prove it, smoking would be banned everywhere.

Anonymous said...

Thank you for your I can finish my final paper for my question is "Should the U.S. government increase the federal excise tax on cigarettes?"... :)

Lucy Josephine Gow said...

I'd like to support damien eldridge in saying it's not always that easy to move away!

I'm a PhD student and serial share-houser.
Twice I have moved into a house, only to find that a few months later, a housemate takes up smoking, then another smoker moves in, and suddenly I find myself living in a house where people smoke indoors... It's so horrible and annoying.

Anonymous said...

I don't smoke. I hate smoking. I hate the smell of smoke in my clothes and hair when I visit a bar.

BUT - I do not want any government to implement as comprehensive a ban as is about to happen in the UK

If I want to spend time with my friends that smoke then I put up with their smoke, and if I don't then I stay out of the pub.

I believe that so long as non-smoking areas with clean air are provided for non-smokers that is enough, and smokers should be free to indulge, just as non-smokers should be free from having smoke inflicted on them. What is wrong with havng smoking and non-smoking areas in restaurants, pubs, and clubs - bar staff that smoke manning smokers bars and non-smoking staff manning non-smoking bars.

The truth is that the legislation is NOT aimed only at protecting non-smokers .. it is also designed to take away all the social pleasure that accompany smoking - so that smoker's give up in despair.

Government in general has become too big, too powerful, and too intrusive. So politicians everywhere, get out of oyur faces and let us make our own choices about how we live our lives.