Last words: Environmental tobacco smoke

'Last twinges of a coffin posting this book where the awning flaps a distant thank-you'. (William S. Burroughs)

The US Surgeon General’s ‘Health Consequences of Involuntary Exposure to Tobacco Smoking’ is a massive 19MB document with a reasonably accessible Executive Summary. The evidence is mainly for the US but many arguments apply to Australia. It is a 2006 report but I have only just had the chance to pour through it with care.

Forget about the lies the tobacco companies (and their allies in the libertarian movement) tell you about the freedom you have to kill yourself and those about you.

Life itself is a somewhat sick joke. We survive for 3 score years (and perhaps ten or twenty) then our bodies and our frantic concerns about income and status turn into dust. But we want to live – or at least I do! That’s the funny bit.

Exposure to environmental tobacco smoke (ETS) has fallen dramatically in the US mainly because of near total restrictions on smoking in the workplace – cotinine concentrations (a metabolite of nicotine) have fallen 75% in 10 years.

Still in 2005 ETS in the US killed more than 3,000 people from lung cancer, approximately 46,000 from heart disease and 430 newborns from SIDs. And still about 60% of non-smokers in the US show exposure to ETS.

The argument that cigarettes mainly cause internalities (market failures due to ignorance, youthful impulsivity) rather than externalities is true. A wonderful paper on internalities by Gruber – that demolishes the ludicrous ‘rational addiction’ model - is here.

Smokers reward non-smokers by paying more in taxes than they recoup in medical benefits simply because they die earlier. Perhaps non-smoking spouses who marry spouses cannot complain of 20-30% higher lung cancer death rates and 20-30% higher risk of heart disease. Perhaps too you can stretch it and say that workers in bars get better salaries that compensate them for higher heath risks. But what do you say about kids who suffer respiratory problems, slower lung development, higher rates of asthma and much higher rates of mid-ear infections because their parents smoke.

There are externalities from ETS and no-one should be forced to experience them.