The cigarette is the deadliest artefact in the history of human civilisation. [...] Cigarettes cause about one death per million smoked³⁵ with a latency of about 25 years, which is why the 6 trillion smoked in 1990 will cause about 6 million deaths in 2015. [...] One-third or one-quarter of those deaths will be from lung cancer; about one every 15 or 20 s. [...] Cigarette companies make about a penny in profit for every cigarette sold, or about US$10 000 for every million cigarettes purchased. Since there is one death for every million cigarettes sold (or smoked), a tobacco manufacturer will make about US$10 000 for every death caused by their products.
Presumably there are even worse legal ways to make a profit, but this sets a nicely unambiguous lower bound, I think.
A lot of industries are going to look really bad if you only score one side of the ledger. Given that a huge number of people continue to smoke and enjoy it, despite knowing the negative implications for their health it seems reasonable to assume that tobacco companies supply the world with a great deal of utility, in addition to the lung cancer.
I smoke cigars once every couple years, and they’re genuinely nice. Never tried cigarettes, but I’d imagine they’re possible to enjoy. I know a couple folks who are not addicted and smoke recreationally once in a while.
This would likely be true of many other (hard) drugs if there had been a history of legally selling them instead of nipping their markets in the bud. In fact, this would probably be true of wireheading too if it was practical, and ultimately, orgasmium. Willing to bite that bullet?
Huh? Jack said that there two sides to the ledger with respect to tobacco. He didn’t say which side would necessarily prevail in this case. Furthermore, there is no reason why the side that’s stronger for one drug is necessarily stronger for another.
Yes, other drugs are not unmitigated evils either. I’ve heard heroin is a 1000 times better than sex. The fact that it will eventually kill you and likely ruin your family life doesn’t change that. I think alcohol and caffeine probably come out on the positive side of the ledger while most don’t. But it is hard to say.
A lot of industries are going to look really bad if you only score one side of the ledger.
Absolutely. However.
Given that a huge number of people continue to smoke
While that’s obviously true...
and enjoy it,
...I think that’s misleading. While smokers like and presumably enjoy the relief cigarettes provide from cravings, I doubt that at reflective equilibrium they’d want to be smokers, or would approve of their smoking. When samples of smokers in Canada, the US, the UK, and Australia were surveyed.pdf), about 90% agreed with the proposition that if they could live their lives again they would not start smoking, and a clear majority (67% to 82%, depending on the country) reported an intention to quit within the next year. In Gallup polls, most US smokers say they believe they’re addicted to cigarettes, and most say they’d like to give up the habit. The CDC reports that in 2010, 43% of US adults who usually smoked cigarettes daily actually did stop smoking for multiple days because they were trying to quit.
despite knowing the negative implications for their health
Not true in general. Another paper based on data from that four-country survey tells us that “[a]bout 10% or more of smokers did not believe that smoking causes heart disease. Over 20% and 40% did not believe smoking causes stroke and impotence, respectively.”
it seems reasonable to assume that tobacco companies supply the world with a great deal of utility, in addition to the lung cancer.
I remain extremely sceptical, not only because of the evidence I summarize above, but also because of economic, philosophical & cognitive considerations of the sort LW likes:
Tobacco manufacturers, in effect, value a life at ~$10k. This is far less than other estimates of the monetary value of a life, at least in developed countries. Is everybody else effectively over-valuing lives, or are tobacco companies effectively under-valuing them?
I can apply the reversal test by asking myself whether humanity would be better off if many more people smoked. Or: would humanity be worse off if cigarettes had never been invented? Or: if cigarettes had only just been invented, would it be a good idea to subsidize their production & distribution to get them into the public’s hands faster? Intuitively, a “yes” answer to these questions seems strange to me.
Cognitive bias is ubiquitous, and people’s preferences over time are often muddles that don’t cohere. In light of this, the fact that many people use/enjoy something isn’t proof that it gives them positive net utility; and when that something dispenses an addictive chemical, it’s weaker evidence still. Various cues can trigger a craving for a cigarette, which is why people giving advice on quitting smoking routinelyrecommendavoidingcuesthatengenderdesirestosmoke; that advice would not be necessary if people decided to light up on the basis of level-headed ratiocination.
All in all, there is a lot of evidence that revealed preference theory gives us the wrong answer when applied to smoking. Most smokers say they regret taking up the habit, are addicted to it, would like to quit, or intend to quit; many have already tried to quit; many smokers cannot identify all of smoking’s potential health implications; applying revealed preference theory to tobacco manufacturers instead of smokers suggests manufacturers value customers’ lives suspiciously cheaply; calling on intuition by imagining counterfactual scenarios suggests that cigarettes aren’t a boon to humanity; and people’s actions are known to correlate imperfectly with their goals, and indeed their desires & decisions to smoke are influenced by sensory cues which would not enter into a rational cost-benefit calculation.
The most parsimonious explanation of these observations, in my judgement, is the mainstream one: the downsides of cigarettes massively outweigh the upsides; people typically begin to smoke cigarettes because of a temporary failure to adequately weigh costs against benefits; and people continue smoking because they become addicted to nicotine, and condition themselves to associate the paraphernalia & physical motions of smoking with nicotine self-administration.
...I think that’s misleading. While smokers like and presumably enjoy the relief cigarettes provide from cravings, I doubt that at reflective equilibrium they’d want to be smokers, or would approve of their smoking. When samples of smokers in Canada, the US, the UK, and Australia were surveyed, about 90% agreed with the proposition that if they could live their lives again they would not start smoking, and a clear majority (67% to 82%, depending on the country) reported an intention to quit within the next year. In Gallup polls, most US smokers say they believe they’re addicted to cigarettes, and most say they’d like to give up the habit. The CDC reports that in 2010, 43% of US adults who usually smoked cigarettes daily actually did stop smoking for multiple days because they were trying to quit.
There is a lot of moralizing around smoking and I suspect those numbers are inflated. It’s like if you call people up and ask them if they recycle or plan on voting. People give answers that they think others want to hear: that’s not the same as reflective equilibrium. Also, the fact that people are interested in quitting doesn’t have anything to do with whether or not it is pleasurable. It’s very pleasurable, which is why people start and continue. They often want to stop because they know that it causes cancer. But they still derive pleasure from it.
Not true in general. Another paper based on data from that four-country survey tells us that “[a]bout 10% or more of smokers did not believe that smoking causes heart disease. Over 20% and 40% did not believe smoking causes stroke and impotence, respectively.”
So up to 90% of smokers know some of the less well-publicized health risks? The numbers for lung cancer and emphysema must approach 100%. Don’t cherry pick your evidence.
As to the rest of your comment: I’m not claiming cigarettes are a boon to humanity. The question was what ways of making a profit cause the largest loss of utility and I was objecting to an answer that failed to consider the actual value created by an industry.
There is a lot of moralizing around smoking and I suspect those numbers are inflated. [...] People give answers that they think others want to hear: that’s not the same as reflective equilibrium.
Although I expect that plays a role, I believe the effect is small.
Even in 1978, when anti-smoking campaigns were far less intense than in the 1990s & onwards, most smokers in a Gallup poll agreed that “[a]ll things considered” they’d like to give up smoking, and while there was more agreement in later surveys the increase was gradual (66% in 1978 vs. 74% in 2014).
Unfortunately the data for the other attitude-related questions don’t reach back as far, although it looks to me like the proportion of smokers answering yes to “Do you consider yourself addicted to cigarettes or not?” has been broadly constant since that time series began in 1990, though the 1990 data point does happen to have the highest proportion answering “No” (graph available further down the page at the previous link). Meanwhile, the proportion answering “No” to “If you had to do it over again, would you start smoking or not?” has grown at only a sedate pace (83% in 1991, 88% in 2013).
A reference in an anti-smoking journal article by Robert Proctor points the way to some older data from “A Study of Cigarette Smokers’ Habits and Attitudes in 1970”, a market research survey of “a representative nationwide cross section” of adults, prepared by Roper Research Associates for Philip Morris. In that sample, 23% of smokers said they “have no intention of quitting”, whereas 72% responded that they’d either “like to stop smoking” but doubted they would, or that “[i]n all likelihood [they]’ll quit smoking before too long”. Another table shows that when asked about enjoyment, most smokers either claimed to smoke “from habit” (50%), or felt there was “[n]othing good about smoking” (16%); only 32% chose the “[e]njoy smoking” option.
Even at that relatively early date, a fair chunk of the people in the survey had already made efforts to quit. 36% of the respondents smoked, but “22% reported they had smoked in the past, but had quit”. Among the current smokers, “well over half (59%) [...] said they had at some time tried to quit smoking and given it up for as long as a week. And further, 40% have tried to quit two or more times”. About four fifths of both the ex-smokers and those who quit temporarily had decided to quit on their own, rather than at the urging of doctors or family.
Summing up, there are quantitative differences between how smokers report feeling about smoking now, and how smokers reported feeling decades ago. But even in the 1970s it appears that most smokers (at least in the US, where we have data) said they’d like to quit, or indeed had tried to quit at some time or another. That this was the case even before much of the recent campaigning against smoking (as well as the fact that most smokers in the Roper survey who’d tried to quit allege doing so on their own initiative) weighs against the idea that smokers, in response to contemporary “moralizing”, are misrepresenting their beliefs to a major degree.
Also, the fact that people are interested in quitting doesn’t have anything to do with whether or not it is pleasurable.
I’d be surprised if this were so. While pleasure isn’t the only factor affecting people’s thoughts on quitting, it’s surely one of them; in a counterfactual universe where nobody derived any pleasure from cigarettes at all I’d expect there to be an even bigger percentage of smokers who’re seriously thinking about quitting, and attempting to quit.
It’s very pleasurable, which is why people start and continue. They often want to stop because they know that it causes cancer. But they still derive pleasure from it.
Some do, at least.
So up to 90% of smokers know some of the less well-publicized health risks? The numbers for lung cancer and emphysema must approach 100%.
It’s a cherry pick in the same way that responding to “Odd numbers are prime” with “what about 9?” is a cherry pick. While the number 9 is, in that scenario, cherry-picked in some narrow technical sense, calling it out as cherry picking is a noncentral fallacy: exhibiting one counterexample of many isn’t what people generally mean by cherry picking. Likewise, if I reply to “smokers know the negative implications for their health” with “how about strokes (or heart disease, or impotence)?”, I wouldn’t say that’s cherry picking; it’s exhibiting a counterexample (or three). That the vast majority of First World smokers nowadays understand they’re risking lung cancer isn’t sufficient to show that smokers have a good idea of the hazards of smoking, because lung cancer is just one cause (and a minority cause!) of smoking-induced mortality.
And come to think of it, I didn’t even probe the level of understanding of smokers outside developed nations. The situation is very likely even worse there...so one could accuse me, with more justice, of cherry picking the evidence most favourable to smoking.
As to the rest of your comment: I’m not claiming cigarettes are a boon to humanity. The question was what ways of making a profit cause the largest loss of utility and I was objecting to an answer that failed to consider the actual value created by an industry.
Yes, and that objection was a legitimate one, which is why I’m bothering to address it by furnishing evidence about the relative size of the other side of the ledger.
It’s a cherry pick in the same way that responding to “Odd numbers are prime” with “what about 9?” is a cherry pick.
“Odd numbers are prime” would normally be interpreted to mean that all odd numbers are prime, with no exception. Conversely, “ducks lay eggs” would not be normally interpreted to mean that all ducks, including males, lay eggs. Which one does “smokers know the health effects of smoking” resemble more?
“Odd numbers are prime” IMO, although there’s room for disagreement there.
Most people would automatically read “ducks lay eggs” as referring to a strict subset of ducks, but I don’t think “smokers know the health effects of smoking” would automatically be read as referring to only a strict subset of smokers.
It’s true that “smokers know the health effects of smoking” wouldn’t be interpreted as rigidly as the mathematical statement “Odd numbers are prime”, but I doubt it’d be interpreted as loosely as “almost all smokers know the most famous health effect of smoking, and most of them know some of the less famous ones” either.
(There’s at least one way to interpret “smokers know the health effects of smoking” a bit less literally than I did: if smokers knew the total health risk they ran by smoking, one could reasonably assert that smokers were fully informed for the purpose of deciding to smoke, even if they couldn’t name every individual health effect, or every effect’s individual magnitude.)
and a clear majority (67% to 82%, depending on the country) reported an intention to quit within the next year
[a]bout 10% or more of smokers did not believe that smoking causes heart disease
Muhammad Wang fallacy. Those numbers sum up to less than 100%, so it’s well possible that all (or nearly all) smokers aware that smoking causes heart disease (would claim they) want to quit.
Obvious example: selling cigarettes.
Presumably there are even worse legal ways to make a profit, but this sets a nicely unambiguous lower bound, I think.
A lot of industries are going to look really bad if you only score one side of the ledger. Given that a huge number of people continue to smoke and enjoy it, despite knowing the negative implications for their health it seems reasonable to assume that tobacco companies supply the world with a great deal of utility, in addition to the lung cancer.
Enjoy it? Or want it because they’re addicted? What we want and what we enjoy are not guaranteed to be aligned.
As someone who occasionally smokes while not being addicted to it: it is definitely enjoyable for people.
I smoke cigars once every couple years, and they’re genuinely nice. Never tried cigarettes, but I’d imagine they’re possible to enjoy. I know a couple folks who are not addicted and smoke recreationally once in a while.
This would likely be true of many other (hard) drugs if there had been a history of legally selling them instead of nipping their markets in the bud. In fact, this would probably be true of wireheading too if it was practical, and ultimately, orgasmium. Willing to bite that bullet?
Huh? Jack said that there two sides to the ledger with respect to tobacco. He didn’t say which side would necessarily prevail in this case. Furthermore, there is no reason why the side that’s stronger for one drug is necessarily stronger for another.
And I replied there were similarly two sides to the ledger with respect to many other drugs.
Neither did I.
Are you saying that out of all existing non-legal drugs, not even one would have a similar profile to tobacco?
Yes, other drugs are not unmitigated evils either. I’ve heard heroin is a 1000 times better than sex. The fact that it will eventually kill you and likely ruin your family life doesn’t change that. I think alcohol and caffeine probably come out on the positive side of the ledger while most don’t. But it is hard to say.
Absolutely. However.
While that’s obviously true...
...I think that’s misleading. While smokers like and presumably enjoy the relief cigarettes provide from cravings, I doubt that at reflective equilibrium they’d want to be smokers, or would approve of their smoking. When samples of smokers in Canada, the US, the UK, and Australia were surveyed.pdf), about 90% agreed with the proposition that if they could live their lives again they would not start smoking, and a clear majority (67% to 82%, depending on the country) reported an intention to quit within the next year. In Gallup polls, most US smokers say they believe they’re addicted to cigarettes, and most say they’d like to give up the habit. The CDC reports that in 2010, 43% of US adults who usually smoked cigarettes daily actually did stop smoking for multiple days because they were trying to quit.
Not true in general. Another paper based on data from that four-country survey tells us that “[a]bout 10% or more of smokers did not believe that smoking causes heart disease. Over 20% and 40% did not believe smoking causes stroke and impotence, respectively.”
I remain extremely sceptical, not only because of the evidence I summarize above, but also because of economic, philosophical & cognitive considerations of the sort LW likes:
Tobacco manufacturers, in effect, value a life at ~$10k. This is far less than other estimates of the monetary value of a life, at least in developed countries. Is everybody else effectively over-valuing lives, or are tobacco companies effectively under-valuing them?
I can apply the reversal test by asking myself whether humanity would be better off if many more people smoked. Or: would humanity be worse off if cigarettes had never been invented? Or: if cigarettes had only just been invented, would it be a good idea to subsidize their production & distribution to get them into the public’s hands faster? Intuitively, a “yes” answer to these questions seems strange to me.
Cognitive bias is ubiquitous, and people’s preferences over time are often muddles that don’t cohere. In light of this, the fact that many people use/enjoy something isn’t proof that it gives them positive net utility; and when that something dispenses an addictive chemical, it’s weaker evidence still. Various cues can trigger a craving for a cigarette, which is why people giving advice on quitting smoking routinely recommend avoiding cues that engender desires to smoke; that advice would not be necessary if people decided to light up on the basis of level-headed ratiocination.
All in all, there is a lot of evidence that revealed preference theory gives us the wrong answer when applied to smoking. Most smokers say they regret taking up the habit, are addicted to it, would like to quit, or intend to quit; many have already tried to quit; many smokers cannot identify all of smoking’s potential health implications; applying revealed preference theory to tobacco manufacturers instead of smokers suggests manufacturers value customers’ lives suspiciously cheaply; calling on intuition by imagining counterfactual scenarios suggests that cigarettes aren’t a boon to humanity; and people’s actions are known to correlate imperfectly with their goals, and indeed their desires & decisions to smoke are influenced by sensory cues which would not enter into a rational cost-benefit calculation.
The most parsimonious explanation of these observations, in my judgement, is the mainstream one: the downsides of cigarettes massively outweigh the upsides; people typically begin to smoke cigarettes because of a temporary failure to adequately weigh costs against benefits; and people continue smoking because they become addicted to nicotine, and condition themselves to associate the paraphernalia & physical motions of smoking with nicotine self-administration.
There is a lot of moralizing around smoking and I suspect those numbers are inflated. It’s like if you call people up and ask them if they recycle or plan on voting. People give answers that they think others want to hear: that’s not the same as reflective equilibrium. Also, the fact that people are interested in quitting doesn’t have anything to do with whether or not it is pleasurable. It’s very pleasurable, which is why people start and continue. They often want to stop because they know that it causes cancer. But they still derive pleasure from it.
So up to 90% of smokers know some of the less well-publicized health risks? The numbers for lung cancer and emphysema must approach 100%. Don’t cherry pick your evidence.
As to the rest of your comment: I’m not claiming cigarettes are a boon to humanity. The question was what ways of making a profit cause the largest loss of utility and I was objecting to an answer that failed to consider the actual value created by an industry.
Although I expect that plays a role, I believe the effect is small.
Even in 1978, when anti-smoking campaigns were far less intense than in the 1990s & onwards, most smokers in a Gallup poll agreed that “[a]ll things considered” they’d like to give up smoking, and while there was more agreement in later surveys the increase was gradual (66% in 1978 vs. 74% in 2014).
Unfortunately the data for the other attitude-related questions don’t reach back as far, although it looks to me like the proportion of smokers answering yes to “Do you consider yourself addicted to cigarettes or not?” has been broadly constant since that time series began in 1990, though the 1990 data point does happen to have the highest proportion answering “No” (graph available further down the page at the previous link). Meanwhile, the proportion answering “No” to “If you had to do it over again, would you start smoking or not?” has grown at only a sedate pace (83% in 1991, 88% in 2013).
A reference in an anti-smoking journal article by Robert Proctor points the way to some older data from “A Study of Cigarette Smokers’ Habits and Attitudes in 1970”, a market research survey of “a representative nationwide cross section” of adults, prepared by Roper Research Associates for Philip Morris. In that sample, 23% of smokers said they “have no intention of quitting”, whereas 72% responded that they’d either “like to stop smoking” but doubted they would, or that “[i]n all likelihood [they]’ll quit smoking before too long”. Another table shows that when asked about enjoyment, most smokers either claimed to smoke “from habit” (50%), or felt there was “[n]othing good about smoking” (16%); only 32% chose the “[e]njoy smoking” option.
Even at that relatively early date, a fair chunk of the people in the survey had already made efforts to quit. 36% of the respondents smoked, but “22% reported they had smoked in the past, but had quit”. Among the current smokers, “well over half (59%) [...] said they had at some time tried to quit smoking and given it up for as long as a week. And further, 40% have tried to quit two or more times”. About four fifths of both the ex-smokers and those who quit temporarily had decided to quit on their own, rather than at the urging of doctors or family.
Summing up, there are quantitative differences between how smokers report feeling about smoking now, and how smokers reported feeling decades ago. But even in the 1970s it appears that most smokers (at least in the US, where we have data) said they’d like to quit, or indeed had tried to quit at some time or another. That this was the case even before much of the recent campaigning against smoking (as well as the fact that most smokers in the Roper survey who’d tried to quit allege doing so on their own initiative) weighs against the idea that smokers, in response to contemporary “moralizing”, are misrepresenting their beliefs to a major degree.
I’d be surprised if this were so. While pleasure isn’t the only factor affecting people’s thoughts on quitting, it’s surely one of them; in a counterfactual universe where nobody derived any pleasure from cigarettes at all I’d expect there to be an even bigger percentage of smokers who’re seriously thinking about quitting, and attempting to quit.
Some do, at least.
94%-95% for lung cancer, but the paper doesn’t have numbers for emphysema, unfortunately.
It’s a cherry pick in the same way that responding to “Odd numbers are prime” with “what about 9?” is a cherry pick. While the number 9 is, in that scenario, cherry-picked in some narrow technical sense, calling it out as cherry picking is a noncentral fallacy: exhibiting one counterexample of many isn’t what people generally mean by cherry picking. Likewise, if I reply to “smokers know the negative implications for their health” with “how about strokes (or heart disease, or impotence)?”, I wouldn’t say that’s cherry picking; it’s exhibiting a counterexample (or three). That the vast majority of First World smokers nowadays understand they’re risking lung cancer isn’t sufficient to show that smokers have a good idea of the hazards of smoking, because lung cancer is just one cause (and a minority cause!) of smoking-induced mortality.
And come to think of it, I didn’t even probe the level of understanding of smokers outside developed nations. The situation is very likely even worse there...so one could accuse me, with more justice, of cherry picking the evidence most favourable to smoking.
Yes, and that objection was a legitimate one, which is why I’m bothering to address it by furnishing evidence about the relative size of the other side of the ledger.
“Odd numbers are prime” would normally be interpreted to mean that all odd numbers are prime, with no exception. Conversely, “ducks lay eggs” would not be normally interpreted to mean that all ducks, including males, lay eggs. Which one does “smokers know the health effects of smoking” resemble more?
“Odd numbers are prime” IMO, although there’s room for disagreement there.
Most people would automatically read “ducks lay eggs” as referring to a strict subset of ducks, but I don’t think “smokers know the health effects of smoking” would automatically be read as referring to only a strict subset of smokers.
It’s true that “smokers know the health effects of smoking” wouldn’t be interpreted as rigidly as the mathematical statement “Odd numbers are prime”, but I doubt it’d be interpreted as loosely as “almost all smokers know the most famous health effect of smoking, and most of them know some of the less famous ones” either.
(There’s at least one way to interpret “smokers know the health effects of smoking” a bit less literally than I did: if smokers knew the total health risk they ran by smoking, one could reasonably assert that smokers were fully informed for the purpose of deciding to smoke, even if they couldn’t name every individual health effect, or every effect’s individual magnitude.)
Muhammad Wang fallacy. Those numbers sum up to less than 100%, so it’s well possible that all (or nearly all) smokers aware that smoking causes heart disease (would claim they) want to quit.