Smoking

Seth Godin has a blog post this morning in which he says

Smoking a pack a day for twenty years is a great way to be sure you’ll die early.

The point of his post was not the dangers of smoking. His point was that “What we do in the long run, over time, drip by drip” matters more than what we do sporadically and I certainly agree. But I disagree with Seth’s comment on smoking.

Smoking certainly cuts your life short on average. But smoking is like playing Russian roulette: Most of the time, you’re OK. Most smokers do not get lung cancer. Smoking does not ensure that you’ll die early. And that may be why smokers ignore warnings. They can point to plenty of fellow smokers who were not killed by smoking. For example, if I wanted to smoke I could point out that my parents smoked and did not die of smoking-related causes. (Another smoker in my family, however, did die of lung cancer.)

People are most strongly motivated by consequences that are immediate and certain. Given a choice between the certain pleasure of enjoying a cigarette now versus a risk of lung cancer years from now, smokers choose the former.

It’s not very effective to tell someone, especially someone young, that if they smoke they will get lung cancer. For one thing, it’s not true: they probably will not get lung cancer. But they do increase their chances of cancer, and even more so their chances of emphysema, heart disease, etc. Still, those are probabilities of future events. Teenagers may be more motivated by the thought of their fingernails turning yellow or their clothes stinking.

Update: I want to be clear that I’m not defending smoking. I couldn’t wait to move out of the smoke-filled house I grew up in. Nor am I trying to down-play the health risks of smoking. The harmful effects are extraordinary well established. As Fletcher Knebel said back in 1961, smoking is the leading cause of statistics. Half a century later we’re still spending money on studies to confirm what we already know.

Related posts:

Cartoon guide to cancer research
Nearly everyone is above average

10 thoughts on “Smoking

  1. Yeh, this is a real pet peeve of mine[1] — this and its dual, that smoking is not unsafe because “Joe smoked all his life and lived to be 97.” It’s not even useful to say the “on average” part, because the average change in life expectancy is far too small for anyone to care about. What’s better is to cite the percentage increase in likelihood of disease (note: not the increase in percentage, which is different).

    I don’t have the numbers handy, and it’s a lazy, rainy day, so I’m not going to research it now, but… suppose non-smokers have a 2 in 10,000 chance of dying from a smoking-related illness, and smokers have a 10 in 10,000 chance. Telling people that smoking increases your chances of dying from one of those illnesses by a factor of 5 — or putting it as “by 500%” — makes things much more obvious.

    You’re right, of course, that people don’t understand these things, and put little stock in something that might happen many years later.

  2. I had the same thought regarding Seth’s mis-assertion (if that’s a real word, which may very well not be the case). That said, having been a smoker for about 30 years, I stopped about, er, 2 years, 10 months, 17 days and about 4 hours ago.

    The trouble is, I suspect, that we don’t worry much about things that are not “real” to us. When the doctor told me at age 14 that I needed to stick to my prescribed exercise plan or I’d have a slipped disc by age 30, I pretty much ignored him. 30? More than a lifetime away. He was wrong anyway, it didn’t actually slip until I was 48…

  3. I think the chances of a smoker developing lung cancer are around 10%. Of course it depends on how much they smoke, etc. But I think the chances of other smoking-related diseases is much higher.

  4. Even Russian Roulette isn’t all that dangerous, it’s the subsequent “lead poisoning” that gets you. ;-)

    If I may rephrase John’s response, around 10% of smokers that are not killed by some other smoking related disease first will live long enough to develop lung cancer.

  5. There is a *huge* difference between roulette and smoking. In roulette, if you end up unlucky, you only kill yourself. But in smoking, your obnoxious habit may kill not only you, but also the hapless passive smokers all around you.

  6. Smoking is not like Russian Roulette in the following sense: in Russian Roulette, if it doesn’t kill you, then no harm was done (other than the brief moment of sheer terror). In the case of smoking, even if it doesn’t kill you, it can have a devastating, cumulative effect on your quality of life, including making you more prone to emphysema, heart disease, and osteoporosis. The people I have known who were very heavy smokers (several packs a day), were in sad, sad shape by the time they were 60 years old. My father died at age 69 (which I considered young, since his father had lived to be 90), and although the cause of his death was congestive heart failure, I really believe that his health problems were caused by smoking. It contributed to his first heart attack (20 years earlier) and decreased his capacity for the exercise that would have improved his cardiovascular health.

  7. @Daryl: I agree that the Russian roulette analogy doesn’t hold if you consider all health effects. But it holds better if you only consider cancer: you either have cancer or you don’t. It’s true that your cells accumulate damage, but if you stop the damage before you actually have cancer, you’re OK. Still, there are all the non-cancer risks that may be more important.

  8. Yes… mention the word “smoking” and you are bound to get people like me commenting also. I am not from the non-smoking industry but I did see an opportunity to create a quit smoking campaign for smokers in the workplace called the Quitober Challenge. I agree that it is how the non-smoking product is marketed that is important. In Australia there is a huge focus by the Quit organisation to frighten, or try to, with exaggerated & negative emotive visuals. Expensive TV ads are their pet choice & they have not changed or added to their approach over the last 20 years. I approached them with the Quitober Challenge idea for them to use as a separate brand for them to be more supportive & encouraging smokers to quit but was rejected. My belief is that smokers are sick of hearing the preaching on the negative aspects of smoking & are ready for a groundswell of smokers getting together to quit.
    Here is a very interesting article on how & why we quit from the Wired magazine titled “Together We Quit, Divided We Fail” http://quitober.com/together_we_quit.php
    Finally Canada run 2 challenge events that had more than 38,000 smokers take part last year, run by their Cancer Society.
    Now that is what I call effective marketing or a good kick-start.

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