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Comment by jbob2000 | Hacker News Reader

jbob2000

> Smoking costs 45,400 lives, $16.2B in a year, study finds [1]

It is the largest single expense to employers and to the [Canadian] healthcare system. It is not dystopian to want to track smokers on their journey away from smoking - it's the only way we know if we're getting better at helping them quit.

28 days is a good measure of smoke free. By that time, you are through the nicotine withdrawal of about 72 hours, which I think is the biggest cause of relapse. After that, you need to resist the social and habitual pressures, and that is wholly up to the individual. Some people can go 20 years resisting these pressures, others collapse in a few days. So 3 weeks is a fair balance, I think.

[1] http://www.cbc.ca/news/business/smoking-economic-cost-1.4357...

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I know this is anecdotal, but I‘ve taken about 8 years and 10 attempts to successfly quit smoking. On half of those attempts, I made it past the 28-day mark, even past five months on one attempt before relapsing. Physical withdrawal is easy, staying on top of your mind is much harder. I’m at 2+ years now. I‘d say a year of not smoking is a meaningful predictor of not relapsing. 28 days shows you‘re making a serious effort.

> It is the largest single expense to employers and to the [Canadian] healthcare system.

I've read numerous times that smokers are actually a net gain for a healthcare system, assuming the same system pays for the whole life of the patient.

The majority of medical costs are incurred by a small minority of patients, usually at the very end of their lives. Smokers die earlier and faster, usually without the slow and expensive deterioration many healthier patients will go through.

Whether actually true or not, tobacco companies have definitely used this argument in lobbying against anti-smoking public health efforts, particularly in Eastern Europe.

Of course at best this argument assumes that you are looking at cost for a comparable standard of care, not cost for comparable health outcomes.

> Of course at best this argument

To me, this deflects from the main question of whether it is true or not. Or in other words, whether those quoting the "costs" of smoking (as a justification for further anti-smoking measures) are using dishonest propaganda. Also known as lying.

> To me, this deflects from the main question of whether it is true or not.

It points out that the question the claim addresses is different then that addressed by the opposing claim (and different than the policy concern that is usually beoing addressed.)

Which means its truth is orthogonal, rather than opposed, to the truth of the other claim.

Plus the same government is paying for pensions / social security so there's a "double dip" of savings when they die earlier.

Lost productivity is a huge cost for smoking (to say: we lose out on the fruits of labor, particularly of some great people). But then most smokers don't just quickly die of cancer, but do have much larger incidents of heart disease, which can pressure the healthcare system.

So squirrel suit fliers must be a huge discount then.

For countries with public health systems, retiree squirrel-suit fliers are the ideal -- they die cheaply, and have finished paying taxes and started taking pensions.

It's dystopian for employers to track their employee's healthcare goals and track their success meeting them. I, personally, don't want HR to send the company an email congratulating me on losing 5 pounds, or for them to bring me to their office to talk to me about how I had 5 drinks on Friday and that's binge drinking and outside company policy.

> I, personally, don't want HR to send the company an email congratulating me on losing 5 pounds, or for them to bring me to their office to talk to me about how I had 5 drinks on Friday and that's binge drinking and outside company policy.

Who's suggesting this? A bit presumptuous to go from tracking "thing that definitely kills people [smoking]" to "things that are bad but not that bad [drinking, unhealthy eating]". Quite the slippery slope that thinking tracking smoking will lead to tracking everything.

First, it's not a slippery slope, because there is a simple and logical progression for it, and examples in other fields - seatbelt laws, for example. Also, the article itself mentions tracking alcohol use and weight.

Why would you track smoking? Because the company pays more for insurance. So, it makes sense to track other things that are indicators for worse health outcomes, also causing higher insurance payments.

> seatbelt laws

What are you saying here? You've lost me. Seatbelts are good and the laws we have in place are there to keep ignorance about them from spreading (ie. if you've never gotten in an accident, why would you wear a seatbelt?). So I definitely agree that we slipped on this slope for a good reason.

The reason seatbelt laws exist is not because they are intrinsically good, or to prevent ignorance. They exist because it is expensive to pay for someone that has slammed through a windshield and requires intensive care. They passed in large part through the argument that putting them in place would lower insurance rates. That's where a lot of the money lobbying for their use came from.

They also passed so that the automakers wouldn't be forced to put airbags into cars.

> seatbelt laws, for example

I was all up with agreeing with you until this point - but I honestly find it quite incredible that there are still people that think seatbelts are a bad thing.

I'm not saying seatbelts are bad, I'm saying the reason the laws exist is in part based on a combination of NHTS data opened up with Reagan's move to regulate federal drinking laws and the idea that mandatory seatbelts would lower insurance costs.

It's an example of one thing being tracked moving down the line to something that the majority of people opposed also being tracked and legislated.

The step from tracking zero things to tracking one thing may be larger then the step from tracking one thing to tracking (almost) everything.

Companies already do this using things like Virgin Pulse.

It takes longer than 72 hours to clear out nicotine from the body. 4 days for the saliva but upto a year it can be measured in hair samples. Not counting the repair/reorganization the body requires to function again.

28 days is probably a good measure.

> It is not dystopian to want to track smokers on their journey away from smoking - it's the only way we know if we're getting better at helping them quit.

The dystopian bit is that they give your personal data to your employer. Was this really unclear to you? I'm confused at why else you would try to derail that point.

There are some funny cost sources in there. Tobacco enforcement? OK, but I mean, that's not the cost of tobacco, that's the cost of your distaste for tobacco. Lost productivity and lost years of life? Yes, I suppose it's true that you don't get to benefit from my productivity when I'm dead, but that's kind of an odd way to look at it.

In fact, yes, smokers do die sooner, which is why they actually cost less:

https://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748...

I understand that people don't like smoking, but that doesn't excuse the loose way that organizations throw around numbers about this topic.

It's instructive to watch the way people reason when they're convinced they've got the moral high ground. There's almost nothing they won't say.

> I understand that people don't like smoking, but that doesn't excuse the loose way that organizations throw around numbers about this topic.

And they never give a source so a person can fact check the numbers.

Luckily, in this case we know we're reading dishonest propaganda, since they make no mention of the revenue side of it.

> It's instructive to watch the way people reason when they're convinced they've got the moral high ground. There's almost nothing they won't say.

Preach brother.

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