Agreed. I also like to think that these aren't necessarily "sin" taxes, but taxes paid up-front for the increased costs to society for the medical/public safety implications that occur from them.
The data on drinking is much fuzzier (because so many people drink in moderation) but my impression is that, as you suggest, it's significantly under-taxed relative to its negative externalities.
Edited to add: For comparison, IIRC a Pigouvian tax on sugary drinks should be something like $3 per 12 oz can. People who drink lots of sugary beverages also tend to die sooner, but they use a ton of medical resources while they're around - the average lifetime treatment cost of Type 2 diabetes is over $100k, and that's just one condition.
Although technically true, if you apply a reasonable discount rate the analysis flips back in favor of smoking cessation [1].
If you ignore the fact that old people aren't just sent out the pasture to die, then sure, maybe you can set gamma to an unreasonable small value, you can decide that more early death is cost-effective.
But such an analysis, which again nets out positive for smoking cessation when applying an appropriate discount factor, ignores the fact that healthy older folks still contribute to society.
The retired population is an enormous social asset. They contribute disproportionately to community volunteer work, play an important role in family formation/childcare, and many also work well past retirement age. The average retired person is still performing an significant amount of socially valuable labor, regardless of whether they're filing a W-2. In many communities/families, Social Security and Medicare are at least in part a significant state-subsidized childcare allowance.
[1] https://www.nejm.org/doi/full/10.1056/nejm199710093371506
You need to apply a discount rate of 10% (which seems unreasonable for the government which can borrow at incredibly low rates.)
Also this analysis ignores that healthcare costs are accelerating faster than inflation, so treatment for an individual in 20 years will likely be far more expensive than treatment today.
It also doesn't include social security.
I always thought a solution would be to tax beers 1 dollar, and then give it back to the patron in untransferrable rideshare credits.
> We also find that heavy purchasers of one sin good (those in the top decile) are likely to purchase larger amounts of other goods subject to corrective taxation. This phenomenon is particularly strong among households with smokers, who tend to also consume larger amounts of [sugar-sweetened beverages] as well as beer and spirits
There is a fundamental fairness question in play here.
I'm okay with the "individual responsibility but don't except affordable healthcare coverage even from medicare/medicaid" approach. I'm also okay with the "coercive policy to force people to change themselves" approach. And I'm okay with a combination of cost/coercion sharing.
What I'm not okay with is all of society bearing the cost of the 10% of the population that smokes heavily, drinks heavily, and consumers larger amounts of sugary beverages.
Disadvantaged people aren't some romantic struggling hard workers, they have all sorts of vices and emotional/mental health problems leading them voluntarily to those behaviors. Smokers aren't just selfish pleasure-seeking lazys.
obesity has the largest impact on healthcare cost by a large margin. might as well tax the obese now because we will pay them back later by keeping them alive
how about: we don’t need to tax lifestyle choices on anyone. because if you’re serious about increased costs to society you very quickly get to a social credit system. where you can show you don’t drink or smoke, aren’t fat, don’t take part in dangerous activities…
Smokers do have higher healthcare costs when young, and miss more workdays, but in the US where government is paying social security and Medicare, smokers dip into the public coffers much less than their non-smoking peers.
This page helpfully presents enormous per-patient costs of lung and other cancers, estimating ~USD$100k for care in the final year of life alone: https://progressreport.cancer.gov/after/economic_burden
Lung cancer symptoms often appear in late stages, which might explain the "quick" part of your comment, but come on. We aren't exactly talking death by gunshot or asphyxiation here. Symptoms of lung cancer include chest pain, a persistent cough, coughing up blood, and metastatic bone pain or headache, none of which seem quick or pleasant: https://www.mayoclinic.org/diseases-conditions/lung-cancer/s...
Healthy or unhealthy, everyone dies. Liver cirrhosis or lung cancer is expensive. But getting Alzheimer's in your 70's and living another 10 years is extraordinarily expensive.