No, I recall Canada doing such a study decades ago. A lung cancer death might be years and expensive treatments but it pales in comparison to say dementia where you’re housing a patient who needs 24/7 care for a couple decades.

Plus smokers pay high tobacco taxes and fully contribute to pension plans prior to their early demise. This particular study found their smoking was a net positive, from a financial perspective.

> The idea smoking actually cuts down social costs is laughable

I never claimed this. I am stating however, that it would appear that the proper equation for the referenced article should be healthcare costs + productivity loss - premature mortality, not the sum of all 3. I would not expect that the total is anywhere close to net negative, but I would expect it to be less than the reported €363 billion.

True. But doesn’t change that twofornone’s estimate of effect on mortality was incorrect.

I imagine there's also some false positives from people who know that "wanting to quit" is the more socially acceptable answer.

I think the second hand smoke thing was largely overblown to make it an "us vs them" thing rather than letting smoking be a personal choice. Smoking is a terrible habit, I hate being around people who are smoking, but I really think that modern anti smoking campaigns were less about health and more about puritan values, and not being able to stand the idea of someone else enjoying themselves in ways you disagree with. We see this regularly but it usually doesn't get enough traction to matter. The "dangers of second hand smoke" happened to be what finally stuck.

From what I understand, anti smoking campaigns have actually had a positive impact on life expectancy in western countries. On that metric, this is a positive thing. Personally I don't believe it outweighs the ills of allowing others to tell you what to do in the name of your health. I actually think all of the covid craziness can trace itself back to some extent to when we gave in and banner indoor smoking in most places. You start letting people make rules "for your safety" (and try to spin it so it's really about others) and next thing you know we've got the current hysteria as a popular thing.

Edit, because everyone that's replied so far has missed the point. I dont mean second hand smoke is pleasant. The rhetoric used to make allowing or disallowing smoking not a business decision but a state mandate, is that it was killing people. This was overblown, and is a completely different bar than "it smells bad and gives me a headache" - I agree with that, but its unreasonable to argue the state should be telling people what they can't do because of it. I'd sooner see Axe body spray outlawed on those grounds, but again, it's not the states business.

Gonna have a hard time trusting information from 'drugabuse.gov', given our nations shakey history with drugs. Egg on my face for saying that though given this quote from a little further down than yours

"However, while a few small, uncontrolled studies have suggested that heavy, regular marijuana smoking could increase risk for respiratory cancers, well-designed population studies have failed to find an increased risk of lung cancer associated with marijuana use."

I would argue in the US, that sort of thing benefits corporate healthcare more than anything. Nobody wants other people telling them what to do. In other words, the more people say we're going to ban ______ because I don't want to pay for your risky lifestyle through my healthcare taxes, the less likely universal healthcare will ever be a thing in the US. If we really want universal healthcare, we should allow everyone to join, thus the universal part.

But people like to preach to other people, so Que Será, Será.

> If we all had to pay for each others hobbies, for example, you'd bet there would be folks trying to get cloud-watching banned in favor of something productive like knitting.

If I had to pay for other people's hobbies, surely I'd want the opposite? Why would I prefer to buy someone yarn rather than let them watch clouds for free?

> Absolutes aside, a smoker should have higher insurance costs than a non-smoker.

This is probably false. Smokers rack up less health care costs than nonsmokers because they die earlier. The study I'm linking doesn't consider the possibility of exiting paying into a healthcare system early, but even most smokers die after retirement:

https://www.nejm.org/doi/full/10.1056/nejm199710093371506

I find it it interesting that spending billions on promoting smoking somehow isn't considered social engineering, but trying to prevent it somehow is.

>However, if each individual pays for the entirety of their own health-care costs, then it is far less obvious what actions should be taken.

This doesn't exist in the nature we find modern civilization in. You pay for others health, one way or another. We either pay for it sooner and reap the benefits of people being able to work, have families, money, or you pay for it with poverty, crime, "blood". You also pay for it with driven yet disadvantaged people not being able to rise to positions that use their abilities. Example: Students.

Health is inherent to humans. To be human at all is to have health and medical requirements. Cloud services are not a requirement of your very existence.

Quite a lot of people on HN are arguing for such social control in the US through promoting a universal healthcare system. And which many countries currently implement… so your contrarian opinion is interesting.

How would you balance tradeoffs in either direction?

"good intentions are a road to hell" is false with some very basic thought experiments. For example, read the U.S. consitution, specifically on its ammendments. Freedom of speech is a good intention. Individual autonomy at all is a "good intention" just as much as fascism is. Everyone can have conflicting good intentions, therefore it's a poor argument that doesn't address the merits.

You could apply that argument to other unhealth habits. Heart Disease is one of the most deadly and debilitating problems in the U.S., which should be met with significant tax on sugary products. The health costs are astronomical and deadly. However you're strawmanning my argument, there is a weight to when someone deserves regulation and does not. Many "unhealthy habits" do not rise to a great enough problem or have other benefits. For example, sitting at the computer is an "unhealthy habit", and it can be quite lucrative in certain work.

Dystopia is when a private company advertises to children that they should take a substance that company designed to be heavily addictive and harmful to themselves and everyone around them.

Social control is an natural part of humans and has always existed. Government regulations, when done in certain methods, demonstrably work. Other times, they do not.

why the prejudice against alcohol then? Drugs are drugs. It's not the alcohol that makes people violent. The majority of people just get more relaxed and funny. Those people that get violent already have a problem - and alcohol is not it.

Yeah slowly dying 5 years and giving your closest the gift of watching you wither away, 1 cell at a time is really peaceful, almost dream-like...