An unexpected uptick in cigarette smoking in Germany | Hacker News Reader

An unexpected uptick in cigarette smoking in Germany

wsj.com

40 pointsbookofjoe108 comments

I have a really controversial view about smoking: it has undeniable downsides but as a society we are now feeling what happens when a huge proportion of the population no longer experiences the cognitive upsides they used to get from nicotine.

It's somewhat similar to what would happen if you banned coffee.

What are the cognitive upsides? The only one that I can think of as an ex-smoker is that helps to control anxiety.

At the same time knowing I was harming myself by smoking added a lot of anxiety.

https://en.wikipedia.org/wiki/Nicotine#Performance

> Nicotine-containing products are sometimes used for the performance-enhancing effects of nicotine on cognition.[57] A 2010 meta-analysis of 41 double-blind, placebo-controlled studies concluded that nicotine or smoking had significant positive effects on aspects of fine motor abilities, alerting and orienting attention, and episodic and working memory.[58] A 2015 review noted that stimulation of the α4β2 nicotinic receptor is responsible for certain improvements in attentional performance;[59] among the nicotinic receptor subtypes, nicotine has the highest binding affinity at the α4β2 receptor (ki=1 nM), which is also the biological target that mediates nicotine's addictive properties.[60] Nicotine has potential beneficial effects, but it also has paradoxical effects, which may be due to the inverted U-shape of the dose-response curve or pharmacokinetic features.

How susceptible to tolerance would the positive effect be? Would a long term smoker still have any benefit? Or is it like coffee, very quickly giving no benefit at all.

This is a good question, along with what happens if that long term smoker then quits altogether.

If you had ways to moderate the withdrawal of things like caffeine and nicotine you could possibly try alternating regimes. Would probably do dreadful things to your heart though.

Studies have shown that nicotine has some mild cognitive benefits on attention and short-term memory.

https://peterattiamd.com/ama23/

I'm not necessarily recommending nicotine to anyone, but there are ways to get it without smoking.

When I was in high school we had a few smokers. They seemed to make a lot of friends while smoking and have better social skills than others.

Cognitive upsides? Sounds like Cowboy Man copy… the Surgeon General aproves this message.

Or do you mean people worked faster because they couldn’t during their cig break?

Nicotine has been added to energy drinks in Japan for years. The claim that it has cognitive upsides is not necessarily cigarette-company propaganda.

Do you have any links for this? I could only find references to nicotinamide, not nicotine.

No links at hand, and I was unaware of the term “nicotinamide” for a form of vitamin B3. I am quite sure that I read claims of nicotine specifically being added, but I now suspect that the people writing that were misled by the name of nicotinamide. Thanks for enlightening me.

I don’t know about nicotine, but I am all cognitive upside from never smelling a cigarette again.

Smoking reduces quality years of life and puts a burden on a nation's health system. The drastic decrease in productivity in a nation from those two things has got to be far more than any increase from any cognitive benefits.

But more importantly, it's morally wrong to suggest we shorten and make our lives worse for some short term stimulant spike.

Many studies actually show that smokers are cheaper to care for over their lifetimes, likely because they die earlier. This study[0] shows a +7% for men/+4% for women increase in healthcare costs if all people stopped smoking. I'm too lazy to vet the epistemological quality of this study, but it seems like there are a bunch of these much along the same lines. One thing these studies seem to neglect is total value lost associated with smoking, instead focusing costs alone. By folding in some QALY-like model, you could come up with the overall impact of smoking on society in quantitative terms.

[0]https://pubmed.ncbi.nlm.nih.gov/9321534/

This number doesn't take into consideration the contributions of these people to society, which could outweigh their additional healthcare cost and make them an actual net positive to the economy (putting aside moral questions about calculating whether people should live or die based on their net value).

Why does this matter? It’s definitionally the least productive years of someone’s life outside of childhood.

A nearly 80 yr old man I know has a nearly 200k per year pension. Every five years he lives adds 1 million to the economy.

If by “add 1 million to the economy”, you mean the local economy where the 80 year old lives, then sure I guess. But in general that’s just money moving around.

How does that work? I mean technically he takes 200k from the economy without producing anything in return. In very basic terms the government printing an extra 200k adds about as much value (assuming he's not actively investing and not doing anything else).

If he was “actively investing” would that change the situation?

Theoretically to some extent it would depending on how he allocated his investments (it could also be the opposite).

Many cancers triggered by smoking hit during late working years.

From a purely utilitarian/dystopian/evil/etc. point of view: aren't most people suffering much older on average?

e.g. in the median age at diagnosis is ~71. Most people at that age have very low productivity live on a pension/from savings/other passive income and economically probably cost more to the society than they contribute.

Smokers also pay more taxes over their lifetime so they contribute more to society in addition to costing less at the end of their life.

>Smoking reduces quality years of life

actually it make worse your worst year, but has no effect on your best years

> and puts a burden on a nation's health system.

listen, I know smocking is bad as anyone else, but if we wanna talk about "burden on a nation's health system" let's talk about cars (fumes are just the tip of the iceberg, we have more than 20 thousand deaths/year caused by car accidents and many more injured and/or left invalid) or having children.

You know what also puts a burden on on a nation's health system?

an aging population!

in my Country more than 25% of the population is over 65, so they not only are retired and do not contribute anymore to the expenditures through their work, they also need a lot of very expensive and prolonged care.

They most probably smoked in their younger years, but survived nonetheless and now they need to be taken care of.

Truth is the nation health system wastes too much money on things that do not help people, we've seen it during the pandemic, the personnel was crushed by the unsustainable shifts and the output was barely sufficient.

said by someone who was born and lives in a Country with a public healthcare system, who happily pays for it through a lot of taxes (half of my salary) and a big chunk of the family employed by the aforementioned public national health care system.

Or, for example, what has been the cost (both economical and social) of the recent opioid epidemic in the US of A caused by the health care system itself?

> But more importantly, it's morally wrong to suggest we shorten and make our lives worse for some short term stimulant spike.

like, for example, firing up combustion engines to drive kids to school? kids that, bear in mind, have perfectly functioning legs and can walk!

>in my Country more than 25% of the population is over 65, so they not only are retired and do not contribute anymore to the expenditures through their work, they also need a lot of very expensive and prolonged care.

If only there was something out there that could thin out this group of people in particular.

> If only there was something out there that could thin out this group of people in particular.

it's the same thing that, eventually, will happen to everyone of us.

But literally where I am from they have on average 20 years more to live (second oldest Country in the World) so, regarding the burden on the national healthcare system, smokers cost less (I must specify I believe the economic angle is rather meaningless when talking about health care. I don't believe health care should ever be profitable, barely sustainable it's enough).

A study concluded that the abuse of medicines causes around 40 thousands deaths/year in my Country, which is an incredibly high number, so maybe the secret lies in moderation and not in abolition and prohibition.

There's also the fact that for many people a long meaningless life is much worse than one lived fully, as the "owner" intended.

Maybe someone in the future will convince everyone to avoid any potentially dangerous habit, but I'm also quite sure that such a society will face an epidemic of depression and suicides.

Is it morally wrong to eat a cupcake? I’m not a smoker nor would I want anyone I care about to smoke, but have you thought through the extrapolation of your assertion?

Similarly, old people are a drag on society. It’s not at all clear that reducing lifespan is a decrease on net productivity.

I would not want those I care about to die early, nor would I deny anyone else the same hope for the sake of productivity. But I can be objective enough to acknowledge the tradeoffs.

I co-own a small bar and help run our trivia night. Between rounds the smokers always go out for a smoke and they ended up all knowing each other.

Asking for a lighter which then leads to a off-hand question, has often led to a interesting conversations, more than one would expect.

>it has undeniable downsides but as a society we are now feeling what happens when a huge proportion of the population no longer experiences the cognitive upsides they used to get from nicotine.

You don't need to inhale burnt tobacco to get nicotine, and there are plenty of other ways to get stimulants into your body; patches, teas, etc. and society is still consuming a shit-ton of stims; ain't been to an empty coffeeshop since COVID.

vaping, while shown to be not great for you, is also still not as awful as inhaling tons of smoke, and can deliver the nico just as well.

and it is the smoke that is the problem -- firefighters who handle a lot of cases often have lung cancer rates far higher than the rest of the population.

I think what doesn't help is that vaping is treated the same as smoking. It's also banned everywhere that smoking is even though it doesn't generate particles.

I think many smokers feel that there's no real upside to vaping for this reason apart from their own health effects. I think they should make vaping more attractive eg allowing it in a vaping area at the office.

Ps I'm not a smoker nor vaper. But I'm getting a bit fed up with this war on nicotine. The current strictness the EU is taking is clearly not working for those who are still smokers. Continuing to increase the price will not either.

Just like the war on drugs is never ending and has not really accomplished much more than increase risk and this rewards that benefit bigger cartels, it's time to evaluate to see what actually works.

>It's also banned everywhere that smoking is even though it doesn't generate particles.

I vape nicotine. That's not true in the slightest, unless you're using some wacky definition of 'particle'.

I agree that the restrictions around where one vapes might need to be a little less lax when compared to cigarettes, but to claim that it doesn't 'generate particles' is disingenuous.

Probably less PM2.5 rating

Well there's no solids. No tar, ashes etc.

Droplets yes but they are just oils. Similar to when you're frying in the kitchen. Probably a lot less than that in fact, considering the amount that goes into a vape pen.

I'd still rather not be breathing someone else's used strawberry flavor though, regardless of health effects or lack thereof.

Drunk driving helps a lot of people to get to work on time.

There isn't really any societal upside with smoking. It's a real net negative for the vast majority of users, financially and healthwise. Maybe smokers should switch to coffee for their high, a drug with no major downsides for most people.

Replace smoking with nicotine/users in your comment. Nicotine is no more dangerous than other pharmaceuticals at normal dosages.

Also adding the caveat about the obvious downsides of smoking before I assert this opinion but one thing that's kinda gotten lost is those micro social encounters you'd get from sharing a cigarette. Whether at work, at uni, at a concert, in a bar, or just about anywhere, those smoke breaks used to be a chance to strike up a 5-10 min convo with someone random. Even today, head to a designated smoke area and more often than not, you'll end up chatting with some stranger asking for a lighter before going back to what you were doing. I don't think society has found some other mundane shared experience to replace this.

In many countries where smoking remains common, the people standing outside an establishment smoking are looking down at their phones, just like they would be looking at their phones on the bus. Trying to strike up any conversation would be a faux pas, and I imagine even asking a stranger for a light could be seen as an intrusion. In our modern world, experiences where people are physically close to one another does not necessarily mean that they will socialize.

Not true at all

It used to be a great way to identify tribes and make friends. You could be at some stuffy conference and the gaggle of smokers would be the drinkers, musicians, poets and rebels. It offered a simple way to give, share and help a stranger that I can't invent in the modern world. I'm sure the non-smokers probably enjoyed our absence too!

Coffee doesn’t emit secondhand fumes which increase cancer in people who have not elected to drink coffee

Coffee breath!

Also, there was routine to take a genuine 10 min break every few hours... interesting to see if the lack of this break (lung cancer aside) has implications on health

Smoking is also not great for your mental health:

https://news.ycombinator.com/item?id=37351135, about https://studyfinds.org/smoking-depression-bipolar-disorder/

During a recent visit to Hamburg I entered a smallish pub/bar and it was so smoky that it seemed like a portal to the 90's!

I remember sometime in the 90's or so taking a trip to California (I'm on the East Coast) when they'd just banned smoking in bars. That was such a revelation. Doubly so because I went to some jazz/blues place and the it was all just so weird but also so nice.

It makes me a totally hypocrite (my poltics are generally against those kind of bans) but it made everything so much nicer that I couldn't help but like it.

They came for the smokers and I did nothing. Niemöller was totally right.

Similarly, traveling from smoke-free to smoking-afflicted regions is a major shock, and I've had to stop myself from commenting where I see people lighting up or encounter smoke-filled premises.

Though my immediate inclination on encountering same is to get out as quickly as possible. The experience is absolutely revolting.

Yup, my culture shock seeing a table of salarymen chain smoking in the restaurant in Japan.

While I prefer non-smoking sections indoors, generally, I've been in a few coffeeshops with such good ventilation that the air felt better inside than on the street. (though that might have been an illusion from it being cold)

IIRC, the country I'm in was the first to ban smoking indoors at venues. 2003 or so, I believe. I was a kid, so I didn't really notice it aside from the warning signs and the first time I went abroad.

When I was a kid, children (or at least teen-agers) could work in foodservice spaces in which smoking was permitted. By end of shift, clothing and hair smelled like an ashtray.

The smoking bans I'm familiar with were phased in beginning in the 1990s, though specifics varied by locale (some cities and counties were earlier on the ban) and type of location (offices, restaurants, bars, etc.).

There are still 12 US states without comprehensive smoking bans, virtually all in the deep south: AL, AR, GA, KT, OK, SC, SD, TN, TX, VA, WV, WY. (SD and WY are the exceptions.)

Notably, the famed liberal strongholds of Missouri and Mississippi do have restaurant smoking bans.

I will point out that it's not as in the Niemoller poem....that's about people you're indifferent to/things that didn't affect your life directly.

Banning smokers actively made your life better - removing the behavior increased your enjoyment of the setting.

Travel advice: This is an experience possible in Hamburg, but, e.g. not in Munich, due to (non-)smoking legislation happening on the state level.

>Health experts think low tobacco prices, a general tolerance of smoking

Yes, people not coerced "for their own benefit" will generally keep their habbits

Why the quotes? Are you saying that people being guided to quit smoking isn't good for them? I'm confused.

Would you submit to be guided (by force) away from any suboptimal for your health behavior you might currently engage in?

Losing weight? Absolutely.

Citizen 440023423, you are being informed by your friendly government monitoring bot that health studies have shown a link between cancer, obesity, and heart disease by frequent computer and phone users. Your account has been deactivated for 2 weeks. Please engage in the recommended 1 hour of daily outdoor activity instead. In addition, we noticed you exceeded the 15 minutes of allowable phone and computer use, as recommended by experts at the ministry of citizen health. Your internet has been disabled for 1 week. A $25 charge for services has been added to your tax bill. Have a nice healthy day citizen 440023423.

Oh thank god, I’ll have so much more free time.

Why is it that whenever people suggest any kind of nudge that might be helpful to society, the immediate response is to take it to a totalitarian nightmare. Don't get me wrong; I think the government should leave people alone as much as possible. But jumping straight onto the slippery slope seems like a thought-terminating cliché — rather than leading to an actual discussion about how best to manage individual freedoms while living in a society. (and no, the answer is not "everybody is free to do everything" just as it isn't "nanny state knows best; eat your veggies or else")

>Why is it that whenever people suggest any kind of nudge that might be helpful to society, the immediate response is to take it to a totalitarian nightmare.

Perhaps because those nudges are already a totalitarian nightmare. People should control the government, not the other way around, and definitely not their personal lives and habbits.

The prohibition or the "war on drugs" weren't some made up fantasy nightmare, but very real history of a totalitarian nightmare.

Why wouldn't I?

The government has determined that engaging in online discussions where users disagree increase blood pressure and decreases happiness. Your comment will be deleted and account suspended. You have exceeded your 15 minutes per day of phone and computer use, deemed as the permissible limit by the council for citizen health, your internet account is suspended until next week. This should help you to walk outside. Your tax bill has increased by $16 for processing fees. Thank you citizen, have a nice day.

You enjoy having fun on occasion.

Because experts of the day are often wrong. 100 years ago Hitler had some expert opinions that later we reject.

Don't be the next agent orange victim. Question things.

Paging Godwin.

Yes, an idiot said something on usenet for fun and now it's considered a "counter-argument"

Paging: Bueller? Bueller?

> Question things

But why should I?

Because you are being lied to and used

You should have used the example of the fats and sugar lies peddled by the fats and sugar lobbies as the cause of fatness.

You absolutely should.

Freedom loving adults on the other hand like to decide for themselves the amount of fun but harmful behaviors they like to have...

I'm saying that third parties like states deciding what is or isn't "for the benefit" of the people (as opposed to being told what the people want) is not good for them. It's crossing boundaries and it's infantilizing.

For two cases where it's gone horribly wrong consider the prohibition and the "war on drugs". Not to mention the "don't eat fat" campaigns...

If not the state, the free market will fill the gap and tell us what is for our own benefit, bet a lot more boundaries get crossed when the tobacco industry, pharmaceutical industry etc. get free reign.

To be frank, alcohol, most drugs, and fat are not the same. Every time I go to a place where smoking is not culturally frowned upon, I can't make a few steps without inhaling vomit-inducing smoke. If it wasn't for this, then I would agree with you.

> as opposed to being told what the people want

If a majority of people in a country want smoking to be disincentivized, and the government acts on that, is it still crossing boundaries and infantilizing?

> Not to mention the "don't eat fat" campaigns...

Bad example, as it turns out that eating a regular amout of fat is fine. The gov't was wrong.

Here's a better example: food corporations actively market sugar-filled cereals, "juices", "fruit snacks", etc to both parents and kids, actively misleading them on what a healthy human diet is. This had contributed to a surge in obesity and all the related health problems. This puts strain on the medical system, raises insurance premiums, and generally makes society worse.

So do I support making it harder for corporations to market their HFC garbage to kids and parents? Hell yes. Do I support making it illegal for tobacco corps to market to kids? Yes again. And I say this as someone who enjoys sugar and smoking, to a reasonable degree.

>If a majority of people in a country want smoking to be disincentivized, and the government acts on that, is it still crossing boundaries and infantilizing?

Yes.

> third parties like states deciding what is or isn't "for the benefit" of the people (as opposed to being told what the people want)

I'm gonna keep picking on this point.

The majority of people want regulation on a variety of things.

It's infantalizing for you to claim that they aren't consciously choosing that.

Regulation is not the same as nudges towards personal health and discouragment-taxation towards "what's good for you".

>It's infantalizing for you to claim that they aren't consciously choosing that.

The "majority of people" aren't even asked about things like this, and they're constantly lied to and betrayed on the subject of electoral promises of all kinds, even on way more major issues. Not to mention being treated like cattle that needs to be "told what to want" and to be whipped into shape by technocrats and policy advisors.

So, invoking what the government does as a proxy of "what people wants" is very shaky grounds...

In this case, it is also for the benefit of others, as second hand smoke causes and/or contributes to cancer, emphysema, and a myriad of other lung and heart diseases.

It's pretty popular in India too, especially among IT workers. These days I see a lot of young ladies smoking as well, which was pretty rare a decade or so ago.

It's more likely that the taxing of vape liquid with 0.16€/ml has a lot of ppl. who are still vaping with nicotine content reach for their cigarettes.

It’s still a habit OF dying, just not a habit that IS dying </pun>

In the last few years after all the health craze of the 2010s a lot of tv shows and movies have smoking actors again AND speaking as a German HHC (a variant of THC... imagine THC light) is not yet banned in Germany and every gas station, vape shop or kiosk is selling it. In Europe a joint is basically what in the US is a split so everyone is mixing their weed with tobacco. It's probably just a coincidence but there is a lot of weed smell in the cities right now.

This doesn't seem true? You have CBD all over the place and while HHC is legal and findable, it is niche and not in every shop.

In the schanze and other "hip" districts in the big cities you can't walk 2 meters without a shop promoting it.

“Spliff,” by the way. “Split” would make heaps of sense, but sense isn’t this word’s milieu.

I lived in Dresden in 1998-1999 and was kinda shocked that they had cigarette vending machines outside like

https://www.alamy.com/stock-photo/cigarette-vending-machine-...

I don't see it in any of those photos but they often used to have candy vending machines for kids mounted underneath them.

I went to Poland (where my grandfather came from) and boy did the people there really seem to smoke a lot.

cigarette vending machines are still super common here in Vienna as well. There's always teens hanging around them asking people to swipe their cards to buy the cigarettes in exchange of cash

A bit of history to this - previously there were just machines, you put in cash and get cigarettes - but then it was decided this made it too easy for underage people to buy cigarettes so now you have to use a bank card (I think?) for identification, so young people just hang around the machines and ask a passerby to lend them their card.

Here in Italy you need to use your Codice Fiscale or Carta d'Identità cards (both official documents) as (debit) cards (pre-paid or connected to some bank account) can be obtained as early as 13 or so (of course authorized by parents).

Still common in Munich area -- can see them on many corners of quiet residential neighborhoods

Kinda tangential, but learning about Wiesn Koks[0] gave me similar culture shock.

[0]: https://www.businessinsider.com/wiesn-koks-oktoberfest-drug-...

This is how I bought my first pack on holiday with family. It took some careful planning to gather the right coins, identify the location of a machine and then create the opportunity to dash to it, get the pack and not be rumbled. I was like 10 years old. I don't think I even learned how to inhale until a few years later, just puffed on them like a cigar... didn't matter, the transgressive act was thrilling enough to give me butterflies in my stomach.

Cigarette vending machines are very common in Germany. Every village has one! One uses their bank card for identification and purchase.

Everyone I see is smoking in Spain, Portugal, Greece, lot of places in the U.K, Germany, China (all parts they think belong to them), etc. It’s dying in some places I guess and definitely not smoking inside is better for all of us.

Last time I was in the Netherlands in 2022 I bought a pack on the ferry (duty free baby!) and I’ve been quit for 10 years or so. Most people I passed in the city were smoking and I loved walking in the evening sucking down the my pack.

Certain countries make my iron will into a type of jelly.

Guess we missed this story yesterday:

https://news.ycombinator.com/item?id=37345565

No surprise since, just like beer, they are so damn cheap.

When I lived in Germany they were even cheaper in Czechia, which wasn't too far from where I was.

I know firsthand that smoking is still a huge part of the social culture in all Balkan countries and even Italy to a lesser extent. OTOH, many studies show that it’s better than vaping. I’ve had some conversations with my pulmonologist and a friend of mine who’s a board certified (nearly retired) cardiologist who both confirm this and tell me that they see increasingly younger patients develop serious disease very quickly after starting vaping, including a 16-yo patient who developed emphysema.

What studies show smoking cigarettes better than vaping? Not a user of either fwiw.

Don’t have them on hand (or necessarily put faith in them) but a couple of studies have claimed to show a link between vaping and higher susceptibility to ordinary lung disease (bronchitis) with the suspected cause being that people vape far more than they smoke in terms of air volume, and that the higher temp of some vape products adversely affects the lungs in a way that cigarettes don’t. I’m pretty skeptical that there’s anything as bad for you as smoking unless it’s obesity or a sedentary lifestyle- all 3 are correlated, as is alcohol abuse, depression, and a number of other bad things. I think vaping is probably too new to know anything definitive about it, though.

I'll have a cigarette and a "Feierabend" beer, please. https://thespectator.com/book-and-art/ode-smoking-cigarettes...

What a weirdly incoherent headline. Why not, "Smoking is Dying Out, Except in Germany", which is an actual sentence that conveys the same information in fewer words?

Smoking suppresses appetite meaning that Germany is less obese than America

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