Smoking costs and health impacts

[Bikeman78]

Moderator Note: Posts #1 - #10 originally in this thread:

Is there a growing sense of apathy over the virus restrictions

Despite statistics showing most people seem to support the restrictions I have observed in my area most do seem to be ignoring them. For example in Scotland we aren’t supposed to be visiting other peoples houses however you see plenty of it going on particularly among families and people are...

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<mumsnet>that's because you can't catch heart disease or cancer and kill your grandma, can you hun?!</mumsnet>


MARK

Something I find astonishing is that an estimated 78,000 people die in the UK each year from smoking releated health problems. I'd imagine that most of those people will need at least one hospital visit in their last year, along with many thousands more that don't actually die. If the government is serious about "protecting the NHS," why hasn't smoking been banned outright?

 

[adc82140]

Something I find astonishing is that an estimated 78,000 people die in the UK each year from smoking releated health problems. I'd imagine that most of those people will need at least one hospital visit in their last year, along with many thousands more that don't actually die. If the government is serious about "protecting the NHS," why hasn't smoking been banned outright?

Two words. Tax revenue.

 

[island]

Two words. Tax revenue.

That and status quo bias. If tobacco was invented/discovered/whatever today it would be banned.

 

[Bikeman78]

Two words. Tax revenue.

Well yes that did occur to me but it's still bonkers. I don't understand why anyone still smokes. The health risks are well known, it costs a fortune and it stinks!

 

[birchesgreen]

Well yes that did occur to me but it's still bonkers. I don't understand why anyone still smokes. The health risks are well known, it costs a fortune and it stinks!

It is highly addictive. Though the first hurdle is wanting to give it up.

I've never smoked myself though know a few who did and gave it up (and a few who haven't been able to...)

 

[duncanp]

Something I find astonishing is that an estimated 78,000 people die in the UK each year from smoking releated health problems. I'd imagine that most of those people will need at least one hospital visit in their last year, along with many thousands more that don't actually die. If the government is serious about "protecting the NHS," why hasn't smoking been banned outright?

And also the 78,000 people who die each year (usually prematurely) from smoking related illnesses will not need to trouble the NHS and social care system, nor will they need to claim their state pension and any other benefits for so long.

When you buy an annuity, you get a higher amount per annum if you are a smoker, because the actuary reckons that you won't live as long as someone who doesn't smoke. (Although it is a matter of supreme irony that the French woman who holds the world record for longevity (122 years 164 days) was a smoker until she was 117)

 

[yorksrob]

And also the 78,000 people who die each year (usually prematurely) from smoking related illnesses will not need to trouble the NHS and social care system, nor will they need to claim their state pension and any other benefits for so long.

When you buy an annuity, you get a higher amount per annum if you are a smoker, because the actuary reckons that you won't live as long as someone who doesn't smoke. (Although it is a matter of supreme irony that the French woman who holds the world record for longevity (122 years 164 days) was a smoker until she was 117)

So she gave up then

 

[duncanp]

So she gave up then

Yes.

The woman's name was Jeanne Calment, and she lived in Southern France. She gave up smoking at the age of 117 according to Wikipedia.

 

[TheGrandWazoo]

Something I find astonishing is that an estimated 78,000 people die in the UK each year from smoking releated health problems. I'd imagine that most of those people will need at least one hospital visit in their last year, along with many thousands more that don't actually die. If the government is serious about "protecting the NHS," why hasn't smoking been banned outright?

Because smoking is something that takes place over 30-40 years (if not longer) before the health impacts are experienced. Even then, whilst you do have chronic effects (e.g. emphysema, COAD, COPD, etc), many die of acute illnesses. The tax revenues over someone's lifetime is massively overshadowed by the impact on the NHS.

The thing is that since smoking in pubs and workplaces was outlawed (to remove passive smoking), it is something for the individual to worry about. Covid isn't so discerning.

And, of course, for every "my nan smoked 40 a day until she was 87", many others die prematurely.

 

[HSTEd]

The tax revenues over someone's lifetime is massively overshadowed by the impact on the NHS.

I doubt it.
Most reasonable estimates put the tobacco duty covering the actual cost to the NHS two or three times over.

 

[TheGrandWazoo]

I doubt it.
Most reasonable estimates put the tobacco duty covering the actual cost to the NHS two or three times over.

Apologies - read that back and understand what you mean. I meant the revenue per smoker is much greater than the cost impact on the NHS.

Duty revenue is about £10bn and ASH (who are most likely to be on the higher side of things) estimate the cost to the NHS as £2.5bn.

 

[GRALISTAIR]

I quit in 1983. One of the best things I ever did. My youngest daughter unfortunately smokes like a chimney still.

I think her cost to the NHS will be high. I hope I am wrong.

 

[HBP]

After 33 years, I quit 79 days ago. Can’t say I have felt any health benefits but have saved £888.75 so far. When I get enough for a 1st Class 14 day All Line Rover, I’m off (Covid permitting)

 

[GRALISTAIR]

And that helps. Have a goal in mind and try and put the money you would have spent aside. When I quit in May 1983 I bought 10 pounds of Premium Bonds every month as a reward and that helped motivate me to keep going. A 14 Day 1st Class All Line Rover would certainly motivate me!

 

[kermit]

Moderator Note: Posts #1 - #10 originally in this thread:

Is there a growing sense of apathy over the virus restrictions

Despite statistics showing most people seem to support the restrictions I have observed in my area most do seem to be ignoring them. For example in Scotland we aren’t supposed to be visiting other peoples houses however you see plenty of it going on particularly among families and people are...

www.railforums.co.uk

Something I find astonishing is that an estimated 78,000 people die in the UK each year from smoking releated health problems. I'd imagine that most of those people will need at least one hospital visit in their last year, along with many thousands more that don't actually die. If the government is serious about "protecting the NHS," why hasn't smoking been banned outright?

Is there not a logic problem here? First a declaration - I'm a lifelong non smoker, and detest the habit, I find the smell awful. But arguments about the "cost of smoking" worry me. Here's the problem; we are all mortal, and especially as medical science advances, we are all likely to be unwell in some ways, probably for some time, before we eventually die. We relatively rarely go from well to dead quickly. In terms of cost to society, it doesn't matter whether that is a smoking related lung or heart or circulatory disease, or non-smoking related chronic kidney or liver disease, or dementia, or any number of unrelated cancers. We may live longer without tobacco, but it's just kicking the can along the road in terms of medical cost.

There is a cost to society of smoking - use of otherwise fertile agricultural land, pointless activity in transport and manufacturing, vomit inducing smell, butts, ash, fire risk etc, but the cost of medical treatment argument, which is so often given prominence, seems to me to be dodgy.

 

[Bikeman78]

Is there not a logic problem here? First a declaration - I'm a lifelong non smoker, and detest the habit, I find the smell awful. But arguments about the "cost of smoking" worry me. Here's the problem; we are all mortal, and especially as medical science advances, we are all likely to be unwell in some ways, probably for some time, before we eventually die. We relatively rarely go from well to dead quickly. In terms of cost to society, it doesn't matter whether that is a smoking related lung or heart or circulatory disease, or non-smoking related chronic kidney or liver disease, or dementia, or any number of unrelated cancers. We may live longer without tobacco, but it's just kicking the can along the road in terms of medical cost.

There is a cost to society of smoking - use of otherwise fertile agricultural land, pointless activity in transport and manufacturing, vomit inducing smell, butts, ash, fire risk etc, but the cost of medical treatment argument, which is so often given prominence, seems to me to be dodgy.

I wasn't protesting about the cost but at the recent emphasis on "protecting the NHS" and the fact that other problems exist besides Covid. But yes you have a point about kicking the can along the road.

 

[najaB]

Didn't we just do this thread?

Has taxation for unhealthy items, such as cigarettes, gone too far in the UK?

I am currently in shock having been relieved of £13 in Tesco for 20 Benson & Hedges Gold o_O My latest "fag run" to Luxembourg last weekend was cancelled by The Foreign and Commonwealth Office's untimely intervention. Had I been able to go I would have been sourcing stock at around £5 a...

www.railforums.co.uk

 

[Condor7]

When you buy an annuity, you get a higher amount per annum if you are a smoker, because the actuary reckons that you won't live as long as someone who doesn't smoke. (Although it is a matter of supreme irony that the French woman who holds the world record for longevity (122 years 164 days) was a smoker until she was 117)

A pilot during the 2nd world war got hit by enemy fire and his plane caught fire burning his parachute, the plane was hurling towards the ground and he was left with the impossible choice of staying with the plane or jumping out without q parachute. He chose the latter, but it had been snowing heavily and he hit a wooded area where the trees where covered in snow which broke his fall, he then landed in deep snow on the ground, and although injured survived.

I appreciate you are not supporting smoking, but you do always seem to get some that quote such things to imply that smokers can live long lives. Men can jump out of planes without a parachute and still survive, but neither is recommended

 

[kermit]

Didn't we just do this thread?

Has taxation for unhealthy items, such as cigarettes, gone too far in the UK?

I am currently in shock having been relieved of £13 in Tesco for 20 Benson & Hedges Gold o_O My latest "fag run" to Luxembourg last weekend was cancelled by The Foreign and Commonwealth Office's untimely intervention. Had I been able to go I would have been sourcing stock at around £5 a...

www.railforums.co.uk

Sorry, I obviously hadn't been paying attention! Having had a quick scan though, I'm not sure anybody had made my "kicking the can along the road" point (see post #15), so maybe, hopefully, I added to the debate!

 

[Harpers Tate]

Not that I advocate anyone starting (or continuing, even) to smoke - but a broader way of evaluating its "costs" would include this:
We happily consider every person who directly costs the health service in treatment for the known effects of smoking.
For a full picture, we'd have to balance that against any other person who dies "prematurely" from its effects but in so doing, "saves" the health service from costs of treatment of a broad spectrum of other age-related degenerative conditions and/or long-term care.
etc.
Alongside balancing the revenues from smokers against their direct costs.

 

[najaB]

For a full picture, we'd have to balance that against any other person who dies "prematurely" from its effects but in so doing, "saves" the health service from costs of treatment of a broad spectrum of other age-related degenerative conditions and/or long-term care.

The difficulty with that approach is that the treatment of illness caused by smoking (even if terminal) can be quite expensive and there's no reason to assume that the care of otherwise healthy senior citizens will be "expensive" in their later years.

 

[Domh245]

there's no reason to assume that the care of otherwise healthy senior citizens will be "expensive" in their later years.

There's plenty of evidence that suggests otherwise. Even healthy senior citizens will require more healthcare the older they get, with according higher spend

eg1 (figs 9 & 10)
eg2 (first graph on page showing the average health spending/person by age)

 

[najaB]

There's plenty of evidence that suggests otherwise. Even healthy senior citizens will require more healthcare the older they get, with according higher spend

I'm not denying that older people require healthcare, just that not all senior citizens will be particularly "expensive" as compared to the treatment of smoking-induced illness. I'm sure we all have known older people who lived independent lives up until the day they died and who didn't require much if anything in the way of costly healthcare intervention.

Consider also that seniors are likely to have contributed to the pot for longer, so their treatment could well be less of a drain on the system than a younger person being treated for illness that occurs while they are still paying in.

 

[Domh245]

I'm not denying that older people require healthcare, just that not all senior citizens will be particularly "expensive" as compared to the treatment of smoking-induced illness. I'm sure we all have known older people who lived independent lives up until the day they died and who didn't require much if anything in the way of costly healthcare intervention.

Consider also that seniors are likely to have contributed to the pot for longer, so their treatment could well be less of a drain on the system than a younger person being treated for illness that occurs while they are still paying in.

Considerations like this are based on averages though, not anecdotes about people's great aunts that lived to 113 with little more than a glass of whisky every day*. Yes there's every chance that a randomly selected senior citizen will not cost much at all to support in their later years but for every 'cheaper than average' there's a corresponding 'more expensive than average'

In the context of doing the maths about how much smoking costs/saves the NHS, there's no choice but to work with averages and sadly the average senior 80 year old is costing over £6k a year to the NHS (+ state pension + other benefits), and at that age likely isn't paying into the pot anymore

*etc, other daily rituals such as laughter/crosswords/nothing at all are available

 

[najaB]

In the context of doing the maths about how much smoking costs/saves the NHS, there's no choice but to work with averages and sadly the average senior 80 year old is costing over £6k a year to the NHS (+ state pension + other benefits), and at that age likely isn't paying into the pot anymore

Yes, but that just makes the point that, on average, diseases of old age aren't that "expensive" as compared to dealing with the consequences of smoking (especially when you consider that a not insubstantial proportion of that £6K will be due to smoking in earlier life). Smoking-induced illness costs the NHS in England around £2.5B a year. (Source: Cost of Smoking to NHS England: 2015)

 

[Cheshire Rover]

I used to smoke cigarettes and loved the nicotine buzz and that satisfaction of a cigarette and a beer or the smoke after a meal.
Two things got me to stop. Price and my children being born. When they reached £3 a pack I got twitchy but when my daughter came along it was time to stop.
What helped an awful lot was a smoking cessation course at work via Occ Health. They gave you free patches and tested you every week with a breath test to see if you had been cheating.
This is the sort of thing the NHS should be doing for everyone. It was the testing that drove me along, knowing I had to answer to a rather formidable nurse every week if I slipped.

 

[Harpers Tate]

@najaB Unless and until we both are presented with what are probably impossible to realistically estimated figures for the total lifetime cost of treating a community, aged at least (say) 25 for everything they suffer, including where applicable conditions considered to be a result of smoking
and compare, at a population level those costs in smokers to non-smokers
then everything else is just conjecture.

My point was solely that it cannot be seen as a cost in isolation. There are broader factors to consider and these include both revenue raised and - where applicable - costs saved. One can only form a judgement as to which is "better" (on cost grounds) when in possession of all these numbers.

 

[najaB]

@najaB Unless and until we both are presented with what are probably impossible to realistically estimated figures for the total lifetime cost of treating a community, aged at least (say) 25 for everything they suffer, including where applicable conditions considered to be a result of smoking and compare, at a population level those costs in smokers to non-smokers then everything else is just conjecture.

I agree, and that was largely the point I was making - the argument that smoking "saves" the NHS money by killing people early is likely impossible to validate.

 

[DynamicSpirit]

Something I find astonishing is that an estimated 78,000 people die in the UK each year from smoking releated health problems. I'd imagine that most of those people will need at least one hospital visit in their last year, along with many thousands more that don't actually die. If the government is serious about "protecting the NHS," why hasn't smoking been banned outright?

Two words. Tax revenue.

That and status quo bias. If tobacco was invented/discovered/whatever today it would be banned.

I would argue that the status quo bias is most significant. As an illustration, everything in these above posts, except for tax revenue, arguably applies equally to refined sugar: It's not required in our diets (humanity managed without it for tens of thousands of years, up until a couple of hundred years ago), there's overwhelming evidence that in the quantities that many of us consume it, it's hugely harmful to our health, shortens lives, and contributes to a massive burden on the NHS. Yet, not only has it never been banned outright, but practically everyone eats it routinely. And suggestions that it should be taxed to discourage consumption are proving hugely controversial. That all suggests to me that status quo bias, rather than tax revenue, is the explanation.

(Also, over the last 20 years, the Government has taken quite a bit of action - often controversial and unpopular at the time - to restrict smoking, even at the cost of tax revenue. Things like banning smoking in many public places. The Government would probably not have done that if it was mainly motivated by tax revenue).

 

[yorkie]

why hasn't smoking been banned outright?

As we've seen with other events, it would be if some incredibly vocal people started getting really hysterical about it.

But the reality is the public accepts deaths due to this reason, and the media doesn't whip up a storm about it, and so there is no real appetite to do much about it.