Smoking kills. But whose life is it anyway?

Columnist

Sunday 19 August 2012

SINCE when did it become the job of the state to save us from ourselves?

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Ian Bell

And if we must be saved, or are even worth saving, why do governments approach the thankless task in ways that are illogical, self-contradictory, or just a little bit stupid?

There is no simple answer to the first question. Historically, you can probably take your pick from religious influences, Enlightenment notions, the rise of socialism, prudery, and the dawning realisation that nothing beats decent health care if you want a population fit for wars and work.

That's fine, as far as it goes. You can put up with lectures from pious politicians if your child is being liberated from slums and disease. You can tolerate being coerced by a government worried about productivity if the quid pro quo is a few extra years of life. But what is going on, in a society that calls itself free, when a democratic government is curtailing your freedom and doing so "for your own good"?Let me be clear. This isn't one of those libertarian arguments that ends up with a demand for the right to own a private grenade launcher. Absolute freedom is an impossibility in any version of society. But our society proclaims the liberty of the individual in one breath and bullies that individual mercilessly in the next. Is he free or not?Whose business is it if you eat too many chips, peacefully drink more than you should, smoke, fail to enjoy fruit and veg, or regard exercise as something best left to people desperate for tin medals? All of these types of behaviour might shorten your life, but it is, surely, your life to waste. There can't be an Australian adult who smokes who has not heard the news about tobacco and death. So why is that person henceforth to be obliged to contemplate revolting pictures of smoking victims on his label-free pack of fags? The failure of the tobacco industry's challenge of the country's ban on company logos on cigarette packets means graphic pictures, including cancer-riddled mouths, will now adorn packets. His government might despise the tobacco companies – a reasonable position – and deplore the effects of the habit. But is humanity therefore to be purged of all the vices it mistakes for pleasures? Pressed on a philosophical point, politicians tend to offer an economic answer. Smoking costs society a fortune, they say. This happens to be perfectly true. But smokers in denial over their stupidity usually have an answer ready. Smoking, they reply, also earns vast revenues for governments, much of it spent on health services and campaigns against the habit.Action on Smoking and Health (Ash) has campaigned relentlessly against tobacco for years. Its own statistics, published in a fact sheet last August, therefore make for fascinating reading. According to this research, smoking costs the NHS £2.7 billion a year. If you add absenteeism from work, productivity lost through cigarette breaks, the cost of fires, the bill for cleaning up fag ends, output forfeited through early deaths, and the estimated impact of passive smoking, you can run this number up to £13.74 billion. Such was the estimate from the Policy Exchange think tank, where the wonks apparently forgot that the one in four adults still smoking also contribute to general taxation.But what else do they pay? Ash concedes that in 2009-10 the Treasury took in £10.5 billion (VAT included) in tobacco revenues. Were I to think like a think tank and estimate, say, the increased productivity of workers refreshed by doses of nicotine, even £13.74 billion wouldn't sound improbable. The serious point is that smoking costs "society" nothing. Why, then, the determination to eradicate both the addiction and personal liberty?You could be truly cynical about it. Imagine if all the smoking Scots (24.2% in 2010, with an estimated 13,473 deaths annually among them) were to quit tomorrow. The Government would certainly be keen to replace all that lost revenue, perhaps with a swingeing wheatgerm tax. But you can also bet that actuarial programs would be running on Treasury computers within hours. What would be the cost to society, after all, of all those reformed smokers living to ripe old ages? It would be greater by far than £13.74 billion. Extended lifespans, with all they imply for the NHS, are already worrying planners. A lot of people are living a lot longer than before, and consuming more resources with each passing year. So some genius wants to keep smokers alive?There are better reasons to oppose the habit. One is the money that smokers simply burn money that could, self-evidently, be put to better uses. Another is the misery that early death imposes on a smoker's family. A third is the fact of addiction. I probably despise my habit most because it puts me in thrall to the most despicable multi-nationals yet devised. But if I choose to sit in a field – or in my own home – burning my money and causing annoyance to no-one, whose business is that?The Australians run the risk of glamorising behaviour that should never pass for pretty. I foresee teenagers attracted to the new, ugly packets simply because they advertise a taboo. I foresee a few otherwise amiable adult smokers deciding to persist just to make a point. But I know this much for certain: horrific photographs don't cure addictions. Where smoking is concerned, I've seen them all.Let's say we agree, nevertheless, that tobacco should be curbed, if only to defeat parasitic multi-nationals and save me money. What should done? This much I know: price works. With each preposterous increase in duty, a few more people get a grip and quit. If that's too slow, or if it fails to satisfy the urge to rid us all of vice, only one answer remains.The constituent elements of a cigarette amount to a fantastically dangerous drug encased in a brilliantly efficient delivery system. As anti-smoking campaigners often observe, no-one would be allowed to introduce such a product today. So why not just ban it? Why tolerate the slaughter?The answer, perhaps, is that our saviours are hopelessly confused. Heroin and morphine were implicated in 254 deaths in Scotland in 2010. In that same year, 208 people were killed on our roads. Two years previously, 198 Scots died with obesity mentioned as an "underlying cause or contributory factor" (the true number was calculated at 3,394). Last year, 1,247 people met "alcohol-related" ends and an estimated 13,500 deaths were blamed on tobacco. What connects these numbers?Heroin is utterly illegal, but any tested teenager can get behind the wheel of a car. One form of booze is our national drink, yet alcohol is our perfectly lawful national disgrace. No-one can stop a young person from taking up the filthy habit of smoking, and no-one dreams of preventing the food industry whipping up addictive tasty treats packed with sugar, fat and salt. Some habits are criminalised, some are demonised, and some merit only stern lectures: the attitudes involved are incoherent. All the habits kill, they all have an economic cost, and all attempts to bring them under control threaten liberty, one way or another. Still, the medical profession is of the belief that obesity will soon supplant fags as our number one killer. Which photographs of open-heart surgery would look best on the pizza packaging?

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Smoking kills. But whose life is it anyway?

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