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Rock Street, San Francisco
Rock Street, San Francisco

Tobacco is a dirty weed. I like it.

It satisfies no normal need. I like it.

It makes you thin, it makes you lean,

It takes the hair right off your bean

It’s the worst darn stuff I’ve ever seen.

I like it.

~Graham Lee Hemminger, Tobacco

There’s a lot of people who, a cigarette is about the only vacation they have. ~Trey Parker, mini-commentary on DVDSouth Park episode “Butt Out”

Smoking is bad for you, but people like it. This ambivalence represents the fundamental conflict at the foundations of health care in America. How can we as a society address a legal, personal behavior that results in bad medical outcomes? What is the moral and financial responsibility of the person, his community, and the country at large for dangerous behavior? This issue has not been addressed properly in our health care debate, and I hope to stimulate such a discussion now.

I have never smoked, and find the only thing that bothers me more than cigarette smoke is cigar smoke. I spent 30 years of my life diagnosing, biopsying, and treating patients with lung cancer, frequently in their terminal stages. I have watched people with emphysema take off their oxygen masks to smoke. Needless to say, I bring a bias here.

However, I cannot call for the banning of tobacco. I believe one main reason for having government is to allow the “pursuit of happiness” for its citizens. If people want to smoke, and they don’t bother others, we should let them. Banning activities that may result in bad outcomes is a slippery slope, and arguments could be made for banning driving, eating, going out in the sun, and having children. As Trey Parker(one of my favorite social commentators) says, some people have so little joy in their life, why should we take this away?

Tobacco has a unique history in America, with many complicating factors. Tobacco farmers, taxes, and exports are integral to the economy of many states. Tobacco companies have been brazenly deceitful in denying tobaccos health risks, and have effectively influenced policy using lawyers, political donations, and advertising. Tobacco is highly addictive, and genetically modified to be more so. Secondhand smoke can harm non-smoking family members. The list goes on, which I can only touch on here.

Any policy decision must also consider that fewer people in the USA are smoking, (I think the reduction is more related to increasing prices due to taxes than the extensive education effort). The risks are primarily to the person actually smoking and usually don’t manifest. Only one smoker in twenty gets cancer (although the risk goes up with intensity) and Emphysema develops only in about one in ten.

The personal choice is between immediate pleasure and a relatively low probability of disease far off in the future.

Whatever your decision, you must always consider the risks. Start smoking or even stop smoking, you have to enjoy it and you have to do it wholeheartedly. USB lighter gives you comfort in smoking, besides being easy to carry and elegant, this lighter does not need any ingredients, because it is an efficient way of charging by means of a USB charge. if you make a decision to smoke, then be an elegant smoker.

How do we as a country balance the issues of personal behavior and health? Who is responsible for paying for the downside of a personal choice? I have already discussed obesity. I need to get to alcohol, violence and drugs before offering some guidelines. More to come.

Post Author: Saul Alexender