How much does the health benefit of giving up cigarettes outweigh the lost pleasure of smoking?
Last spring, the Food and Drug Administration proposed rules to control e-cigarettes along with tobacco products. Under federal law, the FDA is required to determine whether the rules yield significant benefits as measured against the costs.
The FDA, taking a stab at that, has proposed that the benefit of not smoking should be discounted by 70 percent to account for the loss of pleasure.
That offset is mind-bogglingly high, argues a prominent group of economists. That “is a big threat to really taking effective actions that would reduce tobacco use,” says Frank Chaloupka of the University of Chicago at Illinois, a leader of the group.
The FDA calculation is under review. If it stands, tobacco companies might be more likely to succeed in legal challenges to smoking regulations.
The mere effort to calculate a cost vs. benefit in this case seems based on the idea that smokers continue to smoke purely for pleasure – and not because they’re dealing with an unwanted addiction.
Most smokers start before they’re age 18. Who starts smoking at 30 or 40 or 50? Virtually no one.
To the contrary: Most people try to stop. Gallup reported in 2013 that 85 percent of smokers say they have tried to quit at least once in their lifetime and almost half have tried at least three times. In 2010-11, just over half of smokers attempted to quit, the federal Centers for Disease Control and Prevention reported.
FDA spokeswoman Jennifer Haliski said in a statement that the agency’s cost-benefit calculations are complicated and “there is still a great deal of uncertainty surrounding estimates.” She said the FDA is “continuing to explore the issue.”
Clear away the statistical arguments and what’s left is this: Many people try to quit because they know they'll feel better and will increase their life expectancy, but they fail because of the power of the tobacco addiction.
We won’t hazard a calculation on the pleasure of a puff. But given the known costs – lung cancer, other cancers, heart disease, stroke, emphysema, COPD, reduced fertility, higher infant mortality – we suggest a different name for this whole exercise. Let’s call it the misery avoided index.