Offshoring Lung Cancer?

The Wall Street Journal reports on a new World Health Organization study about cigarette smoking around the world. The Journal‘s piece includes data from Euromonitor International about the number of cigarettes sold worldwide by various manufacturers.

Here are the numbers of cigarettes sold (in billions) in 2006 by Philip Morris:

U.S./Canada: 184
Asia Pacific: 197
Eastern Europe: 229
Western Europe: 242

The decline in U.S. smoking rates is pretty remarkable, both in terms of total percentages (42.4 percent of Americans smoked in 1965, versus 20.8 percent in 2006) and the number of cigarettes smoked by people who do smoke (from 19.8 per day in 1974 to 13.9 in 2006). Do you think prices, especially taxes, have had anything to do with that?

With continuing strong demand for cigarettes around the world, especially in poor countries, the W.H.O., in conjunction with Michael Bloomberg‘s personal foundation, is proposing a huge global anti-smoking project. The W.H.O.’s report on the subject calls for “raising cigarette taxes, banning smoking in public places, enforcing laws against giving or advertising tobacco to children, monitoring tobacco use, warning people about the dangers and offering free or inexpensive help to smokers trying to quit.”

Bloomberg’s foundation contributed $2 million to the report. While a great deal has been made of Mitt Romney and Hillary Clinton spending their own money on political campaigns, I have heard little talk (and none of it negative) about Bloomberg’s use of personal money for such causes. It is hard to argue against anti-smoking measures, of course — unless you are Philip Morris.


A book that greatly aided me in quitting smoking is The Easy Way To Stop Smoking by Allen Carr.

One of the amazing things that Carr points out is how anti-tobacco advertising in fact encourages people to smoke.

The average smoker lights up when they get nervous or ashamed to help calm themselves. And what do you think is going to make a smoker nervous? Watching TV ads about how they're going to die a premature, painful, cancerous death.

That's why I don't have much faith in anti-smoking measures. Smokers know the risks; they just need the motivation to quit.


"Aren't there bigger problems in the world today than a little bit of lung cancer?"

Sure, but they are few and far between. As a smoker, I'm sure you are aware that lung cancer kills vastly more people each year than any other type of cancer-more than breast and colon cancers (#2 and 3) in women and more than prostate, colon, and pancreas cancers (#2, 3, and 4) in men. It is the source of almost a third of cancer deaths. Okay, big deal.

*Over a quarter of lung cancer cases in people who don't smoke are estimated to be caused by second-hand smoke.* Almost 3000 people in the US alone every year. Who don't smoke. Just minding their business.

THIS is why this is so important. THIS is why we need a significant paradigm shift in public health practices. To be so blase about it and to have such blatant disregard about a clear problem in this country-all so you can smoke a cig every once in a while-is absolutely ridiculous. Stick with the gum, dude.



I forgot my favorite anecdote...

Where I used to work, the smokers would all go outside and smoke over by the loading dock.. someone got all self righteous and put up a no smoking sign... meanwhile, huge diesel trucks sit there idling, spewing ACTUAL poison into the air...

Try sitting in a closed garage with 100 chain smokers ... then do it with a single running vehicle... see which scenario kills you quicker... then talk to me about the dangers of smoking vs. everything else in the world there is to be irrationally scared of.


Smokers die sooner and are less of a burden on society! Thanks for doing your part, guys.


"Almost 3000 people in the US alone every year. Who don't smoke. Just minding their business."

20% of americans smoke... and less than .001% of people allegedly die from "second hand smoke"... sounds like an epidemic to me... even if we except that second hand smoke is the primary contributing factor in those deaths... lets get a little perspective:

* 5% to 20% of the population gets the flu;
* more than 200,000 people are hospitalized from flu complications, and;
* about 36,000 people die from flu.

so... 13 times the number of people die from the flu as die from smoking... where are all the "no sick people" signs? why isn't there a world wide campaign "educating" people on the dangers of walking around in public with the flu? you see where I am going here?


I got those flu numbers from here:


sorry for all the spam... I'll slow down..

I was incorrect in my post about the flu... I said:

"13 times the number of people die from the flu as die from smoking"

what I meant was:

"13 times the number of people die from the flu as die from second hand smoke"

many more people die from actual smoking... obviously... but smoking is a choice... getting the flu is not... anyway.. I think most people understand what I was getting at.


"I'm shocked at how easily you brush off 3,000 deaths per year. Are there bigger issues? Certainly. But for all your noble talk about these "more important" issues, you seem to have a pretty easy time ignoring 3,000 deaths of completely and totally innocent people. So I'm confident you're not too torn up about the "bigger issues" either. "

Mike, I'm shocked at how much people want to fret over 3,000 innocent deaths when many times that die in wars that we pay for and are done in our names... I'm using a little extreme rhetoric to demonstrate how silly this concern is when held up against the much more pressing issues that face us... It feels like people want to fix a leaky faucet when the dam is about to burst... it makes no sense to me to be discussing what amounts to regulation of personal behavior and a statistical non-problem when people are literally being massacred... if 3,000 is as important as 30,000 here 600,000 there... then we have a prioritization problem that truly needs to be addressed!



Frankly, I'm just glad we have an export that other countries want.

I'm more worried about the trade deficit and the economy than smoking deaths.

Nick Olsen

Hmm, Here's a thought.

Smoking as population control.

Think abt how much more severely taxed our limited global resouces (food, energy, water, land etc.) would be if all the people dying of smoking lived?


danb and other smokers: I don't care that you like to smoke, nor do I wish that you stop. It's your right, and not my problem.

However, at the first sign of any of your smoke coming toward me or my family, it becomes my problem. Your second hand smoke is toxic, and I'm entitled to breathe clean air, aren't I? And what happens in 30 years when you check into the hospital with lung cancer? Will my tax dollars be paying for your operation through Medicare or whatever the socialized medical plan of the day is? That doesn't seem fair either.

Bottom line: you can do what you like as long as it doesn't affect my quality of life or my pocketbook.


MO isn't "offshoring" lung cancer, it's exporting it.


We have known the facts about smoking for a long time now...long enough that anyone under, say, 50 can't play dumb about lung cancer. I say if people are willing to spend so much money on something that will likely kill them, they have a right to do so. They ought not have a right to subject others to it though (especially children). Although only a small percentage of people develop lung cancer as a result of second hand smoke, second hand smoke often causes or exasperates asthma in children. I know, asthma isn't going to kill most kids but it still seems wrong to knowingly nurture it's development in children. Children don't have an option to go somewhere else like adults do.

OK, I've said my piece. Go kill yourself smoking if that's what you choose to do but think twice about who is standing around you and whether they have chosen to do so or are an unwilling victim of your decision.


Marty Beach

The problem is,danb,smokers don't just drop dead from smoking (on average 13 years earlier than the rest of us)...they spend time in hospitals, taking up expensive medical treatment & driving up health care costs for everyone. It's estimated that between 7-8% of all healthcare costs are caused by smoking. That sure as heck drives up premiums for the rest of us. Additionally, Center for Disease Control estimates annual lost productivity at over $81 billion. That translates to higher prices for all of us.


Marty Beach: "they spend time in hospitals, taking up expensive medical treatment & driving up health care costs for everyone."

That's a dangerous argument, Marty... What is the cost of eating fatty foods? drinking too much coffee? Not exercising? watching too much TV? going to work with a cold or flu? Who gets to decide what behavior is acceptable? Should the government hand out a manual of how you should spend every minute of every day to provide the maximum health care value for every American?


danb - no one is saying you can't smoke (I don't think). They're just saying they wish you weren't allowed to smoke in places where it harms other people.

I'm shocked at how easily you brush off 3,000 deaths per year. Are there bigger issues? Certainly. But for all your noble talk about these "more important" issues, you seem to have a pretty easy time ignoring 3,000 deaths of completely and totally innocent people. So I'm confident you're not too torn up about the "bigger issues" either.


Haha! danb you are hilarious. Thinking that smoking is your personal choice when you have been duped by tobacco marketing companies (I should know, my dad used to be VP Marketing at US Tobacco). Thinking that smoking will just shave off a few "useless" years at the end of your life when lung disease (not just cancer, there are others) is severely disabling for a long time. Smoking causes hypertension, artherosclerosis, and stroke in addition to lung problems, but you know all that already. I just want to let you know that now as a med student, I have never encountered a patient who maintains that their choice to continue smoking was worth it. Not one.


Marty, where are you getting that 13 year number? The worst I can find is 10 years and most estimates are less than that... and that's for 20 a day smokers... I roll my own (additive free) and smoke less than 10 a day... I don't see any studies that address that scenario... but I'm pretty confident i'll lose less than 10 years... especially considering the next couple decades of advances in medical science... but I guess that's beside the point.


For those of you concerned about the effect of my behavior on the cost of medical care... you might want to have a look at recent research on the topic:

"The study found that although annual health-care costs are highest for obese people earlier in life (until age 56 years), and are highest for smokers at older ages, the ultimate lifetime costs are highest for the healthy (nonsmoking, nonobese) people. Hence the authors argue that medical costs will not be saved by preventing obesity."

"The consequence is that healthy people live to incur greater medical expenditure subsequently on average, more than compensating for the earlier excess expenditure related to obesity or smoking."

"Yet van Baal and colleagues' study suggests that obese people cost less to health services than nonobese people. Smokers cost still less."

See? not only are my choices my own to make... they help you out!



Not that this has anything to do with TFA, but people ARE over sensitive about second hand smoke. People get all holy about it. Unless you're working in a smoke-filled bar or live with a smoker you aren't part of the 3,000. If you're walking at the county fair and pass a smoker, spare us all your indignation.