Warning: arguing about smoking can damage your health

by Stephen Tall on June 22, 2006

The Financial Times’s Martin Wolf today turns his economist’s mind to analysing the risks of passive smoking, and challenges the authoritarian thinking which underpinned the recent legislation banning smoking in ‘public’ places:

As a life-long non-smoker, I wonder what is driving these assaults. Is it an attempt to improve public health, as campaigners suggest? Or do smokers serve a need every society seems to have – for a group of pariahs that all right-thinking people can condemn? I strongly suspect the latter.

John Stuart Mill himself said that: “As soon as any part of a person’s conduct affects prejudicially the interests of others, society has jurisdiction over it.” The discovery of passive smoking has, for this reason, given the anti-tobacco lobby its success. It has overwhelmed the protests of libertarians. Riding a tide of moral indignation, the government has enacted a draconian law banning smoking even in private clubs.

Now it plans to extend that ban outdoors. So how many lives might this extension “save” (or, more precisely, prolong)? Indeed, how many lives might the ban itself save?

Now here comes the science:

According to a survey [Smoking in Public Places] published in 2003 by the Parliamentary Office of Science and Technology, a mere seven out of 37 studies showed a statistically significant impact of passive smoking on lung cancer. But pooling the results of all the studies indicated that passive smoking increases the risk of death from lung cancer by 25 per cent. This sounds dramatic. But these studies probably contain biased or inaccurate samples: some smokers may, for example, be classified as non-smokers. Moreover, the risk for non-smokers of death from lung cancer is itself only 10 per 100,000. So the increase generated by passive smoking comes to just 2.5 per 100,000.

If every non-smoker were exposed to sufficient quantities of second-hand smoke this would amount to a maximum of 1,000 deaths a year in England, since it contains some 40m non-smokers (both children and adults). Even 1,000 a year would be less than 0.2 per cent of all deaths in the country. In practice, however, the exposure – and so the number of extra deaths from lung cancer caused by passive smoking – must be very much smaller than this. Many people already live in an overwhelmingly tobacco-free environment. Indeed, if that were not the case, studies comparing those having low exposure to tobacco smoke with those having high exposure would be impossible.

All of which might sound like the kind of thing you’d expect an economist to write – it’s perhaps easier to dismiss 1,000 deaths if your trade is academic journalism, rather than competitive politics.

But the fundamental point Mr Wolf goes on to make is resolutely sound: that if those who argue for a ban on smoking in public had the courage of their convictions they would argue for a ban on smoking in the home, the place where children (who are most vulnerable to prolonged exposure) are most likely to be affected. This is the only measure that would have any real impact on the number of deaths from passive smoking.

If the UK government were engaged in a serious health endeavour, as opposed to gesture politics, it would outlaw smoking in the home. This would be perfectly feasible, or at least as feasible as the much discussed possibility of banning smacking. Children could be encouraged to “shop” their parents. Random visits could be arranged. Surely a government that has given us the antisocial behaviour order would find it neither difficult nor, still less, inappropriate to police the behaviour of adults in their homes.

In reality, of course, no political party would ever attempt anything so draconian. Why? Because it would be too unpopular, and because prohibition has never worked anywhere, ever. So, instead, politicians have chosen to sublimate their health concerns by voting into force a law which deliberately fails to tackle the killer issue.

As I said here last year:

I believe that every time governments impose a law designed to compel individuals to improve their health – whether they like it or not – we make the individual less responsible for their own actions. But a functioning liberal society depends on individuals taking full responsibility for their lives.

A ban on smoking in public places will have a negligible effect on the number of deaths from smoking. So we should stop kidding ourselves that this is a serious health proposal. It’s not. It’s simply a half-hearted gesture. A Silk Cut Ultra argument dressed up as a Capston Full Strength measure.