inform, but do not inflame
June 3, 2016 6:05 AM Subscribe
Let Smokers See the Warning They Need [NYT Op/Ed by Joanna Cohen]
Previously: coughin', Warning: Cigarettes are addictive.
Previously: coughin', Warning: Cigarettes are addictive.
the presiding judge agreed that the images were “calculated to provoke” rather than disseminate “purely factual and uncontroversial information.”
This would be a pretty good standard if all advertising were legally held to it.
posted by Faint of Butt at 6:31 AM on June 3, 2016 [13 favorites]
This would be a pretty good standard if all advertising were legally held to it.
posted by Faint of Butt at 6:31 AM on June 3, 2016 [13 favorites]
Funny, the Canadian government just moved to pull all branding off of cigarette packages, leaving only the gory warnings that the US won't show.
posted by Popular Ethics at 6:33 AM on June 3, 2016 [4 favorites]
posted by Popular Ethics at 6:33 AM on June 3, 2016 [4 favorites]
The sad thing is the images are purely factual and uncontroversial. If you smoke this shit will eventually happen to you. Your lungs are going to turn black as shit and be unable to do their job. I have three relatives (grandmother, great uncle and great aunt) who are all lifelong smokers and have nasal cannula hooked to oxygen sources. The other relatives are dead from lung and throat cancers.
Fuck smoking. Fuck the tobacco companies. People need to see what that shit does to you.
posted by Talez at 6:49 AM on June 3, 2016 [10 favorites]
Fuck smoking. Fuck the tobacco companies. People need to see what that shit does to you.
posted by Talez at 6:49 AM on June 3, 2016 [10 favorites]
tobacco is increasingly becoming a kind of demonic soma for the poor
posted by thelonius at 7:15 AM on June 3, 2016 [1 favorite]
posted by thelonius at 7:15 AM on June 3, 2016 [1 favorite]
Forget the provocative images, just put a link to vaping.com on there. Smoking is on the way out, assuming governments don't get in the way too much.
posted by sfenders at 7:24 AM on June 3, 2016
posted by sfenders at 7:24 AM on June 3, 2016
Students of disingenuous argument will have tobacco supporters to thank for their next 100 years of work.
posted by sneebler at 7:25 AM on June 3, 2016 [5 favorites]
posted by sneebler at 7:25 AM on June 3, 2016 [5 favorites]
assuming governments don't get in the way too much
A lack of regulation is what's allowed tobacco use to kill so many people over so many decades after we knew it was killing so many people. There is indeed a "you don't have to outrun the bear" effect here where vaping doesn't need to be 100% safe to be desirable, just safer than tobacco, but having seen how hard it was to fight the tobacco companies, I'm okay with being extremely cautious this time around and putting the burden of proof on the makers of the newer products to show that we're not just trading one set of problems for another.
posted by tonycpsu at 7:30 AM on June 3, 2016 [11 favorites]
A lack of regulation is what's allowed tobacco use to kill so many people over so many decades after we knew it was killing so many people. There is indeed a "you don't have to outrun the bear" effect here where vaping doesn't need to be 100% safe to be desirable, just safer than tobacco, but having seen how hard it was to fight the tobacco companies, I'm okay with being extremely cautious this time around and putting the burden of proof on the makers of the newer products to show that we're not just trading one set of problems for another.
posted by tonycpsu at 7:30 AM on June 3, 2016 [11 favorites]
assuming governments don't get in the way too much.
"Hurr durr it's just vapour bro, it can't hurt you!" is far more harmful to vaping as a concept.
posted by Talez at 7:38 AM on June 3, 2016 [2 favorites]
"Hurr durr it's just vapour bro, it can't hurt you!" is far more harmful to vaping as a concept.
posted by Talez at 7:38 AM on June 3, 2016 [2 favorites]
I like the plain package idea. The US will eventually get around to it, way behind the rest of the world, but when we do, we'll celebrate like it was our idea in the first place and we're the first to make it happen... a lot like the other "progressive" moves our country gets dragged into kicking and screaming, once we collectively realize that MOST people in general want it, even though MOST people donating to politicians do NOT want it.
posted by caution live frogs at 7:38 AM on June 3, 2016 [2 favorites]
posted by caution live frogs at 7:38 AM on June 3, 2016 [2 favorites]
vaping doesn't need to be 100% safe to be desirable, just safer than tobacco
Even if it were just as deadly as tobacco, instead of being possibly as deadly as soft drinks, it is at least much easier to quit. Caution is exactly what's needed, as opposed to panic and fear which seem to be the more usual reactions.
posted by sfenders at 7:46 AM on June 3, 2016 [1 favorite]
Even if it were just as deadly as tobacco, instead of being possibly as deadly as soft drinks, it is at least much easier to quit. Caution is exactly what's needed, as opposed to panic and fear which seem to be the more usual reactions.
posted by sfenders at 7:46 AM on June 3, 2016 [1 favorite]
it is at least much easier to quit
To the citemobile, please.
posted by tonycpsu at 7:53 AM on June 3, 2016 [20 favorites]
To the citemobile, please.
posted by tonycpsu at 7:53 AM on June 3, 2016 [20 favorites]
I wonder, in threads like these, how many of the people commenting have ever actually smoked? I smoked about a pack a day, probably a little more, from the ages of fourteen to thirty-one and non-smokers telling me to quit/telling me how to quit/using scare tactics never, ever worked. I'm one of the people who quit (really happily! It's been super great!) using that Allen Carr book and I think a big part of the reason it was effective was because he smoked more than I did for way longer. He actually understood what smoking was like and what quitting was like and why I smoked and how that felt and could address my real fears and motivations! It was a revelation after fifteen years of non-smokers telling me how bad smoking is (yes, I know! I'm not an idiot!).
It seems like a lot of anti-smoking campaigns are still just focused on telling you how smoking is bad for you (pretty much all of us of us know that, even when we start) and that tobacco companies are immoral (I mean, cool, I totally agree) and when I was smoking it always felt like they cared more about making a moral point than about actually getting anyone not to start smoking or helping them quit, partially because it feels like these ad campaigns are created by non-smokers who don't really understand. I think the pictures seem like another example of that -- yes, when I was smoking, pictures like that absolutely haunted me, but they never got me to stop even though I wanted to. They made me feel scared, which made me want a cigarette. They also made me feel like I was addicted which made me feel afraid I was never going to be able to stop which made me feel hopeless. The article references a study showing that these make people between the ages of eighteen and thirty more wary of smoking. What eighteen-year-old starts smoking? And that's the bottom of the range! According to the Illinois Department of Public Health, 90% of smokers start before age eighteen (which actually seems low to me but they are the numbers people) and the average age at which people start smoking is thirteen. Thirteen-year-olds don't believe their lungs are ever going to look like that.
I don't have a problem with trying to regulate tobacco companies and trying to get people to quit smoking, but it always felt to me like the campaigns I saw were more about making people who didn't smoke feel good than about actually addressing how and why people smoke and how to get them to quit or not start at all, and harsh images like that were really not helpful for me. I don't know what the answer is, but I think there's a lot of back-patting about using really graphic images or really depressing ads and how that makes you tough on smoking even though I don't know that there's a lot of evidence that that approach really helps people quit or refrain from starting.
posted by Mrs. Pterodactyl at 7:58 AM on June 3, 2016 [59 favorites]
It seems like a lot of anti-smoking campaigns are still just focused on telling you how smoking is bad for you (pretty much all of us of us know that, even when we start) and that tobacco companies are immoral (I mean, cool, I totally agree) and when I was smoking it always felt like they cared more about making a moral point than about actually getting anyone not to start smoking or helping them quit, partially because it feels like these ad campaigns are created by non-smokers who don't really understand. I think the pictures seem like another example of that -- yes, when I was smoking, pictures like that absolutely haunted me, but they never got me to stop even though I wanted to. They made me feel scared, which made me want a cigarette. They also made me feel like I was addicted which made me feel afraid I was never going to be able to stop which made me feel hopeless. The article references a study showing that these make people between the ages of eighteen and thirty more wary of smoking. What eighteen-year-old starts smoking? And that's the bottom of the range! According to the Illinois Department of Public Health, 90% of smokers start before age eighteen (which actually seems low to me but they are the numbers people) and the average age at which people start smoking is thirteen. Thirteen-year-olds don't believe their lungs are ever going to look like that.
I don't have a problem with trying to regulate tobacco companies and trying to get people to quit smoking, but it always felt to me like the campaigns I saw were more about making people who didn't smoke feel good than about actually addressing how and why people smoke and how to get them to quit or not start at all, and harsh images like that were really not helpful for me. I don't know what the answer is, but I think there's a lot of back-patting about using really graphic images or really depressing ads and how that makes you tough on smoking even though I don't know that there's a lot of evidence that that approach really helps people quit or refrain from starting.
posted by Mrs. Pterodactyl at 7:58 AM on June 3, 2016 [59 favorites]
when I was smoking it always felt like they cared more about making a moral point than about actually getting anyone not to start smoking or helping them quit, partially because it feels like these ad campaigns are created by non-smokers who don't really understand.
These campaigns are mostly aimed at keeping people from taking it up, and they do work in that capacity. Unfortunately, they haven't found an ad campaign yet that can counter an actual physical addiction.
posted by Etrigan at 8:01 AM on June 3, 2016 [10 favorites]
These campaigns are mostly aimed at keeping people from taking it up, and they do work in that capacity. Unfortunately, they haven't found an ad campaign yet that can counter an actual physical addiction.
posted by Etrigan at 8:01 AM on June 3, 2016 [10 favorites]
On the one hand the tobacco industry is awful. On the other hand- what if the dangers of not getting enough sun are just as serious as smoking? How much long term (20-70 year long studies) do we not do for so many pharmaceuticals that let's face it, there is no money in demonizing because the public isn't as into it as the war on drugs?
On the one hand we likely have protected some people my aggressively demonizing cigarettes and the tobacco industry, on the other hand we have likely wound up throwing a lot of people already facing hard lives with little positives under the bus for reaching for things that make them feel better (in ways that we don't like- if pharma wants you to it's good even if there are long term consequences).
Don't get me wrong, I'm not saying the harms aren't there, but I wonder if generations we will look back on some of the aggressiveness with which we attack those who smoke with the same apprehensions of misguided energy many of us are looking at the drug war in general right now.
There's so much more to the story here that I'm not sure the research is teasing out very well, like that "The average effect of smoking on female life expectancy in the nine countries other than the United States was a loss of 1.07 years. Since the effect in the United States was a loss of 2.33 years, smoking cost U.S. women an average of 1.26 years in life expectancy relative to women in the other countries" That's nearly an extra year and a half that we are saying was caused by "smoking"? Without teasing out what's really going on there?
If we really care about cancer and industries that cause it in people we should also expand our scope to address the fact that "fewer than 10% of the more than 80,000 chemicals currently in use in the United States have been evaluated for safety."
It's also not clear to me that people with high exposures to lung toxins or other health hazards may actually be attracted to smoking for beneficial reasons as there appear to be a lack of research exploring whether high rates of smoking in these populations is a correlation vs causative "As pointed out in the President’s Cancer Panel’s 2010 report,16 research on environmental and occupational causes of cancer have been limited by low priority and inadequate funding. This is especially true for lung cancer research. The large percentage of lung cancer deaths caused by smoking often obscures the fact that nonsmoking-related lung cancer is 1 of the top 10 causes of cancer mortality and, in some cases (eg, medically related radiation exposures, radon), the attributable risk of the agent is increasing. The foregoing data also underscore that in the clinical assessment of lung cancer risk, ascertaining past occupational exposures as well clarifying selected environmental risks should hold an equal place to quantifying cumulative cigarette smoking in pack years."
Certain diseases are actually lessened in smokers including " sarcoidosis and hypersensitivity pneumonitis, two diseases that are actually less likely to develop in smokers" -sarcoidosis being something that "Long lines of evidence have suggested that certain workplace settings are associated with sarcoidosis risk" as hypersensitivity pneumonitis.
I enjoyed the last article here about asking a little more of skeptics to spend a little more time seeing nuance, examinine research and challenging their own and larger scientific (or people who think they are scientific) communities. So, just kind of wanted to expand the thinking. Maybe not just "smoking is bad" which I'm not arguing it isn't, but that the people who often get thrown under the bus here are people who may actually experience some measure of benefits that are being ignored, even if they come with unwanted side effects- which is something we tend to accept as innately ok or even great as long as the pharmaceutical industry says the long term damage is ok and worth the benefits.
I know people who can expect very short lifespans anyway working in miserable jobs or under the table industries and facing a lot of trauma and pain and ten years off life in exchange for feeling a little better for fleeting moments can be worth it to some.
posted by xarnop at 8:03 AM on June 3, 2016 [6 favorites]
On the one hand we likely have protected some people my aggressively demonizing cigarettes and the tobacco industry, on the other hand we have likely wound up throwing a lot of people already facing hard lives with little positives under the bus for reaching for things that make them feel better (in ways that we don't like- if pharma wants you to it's good even if there are long term consequences).
Don't get me wrong, I'm not saying the harms aren't there, but I wonder if generations we will look back on some of the aggressiveness with which we attack those who smoke with the same apprehensions of misguided energy many of us are looking at the drug war in general right now.
There's so much more to the story here that I'm not sure the research is teasing out very well, like that "The average effect of smoking on female life expectancy in the nine countries other than the United States was a loss of 1.07 years. Since the effect in the United States was a loss of 2.33 years, smoking cost U.S. women an average of 1.26 years in life expectancy relative to women in the other countries" That's nearly an extra year and a half that we are saying was caused by "smoking"? Without teasing out what's really going on there?
If we really care about cancer and industries that cause it in people we should also expand our scope to address the fact that "fewer than 10% of the more than 80,000 chemicals currently in use in the United States have been evaluated for safety."
It's also not clear to me that people with high exposures to lung toxins or other health hazards may actually be attracted to smoking for beneficial reasons as there appear to be a lack of research exploring whether high rates of smoking in these populations is a correlation vs causative "As pointed out in the President’s Cancer Panel’s 2010 report,16 research on environmental and occupational causes of cancer have been limited by low priority and inadequate funding. This is especially true for lung cancer research. The large percentage of lung cancer deaths caused by smoking often obscures the fact that nonsmoking-related lung cancer is 1 of the top 10 causes of cancer mortality and, in some cases (eg, medically related radiation exposures, radon), the attributable risk of the agent is increasing. The foregoing data also underscore that in the clinical assessment of lung cancer risk, ascertaining past occupational exposures as well clarifying selected environmental risks should hold an equal place to quantifying cumulative cigarette smoking in pack years."
Certain diseases are actually lessened in smokers including " sarcoidosis and hypersensitivity pneumonitis, two diseases that are actually less likely to develop in smokers" -sarcoidosis being something that "Long lines of evidence have suggested that certain workplace settings are associated with sarcoidosis risk" as hypersensitivity pneumonitis.
I enjoyed the last article here about asking a little more of skeptics to spend a little more time seeing nuance, examinine research and challenging their own and larger scientific (or people who think they are scientific) communities. So, just kind of wanted to expand the thinking. Maybe not just "smoking is bad" which I'm not arguing it isn't, but that the people who often get thrown under the bus here are people who may actually experience some measure of benefits that are being ignored, even if they come with unwanted side effects- which is something we tend to accept as innately ok or even great as long as the pharmaceutical industry says the long term damage is ok and worth the benefits.
I know people who can expect very short lifespans anyway working in miserable jobs or under the table industries and facing a lot of trauma and pain and ten years off life in exchange for feeling a little better for fleeting moments can be worth it to some.
posted by xarnop at 8:03 AM on June 3, 2016 [6 favorites]
even though I don't know that there's a lot of evidence that that approach really helps people quit or refrain from starting
It may or may not have helped you, but many studies have concluded that it does help:
World Health Organization: The impact of pictures on the effectiveness of tobacco warnings
It may or may not have helped you, but many studies have concluded that it does help:
World Health Organization: The impact of pictures on the effectiveness of tobacco warnings
Evidence for the greater potential impact of pictorial warnings have come from focus groups and interview studies, experimental exposure studies1 and population-based surveys among Canadian smokers,3–5 Australian youth,1 Dutch smokers1 and from several countries of the 20-country ITC Project: prospective cohort surveys of adult smokers in Australia, Canada and the United States of America (USA),3,5–8 smokers in New Zealand,9 smokers in Canada and Mexico,10 smokers11 and youth12 in Malaysia and Thailand. In addition to the ITC surveys, there are other research studies that support the use of pictorial warnings, notably in the European Union. Taken as a whole, the research on pictorial warnings show that they are: (i) more likely to be noticed than text-only warning labels;3,4,6–8,10–12 (ii) more effective for educating smokers about the health risks of smoking and for increasing smokers’ thoughts about the health risks;7,10 and (iii) associated with increased motivation to quit smoking.3,6–9posted by tonycpsu at 8:05 AM on June 3, 2016 [10 favorites]
A recent analysis of data from the ITC Four Country Survey compared the impact of the introduction of pictorial warnings in Australia in 2005 to that of the introduction of larger text-only warnings in the United Kingdom in 2003. Cognitive and behavioural indicators of label impact that are predictive of quit intentions and quit attempts (e.g. forgoing cigarettes because of the labels; thinking about the health risks of smoking) increased to a greater extent among smokers after the Australian pictorial warnings were introduced than they did in the United Kingdom after enhanced text-only warnings were introduced.6 Pictorial warnings are also cited by former smokers as an important factor in their attempt to quit and have been associated with increases in the use of effective cessation services, such as toll-free telephone “helplines”.9 Although all warnings are subject to wear-out over time, pictorial warnings have also been shown to sustain their effects longer than text-only warning labels.7,8
Now that smoking is strongly correlated with class it will be much easier to regulate it. But I take xarnop's point seriously: should we? Certainly images are better than ruinous cigarette taxes, which can also be effective deterrents.
posted by anotherpanacea at 8:12 AM on June 3, 2016 [1 favorite]
posted by anotherpanacea at 8:12 AM on June 3, 2016 [1 favorite]
These campaigns are mostly aimed at keeping people from taking it up, and they do work in that capacity.
That's great! I'm really happy to hear that (genuinely -- thanks also to tonycpsu for the citation). If gross horrible pictures actually help idiot teenagers (such as young myself) from making profoundly stupid choices then cool, whatever, go for it. If anyone has further information on what is actually effective in terms of smoking prevention ad campaigns, I'd love to hear more (because, again, convincing teenagers of anything, especially their own vulnerability, is REALLY HARD).
posted by Mrs. Pterodactyl at 8:13 AM on June 3, 2016 [3 favorites]
That's great! I'm really happy to hear that (genuinely -- thanks also to tonycpsu for the citation). If gross horrible pictures actually help idiot teenagers (such as young myself) from making profoundly stupid choices then cool, whatever, go for it. If anyone has further information on what is actually effective in terms of smoking prevention ad campaigns, I'd love to hear more (because, again, convincing teenagers of anything, especially their own vulnerability, is REALLY HARD).
posted by Mrs. Pterodactyl at 8:13 AM on June 3, 2016 [3 favorites]
To the citemobile, please.
There may be a study out there somewhere to be cited, but there's also a considerable amount of crazy partisan pseudo-research on both sides, or at least there seemed to be when I was looking about a year ago.
So instead I will cite common sense and personal experience for the claim that vaping is easier to quit than smoking. The common sense part being: a) Tobacco smoke contains miscellaneous hundreds of chemical compounds of which several besides nicotine are known to be psychoactive and/or addictive. Many more are entirely un-studied and of unknown effect. b) With vaping you have total control over the dosage of nicotine, the only addictive ingredient, and can reduce it as gradually as you like. You can easily reduce it to zero without changing the experience in other ways. It's not effortless, but in my experience it's approximately a zillion times easier.
posted by sfenders at 8:17 AM on June 3, 2016 [1 favorite]
There may be a study out there somewhere to be cited, but there's also a considerable amount of crazy partisan pseudo-research on both sides, or at least there seemed to be when I was looking about a year ago.
So instead I will cite common sense and personal experience for the claim that vaping is easier to quit than smoking. The common sense part being: a) Tobacco smoke contains miscellaneous hundreds of chemical compounds of which several besides nicotine are known to be psychoactive and/or addictive. Many more are entirely un-studied and of unknown effect. b) With vaping you have total control over the dosage of nicotine, the only addictive ingredient, and can reduce it as gradually as you like. You can easily reduce it to zero without changing the experience in other ways. It's not effortless, but in my experience it's approximately a zillion times easier.
posted by sfenders at 8:17 AM on June 3, 2016 [1 favorite]
I quit a month ago. We're talking a pack-a-day habit.
When I have brought it up on my twitter an account called @cigarette_kill keeps faving tweets whenever I mention it.
HOLY CRISPY CRAP STOP FAVING MY TWEETS I KNOW THEY KILL THAT'S WHY I STOPPED IF THEY DIDN'T I'D BE SMOKING ONE RIGHT NOW.
No amount of shaming or warnings will get you to stop if you really don't want to. If you don't want to, your lizard brain will find a way to keep you smoking, no matter what evidence is shoved in your face.
posted by Windigo at 8:24 AM on June 3, 2016 [3 favorites]
When I have brought it up on my twitter an account called @cigarette_kill keeps faving tweets whenever I mention it.
HOLY CRISPY CRAP STOP FAVING MY TWEETS I KNOW THEY KILL THAT'S WHY I STOPPED IF THEY DIDN'T I'D BE SMOKING ONE RIGHT NOW.
No amount of shaming or warnings will get you to stop if you really don't want to. If you don't want to, your lizard brain will find a way to keep you smoking, no matter what evidence is shoved in your face.
posted by Windigo at 8:24 AM on June 3, 2016 [3 favorites]
I quit a little more than a year ago. No vaping, no e-cigs: those are substitutes for what my addiction realy wants, which is a Marlboro, and I'm terrified that if I ever start inhaling any kind of nicotine delivery mechanism, I'll be right back to 2 packs a day in no time.
posted by thelonius at 8:29 AM on June 3, 2016 [2 favorites]
posted by thelonius at 8:29 AM on June 3, 2016 [2 favorites]
No amount of shaming or warnings will get you to stop if you really don't want to. If you don't want to, your lizard brain will find a way to keep you smoking, no matter what evidence is shoved in your face.
One's will to quit isn't some endogenous force -- it's influenced by new information, powerful imagery, etc. in ways we aren't consciously aware of. The available evidence shows that the warnings and pictures make people want to quit, making the "you have to want it" argument somewhat moot.
posted by tonycpsu at 8:34 AM on June 3, 2016 [6 favorites]
One's will to quit isn't some endogenous force -- it's influenced by new information, powerful imagery, etc. in ways we aren't consciously aware of. The available evidence shows that the warnings and pictures make people want to quit, making the "you have to want it" argument somewhat moot.
posted by tonycpsu at 8:34 AM on June 3, 2016 [6 favorites]
But... yeah, that Twitter account is some bullshit.
posted by tonycpsu at 8:35 AM on June 3, 2016 [1 favorite]
posted by tonycpsu at 8:35 AM on June 3, 2016 [1 favorite]
Anecdotally, the warning images we have on cigarettes in Canada were not what got me to stop. Even as a teenager. They didn't even get me thinking about quitting. Half the time we'd just joke about them; like holding the teeth image over our mouths. Not sure if the data suggests I was in a minority on that or not, but still. The biggest factor for me was the price. Pretty sure we're looking at $11 or so for a pack of 20 these days. You could get beer and weed for that much money and it's more fun anyway.
posted by Hoopo at 9:10 AM on June 3, 2016 [3 favorites]
posted by Hoopo at 9:10 AM on June 3, 2016 [3 favorites]
I'm terrified that if I ever start inhaling any kind of nicotine delivery mechanism, I'll be right back to 2 packs a day in no time.
Anecdotally, I smoked sometimes as much as 3 and a half packs a day from the time I was 15 until my mid thirties or so. I vape now for two reasons: one, nicotine has turned out to be far more effective for managing my ADD than ritalin or any of the other medications I've tried; and two, I have complete control over my smoking habits now with vaping in my tool kit. I've smoked casually socially quite a few times now without any desire to buy another pack for myself or to smoke compulsively. But I suspect the way addiction works is so personal and specific to each individual that my results wouldn't necessarily be the same as yours. It's really nice being able to breathe well enough again to do things like go biking and play tennis and watch my son get exhausted and out of breath before I do, though!
posted by saulgoodman at 9:15 AM on June 3, 2016 [1 favorite]
Anecdotally, I smoked sometimes as much as 3 and a half packs a day from the time I was 15 until my mid thirties or so. I vape now for two reasons: one, nicotine has turned out to be far more effective for managing my ADD than ritalin or any of the other medications I've tried; and two, I have complete control over my smoking habits now with vaping in my tool kit. I've smoked casually socially quite a few times now without any desire to buy another pack for myself or to smoke compulsively. But I suspect the way addiction works is so personal and specific to each individual that my results wouldn't necessarily be the same as yours. It's really nice being able to breathe well enough again to do things like go biking and play tennis and watch my son get exhausted and out of breath before I do, though!
posted by saulgoodman at 9:15 AM on June 3, 2016 [1 favorite]
I quit a decade or so ago. (This wasn't nearly the feat for me that it is for some folks - I was always an intermittent, mostly-social smoker anyway.) Every once in a blue moon I miss the hell out of it, primarily when I'm really fucking stressed out about something and probably already making terrible decisions. I can imagine that something like Canada's cigarette packages might provide a swift sharp kick to the head to jar me out of that particular decision if I got far enough into it to buy one.
(That said, I don't think it would have worked when I was younger. I distinctly remember buying cigarettes in Canada during a vacation there in my early twenties, in which my friends and I ended up treating the packages like trading cards, trying to collect a full set of gory photos. We were...maybe not the greatest decision makers, at that time.)
posted by Stacey at 9:19 AM on June 3, 2016 [1 favorite]
(That said, I don't think it would have worked when I was younger. I distinctly remember buying cigarettes in Canada during a vacation there in my early twenties, in which my friends and I ended up treating the packages like trading cards, trying to collect a full set of gory photos. We were...maybe not the greatest decision makers, at that time.)
posted by Stacey at 9:19 AM on June 3, 2016 [1 favorite]
assuming governments don't get in the way too much
State and Federal government get a serious chunk off the retail price of a pack of cigarettes, depending on the state. They used to get more, though never as much as the UK.
Of course the government wants it both ways, look righteous, take the money. Remember the Big Settlement, the one that was supposed to fund anti-smoking? Didn't really work out that way.
posted by IndigoJones at 9:50 AM on June 3, 2016 [1 favorite]
State and Federal government get a serious chunk off the retail price of a pack of cigarettes, depending on the state. They used to get more, though never as much as the UK.
Of course the government wants it both ways, look righteous, take the money. Remember the Big Settlement, the one that was supposed to fund anti-smoking? Didn't really work out that way.
posted by IndigoJones at 9:50 AM on June 3, 2016 [1 favorite]
Quitting's easy, I've done it hundreds of times!
A few months ago I switched from 2 packs of Camel filterless a day to an e-cig using about 15ml of 20% nicotine fluid a week. Way cheaper and my smokers' hack is gone. Next will be cutting the tobacco flavor, who knows what's in that. Giving up nicotine? Who knows?
posted by ridgerunner at 10:27 AM on June 3, 2016 [3 favorites]
A few months ago I switched from 2 packs of Camel filterless a day to an e-cig using about 15ml of 20% nicotine fluid a week. Way cheaper and my smokers' hack is gone. Next will be cutting the tobacco flavor, who knows what's in that. Giving up nicotine? Who knows?
posted by ridgerunner at 10:27 AM on June 3, 2016 [3 favorites]
Giving up nicotine? Who knows?
I've been amazed how easy it's been to step down, though I think I've kind of reached the dosage where I might level off to manage my ADD now, and of course, life stress can effect that (and I'm under a lot again, goddammit!). I started out on extra strong, 32 mg nicotine ejuice, now I'm down to only 9 mg, sometimes even as low as 6. It might be possible!
posted by saulgoodman at 10:36 AM on June 3, 2016 [1 favorite]
I've been amazed how easy it's been to step down, though I think I've kind of reached the dosage where I might level off to manage my ADD now, and of course, life stress can effect that (and I'm under a lot again, goddammit!). I started out on extra strong, 32 mg nicotine ejuice, now I'm down to only 9 mg, sometimes even as low as 6. It might be possible!
posted by saulgoodman at 10:36 AM on June 3, 2016 [1 favorite]
The states should absolutely be spending more on prevention / cessation, but the rise in the use of "sin taxes" to plug holes in unrelated parts of the budget is a direct result of resistance to higher income / sales taxes among the broader population. Both the cowardly politicians and the electorate that won't accept tax increases are to blame, and since there was nothing in the settlement that forces the states to comply with CDC guidelines, nor anything in state constitutions that requires sin taxes be related to what they're paying for, this is the expected result when residents demand programs and services but don't want to pay them any other way.
posted by tonycpsu at 10:39 AM on June 3, 2016 [2 favorites]
posted by tonycpsu at 10:39 AM on June 3, 2016 [2 favorites]
what if the dangers of not getting enough sun are just as serious as smoking?
They absolutely are fucking not.
So hi, I did a PhD in cancer research. Your link is broken for me, but I can still tell you this with 100% certainty, no matter what source you've found that suggests otherwise. If you're referring to the Vitamin D stuff, sure, there's some inconsistent but growing evidence that Vitamin D protection induced by sun exposure may be somewhat protective for some cancers (versus of course the substantial and consistent evidence that too much sun causes skin cancers). On the other hand, the increased lung cancer risk from tobacco is many orders of magnitude higher, and very, very well-proven by evidence. And that's not even counting the multitude of other cancers and health problems caused by tobacco.
I have no financial or other links to the pharmaceutical industry or anyone else who might financially benefit from tobacco being known as harmful. I'm just telling you what I know, as someone who very much wants the public to be accurately informed about cancer risk factors.
The reason everyone makes such a big deal about tobacco is that the evidence is very, very, very clear that it is extremely bad for your health. If any other products or "chemicals" people use daily were anywhere nearly as harmful, it would quickly become obvious, as it did with smokers several decades after smoking became very widespread. If the stress-relieving benefits of smoking are worth the health risks for you, that's fine. It's your decision what you put in your body. But don't mislead people into thinking smoking is on the same deadliness level as exposure to other known carcinogens, let alone "untested" chemicals or pharmaceuticals. It's the number one cancer risk factor by a very large margin. And the deaths from lung cancer, head and neck cancers, emphysema, or the many other ways smoking can kill you are very much NOT painless or peaceful deaths.
posted by randomnity at 10:39 AM on June 3, 2016 [37 favorites]
They absolutely are fucking not.
So hi, I did a PhD in cancer research. Your link is broken for me, but I can still tell you this with 100% certainty, no matter what source you've found that suggests otherwise. If you're referring to the Vitamin D stuff, sure, there's some inconsistent but growing evidence that Vitamin D protection induced by sun exposure may be somewhat protective for some cancers (versus of course the substantial and consistent evidence that too much sun causes skin cancers). On the other hand, the increased lung cancer risk from tobacco is many orders of magnitude higher, and very, very well-proven by evidence. And that's not even counting the multitude of other cancers and health problems caused by tobacco.
I have no financial or other links to the pharmaceutical industry or anyone else who might financially benefit from tobacco being known as harmful. I'm just telling you what I know, as someone who very much wants the public to be accurately informed about cancer risk factors.
The reason everyone makes such a big deal about tobacco is that the evidence is very, very, very clear that it is extremely bad for your health. If any other products or "chemicals" people use daily were anywhere nearly as harmful, it would quickly become obvious, as it did with smokers several decades after smoking became very widespread. If the stress-relieving benefits of smoking are worth the health risks for you, that's fine. It's your decision what you put in your body. But don't mislead people into thinking smoking is on the same deadliness level as exposure to other known carcinogens, let alone "untested" chemicals or pharmaceuticals. It's the number one cancer risk factor by a very large margin. And the deaths from lung cancer, head and neck cancers, emphysema, or the many other ways smoking can kill you are very much NOT painless or peaceful deaths.
posted by randomnity at 10:39 AM on June 3, 2016 [37 favorites]
A lack of regulation is what's allowed tobacco use to kill so many people over so many decades after we knew it was killing so many people. There is indeed a "you don't have to outrun the bear" effect here where vaping doesn't need to be 100% safe to be desirable, just safer than tobacco, but having seen how hard it was to fight the tobacco companies, I'm okay with being extremely cautious this time around and putting the burden of proof on the makers of the newer products to show that we're not just trading one set of problems for another.
"Hurr durr it's just vapour bro, it can't hurt you!" is far more harmful to vaping as a concept.
This is pretty mixed I think. On one hand the vape market right now is some wild west shit that definitely needs to be regulated. On the other hand it definitely seems like parts of the anti-tobacco establishment are stuck in a mode of thinking where they can't even imagine that e-cigs have the potential to represent a form of harm reduction - which is what policy should support - rather than just another gateway to smoking etc.
posted by atoxyl at 10:41 AM on June 3, 2016 [2 favorites]
"Hurr durr it's just vapour bro, it can't hurt you!" is far more harmful to vaping as a concept.
This is pretty mixed I think. On one hand the vape market right now is some wild west shit that definitely needs to be regulated. On the other hand it definitely seems like parts of the anti-tobacco establishment are stuck in a mode of thinking where they can't even imagine that e-cigs have the potential to represent a form of harm reduction - which is what policy should support - rather than just another gateway to smoking etc.
posted by atoxyl at 10:41 AM on June 3, 2016 [2 favorites]
Also, the big tobacco companies have a huge leg up in the regulatory capture game, and there are legitimate concerns among independent vape operators that the tobacco industry will buy and coerce the regulations they'd prefer to see in order to establish and maintain a tobacco industry monopoly on the vape market.
posted by saulgoodman at 10:50 AM on June 3, 2016 [1 favorite]
posted by saulgoodman at 10:50 AM on June 3, 2016 [1 favorite]
20% nicotine fluid
If you mean 20 mg/ml, that's 2%. That's what I started with too, and it took me about a year to go from there to zero, which I did because... uh, why not I guess?
The main health risk with vaping, from what I heard, is thermal decomposition of the liquid if it's overheated. Far as I'm aware it's not yet totally clear where the limit is, no way to know exactly what voltage you can use on a given coil with a particular liquid before you start getting more than trace amounts of acetaldehyde and stuff. Not that it's anything like smoking, but it's a potential risk that hadn't been completely ruled out as of a year ago when I read all the papers.
If anyone out there vaping long-term is worried and wants to make it safe as possible I'd recommend a variable-voltage power supply turned down to the lowest level you find satisfying -- don't even worry about it until you've quit smoking first, of course.
posted by sfenders at 11:02 AM on June 3, 2016 [1 favorite]
If you mean 20 mg/ml, that's 2%. That's what I started with too, and it took me about a year to go from there to zero, which I did because... uh, why not I guess?
The main health risk with vaping, from what I heard, is thermal decomposition of the liquid if it's overheated. Far as I'm aware it's not yet totally clear where the limit is, no way to know exactly what voltage you can use on a given coil with a particular liquid before you start getting more than trace amounts of acetaldehyde and stuff. Not that it's anything like smoking, but it's a potential risk that hadn't been completely ruled out as of a year ago when I read all the papers.
If anyone out there vaping long-term is worried and wants to make it safe as possible I'd recommend a variable-voltage power supply turned down to the lowest level you find satisfying -- don't even worry about it until you've quit smoking first, of course.
posted by sfenders at 11:02 AM on June 3, 2016 [1 favorite]
On the other hand it definitely seems like parts of the anti-tobacco establishment are stuck in a mode of thinking where they can't even imagine that e-cigs have the potential to represent a form of harm reduction - which is what policy should support - rather than just another gateway to smoking etc.
The public messaging I've heard from anti-tobacco activists has been (a) we want to know what's in the liquids and that those ingredients are safe, and (b) we want studies to show that they don't encourage people to transition to tobacco. I don't see those as problematic positions to take when the other side's ask is zero regulation.
There are of course dangers of overreach, but I really don't see those as likely to occur given the immense lobbying capacity of the companies who want to sell to this expanding market. With many decades of the makers of these products getting everything they want, I think it's fair to err on the side of wanting the products to be proven safe first.
posted by tonycpsu at 11:04 AM on June 3, 2016 [6 favorites]
The public messaging I've heard from anti-tobacco activists has been (a) we want to know what's in the liquids and that those ingredients are safe, and (b) we want studies to show that they don't encourage people to transition to tobacco. I don't see those as problematic positions to take when the other side's ask is zero regulation.
There are of course dangers of overreach, but I really don't see those as likely to occur given the immense lobbying capacity of the companies who want to sell to this expanding market. With many decades of the makers of these products getting everything they want, I think it's fair to err on the side of wanting the products to be proven safe first.
posted by tonycpsu at 11:04 AM on June 3, 2016 [6 favorites]
The main other regulation related to vaping that anti-tobacco activists (I work for such a group) want are: age restriction on sales (which are not universal yet, although the new FDA restrictions should cover that), restrictions on marketing to minors, restricting/banning flavors (since those appeal most strongly to minors), and applying clean air related laws (where you can or cannot vape) to vapes as well as combustible tobacco.
But, a lot of research is ongoing if vapes could be useful as either/or/both harm reduction or assistance in quitting--including from and by anti-tobacco groups in concert with research organizations.
And since I've been involved with people who do serious research with smoking cessation, it seems like many, many people are different in how they quit best. So just because one campaign didn't help you, doesn't mean it helped no one. There are a huge number of people who still smoke some form of tobacco (cigarette usage has falling a lot, but largely replaced with things such as hookah, cigarillos, and the such) so campaigns play the numbers game still.
posted by skynxnex at 11:13 AM on June 3, 2016 [3 favorites]
But, a lot of research is ongoing if vapes could be useful as either/or/both harm reduction or assistance in quitting--including from and by anti-tobacco groups in concert with research organizations.
And since I've been involved with people who do serious research with smoking cessation, it seems like many, many people are different in how they quit best. So just because one campaign didn't help you, doesn't mean it helped no one. There are a huge number of people who still smoke some form of tobacco (cigarette usage has falling a lot, but largely replaced with things such as hookah, cigarillos, and the such) so campaigns play the numbers game still.
posted by skynxnex at 11:13 AM on June 3, 2016 [3 favorites]
the other side's ask is zero regulation.
I'm firmly on the other side, and wouldn't mind some regulation. Just not completely fucking insane regulation that appears designed to reflexively shut down the new thing and/or hand it all over to the big tobacco companies. Age restriction? It's not clear to me whether that does more harm or more good, but sure, sounds reasonable at least as a temporary precaution. The "more studies" you ask for? Yes we need more in both quantity and quality. Mandatory disclosure of all ingredients? Yup, sounds good. Legislatively attack it as if it were a tobacco product to be eradicated? As a former smoker, it makes me very angry every time I hear about yet another government acting to take away this option from those who might still need it as badly as I did.
posted by sfenders at 11:31 AM on June 3, 2016 [4 favorites]
I'm firmly on the other side, and wouldn't mind some regulation. Just not completely fucking insane regulation that appears designed to reflexively shut down the new thing and/or hand it all over to the big tobacco companies. Age restriction? It's not clear to me whether that does more harm or more good, but sure, sounds reasonable at least as a temporary precaution. The "more studies" you ask for? Yes we need more in both quantity and quality. Mandatory disclosure of all ingredients? Yup, sounds good. Legislatively attack it as if it were a tobacco product to be eradicated? As a former smoker, it makes me very angry every time I hear about yet another government acting to take away this option from those who might still need it as badly as I did.
posted by sfenders at 11:31 AM on June 3, 2016 [4 favorites]
Just not completely fucking insane regulation that appears designed to reflexively shut down the new thing and/or hand it all over to the big tobacco companies.
Too late. They've got billions of dollars to take over that market, and they're working on it.
posted by Etrigan at 11:49 AM on June 3, 2016 [3 favorites]
Too late. They've got billions of dollars to take over that market, and they're working on it.
posted by Etrigan at 11:49 AM on June 3, 2016 [3 favorites]
But, a lot of research is ongoing if vapes could be useful as either/or/both harm reduction or assistance in quitting--including from and by anti-tobacco groups in concert with research organizations.
That's good. I should point out that I am neither a smoker nor a vaper (of nicotine products, anyway)- I'm just someone who's been involved in harm reduction and decrim campaigns for illegal drugs. I guess from where I stand on the sidelines this:
we want to know what's in the liquids and that those ingredients are safe
seems like the most important thing by far while this
restricting/banning flavors (since those appeal most strongly to minors)
seems like a possibly counterproductive focus (though I know where it comes from in the history of anti-tobacco efforts), this
we want studies to show that they don't encourage people to transition to tobacco.
is worth ruling out but strikes me as rather unlikely and the rest depends a lot on how the research pans out.
posted by atoxyl at 12:38 PM on June 3, 2016 [4 favorites]
That's good. I should point out that I am neither a smoker nor a vaper (of nicotine products, anyway)- I'm just someone who's been involved in harm reduction and decrim campaigns for illegal drugs. I guess from where I stand on the sidelines this:
we want to know what's in the liquids and that those ingredients are safe
seems like the most important thing by far while this
restricting/banning flavors (since those appeal most strongly to minors)
seems like a possibly counterproductive focus (though I know where it comes from in the history of anti-tobacco efforts), this
we want studies to show that they don't encourage people to transition to tobacco.
is worth ruling out but strikes me as rather unlikely and the rest depends a lot on how the research pans out.
posted by atoxyl at 12:38 PM on June 3, 2016 [4 favorites]
20% nicotine fluid
If you mean 20 mg/ml, that's 2%.
Yep. Thanks.
no way to know exactly what voltage you can use on a given coil with a particular liquid before you start getting more than trace amounts of acetaldehyde and stuff.
Even if it was quantified, I wouldn't trust these coils to be calibrated, the battery packs are for sure junk. The 1"x4" batteries at the lowest setting are averaging about 40 discharge/recharge cycles, pathetic.
I'd recommend a variable-voltage power supply turned down to the lowest level you find satisfying -- don't even worry about it until you've quit smoking first, of course.
Yep. Apparently cutting back by 80% won't do as much good as most people would guess. Just go ahead and give up that first thing in the morning cigarette and the after supper treat.
So far the only downside is for my hound, she's getting more baths as my sense of smell comes back.
posted by ridgerunner at 2:30 PM on June 3, 2016 [2 favorites]
If you mean 20 mg/ml, that's 2%.
Yep. Thanks.
no way to know exactly what voltage you can use on a given coil with a particular liquid before you start getting more than trace amounts of acetaldehyde and stuff.
Even if it was quantified, I wouldn't trust these coils to be calibrated, the battery packs are for sure junk. The 1"x4" batteries at the lowest setting are averaging about 40 discharge/recharge cycles, pathetic.
I'd recommend a variable-voltage power supply turned down to the lowest level you find satisfying -- don't even worry about it until you've quit smoking first, of course.
Yep. Apparently cutting back by 80% won't do as much good as most people would guess. Just go ahead and give up that first thing in the morning cigarette and the after supper treat.
So far the only downside is for my hound, she's getting more baths as my sense of smell comes back.
posted by ridgerunner at 2:30 PM on June 3, 2016 [2 favorites]
It's a pitty the link didn't work for you as I would have liked to actually hear your opinion on the fact that smokers with sun exposure had similar life expectancy as non-smokers with less sun exposure in the study. That is not the same thing as saying there is no risk or the diseases aren't serious, which I did not say. Just that who we shame for what and how we judge human behavior- and who is profiting from it and in what ways- is worth examining. I'd like to se a more nuanced conversation.
posted by xarnop at 3:07 PM on June 3, 2016
posted by xarnop at 3:07 PM on June 3, 2016
What I think would be interesting is if we posted pictures of gory car wrecks on cars, diseased hearts on foods with high fat or unhealthy additives, animals dying of oil spills at gas stations, children doing labor, slavery, and people working in sweatshops on products produced by companies who have problems with this, rainforests being destroyed on products that use their goods, animals being slaughtered or mistreated on meat and animal products, the devastation and ruin of areas where the earths resources are being taken in toxic environmentally destructive ways to produce many of our products and the people left in the mess or working within it...
There is SO MUCH harmful human behavior we need to be curbing- I guess if I can agree this is a good idea, then I hope we can expand it to all the areas it's really needed that people see the realm harm their behavior and purchases are causing, not just to themselves but to others also.
I find it interesting that people found that the rights of racists were being violated with targeted ads when they search racist content- however targeting people for buying cigarettes with graphic messages is not considered a similar violation? Are they different, and how so? (I'm genuinely asking, maybe there's a significant difference I'm not seeing.)
posted by xarnop at 3:36 PM on June 3, 2016 [1 favorite]
There is SO MUCH harmful human behavior we need to be curbing- I guess if I can agree this is a good idea, then I hope we can expand it to all the areas it's really needed that people see the realm harm their behavior and purchases are causing, not just to themselves but to others also.
I find it interesting that people found that the rights of racists were being violated with targeted ads when they search racist content- however targeting people for buying cigarettes with graphic messages is not considered a similar violation? Are they different, and how so? (I'm genuinely asking, maybe there's a significant difference I'm not seeing.)
posted by xarnop at 3:36 PM on June 3, 2016 [1 favorite]
Oh good, a slippery slope argument. And here I thought those were just being deployed in the swimming pool story today.
posted by Etrigan at 3:38 PM on June 3, 2016 [4 favorites]
posted by Etrigan at 3:38 PM on June 3, 2016 [4 favorites]
I'm actually genuine. I think we might should actually be putting the graphic reality of the harms of what people are causing on their products.
posted by xarnop at 4:44 PM on June 3, 2016 [1 favorite]
posted by xarnop at 4:44 PM on June 3, 2016 [1 favorite]
I find it interesting that people found that the rights of racists were being violated with targeted ads when they search racist content- however targeting people for buying cigarettes with graphic messages is not considered a similar violation? Are they different, and how so? (I'm genuinely asking, maybe there's a significant difference I'm not seeing.)
a.) who is "people?"
b.) presumably people were made uncomfortable seeing the intersection of online behavioral tracking and political persuasion made visible. Putting a sticker on the actual package that you buy doesn't make you wonder whether they will start mailing additional gruesome warnings to your home address. (I'm pretty sure the refugee ads were targeted just by content keywords which seems like totally fair game to me but the whole idea does sorta highlight the more sophisticated targeting capabilities that exist and murkier potential uses.)
posted by atoxyl at 5:11 PM on June 3, 2016 [1 favorite]
a.) who is "people?"
b.) presumably people were made uncomfortable seeing the intersection of online behavioral tracking and political persuasion made visible. Putting a sticker on the actual package that you buy doesn't make you wonder whether they will start mailing additional gruesome warnings to your home address. (I'm pretty sure the refugee ads were targeted just by content keywords which seems like totally fair game to me but the whole idea does sorta highlight the more sophisticated targeting capabilities that exist and murkier potential uses.)
posted by atoxyl at 5:11 PM on June 3, 2016 [1 favorite]
It's a pitty the link didn't work for you as I would have liked to actually hear your opinion on the fact that smokers with sun exposure had similar life expectancy as non-smokers with less sun exposure in the study.
Hmm, based on that description, and since it's been in the news recently, I'm guessing you mean this study? Yay, wildly misleading science journalism, my favourite pet peeve. I'm not blaming you for believing what's been reported about that study....the fault lies mostly with the gross incompetence of (some) journalists. They often neglect to point out very basic and critical facts, e.g. that this is a single study of Swedish women (vs. the many many studies in both men and women worldwide showing how harmful smoking is) or that this study only looks at correlations, not causation. As if that wasn't bad enough already, this study is really very weak in its own right, and I'm very suspicious about several strange things about their data analysis methods. I typed way too much picking the paper apart but I think it's a bit of a derail for this thread so I deleted it all. If you're still curious we can discuss more details over me-mail, but to briefly summarize, that particular study does not convince me at all that sun exposure has any positive impact on health, let alone outweighs the harm from smoking. (ok, I can't resist pointing out just one glaring flaw - they did not adequately control for activity level or pre-existing health conditions, but drew their conclusions by comparing people who died of any cause....gee, I wonder if sick, obese, and/or less active people would be any less likely than highly active, healthy people to head out to the beach to sunbathe??)
I do think there is fairly convincing evidence overall that vitamin D induced by sunlight (or at least avoiding vitamin D deficiency) has some positive health effects, just not anywhere near the same magnitude as the negative health effects of smoking.
I am also all in favour of raising awareness about other major causes of death. Just not at the expense of minimizing the very real dangers of smoking. Cancer and cardiovascular problems, which are both increased by smoking, together account for about 50% of all deaths in Canada (the US and other culturally similar countries have fairly similar stats). The next most common causes of death are chronic respiratory diseases (again, greatly increased by smoking) and accidents, lagging far behind at about 4-5% each. Within the cancer category, which represents about 1/4 to 1/3 of all deaths, lung cancer (80-90% of which is caused by smoking) kills more than twice as many people as any other kind of cancer (the next runners up are colorectal, breast and prostate cancers, if you're curious). You can see very detailed and quite well-presented information here providing (again, Canadian) context and data sources for those statistics if you're interested.
posted by randomnity at 5:57 PM on June 3, 2016 [10 favorites]
Hmm, based on that description, and since it's been in the news recently, I'm guessing you mean this study? Yay, wildly misleading science journalism, my favourite pet peeve. I'm not blaming you for believing what's been reported about that study....the fault lies mostly with the gross incompetence of (some) journalists. They often neglect to point out very basic and critical facts, e.g. that this is a single study of Swedish women (vs. the many many studies in both men and women worldwide showing how harmful smoking is) or that this study only looks at correlations, not causation. As if that wasn't bad enough already, this study is really very weak in its own right, and I'm very suspicious about several strange things about their data analysis methods. I typed way too much picking the paper apart but I think it's a bit of a derail for this thread so I deleted it all. If you're still curious we can discuss more details over me-mail, but to briefly summarize, that particular study does not convince me at all that sun exposure has any positive impact on health, let alone outweighs the harm from smoking. (ok, I can't resist pointing out just one glaring flaw - they did not adequately control for activity level or pre-existing health conditions, but drew their conclusions by comparing people who died of any cause....gee, I wonder if sick, obese, and/or less active people would be any less likely than highly active, healthy people to head out to the beach to sunbathe??)
I do think there is fairly convincing evidence overall that vitamin D induced by sunlight (or at least avoiding vitamin D deficiency) has some positive health effects, just not anywhere near the same magnitude as the negative health effects of smoking.
I am also all in favour of raising awareness about other major causes of death. Just not at the expense of minimizing the very real dangers of smoking. Cancer and cardiovascular problems, which are both increased by smoking, together account for about 50% of all deaths in Canada (the US and other culturally similar countries have fairly similar stats). The next most common causes of death are chronic respiratory diseases (again, greatly increased by smoking) and accidents, lagging far behind at about 4-5% each. Within the cancer category, which represents about 1/4 to 1/3 of all deaths, lung cancer (80-90% of which is caused by smoking) kills more than twice as many people as any other kind of cancer (the next runners up are colorectal, breast and prostate cancers, if you're curious). You can see very detailed and quite well-presented information here providing (again, Canadian) context and data sources for those statistics if you're interested.
posted by randomnity at 5:57 PM on June 3, 2016 [10 favorites]
(I hope that didn't come off too harshly. I am annoyed, but not at you - rather at the depressingly high prevalence of clickbaity "science" "journalism" and non-evidence-based health advice, neither of which seem likely to improve anytime soon...)
posted by randomnity at 6:13 PM on June 3, 2016 [1 favorite]
posted by randomnity at 6:13 PM on June 3, 2016 [1 favorite]
here is an example of the sort of thing that doesn't seem particularly helpful to me
posted by atoxyl at 7:10 PM on June 3, 2016
posted by atoxyl at 7:10 PM on June 3, 2016
non-smokers telling me to quit/telling me how to quit/using scare tactics never, ever worked
The great thing about plain packaging, is we have a huge preponderance of evidence, showing that it works for both new and existing smokers
Another great round up here
And the last one from out own department of health - "Dr Chipty found that after controlling for a range of variables, including excise tax increases since 2010, and socio-demographic factors, tobacco plain packaging in combination with graphic health warnings was associated with a statistically significant estimated decline in smoking prevalence of around 0.55 percentage points between December 2012 and September 2015, or about one quarter of the total drop in prevalence during the period."
This is one of those things that illustrated what a poor guide feelings or hunches, or even 'common sense' is for guiding public policy. Plain packaging has been an unmitigated success in Australia.posted by smoke at 8:11 PM on June 3, 2016 [4 favorites]
The great thing about plain packaging, is we have a huge preponderance of evidence, showing that it works for both new and existing smokers
Fourteen separate studies on the impact of plain packaging in its first year were published today in a special supplement to the British Medical Journal."New figures, released by the Australian Bureau of Statistics (ABS), show that there was a general decrease in the smoking rate following the introduction of the plain packaging laws.The results from the survey demonstrate a drop from 15.1 per cent in 2010 to 12.8 per cent in 2013i.
The research found after the laws were implemented, there was a "statistically significant increase" in the number of people thinking about and making attempts to quit smoking.
Another great round up here
And the last one from out own department of health - "Dr Chipty found that after controlling for a range of variables, including excise tax increases since 2010, and socio-demographic factors, tobacco plain packaging in combination with graphic health warnings was associated with a statistically significant estimated decline in smoking prevalence of around 0.55 percentage points between December 2012 and September 2015, or about one quarter of the total drop in prevalence during the period."
This is one of those things that illustrated what a poor guide feelings or hunches, or even 'common sense' is for guiding public policy. Plain packaging has been an unmitigated success in Australia.posted by smoke at 8:11 PM on June 3, 2016 [4 favorites]
I don't disagree at all that smoking increases cancer risk-- I think that is so well established a fact that we can afford to discuss nuance without people in this community in particularly suddenly getting the idea that smoking doesn't have a direct causal relationship with some forms of cancer. I do still think there is room to look at the details though and I appreciate you looking at the study. There is in fact a very large body of research that I was seeing, well beyond this one study, exploring sun exposure and cancer protection though! Overwhelmingly in the studies I am seeing statements like these "Invasive cancer risk is inversely related to ultraviolet light exposure." I do hope they do some clear studies that measure the differences between people who exercise indoor and avoid sun, and who exercise outdoor in the same amount. Would be very interesting! I don't think expanding our focus and attention to all people who do things that increase cancer, disease or death risk would mean we have to diminish that smoking can cause cancer. Just open our eyes to how much dangerous behavior is common so that smokers aren't the scapegoat for everyone who wants to think smokers are uniquely bad in doing risky things or that the tobacco industry is the only one giving people serious disease and early death for profit. From a harm reduction perspective the aggressive approaches often fail for the most vulnerable people who may wind up still unable to quit and also socially shamed on top of that. That's what I'm concerned about. Now you die of lung cancer, while hated and blamed for it. A lot of people are making decisions that increase their risk of death or disease and are pleasure/convenience not survival based.
Now if I weren't at metfilter (where overwhelmingly anti-smoking ideology is predominant) I would be worried about discussing this at all without worrying about feeding the tobacco industries BS (And yes they need to be countered, I just hope, not at the expense of smokers themselves). And no I am not a smoker, but when I was that was the last of my worries. Surviving was more important and many of my friends with no family support or money or ability to take some time off have not been as lucky with quitting smoking attempts- and I don't think that's because I'm superior or I care more.
posted by xarnop at 5:48 AM on June 4, 2016 [1 favorite]
Now if I weren't at metfilter (where overwhelmingly anti-smoking ideology is predominant) I would be worried about discussing this at all without worrying about feeding the tobacco industries BS (And yes they need to be countered, I just hope, not at the expense of smokers themselves). And no I am not a smoker, but when I was that was the last of my worries. Surviving was more important and many of my friends with no family support or money or ability to take some time off have not been as lucky with quitting smoking attempts- and I don't think that's because I'm superior or I care more.
posted by xarnop at 5:48 AM on June 4, 2016 [1 favorite]
"Dr Chipty found that after controlling for a range of variables, including excise tax increases since 2010, and socio-demographic factors ..."
I was taking it for granted that it was understood how well this tactic worked, what with all the impressive-looking links to serious studies, but I wonder what fraction of research measuring the benefits of ugly cigarette packaging follows this kind of procedure where they carefully adjust for a wide range of demographic factors, and yet completely ignore these "electronic cigarettes" that coincidentally started becoming popular right in the middle of the time-frame studied.
On the other hand, the conclusion that ugly packaging makes the packaging less appealing to people seems robust.
posted by sfenders at 7:13 AM on June 4, 2016 [2 favorites]
I was taking it for granted that it was understood how well this tactic worked, what with all the impressive-looking links to serious studies, but I wonder what fraction of research measuring the benefits of ugly cigarette packaging follows this kind of procedure where they carefully adjust for a wide range of demographic factors, and yet completely ignore these "electronic cigarettes" that coincidentally started becoming popular right in the middle of the time-frame studied.
On the other hand, the conclusion that ugly packaging makes the packaging less appealing to people seems robust.
posted by sfenders at 7:13 AM on June 4, 2016 [2 favorites]
A lot of people here assume that all smokers and potential smokers know (and understand) the risks already. Is that true for Americans under 20? I don't know what kind of information they have these days.
I can tell you that virtually all of my East Asian, Middle Eastern, and European young adult students (most of whom are wealthy, FWIW) smoke, and most of them are completely unaware that tobacco has any serious health effects at all (other than a firm belief that smoking helps them stay slim). When it's come up in textbook units about health or whatever, most of them laugh disbelievingly. I guess they think it's some kind of weird American propaganda? Not surprising, since the Chinese government owns the tobacco company that has a virtual monopoly on cigarettes in China, and the Japanese government only sold off their stake in Japan Tobacco a couple of years ago.
I don't know about other national-tobacco relationships, but anyway: Some photographic evidence would be a good thing for these young smokers to encounter. (Unbranded cigarette packages would be even better.)
posted by wintersweet at 10:49 AM on June 4, 2016
I can tell you that virtually all of my East Asian, Middle Eastern, and European young adult students (most of whom are wealthy, FWIW) smoke, and most of them are completely unaware that tobacco has any serious health effects at all (other than a firm belief that smoking helps them stay slim). When it's come up in textbook units about health or whatever, most of them laugh disbelievingly. I guess they think it's some kind of weird American propaganda? Not surprising, since the Chinese government owns the tobacco company that has a virtual monopoly on cigarettes in China, and the Japanese government only sold off their stake in Japan Tobacco a couple of years ago.
I don't know about other national-tobacco relationships, but anyway: Some photographic evidence would be a good thing for these young smokers to encounter. (Unbranded cigarette packages would be even better.)
posted by wintersweet at 10:49 AM on June 4, 2016
I don't think expanding our focus and attention to all people who do things that increase cancer, disease or death risk would mean we have to diminish that smoking can cause cancer.
It doesn't but there's a good reason that there's been so much focus on smoking which is that it's a single factor that accounts for a huge percentage of harm and death from cancer. It's not disproportionate, is all I'm saying.
posted by atoxyl at 3:29 PM on June 4, 2016 [2 favorites]
It doesn't but there's a good reason that there's been so much focus on smoking which is that it's a single factor that accounts for a huge percentage of harm and death from cancer. It's not disproportionate, is all I'm saying.
posted by atoxyl at 3:29 PM on June 4, 2016 [2 favorites]
I agree with Mrs. Pterodactyl above that there is little effect that negative campaigns will have for a certain type of smoker (e.g. my father), even though at a population level these measures clearly pay off.
Here in Oz we have a lot of anti-smoking advertising. These are probably my favourite posters, precisely because they promote the positive effects of quitting rather than the consequences of not quitting. We also had an ad that I’m struggling to find that points out that that most people attempt to quit more than once before actually succeeding, and that each successive attempt has a greater chance of success.
FWIW: I smoked for 15 years and quit in my late 20s. It has actually made me a bit of an unforgiving prick around smokers, particularly dad.
posted by kisch mokusch at 5:05 AM on June 6, 2016 [2 favorites]
Here in Oz we have a lot of anti-smoking advertising. These are probably my favourite posters, precisely because they promote the positive effects of quitting rather than the consequences of not quitting. We also had an ad that I’m struggling to find that points out that that most people attempt to quit more than once before actually succeeding, and that each successive attempt has a greater chance of success.
FWIW: I smoked for 15 years and quit in my late 20s. It has actually made me a bit of an unforgiving prick around smokers, particularly dad.
posted by kisch mokusch at 5:05 AM on June 6, 2016 [2 favorites]
US anti-plain packaging ad and its 'terrible' Australian accent
posted by kisch mokusch at 1:39 AM on June 7, 2016
posted by kisch mokusch at 1:39 AM on June 7, 2016
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I'm starting to feel like "American exceptionalism" really only refers to the US's ability to be the only nominally first-world country to be so bad at basically everything that benefits Society as a whole, almost exclusively because some already-rich entity can become richer as a result.
posted by DoctorFedora at 6:22 AM on June 3, 2016 [21 favorites]