Sanity check. From 1990 to 2000 ~1/4 of US adult population smoked. Suggesting that smoking adds 750,000 * ~50,000,000 people / (75 years lifespan) ~500 Billion per year to US heath care costs is wildly off base.

It turns out smokers do cost more while alive, but die sooner which mostly erases the difference in medical costs. There are estimates for lost productivity amounting to 150 Billion per year in the US, but again these ignore the fact Nicotine is a stimulant.

Not all of them die early. Plus there are a variety of high priced treatments that they use along the way.

And some have almost no healthy issues. But the average is overall cheaper costs, which is what we're discussing.

The number is closer to $200 billion according to the CDC. Still crazy high and of the same order of magnitude, so hardly "wildly off base"

The CDC lists $170 billion in direct medical costs. https://www.cdc.gov/chronicdisease/resources/publications/fa...

Clearly the living have higher medical costs than the dead so some indirect savings exist. Thus, net costs are below that 170B and thus wildly off of a 500B net healthcare cost.

So I can't count the $ in lost productivity from these people dying early, but you can count their deaths as savings on healthcare?

You can and should count lost productively, though not as a healthcare cost as it’s not under healthcare budgets. However, you need to balance that with the productivity gain from people using a stimulant.

I don’t want to defend cigarettes which are I feel are very much a bad thing. However, I object to people misusing statistics and generally deceptive practices.

Cigarettes are bad because they kill people and cause direct suffering. The relative impact to your taxes and national GDP are irrelevant by comparison.

I would be surprised if the stimulating effects outstripped the dying early effects, given that in one case you are less performant and in the other you cease to exist.

I agree that we should be honest with the stats, which is why I think it was disingenuous to claim that $500 billion was wildly off when the reported costs from the CDC were a substantial portion of that. Sure, we can start considering secondary effects like cost savings from people dying early and productivity lost, etc. etc. But all I'm saying is that I don't think the original claim was on its face absurd.

Agreed that we shouldn't be doing some absurd cost-benefit analysis for the economy when considering whether to combat smoking, obviously people dying is sort of a priori bad.

That’s reasonable. Personally I doubt the stimulant effects come close to zeroing out the lost productivity from heath issues and early deaths. But, at these scales it’s a multi billion dollar effect and needs to be accounted for.

Also, if you object to wildly off base that’s fair. I would call even the 3x difference between the CDC’s 170B and my simplified 500B sanity check as wildly off base. But, that’s just my scale +/- 50% is fine, 2x raises read flags for me, but out at 3+x is a fundamental incompatibility in different estimates.

If you did that you would also have to count all the impossible to count effects like increased productivity from using smoking as a stimulant. It is possible that some smokers wouldn't have the willpower to maintain a job if they didn't have smoking as a stress reliever.

The entire idea is that vaping replaces the cigarette and most of the harmful substances in the tobacco. Cigarettes don't provide a kick because it's full of the shit that makes your lungs go black. It's the nicotine. And while nicotine is no saint, it's not the main culprit of the health problems smokers face.

Remove cigs, replace them with vapes. Presumably the effect is the same, but the vapers live slightly longer than they would've if they were smokers.

I feel like increased productivity from smoking tobacco wouldn't be impossible to calculate if you just compare performance of smoker vs non-smoker in aggregate.

I would be surprised if the stimulating effects outstripped the dying early effects.

edit: just did a brief search and apparently on aggregate former smokers who quit have increased productivity following quitting, so even while smoking there is decreased productivity effects

That is still the same order of magnitude.

$5T would be "wildly off"...

And you must concede that even "only" a $170B reduction in medical costs could change the entire market.

As I said it’s not a difference in net costs of 170B.

It may cost 20$ to eat out at lunch, but the alternative is not skipping eating. So the net cost for eating out is the delta between my options.

Random study: Results Smoking was associated with a greater mean annual healthcare cost of €1600 per living individual during follow-up. However, due to a shorter lifespan of 8.6 years, smokers’ mean total healthcare costs during the entire study period were actually €4700 lower than for non-smokers. For the same reason, each smoker missed 7.3 years (€126 850) of pension. https://bmjopen.bmj.com/content/2/6/e001678.

But we’re converting smokers to non-smokers, not executing them out of hand, so you’re only saving $250k. Of course, allowing smokers to buy their own vapes seems like a trivial cost to save $250k/person (and, you know, their lives).

Which also doesn't include the economic output of their still being fit enough to work (and still living).