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Why do we still permit tobacco use? (2015)

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Re: Why do we still permit tobacco use? (2015)

#231
> There is no level at which tobacco smoke is safe for the consumer or the people around them or, as we are seeing, even those who are exposed in a tertiary environment (5).

This framing drives me nuts. It's the same claim the CDC makes on their website:

> There is no safe level of smoking.

> Each cigarette you smoke damages your lungs, your blood vessels, and cells throughout your body. Even occasional smoking is harmful, and the best option for any smoker is to quit completely. The more years you smoke, the more you damage your body. Quitting at any age has benefits.

Source: https://www.cdc.gov/vitalsigns/adultsmoking/index.html

First of all, it's absurd. If you smoke, let's just say, I dunno, one puff off a cigarette once a year I am certain there is no measurable health effect. So the claim is wrong.

But more important, this kind of argument could be applied to all kinds of things. In a technical sense, there is no safe amount of air travel, for example. You are exposed to background radiation at measurably higher levels every time you fly and this has measurable impacts on longterm health (pilots and other flight staff have measurably higher rates of cancer). But does the CDC say, "there's no safe amount of air travel?" Do they point out that every flight does some amount of damage to the cells in your body? Do they warn you that the more you do it, the more harmful it is? Do they tell you that quitting is the only way to be sure you're doing no damage?

No! They give actual figures, explain that the risk of infrequent exposure is relatively low, and then provide a simple point of reference to help the public contextualize the risk:

> We are exposed to low levels of radiation when we fly. You would be exposed to about 0.035 mSv (3.5 mrem) of cosmic radiation if you were to fly within the United States from the east coast to the west coast. This amount of radiation is less than the amount of radiation we receive from one chest x-ray.

Source: https://www.cdc.gov/nceh/radiation/air_travel.html

Re: Why do we still permit tobacco use? (2015)

#232

Earlier quoted context omitted.

Given that most smokers/obese people tend to die right around retirement age, we probably aren't leaving much on the table (from a purely economic perspective). Smokers probably aren't missing enough days of work to cancel out the $60k they save the system by smoking (not to mention all the extra taxes they pay). But there's more value to human beings than their economic value, hence my talk about non-monetary costs.…

Lots of tremendously valuable labor is done by people who don't pull down a wage. I.e., retired people who volunteer and watch the grand kids. Many people -- perhaps most -- contribute more value to society in retirement than in their wage labor years.

> Lots of tremendously valuable labor is done by people who don't pull down a wage.

Sure. I can believe that.

Is the unspoken claim here that it averages out to more than ~$60k/person?

Re: Why do we still permit tobacco use? (2015)

#233

Earlier quoted context omitted.

> Nicotine is fairly non-addictive (in gum and patch form. Vapes, may be slightly more addictive due to oral fixation -- but still nothing compared to actual tobacco). You are somewhat mistaken. Natural tobacco is fairly non-addicting because it doesn't contain nearly the amount of nicotine than what is in cigarettes, and what is in cigarettes is not natural tobacco. Nicotine, itself, is highly addictive, and there a…

I still don't see it. The only justifications I've come across are a matter of post-hoc rationalization ("because nicotine is addictive, X, Y, and Z"; but no "nicotine is addictive, because A, B, C"), and taking it as granted. I have yet to see anything explaining why nicotine is addictive (not merely, how it could be addictive, but the evidence behind why this statement is just taken as fact). Everything being writt…

https://en.wikipedia.org/wiki/Nicotinic_acetylcholine_recept...

Dig in.

Re: Why do we still permit tobacco use? (2015)

#234

Earlier quoted context omitted.

I still don't see it. The only justifications I've come across are a matter of post-hoc rationalization ("because nicotine is addictive, X, Y, and Z"; but no "nicotine is addictive, because A, B, C"), and taking it as granted. I have yet to see anything explaining why nicotine is addictive (not merely, how it could be addictive, but the evidence behind why this statement is just taken as fact). Everything being writt…

https://en.wikipedia.org/wiki/Nicotinic_acetylcholine_recept... Dig in.

I read through that article, as well as https://en.wikipedia.org/wiki/Nicotinic_agonist , but they're shallow on details.

I understand the low-level pharmacodynamics (but these are seldom useful when talking about high-level, system-wide, and complex effects).

BUT, this portion https://en.wikipedia.org/wiki/Nicotine#Reinforcement_disorde... has a few interesting tid-bits, especially the article on DeltaFosB/"as a critical factor in the development of virtually all forms of behavioral and drug addictions." (https://en.wikipedia.org/wiki/FOSB#Delta_FosB) As well as, "Based upon the accumulated evidence, a medical review from late 2014 argued that accumbal ΔFosB expression can be used as an addiction biomarker and that the degree of accumbal ΔFosB induction by a drug is a metric for how addictive it is relative to others."

Fascinating stuff -- and exactly what I was complaining about.

A more nuanced take on why drug-mediated DeltaFosB expression may be involved in addictive (see: habitual drug usage) behaviors: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2607320/

BUT, so many things cause DeltaFosB expression (e.g. sugar, exercise, drugs, etc.), that we need to establish how significant of an effect nicotine has compared to everything else. Fortunately, we do have one study comparing caffeine's and nicotine's DeltaFosB expression: https://sci-hub.se/10.1016/j.jchemneu.2017.10.005

Results (page 9; "number of DeltaFosB-immunoreactive nuclei per 1 mm^2" in the nucleus accumbunus):

| Control | Nicotine | Caffeine |

| 43,83 ± 16,80 | 117,33 ± 14,36 | 112,77 ± 10,12 |

To me, that looks like a similar addiction-profile. Granted, DeltaFosB is probably not the be-all end-all, but a small piece in untangling why and how nicotine (and other drugs) may or may not be addictive.

It would be even better, if we could put these two side-by-side with other drugs, notably cocaine and heroin, to see if the effect expression is logarithmic (and DeltaFosB over-expression is similar across-the-board for all drugs considered addictive).

Re: Why do we still permit tobacco use? (2015)

#235
post #181

Earlier quoted context omitted.

> Pipe smokers don't seem to suffer the fates of cigarette smokers. Oh yes they do. See eg [1]. Also logically, both are inhaling smoke from burning organic matter. There is no way it is not going to be very unhealthy, once you look at the chemical composition of the smoke. [1] Between pipe and cigarette smokers, no or only minor differences were found in mortality from any cause and the specified smoking-related dis…

According to the US Surgeon General report I cited, my statement is true. > Also logically, both are inhaling smoke from burning organic matter. No, that is my point. At least half of what is in national brand cigarettes is not organic. [1] > There is no way it is not going to be very unhealthy, once you look at the chemical composition of the smoke. Since I made no mention of health, this is a straw man. Please take…

> what you are (effectively) claiming is that the infusion of 300+ known carcinogens in cigarette tobacco has no effect on mortality, which is absurd on its face

It's not absurd once you account for the already present carcinogens from burned plant material. And even smokeless tobacco (chewing etc) causes oral, oesophagus, and pancreas cancer.

Re: Why do we still permit tobacco use? (2015)

#236
post #221
post #161

Earlier quoted context omitted.

> Does freedom have inherent value, or does it have to lead to something else in order to be valuable? If you assume the first then you're a fundamentalist. In order to compare different moral values, we need to look at what they lead to in practice, and weigh that. So the abstract "freedom" doesn't cut it, you need to be able to say, what is the practical benefit of such freedom? So that we could compare it with pra…

>If you assume the first then you're a fundamentalist. Apparently your opinion is that I should be dismissed out of hand as a "fundamentalist". >So the abstract "freedom" doesn't cut it, you need to be able to say, what is the practical benefit of such freedom? This is the conceit I intended to highlight, yes.

> Apparently your opinion is that I should be dismissed out of hand as a "fundamentalist".

I don't know, do you hold the position that abstract freedom is valuable, regardless of the real-world consequences? In any case, I think giving you an option to change your mind is not a dismissal. :-)

I don't think anything is valuable in itself, without a real-world context. The story of Midas' gold illustrates that.

And when we think about the practical context, we find that lots of freedoms (for starters, the ones in EU Charter of Fundamental Rights) are actually valuable in most circumstances. But that doesn't mean we can generalize it to freedom to do anything is valuable in all contexts, which I think is a logical consequence of attributing value to freedom in the abstract.

Re: Why do we still permit tobacco use? (2015)

#238
post #235

Earlier quoted context omitted.

According to the US Surgeon General report I cited, my statement is true. > Also logically, both are inhaling smoke from burning organic matter. No, that is my point. At least half of what is in national brand cigarettes is not organic. [1] > There is no way it is not going to be very unhealthy, once you look at the chemical composition of the smoke. Since I made no mention of health, this is a straw man. Please take…

> what you are (effectively) claiming is that the infusion of 300+ known carcinogens in cigarette tobacco has no effect on mortality, which is absurd on its face It's not absurd once you account for the already present carcinogens from burned plant material. And even smokeless tobacco (chewing etc) causes oral, oesophagus, and pancreas cancer.

To be clearer...

What is in national brand cigarettes is not tobacco, but a product made from tobacco that is almost entirely unlike tobacco. Tobacco is put in a vat, the nicotine is extracted, a mash is made into which nicotine is infused at higher levels than in natural tobacco, and 300+ known carcinogens are added called additives, from the mash a paper is made, the paper is sliced into little pieces, this is mixed with cut stems, whatever fell on the floor, and previous recycled product that was never sold, all stuffed into paper.

Natural tobacco, on the other hand, is grown, dried, and sold. Sometimes water is added.

Your claim is both products are equally lethal. If smoking pipe tobacco (which as I have always seen it sold, is natural tobacco, easy to tell by looking at it) is just as bad as smoking cigarettes, then adding 300+ carcinogens to cigarettes has no ill effects. This is what is absurd, because, of course adding 300+ carcinogens is going to make the product more lethal. The 300+ carcinogens is the reason why 400K Americans die every year do to smoking-related illness. Prior to the 1950's chemical revolution, the mortality rate of smokers did not even begin to approach this number. Beginning in the 1950's is when smokers started dying en mass every year.

There is a massive difference between natural tobacco and what is in cigarettes. The latter is lethal, the sole cause of the high mortality rates of smokers. The former is merely unhealthy. Pipe smokers that inhale live as long as non-smokers, and pipe smokers that do not inhale live longer than non-smokers. That's what the US Surgeon General report says.

Am I getting through?

Re: Why do we still permit tobacco use? (2015)

#239
post #235

Earlier quoted context omitted.

> what you are (effectively) claiming is that the infusion of 300+ known carcinogens in cigarette tobacco has no effect on mortality, which is absurd on its face It's not absurd once you account for the already present carcinogens from burned plant material. And even smokeless tobacco (chewing etc) causes oral, oesophagus, and pancreas cancer.

To be clearer... What is in national brand cigarettes is not tobacco, but a product made from tobacco that is almost entirely unlike tobacco. Tobacco is put in a vat, the nicotine is extracted, a mash is made into which nicotine is infused at higher levels than in natural tobacco, and 300+ known carcinogens are added called additives, from the mash a paper is made, the paper is sliced into little pieces, this is mixe…

I don't care about some chemicals that go into American cigarettes. I am not American and I don't smoke. I only know people died from lung and other cancers or copd on a massive scale long before anything was added to tobacco. I objected to your claim that "Pipe smokers don't seem to suffer the fates of cigarette smokers", because of course they do. One of my uncles died of aggressive lung cancer and he smoked natural tobacco from a pipe. Smoking tobacco will not be healthy even if it is the most bio organic tobacco available.

Re: Why do we still permit tobacco use? (2015)

#240
post #47

And this is why we can't have nice things... because "we" don't "permit it". How does someone even write this sentence? Did they glance over at their crown, which says "King We", and think "thou shall not smoke!"?

Well. There's plenty of things that are illegal. How far down the libertarian rabbit hole are you prepared to go?

That rabbit hole is full of good and bad, and a good dig into that hole is what makes society work... so yes we should go down.
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