Tobacco Industry: Playing Down the Risks of Smoking and Passive Smoking

message฀of฀the฀cigarette฀industry฀that฀is฀especially฀dangerous฀is฀that฀people฀should฀“smoke฀ in฀moderation.”฀How฀is฀an฀alcohol฀addict,฀for฀instance,฀supposed฀to฀drink฀in฀moderation?฀ The฀nicotine฀in฀cigarettes฀leads฀many฀people฀to฀increase฀their฀intake,฀with฀all฀the฀hazards฀ associated฀with฀the฀combustion฀products.฀In฀this฀context,฀attention฀is฀once฀again฀drawn฀to฀ the฀conidential฀position฀paper฀issued฀by฀the฀tobacco฀industry,฀which฀has฀been฀mentioned฀ before฀ [15] . In฀light฀of฀the฀various฀legal฀actions฀against฀the฀tobacco฀industry,฀Philip฀Morris฀has฀now฀ adopted฀a฀new฀policy.฀The฀Department฀of฀Justice฀wishes฀to฀claim฀compensation฀for฀the฀ costs฀incurred฀annually฀by฀Medicare฀for฀the฀treatment฀of฀smoking-related฀disease.฀“For฀ over฀45฀years,฀the฀cigarette฀irms฀have฀been฀conducting฀their฀business฀with฀no฀regard฀for฀ the฀truth,฀the฀law,฀or฀the฀health฀of฀the฀American฀population,”฀as฀Janet฀Reno,฀the฀former฀US฀ Attorney฀ General,฀ put฀ it฀ [81] .฀ For฀ this฀ reason,฀ Philip฀ Morris฀ is฀ now฀ using฀ the฀ slogan:฀ “Smoking฀can฀make฀you฀ill”฀ [82] .฀The฀company’s฀advertising฀also฀adopts฀a฀similar฀vein:฀ “Don’t฀smoke฀our฀cigarettes”฀is฀one฀advertising฀message฀that฀has฀even฀been฀shown฀on฀US฀ television฀ [83] .฀The฀director฀of฀BAT,฀Martin฀Broughton,฀stated฀in฀March฀2002฀to฀The฀Times฀ newspaper:฀“I฀think฀smoking฀does฀involve฀health฀risks.”฀He฀himself฀does฀not฀smoke,฀he฀ said,฀apart฀from฀an฀occasional฀after฀dinner฀cigar,฀because฀he฀is฀afraid฀of฀the฀risk฀of฀illness฀ through฀smoking.฀He฀has฀also฀advised฀his฀two฀children฀against฀smoking฀cigarettes฀ [84] . A฀highly฀typical฀example฀for฀the฀obfuscation฀of฀scientiically฀substantiated฀facts฀is฀the฀ activities฀of฀the฀tobacco฀industry฀concerning฀the฀harmfulness฀of฀environmental฀tobacco฀ smoke฀ETS฀ [85] .฀In฀this฀case,฀the฀tobacco฀industry฀has฀got฀together฀a฀network฀of฀scien- tists฀who฀claim฀that฀ETS฀has฀not฀been฀proved฀to฀cause฀damage฀to฀health.฀The฀tobacco฀ industry฀has฀set฀up฀ostensibly฀independent฀research฀institutes฀which฀concern฀themselves฀ with฀the฀ETS฀problem.฀Examples฀of฀such฀institutes฀are฀the฀“Project฀Viking,”฀the฀Tobacco฀ Action฀Committee฀TAC,฀the฀“Whitecoat,”฀the฀Centre฀for฀Indoor฀Air฀Research฀CIAR,฀ the฀Occupational฀Health฀and฀Safety฀Association฀OHSA฀etc.฀Between฀1965฀and฀1993฀ alone,฀these฀and฀various฀other฀bodies฀organised฀11฀symposia฀on฀ETS,฀of฀which฀six฀were฀ overtly฀funded฀by฀the฀tobacco฀industry฀ [86] .

14.10 Smoking and Non-smoking: Weighing the Benefits

One฀claim฀that฀smokers฀and฀sympathisers฀of฀the฀tobacco฀industry฀have฀been฀making฀for฀ decades฀is฀that฀smokers฀are฀the฀cheapest฀citizens฀because฀they฀die฀younger,฀tend฀to฀contract฀ illnesses฀that฀quickly฀lead฀to฀death,฀and฀therefore฀cost฀less฀in฀the฀way฀of฀pension฀payments.฀ This฀often฀used฀argument฀is฀untrue฀and฀needs฀refuting฀ [87] .฀As฀long฀ago฀as฀1999,฀the฀World฀ Bank฀showed฀that฀while฀the฀life฀of฀a฀smoker฀is฀shorter,฀it฀is฀also฀more฀expensive฀than฀that฀ of฀a฀non-smoker฀if฀the฀costs฀of฀health฀care฀and฀the฀loss฀of฀working฀days฀are฀also฀taken฀into฀ account฀ [88] . According฀to฀the฀calculations฀of฀a฀group฀working฀in฀Heidelberg,฀the฀costs฀for฀reproduc- tion฀and฀loss฀of฀resources฀caused฀by฀smoking฀are฀signiicantly฀higher฀than฀those฀caused฀by฀ alcohol,฀obesity฀and฀even฀road฀trafic฀Table฀ 14.3 ฀ [87] .฀On฀conservative฀estimates,฀the฀ costs฀ to฀ the฀ economy฀ caused฀ by฀ smokers฀ amount฀ to฀ 40฀ billion฀ 11.75฀ through฀ work฀ disability,฀6.75฀through฀excess฀mortality฀and฀21฀through฀premature฀invalidity,฀while฀the฀ revenues฀of฀the฀state฀from฀tobacco฀duties฀and฀taxes฀amount฀to฀only฀11.5฀billion.฀It฀should฀ also฀be฀taken฀into฀account฀in฀this฀context฀that • ฀ Considerable฀portion฀of฀the฀cigarettes฀smoked฀were฀smuggled฀into฀the฀country,฀thereby฀ reducing฀the฀state’s฀revenues • ฀ The฀treatment฀of฀smoking-related฀diseases฀is฀paid฀for฀not฀out฀of฀tobacco฀tax฀revenues฀ but฀by฀the฀health฀insurance฀funds฀into฀which฀everybody฀pays฀contributions฀ [62] ;฀the฀ costs฀for฀such฀treatment฀from฀tobacco฀duties฀and฀taxes฀by฀6–7฀billion฀ [89] The฀state฀uses฀the฀money฀from฀tobacco฀tax฀for฀all฀kinds฀of฀activities,฀but฀not฀for฀the฀health฀ system.฀According฀to฀a฀study฀by฀the฀Umwelt-Prognose-Instituts฀Heidelberg฀e.V.,฀an฀envi- ronmental฀ forecasting฀ body,฀ the฀ costs฀ for฀ the฀ treatment฀ of฀ smoking-related฀ diseases฀ amounted฀to฀15.65฀billion฀in฀1997฀ [90] .฀In฀view฀of฀this,฀the฀demands฀of฀the฀health฀insur- ance฀funds฀that฀part฀of฀the฀tobacco฀tax฀revenues฀should฀be฀used฀to฀inance฀the฀treatment฀of฀ smokers฀appear฀highly฀justiied:฀the฀Deutsche฀Angestelltenkasse฀German฀Health฀Insurance฀ Fund฀for฀Salaried฀Employees,฀for฀instance,฀has฀demanded฀that฀30฀of฀the฀revenues฀from฀ the฀duty฀on฀tobacco฀and฀spirits฀tax฀should฀be฀put฀towards฀the฀treatment฀of฀smoking-related฀ diseases฀ [91] .฀ If฀ health฀ levies฀ were฀ imposed฀ on฀ alcoholic฀ beverages฀ and฀ tobacco,฀ they฀ would,฀even฀at฀moderately฀rising฀rates,฀be฀able฀to฀generate฀revenues฀of฀up฀to฀65฀billion฀per฀ year,฀which฀would฀even฀allow฀the฀contribution฀rates฀to฀the฀health฀insurance฀funds฀to฀be฀ reduced฀from฀14฀of฀wages฀to฀8.5฀ [90] .฀At฀the฀same฀time,฀this฀would฀mean฀a฀reduction฀ in฀ancillary฀wage฀costs฀of฀40฀ [90] .฀With฀192.5฀billion฀cigarettes฀produced฀in฀the฀year฀ 1996฀ [3] ,฀a฀“cigarette฀penny”฀would฀already฀produce฀revenues฀of฀98.42฀million,฀which฀ could฀be฀put฀towards฀health฀expenditure. If฀the฀costs฀for฀the฀treatment฀of฀a฀patient฀with฀ischaemic฀heart฀disease฀or฀lung฀cancer฀are฀ compared฀with฀the฀costs฀of฀therapy฀to฀enable฀people฀to฀stop฀smoking,฀the฀difference฀in฀is฀ considerable.฀ Even฀ including฀ several฀ consultations฀ with฀ a฀ doctor,฀ nicotine฀ replacement฀ therapy฀could฀amount฀to฀at฀most฀650฀a฀head,฀while฀the฀costs฀for฀treating฀a฀patient฀with฀ coronary฀heart฀disease฀or฀lung฀cancer,฀who฀will฀then฀probably฀die฀anyway,฀is฀estimated฀at฀ 49,340฀heart฀attack฀and฀41,785฀lung฀cancer฀ [92] .฀If฀patients฀were฀themselves฀to฀pay฀for฀ the฀nicotine฀instead฀of฀for฀the฀cigarettes฀they฀smoked,฀the฀costs฀for฀medical฀consultation฀in฀ Germany฀would฀amount฀to฀200–250฀at฀most. Cause Reproduction฀costs a Costs฀of฀lost฀resources b Total Smoking 15.7 19.6 35.2 Alcohol 0.9 4.2 5.1 Sugar,฀meat฀animal฀fats 7.1 4.1 11.2 Road฀trafic 5.6 25.2 30.8 Total 29.2 53.2 82.4 Table 14.3 ฀Costs฀to฀the฀economy฀through฀damage฀to฀health฀in฀Germany,฀with฀attribution฀to฀the฀ various฀causes Figures฀in฀billion฀€฀per฀year฀ [87] a Costs฀of฀medical฀treatment,฀including฀administrative฀costs b Loss฀of฀economic฀production฀because฀of฀illness,฀injury฀or฀death