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    Advertising Against Lung Cancer
    By Tommaso Dorigo | April 29th 2010 04:03 AM | 35 comments | Print | E-mail | Track Comments
    About Tommaso

    I am an experimental particle physicist working with the CMS experiment at CERN. In my spare time I play chess, abuse the piano, and aim my dobson...

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    I cannot but be happy about the decision of the Australian government led by Kevin Rudd to further tighten the moral suasion against smoking. They decided that starting in 2012, the name of the brand of cigarettes and other logos will be moved away from the front of the pack, making all the packs of cigarettes look equal in their appearance: the one of the picture below. On the left how packs look like now, on the right the new look.



    Cigarette smoke is the most common cause of lung cancer: according to cancerhelpUK, nine cases out of ten are due to smoking. And lung cancer kills about 160,000 men and women each year. The death rate per 100,000 individuals in 2006 (the last year for which there is available data) in the US looked like this:


    So your chance of getting a lung cancer this year are about 5 in ten thousand, on average. Of course the different colors in the map above should not deceive you: they mostly reflect the presence of smokers in the various states. So if you are a smoker, living in New Mexico (the state with the lowest death rate, 23.4 per 100,000 per year) is not going to be three times better than living in Kentucky (the state with the highest death rate, 74.8 per 100,000). For a smoker, the death rate is going to rather depend on the kind of prevention screening one subjects oneself to, and on the quality of medical treatment.

    I have been a smoker myself -not a heavy smoker, arguably- and although I have quit four years ago, I know that my odds of getting lung cancer later on are significantly higher than those of individuals who have never entertained themselves with fags and matches. I have always been aware of the risk, but I am convinced that if the cigarette packs had looked as unattractive as the ones of Australia, my decision of quitting would have come earlier. So I applaud at the initiative, and I boo the bigots who argue against the "obscene" show of lung details in affected patients. Obscene is to not act!

    Finally, I would like to note that lung cancer appears to kill over one order of magnitude more men and women than terrorism, but we seem to pay way less attention to the former. Maybe because we most of all need to preserve our lifestyle, rather than our life.

    Comments

    Hank
    I think, as in anything, there are legal and then practical issues to continuing to hammer on smoking.  The legal ones are unfair restriction of commerce; a perfectly legal business can't be unfairly restricted, at least in the US - cars kill people too but no advertisement will be forced to discuss how many car deaths occur per year and obscure the automaker's brand.  

    The practical issue is how much money does a society want to keep spending to prevent people from killing themselves when they clearly must know better by now?  To-date, no one has gotten lung cancer from second-hand smoke, for example, and in the US only 10% of smokers get lung cancer at all.  50% of people who get lung cancer have never smoked (the UK percentage is much lower, thus the inconsistency of smoking's effect - a lot more people smoke in the UK also).

    It's obviously bad for you and I have never smoked a cigarette but I hate junk law more than smoking.  At some point we have spent enough money - people know it is stupid - so we should outlaw cigarettes entirely or spend the money wasted on cigarette awareness on other things.
    Hank, your comment is full of inaccuracies and incorrect claims, possibly starting with "I think".
    It is very naive to call the tobacco business a "perfectly legal" business. Of course "legal" very much depends on the specific country, but can you call it "legal", when cigarette producers add ingredients to enhance addictiveness without declaring them, or intentiously lying about health effects? For the consumer, the main difference between cigarette brands and drug dealers is that cigarettes are legal and drugs like cocaine, THC (in many countries) etc. aren't.

    Your comparison with the cars seems clever at first sight, but fails on second thought: First: If at all, this is an argument contra cars, not pro cigarettes. Second, an more important: A car accident is most probably caused by bad driving habits, most prominently drunk driving. Thankfully, there is advertisement against drunk driving!
    And like the anti smoking ad, it is of course independent of the specific brand, so not leading to any unfairnesses at least inside the tobacco sector.

    "To-date, no one has gotten lung cancer from second-hand smoke"
    This is at least uninformed, if not untrue. If you consult your physician and he tells you that you have lung cancer, does he ask you "Have you ever smoked second hand?" or anything like that? Of course not, because it is quite impossible not to smoke second hand the whole life. On the other hand, you can estimate the expected effects of second hand smoking very easily by the amount of tar and other carcinogenic things inhaled. Consider for example an evening in a small pub where the majority of people smoke and guess the equivalent number of cigarettes for a non-smoker inhaling the pub air. Your number of 0 seems very unrealistic.
    Additionally, your numbers partially contradict Tommasos. If really your's are right and his are wrong, what are your references?

    The so called "inconsistency of smoking's effects" are - Tommaso already explained this - due to the differing quality of medical treatment and provision. Clearly, UK smokers don't "smoke healthier" because they are UK citizens.

    Outlawing the cigarette is hiding from the problem, not solving it. For example the prohibition of alcohol in some countries, roughly in the 1910s to the 1930, was not at all succesful, as black market alcohol business immediately took off like a rocket.
    The more intelligent thing is a sustained education of children and adolescents. This might be accomplished by Rudd's proposal.

    Hank
    It is very naive to call the tobacco business a "perfectly legal" business.
    You start off your comment with an insult and then your first actual real point tells me (and us) that you don't actually know what words like 'legal' even mean.   If tobacco is not legal, company executives would be in jail, just like cocaine dealers.  They are not in jail, thus it is legal.  They are running public companies, the companies pay taxes, they advertise, they have government permission to be in business.

    They are in every way as legal as any business on the planet.
     
    I didn't bother to read the rest of your diatribe because if you can't even accept what the word 'legal' means, your agenda-based rant is unlikely to understand a nuanced argument like 'people will do things that are bad for them so throwing more money at them makes no sense'.
    So you think your argument proves smoking is illegal? You may not realize it but stupidity also kills, your life is clearly in danger.

    "50% of people who get lung cancer have never smoked"
    Where do you get your stats? The Center for Disease control says something much different http://cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effect...

    "To-date, no one has gotten lung cancer from second-hand smoke"
    How can you claim to know that? It's quite plausible to me that cigarette smoke, which is known to contain many carcinogens, could possibly cause cancer in someone who spends time around and near a smoker or smokers, as they are taking in the smoke as well. Why else do I find myself gasping for air and coughing when I walk by one? It's not placebo when I figure out the reason I coughed was because of a smoker I wasnt aware of.

    Also comparing cars to cigarettes doesn't make sense when automobiles bring a benefit to society, whereas cigarettes do not. True it probably isn't the governments place to save people from themselves if there is no excuse to be ignorant. However I think, and most of you I hope will agree, that the government should protect us to some extent from other people(why else have a justice system?). As soon as a smoker smokes around people they are harming those around them.

    Gerhard Adam
    As soon as a smoker smokes around people they are harming those around them.
    Oh please.  Perhaps you think the government should protect you from campfires, and barbecues, and other sources of smoke as well?  After all, you don't mind breathing in carbon monoxide because it's good for society, perhaps we should only allow people to smoke cigarettes if they contribute more to society than those that are exposed to their second-hand smoke?

    All I can say, is that for the people that are so worried about second-hand smoke and being so healthy ... if I ever meet them they better be looking fit and trim, because there's nothing more annoying that seeing someone hype being healthy while they're packing around an extra 30 pounds and munching on chips.

    ... and please spare me the poor helpless victim of second-hand smoke speech.  I happen to know that on the west coast during a forest fire, you may have days of where you're breathing in smoke that has nothing to do with cigarettes, so stop whining.  A cigarette smoker isn't going to kill you when you're outside.
    Mundus vult decipi
    Hank
    The CDC does not dispute what I said - my number was the most generous - they cite one analysis from 2004 which claims that 90% of all lung cancer deaths are attributable to smoking - not cases of lung cancer but deaths from lung cancer.   Like bizarre '50% of people get divorced' statistics where they see twice as many marriages as divorces in one year and make a broad claim, the death statistics make no sense.
     
    Fewer people smoke than any time in the last hundred years so how in the 20 year period they analyzed (the 2004 analysis was 1960s to 1980s) did deaths from lung cancer triple and get smoking as the cause while smoking dropped?   

    I am not a shill for smoking but I am against agenda-based science claims and as smoking has dwindled but the need for money remains, the claims have gotten more outrageous.
    "To-date, no one has gotten lung cancer from second-hand smoke"
    How can you claim to know that? 
    That is what science is.  Science is not "unless you can prove it did not happen, it did" or else I could claim "aliens from Mars are caused by second-hand smoke" and demand you prove it wrong.  There is no case where someone has gotten lung cancer and can have it attributed to second-hand smoke, unless  you ask an 80 year old person if they have ever been around a person who smoked and declare that a second-hand smoke death.

    Risk

    You have to understand the difference between risk, relative risk and absolute risk.  Smoking tobacco is the major risk factor for lung cancer.

    As a smoker, the CDC says you have a 10% higher risk of dying from lung cancer as a non smoker.   Lung cancer kills no matter how you got it.    That's not to say that smoking may not be responsible for a variety of other things, cigarettes have some 60+ carcinogens, but this is a science site and we need to deal in facts, even on hot button issues like cigarettes.

    There will be 170,000 cases of lung cancer in the US this year but there are 60,000,000 smokers, so even the most aggressive massaging of numbers does not add up to claims that make people believe if you smoke you will get lung cancer.
    dorigo
    Wait a minute Hank. I also do not want to enter the diatriba of the above exchange, but I need to say something about your last sentence. The following:

    changing the appearance of a box of cigarettes does in no way throw money at the issue.

    Instead, we throw money at tobacco companies by having to spend money on public health, curing the damage of tobacco smoke. Those companies make large profits while they do not contribute to the social impact of their business, and this is quite the opposite of throwing money at people who do bad things to themselves: we do it when we have to cure their disease (here's a topic on which your republican brain should resonate ;-) while it would be much better if big Tobacco did that. In some way they do (taxes), but too little IMHO.

    What I really think ? If we agree that smoking is bad, we certainly do not take it off the shelves - that is guaranteed to not work. However, we find it immoral that somebody should get rich by killing people, so we prohibit anybody from earning a profit from it. I.e., the state should buy tobacco and sell it as a monopoly. But on this you do not resonate I guess :-D

    Cheers,
    T.
    Hank
    :)  Well, you are on a different issue but, yes, I think the only thing that would make smoking worse for society is to have the government losing taxpayer money in that business - and the government would lose money, since they lose money on everything.  Under 30% of people smoke in the US so having 100% of people pay tax revenue toward manufacturing and selling it is bad.

    My contention is primarily a legal one, though maybe too philosophical for opponents of smoking.   We have spent a great deal of money on anti-smoking campaigns and some still do it so what is the actual benefit of spending any more?  Adding more regulations to any business means more cost - governments do not write laws or enforce them or fight in court over them for free.

    If cost is deemed irrelevant even though the number of lives being saved is less and less for each extra dollar spent, why not lower the driving speed limit to 5 KM per hour?   All lives from accidents would effectively disappear if that were done, saving many more people than smoking restrictions will.

    The answer; because it is impractical.   Lives saved at 80KM/hour are apparently worth while but lives that would be saved under that are apparently not.

    And so it goes with even more passive-aggressive legislation toward smokers.   Just abolish it, make it illegal, or accept that some people want to act in stupid ways and more legislation and money will not cure that.
    "who never entertained themselves with fags and matches"

    ..... uhmmmm *looks around nervously*

    Gerhard Adam
    What about all the other things that kill people (by their own doing)?  Why not put pictures of cirrhotic livers on alcohol bottles? or fatty hearts and fat on hamburger advertisements?  or mangled bodies from car accidents(not just drinking but consider cell phones and texting)?

    In the end, the question comes down to the degree society is responsible for protecting us from ourselves when the ability to make informed decisions already exists.  This is nowhere more obvious that the issue of sex education, where it continuously amazes me that given the fact that no one would claim to be ignorant, they remain ignorant enough to fail to properly use birth control.

    One can only conclude that people will do what they will until they decide to stop doing it and no amount of external intervention will ever change that fact.


    Mundus vult decipi
    Just one comment from an inveterate smoker who will never get a single cent from government or big business for anything.

    The difference between tobacco and any other cause of bad health you might consider (car accidents, hamburgers, etc), except cocaine, is that tobacco is the most addictive substance known, with the exception of cocaine. And addiction happens very quickly. So, the decision by states to regulate it is the correct one, only it should be more heavily regulated. The goal, of course, being that non-addicted people do not become addicts.

    "since they lose money on everything"

    I take it you'll never accept any help from government unless they can prove to you that by providing such help they're making a profit.
    If, for example, and may God forbid it, your house started burning.

    Gerhard Adam
    The goal, of course, being that non-addicted people do not become addicts.
    While I can understand the objective, why is that the responsibility of society or the state?  We know how addictive heroin is, as well as the law surrounding it's availability.  So tell me how's that working out?

    Stronger regulation only criminalizes an activity that the state has no business regulating.  Human behavior cannot be controlled by legislation.  There isn't a single law on the books that has ever stopped something from happening.  The law's purpose is only to define what the state can do when the "law" has been violated.
    Mundus vult decipi
    "Stronger regulation only criminalizes an activity that the state has no business regulating. Human behavior cannot be controlled by legislation. There isn't a single law on the books that has ever stopped something from happening. The law's purpose is only to define what the state can do when the "law" has been violated."

    Are you saying laws are useless as a deterrent? That no one has never not harmed another human being out of fear of their own death or loss of freedom? So essentially it sounds like you are proposing that if nothing were illegal tomorrow and thus not punishable by law tomorrow things would continue the same? (aside from lawyers not being too happy)

    Gerhard Adam
    Of course ... you can't really expect me to believe that it's the law that prevents you from murdering your neighbor, or from stealing his car.  Equally you can't expect me to believe that our prisons are filled with people that didn't know that what they were doing was illegal.

    The law has never been a deterrent, which is evidenced by the fact that even the death penalty fails as a deterrent.  History is replete with examples of public executions being the trolling ground of petty thieves and pickpockets, who would've also been subjected to the same punishment.

    Are you telling me that the only thing that separates you from being civilized versus being a savage is the law?

    More importantly, provide any example of any instance where the law prevented something from happening?  Perhaps relatively innocuous situations where you might behave to avoid some penalty (like following speed limits), but in more serious matters, the law is ineffective as a preventative tool.

    Laws are invariably obeyed by individuals that were inclined to follow those rules in the first place.  Anyone not so inclined isn't going to let something like the law get in their way.  This is why every law passed is only effective against those that would've obeyed it anyway.
    That no one has never not harmed another human being out of fear of their own death or loss of freedom?
    Absolutely.  That's a common myth in today's society.  The truth of the matter is, if the law compelled you to kill for your own protection, the majority of people would still not be able to do it. In fact, that's the primary impetus for most legislation ... the fact that people think that laws can compel others to behave in a manner that makes them feel more comfortable.  It's also why no law has ever been effective at achieving that objective.
    Mundus vult decipi
    Your position is absurd.

    Of course law and punishment act as a deterrent, it's far from perfect but it certainly works. I know it works for me as I do take potential punishment into account.

    It only works to some level but that doesn't change the fact that it works. For example if murder was legal it would be much more common - I might have already done it myself (and yes I could easily kill if I had good reasons).
    On the other hand rising the penalty from 40 years in prison to 50 is unlikely to have any effect at all as the punishment is already such that only those brake the law who think they won't get caught.

    Gerhard Adam
    Not at all.  The reality is that everyone that thinks killing is a casual business would quickly discover that their intended victim (and their relatives) would also be in a perfectly legal position regarding any retribution.  So while there are a few morons that might degenerate into blood feuds, the majority of people would realize that they need to get along just like everyone else.

    The law serves only one purpose, and that is to define the power the state has in exacting retribution.  It does little or nothing for the victim and it isn't particularly interested in justice.  Laws aren't there to help you, but only to define what the state is allowed to do, while denying you the same opportunity.  It is simply a transfer of power from you to the state.

    In particular, having no law on a matter doesn't mean that there may not be consequences to your actions, but only that those consequences will not be exclusively in the hands of the state.

    As for your comment that you "might have already done it" yourself, demonstrates that you are either being glib or irresponsible, since it is highly unlikely that anyone you've encountered deserves death at your hand. 
    Mundus vult decipi
    I understand more now what you are trying to say and thank you for replying, however I personally know people that would have committed crimes, generally petty ones, but did not because of deterrent of being caught and imprisoned. I understand your point that people who are moral follow laws and people who are immoral wont follow laws, I once thought that. But Ive come to find that most people are probably something in-between. Thats just my thoughts, I could be wrong you may be right.

    While I can understand the objective, why is that the responsibility of society or the state?

    Because in civilized societies it is the state who's responsible for regulating the relations among the different social actors. Just like it's the state's responsibility to regulate food, medicines, and so on and so forth. It's obviously more profitable, for example, to sell rotten pizza than good pizza, and many people do it, and many people get ill and even die of food poisoning. Now, if you're the kind of libertarian that would eliminate the FDA, for example, well, there's not much I can say to you that will change your mind.

    We know how addictive heroin is, as well as the law surrounding it's availability. So tell me how's that working out?

    I think it's working out pretty well, though it could of course be much better. There's not an epidemic of heroin addiction now, as far as I know, as serious as, for instance, the tabaquism epidemic in Eastern Europe, or the alcoholism epidemic in England.

    If heroin were made legally available, and that would also lead to a lower cost on the streets, then things would probably be very from what they are now.

    Gerhard Adam
    Because in civilized societies it is the state who's responsible for regulating the relations among the different social actors.
    What does that even mean?  You compare the FDA and it's policing of food quality (because that knowledge is NOT readily available to every consumer) with regulating cigarette smoking because it's unhealthy (which is knowledge that IS readily available to every consumer).

    Regarding your point about addictions, completely ignores the fact that the laws clearly don't work.  If you don't think having prisons bulging at the seams being predominantly occupied by drug crimes and addicts, then you aren't looking very hard.  We spent billions of dollars with numerous government agencies and Afghanistan is still having a record year in their poppy crop.  I would submit that the law is remotely effective at any level of measurement.

    You then mention the alcoholism epidemic in England.  Why?  It's not illegal in the U.S., why should there be an epidemic in England any more than anywhere else based on the legal system?  Once again I don't think you've demonstrated a causal relationship between the legal system and behavior.  For whatever reason that people choose to engage in dangerous and unhealthy activities, the law rarely enters into the decision-making process.

    People are always glib in talking about what they would do if there was no law, but that's simply rubbish.  The vast majority of people would behave exactly as they do today, with the only exception being those areas that are governed more by "rules" than criminal laws.
    Mundus vult decipi
    Hank
    There is also a crime epidemic in the UK; Wales, England and Scotland are the top 3 in crime in the civilized world despite guns being illegal - and an obvious contention is that crime is so high because guns are illegal and people cannot defend themselves.

    More government involvement that limits the choice of law-abiding people to penalize or benefit a minority has never worked out well.

    In California we have gotten even sillier; they have now added even more taxes onto cigarettes to close the gap in its bloated government budget.  So the government is making itself even more dependent on revenues from people it is trying to prevent from doing what is making its revenue, including government-funded anti-smoking campaigns.
    "There isn't a single law on the books that has ever stopped something from happening."

    You bet. There are quite a few things I'd like to do if they were legal.

    To quote Enrique Jardiel Poncela, a famous Spanish playwright and novelist, "There's nothing I hate more than fatuous people, and I'd love to spend Sunday afternoons shooting them dead."

    Gerhard Adam
    That's just flip nonsense.  Killing is a lot harder to do than it is to talk about.
    Mundus vult decipi
    The resistance to killing very much depends on the person, and the society they're a part of. Humans are very adaptable. The US murder rate has always been very high, right back to the first settlers.

    Well, that's what Poncela says... But, I don't quite get your point about laws not having influence on behavior. You sound to me like an anarchist who wants to abolish the state. But that cannot be what you mean, because we all know perfectly well what the absence of government and law looks like. Places like the tribal areas of Afghanistan/Pakistan and Darfur are good examples. When a society eliminates the rule of law and its enforcement by government, what it gets is the KKK, the Taliban, the Janjaweed. Which, by the way, is just government by warlords and laws made on the fly at their whim.

    Gerhard Adam
    Places like the tribal areas of Afghanistan/Pakistan and Darfur are good examples. When a society eliminates the rule of law and its enforcement by government, what it gets is the KKK, the Taliban, the Janjaweed.
    Actually everything you're describing exists precisely because of government.  Specifically outside governments and organizations that are providing money and arms to maintain the warlord system.  Why do you think Afghanistan is under warlord control?  It's because we think that we can bring order into that chaos, which provides the power to the warlords to negotiate for more favorable terms and conditions.  Consequently we have our military in a position of protecting our "allies" thereby granting them record production of heroin.  Yeah ... that system really works well.

    Of course, if you were really going to talk about the benefit of government versus small or non-existent government then you'd have to consider all the aspects of it to make an realistic assessment.  In the first place, government is necessary in modern society because of the sheer volume of the human population.  It is impossible to break down into small enough social groups, therefore government must exert the power to try and provide the cohesion.

    In the second place, even if the population were small enough to break up into smaller social groups, a sudden shift from the status quo would also be chaotic as individuals vie for position and power.  It's only after things settle down that an honest evaluation can occur.  This is no different than the chaos that accompanied the American Revolution or any other establishment of a government authority.  Looking at it during any instant of time before it's established, would always make it look unworkable.

    I do find it interesting that you think that by eliminating the law, we would fall under the power of the KKK or Taliban-like entity.  In fact, you're not presenting anarchy, but rather an alternative repressive government.  It has nothing to do with anarchy.   Once again with a smaller population broken up into smaller social groups, entities like the KKK would have small places where they could gather, but they wouldn't be nearly as effective, nor would they be terribly influential.  Once again, it's the existence of government that provides the social infrastructure necessary for groups like that to arise.  After all, they don't have to expend energy for their own survival, since the government already guarantees that.  In addition, groups like the KKK or the American Nazi Party, specifically rely on the government protections that prevent people from taking them out.
    Mundus vult decipi
    Bye the way, after seen what deregulation in the US financial system led to, you still think that regulation by the state makes no difference?

    Gerhard Adam
    You're looking at a tiny piece of the law.  Deregulation has little to do with it.  Start from the premise of why corporations are protected from personal liability so that a corporation has the same rights that an individual does.  From that basic protection, corporations then gain protections against their decisions by government underwriting and the "regulations" that define the behavior that will be considered "legal".  Amidst all of this toss in "deregulation".  By this point, the concept doesn't even make sense, since everything about their existence and their decisions exists only as legal concepts,so what does it mean to "deregulate" such an entity? 

    In case, I wasn't clear, it makes no sense to discuss "deregulating" something that only exists as a figment of legal imagination.  This is hardly on par with regulating individuals that are quite capable of making their own decisions.
    Mundus vult decipi
    Geez... Sorry, that should have been "By the way, after seeing..."

    Why does Tommaso refer to those who don't like the picture on the box as "bigots"? That was not only a gratuitous slap, but an incomprehensible one as well.

    Oh, wait ... I understand. Lots of smokers in the American South, a veritable nest of bigots and way uncool types, news of whose infamy has traveled unto the ends of the Earth. Never mind. Carry on.

    dorigo
    Mike, I apologize. I am not a native English speaker. Sometimes I do use a wrong word here and there. What I meant was that there are people who will call obscene those images, while their own life is more obscene. I mean, hypocrites.

    Cheers,
    T.
    I'm sorry. I should have thought of that before I jumped in.

    I've read many of your articles, and your English is excellent.

    I'm a smoker. Tried to quite a couple of dozen times in a couple of different ways including Chantix. At age 54, I figure I've got to die of something, so it might as well be from something I enjoy. As far as the package goes, when I'm craving a cigarette, I couldn't care less about what's on the pack. And if it helps some people quit or keeps others from starting to smoke in the first place, then I say more power to them!
    dorigo
    This looks like a automated comment, but if it is not, welcome.
    T.
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