Smoking – A World Bank Study

NEW YORK, Reuters –
New York Times. July 31st, 2001
By Bob Herbert

A counterpoint to the egregious Philip Morris report, suggesting that the early death of smokers can benefit a nation's economy, is an extensive study by the World Bank that details the chilling, and very expensive, toll that cigarettes are taking around the world.

According to the report, called "Curbing the Epidemic," the only two causes of death that are huge and growing worldwide are AIDS and tobacco-related illnesses.

According to the Centers for Disease Control and Prevention, tobacco is expected to become the biggest killer in most developing countries within the next 20 years, causing more deaths than AIDS, malaria, tuberculosis, automobile crashes, homicides and suicides, COMBINED!

If current patterns hold, a half-billion people who are alive today will eventually be killed by tobacco.

More than half of these are now children and teenagers. By the year 2030, tobacco is projected to be the single biggest cause of death worldwide, accounting for about 10 million deaths per year.

Big Tobacco ought to send thank-you notes to new moms and dads around the world, because their newborns are absolutely essential to Big Tobacco's strategy of addicting ever-larger waves of young customers to replace the ever-increasing loads of smokers lost to early death. The World Bank estimates that in affluent countries, 14,000 to 15,000 children and young people take up smoking each day. In middle-income and low-income countries, somewhere between 68,000 and 84,000 take their first insidious puffs.

And this is significant when talking about the economics of smoking. According to the World Bank study (which was done before the recent study commissioned by Philip Morris), it appears that smokers' lifetime health care costs in affluent countries are "somewhat higher" than non-smokers', despite their shorter lives. It is not at all clear what the situation is in less affluent countries with less extensive health care networks.

But that, of course, should not be the issue. The first issue to be addressed is the non-economic value, one would hope it would be a high value, that we ascribe to human beings based solely on the fact that they exist. But even if the discussion is limited to economic matters, there is a problem with Philip Morris' contention that countries can derive benefits from the early demise of smokers. It flies in the face of accepted economic theory, which argues that the benefits of a free market flow from rational decisions made by consumers who, when spending their money (and only their money), understand the risks and rewards of the choices they make.

That is largely not the case with smokers. Despite all the warnings about the murderous effects of tobacco, it seems clear that, as the World Bank study noted, "People's knowledge of the health risks of smoking appears to be partial at best."

That is especially true with young smokers and smokers in poorer countries, where information about the hazards of smoking is limited. The study said, "In China, for example, 61% of adult smokers surveyed in 1996 believed that cigarettes did them 'little or no harm."

People tend to underestimate the addictive effects of nicotine and grossly underestimate the likelihood they will contract a horrible disease.

Some years ago, an anti-smoking activist named David Goerlitz, who had once been known as the Winston Man because he had appeared in Winston ads for the R.J.Reynolds Tobacco Company asked a group of R.J. Reynolds executives if any of them smoked.

They all said no.

Goerlitz said one of the executives shook his head and said: "Are you kidding? We reserve that right for the poor, the young, the black and the stupid."

Not much has changed.

That philosophy is now being played out on a global scale.


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