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Jackie A.'s avatar

Another excellent blog, Claudio. Those in the lower socioeconomic class often have higher prevalence of smoking rates. Sadly, due to the UK's recent about-turn with regards to safer forms of nicotine (vaping), and insisting they are upgrading regulations, to curb youth appeal. With banning disposables, and later in 2026 taxing vaping e-liquids, even those without nicotine, as well as a possible flavour ban. These proposed draconian polices will not produce fewer smokers. If anything, it will only boost illicit supplies of cigarettes. As well as boost the illicit supply and demand for vaping products. It sends the wrong message to the public by insisting that vaping is equal to smoking. While public health advocates still insist that those who cannot quit smoking with traditional methods, vaping offers them a harm reduction alternative to quit smoking, which can spare them from smoking-related diseases related to combustible tobacco use (cigarettes). I'm sure the same graph would showcase the same results in many other countries. Those in the lower socioeconomic classes, those who identify as LGBTQ+, and those who work in service industries often have higher smoking rates. Over-regulations on vastly less risky forms of nicotine, vapes, Snus, & oral nicotine pouches just keep a population trapped in smoking. Ensuring that a set percentage of people will remain trapped in smoking habits. Public policies should always be based on science and evidence, and not based on fears or ideologies for a nicotine-free world. As a nicotine-free world will never exist. There will always be a set % of people who will use nicotine recreationally. The same as there will always be a set percentage of people who use caffeine, or drink alcohol. A Puritan world will never exist. So why not push for more harm reduction methods in all vices that people may have? Thanks again, I always enjoy reading your blogs/ articles.

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Paul McNamara's avatar

Firstly, let me say you write very well, you're a pleasure to read. But there is a couple of points I wish to take up. You say:

"Translated into everyday terms, that’s about £0.12 for every cigarette lit—a silent debt paid by the public system and, ultimately, by society as a whole for each puff."

Yes, it is of course true that society pays the costs in healthcare. But isn't this the very reason public healthcare was setup in the first place? Specifically to look after the poor and socially disadvantaged? The very same groups you have pointed out bear most of the harms from smoking? The problem I have with this argument is that it is public health groups, specifically Tobacco Control, who use this argument to lobby for more pain and suffering to be inflicted on these same groups by raising the excise tax on smoking.

You introduce the above by pointing out:

"England alone, smoking accounts for around £2.9 billion annually in healthcare and social care costs."

Ok, but compared to what? How much do Muslims cost in healthcare and social care costs? If I asked this question in public I would be called a racist. It would be pointed out that it is wrong to target a specific group like this. Yet targeting smokers by counting up their costs is perfectly acceptable practice? This in country where public healthcare was deliberately setup to look after the less fortunate?

Furthermore, by what calculation does one come to the conclusion that if all smokers gave up smoking that healthcare and social care costs would diminish? I know you haven't made this argument but it is the implied implication of quoting these costs.

Do non-smoking deaths cost less than smoking deaths? Has anyone ever provided the evidence for this? Would the costs of pensions decrease if everyone gave up smoking? - or would they increase? Would the social care costs be less if all smokers gave up and lived for an extra 5 to 10 years? Who has ever provided any evidence for these implied claims of reducing healthcare and social care costs?

Anyway, I don't mean to be having a go at you personally, I agree with most of what you have written and very much enjoy your writing.

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