by Carl V Phillips
Yesterday I pointed out how out of touch the tobacco control industry, and “public health” people in general, are with respect to basic consumer economics. Today I will expand a bit on their key failure. For more on this and its specific implications for THR, see my recent paper (which is rather longer and more detailed than a blog post, or ten, of course, but worth your time if you really want to understand this stuff; it is intended to be accessible to those with only a newspaper-reader level of familiarity with economics, and will be no more difficult than blog reading if you took an econ class or two).
Economics tells is that, in the ideal, everyone is presented with a choice of which goods to consume and they choose the combination, subject to their budget, that makes them happiest. This is a pretty good starting point, and is fairly useful for population-level analysis, though it is clearly too idealized to provide much of a bedrock for analyzing each person’s decisions (e.g., none of us are aware of all of our choices). But take a thin slice of that and you are on much firmer ground: For each choice about consuming a particular good and paying the costs of doing so versus not consuming it, people choose whichever of those makes them happier. (If you want to split hairs about the choice of words, you could elaborate “happier” into “whichever makes them better off” or “whichever makes them and those they care about better off”, but you get the idea.)
To claim otherwise — that people are making a choice that makes them worse off, all things considered, and their revealed preference somehow does not represent their true preferences — requires some strong arguments. The tobacco control people implicitly claim otherwise, since a key bit of their subtext is that people must be worse off if they use tobacco/nicotine. But they do not even attempt to make the necessary arguments, let alone make a legitimate case. Indeed, the fact that they bury it in their subtext rather than making the claim explicitly is a good indication that they know they cannot really defend it.
One legitimate reason that someone’s choice might not really reflect their preferences is that they do not actually know the real costs and benefits, and if they knew the truth they would make a different choice. This argument can certainly be made about smokers half a century ago, and perhaps some people today in highly uneducated populations (who have rather bigger problems to worry about). Half a century ago, smokers make their decision based on a huge underestimate of the (health) costs. But this can no longer be said about tobacco users in any educated society. Indeed what evidence we have suggests that smokers somewhat overestimate their risk. Smokeless tobacco users grossly overestimate their risk in most populations (with Swedes and other aficionados of snus understand the truth more often). Casual empiricism suggests that e-cigarette users may slightly underestimate their risks as compared to a best educated guess about the real risks, but since both the popular and best scientific estimates are that the risk is low (and e-cigarette users are basically all recent ex-smokers, so they chose smoking over abstinence) this hardly seems likely to affect consumption decisions.
So the tobacco control industry has no safe haven from economics there. Of course, they still try to vaguely insinuate that people do not understand the risks, but no one other than some of the clueless useful idiots actually makes that claim. Indeed, most of the time when there is an insistence that more must be done to “educate young people about the risks” or whatever, it is clearly a rationalization for producing propaganda that does not actually educate, but rather is intended to create a racism- or homophobia-like irrational hatred of tobacco users and similar disdain for the products.
Failing this semi-rational explanation (that people are making a rational choice, but based on incorrect beliefs), the task becomes rather more difficult. One argument is that people tend to discount their welfare in the far future compared to immediate gratification more than is rational (based on other measures of how the make comparisons across time). This is a defensible argument that is made by legitimate scholars and researchers who look at risk in general, and can apply it to smoking in particular. (There are no longer any legitimate scholars and researchers in tobacco control as far as I can tell, but this point is made by those outside that industry.) This is possibly a legitimate argument for not believing that smokers are really making the welfare-maximizing choice, though it does not seem to apply to tobacco products like snus or e-cigarettes that have such low risk that there is very little long-term consequence. Moreover, even to the extent that it applies, the scientific argument needs to be made, and there needs to be the additional argument that aggressive intervention is ethical based of this.
Instead of making one of the potentially legitimate arguments, tobacco control hides behind an unstated notion that the choice to use tobacco products is some sort of involuntary tic that people stumble into for no explicable reason (or perhaps because of pretty packaging) and just keep doing. This allows them to pretend that they are not attacking a choice that people are making for some legitimate reason, and thus lets them pretend that they are attacking some inanimate force, not the people that they claim they are trying to help. But such fictions are not without costs to those who believe them. It is difficult to formulate effective tactics when your view of what you are dealing with departs so substantially from reality.
Bottom line: The main reasons tobacco control consistently fails to meet its own expectations are a matter of basic economics (people make choices based on preferences) and basic warfare strategy (if you have no understanding of what motivates your enemies, you will have a difficult time defeating them via any method other than obliteration).
[..."what about addiction?" some of you are asking. Well, what about it? Whatever it means, does it change the basic economic principles? Comments welcome, but more on that later...]