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America’s new tobacco crisis: The rich stopped smoking, the poor didn’t
- gruturo 9y agoThis, if correctly publicized, would be the best motivation in getting huge amounts of people to stop. Think of a slogan like "Only the poor still smoke" or "it's what losers do" and how it would impact people. Suddenly you'd be embarrassed of being seen smoking.
- Neliquat 9y agoExcept there is prid3 in being poor in this country.
- kemiller2002 9y agoI don't think so. You are correct that there are a large number of people who don't want the social stigma of being poor etc., but for many they see it as one of the few pleasures they can still have. To these people, they smoke, most of their friends and family smoke, and life is a struggle on a day to day basis. To them calling them a loser doesn't shame them, it just makes them more angry towards you.
- anovikov 9y agoBut it will help a lot for the remaining ~10% or so of middle class people who smoke, to quit.
- bryanrasmussen 9y agoso when the poor eat the rich and middle classes at least the meat will be of higher quality?
- kemiller2002 9y agoSadly enough, the poor never eat the middle and upper classes. The upper and the middle may switch and inconvenience the other for a time, but the poor will always be the poor. They never get to go anywhere.
- thinkfurther 9y agoI once spent a night in the home of an elderly very poor couple on Tenerife, because they offered some sort of service where the husband would fetch people from the ferry, and bring them to the airport the next day. They were so kind. He was near mentally challenged, a super sweet guy working as a garbage man there, so they could just barely afford it. They lived there because she had horrible arthritis and the climate there was the only thing that had ever helped. They had basically no friends there, lived in a poor village in some outskirts, the broken down look over your shoulder kind. And I still remember how she offered, just to be hospitable, some watered down fruit juice with like just a whiff of alcohol, and how she pointed to her super cheap cigarettes and said with a voice that was so full of cynicism and despair at the same time, that this was her only pleasure. I still remember that voice, the look her face had at that second, some kind of snarl -- not against me, they were so kind to me.. but against her fate I guess, and/or herself. It's impossible for me to describe, but indelible. Like all that misery, that is mostly pent up and that will follow her into the grave, escaping a bit in a short hiss. There is a German saying, to make a good face in a bad situation, and for just a split second, her face stopped doing that altogether, and I will never forget. God forbid that I do. None of what I'm writing makes sense to anyone I'm sure, but I so wish I could describe the pang I felt then -- and the pang I felt just now, reading the suggestion that, basically, "they" are beyond help anyway, so let's make advertisements shaming people for smoking, so that those who still have something to lose might fear to be associated with those who don't. Would you also say this in the presence of "the" poor? If I could make one invention, it would be something that swaps the brains of humans around every 5 years, completely randomly. People would sober up rather quickly I'm sure.
- jacquesm 9y ago> If I could make one invention, it would be something that swaps the brains of humans around every 5 years, completely randomly. People would sober up rather quickly I'm sure. A variation on that is that the world where you have no control over who you will be in it is the world that you should strive to create.
- ss248 9y agoThis is called "Veil of ignorance". [1] [1] https://en.wikipedia.org/wiki/Veil_of_ignorance https://en.wikipedia.org/wiki/Veil_of_ignorance
- gruturo 9y ago(Mis-)Quoting John Steinbeck, "the poor see themselves not as an exploited proletariat, but as temporarily embarrassed millionaires". This can be a powerful driver. And if it gets people to stop smoking, which is a devastatingly unhealthy habit, well, I'm ok with that.
- whatok 9y agoReally can't tell if this is sarcasm or someone who just missed the entire US presidential cycle.
- deleted 9y ago[deleted]
- BOBOTWINSTON 9y agoThere might be something there with economics, but a government (or any authority) calling people losers I doubt would have any effect. The "drugs aren't cool" campaign's have never really worked.
- flipp3r 9y agoHahaha, this reminded me of a The Onion video. I'm sure it would eliminate smoking among kids almost entirely; https://www.youtube.com/watch?v=HjsSVCLxcZ4 https://www.youtube.com/watch?v=HjsSVCLxcZ4
- TausAmmer 9y agoFat shaming works too.
- cafard 9y agoOutstanding! And maybe we can call them "deplorables", because that worked so well last fall.
- josefresco 9y agoSome of those anti-tobacco (I'm blanking on the name) commercials targeted at teens/kids use this approach. I forget the actual line, but they mention something about how smokers make less money .. anyone have a link?
- fjdlwlv 9y agohttps://en.m.wikipedia.org/wiki/Truth_(anti-tobacco_campaign) https://en.m.wikipedia.org/wiki/Truth_(anti-tobacco_campaign...
- almonj 9y agoProhibition makes things edgier and cooler, it only makes people want to do it more. Pretty sure there are places that legalized drugs and usage rates went down.
- tertius 9y agoAlso, prohibition does not remove addiction. But I'm sure there's something they can add to our drinking water to change that...
- tertius 9y agoI'm not kidding, advances in anti-addiction medication is going pretty well...
- gruturo 9y agoBut this isn't prohibition - tobacco products are still for sale (except to minors, where the mechanism you mention definitely is at play). It's just building a social stigma about the use of the product - which happens to be based on facts.
- jayess 9y agoWhat a completely tone-deaf, condescending position.
- psyc 9y agoUh, what? I know I'm a poor loser, and all the poor losers I know, know we're poor losers. We don't exist in an arena where that's embarrassing. That's just you lot.
- throwanem 9y agoThat's already more or less the attitude that prevails among those of moderate to high socioeconomic standing. Making it official doesn't seem likely to change anything, especially in light of the fact that you don't really find a lot of cases in which people from different situations mix like that - it's pretty difficult for social opprobrium to exert much pressure upon people who never actually experience firsthand because they're never around those who would express it, or vice versa. Quite aside from which, as I mentioned before, this is already pretty much the attitude, and the natural response to contempt is resentment. I've gotten any number of sidelong looks and smartassed comments from people who seem to find it a trespass upon their persons that I happen to be smoking within their eyeshot, and I can't say it has made me any more inclined to quit than the perceptible effects of maintaining the habit already do.
- amelius 9y agoOr how about a mandatory message like "drinking may decrease libido" on every alcohol-related commercial?
- coldtea 9y ago>Suddenly you'd be embarrassed of being seen smoking. Or, you know, even more determined than ever to smoke. Psychology is not that simple. (Some english guy, don't remember who, described the same reaction when someone like Princess Diana was on TV telling people to "Say no to drugs").
- Overtonwindow 9y agoI don't think so. You're talking about a class of people who have been beaten up so much by society for being poor, that I think most will look at that sign and go "yeah no shit" and light up again. Followed by a few more choice words at you and the sign.
- ErikVandeWater 9y agoWho do you think would think fund the "Only the poor still smoke" campaign? It looks really bad from a PR perspective.
- dsjhfiuerheru 9y agoThat is like body shaming someone for eating junk food. They know they are poor, everyone can see that they are poor, no need to point it out.
- anovikov 9y agoIsn't this in general normal for the poor? Poor are poor because they prefer instant gratification and don't think about what it means long term.
- gue5t 9y agoWhereas rich are rich because their parents were rich.
- anovikov 9y agoThat is simply not true, at least not in any even minimally developed country.
- John23832 9y agoThe same can be said about your original comment.
- JumpCrisscross 9y agoYou're both talking in extremes. There is a lot of inherited wealth in the developed world [1]. There is also a relationship between "marshmallow test" impulsiveness and peoples' tendency to squander the opportunities their life presents them [2]. The relative balance between these factors is debatable. Their presence is more difficult to dismiss. [1] https://www.bloomberg.com/news/articles/2016-08-23/how-to-stay-rich-in-europe-inherit-money-for-700-years https://www.bloomberg.com/news/articles/2016-08-23/how-to-st... [2] https://en.m.wikipedia.org/wiki/Delayed_gratification https://en.m.wikipedia.org/wiki/Delayed_gratification
- awinder 9y ago35-45% of wealth as a raw figure is inherited, if you consider wealth ownership by the top 1%, that is a hell of an advantaged start. https://www.brookings.edu/blog/social-mobility-memos/2015/01/30/wealth-inheritance-and-social-mobility/ https://www.brookings.edu/blog/social-mobility-memos/2015/01...
- iscsisounddirty 9y agoNice pay wall
- jessaustin 9y agoI wish! If there's any publication we could stand to read less of, it's WaPo.
- ackfoo 9y agoIn the documentary, "A Billion Lives", the former spokesman for Winston says he was told by tobacco executives (who did not smoke) that smoking is for "the poor, the black, the young, and the stupid".
- passivepinetree 9y agoCan you speak to the quality of the documentary at all? That sounds fascinating/worth watching.
- metaphorm 9y agowould add to that, perhaps, "and for foreigners". Tobacco sales in developing countries are huge. China alone keeps them in so much profit that almost don't care what happens in America.
- _acme 9y agoI think people in developing countries would count as "poor" under this executive's analysis.
- madengr 9y agoYears ago my mother had me buy her a carton. She does not smoke, but was traveling to the 3rd world, and used them as currency; American cigarettes were like gold. Need to hail a taxi? Hold up a pack of American cigarettes.
- wmeredith 9y agoThis reminds me of the line from The Godfather when the New York mob families are getting into the drug trade, discussing the distastefulness of the business, "In my city, we would keep the traffic in the dark people - the colored. They're animals anyway, so let them lose their souls." It's much easier to profit of someone else's suffering if you convince yourself of their inhumanity or otherness.
- aszantu 9y agosince poor people have shitty or no jobs at all, why does it matter if they die off of smoking?
- sctb 9y agoI understand that this comment may be an expression of exasperation, but please post civilly and substantively on HN or not at all. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- smileysteve 9y agoIt seems smoking could be strongly correlated with the growing life expectancy disparity.
- jacquesm 9y agoThat's not just limited to America. I travel a lot, a few years ago, say 15 or so it would be pretty rare to see young people smoke and now somehow it is 'cool' again. I've had the unfortunate experience of delivering a couple of friends to an early grave courtesy of lung cancer, the one thing that seemed to unite them was that they wished they had never started smoking and that once they did they had the strength to quit. The youngest of those was mid 40's. It's an intelligence test of sorts with a very high price if you fail.
- mordechai9000 9y agoI just got back to the States from Germany. I was struck by how common smoking seems to be there, but I was glad that it was strictly an outside activity. I smoked when I was younger, but I started as a teenager. (Intelligence test failed.) Once you are addicted, it operates directly on the brain's reward mechanism, much the same way I imagine opiates would. It seems as vital and necessary as breathing. (I am generalizing from my experience, not everyone is affected as strongly as I was.) I am so glad I quit, and now it is more or less completely out of my system. On the nine hour flight into Frankfurt, the airline had the flight attendants try to sell duty free cigarettes to the passengers. They walked up and down the aisles offering cheap cartons. Of course you can't smoke on the plane. As a former smoker, that must be torture to people who respond to nicotine the way I did. I really hope smoking doesn't become cool again here in the U.S. I have kids, and I suspect they have inherited at least some of the tendency toward risk taking I had in my younger years.
- tnorthcutt 9y agoSame thing in Italy and France, in my experience. Quite baffling, really.
- exergy 9y agoThe French have it down to an art form. The difference here is smokers still seem to be outside hiking, walking, snowboarding, biking and doing all manner of outdoor things. I'd be interested in how lung cancer rates compare between the US and France.
- falcolas 9y agoMeta: I appreciate how WP interprets a network failure to load assets as an ad blocker. Makes for a great user experience.
- deleted 9y ago[deleted]
- TACIXAT 9y agoEven better, I have an adblocker and have no problem with the article.
- darkerside 9y agoThe smoking cessation class teacher they referenced in the article really made me cringe. She seems like a very positive person, but her ideas about how to quit smoking just seem so very misdirected. I wonder if she has smoked in the past and quit herself?
- Overtonwindow 9y agoShe's not relating to the people she's trying to help. It's like a wealthy person trying to reason with a poor person.
- skybrian 9y agoDoesn't mention e-cigarettes. Hmm.
- coldtea 9y agoThe decline of the middle class and the huge explosion of the riches of the rich class will ensure that rich and poor in 50 and 100 years look and live like different species... Slum dwellers and "city trash" on one hand, and 150 year old clean shaven organic vegan genetically modified uberlords on the other. Warlocks vs Elois all over again...
- KekDemaga 9y agoA theory postulated without evidence: Considering throughout history power and wealth inequality was in many ways much worse (monarchies, despotism, no voting rights without land etc) I wonder if the current distribution is simply an artifact of genetic changes that have already occurred. Perhaps the slum dwellers of yesteryear adapted to those conditions and now in some way subconsciously seek them out.
- BEEdwards 9y agoEvidence right here. https://www.bls.gov/opub/mlr/2017/beyond-bls/income-and-health-outcomes.htm https://www.bls.gov/opub/mlr/2017/beyond-bls/income-and-heal... They note that the average age of individuals in the middle- and high-income groups has increased since the 1976–80 period, while the average age of those in the low-income group has decreased. Ultimately, individuals from families with top incomes overwhelming report being in good health. Indeed, individuals in this group were more than twice as likely to report being in very good or excellent health than individuals in the bottom group. If that isn't leading to the scenario described I don't know what you think it's leading to, but it can't be good.
- Pxtl 9y agoExcept that wealth is consolidating into the cities where you can't hide from poverty within gated communities.
- qbrass 9y agoSure you can. They're doing such a good job that you didn't notice them.
- davidf18 9y agoAs of roughly 5 or more years ago, half of tobacco consumed in the US is by people who are mentally ill and/or substance abusers. For example, people with Schizophrenia are heavy smokers and 90% smoke. Those with clinical depression 60%. They are self-medicating for their underlying illness. We need to ensure that they are getting proper treatment. Income Disparities in Absolute Cardiovascular Risk and Cardiovascular Risk Factors in the United States, 1999-2014 https://www.ncbi.nlm.nih.gov/pubmed/28593301 https://www.ncbi.nlm.nih.gov/pubmed/28593301 This study shows that in the 15 years studied, only the smoking rate of high income individuals has decreased from 14% to about 9%. Those at the poverty level or below has remained about 36.5% who are smokers (some of those will be the mentally ill and/or substance abusers) and middle income is about 24% who are smokers. Former NYC Mayor Mike Bloomberg with his latest donation of $360 million in December, now donated a total of $960 billion to combat tobacco in low- and middle-income countries (e.g. China, Russia, Bangladesh, but also Turkey). Bill Gates added another $125 million. The plan is to implement the World Health Organization's (WHO) MPOWER program which has been implemented in NYC since 2001. Raising the cost of tobacco has over half the effect of getting people to quit or never start. Also very important is banning smoking in public places and hard-hitting, scary, advertisements spending about $1 to $2 per capita. Clinical interventions such as doctors speaking with patients about quitting, providing nicotine replacement therapy, and telephone counseling support are also important. But most of the gains are from the public policy initiatives. A frustration I have with the healthcare system in the US is that too little is sent on public health interventions such as MPOWER compared with the spending on clinical interventions. If you want to lower healthcare costs, ultimately more effort has to be put in public health interventions which is much more scalable and more effective than clinical interventions. Under ObamaCare, smokers can be charged premiums 50% higher than non-smokers because the healthcare costs of smoking are so high, yet most insurance plans don't charge the premium nor does the ObamaCare let insurers really verify if someone is a non-smoker. If you want to lower the high costs of healthcare, nationally implement MPOWER in the US as well as other public health interventions. ObamaCare made a huge mistake when they did not implement the tobacco tax policies of Canada, UK, France and other nations which have universal care which is pay for the healthcare partially with high tobacco taxes in the range $5 to $7 per pack or more. Our federal tax is about $1. Raising that of these other nations would result in tens of billions of dollars for paying for healthcare while helping people, especially the poor, to quit smoking.
- ryan606 9y agoI was able to quit my 1/2 pack a day addiction four years ago after 15+ years, but it was challenging. Smoking was expensive (four years ago: 4 packs a week = $40), but quitting smoking was even more expensive. In addition to the expense of Chantix, I also started surfing Amazon for things to reward myself instead of going outside for a smoke break. So it was probably $100 - $200 a week. Now nicotine-free for 4+ years, it's less costly all around (not to mention the health costs), but I understand all too well the difficulty and economics of quitting.
- jacquesm 9y agoThe long term rewards are the ones that matter most. Congratulations!
- tomatsu 9y agoI quit cold turkey and ate 2 large bags of sunflower seeds in the first 3 weeks. Quitting was cheap. Quitting isn't that hard. It's just super annoying. Things like exercising regularly and eating properly take more discipline and willpower, for example.
- mercer 9y ago> Things like exercising regularly and eating properly take more discipline and willpower, for example. From what I've read quitting smoking is one of the most difficult things to pull off in general (even compared to 'hard drugs'). Do you have any references in support of your view?
- torrent-of-ions 9y agoOne of the things that surprised me in Germany was the extremely high smoking rate. Apparently the adult smoking rate is between 40-45%. My experience was that it is by no means limited to poor people either. It was really surprising to me to see a country which presents itself as a modern, progressive force in the world having cigarette vending machines on almost every street in the country. To contrast, I was recently in South Africa at a wedding full of people of all ages (all white, though). We noted that out of 100+ guests only 2 were smokers. A recent study shows that the overall rate in both whites and blacks is about 15%, while in coloureds it is 40%. It's interesting because it shows more of a race divide rather than class divide.
- Cyph0n 9y agoRegarding your last point, how do you know that it's not also a class divide? I wouldn't be surprised if South African blacks were more impoverished overall.
- torrent-of-ions 9y agoBlacks and coloureds tend to be more poor. But maybe many of the blacks are too poor to smoke, while the coloureds are not so poor, but still as poor as a poor American.
- drivebyops 9y agoIt's about what government can do to promote against smoking. Anti smoking ads, anti smoking packaging laws, school exercises, etc about smoking over the years in Australia have led to a rapid decrease in smokers over there.
- dpark 9y ago> It was really surprising to me to see a country which presents itself as a modern, progressive force in the world having cigarette vending machines on almost every street in the country. This surprised me, too, the first time I went. Seeing 12 year olds smoking in public spaces was really, really bizarre. The only logical conclusion is that the German government and/or populace simply doesn't care about reducing cigarette usage. > A recent study shows that the overall rate in both whites and blacks is about 15%, while in coloureds it is 40%. What are "coloureds" in this context? Typically blacks would be categorized as "colored".
- protonfish 9y agoThere are some lovely comments about here about how the poor are stupid, they deserve it, etc. While discussing this, we should also consider that in situations where there is very little to lose (e.g. going to die soon anyhow, little chance of a successful life) risky behaviors make more strategic sense than if the subject had the promise of better opportunities. Also, the pleasures available to the impoverished are by definition fewer and smaller than the wealthy. Cigarettes should appear undesirable by those than can easily afford superior enjoyable experiences. A pack of cigarettes is one of the most luxurious pleasures available if all you have is $5. The poor aren't stupid. They are just making the best of poor hand they were dealt.
- Pxtl 9y agoNot to mention self-medicating. Cigarettes are expensive but they're cheaper than dealing with mental health issues for the uninsured.
- quantdev 9y agoExactly. Nicotine has mental health benefits (e.g., schizophrenia ) and is a nootropic, stimulant, and feel-good drug. By smoking, the poor are trading years in the future for pleasantness now. Calling them stupid or irrational just makes too many assumptions about their opportunities, situations, and goals.
- LanceH 9y ago"the poor are trading years in the future for pleasantness now" This also describes how a lot of people are poor.
- CryptoFascist 9y agoNo, it really doesn't. Depending on one's discount function, such a trade is perfectly rational. This thinking also reeks of the 'just world fallacy', in which the predicament of the poor is deemed to be a deserved consequence of their moral failings.
- Overtonwindow 9y agoI think cigarettes share something in common with the meth epidemic in rural America, and I'm not talking addiction: When you don't have a job or you're seriously underemployed, no money, no hope, no opportunities for upward mobility, you look at things almost as a "why not?" issue. Anything to take the edge off of life, make things a little different. It gets compounded by the addictive nature of cigarettes and meth and other drugs.
- mmagin 9y agoWell, duh. Anyone with their head out of their ass for the past 15 years would have noticed that.
- GeekyBear 9y agoSo America has massively increased the tax burden on the poorest Americans (ever increasing tobacco taxes) while simultaneously cutting taxes on Capital Gains and Inheritance and now we are considering a large cut to the Corporate rate? Not to mention all the states with a lottery, which can also be thought of as a tax on poor people who are bad at math. This seems like class warfare.
- gscott 9y agoIn California we have a crisis, not enough people are smoking and paying the taxes. So the cigarette taxes have to be raised again and again then other tax sources have to be found.
- ManFromUranus 9y agoWith that spin, sure it would seem that way. You might consider it "Warfare" if the poor were being forced to smoke, or say there weren't pictures of cancer on the cover of the packages of cigarettes, or minors were allowed to smoke or there wasn't a huge vice tax on cigarettes essentially everywhere in the world, and a ban on cigarette advertising in most countries then yeah if you ignore all of that you might consider it class warfare...
- CryptoFascist 9y agoYou can apply post-facto justification all you like, but cigarette taxes are still regressive, no matter how you look at it. Whether it's part of a general attack on the poor is a separate question, but it does fit a pattern of punching downwards.
- kardos 9y ago> Cigarette companies are focusing their marketing on lower socioeconomic communities to retain their customer base, researchers say. > Advocacy groups say funding for smoking cessation is dropping It seems like an uphill battle to let the tobacco industry tell everyone to smoke, and then try and undo that with anti-smoking campaigns. Is there a reason we can't rein in or eliminate tobacco advertising?
- bdavisx 9y agoSeems to me like that's a Freedom of Speech issue.
- MBCook 9y agoYep. Short of making tobacco illegal or declaring it to be in a drug class that can't advertise to the public I'm not such there is anything that can be done except consent decrees.
- chc 9y agoCase law has established that commercial speech is not the same as other speech and is much more prone to restrictions.
- fjdlwlv 9y agoIs is reined in. No ads on TV, for example
- deleted 9y ago[deleted]
- mythrwy 9y agoShort term gratification vs. long term thinking may be a common factor in both smoking and poverty. Perhaps in the past more rich smoked because it wasn't so manifest how bad smoking was for a person. Also culture. In more well off circles being a smoker may raise an eyebrow or two now as opposed to the past.
- tmaly 9y agoI lost my father to lung cancer. What always puzzles me is if the lower socioeconomic class is disproportionately affected by smoking and money issues, why are sin taxes the only political solution? Some interesting fact on the quitting front, there are some vape shops that actually help people quit by gradually lowering the amount of nicotine over time.
- Mz 9y agoAmong the nation’s less-educated people — those with a high-school-equivalency diploma — the smoking rate remains more than 40 percent.. This fits what I have always heard: That education is more predictive of smoking than income. I am homeless, as are my two adult sons. We do not smoke. I have about six years of college. Some random thoughts, in no particular order and not backed up by citations: Smoking helps control depression. One anti-depression medication has a shockingly high side effect of causing people to stop smoking. Smoking suppresses appetite. I strongly suspect this is one of the reasons that so many homeless people smoke: Because they sometimes don't eat for up to three days at a time. Smoking also seems to be common in certain situations where it is the only stress relief. Many years ago, I volunteered at a homeless shelter in Vacaville, CA. All the employees seemed to smoke. They had enormous difficulty giving it up because there was nothing else to do on their breaks but either smoke or sit with co workers and talk, who were themselves smoking. If you want to combat this, trying to education the least educated peoples is probably a better path than framing it as a poor vs rich thing. Poverty grows out of lack of education, but some very educated people don't have much money for various reasons. I run the San Diego Homeless Survival Guide in part because I am convinced that good information is sorely lacking and is a genuine means to start solving the difficult problems of the poorest of the poor in the U.S.
- omginternets 9y ago>“People down here smoke because of the stress in their life,” Seals said. “They smoke because of money problems, family problems. It’s the one thing they have control over. The one thing that makes them feel better. And you want them to give that up? It’s the toughest thing in the world.” I'm sorry but this is facile. "Stress" and "problems" cause people to smoke only in the broadest sense of the word "cause". Something else is at work, here, and my hunch is that it's cultural. I've found that in much of blue-collar America, smoking is something of a status symbol.