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I quit – Peak indifference, big tobacco (doctorow.medium.com)
285 points by Arubis on Sept 21, 2021 | hide | past | favorite | 212 comments



I "gave up smoking" by not giving up.

I just deferred the decision to have one cigarette.

When the urge came up, I put it off five minutes.

And crucially, the rules allowed me to have one if I really wanted.

At first there was lots of deferring and then deciding to have one.

Eventually I just deferred the decision five minutes then five minutes more and on and on forever.

The reasoning is that your subconscious mind does not like "giving up" anything. "Giving up" implies you are losing something you value for nothing in return.

When you defer the decision to indulge your addiction, you are not fighting against your subconscious - remember the rule is you are allowed to have the thing you crave.

So in effect I never gave up smoking, I'm just a smoker who deferred the decision and never decided to do it.

I "stopped smoking" about 20 years ago. I'm still a smoker but just haven't had one for a long time.

"Giving up smoking" is very hard. Deferring one cigarette for five minutes is easy.

Off topic also, I highly recommend the podcast "The Vaping Fix". It's closely related to Silicon Valley and is compelling binge listening.

https://podcasts.apple.com/au/podcast/the-vaping-fix/id15628...


Also having smoked for almost 20 years, and finally kicked it about a year ago, in hindsight I found this kind of advice very unhelpful.

There's lots of different people, and there's not really a universal way that's going to work for everyone. I doubt that there's solutions that work for the majority. I believe most smokers wish they never started, so if it was as simple as 'deferring for 5 minutes' or 'have willpower' we'd have a lot less of them.

> "Giving up smoking" is very hard. Deferring one cigarette for five minutes is easy.

For me, it definitely wasn't, but when I read things that are written as 'general advice' that I couldn't follow it made less motivated to try to find a way to quit. It's was also frustrating to read other people being successful with seemingly 'simple tricks'.

"Allen Carr's Easy Way to Stop Smoking" is another example that has near universal praise, and was mentioned here on HN. Also a total dud for me, which only made me more depressed; there must be something more wrong with me...

My suggestion now would probably be to treat it as an illness and go talk to your family doctor. But also: your mileage may vary and perhaps just waiting 5 minutes at a time will do it for you!

Hang in there.


Exactly. Smoking wouldn't be so widespread if those "simple tricks" everybody is fond of sharing were actually effective. Delaying your next cigarette is as effective a smoking cessation tool as praying your deity to wake up tomorrow and be reborn a non-smoker. I'm certain it has worked for someone.

I have quit January 2020, and it's taken me 12 years of hating myself, 3 years of electronic cigarette, 6 months of patches, a pandemic where I was away from people and temptation and now the rest of my life of constant vigilance and fortitude not to fall into the pit again. I am happy and don't think about smoking anymore, but I can feel the good old mental pathway faintly light up whenever I'm a little bit distracted or vulnerable.

It's incredibly fucking hard to transform yourself back into a non-smoker.


Yep, I started when I was 15. Quit many times, and finally managed to get off them about 10 years ago. But I could take it up again in a second, the thought of having one never completely goes away.


Want to add to the testimonials of people that this absolutely didn't work for. For me this was just an excuse to open another pack of Juul pods, "oh this time I'll wait longer between puffs, I'll be puffing less and less this time until I'm not addicted". I would open pod after pod, pack after pack, every time thinking this exact thought. The only thing that worked for me is switching off juuls to some other brand where I could mix my own liquid and titrate down.

I would also be very interested in the percentage of people for whom deferring a cigarette for five minutes is easy. Maybe if you were waiting five minutes for a smoke buddy.


> I would also be very interested in the percentage of people for whom deferring a cigarette for five minutes is easy.

I would be too. But I can’t imagine it’s very low. It’s like holding your pee for 5 minutes, uncomfortable, but eminently doable as long as you know you’ll find a toilet soon.

I think the problem is with knowing that those 5 minutes are supposed to mean deferring the smoking forever.


> It’s like holding your pee for 5 minutes, uncomfortable, but eminently doable as long as you know you’ll find a toilet soon.

Does it get worse with time? The first five minutes might just be uncomfortable for holding your pee, but the discomfort rises until by the tenth or twentieth it may be physically impossible.

In my (non-smoker's) understanding, withdrawal symptoms/cravings also increase with time between cigarettes, at least at first. Maybe not as strongly?


I mean, it's doing something you love, that you get to do all the time. Knowing you could do it but choosing not to...yes it's uncomfortable but you eventually get to a point where you forget you were ever a smoker. Maybe some people have "symptoms" but I believe it's psychosomatic.


I think there was a study that showed psychopaths don't get addicted to drugs. Something something brain reward centers something. Or maybe it's anecdotal, a drug dealer's one customer who's "like a machine" and can quit whenever he wants.


It is likely Juul pods contain monoamine oxidase inhibitors just like natural tobacco. They could even have been added to the mix.

Big tobacco knows, but they won’t tell you.


Over the last decade, your family doctor would've likely prescribed a drug like Chantix. One that has very recently been recalled due to increased risk of cancer:

https://khn.org/morning-breakout/pfizer-recalls-chantix-anti...

Unfortunately, your doctor's recommendation is not necessarily the ideal option for your overall health.

As a former smoker, I applaud any and all strategies that could be effective without pharmaceutical intervention, at least as a first option for addicted individuals.


>Unfortunately, your doctor's recommendation is not necessarily the ideal option for your overall health.

What method would you suggest that would be more effective than evidence-based medicine? I seem to recall that there is somewhat of a cancer risk for continuing to smoke. So if Chantix is effective at getting you to quit, you would still be at a much lower cancer risk overall. It is also worth noting that the drugs were recalled because of an impurity in batches that could cause a cancer risk, not a risk from the drug itself.

This just seems like terrible logic to me. Don’t use evidence based approaches to help you quit something that is definitely increasing your risk of cancer by a lot, because at some point down the road it could maybe be found that the approach you took had a much smaller risk of causing cancer. This is just fear of active risk vs passive risk. Accepting a much larger risk of maintaining the status quo over a lower risk of actively seeking out and taking a drug.


The news was also mischaracterized as it's not the active ingredient that is associated with cancer risk, it's a contaminant/by product of the production process, so it's more of a product safety recall than a drug safety recall. As far as I know, this was a voluntary risk-reduction recall by the manufacturer and not an FDA recommended or ordered recall based on safety data.


I'm still a 25-year smoker, and my experience with those things has been that yeah, I can delay for 5 minutes, or an hour, or 15 hours on an international flight, but I swear to god the speed and volume of nicotine I suck in from the next cigarette is directly proportional to how long I delayed it. If I land after 15 hours, that cigarette is gone in the time it takes to get in a taxi. If I were ever to quit, I don't think allowing myself any outs to return to it would be a good idea. It would put me right back where I started, instantly. And I also don't have the willpower to go cold turkey. So I'm mostly hoping there will be a cure for cancer before I'm sixty.


Smokers are not addicted to nicotine per se. Your craving is towards the monoamine oxidase inhibitors in tobacco smoke.

I take it you have tried alternatives containing only nicotine, but they just weren’t the same?

Note that successfully quitting smoking usually means quitting coffee, too, since coffee contains the exact same monoamine oxidase inhibitors.


I don't know anything about this other chemical. (1) It is true that no other nicotine product produces the same "fix" as burning tobacco. But (2), other nicotine products definitely do fill 70-80% of the craving, and I think the rest is mostly down to habit.


Bollocks. I chain-vaped (juice which contained only propylene glycol, glycerol and nicotine) as much as I chain-smoked. Perhaps more, as vapour wasn't as hard to my lungs as actual smoke.

MAOI just make the addiction stronger, but are not the addiction themselves.


Does Juul contain those? Because I know plenty of people who quit smoking cigarettes for Juul and get lots of cravings towards that instead.


Unlike liquid-based vapes which use pure nicotine, Juul pods contain a tobacco leaf extract. I don’t have a source to confirm, but I find it likely they do contain MAOIs.


"Two young Silicon Valley entrepreneurs set out to rid the world of smoking with an incredible new product."

This seems a little like revisionist history? Apologies for awful forbes link, but it has some of their early ads: https://www.forbes.com/sites/kathleenchaykowski/2018/11/16/t...

I don't really hold a strong position on this issue, but it seems obvious their early ads targeted high school kids (and it worked). It was only later after their success (and regulators started looking at them) that they focused on smoking cessation and being an alternative for smokers as their purpose (rather than getting non-smokers to vape).

That plus it came out after the success of their weed vaporizor Pax which they made first right? I don't really know if nicotine vapes are dangerous or not, almost certainly better than tobacco - but I don't buy that it was about switching smokers to vaping early on. Maybe the podcast gets into it more and I'm over indexing on that subtitle. If so, I'd be happy to read your reply.


I listened to the entirety of this podcast and felt it to be friendly to Juul to the extent of being sort of bizarre. The host routinely brought up criticisms of Juul but then immediately dismissed them and moved on without further analysis---seemingly never even entertaining the idea that Monsees and Bowen could have been complicit in their ignorance of underage abuse, and much less that they might have been intentionally deceptive (which seems, to me, like a pretty strong possibility). Juul was repeatedly depicted as the victim in the whole thing.

Even odder, the podcast makes it sound like Monsees and Bowen invented the concept of the electronic cigarette completely from scratch, making no mention of the decades-long history they have in China. It's completely possible that they were unaware of the Chinese precedent and working independently (I feel like e-cigarettes in the Chinese style had started to appear in the US, although not yet taken off, by 2007 when they launched Pax but I could be remembering this wrong), but the host not mentioning it at all was another factor that made the podcast feel very shallowly researched and, in general, like a puff piece for Juul.

Further, the podcast makes it sound like the popularity of Pax for cannabis, which was not yet legal anywhere at the time, was unforeseen and unintentional. Maybe this is true, but it strikes me as a bit odd as I have never known the Pax brand to be associated with anything but cannabis, and my first exposure to it was around 2009. I would be very interested in digging into old Ploom/Pax advertising around this point. I don't begrudge Pax as a cannabis product but this just felt like another questionable and self-advantageous claim by Pax/Juul that the podcast just took for granted.

I don't necessarily know that I'd allege the podcast to have been bought off by Juul or something, but it very much had the feeling of a newspaper article about a company with that company's own press release as the sole source. I think it may have just been lazy rather than malicious per se.


Yeah the Pax was obviously for cannabis and the wink wink copy on the website about tobacco or “herbs” was just what everyone did back then prior to recreational legalization. If they’re not acknowledging that in the podcast I’d have little trust in the rest of it.


Yes, it was made by the same people who invented the Pax. I don't think they'd ever come out and say it but I would fully believe they were just looking for a better way to consume nicotine, in that the Pax was supposed to be a better way to consume THC. I think they probably just wanted to make a better cigarette using technology. Whether it was used by people trying to quit or people who had never tried before, I suspect was orthogonal to their cause, though I believe they were themselves smokers.


What you are doing is a core tenant of survival training. When in a situation that seems doomed (ie: lifeboat in the ocean, lost deep in the woods, etc), you don't focus on what will happen tomorrow, you just do what you need to do to survive the next 4 hours. You repeat this over and over until things get better.

Check out the book "Deep Survival" by Laurence Gonzales if interested.


Same thing in endurance sports racing (running, cycling, etc.). Mentally break the race down into little pieces. Just suffer for one more minute. Make it to the next mile marker.


Hah! When I’m doing reps at the gym, I’ll count down the Fibonacci sequence, so a set of ten I’d count five, then three, then two. Works like a charm when each subset is “easier” than the previous one.


It’s good advice. Although from my experience this is truly automatic and effortless when you’re extremely hungry, tired, and cold. I went through USAF SERE school and you have little opportunity to start worrying about tomorrow, or even 4 hours from now really ;P


In a similar vein I "stopped drinking" 18 months ago with no set goal for how long (but one year was a desirable milestone) and I sometimes say I "quit drinking" but really it's more about deciding not to do it for a while and then not deciding to do it again. Maybe I will some day but I actually don't desire it right now and I do like having this long time period "18 months no alcohol" so if I drank it would reset that. Which some day may be fine, but it's nice for now.

I also quit smoking in my 20's. I succeeded by focusing on how physically bad a cigarette made me feel. There was some kind of tobacco buzz but also an obvious depressant effect and it made me feel like shit. During the period I was quitting I would sometimes smoke a little more to make myself feel physically worse so that I would be reminded of this bad feeling and want to avoid it. It worked!


Interesting and probably highly effective. Immediately reminds me of a study where they got people exercising to focus only on the track ahead of them and only on the finish line, in some trial to the point of putting horse-blinker like glasses on them. Alternate sessions were to widen their focus to the entire workout.

Those who were in the narrowed focus trials ran on average 22% faster and simultaneously felt that their effort was subjectively 17% easier.

Similar advice I read from a former Navy Seal about their training sessions and in particular "Hell Week". He succeeded by narrowing his focus to 'just last until the next meal - they have to feed us every 6 hours', and he made it through, but many in his entering class did not, and he noticed that they were overwhelmed by 'how am I going to last this whole week?'.

You just narrowed your focus to the next 5min, and succeeded - congratulations!


I was a heavy smoker once (2+ packs per day for 15 years) and stopped abruptly. My motivation was simply that being a smoker was horrible. Everywhere I went the only thing I could think about was, where are the tobacco shops, when do they close, do I have enough cigarettes with me to get me through the day, or the evening, etc.

(Also I smoked so-called "brown tobacco" which meant I couldn't really ask other people for a smoke -- I could, but I strongly disliked more mainstream cigarettes; so I had to take care of my own supply).

The first two weeks of quitting were horrible, it was as if somebody constantly pulled on my arms to elongate them; in fact during those weeks I stayed in bed most of the time. (In a way it was so horrible and strange that it seemed kind of enjoyable; the pain transforms into something bizarre where you're a kind of "pure pain" that isn't, somehow, insufferable.)

And then after those two weeks the carving was gone, and I was free.

It's been 20 years since I quit and I have never wanted to smoke again; I still remember vividly how painful it was to quit, and this is an excellent deterrent to wanting to start again.


I think you're on to something. Similarly, doing this one exercise, one more time can be easy, but committing to a lifetime of it? No way.


> When the urge came up, I put it off five minutes.

I smoked for 13 years and stopped 13 years ago. I have had maybe two or three cigarettes since. I started by gradually cutting down then after a few weeks adopted this exact strategy. When the urge arose I just waited a few minutes and it usually pass. It's also worth noting that in addition to the nicotine addiction, I had to deal with built up habits and being used to having a cigarette in my mouth but after a few months these went away.

To this day I have the occasional craving but these pass much quicker (generally in a few seconds) than they did 13 years ago.

Looking back, it was fairly easy for me but I understand that it's not the same for everyone. My dad quit after 2 decades of smoking, he had vomiting spells and chills for weeks. I know of at least one person who had quit for a decade, had one cigarette and is now back to regularly smoking.


”he had vomiting spells and chills for weeks”

These are effects of MAOI withdrawal. Nothing to do with nicotine.

I’ve just about had it with the half-truths surrounding tobacco, coffee and alcoholic beverages. MAOIs from the Harmala alkaloid family as well as various flavonoid families are prevalent in all of our ”legal highs” in copious quantities, yet all we ever hear is ”nicotine”, ”caffeine” and ”alcohol”.


Could you please cite peer reviewed work that supports your repeated assertions about the role of MAOIs in cigarrete addiction?


This works pretty well for establishing an exercise routine as well. I wouldn't feel like exercising, but I could convince myself to exercise for 10 min. What's 10 min?

Then once you hit the 10 min mark, what's another 10 min?


Is there anything you picked up instead when you had the urge. I’ve never tried quitting, but I have ceased for up to a week (visiting family, etc.) and get incredibly agitated and fidgety after a day or so.


If you really want one, have one, don't fight it.

Just ensure that every time the urge comes up, you say to yourself:

"Do I really want this cigarette RIGHT NOW, or can I have it in five minutes?"

If you cannot wait then have it.

In five minutes time when. the deferral has expired, ask the same question.

Don't fight yourself, agree with yourself.

And don't attack yourself for making the decision to have one - just ensure that the next cigarette gets the same question.

This process might happen hundreds of times but don't worry about it, just keep asking the question.

It's a long series of very short term decisions.

It doesn't work if you have a rule in place that you cannot have a cigarette - this approach means you can, so your subconscious can relax - you are not depriving it of what it wants.


A different perspective is that it's decoupling the impulse from the reward. Very powerful at taming these kinds of habits.


i find this utter hogwash. Nicotine is physically addictive and tolerance builds up. When one that has been smoking moderately to heavily for years quits smoking, one goes through days of physical withdrawal.

These "simple tricks" are just another way to fail. You can postpone 1-2-3-4 cigarettes, but eventually you will smoke 4 in a row to get the nicotine high with the intensity and duration your body is used to.

Which is why the patch is effective, it helps with physical withdrawal. These jedi mind tricks don't.


Thanks, will try this out soon (with a different addiction)


The book that had an amazing impact on lots of friends who smoked is Easy Way by Allen Carr: https://www.amazon.com/Allen-Carrs-Easy-Stop-Smoking/dp/0615...

(No affiliation).

Friends report there are no lasting urges, no mental blocks, no inner demons etc. etc.

reddit testimonials: https://www.reddit.com/r/stopsmoking/comments/odyv6/anyone_t...


There is nothing, you will have to run the gauntlet of addiction. It isn't pleasant but in the end it is incredibly rewarding. You're basically given your life/freedom back. Quit a 2 pack a day habit cold turkey back in 2009. These days I get nauseous when I'm around smokers and can't believe I was once one of them.


Anecdotal, but things get much much easier after like 2 months. The first few weeks are the worst.


I gave up smoking 20 years ago. The one thing that helped was that I moved for work which means I had no smoker friends to party with. I picked up on my swimming and running to pass the time. Luckily the exercise and lack of company to smoke made quitting relatively painless for me. At the time of quitting I had probably smoked for around 8 years and had a 1 pack/day habit of Marlboro reds.

I agree with the parent comment. I took it one at a time and in about a month felt no compulsion to smoke.


I inadvertently did the same with sugar in my tea. Where I worked we each prepared our own tea and coffee from our own supplies. I forgot to replenish my jar of sugar and eked it out by putting less and less in each cup. For some reason that I can no longer remember I forgot to fill it up so of course it eventually was empty. But by then I was taking so little sugar that it was a small step to taking none at all.


For me the catalyst for change was a period of personal transformation fueled by psychedelics. Another “addiction” I gave up during this time was meat. It’s been 20 years and I’ve been fortunate not to have any desire for either.

I want to acknowledge how incredibly difficult it can be to give up smoking and express my support to all of you who are trying. I hope you find your path.


This is interesting. It reminds me both of a common piece of advice for meditating ("If you feel overwhelmed by the task of paying attention to your breath for X minutes, just ask yourself if you can pay attention to just one breath, then just one more, etc.") and procrastination. Two things that I don't normally associate with each other.


Quitting by induction...


By procrastination, really.


Interesting. I quit smoking in a similar fashion. Actually, I still consider my self a smoker. I can have a cigarette whenever I want to. But I chose not to.

It helped me finally stop trying to quit. And just chose not to smoke.


> I "stopped smoking" about 20 years ago. I'm still a smoker but just haven't had one for a long time.

Nicely put, and congrats. Your health says thank you.


This advice works excellent for natural procrastinators! But sadly, does little for other personality types.


You can stand anything for 10 seconds!

https://youtu.be/xSX3KG1hisk


That was always my dad's pitch to me. Don't give those fuckers one thin dime. I casually smoked cigarettes in college, but never seriously and every time I bought a pack I looked at the logo on the back and reminded myself that I hated those fuckers and I wasn't going to keep doing it. I quit before my first kid was born.

My grandfather had lung cancer twice. He quit smoking after the first time. His wife couldn't. She spent 10 years in long, slow COPD decline after he passed.

Don't fucking do it. And don't buy fucking nicotine vapes, either. Fuck those assholes.


You realize the NHS in the UK recommends using e-cigs as harm reduction?

https://www.nhs.uk/live-well/quit-smoking/using-e-cigarettes...


E cigs worked for me quitting: I replaced analogue smoking with strong nicotine (18mg) MTL vaping which I used whenever I had the urge. Over the course of 6 months I gradually moved to a 3mg suspension as I found the stronger liquids were making me feel sick (especially in the morning). After about a year I couldnt decide on a vape flavour I liked any more (they all tasted odd) at which point I stopped carrying the vape with me and didn't miss it. I now dont use it at all. I realised the times I smoked were more from habit i.e. Ive just had lunch, a ciggy follows that" "Im going to make a phone call light up", rather than than an addiction that harrasses you to the core, 24x7. My wife still smokes and has tried various ways to quit, but ultimately she wants to smoke so continues. I smell tobacco smoke now and whilst I don't dislike the smell, being a room while someone smokes is not something I enjoy and can barely believe I used to happily sit in (UK) pubs all weekend smoking, playing pool etc.

It's been 2 years since quitting - started at 17 and quit age 39 as a very heavy smoker (20 pack + a day). I have always been very active but found my lung capacity, endurance and ability to perform are all much increased. I used to get the occasional chest pain and those have gone now, too. I just hope I havent done too much damage and can enjoy my kids, my garden, my physicality.. for as long as I can - my father in law has COPD and it is not a pretty end to a guy who used to be very a strong, physically capable guy.

I would encourage anyone to quit tobacco by whatever reasonable means & (my hunble) experience tells me vaping is way better than tobacco smoking.


Guess which fuckers paid for that


Huh? It's called following the science.


Yes, but one should understand how science is usually done. Some scientists are getting grants from private funds, some don’t, and most scientists rely heavily on getting grant money to live and to continue their research. In medical science, nutrition, psychology, economics, sociology, it’s very easy to conduct a research that would be favorable to major fund donors.

Refer to how “science” covered smoking for decades, how eating fat was thought to be harmful for decades, how major economists missed every single crisis, and how many economist-led mutual funds went bust. And also who sponsored each research.

Of course, it’s not how it works in “real” sciences like physics, because criteria on research results are very strict there. But you should by default be very skeptical about any groundbreaking results in social sciences.


This isn’t social science?

It’s a “vaping has far fewer toxic chemicals compared to cigarette smoke” type science.


I’d argue that “far fewer” is not that much of a science. How much less of each exactly? How does the smaller amount affect cancer and other diseases? (linearly? sublinearly? no long-term effect from this reduction in dose? Higher cancer risk because of the vapor?)

How smokers’ habits change with vaping? Do they vape more often than they had smoked? Is vaping more social, hence more people get “sucked in”? Do children start vaping earlier? Long term, is starting vaping better than trying to stop smoking?

So many facets, so much beyond “we found this number smaller, therefore we recommend smokers to vape now”


What are the negative health effects of nicotine versus, for example, caffeine? I've always wondered how much "healthier" vaping really is compared to cigars and cigarettes, but I wouldn't know how to make an evidence-based argument. Googled it a few times with mixed results.


Pure nicotine seems to be harmless except in overdose, the main side effect being a compulsive need to consume more nicotine. Whether the delivery mechanism in vaping, year after year, is harmless, is a different question. Anecdotally, I used a nicotine vape to quit smoking -- and they're wonderful for that -- but when I quit that as well, my chest went through a phase where it cleared out all manner of gunk not unlike when I quit smoking cigarettes.


> Pure nicotine seems to be harmless except in overdose

I think there’s also some sort of negative cardiovascular symptoms, but I would be unsurprised if caffeine had its own.


It's hard to separate the impacts of plain nicotine from the impact of cigarettes because the literature is almost entirely focused on smokers, and scientific writing sometimes conflates the two. That said,

> Nicotine constricts blood vessels, including those in the skin and coronary blood vessels, but dilates blood vessels in skeletal muscle. Vasoconstriction of the skin results in reduced skin blood flow and reduced fingertip skin temperature.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4958544/


Vessel constriction or dilation by itself is not necessarily a bad thing. CO2 is a potent vasodilator, but no one would claim holding/pacing your breath for swimming is a bad thing. Caffeine too has a strong vasoconstricting effect.


Sure, I was not trying to make the claim that constriction or dilation was a bad thing.


Cardiovascular effects of nicotine are probably more dangerous than potential carcinogenic nature of smoking.

edit: smoking is carcinogenic, but how much of it is because of nicotine I wouldn't know; a smoker might not live long enough to find out at what age the cancer develops if he drops dead because of the heart infarct.


I cannot imagine sincerely believing a statement that is so blatantly wrong. Moreover, there’s nothing ‘potentially’ carcinogenic about smoking, it is a known carcinogen.


> Cardiovascular effects of nicotine are probably more dangerous than potential carcinogenic nature of smoking.

Have any evidence to support this novel claim?


Smoking is carcinogenic because it involves incomplete combustion of tobacco, the products of which are directly inhaled. Nothing to do with nicotine.


This is contrary to everything I have read about the health impact of nicotine. Do you have suitable references to back up these claims?


It’s not super helpful for aiding concentration. I tried it for a few months this year in my 30s, thinking it’d help with my ADHD. Never been a smoker. It didn’t help. Also any time I had it on me I’d find myself absentmindedly puffing on it. If you really are into nootropics just be real and get an Adderall prescription.


Dr. Peter Attia has a podcast with detailed medical information on the effects of nicotine.

https://peterattiamd.com/ama23/


I don't know the health effects of pure nicotine (say, in liquid form) vs caffeine, but one is certainly much more addictive than the other.


> I don't know the health effects of pure nicotine (say, in liquid form) vs caffeine, but one is certainly much more addictive than the other.

Which one did you have in mind, and why do you say certainly?


Nicotine is more addictive than caffeine. I'm not going to find peer-reviewed, double-blind studies to back up my claim. I'm going to go with the anecdotes I've heard for decades and from personal experience.


I'm not going to argue with your opinion -- but I suspect you are conflating tobacco (usually smoked) with nicotine.


Isn't nicotine the primary addictive chemical in cigarettes and vapes


https://www.gwern.net/Nicotine#sn2

The vapes don't have the MAOIs, which could also be why my brother didn't find them very satisfying (apart from the THC vapes).


There are "whole tobacco alkaloid" liquids (full-spectrum extract of tobacco vs. pure nicotine) available which contains a lot of the other stuff. Probably more addictive so I'd avoid it if your goal is to quit.


I believe it. There's vapes for everything. Was just focusing on parent's nicotine addictiveness statement that gwern addresses.


I've seen a few posts around saying vapes are about to be banned here in Australia. Have no idea if its true or not.



Get a dry herb vaporizer and vape loose leaf tobacco. Takes a while to find the combination of temperature and herb that doesn't taste like shit, and it's also not the same as a real cigarette but it does the thing.

You also inhale less matter than with an ecig, so I think it may end up being healthier... but I'm like, the only person I know that does this daily so science may never know.


Totally with you, my intuition is loose leaf pure tobacco is much less harmful and for a while when I still smoked I couldn't stand regular cigarettes, also preferred rolling my own, both for the gesture and the taste.


Nicotine vapes have been banned for about a year here, the stupid fucks in government just love to funnel cash to big tobacco.

Nicotine is as harmful as caffeine, no more, no less. Nobody's going around campaigning against Big Espresso.


That nicotine is fine because it’s no worse than caffeine is a lie I see pedalled unquestioningly by pro-vape folk on the internet all the time. Linking the harmfulness of cigarettes to coffee is an old tactic of tobacco companies and they still use it for vaping. It’s not true.


I never said anything about cigarettes, I was talking about nicotine. Cigarettes give you cancer. Nicotine does not.


My dad always said that too. I've gotten around that one by accumulating a lot of Altria stock in my IRA over the years. Now I am those fuckers. Really, I view their massive dividend as sort of a health plan. At least I'm getting something back.


You're making money off of the death of your fellow man and you're trying to tell us that it's okay. It's not okay, you're helping them.


Pff. Please. I smoke a pack a day. I'm getting cash back on my own medical bill. If you invest in Altria, then yeah, you'd be profiting off my death.


John Safran has just released a book Puff Piece about the incredible way Philip Morris has rebranded as a "health enterprise" and released the "heatstick" with their "vaping" IQOS platform (quotes are intentional, because as the books shows, words mean nothing!)

https://johnsafran.com/

The podcast below sums it up perfectly:

Three years ago, tobacco giant Philip Morris announced they were moving away from cigarettes and that they were campaigning to "unsmoke the world".

They said they would offer people a better alternative to the cigarette, a device that would give you your nicotine fix from a "HeatStick".

Author and documentary maker John Safran discovered the HeatStick is made primarily from tobacco, and that it still generates carcinogenic tar.

John soon found that Philip Morris were financing "anti-smoking" initiatives all over the world.

They look just like conventional Quit programs, but they are designed to shift people onto this new device.

https://www.abc.net.au/radio/programs/conversations/john-saf...


>John soon found that Philip Morris were financing "anti-smoking" initiatives all over the world.

They are literally obligated to fund them according to the Tobacco Master Settlement Agreement: https://en.wikipedia.org/wiki/Tobacco_Master_Settlement_Agre...


What's being discussed here is not real "quit smoking" campaigns but "get addicted to our shiny new thing" campaigns disguised as such. The anti vape campaigns and reporting in recent years has been heavily influenced by Philip-Morris and their iqos strategy, which is to get people to switch to non- combusted tobacco sticks instead of alternative methods of delivery.

Vapes have turned out more or less ok, with a negligible impact on health and lung capacity. Chronic nicotine has its own impact, certain flavorings are problematic, but it's orders of magnitude better than smoking. There's no indication that iqos is any better, but it's certainly far more expensive.

IQOS by Philip Morris is the latest cynical plot to get people hooked and extract endless streams of cash. Vape is cheaper, iqos far more expensive.

It's an interesting bellwether for news organizations. If they run anti-vape, PM has their hooks in.


In a big picture sense they've managed to reverse engineer this from a message of "quit" (i.e. do not ingest anything, which is what basically all health-based quit campaigns are about) to "stop smoking" where their IQOS system, which uses non-combustable tobacco-in-a-cylindrical-package-with-a-filter tip "HeatSticks" is "not smoking".


Private advertisements that pretend to be public service health announcements seem particularly evil!


> Importantly, it helped me overcome my fear that if I quit smoking, I wouldn’t be able to write anymore, since I’d always done the two activities together (today I tell writing students not to smoke at all, but if they must, not to smoke while writing, lest they prolong their addiction to protect their artistic production).

this.

psychological nicotine addiction has the uncanny ability to find the tiniest smidge of what-you-thought-was-dealt-with impostor syndrome buried deep within your soul, poke it with a stick and then chase you around with it with threats of total ruin, hoping you'll give in.

there's a famous book by allan carr called "the easyway to stop smoking." it can be a little silly at times, but it did have one idea i liked that basically boiled down to anthropomorphizing your nicotine addiction, imagining refusal to smoke as a way of starving it and then basking in the schadenfreude as it dies a slow, painful death.


I never understood how anyone under the age of 50 could take up smoking. It's been abundantly clear since I was a kid that smoking would kill you slowly and painfully and we had numerous presentations at my grade school in the 70s to that effect. And yet there was a crowd of teenagers at my high school in the designated smoking area in the outside space between D and F halls (the location seems ironic in retrospect).


Let me help your intuition. Think of all the bad habits you have that other people wish you didn't.

Everyone has a vice. smokers are just easy targets.


Great answer. Based on the sheer ignorance in this thread, of things like what the difference is between nicotine and caffeine, I don't think most of these people are capable of assessing their own bad habits in the way that all smokers are. I never met anyone who smoked who wasn't conscious of their own vices, and slower to demonize or criticize other people's. Reserving judgment and criticizing your own flaws first is apparently no longer considered a good thing. In fact, I think that kind of conversation is one reason the braindead always want to ban smoking. It is and has always been part of open conversation about the risks of living, personal freedom, and nonconformity.


> I never met anyone who smoked who wasn't conscious of their own vices, and slower to demonize or criticize other people's

I sure have. I've met all kinds of people who smoked. From kind to unkind, self-aware to insufferable, big to small, etc. I will say people who smoke are exactly like people.


The "ima be dead by im 30" mentality is common. I've smoked my fair share of cigarettes but never found nicotine addictive. Lots of people just dont care about themselves.


Don’t expect to dead at 30, but don’t expect to be in any position in life where I would care either way.

FWIW I picked up smoking hanging in certain social circles. It was kind of just a thing other people I was hanging out with did.


Do you drink alcohol, regularly? It's also very likely killing you slowly, and leading to a diminished quality of your later years.

People smoke for similar reasons to why people drink: it's social, there's a (pleasing to some) chemical component, it's habitual, and so on. For many, it's the cheapest way to manage to self-source some quick relief in their day.


As a light smoker (1 to 3 cigarettes or mini cigars a day) I looked at the probability of cancer or death based on my consumption and weighed it against the pleasure and utility I derived from it. I decided the risk was worth it.

It's also a cultural signifier. I know I'm more likely to get along with someone who smokes.


Wise. Social smoking is a great experience, and I'm not sure why. Definitely hard to quantify.


Have you tried it? Your first few packs are very enjoyable until you need to smoke to feel normal.


Sounds like you haven't tried it.

First few packs are disgusting, one is not used to nicotine so can get vicious headaches and nausea, the smoke is harsh and irritates your nostrils and your throat. Once you get addicted to nicotine and your tolerance builds up smoking becomes enjoyable since, since the nicotine high kicks in at maximum effect.


> in the outside space between D and F halls (the location seems ironic in retrospect).

Was there an E hall?


I understand why people take up smoking but I don't understand why people expect credit for breaking out of it. Addiction is an ugly thing and seeing a public personality parlay their experience into an excuse to write a blog post is pretty distasteful to me. Just quietly stop; not everything has to be an event in the history of internet culture.


Just quietly ignore it and move on; not everyone needs to hear about what you find distasteful.


I find your perception of this blog post bizarre. Who is asking for credit for quitting? Who is making this an event in the history of internet culture?


I've made a habit of putting myself through nicotine withdrawal (I like the on-edge feeling, yes I'm weird), and smokers who quit deserve a lot of credit. It's hard, and I don't think anyone who hasn't been through it would understand how hard it is.


If you're assuming I haven't gone through nicotine withdrawal myself then that's mistaken.


I smoked for 15 years, and it's been 10 since I quit. I'm glad I did. That said, I hate it when I hear the "don't make the same mistake I did" stuff from ex smokers, especially ones who obviously enjoyed smoking and for whom it was a big part or their identity - certainly this was true for me, and it appears that way for CD.

Keeping on the theme of "science denial" - it reminds me a lot of the developed world lecturing developing countries about pollution. Yes, from the hindsight of maturity and comfort it's a bad idea, but when you have other immediate concerns, the calculus is very different.

Smoking is unhealthy, but people have to make their own mistakes.


There's a sweet spot where the risk is significant compared to not smoking, but average compared to the rest of the things in your life like riding a motorcycle. It's probably less than a few cigarettes a day but a lot more than a pipe full a month. Unfortunately the "not even once" crowd and compulsive addicts normally dominate the conversation.


Dear Cory Doctorow.

> You have 2 free member-only stories left this month. Sign up for Medium and get an extra one

Why write something if a good many of your readers will not be able to read it?

Do these writers realize they're standing behind someone else's gate? This is the internet! You can publish your own blog with absolutely minimal effort. For free even!

I just do not get it. Why do people give their content to Medium!?


They get paid


Can it really be enough money to matter? If you're someone worth following, is this really the best way to make money?


It seems like blogging is a hard thing for people to monetize, especially for some topics that aren't so "sponsor friendly"


I expect it's like all other power law pursuits - if you get to that 0.1% it's totally worth it.


Will we eventually end up with this same sentiment but for cannabis? Something which is gaining widespread acceptance and becoming a regular part of every-day life, at least in some parts of the world. Is it "smoking" that's bad or "smoking cigarettes"

I started smoking occasionally before the pandemic. Since the pandemic my usage as increased to nightly. It has without question helped me manage my anxiety levels (and isn't the only tool I've used along the way) but I'm not sure which is the lesser evil. At this point I teeter between wanting to stop and really appreciating the help. I convince myself I'm at least a little safer by using a vaporizer (flower, not oil based) and keeping the temps below 400.


I quit smoking in 2014 after having done it for ~8 years. I replaced it with nicotine gum, which worked, but I became more addicted to the nicotine gum than cigarettes. I got up to chewing the equivalent of two packs a day.

Then one day this year I woke up and felt sick. I didn't have any gum, and I didn't purchase anymore either, because I felt sick for one day. Now I'm finally nicotine free.


This is a terrible argument. It starts with something we have high confidence about (yes, smoking is proven to be bad), and the fact that there were companies that profited from it, and then extends that to say that doubt and epistemic uncertainty are bad.

And therefore you should believe the author’s other hobby-horses, because if you doubt it you’re the enemy, or a sucker.

Being able to recognize what you don’t know isn’t going to help you quit smoking, but it helps you from falling for conspiracy theories, and that’s important too.

(A good way to learn to live with doubt is to collect questions you don’t have good answers to yet.)


I really like tobacco/nicotine. I have a cigar collection, I love my pipes, I'll have an occasional (10 this year, so far) cigarette, and I vape on-and-off.

I despise big tobacco. They remove the craft from the product. A well-made cigar or a masterfully blended pipe tobacco is akin to a fine whiskey: meant to be enjoyed in moderation and with a mind for the experience that went into making it. Even a hand-rolled cigarette using locally-grown tobacco has a degree of craft involved.

Vapes are just a convenient, relatively harmless delivery mechanism, but they're removed so far from the tobacco plant that I can't bring myself to consider them in the same category. They're a separate vice.

Point is, tobacco is a wonderful plant that lends itself to being cultivated and artfully made into fine products. Marlboros are little cancer sticks, and I wish Big Tobacco all my worst. Thanks for ruining it.


It's kind of jarring to see Doctorow praise hypnosis in one paragraph and then excoriate tobacco companies for their science obscurationism in literally the next paragraph.


Why? Don’t get me wrong, there’s a lot of woo practitioners around hypnotism, but hypnotherapy does seem to have some scientific support (even if there’s ongoing debate). It’s not like he was having his auras aligned or anything.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2752362/

https://www.thegutcentre.com/pdf/research/hypnotherapy-for-i...


He didn't make the claim that hypnosis was scientifically sound and better than other forms of medicine. He just said that he tried it and it worked for him. It seems entirely different from what tabacco companies do to me.


This article is a little frustrating; like a lot of Doctorow's writing it kinda comes from a place of superiority. How are we supposed to know the difference between healthy skepticism and "epistemological chaos" (literally the most ridiculous way of saying that)? It seems like the article's suggestion is "just trust the people who are right". Mmhmm. It also implies that anyone arguing against "what's correct" is doing it knowing they are wrong, or because they have been misled by someone who knew _they_ were wrong -- like the tobacco companies promoting smoking. I don't think that's the case? That's a pretty bleak perspective, but I mean I guess it could be true.

The piece that most resonated with me was "The pandemic revealed the high price [...] of *replacing informed debate with cynical doubt*". Informed debate feels like an absolute lost art thanks to the internet. You can't fit informed debate into a tweet. Or into a Facebook post. And when everyone speaks with absolute confidence on their opinion, how can people distinguish informed opinions from uninformed opinions? This is I believe one of the core problems of the internet today.

Regardless, congrats on the many laptop-full and cigarette-free years :)


Lumping anti-vaxxers, homeopaths, eugenicists, and drinkers of raw milk is a pretty clear example of this. I get that Smug is his brand, but it's just overly reductive; you've got three categories of people here: the anti-establishment-science (let's not leave chiropractors out, here), the morally bankrupt, and the risk-takers. Then again, this is a slightly behind the trend article about losing patience with disagreeable people, so I guess it's on message.


He is a snappy writer, but everything he writes is pushing his personal agenda around his pet issues.


Wow, I had not known this:

> As Tim Harford documents in his brilliant 2021 book The Data Detective, the 1954 classic “How to Lie With Statistics” was authored by a payrolled shill for Big Tobacco, Darrell Huff, whose planned (and never realized) followup was to be called “How to Lie With Smoking Statistics.” Huff’s work wasn’t just about debunking bad stats: it was also about casting doubt upon the statistical evidence linking tobacco with cancer.


It's a great book that's still relevant today. I'd love to read the follow-up, and see a modern criticism of it.


Note that this explains _why_ Cory Doctorow gets a new laptop every year... which was one of the central mysteries of the article currently at #1 on HN, "The Framework is the most exciting laptop I've ever used."[0]

https://news.ycombinator.com/item?id=28606962


Are authors of the article the same?


Yes, they're both Cory Doctorow


Thx. The laptop article does not display the author’s name. That’s why I asked.


> you disagree on whether there is such a thing as truth, and, if there is, how it can be known

People will only believe information to be true if it comes from a source they trust. And when a source of information becomes politicized, then suddenly only half of the population will believe information from it, while the other half will be suspicious and distrusting of it.


The neat part is that you do not have to be part of the source of information in order to politicize the source of information.


The war on smoking is so interesting to me. It has been over a lifetime that the war has been occurring. The percentage of people smoking is a fraction of what it was. So you would assume lung cancer has been reduced similarly? It hasn't reduced for 30 years. Worse yet, the correlation between lung cancer and smoking inverted in around the 1980s-1990s. So antismoking 'evidences' are now split around that time.

For some reason and I don't know why, the data actually says you should start smoking to prevent lung cancer. Which sounds absolutely batshit crazy to me. Which is why it's so interesting. We misidentified what is causing the cancer and none of the obvious other possibilities are explaining it. Though the good news is stuff like radon or asbestos being eliminated has been a good thing.


This is interesting, but can you provide some references for it? Data sources?


>This is interesting, but can you provide some references for it? Data sources?

I may have confusion over https://en.wikipedia.org/wiki/Incidence_(epidemiology)#Incid... but so does the data.

https://en.wikipedia.org/wiki/File:Smoking_lung_cancer.png

Notice the clear dip. Yes there's a delay, but you don't develop lung cancer and die the next year. It often can take over a decade for lung cancer to kill you; but it does. If you get lung cancer, you will die. You virtually never survive. This also measures deaths, but right about the peaks there is when chemotherapy(methotrexate) and many other treatments for cancer started. So in fact, this graph is quite biased because it doesnt show tobbaco vs lung cancer. It shows chemotherapy working. Surely this graph should have been updated beyond 2000-2005? Why did they cut off there?

https://en.wikipedia.org/wiki/Lung_cancer#/media/File:Cumula...

Why then does this one only go about 1990? Also who is smoking 25 cigarettes/day? And while getting lung cancer is practically certain death. At 25/day it only increases your risk by 25%? At only a couple cigarettes/day it's around only 5% increase risk? That's actually very bad correlation.

https://ourworldindata.org/grapher/lung-cancer-deaths-per-10...

Why the cut off around 2002? What about 2002 makes these data? Wait why do spanish women basically not get lung cancer? In fact, despite all the antismoking advertisements and efforts. ~20% of spanish women still smoke today. https://www.statista.com/statistics/750687/proportion-of-dai...

In fact, yes there's a delay but there's clearly no improvement on US females despite drastically decrease smoking rates and significant increases medical science on how to fight cancer.

How about second hand smoke? https://clincancerres.aacrjournals.org/content/15/18/5646

~50% of lung cancer is from people who never smoked. I know here in Canada it's rather difficult to find places to smoke and you virtually never get second hand smoke anymore. They used to assert it was second hand smoke like waitresses in smokey bars. However that can't be the explanation anymore.

https://www.semanticscholar.org/paper/Genetics-of-lung-cance...

There's virtually no risk until 50s?

How's it going in Canada? https://www.lungcancercanada.ca/Lung-Cancer/Causes/Smoking.a...

We avoided some deaths relative to expectations but lung cancer deaths are actually going up since the 1980s? Up every year?

Now we know why so many graphs havent been updated since the 2000s. We have something like 500% tax on smoking and smoking 25 cigarettes/day can only be done by very wealthy people.

You might jump back and say, but surely tobacco smoke with 69 confirmed carcinogens/poisons is causing cancer to some amount?

But what is chemo? It's a poison that kills cancer because cancer tends to split dna more often and is vulnerable to being killed by poisons. Virtually any poison can be used, but the trick is finding something that won't kill you or do more harm. Anthrax can even be used to treat cancer. https://pubmed.ncbi.nlm.nih.gov/12370003/

It seems what we discovered is that lung cancer was actually being killed by the toxic cigarette smoke. That the cause of lung cancer is something else and toxic tobacco smoke was actually helping some amount as a shitty chemotherapy. The antismoking folks know this and that's why all the graphs are cherry picked.

Also note; I'm not recommending to smoke lol. The somewhat recent discovery is that it's something else and we either don't know or aren't allowed to know for political reason.


That was my homework: go away and think of an immediate reason not to smoke.

Smokers truly are oblivious to how godawful they smell to everyone else. I'd rather sit next to someone actively shitting his pants than someone who's smoked in the last three hours.


Marijuana smokers too. Wish more of them would switch to edibles but apparently it's a different type of high that some simply don't like as much as what they get from smoking it.


> apparently it's a different type of high that some simply don't like as much as what they get from smoking it.

The main downside (upside?) of edibles is that the high lasts much, much longer. I like them, but I'm not gonna take one during the day unless I definitely don't have anything important to do for the rest of the day.


As a former day-blazer, I can tell you that you don't want to take an edible before bedtime else... it's bedtime.


Demanded I sign in to read the article, but it worked in a Private Window.


I do have to admit, he has a way with words.

"It’s how homeopaths, anti-vaxers, eugenicists, raw milk pushers and other members of the Paltrow-Industrial Complex played the BBC and other sober-sided media outlets, demanding that they be given airtime to rebut scientists’ careful, empirical claims with junk they made up on the spot."


"but I also know that keeping an open mind doesn’t require that you open so wide that your brains fall out."


Tabacco is a magical plant that will grant you increased alertness, stress and anxiety release, decreased hunger, ...

Our problem is not smoking. Our problem is how and why we smoke. It has nothing to do with the drug itself but everything to do with us.


"stress and anxiety release" is strictly bs. Smoking raises your baseline anxiety and stress. Those only continue to increase as the time it takes for you to start withdrawal shrinks as you become more tolerant. A quick google will confirm this or I can do it and provide sources.

I also know this empirically because I was a half a pack a day smoker for a few years and I have never been more anxious, it was what drove me to quit.

You feel relief shortly because you're satisfying the addiction but at the general level you have more stress.


Withdraw shrinks in only when you use tabacco regularly.

It is not the drug that is the problem but how you used / abused it.


Then you get no relief when smoking, it's literally a stimulant.


It is both. A stimulant and a sedative (dumb categories).


TIL and it's actually the fact that causes the seeking behavior which eventually forms the addiction. Epinephrine causes the kick and beta-endorphin the drop. Neat. I went and searched it up because I was curious and you surely are correct. Not sure why they're dumb categories though


> Not sure why they're dumb categories though

How can something stimulate and sedate at the same time? It's legacy nomenclature that has become counterintuitive. Like how electrons are negative and holes are positive.


I mean it effects two separate systems that produce chemicals that cause different effects, one stimulates, and one sedates/depresses. It's not like the nicotine itself is doing both.


Same thing goes for caffeine, alcohol, and many other drugs.


The worst part is the carcinogenic chemical soup they add to cigarettes is to make it more palatable to smoke several times a day. Self-medicating is big business.


Are they really doing this?



"According to the U.S. National Cancer Institute: "Of the more than 7,000 chemicals in tobacco smoke, at least 250 are known to be harmful, including hydrogen cyanide, carbon monoxide, and ammonia. Among the 250 known harmful chemicals in tobacco smoke, at least 69 can cause cancer."

https://en.wikipedia.org/wiki/List_of_additives_in_cigarette...


You got the right link, but the quoted excerpt is not responsive to GP's question.

The short answer is, "yes."

> This is the list of 599 additives in tobacco cigarettes submitted to the United States Department of Health and Human Services in April 1994.


Those smokers that live to 85 or 90? They're the edge cases.

Most do not make it that far, like my grandfather. He smoked Chesterfields, just like the ad with Ronald Reagan in Cory's article, only the unfiltered kind.


unfiltered may be safer because smokers do not inhale as deep


In the general case, maybe. Not in his specific case.

There is probably a mortality study of filtered vs. unfiltered smoker preferences.


If you have a history of struggling with your weight or are shy in social settings, pick up cigarettes.

Obesity and loneliness are far more dangerous.


How do I make my parent stop? She says she enjoys it.. I have smoked socially myself here and there, but never became addicted.


How soon until someone can write the same article about the oil companies? Whenever that it it's not soon enough.



Is there a healthy alternative to smoking?


Breathing techniques, meditation, that sort of thing. Try autogenic training for starters.


"denying the science"

and yet ppl still smoke in spite of warnings and knowing the risks ...


> the mere existence of the tobacco companies today is a blazing signal that corporate evil attracts no penalties, emboldening the sociopaths and criminals who will kill us all to make a buck

That resonated with me.


It's not just corporate, it's human nature. Many people will steal your wallet if you leave it unattended. Some will steal it out of your own pocket and others will actually stab and kill you for it.


> Many people

That's true in absolute numbers, because there's billions of people. But in percentage? Are we talking about 80% of the population, or is it closer to 1%?

If it's 1%, or close, then it isn't "human nature", it's an aberration. I believe that's the case. I also believe that corporations attract that kind of people in particular.


Cory Doctorow is behind a paywall. How appropriate.


FTA

>Denialism over masks, vaccines, opioids, problem gambling and gun proliferation all follow the same playbook, often because the same handful of profiteering firms are behind them.

Before we start congratulating each other for being such smart fellows, let's all keep in mind that it works both ways.


People who label themselves as skeptics are often the most blind to their poorly supported beliefs but that sure doesn't stop them from using the skeptic label as proof of their correctness.


Smokers and the Obese save Governments money on healthcare costs, by dying earlier:

https://www.nytimes.com/2008/02/05/health/05iht-obese.1.9748...

This study only included healthcare costs, and so the savings would thus be even greater when considering pensions.

"On average, healthy people lived 84 years. Smokers lived 77 years and obese people 80 years.

The healthy group cost $417,000, the obese $371,000, and smokers $326,000."


I wouldn't expect that to stay stable any more than doing the lifetime cost calculations for HIV initially and today. Cancers are increasingly being survived, usually with at least some additional lifelong health care requirements (which pharma will always be looking to expand upon) on top of the costs for a healthy individual.


Using that logic, the government should be eager to keep covid around as long as possible because of money being saved by people dying early.


The question would be how does that balance against "productive" years, where they're paying taxes, their work increases the GDP etc.


According to this UK COVID Risk Calculator:

https://qcovid.org/Calculation

An average healthy White British male of 66 years (retirement age) has a hospitalisation risk of 1 in 831; death risk of 1 in 2786.

By contrast the yearly risk of death in that age bracket generally, from any cause, is 1 in 42:

http://www.bandolier.org.uk/booth/Risk/dyingage.html

COVID is accelerating deaths from existing comorbidities or very old age; based on this data it is not felling healthy workers.


One could argue that fighting against covid was worst thing we could have done for climate in long run...


We just voted out a government that tried to do that.


Not really.

When your diabetes leads to kidney problems and stroke, your last 5 years of life likely cost more than the rest combined.


Complicating things are some of those people dying early could otherwise be happy and productive members of society. And government doesn't exist to save money.


[flagged]


You consider belief in peer reviewed science and universally accepted empirically tested medical research "prejudices and bigotry", so you play the victim of science and medicine, yet you don't consider yourself the victim of corporate sponsored tobacco addiction and self-inflicted lung cancer and heart disease, who will lose a hell of a lot more than a minute of life over it. Ok, boomer.


>there’s no ethical consumption under capitalism

This part of the article seemed like a non-sequitur.

I smoke two or three packs of cigarettes a year. It doesn't seem like it's an unhealthy thing to do, and I enjoy it.


I'm ready to be judge and called an idiot (Not even going to disagree) :/

I use to smoked for little over 10 years. I also quit smoking about 11 years ago.

Recently I started pipe smoking again. Man do I love it :) The *hunt* for the next perfect blend is fascinating and lol I dare say addictive. Cracking open that new "tin" (yes pipe tobacco comes in tins, like big shoe-polish-tins). Nothing like the expectation of waiting in the mail for that new batch of tinned pipe tobaccos you bought after spending days reading their reviews and comparing notes.

Of course we don't inhale ! (like that is really going to save us).

PS. Not suggesting its anyway healthier nor better for you that *yukky* cigarettes, I kinda wish someone can just make it less of a health risk :(

I can say smoking 1-2 pipes (yes the bowls are bigger than your avg cigarette) a day is way wayyy more enjoyable than 20+ cigarettes a day.

Oh well, time to load up some "SeattlePipeClub - Plum Pudding" (it's been called the nirvana of pipe tobacco) in my ole'reliable-but-not-fancy Lorenzo pipe :)


Yesss. Pipe tobacco is an art form, and even if it does shorten your life (certainly less than cigarettes!), the pleasure derived from it is immense.

Plum Pudding is a great blend, too. I'd give Captain Black — Dark a try if I were you. One of the best blends I've had the pleasure of trying, and my wife swears by it.


ahhh thanks :) Will do !


Ironically, given that the data on tobacco use and COVID gives the medical establishment fits, now may not be the best time to quit. Not an argument for starting, of course.


No, that appears to be a myth.

https://www.nature.com/articles/s41533-021-00223-1

> To date, there is no strong evidence (i.e., evidence based on causal research) that smokers are protected against SARS-CoV-2 infection. Moreover, there is growing evidence that smokers have worse outcomes after contracting the virus than non-smokers.


There was at least one study in France showing that smokers had a lower risk from COVID-19. (I'm not recommending smoking.)

https://academic.oup.com/ntr/article/23/8/1398/6073671


That's an example of the "fits". Lots of data, replicated across the world, but plainly it suggests something unacceptable so it is not evidence.


Can you provide some links to the data?

edit: Oh, I see the link you posted below.

edit: That's a link to an ongoing clinical study, no published data yet. Can you provide some links to the data?


Read the Nature article; it cites a large number of studies and dismisses them.


Interesting. Just intuitively I bet the cons of smoking outweigh any benefits, but now I'm curious as to the outcome of the nicotine trial. Thanks for sharing the smoking-COVID rumor, I'd never heard that one before.


What is this? You think smokers beat the 'rona?


There were some studies that observed a low prevalence of current smokers hospitalized for Covid, compared to smoking rates in the population, and hypothesized that nicotine might be having a beneficial effect. On the other hand, it obviously stands to reason that having stronger lungs would be better for outcomes of a respiratory disease. I'm pretty sure there's been no definitive research findings one way or the other.


Might have been a weight issue since smokers are usually 10-15 lbs lighter.


It also stands to reason that not developing a respiratory illness at all is better than having a better outcome when you do. Note that data that doesn't "stand to reason" is super interesting as science. There are a lot of such studies now; the Nature article cited above has a whole list of them. The authors' argument of "the myth" is basically "smoking is still bad because smokers have worse outcomes if they're hospitalized for COVID, also smoking is bad, mkay" which is just avoiding the point.

You and they are right that it is not clear whether smokers have an overall benefit or not with regards to the whole chain of causality from contracting COVID to hospitalization to "worse outcomes"


> The authors' argument of "the myth" is basically "smoking is still bad because smokers have worse outcomes if they're hospitalized for COVID, also smoking is bad, mkay" which is just avoiding the point.

The author engages the data directly, as well as broader context about smoking and infectious disease. Now, they may be lying by either commission or omission, for all I know, but the above does not accurately characterize the piece.


They give two methodological nitpicks, which is not really "engaging the data directly". One is basically, there are other paradoxical results in with this paradoxical result, so obviously this paradoxical result can't be true! Really, even in the COPD patients they saw the same result, which means it's obviously wrong. Right? Right?

The other one is fair enough: self-reporting has its limits. But what are they really?

Let's do the thought experiment: if the converse result were being reported, i.e. non-smokers were having worse outcomes than expected, but growing evidence showed smokers developed serious cases more frequently than non-smokers, would that article be any different? I think you could just write it paint-by-numbers. Also, kids, don't start smoking no matter how cool you think it is, mkay?


It could be related to smokers spending more relative time outside, since covid-19 seemed to not do well in fresh air and sunlight (significantly faster oxidation and high susceptibility to uv.) Some newer variants seem to be surviving outdoors a little better, but we'll need months to see reliable data.

It could also be related to buildup from smoking coating the lungs and reducing the available points of infection, which in not sure you want. All that black tar and crud... I'd rather get covid.


Oh yes, smoking is very bad and only very bad people do it and they will die and you will live forever if you don't smoke. Is it a happy story now?

Please don't accuse me of "thinking" anything I didn't say.

In the meantime, there are clinical trials going on now for the use of nicotine to prevent COVID: https://clinicaltrials.gov/ct2/show/NCT04583410


"Oh yes, smoking is very bad and only very bad people do it and they will die and you will live forever if you don't smoke. Is it a happy story now? Please don't accuse me of "thinking" anything I didn't say."

Nobody accused you of any of that.


I didn't say smokers "beat the 'rona" and I'm not arguing for the virtue of smoking. I also do think the moral tone in "what is this?" is childish and inappropriately peckish.


There are lots of reasons to like nicotine, there are no good reasons to get it through smoking.




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