Dinah, ClinkShrink, & Roy produce Shrink Rap: a blog by Psychiatrists for Psychiatrists, interested bystanders are also welcome. A place to talk; no one has to listen.
Tuesday, June 23, 2009
38 Cents per Cancer Stick
When I was growing up, cigarettes were something people bought from vending machines. I've never been a smoker, but I want to say they cost about a dollar? I'm not so sure, and it's not something I pay much attention to. Today, I learned that a carton of cigarettes cost $75! $7.50 a pack, or 38 cents a cigarette. So someone who smokes 2 packs/day, pays about $450 a month.
The funny thing is, I didn't know this because people never complain to me about the cost of cigarettes. They complain about the cost of medicines (this sometimes includes patients with medicaid who have a $1 co-pay for their meds), the cost of health insurance, and the cost of medical treatment. At times, I've suggested that patients with heavy habits cut down by one pack a month (so less than a cigarette a day) to be able to afford their medicines and I've been met with groans.
Do I think cigarettes should cost this much? Yes. The health problems they cause and the cost they inflict on society is so huge, that I believe they should be heavily taxed-- and the monies should go to medical expenses incurred by smokers and research on how to better prevent addictions (my personal rant, added at no additional cost). But I think it speaks to power of their addiction that people are willing to put out this huge sum of money on cigarettes-- people who don't have it, people who really can't afford it, people who would go without necessary medical insurance or medical care, meals at nice restaurants, vacations, and many other things that $5,000 a year would buy.
So why is this a Shrink Rap post? Patients with severe and persistent mental illnesses have higher rates of smoking than the population as a whole, and they also die a lot younger, often from cardiovascular disease. Check out this post on Psych Central.
Posted by Dinah on Tuesday, June 23, 2009
Labels: addiction, dinahrants
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And while we are at it, add a stiff tax to all fatty foods since that contributes to obesity. And sodas too. And a higher tax on alcohol. Same old argument.
Before you claim that smokers' health problems inflict a cost on society, you should really do some research. People who smoke, on average, spend less in medical costs over the course of their lifetimes than people who don't smoke. The argument that they cost society more is simply false.
It is the only pleasure they have in life.
I am and have been chronically depressed most of my own life, and while I do not smoke or drink, I am overweight. I read somewhere that the societal costs from obesity will shortly equal the costs from smoking so I feel that I cannot judge.
I KNOW I shouldn't eat bad stuff, but I do. I love sweets. Recently I broke a very bad habit that I only had for a couple of weeks and that was going to Braum's every few days and getting a double dip of their new flavor called birthday "cake."
For too long I have rationalized my over-eating with the excuse that, well, I'm depressed and miserable so I "deserve" the simple pleasure of something sweet.
Maybe that's how they excuse their smoking.
Sometimes I wish I smoked because maybe I would be thinner, but I have asthma and I appreciate being able to breathe!
I can definitely say Amen to this post.
As a former smoker, I can tell you that it's not a pleasure to smoke. It leaves your mouth tasting disgusting and your clothes smelling awful.
It's also not a good replacement addiction for eating. I was 240 lbs as a smoker, it wasn't until I stopped smoking and eating and just focused on being healthy that I was able to lose my weight.
I'm fine with soda being heavily taxed: it has no nutritive value, is likely harmful, and yes, I love it.
"Fatty foods" is a stretch. Many people eat them and are healthy and not overweight. It's too vague a category, the precise roll of fats in causing illness are not clearly elucidated (and they change weekly!) and many fatty foods also have nutritional value, such as protein in fried chicken, protein and calcium and vitamin D in milk shakes. Lollipops have no fat and no real food value. It's just too vague. You can tax my diet coke, and it does give me pleasure.
Anon: Huh? No reference? People who smoke spend less on medical costs? Is this because they die young?
My main point here was the power of the addictions, not to pass judgment. No one takes that first puff saying "I can't wait to smoke 2 packs a day for 40 years"....they become addicted over time, and it seems it would be easier not to start.
I'm sorry anyone extrapolated this to obesity. People have to eat, bodies likely have set points, genetics and culture may contribute to weight, food preferences, satiation, and appetite. Cigarettes are a man-made phenomena and at some level, someone chooses to start. There may be less choice involved in who likes it, who gets addicted, and how hard it is to stop.
That first hot fudge sundae did me in.
Maybe we need to also add a stiff tax to psychiatric medications that stimulate appetite and make people fat and diabetic. It isn't just smoking that's the problem. Psychiatrists need to also look at how their prescriptions are impacting their patients' physical health.
It seems to me that if patients smoke and psychiatrists are oncerned about their cardiovascular health, then they would be even more cautious with prescribing drugs that cause weight gain in those patients. And yet, that doesn't seem to be the case.
I just wanted to add that yes adding tax will hopefully deter people from high fat and high sugar foods but why don't we also try lowing the price of good nutritious food? Make the choice to be healthy VERY EASY.
Also the increase in female smokers is quite shocking and I think they should be a target audience for the anti-smoking war.
Dinah, I agree, fatty foods would have to be better defined. Possibly foods containing more than a certain amount or percentage of fat/calories/cholesterol? I would have to play with numbers and do research first.
As a former smoker, I know that in many ways it is harder to cut down on smoking than to just quit. I remember having trouble going to movies because I'd be so desperate for a cigarette I could not make it through. I agree with Music Lady that there is no pleasure in smoking. Ironically I started cigarettes as a result of smoking marijuana. This was late 60's/early 70's when we sat on the floor in a circle passing a pipe or joint and then somebody would light a cigarette and pass it. It's extremely easy to get hooked on cigarettes and extremely difficult to get off. Quitting smoking was the hardest thing I have ever done and I had cravings for several years after I quit. I'm shocked at the price of cigarettes. The last time I smoked, the vending machine packs were 75 cents and cartons were $5.50. How do 14-year old high school students afford to smoke? In low socioeconomic areas the majority seem to smoke.
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