[tjr225]

Isn't it incredible how much the smoking culture of America has shifted over time? If only the forces who put the anti-smoking effort into motion could come together and work towards making renewable energy, alternative commuting methods, or universal healthcare acceptable ideas in this country.

I used to smoke a pack a day and I'm glad I don't anymore.

[dfee]

Over the weekend a friend of mine pointed out that while nicotine use has dropped, cannabis use has heavily increased. As if, the rise on tobacco prices has driven folks to alternative drugs.

I wonder (and if someone on HN knows how, please share) if you were to track use and abuse of pills, stimulants (including things like 5 hour energy), cannabis and other forms of what’s becoming not-so-recreational drug usage — what would we find?

[shpx]

There's recently been a big uptake of juuling (a mass produced high nicotine concentration vape) with teenagers.

https://www.newyorker.com/magazine/2018/05/14/the-promise-of...

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

https://www.reddit.com/r/juul/comments/7xnhzm/juuling_in_sch...

https://news.ycombinator.com/item?id=17427712

[nkozyra]

Well at minimum we mostly know that alcohol and tobacco are on the higher level on the "harm" spectrum than other illegal drugs.

My takeaway is American drug usage has been shaped by a lot of socio economic factors that do not have human or societal health ramifications. There needs to be a total, science-backed overhaul of drug policy for this reason.

[dfee]

> Well at minimum we mostly know that alcohol and tobacco are on the higher level on the "harm" spectrum than other illegal drugs.

I don’t know who “we” is, but don’t count me in that group.

https://unitedrecoveryproject.com/10-most-dangerous-drugs/

And that’s by frequency.

https://www.independent.co.uk/news/uk/home-news/from-krokodi...

That’s by potency.

Sure. Don’t get me wrong. Nicotine is bad for you, so is Alcohol, but it doesn’t make you do this: https://en.m.wikipedia.org/wiki/Miami_cannibal_attack

[toomanybeersies]

I'm not going to trust an article that says that using ketamine gives you HIV.

[dfee]

You probably shouldn't trust any information thrown at you without critical thinking (including the first three articles that came across my Google search).

[nkozyra]

> I don’t know who “we” is, but don’t count me in that group.

Your article supports my premise.

If you need me to post people doing horrible things while drunk or tobacco related death statistics I'm happy to do so as a counterargument.

[InclinedPlane]

I'd like to see the statistics on that. Marijuana used to be illegal, so a lot of use was hidden.

Also, 5 hour energy is just caffeine and I highly doubt that caffeine usage in the US has changed significantly (from ubiquitous) over the past few decades.

[anewone]

Smoking is scary on an individual level, not to mention expensive. Those other causes you mentioned aren't interesting if you don't personally need them. It's harder to get someone to make a short term sacrifice for other people's long term gains.

[zavi]

A better analogy would be a potential campaign to reduce obesity. If US could pull off a public fat shaming campaign as successful and the one around tobacco it would be a huge benefit to individual people's quality of life as well as economy as a whole.

[JunkDNA]

I would argue this is already underway. There is a concerted campaign against fast food and sugary drinks. There are all sorts of programs to encourage people to exercise. Big corporations have annual “health screenings” where they fat shame you if your BMI is a point over and you drink alcohol once a week.

The problem is that obesity is a complex problem. Not everyone who is overweight is a lazy person who eats Doritos on the couch wile watching daytime tv and wondering why they’re so overweight.

Smoking was easy: with extremely rare exception, smokers get lung cancer. Period. Smoking is one of the very few personal behaviors that basically guarantees you will get cancer. It also has the side benefit of annoying the living daylights out of people who don’t smoke which creates social pressure against it. It was pretty much a slam dunk.

[notyourwork]

I hate to say it but generally people are overweight because they eat more than they should. Not much more to it for majority of the overweight population. Exercise is great but lack of it isn’t the obesity drover.

[nvarsj]

Well, there's a darker side to that as well. Obesity is a problem for low income people - because cheap food is usually terrible for you - high calories, high salt, high fat and easy to eat a lot of. Think of your typical fast food - the amount of calories that can be bought for a few dollars. Same with soft drinks. Shaming people who get large might be one strategy, but we also need to stop the fast food peddlers that make it so easy, cheap, and addictive.

[chosenbreed]

> Well, there's a darker side to that as well. Obesity is a problem for low income people - because cheap food is usually terrible for you - high calories, high salt, high fat and easy to eat a lot of. Think of your typical fast food - the amount of calories that can be bought for a few dollars. Same with soft drinks. Shaming people who get large might be one strategy, but we also need to stop the fast food peddlers that make it so easy, cheap, and addictive.

Possibly...I see it more as a matter of education and at the end of the day personal choice. I suspect that for the price of a basic McDonald's meal you could get enough potatoes/pasta, cheese and frozen peas to feed an entire family.

I concur with your thoughts on the addictive nature of some of the foods. But that is slightly misleading. Generally speaking our bodies enjoy fat, sugar, etc no need to fight it. Again I'd rather focus on empowering (or at least trying to) people to make informed decisions regardless of what's being peddled at them ;-)

[saiya-jin]

Sorry but I don't fully agree on this one - you can cook your own stuff from cheap ingredients, you can eat cheap pre-made salads etc. I had my share of burgers and other crappy food in my life, but it was always my conscious decision over healthier options. blaming some evil forces out there is beyond pathetic

Let's stop treating people who eat what they want as children who don't have the willpower to decide for themselves (or like heroin addicts).

You want a simple solution? Tax food based on sugar content, and tunnel those extra billions into some meaningful part of healthcare system. Make obvious junk food more expensive. Of course this won't happen so easily, but even marginal steps can save hundreds/thousands of lives.

[hfdgiutdryg]

high calories, high salt, high fat

None of those are bad things (except salt if you have existing health conditions, and even then it may be a lack of potassium rather than an excess of salt). The single worst part of fast food is probably the sugar content. Mostly soda, but it's also added to nearly everything (a fast food bun I had the other day was ridiculously sweet).

Before WWII, the US was primarily an agricultural economy. People worked hard, without much automation, and food was comparatively expensive. IMO lack of physical exertion is a huge part of the problem, if only because of the discipline it builds and the reduced opportunities to snack.

[orhmeh09]

Can you expand on the near-certainty of cancer for smokers? I’ve seen figures more in the range of 10-15%. https://www.ncbi.nlm.nih.gov/m/pubmed/7895211/

[wild_preference]

By that rationale, obesity is easy since it causes straightforward issues. Notice how you didn’t discuss the reasons people smoke but you waved away obesity due to complexities in which people become obese.

[Freak_NL]

Obesity hurts society by taxing the healthcare system, and by setting an unhealthy example (mainly by normalizing being fat). Smoking does this, but also directly harms non-smoking individuals via second and third hand (via clothing, carpets, drapes, etc.) smoke. The latter (harm to others) made it a lot easier to change society's views on smoking.

[dionidium]

Well, the obviously better analogy is drinking. Just as people in the U.S. once thought smoking was essential to the enjoyment of all kinds of human activity, so now do people think this way about alcohol, to enormous social detriment.

Interestingly, the anti-smoking crowd won by convincing the public that absolutely any amount of smoking is so harmful to yourself and (crucially!) everyone around you that consuming even the smallest amounts is unconscionable. That's obviously untrue, but it's a very successful narrative (so successful that I suspect most of you will bristle at the suggestion that it's not true).

This was crucial because it convinced people that: 1) no, moderation isn't acceptable; and 2) every bit of intake is harming somebody else.

A truthful campaign couldn't have made these two arguments and so wouldn't have been as successful.

[briandear]

Except people have no problem making snide comments to smokers when they are smoking outside of a building, but there’d be all sorts of #meTooImFat outrage if you started tsk-tsking fat people eating ice cream.

However, it really isn’t anyone’s business if I’m fat. You could argue health insurance is a shared risk pool, but under that logic, we’d be giving the government the right to dictate every aspect of your life and I am not willing up to give that freedom. Because why stop there — why not have the government mandate hours of sleep or require morning group exercises or require that you get married (since studies have shown that married people have lower heart disease risks.) It could get absurd, but the moment you let the government control even something small, it just keeps growing until we are quite literally Nazi germany where only “ideal” people are allowed to breed or receive permission to open businesses or get desirable jobs.

I’d rather a fat, free society where you can smoke if you want or drink whisky every night than a “healthy” society where the government literally monitors your every breath.

We talk about digital privacy with almost religious conviction, yet when it comes to things like public health, many are willing to let the government sit down with you at the dinner table.

“Get the government out of the bedroom..” I agree. I also want them out of every other room of my house as well. Government’s role is to provide shared infrastructure that is impractical for private individuals to provide for themselves. Government’s role is to have a legal system where contracts can be enforced. It’s role is also to provide for a common defense: protecting property, protecting us from crime. In short, a government’s job is to protect liberty. It isn’t government’s job to tell people what to consume. We saw Nazi Germany, the Soviet Union, China, Cambodia and now Venenzuela, why the hell would we ever want a government so ubiquitous and powerful that it could descend into such totalitarianism?

I have no problem with government providing for the destitute or providing public goods, but I have a huge problem with the government attempting to regulate the freedom of the individual under the guise that it’s “good” for society. Because “good for society” in Nazi Germany evolved into killing millions of people. It’s all incremental, the march towards a complete Orwellian nightmare. Russians never imagined that Bolshevism would lead to the horrors of the KGB and NKVD. Purges were never expected. Cubans never expected that supporting the revolution would mean millions of them would end up in prison or executed for thought crimes.

As far as “good for the economy” — the US economy got so powerful because of freedom; start messing with that and you could disrupt the very foundation upon which the largest economy in the world was built.

Sure, let’s fat shame — but let’s leave the government far out of it.

[squiggleblaz]

There's a difference between the government telling you (i.e. a real person) what to do on the one hand, and the government telling a corporation (i.e. a system that can neither live nor die, can neither suffer nor experience pleasure) how they can advertise their wares on the other hand.

For instance, Australian adults are free to smoke cigarettes. But companies operating in Australia are not allowed to sell cigarettes without conforming to various restrictions and regulations. Those aren't the same thing.

So the analogy here would be that Coca-Cola is freely allowed to sell their goods, but (a) they're not allowed to advertise them and (b) when they sell them, they should say something like "sugary beverages cause diabetes" (if that's the valid and analogous claim) and show a picture of person with a foot that needs amputating.

If you still want to buy a coke when the bottle looks like a scene from a horror show, you'd be allowed to. But they'd have to give you a reasonable assessment of the consequences of drinking this beverage (which are generally not becoming a hot fit 20 year old on the beach). (Assuming that there is a valid link between regular consumption of sugary beverages and obesity-related health problems - it's not a topic I've specifically investigated but it seems to be the general assumption.)

[pg314]

> It could get absurd, but the moment you let the government control even something small, it just keeps growing until we are quite literally Nazi germany where only “ideal” people are allowed to breed or receive permission to open businesses or get desirable jobs.

You are making a non-sensical slippery slope argument. Heroin has been prohibited for a long time in the US, yet it hasn't turned into Nazi Germany.

[hfdgiutdryg]

On the other hand, many of the worst parts of our society have come about as a direct result of drug prohibition. Police corruption and empowerment of drug cartels to name two.

[dragonwriter]

> It could get absurd, but the moment you let the government control even something small, it just keeps growing until we are quite literally Nazi germany where only “ideal” people are allowed to breed or receive permission to open businesses or get desirable jobs.

Every government controls more than something small. Very few of them ever turn into Nazi Germany. So, no, I don't think that slippery slope is a useful guideline for evaluating real world questions.

[flukus]

> If only the forces who put the anti-smoking effort into motion

Looking at the consumption/events chart (https://ourworldindata.org/wp-content/uploads/2013/05/Annual...) it doesn't look like any of those efforts was particularly causal. Some like nicotine medication being available seem to have even slowed the decline.

[mertd]

I wonder how anti-smoking campaign would have played out today when a good chunk of population can't be convinced that vaccines are a good thing.

[TheSpiceIsLife]

I haven’t seen any numbers, but I would have thought tiny minority would be more accurate?

[geomark]

In some areas the percentage of unvaccinated is quite high. See this map of anti-vaxxers by county http://rpubs.com/markdg/AntivaxxerHotspots It uses the Personal Belief Exemption for school children as a proxy for the general population of anti-vaxxers. So arguably a bit inaccurate.

[dragonwriter]

> It uses the Personal Belief Exemption for school children as a proxy for the general population of anti-vaxxers. So arguably a bit inaccurate.

Well, also there's been a lot of news events around the issue since 2015, which led to the elimination of the exemption, so its quite possible there have been signficant movements in attitudes in the last three years.

[dragonwriter]

So, overall, a tiny minority; sure, it's a somewhat less tiny minority in some counties (and a significant one in a few) but those are mostly very low population counties, too.

[geomark]

State-wide that's true. But herd immunity is a local issue. So if your kid is going to a school where more than 10% of the other kids are unvaccinated then they won't benefit from herd immunity, despite the fact that the number of those unvaccinated kids is a tiny minority of all California kids.

[MarkusAllen]

Nevada, California - more than 20% opt out. Fascinating.

I would love to see hotspots of places where people have no religion - not even atheist... just none.

[Scarblac]

Why would you consider "atheist" a religion? They're just people without religion who get asked about gods.

[nigifabio]

Here a map https://en.m.wikipedia.org/wiki/List_of_countries_by_irrelig...

[TheSpiceIsLife]

Colour me highly in accurate!

I sit not just corrected, but fairly shocked.

[geomark]

I was also a bit shocked when I saw how high the Personal Belief Exemption was in some counties. Above 5% unvaccinated pretty much destroys herd immunity. So most of northern California is a no-go zone for people who appreciate the value of herd immunity.

What I have not seen, but would like to, is data for other states.

[telotortium]

Fortunately, the highest-population counties in northern California are not too high - the number of schoolchildren in such counties is much lower that this map would indicate.

[TheSpiceIsLife]

I’m in Australia so:

One in 10 Australian parents believe that vaccines can cause autism, and a another 30 per cent are unsure

http://mobile.abc.net.au/news/2017-03-08/children-without-va...