Blowing Smoke About Tobacco‐​Related Deaths

April 29, 1999 • Commentary
By Robert A. Levy and Rosalind B. Marimont
This article is excerpted from an article in the Fall 1998 issue of Regulation.

The crusade against the tobacco industry began with a kernel of truth — that cigarettes are a high risk factor for lung cancer — that has exploded into a war driven by greed and bad science. In today’s commentary, Robert A. Levy and Rosalind Marimont take a fresh look at the case against smoking minus the propaganda fueling the fire of debate. They argue that the claim of smoking causing 400,000 premature deaths each year in the U.S. does not hold up under close scrutiny.

First a proposed federal tax hike of 55¢ per pack, then Clinton’s surprise announcement tucked away in his State‐​of‐​the‐​Union grab bag: The Justice Department will be preparing a litigation plan to recoup health costs associated with smoking. Never mind black markets, regressive taxes or personal responsibility. Whenever Clinton needs money, he applies this tried‐​and‐​true — but utterly dishonest — maxim: In Washington, D.C., any policy initiative can be sold if it’s pitched as being for the benefit of children. Before we let him get away with that ploy, it’s time to take a fresh look at the case against smoking — especially the relationship between cigarettes and the health of our kids.

The hyperbole, repeated ad nauseam in anti‐​tobacco circles, is that smoking causes more than 400,000 premature deaths each year in the United States. Although it started with a kernel of truth — that cigarettes are a high risk factor for lung cancer — the war on tobacco is now driven by greed, eroding the credibility of government and subverting the rule of law. Junk science has frequently replaced honest science and propaganda often parades as fact. Our legislators and judges, in need of dispassionate analysis, are instead smothered by an avalanche of statistics — in many instances tendentious, inadequately documented, and unchecked by even rudimentary notions of objectivity.

Teenagers die by the thousands in accidents, suicides, and homicides. But look at the table below from the Centers for Disease Control and Prevention [CDC]. Examining the age distribution of “smoking‐​related deaths,” we discover that — aside from burn victims and pediatric diseases — tobacco does not kill a single person below age 35! Burn victims obviously don’t belong among “smoking‐​related deaths” — unless you believe that Philip Morris is responsible when a smoker falls asleep with a lit cigarette — and neither do the 1,591 infants under the age of one who were tossed into this category despite no proven relationship between parental smoking and pediatric disease.

U.S. Smoking‐​Related Mortality by Cause and Age of Death
1990–1994 Annual Average
Age at Death Pediatric Diseases Burn Victims All Other Diseases Total
Under 1 1,591 19 0 1,610
1 — 34 0 300 0 300
35 — 49 0 221 21,773 21,994
50 — 69 0 286 148,936 149,222
70 — 74 0 96 62,154 62,250
75 — 84 0 133 120,537 120,670
85 + 0 45 71,652 71,697
Totals 1,591 1,100 425,052 427,743

The truth is that smoking‐​related deaths, even under the generous definitions used by CDC, are associated with old age. Nearly 60 percent of the deaths occur at age 70 or above; nearly 45 percent at age 75 or above; and almost 17 percent at the grand old age of 85 or above! Nevertheless, without the slightest embarrassment, the public health community persists in characterizing those deaths as “premature.” Regrettable, yes; premature, no.

Suppose for a moment that all tobacco‐​related deaths occurred at age 99. Surely the gravity of that problem would be tempered by the fact that the decedents would have died soon from some other cause. Actually, tobacco‐​related deaths occur at an average age of roughly 72, an age at which mortality is not unusual among smokers and non‐​smokers alike.

By comparison, car accidents, suicide, and homicide kill nearly 97,000 people annually; but the average age at death is only 39. Contrasted with a 72‐​year life expectancy for smokers, each of those non‐​smoking deaths snuffs out 33 years of life — our most important years from both an economic and parenting perspective. Yet states go to war against nicotine — which is not an intoxicant, has no causal connection with crime, and poses little danger to young adults or family members. The unvarnished fact is that children do not die of tobacco‐​related diseases. If they smoke heavily during their teens, they may die of lung cancer, fifty or sixty years from now, assuming lung cancer is still a threat by then. No matter how you slice it, a high‐​intensity government campaign against tobacco — in the guise of “protecting children” — is disingenuous at best.

None of this is to suggest that the attack against cigarettes is entirely dishonest. Without question, the evidence is that cigarettes substantially increase the risk of lung cancer, bronchitis, and emphysema. But most deaths from those diseases occur at an advanced age. The relationship between smoking and other diseases is not nearly so clear; and the scare mongering that has passed for science is quite simply appalling. The unifying bond of all science is that truth is its aim. That goal must not yield to politics, and science must not be corrupted to advance predetermined political ends. Sadly, that is exactly what has transpired as our public officials fabricate evidence to promote their crusade against big tobacco.

About the Authors
Robert A. Levy is senior fellow in constitutional studies at the Cato Institute. Rosalind B. Marimont is a retired mathematician and scientist, formerly with the National Institutes of Health.