Blowing Smoke About Tobacco‐​Related Deaths

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 surpriseannouncement tucked away in his State‐​of‐​the‐​Union grab bag: The JusticeDepartment will be preparing a litigation plan to recoup health costsassociated with smoking. Never mind black markets, regressive taxes orpersonal responsibility. Whenever Clinton needs money, he applies thistried‐​and‐​true — but utterly dishonest — maxim: In Washington, D.C., anypolicy initiative can be sold if it’s pitched as being for the benefit ofchildren. Before we let him get away with that ploy, it’s time to take afresh look at the case against smoking — especially the relationshipbetween cigarettes and the health of our kids.

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

Teenagers die by the thousands in accidents, suicides, and homicides. Butlook at the table below from the Centers for Disease Control and Prevention[CDC]. Examining the age distribution of “smoking‐​related deaths,” wediscover that — aside from burn victims and pediatric diseases — tobaccodoes not kill a single person below age 35! Burn victims obviously don’tbelong among “smoking‐​related deaths” — unless you believe that PhilipMorris is responsible when a smoker falls asleep with a lit cigarette — andneither do the 1,591 infants under the age of one who were tossed into thiscategory despite no proven relationship between parental smoking andpediatric 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 generousdefinitions used by CDC, are associated with old age. Nearly 60 percent ofthe 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 incharacterizing 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 thedecedents would have died soon from some other cause. Actually,tobacco-related deaths occur at an average age of roughly 72, an age atwhich mortality is not unusual among smokers and non‐​smokers alike.

By comparison, car accidents, suicide, and homicide kill nearly 97,000people annually; but the average age at death is only 39. Contrasted with a72‐​year life expectancy for smokers, each of those non‐​smoking deaths snuffsout 33 years of life — our most important years from both an economic andparenting perspective. Yet states go to war against nicotine — which isnot an intoxicant, has no causal connection with crime, and poses littledanger to young adults or family members. The unvarnished fact is thatchildren do not die of tobacco‐​related diseases. If they smoke heavilyduring their teens, they may die of lung cancer, fifty or sixty years fromnow, assuming lung cancer is still a threat by then. No matter how youslice it, a high‐​intensity government campaign against tobacco — in theguise of “protecting children” — is disingenuous at best.

None of this is to suggest that the attack against cigarettes is entirelydishonest. Without question, the evidence is that cigarettes substantiallyincrease the risk of lung cancer, bronchitis, and emphysema. But mostdeaths from those diseases occur at an advanced age. The relationshipbetween smoking and other diseases is not nearly so clear; and the scaremongering that has passed for science is quite simply appalling.The unifying bond of all science is that truth is its aim. That goal mustnot yield to politics, and science must not be corrupted to advancepredetermined political ends. Sadly, that is exactly what has transpired asour public officials fabricate evidence to promote their crusade against bigtobacco.

Robert A. Levy and Rosalind B. Marimont

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.