Rosenblum: 'Happiness' analysis is hazy on smoking's ill effects

  • Article by: GAIL ROSENBLUM , Star Tribune
  • Updated: August 22, 2014 - 2:33 PM
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Cigarette and ashtray

More good news about the benefits of quitting smoking has arrived from across the pond.

British researchers have found that moderate and heavy tobacco smokers get a mental health boost after quitting that’s equal to taking antidepressants.

Add that to the “why to quit” list and say goodbye to certain forms of cancer, blindness, impotence, heart and gum disease, and hello to walking around the block, tasting your food and seeing your kids graduate.

This should come as welcome news to the Food and Drug Administration, the government agency charged with protecting us from public health ills. They’ll no doubt throw a party as soon as they stop licking their wounds.

The FDA has been on the defensive the past few weeks, ever since word got out about a deeply buried federal rule many say is being comically misapplied. Except that nobody’s laughing.

The rule suggests that any benefits from reducing smoking must be weighed against the loss of pleasure smokers experience when they quit. The formula is so complicated that even an FDA spokeswoman couldn’t explain it to me, but it’s heavily weighted on the side of smokers and their right to a “happiness quotient.”

Many unhappy economists, policymakers and health care providers have responded with a variety of counterpoints that can be summarized in a word:

“Huh?”

“This is taking an economic concept and literally turning it on its head to reach a conclusion which only a Ph.D. could think sounded reasonable,” said Matt Myers, president of Tobacco-Free Kids, a Washington, D.C.-based advocacy organization.

“Given everything we know about smoking, the loss of pleasure [after quitting] would be tiny,” he said. “Any rational human being would say, ‘What are you talking about?’ ”

One big concern if the FDA approves the formula, now in review, is that tobacco companies (which have been obscenely happy for too long) could sue. In theory, these companies could argue that smoking cessation efforts, including warning labels, are not cost-effective and, therefore, should be shelved.

This quirky tale began in 2011, when the FDA proposed those very warning labels on cigarette packages. Out came what is called the cost-benefit analysis (CBA), which is a widely used and terribly dry economic tool for deciding whether to make a change to the status quo. The analysis works well when deciding, for example, whether to design a storage tank for hazardous waste with a double or single wall or to build, say, a new light-rail route.

While largely subjective, CBA is generally effective when applied to rational, well-informed adult consumers. This is where the screaming started.

Smokers are neither rational, well-informed nor adult when they begin the habit, Myers said. In fact, 90 percent of long-term smokers begin before they turn 18, meaning they’re usually addicted before they can even buy cigarettes legally.

Nearly half of smokers have tried, unsuccessfully, to quit, “and the majority say they wish they’d never started,” Myers said. In other words, common sense and mounds of research simply trump any cost-benefit analysis here.

That view is supported by MIT economist Jonathan Gruber, who was among an eminent group who crafted a response to the FDA during the public comment period, which just closed.

“What the FDA did is not bad economics,” he said. “It’s just misapplied economics. Worrying about lost pleasure among people who want to quit smoking is the ultimate absurdity.”

Danise Holbein would concur. “It’s disgusting. It stinks. I should never have started,” said the 52-year-old, whom I cornered just after she grabbed a smoke in front of the St. Paul hair salon where she works as a stylist. She started smoking at 18, which was later than most of her friends, who picked up the habit at 15. She remembers her first cigarette and how it burned her throat. But she kept smoking. “I don’t know why,” she said. “It’s stupid.”

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