9 comments on “Timmy Elsewhere

  1. Tim,

    This study is as flawed as the infamous Philip Morris study. For a start, it only looks at medical care costs. It does not take into account the fact that people with unhealthy lifestyles contribute less due to increased illness or death during their working lives. For example, I know a family where the father died prematurely (in his 30s) due to smoking. His family now rely almost entirely on the taxpayer to provide their income.

    It also assumes that the divide is between smokers and the obese and everyone else. Smoking and obesity may well finish you off far quicker but many other conditions caused by poor lifestyles require long term treatment. There was no attempt to look at diet, fitness or other major factors.

  2. “The study, paid for by the Dutch Ministry of Health, Welfare and Sports, did not take into account other potential costs of obesity and smoking, such as lost economic productivity or social costs.”

    It also claims that non-smokers are more likely to suffer strokes. Age is a major risk factor in strokes (risk doubles for every decade after 55) so you’d expect those living longer to suffer more strokes, all else being equal. But all else isn’t equal as smokers double their risk at any age and as they live only 7 years fewer on average, so this claim is also highly questionable.

  3. 1) it is *incredibly* rare for people to die of smoking-related diseases in their 30s, despite your acquaintance’s sad tale. Smoking lowers the median age of death by 10 years – i.e. from late 70s to late 60s, at which point few people are net financial contributors anyway.

    2) the study found that *actually* non-smokers are more likely to suffer strokes. Your comment here is the equivalent of “this may work in practice, but does it work in theory?” – clearly, in real life, the dying-young impact of smoking on strokes outweighs its direct stroke-provoking effects.

  4. 1. The median age of death doesn’t tell us anything. The point is how many more die at working age due to smoking (or obesity).

    “A study of 50,000 people over a period of 25 years found that 41 percent of people who smoked a pack of cigarettes or more per day died between ages 40-70, compared to 14 percent of nonsmokers. Among female smokers the death rate was 26 percent, compared to 9 percent of nonsmokers.”

    2. The study DID NOT find that that non-smokers are more likely to suffer strokes. It was a prediction of the model used – a prediction which, as I have pointed out, is inconsistent with other published data.

    Some quotes for you from the report:

    “With a simulation model, lifetime health-care costs were estimated for a cohort of obese people aged 20 y at baseline”

    “As with all mathematical models such as this, the accuracy of these findings depend on how well the model reflects real life and the data fed into it. In this case, the model does not take into account varying degrees of obesity, which are likely to affect lifetime health-care costs, nor indirect costs of obesity such as reduced productivity.”

    “The study, paid for by the Dutch Ministry of Health, Welfare and Sports, did not take into account other potential costs of obesity and smoking, such as lost economic productivity or social costs.”

    “Moreover, quite apart from health-care costs, the other costs to society from obesity are also greater because of absences from work due to illness and employment difficulties; these costs amount to considerably more than health-care costs”

    “In recent years several estimates of health-care costs attributable to obesity have been published [4,10–20]. Not only do such estimates vary enormously because of differences in methodology and definitions of health-care costs, these studies do not take into account the additional costs of “substitute” diseases that might occur during life-years gained. To our knowledge only two studies used the appropriate lifetime perspective [19,20], while only one [20] took into account medical costs of substitute diseases in life-years gained. It concluded that obesity causes higher lifetime medical costs, implying that prevention in this area can indeed result in cost savings.” (In other words, other studies disagree with this one)

  5. Smoking cigarettes kills: the evidence is as good as we can get in a world where the obvious controlled experiments are, for good reason, forbidden. But much else that’s believed about “lifestyle” may well be utter crap – the evidence is often feeble, contradictory, or even mere lies. It really isn’t wise to try and reorganise our lives around such, um, prejudice.

  6. “A study of 50,000 people over a period of 25 years found that 41 percent of people who smoked a pack of cigarettes or more per day died between ages 40-70”

    Completely useless information. Fifty quid says that well over half of the above died between ages 60-70 – my contact details are above if you want to take that one up.

    “The other costs to society from obesity are also greater because of absences from work due to illness and employment difficulties”

    Who cares? That’s a contractual matter between employers and employees…

  7. “A careful analysis
    published in the Milibank Quarterly economic journal in 1992 shows that, on average, a
    smoker’s lifetime health costs are at least $12,000 higher than nonsmoker’s healthcare costs,
    despite the fact that smokers tend to die sooner.

    Supporting this finding, research studies published recently in the Tobacco Control journal and elsewhere have established that many prior estimates of smoking-caused health care costs (which many death benefit calculations rely on) have been too low because they did not reflect the fact that smoking makes diseases and health problems not caused by smoking more severe and more costly to treat.”

    In addition, an August 2000 study in the Journal of Epidemiology and Community Health
    established that smokers, on average, experience more years of disability and illness than
    nonsmokers, despite living shorter lives, and that eliminating smoking would not only increase
    life spans but also increase the average period of disability-free life — thereby delaying and
    reducing overall healthcare costs. ”

    http://www.tobaccofreekids.org/research/factsheets/pdf/0036.pdf

    Tim’s point was that smokers save money for the NHS. The effect on the NHS of more absences from work and lower employment rates is lower contributions. This isn’t a contractual matter between employers and employees.

    It may well be the case that it should be down to employers, employees and health insurance but, at present, it isn’t.

    Smoking approximately doubles your risk of dying before retirement age (it’s around 18% for non-smokers) and 40% for smokers as various studies in various countries have .

    john b – I suggest that you don’t make bets based on your understanding of numbers. You made a fool of yourself before asserting that a number “four times less” is a quarter as big*.

    *see my previous demolition of this claim

  8. “Tim’s point was that smokers save money for the NHS. The effect on the NHS of more absences from work and lower employment rates is lower contributions.”

    Do people not pay tax on sick days now? Who knew…? Yes, lower employment -> lower wages -> lower taxes -> less money for the government to spend, but that’s got bollocks-all to do with saving or not saving money for the NHS.

    “You made a fool of yourself before asserting that a number “four times less” is a quarter as big”

    No I didn’t – you made a pompous arse of yourself by deliberately misunderstanding something whose meaning was entirely obvious. And you’re doing it again. Are you naturally this much of a smug git, or do you have to work at it?

  9. john b – I asked a perfectly reasonable question about what you meant by “four times less”. You tried to patronise me by implying that I was an idiot and that the answer was obvious. You are the smug git – and a thick one at that.

    Something that is “four times less” is one fifth of the size, not one quarter. If you can’t understand this, you are the idiot.

    Do you have to work hard at being so stupid and so self satisfied at the same time? Silly question – it obviously comes naturally.

    If people spend more time off work, they produce less and so less tax is paid. Workers who smoke typically are ill two more days every year – so they work one per cent less. Even in the NHS directly (which spends about £50bn on employing people) this costs £500m onlost productivity.

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