[HN Gopher] An unexpected uptick in cigarette smoking in Germany
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       An unexpected uptick in cigarette smoking in Germany
        
       Author : bookofjoe
       Score  : 19 points
       Date   : 2023-09-01 14:11 UTC (8 hours ago)
        
 (HTM) web link (www.wsj.com)
 (TXT) w3m dump (www.wsj.com)
        
       | bigfryo wrote:
       | Smoking suppresses appetite meaning that Germany is less obese
       | than America
        
       | fidotron wrote:
       | I have a really controversial view about smoking: it has
       | undeniable downsides but as a society we are now feeling what
       | happens when a huge proportion of the population no longer
       | experiences the cognitive upsides they used to get from nicotine.
       | 
       | It's somewhat similar to what would happen if you banned coffee.
        
         | glimshe wrote:
         | There isn't really any societal upside with smoking. It's a
         | real net negative for the vast majority of users, financially
         | and healthwise. Maybe smokers should switch to coffee for their
         | high, a drug with no major downsides for most people.
        
         | lencastre wrote:
         | Cognitive upsides? Sounds like Cowboy Man copy... the Surgeon
         | General aproves this message.
         | 
         | Or do you mean people worked faster because they couldn't
         | during their cig break?
        
         | drpgq wrote:
         | I co-own a small bar and help run our trivia night. Between
         | rounds the smokers always go out for a smoke and they ended up
         | all knowing each other.
        
         | lotsofpulp wrote:
         | I don't know about nicotine, but I am all cognitive upside from
         | never smelling a cigarette again.
        
         | bigbillheck wrote:
         | Drunk driving helps a lot of people to get to work on time.
        
         | CoolestBeans wrote:
         | Smoking reduces quality years of life and puts a burden on a
         | nation's health system. The drastic decrease in productivity in
         | a nation from those two things has got to be far more than any
         | increase from any cognitive benefits.
         | 
         | But more importantly, it's morally wrong to suggest we shorten
         | and make our lives worse for some short term stimulant spike.
        
           | peoplefromibiza wrote:
           | >Smoking reduces quality years of life
           | 
           | actually it make worse your worst year, but has no effect on
           | your best years
           | 
           | > and puts a burden on a nation's health system.
           | 
           | listen, I know smocking is bad as anyone else, but if we
           | wanna talk about "burden on a nation's health system" let's
           | talk about cars (fumes are just the tip of the iceberg, we
           | have more than 20 thousand deaths/year caused by car
           | accidents and many more injured and/or left invalid) or
           | having children.
           | 
           | You know what also puts a burden on on a nation's health
           | system?
           | 
           | an aging population!
           | 
           | in my Country more than 25% of the population is over 65, so
           | they not only are retired and do not contribute anymore to
           | the expenditures through their work, they also need a lot of
           | very expensive and prolonged care.
           | 
           | They most probably smoked in their younger years, but
           | survived nonetheless and now they need to be taken care of.
           | 
           | Truth is the nation health system wastes too much money on
           | things that do not help people, we've seen it during the
           | pandemic, the personnel was crushed by the unsustainable
           | shifts and the output was barely sufficient.
           | 
           | said by someone who was born and lives in a Country with a
           | public healthcare system, who happily pays for it through a
           | lot of taxes (half of my salary) and a big chunk of the
           | family employed by the aforementioned public national health
           | care system.
           | 
           | Or, for example, what has been the cost (both economical and
           | social) of the recent opioid epidemic in the US of A caused
           | by the health care system itself?
           | 
           | > But more importantly, it's morally wrong to suggest we
           | shorten and make our lives worse for some short term
           | stimulant spike.
           | 
           | like, for example, firing up combustion engines to drive kids
           | to school? kids that, bear in mind, have perfectly
           | functioning legs and can walk!
        
             | nisegami wrote:
             | >in my Country more than 25% of the population is over 65,
             | so they not only are retired and do not contribute anymore
             | to the expenditures through their work, they also need a
             | lot of very expensive and prolonged care.
             | 
             | If only there was something out there that could thin out
             | this group of people in particular.
        
               | peoplefromibiza wrote:
               | > If only there was something out there that could thin
               | out this group of people in particular.
               | 
               | it's the same thing that, eventually, will happen to
               | everyone of us.
               | 
               | But literally where I am from they have on average 20
               | years more to live (second oldest Country in the World)
               | so, regarding the burden on the national healthcare
               | system, smokers cost less (I must specify I believe the
               | economic angle is rather meaningless when talking about
               | health care. I don't believe health care should ever be
               | profitable, barely sustainable it's enough).
               | 
               | A study concluded that the abuse of medicines causes
               | around 40 thousands deaths/year in my Country, which is
               | an incredibly high number, so maybe the secret lies in
               | moderation and not in abolition and prohibition.
               | 
               | There's also the fact that for many people a long
               | meaningless life is much worse than one lived fully, as
               | the "owner" intended.
               | 
               | Maybe someone in the future will convince everyone to
               | avoid any potentially dangerous habit, but I'm also quite
               | sure that such a society will face an epidemic of
               | depression and suicides.
        
           | tschwimmer wrote:
           | Many studies actually show that smokers are cheaper to care
           | for over their lifetimes, likely because they die earlier.
           | This study[0] shows a +7% for men/+4% for women increase in
           | healthcare costs if all people stopped smoking. I'm too lazy
           | to vet the epistemological quality of this study, but it
           | seems like there are a bunch of these much along the same
           | lines. One thing these studies seem to neglect is total value
           | lost associated with smoking, instead focusing costs alone.
           | By folding in some QALY-like model, you could come up with
           | the overall impact of smoking on society in quantitative
           | terms.
           | 
           | [0]https://pubmed.ncbi.nlm.nih.gov/9321534/
        
             | glimshe wrote:
             | This number doesn't take into consideration the
             | contributions of these people to society, which could
             | outweigh their additional healthcare cost and make them an
             | actual net positive to the economy (putting aside moral
             | questions about calculating whether people should live or
             | die based on their net value).
        
           | tmn wrote:
           | Is it morally wrong to eat a cupcake? I'm not a smoker nor
           | would I want anyone I care about to smoke, but have you
           | thought through the extrapolation of your assertion?
           | 
           | Similarly, old people are a drag on society. It's not at all
           | clear that reducing lifespan is a decrease on net
           | productivity.
           | 
           | I would not want those I care about to die early, nor would I
           | deny anyone else the same hope for the sake of productivity.
           | But I can be objective enough to acknowledge the tradeoffs.
        
         | red-iron-pine wrote:
         | >it has undeniable downsides but as a society we are now
         | feeling what happens when a huge proportion of the population
         | no longer experiences the cognitive upsides they used to get
         | from nicotine.
         | 
         | You don't need to inhale burnt tobacco to get nicotine, and
         | there are plenty of other ways to get stimulants into your
         | body; patches, teas, etc. and society is still consuming a
         | shit-ton of stims; ain't been to an empty coffeeshop since
         | COVID.
         | 
         | vaping, while shown to be not great for you, is also still not
         | as awful as inhaling tons of smoke, and can deliver the nico
         | just as well.
         | 
         | and it is the smoke that is the problem -- firefighters who
         | handle a lot of cases often have lung cancer rates far higher
         | than the rest of the population.
        
         | jayski wrote:
         | What are the cognitive upsides? The only one that I can think
         | of as an ex-smoker is that helps to control anxiety.
         | 
         | At the same time knowing I was harming myself by smoking added
         | a lot of anxiety.
        
           | nradov wrote:
           | Studies have shown that nicotine has some mild cognitive
           | benefits on attention and short-term memory.
           | 
           | https://peterattiamd.com/ama23/
           | 
           | I'm not necessarily recommending nicotine to anyone, but
           | there are ways to get it without smoking.
        
           | im3w1l wrote:
           | When I was in high school we had a few smokers. They seemed
           | to make a lot of friends while smoking and have better social
           | skills than others.
        
           | fidotron wrote:
           | https://en.wikipedia.org/wiki/Nicotine#Performance
           | 
           | > Nicotine-containing products are sometimes used for the
           | performance-enhancing effects of nicotine on cognition.[57] A
           | 2010 meta-analysis of 41 double-blind, placebo-controlled
           | studies concluded that nicotine or smoking had significant
           | positive effects on aspects of fine motor abilities, alerting
           | and orienting attention, and episodic and working memory.[58]
           | A 2015 review noted that stimulation of the a4b2 nicotinic
           | receptor is responsible for certain improvements in
           | attentional performance;[59] among the nicotinic receptor
           | subtypes, nicotine has the highest binding affinity at the
           | a4b2 receptor (ki=1 nM), which is also the biological target
           | that mediates nicotine's addictive properties.[60] Nicotine
           | has potential beneficial effects, but it also has paradoxical
           | effects, which may be due to the inverted U-shape of the
           | dose-response curve or pharmacokinetic features.
        
             | pluijzer wrote:
             | How susceptible to tolerance would the positive effect be?
             | Would a long term smoker still have any benefit? Or is it
             | like coffee, very quickly giving no benefit at all.
        
               | fidotron wrote:
               | This is a good question, along with what happens if that
               | long term smoker then quits altogether.
               | 
               | If you had ways to moderate the withdrawal of things like
               | caffeine and nicotine you could possibly try alternating
               | regimes. Would probably do dreadful things to your heart
               | though.
        
       | miguel_rdp wrote:
       | During a recent visit to Hamburg I entered a smallish pub/bar and
       | it was so smoky that it seemed like a portal to the 90's!
        
         | hackeraccount wrote:
         | I remember sometime in the 90's or so taking a trip to
         | California (I'm on the East Coast) when they'd just banned
         | smoking in bars. That was such a revelation. Doubly so because
         | I went to some jazz/blues place and the it was all just so
         | weird but also so nice.
         | 
         | It makes me a totally hypocrite (my poltics are generally
         | against those kind of bans) but it made everything so much
         | nicer that I couldn't help but like it.
         | 
         | They came for the smokers and I did nothing. Niemoller was
         | totally right.
        
       | melling wrote:
       | Guess we missed this story yesterday:
       | 
       | https://news.ycombinator.com/item?id=37345565
        
       | NoraCodes wrote:
       | What a weirdly incoherent headline. Why not, "Smoking is Dying
       | Out, Except in Germany", which is an actual sentence that conveys
       | the same information in fewer words?
        
       | bookofjoe wrote:
       | https://archive.ph/4OTBi
        
       | temporallobe wrote:
       | I know firsthand that smoking is still a huge part of the social
       | culture in all Balkan countries and even Italy to a lesser
       | extent. OTOH, many studies show that it's better than vaping.
       | I've had some conversations with my pulmonologist and a friend of
       | mine who's a board certified (nearly retired) cardiologist who
       | both confirm this and tell me that they see increasingly younger
       | patients develop serious disease very quickly after starting
       | vaping, including a 16-yo patient who developed emphysema.
        
       | suchire wrote:
       | It's still a habit OF dying, just not a habit that IS dying
       | </pun>
        
       | PaulHoule wrote:
       | I lived in Dresden in 1998-1999 and was kinda shocked that they
       | had cigarette vending machines outside like
       | 
       | https://www.alamy.com/stock-photo/cigarette-vending-machine-...
       | 
       | I don't see it in any of those photos but they often used to have
       | candy vending machines for kids mounted underneath them.
       | 
       | I went to Poland (where my grandfather came from) and boy did the
       | people there really seem to smoke a lot.
        
         | dionys wrote:
         | cigarette vending machines are still super common here in
         | Vienna as well. There's always teens hanging around them asking
         | people to swipe their cards to buy the cigarettes in exchange
         | of cash
        
           | adrianmsmith wrote:
           | A bit of history to this - previously there were just
           | machines, you put in cash and get cigarettes - but then it
           | was decided this made it too easy for underage people to buy
           | cigarettes so now you have to use a bank card (I think?) for
           | identification, so young people just hang around the machines
           | and ask a passerby to lend them their card.
        
             | jaclaz wrote:
             | Here in Italy you need to use your Codice Fiscale or Carta
             | d'Identita cards (both official documents) as (debit) cards
             | (pre-paid or connected to some bank account) can be
             | obtained as early as 13 or so (of course authorized by
             | parents).
        
       | anonzzzies wrote:
       | Everyone I see is smoking in Spain, Portugal, Greece, lot of
       | places in the U.K, Germany, China (all parts they think belong to
       | them), etc. It's dying in some places I guess and definitely not
       | smoking inside is better for all of us.
        
       | r9295 wrote:
       | I'll have a cigarette and a "Feierabend" beer, please.
       | https://thespectator.com/book-and-art/ode-smoking-cigarettes...
        
       | CrzyLngPwd wrote:
       | No surprise since, just like beer, they are so damn cheap.
       | 
       | When I lived in Germany they were even cheaper in Czechia, which
       | wasn't too far from where I was.
        
       | coldtea wrote:
       | > _Health experts think low tobacco prices, a general tolerance
       | of smoking_
       | 
       | Yes, people not coerced "for their own benefit" will generally
       | keep their habbits
        
         | Loughla wrote:
         | Why the quotes? Are you saying that people being guided to quit
         | smoking isn't good for them? I'm confused.
        
           | willcipriano wrote:
           | Would you submit to be guided (by force) away from any
           | suboptimal for your health behavior you might currently
           | engage in?
        
             | hu3 wrote:
             | Why wouldn't I?
        
               | program_whiz wrote:
               | The government has determined that engaging in online
               | discussions where users disagree increase blood pressure
               | and decreases happiness. Your comment will be deleted and
               | account suspended. You have exceeded your 15 minutes per
               | day of phone and computer use, deemed as the permissible
               | limit by the council for citizen health, your internet
               | account is suspended until next week. This should help
               | you to walk outside. Your tax bill has increased by $16
               | for processing fees. Thank you citizen, have a nice day.
        
               | willcipriano wrote:
               | You enjoy having fun on occasion.
        
               | coldtea wrote:
               | You absolutely should.
               | 
               | Freedom loving adults on the other hand like to decide
               | for themselves the amount of fun but harmful behaviors
               | they like to have...
        
               | ipaddr wrote:
               | Because experts of the day are often wrong. 100 years ago
               | Hitler had some expert opinions that later we reject.
               | 
               | Don't be the next agent orange victim. Question things.
        
               | throwaway5959 wrote:
               | Paging Godwin.
        
               | ipaddr wrote:
               | Paging: Bueller? Bueller?
        
               | coldtea wrote:
               | Yes, an idiot said something on usenet for fun and now
               | it's considered a "counter-argument"
        
               | karmakurtisaani wrote:
               | > Question things
               | 
               | But why should I?
        
               | ipaddr wrote:
               | Because you are being lied to and used
        
             | throwaway5959 wrote:
             | Losing weight? Absolutely.
        
               | program_whiz wrote:
               | Citizen 440023423, you are being informed by your
               | friendly government monitoring bot that health studies
               | have shown a link between cancer, obesity, and heart
               | disease by frequent computer and phone users. Your
               | account has been deactivated for 2 weeks. Please engage
               | in the recommended 1 hour of daily outdoor activity
               | instead. In addition, we noticed you exceeded the 15
               | minutes of allowable phone and computer use, as
               | recommended by experts at the ministry of citizen health.
               | Your internet has been disabled for 1 week. A $25 charge
               | for services has been added to your tax bill. Have a nice
               | healthy day citizen 440023423.
        
               | throwaway5959 wrote:
               | Oh thank god, I'll have so much more free time.
        
           | coldtea wrote:
           | I'm saying that third parties like states deciding what is or
           | isn't "for the benefit" of the people (as opposed to being
           | told what the people want) is not good for them. It's
           | crossing boundaries and it's infantilizing.
           | 
           | For two cases where it's gone horribly wrong consider the
           | prohibition and the "war on drugs". Not to mention the "don't
           | eat fat" campaigns...
        
             | kdmccormick wrote:
             | > as opposed to being told what the people want
             | 
             | If a majority of people in a country want smoking to be
             | disincentivized, and the government acts on that, is it
             | still crossing boundaries and infantilizing?
             | 
             | > Not to mention the "don't eat fat" campaigns...
             | 
             | Bad example, as it turns out that eating a regular amout of
             | fat is fine. The gov't was wrong.
             | 
             | Here's a better example: food corporations actively market
             | sugar-filled cereals, "juices", "fruit snacks", etc to both
             | parents and kids, actively misleading them on what a
             | healthy human diet is. This had contributed to a surge in
             | obesity and all the related health problems. This puts
             | strain on the medical system, raises insurance premiums,
             | and generally makes society worse.
             | 
             | So do I support making it harder for corporations to market
             | their HFC garbage to kids and parents? Hell yes. Do I
             | support making it illegal for tobacco corps to market to
             | kids? Yes again. And I say this as someone who enjoys sugar
             | and smoking, to a reasonable degree.
        
             | pluijzer wrote:
             | If not the state, the free market will fill the gap and
             | tell us what is for our own benefit, bet a lot more
             | boundaries get crossed when the tobacco industry,
             | pharmaceutical industry etc. get free reign.
        
             | hakunin wrote:
             | To be frank, alcohol, most drugs, and fat are not the same.
             | Every time I go to a place where smoking is not culturally
             | frowned upon, I can't make a few steps without inhaling
             | vomit-inducing smoke. If it wasn't for this, then I would
             | agree with you.
        
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