Kreskin, again

Last week I pointed to Richard Edwards' plenary address on tobacco control:

He cites increased "social smoking" among young adults - folks that might have a cigarette while out drinking, but otherwise don't smoke. I'd find it a bit surprising if that level of smoking resulted in substantial negative health effects. Says Edwards "The frequency of XS alcohol consumption, and its role in promoting uptake and maintenance of smoking and undermining quitting, suggests co-interventions may be needed and that we cannot tackle smoking in isolation." So anti-alcohol policy may be part of anti-tobacco policy...stay tuned. [emphasis added]

And today the excellent Chris Snowdon points to TV3:

"The problematic aspect is that since most smokers want to quit, and here, because of the high occurrence of hazardous drinking in the New Zealand situation, they have difficulty quitting," Associate Professor Wilson told NZ Newswire.

Smoking is estimated to cost $1.9 billion in direct costs to the health sector, but the social cost has been estimated as high as $22.5bn.

The researchers recommend lawmakers explore:

• Higher alcohol taxation, given some evidence that tobacco consumption has been found to decline with higher alcohol taxes.
• Raising the legal alcohol purchase age. US evidence shows this reduces adolescent smoking.
• Explore policies to further decouple smoking and drinking by making the outdoor seating areas around cafes and pubs smokefree.
• Consider additional funding health services to to address both heavy drinking and smoking cessation together.

Where to start. First, smoking does not cost the health system $1.9 billion. Here's the post where I summarized things. Long story short: MoH effectively assumed that smokers would live forever and never impose any end-of-life costs on the government if they weren't smokers. Surprisingly, I can no longer find the $1.9bn figure on the MoH website. The best I can now find is their 2010 submission on the proposed excise changes where they wrote:

The social costs of smoking have been estimated at 62,800 life years lost to tobacco-related premature deaths, and 19,000 quality adjusted life-years lost to tobacco-related illness [¹] . A 2007 estimate put the cost of smoking to the health system at $300 to $350 million per annum; however current work within the Ministry of Health suggests that figure may be as high as $1 to $1.6 billion per annum [²].

...

2. Please note that this analysis is work in progress and methodological issues are currently being addressed.

I'm not sure of the source on the $22.5bn figure. But there's no way you can get a number that high without including smokers' spending on tobacco and a rather long list of other costs borne by smokers, with little consideration of that at least some smokers enjoy smoking.

But last week's prediction was right. I hate being right. I hated it last time too.