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Reminder: cigarettes kill 7x as many people in the US every hour, day, week, and month as the "opiate epidemic" in the USA.

One is an "epidemic" and "public health crisis" and access is locked behind a prescription. One is available to anyone 18 or older on each streetcorner.



Smoking cuts your life expectancy by something like ~10 years. Most of those smoking deaths are people who've already smoked 30+ years; there's not a lot we can do to prevent those deaths now, even if they all stopped smoking tomorrow. They'd still get cancer and everything else at higher rates. We've also done a pretty good job at lower smoking rates, especially among young people. Sure, we can ban or restrict tobacco more (maybe we should) but the "public health crisis" is mostly done.

Opiate addiction cuts life expectancy by ~35 years. And getting them onto safer drugs would save lives very immediately. There's stuff that could be done, and everyone knows it, and it's not happening. That's the public health crisis.

edit: and, yes, also, opiates are also more socially destructive, due largely to the criminality.


This isn't really true. Most of the death from smoking comes from other lung & heart problems, not cancer.

As such even if you smoke for many decades and quit your risk decreases dramatically pretty quickly, even within days.


Quite an interesting chart near the bottom of this page - https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/benefit... - doesn't quantify everything, unfortunately, but yeah even after a year the "risk of heart attack drops sharply". Interesting.


And even cancer is getting more treatable these days. Lung cancer is no longer an automatic death sentence (although it often does still kill.)


That may be true but the people who broke into my car twice didn’t do it because they were addicted to nicotine - they did it because they were addicted to opiates.


Hmm. But is that the difference between opiate and nicotine addiction? Or the difference between the restrictions we placed on them?

In other words if we would treat tobaco the way we treat the hard drugs, would people addicted to it perform crimes to get their fix on the surely much more expensive black market?

I truly don’t know the answer.


No, they did it because the government supports the prices of opiates, which could easily be made for a nickel a dose. There's nothing intrinsic about opiates that gives you an unquenchable appetite for money. That's cocaine.


While I'm not suggesting tobacco is fine or anything; they really aren't comparable. Opiate addiction is going to completely take any quality of life away from you (tbh regardless of legality, people that were on prescription opiates still had horrendous disability and mental illness caused by the constant abuse of them, though obviously having to spend hundreds of dollars a day on an illegal supply adds a whole new dimension of horror).

Most people who smoke tobacco don't experience any significant quality of life issues until many decades in when the COPD and serious illness starts. Obviously horrible - but I would say you'd lose more than 7x more quality of life (disability adjusted years?) being an opiate addict over being a smoker.


Smokers are functional. Junkies... well, they're junkies. One is a useful member of society, the other is a liability at the best of times.

And smokers die old. Quickly too... don't linger on with chronic disease like other old people. Helps keep Medicare solvent.


i'm not interested in defending tobacco/cigarettes, but comparisons like this beg the question : do you see a difference between an addiction that leads to eventual chronic health issues/injury/death sometimes many many decades after first-onset versus an addiction that will many times kill even first-time users, and rarely allows for habits that last many decades?

if you want to compare the health crises, then divide the results by time to create an 'impact' score.

That's why we're focusing on opiates collectively.


I knew that my country really won't be prepared with anymore relaxation on narcotics because we smoke cigarettes much more than almost every other country in the world despite long long campaign on health issues. Heck, Big Tobacco manages to capture religious sector! That's how powerful legalized capitalized drugs are.


Why do people on this forum always say “my country”. Why not just say the name of the country?

This information is not useful to anyone without that context.


It’s also poor personal infosec if they mention “my country” and include the country name as it reveals a part of their location.


Most of us aren't all that concerned about country-level doxing.


This is a pretty poor equivalence, I don't think I need to detail all the reasons, suffice to say a life shortened by smoking is not the same as one destroyed by opiates, either in years lost or in quality of life. Smoking is a poor long term health choice and should be discouraged, it's nothing like what's happening with opiates.


So we should give all the cigarette smokers opiates right? Reduce the mortality rate drastically that way.


What are the age ranges of people dying from cigarettes vs. opiate abuse?


Ex-tabber here, 5.5 years clean, with some remaining ... issues.

It is bloody hard to give up, really hard but not impossible. If you want to give up then I do recommend that you prepare yourself mentally. I ended up coming up with a couple of "downside mantras" that I would repeat to myself, whenever thoughts of smoking happened.

I initially thought I would use a vape but realized very quickly that would not work for me. If nicotine is the (only) addictive substance then patches, gum, vapes etc would just work. The habit thing is relatively easy to crack but there must be other addictive components to smoking, including sensation (you need to be a smoker to understand that one). Also I didn't want to substitute one thing for another, so abstention was the way to go for me. Some may find help with gum and patches - gum is probably the best substitute, being "active" (and might even improve mouth hygiene).

I stopped mid afternoon on a Friday and had a lie in on Saturday. That got me to around 18 hours. I made it to 24 hours. Then I managed two days, then four, then a week (a landmark one day less than the next double - every little helps). Then two weeks. Visited the kids and bummed a drag on a fag and hated it.

At around a week my sense of taste and smell re-arrived with a major jolt! I can remember smelling people entering the room and other mad things. It calmed down to normal about week three and I now have a sense of smell that accords with other non smokers.

In the end, if you want to give up, then get cracking sooner rather than later and develop strategies but do not try to rely on things like vapes and gum to do it for you. You have to quite literally give yourself a massive mental kicking too.

For me I focused on two aspects I hated about smoking and I would mentally repeat this to myself whenever I thought of it:

"I don't want to smell and I don't want to die"

Even with my denuded sense of smell I could tell I reeked and the second one is pretty obvious. When I did that the craving or thought would be quashed for a while. I did have dreams where I smoked and sometimes woke up convinced I had been smoking. You do have to wrestle with yourself somewhat and decide to win!

I continued: ... then a month. Now I have saved £10.50 x 30 = £309 (I thought I smoked 20 a day but I smoked more - self delusion, probably more like 25-30). Cool.

... two months, four months (quarter of a year). Six months. Now I have realistically saved around £2000, have a functional sense of taste and smell and I no longer cough all the time.

... one year. Fuck me, how the hell did I manage that?

... pandemic etc

... 29 July 2023 - rarely think about smoking until an article on HD hoves into view.


21*


What’s the average age of death though?




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