ASH Scotland's new nonsense on smoking costs up in smoke

Even an almost erudite sounding website named Egovmonitor takes ASH Scotland's word entirely at face value. Its claims of the smoking costs are laughable, but they are uncritically stated. Smoking costs Scotland £1.1 bn a year, says ASH Scotland's Up in Smoke campaign.

Clearly the whole point of this exercise is to ensure that costs to the economy attributed to smoking minus Scotland's share of tobacco revenue gives a negative balance. Scotland takes £940 million in revenue directly from tobacco. So did ASH Scotland make its point? It makes the following claims:

• treating smoking attributable disease in the NHS costs £271 million
• productivity losses due to excess absenteeism, smoking breaks and lost output due to premature death cost £692 million
• premature deaths due to second-hand smoke exposure in the home cost £60 million in lost productivity
• clearing smoking-related litter from the streets costs £34 million
• fires caused by smoking in commercial properties cost £12 million.

Even the first point raises alarm bells. 'Attributable' does not mean 'caused by'. It means 'could have been caused by'. It is all guesswork, evident where the relevant web page states the costs are 'conservatively, around £1.1 billion'.

But lost productivity because of premature death or disability amounts to a private cost borne only by the smoker (since health care costs are accounted separately). And how do they come by 'second-hand exposure in the home'? How does ASH Scotland know, when they cannot even identify who is dying of the effects of exposure to secondary smoke, 1) where casualties are exposed and 2) at what age they died. Using ASH Scotland's figure of 1,000 deaths from the effects of secondary smoke every year, this means a productivity loss of £60,000 per person who died (assuming all 1,000 died of inhalation in the home). But again, how does this loss affect the economy? The only studies giving even marginal significance to the risks of secondary smoke exposure refer to lifetime spousal or occupational exposure, so even if it could be shown that 1,000 people die annually from secondary smoke exposure, many of them would be beyond retirement age.

This does not equate to a loss over £940 million. Also tobacco is a healthy investment these days, and Edinburgh is a city deep in financial institutions. A few fund managers include tobacco in their investment portfolios, and tobacco features even in some local government pension stocks.

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'By contrast', says ASH Scotland, 'effective interventions to reduce tobacco harm offer excellent value for money'. Sheila can't have read this yet: 'Currently stop smoking services are evaluated on the percentage of 4-week quitters, but around three-quarters relapse after this date.'