Padraic P. McGuinness, The Australian, May 29, 1991, p. 11.
It is difficult not to get the impression sometimes that the opponents of smoking and drinking are slightly, or not so slightly, unbalanced.
Of course both tobacco and alcohol are often abused, and the effects of such abuse can have considerable social and economic costs. But it is also clear that these activities are of such an ancient lineage that they must have considerable benefits also.
A recent item in the New Scientist cited evidence that wine drinking in the Middle East dates back at least 3500 years, and beer drinking has a lineage that goes back perhaps 10,000 years. Tobacco smoking is much more recent in the Old World, having been brought back after the European discovery of the Americas (the 500th anniversary of which is to be celebrated next year). Indeed, along with syphilis, the other major gift of the New World to the Old, tobacco has some clear adverse health impacts. But ingestion of that well-known tobacco substitute, cannabis, has a much longer history in the Old World.
It is obvious that there is very considerable individual benefit in the use of all these substances. Yet when the Department of Community Services and Health commissioned a couple of academic economists to prepare a report, Estimating the Economic Cost of Drug Abuse in Australia (published in January), the report did not even seriously attempt to estimate the benefits of drug use and abuse.
It did not totally ignore them — as a piece of economics it is not bad. (The authors are David Collins and Helen Lapsley.) But the essence of the report is in making an assumption that some 30 per cent of expenditure on these drugs is abuse (as distinct from moderate usage), and in making some fairly wild estimates of the total cost of the supposed abuse. However, the authors do conscientiously discuss the actual direct costs (that is, costs imposed on the health system, by way of income loss, etc) and the supposed indirect costs.
This distinction, however, was totally lost on the minister, Peter Staples, in an address to the conference on Alcohol and Drugs in the Workplace in Melbourne last month.
In this address, Mr Staples managed to ignore all the careful qualifications of the report, and asserted that it gave a “baseline cost” of the abuse of drugs of $14.3 billion per annum. Thus he ensured that this is the figure which will be bandied about by the wowser lobby. He even added that this is “an extremely conservative figure”. In fact, the minister was talking nonsense.
Now it has to be said that there are, of course, real economic and social costs from the abuse of alcohol and tobacco. The costs associated with alcohol in hard economic terms are higher. There is a case for arguing that it should be either illegal or extremely hard to get. And the social costs of alcohol abuse, as any battered wife or neglected and underfed child can tell you, can be very great also. It would clearly be better if neither substance was produced, sold or used.
Or would it? The very antiquity of their use, especially in the case of alcohol, suggests that they satisfy very fundamental needs. And if they are not easily available legally, then illegal versions or substitutes are sought. Thus in countries or places where cheap legal alcohol is not available, methylated spirits drinking or petrol sniffing tend to come into use. In the Soviet Union, when the price of vodka was raised and its purchase made more difficult, sugar consumption for illegal distilling rocketed. Or illegal drugs become prevalent.
This suggests that there is an important social, psychological (and possibly physical) role for drugs like alcohol and tobacco which will be satisfied in one way or another. That is, research should be directed towards finding substitutes for them which do not have unfortunate physical side-effects.
One of these might well be heroin, which has no adverse physical or mental side-effects whatsoever if used in its pure unadulterated form. Addiction, which does occur in a minority of users, is no problem at all if the drug is available cheaply and legally. All the huge social costs of heroin use and addiction, all the crime and tragedy surrounding it, derive simply from the fact that it is both powerfully addicting and illegal. But it is less harmful than tobacco or alcohol. So a genuine policy, sincerely directed towards reducing the impact of tobacco and alcohol abuse, would involve the free and legal availability of cheap heroin and other drugs which satisfy the human need for psychotropic drug use.
But this is what the wowsers do not want. They would rather people be deprived of the pleasures and benefits of alcohol, tobacco and other drug use. And in the process they are prepared to misrepresent even serious research which partially but not wholly supports their worst fears. (Remember the remark of H.L. Mencken to the effect that puritans are people who live in perpetual fear that someone, somewhere, might be enjoying himself.)
The Tobacco Institute commissioned a critique of the Collins and Lapsley study from Coopers & Lybrand. This picks some obvious faults in the methodology, but basically picks up nothing the authors are not aware of. It is part of the moral weakness of the tobacco lobby that it can never admit the basic fact that tobacco use is clearly harmful. There is nevertheless a real civil liberties issue involved, namely that adults are perfectly entitled to inflict harm on themselves if they want to, and provided they are informed of the reality. So if you smoke like a chimney and get lung cancer, or your legs drop off or whatever, the only social interest is in the costs you impose on the community by doing so.
These are twofold. One is the cost to the health system. The real problem here is not the ill-effects of smoking, but the poor design of the health system. If you smoke tobacco in a system which provides free or nearly free health care, then you may well impose social costs on the community. The obvious answer is to ensure that you pay the costs of your own demands on the health system, through proper health insurance and full cost pricing of health and medical services. But it is absurd to set up a health system which will be abused and then punish people for behaviour which abuses it. This is entrapment.
Perhaps there is a case for lading additional insurance costs on to the price of tobacco (which the Government does not do, since there is no link between tobacco excise revenue and public expenditure on the treatment of tobacco sufferers). The second cost is the loss to output. This of course derives from the lower efficiency of smokers and drinkers, and their ill-health. But again, this is the fault of the wages system and the unions who insist that people should be paid and enjoy job tenure regardless of their efficiency and productivity. Why blame smoking and drinking for the abuses of regulated labour markets?
There are clear ill-effects of tobacco and alcohol abuse. The actual estimated cost of these is far lower than the figure bandied about by Mr Staples. He did not see fit to mention that the tangible costs in 1988 of alcohol abuse estimated by the economic study was $3.24 billion, and that of tobacco abuse was $813 million — a lot less than the $14 billion figure, which included illicit drugs and also a very large figure for intangible costs. These intangible costs include the very shonky notions of pain and suffering involved, as well as the “value of loss of life”.
