. "PART II A BLUEPRINT FOR REDUCING TOBACCO USE, 4 Reducing Tobacco Use: A Policy Framework." Ending the Tobacco Problem: A Blueprint for the Nation. Washington, DC: The National Academies Press, 2007.
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Ending the Tobacco Problem: A Blueprint for the Nation
the statistical evidence. When young people begin to smoke, they typically fail to appreciate the serious possibility that they will continue smoking for many years (see Chapter 2).
Inconsistent Preferences and Regret
Many people neglect long-term risks to their health, simply because they tend to have a short-term perspective when they consider the risks and the benefits of a particular behavior. In the language of economists, they apply a high “discount rate” to future harms. This neglect of the long-term danger is especially serious for young people. Because the most serious health risks of smoking do not come to fruition for many years, young smokers often treat those risks as if they were trivial. Even adult smokers often fail to take adequate account of the associated risks, simply because those risks are not likely to materialize for decades. Smokers themselves will typically change their minds later on, reflecting a difference between their preferences when they start smoking and the preferences that they have later in life, when they want to quit. (Economists call this problem “inter-temporal inconsistency.”) In short, when people begin to smoke, at whatever age, they tend to give more weight to the pleasures of smoking and too little weight to the possible impact of smoking on their long-term well-being. Once people have become addicted, they give more weight to the health concerns and regret having become smokers. Most of them want to stop.
In some domains, people are unrealistically optimistic about risks, believing that they are immune from the dangers that others who are similarly situated face. For smokers, the problem of unrealistic optimism takes three distinct forms. First, many smokers, even those who have an adequate sense of the statistical realities, falsely believe that they are unlikely to face the risks that most smokers face. Second, many smokers, both young and old, are unrealistically optimistic about their future health and their longevity if they quit at some later point. Third, many smokers believe, falsely, that they will quit in the near future. Taken together, these forms of unrealistic optimism can be deadly.
More than four decades after the Surgeon General’s initial report (HEW 1964) on the health risks of smoking, policymakers have not addressed these three problems with anything like the seriousness that they deserve. To be sure, the problem of addiction plays a large role in current thinking; and both states and localities, along with the private sector, have adopted commendable steps to protect and to inform young people. However, the whole notion of consumer sovereignty—of unambivalent respect for private