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Smoke-Filled Rooms: A postmortem on the tobacco deal by W. Kip Viscusi, University of Chicago Press, £17.50/$27.50 ISBN 0226857476 Reviewed by Kurt Kleiner

SMOKING isn’t as bad for you as most people think. Smokers actually save the healthcare system money, and tobacco companies have been unfairly treated by politicians, juries and the media. So, at any rate, says W. Kip Viscusi in Smoke-Filled Rooms. But how right is he?

Viscusi is an economist at Harvard Law School and a frequent expert witness for the tobacco companies. It’s clear where his sympathies lie, but that doesn’t mean he’s wrong when he points out some of the illogicality and self-righteousness behind the anti-tobacco lawsuits and public health campaigns.

In 1998, the major US tobacco companies reached a settlement in which they agreed to pay $243 billion over 25 years to compensate states in the US for increased medical expenditure on smokers. Viscusi argues, however, that smokers don’t really cost the healthcare system money overall. They may get more diseases like lung cancer, but they make up for it by dying younger, saving the costs of extended care. Viscusi figures smokers save states a total of about $7.4 billion a year. If that calculation seems cold-blooded, blame the states. They’re the ones trying to recover healthcare costs.

Contrary to the assumption that smokers don’t understand the risks they take, Viscusi says they actually overestimate their risks. For instance, they estimate their chances of dying from lung cancer at about 1 in 3, whereas in reality it’s closer to 1 in 10.

Likewise, although he doesn’t deny that tobacco is addictive, Viscusi thinks the problem of addiction is overblown. He points out – simplistically, I think – that more people are alive today who have quit than now smoke, and that every time cigarette prices rise, consumption goes down, as with any other product.

Viscusi thinks that there’s nothing wrong with choosing to smoke, using the classical economic assumption that rational actors will make the best choices for themselves.

But he doesn’t address the strongest argument of anti-cigarette campaigners, that most smokers start when they are under 18. If adult smokers became addicted when they were too young to make a rational choice, perhaps extraordinary measures are justified to encourage them to quit.

Viscusi’s arguments are worth considering, but the book will mostly be interesting to specialists already heavily involved in the debate – and maybe to smokers who are feeling hard done by.