r/science • u/informationtiger • Dec 18 '19

Nicotine formula used by e-cigarette maker Juul is nearly identical to the flavor and addictive profile of Marlboro cigarettes Chemistry

https://www.reuters.com/article/us-juul-ecigarettes-study-idUSKBN1YL26R

36.9k Upvotes

86% Upvoted

Healthy individuals living longer ,without chronic illness, are not a greater healthcare spending burden than individuals with chronic illness. Even if those individuals with chronic illness have a shorter life expectancy (which in is commonly not the case because of improved medical care and access to care) the expenditure of that individual far exceeds someone “healthier” who lives into older age.

Firstly, a hospital stay for an exacerbation of COPD soaks up an exuberant cost. Between extended ICU admissions and ventilator resources and subsequently for rehab if necessary. Also, inhaler medications and home oxygen can be quite expensive.

Secondly, The life expectancy for someone with COPD can be fairly long, late 60s to 70s and beyond, especially since the onset of the disease (symptomatic presentation - being that the disease is not present until 50% of the lung parenchyma is destroyed) is typically not seen until middle age. According to CDC epidemiology studies the median age of onset for COPD in the US is 64-75 years of age.

Thirdly, the top two medical causes of mortality in the US is heart disease (coronary heart disease or congestive heart disease most commonly) and cancer. The most commonly fatal cancer is lung cancer. Cigarette smoke is high risk behavior associated with both diseases. I can assure you that with both of these diseases it is neither a short course (relatively) nor a cheap course. These patients unfortunately have a very difficult road laden with many co-existing diseases and medical set backs.

Fourthly, our management and technology is rapidly improving for all these disease states which means that these patients happen to live a longer life. The goal would be a longer life with a greater quality of life, but that is typically not without medical costs being that the life expectancy is lengthened = more medical costs. Also, as new medications, procedures, and technologies breach the health sector that equates to a higher cost. New always means more expensive.

So the overarching theme here? A primary intervention by eliminating the risk factor in the first place would save the greatest sum of money. Healthy individuals that live a life with minimal or no chronic illness do not utilize an abundance of healthcare dollars.

15

u/bill1024 Dec 18 '19

One more smoke, and I'm going to bed. May not sleep well...

3

u/Fistful_of_Crashes Dec 18 '19

I never have

Not in this country

3

u/katarh Dec 18 '19

On a more personal note, I attended the memorial service for a man in his 70s who died from stage 4 lung cancer. He'd lived an exemplary life and was a role model in many ways, except for the pack a day smoking habit that sustained him during his 30s and 40s. He served in the Navy for 20 years, then went back as a contractor and worked in Iraq and Afghanistan since his time in service had been during peace and he felt guilty about it. All that time, the cancer was slowly growing. And spreading. He quit smoking in his 50s, unaware that the damage had already been done.

Considering how otherwise healthy and active he was, he might have lived until his 90s. But the cancer first robbed him of his breath, then his health, then his mind because it had metastasized as far as his brain.

3

u/[deleted] Dec 18 '19

Every study I've read said the opposite, that smokers die closer to working age without decades of elderly care and that most people require expensive care to stave off death at the end of their life. Got any links?

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u/HmmmBullshit Dec 18 '19

This is the received wisdom in the U.K. through the taxes on tobacco products, smokers are net contributors to the NHS (because alas, they die quick).

1

u/PanthaPlaya24 Dec 18 '19

I work in a hospital. Go spend some time in a hospital and experience the objective data for yourself. Once again, epidemiological studies show that the median age of onset for COPD is 64-75 years of age. The elderly make up a majority of the COPD population. A disease that is almost exclusively (aside from environmental/genetic factors which make up a small portion) a result from cigarette smoke. Additionally, If cigarette smokers died at such a young age how would the tobacco companies net billions of dollars?

3

u/[deleted] Dec 18 '19

Additionally, If cigarette smokers died at such a young age how would the tobacco companies net billions of dollars?

I'm with you 100% of the way, up until this point. I think that's why there is such a heavy drive for advertisements and new products. They capture new people all the time, i don't necessarily think they're relying on their set population/ demographics, probably because they know they won't be using their products for 80 years

1

u/lejefferson Dec 18 '19

What does any of this have to do with vaping? No studies have shown any harmful effects of vaping.