QUOTE(Martyn @ Mar 11 2007, 06:16 AM)

QUOTE
Rather less than we are going to be forking out to care for people with the illnesses (such as dementia) that will increase in prevalence as smoking-related diseases become rarer.
Am I missing, or have I missed something here?
Are you saying, J, that it's better for the NHS and society for people to be killing themselves off in droves by smoking unmolested by any legislation whatsoever? Even if the legislation produces longer healthier lives for smokers as a by product of its original intention which is to make life tolerable for people who have given up smoking or who've never smoked at all.
No, I was addressing a specific argument about smoking, namely the assertion that smoking costs the NHS money which will be saved if fewer people use tobacco. I think that that argument is fallacious and even potentially dangerous.
The problem is that whilst a reduction in smoking will increase life expectancy, it will not necessarily reduce the demands for treatment and care from the NHS and may even lead to an increase in such demands. People who don't die from smoking-related diseases will contract others, even (especially?) if they live longer; the single condition that currently costs the NHS most at present is dementia, and the prevalence of dementias will increase as people live longer. So if restrictions on smoking lead to people generally living longer, the result may well be that we either need to spend more on health and social care or ration the resources that they require.
Care for people with dementia is already underfunded (partly because of the unfair and unjustifiable distinction between health care and social care) and the result is some scandalously poor standards of life for those afflicted and an appalling burden on informal carers.
There are other arguments for restrictions on smoking, but the economic one is dubious to say the least; and if the argument is not challenged, the danger is that health planning will be skewed by unrealistic expectations of savings resulting from a decline in smoking that subsequently fail to materialise.
And on the "spies" issue, local government has been allocated £29.5 million for enforcement officers, some of who will work undercover - it's been widely reported by the BBC.
The evidence that "passive smoking" is harmful has also been challenged, but that's a different debate.