Are Smokers Responsible for Illnesses?

Anne Mitchell Health Guide
  • An interesting question came up from comments to my post about health care and Obama’s victory. Should other people be required to pay for the treatment of illnesses brought on by smokers who can't quit?

    As a former smoker who struggled for many years to quit, I know how easy it is for someone to say, “you should quit smoking, it’s bad for you” and how hard it is to actually quit smoking.

    When addiction kicks in (as it does for most smokers within a matter of days), we no longer have full control over our smoking. We can tell people, “I’m just not ready to quit”, but the truth is that most people who smoke do not want to smoke. Or they would like to smoke just a little bit - perhaps at parties - and not feel compelled to light up several times each day to feed their addiction.

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    I always felt that if I did get sick from my years as a smoker, that I indeed would hold myself responsible for the illness. I would feel guilt and shame for having done this to myself (or at least I imagine I would since I know what kind of person I am). I am fortunate enough to have (so far) escaped that particular demon. I pray that I don’t suffer as I know so many people do - from lung cancer, COPD, blood clots, or any of the dozens of illnesses that smoking can cause.

    When smokers get addicted, they don’t stop having responsibility for their smoking, but they do often lose control over their ability to act upon the simple decision to quit. Or they quit and quit and quit, unable to sustain success. Even those who have quit can still suffer long-term consequences from their former habit - Paul Newman quit smoking decades ago yet recently died of lung cancer.

    Because it is so difficult to quit (and the tobacco companies seem just fine with that), it seems to be less a question of personal responsibility than it does a question of whether any of us is responsible for each other at all.

    Should others have to pay for the health treatment of smokers if they are unable to pay for their own health care either because of a personal economic downturn or lack of insurance?

    My answer is yes, and it’s not because I don’t think smokers are responsible for their own health. I do. We all are. But if we get sick and we can’t pay for treatment, then as a society we need to be there for each other.

    If someone gets ill because they watched TV all day and ate potato chips and ice cream, then they are responsible for that state. If they never took walks or decided that video games were more important than fresh air and sunshine, then they are responsible for the consequences of those choices.

    The same is true for bicyclists and motorcyclists who don't use helmets, people who don't eat enough fiber, people who eat too much sugar, all those people who engage in risky behavior and deserve medical treatment when they are in need yet may not get it because of their economic status.

    Of course, many people become ill for no apparent reason. And not all smokers become ill, so there is a greater power at work here than just cause and effect.


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    I believe that we have control over our behavior; that we can become addicted to the point were it seems as if we have lost that control; and that things often happen that are completely outside of our control, such as illness.


    Bad things sometimes just happen. Whether someone asked for it or not is really irrelevant when it comes to fighting the illness. What matters is that we be there for each other and help pay for expenses that not everyone is fortunate enough to be able to pay for on their own.


    My wish for universal healthcare is that those who have been trapped by the smoking addiction can receive the medical care they need without going bankrupt.

    My belief is that it is the responsibility of all of us to care for our fellow human beings. By providing things like clean water, safe food, good schools, safe streets, and healthcare for all, we advance everyone's welfare, not just those who are poor.

    And yes, I believe that we should pay for these things even if we never get sick ourselves or get mugged or suffer from an addiction or we grow our own food or don't have any children. By making our common good the responsibility of everyone, we all enjoy the improved society that results. As the saying goes: a rising tide lifts all boats.

Published On: December 03, 2008