Smoking: Making the Risky Decision.

• Author: Sullum, Jacob

Are smokers crazy? This is what public-health officials and anti-smoking activists seem to think, although they never quite say it directly.

They do come close. The Department of Health and Human Services says, "Tobacco use is a disorder which can be remedied through medical attention." Leaving aside the dubious proposition that behavior is a disease that doctors can cure, the government's message is that no person in his right mind would voluntarily choose to smoke. People start smoking because they are tricked; they continue smoking because they are hooked. The possibility that there might be other reasons for smoking--that people might actually like it--is rejected out of hand. "There is no positive aspect to it," says Scott Ballin, former director of the Coalition on Smoking OR Health. "The product has no potential benefits ....It's addictive, so people don't have the choice to smoke or not to smoke."

In Smoking: Making the Risky Decision, W. Kip Viscusi demolishes this view of smokers, which has long been a basic tenet of U.S. health policy. Familiar from decades of anti-smoking propaganda, the stereotype of smokers as nicotine slaves often plays a role in calls for higher tobacco taxes and restrictions on cigarette advertising. Viscusi observes that the "stylized smoker" is passive, generally impervious to risk information, and in any case unable or unwilling to act on it. But do smokers actually behave this way?

Viscusi, an economics professor at Duke University and founding editor of the Journal of Risk and Uncertainly, looks at evidence of what people believe about smoking, the choices they make, and the relationship between the two. He finds that far from underestimating the hazards of smoking, both smokers and non-smokers tend to exaggerate them, especially the risk of lung cancer. Furthermore, risk perceptions have the sort of effect on smoking decisions that you would expect if people were acting rationally: The higher the perceived risk, the less likely a person is to smoke.

But Viscusi notes that the decision whether to smoke also depends on tastes and preferences--on the value that people attach to the pleasures of smoking, the strength of their desire to avoid health risks, and the trade-offs they are willing to make. He bolsters this point by examining how smokers and non-smokers approach other risky decisions. The upshot is that smokers are crazy only in the sense that their tastes and preferences do not correspond to...