Everyone has heard, dozens of times, how many lives which will be saved, or have been saved, by smoking bans. Here's Sir Richard Peto, in July 2007:
AT least half a million deaths a year are likely to be prevented by England's smoking ban, one of the world's leading health experts said today.
In fact, Sir Richard was just speculating. He believed that half of all smokers were killed by their habit. And he hoped that a million smokers might give up smoking as a consequence of the ban. And so half of those million smokers' lives would be saved. By an ever-so-simple calculation - dividing one million by two - a number was created to make yet another published newspaper headline.
Occasionally such numbers as these are set alongside other mortality figures. So a factsheet by Action on Smoking and Health (ASH) reports:
The most recent estimates show that around 114,000 people in the UK are killed by smoking every year, accounting for one fifth of all UK deaths.. Deaths caused by smoking are five times higher than the 22,833 deaths arising from: traffic accidents (3,439); poisoning and overdose (881); alcoholic liver disease (5,121); other accidental deaths (8,579); murder and manslaughter (513); suicide (4,066); and HIV infection (234) in the UK during 2002.
Note first that while the smoking deaths are 'caused' by smoking, the other deaths merely 'arise from' traffic accidents and so forth, as if there were rather less certainty about the cause of death in the case of traffic accidents and suicides than with smoking.
Here estimated mortality is set beside actual mortality, and an attempt is made to pass off the estimate as if it were an actual number of real deaths, as if estimated and actual numbers were interchangeable things.
But they are not. The actual mortality figures are arrived at by counting the recorded deaths of real people in traffic accidents and the like. These real people had names and addresses. They left real mothers and fathers, husbands and wives and children grieving their death. The estimated mortality figures are arrived at by multiplying populations by risk factors, conjured out of air. Nobody really dies, nor does anyone mourn their deaths. The two are chalk and cheese.
For example, the actual numbers are accurate to the nearest integer: there were exactly 3,439 deaths in traffic accidents, not 3,438 or 3,440, and this number will not change. But the estimated mortality figures will vary as the risk factors are adjusted, and will always be rounded to the nearest thousand or million, reflecting their inherent inaccuracy. The estimates are akin to the estimated costs of hosting the Olympic Games - always changing, and almost invariably increasing -, while the actual costs will be whatever the bill eventually totals up to.
The estimate is an imaginary number, a fiction and an invention. It is the number of people who might have died. And it is arrived at by torturing numbers, by bloating risks, by squeezing out confounding factors, by selecting, trimming, and rounding.
An estimate is like a portrait painting, while the actuality is a passport photo. The estimate is the work of statisticians and publicity departments and think tanks, while the actuality is the entry in a ledger by an anonymous clerk. One is art, the other is science. One is fiction, the other is real.
Comparing estimated figures with actual recorded numbers is a form of mathematical pornography. Like is not being compared to like. To divide one by the other is like dividing the price of carrots by the weight of potatoes.
Here we have entered a world in which fiction has become more real than fact, where the imaginary is more real than the actual. Where what might be is more important than what is. It is an upsidedown world, an inverted world.
Estimates of smoking-related deaths - which convert into lives saved as soon as smoking is banned - are always large. And the advocates of smoking bans are always relentlessly optimistic. There are never any costs to such bans, but only a great many benefits. Smoking bans are always save thousands, or even millions, of lives. The bans are portrayed as being universally popular. They are said to be welcomed by smokers, many of whom are supposed to see them as an opportunity to give up smoking. And they are welcomed by a hospitality industry which expects to see many more non-smoking customers in their wake.
In fact, anti-smoking campaigners simply ignore any downside to smoking bans. When pubs close, and communities are fragmented, anti-smoking campaigners make no comment. They count and trumpet only the estimated benefits, and never the real costs.
And shouted down by these huge numbers of estimated lives saved are the real deaths, that pass almost unreported.
The deaths caused by, or consequent upon, smoking bans are seldom so dazzlingly numerous as the estimated number of lives saved. They are not gathered and collated. They are only encountered by chance, here and there, like those wilting roadside flowers at a road death crash site.
But we can be fairly sure that when Lorraine Adolph went outside to smoke a cigarette, it was not because she preferred smoking outdoors, but because she had been banned from smoking indoors.
EDMONTON - Family members of a 68-year-old woman who was found frozen to death outside Alberta Hospital are gathering signatures for a petition demanding an investigation. Lorraine Julia Adolph's family wants the Alberta Fatality Review board to look into her death.
The woman, who suffered from schizophrenia, disappeared from the geriatric unit of the Alberta Hospital on Dec. 4 after she went outside to go have a cigarette.
This was a real death, not some imaginary death conjured up by a statistician. We can almost see Lorraine Adolph stepping out into the frozen air to light her cigarette, its warm tip glowing with each breath she took upon it. And we can see her making her way back to the door that had been locked behind her, first to knock upon it, and then to beat furiously upon it again and again with her helpless fists as she grew gradually grew colder and weaker.
Or what about Barry Collen?
WINNIPEG: The Winnipeg Regional Health Authority is investigating the death of an elderly man whose frozen body was found outside a personal care home last week. The body of Barry Collen, 74, was discovered around 4:30 a.m. on Jan. 2 outside the Sharon Home at Kanee Centre, a 157-bed personal care home in the city's William Whyte neighbourhood.
Members of Collen's family say they have been told he went into the care home's courtyard around 1 a.m. to have a cigarette. The temperature was around -20 C the night of Collen's death, with a wind chill of -31.
Here is another real death. Barry Collen was not a statistic. He was not a mathematical construct. He was real person. Did he really want to smoke a cigarette outside? Of course he didn't. He'd been driven outside. In a kinder and more tolerant age, he'd have lit his cigarette in his room, or in a lounge full of other people. Not these days. Barry Collen had to grope his way outside into the darkness, feeling his way towards his death.
Or what about Lawrence Walker?
CORNWALL: Lawrence Walker, 61, barely went out when cigs were barred from his local pub.
Friend Robert Lye said: "He felt insulted to have to stand outside and smoke.
"We think the ban killed him. He was so depressed about it he hardly went out. It made him very solitary."
Mr Walker, of St Columb, Cornwall, leapt to his death from cliffs at Porth beach, Newquay, in June. Coroner Dr Andrew Cox recorded a verdict of suicide.
Is it too hard to understand how this upright member of society - and who is a greater pillar of society than a tax collector? - responded to being expelled from that society? One day he was an accepted and valued member of that society, and the next day he was an outcast. One day he could sit with his friends - friends like Robert Lye - in the warm snug of a Cornish pub, and the next he had to stand outside, just like Barry Collen and Lorraine Adolph. What did that do to his self-esteem? What did that do to his sense of worth? It utterly destroyed it.
Or this anonymous girl?
WISCONSIN: In Wisconsin a 14-year-old girl, a grade A and B student who was active in athletics and cheerleading and the choir, committed suicide rather than tell her parents she had been caught with one cigarette in her backpack at school (AP wire, 11-9-99)
Here was a young and beautiful girl, in shame and terror at the awful crime of being found in possession of a single cigarette, taking her own life. When Lorraine Adolph and Barry Collen and Lawrence Walker died their separate lonely deaths, they had already lived most of their lives. Not so this young girl. She had her whole life before her. She had before her a career, a husband, sons and daughters.
The four of them - Lorraine Adolph, Barry Collen, Lawrence Walker, and this anonymous girl - were victims in one way or other of smoking bans. If smoking had not been banned, they would be alive today. These were people who were killed by smoking bans.
And all this the real consequence of smoking bans, and of a global war on tobacco, whose primary purpose is supposedly to save lives!
Fiction vs. Reality
We cannot allow ourselves to be guided by fictions. We cannot make decisions based upon imaginary numbers conjured out of air. We can construct any number of imaginary outcomes, any number of likelihoods and possibilities and plausible projections. And we can invent any number of fictional deaths that anyone might die.
But there is only ever one real death.
And it is upon those real deaths that we should fix our eyes, and disregard every and any imaginary 114,000 death toll that mathematical sorcery might conjure up before us. We should remember instead the very real deaths of Lorraine Adolph, and of Barry Collen, and of Lawrence Walker, and of a teenage girl known unto God.