Tuesday, October 12, 2010

Cognitive Dissonance and Smoking

An important skill for a sceptic is the ability to identify cognitive dissonance in yourself, and in doing so, hopefully apply reason to the situation and thereby resolve it. I've managed to identify an instance of cognitive dissonance residing in my own brain, but despite my best efforts at reasoning through it, I can't seem to resolve it.

Let's start by defining the term: cognitive dissonance is a state in which you simultaneously hold two mutually exclusive ideas to be true. The classic example (and surprisingly relevant to my topic) is the person who knows that smoking significantly increases their risk of contracting lung cancer, but decides to smoke anyway. Such a person has found a way of resolving that dissonance, which usually involves convincing themselves of a lie... in this case, that for some imagined reason, their own odds of contracting lung cancer from smoking are diminished to such an extent that the short-term gain of the nicotine buzz is worth the long-term risk of a horrible death.

My own case of cognitive dissonance also relates to smoking, although I myself am not a smoker. Here's my dilemma:

I am, and have always been, pretty strongly anti-smoking. Not only am I convinced by the evidence of harm it causes, but I also find the whole thing pretty distasteful. I hate the smell, I dislike the appearance of it, and I find it unfair that smokers are accorded all sorts of privileges (like the right to take as many breaks during a work day as they like, so as to feed their addiction). Not to mention the fire hazard.

It's because of my strong dislike for it that I am somewhat grateful to the late moron, Manto "The Genocidal" Tshabalala-Msimang. Thanks to her new legislation placing strong restrictions on smoking in public, I'm not forced to deal with the unpleasantness of it as often as I used to be.

Here's where the dissonance comes in.

The problem is that Manto used a scientific argument to justify the implementation of her anti-smoking laws. And it just so happens that that argument had about as much scientific merit as all her arguments: none at all.

Specifically she cited the "fact" that second-hand smoking (aka 'passive smoking', the act of sitting near someone who is smoking) has shown significant increase in risks of lung cancer and other smoking related illnesses. While on the surface it stands to reason that this should be true, there has been quite a lot of research done on this question (of varying quality). The literature isn't at all clear on the link between second-hand smoke and lung cancer (or any other disease) risk. Given that ambiguity, it's not really justified to claim it to be an established fact... doing so is basically a lie.

So there's my dissonance. On the one hand, I have a vested aesthetic interest in supporting the anti-smoking laws. But on the other hand, the reasons given for those laws are bullshit. And I'm not comfortable with supporting bullshit.

Given that South Africa is supposedly a liberal democracy, I can't support the notion of using the mechnisms of state to restrict people's behaviour without just cause. As long as a smoker isn't actually harming the people around him, he should be able to puff away to his heart's content. If he wants to take the risk of dying an early and excrutiating death, that should be his prerogative. As disgusting as I think it is, I kinda have to support people's right to smoke.

(There's a line that should be drawn here, and this is when the people smoking are in my family. If my spouse, parents or children were to smoke, that could have a knock-on effect on my life and wellbeing, and I would feel justified in being upset about it. I'm talking here about strangers and other people whose wellbeing doesn't directly influence mine.)

But there's another issue here: public health.

There is a substantial precedent of governments taking steps, using the mechanisms of state to manage threats to the health of society as a whole. For example: obligatory vaccinations.

Vaccines are a hot-button topic in sceptical circles. We've started seeing resurgances of vaccine-preventable illnesses in first-world countries as a result of people failing to vaccinate their children. In South Africa there is a precedent of making certain vaccinations mandatory, like in the case of the current rabies outbreak in Gauteng. It's my understanding that the CDC in the United States, and similar government organisations in other countries, are sometimes granted special emergency powers in order to deal with high-risk epidemics and outbreaks.

Since there is a precedent for government intervention on preventable illnesses, why shouldn't the government intervene in order to try and reduce instances of diseases like lung cancer, emphysema and heart disease?

I'm not talking about an all-out ban on cigarettes here. I'm talking about legislation which could make it sufficiently difficult to smoke that a statistically significant portion of smokers will be encouraged to quit, thereby reducing their risk of lung cancer. In other words, legislation not unlike South Africa's current anti-smoking laws.

I haven't seen the statistics on smoking rates since the introduction of the new anti-smoking laws (if such data exists), but I imagine there could potentially be an impact there. If I were a smoker, and the number of places I was able to smoke was reduced to rainy balconies and smelly smoking-rooms, I might be more strongly motivated to quit.

Right, so, to recap: I like the anti-smoking laws for selfish, aesthetic reasons. I can't support those laws on the basis that they impede freedoms without adequate justification. But I could see a potential alternate set of justifications for those laws which would, at least, be precidented, if not commendable and desirable.

Of course more research is needed. If the data does bare out my suspicions about the whole public health thing, that it would resolve itself. But until then, I'm stuck with these two ideas duking it out in my melon when I'm supposed to be concentrating on more important things.