There is an interesting and very readable article in The Atlantic this week by Benjamin Mazar titled “COVID Won’t End Up Like the Flu. It Will Be Like Smoking. Hundreds of thousands of deaths, from either tobacco or the pandemic, could be prevented with a single behavioral change.” (1)
He thus relates future mortality from the pathogen SARS-CoV-2 with that caused by the behavior of smoking. In the past two years, smoking has killed over 800,000 people, COVID-19 over 900,000. With the advent of vaccines, the future death rate from the virus would be expected to decrease, unfortunately it will most probably still be significant and ongoing.
The information is out there, quitting smoking and getting immunized against COVID-19 significantly decrease the adverse consequences of each, yet people voluntarily and stubbornly choose not to do so. (Yes, nicotine is addictive, but there are non-smoking alternatives and support programs for any person with a desire to quit smoking.) It is interesting that about 13% of US adults are unvaccinated and 14% are smokers. How much these two groups overlap is not stated, though both groups tend to be poorer and less educated.
From the public health perspective, there will be no easy fixes. The campaign to convince the vaccine-resistant to get immunized will thus resemble the decades long battle against tobacco. For example, one could imagine that life and health insurance premiums for the unvaccinated would be increased. It will be a long process. He concludes, “Compassionate conversations, community outreach, insurance surcharges, even mandates – I’ll take them all. Now is not the time to quit.”
1. https://www.theatlantic.com/health/archive/2022/02/covid-anti-vaccine-smoking/622819/