Mike Pence and Rush Limbaugh on smoking, cancer, and the coronavirus

This is newsworthy because it was reported that Vice President Mike Pence was assigned to coordinate the government’s response to the coronavirus.

Paul Alper pointed me to this statement from Pence in 2001:

Time for a quick reality check. Despite the hysteria from the political class and the media, smoking doesn’t kill. In fact, 2 out of every three smokers does not die from a smoking related illness and 9 out of ten smokers do not contract lung cancer. This is not to say that smoking is good for you. . . . news flash: smoking is not good for you.

This is not science denial . . . it’s incoherence! Smoking’s not good for you, and one out of every three smokers dies from a smoking related illness . . . but smoking doesn’t kill? That’s just weird. That said, I heard pretty much the same argument at an NIH panel once, so I guess Pence is not alone in his incoherence.

Earlier Alper had sent me this quote from recently-honored radio host Rush Limbaugh, from 2015:

Firsthand smoke takes 50 years to kill people, if it does. Not everybody that smokes gets cancer. Now, it’s true that everybody who smokes dies, but so does everyone who eats carrots. . . . If tobacco is so deadly, if it is so bad, why does our government permit it to be sold? . . . I’ve never seen Cause of death: Tobacco products. Not everybody who smokes gets cancer. . . .

This all seemed bad too, but it’s hard to know what to say about it because, while Limbaugh has been an influential public figure, he’s an entertainer, and I’d assume that if you press him on his reasoning (for example, just because “not everybody who smokes gets cancer,” is that a good reason to dismiss the dangers of smoking?), that he’d respond that he’s just exaggerating for comic effect. Of course everyone knows that smoking causes cancer and kills people. OK, not Mike Pence, but everyone else.

More recently, Limbaugh said this:

Now, I want to tell you the truth about the coronavirus. . . . Yeah, I’m dead right on this. The coronavirus is the common cold, folks. . . . I’m telling you, the Chicoms are trying to weaponize this thing, . . . Well, every nation is working on things like this, and the Chicoms obviously in their lab are doing something here with the coronavirus — and it got out.

As with Pence on smoking, Limbaugh on the coronavirus is incoherent: he can’t seem to decide whether it’s no big deal (“the common cold”) or some sort of military bioweapon.

Limbaugh’s statement about smoking from 2015 is shtick, humor. It may or may not be irresponsible, but I can only assume he was joking. But his more recent statement on coronavirus doesn’t sound like a joke at all.

To return to Pence: it doesn’t seem good for him to be in charge of a public health effort, if he’s out there in public saying, “smoking doesn’t kill.”

A few days ago we had some discussion of the Heartland Institute, which has been funded by cigarette companies and has taken strong positions in favor of that industry. Here’s what they say:

Heartland’s long-standing position on tobacco is that smoking is a risk factor for many diseases; we have never denied that smoking kills.

It turns out that Vice President Pence is a long-time friend and admirer of The Heartland Institute. Perhaps he could give them a call and ask them to explain to him that smoking does kill. And I hope that before going forward on this coronavirus thing, he can decide on the party line: Is it equivalent to the common cold or is it a Chinese-engineered bioweapon?

I thought PNAS was bad news, but this stuff really matters, right?

48 thoughts on “Mike Pence and Rush Limbaugh on smoking, cancer, and the coronavirus

  1. Being charitable, I think that Pence’s point is about a distinction between direct causality and probability manipulation. He agrees that smoking increases the risk of developing lung cancer. But increasing the risk of death is (according to him) insufficient to be called “killing”, which requires essential causation. For example, cutting off someone’s head kills them, because every time someone has their head cut off they die. Every time someone smokes, they don’t die, so smoking can’t be considered a sufficient cause of death, which he claims to be what is meant by X killing people.

    • Hey, this gives a new avenue to the “Guns don’t kill people” people: Guns don’t kill people, because not everybody who is shot dies.

      Hmm, I wonder: what fraction of shooting victims die? If it’s less than 1/3 then Mike Pence could say “smoking doesn’t kill people, and neither does shooting them,” and he would actually be more correct about the smoking than about the shooting!

      • Phil:

        To paraphrase the vice president: “Time for a quick reality check. Despite the hysteria from the political class and the media, getting shot doesn’t kill. In fact, 2 out of every three shooting victims do not die from a shooting related illness and 9 out of ten shooting victims do not contract gangrene. This is not to say that getting shot is good for you. . . . news flash: getting shot is not good for you.”

        • Actually that’s an interesting point because I was thinking about the relative risk of dying from tobacco use and dying from alcohol use. So if your drunk friend shoots you over a card game, were you killed by alcohol or by firearms? :)

          Because I’m willing to bet that, even with the DUI vigilance we have today, between highways, domestic violence, other alcohol related violence, alcohol-related diseases etc, I’m willing to bet that alcohol takes more years of life than tobacco, and causes much more collateral damage to boot.

          The other thing I’ve thought for a long time is that smoking probably has some kind of survival benefit for younger people. I say this because every primitive culture I’ve ever heard of smokes something. Humans LOVE to smoke. My guess is that the smoke kills or nic or other chemicals in it kills or disrupts pathogens.

          It’s interesting also that the uproar about smoking occurred starting in the 1950s – just as US life expectancy was hitting about 65. I presume before that, it wouldn’t have mattered so much if you smoked or not, you were likely to die of other causes before you would be killed by smoking.

        • > My guess is that the smoke kills or nic or other chemicals in it kills or disrupts pathogens.

          Alternative hypothesis: smoking (tobacco, marijuana, opium, whatever) makes you feel good.

        • Consider alcohol. You can die from alcohol poisoning if you drink too much in a short period, or you can die from cirrhosis or some other long-term disease due to chronic overuse. You could make the same point about heroin and overdosing, though I’m less familiar with the long-term consequences from that are.

          I think that’s the point that Pence was making with respect to smoking. Getting shot is more like alcohol poisoning or overdosing than smoking. You never hear about adults dying from nicotine poisoning.

        • Good point. 100 years ago infectious diseases were the main drivers of mortality and cut people down in their youth. In such a world, no one would notice or even care about about a toxin that took decades to kill you. So, look on the bright side with Pence in charge of our response to the coronavirus, we can go back to not worrying about whether smoking kills. Light ’em up.

        • I heard in the news about a couple guys who has a cigarette smoking contest, and one died from acute nicotine poisoning (after smoking about 100 cigarettes). So it happens. But it’s rare.

        • Actually the OSHA piece doesn’t state anything about adults dying from nicotine poisoning. It addresses green tobacco sickness amongst certain fieldworkers and how that excess nicotine absorption creates a greater risk of heat stroke potentially resulting in death. Were you trying to support Pence’s position?

  2. I agree with Hbacovci. In addition, “dying of a smoking related illness” is ambiguous. Heart disease is a smoking-related illness (in that it may be exacerbated by smoking) but it is not necessarily the case that all smokers who died of heart disease had their lives shortened by smoking, nor is it even the case that everyone who has smoking-related heart disease will die of it. And having heard anti-smoking public health warnings all my life (and never having been a smoker) I was frankly very surprised when I first read the statistics how few lifelong smokers get lung cancer, though granting that the vast majority of lung cancer deaths are smoking-related.) So it seems to me that Pences’s statement is not incoherent, just inartfully phrased, since he admits smoking is bad for you. I take him to be saying it’s not as bad for you as you’ve been told. I think he may be correct about that, since the public health warnings aren’t marked by subtlety.

      • Roger:

        In short: The problem is that smoking does kill, coronavirus is not the common cold, there’s no evidence that the coronavirus came from a Chinese lab, and the fact that many smokers do not die of smoking-related causes is not evidence that tobacco is not deadly. For public figures to claim otherwise is ridiculous. There are so many actually true things that can be said about smoking and the coronavirus; is it too much to ask our public health response to be led by people who know what they’re talking about?

        • Suppose I searched your blog, and found an example of you criticizing someone for exaggerating murder statistics. Should we all then attack you for downplaying the bad effects of murder?

          You seem to be saying that smoking is bad, so we should only say bad things about it. Murder is also bad.

          Limbaugh is predicting that the coronavirus outbreak will not be the big deal that many others believe it is. He may be wrong, but who cares? He is not a medical expert. Political analysis is his thing, and he is much more interested in the politics than the medicine.

        • Roger:

          You write, “You seem to be saying that smoking is bad, so we should only say bad things about it.” Huh? I never said that!

          I’m not criticizing Pence for criticizing someone for exaggerating smoking statistics. I’m criticizing him for saying that “smoking doesn’t kill”—a statement, incidentally, that’s too extreme even for the cigarette-funded Heartland Institute, which flatly states that “smoking kills.” I’m also criticizing Pence for using the fact that many smokers do not die of smoking-related causes as evidence that tobacco is not deadly. That’s a bit of folk epidemiology that I’ve heard before, but it’s wrong, and it’s terrible for someone with that level of misunderstanding to be leading the national response to a public heath crisis. I mean, it’s absolutely ridiculous, it’s a scandal.

          I’m not criticizing Limbaugh for criticizing someone for exaggerating smoking statistics. I’m criticizing him for saying that coronavirus is the common cold and that coronavirus came from a Chinese lab. Look, I know the guy’s an entertainer, he loves publicity, and saying ridiculous things is a good way to get publicity. It’s still incredibly irresponsible. If he’s not a medical expert, that’s fine, he could try listening to a medical expert before saying that coronavirus is the common cold and that coronavirus came from a Chinese lab.

        • Good Lord, people….did anybody even read the Pence op ed?

          The point was not that smoking doesn’t kill (in the next sentence, he agrees that it does) it was that it doesn’t kill enough for us to give up civil rights or civil liberties to overly intrusive big government, and if it started with the tobacco legislation that was ongoing at the time, where would it end?

          And he was right. The legislation….the tobacco suit….huge settlement…. that went mostly to the lawyers, and the end result was that they “punished bad behavior” by raising the price of tobacco to cover the cost. So, smokers pay more for tobacco, tobacco companies still keep making their money, and no more of it gets passed on to cover smoking related health care costs.

          Was his wording clumsy? Obviously yes. But he was trying to warn about an impending head-on collision, and everybody is arguing about how fast the cars are going.

          More than a little ironic that the same people going apey and completely missing the point over Pence’s clumsy wording are also backing Joe Biden, perhaps the all time King of clumsy wording.

        • Ripsaw:

          If, as you say, “the point was not that smoking doesn’t kill,” then maybe Pence shouldn’t have directly written, “smoking doesn’t kill.” I don’t think it’s “apey” to point this out.

          Yes, Joe Biden is a liar. Not just clumsy wording, the guy’s notorious for flat-out lying.

          The fact that one politician is a liar doesn’t make me feel any better about the appointment to a major public health position of a different politican who “smoking doesn’t kill” and who otherwise muddies the waters regarding major health issues.

  3. I think the link to “at NIH Panel” is going to the wrong place, or perhaps I didn’t read far enough down to get the reference.

    Otherwise get out the Sharpies. A day ago Matthew Miler tweeted:

    “How long until we see the first big story about the president and other political officials pressuring the CDC behind the scenes to downplay warnings about the Coronavirus? My guess is three days.”

    He was off, it was a day. And if you don’t believe that a few days go there was a bunch of documents released related to SharpieGate showing just how much political pressure was brought to bear to alter the truth in order to make certain people look good. For a possibly pandemic virus, the public should be getting the most complete and accurate information as possible.

  4. Andrew distinguishes Limbaugh’s incoherence from Pence’s because Limbaugh is an “entertainer” while Pence is merely the Vice President. However,from
    https://en.wikipedia.org/wiki/Mike_Pence#Early_life_and_career

    “In 1992, Pence began hosting a daily talk show on WRCR, The Mike Pence Show, in addition to a Saturday show on WNDE in Indianapolis.[25][28][29][30] Pence called himself “Rush Limbaugh on decaf” since he considered himself politically conservative while not as bombastic as Limbaugh.”

    “In 2001, [Representative] Pence wrote an op-ed arguing against the tobacco settlement and tobacco regulation, saying they would create “new government bureaucracies” and encroach on private lives.”

  5. I’d say Mike Pence is playing with the interpretation of generic sentences, which are often strictly speaking false even when most people would consider them true. Whether the sentence is considered true is not just about the relative number of cases in which the proposition holds but also about something like prototypicality: compare “Lions have manes” and “Lions are more than one year old”: the latter is true for more lions than the former, but still sounds more odd. Relatively speaking, smoking kills more people than many other activities, which may be why “Smoking kills” is a proposition that most people would accept.

    Of course, Pence does not make explicit in his argument that he means smoking does not *always* kill because that would give the game away – his audience is supposed to interpret his claim as something more profound than it actually is.

  6. First off, Rush Limbaugh may be an entertainer, but he has been an influential voice from within the Republican Party and within the conservative political movement in the US more broadly. For example, he has frequently been invited to or helped organize the various Conservative Political Action Conferences (CPAC for short) for years, and this event frequently attracts Republican politicians (including Mike Pence, if I’m not mistaken).

    Second, I’m curious, given Mike Pence’s seeming defense of the tobacco industry, if he is in fact a smoker himself. My understanding is that he is not.

    Third, given past dubious statements on science-related issues, should Mike Pence really be leading on the US response to COVID-19, as opposed to someone with a public health background? You would think the head of the CDC, or a public health researcher, may be better suited to lead on this issue.

    • My impression is that Trump assigns particular duties to people based not on the person’s qualifications in the area involved, but based on their loyalty to Trump.

  7. Many activities could reduce life expectancy. Does sky diving kill? Does drinking? How about driving? It all depends on the effect size, dose, and personal risk tolerance.

  8. US life expectancy by gender is 81.4 (Female) and 76.3 (Male), with 17% male and 14% female smoking.

    China life expectancy by gender is 79.1 (Female) and 74.5 (Male), with 48% male and 2% female smoking.

    This is kind of comparing apple to orange, but seems interesting in many aspects.

  9. In my introductory microeconomics textbook, I have a chapter on government. In it is a section on state capacity which lists three main components, the political autonomy of the state, the revenue base, and the competence of the state apparatus. With Trump in mind, here is a paragraph on #3:

    “The single most important element in the development of government competence is the creation of an
    independent, professional civil service. The hallmarks of such a force are formal qualifications and a high
    level of job security. Without them, there is no accumulation of know-how, nor will government functions be
    carried out according to professional rather than political criteria. In every society there is a tug of war
    between the immediate political interests of those in temporary control of government and the permanent
    employees who staff the apparatus. The political motive seeks to remove as many posts as possible from
    civil service jurisdiction and to exercise as much control as possible over the work of the bureaucracy. The
    maintenance of state capacity depends on institutions that safeguard civil service prerogatives and keep
    political forces at bay.”

    • “The single most important element in the development of government competence is the creation of an
      independent, professional civil service. The hallmarks of such a force are formal qualifications and a high
      level of job security. Without them, there is no accumulation of know-how, nor will government functions be
      carried out according to professional rather than political criteria. In every society there is a tug of war
      between the immediate political interests of those in temporary control of government and the permanent
      employees who staff the apparatus. The political motive seeks to remove as many posts as possible from
      civil service jurisdiction and to exercise as much control as possible over the work of the bureaucracy. The
      maintenance of state capacity depends on institutions that safeguard civil service prerogatives and keep
      political forces at bay.”

      This sounds like a quote out of Yes, Minister. Great show if you’ve never seen it: https://www.youtube.com/watch?v=nUHWKSwDeXs

    • Peter
      This is an eloquent statement and one I agree with. However, I do wonder if you are stating an empirical fact (or, rather, I should say something that has empirical support) or a belief. I happen to share that belief, but I find it hard to believe there is anything resembling evidence to support it. For example, there are many countries with large professional civil services, though it would be hard to measure how independent they are. Is the Chinese government competent? How would you propose we measure that? Though I share your belief, this is a reason I became disenchanted with teaching economics – much of what I believe I came to view as indoctrination if I were to teach it. I’m not sure there is much good evidence that government competence depends on a professional and/or independent civil service. Yet, I found the most disturbing aspect of the last 3 years in American politics the disregard of civil servants in favor of political ideology (well, second most disturbing, after the virtually complete loss of civil discourse).

  10. Guys, smoking causes lung cancer. True, it doesn’t cause it with the first cigarette. True, there are other causes such as radon. True, some people escape this hazard. However, smoking is the cause of lung cancer in the overwhelming majority of sufferers. The arguments in opposition to this are casuistry. The 2001 Pence statements are irresponsible. Further, sex causes pregnancy; I know not every coitus results in pregnancy, and there are infertile couples despite coitus. Actually pregnancy is the result of union of ova and semen not sex.

    • Even ‘radon causes lung cancer’ is mostly true of smokers rather than nonsmokers. The uncertainties are large but a given level of radon exposure is thought to be 5x to 20x as likely to cause lung cancer in smokers as in nonsmokers.

      But it’s always worth remembering that the most common fatal side effect of smoking is heart disease. Most people think of lung cancer first for some reason.

  11. Okay, if it’s “settled science” that smoking causes cancer, why has it not been outlawed years ago? Why is there no actual proof that second hand smoking harms anyone (there isn’t). And why does the government send cigarettes all over the world? It’s all a crock. It’s like global warming. There’s no real proof for it, but it’s become a cult to believe that smoking is going to kill you next week. The country is losing the battle against drugs, so the solution the powers that be have come up with is to attack smoking, legalize pot so that they get little kids hooked on it, and now are working to legalize all, ALL, drugs. Stop being fooled, people. Stop being so easily led around by the nose and blown about by every wind. Research and think for yourself.

  12. First, in this day and age, I am immensely impressed by the civility of the discourse in this tread, so much so, I broke with tradition and decided to throw my hat into the ring. Second, I know this is an old thread and we now know much more about COVID, but still I find the arguments very relevant.

    On Pence and his comments, I was never hugely impressed, but think he’s more competent than what just landed in our lap. The point about about his qualifications… um, what’s going on now? I’m on board with the context argument. Some badly formed messaging or sentences, but that oped was an argument about giving up your civil liberties. Its not the state’s job to protect me from myself. Motorcycle helmets? Seat belts (maybe for children too young to know better)? Do these things mitigate some of your life risks? You bet they do! But is it wise to let the government impose one more restriction on you? I say NFW. I can teach my kids to do these things just fine all on my own… and, I hate to be selfish, but when my kids know it and yours don’t, my genes improve their chances over yours. Its Darwin. Why let government meddle with that. On the SARS thing, unfair to blame him. Its political chicanery.

    On Limbaugh, yeah, I don’t know. I didn’t hear the whole rant or read the transcript to get the context, so no comment.

    On whether smoking causes cancer, I say here it is: Not everybody who smokes gets cancer, heart disease or whatever, However, it should be pretty clear to everyone by now that higher incidence of these bad things happen to smokers (although the China vs. US stats link was interesting – but can you really trust any numbers coming out of China). Here is the thing nobody has put forth: Smoking all by itself doesn’t cause these things, it triggers them in those who have the genetic predisposition to succumb to them. Otherwise smoking would be like getting your head chopped off. So I do tell my kids its OK to smoke because they MAY not have that predisposition? No, I teach my kids to seek out good sources of information (gleaning through an Internet full of crap), learn what are and are not risk factors, and mitigate them where practical. And never, never, never give up civil liberties, any of them, unless absolutely necessary for the survival of themselves and those close to them. Maybe take it one step beyond to where they are educating the ones dear to them to do the same.

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