This year marks the fiftieth anniversary of the date when the surgeon general at long last admitted that smoking was a clear and present health hazard (1), particularly as it relates to lung cancer. And even though great strides have been made against smoking since then, much more needs to be done. More than 400,000 Americans still die prematurely each year from smoking.

And indeed, the current warning printed on each pack of cigarettes is as follows: "SURGEON GENERAL WARNING. Smoking Causes Cancer, Heart Disease, Emphysema, And May Complicate Pregnancy."

This warning is unequivocal. It says smoking causes these diseases, not that smoking 'may cause' them. And aside from the premature deaths that smoking causes, imagine the cost involved.

Take lung cancer. It is the leading cause of cancer deaths, and of it, it is often said that prevention is its cure. That's because smoking is the main cause of lung cancer. But such an understanding wasn't always so.

Smoking only began on a massive scale at the end of the nineteenth century after the safety match (1855) and automatic cigarette roller (1880) were invented. Also, there is typically a time lag of about thirty years from when a person starts smoking and he/she can die from it. Lung cancer was so rare up until the 1920s, that as of 1912, fewer than 200 total cases of the disease had been reported. 

Today, it is a given that smoking is the main risk factor for lung cancer. According to the American Lung Association, 90% of the people with lung cancer are (or were) active smokers. This correlation has been backed up by studies of the some 4,000 chemicals in cigarette smoke, forty of which have been demonstrated to be carcinogens.

So why is smoking still with us? Why is it still legal? Just posing this last query is sure to ruffle the feathers of libertarians everywhere. Prohibition of just about anything is an anathema to them. Libertarians believe that what a person does with his/her own money and life is their business and their business alone, as long as they are not directly harming anyone else.

That's where we part company. The societal center cannot hold if people are reduced to atomized individuals bouncing around attempting to maximize their own personal pleasure. Civil society requires that we have certain responsibilities to each other, especially to the vulnerable. And make no mistake about it; smoking, like vices of gambling and the use of mind-altering drugs, tend to target the vulnerable among us. That is why, for example, addictive drugs like cocaine, meth, and heroin are illegal and why payday loans have been curtailed.

How do the libertarians -- or any of us -- square the circle that smokers are adding to the nation's healthcare burden and that this cost has to be paid by all of us? To say that smokers should be forced to pay for their lung cancer or emphysema treatments on their own dime or die in the streets shows a lack of understand of the type of society we live in.

The number one principle of libertarianism is to maximize freedom. I agree, but we differ on how to do that.

Here, a look at operations research might be helpful. As I understand optimization, it basically says: Except for the simplest cases, you cannot maximize performance of a system -- be it an organization, a process, or a product -- by optimizing the various individual components of the overall system.

That's because of the interdependence of the individual parts and feedback loops. Maximizing A and B separately does not mean that AB will give optimized performance. For that, tradeoffs most often have to be made, whereby one or both of the components have to be suboptimized to get the best performance of the system.

And isn't this a lesson that history shows? Detach a society from its moral tethering -- i.e., restraints -- and it descends first into chaos and then quickly into some form of authoritarianism. In such cases, freedom was maximized on an individual (component) basis only to ultimately be diminished overall. And yes, although many moral restraints tend to be self-imposed, they often have to be backed up by law for support and longevity through the generations.

What is discussed here illustrates the classical divide between conservatism and libertarianism, and it is a disagreement that obviously applies to many more issues than just smoking. But I would like to close on an area where the beliefs of libertarians and conservatives have considerable overlap. Outlawing tobacco is probably a bridge too far for society to cross. But can't we at the very least agree to eliminate all of the numerous agriculture subsidies that the tobacco industry enjoys and perhaps some of tobacco's legal protection from lawsuits, too?