Recently in my job, I had to research and write my position about "Who has to pay for smokers' bills?". The government was trying to get compensation for smokers' treatment in the public health system, so my job was to argue whether or not this makes sense.

My point of view changed several times and even now I am not sure. During my research, I found pros and cons. The first one and more recurrent was that smoking companies sell their products and make billions of dollars, their product harms not only the smokers but also people around them. On the other hand, a lot of people argue that smoking is a particular choice, and only smokers should have to pay for whatever harm they do to society.

These two points are at the extreme of the discussion and there is a lot of gray area. For example, the particular health system can differentiate between their patients by charging more from people that do not have a healthy lifestyle, this makes the smokers deal with their costs to some extent. But, the public health system cannot do this type of differentiation and have to pay for whatever treatment appears. In this case, the costs go to society. Another problem emerges from this last point, how can we measure this cost? Is the cost of smoking just the healthcare treatment? What about passive smokers? Are there other effects from smoking, such as environmental effects? If the estimated costs are too big, the opinions about this issue can change and someone has to pay compensation.

The only strategy to solve this question from an economic point of view is to compare our world to a world without smoking. We have to do an imaginative exercise about how this new world could be. Would there be less demand on the healthcare system? Would it have fewer costs since people smoke less? Or maybe in this world, people would be addicted to other things, something worse?

In practice, we can use some groups in society to simulate this world -- people that live in some cities that forbid smoking or that are from some religion that does not allow the practice. After this group selection, we have to compare people with similar characteristics and see the health differences. Perhaps after this research, I would have a stronger opinion, but until then I cannot say who should have to pay for smokers' bills.