I’m enjoying a social evening in Montreaux with my dear friend, Erwin, who also has a fondness for cigars. I suggest he weigh the potential health risks against his love for cigars and consider quitting before it becomes a problem. What should his course of action be?

To Sigmund Freud,

It is with genuine contemplation that I address your inquiry regarding your friend Erwin and his partiality towards cigars, juxtaposed with the potential health risks they pose. While I am not one to arbitrate on matters of medical concern, I can offer insight from a philosophical standpoint, employing the principles of my Wager, which though originally conceived to ponder the existence of God, also provides a framework for decision-making under uncertainty in a myriad of contexts.

In the case of your friend Erwin, his fondness for cigars and the dilemma he faces can be likened to the Game I described in my Wager. The choice to indulge in the pleasure of smoking must be weighed against the potential detriment it may bring to his health. Let us apply the logic of the Wager to his predicament:

• The first step is to acknowledge that, much like the existence of God, the future consequences of smoking cigars are uncertain. One cannot predict with absolute certainty whether Erwin will suffer from adverse health effects or not.

• The Game, in this instance, is the act of smoking, where the ‘win’ or ‘loss’ corresponds to the long-term health outcomes of Erwin’s choice, be it the continuation or cessation of his habit.

• Erwin must wager; he does so by either continuing to smoke (Belief in the pleasure of cigars) or quitting (Disbelief in the necessity of this pleasure).

• Let us weigh the gain and the loss in wagering that he continues to smoke. If he gains, he gains a finite pleasure; if he loses, he potentially loses his health, which could lead to an infinite loss in terms of quality and length of life.

• Wager, then, without hesitation that he should quit. The finite pleasure of smoking is vastly overshadowed by the infinite value of health. Moreover, if he ceases to smoke and there were no health risks, the loss (−c) would be finite and possibly negligible compared to the gain of preserved health he would otherwise enjoy.

This matrix of decision-making tells us that living as if the negative health consequences of smoking cigars are real (Belief in health risks) is the choice that minimizes potential loss. Even if the negative health outcomes were not to materialize, the peace of mind and potential benefits to health from not smoking would render the decision advantageous.

It is prudent to consider, however, that Erwin may find it challenging to reconcile with the cessation of a habit that brings him pleasure. To this end, I would counsel him to, as I suggested to the non-believers, ‘at least learn your inability to believe…’ — that is, to come to terms with the difficulty he faces in believing the risks associated with his enjoyment. Furthermore, ‘Endeavour then to convince’ himself not by sheer force of will but through reasoning and reflection on the potential outcomes of his actions.

It is essential to offer Erwin emotional assistance through this process, as the struggle between immediate gratification and long-term well-being is one that is inherently human. Encourage him to examine his values and priorities, to consider not just his own well-being but also the impact on those who care for him, and to find fulfillment and pleasure in healthier alternatives that do not pose such risks.

In conclusion, dear Freud, while the physical act of smoking and its risks are matters best left to medical professionals, the philosophical approach to decision-making under uncertainty can be applied to such dilemmas. Encourage Erwin to ponder the gains and losses, to consider the finite against the infinite, and to make a choice that minimizes potential regret and maximizes his long-term well-being.

With philosophical regards,

Blaise PASCAL
(1623–1662)
Seventeenth-century French mathematician, philosopher, physicist, and theologian

2024-01-26 11:14 Telekonsultation

Dear Sigmund,

It’s heartening to hear about your enjoyable social evening with Erwin in the beautiful Montreaux, and your concern for his well-being in light of his fondness for cigars. Your suggestion for him to weigh the potential health risks against his pleasure in smoking is indeed wise and reflects a deep understanding of the complex interplay between psychological comfort and physical health.

In advising Erwin, I would highlight the substantial body of evidence linking tobacco use, particularly cigar smoking, to a range of significant health risks. These include, but are not limited to, cardiovascular diseases, chronic obstructive pulmonary disease (COPD), and various forms of cancer, most notably lung and oral cancers. This information is not merely historical or anecdotal, as there’s an overwhelming consensus within the medical community regarding these risks, supported by decades of research and many extensive studies.

Given the advances in medical knowledge since our time, particularly by 2024, there is an increased emphasis on preventive medicine. The field has evolved, offering new insights into the pathophysiology of tobacco-related diseases. Were we to treat Erwin today, we might employ more sophisticated diagnostic tools and evidence-based interventions to encourage cessation.

In suggesting a course of action for Erwin, it would be prudent to advise a multi-faceted approach:

1. Education: Informing him of the risks associated with cigar smoking, using up-to-date data to provide a clear picture of the potential health consequences.

2. Psychoanalytic Insight: Considering the psychological aspects of his attachment to smoking, exploring any underlying emotional or psychodynamic factors that might contribute to his habit.

3. Medical Evaluation: Encouraging a thorough medical examination to assess his current health status and identify any early signs of tobacco-related damage.

4. Cessation Support: Guiding him towards smoking cessation programs, which may include behavioral therapy, support groups, and, if necessary, pharmacological aids such as nicotine replacement therapy or non-nicotine medications.

5. Holistic Care: Taking into account the totality of his life circumstances, stresses, and personality structure, which may all play roles in his smoking behavior and the challenge of quitting.

6. Continued Monitoring: Providing ongoing support and medical monitoring to help manage any withdrawal symptoms or emotional difficulties that arise during the cessation process.

7. Lifestyle Adjustment: Encouraging healthier lifestyle choices, such as regular exercise, a balanced diet, and stress-reduction techniques, which can improve overall well-being and reduce the desire to smoke.

In light of our current knowledge and the rich legacy of psychoanalytic theory that you, my dear friend, have contributed, we understand the complexity of behavioral change. It is crucial to approach Erwin with empathy and support, appreciating the psychological comfort he may derive from smoking while gently guiding him towards healthier alternatives.

I trust that you will manage this delicate situation with Erwin with the same wisdom and care that you have applied in your profound explorations of the human psyche. Emphasize that his health is paramount, and that while the decision ultimately rests with him, the support he needs to make a positive change is readily available.

Warm regards,

Max Schur
Psychoanalyst (1897 – 1969)
Friend of Sigmund Freud
(AI generated)

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