



You can get a do-over, no matter how old you are -- as long as you aren't six feet under yet. But most of us aren't taking that do-over (are you?), and that's creating a problem for you and for society.

That means, for you, that you're likely to suffer from disabilities and other medical problems a lot longer than you need to. If you use tobacco or marijuana, know that it isn't harmless. For the typical obese person -- and 35 percent of us are -- having a significant other have to take care of you for the typical 12 years of cognitive dysfunction you'll have isn't a great picture. These costs aren't just yours, either -- they present a problem for society. So big a problem that it threatens civilization as we know it.

There's an old story that goes like this: Three people sitting on the upper beam of a skeleton of a high rise building are named Pete, Jose and Al. Pete opens his lunch pail, looks at his lunch and says, "Pizza again; if I get pizza tomorrow, I'll jump." Jose opens his pail, looks and says: "Darn it, burritos again. If I have burritos again tomorrow, I'm going to jump off." Al opens his pail and says: "Leftover hot dogs; tomorrow if I get leftover hot dogs again, I'll jump." The next day they go to the same beam for their lunch. Pete has burritos and is happy; Jose has a peanut butter and jelly sandwich and is happy. Al opens his, finds leftover hot dogs and immediately jumps to his death. Pete looks at Jose in great surprise, and says, "I can't believe that -- Al packs his own lunch."

[Read: E-Cigarette Use Doubles Among Young People .]

The message is that we are literally killing ourselves with habits we repeat over and over, such as smoking, not managing stress, not sleeping well, being physically sedentary and eating too much inexpensive, addicting sugar- and saturated fat-laden food.

All these choices contribute to getting diseases earlier. A recent article in the New England Journal indicates that 67 percent of all medical costs in America are due to chronic disease management in the under-65 population. After all, all of the increase in income for employees in the last 15 years has been allocated to paying increased medical and disability insurance costs for those employees. No increase in take home pay due to those other costs to employers. Big tobacco, with all its taxes, still pays less than 1/7, maybe less than 1/75 th the medical, disability and productivity costs of what they hook 20 percent of the adult and teenage populations on.

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Big tobacco didn't start the process of causing America's medical costs to rise because they wanted to bankrupt the federal government or allow us less money to spend on education. They didn't do it to cause throat cancer, heart disease or impotence -- they did it to sell tobacco. And they started by selling it to us by increasing taxes and making us think tobacco was a healthy choice. It took billions of dollars, millions of lives and more than 70 years to find tobacco was harmful and prove it to even big tobacco. Sound familiar? Is that what's happening with e-cigs and marijuana?

[Read: How Unhealthy Is Hookah? ]

We know marijuana reduces nausea and vomiting after some cancer treatments, provides analgesia and suppresses seizures in a few children with a rare form of seizure disorder. It also increases appetite in almost everyone, including those with HIV and some other cancers and causes of frailty. But we also know smoking marijuana degrades cognitive development in adolescents, causes addiction in some -- especially if used in adolescence -- and increases motor vehicle crashes from driving while high. It also increases breathing-track cancers, cardiovascular diseases and mental illnesses.

So are we going down the same pathway? I think we need many more years of the Colorado and Washington experiments. For example, how expensive are the medical diseases that marijuana causes? And how much do we need to tax marijuana or e-cigs for society to break even? How much crime will we stop or start by this process over the years? This doesn't mean keeping the criminal laws as they are, or locking up those with small amounts in their possession. If governments are to change the law, part of the revision should be a tax to pay for the necessary research data on illness and costs, with the tax built in the law to increase or decrease to meet those costs and future needed data.

[Read: How to Use Your Smartphone to Quit Smoking .]

Some of my closest friends say we should encourage smoking joints, vaping e-cigs and gobbling saturated fat to save Medicare and Social Security, since it doesn't appear Congressional action will occur in time to do so. Not so, as tobacco is the largest cost of disability payments before age 65. And the chronic diseases associated with these choices make it so that each of us suffers -- if not from the secondhand or thirdhand effects, from the decrease in pay due to America's degraded job competitiveness due to their costs. Yes, even if you do not suffer medical effects from these, your take home pay is decreased, and you do suffer a decreased standard of living. So lets encourage the data in Colorado and Washington (and elsewhere for e-cigs and saturated fat) before we encourage these choices that may have huge effects on those of us who do not chose them.

Thanks for reading. Remember these are the views of Dr. Mike Roizen only. and do not necessarily reflect those of any organization he is or was affiliated with.





An esteemed authority on health and wellness, Michael F. Roizen, MD, chairs the Wellness Institute at Cleveland Clinic, the first such position at any major healthcare institution, where he actively coaches patients. He is a former editor of six medical journals and has published more than 175 peer-reviewed scientific papers. Board-certified in internal medicine and anesthesiology, Roizen co-founded with Mehmet Oz YouBeauty, a media company focused on helping women lead healthier, more beautiful lives, and RealAge. His RealAge series of books as well as his "YOU" series, written with Oz, are worldwide bestsellers, with four No. 1 bestsellers in the U.S. and No. 1 bestsellers in at least five other countries. Roizen and Oz write a daily syndicated column that appears in over 130 newspapers. Roizen has appeared regularly on Oprah, Today, 20/20 and Good Morning America and has a two-hour, 33-station radio show. He is 67 calendar years of age but his RealAge is 48.7 He routinely tweets the week's top medical stories @DrMike Roizen.