I wouldn't have an answer. My thoughts would be what is the source of this information and how valid and comprehensive is it. Once I was sure I had the best data possible data regarding the health risks of these three conditions I'd have an opinion.

This could be a hot topic. I have an opinion but it is not based on stats so I won't share it. I hope someone does though.

Hmm, interesting question.

I would say smokers.

Obesity and alcoholism is subjective and would differ depending on whose threshold. BMI is not a great indicator unless you're talking the morbidly obese. Alcoholism would be hard to measure. Would the insurance just take the doctor's word that the patient is an alcholic? There would be way too many slippery slopes in trying to define those two. Smoking is black and white.

Additionally, smoking is the only one of the three that harms other people and could possibly increase their health costs. I know I often have other people's smoke in my apartment from when they smoke outside and it makes me cough. It also raises my blood pressure because I get so mad at the invasion! Secondhand smoke is very real and deadly and has the potential to drive up insurance costs.

It makes total sense to me for smokers to have a higher premium. And yes, I'm very biased because I lost my mom to lung cancer when she was only 46.

I would think they would all be put in the same risk pool. Some insurances pay for gym membership, smoking cessation, and alcohol treatment. . .

Smoking causes Emphysema, bronchitis again and again, atherosclerosis, and increases the risk of blood clots. Compared to people who don�t smoke, smokers face twice the risk of stroke and they are likely to have that stroke nearly a decade sooner. The study also showed smoking increases the risk for complications from stroke and the likelihood of subsequent strokes.

Obese people also run a bigger risk of developing cancer, a multitude of physical problems, death...

Alcoholics also run the risk of more accidents, loss of jobs, family, etc...cancers too I believe.

Lets face it, they all have a multitude of problems... all three of these factors.

In 2010, around 43% of cancer cases seen in the UK were caused by lifestyle and environmental factors, according to several news sources today. This equated to around 134,000 cancers caused by potentially avoidable behaviours such as smoking, drinking alcohol and eating a poor diet.

Smokers for the same reason as chi83. Smokers have an increased rate of several cancers. Second hand smoke on family members ruins their health also.

well since i'm one of the 3, i'd have to say the other 2...

You'd need a more complete list of health problems here. I just had a malignant tumor removed from my bladder, and the doc said the main cause of that type cancer WAS cigarette smoking. So, it would be a long list of all the ailments these 3 things can cause. By the way, I don;t smoke.

Smokers.....hypertension, increased risk of strokes and heart attacks, increased wrinkles, especially around the lips, emhysema and other lung related diseases, cancer, gum disease and exposing others to second hand smoke.
Increased risk to young children in the home for ear infections.
When I was a student nurse I saw back to back lung surgeries. Both patients were about the same age (middle aged) and same sex......the first one was a smoker. His lungs were horribly black and had a cancerous tumor.
The second one had never smoked but had a lung lesion caused from coccidiodomycosis (Valley Fever caused by a fungus)......one lesion but the lungs were pink and more healthy looking.
Had I ever smoked I would have quit right then and there.
But I never had smoked but now have lung problems from being exposed to second hand smoke at home as a child and as a nurse until, finally the hospitals banned smoking.
Our county was the first one in America to ban smoking in public places of business.

I would have to understand the risk for which cancers and understand/know the health costs for those cancers and other illnesses. Let's face it, cancers vary... with some you can die rather quickly while others can be very prolonged and financially draining... same with other health conditions.

It's not always the condition itself but how expensive, extensive and prolonged the illnesses can be. And, I just don't know enough about the possible expenses for the conditions you mentioned to even make a decent guess with the info you provided.

Hmm, I have to say the alcoholic. We have had alcoholic friends and you can see the harm it does to the family and the liver, and what about drunk driving and killing people while on the road drunk. This is a major social problem.
Yep, I think this can be a really hot topic!
I am an exsmoker, a type 2 diabetic, overweight, etc. BUT I don't drink.
Kathy G in MI

What about the obese smoker who drinks a lot? I'm not trying to be funny, I see it everyday. I don't know how these people are still walking around sometimes. Just had one who was 49 and looked like she was 70.

You pose a question that has no "right" answer. The answer 'depends upon' severity of the malady and other factors. If you are the insurer, you are most interested of longivity or other harms that you company might become liable for. All three are at greater risk than the average population. I'd say that the smoker or alcoholic were at greater risk unless the obese person was horribly over-weight - there's that 'it depends' thing again.

If the alcoholism was severe, I would choose that as the worst. That habit is less likely to come under control than the other two, it is more likely to worsen, and it can create collateral damage (to others) before the user dies.

Alcohol can cause one to loose control of his good sense and inhibitions whereas smoking and obesity do not.

I'm slim, a non smlker, and have maybe one alcoholic drink a month. In 2001 at age 48, I had a massive stroke. I survived after a month in the hospital, but found I had bad kidneys, leading to total kidney failure and dialysis in 2007. What caused all this? Undiagnosed hypertension (high blood pressure) AKA "The Silent Killer". I had had a physical six months earlier and everything was normal. Then again, my Dad suddenly developed liver disease in his early 70's. He died of cirrhosis of the liver, even though he only drank a couple of glasses of wine a year. You can't figure everything.

The discussion starts from a false premise, thus hindering a reasoned response.

My guess is someone who smokes had their health insurance premiums increased while others in their group who were fat &/or alcoholic had no such increase. Unfair, you say? Maybe. Maybe not. But it is certain that smoking causes all manner of serious health issue... not just the 2 you mentioned. Health insurance companies have tons of data that they pour over to calculate their financial risks. Without a doubt smoking is at the top of their list. And you pay for the "pleasure" of smoking... thru your own health, thru your insurance premiums (health & life), and every time you buy that high-priced pack or carton.

"Alcohol can cause one to loose control of his good sense and inhibitions whereas smoking and obesity do not."

I have to disagree with this statement. After taking care of many smokers, I've seen their good sense go out the window when it comes to smoking. They have to go down for a procedure or scan, "can I go smoke first?". Having surgery or lung biopsy, "can I go smoke?" Just diagnosed with esophageal cancer, "I have to go smoke". I've had patients who light up in the room because they are too weak to take themselves out to smoke, even though they know they aren't supposed to smoke in the building. I don't know how many times I've gone to start an iv antibiotic and they HAVE to go smoke before I do it and want me to come back later.

Same with the obesity thing. I had a guy who was having open heart surgery the next day, have his friend bring him a Big Mac and giant fry. That's not rational thinking. I've had extremely obese patients who have their families bring them all kinds of snacks to stash in the drawer so the patient has easy access when they aren't there. These men are bed bound and could never get up and get it themselves. Same with diabetics who eat all kinds of crap all day long. They know they shouldn't but they can't help themselves. Or it's the only thing they feel they can control in their lives, I don't know. But it's not helping them and they know it, yet they keep doing it.

I'm not obese and i don't smoke, but I do drink alcohol on a daily basis. (I do not drive while drinking.) I'm almost 70, currently healthy and you have to die from something. It seems that longevity is based more on genes than anything. That's my attitude and I'm sticking to it.