I'm a "learn the hard way" kind of guy. I need to feel or experience them first hand to really get it sometimes. That being said I've been lucky enough to just never have gotten into smoking.

I'm learning to be a doctor right now and I had a patient with emphysema the other day. This is first time I had ever seen the long term effects of smoking.

The first thing I noticed was just how thin he was. Just skin and bones really with a very sunken in face. I mean, you could see every vein and muscle with him lying perfectly still. When you get emphysema, you begin to spend a lot of energy breathing. This guy ended up losing around 60 pounds in about 2 years.

Now he wasn't in the hospital for the emphysema. He had gotten an infection. So he had a bucket so that he had somewhere to spit all of the dark yellow mucus he was coughing up. He would have to stop giving us a history every few minutes to do this.

He didn't just have a hard time breathing when he was walking, he had to use accessory muscles just to breath lying in bed. No exertion unless you count talking. His chest looked this this.

Now this guy already knew he had emphysema and he knew how he most likely developed it. But he still wanted to make sure we knew about a few months of him being a boat captain on diesel ship that had poorly ventilated cabins. He was convinced it was carbon monoxide poisoning that had done this to him and not the 50 Pack Years.

So like I said, I have to learn things the hard way. I empathize. But we have a whole population of people who are as well and then deny that they've more or less done this to themselves. You have anywhere from a 1/6 to a 1/5 chance of getting emphysema so this is like handing some a die and saying "You don't have to play, but if you do, you better hope it doesn't land on 3". These just aren't great odds. And this is only talking about one complication of smoking. Let's not forget about lung cancer or chronic bronchitis.

Over a billion people on this planet smoke. That is an astounding number. And if putting really gross pictures on the packaging helps some but entrenches others, I think we should focus on the people it deters. Because while there might be effective ways to prevent smoking related illnesses, they aren't nearly as practical or cost effective as those pictures.