Since the life insurance industry started underwriting cigarette use some 30 years ago, the focus has largely been directed at two primary considerations
o Do you currently smoke?
o If you quit, how long have you been cigarette-free?
The Problem is, by limiting the questioning in this manner, underwriters ignore two additional aspects of cigarette use that are far more relevant to insurability.
In a 2009 tele-underwriting survey involving over 100 North American insurers and managed by my firm, 92% of chief underwriter respondents agreed that they get more truthful information about smoking by using tele-interviews than they once did with traditional history-taking via non-medicals, paramedicals and physician exams.
Given this robust consensus on the credibility of tele-interviews, it is likely that life underwriters will get equally reliable responses by going further with the smoking questions to get at what matters most.
The driver of cigarette-induced health consequences is not current use in a vacuum. Rather, it is aggregate exposure over decades to the literal "stew" of toxins. Excess mortality associated with this pervasive habit is due to cumulative toxicity, not the direct consequences of current smoking.
Bottom line: Current use pales by comparison with lifetime exposure as the main criterion for measuring smoking-related risk.
Ex-smokers who have accumulated extensive pack-years continue to manifest significant excess mortality long after they quit. This exposes the flawed nature of forgiving prior heavy smoking once the applicant attests to a relatively short interval of ostensible abstinence and has "passed" one last cotinine test (this measures a substance that remains in body fluids after a person has used nicotine).
Lung carcinoma is the leading cause of cancer death and, as everyone knows, the vast majority of cases are attributable to cigarette use. It is also one of the most common causes of death seen in the first few years that life policies are in force. Therefore, underwriters need to appreciate that pack-years smoking, whether the person is an ex-user or continues to consume cigarettes, is the key determinant of excess lung cancer claims.
