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Commentary
Double standards and arguments for tobacco regulation
  1. Jessica Flanigan
  1. Correspondence to Jessica Flanigan, Leadership Studies and PPEL, University of Richmond, 28 Westhampton Way, Richmond VA, 23173; jessica.flanigan{at}gmail.com

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Several ethicists recently defended regulations that aim to reduce the harm associated with nicotine and tobacco use. Halliday argues for smoking licences.1 van der Eijk endorses strict limits on access to electronic nicotine delivery systems (ENDS)2 and Grill and Voigt defend a complete ban on the sale of cigarettes.3 These proposals are supported by principles that are widely shared by public health officials and many philosophers. For example, Goodin,4 Conly,5 Proctor,6 Hooper and Agule7 and Wilson8 all express support for smoking bans or cigarette taxes.

It is uncontroversial that smoking is a very unhealthy practice. Smoking limits a person's life expectancy by a decade on average, causes chronic diseases and is often a choice that people come to regret.3 Smoking is the largest preventable cause of death in the world, which is why Proctor calls cigarettes a public health catastrophe.6 But it does not follow from the fact that smoking is enormously bad for people's health that prohibitive tobacco and nicotine laws are justified. Though criticism of the tobacco industry is warranted,6 I argue that policies that amount to coercive paternalism are nevertheless unacceptable and only a non-prohibitive approach to smoking cessation is justifiable.

Philosophers rely on four double standards when arguing for prohibitive antismoking policies. First, they hold addictive nicotine products to more restrictive standards than other threats to individual autonomy. Second, they hold the tobacco industry to more restrictive standards than other potentially harmful industries. Third, they hold public health officials to weaker moral standards than they would apply to other citizens. Fourth, they hold their own proposals to standards of ideal enforcement while citing the non-ideal effects of a non-prohibitive system. Many of the arguments in favour of restricting tobacco and nicotine products also overlook less …

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Footnotes

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

  • i In the EU, see Directive 2003/33/EC of the European Parliament and of the Council of 26 May 2003 on the approximation of the laws, regulations and administrative provisions of the Member States relating to the advertising and sponsorship of tobacco products. The WHO Framework Convention on Tobacco Control is a treaty that has been ratified by 180 countries. In a later section, I note that I am in agreement with WHO's call for drug decriminalization. In both cases, I do not doubt WHO's claims about whether a policy would promote public health. But in this case, I argue that public health is not a sufficient reason for restrictions on speech.

  • ii Another notable exception is pharmaceutical advertising, which is regulated in part by the US Food and Drug Administration, which prohibits manufacturers from advertising truthful information about the off-label uses of drugs.

  • iii Grill and Voigt write, “We assume that such a ban would be effective. In the real world, of course, any all-things-considered judgment must be informed by an assessment of a ban's likely effectiveness in different contexts, with due consideration of problems such as smuggled cigarettes and black markets.” Yet Grill and Voigt are focused on ‘the fundamental normative issues’ surrounding a cigarette ban.3

  • iv This argument does not rule out a middle ground approach. One may reply that coercive paternalism could be justified by the same standards that would justify a less coercive tobacco policy. Though I have argued elsewhere that coercive public health paternalism is generally unjustified,15 my arguments in this essay do not rule out the possibility that some coercive tobacco policies could be justified as long as they were held to the same standards as other policies. In any case, such policies would not include the policies that I have discussed so far.

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