ICBioethics Blog 

Smoking: Complicated Issue Beyond Health Concerns

Written by: Leah Jeunnette, Ph.D.(c)

Sometimes I forget just how complicated a healthcare issue can be: smoking for instance. This issue pits individual rights against the public health or welfare of the community. On one hand, individuals have the right to make their own decisions, weighing the benefits against harms. At the same time, non-smokers have rights to smoke-free air, and shouldn’t be burdened with absorbing costs associated with smokers’ habits or illnesses (higher insurance rates across the board, tax dollar funded healthcare and public awareness/prevention programs, etc.).

Now, few would insist that smoking is beneficial to health, but when does legislation that restricts citizens’ access intrusively cross the line?

According to a The Lancet’s recent article, an international group of policy and public health experts calls for a tobacco free world by 2040, hoping to reduce smoking to under 5% worldwide. Realistic goal, or not?

Increased efforts in the US have decreased smoking overall. Some businesses have become smoke free or tobacco free. Some states (Alabama, Alaska, New Jersey, Utah) and cities (NYC and Dover, MA) increased the minimum age to purchase. Even drugstore chain CVS no longer sells cigarettes.

Still, cigarettes remain popular worldwide. Tobacco companies market to developing countries without great restrictions, and some countries, like China, see smoking rates continue to increase.

Support for the tobacco industry is complex. Big money is involved — that large industry employs many people, and substantial tax revenues are generated at multiple layers of government, thanks to sin taxes. And we certainly need profitable US manufacturers to shore up our economy—even if all don’t like their products or agree with their use.

Furthermore, we don’t want government limiting our personal freedoms – choosing some opportune issues while glaringly ignoring others.

But then we don’t need a sickly population either . . . hmmm.

Each opposing side holds a valid and defensible banner. Support individual rights and freedom to make personal choices! Protect the health and welfare of all!

If this is a stalemate, what should happen next . . . continued bickering/leveraging, like the disagreements over fast food regulation or gun ownership?

Can we find a practical and ethical compromise acceptable to most?

Mitch Gennuso