No smoking
The New England Journal of Medicine published a non-technical article last month about New York City's recent smoking ban entitled, Nowhere Left to Hide? The Banishment of Smoking from Public Spaces. It raises some interesting questions. Nobody disputes the fact that cigarettes are responsible an enormous number of excess death and illness each year, nor that exposure to secondhand smoke can have short- and long-term health effects. What I learned in this article is that these health risks were not what inspired the first round of smoking bans in the 1970s, and history may be repeating itself without any public health benefit.
The stated rationale for these early measures was not a paternalistic one - that smokers must abstain for their own good - but rather the protection of nonsmoking bystanders. Strikingly, these early restrictions were implemented in the absence of scientific data that secondhand smoke posed a health threat to nonsmokers. Instead, the measures advanced on the premise that secondhand smoke was unpleasant and annoying.
It's hard to argue the opposite point-that secondhand smoke is not unpleasant and annoying-and the authors are quick to point out that good science eventually revealed the risks posed by secondhand smoke. The idea of a non-smoking section of an airplane now seems absurd. Can you imagine how nasty it would be if one person smoked just one cigarette during a cross-country flight?
But now NYC officials have voted to ban smoking in public places like parks and Times Square, based largely on what appears to be the moral judgment that smoking is “bad” and not on any compelling science. According to the article, brief exposure to second-hand smoke in an open-air environment has not been convincingly shown to pose serious health risks. In other words, if you're sitting more than two meters away from someone who's smoking on the terrace at a restaurant or on the beach, you don't really experience any increased risk of lung cancer. If you were inside the restaurant or an airplane, it would be a different story.
It's tempting to say that smoking is bad and that we should therefore support any measures that make it more difficult or less socially acceptable to do. If only it were that simple. But it's not:
Given the addictive nature of nicotine and the difficulty of quitting smoking, strategies of denormalization raise both pragmatic and ethical concerns. Some tobacco-control experts have questioned whether the denormalization of smoking may have unwanted negative effects on the mental and physical health of smokers but fail to lead them to quit. Also relevant are issues of social justice… Since smokers are more likely to be poor and therefore dependent on free public spaces for enjoyment and recreation, refusing to allow them to smoke in those places poses potential problems of fairness.
Furthermore, anti-smoking efforts typically experience diminishing returns. Raising taxes on cigarettes or disseminating information about the risks of tobacco products has some initial success in decreasing the prevalence of tobacco use, but after a while things even out and a certain number of people keep smoking. And start smoking each year. I don't see the social benefit in making smokers feel alienated, stigmatized and antisocial without making it easier to quit, deterring new users or protecting nonsmokers.
Finally, there's the question of how much control we want the government to have over our private lives. I'm generally pro-government. I support taxes to pay for schools and public services, I favor some form of “socialized medicine” and I even voted for the indoor smoking ban here in Washington state. But I have a hard time supporting an outdoor smoking ban that provides no clear public health benefit, to smokers or nonsmokers, just so some people can enjoy Central Park a tiny bit more. At times I've wished that obnoxious children or country music were banned from public parks and beaches, just so that these spaces would be more conducive to my happiness, but I would never want the government to actually outlaw these nuisances.
The stated rationale for these early measures was not a paternalistic one - that smokers must abstain for their own good - but rather the protection of nonsmoking bystanders. Strikingly, these early restrictions were implemented in the absence of scientific data that secondhand smoke posed a health threat to nonsmokers. Instead, the measures advanced on the premise that secondhand smoke was unpleasant and annoying.
It's hard to argue the opposite point-that secondhand smoke is not unpleasant and annoying-and the authors are quick to point out that good science eventually revealed the risks posed by secondhand smoke. The idea of a non-smoking section of an airplane now seems absurd. Can you imagine how nasty it would be if one person smoked just one cigarette during a cross-country flight?
But now NYC officials have voted to ban smoking in public places like parks and Times Square, based largely on what appears to be the moral judgment that smoking is “bad” and not on any compelling science. According to the article, brief exposure to second-hand smoke in an open-air environment has not been convincingly shown to pose serious health risks. In other words, if you're sitting more than two meters away from someone who's smoking on the terrace at a restaurant or on the beach, you don't really experience any increased risk of lung cancer. If you were inside the restaurant or an airplane, it would be a different story.
It's tempting to say that smoking is bad and that we should therefore support any measures that make it more difficult or less socially acceptable to do. If only it were that simple. But it's not:
Given the addictive nature of nicotine and the difficulty of quitting smoking, strategies of denormalization raise both pragmatic and ethical concerns. Some tobacco-control experts have questioned whether the denormalization of smoking may have unwanted negative effects on the mental and physical health of smokers but fail to lead them to quit. Also relevant are issues of social justice… Since smokers are more likely to be poor and therefore dependent on free public spaces for enjoyment and recreation, refusing to allow them to smoke in those places poses potential problems of fairness.
Furthermore, anti-smoking efforts typically experience diminishing returns. Raising taxes on cigarettes or disseminating information about the risks of tobacco products has some initial success in decreasing the prevalence of tobacco use, but after a while things even out and a certain number of people keep smoking. And start smoking each year. I don't see the social benefit in making smokers feel alienated, stigmatized and antisocial without making it easier to quit, deterring new users or protecting nonsmokers.
Finally, there's the question of how much control we want the government to have over our private lives. I'm generally pro-government. I support taxes to pay for schools and public services, I favor some form of “socialized medicine” and I even voted for the indoor smoking ban here in Washington state. But I have a hard time supporting an outdoor smoking ban that provides no clear public health benefit, to smokers or nonsmokers, just so some people can enjoy Central Park a tiny bit more. At times I've wished that obnoxious children or country music were banned from public parks and beaches, just so that these spaces would be more conducive to my happiness, but I would never want the government to actually outlaw these nuisances.