Tobacco regulation: autonomy up in smoke?

Abstract

Over the past few decades, "Big Tobacco" has spread its tentacles across the developing world with devastating results. The global incidence of smoking has increased exponentially in Africa, Asia and South America and it is leading to an equally rapid increase in the incidence of smoking-induced morbidity and mortality on these continents. The World Health Organization (WHO) has tried to respond to this crisis by devising a set of regulations to limit the spread of smoking, and many countries have bound themselves to follow the WHO's guidelines. This article provides an overview of these regulatory measures and the authors attempt to defend them from the perspective of liberty and autonomy. Their motivation is to countermand any attempt by the tobacco industry to attack the regulations on the grounds that they infringe the liberty rights of producers and consumers. It is also argued, however, that a blanket ban of the production, sale and consumption of tobacco cannot be justified on the grounds of autonomy alone.

Double standards and arguments for tobacco regulation

“…Consider first the argument that poor health and limited life expectancy undermine autonomy, put forward by several proponents of coercive regulation 3 4 7. Though poor health and limited life expectancy are pro tanto barriers to choosing among the widest possible range of options, they may be part of a set of autonomous choices.…”

“…A second argument in favour of bans is that nicotine is very addictive, addiction impairs autonomy, so therefore effective limits on access to nicotine products could strengthen autonomy in some ways 3–5 7. For example, to further make the autonomy-based case for a cigarette ban, Grill and Voigt also distinguish between internal and external autonomy, where internal autonomy is a person's ability to choose without psychological impediments such as ignorance, bias or illness and external autonomy is a person's ability to choose without interference from other people 3.…”

“…Arguments for bans on tobacco use in public places are also justified by appeal to a double standard. Proponents of smoking bans argue that public smokers harm other patrons and employees in places that allow smoking 7. For this reason, van der Eijk also supports a ban on ENDS use in public spaces on the grounds that long-term evidence about passive inhalation of ENDS vapour could find that it is harmful 2.…”

“…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.…”

The Public Health VS the People’s Autonomy: Banning Smoking in Orthodox Jewish Community

“…The only thing that the author can think to justify the option to smoke is that it is the only option of the orthodox to rebel. The option to rebel is problematic because it is happening most of the time before the age of 18 and the law forbids from smoking in this age; the reason is that the kid is not adult and maybe he does not have all the information he needs to the maturity (Hooper and Agule 2009) to understand what he does.…”