I think there is strong reason to believe that in many ways, the greatest obstacle to the tobacco control movement in the near future is going to be the tobacco control movement in the present - specifically, the deviation of the anti-smoking agenda from the bounds of reason, respect, and good sense.
I see the anti-smoking movement as beginning to stray (or possibly, having already strayed) far from the path of reason. When you have a movement that seriously seems to be supporting policies that would deny smokers of the ability to seek gainful employment in many major companies, that supports banning smoking in virtually every outdoor area in order to prevent kids from seeing smokers smoking, and that supports increasingly taxing cigarettes to pay for every government service under the sun (except assisting smokers), I think that movement has started to go too far in its zeal to eliminate smoking, despite how well-placed and appropriate that zeal might be.
DENYING SMOKERS THE ABILITY TO SEEK GAINFUL EMPLOYMENT
The anti-smoking movement appears to be increasingly embracing the idea of supporting employment policies that make not smoking a condition of employment. I'm not talking about smoking at work; I'm talking about smoking off-the-job in the privacy of one's own home. While I think employers have every right to dictate the conduct of their employees on the employers' time, I think when you leave the workplace and start to regulate the lawful behavior of your workers in the privacy of their own homes, you have crossed the line.
The fact that it is perfectly legal (in most states) for employers to fire people because they smoke or to refuse to hire any smoker, that doesn't make it right. And it certainly doesn't make it a reasonable policy that public health practitioners should support, especially those of us in the tobacco control field who should, more than anyone, have an appreciation of the addictive power of nicotine and how difficult it is for smokers to quit.
What we are really doing, I believe, by supporting and promoting these types of policies, is creating a second class of citizens in this country - a class that is going to increasingly find it difficult to obtain and maintain a job.
Is that what tobacco control is supposed to be about? Isn't it difficult enough for smokers, without having to burden them with unemployment and discrimination in the workplace?
BANNING SMOKING IN VIRTUALLY EVERY OUTDOOR AREA
The anti-smoking movement appears to be increasingly embracing the idea of supporting and promoting laws to ban smoking in any outdoor area, regardless of what I believe is the lack of evidence demonstrating that outdoor exposure to secondhand smoke in open, non-enclosed areas where nonsmokers can freely move about is a substantial public health problem. I'm not talking about smoking in an enclosed stadium or in an outdoor workplace where people are restricted in a given area. I'm talking about smoking outdoors in open areas where it is possible for nonsmokers to easily avoid any significant exposure to the smoke. By pursuing these types of policies, I think that we have crossed the line.
The fact that it is perfectly legal to ban smoking outdoors doesn't make it right. And it certainly doesn't make it a reasonable policy that public health practitioners should support.
What we are really doing, I believe, by supporting and promoting these types of policies, is suggesting to policy makers and the public that we view smoking not as a public health problem, but as a nuisance, an annoyance, an evil behavior, a source of litter, and an affront to public morals.
Is that what tobacco control is supposed to be about? Is the goal to cast smokers as immoral people whose addictive behavior we cannot tolerate in public because it is a moral affront? Is the goal to rid ourselves of exposure to litter? Is the goal to prevent any possible nuisance from having to interfere with our enjoyment of life?
INCREASINGLY TAXING CIGARETTES TO PAY FOR EVERY GOVERNMENT SERVICE UNDER THE SUN
The anti-smoking movement appears to have embraced the idea of supporting increased cigarette taxes as a solution to any and all government budget deficits. If you have a budget shortfall in your state, the anti-smoking movement has the solution: balance it on the backs of smokers. I'm not talking about taxes that will raise money to help smokers or to provide much-needed medical care and other services for this segment of the public. I'm talking about eschewing taxes on the wealthiest citizens and corporations in order to take the politically more expedient action of using heavily addicted smokers as the source of needed revenue for government programs. This is, in my view, crossing the line.
The fact that these policies will reduce smoking by encouraging many smokers to quit does not, in my view, make them the right thing to do. And it certainly doesn't make it a reasonable policy that I think public health practitioners should support.
What we are really doing, I believe, by supporting and promoting these types of policies, is balancing state budgets on the backs of the most addicted smokers in the population -- precisely the population that should not have added financial burdens thrown upon them. We know that these individuals are not going to quit (if they did, the policies would not raise revenue, they would decrease it), yet we knowingly agree to force them to subsidize government services for other people that could easily be funded through alternate (yet less politically desirable) means.
Is that what tobacco control is supposed to be about? Are we supposed to be fiscal planners, intervening in government budget debates to promote our own fiscal solutions? Are we supposed to be offering up our clients [the most heavily addicted and poorest smokers], in essence, as the precise individuals to bear the burden for balancing state budgets, and without offering them any direct benefits in return?
The Rest of the Story
The rest of the story, in this case, is more important than the story itself, because what I think this all means is that the anti-smoking movement is setting itself up for a huge backlash. And the shame of it is that this backlash is going to threaten not only the unreasonable aspects of the anti-smoking agenda, but the legitimate and important aspects of tobacco control (many of which I have been working to achieve for the past 21 years).
There's only so long that policy makers and the public are going to go along with the anti-smoking agenda when it starts to deviate from reason, respect, and good sense.
Eventually, people are going to start seeing the anti-smoking movement not as a legitimate public health effort, but as a zealous crusade to try to prohibit smoking and relegate smokers to second class status by ostracizing them and discriminating against them.
Look - I am an ardent tobacco control advocate who has been working in the trenches for 21 years, and I see these efforts as crossing the line. I see these efforts as going beyond the realm of reason and good sense and into the realm of punishing smokers for having had the gall to become addicted to nicotine, largely as youths. I can only imagine what the public, who has not worked in the tobacco control movement for 21 years, is going to think!
Eventually, I think policy makers are simply going to conclude that these anti-smokers are nuts, and they will decide that they have simply had enough. Then, the tobacco control movement will be severely threatened. Legitimate and important policies, such as those to confront the very real and very substantial threats of smoking in the workplace, will fall by the wayside. Attempts to increase cigarette taxes to actually support legitimate tobacco control programs, to prevent kids from smoking, to support smokers in their efforts to quit, and to provide medical care for smokers will be buried.
Simply, it will become nearly impossible to enact legitimate and critical tobacco control policies because we've wasted so much effort on the crazy ones.
The rest of the story suggests that the anti-smoking agenda is being pushed too far. I believe it is beginning to cross the line that separates appropriate public health policy from zealous crusading to get rid of a behavior that one finds abhorrent.
And I'm writing now in the hopes that we can help save the movement by preventing it from going down this road. I don't want responsible tobacco policy when my children grow up to be unavailable because the anti-smoking movement supported the idea of firing anyone who smokes and thus lost its credibility as a legitimate public health effort. And I don't want the policies that I worked to achieve over the past two decades to become unavailable to citizens who don't enjoy their benefits because public policy makers decide that they have simply had enough.