Monday, January 08, 2007

Bangor City Council to Consider Car Smoking Ban Tonight

This evening, the Bangor (Maine) City Council will consider a proposal to ban smoking in cars with children present. No person would be allowed to smoke in a car if anyone under 18 were present. The penalty would be a $50 fine, but the offense would be a secondary one - this means that the police could not pull over a motorist for smoking in a car, but could only issue a ticket if the person were pulled over for some other reason.

According to an article in the Bangor Daily News, the measure is being supported by a number of public health groups.

The push to ban smoking in cars with children present is gaining momentum across the country. Arkansas and Louisiana have enacted such legislation, California is considering legislation now, and similar legislation will be considered in Connecticut during the upcoming legislative session.

The Rest of the Story

In the reader comments to the Bangor Daily News articles, a number of Maine residents make some compelling arguments which I think need to be considered.

For example, EJ states: "I understand the need to protect the children. But what about the children that are overweight...I cringe everytime I see a parent buying fast food french fries for their overweight/obese child. Facts: Doctors are finding that more and more severely overweight children have medical problems such as a fatty liver, a precursor to liver disease, high blood pressure, and an increasing likelihood of Type 2 diabetes. In addition, obese children are becoming prime candidates for heart attacks and strokes even while in their teens. Researchers say it's important to realize that obesity is a health problem -- not a judgment about how people's bodies should look. Everyone has their own idea about how they like to look, but nobody wants to have a heart attack. I have to ask, will there be fines against the parents that contribute unhealthy diets for their children as well?"

This is a very strong argument. If we are willing to interfere with parental autonomy to make decisions regarding health risks to which their children are exposed, then we should be willing to regulate exposure of kids to fast food and a host of other health hazards and not only to secondhand smoke. So the same reasoning that would justify the imposition of a ban on smoking in cars would also justify regulations on many other health-related risks to which parents expose their children.

Anti-smoking advocates who are concerned about regulating children's exposure to secondhand smoke would want to focus first on exposure in the home, since it far exceeds exposure in cars, which is short in duration for most children. Parents who smoke in a car are also likely to smoke in the home, and the duration of this exposure is almost certainly going to be far higher than car exposure for the overwhelming majority of children, if not for all of them. So it makes no sense to ban smoking in cars with children present and yet allow smoking in homes with children present. And once you are willing to interfere with parental autonomy and regulate behavior in a private car, there is no reason not to also regulate behavior in a private home.

But medical, public health, and anti-smoking advocates in Bangor are not calling for bans on smoking in the home, nor for regulation of many serious health risks to which parents in Bangor expose their children - these advocates are only calling for banning smoking in cars. Moreover, they are apparently not too serious about enforcing this proposed law, because they propose to only make it a secondary offense, which essentially means that it is just there to rub someone's face in the dirt once he or she is already pulled over for speeding or some similar moving vehicle violation. This leads me to question the sincerity of these advocates in terms of the strength of their commitment to protecting the health of the children from risks that they apparently consider to be unacceptable.

And more importantly, it leads me to question the real intent behind the proposal. Quite clearly, the intent does not seem to be to protect children from secondhand smoke exposure. If it were, the advocates would be calling for smoking in cars to be a primary offense, and for smoking in homes with children to also be banned. Instead, they are merely proposing a "feel-good" law that will make them feel better, but will do little to actually protect childrens' health.

The proposal, then, essentially amounts to little more than moralizing. It is turning smoking into a morally unacceptable behavior, not merely a behavior that poses health risks. Smoking around children is being singled out as a behavior that is morally unacceptable; all other parental behavior that exposes children to health risks is not morally unacceptable - it is merely a health risk.

Why this distinction? Why this inconsistency?

The answer, I believe, is that anti-smoking groups have increasingly been turning the smoke-free movement from a public health movement to one that is essentially a moral crusade.

And instead of aiming to truly help smokers, which was the primary reason behind my decision to dedicate my career to tobacco control, we as a movement are increasingly trying to punish smokers and make their lives more difficult because of intolerance and social ostracization.

If we truly wanted to help smokers, then we would take Rae-Shawna's excellent suggestion and provide low-cost or free smoking cessation assistance to smokers who want to quit: "I don't get it! Millions of dollars are spent on helping to clean up drug addicts & alcoholics, but no one helps the smokers! The helpline is a joke! Smoking is an addiction! I can't afford to pay $50-$100 for help to stop, but I can usually come up with $5 for a pack of cigarettes! Now you want to fine people for smoking! Are you kidding me? I've got drug dealers and pedophiles moving into my quiet neighborhood and no one does anything to them, but because I smoke I risk being fined!? Please take care of the real criminals first! Most of your smokers are from low to middle class incomes and can't afford the high cost of quitting. If you really want to help smokers stop smoking...come up with a way to help them that they can afford!"

Attempting to regulate smoking in cars is not, in my opinion, a good way for the tobacco control movement to begin the new year in 2007.

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