Friday, June 27, 2008

Action on Smoking and Health Suggests Banning Smoking in All Homes

For the first time, to the best of my knowledge, an anti-smoking group has publicly and officially called for a ban on smoking in all homes, suggesting that this is the next front in the war against smoking.

In a press release issued on Wednesday, Action on Smoking and Health (ASH) - a Washington, D.C.-based national anti-smoking group - called banning smoking in homes the next front in the war on smoking and cited a new survey showing that a majority of people in Ireland expressed support for a total ban on smoking in homes and cars.

According to the press release: "A clear majority wants smoking banned in all homes, even if children are not present, and even if the smoke is not drifting into an adjoining dwelling. This could expand the latest front in the war to protect nonsmokers, says the man who started the nonsmokers' movement by getting smoking first restricted and then banned on airplanes and then in workplaces and public places, and who is racking up victories in the battle to ban smoking in private dwellings and cars. According to a new survey, 57% of the people in Ireland support a ban on smoking in all homes and cars."

"This could indicate growing support for smoking bans both here and abroad, says public interest law professor John Banzhaf of Action on Smoking and Health (ASH) -- America's first antismoking organization, and the group behind restrictions on smoking in homes in almost three fourths of the states -- because the percentage of smokers in Ireland is substantially higher than in the US." ...

"'As politicians in many states continue to debate whether to ban smoking in restaurants, bars, casinos, and other public places, it looks like legislators are once again far behind the growing public sentiment for smoking bans, and also far behind how far judges and regulatory agencies are willing to go,' says Banzhaf. ... Since restrictions of smoking are one of the most effective -- and virtually the least expensive -- way to help smokers quit, it is no surprise that there is growing support for smoking restrictions, even if no nonsmokers' health is being put at risk by the smoking, suggests Banzhaf."

The Rest of the Story

This is an important story and perhaps a sentinel moment in the history of the tobacco control movement because to the best of my knowledge, this is the first time that an anti-smoking group has publicly and officially called for a ban on smoking in all homes and suggested that this is the next front in the war against smoking.

This is a troubling development for many reasons. For one, banning smoking in homes for the purpose of protecting children from secondhand smoke exposure is an appallingly bad place to be in terms of public health policy. It represents an undue invasion of privacy and as well as an unwarranted interference with parental autonomy to make their own decisions regarding health risks to which their children are or are not exposed.

Banning smoking in homes to protect children would be qualitatively no different from prohibiting parents from taking their kids to fast food restaurants, feeding them food containing trans-fats, allowing them to engage in risky activities like ice hockey or football, allowing them to watch violence-ridden movies and play violence-ridden video games, letting them go to R-rated movies, and not forcing them to get enough physical activity.

Clearly, these other behaviors are not ones which society would choose to regulate. Smoking in the home is qualitatively the same. If one supports a ban on smoking in the home in order to protect children's health, then the same reasoning would lead to support for a ban on each of these other parental behaviors, which would clearly be unacceptable.

Second, banning smoking in homes in order to reduce smoking is even less acceptable. That would be a complete invasion of privacy and autonomy. It would represent completely unenlightened paternalism. Public health practitioners need to remember that there are other important values that need to be preserved in society beyond merely getting people to stop smoking. We also need to make sure that our interventions respect individual autonomy, freedom, and privacy. Banning smoking in homes to reduce smoking rates violates all three of these principles.

What scares me most about ASH's latest pronouncement is not merely ASH's support for this policy. I don't think that ASH's support alone would be enough to convince policy makers to enact such policies. However, what scares me the most is that if no other anti-smoking groups speak out publicly to reject ASH's statement, this will become the de facto policy position of the tobacco control movement. And because, as I have learned, dissent is not allowed in tobacco control and you cannot criticize another group in the movement, I fear that no anti-smoking groups will speak out to condemn ASH's support for banning smoking in homes.

I must also say that ASH is making the pronouncements of smoking ban opponents look good. Many years ago, when I was lobbying for smoke-free workplace laws, opponents of these laws argued that this was just the first step: workplaces were the first step and eventually we [the antis] would be trying to get smoking banned in the home. I countered these arguments by stating no - you're wrong - we are going to stop after getting smoking banned in the workplace. Unfortunately, it looks like I was wrong and the smoking ban opponents were correct. Thanks to ASH, all those smoking ban opponents can now say "I told you so."

Why would ASH make a public statement like this? Wouldn't ASH recognize that by doing this, it paints all anti-smoking advocates and groups as being complete fanatics whose ultimate goal is to ban smoking everywhere, even inside the home? Doesn't ASH recognize that its action is going to give smoking ban opponents great ammunition in their fight to oppose these ordinances - that they can now point to ASH's press release as evidence that the ultimate goal of the tobacco control movement is indeed to ban smoking everywhere, including the home?

This action by ASH puts a significant dent in the legitimacy of not only the tobacco control movement, but of public health in general. The only way to prevent damage from occurring would be if the public merely views ASH as a fanatic group that has gone off the deep end. But that will not happen unless other anti-smoking groups are willing to publicly condemn ASH's support for banning smoking in the home. As I don't see that happening due to the poisonous groupthink mentality in the tobacco control movement, I fear that ASH's action will damage the legitimacy of tobacco control.

Finally, I must note that it strikes me that ASH's actions appear to be motivated by something more than simply a concern for the health of smokers. Instead, I get the distinct impression that ASH is acting, at least in part, out of pure hatred for smokers and a desire to punish them. It seems to me like one can feel the hatred oozing out of the press release and that ASH is trying to punish smokers in any way it can find - no matter how much damage that might cause to the children of those smokers or to societal values like privacy and autonomy.

ASH seems to think that it is more important for kids to be protected from even the smell of tobacco smoke on a parent's clothing than for those kids to have a parent to be with in the first place. ASH's priorities are completely out of whack. And unless other anti-smoking groups speak out now, so will - by default - the priorities of the tobacco control movement. In some sense, we are only as strong as our weakest link. By pushing for home smoking bans, ASH is unfortunately painting the entire tobacco control movement as fanatics whose ultimate goal is to ban smoking everywhere. We can't prevent the movement from being successfully painted in that way unless we speak out and distance ourself from that paint brush.

(Thanks to Gilster for the tip).

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