Monday, May 08, 2006

Anti-Smoking Advocates Calling for Judicial Intervention into Parental Smoking

In response to my post criticizing one prominent anti-smoking organization's and one prominent anti-smoking advocate's proposal to treat smoking in the presence of children in the home as a criminal offense and as a form of child abuse, several more anti-smoking advocates have called for judicial intervention for parental smoking in the home. I am deeply disturbed by this alarming turn of events in the anti-smoking movement.

One proposal that has surfaced is the idea of referring to family court parents who smoke in the presence of a child when that child suffers a health effect such as a middle ear infection (otitis media). I think this is a dangerous and unwarranted suggestion for several reasons.

First of all, it represents an invasion into individual privacy and parental autonomy. What goes on in the home is the business of the parents, except where there is severe, immediate, and inevitable damage to the physical or mental health of the child. To be sure, if a child is being physically or sexually abused, invasion into individual privacy and parental autonomy is warranted.

But a middle ear infection hardly represents severe physical damage for which we need to move into the home of the patient and invade the privacy of the home and the family. So what if a kid gets an ear infection? Kids get ear infections all the time. I don't mean so what in the sense that we shouldn't do what we can to prevent the ear infections through non-invasive means. But an ear infection doesn't justify intruding into the home.

More important is the real and severe threat to the child's well-being that comes from the potential threat of being removed from a parent or having the parent removed from the child. Once you enter the family court system, the ultimate remedy is, in fact, separation of the parent from the child (either placement of the child in foster care or placement of the parent in jail for violating court orders).

Some have argued that they are not calling for removal of children from the offending parent, just for court sanctions, such as an order that the parent cannot smoke in the child's presence. But a court sanction means nothing if there is no possible enforcement behind it. It's basically a slap on the wrist which will be ignored if the defendant's lawyer informs him that he need not worry about any repercussions for violating the court order.

Obviously, violation of the court order is going to be a punishable offense, and the ultimate punishment is jail time. In other words, what advocates are ultimately calling for is the separation of the parent and the child. Alternatively, repeated violation of court orders might result in placement of the child in foster care. There is already enough of a shortage of foster parents. Do we really need to overburden the system by adding to it all the kids whose parents smoke around them and who might have suffered an ear infection?

Not to mention the fact that family courts have enough severe problems to deal with that they don't need to be overwhelmed by parents being brought in for smoking around their children. Do we really want to divert the already overburdened system from being able to properly attend to the severe problems of sexual and physical abuse of children and parental neglect that are plaguing so many children and families?

Worst of all is the severe damage that is done to a child when that child is separated from the parent, whether it be because of removal from the home or from the parent serving jail time. I know from personal observation the toll that it takes on a child even when a parent serves a limited amount of jail time.

Yet another intractable problem is that not every ear infection in a child exposed to secondhand smoke is due to the secondhand smoke exposure. There are lots of causes of ear infections and it is not usually possible to definitively conclude that a child's ear infection was caused by the parent smoking around her. Treating all cases of ear infections among children whose parents smoke in the home as a form of abuse or referring all such cases to the court system would be an abuse of justice for those parents.

But perhaps the most disturbing aspect of this story is that we are supposedly doing this in order to "protect the children." How exactly does it protect a child to yank them out of the home and into foster care? How does it protect a child to throw their parent in jail for smoking? Our movement is on the verge of breaking up families and destroying the lives of children in the name of protecting them. It shows how deranged our thinking as become because of its narrow and single-minded focus.

Is this what the anti-smoking movement is really coming to? Is this really what we want to do with our time and resources? Do we really want to be part of this? Do we want to be contributing to the separation of parents from their children, and to the separation of children from their parents? Do we have this little respect for people's privacy and for the autonomy of parents?

This issue is particularly disturbing to me because I cannot with a clean conscience watch this happen in my own movement. I am a part of the movement and it pains me to see the danger to the well-being of children that is now arising from that movement. Now, not only do I need to do what I am doing in tobacco control, but now on top of all that I need to devote time to try to prevent our movement from destroying childrens' lives by breaking up families.

And what this issue comes down to is nothing less than that: destroying the lives of children.

I am the first to say that childrens' exposure to secondhand smoke is a terrible thing, but it is not so terrible that we need to destroy those childrens' lives in order to eliminate the exposure.

Talk about having blinders on and not being able to see the forest for the trees. Are we so narrowly focused on eliminating secondhand smoke exposure and punishing smokers for exposing others that we are willing to trash childrens' relationships with their parents to allegedly "protect" those children?

If the situation is so dire that secondhand smoke exposure among children is so devastatingly hazardous that we have to resort to separating parents and children, then it is time to simply prohibit the sale of cigarettes. Of course, I don't think the situation is that dire.

There are many things that we can and should be doing to address the problem of childrens' exposure to secondhand smoke in the home. We should be educating parents about the potential hazards posed by secondhand smoke exposure. We should be implementing interventions to try to reduce smoking and to convince smokers who do not wish to quit or who are unable to do so not to smoke in the presence of children. We should be promoting the allocation of resources to support and provide services that will help smoking parents to quit. But making those parents criminals, putting them into the family court system, and threatening them with jail time or the removal of their children is disgusting and disgraceful.

More than that, it is sabotaging the tobacco control movement. When the public becomes aware that this is what we are pushing for (as they quickly are), they are going to view us as being complete fanatics and crusading zealots (and rightly so if this is what we are pushing) and we are going to completely lose our credibility and destroy our reputation.

And to be honest, if we're serious about this then we should.

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