Thursday, May 04, 2006

IN MY VIEW: Anti-Smoking Movement on One Way Street Towards Promoting Prohibition

I don't exactly understand why the agenda of the anti-smoking movement in 2006 is so different than what it has been in the past. In the past, the focus of the movement has been on clean indoor air laws, smoking prevention and education programs, media campaigns, and increasing cigarette taxes to support comprehensive tobacco control programs. But today, a significant portion of the anti-smoking agenda is devoted to advocating for banning smoking everywhere outdoors, banning smoking in cars and homes with children present, refusing employment to smokers, making smoking an issue in custody disputes, and attempting to criminalize smoking around other people.

As I have documented in the past few weeks, mainstream anti-smoking groups are supporting each of these interventions. The barrier that used to keep the home protected from our attempts to regulate where smokers could and could not smoke has clearly been eroded. We have gone from the workplace to the great outdoors and now even into the privacy of people's cars and homes.

Not only is the agenda changing, but the science that is supposed to be driving the movement is running amok. We are seriously claiming that banning smoking in restaurants in a town will reduce heart attacks by 40%. We are trying to convince the public that 30 minutes of secondhand smoke exposure increases their risk of heart disease to the level of active smoking. We are publicly claiming that even 5 minutes of exposure causes arteries to start to close off.

The combination of these two trends in the movement makes for an imminent disaster. After all, if we are already on a path where we are looking for ways to punish smokers, if we are already on a path where we are willing to tell people what health behaviors they must practice in their own homes, and if we now think that we have evidence that only 5 minutes of secondhand smoke exposure is a serious risk for causing catastrophic health effects, then there can hardly be a reason to allow smoking at all and our advocating for prohibition must be just around the corner.

It hasn't escaped my attention that the location and timing of the push to make smoking around children a criminal offense was in Washington State, right after the passage of a 100% workplace smoking ban. And that ASH's advocacy for banning smoking nearly everywhere, including in homes and cars in some situations, comes right when the trend of state enactment of workplace smoking bans seems to have been established.

In other words, it certainly has the appearance to me that anti-smoking groups are looking for a new item for the agenda. There is a perception that we have succeeded in advocating for no smoking in workplaces, so now we must move on to the next frontier. And then to the next. We're like pioneers who must constantly push the frontier westward simply because it's there. Nothing can stop us.

The reason I have obtained the impression that we're on this street to prohibition is not simply the changing agenda of the anti-smoking movement. Even more so, it's the reception that I have received to my (what I consider modest) suggestions that perhaps we shouldn't bar smokers from employment, ban smoking everywhere outdoors, ban smoking in cars, ban smoking in homes, and consider smoking around children to be a form of child abuse.

The overwhelming response has been one of condemnation from within the tobacco control movement. I have been accused of being a traitor, censored from expressing my opinions, and told repeatedly that I am supporting the tobacco industry.

This is what scares me much more than the agenda itself. Because what it suggests to me is that I represent a threat to that agenda. The fact that colleagues have reacted in this way suggests that they are actually afraid that I am threatening the agenda. And this means that they really must support this agenda. The fact that they are willing to use such tactics to suppress the expression of dissent means that the agenda has taken on a life of its own. The agenda is now the ends itself, not the means to achieve some reasonable public health goals.

What this also means is that there are no longer any checks and balances in the anti-smoking movement. Dissent is met with censorship or ostracism; thus, there is no room for serious challenge to the proclaimed anti-smoking agenda. There is no turning back because if you dare suggest that we're on the wrong road, you will be attacked as being on the other team. It becomes a self-fulfilling progression towards the most extreme goals of those within the movement.

I'll be honest. I would actually have a lot more respect for anti-smoking groups that are pushing this agenda if they simply admitted that they can't stand smokers and that they simply want to get rid of them, and that they are ultimately pursuing a strategy of prohibition. I'm not saying that I would support such a goal, but at least the groups would be forthright, rather than pursuing prohibition through the back door. I can respect groups that take a strong, even extreme stand, if they are willing to simply stand up and make their goals and rationale clear. But pushing a prohibitionist agenda in the name of other goals (e.g., saving employers money) is disingenuous and somewhat cowardly.

I'll also be honest about something else. When I used to hear smokers' rights groups claim that the anti-smoking movement was really about prohibition, I thought it was complete crap. But within the past few months, I'm starting to see that there is an element of truth to those claims. There is a faction within the tobacco control movement that I believe is motivated primarily by a hate for smokers and nothing short of prohibition will ever satisfy this element. But since anyone who suggests that perhaps we're going down the wrong path will be censored or attacked, this element will never truly be challenged. And most scary, this element now seems to be the driving force, or a major driving force, within the movement. I think, therefore, that it is not inaccurate to state that the anti-smoking movement is now on a path towards advocating prohibition. As such, the anti-smoking movement is leaving the realm of public health and becoming more of a crusade. I think we need to turn back now before it's too late.

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