Friday, May 05, 2006

IN MY VIEW: On the Entrance of Classism into the Anti-Smoking Movement

This week, I have highlighted (post 1; post 2) the efforts of some anti-smoking groups and advocates to criminalize smoking in private homes, since they apparently consider this to be a form of child abuse. Here, I argue that this aspect of the anti-smoking agenda has now introduced classism into the movement.

The Rest of the Story

The apparent attempt by at least some anti-smoking groups and advocates to intervene in the home and coerce parents to adopt a certain health behavior (not smoking around their kids), in the absence of evidence that this behavior necessarily leads to severe and immediate harm, is not only troubling because of its implications for parental autonomy and individual privacy rights, but also because it represents prejudice and discrimination based on social class.

Essentially, what such a policy says is that we as the more privileged, better educated class of citizens (nonsmokers) are going to tell a less privileged and less educated class of citizens (smokers) how to live their lives and how to raise their children within the privacy of their own homes.

Education is the strongest predictor of smoking status. So intervening to regulate smoking in the home is essentially an intervention that is going to punish less educated and less well off people for engaging in an unhealthy behavior. But because this is an isolated call for intrusion into the home (we are not calling for regulation of other health behaviors on the part of parents that affect their children), it has the appearance of being a class issue, rather than a true public health issue.

I don't see anyone calling for fines on parents who feed their children steak four nights a week, even though this is arguably doing health damage and increasing their risk for a number of chronic diseases. I don't see a call for criminalization of parents who don't put enough sunscreen on their children when they send them out to the country club swimming pool for the afternoon.

If anti-smoking groups really want to do something to help children who are exposed to secondhand smoke in the home, then how about offering free smoking cessation services to parents who want to quit smoking? How about using cigarette taxes to help these smokers, to benefit them directly, rather than call for taxes on smokers to fund completely unrelated programs that do not benefit the people who need the resources the most?

Classifying smoking around kids as child abuse, criminalizing this behavior, or outlawing it does nothing to address the social class disparities inherent in the public health problem of smoking. In fact, it exacerbates the very problem that we should be aiming to solve.

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