Friday, June 23, 2006

Attempt to Control Pregnant Women's Behavior Giving Tobacco Control a Bad Name

In a piece published Thursday in the Orlando Sentinel and many other national and international newspapers, columnist Kathleen Parker blasts the anti-smoking movement for invading into womens' privacy by attempting to regulate smoking by pregnant women (see my earlier posts - #1 and #2 on this Arkansas initiative).

Parker takes on the anti-smoking movement in sweeping fashion, calling us jihadists who, not satisfied with banning smoking in workplaces, are now crusading into people's cars, homes, and even into the womb:

"First they came for the workplace, then for people's homes and cars, and then the great outdoors. Now the anti-tobacco jihadists, having helped ban smoking in most public and many private places, have turned their attention to the most private space of all -- the womb. That very personal place where humans incubate could be the next battlefield between smokers and those who have never uttered the words: 'It's none of my beeswax.' This latest brainstorm comes from Arkansas, where Rep. Bob Mathis successfully shepherded legislation making it unlawful to smoke in cars in which small children are passengers. Apparently not satisfied with saving the recently born, Mathis wondered whether it would be constitutional to prohibit mothers from smoking while pregnant. Studies show, after all, that fetuses are at risk for low birth weight if their mothers smoke while pregnant. ...

Already Banzhaf is setting his sights on fetal rights related to their smoking mums. While it is legally defensible to abort a fetus up until moments before birth, it is apparently inconceivable that a woman would expose her unborn child to the harmful effects of smoking. While you're struggling to wrap your mind around that nonsensical nugget, Banzhaf is already issuing press releases. In a recent one from the organization he heads, Action on Smoking and Health, Banzhaf predicts that prohibiting smoking by pregnant women would pass constitutional muster. ... Certainly life offers enough problems to keep government regulators and litigators indefinitely occupied, but one has to ask: Are smoking mothers worthy of our censure? What about pregnant women who drink? Or who refuse to take their vitamins? Or who listen to hip-hop when studies show that Bach makes you smarter? 'Sorry lady, but you're under arrest for dereliction of maternity duty.'"

Parker argues that we should not coerce people, through the arm of the law, to make wise decisions regarding personal health behaviors: "No one's suggesting that pregnant women should smoke, or drink, or pole-dance -- or whatever tempts the masses these days. But people have a right to be stupid, to make bad decisions, to marry the wrong guy, to eat the wrong foods and, alas, to elect the wrong people to public office."

She also notes that if one argues that legislating women's behavior during pregnancy is not being done in a paternalistic fashion, but to protect another human life (that of the fetus), then ASH is actually supporting the ultimate intrusion into womens' privacy - outlawing abortion: "In a final bit of irony, the move to prohibit smoking while pregnant would seem to lend strength to the argument that a fetus is a human being entitled to all the rights and privileges accorded personhood. Instead, it merely strengthens the case that government has no business regulating a woman's womb. Or any other body part."

The Rest of the Story

This story demonstrates how anti-smoking groups like ASH, through their fanaticism, are harming the credibility and reputation of the entire tobacco control movement. These groups' efforts are legitimizing opponents' claims that we are indeed fanatical, overzealous crusaders rather than reasonable, evidence-based public health practitioners.

Often in the past, when I've seen columnists using this type of jargon about the anti-smoking movement (i.e., calling us extremists), it has been clear that the writer simply failed to appreciate what I saw as legitimate public health concerns. However, I have to admit that here, Parker seems to be quite on target with her commentary, and she in fact makes many of the same arguments that I offered in my own commentary in which I myself took issue with the initiative, supported by the anti-smoking movement, to ban smoking during pregnancy.

In their zeal to punish smokers and make their lives miserable, ASH and other anti-smoking groups are going to take all of us tobacco control practitioners down with them. Because no anti-smoking group is, or will speak out against this nonsense, the entire movement will come to be seen as pushing for this extreme invasion of individual privacy and autonomy. The credibility and reputation to be tarnished will be not merely that of ASH, but of the entire tobacco control movement.

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