Tuesday, October 30, 2007

Anti-Smoking Advocate Quoted as Saying that It Doesn't Reflect Well on the Community for People to See Smokers

The tobacco prevention coordinator at the Richland County Health Department in North Dakota was quoted as saying that it doesn't reflect well on the community for people to see people smoking in that community.

According to an article in the Wahpeton Daily News (North Dakota), Richland County tobacco prevention coordinator Jason Bergstrand was at the campus of North Dakota State College of Science to promote a 100% smoke-free campus policy. Such a policy would ban smoking throughout the campus, not only indoors and in surrounding outdoors or crowded outdoors areas.

According to the article: "A timely matter continues to present itself to the North Dakota State College of Science campus. Many campuses in the state of North Dakota as well as several state universities in Minnesota have gone smoke-free or tobacco-free. Jason Bergstrand, tobacco prevention coordinator at the Richland County Health Department, presented a slideshow on campus Wednesday on the benefits of having a smoke-free or tobacco-free campus. ... Tobacco use is also the No. 1 preventable cause of death and disability in the United States. More than 430,000 die annually. "Secondhand smoke is equally dangerous," Bergstrand said. ...

"Bergstrand said more often than not, in driving by campus, students or others are standing outside smoking and 'it doesn't reflect very well on the community as a whole,' he said. Benefits of going to a tobacco-free campus include a cleaner and healthier campus, an improved social and community reputation and 'I'm almost positive you'll see a less burden to your student health service,' Bergstrand said.

"In addition, the campus would more then likely see improved student health with increased class attendance and better academic comprehension by the students. Also, because many employers are seeking workers who don't smoke, a campus that promotes no smoking would ultimately provide more marketable students to enter the workforce."

"The last of the benefits Bergstrand included, although there may be many more, was a no tobacco use policy would cause less exposure to secondhand smoke."

The Rest of the Story

If quoted correctly, what this anti-smoking advocate appears to be saying is that it doesn't reflect well on a community for people to be driving by and to see smokers.

I wonder if the same sentiment holds for people driving by and seeing fat people. Do people who are fat reflect poorly on the community as well?

Perhaps the North Dakota State College of Science could present a better front to the community if it also banned the ingestion of fatty foods and severely limited the total number of calories that could be consumed each day on campus. People driving by would be less likely to see fat people.

Seeing people using illicit drugs, having public sex, or walking around nude on campus would legitimately reflect poorly on the community (although it might increase applications to the college). But there is a major difference between public sex, drug use, and nudity on the one hand and smoking on the other. The former are seen as violating well-established public morals. It is viewed as a moral affront for people to be engaging in illicit drug use, sex, or nudity in public.

So what Bergstrand is actually saying here is that he sees smoking in public not as a health issue, but as a moral issue. Smoking in public is a moral affront to the community.

This is why it seems offensive to most of us to hear someone suggest that fat people don't reflect well on a community. Because such a statement gives moral value, not just health value, to being thin or "normal" weight. Most of us do not believe that weight carries with it any moral value. Decisions about not exercising or eating lots of high-fat foods may not be healthy; but as of yet, they are not viewed as immoral. These decisions may be poor for your health, but they are not viewed as violating community morals.

Not so, apparently, with smoking. The issue here seems clearly to be more than merely the health consequences of smoking. It is all about the moral value of not smoking. Smoking carries with it a lack of moral value. The decision to smoke is not only an unhealthy one, it is also viewed as immoral. Such a decision is not only bad for your health, but it is also viewed as violating community morals.

This is where I must jump in and vehemently take issue with the statement and perspective illustrated by that statement. Smoking is a health behavior decision -- just like not exercising, eating poorly, or not putting on sunscreen. It is not a moral issue.

To suggest otherwise is not only foolish; it is also dangerous. We do not want society to start making moral judgments based on people's lawful health behavior decisions. It will lead down the road to discrimination and intolerance.

Another part of this story that is problematic is the assertion that secondhand smoke exposure is "equally dangerous" as active smoking. There is no need to exaggerate the health effects of secondhand smoke (or downplay the health effects of active smoking, whichever you want to call it) in order to promote all-out smoking bans on college campuses.

On second thought, it is necessary to exaggerate the effects of secondhand smoke, because we all know that the effects of momentary exposures as one might encounter with a policy that restricts smoking to certain designated outdoors locations away from buildings and crowded areas are just not substantial enough to justify an all-out outdoors smoking ban. So it is no wonder that this anti-smoking advocate has to exaggerate the scientific evidence and suggest that secondhand smoke is as dangerous as active smoking.

As far as making students more marketable to enter the workforce, I would ask: "How does whether a person smokes outdoors on campus affect his or her employability?" While it is unfortunately becoming true that smoking is a factor in employment decisions, the consideration is whether or not someone smokes, not whether or not they smoke in remote outdoors locations while on a college campus.

As far as the argument that complete smoking bans will cause smokers to quit, I would first of all say that I'm not sure that is the case. These extreme policies could just as well make smokers angry and feel persecuted and not tolerated and therefore cause them to smoke more (albeit not on campus). However, even if true, this is an example of unjustified paternalism.

You don't ban smoking in order to force smokers to quit. You ban smoking in order to protect nonsmokers from exposure to secondhand smoke. If you are willing to do the former, then there is no reason not to also ban the consumption of fatty foods on campus and to limit the overall intake of calories while on campus.

Interestingly, protecting people from secondhand smoke was the last of the benefits listed by the anti-smoking advocate supporting this policy. However, it really is the only benefit that would justify the policy. And in this particular case, one would need to make the case that a ban on smoking in all indoor areas, outdoor areas near buildings, and outdoor areas which are crowded or where people congregate is not enough to protect nonsmokers from significant secondhand smoke exposure.

I don't think one can compellingly make that argument. Which I guess is all the more reason to rely upon exaggerating the science beyond recognition, calling on intrusive paternalism, and making the anti-smoking movement into an all-out moral crusade.

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