Monday, November 24, 2008

While Progress in Reducing Smoking Comes to a Halt, Anti-Smoking Groups are Pursuing More and More Draconian Policies

While preliminary data show that progress in reducing adult smoking prevalence came to a halt in 2008, anti-smoking groups continue to pursue increasingly draconian policies, including nearly complete bans on outdoor smoking and complete bans on smoking on college campuses.

In Glendale, California, the City Council enacted an ordinance - effective November 5 of this year - which bans smoking virtually everywhere outdoors in the city. The ordinance bans smoking in all non-enclosed (i.e., outdoors) public places, which are defined as an "area, location, place, site, property, lot, building, structure, facility, or complex— public or private— that is open or accessible to the general public, regardless of any fee or age requirement." Thus, virtually every outdoor area in the city is subject to the non-smoking restriction.

While the ordinance makes an exception for streets and sidewalks, the exception does not hold for places that are subject to the ban on smoking in non-enclosed public places. Thus, by my interpretation of this needlessly complicated ordinance language, one cannot smoke in any street or on any sidewalk in Glendale that is open to or accessible to the public (which would seemingly include every street and sidewalk).

While this would seemingly make Glendale's smoking ban the strictest in the nation, since it includes a provision that disallows smoking virtually anywhere outdoors in the city, the ordinance provides a convenient exception for smoking areas at shopping malls.

Meanwhile, in Bristol, Connecticut, city officials are considering a ban on smoking in outdoor areas, including streets and sidewalks.

Bristol's proposal was praised by Connecticut's Attorney General Richard Blumenthal, who was quoted in the Hartford Courant as stating: "This is an important public health goal that's on the cutting edge. The battle is really about life and survival. In Connecticut, we spend $1.6 billion to treat tobacco-related diseases. And the toll is not just in money, it's in families and lives."

The article closes by noting: "Even if such laws proliferate, smokers will still have a final refuge. Nowhere in the country is smoking banned in private homes. 'It's the notion that a person's home is their castle,' said Daniel A. Schwartz, an attorney with the Hartford firm Pullman & Comley."

Elsewhere, last Thursday marked the first day of the total ban on tobacco product use on the campus of Grand Rapids Community College in western Michigan. The ban includes all parking lots, sidewalks, streets, outdoor areas, and even vehicles parked on the campus. Administrators said the purpose of the ban was to help smokers quit and to "promote a healthier learning environment."

The Rest of the Story

The saddest part of this story is that while anti-smoking groups and advocates continue to be obsessed with banning smoking in as many places as they can - regardless of whether anyone is actually exposed significantly to secondhand smoke in those places - the nation's progress in reducing smoking prevalence among adults is coming to a halt.

And frankly, I don't think it is a coincidence. I think that anti-smoking groups have gone so far off track in misplacing their priorities and in going way too far in their policies that they have lost sight of the basic and essential elements of tobacco control - the programs and policies that we know are effective in reducing tobacco use. In addition, I think their efforts are alienating many smokers and causing them to become more resistant to anti-smoking initiatives. They are becoming "hardened" to tobacco use - if you will.

By going way too far, the anti-smoking groups also risk losing their reputation as sensible, reasonable public health groups that base their policy recommendations on solid science.

But most importantly, these groups are demonstrating a lack of consideration for the intrusion into individual autonomy that their policies represent. These are paternalistic policies without any reasonable justification. While protecting people from secondhand smoke is reasonable, trying to ban smoking everywhere so that smokers will quit is not. And arguing that banning smoking everywhere on campus is necessary to create a healthy learning environment is simply hogwash.

Unfortunately, I do not believe that Attorney Schwartz's statement that a man's home is his castle and therefore smoking bans will not spread to the private home is true any longer. I am led to believe that the anti-smoking groups will stop at nothing - even throwing away parental autonomy - in order to eliminate secondhand smoke exposure. A number of groups have already expressed public support for smoking bans in the home, including bans on smoking by foster and adoptive parents. Bans on smoking by all parents are next.

Of course, the irony in this whole story is that by going overboard, the anti-smoking groups are losing sight of the real problem and the proven solutions. Draconian policies may make anti-smoking advocates feel good, and they sure punish smokers and make their lives more miserable, but they do not represent sound and effective public health policy.

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