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Stub it out

South China Morning Post – 17 Nov. 2011

Peter Singer says the addictive nature of tobacco foils efforts to educate against it, and stronger regulation of the drug is the only way to save lives

US President Barack Obama’s doctor confirmed last month that the president no longer smokes. At the urging of his wife, Michelle, the president resolved to stop smoking in 2006, and has used nicotine replacement therapy to help him. If it took Obama, a man strong-willed enough to achieve the US presidency, five years to kick the habit, it is not surprising that hundreds of millions of smokers find themselves unable to quit.

Worldwide, the number of cigarettes sold – six trillion a year – is at an all-time high. Six million people die each year from smoking – more than from Aids, malaria and traffic accidents combined. Of the 1.3 billion Chinese, more than one in 10 will die from smoking.

Earlier this month, the US Food and Drug Administration announced it would spend US$600 million over five years to educate the public about the dangers of tobacco use. But Robert Proctor of Stanford University argues that using education as one’s only weapon against a highly addictive and often lethal drug is unforgivably insufficient.

“Tobacco control policy,” Proctor says, “too often centres on educating the public, when it should be focused on fixing or eliminating the product.” He points out that we don’t just educate parents to keep toys with lead-based paints away from their children; we ban the use of lead-based paint.

Proctor calls on the FDA to use its new powers to regulate the contents of cigarette smoke to do two things. First, because cigarettes are designed to create and maintain addiction, the FDA should limit the amount of nicotine they contain to a level at which they would cease to be addictive. Smokers who want to quit would then find it easier to do so.

Second, the FDA should bear history in mind. The first smokers did not inhale tobacco smoke; that became possible only in the 19th century, when a new way of curing tobacco made the smoke less alkaline. The FDA should therefore require that cigarette smoke be more alkaline, which would make it less easily inhaled, and so make it harder for cigarette smoke to reach the lungs.

As Proctor says, cigarettes, not guns or bombs, are the deadliest artefacts in the history of civilisation. If we want to save lives and improve health, nothing else that is readily achievable would be as effective as an international ban on the sale of cigarettes.

Some argue that as long as a drug harms only those who choose to use it, the state should let individuals make their own decisions. But tobacco is not such a drug, given the dangers posed by second-hand smoke. Even setting aside the harm that smokers inflict on non-smokers, the free-to-choose argument is unconvincing with a drug as highly addictive as tobacco, and it becomes even more dubious when we consider that most smokers take up the habit as teenagers and later want to quit.

The other argument for the status quo is that prohibiting the sale of tobacco would funnel billions of dollars into organised crime and fuel corruption in law enforcement agencies, while doing little to reduce smoking.

But that may well be a false comparison. After all, many smokers would actually like to see cigarettes banned because, like Obama, they want to quit.

Peter Singer is a professor of bioethics at Princeton University and Laureate Professor at the University of Melbourne. Copyright: Project Syndicate

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