smoking should be illegal essay

Tobacco Smoking Trend in Australia Words: 1590
Cigarette Smoking Cessation Methods Words: 925
Why Should Smoking Be Illegal? Words: 1679
Discussion: Smoking and Health Risks Words: 1240
Harmful Effects of Smoking: Why to Quit Smoking? Words: 1920
Smoking Should Be Banned in Public Places Words: 952
Problems of Smoking in Public Places Words: 1318
Ban on Smoking in the Workplace Words: 1310
Is Smoking Cigarettes Just for Fun or a Death Sentence? Words: 883
Smoking-Related Harmful Health Effects Words: 1920

Should Smoking Be Illegal?

Should smoking be banned? What are the pros and cons of banning cigarettes in public places? If you’re writing an argumentative essay or persuasive speech on why smoking should be banned, check out this sample.

Smoking Should Be Banned: Essay Introduction

Reasons why smoking should be banned, why smoking should not be banned: essay arguments, why smoking should be banned essay conclusion.

Smoking involves burning a substance to take in its smoke into the lungs. These substances are commonly tobacco or cannabis. Combustion releases the active substances in them, like nicotine, which are absorbed through the lungs.

A widespread technique through which this is done is via smoking manufactured cigarettes or hand-rolling the tobacco ready for smoking. Almost 1 billion people in the majority of all human societies practice smoking. Complications directly associated with smoking claim the lives of half of all the persons involved in smoking tobacco or marijuana for a long time.

Smoking is an addiction because tobacco contains nicotine, which is very addictive. The nicotine makes it difficult for a smoker to quit. Therefore, a person will become used to nicotine such that he/she has to smoke to feel normal. Consequently, I think smoking should be banned for some reason.

One reason why smoking should be banned is that it has got several health effects. It harms almost every organ of the body. Cigarette smoking causes 87% of lung cancer deaths and is also responsible for many other cancer and health problems. 

Apart from this, infant deaths that occur in pregnant women are attributed to smoking. Similarly, people who stay near smokers become secondary smokers, who may breathe in the smoke and get the same health problems as smokers. Although not widely smoked, cannabis also has health problems, and withdrawal symptoms include depression, insomnia, frustration, anger, anxiety, concentration difficulties, and restlessness.

Besides causing emphysema, smoking also affects the digestive organs and the blood circulatory systems, especially heart arteries. Women have a higher risk of heart attack than men, exacerbating with time as one smokes. Smoking also affects the mouth, whereby the teeth become discolored, the lips blacken and always stay dry, and the breath smells bad.

Cigarette and tobacco products are costly. People who smoke are therefore forced to spend their money on these products, which badly wastes the income they would have otherwise spent on other things. Therefore, I think that smoking should be forbidden to reduce the costs of treating diseases related to smoking and the number of deaths caused by smoking-related illnesses.

However, tobacco and cigarette manufacturing nations would lose a lot if smoking was to be banned. I, therefore, think that it should not be banned. Some nations largely depend on exporting cigarettes and tobacco products to get revenue.

This revenue typically boosts the economy of such nations. If smoking were banned, they would incur significant losses since tobacco companies are multi-billion organizations. Apart from these, millions of people will be jobless due to the ban.

The process by which tobacco and cigarette products reach consumers is very complex, and it involves a chain process with several people involved in it. Banning smoking, therefore, means these people will lose their jobs, which most may depend on for their livelihoods.

In conclusion, the ban on smoking is a tough step to be undertaken, especially when the number of worldwide users is billions. Although it burdens nations enormously in treating smoking-related diseases, it may take a long time before a ban can work. Attempts by some nations to do this have often been met with failures.

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Home — Essay Samples — Nursing & Health — Nursing — Argumentative Essay On Smoking Cigarettes

Argumentative Essay on Smoking Cigarettes

Categories: Nursing

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Words: 507 |

Published: Mar 13, 2024

Words: 507 | Page: 1 | 3 min read

Health effects of smoking, economic implications, impact on non-smokers, the case for regulation, references:.

Centers for Disease Control and Prevention. (2020). Smoking & Tobacco Use. Retrieved from https://www.cdc.gov/tobacco/data_statistics/index.htm

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Essay on Smoking

500 words essay on smoking.

One of the most common problems we are facing in today’s world which is killing people is smoking. A lot of people pick up this habit because of stress , personal issues and more. In fact, some even begin showing it off. When someone smokes a cigarette, they not only hurt themselves but everyone around them. It has many ill-effects on the human body which we will go through in the essay on smoking.

Ill-Effects of Smoking

Tobacco can have a disastrous impact on our health. Nonetheless, people consume it daily for a long period of time till it’s too late. Nearly one billion people in the whole world smoke. It is a shocking figure as that 1 billion puts millions of people at risk along with themselves.

Cigarettes have a major impact on the lungs. Around a third of all cancer cases happen due to smoking. For instance, it can affect breathing and causes shortness of breath and coughing. Further, it also increases the risk of respiratory tract infection which ultimately reduces the quality of life.

In addition to these serious health consequences, smoking impacts the well-being of a person as well. It alters the sense of smell and taste. Further, it also reduces the ability to perform physical exercises.

It also hampers your physical appearances like giving yellow teeth and aged skin. You also get a greater risk of depression or anxiety . Smoking also affects our relationship with our family, friends and colleagues.

Most importantly, it is also an expensive habit. In other words, it entails heavy financial costs. Even though some people don’t have money to get by, they waste it on cigarettes because of their addiction.

How to Quit Smoking?

There are many ways through which one can quit smoking. The first one is preparing for the day when you will quit. It is not easy to quit a habit abruptly, so set a date to give yourself time to prepare mentally.

Further, you can also use NRTs for your nicotine dependence. They can reduce your craving and withdrawal symptoms. NRTs like skin patches, chewing gums, lozenges, nasal spray and inhalers can help greatly.

Moreover, you can also consider non-nicotine medications. They require a prescription so it is essential to talk to your doctor to get access to it. Most importantly, seek behavioural support. To tackle your dependence on nicotine, it is essential to get counselling services, self-materials or more to get through this phase.

One can also try alternative therapies if they want to try them. There is no harm in trying as long as you are determined to quit smoking. For instance, filters, smoking deterrents, e-cigarettes, acupuncture, cold laser therapy, yoga and more can work for some people.

Always remember that you cannot quit smoking instantly as it will be bad for you as well. Try cutting down on it and then slowly and steadily give it up altogether.

Get the huge list of more than 500 Essay Topics and Ideas

Conclusion of the Essay on Smoking

Thus, if anyone is a slave to cigarettes, it is essential for them to understand that it is never too late to stop smoking. With the help and a good action plan, anyone can quit it for good. Moreover, the benefits will be evident within a few days of quitting.

FAQ of Essay on Smoking

Question 1: What are the effects of smoking?

Answer 1: Smoking has major effects like cancer, heart disease, stroke, lung diseases, diabetes, and more. It also increases the risk for tuberculosis, certain eye diseases, and problems with the immune system .

Question 2: Why should we avoid smoking?

Answer 2: We must avoid smoking as it can lengthen your life expectancy. Moreover, by not smoking, you decrease your risk of disease which includes lung cancer, throat cancer, heart disease, high blood pressure, and more.

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The cigarette is the deadliest artefact in the history of human civilisation. Most of the richer countries of the globe, however, are making progress in reducing both smoking rates and overall consumption. Many different methods have been proposed to steepen this downward slope, including increased taxation, bans on advertising, promotion of cessation, and expansion of smoke-free spaces. One option that deserves more attention is the enactment of local or national bans on the sale of cigarettes. There are precedents: 15 US states enacted bans on the sale of cigarettes from 1890 to 1927, for instance, and such laws are still fully within the power of local communities and state governments. Apart from reducing human suffering, abolishing the sale of cigarettes would result in savings in the realm of healthcare costs, increased labour productivity, lessened harms from fires, reduced consumption of scarce physical resources, and a smaller global carbon footprint. Abolition would also put a halt to one of the principal sources of corruption in modern civilisation, and would effectively eliminate one of the historical forces behind global warming denial and environmental obfuscation. The primary reason for abolition, however, is that smokers themselves dislike the fact they smoke. Smoking is not a recreational drug, and abolishing cigarettes would therefore enlarge rather than restrict human liberties. Abolition would also help cigarette makers fulfil their repeated promises to ‘cease production’ if cigarettes were ever found to be causing harm.

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Six reasons to ban

The cigarette is the deadliest object in the history of human civilisation. Cigarettes kill about 6 million people every year, a number that will grow before it shrinks. Smoking in the twentieth century killed only 100 million people, whereas a billion could perish in our century unless we reverse course. 1 Even if present rates of consumption drop steadily to zero by 2100, we will still have about 300 million tobacco deaths this century.

The cigarette is also a defective product, meaning not just dangerous but unreasonably dangerous, killing half its long-term users. And addictive by design. It is fully within the power of the Food and Drug Administration in the US, for instance, to require that the nicotine in cigarettes be reduced to subcompensable, subaddictive levels. 2 , 3 This is not hard from a manufacturing point of view: the nicotine alkaloid is water soluble, and denicotinised cigarettes were already being made in the 19th century. 4 Philip Morris in the 1980s set up an entire factory to make its Next brand cigarettes, using supercritical fluid extraction techniques to achieve a 97% reduction in nicotine content, which is what would be required for a 0.1% nicotine cigarette, down from present values of about 2%. 5 Keep in mind that we're talking about nicotine content in the rod as opposed to deliveries measured by the ‘FTC method’, which cannot capture how people actually smoke. 5

Cigarettes are also defective because they have been engineered to produce an inhalable smoke. Tobacco smoke was rarely inhaled prior to the nineteenth century; it was too harsh, too alkaline. Smoke first became inhalable with the invention of flue curing , a technique by which the tobacco leaf is heated during fermentation, preserving the sugars naturally present in the unprocessed leaf. Sugars when they burn produce acids, which lower the pH of the resulting smoke, making it less harsh, more inhalable. There is a certain irony here, since these ‘milder’ cigarettes were actually far more deadly, allowing smoke to be drawn deep into the lungs. The world's present epidemic of lung cancer is almost entirely due to the use of low pH flue-cured tobacco in cigarettes, an industry-wide practice that could be reversed at any time. Regulatory agencies should mandate a significant reduction in rod-content nicotine, but they should also require that no cigarette be sold with a smoke pH lower than 8. Those two mandates alone would do more for public health than any previous law in history. 5

Death and product defect are two reasons to abolish the sale of cigarettes, but there are others. A third is the financial burden on public and private treasuries, principally from the costs of treating illnesses due to smoking. Cigarette use also results in financial losses from diminished labor productivity, and in many parts of the world makes the poor even poorer. 6

A fourth reason is that the cigarette industry is a powerful corrupting force in human civilisation. Big tobacco has corrupted science by sponsoring ‘decoy’ or ‘distraction research’, 5 but it has also corrupted popular media, insofar as newspapers and magazines dependent on tobacco advertising for revenues have been reluctant to publish critiques of cigarettes. 7 The industry has corrupted even the information environment of its own workforce, as when Philip Morris paid its insurance provider (CIGNA) to censor the health information sent to corporate employees. 8 Tobacco companies have bullied, corrupted or exploited countless other institutions: the American Medical Association, the American Law Institute, sports organisations, fire-fighting bodies, Hollywood, the US Congress—even the US presidency and US military. President Lyndon Johnson refused to endorse the 1964 Surgeon General's report, for instance, fearing alienation of the tobacco-friendly South. Cigarette makers managed even to thwart the US Navy's efforts to go smoke-free. In 1986, the Navy had announced a goal of creating a smoke-free Navy by the year 2000; tobacco-friendly congressmen were pressured to thwart that plan, and a law was passed requiring that all ships sell cigarettes and allow smoking. The result: American submarines were not smoke-free until 2011. 9

Cigarettes are also, though, a significant cause of harm to the natural environment. Cigarette manufacturing consumes scarce resources in growing, curing, rolling, flavouring, packaging, transport, advertising and legal defence, but also causes harms from massive pesticide use and deforestation. Many Manhattans of savannah woodlands are lost every year to obtain the charcoal used for flue curing. Cigarette manufacturing also produces non-trivial greenhouse gas emissions, principally from the fossil fuels used for curing and transport, fires from careless disposal of butts, and increased medical costs from maladies caused by smoking 5 (China produces 40 percent of the world's cigarettes, for example, and uses mainly coal to cure its tobacco leaf). And cigarette makers have provided substantial funding and institutional support for global climate change deniers, causing further harm. 10 Cigarettes are not sustainable in a world of global warming; indeed they are one of its overlooked and easily preventable causes.

But the sixth and most important reason for abolition is the fact that smokers themselves do not like their habit. This is a key point: smoking is not a recreational drug; most smokers do not like the fact they smoke and wish they could quit. This means that cigarettes are very different from alcohol or even marijuana. Only about 10–15% of people who drink liquor ever become alcoholics, versus addiction rates of 80% or 90% for people who smoke. 11 As an influential Canadian tobacco executive once confessed: smoking is not like drinking, it is rather like being an alcoholic. 12

The spectre of prohibition

An objection commonly raised is: Hasn't prohibition already been tried and failed? Won't this just encourage smuggling, organised crime, and yet another failed war on drugs? That has been the argument of the industry for decades; bans are ridiculed as impractical or tyrannical. (First they come for your cigarettes.…) 13

The freedom objection is weak, however, given how people actually experience addiction. Most smokers ‘enjoy’ smoking only in the sense that it relieves the pains of withdrawal; they need nicotine to feel normal. People who say they enjoy cigarettes are rather rare—so rare that the industry used to call them ‘enjoyers’. 14 Surveys show that most smokers want to quit but cannot; they also regret having started. 15 Tobacco industry executives have long grasped the point: Imperial Tobacco's Robert Bexon in 1984 confided to his Canadian cotobacconists that ‘If our product was not addictive we would not sell a cigarette next week’. 12 American cigarette makers have been quietly celebrating addiction since the 1950s, when one expressed how ‘fortunate for us’ it was that cigarettes ‘are a habit they can't break’. 16

Another objection commonly raised to any call for a ban is that this will encourage smuggling, or even organised crime. But that is rather like blaming theft on fat wallets. Smuggling is already rampant in the cigarette world, as a result of pricing disparities and the tolerance of contraband or even its encouragement by cigarette manufacturers. Luk Joossens and Rob Cunningham have shown how cigarette manufacturers have used smuggling to undermine monopolies or gain entry into new markets or evade taxation. 17 , 18 And demand for contraband should diminish, once the addicted overcome their addiction—a situation very different from prohibition of alcohol, where drinking was a more recreational drug. And of course, even a ban on the sale of cigarettes will not eliminate all smoking—nor should that be our goal, since people should still be free to grow their own for personal use. Possession should not be criminalised; the goal should only be a ban on sales. Enforcement, therefore, should be a trivial matter, as is proper in a liberal society.

Cigarette smoking itself, though, is less an expression of freedom than the robbery of it. And so long as we allow the companies to cast themselves as defenders of liberty, the table is unfairly tilted. We have to recognise that smoking compromises freedom, and that retiring cigarettes would enlarge human liberties.

Of course it could well be that product regulation, combined with taxation, denormalisation, and ‘smoke-free’ legislation, will be enough to dramatically lower or even eliminate cigarette use—over some period of decades. Here, though, I think we fail to realise how much power governments already have to act more decisively. From 1890 to 1927 the sale of cigarettes was banned virtually overnight in 15 different US states; and in Austin v. Tennessee (1900) the US Supreme Court upheld the right of states to enact such bans. 19 Those laws all eventually disappeared from industry pressure and the lure of tax revenues. 20 None was deemed unconstitutional, however, and some localities retained bans into the 1930s, just as some counties still today ban the sale of alcohol. Bhutan in 2004 became the first nation recently to ban the sale of cigarettes, and we may see other countries taking this step, especially once smoking prevalence rates start dropping into single digits.

Helping the industry fulfil its promises

One last rationale for a ban: abolition would fulfil a promise made repeatedly by the industry itself. Time and again, cigarette makers have insisted that if cigarettes were ever found to be causing harm they would stop making them:

In March 1954, George Weissman, head of marketing at Philip Morris, announced that his company would ‘stop business tomorrow’ if ‘we had any thought or knowledge that in any way we were selling a product harmful to consumers’. 21

In 1972, James C Bowling, vice president for public relations at Philip Morris, asserted publicly, and in no uncertain terms, that ‘If our product is harmful…we'll stop making it’. 22

Helmut Wakeham, vice president for research at Philip Morris, in 1976 stated publicly that ‘if the company as a whole believed that cigarettes were really harmful, we would not be in the business. We are a very moralistic company’. 23

RJ Reynolds president Gerald H Long, in a 1986 interview asserted that if he ever ‘saw or thought there were any evidence whatsoever that conclusively proved that, in some way, tobacco was harmful to people, and I believed it in my heart and my soul, then I would get out of the business’. 24

Philip Morris CEO Geoffrey Bible in 1997, when asked (under oath) what he would do with his company if cigarettes were ever found to be causing cancer, said: ‘I'd probably…shut it down instantly to get a better hold on things’. 25 Bible was asked about this in Minnesota v. Philip Morris (2 March 1998) and reaffirmed that if even one person were ever found to have died from smoking he would ‘reassess’ his duties as CEO. 26

The clearest expression of such an opinion, however, was by Lorillard's president, Curtis H Judge, in an April 1984 deposition, where he was asked why he regarded Lorillard's position on smoking and health as important: A: Because if we are marketing a product that we know causes cancer, I'd get out of the business…I wouldn't be associated with marketing a product like that. Q: Why? A: If cigarettes caused cancer, I wouldn't be involved with them…I wouldn't sell a product that caused cancer. Q: …Because you don't want to kill people? … Is that the reason? A: Yes. Q: …If it was proven to you that cigarette smoking caused lung cancer, do you think cigarettes should be marketed? A: No…No one should sell a product that is a proven cause of lung cancer. 27

Note that these are all public assurances , including several made under oath. All follow a script drawn up by the industry's public relations advisors during the earliest stages of the conspiracy: On 14 December 1953, Hill and Knowlton had proposed to RJ Reynolds that the cigarette maker reassure the public that it ‘would never market a product which is in any way harmful’. Reynolds was also advised to make it clear that If the Company felt that its product were now causing cancer or any other disease, it would immediately cease production of it. 28 To this recommendation was added ‘Until such time as these charges or irresponsible statements are ever proven, the Company will continue to produce and market cigarettes’.

What is remarkable is that we never find the companies saying privately that they would stop making cigarettes—with two significant exceptions. In August 1947, in an internal document outlining plans to study ‘vascular and cardiac effects’ of smoking, Philip Morris's director of research, Willard Greenwald, made precisely this claim: ‘We certainly do not want any person to smoke if it is dangerous to his health’. 29 Greenwald had made a similar statement in 1939, reassuring his president, OH Chalkley, that ‘under no circumstances would we want anyone to smoke Philip Morris cigarettes were smoking definitely deleterious to his health’. 30 There is no reason to believe he was lying: he is writing long before Wynder's mouse painting experiments of 1953, and prior even to the epidemiology of 1950. Prior to obtaining proof of harm, Philip Morris seems honestly not to have wanted to sell a deadly product.

Summary points

The cigarette is the deadliest object in the history of human civilisation. It is also a defective product, a financial burden on cash-strapped societies, an important source of political and scientific corruption, and a cause of both global warming and global warming denial.

Tobacco manufacturers have a long history of promising to stop the production of cigarettes, should they ever be proven harmful.

The most important reason to ban the sale of cigarettes, however, is that most smokers do not even like the fact they smoke; cigarettes are not a recreational drug.

It is not in principle difficult to end the sale of cigarettes; most communities–even small towns–could do this virtually overnight. We actually have more power than we realize to put an end this, the world's leading cause of death and disease.

Benowitz NL ,
Henningfield J
Hatsukami DK ,
Perkins KA ,
LeSage MG ,
Peretti-Watel P ,
Constance J ,
Muggli ME ,
Oreskes N ,
Giovino GA ,
Henningfield JE ,
↵ A Study of Cigarette Smokers' Habits and Attitudes in 1970. May 1970. Philip Morris. http://legacy.library.ucsf.edu/tid/jyx81a00 (accessed 4 Apr 2012) . pp. 13, 18, 39 .
Hammond D ,
Joossens L ,
Cunningham R
↵ Austin vs. State of Tennessee , Decided Nov. 19. Cases argued and decided in the Supreme Court , Book 45 . Rochester : Lawyers Co-operative Publishing , 1900 : 224 – 43 .
↵ Hill and Knowlton . Suggested approach and comments regarding attacks on use of cigarettes. 1953. Bates 3799, http://legacy.library.ucsf.edu/tid/tao66b00 (accessed 1 Jun 2012).
Greenwald WF

Competing interests The author has served as an expert witness for plaintiffs in tobacco litigation.

Provenance and peer review Not commissioned; externally peer reviewed.

Open Access This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

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The pros and cons of a total smoking ban

Plans to phase out the sale of tobacco completely have won cross-party support

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Pro: saving lives

Con: black markets, pro: avoiding poverty, con: risk to civil liberties, pro: environmental protection, con: losing tax revenue.

Rishi Sunak's plans to phase out the sale of cigarettes appears to have gained cross-party backing, making a total smoking ban in the UK a real possibility.

The prime minister used his Conservative Party conference speech to announce plans to raise the age at which people can buy tobacco in England year by year until it applies to the whole population. This would mean a 14-year-old today will never legally be able to buy a cigarette, putting England on a par with the likes of New Zealand, which introduced a similar law last year, in having "some of the strictest smoking laws in the world", Sky News reported.

While an outright ban – even one introduced over several decades – may prove controversial, its chances of coming into law have received a boost after it won support from Labour, as well as Welsh and Scottish governments, where laws on smoking are devolved.

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"Political instincts on this issue are coalescing around a similar position," said BBC political editor Chris Mason, meaning the plan could be both "profound and long-lasting".

Almost six million people in England smoke, and tobacco remains the single biggest cause of preventable illness and death. Tobacco smoke can cause cancer, stroke and heart disease, with smoking-related illnesses costing the NHS £17 billion a year, according to campaign group Action on Smoking and Health (ASH).

An independent government-commissioned review , which last year recommended proposals similar to those announced by Sunak, argued that tackling tobacco use and supporting smokers to quit would help prevent 15 types of cancer – including lung cancer, throat cancer and acute myeloid leukaemia. Recent data showed that one in four deaths from all cancers were estimated to be from smoking.

Speaking on BBC Radio 4 's "Today" programme, the prime minister said his proposals represented the "biggest public health intervention in a generation", a claim backed up by England's chief medical officer, Sir Chris Whitty, who stressed how beneficial the health improvements would be.

Simon Clark, of smokers' lobby group Forest, told the BBC that "creeping prohibition won't stop young adults smoking" but it will "simply drive the sale of tobacco underground and consumers will buy cigarettes on the black market where no-one pays tax and products are completely unregulated".

The illicit trade in tobacco products "poses major health, economic and security concerns around the world", according to the World Health Organization , which estimates 1 in every 10 cigarettes and tobacco products consumed globally is illicit.

Writing for The Conversation , Dr Brendan Gogarty, of the University of Tasmania, argued that "laws that rely on prohibition to reduce the prevalence and harm from drugs generally fail to achieve their aims".

Smoking causes a disproportionate burden on the most disadvantaged families and communities, last year's independent review found. The average smoker in the North East of England spends over 10% of their income on tobacco, compared to just over 6% in the South East.

This mirrors research from 2015 conducted by University of Nottingham, which found parents who smoke were "plunging nearly half a million children into poverty", The Independent reported.

As smokers quit, said Sudyumna Dahal for The Conversation , household budgets "become easier, facilitating what a study in the British Medical Journal describes as an income transfer from male smokers to females and other family members".

Therefore, argue anti-smoking campaigners, banning smoking would bring greater benefits to the less well-off.

Smokers and the groups who advocate on their behalf argue that their habit is a civil right, even if it kills the smoker. In a report published in 2019, the smokers’ group Forest argued that "smokers are the canaries for civil liberties".

It added that the call for a ban "directly violates the harm principle that assumes a person has autonomy over their own life and body as long as they do not hurt other people".

As The Spectator editor Fraser Nelson pointed out on Twitter , plans to phase out the sale of cigarettes could lead to the absurd situation where pensioners will have to produce ID to prove which side of the ever-moving line of legality they are on.

"I'd love to live in a smoke-free world," wrote Rachael Bletchly in the Daily Mirror . "I wish people would stop wrecking their health with cigarettes. But I don't think it's the job of politicians to police other grown-ups' filthy habits. And I fear that Rishi Sunak's new smoking ban is just well-meaning, populist puff."

Cigarette smoking has several negative environmental impacts and banning smoking would bring these to an end. Smokers release pollution into the atmosphere, cigarette butts litter the environment, and the toxic chemicals in the residues cause soil and water pollution.

Tobacco is commonly planted in rainforest areas and has contributed to major deforestation, said Conserve Energy Future .

A 2013 report in the journal Tobacco Control found that cigarette manufacturing “consumes scarce resources in growing, curing, rolling, flavouring, packaging, transport, advertising and legal defence” and “also causes harms from massive pesticide use”.

Taxation on smoking raises more than £8.8 billion per year for the Treasury, noted Politics.co.uk . The TaxPayers’ Alliance rejected the argument that smokers also cost the taxman more due to their health burden, arguing that smokers who suffer major health problems are more likely to die prematurely, reducing expenditure on state pensions and other age-related benefits.

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Why ban the sale of cigarettes? The case for abolition

Six reasons to ban

The cigarette is also a defective product, meaning not just dangerous but unreasonably dangerous, killing half its long-term users. And addictive by design. It is fully within the power of the Food and Drug Administration in the US, for instance, to require that the nicotine in cigarettes be reduced to subcompensable, subaddictive levels. 2 3 This is not hard from a manufacturing point of view: the nicotine alkaloid is water soluble, and denicotinised cigarettes were already being made in the 19th century. 4 Philip Morris in the 1980s set up an entire factory to make its Next brand cigarettes, using supercritical fluid extraction techniques to achieve a 97% reduction in nicotine content, which is what would be required for a 0.1% nicotine cigarette, down from present values of about 2%. 5 Keep in mind that we're talking about nicotine content in the rod as opposed to deliveries measured by the ‘FTC method’, which cannot capture how people actually smoke. 5

The spectre of prohibition

Another objection commonly raised to any call for a ban is that this will encourage smuggling, or even organised crime. But that is rather like blaming theft on fat wallets. Smuggling is already rampant in the cigarette world, as a result of pricing disparities and the tolerance of contraband or even its encouragement by cigarette manufacturers. Luk Joossens and Rob Cunningham have shown how cigarette manufacturers have used smuggling to undermine monopolies or gain entry into new markets or evade taxation. 17 18 And demand for contraband should diminish, once the addicted overcome their addiction—a situation very different from prohibition of alcohol, where drinking was a more recreational drug. And of course, even a ban on the sale of cigarettes will not eliminate all smoking—nor should that be our goal, since people should still be free to grow their own for personal use. Possession should not be criminalised; the goal should only be a ban on sales. Enforcement, therefore, should be a trivial matter, as is proper in a liberal society.

Helping the industry fulfil its promises

In March 1954, George Weissman, head of marketing at Philip Morris, announced that his company would ‘stop business tomorrow’ if ‘we had any thought or knowledge that in any way we were selling a product harmful to consumers’. 21
In 1972, James C Bowling, vice president for public relations at Philip Morris, asserted publicly, and in no uncertain terms, that ‘If our product is harmful…we'll stop making it’. 22
Helmut Wakeham, vice president for research at Philip Morris, in 1976 stated publicly that ‘if the company as a whole believed that cigarettes were really harmful, we would not be in the business. We are a very moralistic company’. 23
RJ Reynolds president Gerald H Long, in a 1986 interview asserted that if he ever ‘saw or thought there were any evidence whatsoever that conclusively proved that, in some way, tobacco was harmful to people, and I believed it in my heart and my soul, then I would get out of the business’. 24
Philip Morris CEO Geoffrey Bible in 1997, when asked (under oath) what he would do with his company if cigarettes were ever found to be causing cancer, said: ‘I'd probably…shut it down instantly to get a better hold on things’. 25 Bible was asked about this in Minnesota v. Philip Morris (2 March 1998) and reaffirmed that if even one person were ever found to have died from smoking he would ‘reassess’ his duties as CEO. 26

A: Because if we are marketing a product that we know causes cancer, I'd get out of the business…I wouldn't be associated with marketing a product like that.

A: If cigarettes caused cancer, I wouldn't be involved with them…I wouldn't sell a product that caused cancer.

Q: …Because you don't want to kill people? … Is that the reason?

Q: …If it was proven to you that cigarette smoking caused lung cancer, do you think cigarettes should be marketed?

A: No…No one should sell a product that is a proven cause of lung cancer. 27

If the Company felt that its product were now causing cancer or any other disease, it would immediately cease production of it. 28

To this recommendation was added ‘Until such time as these charges or irresponsible statements are ever proven, the Company will continue to produce and market cigarettes’.

Abolition is not such a radical idea; it would really just help the industry fulfil its long-standing promises to the public. The cigarette, as presently constituted, is simply too dangerous—and destructive and unloved—to be sold.

Summary points

The cigarette is the deadliest object in the history of human civilisation. It is also a defective product, a financial burden on cash-strapped societies, an important source of political and scientific corruption, and a cause of both global warming and global warming denial.
Tobacco manufacturers have a long history of promising to stop the production of cigarettes, should they ever be proven harmful.
The most important reason to ban the sale of cigarettes, however, is that most smokers do not even like the fact they smoke; cigarettes are not a recreational drug.
It is not in principle difficult to end the sale of cigarettes; most communities–even small towns–could do this virtually overnight. We actually have more power than we realize to put an end this, the world's leading cause of death and disease.

Competing interests: The author has served as an expert witness for plaintiffs in tobacco litigation.

Provenance and peer review: Not commissioned; externally peer reviewed.

Open Access: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

Should Cigarettes Be Illegal?

A proposed bill in Oregon to make the possession of cigarettes illegal is well-intended, but from a practical standpoint, it's unlikely to happen, bioethicists and public health experts say.

The ban, sponsored by State Rep. Mitch Greenlick of Portland, would make nicotine a controlled substance, and says possessing more than 0.1 milligrams would be illegal, punishable by a year in prison or a $6,250 fine. Exceptions would be made for people who had a doctor's prescription for the drug, according to the bill .

Tobacco clearly takes a significant toll on the lives of Americans, causing 450,000 premature deaths each year, and drastic measures should be taken to eliminate the habit from our lives, including, some say, banning cigarettes. But others argue that, in today's society, such a goal is overly idealistic, and would be extremely difficult to implement.

"As someone who's looking out for public health, I think it’s a great thing," said Dr. Bradley Flansbaum, a hospitalist at Lenox Hill Hospital in N.Y. "Knowing that tobacco is public enemy No. 1 in preventive illness...I don’t think I can endorse smoking for any reason," Flansbaum said.

However, "Politically, it's going to be a tough if not impossible sell," Flansbaum said.

In 2009, the Food and Drug Administration banned the manufacture and distribution of flavored cigarettes, such as chocolate and cherry, over concerns that the products encouraged youth smoking. However, banning all cigarette products is a different matter entirely. Barriers to passing such a ban include the power of big tobacco companies, the cost of enforcing such a law, and the rise of a black market for cigarettes, experts say.

"Once you have a substance out there like tobacco in wide use it's hard to turn around and make it illegal," said Arthur Caplan, a bioethicist at New York University School of Medicine's Division of Medical Ethics, "You can certainly tax it, you can certainly stigmatize it," and educate against its use. But ban it? "In reality, it's not going to happen," Caplan said.

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"Smoking has been around too long, and the industries that profit from it are huge and will fight to the end," Caplan said.

Rosalie Liccardo Pacula, co-director of the Drug Policy Research Center at the RAND Corp., a nonprofit research organization, said she was surprised to hear of the bill. "The policy would require an enormous cost to enforce if it is to have any teeth, which most states are not in a position to absorb," Pacula said.

However, others argued such barriers should not deter the action.

"That's really the ultimate goal — to have the world free from the death and destruction it causes," said Dr. Amy Lukowski, clinical director of Health Initiatives Programs for the National Jewish Health Center in Denver. "How we do that? That's the million-dollar question." Although anti-smoking policies have made strides in reducing the number of people who smoke, "I think we have to do something drastic about this," Lukowski said. "[It's] taking the lives of Americans every day." Indeed, a study published today (Jan. 24) in the New England Journal of Medicine found that smoking takes at least 10 years off a person's life.

"I think we should try," said Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine. "What's possible begins with what we try to do. I think there is a strong argument for never allowing another child to become addicted to tobacco ," Katz said. "This would never be approved for sale today, and we should get rid of it."

Pass it on: The idea to ban cigarettes is well-intended, but unlikely to happen.

Follow Rachael Rettner on Twitter @RachaelRettner , or MyHealthNewsDaily @MyHealth_MHND . We're also on Facebook & Google+ .

Rachael is a Live Science contributor, and was a former channel editor and senior writer for Live Science between 2010 and 2022. She has a master's degree in journalism from New York University's Science, Health and Environmental Reporting Program. She also holds a B.S. in molecular biology and an M.S. in biology from the University of California, San Diego. Her work has appeared in Scienceline, The Washington Post and Scientific American.

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Smoking in Public Places: A Call for Legal Prohibition

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Understanding the Health Implications

The unjust impact on non-smokers.

Evidence of Secondhand Smoke Dangers

Impact on vulnerable populations, the chemical composition of cigarette smoke, successful implementation of smoking bans, positive impact on businesses, public support and behavioral changes, protecting non-smokers' rights, conclusion: a call to action.

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Smoking in Public Places: A Call for Legal Prohibition essay

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Kalle Grill 1 ,
Kristin Voigt 2 , 3
1 Department of Historical, Philosophical and Religious Studies , University of Umeå , Umea , Sweden
2 Ethox Centre, Nuffield Department of Population Health, University of Oxford, UK
3 Institute for Health and Social Policy & Department of Philosophy, McGill University, Canada
Correspondence to Dr Kristin Voigt, Ethox Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford OX3 7LF; kristin.voigt{at}ethox.ox.ac.uk

Lifelong smokers lose on average a decade of life vis-à-vis non-smokers. Globally, tobacco causes about 5–6 million deaths annually. One billion tobacco-related deaths are predicted for the 21st century, with about half occurring before the age of 70. In this paper, we consider a complete ban on the sale of cigarettes and find that such a ban, if effective, would be justified. As with many policy decisions, the argument for such a ban requires a weighing of the pros and cons and how they impact on different individuals, both current and future. The weightiest factor supporting a ban, we argue, is the often substantial well-being losses many individuals suffer because of smoking. These harms, moreover, disproportionally affect the disadvantaged. The potential gains in well-being and equality, we argue, outweigh the limits a ban places on individuals’ freedom, its failure to respect some individuals’ autonomous choice and the likelihood that it may, in individual cases, reduce well-being.

Population Policy
Public Health Ethics
Public Policy

https://doi.org/10.1136/medethics-2015-102682

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Introduction

Lifelong smokers lose on average a decade of life vis-à-vis non-smokers. Globally, tobacco causes about 5–6 million deaths annually. 1 This number is expected to grow: a total of one billion deaths are predicted during the 21st century, with about half occurring before the age of 70. 1 , 2 It is against this background that we will argue for a complete ban on the sale of cigarettes. While our argument focuses on tobacco cigarettes, which in many countries are by far the most popular tobacco product and in the aggregate the most harmful, we think it could be extended to include other forms of combustible tobacco as well.

As with many policy decisions, the argument for a ban requires a weighing of its pros and cons, including its impact on different individuals, both current and future. The weightiest factor supporting a ban, we argue, is the often substantial well-being losses many individuals suffer as a result of smoking. These harms, moreover, disproportionately affect the disadvantaged. The potential gains in well-being and equality, we argue, outweigh the limits a ban places on individuals’ freedom, its failure to respect some individuals’ autonomous choice and the likelihood that it may, in individual cases, reduce well-being.

The idea of a complete ban on the sale of cigarettes is not new. Bans were in place in 15 US states from 1890 to 1927, and Bhutan has had a ban since 2004. 3 Bans on the sale of (at least some) tobacco products have also been endorsed by members of the international tobacco control community. 3–6

In order to bring into focus the fundamental normative issues surrounding a ban on sales, we will simplify our discussion in two ways. First, we assume that a ban would be effective. In the real world, of course, any all-things-considered judgement must be informed by an assessment of a ban's likely effectiveness in different contexts, with due consideration of problems such as smuggled cigarettes and black markets. Second, we focus on a complete ban on sales, comparing this only to the status quo and not to the full range of policy alternatives. i We believe that the necessary debate about different policy instruments in various contexts will be greatly facilitated by consideration of the principled argument for a perfectly effective ban, which is what our paper seeks to provide.

We discuss smoking as a global problem, although most real bans would likely be implemented domestically and our argument might have to be adapted to reflect the situation of individual countries or regions. In rich countries, factors such as the greater availability of cessation resources and information about the risks of smoking make a ban less warranted than in countries where much of the population may be unaware of the risks associated with smoking. We therefore focus our discussion on rich countries in order to tackle the most challenging case for our position. This should not detract from the fact that the majority of death and disease a global ban would prevent will occur in low-income and middle-income countries.

We begin by considering the impact of smoking on health and well-being (section ‘Health and well-being’) and the egalitarian effects of a ban (section ‘Equality’), both of which will be central to our argument. We then discuss how individual freedom and autonomy are affected by a ban in the section ‘Freedom and autonomy’. The sections ‘Voluntariness’, ‘Irrationality’ and ‘Preferences and endorsement’ consider three putative aspects of smoking choices that have been emphasised in the literature: non-voluntariness, irrationality and inconsistency with smokers’ endorsed preferences. These aspects do strengthen the argument for a ban, but their role is different from what is often proposed. In ‘Banning cigarettes: pros and cons’, we bring together these various considerations and explain why overall they speak in favour of a ban. The final section concludes by briefly commenting on how e-cigarettes could help address some of the problems and opposition facing a ban on conventional cigarettes.

Health and well-being

The health risk of smoking naturally varies with the extent of tobacco use. Long-time smokers face significantly increased health risks, including higher risks of lung and other cancers, cardiovascular disease and chronic obstructive pulmonary disease. Significant differences in mortality rates between smokers and never-smokers become apparent from middle age onwards. 8 Studies suggest a 10-year to 11-year difference between the lifespans of long-term and never-smokers. 8 , 9 In addition, smoking is implicated in causing many non-fatal conditions that can substantially lower individuals’ quality of life, ranging from asthma, tuberculosis, digestive problems and gum disease to vision problems, reduced fertility as well as impotence. 10

While heavy tobacco use is of course more harmful than light use, even light use, when long term, yields substantial health risks, in some respects approximating those of long-term heavy use. For example, ischaemic heart disease risk is similar in light, intermittent and heavy smokers. 11 With respect to lung cancer, for men smoking 1–4 cigarettes per day, the risk is three times that of never-smokers; for women, it is five times as high. 12

Conversely, cessation—which an effective ban would ensure—is associated with substantial health benefits. While for those who quit before their 30s excess mortality is reduced almost to the level of never-smokers, even those who quit at the ages of 40, 50 and 60 gain about 9, 6 and 3 years of life expectancy, respectively. 8 , 9

We believe that a comprehensive argument for a ban should look beyond health to overall well-being: improving health outcomes would not be worthwhile if this left people worse off overall. Many health risks are quite reasonably considered worth taking by the individuals concerned because of the benefits they bring in other, non-health areas of their lives.

While there may be disagreement in specific instances, on most accounts of well-being both the premature mortality and various diseases associated with smoking will reduce lifetime well-being. On hedonist views, the pain and frustration associated with non-fatal diseases typically decrease well-being with no countervailing benefit. Regarding mortality, life is, with some tragic exceptions, on balance a positive experience, and so more life is better. On preferentist or desire-based views, more of a person's most important preferences will typically be satisfied, and fewer frustrated, if she lives longer and has better health. A longer and healthier life also advances typical objective list entries such as developing and sustaining human relationships, and various moral and rational pursuits. Even if one refrains from specifying the nature of well-being, in line with liberal neutrality, long life and good health are all-purpose means that contribute to the pursuit of almost any life plan.

Importantly, we do not deny that smoking can also promote well-being in certain respects; in fact, we will emphasise below that it can do so and consider the possibility that there may be individuals for whom smoking leads to an overall gain in well-being. However, in the aggregate, the negative well-being effects of smoking are likely much larger than its positive effects.

Smoking also contributes to inequality. Most obviously, smokers are, to varying degrees, worse off than non-smokers because of the health risks and the monetary costs associated with smoking. Less obviously, because of the denormalisation of smoking, smokers are increasingly stigmatised and discriminated against. 13 , 14

What makes smoking particularly problematic from the point of view of equality is that it disproportionately harms people who are disadvantaged in other regards. In many rich countries, smoking rates are significantly higher among low-income groups. In the UK, for example, smoking prevalence in routine or manual occupations is 30% while in managerial and professional occupations it is 16%. 15 Among the most deprived groups, smoking rates reach >70%; among homeless people sleeping rough, 90% are smokers. 16

Of course, not all disadvantaged people smoke, and not all smokers are disadvantaged, socio-economically or otherwise. In the aggregate, however, a ban could help reduce inequalities in health outcomes. Studies suggest that, in Europe, smoking could be the largest single contributor to socio-economic inequalities in health, particularly among men. 17 In the UK, tobacco is considered the cause of about half of the socioeconomic status difference in death rates. 18

Many factors may contribute to unequal smoking rates. Smoking norms vary substantially across different groups. 19 In deprived communities, smoking often plays an important social role. 20 Support with cessation, including nicotine replacement therapy (NRT), counselling and medical advice, may also be more accessible for those from better-off groups. Further, the tobacco industry has specifically targeted disadvantaged populations, for example by placing its advertising disproportionately in low-income and ethnic minority neighbourhoods 21 , 22 and devising marketing strategies with particular appeal to the homeless and those with mental health problems. 23 These factors may help explain differences in cessation rates: studies suggest that across social groups smokers make similar numbers of cessation attempts but those in better-off groups are more likely to succeed. 24 It is an ongoing concern that many tobacco control strategies have greater effects on cessation rates among better-off groups vis-à-vis disadvantaged groups; 25 ii an effective ban would enforce cessation equally across social groups, avoiding these inegalitarian effects.

The idea that a ban would enhance equality in health outcomes assumes that those who quit as a result of a ban will substitute smoking with something less harmful to their health. The fact that, as we noted above, cessation is associated with such substantially improved health outcomes suggests that those who quit do so in ways that are overall beneficial for their health. It is not implausible that many of those who would quit as a result of a ban (many of whom, as we note below, are very motivated to quit) would see similarly improved health prospect. However, much will depend on how exactly a ban is phased in and the extent to which it is accompanied by measures to help smokers quit.

Our assessment of a ban should be based on its likely effects not only on health inequalities but on inequalities more broadly conceived. One important concern is that, while unequal smoking rates across different socio-economic groups mean that the health loss averted by a ban should be much greater among disadvantaged groups, a ban could also impose additional burdens on these smokers. As Gostin emphasises, a complete ban would leave many highly addicted smokers in withdrawal and distress, 26 many of them from vulnerable populations, including the poor, prisoners and the homeless, as well as those with mental health problems, for whom the immediate effects of quitting might be more complicated and/or more difficult to deal with. 27

More generally, being disadvantaged—be it socio-economically or in other ways—may also affect people's ability to respond or adapt to a ban. Different ways of ‘phasing in’ a ban might help address these concerns, as could the availability of suitable substitutes, such as e-cigarettes. For example, a ban could be accompanied by free NRT for those on low incomes, prison populations or those in mental health institutions.

For some smokers, the burdens imposed by a ban may be so significant that they will not be compensated for by the benefits cessation would bring; smokers in their 80s or 90s might be a case in point. Limited licensing schemes might be a suitable strategy for this group. Importantly, as we explain in more detail below, these concerns arise in relation to the current generation of smokers and will have much less significance with respect to future generations, who—because of the ban—would not become smokers in the first place. We return to this issue in the section ‘Banning cigarettes: pros and cons’.

Freedom and autonomy

An important concern about our proposal is that a ban would pose an undue restriction on individual freedom and autonomy. Regarding freedom, we accept that any restriction of the available opportunities reduces freedom of choice. iii However, more freedom is not always better, nor is it always preferred. The disvalue of a particular restriction on freedom depends both on the interest people have in using the opportunity that is being removed, and on the interest people have in having or keeping the opportunity as an opportunity , whether or not they use it. Even non-smokers may have an interest in having the opportunity to smoke: this might be quite a specific interest (eg, in resisting temptation) or a more general interest in having a wide range of options.

Autonomy we understand here as self-direction, involving both an internal and an external aspect. Internal autonomy is the absence of internal obstacles to self-rule, such as ignorance, poor self-confidence or sense of self-worth, incoherent desires or preferences, and various psychological conditions such as clinical depression and obsessive-compulsive disorder. External autonomy is the absence of external obstacles to self-rule, most obviously various malign influences from others to manipulate one's deliberations and so undermine one's independence. iv So understood, a ban will not necessarily reduce autonomy. Quite to the contrary, to the extent that a ban frees many smokers of a debilitating addiction, it strengthens their internal autonomy.

A ban may fail to respect individual autonomy. Respecting autonomy, we propose, requires abstaining from frustrating the choices of relatively autonomous people. We accept that there are strong reasons to respect autonomy in this sense. While significant shortfalls from full autonomy reduce our reasons to respect choices, they do not fully eliminate such reasons; interference still requires some justification. v Indeed, since people are typically quite prone to make choices that are far from fully autonomous, we think that almost any choice should warrant some respect. Note that one may choose something even if one does not find the freedom to do so important, or indeed even if one would prefer not to have this freedom. Such choices indicate some sort of inner conflict, but it may still be disrespectful of others to interfere with them.

Freedom and respect for autonomy, as we have described them, can pull in different directions when it comes to evaluating a ban on cigarettes. An autonomous smoker may choose to restrict her own freedom to smoke. For example, she may engage her partner in keeping their shared home free of cigarettes. If someone prevents her from making this arrangement, this protects her freedom to smoke but fails to respect her autonomy. Similarly, smokers may try to engage their government in keeping their society free of cigarettes (in fact, many smokers would welcome a ban imposed by the government; we return to this issue in the section ‘Preferences and endorsement’); for these smokers, a ban, by restricting their freedom, will respect their autonomy.

Respect for autonomy can also part ways with well-being considerations. A person may autonomously choose to smoke because she does not care about her future well-being or because she falsely believes that a shorter and less healthy life will not decrease her well-being (eg, because she believes, at 21, that she will never want to live past the age of 40 anyway). We have reason both to respect this choice and to protect this person's lifetime well-being.

The next three sections address three related considerations that have been taken to strengthen the case for a ban: the degree to which smoking choices are less than fully voluntary, the limited rationality of these choices and the fact that many smokers do not endorse their smoking choices. Sometimes, these factors are explicitly invoked in relation to freedom or autonomy, sometimes they are invoked as arguments in their own right. As will become apparent, we believe that these considerations can indeed play an important role in the argument for a ban; however, their role has been overstated in the literature and must be qualified in various respects.

Voluntariness

The most comprehensive philosophical argument for strict regulation of smoking (though not explicitly a complete ban on cigarettes) has arguably been put forth by Robert Goodin, especially in his 1989 book, No Smoking: The Ethical Issues . One of Goodin's central arguments for tobacco regulation starts from the idea that because smokers typically have not fully appreciated the risks of smoking, and because smoking is addictive, the associated risks are not voluntarily assumed. This, in Goodin's argument, makes interference with smoking choices much less problematic than interference with other kinds of choices.

Goodin proposes that people are often not sufficiently informed about the consequences of smoking. Being sufficiently informed, on his account, requires not only being able to state the relevant probabilities about risks but also to ‘appreciate them in an emotionally genuine manner’ (ref. 33 , p. 24, citing Gerald Dworkin 34 ). Goodin does not seem to believe that being uninformed completely removes any reasons against regulation, but rather that the less informed a choice is, the less reason we have to abstain from frustrating it (ref. 33 , p. 21).

We share Goodin's concern that smokers must know the risks associated with smoking if we are to fully respect their choice to smoke. Knowledge of the risks of smoking is now well spread in developed countries, but much less so in many developing countries, 35 making the concern about involuntarily incurred risk highly relevant in these countries. This is important not least because 82% of the world's smokers currently live in low-income and middle-income countries. 36

However, Goodin's claim that in order to be sufficiently informed we must also have an emotionally genuine appreciation of these risks amounts to a very strong requirement. It may be very difficult for a 20-year-old to appreciate, ‘in an emotionally genuine manner’, the suffering she might endure as a victim of emphysema 40 years later, especially if she lacks experience of major illness in herself or those close to her. Such a demanding requirement may be more reasonable for choices with immediate effects, but one of the problems with smoking is precisely that people typically start young and suffer the consequences much later. Goodin's criterion of what counts as informed choice may turn out to be too high a bar to clear for most of the choices people make, including our most important choices, such as whether and with whom to have children. On Goodin’s account, we have strong reasons to interfere with such choices if we believe them to be unwise. It is beyond the scope of this article to fully engage with Goodin's arguments on its own terms. However, we believe that the best argument for a tobacco ban does not depend on such a controversial interpretation of informed choice. We think that the argument for a ban can succeed even if we accept that we have strong reasons to respect the choices smokers make, even if they do not fully appreciate the risks of smoking.

The second factor Goodin emphasises is the addictiveness of smoking. He argues that while it is not impossible to overcome addictions, what matters normatively is whether the addictiveness makes it ‘unreasonably costly’ (ref. 33 , p. 25) to do so: if the addiction is so strong “that even someone with ‘normal and reasonable self-control’ would succumb to it, we have little compunction in saying that the addict's free will was sufficiently impaired that his apparent consent counts for naught” (ref. 33 , pp. 25–6, citing Gary Watson 37 ). This condition, Goodin argues, is met in the case of smoking. Thus, a smoker's continuing to smoke cannot be taken as consent to the risks involved. Further, many smokers become addicted below the age of consent and so, Goodin argues, they cannot be taken to have consented to the risk of becoming addicted to nicotine.

While we share some of Goodin's concerns about the implications of addiction, the heterogeneity of smokers means that his argument applies to fewer smokers than Goodin suggests. Consider first the matter of age. It is often claimed that the quota of smokers who become addicted below the age of 21 is extremely high; Goodin puts this number at 95%. However, these numbers are typically based on studies that ask respondents at what age they first started smoking. This question may lead them to focus on their first ever cigarette, which need not indicate the beginning of addiction. Studies that instead ask respondents when they started smoking regularly indicate that the number of smokers who took up smoking as minors is substantially smaller. Surveys of UK smokers indicate that 55–66% start before the age of 18 (ref. 38 , p. 42, ref. 39 , p. 11).

Even regular smoking, however, is not necessarily a good indicator of addiction. Some adolescents may be able to maintain intermittent smoking without developing dependence. 40 Among adults, too, not all smokers become dependent. One study finds that almost 40% of daily smokers fail to meet the criteria of nicotine dependence (though they may exhibit individual symptoms of addiction, such as difficulties abstaining from cigarettes). 41 While there is disagreement about how to define addiction and what proportion of smokers meet the required criteria, there may be a significant proportion of smokers to whom this part of Goodin's argument does not apply.

Furthermore, it is not clear that addiction fully undermines the voluntariness of smoking in all regards. Even if addiction makes it ‘unreasonably costly’ to abstain from one's next cigarette, there may still be scope for devising a longer-term cessation strategy. This kind of long-term planning is arguably less susceptible to the forces of addiction. The addictiveness of tobacco may of course still thwart any cessation attempts smokers do make (we return to this below); but Goodin's argument, by not addressing this issue, proceeds too quickly.

Finally, irrespective of the degree to which addictiveness undermines the voluntariness of smoking, we are more concerned than Goodin that we have some reason to abstain from frustrating even those choices that are substantially non-voluntary. As John Christman notes, “I might know that a person is to some degree under the sway of external pressures that are severely limiting her ability to govern her life and make independent choices. But as long as she has not lost the basic ability to reflectively consider her options and make choices, if I intervene against her will (for her own good), I show less respect for her as a person than if I allow her to make her own mistakes”. 42

Our scepticism about Goodin’s argument should not be taken to imply that we think addictiveness is irrelevant. It is certainly true that many smokers are addicted and have become addicted in their youth; we agree that we have less reason to respect these smokers’ choice to smoke. Moreover, the addictiveness of smoking is often an intermediary cause in people becoming long-term smokers and thus facing substantial health risks. However, the lack of consent argument may apply to a smaller proportion of smokers than Goodin suggests.

More generally, we think that the broader concern here—whether or not smokers voluntarily accept the risks of smoking—should play a somewhat different role in the argument. On the one hand, as we have said, the degree of voluntariness affects the degree to which the choices involved are autonomous and so to what degree we have reason to respect them. At the same time, though, even if risks were accepted in a fully voluntary manner, this does not mean that the resulting harm is not undesirable or that we should not seek to prevent it.

Harms can be undesirable even if they result from risks that are voluntarily assumed. If, for example, I risk my health by donating a kidney to a relative, this does not detract from the undesirability of any ensuing harms. There may be an exception for harms that are actively sought out: a person may want to die, or want to amputate an arm, where this is not merely instrumental to some aim that can be reached in less harmful ways. However, when a person simply accepts a risk of what is for her an undesirable outcome, this is clearly not by itself a reason to disregard the risk or outcome.

Jason Hanna makes a persuasive argument against tying the justifiability of paternalism to voluntarily assumed risks. 43 Hanna gives the example of a reckless hiker who voluntarily abstains from gathering information on which bridges in the area are dangerous. Later on, the hiker unknowingly starts to cross a dangerous bridge, not because he wants to court danger but simply to finish his hike. If respect for autonomy precludes from moral consideration voluntarily assumed risks, then a bystander has no reason to intervene, which seems an unacceptable conclusion (ref. 43 , pp. 424–5). Similarly, we cannot conclude that we should abstain from intervening with smoking simply because smokers have voluntarily assumed the health risks.

Irrationality

A further concern in the normative debate about smoking and about how governments ought to respond to it is that smoking choices are in some sense irrational. This is the argument Sarah Conly pursues in her recent book, Against Autonomy: Justifying Coercive Paternalism , where she argues that we should often disregard, at least to some extent, smokers’ apparent preference for smoking. Goodin takes similar considerations to bolster his argument from lack of consent. The argument from irrationality can start from either impairments in the decision-making of smokers (in particular, cognitive biases) or, relatedly, from a discrepancy between smokers’ own goals and their choices.

Invoking impairment, Goodin argues that intervention into the choice to smoke is especially warranted if smokers’ false beliefs are caused by cognitive biases. Goodin points to evidence that smokers are subject to three biases, which are now most often called optimistic bias (‘wishful thinking’), the availability heuristic (‘anchoring’) and hyperbolic or temporal discounting (‘time discounting’). 33 As is more thoroughly researched and more widely appreciated now than when Goodin wrote his book, these biases are quite general, and not particular to smokers. 44 Therefore, either of two conclusions are possible: either the charge that smoking choices in particular are impaired loses its force or the charge is expanded to very many decisions we make. The latter option is the one pursued by Conly.

Conly cites a wide range of research in behavioural psychology and concludes: “We generally suffer from many flaws in instrumental reasoning that interfere with our ability to make effective and efficient choices” (ref. 45 , p. 23). The same conclusion has motivated Richard Thaler and Cass Sunstein to promote what they call libertarian paternalism—benevolent structuring of choice situations that does not significantly affect the outcomes of the various options in the choice set. 46 , 47 Conly argues that libertarian paternalist measures are insufficient to ensure that people's choices promote their well-being and that we have no good reason to abstain from coercive measures. Her argument, however, is thoroughly consequentialist and does not give a role to respect for autonomy as we understand it. Instead, she assumes that we have reason to respect autonomy only if this is an effective means of promoting some other goal: “the basic premise of liberalism […] is that we are basically rational, prudent creatures who may thus, and should thus, direct themselves autonomously” (ref. 45 , p. 30). Conly rejects this premise and draws the conclusion that “when it comes to respect for autonomy, we can see that our belief that autonomous actions should not be interfered with was based on a mistake” (ref. 45 , p. 192).

Since we believe that there is reason to respect an agent's choices, even when these choices do not promote the agent's well-being, we find the argument from irrationality unpersuasive. Behavioural research may have proven that poor instrumental rationality is a general aspect of human decision-making. This, however, does not necessarily undermine our reasons to respect choices that are about as autonomous as choices typically are. What would be more relevant is if smokers in particular were prone to irrationality. There is some evidence that addiction causes behaviour that may be deemed irrational, though this is disputed. vi

We now turn from the proposal that poor instrumental rationality is an impairment to the more consequentialist observation that poor instrumental rationality, impaired or not, is prone to create a discrepancy between goals and actions. It is clear that people make choices that do not further their own well-being. What has been open to interpretation and debate is whether this means that people fail to effectively promote their goals or whether, instead, they might have goals other than furthering their own well-being. The extensive study of cognitive biases has given us some reason to favour the first interpretation: if people are under the constant influence of cognitive bias, we can expect that they will not effectively further their own goals. Therefore, the fact that they do not promote their own well-being need not indicate that this is not their goal.

Conly argues that “[w]hat we need to do is to help one another avoid mistakes so that we may all end up where we want to be ” (ref. 45 , p. 2, emphasis added). Where we want to be, Conly assumes, there are no cigarettes. She describes smoking as a “bad course[] of action” (ref. 45 , p. 8) and an instance of people “choos[ing] poorly” (ref. 45 , p. 9). Smokers, she says, “spend a disproportionate amount of their income on a habit that will probably leave them in worse health and possibly shorten their life without bestowing compensating benefits ” (ref. 45 , p. 33, emphasis added). Goodin similarly argues that “what is involved here is a weak form of paternalism, working within the individual's own theory of the good and merely imposing upon him better means of achieving his own ends ” (ref. 50 , p. 23, emphasis added).

While we agree that we should be concerned about a possible discrepancy between smokers’ goals and their choices, Conly's argument does not give sufficient weight to the fact that many people find smoking pleasurable and enjoy the taste or the buzz and relaxing effects that come from nicotine. As summarised in a recent study, “nicotine induces pleasure and reduces stress and anxiety. Smokers use it to modulate levels of arousal and to control mood. Smoking improves concentration, reaction time, and performance of certain tasks” (ref. 51 , p. 2298). The behavioural components of smoking may also be experienced as relaxing. 52 It is certainly not obvious that the net effect of smoking on well-being is necessarily negative. While Conly briefly discusses pleasure in the context of tobacco and acknowledges the pleasure addicted smokers experience from cigarettes (mainly the pleasure of alleviating withdrawal symptoms) (ref. 45 , pp. 170–1), she dismisses too quickly the possibility that those who smoke but are not addicted can derive substantial pleasure from cigarettes. vii This is particularly important because, as we noted above, a significant portion of smokers may not in fact be addicted.

Could these pleasures indeed outweigh the risks and so make smoking consistent with the goal of furthering one's own well-being? This, we think, can vary, depending primarily on an individual's level of tobacco consumption. Consider lung cancer, which is one of the most severe conditions associated with smoking (though, of course, not the only one; lung cancer causes less than half of the excess mortality among smokers). 8 For heavy, life-long smokers, studies estimate the risk of developing lung cancer over the course of one's life to be up to 25% compared with 0.2–1% for never-smokers. 54 For these smokers, it seems plausible to claim that the benefits could not possibly outweigh the risks. However, this is much less clear at lower levels of consumption. Though smoking 1–4 cigarettes a day, as noted above, increases the risk of lung cancer by 3–5 times, 12 this must be seen in relation to the very low risk for never-smokers. Further, while the literature emphasises that there is no ‘safe’ or ‘risk-free’ level of tobacco consumption, those who quit before age 30 appear to avoid almost all of the excess mortality risk associated with continued smoking. 8 , 9 , 55 Given that smoking can further such goals as pleasure, manifesting a romantic nonchalance and social belonging, these risks seem potentially quite acceptable. viii Moreover, given that the cost of cessation is typically higher than the cost of not starting, it may be more rational to keep smoking than to start.

Further, even when the harms of long-time smoking and the limited benefits it brings combine to make smoking apparently irrational for the typical smoker, it does not follow that we should completely disregard these choices. Some limited irrationality is common and should not automatically undermine respect for individuals’ choices. At the same time, outright irrationality, caused by smoking-specific cognitive failures or simply inferred from severe lack of goal orientation, may remove or significantly weaken our reasons to respect choice. To the extent that smokers display such irrationality, this strengthens the case for a ban. However, the degree to which this concern applies to individual smokers will vary and we should be cautious in giving it too much weight in our argument.

While the irrationality of smoking has played an important role in arguments for tight tobacco control, we have emphasised two broad concerns in this section: first, smoking choices may be more rational than is often assumed and, second, even irrational choices warrant more respect than is typically allowed in the literature on smoking. Our argument for a ban on cigarettes focuses instead on the well-being losses it would avert; that people may be irrational and not secure these benefits for themselves in the absence of a ban is an additional consideration in its favour but should play a much smaller role in the argument than it does for Goodin and Conly.

Preferences and endorsement

A further factor supporting the case for a ban is that smokers often do not endorse their preference for smoking: They have a preference to smoke but also a preference about that preference : they would prefer not to have it. In a 1991 article, Goodin argues that public policy “can hardly be said to be paternalistic in any morally offensive respect [if] the preferences which it overrides are ones which people themselves wish they did not have” (ref. 56 , p. 48). For Goodin, the fact that smokers typically go through many failed cessation attempts shows that their preference for smoking is often not endorsed. The preference for quitting, on the other hand, typically has second-order endorsement (ref. 56 , pp. 47–48).

Studies indeed suggest that the majority of smokers want to quit. US data puts this proportion at 70%, 57 UK data at 64% of smokers. 39 Further, in a study with participants from Canada, the USA, the UK and Australia, about 90% of smokers agreed with the statement, “If you had to do it over again, you would not have started smoking”. 58 This indicates that many smokers themselves do not find smoking consistent with their goals, lending support both to concerns about irrationality and non-voluntariness, which we discussed above. It also indicates, more directly, that many smokers are unhappy with their smoking.

However, if (endorsed) preferences are to guide policy decisions, then a policy designed to prevent smokers from smoking may also need to be evaluated based on smokers’ preferences about that policy : it is quite possible that I would prefer not to prefer to smoke, but that I also prefer that the government not prevent my smoking. In fact, Goodin seems to assume that smokers will themselves be opposed to regulation (ref. 56 , p. 42). It is not clear why, on his account, such preferences about policy would not tell against a ban.

Looking at preferences about a ban, a somewhat different picture emerges. Many smokers would welcome a ban, though not a majority. Studies from the USA, England, Hong Kong, New Zealand and the Australian state of Victoria suggest that among current smokers about 25–38% would support the introduction of a ban over the next 10 years or so. 59–63

Where does this leave the argument for a ban? Though Goodin’s treatment is not sufficiently sensitive to vast individual variations, the high degree to which smokers want and try to quit certainly weakens those reasons against a ban that are based on respect for autonomy and the value of freedom: it is arguably more important to respect choices that are endorsed by the chooser, and people generally have a greater interest in preserving options that they would like to make use of. We must also consider smokers’ preferences about the ban. As noted, studies from several countries indicate that about a third of them support such a proposal; for these smokers, respect for autonomy actually tells in favour of a ban.

Importantly, people will not have equal ‘stakes’ in this decision. On the one hand, those supporting the ban may be heavy smokers who find themselves unable to quit, seeking to free themselves of a substantial burden on their health, well-being and finances. On the other hand, those who are not addicted and enjoy the occasional cigarette may find that a ban removes a source of pleasure for them. Non-smokers, too, may value the opportunity to smoke; as we noted above, people can value opportunities even if they have no intention of making use of them. However, if—as seems likely—very few non-smokers actually have any intention of using this option, their interest in keeping it open should weigh much less heavily in decisions about tobacco control. Simply ‘adding up’ these different preferences may, therefore, not be an appropriate way to give them the respect they are due. ix

Banning cigarettes: pros and cons

It is time to bring together the various strands of our argument and consider how they inform the desirability or otherwise of a ban on the sale of cigarettes. Much of the literature on strict tobacco regulation focuses on various ways in which smoking choices are significantly less than fully autonomous—involuntariness, irrationality and lack of endorsement of smoking choices are the most prominent considerations in the literature, as we discussed in the preceding sections. We agree that these factors are crucial; however, contrary to how they are viewed by other proponents of strict tobacco regulation (such as Conly and Goodin), these factors do not by themselves establish that a cigarette ban is justified, for two reasons: first, many smokers and/or smoking choices do not in fact meet the identified criterion: a significant proportion of smokers may not be addicted, not all smoking choices reflect an irrational assessment of benefits and risks, and so on. Second, when smoking choices do fall short of requirements of autonomy in these ways, interference with these choices becomes more acceptable but it does not become wholly unproblematic. As we discussed above, the primary concern for us is the well-being loss that is associated with cigarettes. We accept that a ban would interfere with some (reasonably) autonomous choices as well as restrict individual freedom, but these negative implications are far outweighed by the well-being gains a ban would imply for both current and future generations.

What speaks against a ban is, first, its negative effects on freedom, in terms of the loss of a valued opportunity to smoke and, second, its failure to respect the autonomy of the many smokers who apparently choose to smoke. With respect to the first concern, we noted that non-smokers have an interest in keeping the option of smoking open and a cigarette ban will involve a restriction of their freedom, even if they have no intention of consuming cigarettes. While it is important to acknowledge this point, we must also emphasise that this is a fairly minimal cost, especially relative to what is at stake for smokers.

The degree to which smokers value the freedom to smoke is likely to vary. Indeed, about a third would favour a ban, which indicates that they do not value the opportunity to smoke very highly, or at least that this value is outweighed by other considerations. Furthermore, it seems that the majority of smokers plan to quit and wish they had never started. Therefore, the freedom to smoke may be unimportant for many—possibly the majority of—smokers.

Regarding autonomy, we noted that by removing a source of addiction a ban would contribute to many current smokers’ internal autonomy. This is, of course, a strong reason in favour of a ban. At the same time, a ban fails to respect the choices of the many people who currently smoke, especially those who wish to continue. We have discussed how lack of voluntariness, irrationality and lack of endorsement may mean that many smoking choices warrant less respect than choices typically warrant. Of these facts, lack of voluntariness due to early smoking initiation and due to addiction, lack of second-order endorsement of the preference to smoke and a positive preference for a ban strike us as the most significant. However, many choices to smoke are not burdened by any of these factors, and even when they are, they warrant some respect.

These concerns with freedom and autonomy must be weighed against what we considered the two main considerations supporting a ban: first, the well-being gained by averting substantial health losses that many individuals would otherwise face. This includes averting the expected increase from the current 5–6 million annual premature deaths from tobacco, many of which occur in middle age, and eventually reducing this number to zero, as well as avoiding many non-fatal but severe health conditions. Second, the positive effects on equality achieved by removing a source of poor health that disproportionately affects those who are already disadvantaged.

We recognised that some smokers’ well-being might be negatively affected by a ban. This is most likely for two kinds of smokers. First, those who enjoy smoking and only smoke occasionally and thus face much smaller health risks that are outweighed by the pleasures they gain—think, for example, of people who like to smoke a cigar a few times a year. Second, those who, despite substantial cigarette use, will not see substantial benefits from cessation, for example, because they are very old or fatally ill. Cessation support and limited licensing schemes may help this latter group but do not necessarily address this concern fully. While these burdens should not be downplayed, it must be noted that a ban would lower well-being for only a small minority of people and only for the current generation.

The group that stands to gain the most from a ban, on the other hand, are lifelong heavy smokers for whom the pleasures of smoking are not worth the risks and who, because of tobacco's addictive properties, find it extremely difficult or even impossible to effectively act on their preference not to smoke. These smokers are often among the most disadvantaged in society in other regards. Significant well-being gains can also be expected for those who smoke less, and even much less—as we noted above, even low levels of tobacco consumption can be associated with significant health risks.

As far as the current generation is concerned, then, four factors speak in favour of a ban: first, very large benefits in aggregate well-being. Second, reduced inequality in well-being because the benefits accrue largely to the disadvantaged. Third, improvements in internal autonomy for those who would prefer not to smoke. Fourth, respect for the autonomy of that proportion of the smoking population who want a ban (the evidence we cited suggests that this is about a third). These considerations stand against three opposing considerations: first, diminished well-being for those smokers whose well-being is improved by smoking (which we consider to be a small number of smokers). Second, a reduction in freedom that, as we argued, should be given less weight where non-smokers are concerned, and which is unimportant to many smokers (at least to those who want a ban and perhaps also to many who do not but who do not want to smoke). Third, a ban will fail to respect the autonomy of current smokers—though some of our reasons for such respect are weakened by lack of voluntariness, irrationality and lack of endorsement. This failure of respect is arguably greatest with regard to that proportion of smokers who do not favour a ban (about two-thirds). To us, despite the weighty considerations opposing a ban, the balance is very much in its favour.

Consider now all those potential future people who have not yet faced the choice of whether or not to smoke. With an effective ban, these people will not be tempted by the presence of cigarettes. They will not encounter social settings where smoking is advantageous. They may simply regard smoking a historical curiosity. While their freedom is restricted by a ban, it seems likely that the lost option will be quite insignificant to most of them. Some future people might have improved their well-being by smoking, some will surely oppose the ban and some will think they would have liked to smoke. For some of them, the choice to smoke may have been rational and/or endorsed. We expect, however, that this group will form a small minority and a significantly smaller section of the population than is the subsection of the present population who smoke and oppose a ban. For future people, therefore, the arguments against a ban are much weaker than for current people. The arguments for a ban, on the other hand, are just as strong: well-being and equality will be promoted by preventing the harms of smoking, for future people as for current people. With respect to future generations, therefore, the case for a ban seems even more clear-cut than for the current generation.

Some of these future people, it should be noted, are already alive, in the form of children who are too young to have faced the choice of whether or not to smoke. Especially in poor countries, this group is not as large as one would like since children encounter smoking very early. Still, >600 million people are below the age of five. x This group will supply many of the 10 million annually who are expected to face premature death from smoking from 2050 and on. For them, as well as for future people, the case for a ban seems overwhelming.

For those who consider freedom and/or respect for autonomy more important than we do, or promotion of autonomy and/or well-being and/or equality less important, taking a more long-term perspective is likely to shift the balance of reasons to favour a ban. Indeed, it seems to us merely a matter of how long a perspective one takes. If we consider all the people who will be born in this present century, it is hard to see how prevention of the more than one billion expected premature deaths and the substantial individual suffering that comes with it could be outweighed by respect for the choice of some present (and some future would-be) smokers and concern for the restrictions on freedom involved.

One concern we might have about making the case for a cigarette ban is that of a ‘slippery slope’: once we acknowledge the possibility that cigarettes should be banned, what would stop us from banning, say, certain types of food, alcohol or risky sports? In response, it is crucial to emphasise that arguments about banning or legalising any particular substances or activities need to be made on their own terms and focus on the characteristics of the activity or substance in question. Much of the argument we present here relies on a combination of features that is specific to cigarettes and could not be easily extended to other substances—such as the high risks for long-term users and the high level of addictiveness. At the same time, we think that the broad strategy we pursued here—going beyond questions about individual freedom to consider the well-being impact of smoking on different individuals—could be helpful in discussing the status of other substances and activities.

Philosophical arguments for bans typically focus on particular features of smoking choices—that they are irrational, non-voluntary and/or unendorsed—that are taken to make it (fairly) unproblematic for policymakers to interfere. However, these arguments are too quick in two respects: first, many smoking choices do not, in fact, share the identified characteristic. Second, while irrationality, non-voluntariness and lack of endorsement may weaken our reasons for protecting choices, they certainly do not remove them entirely. Much of the opposition to bans rests precisely on the understanding that we have reason to respect people's choices, even when these choices are problematic in various respects. Our argument has sought to stake out a more nuanced position, which acknowledges and gives substantial weight to the potential of a ban to disrespect individual autonomy and restrict freedom but emphasises the well-being losses such a ban could avert.

Of course, the argument for a ban faces not only philosophical but also political opposition. However, the idea is slowly gaining traction in the tobacco control community and various ways of phasing in such a ban are being explored. What is more, electronic cigarettes and the debate surrounding them could provide a helpful entry point towards a serious discussion about a ban on conventional cigarettes. E-cigarettes deliver nicotine to users in a way that is much more similar to conventional cigarettes than other currently available nicotine delivery systems. While the jury is still out on the harmfulness of e-cigarettes to users and bystanders, 65 there is a decent chance that these devices will turn out to be much less harmful than conventional cigarettes. Appropriate regulation could help ensure that these harms remain below acceptable levels. To the extent that e-cigarettes can provide a substitute for conventional cigarettes, many of the costs associated with a ban—in terms of limiting freedom and forcing current smokers to quit—would be alleviated. At the same time, many of the concerns about e-cigarettes—for example, that they would act as a ‘gateway’ to conventional cigarettes 66 and that they would ‘renormalise’ smoking 67 —would fall away if conventional cigarettes are effectively banned.

Some readers may not agree with the weighing we have given to the different pros and cons of banning cigarettes. For these readers, a more cautious conclusion is that it is important to recognise the variety of considerations at stake, as well as the fact that the costs of a ban would diminish with respect to future generations as these would grow up without cigarettes. Our conclusion, however, is that in light of the substantial death and disease it could avert, the case for a complete and effective ban on the sale of cigarettes is very strong.

Acknowledgments

The authors would like to thank Adina Preda for helpful comments on an earlier draft. KG's work is supported by the Swedish Research Council for Health, Working Life and Welfare (grant no. 2009-2189). KV's work is supported by the Fonds de recherche du Québec – Société et culture (grant no. 172569).

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Provenance and peer review Commissioned; externally peer reviewed.

↵ i Note that many proposals are not alternatives to a ban but rather strategies for its implementation. This includes gradual phase-out schemes, such as the Tobacco Free Generation legislation currently under consideration by Tasmania’s government. 7

↵ ii A possible exception to this appears to be increased taxation. However, taxation comes with a set of egalitarian concerns of its own; see Voigt 19 for further discussion.

↵ iii This is in accordance with the mainstream liberal tradition whose proponents include Isaiah Berlin, 28 Joel Feinberg 29 and Ian Carter. 30 This is, we believe, a quite intuitive way to think about freedom.

↵ iv By defining autonomy negatively, we hope to remain somewhat neutral between various more substantial accounts. Sometimes, external autonomy is taken to require freedom (ref. 31 , p. 204). Since we consider freedom separately, we will leave this possibility to the side here.

↵ v For an extensive treatment of respect for less than fully autonomous choice, see Grill. 32

↵ vi For a range of perspectives, see Elster and Skog; 48 for a convincing case that addicts do display some particular irrationality, see Rachlin. 49

↵ vii The idea that smoking might be pleasurable typically receives little attention in the literature. For an interesting discussion of how the relationship between harm and pleasure is viewed in public health discourses about smoking, particularly in the context of e-cigarettes, see Bell and Keane. 53

↵ viii This should not detract from the concern that unfair inequalities can affect the costs and benefits associated with smoking and thereby the extent to which the risks of smoking become acceptable. For example, as we mentioned in the section ‘Equality’, social norms around smoking vary across social groups, with smoking often playing an important social role in disadvantaged communities but much less so in affluent ones; this means that not smoking can come with a cost for those in disadvantaged communities that does not exist for those in wealthier ones. That this can make the risks of smoking more acceptable in some social groups than others should be viewed as an unfair disadvantage. 19

↵ ix On respect for divergent preferences in groups, cf. discussion on group consent by Grill. 64

↵ x CIA World Factbook, https://www.cia.gov/library/publications/the-world-factbook/geos/xx.html

Linked Articles

Mini-Symposium: Regulating smoking Ethics of tobacco harm reduction from a liberal perspective Yvette van der Eijk Journal of Medical Ethics 2015; 42 273-277 Published Online First: 26 Nov 2015. doi: 10.1136/medethics-2015-102974
The concise argument Paternalism on Mars Dominic Wilkinson Journal of Medical Ethics 2016; 42 271-272 Published Online First: 25 Apr 2016. doi: 10.1136/medethics-2016-103598

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Conclusion of Smoking Should Be Banned on College Campuses Essay

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Introduction

Arguments in favor of smoking in campus, arguments against smoking in campus, reconciliation of the two positions, campus smoking: conclusion of the essay, works cited.

The idea of smoking in colleges and campuses has developed a mixed reaction in the USA and in many other parts of the world such that it has posed a very hot and contentious universal debate.

Several campuses and colleges have tried to impose a total ban on smoking within their environs, some of them succeeding while others failing to do so. For instance, colleges like Santa Ana and Fullerton have managed to ban smoking completely within their environs, while others such as Huntington Beach and Golden West College still allow smoking in prescribed places such as in parking lots.

Fullerton College was the first to successfully impose a smoking ban in the year 2007 (Bates 57). Nevertheless, many colleges and campuses have not managed to follow suit because of some state laws which assert that smoking is only proscribed inside buildings and within 20 feet from entry points of buildings in all campuses. These laws continue to give students the right to smoke within certain areas of their campuses.

As aforementioned, section 7595 of the government code affirms that smoking is proscribed only in public buildings and within 20 feet from entry points of buildings in all campuses (Merrill 36).Therefore, the opponents of this subject believe that since it is the right of every citizen to do anything that is recognized as legal, it is very wrong to impose a total ban on smoking, especially in campuses.

The most important thing is to ensure that students follow the laid down rules and regulations such as the strict use of the recommended areas of smoking. In deed, it is very unfair to send students off campus to smoke.

In addition, the opponents of this argument believe that smoking should not be banned because it helps students to relax whenever they are in stressful situations. Concerning the health risks that are brought about by smoking, they assert that every mature citizen should be in a position to separate good behavior from wrong behavior.

They say that since there has been an integration of cigarette smoking topics in schools for several decades, by the time a student reaches campus, he/she must be in a position to understand the risks that cigarette smoking poses to their health and therefore they should be able to make informed decisions about smoking. They also argue that it is very unfair to impose an immediate ban on cigarette smoking in campus yet it is clearly understood that smoking is an additive activity which can not be stopped at once.

Even though campus students have the right to smoke within some prescribed areas whenever they wish to do so, as mandated by some state laws, they ought to realize the fact that cigarette smoking has got very serious and detrimental effects on human health. Smoking of cigarettes can bring about lung infections to both first-hand and second-hand smokers. Therefore, smokers need to recognize that their right to smoke may greatly infringe on the rights of their non-smoking counterparts.

It is obvious that students know the negative effects of smoking cigarettes. For instance, it is expensive for them and it may also reduce their lifetime. Generally speaking, cigarette smoking is just bad. Currently, at least forty three colleges in the USA have imposed a total ban on cigarette smoking in their campuses and this trend is increasing especially among commuter schools and community colleges (Merrill 40).

However, it is hard to impose such a ban in some colleges because of the mixed reactions that are held by different stakeholders about the issue of smoking, and the existing campus policies which give the smokers the right to smoke in prescribed areas. According to the research that was carried out by the U.S. Department of Health and Human services, 31% of college students smoke cigarettes. This figure exceeds the national general average of 25% (Longmire 15).

It is also worth to note that even though there has been an integration of cigarette smoking topics in schools for several decades, cigarette smoking has continued to attract many youths and this continues to raise a lot of alarm about their future. This is because cigarette smoking is the major contributor of the cases of lung cancer in the entire world.

Research indicates that close to eighty percent of men who die from lung cancer, and seventy five percent of women who die from the same disease do so because of smoking tobacco. Research also indicates that the risk of lung cancer increases when a person starts smoking at an early age, and with an increase in the number of cigarettes that a person smokes in a day (Robicsek 56).

Scientific research has proved that cigarette smoking is harmful to the body. The smoke that comes out of a burning cigarette is a compound mixture of several chemicals which are produced when tobacco is burned.

This smoke contains a deadly compound called tar, which consists of more than four thousand chemicals which are very poisonous, and a majority of them have been clearly identified to be the main cause of cancer. Most of these chemicals are also known to cause lung diseases and heart problems. Some of these chemicals include cyanide, benzene, methanol, ammonia, formaldehyde and acetylene (Merrill 45).

Other deadly substances that are found in cigarettes include carbon monoxide and nitrogen oxide gases which are very poisonous. The most active component of a cigarette is nicotine. Nicotine is a very addictive compound. Cigarette smoking can cause several problems such as cancer, lung damage and heart infections among many other diseases.

Research also indicates that more than thirty percent of the deaths that result in the United States occur due to the use of tobacco. Cigarette smoking also causes eighty seven percent of the deaths that result due to lung cancer. Other types of tobacco-related cancers include mouth cancer, cancer of the larynx, cancer of the throat and esophagus and cancer of the bladder. There is also a very close connection between cigarette smoking and the occurrence of the cancers of the kidney, pancreas, stomach and the cervix.

Cigarette smoking can also cause lung damage which begins at the early stages of smoking. Cigarette smokers encounter many problems with their lungs as compared to non-smokers and this situation gets worse when an individual increases his/her capacity to smoke. Smoking is linked to many dangerous lung infections which are just as perilous as lung cancer. These infections include emphysema and chronic bronchitis which cause difficulties in breathing and may even cause death.

Cigarette smoking also augments the risk of heart infections which stand out as the major causes of deaths in the U.S. Out of all the risk factors of heart infections, i.e. excess cholesterol, diabetes, obesity, cigarette smoking, physical lethargy and high blood pressure, cigarette smoking remains the leading risk factor for impulsive deaths that result from heart attacks (Bates 78).

In addition, low levels of cigarette smoking which may not be able to cause lung infections are capable of damaging the heart. Therefore, second-hand smokers also stand a very high chance of getting heart infections.

As stated earlier, Section 7595 of the government code affirms that smoking is proscribed in all public buildings and within 20 feet from entry points of buildings in all campuses (Merrill 36). Even though this ruling is good, it is not sufficient because it seems to discriminate the innocent second-hand smokers who continue to suffer from cigarette smoke which pollutes the air around them.

Cigarette smoking has also very detrimental effects to the real smokers and therefore they should be able to accept this ban because it is meant for their own good. Though it is very hard to ban citizens from doing something which is legally right, smoking should be gradually banned in campuses so as to protect the non-smokers. This is because campuses are public places which consist of both smokers and non-smokers.

My stand on this issue differs significantly from my opponents who believe that smoking should be allowed in some prescribed areas in campuses. My stand is that cigarette smoking should be banned in campuses because it impacts negatively on the non-smokers. Banning of cigarette smoking in campuses would enable the non-smoking citizens to enjoy the delight of breathing unpolluted air.

Nevertheless, my stand does not include cigarette smoking in private places such as in homes. At the same time, cigarette smokers should understand that the non-smokers are not trying to be intolerant when they keep on complaining about them. Rather, they are doing it for the sake of their own health.

In conclusion, smoking should be totally banned in campuses and colleges because of its severe health risks to both smokers and non-smokers. The health risks are much more to non-smokers because they may double up especially to those who already suffer from other ailments such as heart and lung problems.

In addition, a very short exposure by a non-smoker to secondhand smoke may have abrupt severe effects on his/her cardiovascular system thus escalating the risk for lung and heart infections. This makes the non-smoker to have a higher risk of catching infections from cigarette smoke than the real smoker yet he/she is very innocent. A more effective way of reducing smoking in campuses would be to provide tobacco termination counseling programs in the campuses.

Bates, Tim & Gordon Mangan. Smoking and Raven IQ. New York: Pocket Books, 2007.

Longmire, Wilkinson, & Torok Edgar. Oxford Handbook of Clinical Medicine. Oxford: Oxford University Press, 2006.

Melo, Maurice. Cigarette Smoking and Reproductive Function. Oxford: Oxford University Press, 2009.

Merrill, David. How Cigarettes are made. London: Oxford University Press, 2000.

Robicsek, Francis. Ritual Smoking in Central America. Cambridge: Cambridge University Press, 2008.

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Should smoking in...

Should smoking in outside public spaces be banned? Yes

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George Thomson , senior research fellow 1 ,
Nick Wilson , senior lecturer 1 ,
Richard Edwards , associate professor 1 ,
Alistair Woodward , professor 2
1 University of Otago, Wellington, Box 7343, Wellington, New Zealand
2 University of Auckland, Private Bag 92019, Auckland, New Zealand
Correspondence to: G Thompson george.thomson{at}otago.ac.nz

After success in stopping smoking in public buildings, campaigns are turning outdoors. George Thomson and colleagues argue that a ban will help to stop children becoming smokers but Simon Chapman (doi:10.1136/bmj.a2804) believes that it infringes personal freedom

Legislation to ban smoking indoors in public places is now commonplace, driven mainly by the need to protect non-smokers from exposure to secondhand smoke. A new domain for tobacco control policy is outdoor settings, where secondhand smoke is usually less of a problem. However, the ethical justification for outdoor smoking bans is compelling and is supported by international law. The central argument is that outdoor bans will reduce smoking being modelled to children as normal behaviour and thus cut the uptake of smoking. Outdoor smoke-free policies may in some circumstances (such as crowded locations like sports stadiums) reduce the health effects of secondhand smoke 1 ; will reduce fires and litter 2 ; and are likely to help smokers’ attempts at quitting.

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Band 5+: Smoking can cause serious illnesses and should be made illegal. To what extent do you agree or disagree?

Nowadays seriously diseases are raising and the smoking is the particular reason for it. Therefore, many consider that it should take an action by legal. I completely agree with tis opinion and think that it will cause to survive peopleʼs life who are dying from smokingʼs hazards.

First of all I beleive that currently

many people are suffering from dangers of this bad habit. According to the statistics, thousands of people decease from it everyone year. Also smoking result in many diseases such as vascular diseases, various cancers and other serious sicknesses as well. Thatʼs why it would be better if government ban the sale of cigarettes or customers of this will be fined expensive penalties then probably the sale will reduce. It is impossible to ban it completely. So plus, the demonstration of dangers of tobacco products on TV on a regular basis can also effect to decreasing.

As coin has two sides, the prohibitions have some disadvantageous sides. One good illustration of this is there are a lot of tobacco product brands,many manufactures. If saling bans, this merchans also will face failures.Moreover Many people are addict to this habit and giving up will not be easy.

To sum up, maybe we can not disallow it fully as I mentioned before, however we can mitigate and decrease to sale at least. Besides people are responsible of their health and they have to concern about it.

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More and more people decide to eat healthy food and exercise regularly. What are the reasons for this trend? What can be done to encourage more people to eat healthier and exercise?

Some people think that environmental problems are too big for individuals to solve. Others believe that individual actions can help improve the environment. Discuss both views and give your opinion.

Newspapers have an enormous influence on people’s opinions and ideas. Do you think it is a positive or negative situation?

Many people prefer to watch foreign films rather than locally produced films. Why could this be? Should governments give more financial support to local film industries?

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