National Academy of Sciences | 150 Year Anniversary

Questions? Call 800-624-6242

| Items in cart [0]

The National Academies Press

HARDBACK
price:$49.95
add to cart

Rights & Permissions

topleft topright

Ending the Tobacco Problem: A Blueprint for the Nation (2007)
Board on Population Health and Public Health Practice (BPH)

Citation Manager

. "PART II A BLUEPRINT FOR REDUCING TOBACCO USE, 4 Reducing Tobacco Use: A Policy Framework." Ending the Tobacco Problem: A Blueprint for the Nation. Washington, DC: The National Academies Press, 2007.

Please select a format:

BibTeX EndNote RefMan


Page
150
bottomleft bottomright

The following HTML text is provided to enhance online readability. Many aspects of typography translate only awkwardly to HTML. Please use the page image as the authoritative form to ensure accuracy.


Ending the Tobacco Problem: A Blueprint for the Nation

liberty-enhancing effects (achieved by assisting addicted smokers to quit) and liberty-restricting effects (insofar as they also “burden” the choices of smokers who do not want to quit or who object to the restrictions or costs imposed on them). Thus ethical analysis of tobacco control interventions within the libertarian paradigm requires a weighing of the liberty-reducing effects of particular intervention against the liberty-enhancing effects of these interventions for nonsmokers whose freedom to avoid ETS exposure is protected, for youths whose long-run autonomy is preserved, and for adult smokers whose ability to quit is enhanced (and who therefore regard the intervention as a benefit rather than a cost).

Even within these boundaries, however, burdens on individual smokers that are intrusive or coercive do require heightened justification. The more restrictive the intervention (and, consequently, the greater the burden on smokers’ freedom) the stronger the case must be that the intervention protects youths or nonsmokers or helps smokers quit. That important principle is embraced by the committee in its evaluation of each of the tobacco control interventions considered in the following chapters.

AN ASIDE ON THE PATERNALISM PROBLEM

It can also be argued that paternalism in this context is a justified response to irremediable deficiencies in smokers’ capacity to successfully exercise self-interested decision-making about whether they should continue to smoke. Although the committee’s blueprint need not rest on this argument, many committee members do find elements of it convincing, and that is why we summarize it here.

The argument runs as follows: (1) virtually all addicted adults begin smoking (and probably become addicted) while they are adolescents before they have developed the capacity to exercise mature judgment about whether or not to become a smoker; (2) the preferences expressed when people begin to smoke, which tend to ignore long-term health risks, are inconsistent with the health-oriented preferences they later come to have, and they soon regret the decision to have become a smoker; and (3) once smokers begin to be concerned about the health dangers of smoking, their judgment is often distorted by optimism bias (“the harms will happen to other people, not to me”), thereby weakening their motivation to quit.

Adolescent Initiation

As shown in Chapter 2, between 80–90 percent of smokers start smoking before they turn 18 years of age. When they begin to smoke, they typically lack a full and vivid appreciation of the consequences of smoking and the grip of addiction, even if they have a roughly accurate understanding of

Page
150
Front Matter (R1-R16)
Summary (1-28)
Introduction (29-38)
PART I BACKGROUND, 1 Epidemiology of Tobacco Use: History and Current Trends (39-76)
2 Factors Perpetuating the Tobacco Problem (77-106)
3 Containing the Tobacco Problem (107-142)
PART II A BLUEPRINT FOR REDUCING TOBACCO USE, 4 Reducing Tobacco Use: A Policy Framework (143-156)
5 Strengthening Traditional Tobacco Control Measures (157-270)
6 Changing the Regulatory Landscape (271-340)
7 New Frontiers of Tobacco Control (341-354)
Index (355-372)
Appendix A Comprehensive Smoking Cessation Policy for All Smokers: Systems Integration to Save Lives and Money (373-422)
Appendix B Clean Air Laws (423-434)
Appendix C Warning Labels and Packaging (435-448)
Appendix D The Long-Term Promise of Effective School-Based Smoking Prevention Programs (449-477)
Appendix E Adolescents' and Young Adults' Perceptions of Tobacco Use: A Review and Critique of the Current Literature (478-494)
Appendix F Interventions for Children and Youth in the Health Care Setting (495-502)
Appendix G Reducing and Preventing Tobacco Use Among Pregnant Women, Parents, and Families (503-515)
Appendix H Smoking in the Movies: Its Impact on Youth and Youth Smoking (516-551)
Appendix I State Statutes Governing Direct Shipment of Alcoholic Beverages to Consumers: Precedents for Regulating Tobacco Retail Shipments (552-577)
Appendix J The Role of Public Policies in Reducing Smoking Prevalence: Results from the SimSmoke Tobacco Policy Simulation Model (578-598)
Appendix K Commissioned Simulation Modeling of Smoking Prevalence as an Outcome of Selected Tobacco Control Measures (599-640)
Appendix L Controlling the Retail Sales Environment: Access, Advertising, and Promotional Activities (641-652)
Appendix M Sales and Marketing of Cigarettes on the Internet: Emerging Threats to Tobacco Control and Promising Policy Solutions (653-678)
Appendix N Media Campaigns and Tobacco Control (679-689)
Appendix O Advocacy as a Tobacco Control Strategy (690-703)
Appendix P Special Populations with Higher Rates of Cigarette Smoking: Identification and Implications for Tobacco Control (704-716)