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

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. "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.

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Ending the Tobacco Problem: A Blueprint for the Nation

should be permitted to continue to promote and market this admittedly dangerous product.

The central point is that cigarettes and other tobacco products are not ordinary consumer products. For no other lawful consumer product can it be said that the acknowledged aim of national policy is to suppress consumption. For alcohol, the generally accepted aim of national policy is to suppress underage drinking and excessive or otherwise irresponsible use by adults; reducing adult consumption per se is not the nation’s goal. Indeed, in many respects, state and federal governments aim to facilitate alcohol consumption, such as by liberalizing access (IOM/NRC 2004). Similarly, although firearms are indisputably dangerous products, and their unlawful sale, possession, and use is suppressed, their lawful use is widely regarded as a valued constitutional right, and many aspects of recent changes in state law have been designed to facilitate access to weapons by lawful purchasers and owners. In terms of its goal, tobacco policy has more in common with the nation’s policy toward marijuana and other illegal drugs than it does with policies pertaining to alcohol or firearms.

It has become commonplace for critics of aggressive tobacco control measures to invoke the classic slippery slope argument, claiming that restrictions on tobacco will lead down the slope to measures taking away food and drinks that people like on the ground that they are not healthy enough. After all, it is said, if the “nanny state” is empowered to suppress tobacco use, it will go after the Big Mac­® next. This argument underappreciates the extent to which tobacco products are unlike ordinary consumer products. Tobacco is a highly addictive, carcinogenic, and deadly product. Foods rich in fats or carbohydrates may lead to overweight and increase disease risks if consumed in excess, but they are not addictive or inherently dangerous. It therefore bears repeating that tobacco is the only lawful consumer product for which the nation’s unequivocal aim is to suppress consumption altogether—rather than promoting informed, healthy choices and moderation.

That being the case, governments at all levels must play a central role in the effort to overcome and reverse the forces that create and sustain tobacco use. Governments have both the authority and the obligation to establish and sustain conditions under which people can be healthy while respecting the constitutional liberties and other important values (IOM 1988, 2003). People trust and expect the government to protect children from hazards such as poisons, lead, and tobacco; to prevent the tobacco industry from misleading people and drawing them into or sustaining an addictive behavior that they will regret; to counteract industry efforts to stimulate and sustain demand for its dangerous products; and to help people quit if they want to do so.

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153
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)