Friday, May 25, 2007

The FDA and Tobacco

Multiple media outlets (USA Today, FOXNEWs, etc.) reported yesterday that a governmetn advisory panel has advised that the FDA should regulate tobacco:

"A government scientific advisory panel proposed sweeping changes Thursday to reduce the health burden of tobacco, which claims 490,000 American lives a year.

"The report from the prestigious Institute of Medicine calls on Congress to allow the Food and Drug Administration to regulate cigarettes as drugs and control the way tobacco is marketed. Authors from the IOM, a panel of independent experts who advise the government on health policy, say they aim 'to reduce smoking so substantially that it is no longer a significant public health problem.'"
The report suggested several specific steps to reduce tobacco use:
  • Requiring all insurers — including the Medicare and Medicaid programs — to cover smoking-cessation programs.
  • Licensing retailers that sell cigarettes, just as states issue licenses to sell alcohol.
  • Raising cigarette taxes as much as $2 a pack, an effective way to reduce smoking.
  • Dedicating $15 to $20 per capita annually of the proceeds from higher taxes or other resources to fund tobacco control efforts in each state.
  • Banning smoking in all non-residential indoor areas.
  • Limiting tobacco advertising and promotional displays to text-only, black-and-white formats.
  • Launching additional efforts aimed at curbing youth interest in smoking and access to tobacco, including bans on online sales of tobacco products and direct-to-consumer shipments.
  • Requiring new, large pictorial warnings on the harmful effects of smoking -- similar to those required in Canada -- on all cigarette packs and cartons.
So, the purpose of these changes would be to "reduce the health burden of tobacco." The question occurs to me: on whom is the burden? The individual or society? If the health burden of tobacco is on the individual (and assuming no one has forcibly detained the individual for a significant portion of his or her life, forcing them at gun point to smoke a pack or more a day), then it is a self-imposed burden.

One must ask, therefore, why society should try to "save" people from themselves.


As soon as one asks that question, however, it seems to me that they have a problem: that's no what anti-smoking activists want to do. They never say "we want to regulate this product to save people from themselves" rather, they say "we want to regulate this product to save people from the harmful effects of a product that is aggressively marketed by powerful corporations who control powerful lobbyists in Washington."

Anti-smoking campaigns seem to go to pain to gloss over the fact that people choose to smoke. Rather, they focus on everyone except the person who has actually chosen the activity (and the burden): the company that sold them the product, the government that allowed it to happen, etc.

I suspect that at least one reason for this tactic is that, generally speaking, people do not sympathize with people who get themselves into trouble (especially knowingly) and then want others to get them out.


If someone has freely chosen to accept the consequences of their actions, why should others be taxed, or forced to pay higher insurance premiums, or not allowed to use their property in the way in which they wish, etc. in order to "make up for" the mistake of the individual?

If however, the health burden is on society (for example, in the form of increased health insurance costs or taxes on everyone in order to pay for the subset that smokes), then one must ask "why?" Why does society bear the burden of an individual's heath problem that was brought on by an extremely long series of decisions to smoke a cigarette? Perhaps a better way to discourage smoking (whether or not that in itself is a good end) would simply to shift the burden back to the individual by allowing insurance companies to offer people plans that do not cover smoking cessation programs nor smoking related health problems. The fact that these plans would be cheaper (and, therefore, attract a lot of eligible people away from other plans) would raise the cost of the plans that cover smoking - thus increasing the cost of smoking to the smoker.

In any event, it seems to me that this series of recommendations aimed at reducing smoking is another example (others being proposed bans on fast food and proposed bail outs for defaulting sub-prime mortgagees) of a mentality that the individual does not (or should not) bear the responsibility of their actions - rather, that responsibility is shifted to society (or the government), especially when, by "responsibility", we mean "burden".

This seems to me to be a variation on the theme of socialism (both in the economic and political senses) - mistakes are not punished, achievements are not rewarded. Everyone bears the burden of everyone else's problems (even when they are self imposed) and everyone gets to consume the fruits of everyone else's labor.


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