Public Health

The Problem With Licensing Smokers: Too Much Individual Responsibility

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Simon Chapman, an Australian anti-smoking activist, argues in PLoS Medicine that "new, creative, and radical efforts to achieve the tobacco control endgame" are "vitally important." Jeff Collin, a public health specialist at the University of Edinburgh, agrees, especially since "the attainment of a tobacco-free future, so critical to any global conception of health for all, remains elusive." But Collin objects to Chapman's proposal for a smart-card-based smoker's license, arguing that "effectively curbing this industrial epidemic is best achieved via actions that tackle the disease vector"—i.e., tobacco companies.

This is what passes for a debate in public health circles, where no one questions the government's duty to protect us from our own risky choices.The only argument concerns the best method of achieving "health for all." Worries about creeping totalitarianism are limited to the possibility that public perceptions of it might impede the march to a world in which no one sacrifices health or longevity for the sake of pleasure or convenience.

In this case, Chapman imagines an electronically monitored system in which smokers would pay progressively higher fees for rations of one to 10, 11 to 20, or 21 to 50 cigarettes per day. The annual fees would serve as a stick, penalizing smokers for their unhealthy habit, and a carrot, since they could be recovered (with interest!) by smokers who surrendered their licenses and committed themselves to a tobacco-free lifestyle. New smokers would have to pass a test showing their knowledge of the relevant health risks, and the minimum age for smoking would be gradually raised to 23. Chapman argues that the license fees—which "would neither be trivial nor astronomical," perhaps ranging from $100 to $200 a year (27 to 55 cents a day)—would encourage people to quit. Furthermore, "the requirement for a license would send a powerful, symbolic message to all smokers and potential smokers that tobacco was no ordinary commodity."

While "opponents of the idea would be quick to suggest that Orwellian social engineers would soon be calling for licenses to drink alcohol and to eat junk food or engage in any 'risky' activity," Chapman says, they can be reassured that there is no slippery slope because smoking is uniquely dangerous. He further positions himself as a moderate by questioning a Singaporean proposal for a complete ban on smoking by anyone born after 1999, saying "libertarian objections that adults should be free to take informed risks, as with smoking, may render such a plan politically unacceptable." Not that there is anything to such libertarian objections, mind you; it's just that tobacco controllers need to take such antiquated political prejudices into account.

Collin, Chapman's ostensible opponent in this quasi-debate, likewise worries that "the authoritarian connotations of the smoker's license," although not inherently problematic, "would inevitably meet with broad opposition." Similarly, Collin warns that people might object to the data collection necessary for Chapman's scheme to work, although "in countries where digital ID cards are routinely carried or objections to authorities holding data are limited…linking tobacco purchases to such [smart] cards may be largely unproblematic technically or politically." Collin also complains that Chapman's plan puts "a direct focus on smokers," as if they are responsible for their behavior, when we all know it is really the fault of evil corporations. Charging for cigarette licenses "would be censuring the poor," he says, and "has the potential to dramatically exacerbate [smokers'] stigmatization"—unfair, presumably, because they just can't help themselves. Collin reminds Chapman that "a fundamental challenge confronting any endgame strategy is that the move towards a tobacco-free society should address the social determinants of health and promote equity and social justice."

Yes, that is the problem with forcing smokers to pay for a government-issued smart card that keeps track of their consumption and punishes them for their own good: insufficient social justice.

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  1. Jesus, this is like a whole new level of asshole.

  2. First. Congratulations on a fantastic and takedown of a terrible idea from a terrible person. The final line is gold.

    Yes, that is the problem with forcing smokers to pay for a government-issued smart card that keeps track of their consumption and punishes them for their own good: insufficient social justice.

    Funny and sad at the same time.

    1. What’s this “First” shit, kemosabe?

      1. First ‘Murrican

        1. Although, to be fair, most of the commentators here would altogether prefer to not consider California part of America.

  3. Activists aren’t known for their rationality in their field of interest and should generally be ignored in policy making.

  4. critical to any global conception of health for all,

    Funny, my global conception of health for all involves eliminating all cancer and other diseases, not just smoking-related cancer/disease. Once we crack that nut, whether via genetics, nanotechnology, or whatever, there won’t be any health-based reason for a “tobacco-free” dystopia at all.

    1. This has nothing to do with health. Nothing. As always, it is about control. It is always about control.

      “Perhaps I’m not a good actor, but I would be even worse at doing anything else.”

      1. This. There are two chances that the tobacco jihadists would back off if the disease aspect went away: Slim and none.

    2. Actually, shouldn’t the feds be encouraging more people to smoke? Early deaths, less people for the unfunded pensions/Medicare/Social Security. Easiest way to balance the budget!

  5. They were scolding Bond for his unhealthy ways a long time ago.

    1. I remember that You Only Live Twice had some jabs at his smoking habit.

  6. When I was a child, cigarette smoking was ubiquitous. You were an adult, you smoked. It was a given. Non-smokers were a true discrete and insular minority.

    (And if there was any truth at all to the “second-hand smoke” hysteria, with the perpetual tobacco smog in my grandparents’ apartment in Brooklyn, I should have been dead years ago).

    By the time I graduated high school everything had changed. Smoking had become the activity of a minority, with the majority of adults having either never smoked or having had quit. And it was not the result of oppressive legislation or petty legal harassment. Astoundingly for statists and “activist” such as those described in Jacob’s story, adult human beings, when presented with the facts, made their own decisions not to smoke. Freely, voluntarily, and without coercion.

    Compare this to the War on Drugs and Prohibition, when the force of law was used to change behavior. Both failed.

    The prohibitionists and the professional busibodies never seem to learn this lesson. But it isn’t really about success, is it? It’s about using the power of the state to beat on people you do not like.

  7. Hell, it’s always guys named Chapman.

  8. “…the attainment of a tobacco-free future, so critical to any global conception of health for all…”

    ‘Health for all’ = ‘Control of all’

    i.e. “Once you buggers decided that Government should run the healthcare system, it was really only a matter of time before they took their mandate to ‘look out for you’ on your behalf to its logical conclusion = make all decisions about your behavior for you as well.”

    Seriously…anytime I hear the words ‘social justice’, i hear, “MORE CONTROL MUST HAVE MORE CONTROL”

  9. I can’t even remember what they topic was, but as I told Mrs. Dean this morning “Once you’ve got jackboots on, everybody looks like they need a good kicking.”

    1. No one wants to hear about your sex life, RC. Except maybe NutraSweet.

    2. I hope you didn’t tell her that while you were wearing jackboots and flashing the MALE GAZE at her.

      1. I believe I was wearing wingtips, and peering through my monocle at the morning news.

  10. “The annual fees would serve as a stick, penalizing smokers for their unhealthy habit, and a carrot, since they could be recovered (with interest!) by smokers who surrendered their licenses and committed themselves to a tobacco-free lifestyle.”

    Well that sounds like a hell of a retirement savings program!

  11. Of course it’s about control. Even these jackoffs had to have noticed that prohibition never works.

    If anything, they look forward to the black markets this would create: new vast opportunities for graft. Money and power! Yippee!

  12. Youve got to admit that makes a lot of sense dude.

    http://www.Anon-Day.tk

  13. One the one hand, I’m anxious to see Scotland become free in the upcoming vote they have scheduled.

    On the other hand, it’s gov’t is apparently a one-state lefty nightmare, JUST LIKE FUCKING CONNECTICUT, so I don’t know how long they’ll last.

    1. See that independence shrivel like a raisin when the UK requires the Scots to assume their part of the public debt as a precondition.

      See the whole country say “fuck independence!!!” and sing God Save the Queen in one voice.

  14. I am re-posting my post from an earlier smoking thread.

    “My wife wanted to quit smoking, so she got an e-ciggarette. No smoke, no tar, just water vapor. She started smoking it at work. Some co-workers saw her using it and wanted to try it themselves. After a couple of months a dozen people had switched to e-ciggarettes. That was 2 years ago and all but two of those have quit entirely.

    In the mean time the smoke banners struck. No more tobacco smoking on the grounds of the hospital…anywhere. Then the smoke banners showed their true colors. After several people were observed smoking e-ciggarettes those were banned also. It doesnt matter that they are harmless or that they help people quit. Smoke banning isnt about health, it is about punishment and control.

    Fucking sadistic puritans.”

    I will add this; given the opportunity, I will kick the living shit out of simon chapman and jeff collin. I dont mean that metaphorically, I mean I will kick them until shit runs out of them.

    1. I just made the switch to e-cigs myself this week.

      And when looking at all of the brands, one of the things I heard from multiple retailers that I spoke to was that the big, weird ones that look like a Star Trek woodwind instrument are more popular, because bars will generally allow those, while still barring the ones that look like actual cigarettes.

      Well I got one of that latter variety anyway, b/c since my friends are still going outside to smoke, I’m going out with them. I’m used to it anyway. But that really goes to show it’s as much about an icky proletarian image as much as anything else.

      1. What brand did you decide on and where are you getting them from, JJ? I’m thinking of switching over myself.

        1. Everyone (at the tobacco shops) was trying to sell me on these Volcano brand ones, but like I said, I don’t want to look like I’m sitting in a Turkish coffee house.

          That being said, I settled on the V2s, and also have some Choice 7s disposables, for variety.

          It’s not the same, and don’t let anyone lie to you and tell you otherwise. But it’s close enough to make due. Like switching from real beer to an American macro-lager. If the goal is to quit real beer, the Miller Light can still fill in, even though it doesn’t feel quite right.

          And take long, sloooow drags. That’s what produces the most vapor. Inhaling too hard or too fast, as you would do w/ a real cig, doesn’t give the liquid time to vaporize. So that takes some getting used to.

          1. Having a penis in your mouth helps also.*

            *mandatory sodomy joke as per usual w/ all Episiarch conversations

          2. I’m not super addicted to cigarettes in the first place, so all that sounds fine. Basically I still enjoy nicotine but wouldn’t mind removing the smoke factor so that I could smoke inside during the miserable Seattle winter (I never smoke inside my own dwelling).

            1. Few people do anymore, IME. That’s not a social ninny thing; people just figured out that if your house has yellowed walls and stinks to high heaven, you’re going to have a harder time selling it. I only know one friend of mine who actually still smokes in her house.

              I was the same way. I wasn’t a pack-a-day monster or anything, but somewhere between 5 – 8 per day. I cut it down to 4 pretty much on my own, but had a hard time severing that final cord.

              I’m down to 2 real cigs a day, and hope to be down to 1 in a couple of weeks, and then none.

              After that, it’s straight opium for me.

              1. They actually have atomizers now that have been designed specifically for smoking weed in. I haven’t tried that yet as I don’t blaze much anymore, but eventually I’ll get around to trying it.

                1. I very rarely smoke weed, like maybe once every couple of years. A friend has a vaporizer, and I smoked through it back in May. I was fucked up. Super high. Like out of my gourd, crazy eight bonkers high.

      2. I’ve been using the ecig for a couple of years now.

        When I first tried it, I used the ones that looked like a cig too, simply for the convenience and lack of awkwardness of it. But for effect, the others are really the way to go.

        The gold standard among ecigs is the Joye eGo. It uses a standard 510 atomizer, but there’s been a revolution in atomizers now so I would recommend the vision atomizer. Feel free to pick my brain on the subject, as I’ve become a bit of an amateur expert on the subject.

        1. Can you provide some links? Where do you get yours? How much do they cost? What have you experienced in terms of smoking inside various places/establishments?

          1. Gladly.

            Instead of a starter kit (the atomizer on those isn’t as good or as convenient as the newest ones), order your items a la carte.

            The best battery Longer battery life between charges, good hit that gives a throat hit comparable to an actual cigarette.

            Here’s the atomizer I recommend. You can fill it with a couple of milliliters of juice at a time so that you don’t need to constantly refill or direct drip onto the atomizer. Get a couple of those as they do burn out after a month or two of use. You can also check out the ego 2.4ml Changeable Coil cart, which allows you to change the coil instead of needing a new atomizer completely (change coil is $2.50).

              1. As for e-liquids, I recommend if you’re trying to quit smoking, get one of the tobacco-ish juices, but keep in mind that it can’t truly replicate the taste of burning smoke. If anything, the taste is more like the scent of a freshly opened pack of cigs. After a while, you’ll end up preferring that taste to actual cigs (which I still have once in a month or so if I go out drinking with buddies, along with a weekly cigar).

                But you can try out the other flavors too, and may end up liking those. Go to vaportalk.com for a forum where you can learn about different suppliers of juice and hardware, see reviews of different juices and products, and learn about different techniques, mods, products, and maintenance.

                1. Thanks, dude.

                  I’m not trying to quit smoking, I just want to smoke inside and possibly even in restaurants and the like. I don’t smoke a lot (maybe 5 a day, mostly in the evening). But to be able to do it in, say, the movies or the airport would be pretty awesome.

                2. As for e-liquids, I recommend if you’re trying to quit smoking, get one of the tobacco-ish juices, but keep in mind that it can’t truly replicate the taste of burning smoke.

                  Do you have a specific one that you recommend? My dad tried to go to an e-cig, but he abandoned it because it didn’t taste right to him, and he didn’t get enough nicotine out of it. I think the liquid he was using wasn’t flavored.

                  I’ve been thinking of getting him a better one for Christmas with the right juice (he got one of those cheap or free-ish starter kits). He’s one of those that has to have it as close to smoking a real cigarette as possible, or he won’t use it.

                  1. I should note that the stuff he’s smoking now are homemade cigarettes using a “Smooth blend Kentucky Select Gold Pipe Tobacco”. So something close to that (or to Winston Gold, which he smoked before he went to homemade ones) would probably be best.

          2. As for smoking inside various places, I do at work when I go into the office (although I go in once every few months and mostly telecommute). I haven’t used it at bars or restaurants, but I’ll use it outside at smoking areas and whatnot (last time I was at Disneyland, I would only use it at smoking areas). But I use it inside my house all the time, no negative scents that linger, vapor disappears quickly.

            1. I’ve only just dipped my toes in these here waters, but looks like you’ve been full-on skinny dipping in them for quite awhile. I’ll take a look at all of those links.

              I purposefully got the one that looked like a real cig b/c I thought it would help. Now I’m wondering about that choice. I really don’t want to look like I’m plaing an instrument from Star Trek.

    2. I will add this; given the opportunity, I will kick the living shit out of simon chapman and jeff collin. I dont mean that metaphorically, I mean I will kick them until shit runs out of them.

      That’s a little harsh. You should just give them a smartcard and make them pay for having stupid opinions. Of course, if they refuse to pay their fair share for your blood pressure meds, then it’s time for shitkicking.

  15. Whenever I read about these various “activists” the phrase that comes to mind is “Get a fucking life already.”

  16. “the attainment of a(n) x-free future, so critical to any global conception of health for all, remains elusive…”

    For which values of x does this sentence fragment make any sense at all? I can think of a few specific diseases, but little else. Maybe my mind is merely taking the weekend off; it has been a tough couple of weeks. Help me, folks!

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