THE WAY FORWARD
The current state of affairs with regard to adult smoking in developed nations
that have already adopted muscular tobacco control programs poses a
difficult ethical and policy challenge. In the US, smoking among adults
stabilized between 2006 and 2008. In Europe, EU observers stated that
“overall prevalence has reached a level from which it will be difficult to show
further decline unless substantially stronger measures are implemented”.
For some, the data suggested that there was no alternative but to further
tighten the public health vise. The goal of limiting tobacco-related morbidity
and mortality provided ample warrant for pressing on. Others were less
certain. Rabin whose concerns about the potentially prohibitionist goals of
ever higher taxes were noted earlier,
has thus noted: “It is important to
retain perspective on the fact that for some smoking is a pleasurable and/or
psychologically rewarding experience. And correlatively, we should not lose
perspective on the question of how restrictive a society we want to create—
that is, how-far we want to go in reducing individual autonomy, including
what can be perceived as self-destructive behavior.” The issues are especially
complex because significant decreases in the prevalence of smoking at the
population level can only be achieved if measures are targeted at those at the
lower end of the social gradient. To the extent that such individuals will bear
the burden of increasingly restrictive interventions, questions of equity are
bound to emerge."
The PDF is nauseating.
The part I copied and underlined was the best part and it was the final passage in the last two pages of the report.