Warning Smokers Does Not Help

A pictorial warning would do nothing to penalise a smoker for forcing others to smoke passively. Its advocates presume that even a hard smoker is a victim of the tobacco seller’s advertisement, even though beedis are unattractively packaged. We need civic rules making smoking difficult.

Presumably, the 85 per cent coverage of cigarette packs by grotesque anatomical images of cancer in lungs will stop individuals from really bringing the same fate about in their own lungs. That seems to be the collective wisdom of our society after the recent controversy. Some BJP MP questioned the link between smoking and cancer, and the pre-reality revelation erupted that the government was considering only 40 per cent of grotesqueness to be scary enough. Now because it is related to the Modi sarkar, any going back on this arbitrary criterion will be quickly criticised.

All of that would be welcome, if it does any good whatsoever. Evidence points to the contrary. People quickly learn to ignore messages that they want to ignore and get on with their lives. And if their lives involve smoking, they will get on with, well, smoking.

Should we ignore the rampant smoking though? Let there be no mistake. Smoking cigarettes, and certainly beedis, and chewing gutka, are all demonstrably linked to cancer. Numerous studies have proven these facts, and both long-term and short-term clinical observations have made the link between smoking and cancer incontestable. Smoking has a very high probability of leading to cancer. The question, however, is how to deal with this menace from a public policy perspective. And to also consider what is the right and moral way to deal with this widespread problem.

The fundamental question we need to answer is whether in a free society we have the right to ask others to mind their harmful behaviour. A free person is within his rights to harm himself with the weapon of his choice. If he chooses the slow acting one in the form of a cigarette, all power to him! However that is not all what the cigarette does, right? It harms others too, and we will talk about it later. But before we go on devising ways to stop people from harming themselves, let’s consider where we would like the line to be drawn.

Fat and cholesterol kill, too. Should we ask people to not eat unhealthy stuff either? May be the beef ban can then be legitimately counted in that category! What about watching too much TV and not getting enough sleep? A few sermons sheaved in between advertisements to switch off the TV set and do a pranayam may do some good?

While you can persuade people to avoid coming in the harm’s way, we need to focus  better on whether their path is harming others involuntarily. Cigarette qualifies as per this criterion quite well. And it is a legitimate intervention by the government to ask a smoker to pay the price to those who are affected by it involuntarily.

The US presents a successful example of controlling smoking in its population.

Percentage of adult daily cigarette smokers who stopped smoking for more than 1 day in 2010 because they were trying to quit:

– More than 4 out of 10 (42.7 per cent) of all adult smokers

– Nearly 5 out of 10 (48.5 per cent) of smokers aged 18–24 years                   

– More than 4 out of 10 (46.8 per cent) of smokers aged 25–44 years                   

– Nearly 4 out of 10 (38.8 per cent) of smokers aged 45–64 years. 

– More than 3 out of 10 (34.6 per cent) of smokers aged 65 years or older

Percentage of high school cigarette smokers who tried to stop smoking in the past 12 months:

– Nearly 5 out of 10 (48 per cent) of all high school students who smoke

This is an unprecedented decline in the number of smokers in a large country. Smoking was controlled and brought below the threshold of 20 per cent, considered as a ball park line to make smoking uncommon enough not to be a default option for an emulating teen. It is instructive not only because it is successful, but also because it teaches how formulating a problem with clear principles allows to target it effectively.

As I said earlier, there are two fundamental ways to look at smokers. The first is as victims of the insidious campaigns by companies inciting the unsuspected to smoke. The second is to consider the smokers people who cause harm to others, without paying a price for it. In the first case, a smoker is a victim. In the second, he is a culprit. In the first case, he needs to be protected. And in the second, he needs to be penalised for the harm he does to others. The moral case is easy to build for the second one, but for the large smoking population it is very difficult to justify the smoker as a victim story.

When the focus is on deciding whether four-fifth of the packaging should be covered in warning signs or just two-fifths, we are effectively arguing in favour of the ‘smoker as victim’ story: victim of not peer pressure, but of tobacco corporations, who entice smokers by their advertisements, or hiding the harmful effect that their product would cause. No doubt the warning should be clearly mentioned, and no doubt that there is a small segment that buys into a life full of smoke because of some hunk smoking in the television. But we all know that the habit of smoking is mostly acquired from peers and friends at that crucial time in life when curiosity to try the forbidden is at its highest.

Tobacco companies benefit from this habit for sure, but their customers are adults who make a voluntary decision to buy into a bad thing. Do they make an informed decision? That needs to be established. How? By taking the company that deliberately hides this information to the court and making it pay the price for it. It is sad though that the ineffectiveness of courts in India is required to be compensated by excesses in executive orders. But you cannot prevent an adult from buying into a harmful product voluntarily, and with both his eyes open. What you can do is to prevent him from harming others.

And here comes the policy of penalising public smoking. In most of the US, it is very difficult for smokers, I am told, to find a space to smoke. There is a dedicated space in each company to smoke, but it requires a significant effort for the interested to find such a space for solace. At Johns Hopkins Hospital, accompanying a friend who needed to smoke, I had to walk a good half a mile and stand in ice cold weather for him to finish his cigarette. Anybody but only the most persistent would want to smoke in such onerous conditions, and nearly everybody would cut down on the number of cigarettes smoked during working hours.

Such policies will be implemented not by projecting the smokers as victims, but the bystanders. People arguing over the extent of packaging to be covered in warnings should instead petition their work place to designate one, and only one space to smoke. Make it difficult to smoke, not impossible, in your surroundings. You, who are affected by someone smoking, are the victim.

Another way to penalise smoking is taxation. Taxation is required since it is not possible for the smoker to voluntarily compensate everybody who is harmed by his smoking, even if he wants to. Taxing the very product, and may be diverting those gains to the exchequer in some related benefit to the population as a whole, can be a very effective way to control smoking. Of course, with increase in tax black marketing will increase, too. But it will be much better than banning tobacco products altogether, as has been attempted in some countries and cities earlier.

The third effective policy decision is to make smoking ‘uncool’ among the youth. This actually does consider young smokers as victims — not of tobacco corporations, but of social pressure. The government and society should collaboratively work in public awareness programmes, but it is widely recognised as more difficult to counter the psyche of teens than to raise awareness, for instance, for vaccination. Reports of how much public awareness programmes against smoking were successful have been mixed in the US, Britain, and many other Western countries.

It is always easy to target big corporations and ascribe complete responsibility of a complex social ill at their doorsteps. It makes a good story, feeds into the general and innate corporations-are-evil instinct, and more importantly, distracts from undertaking more difficult tasks. No doubt tobacco companies benefit from one of the most pernicious and harmful habit of smoking. But of course they do; that is after all their business. But the reason people smoke is not because they make glittery adverts. No beedi is well packaged and there are no glitzy ads selling them to unsuspecting customers, but they sell everywhere. What is lacking is the information about the link between smoking and cancer, and that needs to be provided to the people.

If we have to tackle smoking in our society, we have to start treating adults as adults, asking them to be more responsible in their behaviour, and pay for the harm they do to others.