|Book Title:||For Your Own Good: The Anti-Smoking Crusade and the Tyranny of Public Health|
|Published:||New York: Free Press, 1998|
|Reviewer:||Pierre Lemieux, Université du Québec à Hull|
Jacob Sullums book is a good and carefully documented piece of critical journalism, which should appeal to the layman while providing information and hypotheses to the scholarly student of smoking issues. Not only is the book written by a nonsmoker but it does not defend the tobacco interests, either. An introductory authors note takes pains to explain that tobacco companies had nothing to do with the publicationa wise precaution, for anything financed by the tobacco industry starts with an insurmountable credibility gap, whereas anti-smoking propaganda financed with money stolen by the state comes with an aura of disinterestedness and truth.
This double standard tends to conceal the powerful interests behind anti-smoking crusaders, who are no more disinterested angels than are the tobacco executives. Stanton Glantz, a University of California researcher and cofounder of Californians for Nonsmokers Rights, is reported as saying, The main thing the science has done on the issue of ETS [environmental tobacco smoke], in addition to help people like me pay mortgages, is it has legitimized the concern that people have that they dont like cigarette smoke (quoted by Sullum, p. 147). Wendell Gauthier, a lawyer involved in the 1994 class action lawsuit on behalf of addicted smokers, declared to the New York Times, Our biggest motivation is money (p. 205).
Sullums book offers fascinating insights into the history of smoking, the long-held concerns about its health effects, and the persecutions and prohibitions to which smokers have been subjected. Seventeenth-century preachers described tobacco as the filthy weed, generating the smoke of perdition; smokers were compared to men possessed, who are in need of exorcizing (pp. 15, 20). Hatred of the devils weed cut across religions and culture: It has been said that love is a brief epileptic fit, said Louis XIVs physician, but smoking is a permanent epilepsy (p. 22).
Two centuries later, Queen Victoria forced the royal guests who smoked to exhale into fireplaceswhich, one should admit, was still more civilized that the current American practice of pushing smokers to the street. In Davis and Palo Alto, California, smoking is prohibited even outdoors within twenty feet of any building open to the public, which means basically everywhere downtown. All public parks in Bellaire, Texas, are nonsmoking areas.
Along with alcohol, smoking was a target of the American temperance movement in the nineteenth century. A lecturer to the New York Anti-Tobacco Society in the 1830s claimed that tobacco leads to prostration of the mental with the bodily powers, and to a craving for alcohol (p. 25). Later in the century, George Trask, the Anti-Tobacco Apostle and founder of the American Anti-Tobacco Society, encouraged young people to take the Band of Hope pledge: I hereby solemnly promise to abstain from the use of all Intoxicating Liquors as a beverage; I also promise to abstain from the use of Tobacco in all forms, and all Profane Language (p. 26).
Like many forms of state coercion, the anti-tobacco movement gained real political momentum only after the Civil War. Lucy Page Gaston began her anti-smoking career as a member of the Womans Christian Temperance Union and later created the Chicago Anti-Cigarette Group and the National Anti-Cigarette League. (Ironically, she died from throat cancer in 1924.) Between 1893 and 1909, notes Sullum, fourteen states and one territory (Oklahoma) enacted laws banning the saleand, in some cases, possessionof cigarettes (p. 30). The secondhand-smoke argument made its appearance in the early twentieth century: What right has anyone to smoke, when other people object to it? asked Charles Towns, the operator of a New York hospital, in 1912 (p. 33).
Yet, despite the bans, cigarettes were growing more and more popular, including among soldiers at war and among women. Although the bans had resisted constitutional challenges, they were difficult to enforce. Their repeal started in 1909, and by 1930 they had disappeared from all states. (One might have liked Sullum to examine more carefully why the repeals occurred when smokers were a smaller minority than they are now and at the very time when Leviathan was advancing openly on other fronts.) Perhaps, after all, America was still America. But wait! The public purity advocates had not said their last word, and the continuous growth of state power in the twentieth century, combined with the reversion of smokers to a clear minority status during the second half of the century, would provide them with golden opportunities.
Now, whats wrong with tobacco, anyway? We dont believe, with George Trask, that smoking only leads to drinkingdrinking to intoxicationintoxication to bilebile to indigestionindigestion to consumptionconsumption to death (p. 26). Or do we?
The scientific evidence strongly points to a link between smoking and diseases therefore called smoking-related. Questions can be raised about other explanations for these correlations, including the well-established differences between the personalities of smokers and nonsmokers. But Sullum admits the generally accepted scientific evidence of the adverse effects of tobacco on the smokers health, and he shows how it has been piling up since, in 1933, Scientific American reported a tentative link between the tar in cigarette smoke and lung cancer. This fact, compounded by government warnings and propaganda since the 1960s, means that no smoker can claim he was ignorant of smoking risksa consideration that was crucial in the general failure of litigation on behalf of sick smokers. Indeed, because of growing health concerns, per capita cigarette consumption started to drop in the mid-sixties.
Sullums main point is that smoking, like all other activities that involve costs to be weighed against pleasure, is a matter of individual choice. Pleasure (or utility, as the economist says) is a subjective phenomenon that has no more place in paternalistic or authoritarian theory than it has in socialist delivery systems of goods and services. Echoing the Spanish historian Fernández de Oviedo y Valdés, who in the sixteenth century said of Indian smokers that he [could not] imagine what pleasure they derive from this practice (p. 67), Scott Ballin of the Coalition on Smoking or Health now asserts, There is no positive aspect to [smoking]. The product has no potential benefits (p. 6). Who are they to make such declarations to the millions of individuals who demonstrate by their actual choices that they find the benefits greater than the risk and costs? The smoking debate pits individual choice against state paternalism. Writes Sullum, The true nature of the crusade for a smoke-free society... is an attempt by one group of people to impose their tastes and preferences on another (p.12).
The contemporary prohibitionists have two answers: addiction on the one hand, and secondhand smoke on the other hand. Sullums discussion of the addiction issue (chapter 7) is enlightening. He contrasts the concept of addiction as a pattern of behavior with the voodoo pharmacology idea that a drugbe it caffeine, nicotine, or opiumcompletely takes over the free will of its impotent victim. Evidence that one smokes because one likes it includes the fact that many former smokers start again months or even years after any withdrawal symptom has long gone away, or that smokers prefer a good cigarette to nicotine gum or patches. The truth, writes Sullum, is that smokers are addicted (i.e., have difficulty giving up the habit) because they like smoking (p. 244).
It is barely an exaggeration to say that the prohibitionists invented secondhand tobacco smoke (and rechristened it environmental tobacco smoke) because it is (still) difficult to justify prohibition for the smokers own good. Anti-tobacco activist Stanton Glantz wrote in 1986: The issue should be framed in the rhetoric of the environment, toxic chemicals, and public health rather than the rhetoric of saving smokers from themselves or the cigarette companies (p. 150).
[It] is safe, writes Sullum, to say that the hazards of secondhand smoke have been grossly exaggerated (p. 159). As the evidence reviewed by Sullum himself suggests (see chapter 5), this conclusion may well be an understatement. The health hazards of secondhand smoke may be the hoax of the twentieth century. The strand of junk science underlying this hoax owes much to the 1992 EPA report that classified secondhand tobacco smoke as a Group A carcinogen. It may be useful to quote a source that was not available to Sullum at the time of his writing, namely, the recent judgment of U.S. District Judge William Osteen: The court is faced with the ugly possibility that EPA adopted a methodology for each chapter, without explanation, based on the outcome sought in that chapter. . . . The record and EPAs explanations to the court make it clear that using standard methodology, EPA could not produce statistically significant results with its selected studies (Flue-Cured Tobacco Cooperative v. EPA, No. 6:93CV00370 at 60, 77, M.D.N.C., July 17, 1998).
The claim of Sullums subtitle, the tyranny of public health, is not without substance. The book explains how the public health movement has drifted from public-good types of concerns, such as sanitation or contagious diseases, toward a frontal attack on individual choices and politically incorrect lifestyles (see especially chapters 2 and 8). A 1978 public health textbook explained that the field includes the social and behavioral aspects of life (p. 62). Ten years later, a surgeon generals report stated: Tobacco use is a disorder which can be remedied through medical attention (p. 68).
If all this were only a pure health craze, little more could be said, but public health advocates want the state to regulate or prohibit behavior that does not fit their conception of public purity. Smoking is an antisocial act, says Stanton Glantz (quoted on p. 150). Because society will not do anything about it, state coercion is required. The American Cancer Society wants laws to help turn smokers into social pariahs (p. 179). Sullums book is full of quotations and one-liners illustrating the witch-hunter mentality of the anti-smoking movement, from William D. Novelli, president of the National Center for Tobacco-Free Kids, describing the tobacco industry as the last of the evil empire (p. 253) to Glantz comparing the tobacco industry to Timothy McVeigh (p. 9), to Ahron Leichtmans hints that smokers should be arrested and put in jail (p. 153).
For public health crusaders fighting the evil empire, the ends often seem to justify the means. Sullum documents many cases in which they use body count numbers that come from nowhere. Joseph DiFranza, who wanted to show that cigarette advertising leads children to smoke, wrote in a private letter before embarking on some research, There, the paper is all ready, now all we need is some data (p. 101).
We are racing down the slippery slope. In a 1994 child-custody case, a New Jersey judge forbade a mother to smoke in her own house, except in her bedroom (p. 158). The Washington-based Center for Media Education attacked a smokers-rights Web site as having a hip rebellious tone . . . with no attempt to balance the presentation of the issues and recommended investigations by regulatory agencies and effective government oversight (p. 272).
An article in a major law review (Jon D. Hanson and Kyle D. Logue, The Costs of Cigarettes: The Economic Case for Ex Post Incentive-Based Regulation, Yale Law Journal 107 [March 1998]: 1163-1361), published at about the time Sullums book hit the market, proposed legislation to force any current smoker to purchase a cigarette card. The card, explain the law professors,
which could be based on the same magnetic strip (or computer chip) technology used for credit cards and ATM cards, would . . . have to be presented by the smoker each time she [sic] purchased cigarettes. The card would keep track of a variety of potentially relevant risk factors, such as the number of packs purchased by the smoker, which brands the smoker purchased, and the smokers age at time of purchase.
As for the fear of Big Brother, the authors argue, it is outdated because he (or she?) is already with us.
Sullum suggests that the public health attack on individual choices has in its sights not only tobacco but also many other consumption activities and types of behavior that are not congruent with the high priests conception of the goodand dulllife. He might have illuminated the striking parallel, as far as junk science and pidgin ethics are concerned, between two of the public health crusades, often waged in the same journals: the one against smoking and the one against the right to keep and bear arms (see Don Kates et al., Guns and Public Health: Epidemic of Violence or Pandemic of Propaganda, Tennessee Law Review 62 [Spring 1995]: 513-96). John Lott offers a similar argument related to liability suits against tobacco companies and gun manufacturers, and he foresees that a future victim will be the automobile industry (Keep Guns out of Lawyers Hands, Wall Street Journal, June 23, 1998).
Sullums book in interesting in many other respects, including its historical review of litigation against the tobacco industry (see especially chapter 6), a long series of attempts to negate the responsibility of individuals for their own consumption choices.
The few shortcomings of the book may arise more from the nature of a journalistic inquiry than from the authors ignorance. The contrast between the public health approach and the conclusions of the economic literature on smoking could have been better emphasized and explained. In view of the books likely audience of lay readers, a better-structured explanation of how private property rights reconcile smokers and nonsmokers preferences would have been welcome. Public-choice considerations and the politics of organized public health interests could have been more fully introduced. Obviously, addiction to the state is much more dangerous than addiction to tobacco or any other herb one can imagine. If an evil empire exists, it is the Nanny State, which has grown out of control during the twentieth century. (See my Smoking and Liberty: Government as a Public Health Problem [Montreal: Varia Press, 1997].)
All in all, For Your Own Good provides a lively and informative treatment of glaring political distortions of science in the service of a shameful witch-hunt waged by public health totalitarians.