Public Health

The Case for Banning Cigarettes Entirely, Forever, This Time I Mean It


The Case for Banning Cigarettes Entirely, Forever, This Time I Mean It

Illustration by Braulio Amado

Doctors in the U.K. will vote on Tuesday as to whether to support a “campaign to ban forever the sale of cigarettes to any individual born after the year 2000.” It’s an appealing thought exercise for public health types: Smoking rates declined steadily in the late 20th century as the health hazards became more widely understood. So what would happen if children born in the 2000s—those just now hitting their years of tobacco experimentation—were barred from buying cigarettes—not just until they reach adulthood, but forever?

The flaws in this prohibition-by-generation proposal aren’t hard to detect. Children under 16 were barred from buying cigarettes in England and Wales until 2007, when the age was raised to 18 (PDF), as it is in most of the U.S.. Despite widespread bans on sales of cigarettes to kids, kids still try smoking cigarettes, and some get hooked.

The author of the motion before the British Medical Association acknowledged as much to the Guardian. “Cigarette smoking is specifically a choice made by children that results in addiction in adulthood,” public health specialist Tim Crocker-Buque told the paper. “Eighty percent of people who smoke start as teenagers. …The idea of this proposal is to prevent those children who are not smoking from taking up smoking.”

Prohibition—the U.S. policy toward alcohol in the 1920s and toward many drugs today—has its own problems. It tends to create a black market trade that carries its own social costs. A ban limited to people born after an arbitrary—albeit round-numbered—date seems even more troublesome: Imagine two brothers heading out for a night on the town 2019 in London. One, born in 1999, could buy as many packs as he pleased. His brother, a year younger, could not under the proposal. (Both could get tanked—the U.K.’s legal drinking age is 18.)

In the U.S., teen smoking has declined significantly since the early 1990s without changes to the age at which people can legally purchase cigarettes.

That suggests that additional forces are at work, including rising prices, the end of most forms of tobacco advertising, and restrictions on where smokers can light up.

Singapore and the Australian island state of Tasmania have both considered similar bans on sales to people born after 2000, says Tom Glynn, director of Cancer Science and Trends at the American Cancer Society. “It’s an indicator of the need we have for bold measures in reducing cigarette smoking,” he says.

The British Medical Association proposal helps shift the public conversation to the “endgame discussion,” he says. Glynn recalls working at the National Cancer Institute in the 1980s and passing then-surgeon general C. Everett Koop in the hallway. Koop handed out lapel pins that said “SFS 2000″—calling for a smoke-free society (PDF) for children born after the year 2000.

Finland and New Zealand have set goals to get smoking rates under 5 percent by 2025, Glynn says. The thinking is that at that level, “it probably will go away on its own,” he says. Both countries, like the U.S. and U.K., have a long way to go, and it’s not clear that a generational ban would get them there.

Update, June 24: The British Medical Association voted in favor of a campaign for the ban.

John_tozzi
Tozzi is a reporter for Bloomberg Businessweek in New York.

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