Stubbing Out Cigarettes for Good
By RICHARD A. DAYNARD
Published: March 3, 2013
Álvaro Domínguez; Photograph by Tom Kelly/Getty Images
PERHAPS no public official was as synonymous with the antismoking movement as C. Everett Koop, who died last Monday at age 96. Dr. Koop, who worked tirelessly to turn America into “a smoke-free society,” did not live to see that goal reached. But the rest of us have the power to make it happen.
Fewer than one in five American adults smoke, a share that’s plunged by about half since the 1960s — an achievement due, in some measure, to Dr. Koop’s antismoking crusade as surgeon general, from 1981 to 1989. Revelations in the 1990s about tobacco companies’ cover-up of smoking’s dangers also played a role. So have a host of other strategies that have included consumer taxes, minimum ages for cigarette purchases, restrictions on smoking in public spaces and programs to help people quit. Continuing on the same path, with some luck, we might be able reduce the smoking rate a little more.
But that would still leave us with a profound public health tragedy: cigarettes continue to kill more than 400,000 Americans a year and cost untold billions in health care spending.
To its credit, the Food and Drug Administration has tried more aggressive approaches, including a recent effort to require hard-hitting graphic warnings on cigarette packages. That proposal, already the rule in dozens of countries, has been held up in United States federal courts over concerns that the ads might infringe on cigarette manufacturers’ First Amendment rights. But even if implemented, more scare tactics would not go far enough.
What we need is an all-out push to reduce smoking rates to well below 10 percent. The notion is nothing new to tobacco-control advocates, many of whom gathered last week in Cambridge, Mass., for a conference on the governance of tobacco, sponsored by Harvard with support from the World Health Organization.
But outside of such academic meetings and journals, little has been said about two possible approaches that could have an immediate impact.
One involves federal action; the other, state or local action. Both are made possible by theFamily Smoking Prevention and Tobacco Control Act, which President Obama signed in June 2009.
Under the act, the F.D.A. has the power to establish tobacco product standards including “provisions, where appropriate, for nicotine yields of the product.” The only limitation on this power is that the F.D.A. may not require that nicotine yields be reduced to zero. The law calls on the F.D.A. to apply public health criteria — “the risks and benefits to the population as a whole” — in designing its regulations. It also encourages the F.D.A. to create tobacco standards that will help existing users stop smoking and decrease the risk that nonsmokers will start.
The F.D.A. would be well within its authority to require nicotine content to be below addictive levels — an idea that originated with a 1994 article in The New England Journal of Medicine urging a nonaddictive nicotine standard.
Cigarette makers would lobby hard to block such a standard. But if the F.D.A. insisted on the change, and cigarettes ceased to be addictive, ample evidence shows that most smokers would quit or switch to less toxic nicotine products. Current nonsmokers, moreover, would be far less likely to become addicted.
Another part of the act affirms the authority of states and municipal governments to prohibit the sale, distribution and possession of — and even access and exposure to — tobacco products by individuals of any age.
This provides an opportunity for states, counties and cities to adopt the Smokefree Generation, a proposal by A. J. Berrick, a mathematics professor in Singapore.
The idea is simple: no one born in or after 2000 can ever be sold cigarettes. Under such legislation, which jurisdictions like the Australian state of Tasmania are considering, the vast majority of this cohort — the oldest are now 13 — would never begin smoking. It’s hard to imagine too many parents objecting, and it would be easy for retailers to enforce. In the United States, it would provide a useful focus for state and local public health officials to do something game-changing, rather than sitting on the sidelines waiting for Washington to act.
Critics will say that, even if a state or city passed such a law, would-be smokers could go to an adjoining one to buy cigarettes. But evidence suggests that border-crossing and smuggling would be minimal. States that have sharply raised their cigarette taxes, after all, have not only increased tax revenue but also reduced rates of smoking prevalence, even among nicotine addicts. Young people, who are generally not addicted (yet) and who tend not to have peers who smoke, are even less likely to chase cigarettes across state or county lines.
Some antismoking advocates who support existing approaches (smoking-cessation programs, higher taxes) fear that pushing for an “end game” — a smoking rate below 10 percent — is too ambitious. But then, banning smoking in restaurants, workplaces and bars was once seen as crazy, too. Sometimes, a little crazy goes a long way.
Richard A. Daynard is a professor of law at Northeastern University and president of its Public Health Advocacy Institute.
(The New York Times)
紐約時報這篇文章再次觸動我反吸煙的神經。中國是生產全球四成香煙的國家，同時也是全球最多煙民的國家，有3億5千萬人。生產香煙帶來的經濟收益嚴重影響打擊吸煙的決心，如果中國再不加強反吸煙及擴大禁煙的方針措施，恐怕隨著人口老化，煙民因吸煙引發的各種疾病，並禍及非吸煙人士引起的疾病，所花的醫療支出，必定比生產香煙的經濟收益為大。比起其他西方國家，如果中國領導人具禁煙滅煙的決心，以打壓維權的手段來禁煙，駕輕就熟，不就可以了嗎？強權也可以施出德政，香煙戰爭也要超英趕美啊！立即通過滅煙法，違例者判監3年，輕者行政拘留15天。吸煙有損國民健康，兼破壞泱泱大國形象，比侮辱國旗更加嚴重。
因應《基本法》附件三的要求，香港隨即彷效，通過《滅煙法》，罰則保存香港特色，法例這樣寫：
任何人藏有中國以外地區生產香煙，即屬犯罪，循公訴程序定罪，可處第5級罰款及監禁3年。
任何人藏有中國生產香煙，即屬犯罪，可處第3級罰款及監禁1年。
法例通過之後，警察立即截查長毛，在他身上一定搜獲香煙，於是落案檢控，帶到覃有方席前(判古思堯侮辱國旗坐9個月監的裁判官)受審，由外聘大律師馬恩國檢控。
馬：梁生我哋冤家路窄。
梁：法官，呢條算唔算問題？駛唔駛答？
官：馬「大」律師請作盤問。
馬：I put it to you you are not even a fucking Chinese smoker.
梁：法官，主控講粗口。
官：被告，主控官熱愛澳洲，澳洲上至總理，下至掃地，在日常生活講f字好平常。主控官人
在香港，惦念澳洲，所以才說溜了嘴。馬「大」律師請小心用字。
馬：Your Worship, I am deeply sorry.
梁：法官，乜唔喺中文審訊咩？
馬：好我用中文。我向你指出你這廝連個鳥中國煙民也不是！
梁：乜鳥吖？打獵咩？
馬：呢句喺山中 教標少 講架......
最後，長毛罪名成立，判監9個月。
Álvaro Domínguez; Photograph by Tom Kelly/Getty Images
PERHAPS no public official was as synonymous with the antismoking movement as C. Everett Koop, who died last Monday at age 96. Dr. Koop, who worked tirelessly to turn America into “a smoke-free society,” did not live to see that goal reached. But the rest of us have the power to make it happen.
Fewer than one in five American adults smoke, a share that’s plunged by about half since the 1960s — an achievement due, in some measure, to Dr. Koop’s antismoking crusade as surgeon general, from 1981 to 1989. Revelations in the 1990s about tobacco companies’ cover-up of smoking’s dangers also played a role. So have a host of other strategies that have included consumer taxes, minimum ages for cigarette purchases, restrictions on smoking in public spaces and programs to help people quit. Continuing on the same path, with some luck, we might be able reduce the smoking rate a little more.
But that would still leave us with a profound public health tragedy: cigarettes continue to kill more than 400,000 Americans a year and cost untold billions in health care spending.
To its credit, the Food and Drug Administration has tried more aggressive approaches, including a recent effort to require hard-hitting graphic warnings on cigarette packages. That proposal, already the rule in dozens of countries, has been held up in United States federal courts over concerns that the ads might infringe on cigarette manufacturers’ First Amendment rights. But even if implemented, more scare tactics would not go far enough.
What we need is an all-out push to reduce smoking rates to well below 10 percent. The notion is nothing new to tobacco-control advocates, many of whom gathered last week in Cambridge, Mass., for a conference on the governance of tobacco, sponsored by Harvard with support from the World Health Organization.
But outside of such academic meetings and journals, little has been said about two possible approaches that could have an immediate impact.
One involves federal action; the other, state or local action. Both are made possible by theFamily Smoking Prevention and Tobacco Control Act, which President Obama signed in June 2009.
Under the act, the F.D.A. has the power to establish tobacco product standards including “provisions, where appropriate, for nicotine yields of the product.” The only limitation on this power is that the F.D.A. may not require that nicotine yields be reduced to zero. The law calls on the F.D.A. to apply public health criteria — “the risks and benefits to the population as a whole” — in designing its regulations. It also encourages the F.D.A. to create tobacco standards that will help existing users stop smoking and decrease the risk that nonsmokers will start.
The F.D.A. would be well within its authority to require nicotine content to be below addictive levels — an idea that originated with a 1994 article in The New England Journal of Medicine urging a nonaddictive nicotine standard.
Cigarette makers would lobby hard to block such a standard. But if the F.D.A. insisted on the change, and cigarettes ceased to be addictive, ample evidence shows that most smokers would quit or switch to less toxic nicotine products. Current nonsmokers, moreover, would be far less likely to become addicted.
Another part of the act affirms the authority of states and municipal governments to prohibit the sale, distribution and possession of — and even access and exposure to — tobacco products by individuals of any age.
This provides an opportunity for states, counties and cities to adopt the Smokefree Generation, a proposal by A. J. Berrick, a mathematics professor in Singapore.
The idea is simple: no one born in or after 2000 can ever be sold cigarettes. Under such legislation, which jurisdictions like the Australian state of Tasmania are considering, the vast majority of this cohort — the oldest are now 13 — would never begin smoking. It’s hard to imagine too many parents objecting, and it would be easy for retailers to enforce. In the United States, it would provide a useful focus for state and local public health officials to do something game-changing, rather than sitting on the sidelines waiting for Washington to act.
Critics will say that, even if a state or city passed such a law, would-be smokers could go to an adjoining one to buy cigarettes. But evidence suggests that border-crossing and smuggling would be minimal. States that have sharply raised their cigarette taxes, after all, have not only increased tax revenue but also reduced rates of smoking prevalence, even among nicotine addicts. Young people, who are generally not addicted (yet) and who tend not to have peers who smoke, are even less likely to chase cigarettes across state or county lines.
Some antismoking advocates who support existing approaches (smoking-cessation programs, higher taxes) fear that pushing for an “end game” — a smoking rate below 10 percent — is too ambitious. But then, banning smoking in restaurants, workplaces and bars was once seen as crazy, too. Sometimes, a little crazy goes a long way.
Richard A. Daynard is a professor of law at Northeastern University and president of its Public Health Advocacy Institute.
(The New York Times)
紐約時報這篇文章再次觸動我反吸煙的神經。中國是生產全球四成香煙的國家，同時也是全球最多煙民的國家，有3億5千萬人。生產香煙帶來的經濟收益嚴重影響打擊吸煙的決心，如果中國再不加強反吸煙及擴大禁煙的方針措施，恐怕隨著人口老化，煙民因吸煙引發的各種疾病，並禍及非吸煙人士引起的疾病，所花的醫療支出，必定比生產香煙的經濟收益為大。比起其他西方國家，如果中國領導人具禁煙滅煙的決心，以打壓維權的手段來禁煙，駕輕就熟，不就可以了嗎？強權也可以施出德政，香煙戰爭也要超英趕美啊！立即通過滅煙法，違例者判監3年，輕者行政拘留15天。吸煙有損國民健康，兼破壞泱泱大國形象，比侮辱國旗更加嚴重。
因應《基本法》附件三的要求，香港隨即彷效，通過《滅煙法》，罰則保存香港特色，法例這樣寫：
任何人藏有中國以外地區生產香煙，即屬犯罪，循公訴程序定罪，可處第5級罰款及監禁3年。
任何人藏有中國生產香煙，即屬犯罪，可處第3級罰款及監禁1年。
法例通過之後，警察立即截查長毛，在他身上一定搜獲香煙，於是落案檢控，帶到覃有方席前(判古思堯侮辱國旗坐9個月監的裁判官)受審，由外聘大律師馬恩國檢控。
馬：梁生我哋冤家路窄。
梁：法官，呢條算唔算問題？駛唔駛答？
官：馬「大」律師請作盤問。
馬：I put it to you you are not even a fucking Chinese smoker.
梁：法官，主控講粗口。
官：被告，主控官熱愛澳洲，澳洲上至總理，下至掃地，在日常生活講f字好平常。主控官人
在香港，惦念澳洲，所以才說溜了嘴。馬「大」律師請小心用字。
馬：Your Worship, I am deeply sorry.
梁：法官，乜唔喺中文審訊咩？
馬：好我用中文。我向你指出你這廝連個鳥中國煙民也不是！
梁：乜鳥吖？打獵咩？
馬：呢句喺山中 教標少 講架......
最後，長毛罪名成立，判監9個月。
中國的問題是它的煙草商全是國有企業；要禁煙等於是砸自己飯碗。中國人健康的最大威脅又不是煙，而是各種各樣的污染。如果我是領導人，我也會想既然都是死，不如讓國企與我撈一大筆才死。
回覆刪除山中，
刪除你講得對，我只是看了紐約時報，借題發揮。中國的問題之大比土地更大，我沒能力評論，於是把近來發生的事用來調笑一番，讓讀者輕鬆一下。
Bill，
刪除對我來説近來發生的事本身就是笑話。唉。
哈哈哈哈,長毛善打拉布.法庭上自辯可拉長些就更隹
回覆刪除That is different. The constitutional right of the legco member to engage in filibustering cannot be extended to the law court. Most of the questions will become irrelevant and disallowed by court.
刪除