Tobacco kills, regardless of boundaries set by either man or nature. Every year more than 5 million people lose their lives because of tobacco, and of these 3,500 live in Lebanon.
In an editorial published in NOW Lebanon last week, Michael Young considered Lebanon’s possible adoption of a public smoking ban “a terrible idea” just because it arrives from abroad. That smoking bans save lives is a fact supported by unequivocal scientific evidence, and it is a “terrible idea” that is endorsed by 168 countries, including Lebanon, representing more than 86% of the world’s population.
Unlike what was suggested by Mr. Young, most smoking bans are anything but universal, and one would be hard pressed to find a place where an “absolutist argument” won out. The tobacco industry is one that intentionally produced and marketed to millions of its loyal customers a product which, even by its own admission, causes death. The industry has a long history of deceit and manipulation of the public. Yet the industry would argue against a smoking ban for fear its profits may decrease. However, the majority of tobacco control advocates base their argument on science. It is a fact that exposure to second-hand smoke in indoor places harms health and increases one’s risk of dying. Second-hand smoke contains thousands of chemicals, of which at least 250 are cancer-causing or otherwise toxic. Why is it acceptable to have anything short of a total ban on smoking in indoor public places? What evidence has Mr. Young that lighting up in other people’s presence is not killing them?
Mr. Young also expressed his support to “give people a choice”, using the same “courtesy of choice” argument that Philip Morris began in the US in 1993 under its Accommodation Program, which is still in use in one recycled form or another by the tobacco industry, especially in developing countries. Exposure to second-hand smoke is not a nuisance subject to courtesy, but literally a matter of health, life and death.
Tobacco control advocates talk of protecting people from second-hand smoke; this includes both smokers and non-smokers, since smokers are also exposed to theirs and other smokers’ fumes. The right to breathe fresh air is not a question of smokers’ or non-smokers’ rights, but rather a human right. Keeping in mind that no rights are without limits, and that some rights take precedence over others, is it reasonable to argue for one’s right to enjoy the pleasure of a cigarette while denying another’s right to life and health? In such a case, the right to life and health always takes precedence. When your freedom to smoke is causing death and disease, then “your freedom ends where my nose begins.”
That there are other causes of death and disease is also not a reason to not tackle tobacco use. Tobacco remains the leading cause of preventable deaths in the world, as well as in Lebanon, and hence should always be considered a public health priority. If we were to accept the reasoning offered of having “a few days knocked off our lives” because of one health risk, would we also accept losing more days (or years) by stopping vaccination programs, restricting access to hospital care and clean water supply, and ignoring road safety and other interventions? And while Mr. Young may consider European or American scenes of people braving the cold to smoke outdoors “dispiriting”, the fact remains that countries and states that have taken measures to protect their citizens from second-hand smoke are saving human lives every single day. Saving lives also means saving money to both the individual and to society.
Leaving a smoking ban up to the restaurant, pub or café owner’s decision, as Mr. Young suggested, does nothing to change the status quo. The fact remains that very few of such locations are smoke-free today, and a self-regulatory approach usually means not doing anything to clean the air up. We also know from several countries that experimented with such voluntary regulation. Two years after Spain took a voluntary approach it has been proven that this did not protect the health of the workers or patrons. Recently Spain’s Health Minister publicly stated that this approach does not work and that they have to go 100% smoke-free.
As for Lebanon, a study recently conducted with experts from Harvard University measured second-hand smoke levels at 28 Lebanese restaurants and cafés, revealing, shockingly, that the mean exposure to second-hand smoke was well above the level considered “hazardous” by World Health Organization Air Quality Guidelines, and is among the highest in the world. The majority of Lebanese continue to be exposed to such high levels of second-hand smoke, especially employees, who would continue to be exposed to second-hand smoke under any partial or voluntary ban. One need not wonder too long why Lebanon has a disproportionately higher incidence of cancer than neighboring countries. Any experimentation with measures other than a comprehensive ban in indoor public places will not happen “with no one really suffering”, unless one is to discount the hundreds, possibly thousands of lives that would have been otherwise saved.
It is interesting to note that only three months after Ireland implemented its 100% smoke-free law, 97% of pubs were smoke-free, whereas five years after a voluntary agreement in the United Kingdom less than 1% of British pubs were smoke-free. The idea that businesses will suffer with a 100% ban is a myth. While not a single independent study has proved a smoking ban produced negative results for the economy, numerous studies in countries such as Italy, Ireland and Canada have shown that business on average remains the same or even increases with such smoking bans.
While the liberal theory perspective of “freedom of choice" is appreciated, it is still considered one-sided by Young's argument which neglects the choiceless passive smokers. A truly liberal belief expands to include the rights of everyone at heart. We should not allow our habits to dictate our stance when countless human lives hang in the balance. We should strive for the betterment of health in our society and uphold fundamental human rights. If that calls for the ban of smoking in all indoor public places, then we shall work toward that to save both ourselves and our children from the cycle of death and misery created by the tobacco epidemic.