Bridging the Ideological Divide: An Analysis of Views on Tobacco Policy

EXECUTIVE SUMMARY

Introduction

Strategies proposed to address smoking-related health consequences in the United States have spurred heated political debate. Bridging the Ideological Divide: An Analysis of Views on Tobacco Policy Across the Political Spectrumexamines attitudes on the issue of tobacco as found in published statements by columnists, publications, organizations and politicians from ideological camps on the political left and political right.

This paper is the first major effort to present the views of both sides of the political spectrum on the issue of tobacco policy. While the report itself avoids taking a stand on specific tobacco policy issues, it attempts to be a catalyst to generate constructive dialogue between the differing ideological groups.

This report is organized so that "left" (liberal) and "right" (conservative and libertarian) perspectives are presented in contrast to one another on issues concerning cigarette smoking as a public health priority and policy options to reduce cigarette-related disease and death. Barriers to collaboration on tobacco policy are also discussed. The study presents evidence that while some of the arguments offered by members of both left and right are based on valid premises and/or scientific data, others both on the left and right have flaws.

Cigarette Smoking as a Public Health Priority: "Left" and "Right" Perspectives on Seven Cigarette-Related Issues

1) Active Smoking as a Cause of Illness and Death

The left and right disagree on scientific findings about the health effects of active smoking. For example, there is debate as to whether 400,000 premature deaths each year in the United States attributed to cigarette smoking is an accurate statistic. While the left generally accepts and often cites smoking-related health statistics such as this, the right tends to be suspicious of these numbers, blaming biased or imprecise data analysis.

2) The Health Effects of Environmental Tobacco Smoke (ETS)

Considerable debate exists between the left and right concerning the scientific and medical facts regarding environmental tobacco smoke and its effects on health. Some on the left equate the risks from passive (secondhand) smoking with the risks from active smoking. In contrast, the right is skeptical regarding the cited statistics and the reported health effects, and generally dismisses ETS as a public health concern.

3) Nicotine Addiction: Is it a Scientific Reality?

There is controversy between the left and right on whether tobacco products containing nicotine are dependency forming. To most all on the left, nicotine is viewed as an addictive drug and tobacco products as drug-delivery devices. The right, however, tends to challenge the notion that smoking is "addictive," stressing that the term addictive implies a physical dependence and mental impairment associated with the use of illicit drugs, but absent in tobacco products.

4) Protecting Children s Health as a Primary Rationale for Tobacco Policy

There is general agreement that stronger efforts are needed to prevent children from smoking. There is disagreement, however, in how the left and right assess the severity of the problem and what the underlying motives are behind their anti-tobacco efforts. The left blames the tobacco industry for targeting and manipulating children through advertising, thus, leading to children s addiction to smoking. The right, in contrast, often see the left s anti-tobacco efforts for children as a way of infringing on the rights of adult smokers.

5) Public Knowledge of Risks of Smoking

The left focuses on the fact that the tobacco industry not only knew of the health effects and the addictive properties of tobacco and kept this information from the public, but also manipulated delivery to addicted smokers. The left, as a result, places blame above all on the industry. In contrast, the right contends that the public was well informed on the dangers of smoking, and therefore, places responsibility on the individual smoker rather than the tobacco industry.

6) The Economic Costs of Tobacco-Related Disease

The left typically argues that the economic costs associated with tobacco-related illnesses in the United States runs into the billions of dollars. The right rejects this argument, claiming that smokers do not cost society money because smokers die prematurely, thus balancing out their cost of care.

7) Involvement in the International Export and Promotion of Tobacco

The left voices its concerns over the tobacco-related activities overseas, especially in developing countries. The right is silent on this topic.

Policy Options to Reduce Cigarette-Related Disease and Death: "Left" and "Right" Perspectives on Ten Topics in Tobacco Policy

1) Individual verses Corporate Responsibility: Who is to Blame for the Consequences of Smoking?

Most on the left blame the tobacco industry for manipulating and lying to the adult public about the dangers of cigarette smoking. The right basically points the finger at the individual smoker as the responsible party, asserting that smokers know the risks of smoking and still chose to smoke. The relevant questions include: Are minors capable of "choosing" to smoke? How detailed should the information about risks be to be considered sufficient? How addictive is nicotine? Can an addicted smoker exert a free choice?

2) The Role of Federal and State Governments in Addressing Cigarette-Related Morbidity and Mortality

While the left generally wants government intervention and supports legislative action to combat the tobacco problem, the right tends to oppose almost all government intervention. Right opposition is grounded in the fear that if the government starts to regulate one area, it will eventually expand into other areas. Although the left often emphasizes that the tobacco issue is unique and that government regulation can be contained, the right believes that the issue of tobacco is no exception, claiming government programs regarding tobacco still threaten individual liberties.

2a) Taxation to Discourage Smoking

The left tends to support an increase in taxation of tobacco products as a means of reducing tobacco use, especially among minors. In contrast, the right generally opposes increases in tobacco excise taxes, arguing that they are regressive, requiring poor smokers to pay a higher percentage of their income.

2b) Regulatory Control of Tobacco Products by the Food and Drug Administration

Congress has exempted tobacco products from coverage under federal health and safety laws. The left, however, argues that tobacco products should be regulated for health and safety (e.g., restricting tobacco advertising and product labeling, disclosing and controlling product ingredients, and restricting sale and distribution). The right tends to oppose such government regulation over the concern that if the FDA regulates tobacco it will lead to further unnecessary and restrictive regulation of consumer products.

2c) Cigarette Advertising Restrictions

The left supports the placement of restrictions and bans on tobacco advertisements as a means towards reducing smoking among youth. In contrast, the right opposes such methods, based on its general belief that tobacco advertisements do not entice youth to smoke and that, therefore, bans and restrictions of tobacco advertisements are unnecessary. Also argued by some on the right is that such actions violate free speech protections of the First Amendment.

2d) Restrictions on Smoking in Public Places

Considering studies that indicate environmental tobacco smoke is harmful to nonsmokers health, many on the left support restriction and elimination of smoking in both private and public places where nonsmokers are potentially exposed. The right s argument is that there is a lack of scientific evidence concerning the adverse health effects associated with environmental tobacco smoke, and that, therefore, such regulations are unduly restrictive of adult smokers freedom.

2e) Public Education about the Dangers of Smoking

Those on the left generally agree that education concerning the adverse health effects of tobacco use is necessary and that educational efforts should be supported. For the most part, the right agrees. But the right is not fully convinced that the proposed strategies will be effective and believes that they might even promote smoking among minors.

2f) Prohibition of Tobacco

Many on the right believe that the left s underlying goal is the prohibition of tobacco. The left continues to deny the right s accusation and emphasizes that it seeks regulation, education, and public health benefits, not prohibition.

2g) Litigation Against Tobacco Companies

Many on the left state that because the tobacco industry is largely to blame for tobacco-related illnesses, legal action against the industry is justified. They also believe that such action will help force the tobacco industry to behave more responsibly. Many on the right, however, contend that the public has been well informed of the dangers of smoking, and therefore, litigation against the tobacco companies is not justified, and amounts to a "wealth grab" by plaintiff attorneys and government.

2h) Use of "Tobacco Money"

Most on the left support the use of tobacco tax revenues and tobacco settlement proceeds for smoking prevention and education. Many on the left feel that too much of the "tobacco money" is spent on other non-tobacco projects, such as improving infrastructure. Some on the left encourage use of tobacco settlement funds for a spectrum of non tobacco-related causes, such as children s health and welfare. The right looks at tobacco settlement funds as just another form of general taxation to be "hijacked" at will for any cause.

Barriers to Collaboration on Tobacco Policy

Passion and Priorities

Many on the left express passion and concern over the devastating health effects from tobacco use and are outraged over the manipulation and deceit used by the tobacco companies that led to these consequences. In contrast, the right appears almost apathetic on the issue and its public health impact. They appear to believe that other public health threats warrant our attention over tobacco.

Attribution of Motive

Both the left and right tend to believe that the other side has underlying agendas, motives, and goals. The left, generally speaking, accuses some on the right of being influenced by tobacco financial contributions. The right, on the other hand, suspects that left-oriented tobacco policy is motivated more by a general contempt for corporate profits than it is by a desire to promote public health. As a result, the two sides are extremely wary of each other s programs. Viable, productive dialogue leading to significant public health improvement is all but impossible in an atmosphere where basic underlying motivations are in question.

Conclusion

The left and right often disagree on issues related to tobacco. This study reveals that it is generally those on the left who are concerned with the health consequences of cigarette smoking and who propose strategies to deal with it. In contrast, those on the right tend to reject or remain silent on these issues.

Apparent from this analysis is that there are many on both sides of the tobacco issue who have stereotyped views of the other. For example, both appear to think that each has underlying motives, and as a result, feelings of distrust, disrespect, and ad hominem attacks resonate. When the time comes for discussion, there is more name-calling and anger rather than insightful and constructive interaction. Such an atmosphere makes it difficult to make progress.

The right typically considers the tobacco debate a war between the ideological camps. This creates an "us against them" mentality with the right lumping all left-sided organizations together as having an anti-tobacco stance. Several left-leaning organizations, however, do not have a strong or consistent anti-tobacco agenda. This diversity of opinions on the left has sometimes led to tension and division among themselves.

While this study appears to focus on the extremes of left and right, it does note the importance of those who dissent from their political affiliations on tobacco related issues. These individuals are critical for facilitating collaboration and demonstrating that agreement on effective tobacco policy can be a shared left and right goal. It is essential that policy makers from all shades of the political spectrum become educated about the health consequences related to cigarette smoking. This knowledge might then help to bridge the gap between them and lay the foundation for dialogue that is grounded in fact, not ideology. The hope is that those on both sides of the political spectrum will engage in a productive discourse, whose eventual outcome will be a reduction in the deadly toll of smoking in America.

Appendix A

Appendix B