From: rnj%lila #0 @us.oracle.com (Robert Jesse) Internet
Re: Partial Prohibition of Cigarettes: A Modest Proposal
 
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From: rjesse@oracle.uucp (Robert Jesse)
Newsgroups: sci.med,alt.drugs,talk.politics.drugs
Subject: Partial Prohibition of Cigarettes: A Modest Proposal
Keywords: smoking, cigarettes, drug policy
Message-ID: <1994Mar3.051805.27366@oracle.us.oracle.com>
Date: Thu, 3 Mar 1994 05:18:05 GMT
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following is an op-ed piece written by a friend of mine who teaches public 
policy at harvard's kennedy school of government.  he is also the author of a 
book on drug policy called Against Excess (BasicBooks 1992).  the book offers 
a method of analysis - taking into account factual beliefs, values, and desired 
outcomes - to generate new policy ideas that will produce the desired results 
more effectively than policies that come from libertarian or conservative 
ideology.  the op-ed is a sample (explored in more depth in one chapter of the 
book) of how this kind of analysis might apply to cigarettes.

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        February 27, 1994
    
        A MODEST PROPOSAL FOR THE PARTIAL PROHIBITION OF CIGARETTES 
        
             by Mark A.R. Kleiman
        
             The Food and Drug Administration tossed a bombshell into the 
        smoking-policy debate this week by asking Congress for guidance 
        about how to regulate the addictive drug nicotine.  That is 
        exactly the right question.  But unless we can change old habits 
        of thinking, about cigarettes and about addictive drugs 
        generally, it risks producing the wrong answer.  The key to 
        greatly reducing the number of teenagers who get hooked on 
        nicotine, without creating a huge new illicit industry, is to 
        separate the market serving current nicotine addicts from the one 
        serving new smokers.
        
             Debating whether nicotine in cigarette form is an addictive 
        drug is a little like debating whether water is wet.  More than 
        four-fifths of those who smoke would like to quit but can't.   
        Nicotine causes more death and disease than all the other legal 
        and illegal drugs combined.  Not all of this death and disease 
        falls to the smokers; passive smokers, including prenatal passive 
        smokers, also suffer.
        
             If tobacco products were not specifically exempted from the 
        Controlled Substances Act, nicotine would be a Schedule I 
        substance, completely prohibited except for research, like heroin 
        and other drugs with high potential for abuse and no currently 
        accepted medical use.  But with 50 to 60 million active 
        cigarette addicts, that would be a catastrophe.
        
             Simply prohibiting cigarettes could create a black market 
        larger than the cocaine market: if half of the existing smokers 
        continued to smoke a pack or two a day of black-market cigarettes 
        at $5 a pack, criminals would have a $80 billion annual market to 
        serve.  (Annual sales of cocaine are about $30 billion.)
        
             In the very long run, prohibition would greatly shrink the 
        number of smokers, both by causing some current users to quit and 
        by reducing initiation among adolescents.  But over the short run 
        -- the next twenty or thirty years -- the results would be all 
        too familiar:  impoverishment of smokers and their families, 
        crime by users, crime by dealers, and intrusive, expensive, and 
        occasionally even corrupt enforcement efforts.
        
             For intoxicating drugs such as alcohol and cocaine, 
        prohibition reduces some kinds of crime (intoxicated assault, for 
        example) while increasing others (black-market violence and 
        economically-motivated user crime).  In the case of nicotine, 
        prohibition would create new crimes while not preventing any 
        current ones.  The present hardly seems a good time to embrace a 
        new crime-increasing public policy.
 
             Can we find more potent set of anti-smoking policies than we 
        now have, short of a prohibition that would make current smokers 
        into customers for criminals?  Adolescents are the key target 
        group, since the most smoking habits are established before age 
        eighteen.  Taxation, limits or bans on marketing, and "negative 
        advertising" in the form of anti-smoking campaigns could all 
        help, within limits.
        
             Higher taxes are especially effective in reducing smoking by 
        teen-agers, who on average are less addicted and have less money 
        than adults.  Cigarette ads that target kids should be banned.  
        (If you want to know whether a given ad targets kids, hire a 
        market-research firm to ask some kids.)  Anti-smoking advertising 
        could try to make smoking seem unfashionable as well as 
        unhealthy.  The growth of no-smoking areas, especially in malls, 
        fast-food joints, and other adolescent hangouts, will reduce the 
        frequency of cigarette use as well as protecting non-users.
        
             But no plausible amount of persuasion and time-and-place 
        restriction is likely to make a major dent in adolescent smoking.  
        While higher cigarette taxes are clearly desirable, and even 
        popular, above a certain level they begin to share some of the 
        disadvantages of prohibition, as the Canadian experience with $5-
        per-pack taxes illustrates.  The basic problem is that smokers 
        who cannot or will not quit are faced with crushing financial 
        burdens:  a two-pack-a-day Canadian smoker who buys non-smuggled 
        cigarettes pays more than $3500 per year to support his habit.
        
             The ideal system would make cigarettes available on 
        reasonable terms to current smokers, but unavailable to potential 
        new smokers, especially adolescents.  Neither simple prohibition 
        nor any level of taxation can do both at once.  
        
             Why not, then, ban tobacco products, or at least cigarettes, 
        from ordinary commerce, but provide maintenance supplies to 
        current addicts?  Since new smokers are fewer, smoke less, and 
        are less committed to smoking than current addicts, the black 
        market that would spring up to serve them would be much smaller 
        and much easier to control than the one we would have to face if 
        we banned cigarettes altogether.
        
             Such a system might work this way:  Each current smoker 
        could sign up, before a cut-off date, with one of a number of 
        licensed tobacco-products retailers.  The vendor (typically a 
        chain pharmacy) would verify that the buyer was of legal age, was 
        not registered with another vendor, and did not buy more than 
        some predetermined number of packs per week (to prevent massive 
        leakage to the juvenile market).  The FDA would audit vendors' 
        compliance with the rules.  
 
             Such a system wouldn't be as easy to operate as it is to 
        describe, it wouldn't be even nearly perfect in preventing the 
        flow of cigarettes to juveniles, and it would generate 
        enforcement costs and corruption.  It only looks good by 
        comparison with total prohibition of cigarettes.
        
             Or, of course, by comparison with our current policies, 
        which sacrifice 400,000 American lives every year to tobacco and 
        its promoters.

