Amanda Fox

MPH 560

Ethical Considerations of Smoking

  1. What are some of the social and economic conditions that influence tobacco use worldwide?

Several factors influence tobacco use including social and economic conditions. From an economic standpoint, in the United States, the tobacco industry gave longtime support to the racial and ethnic communities. There were five ways the tobacco industry directly supported the African American economy; "(1) direct employment of African Americans, (2) support for social services and civil rights organizations, (3) contributions to politicians and political organizations, (4) support for educational and cultural programs, and (5) contracts with small businesses" (CDC, n.d.). Currently, the tobacco industry conducts promotional and marketing positions for ethnic groups, which increases revenue in those specific areas. This increases the usage of tobacco and promotes, especially these groups, to smoke because it improves their overall economy. On the other hand, banning tobacco usage in public places could decrease revenue for companies, which would hurt the company overall.

Some social conditions that influence tobacco use, similar to a component listed above is whether or not people are allowed to smoke in specific places. My sister smokes, and makes sure she is able to smoke when she goes places. Some people decide not to fly because they are not allowed to smoke on airplanes, so they drive. Some other social factors that influence the increase in tobacco use include; for adolescents being the "cool" thing to do with their peers, and smoking derives functional value from group belonging and stress management (CDC, n.d.).

  1. Some smokers might say that they are only hurting themselves by smoking. What arguments would you use to try to demonstrate the impact of smoking on public health? What ethical arguments would you evoke to try to convince someone to stop smoking?

Smoking not only impacts those who are smoking, but also individuals who are around them. There is a major argument one could give on the impact of smoking on public health which is secondhand smoke. Secondhand smoke is the combination of the smoke coming off of the burning end of a cigarette and the smoke exhaled by smokers. This type of smoke contains more than 7,000 chemicals, many of which are toxic and 70 are known to cause cancer (U.S. Department of Health and Human Services, 2014). "In the United States, approximately 3,000 adults die each year due to lung cancer from secondhand smoke exposure. According to the U.S. Surgeon General, living with a smoker increases a nonsmoker’s chances of developing lung cancer by 20% to 30%" (U.S. Department of Health and Human Services, 2014, pg. 1). Not only does secondhand smoke cause lung cancer, there are several other health effects on individuals that occur. "Second-hand smoke is a real public health hazard, including causing childhood diseases such as asthma, bronchitis, cot-death and glue ear, and is a cause of lung cancer and heart disease in adults" (WHO, 2014).

Ethically, smokers need to take into consideration the health of those around them. Seeing the statistics above, many health issues come from secondhand smoke including health issues in unborn children. If people are in their own home, they can do as they please, but in public places, the health of others need to be taken into consideration.

  1. What are some of the medical, ethical, and societal issues that surround the passage of laws regarding smoking in indoor public areas and the subsequent pressure on eliminating public outdoor sources of second-hand smoke? Which of these are scientifically based reasons?

Medically, there is much proof that cigarettes and secondhand smoke from cigarettes causes many health-related issues. Tobacco products in general or related to 3 million deaths annually worldwide (WHO, 2014). As seen above, secondhand smoke causes 3,000 deaths amongst adults just in the United States alone annually. Ethically, as seen above, people are put into harm's way daily with secondhand smoke. There is an increase in lung cancer due to secondhand smoke, along with other health factors, including premature babies. From a public health standpoint, is it ethical to allow someone to smoke in public which, in turn, puts the health of others at risk? Along with medical and ethical issues are societal issues. Although above there were positive factors economically/societal that took place due to tobacco, many negative factors come into play. One of the greatest is the cost it has on people who pay insurance. Higher premiums occur because people smoke, and then have some type of cancer or illness.

With all these components being taken into consideration, the federal and local governments are starting to make certain restrictions to smoking in public places and even outdoor places. It has raised some concern in businesses due to a decrease in the business of smokers, but ultimately it is for the overall health of the entire population in decreasing chronic diseases.

  1. Do you think that the decision to ban smoking in public indoor areas is a national, state, or local governmental issue? Why?

Overall, I think the decision to ban smoking in public indoor places is a combination of national, state, and local governments. With that being said, local governments have seen the greatest success in implementing bans. "One reason for this is that local governmental bodies tend to be relatively responsive to public sentiment, which increasingly favors comprehensive smoke-free legislation. Local smoke-free policy initiatives also typically engage communities in an intensive process of public education and debate" (CDC, 2006, pg. 1). Nationally, policies affect a large number of people, but only cover a small portion of public places. Nationally, the federal government should make a law, which is then followed by state regulations and funding, then passed on to the local governments.

  1. You have been asked to play a role might in guiding the decision making on banning or not banning smoking in public areas (smoking restricted to designated areas only, inside and outside). What would you add to the discussion? Does your code of Ethics provide you any guidance?

As a public health professional, the entire population as a whole is my main concern. As the statistics have shown, the population, as a whole, as been affected by smoking and secondhand smoke. I would add all the statistics on the impact secondhand smoke and the health of individuals who do not smoke. Also, I would add the statistics showing that individuals even in contact in public places for a short time frame are affected by secondhand smoke. Ethically, this is the right measure to take to ensure the health of the population as a whole.

References

Center for Disease Control. (n.d.). Factors that influence tobacco use.Retrieved on June

7, 2014, from

pdf.

Center for Disease Control. (2006).The health consequences of involuntary exposure to

tobacco smoke. Retrieved on June 7, 2014, from

U.S. Department of Health and Human Services. (2014).What is secondhand smoke?Retrieved

on June 7, 2014, from

smoke/index.html.

World Health Organization. (2014).Encourage people to stop smoking.Retrieved on June 7,

2014, from