The Attack on Dignity and Moral Autonomy: The Case of Cigarettes

by Mario Rizzo

The latest in the paternalistic actions of the federal government are a kind of reductio ad absurdum.  At least this is how it might have seemed ten or fifteen years ago if someone would have said that cigarette-pack health warnings would become graphic pictures designed to horrify the public into not smoking. 

What is especially interesting about this development is the subtle change in arguments over the years about the purpose of government interference in this area.

  1. In the beginning we had the Surgeon General’s Report simply warning people about the health consequences of cigarette smoking. Of course people realized that cigarette smoking was harmful even before the 1962 report.
  2. Then we had fairly general warnings about “hazards” to health. In fact, at first it was simply said that smoking may be hazardous to one’s health.
  3. Warnings evolved to include mention of specific illnesses.

All of this is the provision of information, although with the warnings on the package itself the idea was to remind people at the moment of purchase.

Why was it perceived by some that the provision of information, even at the moment of sale, is not sufficient? Why must we move to dramatic presentation of low-probability events? (Most people who smoke do not turn out as the photographs suggest, and many people who do not smoke will have breathing tubes, feeding tubes and nasty medical procedures sometime before they die.)

There are two answers to this question. The first is the “scholarly” answer.  Behavioral economists tell us that many people exhibit “optimism bias.” This is the cognitive attribute in which the person simultaneously realizes that the probability of, say, getting ill from tobacco smoking is p but that this population frequency does not apply to him. It does not apply to him for “magical reasons.” He has good luck and so forth. So the probability of getting ill is for him (significantly?) less than p.

In view of this, some behavioral economists have suggested that policy makers use another cognitive bias – “availability bias” – to offset the optimism bias. Availability bias refers to the exaggerated fear and estimate of the probability of harm when one is confronted with, say, a plane accident or instance of terrorism. After a plane accident many people think that the probability of dying in a plane crash is much higher than a cool statistical analysis would suggest.

So now let us put the two biases together and construct a policy. Telling people that smoking is dangerous – even providing people with statistics – is not enough. They will still think that their personal good luck will save them. So we must use their availability bias. We must make the images of a horrible death so available to their minds that they are jolted out of their optimism bias.

But wait. There is evidence that smokers already think that the probability of death and illness from smoking is higher than it really is. So it is unclear what optimism bias does here. Perhaps it just offsets it? In addition, how scary should the advertising campaigns be? Theoretically, they should just be scary enough to offset the optimism bias.

Thus we need to know the effective personal probability the individual places on disease from smoking and the degree to which the scary graphic offsets that.  Bottom line: We do not have this information nor are we likely to get it soon.

The second answer follows from the practical irrelevance of the first.  The campaign of scary pictures, scenarios and the like, will be deemed successful only when cigarette smoking is reduced to an extremely low level. The “optimum” is not well-informed decisionmaking by morally autonomous agents.  It is doing what the paternalist thinks you should be doing or not doing. Case closed.

So the whole campaign is an insult to the dignity of the individual. It is an attack on the older principle of informed choice. It does not respect individual moral autonomy.  It is an example of the sickness of modern American society.

13 thoughts on “The Attack on Dignity and Moral Autonomy: The Case of Cigarettes

  1. How about the negative externalities borne by those of us who don’t smoke but have to look at these disgusting cigarette packs that litter-prone smokers are likely to toss on the streets and into our innocent fields of view? Not to mention the horrifying commercials on TV that show sick smokers in agonizing pain in graphic detail. The paternalists don’t have to consider us as long as a few stupid smokers are scared out of the decision to possibly kill themselves. I think they need broader priorities.

  2. I thought I was alone at being outraged at having to see these low-probability horrors on tv. Luckily, however, I have a DVR and am able — most of the time — the zoom through these “commercials.”

    I am hoping that some clever entrepreneurs will sell cheap covers that people can put over the cigarette packs to hide the photos. I hope that the vendors of cigarettes will sell them right next to the cigarettes! Watch the paternalists go nuts.

  3. I am reminded of Coase and the distinctions he once made between the market for goods and the market for ideas. Injunctions against actors in the goods market are often promoted by those in the ideas market. There is no controversy here–actors in the ideas market are protected by the first amendment in most cases, even when they produce falsehoods or deliberately mislead.

    Now the government asserts itself into the market for ideas in order to regulate the market for goods. What first amendment right does the government have to distort statistics and manipulate public misconception of risk? Note too that the government is never required to show pictures of dead and wounded soldiers while building its case for war, yet war impacts the physical and emotional well-being of people as surely as cigarettes do.

  4. Well, how about the FDA allow the SAME graphic warning photos for abortion clients? That would cut down on the number of abortions, too!

  5. In Australia we have had “those” pictures for three (?) years. And those adverts. We have, however moved away from the graphic advert as research showed that Prof Rizzo’s comments were borne out in smoker’s responses. We now have ” the doctor said smoking killed my loved one – I really miss them” adverts”. Further for the last 2 years (?) cigarette packets can not even be displayed behind shop counters. (The cigarette packets are kept in a closed plain fronted cupboard.) Moreover, the actual area of that cupboard is regulated, with maximum size requirements. The Federal Govt is now proposing legislation (despite warnings it may be unconstitutional, against WTO guidelines and in breach of the US/ Aus FTA) to legislate that all cigarettes be retailed in generic white packages bearing only the name of the brand but all the health warnings including the pictures.
    In response, the tobacco companies are running the argument, amongst others, that this is the beginning of a slippery slope with alcohol products (beer specifically) next.
    I regret I must confess that my personal distaste of smoking, in this case, over-rules my dismay at the socialist nannies wasting my tax dollars despite the obvious possible long term consequences to me.

  6. If the externalities on others were to be a justification for this anti-smoking campaign and the graphic images soon to be on cigarette packs — because of the social and government-funded medical costs on others in society — then surely the same logic should apply to other dangerous forms of behavior.

    Anyone buying a pair of down-hill snow skies should have to see a picture of a bleeding, cracked-wide-open human skull next to a tree that the skier would have smashed into.

    Or anyone sky-diving should have to purchase a parachute that has a picture on it showing a person who has smashed into the ground and broken every bone in their body.

    Or anyone purchasing a cell phone should have to buy it with a picture on the box of a human head smashed into the front windshield of an automobile due to talking on the cell phone while driving.

    Or . . .

    The fact is smoking , for a while now, has become the latest and most “sinful behavior” to punished and condemned by the puritanical paternalists who insist upon prying into our personal lives.

    Unwilling or unable to banish smoking altogether from society due to the remaining negative imagery of the Prohibition era (and the fear that it might undermine the case for legalizing marijuana!), those puritanical paternalists are determined to make life so miserable for the smoking sinners that people will stop this “evil and filthy habit” through a tightening of the legal and social-pressure “noose” around their necks.

    As for the negative visual and smelling externalities that some experience from being around smokers. Well, its a negative externality for me to see obese men and women in tight sweat pants.

    Or, the smell of those on the subways who have not showered that morning before getting on the train at rush hour time. (Oh, what a pleasure not to have to ride on NYC subways any more!)

    Or, people driving with the car windows wide open playing rap music or Latin salsa music at full blast.

    Or . . .

    We might as well carbon copy what we see in news photos of people on the streets of Pyongyang, the North Korean capital. Everyone dressed alike; not talking; looking straight ahead with no facial expression (no chance of verbal or gesture gender or verb harassment, there!); no one smoking or drinking; no one driving recklessly (because there are no private cars — just the “people’s cars” for the “servants of the masses”).

    Why a visit to Pyongyang by some of our puritanical paternalists would probably make them feel that they had died and gone to cultural-uniformity heaven.

    What is disturbing is that so many Americans seem to have become those passive sheep led around by a government Shepard about whom de Tocqueville was so fearful as one of the dangers of egalitarian democracy. Our fellow citizens to often just accept the tightening of the behavioral straightjacket.

    Richard Ebeling

  7. Liberties are won or lost by whether unpopular people or practices are protected. At the risk of saying what should be obvious, the issue was sorted out by free association and free markets.

    The Hotel Russell in NYC, now just a memory, used to have a wonderful bar with world class technology that allowed cigar smokers to enjoy themselves w/o any externalities. My wife sitting next to me could not smell my cigar because the fans sucked the smoke up and out of the bar.

    Mayor Bloomberg thought this voluntary solution to potential conflict could not be allowed to stand.

  8. Personally, I think only non-smokers are going to be victimized by this tactic. Pigouvian taxation has already ensured that more and more of the smokers who have no intention of quitting are either rolling their own or buying on the black market. The move to strip branding from Big Tobacco cigarette packaging will only make it that much easier for black market generic substitution to take place.

  9. Something everyone is forgetting here is how comical and ridiculous this all is. At least where I live this has been a joke for years now.

    In Britain they tried to introduce the gruesome cigarette packets in a particular area of london first. They wanted to see if smoking rates fell there and use the rest of the country as a control. It didn’t work because as soon as they became available every teenager wanted a pack.

    Imagine decades in the future how stupid all this will look, that by itself will do great damage to causes like this.

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