The Tragedy of Tobacco and the State: Part 2 – Normalization of a Toxic Addiction

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Erik Devereux
May 24, 2024

This is the second column in a series on the responses of democratic governments to the public health disaster caused by nicotine addiction (read the first column here). I took the photograph accompanying this column just a few weeks ago at an independent candy store in Frederick, Maryland. Those of us of a certain age will recognize the objects in the photo immediately—boxes of candy “cigarettes”—actually long, white sticks of bubble gum packaged to look to children exactly like their nicotine-addicted parents’ packs of smokes. I had not seen candy cigarettes in decades; in fact, I was under the false belief that they had been taken off the U.S. market as part of recent efforts to cease conditioning children to accept nicotine products as normal and inevitable.

Historically, those seven-year-olds enjoying their candy cigarettes are just four years away from experimenting with the real thing for the first time. One of the most crucial aspects of the narrative of nicotine addiction is that it almost always begins in childhood. People who avoid nicotine under the age of 18 have a very low probability of becoming addicted thereafter.

Right here is where the obligations of a democratic state come into sharp relief. Critics of efforts to regulate nicotine products, or even ban them outright, frequently invoke the “nanny state” critique. This perspective chides governments for taking away the agency of individuals to make their own choices about what products to consume whether that be in the realms of food, beverages, tobacco or risky thrills like sky diving. That critique only applies to the decisions of adults and falls apart completely when discussing choices made by children regarding nicotine, one of the most addictive substances humans have ever experienced. Notably, many of those who invoke the “nanny state” critique of government efforts to restrict access to nicotine are aggressively in favor of restricting children under 18 from learning about their sexuality in schools.

If democratic governments have any obligations at all to their citizenry then that must be to attend to the well-being of children. Indeed, across the 20^th century the U.S. government and the state governments gradually took up that cause through such measures as the current foster care system and a wide range of laws pertaining to protecting those under 18 from abuse, neglect and predation. When it comes to children the voters should demand that the state be the best possible nanny.

So what happened with nicotine during the period starting with World War One to the present? It seems evident that a highly lucrative and politically connected tobacco industry selling a product whose use does not produce cognitive impairment or intoxication and having broad financial consequences across the economy simply overwhelmed the democratic process. For many decades, most democratic governments around the world championed the success of their domestic nicotine industries as their nicotine-addicted citizens began dying in huge numbers from smoking habits that began in childhood. This all served to undermine the public trust, to damage governance at the most fundamental level. Why should anyone trust a government that would sit back and allow this to happen?

The treatment of the nicotine industry by democratic governments also sharpened the divide between politics and administration. On one side were elected officials actively seeking to block efforts to regulate nicotine. On the other side were public administrators connected to public health increasing aware of the rising death toll from smoking. For a democratic system of public administration to thrive, the politicians generally should not order the administrators to stand on the side of an industry like tobacco. There must be boundaries related to unambiguous judgements regarding public well-being. Tens of millions of Americans would have enjoyed longer, healthier, happier lives if democratic governments had taken rapid action in the 1960s to stop nicotine use.

The next problematic participant in this narrative I will discuss is the health care sector. The nicotine industry is profitable and powerful but it is nothing in both regards when compared with the cancer treatment industry spanning doctors, hospitals and pharmaceutical companies. The blunt reality is that a cancer treatment industry existing to treat the consequences of nicotine addiction—and make huge profits along the way—would find itself substantially out of business if democratic governments actively opposed the sale of nicotine products.

The sale of those nicotine products also is subject to direct taxation all around the world. This is the third “plank” in how governments chose not to pursue public health as the primary goal when it comes to nicotine addiction. Democratic governments facing intense political pressures related to tax policy found it the easiest to tax “sins” like tobacco, alcohol and now cannabis. Once those tax revenue streams become enshrined in public budgets, governments become incentivized to promote the sale of nicotine. And that means ensuring that children continue to have access to cigarettes for otherwise they will not become adult addicts. There is no escaping the implied accountability.

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Author: Erik Devereux will be Associate Teaching Professor in the Department of Public Policy, Management, and Analytics at the University of Illinois-Chicago beginning this August. He has a B.S. from the Massachusetts Institute of Technology (Political Science, 1985) and a Ph.D. from the University of Texas at Austin (Government, 1993). He is the author of Methods of Policy Analysis: Creating, Deploying, and Assessing Theories of Change (available for free here). Email: [email protected]. More content is available here.

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