‘‘Not Safe’’ Is Not Enough: Smokers Have a Right to Know More Than There Is No Safe Tobacco Product

Department of Biobehavioral Health, The Pennsylvania State University, 315 East Health and Human Development, University Park, PA 16802, USA.
Tobacco control (Impact Factor: 5.93). 09/2005; 14 Suppl 2(suppl_2):ii3-7. DOI: 10.1136/tc.2004.008334
Source: PubMed


The right to health relevant information derives from the principles of autonomy and self direction and has been recognised in international declarations. Providing accurate health information is part of the basis for obtaining "informed consent" and is a recognised component of business ethics, safety communications, and case and product liability law. Remarkably, anti-tobacco and pro-tobacco sources alike have come to emphasise the message that there is "no safe cigarette" or "no safe tobacco product". We propose that the "no safe" message is so limited in its value that it represents a violation of the right to health relevant information. There is a need to go beyond saying, "there is no safe tobacco product" to indicate information on degree of risks. The "no safe tobacco" message does not contradict, for example, the mistaken belief that so called light or low tar cigarettes are safer choices than higher tar cigarettes. We encourage a kind of "rule utilitarian" ethical position in which the principle of truth telling is observed while trying to produce the greatest good for the greatest number of people. Although harm reduction approaches to easing the burden of tobacco related diseases are founded on science based comparative risk information, the right to health information is independently related to the need to promote health literacy. This right should be respected whether or not harm reduction policies are judged advisable.

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    • "Also, the concept of promoting ST as an alternative to smoking could entice non-tobacco users to start using smoked tobacco. However, as Kozlowski has argued, the primary responsibility of health authorities is to ensure that the public is well informed about the relative harms of alternative nicotine delivery systems [16]. "
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    ABSTRACT: Background This study explored the value of providing information in a Fact Sheet to correct misperceptions about the relative harmfulness of nicotine replacement products (NRT) and smokeless tobacco (ST), when compared to cigarette smoking. Methods Four convenience samples from different countries (Australia, UK, Sweden and USA) were surveyed concerning their beliefs about the relative harmfulness of smokeless tobacco and NRT. Study participants were given the Fact Sheet that explained that nicotine, as used by consumers, is not particularly harmful and explained why. They were resurveyed one week later regarding their beliefs about the relative harmfulness of smokeless tobacco and NRT and future intentions to use the products. Results In all four samples knowledge increased by similar amounts and beliefs regarding the lower harmfulness of smokeless tobacco increased. However, misconceptions remained common and responses to belief measures were not always consistent. Likelihood of use of ST increased in all four samples after exposure to the Fact Sheet, but interest in NRT use only increased in the US sample. Conclusions A Fact Sheet such as this one can help address misconceptions about NRT and smokeless tobacco, at least in the short term. However, as is true of most educational interventions, exposure to a single educational session is not sufficient to overcome misperceptions that smokers have about the relative harmfulness of oral versus combustible forms of nicotine delivery.
    Full-text · Article · Jun 2012 · Harm Reduction Journal
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    • "" What could be safer, " critics have wondered, " than to align completely with a dominant government message? " (Kozlowski and Edwards 2005:5). "
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    ABSTRACT: In this article, I analyze the central role of economic liberalization in Philip Morris's makeover into a “responsible corporate citizen,” including the firm's unlikely support for U.S. Food and Drug Administration (FDA) regulation of tobacco products. On the basis of fieldwork in North Carolina, I provide an ethnographic view of how the recent shift from traditional auction marketing to private contract agriculture affects differently positioned farmers and farmworkers. This transition has galvanized both potent cultural meanings associated with locality and modes of stigmatization deployed by various actors to respond to social and economic restructuring. Ostensibly about improving public health, Philip Morris's makeover, linked to stringent producer contracts and government regulation of consumption, makes U.S. farm businesses less stable, deepens their dependency on a transnational flow of low-wage labor migration from Mexico and Central America, and compounds social and housing problems that affect migrants. The tobacco industry's transition is an exemplary case of biocapitalism, a strategic merger of economic, ethical, and public health values that mirrors trends in the pharmaceutical industry. Analyzing social dynamics of stigmatization in light of health-driven production models, I show how the involvement of a private firm in regulatory politics builds on uneven social and economic conditions among people who manage and work on tobacco farms. This study expands the scope of tobacco's public health picture beyond a narrow focus on consumer health to include important social and health problems related to commercial leaf production. [tobacco, cigarettes, smoking, corporate social responsibility, agriculture, farm labor, stigma, biocapitalism, North Carolina]
    Preview · Article · Jul 2008 · American Ethnologist
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    • "More recently, Kozlowski and Edwards (2005, p. ii5) have suggested that smokers deserve more information, declaring: "
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    ABSTRACT: Purpose – The aim of this paper is to examine the confusion and misperceptions regarding the actual risk involved in smokeless tobacco use as an alternative nicotine delivery option for inveterate smokers. Design/methodology/approach – The paper cites published research and current government guidelines to demonstrate misinformation on the part of some in the public health community. Findings – The paper finds that smokeless tobacco is substantially safer than smoking and is a viable choice to increase smoking cessation for those unwilling or unable to quit. Practical implications – The public is entitled to know the facts about nicotine and the truth about the actual risk levels involved in consuming various forms of tobacco. Originality/value – Consumers are capable of making an informed choice for themselves regarding the risks of using smokeless tobacco if the truth is communicated to them.
    Preview · Article · Mar 2007 · Journal of Consumer Marketing
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