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Tob Control. 2013 May;22 Suppl 1:i55-7. doi: 10.1136/tobaccocontrol-2012-050839.

Tobacco endgame strategies: challenges in ethics and law.

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  • 1O'Neill Institute for National and Global Health Law, Georgetown University Law Center, 600 New Jersey Avenue, NW, Washington, DC 20001, USA.


There are complex legal and ethical tradeoffs involved in using intensified regulation to bring smoking prevalence to near-zero levels. The authors explore these tradeoffs through a lens of health justice, paying particular attention to the potential impact on vulnerable populations. The ethical tradeoffs explored include the charge that heavy regulation is paternalistic; the potentially regressive impact of heavily taxing a product consumed disproportionately by the poor; the simple loss of enjoyment to heavily addicted smokers; the health risks posed by, for example, regulating nicotine content in cigarettes--where doing so leads to increased consumption. Turning to legalistic concerns, the authors explore whether endgame strategies constitute a form of 'regulatory taking'; whether endgame strategies can be squared with global trade/investment laws; whether free speech rights are infringed by aggressive restrictions on the advertisement and marketing of cigarettes.

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