The School for Moral Ambition (SMA) describes itself as a movement of idealists taking on the world’s most pressing problems. Their proposed campaign to 'abolish the tobacco industry altogether' is one of their more ambitious proposals. This would require governments to override the consumption choices of the roughly one in five adults globally who use tobacco.
SMA quickly dismisses the idea that these billions of adults are making free choices about what to put into their bodies, stating
The problem with this “free choice” argument is that, for most smokers, it’s not: more than two-thirds say they want to quit and over half have made a serious attempt to quit. The comparison often made with alcohol consumption also doesn’t wash for this reason: only 3 to 4 percent of people who drink alcohol are addicted, and many consider it an enjoyable part of their lives.
But if regretted choices are treated as non-choices, the implication is extremely broad: many of us regret our social media use, diet, screen time, or sleep habits. We generally do not conclude from this that the state should control those behaviors. It is also ironic SMA chooses alcohol as an example of a more permissible industry, given that they eventually aim to target that industry, as well as junk food, in further campaigns. They also neglect to mention that most cigarette consumers report benefits from their use.
SMA further states
What about the decision to start smoking? Isn’t that a free choice? This idea doesn’t hold up either, because the vast majority of smokers start lighting up in their teens. Research by the Trimbos Institute found that the average age at which people in the Netherlands take up smoking is 17, and that two-thirds start before reaching 18 (and almost all smokers start before the age of 26). Plus, the younger smokers are when they start, the more cigarettes they smoke and the harder it is for them to quit.
When you lay out the facts, we’re dealing with a product that hooks people at a young age, right when their brains are most susceptible to nicotine. So, just how is that a “free choice”?
Even if we grant that those who started smoking before adulthood are not making a free choice to continue smoking, the conclusion would not be that all adult smoking lacks autonomy or that a blanket abolition is justified. SMA does not argue that two-thirds of the industry should be abolished; they argue for abolishing the entire thing.
Those making the case for tobacco abolition will cite statistics on the health cost; years of life lost, increase in incidence of respiratory illness. But this is a one sided perspective, considering only one side of the ledger - the lessened health from smoking - and not the other side: the benefits the smokers gain (which, by revealed preference, outweigh the health costs in the minds of the smokers.) This is the fundamental problem with analyses of the impact of tobacco control policy, such as Open Philanthropy's and Givewell's; these analyses implicitly assume that health is the dominant or overriding component of welfare, a assumption rarely defended explicitly.
As economist Walter Block puts it in 'Defending the Undefendable'
...is up to the individual to determine the kind of life he will lead—a short one, including what he considers to be pleasurable activities, or a longer one, without such enjoyment. Since there is no objective criterion for such choices, there is nothing irrational or even suspect about any choice on the spectrum. One may choose to maximize the possibility of longevity, even if this means the renunciation of liquor, tobacco, gambling, sex, travel, crossing the street, heated debate, and strenuous exercise. Or, one may choose to engage in any or all of these activities, even if that means a shortened lifespan
'No objective criterion' may be going to far. If we believe in an objective morality we may believe some tradeoffs between pleasure and longevity are intrinsically more valid than others. But how confident should we be? Confident enough to use the state to force specific answers to these tradeoffs upon the public?
According to Jackson et al. (2024), smoking a cigarette decreases life expectancy by approximately 20 minutes. Is it not possible a rational person would forgo 20 minutes of life for a short pleasure (to say nothing of the possible social and emotional-regulation benefits)? I fail to see how this choice is different in kind from that of someone who waits in a tedious line to see a performance, or who risks death by hiking a treacherous trail to access a remote peak.
If the SMA is confident the costs of tobacco are never worth the harms to consumers, they can attempt to educate the public of this fact and to assist those who choose to quit. But before trying to enforce this view upon others, they should remember their core principle of epistemic humility as stated on their webpage; "the world is complicated, and there are many things we don’t know or aren’t sure about."
It isn't necessary to conclude that the benefits of tobacco are not worth the costs for any user, or that no user would continually make a free choice to consume if fully apprised of the facts, to conclude that the tobacco industry should be eventually abolished.
Policymaking inherently paints with a fairly broad brush; it is often not possible to avoid sweeping up some desirable behaviors or events in the scope of a broadly welfare-maximizing policy. As a society, we do not generally require showings that no one would benefit from something before concluding that it should be banned.
The quotes provided so far don't convince me that SMA is asserting that no one has a free choice, or even that no one receives a net benefit: they assert that "for most smokers" their continued smoking is in contrast with their desire to stop, and "the vast majority of smokers" started as teenagers when they are the most vulnerable to nicotine addiction.
Of the 1/3 of smokers who did not express a desire to quit, I wonder how many of them would express a desire to return to smoking if we were to wave a magic wand that cured addiction and associated cognitive distortions and then asked them to make an actually free choice about whether to resume smoking. Cognitive dissonance is quite a drug! I don't put that much weight on the fact that each smoker decided to start smoking at some prior point in time as evidence of their preferences in a non-addicted state. Unless the smoker decided to partake the first time that cigarettes were a possibility, they also made decisions not to smoke in the past.
There are a number of reasons one might accept that some people would freely choose to continue smoking, yet conclude that an outright ban (eventually) is warranted. For example, one might conclude that only a ban will be sufficiently effective in keeping cigarettes out of the hands of minors, or in protecting society from secondhand smoke. Moreover, even if some people would freely choose to continue smoking, there is no known way to figure out who those people are in advance. Allowing them to discover the alleged joys of nicotine also means others getting trapped in addiction from which they would prefer to escape. There is no known realistic way to abolish only the part of the industry that sells to people who would prefer to be free of their addiction.
Agreed. However, the post as I read it isn't arguing that stricter regulation of some or all tobacco products is inherently unjustified. It's postulating that our confidence in the claim that it's net positive is shakier than the current models make it seem, because SMA and other organizations favoring such regulation are ignoring a major factor when modeling its costs and benefits, namely the enjoyment people get from using the products. It's one thing to disagree about the extent to which this matters and what weight to assign it in a model; it's another thing to fail to include it altogether.
IMO this is a crux of the disagreement the OP has with SMA's approach. The concept of addiction is doing a lot of work here in justifying treating smoking as a special case in a way that isn't applied to less socially stigmatized risks like a dangerous hike or regretted choices the OP mentions like those about social media use and diet. I'd be interested in understanding what you mean by "curing addiction" in this context - would it be something like never having known the pleasure of smoking, adding a moment of mindful reflection before each cigarette, or something else? And how can we tell whether someone is making the choices they are making because they are addicted vs. because they have weighed the pros and cons sufficiently for us to believe they are making a free choice?
Of the 2/3 of people who smoke and did express a desire to quit despite not having done so, I also wonder how many of them respond in this way at least in part because of the stigma surrounding smoking (this seems to happen in at least some subpopulations). Social desirability bias is also a hell of a drug.
Do you think there's a known realistic way to abolish the industry as a whole when more than a billion people in the world smoke daily? If yes, what's a tractable path given the track record of prohibition of psychoactive substances more generally, and tobacco specifically (e.g. recent bans and subsequent reversals in South Africa and Bhutan)? If not, why is this a reasonable goal for an evidence-driven organization to set, compared to educating the public about the risks of smoking and assisting those who desire to quit, as the OP suggests?
I think you're right that this is a significant crux. It's a thought experiment (hence "magic wand"), so I don't think it's necessary to have a perfect operationalization or measurement criteria here. That being said, I was envisioning that the wand would put smokers in the same position as people who have experienced pleasurable but generally non-addictive events in the past. For example: sex is generally pleasurable, people know it is generally pleasurable, but people aren't generally addicted to it. If they choose to have sex, even under circumstances where I might think it isn't the best decision for them, I don't generally question that this is their free choice.
I expect that, at a minimum, the magic wand would reverse neurobiological changes commonly seen with addictive behavior and would leave the subject with the firm conviction that they could choose to stop without any withdrawal symptoms, cravings, and so on.
The results would be a 2x2 matrix: did the smoker decide to return to smoking after the wand treatment, and did they decide correctly (based on what would make them happier given their own values and preferences?) People make suboptimal decisions all the time -- or at least I do! So I do not presume that their choice in thought experiment was the correct one for them. On the other hand, I do want to give their choice significant weight.
Unfortunately, magic wands don't exist, and so we can only speculate about the relative sizes of these groups. But if one believes that Group 1C is much larger than the rest (and especially if one believes that Group 2C is pretty small), then accounting for the net costs to Group 2C actually isn't that important in generating a model.
I think SMA's stated goal is somewhat hyperbolic in the short/medium run, although it might be a realistic goal over something like 75-100 years. For example, public support for proposed generational-ban legislation in the UK appears strong.
Even assuming that a generational ban would be dead on arrival, running an abolitionist campaign has some helpful potential failure modes. First, it could move the Overton window and make it earlier to establish policies that reduce usage levels and/or move usage toward less harmful forms. Second, pushing for a generational ban (e.g., raising the age of legal purchase by one day each day) could get watered down in the legislature to (e.g.) gradually increasing the legal age to the mid-20s, or to imposing a generational ban for only higher-harm products. Those would be massive wins.
In contrast, "educating the public about the risks of smoking and assisting those who desire to quit" sounds a lot like the status quo approach -- which has led to over a billion people smoking, most of whom wish they could quit. Governments have already spend quite a bit on educating the public, and the quitting-nicotine market is already quite large (even if its offerings leave much to be desired in terms of efficacy). There's no reason to think SMA folks would be more skilled at educating people about the harms of nicotine than public health experts, or that they would be better at designing anti-addiction drugs than expert psychopharmacologists whose firms have a massive financial incentive to succeed.
SMA condemn the tobacco companies for claiming that vapes are safer, but don't discuss whether this key claim is actually true. Yet as far as I can see it clearly is true. There is debate about exactly how much safer they are - e.g. how convincing we should find the NHS claim that vapes are 95% safer - but I haven't seen any credible argument that vapes aren't safer at all. It's not 'dodging' safety rules to release a considerably safer product.
Further, I think vapes are also pretty good evidence again SMA's defense of paternalism. If smoking cigarettes wasn't really a choice, why has the availability of vapes and pouches been associated with a decline in cigarettes? The most natural explanation here is that previously people choose to smoke cigarettes, and then a superior product came along, so people started choosing that instead.
I also found their neglect to mention to mention smokeless products strange. In Norway and Sweden, for example, snus has been replacing cigarettes.
Excellent post. I would add that SMA's approach to reducing smoking-related harm has another defect that doesn't require one to have a position on the question of how to model the benefits of smoking, which is their position on much safer, noncombustible forms of tobacco and nicotine use like vaping, nicotine pouches, and snus.
There's plentiful evidence that all of these products hugely diminish risks to longevity, are the most effective known way to stop smoking, and have a major measurable impact on population-level disease incidence when widely available. An Our World in Data post from a few weeks ago summarizes the bulk of it, and I've also written a sequence on this for the EA forum. SMA describes vaping as a "way the tobacco industry is dodging the rules," puts scare quotes around "safer" when discussing (and dismissing) its health benefits to people who smoke, and their incubatees appear to be lobbying against regulation that would make it more available while ignoring the countervailing evidence when confronted with it publicly.
I don't have any reason to think SMA has anything but good intentions in helping people achieve better outcomes (health-related or otherwise) for their lives, but from the tone of their communications it appears that they are conflating hurting the tobacco industry with helping people that suffer because of the defects of their products. The idea that an industry that created a problem that causes so much death and suffering may, if properly regulated and incentivized, also be part of the solution to that problem appears to be beyond their moral imagination (or ambition, one might say) even though this approach seems to me pretty standard in other causes EA is interested in, like working with farmers and the meat industry towards progress in animal welfare or with fossil fuel companies to mitigate climate change.
I'm a huge fan of epistemological humility, but it seems odd to invoke it for a topic where the societal effects have been exhaustively studied for decades. The measurable harms and comparatively small benefits are as well known as you could reasonably expect for a medical subject.
Your counterargument seems to be that there are unmeasured benefits, as revealed by the fact that people choose to smoke despite knowing the harm it does. But I don't think these are an epistemological mystery either: you can just ask people why they smoke and they'll tell you.
It's seems like this is more of a difference in values than a question of epistemics: one might regard the freedom to choose self-destructive habits as being an important principle worth defending.
fair points! I should have been explicit here but I was invoking epistemological humility primarily in response to SMA's public statements about the tobacco industry which in my view do not seriously engage with the idea that tobacco use could be a free-but-harmful or free-and-beneficial choice for any consumers.
I would push back on the idea that the harm/benefit ratio to smoking is somehow 'medically settled'. The fact that cigarettes greatly increase risk of lung cancer, say, is settled but for the harm/benefit ratio to be settled it would require us to be able to put the harm and benefit in comparable units; the correct procedure for which is, in my view, a epistemological mystery (the problem here seems similar to trying to get an unambiguous answer with health economics whether to go on a fun-but-risky rafting trip or a safe-but-boring trip to the mall).
I do believe the freedom to choose self-destructive habits is an important principle worth defending though I don't think that claim is necessary for the more narrow point I was making in this post.
I would argue harms vs. benefits of tobacco are settled, to the point where we don't really need further calculations. ITs implausable that a calculation could find the small potential psychological benefits would outweigh 10 years less life expectancy. This would require a 15%-20% ish continual wellbeing improvement from smoking which is impossible....
The problem isn't similar to a fun and risky rafting trip which might lower your life expectancy by a day or something.
If you are a libertarian and believe in Freedom to destroy yourself and others (second hand smoke) that's a different argument.
This isn't directly related to the points raised in the post or in any of the top-level comments so far, but I can't help but wonder: would efforts to quash tobacco go any better than efforts to quash illegal drugs? Is the crux of the matter really whether a drug is net harmful — if it is, try to abolish, if it isn't, leave it alone? What about considering the most effective forms of harm reduction?
That's certainly a relevant question, and I think some of it would depend on the contours of the attempting quashing. It's quite plausible -- maybe even probable -- that some combination of demand reduction (without outright banning), harm reduction, and other softer techniques would achieve superior results as a practical matter.
That being said, the volume of tobacco consumed by an active smoker (e.g., a pack a day) is many times greater in volume of (e.g.) street opioids where even 2 mg of fentanyl can be a fatal dose. There are about 425MM pounds of tobacco harvested in the US on about 200K acres. I'd expect the volume involved to make smuggling enough tobacco-leaf products significantly more challenging than it is for most drugs. (Or alcohol, which can be produced quite easily using basic equipment.) And so a ban on tobacco leaf might stand a better chance than the median drug ban. On the other hand, it may not be particularly hard to synthesize and smuggle nicotine itself.
Another possible difference might be how society manages addiction in this hypothetical new world. There's already broad acceptance for treating nicotine addiction as a health problem that warrants professional treatment. If there were a safe, legal, inexpensive way for people with nicotine dependence to get treatment (including nicotine replacement therapy) in a post-quash world, that would take a lot of the wind out of the sails of the black market.
There are not too many case studies to look at here, but in Bhutan, their 2010 ban on the importation and sale of all tobacco products (which was coupled with government counseling and treatment to facilitate cessation) proved controversial and difficult to enforce in the face of large-scale smuggling and was eventually scaled back in 2021.
One can, indeed, make the argument that an outright ban on smoking would violate the rights of people who have been smoking for their entire lives.[1]
But most citizens would probably agree that at least some level of government intervention is justified for tobacco, when you consider that smoking is responsible for the deaths of 7 million people every year.
https://en.wikipedia.org/wiki/Smoking_ban#Criticism ↩︎
Great post!
Seems like a case where marginal thinking strictly dominates the abolitionist case. I'd imagine many more people could get on board with doing more to stop child smoking addiction and reducing the consumption of the most harmful tobacco products.
I'd expect the less controversial interventions to be more tractable and therefore impactful as well. Why not aim at that?
Has anyone seen a more thorough discussion of SMA's tobacco-control strategy and its theoretical underpinnings?
The two links here are somewhat polemical in style. Perhaps the argumentation wouldn't get a good grade if submitted in a philosophy seminar, but I don't think either of the pieces were written with philosophical rigor centrally in mind.
This article from one of their incubatees describes their strategic approach:
They appear to see the tobacco industry as an emblematic example of industries that are net harmful, and legal action as a specifically effective way to fight them:
One of their other fellows authored a report for the European Respiratory Society that specifically advocates for and "endgame" strategy for eventual full prohibition via generational sales bans: