Ethical Issues with Healthcare and Tobacco Use

The 20


century was marked by different innovations that improved the overall condition of life. From the beginning of this time period, there was much development in the field of health, along with rising awareness of what health in the public. However, despite all the key breakthroughs in medicine and health, the general welfare and health was not in correspondence with the research and development. Using tobacco as a case study for understanding the public’s view, the public – the society, government, and individuals – do not really care about the general welfare and health.

Some scholars argue that as seen through tobacco’s steady decline, the public is benefitting much from it. Thus, people do concretely care about the general welfare and health. After the 1950s when the key research was presented in the association with tobacco and lung cancer, there was a steady decline in smoking. “Smoking became less popular due to a rapid increase in knowledge of the health effects of both active and passive smoking”. Also, “people became more aware of the tobacco industry’s efforts to mislead the public about the health effects of smoking and to manipulate public policy for the short-term interests of the industry”. As these problems spurred up to the public, people had the tendency to stray away from tobacco. So it is plausible to argue that people care about the general welfare and health of the public. However, this kind of consideration, in the same way, is for the latter side of the argument. It is plausible to argue that people only care about their individual welfare and health. People started to see the negative effects on their own lives, thus choosing to protest against what is potentially harmful to them on a personal level. If tobacco, however, was consisting of livelihood, this protest diminishes. When one’s life is in the line of death, do ethics and morals really matter?

When tobacco constitutes the livelihood of one, they will choose to continue to utilize tobacco. Likewise, developing countries saw a steady increase in tobacco production in the latter half of the 20


century. China is on the forefront of producing tobacco, as seen through its large percentage of total production. China is the “world’s largest producer with 2.6 to 2.9 million tons in 2010, well above India with 0.68 million tons and Brazil with 0.58 million tons”. As seen through these statistics, it is reasonable to argue that banning tobacco use and production is a luxury of the developed countries. Developing countries depend on exports for their economy to function. [insert statistical document]

Tobacco brings up the question of the struggle between public and private. There is the struggle with the individual beliefs and reputation. There is also the question of government funded versus privately funded. There is also the problem with smoking privately vs publicly. There is the struggles of the public health component against the personal choice with tobacco. Another question that comes up is the gender proportionality when considering tobacco as a way of fighting for equality. Women were initially banned to smoke until after world war I (citation). Women started to become major consumers of tobacco.

Tobacco was first introduced into the European world when Europeans went over to the Americas. However, tobacco was mainly a product for wealthy men, and was not circulated as much during the past centuries. However, when in the late 19th century the cigarette-making machines were invented, tobacco became popularized in the mass market. There are different reasons why tobacco consumption increased, but there were specific peaks of increase after WWI and WWII. The depressing realities from the wars increased the smoker population. From the UK statistics, it is clear the extent of cigarette affected the population. By the mid 1960s, UK had 70% of male and 43% of female population smoking. It was a common norm to smoke and “regarded more or less as a fact of life”. Smoking was everywhere in the social sphere, ranging from theaters, restaurants, public transport systems to hospitals and schools. This can be understood as society almost needed tobacco for them to function. It can be compared to other commonalities we need in life, such as water. With tobacco’s highly addictive and calming affects, people depended on tobacco emotionally and physically.

After the study was released in 1960s, people became more aware of the negative effects of tobacco. It was so severe that it outweighed the benefits in every aspect. There was the aspect of smoking tobacco directly affecting the smoker’s health, but the effects of second hand smoking became widely known. People who are exposed to second hand smoking are more likely to get lung cancer than the “first-hand” smokers (insert citation). This frightened much of the public, as shown in the reaction of people in the UK. Parents protested against smoking in educational places – school, library, etc. – along with hospitals and other public places. More people started to join the rally as second hand smoking would affect themselves when they are within the spheres of smokers. This reaction showed the mass mobilization of the society fighting against tobacco. It is reasonable, then, to claim that the public does care about the general welfare and health, as their movements led to the prohibition of smoking in many public spaces. However, this reaction only came forth when the mal effects were known to affect them directly, whether it’s their own personal health or the health of their loved ones. Yet it is safe to assume that because of these individual efforts of all people, it led to the public mass movement.

Tobacco affects our economy in many ways.  One of the biggest economy for China is tobacco production. For many developing countries, this is how they increase their revenue. For developed countries, like United States, the tobacco industry creates one of the biggest profits in the economy. Annually, with a profit of a half trillion U.S. dollars , their profit is equal to the “combined profits of Coca-Cola, Microsoft, and McDonald’s in the same year”. Surpassing these mega companies, their profit exceeds many countries’ total GDP (citation). To halt these soaring profits and diminish the health effects from tobacco, many countries created tobacco on taxes. However, even with the attempts to “control consumption” and “raise revenue, their effectiveness depends on the extent of smuggling” (citation). The attempts to control tobacco in the government side can be counteracted when smuggling becomes  now the major concern. When people are in need of tobacco because of either addiction or because of their survival depending on its commerciality, these taxes and morals from health concerns are neglected. These people will react to find ways to go around the system.

Tobacco has no obvious benefits to our society. The negative impacts are clear and proven throughout many studies. Yet, the government does not ban its use and benefits off of tobacco tax revenues. Then the question of their underlying attempts is unclear. If the government wants to truly rid tobacco and discourage its use, imposing tax is not the only solution they have. There are many non-profit organization attempts to make the public more aware of tobacco’s dangerous affects. As seen through (citation) this ad, smokers are depicted as gross and deathly. It allows the audience to understand its extreme impact in not only the physical health but also their social life as well. These ads work to a certain extent, as it is the common understanding that smoking is bad for health. However, the continual media portrayal of tobacco counteracts this understanding. Novels, magazine articles, television shows, and movies use tobacco to portray characters as “bad-ass”, fierce personalities. Similarly, they put cigarettes upon women characters to create a “girl-crush” personality.  These portrayals diminish its negative effects and create the connotation that smoking is acceptable and almost necessary to establish characters as certain personalities. The question remains – is the connotation of tobacco really changing? Yes, in a way, people are more aware that tobacco is bad. However, that is it. There is no efforts in the media end to stop its circulation in our lives.

The smoking population from the early 2000s saw a radical change. Most of the developed countries saw a decrease in the overall smoking population. One of the reasons for this was that these countries were hitting a more stabilized economic and social condition. Commerciality was increasing and there seemed to be no more wars in the future. Living conditions improved drastically and people started to care more about the quality of life. On the other hand, smoking increased in developing countries. Most smokers now exist in certain geographical areas of low income, low Human Development Index, and poor quality of governance. These are areas where public health is not a main concern because most citizen’s livelihood matters on a daily basis. In addition, most smokers in general are in a certain social class group. When tobacco was first introduce, it was a product only for wealthy men. Now, tobacco is associated with poorer, low-income social class. Understanding this, companies direct their tobacco advertisement efforts to appeal to these particular groups. In addition, companies aim to sell tobacco to the younger generations as they will be consistent consumers throughout their lives once they become addicted. Younger generations are easier to persuade with the use of media portrayal as showing cigarettes as something “cool”. The appeal to smoke diminishes as people age, so the companies shrewdly use tactics to increase their audience. There ethical stance in the production is questionable. These companies are highly aware of its negative effects in the economy, but they choose to continue to create more money-making strategies for their companies. It is certainly arguable that the impact of money makes the underlying ethical question covered away in their thoughts.

Tobacco had another appeal to the masses as it is one of the biggest uses in weight loss. Tobacco has an impact of suppressing food cravings as well as decreasing the tastefulness of food (citation). In many developed societies where being slim equates to beauty, this appeal to smoking creates an influx of consumers. The second leading reason for people smoking is this weight loss aspect.

Tobacco brings up the question of the ethical and moral concern versus the economic interest. Many times, the economic benefits outweigh everything else, as discussed throughout this paper. It is hard to care if the effects do not directly affect them. Yet as seen through the chain of tobacco’s impacts, people will be affected to a certain extent. Being more aware to certain issues brings them to the forefront. However, “tobacco is bad” is a common understanding. People need to push towards a different perspective in understanding why tobacco is bad and why tobacco became inevitable in our society. In addition, it is time to hold people accountable to a certain extent when they are aware of all these information.

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