Justice requires asking and answering the question of why specific individuals are in a position of inequality.
Smokers, I have found, are inclined to disbelieve just how unpleasant others find their habit. Since they themselves can’t or don’t detect the lingering smell of stale smoke in rooms, in corridors, on clothes, even in books (my second-hand copy of Father Coplestone’s study of Nietzsche is a smoke-filled room in itself), they think that non-smokers exaggerate when they complain of it. They don’t believe that the smoke that gets in your eyes stings, or that it rasps the throat, or that it destroys pleasure in food. The late Christopher Hitchens, an inveterate smoker, told a self-congratulatory anecdote about how he was bravely determined to strike a blow for freedom by breaking the law in New York. Determined to smoke a cigarette in a restaurant, he asked the people at the next table whether they minded if he lit up. It was characteristic of smokers’ egotism, and perhaps that of the author also, that he thought his question a neutral one, such that a reply to the effect that they did not mind meant that they really did not mind. When a guest in my house asks if I mind if he smokes, of course I always say that I do not and make light of my own distaste.
My mother smoked cigarettes until she was 48 years old, and when she was 70 the emphysema which they had given her became manifest and restricted her activity for the rest of her life. My father smoked an evil-smelling pipe, to which I cannot pay better tribute than the last words of James I’s famous Counterblaste to Tobacco of 1604:
… lothsome to the eye, hatefull to the nose, harmfull to the
braine, dangerous to the lungs, and in the blacke stinking fume
thereof, nearest resembling the horrible Stigian smoke of the pit
that is botomlesse.
Smokers, in throwing away the butts of their cigarettes, treat the world not as their oyster but as their ashtray. Whenever I see a smoker toss his cigarette end into the gutter, as unthinkingly as a cow relieves itself in a field, I feel a surge of anger or despair at his implicit assumption that the world is there for his convenience.
I am no friend to smoking, therefore; but even I feel a certain unease about the zealotry of the anti-smokers. The problem is that, in the modern world (though perhaps it was always so), a good cause is turned into rent-seeking, and generally into rent-finding as well.
Examination of the legal proceedings in the United States against the tobacco companies persuaded me that the real tort in the case was, in effect, the transfer of the profits of the tobacco companies from the shareholders to the trial lawyers. The last thing that anyone wanted to do was drive the milch-cow, the tobacco companies, into bankruptcy, or simply to close them down so that they could be sued no more. Governments, which had been deriving large revenues from the tobacco companies’ products for many years in spite of knowledge of the effects of smoking, were at least as responsible for any harm done by tobacco as the companies. No doubt the tobacco companies lied in a disgraceful fashion about the harmfulness of their products, but I have never met anyone who believed their lies; and although no longer young, I grew up knowing that smoking was bad for you in the same way that I knew that the world was round and the Battle of Hastings was in 1066. As to the supposed impossibility of giving up smoking once started because of the addictiveness of nicotine, this was clearly nonsense; what millions of people (including my mother) have done cannot be impossible.
The transformation of a good cause into a bureaucratico-commercial opportunity was illustrated by a little item in the British Medical Journal for January 5, 2013. It was headed ‘Anti-smoking campaign uses images of cancerous tumors on cigarettes,’ and describes how the British government is to spend public money on a series of commercials in which cancers are seen, with startling realism, to be growing in cigarettes as they are smoked. A bizarre comment by a public health doctor perfectly captured the pathology – if I may be allowed a medical metaphor – of modern egalitarianism. He is reported to have said ‘[we] urge caution that the approach may benefit some more than others…’ This seems to imply that it would be better, which is to say more socially just, to save no one from the harmful effect of cigarettes than to save only some. Would a surgeon be justified in refusing to treat a cancer patient on the grounds that there were people with the same cancer undiagnosed in the general population, and that his operation would save only one among all the sufferers from cancer?
However, it was not this that really caught my eye, but rather the information that smokers are to be simultaneously encouraged ’to collect “quit kits” – practical tools and advice to help smokers quit smoking – which are available free of charge from more than 8200 pharmacies across England.’
The question I want to ask is why should such advice and equipment be provided free of charge to people who are prepared to pay $9.60 or more per packet of cigarettes? If they can afford the cigarettes, surely they can afford what will supposedly replace them? Why, then, should these things be provided at public rather than at private expense? It is not implausible, indeed, that having to pay for these things would make them more effective when taken up.
Let us, however, assume the opposite for the sake of argument. Let us suppose that, as a result of their being free of charge, more people take up the ‘kits’ and as a result of doing so stop smoking than would have been the case had they had to pay for them (this is also plausible). What then is the justification?
It is utilitarian. The cost of providing the kits will be more than offset by the savings on healthcare of the people who give up smoking and thereby become healthier. The public expenditure is therefore economically rational.
However, if an economically utilitarian argument is used to justify such public expenditure it must take into account all relevant factors. For example, smoking is now overwhelmingly concentrated among the poorest, least skilled and least productive sector of the population. If smokers work at all, it is in the sector of the economy that requires least training. By dying before retirement age, a smoker who works makes room for an unemployed person who would otherwise be in receipt of social security. (Unemployment is concentrated in the same sector of society as smokers.) Moreover, by dying early, a smoker, having paid an enormous amount of excise tax throughout his life, saves the economy the trouble of paying him a pension for many years. It is therefore far from certain that, from the purely economic point of view, we should be discouraging smoking by the smoking classes: and this quite apart from the fact that the tobacco industry provides employment for many.
These are very unpleasant arguments: but he who lives by utility dies by utility. If the utilitarian shies away from the arguments on the grounds that they are too distasteful to be considered, and turns instead to deontology – that it is obligatory to save human life wherever possible – then they are surely more effective ways of preventing deaths from smoking than by providing free kits at 8200 pharmacies, for example by outright prohibition. Whatever the difficulties and drawbacks of such prohibition, it would almost certainly save lives; and therefore, from the deontological point of view, would be obligatory.
Irrespective of the practical effects of providing such kits free of charge at public expense, there is the psychological and cultural effect of doing so, an effect that is intangible no doubt but important (for, as Einstein pointed, not everything that is measurable is important and not everything that is important is measurable). What providing such kits free of charge tells the population, at bottom, is ‘Indulge yourself and others will take care of the consequences.’
The ‘others’ are an alliance of government and corporate interests. Telling people to indulge themselves and let others take, or at least pay, for the consequences is the way to groom them for life not in a liberal society, a society of individual actors who assume responsibility for their acts, but in a corporatist one, precisely the society that we have. Whether it can or ever will be any different, I have not the faintest idea. It has been different in the past, but the past is another country where they do things differently.