The evidence-free resistance to tobacco bans

As the PBS Newshour recently reported, Westminster, Massachusetts could be the first town in the United States to ban the sale of tobacco. As I watched the debate unfold among neighbors, I was shocked at the level of intensity with which citizens stepped up to defend the sale of tobacco in their town. At one point an elderly gentleman dependent on nasal oxygen due to years of smoking-related pulmonary disease states that he thinks a ban will “just not work.” A middle-aged gentleman states that such a ban is making a “mockery” of the town on a national stage. And at the end of a town hall meeting, a gentleman stands up to sing God Bless America, suggesting that allowing tobacco sales was a patriotic decision.

However, tobacco is the number one preventable cause of death in the United States. One out of three cancer deaths is caused by tobacco (CDC facts). Almost all people who start smoking start below the age of 25, and most long-term smokers wish they could quit or that they never started. For 50 years now, tobacco has been known as a potent carcinogen, yet since that discovery, tobacco has killed more than 20 million Americans. Tobacco has killed more than 15 times as many Americans as all American wars.

Given this carnage, why would the family-friendly people of a small New England town stand so strongly to the defense of tobacco? I believe a large part of the answer is a century of advertising and manipulation by big tobacco. As Stanford Research into Tobacco Advertising has documented, big tobacco has cast smoking as a libertarian crusade. The advertisement below is from 1941, but is not dissimilar from ads we might see today.

As a medical student seeking to treat and prevent disease, it’s dispiriting to see such resistance to an intervention that could save so many lives. But I think we first have to do a better job of informing the public, clarifying the deliberate misinformation spread by the tobacco industry over a century. Once the public understands the extent of misinformation and manipulation, the public outcry and demand for action could be tremendous.


Jake Rosenberg is a medical student. This article originally appeared in the Merck Manual Med Student Stories.

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