The Antismoking Movement
The growing evidence that smoking is unhealthy for both smokers and nonsmokers has led to increasing restrictions on smoking. Since 1964, health warnings have been mandated on tobacco advertising, which has been restricted. In recent years there has been a change in public acceptance of smoking. Many places have passed laws to restrict smoking in public places such as restaurants and workplaces. In places without these laws, there is a trend for businesses voluntarily to become smoke-free. Worldwide, most airlines have prohibited smoking. The U.S. Army has been particularly strict in imposing smoking restrictions. Nonsmokers defend these measures on the grounds that smokers pollute the air for nonsmokers. Cigarettes have long been subjected to taxes, but in California, Massachusetts, and Arizona, voters passed an extra tax to pay for a statewide antismoking campaign. In Canada, cigarette taxes are used to help pay for the national health-care program.
In the late 1980s, a number of smokers dying from smoking-related diseases and their heirs filed damage suits against tobacco companies, although none received any cash damages. This situation changed in the 1990s, when the attorneys general of about 40 states began filing suits to have the states reimbursed for Medicaid costs incurred in smoking-related illnesses. The combination of successful lawsuits by individuals, class action suits, and a push by the FDA to regulate tobacco, led the major tobacco companies to agree in June 1997 to a deal that includes the demise of cigarette vending machines, a few types of tobacco advertising, industry sponsorship of some sporting events, and over $360 billion toward the states' health-care costs and antismoking education of children in exchange for immunity from further legal liability. This agreement triggered great controversy within the public health and legal communities, with many thinking it would help the tobacco industry. Congress was slow to start the legislative action needed to enforce the deal. Meanwhile, the tobacco industry began settling the separate state lawsuits, starting with Mississippi, Florida, and Texas. When the new federal legislation was finally proposed, it called for larger financial contributions from the industry and greater advertising limitations than the original agreement. In April 1998 the tobacco industry announced that it was pulling out of the 1997 deal; President Clinton stated that legislation would move forward, with or without the cooperation of the industry. The tobacco industry continued to settle its state lawsuits; Minnesota settled in May 1998. The industry also mounted a public relations campaign against the costs of the proposed legislation. In June 1998 the legislation was killed by the Senate while it was still being debated; the House of Representatives may propose a much more limited version of the tobacco legislation to focus on limiting teen smoking. In November 1998 the tobacco industry and California, Colorado, New York, North Carolina, North Dakota, Oklahoma, Pennsylvania, and Washington agreed on a new version of the tobacco settlement that would also cover the remaining states that had not settled with the industry, once they signed onto the agreement. In exchange for settling the state-filed lawsuits, the new agreement includes $206 billion to the states over 25 years, as well as restrictions on advertising and marketing. There is no specific penalty if youth smoking is not reduced, and private citizens can still file suit against the industry. The remaining 38 states are expected to sign on.
The tobacco industry and many smokers regard antismoking measures as harassment. The industry has made contributions to politicians, political parties, and special-interest groups and has attempted to organize smokers into a political force. Tobacco continues to be heavily promoted, through regular advertising and brand sponsorship of arts, music, and sportinevents. Cigarette brands have been targeted to age, ethnic, and economic groups, and some cigarette advertising symbols have been successful at attracting very young smokers. As Americans have stopped smoking, the industry has moved aggressively into Asia, Africa, Russia, and Eastern Europe.
Every day about 3,500 Americans successfully quit smoking; many more continue to try. Many programs and approaches to help people quit have been developed, including support groups, behavior modification, acupuncture, and hypnotherapy (see hypnosis). Pharmaceutical companies have developed a nicotine patch and nasal spray to help smokers break the habit while easing nicotine withdrawal symptoms.