“Not safe” is not enough: smokers have a right to know more than there is no safe tobacco product

Abstract

The right to health relevant information derives from the principles of autonomy and self direction and has been recognised in international declarations. Providing accurate health information is part of the basis for obtaining “informed consent” and is a recognised component of business ethics, safety communications, and case and product liability law. Remarkably, anti-tobacco and pro-tobacco sources alike have come to emphasise the message that there is “no safe cigarette” or “no safe tobacco product”. We propose that the “no safe” message is so limited in its value that it represents a violation of the right to health relevant information. There is a need to go beyond saying, “there is no safe tobacco product” to indicate information on degree of risks. The “no safe tobacco” message does not contradict, for example, the mistaken belief that so called light or low tar cigarettes are safer choices than higher tar cigarettes. We encourage a kind of “rule utilitarian” ethical position in which the principle of truth telling is observed while trying to produce the greatest good for the greatest number of people. Although harm reduction approaches to easing the burden of tobacco related diseases are founded on science based comparative risk information, the right to health information is independently related to the need to promote health literacy. This right should be respected whether or not harm reduction policies are judged advisable.