Despite great strides by the tobacco control movement in recent years, both in reducing the percentage of smokers and in dramatically increasing the number of smoke-free workplaces and public places throughout the world, advocates are understandably frustrated that, 45 years after the 1964 US Surgeon General’s report on smoking and health, millions of people continue to die each year from smoking-related diseases worldwide. Some advocates have concluded that it is finally time to consider the nuclear option—a prohibition on the manufacture and sale of cigarettes. While we all share the frustration, in the United States, at least, such a move towards prohibition is misguided, for both political and practical reasons.

Prohibition should be rejected in the US primarily because is politically unfeasible. It is simply inconceivable that the same Congress that could not write a bill giving regulatory authority over tobacco to the Food and Drug Administration (FDA) without tobacco manufacturer Philip Morris’s permission, and then could not pass sensible amendments to the bill when they were opposed by Philip Morris, would even entertain a bill for prohibition, much less enact such a measure. Even the most ardent congressional friends of tobacco control would not spend their political capital on this endeavour. Nor should the tobacco control movement expend its precious resources on such an unlikely project. While smoking is principally a health issue, we must face the fact that it is also a political issue and that we have a powerful and relentless opponent. As someone once said, politics is the art of the possible—and making cigarettes illegal in the US is not possible.

Beyond that, any serious effort to enact prohibition would play right into the hands of the tobacco industry and weaken the tobacco control movement. For years, the tobacco industry and its friends in the media and Congress have taunted those in the movement to advocate prohibition, knowing that it would make us look bad and hoping that we would waste our time and energy on it. When the non-smokers’ rights movement first started, it was typical of reporters to sarcastically ask why we don’t just ban smoking altogether. And in an interview with Senator Jesse Helms of North Carolina some years ago for a television documentary on the harm caused by smoking, Helms asked essentially the same thing, as if to say that there were only two options—a prohibition on smoking or no government regulation whatsoever. Over the years, Americans for Nonsmokers’ Rights has received numerous media requests to provide spokespeople to take a pro-prohibition position in debate with tobacco industry representatives and we have regularly turned down these requests, because they were designed to trap us into advocating an unrealistic and unpopular position that would make the organisation and the movement appear irresponsible. Significantly, the non-smokers’ rights movement has been able to change social norms about smoking and bring about lasting reductions in smoking prevalence precisely because we have not tried to dictate to smokers what they can or can’t do to themselves, but rather have prevented smokers from doing harm to those around them.

The last time the US tried prohibition, it was a total fiasco. Not only was the prohibition of alcohol ineffective in preventing people from drinking, but it engendered one of the worst crime waves in the nation’s history. Given this record, it is doubtful that most Americans, and certainly most politicians, are ready to try the same thing all over again with cigarettes. And if you think the crime problems resulting from alcohol prohibition were bad, just imagine what they would be like when you try to ban a substance to which millions of people are addicted. Actually, we do currently have a model to look at—the prohibition of so-called hard drugs. This prohibition has resulted in tremendous amounts of crime and the destruction of many inner-city neighbourhoods. To fight illegal drug use, the federal government has, for decades, been waging the “War on Drugs,” which has wasted tens of billions of dollars to no good effect. A ban on cigarettes would see the crime multiplied many times over and result in still another fruitless war with incalculable costs.

It has been suggested that prohibition is a more realistic goal today than it might have been previously, because of the availability of nicotine replacement therapies, which would presumably allow most smokers to quit before any prohibition takes effect. But these therapies do not have anywhere near a 100% success rate and although studies show an overwhelming percentage of smokers would like to quit, millions of smokers do not want to do so. Even with a long lead-time between enacting a prohibition measure and its effective date, millions of addicted smokers would remain when that date arrived.

The aforementioned FDA bill has itself caused a serious rift in the US tobacco control movement; a push for prohibition by some movement members would cause an even greater split. We know what works best in tobacco control—smoke-free legislation and high excise taxes. Both have produced solid results over the years and we should continue to do what we do well, rather than reach for a magic bullet. For at least the last 35 years, there has been pretty unanimous opinion in the tobacco control movement that advocating prohibition would be detrimental to the cause and there is no reason to change that position today.

Of course, all of this is not to say that prohibition could not work in other countries with different political systems, legal frameworks and cultural dynamics, although human nature universally resists government dictates over what people do with their own lives and an attempt at prohibition would face an uphill battle almost anywhere.

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Peter Hanauer