University Department of Community Medicine, Westmead Hospital, Westmead, NSW, Australia
In this chapter, I will examine the main ethical parameters of the arguments pertaining to the alleged 'right' to advertise tobacco products and those maintaining that it should be banned. In particular, I will explore the ethics of theadoption of 'partial' bans on tobacco advertising, since there are now few countries which do not restrict tobacco advertising in some way.
The banning of all forms of tobacco advertising and promotion has long been regarded as a central platform of comprehensive tobacco control policy. Ruth Roemer's 1993 review of the regulation of tobacco lists 27 nations which claim to have totally bannedtobacco advertising, with a further 77 having some form of restriction1. More recently, Bulgaria, Hungary, Lithuania, Moldova, Slovakia, Ukraine and Russia have also been reported to have implemented bans. The research and public health policy literature on tobacco advertising has burgeoned as moves to ban advertising have become increasingly contested. This literature has been recently reviewed2"4and its scope covers the nine areas listed below (these are referenced with particularly important examples of each). 1. Documentation and commentary on changing expenditure on tobacco advertising and promotion5, including how this expenditure ranks with other commodity advertising. 2. Econometric research into the relationship between the volume of tobacco advertising and changes in tobaccoconsumption6. 3. Research into the recognition, recall, approval of, or liking for tobacco advertising7 and sponsorship8, usually by children; and research into the relationship between reaction to such advertising and children's subsequent use of tobacco9. 4. Reports of ways by which tobacco advertisers circumvent voluntary codes and legal bans and restrictions10, including evidence for productplacement in films11 and television programs12. 5. Studies of the relationship between tobacco advertising and the (usually reduced) coverage of smoking and health by newspapers, magazines, and other media13.
BrfKsh M « £ c o / B u / U n 19922. No nation prohibits tobacco, and no internationally recognised public health agency has called for tobacco to be banned in the way that Goodin's argument abovemight imply. Almost all international public health agencies, though, have called for tobacco advertising to be banned. The cornerstone of arguments used by proponents of the continuation of tobacco advertising is that the only factor relevant to whether a product should be advertised is its current legal status. By this argument, the industry would agree that illicit drugs should not beadvertised, but would presumably (along with most in public health) support the lifting of any restrictions on the advertising of condoms. This insistence on the current legal status of tobacco is indifferent to the history of research into tobacco whereby its consequences to health only became established long after its use and manufacturing infrastructure became widespread. As many have argued, iftobacco had been recently 'invented' and subject to the tests of safety required of food and drugs, no nation would release it onto the market in the way it is sold today. The rejoinder to this by defenders of tobacco advertising is to make hollow calls for governments to declare tobacco illegal if they are sincere in their concerns. When governments ignore such taunts, supporters of tobaccoadvertising allege hypocrisy on the part of governments, pointing to their appetite for tobacco excise tax. As argued above, concern to control use of any product can be addressed through a variety of policies, of which outright banning is the furthest extreme. Considerations of proportionality — making sure that restrictions and controls imposed are no broader than necessary to