Public Health Ethics 3 (2):91-106 (2010)
Smoking is disproportionately common among the disadvantaged, both within many countries and globally; the burden associated with smoking is, therefore, borne to a great extent by the disadvantaged. In this paper, I argue that this should be regarded as a problem of social justice. Even though smokers do, in a sense, ‘choose’ to smoke, the extent to which these choices can legitimise the resulting inequalities is limited by the unequal circumstances in which they are made. An analysis of the empirical literature reveals a variety of factors—such as targeted advertising, unequal dissemination of information about the health risks of smoking and inequalities in smoking norms—that make the disadvantaged more likely to become smokers and less likely to quit successfully. The paper then considers a range of common tobacco control policies from the perspective of social justice. The social justice perspective developed here poses a challenge for policy-makers: on the one hand, social justice concerns strengthen the case for tobacco control policies because such policies disproportionately benefit the health of the disadvantaged. At the same time, however, we must be particularly sensitive to any harms associated with such policies because such burdens, too, will fall largely on the disadvantaged.
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References found in this work BETA
Guilt, Fear, Stigma and Knowledge Gaps: Ethical Issues in Public Health Communication Interventions.Nurit Guttman & Charles T. Salmon - 2004 - Bioethics 18 (6):531–552.
Egalitarianism and the Undeserving Poor.Richard J. Arneson - 1997 - Journal of Political Philosophy 5 (4):327–350.
Epistemic Paternalism in Public Health.Kalle Grill & Sven Ove Hansson - 2005 - Journal of Medical Ethics 31 (11):648-653.
Citations of this work BETA
The Social Determinants of Health: Why Should We Care?Adina Preda & Kristin Voigt - 2015 - American Journal of Bioethics 15 (3):25-36.
Social Justice, Health Inequalities and Methodological Individualism in US Health Promotion.D. S. Goldberg - 2012 - Public Health Ethics 5 (2):104-115.
Luck Egalitarianism, Social Determinants and Public Health Initiatives.A. Albertsen - 2015 - Public Health Ethics 8 (1):42-49.
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