title: Tobacco endgame strategies: challenges in ethics and law.
abstract: There are complex legal and ethical tradeoffs involved in using intensified regulation to bring smoking prevalence to near-zero levels. The authors explore these tradeoffs through a lens of health justice, paying particular attention to the potential impact on vulnerable populations. The ethical tradeoffs explored include the charge that heavy regulation is paternalistic; the potentially regressive impact of heavily taxing a product consumed disproportionately by the poor; the simple loss of enjoyment to heavily addicted smokers; the health risks posed by, for example, regulating nicotine content in cigarettes--where doing so leads to increased consumption. Turning to legalistic concerns, the authors explore whether endgame strategies constitute a form of 'regulatory taking'; whether endgame strategies can be squared with global trade/investment laws; whether free speech rights are infringed by aggressive restrictions on the advertisement and marketing of cigarettes.
authors.affiliation: O'Neill Institute for National and Global Health Law, Georgetown University Law Center, 600 New Jersey Avenue, NW, Washington, DC 20001, USA. bpt11@law.georgetown.edu
authors.forename: Bryan P
authors.initials: BP
authors.lastname: Thomas
authors.forename: Lawrence O
authors.initials: LO
authors.lastname: Gostin
mesh_terms: D026688:Bioethical Issues; D006293:Health Promotion / Q000941:ethics / Q000379:methods; D006801:Humans; D011634:Public Health / Q000941:ethics / Q000331:legislation & jurisprudence; D012907:Smoking / Q000331:legislation & jurisprudence; D016540:Smoking Cessation / Q000331:legislation & jurisprudence*; D000074606:Smoking Prevention; D019460:Tobacco Industry / Q000941:ethics / Q000331:legislation & jurisprudence