EDITORIAL - Issues still to be addressed in smoking ban

Jamaica's decision to ban smoking in public places from July 15 brings the country on board a growing global movement against the consumption of tobacco, for the preservation of health.

But the announcement by the health minister, Dr Fenton Ferguson, in Parliament on Wednesday left unaddressed the issue of balance between individual rights and the public good as well as the potential impact of the decision on the Government's ability to finance some of its health programmes.

First, however, this newspaper makes clear its general support for the move. For it is an unassailable fact that cigarette smoking is dangerous to people's health - actively or passively.

Smoking, it is estimated globally, accounts for around six million deaths, more than half a million of which are people who never lit up, but were victims of other people's habits.

In Jamaica, data on either the correlation and causation between cigarette smoking and death is not so refined. Nonetheless, there is sufficient information on the prevalence of the kinds of diseases to which smoking contributes and upon which we expect Dr Ferguson's measures will have a lessening effect.

For instance, lung cancer, the one most directly associated with smoking, according to the World Health Organisation, accounts for just over two per cent of all deaths, which, on an age-adjusted basis, translates to more than 16 deaths per 100,000 population.

Coronary heart disease, to which smoking can be a contributor, is the country's biggest killer, responsible for 17.2 per cent of all deaths. Hypertension and diabetes, which, too, are complicated by smoking, are also at near-epidemic proportions.

Significantly, the Jamaican authorities estimate that it costs around J$17 billion, or 53 per cent of the central government's health budget annually, to treat non-communicable diseases. That spend, it is estimated, should progressively decline, in real terms, if the Government meets its target of reducing such diseases by a quarter over the next decade and a half.

Ironically, though, its anti-smoking initiative could, on the face of it, negatively affect the administration's ability to meet current health-care obligations. Among the Government's more successful health-care initiatives is the National Health Fund (NHF), which finances medication for individuals with non-communicable, life-style diseases as well as public-education initiatives in the fight against them.

Reduce NHf cash inflow

The NHF is financed, in part, from 20 per cent of the special consumption tax on tobacco products, which, for the 2010/2011 financial year, was J$1.3 billion, or more than 32 per cent of its income. Success in the anti-smoking initiative will, logically, reduce that inflow, forcing the administration to go in search of replacement cash.

One way the Government can achieve this, we suggest, is to ensure it earns all the taxes from what is a regulated and essentially monopoly industry. The problem here is that an estimated one billion sticks of cigarettes enter the market illegally, losing the Government an estimated J$2 billion in tax revenues. It can't be beyond the authorities to close that loophole.

Then, there is our first point, about individual rights. This is not prohibition. Tobacco remains legal in Jamaica. Until it is otherwise, Dr Ferguson's regulation must provide the avenue for responsible adults to engage in their vice, so long as it doesn't impinge other people's rights. It is, therefore, imperative that 'public space' be clearly defined.

The opinions on this page, except for the above, do not necessarily reflect the views of The Gleaner. To respond to a Gleaner editorial, email us: editor@gleanerjm.com or fax: 922-6223. Responses should be no longer than 400 words. Not all responses will be published.