essay about selling cigarettes

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Essay on Advantages and Disadvantages of Selling Cigarettes

Table of Contents

Advantages of Selling Cigarettes:

One of the primary advantages of selling cigarettes is the potential for profit. Cigarettes can be sold at a high markup, meaning that retailers can make a significant profit margin on each pack sold. Additionally, many smokers are addicted to nicotine and will continue to purchase cigarettes on a regular basis, providing a steady stream of customers for retailers.

Another advantage of selling cigarettes is that they are a small and lightweight product, making them easy to store and transport. This means that retailers can stock a large quantity of cigarettes without taking up too much space in their store or warehouse.

In addition, cigarette sales can help to drive foot traffic to a retailer’s store. While some customers may come in specifically to purchase cigarettes, others may be enticed to make additional purchases while they are there.

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Disadvantages of selling cigarettes:.

The health risks associated with cigarette smoking are a major disadvantage of selling cigarettes. Cigarette smoking is a leading cause of preventable death , with more than 480,000 deaths per year in the United States alone. By selling cigarettes, retailers are contributing to this public health issue.

Furthermore, selling cigarettes can be a legal liability for retailers. In many places, it is illegal to sell cigarettes to minors, and retailers can be held liable if they are caught doing so. Retailers can also be held liable for selling cigarettes that are counterfeit or tampered with.

Selling cigarettes can also harm a retailer’s reputation. Many people view cigarette sales as unethical, and may be hesitant to do business with a retailer that sells cigarettes. This can lead to lost business and a negative image in the community.

In addition, retailers who sell cigarettes may face higher insurance costs and may have difficulty obtaining loans or financing. Some financial institutions may be hesitant to do business with retailers who sell cigarettes due to the associated health risks and legal liabilities.

Conclusion:

In conclusion, while there are certainly advantages to selling cigarettes, the disadvantages outweigh the benefits. The health risks associated with cigarette smoking are too great to ignore, and retailers who sell cigarettes may face legal and financial liabilities as well as harm to their reputation. It is important for retailers to consider these factors when making decisions about whether or not to sell cigarettes in their stores. Ultimately, the health and well-being of their customers should be their top priority.

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Advantages and disadvantages of selling cigarettes essay

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Question: Should We Ban Cigarettes?

Readers Question: Using data and your economic knowledge assess the case for and against a government completely banning the sale and consumption of cigarettes. AQA (15)

1. Cigarettes are a demerit good. People underestimate the costs of smoking, e.g. lower life expectancy. It has been suggested that the true cost of a packet of cigarettes is over $200. Therefore, the government is justified to try and stop people consuming goods which harm them.

2. Cigarettes have negative externalities on the rest of society. For example, it creates health problems of passive smoking. This leads to over consumption and is another justification for banning smoking.

3. Tax is insufficient for reducing consumption of cigarettes. Demand is very price inelastic because people become addicted. Therefore, banning cigarettes may be the only way to reduce consumption.

Problems of Banning Cigarette Sales and Consumption

1. It would encourage the black market. People are addicted so they would find a way to keep smoking. This would encourage criminal activity which the government would need to try and police. The potential profits for criminals would be very high. It could be a similar situation to prohibition in the 1920s and 30s in the US. Banning alcohol led to big rise in organised crime.

2. The government would lose all tax revenue. This amounts to over £7 billion. It would require other taxes to be increased.

3. It would cause unemployment amongst cigarette companies. However, South Korea is suggesting to bring the complete ban after 10 years. This gives people the chance to change their habits.

4. There are several alternative measures for discouraging cigarette sales. For example, banning cigarettes in public spaces has been quite effective in reducing consumption and discouraging people from starting to smoke. Also advertising to make people aware of the dangers of smoking (e.g. putting warnings on packets of cigarettes)

Cigarettes are definitely harmful to health. In some ways they are more likely to kill than other drugs which are criminalised. However, because cigarette use is so widespread, banning cigarettes completely would lead to very large black market and lose the government substantial tax revenues. It would make many ordinary people more likely to commit a crime to feed their habit. See also:

• Should Taxes on Cigarettes be Increased? 

6 thoughts on “Question: Should We Ban Cigarettes?”

cigarettes are harmful at certain stages. e cigarettes have given the right solution for it.

Both of them are deadly for health. There isn’t one better than the other.

how would you bring elasticity into this type of question ?

You could say the govt could use a tax to reduce demand for cigarettes. However, demand is very inelastic therefore a tax is insufficient. Therefore, banning it may be only solution to prevent people consuming this demerit good.

Do you people not see the bigger picture here. It’s about control and telling you what you can and cannot do. They won’t stop at cigarettes. Think about it you idiots.

The government gave our war veterans cigarettes to help with stress now they are telling us it is unhealthy and we are forced to give up. We are living in a communist country where we are not allowed to make our own decisions about our health or lifestyle. I have smoked all my life, worked hard paid huge amounts of tax and the way you have discriminated against smokers and treated us like leper’s is very degrading and I am not proud to say your a fair government if you thought of how smokers felt at all it would have been more acceptable but as per usual you treat the average workers as mere specks of dust

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Banning the use of Tobacco Essay

Introduction, why the use of tobacco should be banned, works cited.

Tobacco is a product of a species of plant that has nicotine content. Harvested as leaves of that particular plant, tobacco can be used to control pests or even as medicine.

It is however widely used as a drug through smoking, snuffing, chewing among others. This paper seeks to support the banning of the use of tobacco. The paper will give reasons in support of the opinion.

Tobacco and cardiovascular diseases

Tobacco like many other drugs has varied side effects that call for the control of its use. These negative impacts are manifested in individuals and ends up costing lives in the long run. One of the reasons why tobacco should be banned is its danger in relation to cardiovascular diseases.

Cardiovascular diseases are complications that are associated with the heart and blood vessels in the body such as arteries which carry blood to body parts. Once a cardiovascular disease is induced in a person, it manifests in different ways causing threats to a person’s health and thus life.

A significant percentage of heart complications related deaths have, for example, been associated with tobacco smoking with reports ranging this value at about thirty percent. One of the contents of tobacco, carbon monoxide, has for example been identified to have an impact on the oxygen carrying capacity of blood.

Consequently, a person who is under the influence of tobacco will suffer from insufficient supply of oxygen to vital body parts that include the “heart, lungs, brain and other vital body organs” (Wvdhhr 1).

The nicotine content of tobacco also induces increased “heart beat rate and blood pressure” (Wvdhhr 1) as a result, the blood circulatory system is over worked and exposed to risks of being damaged.

This in the long run results in cases such as “heart attacks, high blood pressure, blood clots, strokes, hemorrhages” (Wvdhhr 1) among other disorders. A person who smokes is thus endangered by a number of complications that will negatively hinder the person’s operations and subsequently his or her life due to malfunctioning body parts.

These effects can be easily transferred to aspects such as economic instability of the tobacco victim and immediate family members if the victim was the sole bread winner and is put down by such cardiovascular complications.

A government’s responsibility over the welfare of its citizens therefore calls for a step to control such cardiovascular complications and subsequent impacts and one of the primary ways to do this is by banning the consumption of tobacco.

Tobacco and cancers

Another reason why tobacco should be banned is because of its effect in causing a number of cancers in the body. Cancer is characterized by an induced growth of malignant cells in a person’s body.

These cancerous growths also have an effect of malfunctioning of specified body organs despite the level of pain that might be associated with it. Tobacco smoking has been identified to; for example, cause about “ninety percent of laryngeal cancer and lung cancer and a significant percentage of oral, esophageal and stomach cancers” (Tobacco 1).

Once the cancerous cells start to grow in the body parts, they impair the parts and might even spread causing wounds in the body with subsequent dangers such as death. Lung cancer will, for example, be characterized with growth of foreign cells in the lungs and a corresponding damage of the normal cells.

As a result, the normal functionality of the lungs such as the absorption of oxygen into the body and the elimination of carbon dioxide from the body will be impaired. Respiratory processes that require oxygen and are necessary for cellular activities of the body will therefore be compromised.

Stomach cancer may also impair digestive processes and subsequent poor supply of nutrients to the body. The other cancers such as oral or esophageal may also be associated with a level of pain that can even discourage an individual from eating.

As a result, there will be poor nutritional habit in a victim of these cancers due to insufficient supply of nutrients to the body cells and subsequent insufficient energy generated by the body.

Tobacco therefore with respect to its induced cancers affects the functionality of body organs and the overall health of an individual. These complications have been associated with significant percentage of premature deaths among tobacco users (Tobacco 1).

Tobacco and Addiction

Another reason for alarm over the use of tobacco is the threat of addiction that it poses to its users. Like in cases of other drugs, and induced by its nicotine content, tobacco compels its users into addiction which makes them to even overlook the side effects that the drug has in their lives.

Following the addiction, individual addicts together with help that they receive from social society is not sufficient to help them out of the drug. The only viable control is thus an authoritative step to ban the drug (Dugdale 1).

The use of tobacco is identifiably unhealthy following its risks to the user’s health that is then spread to other members of the society through social and economic costs. Since the drug is addictive, individual users can not easily and willingly stop the consumption the drug. The significant control measure therefore lies in banning usage of the drug.

Dugdale, David. Drug dependence . NCBI, 20101. Web.

Tobacco. Dangers of tobacco . Tobacco Facts, n.d. Web. < http://www.tobacco-facts.info/dangers_of_tobacco.htm >

Wvdhhr. Tobacco and CVD . WVDHHR, n.d. Web. < http://www.wvdhhr.org/bph/cvd/page1.htm >

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1. IvyPanda . "Banning the use of Tobacco." December 5, 2023. https://ivypanda.com/essays/banning-the-use-of-tobacco/.

Bibliography

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Essay on Selling Tobacco should be banned?

Tobacco is a widely used product that has been linked to a variety of health problems, including lung cancer, heart disease, and respiratory illness. Despite the well-documented negative health effects of tobacco use, it is still legal to sell and purchase tobacco products in many countries. However, there are increasing calls for the sale of tobacco to be banned in order to protect public health.

One of the main arguments in favor of banning the sale of tobacco is the negative impact it has on public health. The World Health Organization (WHO) estimates that tobacco use is responsible for the deaths of approximately 8 million people worldwide each year. In addition to the direct health effects of tobacco use, second-hand smoke exposure can also cause serious health problems, including lung cancer and respiratory illness. By banning the sale of tobacco, it would help to reduce the number of smokers and the associated health risks.

Another argument in favor of banning the sale of tobacco is the financial cost of tobacco-related illness. The cost of treating illnesses caused by tobacco use, such as cancer and heart disease, is significant, and this cost is often borne by taxpayers through government-funded healthcare systems. By banning the sale of tobacco, it would help to reduce the financial burden of tobacco-related illness on society.

A ban on the sale of tobacco would also benefit the environment. The cultivation of tobacco is a major contributor to deforestation and soil degradation, and tobacco farming also requires large amounts of water and pesticides. In addition, discarded cigarette butts are a major source of litter. By banning the sale of tobacco, it would help to reduce the environmental impact of tobacco cultivation and use.

Despite the arguments in favor of banning the sale of tobacco, there are also some arguments against it. One of the main arguments against a ban on the sale of tobacco is that it would be difficult to enforce. With the widespread availability of tobacco products, it would be difficult to completely eliminate the illegal sale of tobacco products.

Another argument against a ban on the sale of tobacco is that it would negatively impact the economies of countries that rely on tobacco farming and production. Many countries, particularly those in the developing world, rely on tobacco farming and production as a major source of income and employment. A ban on the sale of tobacco would have a significant impact on these economies.

The sale of tobacco has been linked to a variety of health problems, and there are increasing calls for the sale of tobacco to be banned in order to protect public health. While there are some arguments against a ban on the sale of tobacco, such as difficulty in enforcement and the impact on economies that rely on tobacco, the negative impact of tobacco use on public health, the financial cost of tobacco-related illness, and the environmental impact of tobacco cultivation and use outweighs these arguments. Instead of an outright ban, governments could implement policies such as increasing taxes on tobacco products, and regulations on the advertising and sale of tobacco to reduce the demand and access to the products. Additionally, governments could invest in support and alternative livelihoods for tobacco farmers and workers to mitigate the economic impact of a ban on tobacco. Ultimately, the goal should be to reduce the harm caused by tobacco use and protect public health.

UK set to ban tobacco sales for a ‘smoke-free’ generation. Will it work?

The UK’s smoking ban aims to phase out sales of tobacco, which is one of the main causes of cancer deaths in Britain.

Britain is set to impose tough measures to stub out smoking, which has emerged as one of the biggest causes of cancer deaths in the country.

Parliament approved the government’s “historic” plans to create a “smoke-free” generation on Tuesday in a bid to reduce the number of people dying from smoking-related diseases, a big burden on the country’s publicly funded National Health Service (NHS).

Keep reading

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MPs voted 383-67 to give the Tobacco and Vapes Bill a second reading, overcoming vocal opposition from a section of the ruling Conservative Party, which opposes state interference in people’s lives. It now needs approval from the House of Lords to come into effect. No party in the 790-member Lords has an overall majority, but the Conservatives outweigh Labour 278-173.

“Parliament has now begun the process of consigning smoking to the ash heap of history,” Deborah Arnott, chief executive of the pressure group Action on Smoking and Health, told Al Jazeera.

“The passage of the bill should be expedited to ensure it is on the statute book before the general election. The public, who overwhelmingly support the legislation, expect nothing less,” she said.

What does the UK’s ban cover?

Rather than criminalising the habit, the bill aims to ensure people turning 15 this year and those who are younger will never be able to legally buy tobacco.

Currently, it is illegal to sell cigarettes to anyone under the age of 18. The government intends to bar sales to anyone born after January 1, 2009. Under the legislation, beginning in 2027, the legal age limit would increase by one year every year until it is illegal for the entire population.

If all goes according to plan, the government envisages that smoking among young people would be eradicated by 2040.

Shops in England and Wales caught selling cigarettes and vapes to underage people would face on-the-spot fines of 100 pounds ($125). Courts may already impose fines of 2,500 pounds ($3,118).

“We do expect over time, smoking to die out almost completely,” said Chris Whitty, chief medical officer for England, speaking on BBC Radio 4.

What’s behind the UK’s new rules?

Smoking is the United Kingdom’s biggest preventable killer.

About 13 percent of the adult population – 6.4 million people – were smokers in the UK in 2022, the Office for National Statistics estimated.

That is much lower than other European countries such as Italy, Germany and France, where 18 to 23 percent of adults smoke, according to figures from the Organisation for Economic Co-operation and Development (OECD).

Official figures show the habit leads to 64,000 deaths in England per year, causing about one in four deaths from cancer .

Medical and healthcare experts and charities say the toll is higher, estimating that smoking causes 80,000 deaths every year.

With the new ban, the UK government hopes to prevent more than 470,000 cases of heart disease, stroke, lung cancer and other diseases by the end of the century.

The legislation also seeks to clamp down on young people vaping by restricting flavours and packaging to make it less appealing to children. The jury is still out on vaping with the NHS judging it as “not risk-free”.

How is the ban viewed?

Pollsters found about two-thirds of people in the UK back a phased smoking ban.

Health Secretary Victoria Atkins told the House of Commons there is “no liberty in addiction”.

“Nicotine robs people of their freedom to choose. The vast majority of smokers start when they are young, and three-quarters say that if they could turn back the clock, they would not have started,” she said.

But libertarian-leaning MPs on the right of the ruling Conservatives, including former Prime Minister Liz Truss, have branded the move an attack on personal freedoms. During the parliamentary debate, Truss said it was a piece of “virtue-signalling”.

Business Secretary Kemi Badenoch said she was not a smoker and agreed with Prime Minister Rishi Sunak’s intentions but said she opposed the bill because she was concerned about its impact on people’s rights and difficulty in enforcing the policy.

“We should not treat legally competent adults differently in this way where people born a day apart will have permanently different rights,” she said on the social media platform X.

I’m not a smoker and think it is an unpleasant habit, costly for both the individual and society. The PM's intentions with this Bill are honest and mark him out as a leader who doesn't duck the thorny issues. I agree with his policy intentions BUT….(1/4) — Kemi Badenoch (@KemiBadenoch) April 16, 2024

The legislation is one of Sunak’s flagship policies before the general election  this year, which opinion polls suggest the opposition Labour Party would win.

“It’s world-leading in terms of reducing harms caused by tobacco and may lead to other countries following suit with similar measures,” said Dr Allen Gallagher, a research fellow in the Tobacco Control Research Group at the University of Bath.

Other approaches tried so far include price and tax measures, regulating the content of tobacco products, packaging and labelling measures, and advertising restrictions.

“This is the first test of a generational phasing-out of tobacco,” Gallagher told Al Jazeera.

“Time will tell if it’s enough.”

Have other countries imposed similar anti-smoking bans?

According to the World Health Organization (WHO), tobacco kills more than eight million people each year, including an estimated 1.3 million non-smokers who are exposed to second-hand smoke.

The proposed ban is thought to have been inspired by a similar plan in New Zealand, introduced under former Prime Minister Jacinda Ardern but scrapped this year by the new coalition government before it could be enforced. By stopping a generation from taking up smoking, the country of five million hoped to avoid about 5,000 preventable deaths a year.

In May, Portugal presented legislation to restrict tobacco sales and extend a ban on smoking to outdoor areas, including covered terraces. The country hopes to raise a tobacco-free generation by 2040. According to government estimates, about 13,500 deaths in 2019 were due to tobacco use in Portugal, which has a population of about 10 million.

Last year, Mexico brought one of the world’s most stringent smoking laws into force, implementing a total ban in public places, including hotels, beaches and parks, and stopping advertising. The WHO’s Pan American Health Organisation (PAWHO) estimated that smoking causes more than 10 percent of deaths in the country of 128 million, amounting to about 63,000 per year.

Also last year, Canada became the first country to introduce printed health warnings on individual cigarettes. Messages include “poison in every puff” and “cigarettes cause impotence”. Tobacco use remains the leading preventable cause of illness and premature death in the country of 39 million, killing approximately 48,000 people each year.

Since 2002, India has had a ban on smoking in public spaces although organisations can create specific smoking zones.

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Selling Tobacco Products in Retail Stores

On this page:

How Do I Comply?

• Cigarettes, cigarette tobacco, and roll-your-own tobacco
• Smokeless tobacco
• Hookah and pipe tobacco
• E-cigarettes and other electronic nicotine delivery systems (ENDS)
• Nicotine gels
• Dissolvables

FDA’s Center for Tobacco Products was created in 2009, and since 2016, FDA has regulated all tobacco products, including e-cigarettes, hookah tobacco, and cigars. If you sell tobacco products, you must comply with all applicable federal laws and regulations for retailers.

This page offers a summary of the federal rules broken down by different types of tobacco products. You can find comprehensive federal requirements for tobacco retailers in the Federal Food, Drug, and Cosmetic Act (FD&C Act), Regulations Restricting the Sale and Distribution of Cigarettes and Smokeless Tobacco,  and the  Deeming Tobacco Products To Be Subject to the Federal Food, Drug, and Cosmetic Act .

Note: In April 2021, FDA announced its plans to propose tobacco product standards within the next year to ban menthol as a characterizing flavor in cigarettes and ban all characterizing flavors (including menthol) in cigars.

Generally speaking, these rules apply to all cigarettes, smokeless tobacco, cigarette tobacco, roll-your-own tobacco, and  "covered tobacco products ":

• Check photo ID of everyone under age 27 who attempts to purchase any tobacco product. Only sell tobacco products to customers 21 or older. 1
• Do NOT sell tobacco products in a vending machine unless in an adult-only facility. 2
• Do NOT give away free samples of tobacco products to consumers, including any of their components and parts. 3

These rules, along with rules specific to each tobacco product , are listed below.

FDA’s " This Is Our Watch " program helps retailers comply with federal tobacco law and regulations to protect youth. The "This is Our Watch" program offers a full toolkit of materials available to owners, managers and clerks – including posters, stickers and age verification tools – to help retailers better comply with federal tobacco regulations

Do you mix or prepare e-liquids, make or modify vaporizers, or mix loose tobacco and sell any tobacco product? If so, you may be regulated as both a retailer and a tobacco product manufacturer .

Rules for Cigarettes, Cigarette Tobacco, and Roll-Your-Own Tobacco Sales

These rules have been in place since 2010:

• Check photo ID of everyone under age 27 who attempts to purchase cigarettes, cigarette tobacco, or roll-your-own tobacco.
• Only sell cigarettes, cigarette tobacco, and roll-your-own-tobacco to customers age 21 or older. 1
• Do NOT sell cigarettes, cigarette tobacco, or roll-your-own tobacco in a vending machine or self-service display unless in an adult-only facility. 2
• Do NOT give away free samples of cigarettes, cigarette tobacco, or roll-your-own tobacco to consumers, including any of their components or parts. 3
• Do NOT sell cigarettes, cigarette tobacco, or roll-your-own tobacco that contain a characterizing flavor (except menthol or tobacco flavor).
• Do NOT sell cigarette packages containing fewer than 20 cigarettes, including single cigarettes, known as “loosies.”
• Do NOT break open packages of cigarettes, cigarette tobacco, or roll-your-own tobacco to sell products in smaller amounts.
• Do NOT sell or distribute cigarette tobacco or roll-your-own tobacco products without a warning statement on the package. 4, 5
• Do NOT display advertisements for cigarette tobacco or roll-your-own tobacco products without a warning statement. 4, 5

Rules for Smokeless Tobacco Sales

• Check photo ID of everyone under age 27 who attempts to purchase smokeless tobacco.
• Only sell smokeless tobacco to customers age 21 and older. 1
• Do NOT sell smokeless tobacco in a vending machine or self-service display unless in an adult-only facility.
• Do NOT give away free samples of smokeless tobacco unless in a “qualified adult-only facility” and in limited quantities as specified in the law. 2, 3
• Do NOT break open smokeless tobacco packages to sell products in smaller amounts.
• Do NOT sell smokeless tobacco without a health warning statement displayed on the package.
• Do NOT display advertisements for smokeless tobacco products without a warning statement.

Rules for Cigar Sales

• Check photo ID of everyone under age 27 who attempts to purchase cigars. Only sell cigars to customers age 21 and older. 1
• Do NOT sell cigars in a vending machine unless in an adult-only facility. 2
• Do NOT give away free samples of cigars to consumers, including any of their components or parts. 3
• Do NOT sell or distribute cigars without a health warning statement displayed on the package. 4, 6
• Do NOT display advertisements for cigars without a health warning statement. 4, 6
• If you sell cigars individually, and not in a product package, you must post a sign with six required warning statements within 3 inches of each cash register. 4,6

Rules for Hookah and Pipe Tobacco Sales

Note : If you mix loose tobacco, and you also sell these products, you will be regulated as both a retailer and a tobacco product manufacturer .

• Check photo ID of everyone under age 27 who attempts to purchase hookah tobacco or pipe tobacco. 
• Only sell hookah or pipe tobacco to customers age 21 and older. 1
• Do NOT sell hookah and pipe tobacco in a vending machine unless in an adult-only facility. 2
• Do NOT give away free samples of hookah or pipe tobacco to consumers, including any of their components or parts. 3
• Do NOT sell or distribute hookah or pipe tobacco without a health warning statement displayed on the package. 4, 5, 6
• Do NOT display advertisements for hookah or pipe tobacco without a health warning statement. 4, 5, 6

Rules for Sales of E-Cigarettes, E-liquids, and Other Electronic Nicotine Delivery Systems (ENDS)

Some examples of ENDS include e-cigarettes, e-liquids, vape pens, e-hookahs, e-cigars, personal vaporizers, and electronic pipes.

Note : If you mix e-liquids or make or modify vaporizers, and you also sell these products, you will be regulated as both a retailer and a tobacco product manufacturer .

• Check photo ID of everyone under age 27 who attempts to purchase e-cigarettes, e-liquids, or other ENDS.
• Only sell e-cigarettes, e-liquids, and other ENDS to customers 21 and older. 1
• Do NOT sell e-cigarettes, e-liquids, or other ENDS in a vending machine unless in an adult-only facility. 2
• Do NOT give away free samples of e-cigarettes, e-liquids, or other ENDS to consumers, including any of their components or parts. 3
• Do NOT sell or distribute e-cigarettes, e-liquids, or other ENDS without a health warning statement on the package. 4, 5
• Do NOT display advertisements for e-cigarettes, e-liquids, or other ENDS without a health warning statement. 4, 5

Rules for Sales of Nicotine Gels

• Check photo ID of everyone under age 27 who attempts to purchase nicotine gel. Only sell nicotine gel to customers 21 and older. 1
• Do NOT sell nicotine gel in a vending machine unless in an adult-only facility. 2
• Do NOT give away free samples of nicotine gel to consumers. 3
• Do NOT sell or distribute nicotine gel without a health warning statement on the package. 4, 5
• Do NOT display advertisements for nicotine gel without a health warning statement. 4, 5

Rules for Sales of Dissolvables

These rules apply to dissolvable tobacco products that are not already regulated as smokeless tobacco.

• Check photo ID of everyone under age 27 who attempts to purchase dissolvable tobacco products.
• Only sell dissolvable tobacco products to customers age 21 and older. 1
• Do NOT sell dissolvable tobacco products in a vending machine unless in an adult-only facility. 2
• Do NOT give away free samples of dissolvable tobacco products to consumers. 3
• Do NOT sell or distribute a dissolvable tobacco product without a health warning statement on the package. 4, 5
• Do NOT display advertisements for dissolvable tobacco products without a health warning statement. 4, 5

Why Are These Laws Important?

These laws are designed to make regulated tobacco products less accessible and less attractive to youth. Every day, nearly 1,500 kids smoke their first cigarette and about 200 kids become daily cigarette smokers. 7 Additionally, the CDC and FDA found that in 2020, 19.6 percent of high school students currently used e-cigarettes. 8 Many of these children will become addicted before they are old enough to understand the risks. As a retailer, you play an important role in protecting children and adolescents by complying with the law and regulations.

Additional Resources

• Required Warning Statements on Tobacco Product Packaging and Advertising
• Guidance: Tobacco Retailer Training Programs
• Retailer Education Materials
• FDA's Deeming Regulations for E-Cigarettes, Cigars, and All Other Tobacco Products
• Small Business Assistance
• Manufacturing
• Products, Ingredients and Components

1. On Dec. 20, 2019, the President signed legislation to amend the Federal Food, Drug, and Cosmetic Act, and raise the federal minimum age of sale of tobacco products from 18 to 21 years. It is now illegal for a retailer to sell any tobacco product – including cigarettes, cigars and e-cigarettes – to anyone under 21. FDA will provide additional details on this issue as they become available, and the information on this page will be updated accordingly in a timely manner. Retailers must also follow state and local tobacco laws, even if they are more restrictive. 2. An adult-only facility is one in which individuals under 18 are neither present nor permitted to enter at any time. 3. FDA finalized the Guidance on Prohibition of Distributing Free Samples of Tobacco Products in January 2017. 4. A retailer of any cigarette tobacco, roll-your-own tobacco or "covered tobacco products" will not be in violation of this section for packaging that: (i) Contains a health warning; (ii) Is supplied to the retailer by the tobacco product manufacturer, importer, or distributor who has the required state, local, or Alcohol and Tobacco Tax and Trade Bureau (TTB)-issued license or permit, if applicable, and (iii) Is not altered by the retailer in a way that is material to the requirements of this section. FDA does not intend to enforce these warning statement requirements for products that were manufactured before the compliance date (August 10, 2018) of the new required warning statement for covered tobacco products, cigarette tobacco, and RYO tobacco. For important details about required warning statements, please see the small entity compliance guide. 5. Retailers and distributors may continue to sell products with non-compliant packaging after the compliance date only if the products were manufactured before Aug. 10, 2018. FDA encourages retailers to contact their distributor/supplier for information about the tobacco products in their inventory. 6. The United States District Court for the District of Columbia recently issued an order vacating the health warning requirements for cigars and pipe tobacco set forth in 21 CFR §§ 1143.3 and 1143.5 and remanding the Final Deeming Rule’s warning requirements for cigars and pipe tobacco back to the Agency. See Order, Cigar Ass’n of Am. v. U.S. Food & Drug Admin ., No. 1:16-cv-01460 (D.D.C. September 11, 2020). Although the requirement has been vacated, cigar and pipe tobacco firms may choose to voluntarily comply with these health warning provisions. FDA will continue to enforce the other requirements it was already enforcing for cigars and pipe tobacco under the FD&C Act and its implementing regulations, such as not selling these products to individuals under 21 years of age or marketing them as modified risk tobacco products without an FDA order. The court's order does not enjoin FDA from enforcing the health warning requirements for other product categories, including Electronic Nicotine Delivery Systems (ENDS) products, hookah tobacco, and cigarette tobacco and roll-your-own tobacco products. See Guidance: Compliance Policy for Certain Labeling and Warning Statement Requirements for Cigars and Pipe Tobacco. 7. Substance Abuse and Mental Health Services Administration. (2020). Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/ 8. Centers for Disease Control and Prevention. Tobacco Product Use Among Middle and High School Students - United States, 2020. Morbidity and Mortality Weekly Report 2020; 69(50);1881–188865(14): 367.

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• Volume 22, Issue suppl 1
• Why ban the sale of cigarettes? The case for abolition
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• Robert N Proctor
• Correspondence to Dr Robert N Proctor, Department of History, Stanford University, Bldg 200, Stanford, CA 94305, USA; rproctor{at}stanford.edu

The cigarette is the deadliest artefact in the history of human civilisation. Most of the richer countries of the globe, however, are making progress in reducing both smoking rates and overall consumption. Many different methods have been proposed to steepen this downward slope, including increased taxation, bans on advertising, promotion of cessation, and expansion of smoke-free spaces. One option that deserves more attention is the enactment of local or national bans on the sale of cigarettes. There are precedents: 15 US states enacted bans on the sale of cigarettes from 1890 to 1927, for instance, and such laws are still fully within the power of local communities and state governments. Apart from reducing human suffering, abolishing the sale of cigarettes would result in savings in the realm of healthcare costs, increased labour productivity, lessened harms from fires, reduced consumption of scarce physical resources, and a smaller global carbon footprint. Abolition would also put a halt to one of the principal sources of corruption in modern civilisation, and would effectively eliminate one of the historical forces behind global warming denial and environmental obfuscation. The primary reason for abolition, however, is that smokers themselves dislike the fact they smoke. Smoking is not a recreational drug, and abolishing cigarettes would therefore enlarge rather than restrict human liberties. Abolition would also help cigarette makers fulfil their repeated promises to ‘cease production’ if cigarettes were ever found to be causing harm.

• Denormalization
• Tobacco Industry Documents

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/3.0/ and http://creativecommons.org/licenses/by-nc/3.0/legalcode

https://doi.org/10.1136/tobaccocontrol-2012-050811

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Six reasons to ban

The cigarette is the deadliest object in the history of human civilisation. Cigarettes kill about 6 million people every year, a number that will grow before it shrinks. Smoking in the twentieth century killed only 100 million people, whereas a billion could perish in our century unless we reverse course. 1 Even if present rates of consumption drop steadily to zero by 2100, we will still have about 300 million tobacco deaths this century.

The cigarette is also a defective product, meaning not just dangerous but unreasonably dangerous, killing half its long-term users. And addictive by design. It is fully within the power of the Food and Drug Administration in the US, for instance, to require that the nicotine in cigarettes be reduced to subcompensable, subaddictive levels. 2 , 3 This is not hard from a manufacturing point of view: the nicotine alkaloid is water soluble, and denicotinised cigarettes were already being made in the 19th century. 4 Philip Morris in the 1980s set up an entire factory to make its Next brand cigarettes, using supercritical fluid extraction techniques to achieve a 97% reduction in nicotine content, which is what would be required for a 0.1% nicotine cigarette, down from present values of about 2%. 5 Keep in mind that we're talking about nicotine content in the rod as opposed to deliveries measured by the ‘FTC method’, which cannot capture how people actually smoke. 5

Cigarettes are also defective because they have been engineered to produce an inhalable smoke. Tobacco smoke was rarely inhaled prior to the nineteenth century; it was too harsh, too alkaline. Smoke first became inhalable with the invention of flue curing , a technique by which the tobacco leaf is heated during fermentation, preserving the sugars naturally present in the unprocessed leaf. Sugars when they burn produce acids, which lower the pH of the resulting smoke, making it less harsh, more inhalable. There is a certain irony here, since these ‘milder’ cigarettes were actually far more deadly, allowing smoke to be drawn deep into the lungs. The world's present epidemic of lung cancer is almost entirely due to the use of low pH flue-cured tobacco in cigarettes, an industry-wide practice that could be reversed at any time. Regulatory agencies should mandate a significant reduction in rod-content nicotine, but they should also require that no cigarette be sold with a smoke pH lower than 8. Those two mandates alone would do more for public health than any previous law in history. 5

Death and product defect are two reasons to abolish the sale of cigarettes, but there are others. A third is the financial burden on public and private treasuries, principally from the costs of treating illnesses due to smoking. Cigarette use also results in financial losses from diminished labor productivity, and in many parts of the world makes the poor even poorer. 6

A fourth reason is that the cigarette industry is a powerful corrupting force in human civilisation. Big tobacco has corrupted science by sponsoring ‘decoy’ or ‘distraction research’, 5 but it has also corrupted popular media, insofar as newspapers and magazines dependent on tobacco advertising for revenues have been reluctant to publish critiques of cigarettes. 7 The industry has corrupted even the information environment of its own workforce, as when Philip Morris paid its insurance provider (CIGNA) to censor the health information sent to corporate employees. 8 Tobacco companies have bullied, corrupted or exploited countless other institutions: the American Medical Association, the American Law Institute, sports organisations, fire-fighting bodies, Hollywood, the US Congress—even the US presidency and US military. President Lyndon Johnson refused to endorse the 1964 Surgeon General's report, for instance, fearing alienation of the tobacco-friendly South. Cigarette makers managed even to thwart the US Navy's efforts to go smoke-free. In 1986, the Navy had announced a goal of creating a smoke-free Navy by the year 2000; tobacco-friendly congressmen were pressured to thwart that plan, and a law was passed requiring that all ships sell cigarettes and allow smoking. The result: American submarines were not smoke-free until 2011. 9  

Cigarettes are also, though, a significant cause of harm to the natural environment. Cigarette manufacturing consumes scarce resources in growing, curing, rolling, flavouring, packaging, transport, advertising and legal defence, but also causes harms from massive pesticide use and deforestation. Many Manhattans of savannah woodlands are lost every year to obtain the charcoal used for flue curing. Cigarette manufacturing also produces non-trivial greenhouse gas emissions, principally from the fossil fuels used for curing and transport, fires from careless disposal of butts, and increased medical costs from maladies caused by smoking 5 (China produces 40 percent of the world's cigarettes, for example, and uses mainly coal to cure its tobacco leaf). And cigarette makers have provided substantial funding and institutional support for global climate change deniers, causing further harm. 10 Cigarettes are not sustainable in a world of global warming; indeed they are one of its overlooked and easily preventable causes.

But the sixth and most important reason for abolition is the fact that smokers themselves do not like their habit. This is a key point: smoking is not a recreational drug; most smokers do not like the fact they smoke and wish they could quit. This means that cigarettes are very different from alcohol or even marijuana. Only about 10–15% of people who drink liquor ever become alcoholics, versus addiction rates of 80% or 90% for people who smoke. 11 As an influential Canadian tobacco executive once confessed: smoking is not like drinking, it is rather like being an alcoholic. 12

The spectre of prohibition

An objection commonly raised is: Hasn't prohibition already been tried and failed? Won't this just encourage smuggling, organised crime, and yet another failed war on drugs? That has been the argument of the industry for decades; bans are ridiculed as impractical or tyrannical. (First they come for your cigarettes.…) 13

The freedom objection is weak, however, given how people actually experience addiction. Most smokers ‘enjoy’ smoking only in the sense that it relieves the pains of withdrawal; they need nicotine to feel normal. People who say they enjoy cigarettes are rather rare—so rare that the industry used to call them ‘enjoyers’. 14 Surveys show that most smokers want to quit but cannot; they also regret having started. 15 Tobacco industry executives have long grasped the point: Imperial Tobacco's Robert Bexon in 1984 confided to his Canadian cotobacconists that ‘If our product was not addictive we would not sell a cigarette next week’. 12 American cigarette makers have been quietly celebrating addiction since the 1950s, when one expressed how ‘fortunate for us’ it was that cigarettes ‘are a habit they can't break’. 16

Another objection commonly raised to any call for a ban is that this will encourage smuggling, or even organised crime. But that is rather like blaming theft on fat wallets. Smuggling is already rampant in the cigarette world, as a result of pricing disparities and the tolerance of contraband or even its encouragement by cigarette manufacturers. Luk Joossens and Rob Cunningham have shown how cigarette manufacturers have used smuggling to undermine monopolies or gain entry into new markets or evade taxation. 17 , 18 And demand for contraband should diminish, once the addicted overcome their addiction—a situation very different from prohibition of alcohol, where drinking was a more recreational drug. And of course, even a ban on the sale of cigarettes will not eliminate all smoking—nor should that be our goal, since people should still be free to grow their own for personal use. Possession should not be criminalised; the goal should only be a ban on sales. Enforcement, therefore, should be a trivial matter, as is proper in a liberal society.

Cigarette smoking itself, though, is less an expression of freedom than the robbery of it. And so long as we allow the companies to cast themselves as defenders of liberty, the table is unfairly tilted. We have to recognise that smoking compromises freedom, and that retiring cigarettes would enlarge human liberties.

Of course it could well be that product regulation, combined with taxation, denormalisation, and ‘smoke-free’ legislation, will be enough to dramatically lower or even eliminate cigarette use—over some period of decades. Here, though, I think we fail to realise how much power governments already have to act more decisively. From 1890 to 1927 the sale of cigarettes was banned virtually overnight in 15 different US states; and in Austin v. Tennessee (1900) the US Supreme Court upheld the right of states to enact such bans. 19 Those laws all eventually disappeared from industry pressure and the lure of tax revenues. 20 None was deemed unconstitutional, however, and some localities retained bans into the 1930s, just as some counties still today ban the sale of alcohol. Bhutan in 2004 became the first nation recently to ban the sale of cigarettes, and we may see other countries taking this step, especially once smoking prevalence rates start dropping into single digits.

Helping the industry fulfil its promises

One last rationale for a ban: abolition would fulfil a promise made repeatedly by the industry itself. Time and again, cigarette makers have insisted that if cigarettes were ever found to be causing harm they would stop making them:

In March 1954, George Weissman, head of marketing at Philip Morris, announced that his company would ‘stop business tomorrow’ if ‘we had any thought or knowledge that in any way we were selling a product harmful to consumers’. 21

In 1972, James C Bowling, vice president for public relations at Philip Morris, asserted publicly, and in no uncertain terms, that ‘If our product is harmful…we'll stop making it’. 22

Helmut Wakeham, vice president for research at Philip Morris, in 1976 stated publicly that ‘if the company as a whole believed that cigarettes were really harmful, we would not be in the business. We are a very moralistic company’. 23

RJ Reynolds president Gerald H Long, in a 1986 interview asserted that if he ever ‘saw or thought there were any evidence whatsoever that conclusively proved that, in some way, tobacco was harmful to people, and I believed it in my heart and my soul, then I would get out of the business’. 24

Philip Morris CEO Geoffrey Bible in 1997, when asked (under oath) what he would do with his company if cigarettes were ever found to be causing cancer, said: ‘I'd probably…shut it down instantly to get a better hold on things’. 25 Bible was asked about this in Minnesota v. Philip Morris (2 March 1998) and reaffirmed that if even one person were ever found to have died from smoking he would ‘reassess’ his duties as CEO. 26

The clearest expression of such an opinion, however, was by Lorillard's president, Curtis H Judge, in an April 1984 deposition, where he was asked why he regarded Lorillard's position on smoking and health as important: A: Because if we are marketing a product that we know causes cancer, I'd get out of the business…I wouldn't be associated with marketing a product like that. Q: Why? A: If cigarettes caused cancer, I wouldn't be involved with them…I wouldn't sell a product that caused cancer. Q: …Because you don't want to kill people? … Is that the reason? A: Yes. Q: …If it was proven to you that cigarette smoking caused lung cancer, do you think cigarettes should be marketed? A: No…No one should sell a product that is a proven cause of lung cancer. 27

Note that these are all public assurances , including several made under oath. All follow a script drawn up by the industry's public relations advisors during the earliest stages of the conspiracy: On 14 December 1953, Hill and Knowlton had proposed to RJ Reynolds that the cigarette maker reassure the public that it ‘would never market a product which is in any way harmful’. Reynolds was also advised to make it clear that If the Company felt that its product were now causing cancer or any other disease, it would immediately cease production of it. 28 To this recommendation was added ‘Until such time as these charges or irresponsible statements are ever proven, the Company will continue to produce and market cigarettes’.

What is remarkable is that we never find the companies saying privately that they would stop making cigarettes—with two significant exceptions. In August 1947, in an internal document outlining plans to study ‘vascular and cardiac effects’ of smoking, Philip Morris's director of research, Willard Greenwald, made precisely this claim: ‘We certainly do not want any person to smoke if it is dangerous to his health’. 29 Greenwald had made a similar statement in 1939, reassuring his president, OH Chalkley, that ‘under no circumstances would we want anyone to smoke Philip Morris cigarettes were smoking definitely deleterious to his health’. 30 There is no reason to believe he was lying: he is writing long before Wynder's mouse painting experiments of 1953, and prior even to the epidemiology of 1950. Prior to obtaining proof of harm, Philip Morris seems honestly not to have wanted to sell a deadly product.

Summary points

The cigarette is the deadliest object in the history of human civilisation. It is also a defective product, a financial burden on cash-strapped societies, an important source of political and scientific corruption, and a cause of both global warming and global warming denial.

Tobacco manufacturers have a long history of promising to stop the production of cigarettes, should they ever be proven harmful.

The most important reason to ban the sale of cigarettes, however, is that most smokers do not even like the fact they smoke; cigarettes are not a recreational drug.

It is not in principle difficult to end the sale of cigarettes; most communities–even small towns–could do this virtually overnight. We actually have more power than we realize to put an end this, the world's leading cause of death and disease.

• Benowitz NL ,
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• Perkins KA ,
• LeSage MG ,
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• Henningfield JE ,
• ↵ A Study of Cigarette Smokers' Habits and Attitudes in 1970. May 1970. Philip Morris. http://legacy.library.ucsf.edu/tid/jyx81a00 (accessed 4 Apr 2012) . pp. 13, 18, 39 .
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• Joossens L ,
• Cunningham R
• ↵ Austin vs. State of Tennessee , Decided Nov. 19. Cases argued and decided in the Supreme Court , Book 45 . Rochester : Lawyers Co-operative Publishing , 1900 : 224 – 43 .
• ↵ Hill and Knowlton . Suggested approach and comments regarding attacks on use of cigarettes. 1953. Bates 3799, http://legacy.library.ucsf.edu/tid/tao66b00 (accessed 1 Jun 2012).
• Greenwald WF

Competing interests The author has served as an expert witness for plaintiffs in tobacco litigation.

Provenance and peer review Not commissioned; externally peer reviewed.

Open Access This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

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Beyond the Chokehold: The Path to Eric Garner’s Death

After the fatal confrontation with the police on Staten Island was captured on video, the focus on an officer’s chokehold left many questions unexplored.

Eleven months after Eric Garner's death, his grave is covered by a lush patch of grass in Union County, N.J. His mother, Gwen Carr, is pulling together money for a headstone. Credit... Mark Kauzlarich/The New York Times

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By Al Baker ,  J. David Goodman and Benjamin Mueller

• June 13, 2015

[ For more about police violence and unrest, go here ]

Eric Garner was lumbering along a sidewalk on Staten Island on a July day when an unmarked police car pulled up.

The plainclothes officers inside knew Mr. Garner well, mostly for selling untaxed cigarettes not far from the nearby Staten Island Ferry Terminal.

Mr. Garner — who at 6 feet 2 inches tall and 395 pounds was hard to miss — recognized them, too. Everyone did, at least among those who hawked cigarettes and cheap goods on that stretch of Bay Street along Tompkinsville Park. For years, they played a cat-and-mouse game with the New York City officers who came to arrest them.

As the officers approached, Mr. Garner, 43, shouted at them to back off, according to two witnesses. He flailed his arms. He refused to be detained or frisked. He had been arrested twice already that year near the same spot, in March and May, charged both times with circumventing state tax law.

But on that sweltering day in July, the officers left him with a warning.

“It was the first time I ever saw them let him go,” said John McCrae, who watched the encounter near the park. Mr. Garner took that experience to heart, Mr. McCrae said.

“You figure if it stops them the first time,” he said, “it might get them to stop the second time.”

The next time came later that month: July 17, a Thursday.

One of the officers, Justin Damico, returned, accompanied by a different partner, Daniel Pantaleo . As they moved in, a cellphone camera held by a friend of Mr. Garner recorded the struggle that would soon be seen by millions.

The chokehold. The swarm of officers. The 11 pleas for breath.

Mr. Garner’s final words — “I can’t breathe” — became a rallying cry for a protest movement. On screens large and small, his last struggle replayed on a loop. Official scrutiny and public outcry narrowed to focus on the actions of a single officer.

But interviews and previously undisclosed documents obtained by The New York Times provide new details and a fresh understanding of how the seemingly routine police encounter began, how it hurtled toward its deadly conclusion and how the police and emergency medical workers responded.

This was not a chance meeting on the street. It was a product of a police strategy to crack down on the sort of disorder that, to the police, Mr. Garner represented. Handcuffed and motionless on the ground, he did not receive immediate aid, and the apparent lapses in protocol prompted a state inquiry. The first official police report on his death failed to note the key detail that vaulted the fatal arrest into the national consciousness: that a police officer had wrapped his arm around Mr. Garner’s neck.

Medical Workers Attend to Eric Garner

The actions of emergency medical technicians, from arriving at eric garner’s motionless body to wheeling him away on a stretcher, were captured in a cellphone video..

Mr. Garner’s death was the start of a succession of police killings that captured national attention and ignited debate over race and law enforcement. From Michael Brown in Ferguson, Mo., to Walter Scott in North Charleston, S.C., to Freddie Gray in Baltimore, the deaths of black men at the hands of the police have faced a level of scrutiny that would have been unlikely just a year ago, before Mr. Garner died and before a grand jury in December declined to bring charges in his death.

Of the unarmed black men killed by the police, most were shot. Mr. Gray died after being handcuffed without a seatbelt in a Baltimore police van. Mr. Garner, who was unarmed, died at the bare hands of officers.

Nearly a year after the fatal encounter on Staten Island, the actions of the officers, their commanders and the emergency medical workers remain the subject of official investigations.

Even as those investigations have yet to yield any public conclusions about the case, the intervening months have allowed the events that led to Mr. Garner’s death to come into clearer focus.

Cellphone video gave the world an unobstructed view of the chokehold , which was found to be a cause of Mr. Garner’s death, along with the compression of his chest by officers who helped to handcuff him. For all the clarity the video seemed to provide, the focus on the chokehold left largely unexplored crucial events before, during and after the fatal confrontation.

Tensions had been building well before July 17. That day, a lieutenant from the 120th Precinct, on his way to a meeting, saw a group of men on Bay Street and recognized them as a chronic source of problems in the area, said Lou Turco, the head of the lieutenants’ union. The lieutenant called the precinct. Officers Damico and Pantaleo were sent to address it.

At the scene, the two plainclothes officers moved in, and the supervisors who arrived moments later never gained control. Two witnesses said they heard a sergeant tell the officers to ease up as they held Mr. Garner down on the sidewalk. “Let up,” a beauty store manager, Rodney Lee, recalled hearing the sergeant say that day. “You got him already.”

For minutes as Mr. Garner lay on the ground, he was not given oxygen by the responding emergency medical personnel, who were from Richmond University Medical Center.

New Perspective on Eric Garner's Death

Interviews and previously undisclosed documents provide a fresh understanding of how a seemingly routine police encounter hurtled toward its deadly conclusion.

“If someone was choked out, probably they need oxygen right away,” said Israel Miranda, president of the Uniformed E.M.T.s, Paramedics and Fire Inspectors F.D.N.Y. Local 2507, which does not represent the Richmond University medical personnel.

In the hours after Mr. Garner died, an initial five-page internal report prepared for senior police commanders, known as a 49, did not refer to contact with his neck. The report, as well as the actions of supervisors involved, is part of the review by the New York Police Department , a spokesman said.

Instead, the report quotes by name a witness who described seeing how “the two officers each took Mr. Garner by the arms and put him on the ground.” That same witness, Taisha Allen, later said she told the grand jury on Staten Island that she saw a chokehold. She said the statement attributed to her in the report was not accurate.

Without video of his final struggle, Mr. Garner’s death may have attracted little notice or uproar. Without seeing it, the world would not have known exactly how he died.

The video images were cited in the final autopsy report as one of the factors that led the city medical examiner to conclude that the chokehold and chest compression by the police caused Mr. Garner’s death. Absent the video, many in the Police Department would have gone on believing his death to have been solely caused by his health problems: obesity, asthma and hypertensive cardiovascular disease. The autopsy report, which is confidential, was provided by a person close to Mr. Garner’s family.

“We didn’t know anything about a chokehold or hands to the neck until the video came out,” said a former senior police official with direct knowledge of the investigation, who spoke on the condition of anonymity to protect his access to confidential department information. “We found out when everyone else did.”

A Site of Disorder

It was March of last year and Gjafer Gjeshbitraj had had enough. A landlord on Bay Street, Mr. Gjeshbitraj went online to 311, the municipal hotline’s website, to complain about men loitering outside his Staten Island apartment building.

They gathered there to sell cigarettes and drugs, he said. One was named Eric.

The business of loose cigarettes is simple and longstanding. Drive to Pennsylvania or Delaware or a nearby Indian reservation. Return to heavily taxed New York City with cheaper boxes of cigarettes. Sell for a profit. Repeat.

For years, such cigarettes had been sold around Bay Street and the park, a poor and working-class area whose population swells each day with those bound for the welfare office across the street. Some readily opt to buy cigarettes individually at $1 or less, rather than a whole pack for 10 times that.

Mr. Garner was among a handful of men, mostly middle-aged and black or Hispanic, who sold near the park. He used the money to help support his wife, Esaw, and their six children.

“We met because I asked him to have a place there to sell cigarettes,” said Hiram Guzman, who sold loose cigarettes alongside Mr. Garner for years. “He said, ‘You do whatever you want.’ That was about six years ago.”

To the local merchants, Mr. Garner was a daily presence — a friendly face to some and an unwanted competitor to others.

To the Police Department, he was a “condition,” a nettlesome sign of disorder well known in the 120th Precinct, whose ranks are filled with officers who also call Staten Island home.

Teams of officers, such as the one Officer Damico belonged to, are supposed to address such conditions. Commanders are grilled at weekly meetings on how well the conditions are being addressed.

That intense focus is borne of a policing strategy — variously known as quality of life or “broken windows” policing — that was popularized by William J. Bratton during his first tour as New York’s police commissioner in the mid-1990s. It remained in place when he returned in 2014, and it continues to be the lodestar of his crime-fighting approach, even as city leaders debate the merits of less punitive measures for minor offenses in this era of lower crime.

On Staten Island, Tompkinsville Park provides a microcosm for that approach. The park and surrounding streets, familiar to veteran Staten Island officers from past drug arrests, have seen improvements, including renovated apartment buildings on Victory Boulevard. But the area remains a magnet for crime and complaints.

The spot where officers approached Mr. Garner on July 17 had already that year been the site of at least 98 arrests, 100 criminal court summonses, 646 calls to 911 and nine complaints to 311.

Among the most consequential of those complaints appeared to come from Mr. Gjeshbitraj, 47. He said in a recent interview that he complained only after physically fighting with the men on the block who sold drugs. The cigarette sellers, he said, provided cover for more illicit activities.

(Though police officials understood the Eric of his complaint to be Mr. Garner, Mr. Gjeshbitraj said he was referring to someone else.)

The complaints eventually reached Police Headquarters, where leaders track spikes in 311 calls for problems such as noise or graffiti as harbingers of more serious crime. Staten Island commanders were briefed in March on the conditions around Tompkinsville Park, a triangle of land just south of the borough’s main courthouse. Mr. Gjeshbitraj was not the first to lament the disorder there. But after his March complaint, he saw swift changes, mostly in the form of arrests.

Despite the extra attention, he said the problem persisted.

In June, a unit of officers recorded video of the cigarette sales around the park. The Times viewed some of the footage.

The footage was viewed by police commanders. Word trickled back to the local precinct: There were complaints; this condition persists; officers need to address it.

“We chased him; we arrested him,” one police official said of Mr. Garner, speaking on the condition of anonymity because the department’s internal investigation has yet to be disclosed publicly. “But once you’ve chased a guy, what’s a warning going to do?”

The Times tried to reach each of the officers listed as taking part in Mr. Garner’s arrest — some in person, others by phone or through their lawyers. None provided a comment or responded to requests to talk about the encounter. Department policy precludes officers from speaking publicly without authorization.

A Fatal Encounter

Most days Mr. Garner could be found around Bay Street. He played chess and checkers on stools near the curb, peeled off dollar bills for children when the ice cream truck came around and served as a kind of peacekeeper for the motley regulars who occasionally found themselves at odds, said friends and those who knew him from the neighborhood.

On July 17, Mr. Garner had just come from eating lunch with a 23-year-old friend, Ramsey Orta, when a scuffle broke out in front of them on Bay Street. One man accused another, known locally as Twin, of talking inappropriately with his daughter. The girl’s father punched Twin in the face; Mr. Garner shot up from the stoop. “You can’t keep doing this; there are kids out here,” Mr. Garner said, as he held the men apart, according to Ms. Allen.

The men went on their way. Soon after, Officers Damico and Pantaleo arrived.

For Officer Pantaleo, 30, who joined the department in 2006, it was not a typical call. He usually worked in a plainclothes unit focused on violent street crime.

But that afternoon, Lt. Christopher Bannon, driving by, had spotted a group that included Mr. Garner on the sidewalk. He called the precinct to tell officers to “get out there,” according to the former police official. Officer Pantaleo was ordered to go with Officer Damico, 26, an officer since 2010.

With Officer Pantaleo behind the wheel of an unmarked police car, the two officers, in shorts and T-shirts, circled twice, watching Mr. Garner. As they approached, many on the block recognized them as officers and believed they had come in response to the fight, witnesses said; that they moved to arrest Mr. Garner was a surprise.

As the two officers closed in on Mr. Garner, Mr. Orta began taking video that would total about 16 minutes and would be shown to the grand jury impaneled on Staten Island in September to hear evidence in the case against Officer Pantaleo.

“We can do this the easy way or the hard way,” Officer Damico told Mr. Garner, according to a transcript of the videos prepared by the Police Department’s Internal Affairs Bureau and reviewed by The Times.

The transcript documents nearly two minutes of back-and-forth between the officers and Mr. Garner preceding the chokehold — footage not included in the widely circulated clip of Mr. Orta’s video, first posted by The Daily News six hours after Mr. Garner died.

“For what, what did I do?” Mr. Garner said.

“For selling cigarettes,” Officer Damico replied.

In the course of the encounter, officers tried to grab his arms at least twice, according to the transcript.

“Don’t touch me please, do not touch me,” Mr. Garner told them.

Officer Pantaleo, anticipating an arrest, radioed for backup before swinging one arm over Mr. Garner’s shoulder and around his neck and another under his arm, an attempt to twist the larger man’s body to the ground. The pair rammed against the plate glass window of Bay Beauty Supply; by that time, at least four uniformed officers had arrived.

As Officer Pantaleo and other officers pressed Mr. Garner onto the sidewalk, a uniformed patrol sergeant, Kizzy Adonis, entered the tight frame of the video. It was not clear exactly when a second sergeant, Dhanan Saminath, arrived. In the report, both described arriving after Mr. Garner was on the ground.

The beauty store manager, Mr. Lee, said he heard the female sergeant say, “Let up, you got him already.” An officer looked up but did not let go, Mr. Lee said.

Before the grand jury, Mr. Lee said he testified briefly about what he saw, but left feeling the jurors, who were able to ask questions, were uninterested. “They didn’t ask me nothing,” he said.

Mr. Orta also told the grand jurors that a sergeant instructed officers to ease up. “Let him go, let him go, he’s done,” Mr. Orta recalled her saying.

In the video, Officer Pantaleo, who moved from holding Mr. Garner’s neck to pressing his head to the pavement, Officer Damico and two uniformed patrol officers, Mark Ramos and Craig Furlani, helped handcuff Mr. Garner. As they did so, Mr. Garner repeated, “I can’t breathe.”

Edward D. Mullins, the head of the sergeants’ union, said the officers and their supervisors did nothing wrong. Officers can take action without sergeants present and regularly do, he said. The lack of any reference to contact with Mr. Garner’s neck in the initial police report was not troubling, Mr. Mullins said, because the Internal Affairs Bureau would later prepare its own, more detailed report.

In addition, Mr. Mullins said, “no one” at the scene thought a chokehold was used.

He said the sergeants were still “being kept inside,” or off the streets, pending results of the department’s investigation.

A lawyer for Officer Pantaleo, Stuart London, declined to comment and pointed to a summary he provided in December of the officer’s statements to the grand jury. Officer Pantaleo testified to trying a takedown move during the arrest and said he began holding Mr. Garner’s neck out of fear that they would both crash through a glass storefront.

“He thought that once E.M.T. arrived, everything would be O.K.,” Mr. London said at the time.

Difficulty Breathing

Officers in the videos did not appear to respond to Mr. Garner’s pleas. Sergeant Saminath reported Mr. Garner had difficulty breathing and called an ambulance, but he said Mr. Garner “did not appear to be in great distress,” the report said.

The department’s Patrol Guide, its manual of rules, calls for officers to immediately send a person with a life-threatening medical condition — “apparent heart attack, breathing difficulties” — to the nearest hospital.

At 3:32 p.m., officers radioed for an ambulance, said a city official, who requested anonymity to discuss details of the response that remained under investigation by state authorities. About a minute and a half later, another request was made. Both were categorized as “unknown,” a low priority.

Sergeant Adonis told investigators that she “believed she heard the perpetrator state that he was having difficulty breathing,” according to the department’s initial report. Sergeant Saminath said the ambulance he requested arrived about five minutes later.

Witnesses said the officers did not react in accordance with Mr. Garner’s medical distress. (After his death, current and former officers said those at the scene might have believed his pleas were part of a ruse to avoid arrest.)

But even after emergency medical workers arrived, the response appeared disorganized.

Their actions, from arriving at Mr. Garner’s motionless body to wheeling him away, were captured in an eight-minute video recorded by Ms. Allen, who lives in the area and was on the block shopping for sandals. The video of the medical response has not been as widely understood as those of the physical struggle recorded by Mr. Orta.

An ambulance crew arrived unaware of Mr. Garner’s condition, or that police officers were involved. A stretcher was not immediately brought to him. A bag with oxygen equipment that should have been near his body at all times was carried away.

Ms. Allen said in an interview that when medical workers arrived, they casually asked Mr. Garner to wake up, appearing to believe he was “faking it,” she said, recounting her testimony before the grand jury.

At first, one emergency medical technician, Nicole Palmeri, leaned over Mr. Garner to feel for a pulse, first on his wrist and then his neck, according to Ms. Allen.

As Ms. Palmeri checked for a pulse, another E.M.T., Stephanie Greenberg, walked back to the ambulance to retrieve a stretcher. An E.M.T. trainee followed her, walking away from Mr. Garner with the oxygen equipment.

Five medical workers were there: the two medical technicians, the trainee and two paramedics who arrived later and are not seen on video. They were from Richmond University Medical Center. Supervisors from the Fire Department are routinely dispatched to serious medical calls, but the Garner call was not initially considered serious. No supervisorsassisted in his medical care on the scene.

Ms. Palmeri did not respond to phone messages or a letter left with a relative. Ms. Greenberg declined to comment.

Mr. Miranda, the union leader for city medical technicians, said he thought the care could have been more aggressive. “I didn’t see any real attempt initially to treat the patient.”

A hospital spokesman declined to comment, citing patient confidentiality, but said the medical technicians are still being kept on non-patient duty, while the paramedics have returned to normal duty.

Ms. Allen said the medical response and Mr. Garner’s prior ailments seemed to preoccupy the prosecutors and grand jurors when she testified. Mr. Garner had acute asthma, hypertension and a history of diabetes. He was also obese; these conditions were all listed as contributing factors to his death.

Several times during her testimony, which is kept secret under grand jury rules, Ms. Allen said prosecutors urged her to watch her words. When she said Mr. Garner did not appear to have a pulse, a prosecutor stepped in. “Don’t say it like that,” she recalled the prosecutor saying. “You’re only assuming he didn’t have a pulse.”

A prosecutor also interjected when she told jurors how Mr. Garner was taken to the ground. “I said they put him in a chokehold,” Ms. Allen recalled saying. “ ‘Well, you can’t say they put him in a chokehold,’ ” she said a prosecutor responded.

A spokesman for the Staten Island district attorney’s office declined to comment, citing restrictions on grand jury proceedings.

Roughly four minutes after medical workers arrived, Mr. Garner was lifted onto the stretcher, with the emergency medical staff assisted by police officers.

At 3:44 p.m. — 12 minutes after the first request for an ambulance — emergency medical workers upgraded the seriousness of the situation to the highest priority level, or Segment 1. They did so, the city official said, because Mr. Garner was in cardiac arrest.

Sergeant Saminath instructed Officer Damico to ride in the ambulance with Mr. Garner. Mr. Garner was declared dead at 4:34 p.m. at Richmond University Medical Center.

An autopsy was performed the next day. “On external examination of the neck, there are no visible injuries,” according to the final report. On the inside, however, were telltale signs of choking: strap muscle hemorrhages in his neck and petechial hemorrhages in his eyes. No drugs or alcohol were in his system.

The results of the examination contrasted sharply with the Police Department’s initial account, titled “Death of Perpetrator in Police Custody, Within the Confines of the 120 Precinct.” It contained no mention of any contact with Mr. Garner’s neck.

Struggling to Move On

Eleven months later, a lush patch of grass in a faded field in Union County, N.J., is all that marks Mr. Garner’s grave. His mother, Gwen Carr, said she was waiting for the ground to settle as she tried to gather money for a headstone. Frustration and anger remain over his death as many of its central players have struggled to move on.

Ramsey Orta, the man who recorded the deadly confrontation, is facing charges for gun and drug offenses that his family believes are retaliation by the police. Both arrests were made after Mr. Garner’s death.

The family of Mr. Garner is in talks with the city about a financial settlement . “If we haven’t made progress with resolving it by the anniversary of his death, we will go forward with a lawsuit,” Jonathan Moore, their lawyer, said.

One of Mr. Garner’s granddaughters, Kaylee, now runs to the television when activists appear, chanting “Hands up, don’t shoot” and “No justice, no peace.”

“It’s cute, but it’s a shame at 3 years old that she knows that,” Mr. Garner’s wife, said. “She should be reciting the A B Cs.”

Visits with hip-hop stars and protest organizers have not muted the pain of her husband’s death. “Empty, empty,” Ms. Garner said, lifting a cup of coffee from beside an ashtray. “From day to day, I don’t even know what to do sometimes.”

Reverberations from death after death of unarmed black men have not helped Mr. Garner’s family. “It’s like a vision that I’m seeing again, seeing my son dying again,” Ms. Carr said.

New York City leaders, including Commissioner Bratton, are changing how minor criminal offenses are handled, exploring ways to make the outcomes less punitive and mulling a new form of warnings in lieu of arrest or summons.

Earlier this year, the Police Department created a new centralized unit, the Force Investigation Division, to investigate fatal police encounters.

In a written response to questions, Mr. Bratton said the creation of the unit “was not a direct result of the Garner incident but rather something that I recognized a need for on a more general basis.” He said the notion of retraining predated Mr. Garner’s death, but added that “there is no question that the Garner incident added new dimensions and certainly new immediacy.”

Though the Police Department has concluded its investigation into Mr. Garner’s death, the results — and any internal discipline that may come for officers — are delayed until a civil rights inquiry by the United States attorney for the Eastern District of New York is completed. An investigation by the Civilian Complaint Review Board, an independent agency that investigates police misconduct, has been similarly delayed.

Stephen Davis, the Police Department’s top spokesman, declined to respond to a list of questions about Mr. Garner’s death and the police response because of “the ongoing federal and departmental reviews into this matter.”

In the only inquiry completed so far, a Staten Island grand jury found Officer Pantaleo committed no crime when he used a chokehold — a technique banned by police rules.

Daniel M. Donovan Jr., who was the Staten Island district attorney, fought to keep secret the testimony and other evidence presented to the grand jury. In May, Mr. Donovan was elected to Congress.

Elected officials and civil liberties advocates have unsuccessfully tried to pry open the grand jury transcripts. Separately, lawyers from the civilian review board argued before a Staten Island judge on Friday for access to the transcripts.

“Efforts to obtain N.Y.P.D.’s investigative file of the incident from the N.Y.P.D. have been unsuccessful,” the board’s lawyers wrote in legal filings.

On a recent afternoon, steps from where Mr. Garner was arrested in July, a dozen men congregated on the stoop of a Bay Street building owned by Mr. Gjeshbitraj, the landlord who named an “Eric” in his 311 complaint. A man sweating through a red tank-top turned his back to a companion, who put a cigarette in his palm. He raised it to his lips and walked away.

Mr. Gjeshbitraj said in a recent interview that he no longer called the city or the police to complain about the conditions around his building, as he had frequently in the months and years before Mr. Garner died.

“The last time I called the cops, someone got choked to death,” he said. “Eric got killed because I called.”

Nate Schweber and Benjamin Weiser contributed reporting, and Elisa Cho and Alain Delaquérière contributed research.

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Essay on Selling Tobacco should be banned

This essay examines the ethical and health implications of selling tobacco products and argues that it should be banned. The essay looks at the history of tobacco, its effects on health, and the current regulations in place. It concludes that, for the benefit of society, the sale of tobacco should be stopped.

Selling tobacco should be banned because it is bad for people’s health. Smoking cigarettes can cause many health problems, such as cancer and heart disease. Tobacco smoke can also make asthma worse and cause other lung and breathing problems. It is especially dangerous for children because their bodies are still growing. Tobacco is a very addictive substance. Once someone starts smoking, it is hard for them to stop. This can lead to a lifetime of addiction and health problems. It is also expensive, so it can cause financial problems for people. Selling tobacco is also bad for the environment. Burning tobacco produces chemicals that can pollute the air. It is also the cause of forest fires in many parts of the world. For all of these reasons, selling tobacco should be banned. It is dangerous to people’s health and the environment. We should all work together to make sure that tobacco is not sold anymore.

FAQs Related To Essay on Selling Tobacco should be banned

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In my country, the law surrounding the sale of tobacco products is very strict. The sale of tobacco products to anyone under the age of 18 is prohibited, and all sales must take place in establishments that are licenced to sell tobacco products. Furthermore, the display and promotion of tobacco products is also strictly regulated, and any advertisements must adhere to certain regulations.

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It is illegal to sell tobacco to minors in most states in the U.S. Selling tobacco to minors violates state laws, and those found guilty of selling tobacco to minors may be subject to hefty fines and other penalties. Furthermore, most states require retailers to check IDs of anyone purchasing tobacco products, and it is a crime to falsify or misrepresent an individual’s age in order to purchase tobacco.

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The legal age to purchase tobacco varies from country to country. Generally, the legal age to purchase tobacco is 18 years old, although some countries have a higher age requirement. In the United States, the legal age to purchase tobacco is 21 years old. In other parts of the world, the legal age to purchase tobacco may be as high as 25. Additionally, some countries have banned the sale of tobacco completely. It is important to familiarize yourself with your local laws when it comes to purchasing tobacco to ensure that you remain in compliance.

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6. What are the consequences of selling tobacco to minors?

The consequences of selling tobacco to minors can be severe. Depending on the laws in the area, individuals caught selling tobacco to minors can face fines, imprisonment, and a permanent criminal record. There can also be civil penalties associated with selling tobacco to minors such as lawsuits. In addition, businesses may face additional consequences such as losing their license to sell tobacco or being put on probation.

7. What is the process for banning the sale of tobacco in my country?

The process for banning the sale of tobacco in a country will vary depending on the laws and regulations in the country. Generally, the process involves enacting legislation that makes it illegal to sell tobacco products, as well as to manufacture and distribute them. This legislation typically includes provisions for penalties for violations, as well as provisions for enforcement.

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Banning the sale of tobacco has many benefits. For one, it will reduce the number of people who become addicted to tobacco and the health risks associated with it. It will also reduce the amount of secondhand smoke exposure, which is dangerous to those around the smoker. In addition, it will reduce the cost of healthcare for those with diseases related to tobacco use. Finally, it will help reduce the environmental impact of tobacco production and waste. All in all, banning the sale of tobacco is a great step in the right direction for improving public health and the environment.

9. What are the potential legal implications of selling tobacco?

The potential legal implications of selling tobacco are numerous and can vary greatly, depending on the local, state, and federal laws that apply to the sale of tobacco products. Depending on the jurisdiction, sellers of tobacco products may need to obtain a license, ensure that all tobacco products are labeled and taxed appropriately, and ensure that all sales are made to customers over the age of 18 or 21, depending on the local laws.

10. What are the alternatives to smoking tobacco?

Smoking tobacco is a major health risk, so it is important to consider alternatives to the habit. Quitting smoking entirely is the best option for health, but there are other alternatives that can help those who are trying to reduce or eliminate smoking. These alternatives include switching to e-cigarettes, using nicotine gum or patches, and trying other forms of relaxation, such as yoga or meditation.

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What is Rishi Sunak’s anti-smoking bill and will it pass?

Health leaders have welcomed plan to create smoke-free generation – but PM is facing trouble from some Tory MPs

Rishi Sunak’s tobacco and vapes bill aims to create the UK’s first smoke-free generation, in a landmark public health intervention.

What is the ban and how would it work?

The tobacco and vapes bill ensures anyone turning 15 from 2024, or younger, will be banned from buying cigarettes, and aims to make vapes less appealing to children.

The legislation does not ban smoking outright, as anyone who can legally buy tobacco now will still be able to do so if the bill becomes law. It will make it illegal to sell tobacco products to anyone born after 1 January 2009. The plan was first reported by the Guardian , and announced by the prime minister in his speech to the Conservative party conference last year.

It will raise the age of tobacco sale by one year every year, with the aim of stopping today’s young people from ever taking up smoking.

As well as raising the smoking age every year, the legislation includes provisions to regulate the display, contents, flavours and packaging of vapes and nicotine products.

Trading standards officers will be able to fine retailers who ignore the new restrictions, with the revenue raised funding further enforcement.

What are the arguments in favour?

Health leaders , NHS bosses and medical professionals say phasing out smoking will save thousands of lives. Smoking kills about 80,000 people a year.

Ministers say smoking rates among those aged 14-30 could be near zero by 2040 as a result of the legislation.

Prof Steve Turner, the president of the Royal College for Paediatrics and Child Health , said: “By stopping children and young people from becoming addicted to nicotine and tobacco, we decrease their chances of developing preventable diseases later in life, and will protect children from the harms of nicotine addiction.”

The government says creating a “smoke-free generation” could prevent more than 470,000 cases of heart disease, stroke, lung cancer and other diseases by the end of the century.

Government figures show smoking costs the UK about £17bn a year, including £10bn through lost productivity alone. It says this cost dwarfs the £10bn raised through taxes on tobacco products.

And against?

Some Tory MPs have expressed concerns, with the former prime minister Liz Truss saying the plans are “profoundly unconservative”, and her predecessor, Boris Johnson, describing the ban as “nuts” .

Truss said earlier this year: “A Conservative government should not be seeking to extend the nanny state. It only gives succour to those who wish to curtail freedom.”

Kemi Badenoch, the business secretary, was the only cabinet minister to vote against the bill going to a second reading, arguing that the burden of enforcement would fall on private businesses, and that the bill undermined the principle of equality.

“We should not treat legally competent adults differently in this way, where people born a day apart will have permanently different rights,” she posted on X before the vote.

Other Tory MPs object to the plans because they claim they are unworkable and could lead to other things being banned. The former cabinet minister Sir Simon Clarke said: “An enforcement nightmare and a slippery slope – alcohol next?”

How soon will the bill pass ?

A final vote in the Lords is expected to take place in the middle of June after the bill passes its third reading there, but much has to happen in the Commons first.

Tuesday was MPs’ first opportunity to debate the bill and to vote on it. It cleared its first Commons hurdle by 383 votes to 67 , giving a majority of 316, with the support of the Labour party.

The committee stage comes later in April, when amendments can be tabled, before there is a vote on them in May and then a vote by MPs on the bill’s third reading.

What is the likelihood it will run into political trouble?

There was opposition from 57 Conservative MPs and six ministers, including Badenoch, Julia Lopez, Lee Rowley, Alex Burghart, Steve Baker and Andrew Griffith.

The Commons leader, Penny Mordaunt was reported to be wavering but in the end abstained, one of 106 Tory MPs who did not cast a vote. Some of these will have had other reasons for staying away, such as the chancellor, Jeremy Hunt, who was travelling to the International Monetary Fund in Washington.

Tory critics’ best hope for frustrating the bill will now be to overload it with amendments and slow down its passage.

Amendments are likely to include a push to introduce licensing for vaping retailers or to change the age of people affected.

Tory opponents also believe there could be more ideological opposition in the Lords.

The final vote in the Lords is expected to take place in June. While peers have been a block on Sunak’s flagship Rwanda deportation plan, they are not expected, ultimately, to stand in the way of the tobacco bill.

Which other countries have attempted a ban ?

A similar law had been expected to come into effect in New Zealand in July, but was repealed by the country’s new coalition government in February. The toughest anti-tobacco rules in the world would have banned sales to people born after 2009, cut nicotine content in smoked tobacco products and cut the number of tobacco retailers by more than 90%.

Countries with notable restrictions on smoking include Mexico, which has smoking bans at beaches, parks and some homes.

Portugal is aiming to become smoke-free by 2040, with plans to ban the sale of tobacco products in bars and cafes. Meanwhile, Canada became the first country to require health warnings to be printed on individual cigarettes.

More than a quarter of the world’s population are covered by smoking bans in public spaces, according to the World Health Organization.

Of the 74 countries with smoke-free policies, Ireland was the first to ban smoking in all indoor workplaces, in 2004.

• Young people
• Rishi Sunak
• Tobacco industry

More on this story

Saving us from ourselves: how Britain is learning to accept the nanny state

Logical step or overreach? Guardian readers share their views on Sunak’s smoking ban

How New Zealand’s smoking ban got stubbed out – and what the UK can learn from it

MPs vote for smoking ban despite Tories’ division over policy

New Zealand scraps world-first smoking ‘generation ban’ to fund tax cuts

This new bill could wipe out smoking – the only losers would be those who profit from it

Kemi Badenoch to oppose smoking ban in blow to Sunak’s authority

Chris Whitty urges MPs to ignore lobbying and pass smoking ban bill

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Ethical considerations of e-cigarette use for tobacco harm reduction

Caroline franck.

Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, QC Canada

Kristian B. Filion

Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC Canada

Division of Clinical Epidemiology, McGill University, Montreal, QC Canada

Jonathan Kimmelman

Biomedical Ethics Unit, McGill University Montreal, Montreal, QC Canada

Department of Social Studies and Medicine, McGill University, Montreal, QC Canada

Roland Grad

Department of Family Medicine, McGill University, Montreal, QC Canada

Mark J. Eisenberg

Division of Cardiology, Jewish General Hospital, McGill University, Montreal, QC Canada

Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital/McGill University, 3755 Côte Ste-Catherine Road, Suite H-421.1, Montreal, Quebec H3T 1E2 Canada

Due to their similarity to tobacco cigarettes, electronic cigarettes (e-cigarettes) could play an important role in tobacco harm reduction. However, the public health community remains divided concerning the appropriateness of endorsing a device whose safety and efficacy for smoking cessation remain unclear. We identified the major ethical considerations surrounding the use of e-cigarettes for tobacco harm reduction, including product safety, efficacy for smoking cessation and reduction, use among non-smokers, use among youth, marketing and advertisement, use in public places, renormalization of a smoking culture, and market ownership. Overall, the safety profile of e-cigarettes is unlikely to warrant serious public health concerns, particularly given the known adverse health effects associated with tobacco cigarettes. As a result, it is unlikely that the population-level harms resulting from e-cigarette uptake among non-smokers would overshadow the public health gains obtained from tobacco harm reduction among current smokers. While the existence of a gateway effect for youth remains uncertain, e-cigarette use in this population should be discouraged. Similarly, marketing and advertisement should remain aligned with the degree of known product risk and should be targeted to current smokers. Overall, the available evidence supports the cautionary implementation of harm reduction interventions aimed at promoting e-cigarettes as attractive and competitive alternatives to cigarette smoking, while taking measures to protect vulnerable groups and individuals.

Electronic cigarettes (e-cigarettes) have polarized the public health community unlike any previous alternative to smoking. Although their efficacy as smoking cessation aids remains unclear [ 1 ], anecdotal evidence suggests that many people have successfully quit smoking with the use of e-cigarettes. Due to their similarity in form and function to tobacco cigarettes, e-cigarettes could play an important role in tobacco harm reduction. However, intense divisiveness has resulted from the absence of conclusive evidence demonstrating product safety for individual and public health. Several ethical issues have been identified pertaining to their use both as recreational products and harm reduction devices, including their potential appeal to non-smokers, their potential to act as a gateway to cigarette smoking, and their potential to renormalize a public smoking culture. To this end, we examined the ethical issues surrounding the availability and use of e-cigarettes for tobacco harm reduction, with the objective of understanding their potential contributions to public health. Specifically, our framework draws upon tensions between utilitarianism and liberalism in public health ethics [ 2 ], the former aiming to produce the largest public health gains through the greatest reduction in the burden of disease, and the latter holding paramount individuals' right to self-determination in health.

The burden of smoking-attributable disease

Cigarette smoking remains the leading cause of preventable mortality worldwide, contributing to the death of approximately 480,000 Americans annually [ 3 ]. Smoking also produces substantial morbidity costs: estimates show that 6.9 million Americans reported major smoking-related morbidity in 2009, constituting 10.9 million lifetime cases of smoking-attributable disease [ 4 ]. Cessation efforts have largely failed to address the wealth of behavioral and social components to cigarette addiction. The majority of the lifestyle benefits conferred by cigarette smoking, including alertness, focus, stress reduction, and social opportunities [ 5 , 6 ], are not comparably paralleled with existing smoking cessation therapies. In addition, among the strongest habit-forming properties of tobacco cigarettes are the behavioral cues associated with their use, including regular hand-to-mouth action and the production of smoke [ 7 , 8 ]. Consequently, there is an urgent need for novel cessation therapies that target both the physiological and behavioral components of cigarette smoking. A device that retains the feel and function of cigarettes and reduces their associated health costs could lead to substantial public health benefits. Given their striking similarity to tobacco cigarettes and their high degree of acceptability among smokers [ 9 – 11 ], e-cigarettes constitute the closest approximation to such a harm reduction device to date.

The role of tobacco harm reduction in public health

Harm reduction policies attempt to diminish the damaging effects of a particular behavior without aiming to eliminate the behavior itself. Common applications include the provision of needle exchanges and safe injection kits to injection drug users, and the use of methadone to treat opiate addiction. Despite continued resistance to harm reduction interventions, there is strong evidence demonstrating their successes in public health, most notably in reducing the incidence of HIV and Hepatitis C infection [ 12 – 14 ]. Critics may argue that tobacco harm reduction, as it applies to e-cigarettes, remains distinct from harm reduction for other forms of drug addiction. While there is no definitive evidence that either e-cigarettes or needle exchanges promote substance initiation among non-users, critics have expressed concerns about the possibility of a gateway effect of e-cigarettes towards conventional cigarettes [ 15 ]. In addition, unlike e-cigarettes, needle exchanges are not backed by powerful political lobbyists or for-profit companies [ 15 ]. Lastly, injection drug use is comparably invisible relative to the conspicuousness of using an e-cigarette in public [ 15 ]. While these important distinctions highlight the need for closer examination, they do not inherently exclude the harm reduction potential of e-cigarettes.

The burden of smoking-related illness suggests that novel public health interventions designed to reduce the harms associated with cigarette smoking are needed. Virtually all interventions to date have focused on eliminating nicotine use, as standard nicotine replacement therapies are indicated for use up to 12 weeks [ 16 ]. These successes have been limited, with just over 15 % of smokers motivated to quit achieving prolonged abstinence at 12 months with the aid of a smoking cessation therapy [ 17 ]. Despite the fact that an elimination-centered approach is incongruous with the understanding that harm reduction strategies are more practical and feasible than enforcing population-wide abstinence [ 18 ], anti-tobacco activists have expressed concern that harm reduction might overshadow cessation messages, effectively resulting in a reduction in the number of successful quitters [ 19 ].

Tobacco harm reduction continues to be met with skepticism by public health advocates [ 20 ] whose distrust of safer smoking products dates back to a misguided endorsement of “light” cigarettes in the 1950’s and 60’s [ 18 , 21 ]. More recently, critics denounced the use of low-nitrosamine smokeless tobacco products, commonly known as “snus,” for tobacco harm reduction despite evidence that the increased use of snus among Swedish men was accompanied by a reduction in the prevalence of cigarette smoking and tobacco-related disease [ 22 , 23 ]. Arguments against the use of smokeless tobacco for harm reduction are similarly used against e-cigarettes, including the continued promotion of an addictive substance, uncertain long-term safety concerns, the possibility of a gateway effect to conventional tobacco products, and concerns about questionable terms of engagement with the tobacco industry [ 24 ]. An important distinction between e-cigarettes and smokeless tobacco to be considered among public health critics is the former’s inherent likeness to conventional cigarettes, which arguably increases their appeal as an alternative to knowingly harmful combustible products. However, this distinction has not prevented significant controversy and debate in the United Kingdom, stemming from polarized opinions concerning the strength of the evidence regarding e-cigarettes’ potential for harm [ 25 ].

The principal quandaries in framing e-cigarettes as a tool for harm reduction occur first in determining whether it is morally objectionable to promote a product whose long-term health effects remain unknown; second, in establishing whether mitigating a harm that already exists is morally superior to preventing a same or similar harm from materializing [ 26 ]. What is the government’s role in regulating and potentially incentivizing these products? Should physicians encourage tobacco harm reduction by advocating for the use of e-cigarettes? As they are neither tobacco products nor approved cessation devices, e-cigarettes constitute a novel product whose harm reduction potential stands to be weighed against the ethical implications surrounding their availability and use.

E-cigarette safety

E-cigarettes typically contain a solution of propylene glycol or glycerin, with or without nicotine, that is vaporized upon inhalation by the user [ 27 ]. Unlike tobacco cigarettes, e-cigarettes are free of combustion [ 28 ], the mechanism through which toxicants contained in burned tobacco are inhaled and absorbed by the user [ 3 ]. To date, biochemical studies of e-cigarettes have failed to raise any serious health concerns [ 3 , 20 ]. The most frequently reported adverse events associated with their use have included nausea, throat and mouth irritation, headache, and dry cough, all of which were found to resolve over time [ 3 , 29 ]. Although e-cigarettes are believed to have similar toxicity as existing nicotine replacement therapies [ 20 ], the generalizability of these findings remains unclear given the absence of standardized manufacturing practices and the proprietary nature of industry studies. The product’s novelty also entails that there is insufficient data to judge the long-term effects of regular inhalation of propylene glycol or glycerin. However, studies of artificial smoke generators concluded that exposure to propylene glycol mist can cause ocular and upper airway irritation [ 30 ], which could potentially be of concern among users with chronic lung disease, including asthma, emphysema, or bronchitis [ 31 ].

Safety evaluations will require quantifying the degree of risk warranted in the face of incomplete evidence with which to inform decision-making. In turn, promoting autonomy, or the right to make individual decisions with regards to one’s life choices, requires the provision of information concerning the risks and benefits associated with a given behaviour and with voluntary choice [ 32 ]. This rights-based position is compelling given that the majority of e-cigarette users are current smokers attempting to quit or reduce their number of cigarettes smoked [ 33 ]. While autonomy may be compromised through the influence of nicotine addiction, the consequences may be less pronounced where this choice consists of selecting between alternative sources of nicotine (of potential equal or similar satisfaction), rather than choosing between indulgence and abstinence. However, were the demographics of e-cigarette users to change, for instance through an increased number of non-smokers or youth taking up e-cigarettes, from a utilitarian perspective, the autonomy argument may become less convincing in weighing individual harm against public good.

Efficacy for smoking cessation and reduction

The best evidence concerning the efficacy of e-cigarettes for smoking cessation and reduction is presented in a 2014 Cochrane review [ 34 ] that examined 13 studies, two of which were randomized controlled trials (RCTs) [ 11 , 35 ]. While the included studies found some evidence that e-cigarettes help smokers quit or reduce smoking, the authors concluded that a lack of high-quality RCTs reduces the certainty of these effects. Nonetheless, available data from several observational studies suggest that e-cigarettes can lead to substantial smoking reduction among smokers not motivated to quit [ 36 – 38 ]. Many smokers continue to engage in dual use of e-cigarettes and tobacco cigarettes. A study examining the effects of cigarette reduction on cardiovascular risk factor levels in regular smokers (15–45 cigarettes per day) motivated to decrease their consumption demonstrated that reducing the number of self-reported cigarettes per day by at least 40 % led to significant improvements ( p  < 0.05) in several biomarkers of cardiovascular disease [ 39 ]. However, these were only modestly correlated with a reduced risk of disease. Similarly modest risk reductions found in other studies have led researchers to hypothesize that cigarette reduction among heavy smokers is frequently accompanied by compensatory smoking behavior, including prolonging the duration of each cigarette smoked [ 40 – 42 ]. Thus, despite improvements in biomarkers including hemoglobin, leukocyte counts, fibrinogen, and cholesterol, there is no evidence that reducing smoking to as few as ten cigarettes per day produces improvements in clinical cardiovascular disease outcomes [ 3 ].

The absence of improved cardiovascular outcomes, however, does not preclude the existence of benefits attributed to reduced smoking. A population-based cohort study with up to 31 years of follow-up determined that reducing smoking from 20 to fewer than ten cigarettes per day produced a 27 % (95 % confidence interval [CI], 2–46 %) reduction in the relative risk of lung cancer as compared to continuously smoking more than 15 cigarettes per day [ 42 ]. In a second study, smokers unwilling to quit were randomized to either 4 weeks of reduced smoking with subsequent advice to quit or to usual care with only quit advice [ 43 ]. Both groups had similar quit rates at 6 months, suggesting that reduction messages do not hinder cessation attempts. Similarly, a review of 19 controlled, cohort, case–control, and experimental studies examining the impact of reduction messages on smoking cessation revealed no study concluded that smoking reduction decreases subsequent smoking cessation among smokers unwilling to quit [ 44 ]. Rather, reduced smoking likely constitutes a first step to attempt and subsequently achieve abstinence, particularly among smokers who perceive themselves as unable to quit [ 39 ].

Use of e-cigarettes among non-smokers

A key challenge faced by regulatory agencies in choosing how to regulate e-cigarettes rests in considering the possibility of increased use among non-smokers. Data from a 2010–2013 online survey of US adults conducted in samples ranging from 2,505 (in 2010) to 4,170 (in 2012) respondents revealed that ever use of e-cigarettes was highest among current and former cigarette smokers compared to never smokers in every survey year [ 45 ]. Specifically, the proportion of never cigarette smokers who reported ever use of e-cigarettes was 1.3 % in 2010, 1.3 % in 2011, 2.3 % in 2012, and 1.2 % in 2013. Similarly in 2012, just 0.2 % of never smokers reported using an e-cigarette in the past 30 days. The increase in e-cigarette awareness (40.9 to 79.7 %) and ever use (3.3 to 8.5 %) among all US adults between 2010 and 2013 thus appears to be driven by current and former smokers. At present, it is unclear what proportion of use among former smokers can be attributed to recent quitters’ attempts to manage their cessation efforts, or to successful quitters newly initiating e-cigarettes. However, due to their frequent use as unapproved smoking cessation aids [ 10 ], it is likely that many former smokers are also recent quitters.

Concerns have been raised that higher rates of never smokers initiating e-cigarettes would result in net public health harms via increased nicotine addiction, and the possibility for e-cigarettes to act as a gateway to tobacco cigarettes. There is limited evidence that nicotine exerts a priming effect on brain circuitry, which helps to explain why nicotine is frequently used as a precursor to other hard drugs [ 46 ]. However, the implications of such priming are unclear, particularly as concerns a possible gateway effect of e-cigarettes to tobacco cigarettes. Tenets of economics dictate that risk-minimizing strategies, including sunscreen, condoms, and travel vaccines, encourage more people to engage in otherwise risky activities [ 6 ]. The same should be expected of e-cigarettes, probably leading to eventual high product uptake among non-smokers.

A useful paradigm that reconciles liberalism and utilitarianism in illustrating the impact of displacing a high-risk activity with a low-risk one is the risk/use equilibrium (Fig.  1 ) [ 47 ]. For instance, if e-cigarettes reduced a smoker’s risk by 99 %, for every smoker who switched to e-cigarettes, 100 non-smokers would need to initiate e-cigarettes to attain no net public health benefit. Were e-cigarettes so little as 95 % less harmful than tobacco cigarettes, 20 % of non-smoker uptake of e-cigarettes would be required to offset the public health benefits of 1 % of smokers switching to e-cigarettes, generally representing the upper limit of nicotine usage prevalence worldwide [ 6 ]. Consequently, it is unlikely that e-cigarettes would result in net public health harms despite the inevitable uptake of the product in a non-smoking fraction of the population. This framework provides nuance to the absolutist position that any non-smoker uptake of e-cigarettes would have overall adverse effects on population health. In practice, sound public health policy can sustain autonomous choices with deleterious consequences to the extent that these do not outweigh net public health benefits.

The risk/use equilibrium. Each point on this curve indicates the multiplier needed to achieve a constant level of population risk, given specific levels of decreased danger per user. For example, if 100 individuals used a product with full danger (for example, killing 100 % of users), 10 times that number (1000 individuals) would need to use a product that had 90 % decreased danger, to achieve an equal health problem (100 dead in each instance). The formula is Y  = 100/100-X, where Y  = multiplier and X  = decrease in danger, expressed in percentages. If danger is 0.1 %, use would have to increase by 1000 times to produce a problem of the same magnitude as the full risk product (not plotted on figure). For a given risk on the curve, use that is increased by a smaller multiplier represents a public health benefit, and use that is increased by a larger multiplier represents a public health (population level) cost. Figure and legend reproduced from [ 47 ] with permission from BMJ Publishing Group Ltd.

It is important to consider how the risks and benefits of tobacco harm reduction are differentially experienced by disadvantaged populations. It is well documented that cigarette smoking is associated with structural, material, and perceived socioeconomic disadvantage [ 48 , 49 ]. Although e-cigarettes could increase health disparities if used differentially for harm reduction, given their comparable cost to tobacco cigarettes, for which smokers have already found the income to purchase, they are unlikely to increase disparities in practice. However, this remains an issue that requires continued surveillance to better understand practices in different socioeconomic groups.

Use of e-cigarettes among youth

Nicotine liquid (e-liquid) flavourings are widely available in youth-friendly flavors, including strawberry, bubble gum, and chocolate. Flavored tobacco has been shown to have a large market share among youth aged 12 to 17 years [ 50 ], confirming the attractiveness of these products to new and young smokers and their likely contribution to smoking initiation. The appeal of flavorings is particularly disconcerting given an increase in United States (US) reports of accidental e-cigarette exposure (including exposure to e-liquid) in children [ 51 ], with many bottles of e-liquid containing several times the lethal dose of nicotine in children [ 52 ]. Previous studies also highlight positive youth perceptions and expectations of flavored tobacco products, namely that they are both better-tasting and safer than non-flavored tobacco products [ 53 ]. The combination of added flavor to a device that is also perceived to be less harmful than tobacco cigarettes is likely to entice youth to use e-cigarettes. Given the unknown health effects of long-term nicotine use [ 3 ] and inhaled propylene glycol [ 54 ], the safety profile of even the most reliable e-cigarette is yet unknown, and the consumption of nicotine among youth remains undesirable. For this reason, there is widespread consensus concerning attempts to restrict e-cigarette sales to youth in the US [ 55 ].

The gateway hypothesis has its specific application to youth, for whom the balance of potential benefits and risks associated with harm reduction must also be considered. Although the association between cigarette smoking and e-cigarette use has recently been examined in a cross-sectional study of adolescents [ 56 ], given the study design and its temporal ambiguity, it is difficult to draw firm conclusions from these data [ 57 ]. As it is unclear whether youth who use e-cigarettes are more likely to use tobacco cigarettes as a consequence of the e-cigarette itself, there remains a need to evaluate the gateway hypothesis in this population over time.

Marketing and advertising

An extension of youth protection is the question of regulating advertisement and marketing to broad audiences. Comprehensive advertising bans would likely minimize any perceived government endorsement of e-cigarettes. However, the inadvertent message sent to consumers by regulating e-cigarettes as strictly as tobacco cigarettes may be that these products are comparably, if not equally harmful. E-cigarettes are likely to be considerably less toxic than tobacco cigarettes [ 31 ] given the absence of tobacco combustion inherent to cigarette smoking, which releases pulmonary carcinogens including polycyclic aromatic hydrocarbons, N -Nitrosamines, and various other cytotoxic compounds [ 58 ]. From both utilitarian and liberal perspectives, misinformation through the provision of inaccurate comparative risk is fundamentally unethical for its failure to allow consumers to make informed choices, and for effectively conveying the message that smokers may as well continue to smoke [ 59 ].

As marketing and advertisement play an important role in the public’s perception of e-cigarettes, governments have an ethical duty to ensure that the product’s media portrayal is appropriately aligned with its known degree of risk. If the public health community’s aim is to market e-cigarettes to current smokers, it follows that advertisements should have at least equal reach to this target audience as tobacco cigarettes. This strategy, termed “levelling up,” would allow e-cigarettes to be sold and marketed similarly to conventional tobacco products, as well as benefiting from the possibility of lower tax rates owed to their reduced potential for harm [ 60 ]. However, the relative absence of restrictions to date in the US has led e-cigarette marketing to permeate most media outlets through the likes of celebrity endorsements, images associated with youth culture, and statements encouraging consumers to reclaim lost freedoms [ 61 ]. Importantly, today’s youth have never known mass marketing of a recreational nicotine product [ 31 ]. In 2014, the World Health Organization released a statement encouraging government bodies to restrict e-cigarette promotion and sponsorship, including ensuring that any advertisement does not target youth, non-smokers, or people not using nicotine [ 62 ]. However, because e-cigarettes are not currently regulated as tobacco products in the US, they are neither subject to clear nor comprehensive regulations.

Use of e-cigarettes in public places

Ethical concerns surrounding second-hand vaping stem from the unknown health effects of vaporized e-liquid in the presence of potentially vulnerable bystanders. Although e-cigarettes emit significantly fewer toxins than tobacco cigarettes [ 63 ], vaporized e-liquid produces ultrafine particles and volatile organic compounds, including nicotine, which are released into the surrounding air [ 64 ]. One study concluded that aerosolized ingredients contained in e-liquid should be of little concern to bystanders as their exposure is likely orders of magnitude lower than that of e-cigarette users and is unlikely to produce adverse health effects [ 54 ]. However, studies examining the cytotoxicity of e-liquid flavorings found toxicity to be greater in undifferentiated embryonic stem cells relative to human pulmonary fibroblasts [ 65 ], raising potential concerns about exposure risks for pregnant women [ 31 ]. Beyond any immediate emission concerns however, the ethical arguments surrounding second-hand vapor exposure are those that apply to tobacco cigarettes: exposure to e-cigarettes should not be imposed upon those who do not choose to use them, providing a strong argument for use restrictions in public places.

Renormalization of a smoking culture

E-cigarettes theoretically have the potential to subvert decades’ worth of anti-smoking efforts by renormalizing the act of public smoking and the visual presence of smoke-like vapor. This phenomenon could unintentionally encourage the acceptability and eventual uptake of tobacco cigarettes. However, the likelihood of such a phenomenon is difficult to assess and is premised upon e-cigarettes’ potential to act as a gateway to cigarette smoking. One possibility is that the increased conspicuousness of smoke-like vapor may sustain cigarette smoking among smokers who might otherwise have quit [ 66 ]. Conversely, the growing acceptability of e-cigarettes could increase pressure on current smokers to quit tobacco cigarettes by virtue of these becoming perceived as socially undesirable predecessors of a “cleaner,” smoke-free device. This question should be continuously revisited as the long-term implications of e-cigarette use become increasingly clear.

Market ownership

As cigarette companies have acquired the largest e-cigarette brands, they currently benefit from a dual market of smokers and e-cigarette users while simultaneously presenting themselves as agents of harm reduction [ 31 , 67 ]. This raises concerns about the appropriateness of endorsing a product that directly profits the tobacco industry. Importantly, profit alone is unlikely to increase their market share, particularly in the highly restrictive regulatory environment in which tobacco companies operate. In addition, the unequivocal refusal to associate with the tobacco industry which appears, if only for self-serving reasons, to support tobacco harm reduction [ 68 ], could unintentionally damage the credibility of the tobacco control community. Regardless of their industry ownership, e-cigarette companies would nevertheless have a vested interest in maximizing the number of long-term product users. The ethical onus then falls on governments to restrict the influence of industry through appropriate regulations targeting product manufacturing, availability, and use, devised in light of public health interests.

Directions for future research

There is an urgent need for data from high-quality RCTs to establish the efficacy and safety of e-cigarettes for smoking cessation and harm reduction. In addition, longitudinal studies are needed to monitor product awareness and use among various demographics and to further inform discussions concerning the potential of e-cigarettes as tools for tobacco harm reduction. We identified the primary research questions relevant to the ethical considerations of e-cigarette use for tobacco harm reduction (Table  1 ), the answers to which would clarify the major ambiguities concerning their optimal regulatory framework. Until such study data become available, governments have an ethical responsibility to enforce regulations to discourage product use among youth and to ensure that product restrictions are devised with public health goals in mind. Available evidence therefore supports the cautionary implementation of harm reduction interventions aimed at promoting e-cigarettes as attractive and competitive alternatives to cigarette smoking, while taking measures to protect vulnerable groups and individuals.

Ethical considerations surrounding the availability and use of e-cigarettes

Conclusions

In light of incomplete information concerning the safety and efficacy of e-cigarettes as smoking cessation aids, thresholds of reasonable risk must be established through a frequently revisited balance of probable benefits and harms with which they are associated. Their exponential growth in consumer markets has outpaced the development of an ethical framework with which to establish the appropriate conditions for their availability and use. Current evidence suggests that e-cigarettes have the potential to make significant public health gains through their role as tobacco harm reduction devices. In clinical practice, physicians have an ethical duty to provide their patients with evidence-based comparative risk assessments to allow them to make informed choices with respect to their smoking status. At its core, the objective of the smoking cessation agenda should be to improve population health, which will likely require some concessions in the form of harm reduction. This entails a willingness to negotiate the tensions between utilitarian and liberal ethics in designing policy that upholds autonomy while protecting broader public health interests. Although caution in this regard is requisite, caution alone should not obstruct the ethical imperative to explore the product’s potential further.

Funding for this project was provided by a grant from the Canadian Institutes of Health Research (CIHR; KRS-134302). Dr. Filion holds a CIHR New Investigator Award.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

CF developed the arguments and drafted the manuscript. KBF participated in the study design and development of the arguments. JK and RG provided important insights and contributions to the manuscript’s content. MJE conceived of the study and participated in its design and coordination. All authors critically reviewed the manuscript for important intellectual content and approved the final manuscript.

Essay on Smoking Cigarettes

Students are often asked to write an essay on Smoking Cigarettes in their schools and colleges. And if you’re also looking for the same, we have created 100-word, 250-word, and 500-word essays on the topic.

Let’s take a look…

100 Words Essay on Smoking Cigarettes

Harmful habit.

Smoking cigarettes is a dangerous habit that can lead to many health issues. The chemicals in cigarettes damage the lungs and heart, and they can also cause cancer.

Effects on the Lungs

Smoking cigarettes paralyzes the tiny hairs in the lungs that help to keep them clean. This makes it easier for tar and other harmful substances to build up in the lungs, which can lead to lung disease and cancer.

Effects on the Heart

Smoking cigarettes increases the risk of heart disease and stroke. The chemicals in cigarettes damage the blood vessels and make them more likely to form clots. Smoking also raises blood pressure and cholesterol levels, which are both risk factors for heart disease.

Effects on Cancer

Smoking cigarettes is the leading cause of preventable cancer deaths. The chemicals in cigarettes can damage DNA and cause cells to grow out of control. Smoking cigarettes increases the risk of cancer of the lungs, mouth, throat, esophagus, stomach, pancreas, kidney, and bladder.

250 Words Essay on Smoking Cigarettes

Smoking cigarettes: a harmful habit.

Smoking cigarettes is a habit that can have serious consequences for your health. Cigarettes contain harmful chemicals that can cause cancer, heart disease, and other health problems.

Smoking cigarettes is the leading cause of preventable cancer deaths. Cigarettes contain chemicals that can damage the DNA in your cells, which can lead to cancer. The chemicals in cigarettes can also cause inflammation, which is a risk factor for cancer.

Heart Disease

Smoking cigarettes increases your risk of heart disease. The chemicals in cigarettes can damage the blood vessels in your heart, which can lead to a heart attack or stroke. Smoking cigarettes can also raise your blood pressure and cholesterol levels, which are also risk factors for heart disease.

Other Health Problems

Smoking cigarettes can cause a variety of other health problems, including:

• Respiratory problems, such as asthma and bronchitis
• Gum disease and tooth decay
• Wrinkles and premature aging
• Erectile dysfunction
• Infertility

Quitting Smoking

If you smoke cigarettes, quitting is the best thing you can do for your health. Quitting smoking can reduce your risk of cancer, heart disease, and other health problems. It can also improve your appearance, energy levels, and overall quality of life.

There are many resources available to help you quit smoking. Talk to your doctor, pharmacist, or other healthcare provider. You can also find support and information online or through quit-smoking programs.

Smoking cigarettes is a harmful habit that can have serious consequences for your health. If you smoke, quitting is the best thing you can do for your health. There are many resources available to help you quit smoking.

500 Words Essay on Smoking Cigarettes

What are cigarettes.

Cigarettes are small, cylindrical objects made of tobacco leaves that are rolled in paper. They are lit at one end and smoked, with the smoke being inhaled into the lungs.

Why Do People Smoke?

There are many reasons why people start smoking cigarettes. Some people think it looks cool, while others believe it helps them to relax or concentrate. Still others may smoke because they are addicted to nicotine, a chemical found in tobacco that can make people feel good.

The Dangers of Smoking

Smoking cigarettes is a very dangerous habit. It can cause a number of health problems, including lung cancer, heart disease, and stroke. Smoking can also increase the risk of developing other diseases, such as COPD, emphysema, and bronchitis.

The Effects of Smoking on the Body

When you smoke a cigarette, the nicotine in the tobacco quickly enters your bloodstream. This can cause your heart rate and blood pressure to increase, and it can also make you feel lightheaded or dizzy. Smoking can also damage your lungs and other organs, and it can lead to a number of health problems.

If you smoke cigarettes, the best thing you can do for your health is to quit. Quitting smoking can be difficult, but it is possible. There are many resources available to help you quit, such as support groups, counseling, and medication.

Smoking cigarettes is a harmful habit that can lead to a number of health problems. If you smoke, the best thing you can do for your health is to quit. There are many resources available to help you quit, so there is no reason to continue smoking.

That’s it! I hope the essay helped you.

If you’re looking for more, here are essays on other interesting topics:

• Essay on Smoking Ban In Public Places
• Essay on Smoking Ban
• Essay on Smoking And Environment

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