Last week’s tobacco control meeting in Cape Town, South Africa, the World Conference on Tobacco or [sic] Health, produced many awful communications, some of which were previously reported. Probably the worst was an official statement adopted at the meeting entitled, “Cape Town Declaration on Human Rights and a Tobacco-free World.” With this, a lobbying enterprise whose efforts are entirely about denying people’s choices tries to claim the mantle of human rights. The document is so Orwellian that it comes close to literally saying “freedom is slavery.”
The thesis of the declaration is, “We agree that the manufacture, marketing and sale of tobacco is incompatible with the human right to health.” That line alone would be a good exam question in an undergraduate ethics class, asking students to identify the fundamental flaws. First, it is comically absurd to suggest there is a right to health, whether derived from human rights principles or some other foundation. Health is not a dichotomy, such that someone either has it or not. It exists to varying degrees and along various dimensions. Exactly what levels of which conditions must be met before this supposed right is fulfilled?
The fundamental problem is that health is an outcome, something that might be considered as part of a consequentialist ethic (one that judges actions based on their consequences), but cannot be included in a rights-based ethic. A right is a rule limiting or demanding particular acts, a limitation on what other people can do to someone or a requirement about what they must do for someone. By definition, it is not about the outcome. It is thus complete nonsense to refer to a right to health. Consider the question of whether this “right” is violated when someone is born with a genetic disease or suffers the effects of having lived ninety years. If so, who violated it?
If we move beyond that and pretend that the tobacco controllers made some vague claim about health and rights that was not immediate nonsense, there are still fundamental problems. This is where it becomes Orwellian. It widely argued that human rights demand people have access to healthcare, adequate nutrition and other inputs into better health. But notice the key word, “access.” Near the top of the hierarchy of human rights is the right to sovereignty over your own body. It is the preeminent right of modern health ethics, central to every major statement on the topic for the last 70 years. There is a good case to be made it ranks second on the list of all human rights, just behind freedom of thought.
Everyone may have a right to access healthcare. But if medical treatment is forced on someone who does not want it (and is able to make decisions — i.e., not a young child or mentally incompetent), it is the greatest of rights violations. Everyone has the right to choose to not smoke and to not use any low-risk form of tobacco. But imposing such an option is equivalent to imposing medical care on someone, a clear violation of the most fundamental of rights. To suggest that people have the “right” to be denied an choice about their own bodies is utterly twisted, even by the low standard of tobacco control.
The declaration goes on to invoke “the right to protect public health.” This is no better defined than the “right to health.” Additionally, though it is phrased as a genuine right (“no one can take actions to prevent you from protecting public health”), it is clearly not actually a right by any measure. In a free society, someone can choose to exercise their rights of free association and free speech to advocate for whatever they think “protect public health” is supposed to mean. But any opportunity to take action as a result of that advocacy is not a right, but a political decision. It is worth pointing out that the Orwellian “Declaration of Human Rights,” and tobacco control policy more generally, seek to deny to people those same fundamental rights to free association and speech.
Later in the document, the authors try to make these claims more concrete. In so doing, they make their Orwellian nature clearer.
We further agree that the manufacture, marketing and sale of tobacco is incompatible with other human rights obligations States have accepted by ratifying the FCTC and various global and regional human rights treaties, as well as under their own constitutions, in particular the rights to life; to health, including safe and healthy working conditions; children’s rights, including protection of children in tobacco production and from advertising; and women’s rights, including protection from the impact of smoking on pregnancy.
Ratifying the Framework Convention on Tobacco Control treaty (which, incidentally, the U.S. has not done) in no way creates any rights or any obligations to protect rights. Some treaties impose obligations that protect human rights, but this is simply not the case with FCTC. That treaty is entirely about taking away rights, including punishing people for making particular choices about their own bodies, and prohibiting free speech and association. The whole purpose of most laws and treaties is to prohibit particular actions (taking away what someone would otherwise have the right to do), because this supposedly supports some a greater good (the consequentialist assessment says we are better off with the rule in place). Sometimes this “greater good” includes involves protecting the rights of some other party (e.g., prohibiting piracy), but FCTC does not. There is literally nothing in it that creates human rights obligations.
As already noted, it is perverse to claim there is a “right” to have a choice taken away. The “right to life” is catchy sloganeering (see, e.g., the U.S. Declaration of Independence), but it is meaningless and clearly incorrect for the same reasons there cannot be a right to health. The bit about being insulated from advertising is another Orwellian non-right. There is a human right to obtain information if you want (and ignore it if you do not), so this actively violates human rights.
It is widely accepted that workers have rights to particular working conditions, though there are often also valid arguments to the contrary (e.g., if production costs were any higher the local economy would collapse and everyone would be worse off). But if poor working conditions in a production process justified eliminating the product category, everyone would starve (except for those who froze first). Obviously fixing bad working conditions is a legitimate goal, but does not justify tobacco control, who in any case do not genuinely seem to care about workers.
With the reference to women’s rights, the tobacco controllers turn up their Orwell game still further. Who is smoking during pregnancy? Individual women, obviously, not society, industry or the tobacco itself. So this “right” is actually an restriction on the choices of pregnant women and any woman who might become pregnant (since prenatal exposures are most harmful during the early pregnancy, often before the pregnancy is recognized). Some people believe that a woman loses sovereignty over her own body when she is (or might be) pregnant, and they would punish her for using drugs or other potentially damaging behaviors, or for having an abortion. But such views are not exactly considered to be supportive of women’s rights. It is likely that almost every WCTOH delegate from Western countries believes that being able to choose abortion is a right. So they insist a woman can choose to terminate the pregnancy, but they endorsed a statement that would forbid to her a choice that merely slightly increases the chance of a bad birth outcome. Worse, they justify this restriction based on some perverted notion of women’s rights.
Some of this may sound like technicalities, but it is difficult to overstate just how harmful trifling with the notion of human rights — by an influential international lobby group and in the context of a global treaty — is. Even if their cause were good, this would be inexcusable.
The notion of universal human rights is one of the greatest humanitarian accomplishments of living memory. Still, for literally billions of people, those rights are denied or threatened. Quite often this involves governments that feel free to concoct perverse alternative definitions of “human rights” to suit their political agenda. This declaration — affirmed and presumably motivated by delegates from Western democracies — makes that easier.
Tobacco control inflicts a lot of collateral damage. They make public health science look like a total joke, but that is rather deserved. They undermine the credibility of government health advice, but that has some upsides. It is beyond the pale even for them, however, to send the message that “human rights” is a concept that anyone can just redefine to fit their petty political agenda. It is bad enough that tobacco control is a fundamental threat to of human rights, and that they “honor” the likes of Duterte and Mugabe. It is worse that they cloak themselves in the mantle of human rights while doing that. But it is worse still that they are willing to damage the fragile fabric of human rights protections in pursuit of one special-interest goal.