Tobacco Control and Human Rights Before, During, and After COVID-19

Neil Sircar and Stella Aguinaga Bialous

The global COVID-19 pandemic has brought about significant disruption and trauma, and with it a rise in threats to human rights. UN Secretary-General Guterres remarked on April 23rd, 2020 that the pandemic was “fast becoming a human rights crisis” as nations grapple with detecting, preventing, and responding to overlapping social, economic, and health emergencies. The High Commissioner for Human Rights, Michele Bachelet, echoed these same fears on April 27th, 2020 stating that “Given the exceptional nature of the crisis, it is clear States need additional powers to cope. However, if the rule of law is not upheld, then the public health emergency risks becoming a human rights disaster, with negative effects that will long outlast the pandemic itself.”

COVID-19’s threat to human rights is not merely that individuals and communities experiencing vulnerability will be further marginalized in realizing their right to health. It also creates a risk that human rights violations may be simply ignored. The experience of Singapore, where a resurgence originated in crowded dormitories housing migrant construction workers, shows all communities must be included in public health measures from the beginning of any response protocol. Viruses do not discriminate and neither should public health measures. States must fulfill their human rights obligations to citizens and residents by avoiding a “toxic lockdown culture” that works to reinforce stigma and discrimination against communities.

Public health crises, like COVID-19, can act as an “essential warning system” in alerting government leaders at all levels to weaknesses in public services, health care delivery, social and welfare programs, as well as structural inequalities and inequities. COVID-19 is a poignant threat to communities who exist within lower social strata, experience financial insecurity, are detained or rendered homeless, are migrants or refugees. Along with women, children, and racial/ethnic minorities, these groups are a priority for tobacco control advocates and researchers, as they are disproportionately burdened by tobacco’s harmful effects and tobacco industry targeting.

Smoking and vaping are not only deleterious to human health but also place the consumer at greater risk for poor outcomes if infected with COVID-19. We do not yet know if COVID-19 has led to an increase (or decrease) in smoking prevalence and tobacco use. However, research indicates that smoking and tobacco use cessation may be impeded by perceived stress – and a global pandemic can certainly be a stressor. Additionally, adoption of “shelter-in-place” policies may carry the added risk of exposing vulnerable non-smokers, particularly children, to second-hand smoke, especially in the absence of well-implemented smoke-free indoor air laws with accompanying voluntary smoke free homes.

Smokers and vapers, though, are not malicious perpetrators of these harms. We do not put the onus on them to ensure human rights to health are protected, respected, promoted and fulfilled (though we do encourage all tobacco users to quit). But, we do note that the tobacco and vaping industry has sought to capitalize on the global crises, and governments have an obligation both under the Framework Convention for Tobacco Control and their own public health laws to promote community health over commercial interests. For many nations as well this is a core human rights obligation under several international human rights laws, most notably the Convention on the Rights of the Child. Children, youth and adolescents have a fundamental human right to health which includes a healthy environment. Strong tobacco measures are necessary to create such an environment. There is no human right to smoke or vape, and there is no priority as a matter of law or policy to be placed on smoking or vaping over another’s health.

As Hefler and Gartner noted recently, the tobacco epidemic has long preceded COVID-19 and stands to outlast it into the next global pandemic. The massive mobilization of resources to counter COVID-19, despite shortcomings, puts a dim light on the absence of such efforts with respect to the bigger and deadlier tobacco crisis. COVID-19 has exposed latent health inequities in many countries that rights-based approaches to health will help remedy. The drivers that sustain those inequities are similar to the forces that shape the tobacco epidemic and its related disparities. Post-pandemic, tobacco control will also benefit from a rights-based approach that serves to strengthen the realization of human rights for all persons. Like viruses, the risks and harms from tobacco use do not discriminate.

Neil Sircar is a human rights lawyer and postdoctoral scholar with the Center for Tobacco Control Research and Education at the University of California San Francisco, USA. Stella Aguinaga Bialous is an Associate Professor, Social Behavioral Sciences with the Center for Tobacco Control Research and Education at the University of California San Francisco, USA. The authors declare no conflicts of interest.

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