Thursday, November 27, 2014

U.S. and China: Public Health in the Shadow of the First Amendment

 Americans with rare exception tout freedom of speech as a virtue of the highest order.  Communists are lambasted for putting the collective over the individual.  But when a corporation is treated as an person - as the United States Supreme Court does - the results may be less than admirable.

Thus as the call to a recent Yale conference puts it public health now labors under the shadow of the First Amendment:
The regulation of food, medicines, and tobacco all rely crucially today on the regulation of speech, for example through behavioral marketing, disclosures, and restrictions on certain modes of commercial promotion.  First Amendment doctrine has recently changed in significant ways, bringing it into potentially deep tension with such measures.  For example, commercial speech doctrine has been used to invalidate FDA restrictions on off-label marketing of drugs, to prevent graphic warnings on cigarette packages, and to challenge calorie disclosures in restaurants.

In China on the other hand the State Council (the highest decision-making body of the state) has announced that it intends to ban all tobacco advertising and sponsorships, and to ban smoking in public places except in designated smoking areas. 
But this is not a decree.  Rather it has been offered for review and discussion.  When proffered as legislation there will be a public comment period, which could yield amendment or phase-in as the public health education campaign proceeds.  Below is my rough translation:
  据 国务院 法制 办公室 网站 消息 , 卫生 计生委 日前 起草了 《 公共 场所 控制  吸烟 条例 ( 送审 稿 )》( 以下 简称 送审 稿 ), 向 社会 公开 征求 意见 。 送   审 稿 明确 , 全面 禁止 所有 的 烟草 广告 、 促销 和 赞助 。 

A news release on the website of the State Council Office of Legislative Affairs says the National Health and Family Planning Commission recently drafted "Public places - control  of tobacco smoking regulations (tentative draft)"  for public discussion.  The draft specifies comprehensive prohibition of  all tobacco advertising, sales promotion and sponsorship. 

  送审 稿 要求 , 所有 室内 公共 场所 一律 禁止 吸烟 。 此外 , 体育 、 健身 场 馆 的 室外 观众 坐席 、 赛场 区域 ; 公共 交通 工具 的 室外 等候 区域 等 也 全面 禁  止吸烟 。The draft requires - prohibit  smoking   in all indoor public places.   In addition, athletic facilities, gyms and outdoor stadiums,  playing fields; at public transportation outdoor waiting areas smoking is also completely prohibited.

   送审 稿 规定 , 风景 名胜区 、 文物 保护 单位 、 公园 、 游乐园 等 一些 公共  场所 的 室外 区域 可以 设立 吸烟 点 , 吸烟 点 以外 的 区域 禁止 吸烟 。 没有 设立  吸烟 点 的 公共 场所 室外 区域 属于 全面 禁止 吸烟 的 场所 。
The draft specifies that scenic areas, cultural heritage sites, parks, amusement parks, etc. and certain  other outdoor public areas could designate smoking areas, outside those areas smoking would be prohibited.  In all other public areas not designated as smoking areas  tobacco smoking is forbidden.
   送审 稿 明确 , 禁止 吸烟 场所 ( 区域 ) 的 经营者 、 管理者 在 禁止 吸烟 场所 ( 区域 ) 不得 放置 烟具 和 设置 烟草 广告 。 对 违法 吸烟 行为 予以 劝阻 , 对 不听 劝  阻 的 要求 其 离开 。 对 不听 劝阻 且不 离开 的 , 向 有关 监督 管理 部门 举报 ; 对  不听 劝阻 并 扰乱 公共 秩序 的 , 向 公安 机关 报案 。
The draft states, in a posted non-smoking area a business operator  or manager of a non-smoking area must not provide smoking paraphernalia or set up  a tobacco advertisement. One who  despite demand unlawfully smokes  must leave the area. If a person after demand does not leave the area it shall be reported to the supervising authority; such refusal offends public order, and is a matter for the police. 

 I am sure that the state council is confident that - unlike the U.S. where a conservative federal circuit court held found graphic cigarette pack warnings violate tobacco companies' free speech rights - once enacted into law no Chinese court will order a retraction of  such a public health measure.  So in this regard which is more democratic - the U.S. or the `nanny state'P.RC.?

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