What Our Campaign against Smoking Can Teach Us about Our Attitude toward the Unvaccinated

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In thinking about the current controversy between the vaccinated and unvaccinated, who have emerged as America’s latest special-interest identity groups, it might profit to think about the history of the conflict between smokers and non-smokers. Smokers are not precisely analogous to the unvaccinated but there are important similarities. Smoking and COVID-19 are associated with severe respiratory illness. Both can harm the general public: second-hand smoke with smoking, and the easy passing of the coronavirus unless mitigated by mask-wearing and social distancing. It is the fact that the general public can be harmed that generated our response to the unvaccinated and to smokers. Non-smokers have always existed even when cigarette smoking was the rage in the United States, but the unvaccinated only became an identifiable group with the creation of the COVID vaccine. Before that, all of us were unvaccinated and it was, thus, not a mark of distinction but rather, shall we say, an aspect of the human condition. We were all equal then, as the risk seemed completely uncontained. Non-smokers became a politicized group, a recognized activist and grievance community, with the rise of the anti-smoking movement in the 1960s when the health problems associated with cigarette smoking were undeniable and when the tobacco industry was discovered to have been suppressing the truth about its product.

(Smokers, in their defense, have said that claims about the dangers of second-hand smoke were exaggerated. This is not true. Even secondhand marijuana smoke is dangerous. They have also argued that smoking does not impair the smoker the way drinking alcohol impairs the drinker or taking illegal recreational drugs impairs the addict or thrill-seeker. Cigarette smoking does not diminish judgment or reflexes. It does not make a person high. They argue that alcohol and illegal drugs have caused far more damage to society and have wrecked many more lives than cigarette smoking has. Any doctor who has worked in an emergency room will tell you that these assertions are true.)

Of course, the obvious difference is that smoking is, for lack of a better term, a lifestyle choice, although the idea of choice is complicated by both the addictive nature of smoking and the idea that cigarette companies “seduced” the young to smoke through advertising and popular culture, especially movies where movie stars used to smoke like chimneys. This is why the first ban against smoking was prohibiting the advertising of cigarettes. COVID, on the other hand, is an illness that no one chooses to have but rather endures as an affliction that is an act of God. No one merits or deserves to have COVID; that is, no one does who observes the rules which should govern our behavior in this crisis, which now includes getting vaccinated. What complicates COVID with the coming of the vaccine is the idea that getting it is now, well, semi-voluntary; that one’s behavior can determine if one gets the illness or, more reasonably, greatly contribute to one’s chances of getting it. (Echoes of AIDS.) This belief was prominent, to a considerable degree, before the vaccine but has become more pronounced with the vaccine. In other words, COVID is a choice of sorts, just as smoking is a choice of sorts. One is a choice that is seen as a psychological compulsion that needs treatment and the other is an illness that can be reasonably avoided if one follows the proper protocols. Our responses to smoking and COVID are not so much “based on science” but more on the idea that those who “follow the science” are virtuous and those who do not are not. Why would anyone choose to smoke these days, considering the consequences? And why would anyone not get vaccinated, considering the consequences? These are reasonable questions but they are also conventional views, even bourgeois views, some might say. Why does anyone flaunt danger to his or her health? It could be asked, on the other hand, why are people so fixated on safety in a world that will not accommodate us well in providing it? All of this seems a larger story about modern society grappling with its anxieties over publicly rebellious political behavior, breaking taboos, and the role of therapeutics in governing our lives, all of which seem like epidemics that we cannot in any way control. COVID has coalesced these anxieties. It is easy to say that Trump is the cause of all of this, but anyone who knows U.S. history knows Trump is not the origin of America’s war with itself.

Over the years, our response to cigarette smoking became increasingly severe. Once, smokers could light up anywhere. Then, in only designated places, such as little glass sheds in various spots in the airport or in their private offices. There were once smoking sections in restaurants. Smokers can now hardly smoke anywhere in public unless it is on a street corner. There is no smoking in any public building except casinos. Most hotels have banned it. Even outdoor sports arenas will not allow it. In fact, many rental apartments discriminate against smokers. Smoking is disapproved of as a public act. We treat smokers as if they are lepers. Discrimination against them is not only accepted but approved. It has had the desired effect: since 1965 smoking has decreased dramatically but it has not been eliminated and still roughly 14 percent of us are smokers, that is, about 34 million Americans smoke, a not-insignificant number. But there are two things that the government did not do in changing public behavior in regard to smoking: the government did not ban the sale of cigarettes and the government did not force people to be treated for their cigarette addiction.

Treating the unvaccinated as we treat smokers may produce favorable results: fewer COVID infections. But there is a cost to our society in treating them as lepers and feeling ourselves to be superior to them in further polarizing ourselves, in generating the very thing that the liberals claim they do not want: more inequality. But no one, apparently, has abandoned the belief that there is a righteous inequality or a deserved inequality that must be obtained or that should be enforced against the people we do not approve of and whom we think a danger.

Perhaps we should isolate the unvaccinated, if that is possible, discriminate against them, thoroughly shame them in ways that we would find abhorrent if we were to treat other groups similarly because they are a danger to the wellbeing of society. The ultimate question is: Should people be forced to take a vaccine against their will? Here is where the comparison to smoking breaks down. Most of us feel that smoking is not the same level of threat as being unvaccinated is. So, we are not greatly in favor of forcing smokers to be treated for their addiction against their will but much more so about forcing people legally or applying the utmost pressure to make them take a vaccine against their will. But in a democratic society, should people be forced to submit to medical treatment or therapeutics against their will? That is a real question about the meaning of freedom.