A proposed tobacco endgame, banning cigarettes for people born after a certain year, only makes sense if the government also plans to ban cannabis smoking, according to the doctors’ association.

“In isolation, phasing in the banning of cigarette smoking makes sense. But only if this also comes with banning the smoking of cannabis. We have a government actively promoting cannabis and this is extremely contradictory,” said Martin Balzan, a respiratory physician who heads the Malta Medical Association.

He stressed that cigarettes and cannabis were both very harmful to people’s health. Cigarette smoking resulted in more long-term physical diseases such as cancers, heart disease and strokes.

Cannabis was linked with frequent, serious mental health problems and it was proven to impact the brain development in young people, he said.

We have a government actively promoting cannabis and this is extremely contradictory- Respiratory physician Martin Balzan

On Monday, the government proposed initiating discussions to ban cigarette sales to people born after a certain date, effectively creating the first smoke-free generation.

The measure was proposed in a public consultation document, the Children’s Policy Framework, by the Social Policy and Children’s Rights Ministry. It was among 198 measures proposed as part of the government’s vision to improve child well-being for the next six years.

Last month, the UK government said it will ban cigarette sales to those born on or after January 1, 2009. The UK followed in New Zealand’s footsteps – which introduced a very similar anti-smoking bill last year – as part of the government’s wider effort to make the country smoke free by 2025.

'Banning smoking in all public spaces a first natural step'

Balzan said that the first natural step for Malta would be banning smoking in all public spaces. At the moment, smoking outdoors is still allowed. The government also never increased the tax on cigarettes, he said.

PN health spokesperson Stephen Spiteri said the endgame concept was worth exploring as he supported anything that would reduce smoking. Smoking not only had a negative impact on the health of smokers but also had socio-economic repercussions, he said. Yet, like Balzan, he too found it contradictory that this was being suggested after the smoking of marijuana was legalised – as both had adverse health impacts.

They were referring to the decriminalisation of cannabis introduced two years ago. The law allows adults to legally carry up to 7g of homegrown cannabis without the risk of arrest or confiscation.

Commissioner for Children Antoinette Vassallo welcomed any measure to reduce smoking.

“The aim of this measure is to improve the health of present and future generations… At the moment, it is illegal to sell or to provide children with tobacco products. I can, therefore, only emphasise strict enforcement and increased educational programmes for children and adults.”

What about the right to choose?

But would this breach human rights in a way? Shouldn’t everyone have the right to choose whether or not to smoke?

According to a human rights lawyer, Therese Comodini Cachia, it would not violate future smokers’ rights as the government would be protecting citizens from a harmful, addictive substance.

She explained that the European Court of Human Rights and other national human rights courts have, over the years, looked at smoking cases on individual levels. Examples include human rights violations claimed by non-smoking inmates surrounded by smokers in prison and persons committed to hospitals being prohibited from smoking.

“Though the courts have, at times, come to different conclusions in the individual cases, the judgments appear to agree that there is no right to smoke,” she said, adding that banning smoking from a generation onwards can be done without it amounting to an unjustified interference in the exercise of human rights.

To frame a behaviour that is highly destructive to oneself and others as ‘social and cultural development’ is a fragile argument at best- Human rights lawyer Therese Comodini Cachia

The ban has a legitimate aim, that of prohibiting the use of a harmful substance in the public interest. The law needs to be clear and precise and a clear case that a ban is a proportionate means of achieving that aim needs to be established by reference to scientific, social and economic studies.

She referred to an article published in National Library of Medicine which concluded that a tobacco-free generation proposal is “compatible with human rights principles. It supports some fundamental rights, including the rights to life, health and a clean environment, and does not unduly violate the rights to liberty, self-determination, privacy or equality”.

The article noted that governments are duty-bound to protect citizens’ health and this includes protecting children and non-smokers from harmful second-hand smoke and protecting adolescents from being lured into smoking through peer pressure and developing a nicotine addiction.

But what about the right to individual liberty? The human right to liberty is defined as the right to freely pursue economic, social and cultural development.

“To frame a behaviour that is highly destructive to oneself and others as ‘social and cultural development’ is a fragile argument at best… Tobacco-related illnesses and deaths have adverse socio-economic consequences for families, communities, healthcare systems and public resources, while second-hand smoke can affect children and non-smokers… In addition, given the addictive properties of tobacco, it can be suggested that smoking is incompatible with the notion of ‘liberty’, as the addict is not entirely free to choose whether to continue smoking or not… Tobacco phase-out would thus be consistent with the way in which other hazardous, addictive substances are regulated.”