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Should we ban women from smoking while pregnant?

 

In the U.K., a Labour plan has recently been in the news and stimulating some interesting debate – mainly about the over-regulation of smoking.

As can be seen on the BBC news website, Labour peers have “tabled an amendment to the Children and Families Bill detailing their proposal for England, which they said was about “protecting children”. Lord Hunt, who supports the motion, has stated

“Some Lords will argue a car is a private space and that we should not legislate for what happens within such a space. But there are more important principles than that… For one for me is the need for child protection. Unlike most adults, children lack the freedom to decide when and how to travel, they lack the authority most adults have to ask people not to smoke in their company. And in those circumstances I think it is right for Parliament to step in to protect children.”

Now, it is known than passive smoking does harm children. Exposure to second-hand smoke has been strongly linked to chest infections, asthma, ear problems and cot death in children.

It seems, however, that smoking while pregnant causes at least as many health problems – and in all likelihood, is even worse for the unborn child. Smoking while pregnant has been shown to increase the risk of miscarriage and stillbirth, increase likelihood of premature birth, increase the likelihood of babies being born underweight, increases the likelihood of cot death, increases the chance of the baby developing lung problems, and even is associated with longer term developmental learning problems.

Now, if the government perceives its role – as Lord Hunt does – as being a protector of children, why is it not proposing to make it illegal for mothers to smoke while pregnant? If Parliament should step in to protect children, why not protect unborn children?

It seems to me – and this is merely my own impression – that the reason this has not been seriously discussed, and will not be proposed, is that it links too strongly too abortion. That is, if the government starts protecting unborn children against the numerous negative effects of smoking by the mother, should then not also start protecting the rights of unborn children by limiting abortion? That is, if the government begins to protect an unborn child’s health from later health problems, it seems odd to then allow abortion – ending the child’s life.

Whether or not we agree that the government should step in to protect children from smoking, it seems contradictory to ban smoking in cars (where a child may spend some of their time, perhaps 1 or 2 hours a day), while allowing smoking while pregnant (where a child spends about 9 months in the womb).

This consistency is interesting, and I think this arises due to abortion and the general ‘pro-choice’ stance of the British government.

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10 Comment on this post

  1. Interesting, but is there room for a distinction between abortion and smoking while pregnant? One reason in favour of abortion is that aborting does not entail killing a person (as long as it’s performed at the beginning of the pregnancy); rather, one is killing a proto-person, e.g. an entity which, although it is not identical to a person because it lacks consciousness, will give rise to a person (= a person will emerge upon and from it). So aborting is not killing a person and therefore does not infringe any person’s right.

    But the same does not apply, it seems to me, to the case in question. As soon as smoking occurs beyond the “proto-person” threshold, the right that accrues to the child, which is now a person, kicks in and is immediately being infringed by the smoking mother.

    I suppose that, to a lesser extent, this would concern a smoking father as well.

    So my point is not that smoking during pregnancy should be made legally impermissible, but if were to be made impermissible, there would be a moral argument for it.

  2. In more rational times, before the anti-tobacco hysteria began in earnest, women who smoked continued to smoke and enjoy other normal pleasures of life without guilt during their pregnancies. Many even smoked during labor to help them relax and take the edge off their pain. If their doctors mentioned smoking at all, it would be to advise them to perhaps cut down if they were heavy smokers, something which most did intuitively because they didn’t “feel” like smoking as much.
    But pity the poor Bolton smoker today who becomes pregnant, because she will be told that if she continues to smoke at all (or have any alcohol or caffeine) during her pregnancy, she is putting her developing fetus at high risk of death or disability.

    Nothing could be further from the truth.

    Though there is considerable evidence showing that on average the babies of women who smoke during pregnancy weigh on average a few ounces less than babies of women who do not smoke and that the rate of low birthweight babies is somewhat higher for smokers, there is no credible evidence for the hyperbolic claims that the babies of smokers have a higher mobidity and mortality rate. Quite the contrary, the babies of women who smoke during pregnancy have a better survival rate ounce for ounce, a somewhat lower rate of congenital defects, a lower rate of Down’s syndrome, a lower rate of infant respiratory distress syndrome and a somewhat lower rate of childhood cancer than do the babies of non-smokers.

    Dr. Richard L. Naeye, a leading obstetrical researcher who studied more than 58,000 pregnancies, states unequivocally:

    “We recently found no significant association between maternal smoking and either stillbirths or neonatal deaths when information about the underlying disorders, obtained from placental examinations, was incorporated into the analyses. Similar analyses found no correlation between maternal smoking and preterm birth. The most frequent initiating causes of preterm birth, stillbirth, and neonatal death are acute chorioamnionitis, disorders that produce chronic low blood flow from the uterus to the placenta, and major congenital malformations. There is no credible evidence that cigarette smoking has a role in the genesis of any of these disorders.”

  3. About Kids in cars.
    They are using the wrong standard to compare the results to. The EPA standard is to be used for OUTSIDE ambient air quality and it is the average over a period of 3 years.

    The proper standard to compare to is the OSHA standard for indoor air quality for respirable particulate (not otherwise specified) for nuisance dusts and smoke. That standard is 5000 ug/m3 on a time-weighted average (8 hours a day, 5 days a week) and is intended to be protective of health over an average working life of 30 years!

    See my comments on the link below

    Michelle
    http://www.associatedcontent.com/article/366678/stanford_explores_health_risks_of_smoking.html?page=2

    This from Stanford university … again, with the windows opened, the results were just like a bar pre smoking ban …not a bad situation, at all. Particularly since bars pre ban were already using lots of air changes. Dave K

    Further, the EPA standard for ambient OUTSIDE air is NOT established for instantaneous readings or even readings averaged over 8 hours. The EPA standard for ambient OUTSIDE air is established for an average over 3 years! Why did the “scientists” at Stanford University choose the wrong standard to compare the results of the study to? Why did the “scientists” at Stanford University not provide a control sample of respirable particulates in cars WITHOUT smoking? Do they imaging that only respirable particulates from tobacco smoke are harmful? That particulate from ordinary vehicle exhaust are “vitamin-packed” and good for your health? To all smokers and their children. Congratulations! You are NOT part of the 640 % increase in the incidence of childhood asthma that has occurred in direct correlation with the decrease in the smoking rate of the general population! http://www.data-yard.net/30/asthma.htm To all others: Try getting a life instead of wasting your time, try.

    There is only one problem with this whole study! It ain’t science! The standard to which the particulate matter is being compared to is for outside ambient air. The EPA sets the quality standard for OUTSIDE air very high. Why? Well its because outside air is the mother of inside air! Fine respirable particulate in outside air cannot be easily vented from inside an enclosed space (like a home). It tends to accumulate and concentrate in inside air. The reasonable standard for INSIDE air quality is the standard established by OSHA for workplaces. This standard is for respirable particulate (not otherwise specified) and includes unspecified dusts and smoke. The standard for respirable particulate is a time-weighted average over a period of 8 hours. The standard for respirable particulate for inside air is 5000 ug/m3. Further, the EPA standard for ambient OUTSIDE air is NOT established for instantaneous readings or even readings averaged over 8 hours.

  4. Study: Babies’ low serotonin levels cause SIDS – USATODAY.comwww.usatoday.com/news/health/2010-02-03-sids03_st_N.htmCached – Similar
    You +1’d this publicly. Undo
    Feb 2, 2010 – Sudden infant death syndrome researchers say low serotonin may be what prevents infants from waking up when they inhale too much carbon …

    http://www.usatoday.com/news/health/2010-02-03-sids03_st_N.htm

    Researchers may have solved the mystery of what makes some babies vulnerable to sudden infant death syndrome, or SIDS, which kills more than 2,300 babies a year.
    Infants who died of SIDS had low levels of serotonin, a brain chemical that helps the brainstem regulate breathing, temperature, sleeping, waking and other automatic functions, according to an autopsy study in today’s Journal of the American Medical Association.

    Serotonin normally helps babies respond to high carbon-dioxide levels during sleep by helping them wake up and shift their head position to get fresh air, says senior author Hannah Kinney of Harvard Medical School and Children’s Hospital Boston.

  5. Study: Babies’ low serotonin levels cause SIDS – USATODAY.comwww.usatoday.com/news/health/2010-02-03-sids03_st_N.htmCached – Similar
    You +1’d this publicly. Undo
    Feb 2, 2010 – Sudden infant death syndrome researchers say low serotonin may be what prevents infants from waking up when they inhale too much carbon …

    http://www.usatoday.com/news/health/2010-02-03-sids03_st_N.htm

    Researchers may have solved the mystery of what makes some babies vulnerable to sudden infant death syndrome, or SIDS, which kills more than 2,300 babies a year.
    Infants who died of SIDS had low levels of serotonin, a brain chemical that helps the brainstem regulate breathing, temperature, sleeping, waking and other automatic functions, according to an autopsy study in today’s Journal of the American Medical Association.

    Serotonin normally helps babies respond to high carbon-dioxide levels during sleep by helping them wake up and shift their head position to get fresh air, says senior author Hannah Kinney of Harvard Medical School and Children’s Hospital Boston.

    ..

  6. I think if you regulate smoking in pregnant women, to be consistent, you would have to also limit bad foods, a sedentary lifestyle and other bad health habits. I think smoking cannot be singled out. So, the topic becomes about limiting freedom for a pregnant woman overall and what society’s role is in protecting unborn children. I think there are plenty of bad foods, legal medications, pesticides, legal substances like caffiene and diet pills, stress of incarceration from smoking violations, etc. to worry about in addition to smoking. How would enforcement work?

    On a practical level, seems like it would be difficult to legislate good health for a pregnant woman without causing undue stress that may be just as harmful….

    1. There would be an inconsistency if the medical case against bad foods during pregnancy was just as strong as the medical case against smoking during pregnancy. But this does not seem to be the case; rather, it seems that the medical case against excessive smoking of industrial cigarets (so just not any frequence of smoking and not any type of cigaret) during pregnancy is much stronger.

      It is true that it may be harder to set apart smoking from other potentially harmful activities — in part because such activities are usually held to be protected by the basic rights of the people, or be entailed by their basic liberties. However, whenever such an activity depends on a specific susbtance which is intrinsically harmful to one (i.e. mothers) and indirectly to others (i.e. babies), the fact that some of those who might be indirectly harmed are bearers of moral rights (i.e. babies with a consciousness), it might be permissible to ban that specific substance. At least, as long as that specific substance is no irreplaceable means for the satisfaction of fundamental interests of mothers.

  7. Well, Andrew, we could probably find studies to support claims that certain legal medications and other foods and things like diet soda could be just as dangerous as smoking to a developing fetus. I will not split hairs over that or worry about industrial vs. natural cigarettes. But, assuming you are correct, there is still a perplexing inconsistency of law regarding the fetus.

    How could we claim some kind of moral responsibility to fetuses while at the same time by law allowing the destruction of those fetuses? Seems radically inconsistent to me.

    On a practical level, since many women do not even appear pregnant until 4-6 months along, how would you possibly enforce this anyway? Would we peer into medical records and would the government be notified of positive pregnancy tests? Or would we just only enforce this on women who are obviously pregnant and smoking publicly?

    1. Dear Lori,

      You are certainly right that it is, in practice, difficult to say exactly when a fetus holds moral rights. The idea I was propounding, which is my no means original, is that a necessary a sufficient condition for holding a moral right that one is conscious (= that one is a subject of experience), and that fetuses are conscious beyond a certain stage in their development.

      I don’t think there is any inconsistency here; what makes things look as if there were an inconsistency is the fact that we use the same word, “fetus”, somtimes to refer to an entity that lacks consciousness (hence have no moral right), and sometimes to refer to an entity that has consciousness hence possesses moral rights.

      My point was simply that banning women from smoking could be justifed on the ground that smoking harms possessors of moral rights, ie. fetuses beyond a certain stage in their development.

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