The FCTC and the Psychology of Tobacco Control

Abstract

The Framework Convention on Tobacco Control (FCTC) is a promising public health accomplishment, but its emphasis on top-down, command-and-control approaches to tobacco control puts this promise at risk. The World Health Organization’s “Guidelines for Implementation” of the FCTC prescribe restrictive regulation of artistic speech, contributions to popular culture, and even political speech, as well as constraints on promotion of tobacco products. This intrusiveness fails to take account much of what we know, from research in psychology and the neurosciences, about what prompts people to engage in risky behaviors and what empowers them to exercise restraint. The Guidelines (and the FCTC) start from the premise that people smoke either because they become “addicted” (rendering personal choice impossible) or because they fail to comprehend tobacco’s dangers. But recent findings about the workings of the mind suggest a different story, a story of risky behavior (including smoking, unhealthy eating, and unsafe sex) as the product of competition between aspects of the self – between systems of perception and motivation that drive indulgence and restraint. We argue in this Essay that the WHO, in its “Guidelines”, should pursue anti-smoking strategies that support individuals’ self-restraint, rather than merely suppressing tobacco use in a coercive fashion. Alliances between governments and myriad actors that shape social and cultural norms and influence people’s behavior, along with funding for research into the psychological determinants of tobacco use, will prove critical to this approach. Crude coercion, on the other hand, risks cultural backlash and even embrace of smoking as a way to express independence and rebellion.