What is the special case of public health ethics in the area of heavy use over time of addictive products?

There is robust evidence for the high level of population harm caused by heavy use of addictive products (Shield and Rehm, 2015). These harms span health and social dimensions and clearly warrant attention, with the intent to reduce the resulting costs to society and individual human suffering brought about by their HUOT.

Yet there are several features of HUOT that makes it stand out among other public health issues and complicate the application of ethical codes to the regulation of this behaviour at the population level. These characteristics are summarized in Box 3.2:

Box 3.2 Characteristics of heavy use over time which influence ethical considerations

  • ? HUOT is one of several lifestyle choices.
  • ? Because of concurrent intoxication, HUOT has been the subject of extreme levels of social control.
  • ? Because of compulsive nature of the behaviour, HUOT has a parallel impact on individual freedom of choice.
  • ? Economic returns on the sales of addictive products result in a high degree of influence from the corporate sector in policy to address HUOT.

These characteristics, although interlinked, will be dealt with in the subsequent sections.

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