Graphic labels on cigarettes packages

Forcing cigarette companies to put graphic warning labels, including health warnings, pictures of diseased organs, and the 1-800-QUIT-NOW number, on cigarette packages, is a violation of the First Amendment, according to a recent and totally correct ruling by the DC Circuit (pdf).

You might wonder why this is so, since cigarette companies are already required to put warning labels on packs, while alcohol manufacturers have other warning labels, and all makers of packaged food are required to list ingredients, calories and so forth. The legal reasoning behind this regulation is that the government had a legitimate interest in making sure that consumers are accurately informed about the contents and risks of the food, beverages and cigarettes they consume.

Now, there is nothing in the Constitution restricting the ability of government agencies to campaign against smoking, taking the public stand that the risks of smoking outweigh its benefits. The libertarians among us might think that this is not a proper use of the power and money of the state, but the libertarians among us are often disappointed. However, the state still does not have the right to force any individual or company to express a certain opinion. The federal district court and DC Circuit agree that graphic labels and the QUIT NOW message go beyond informing consumers about health risks and amount to discouraging smoking. (In fact, the FDA made no secret of the fact that it hoped the labels would nudge people to quit.) This "ideological" message is one the government cannot force a company to send.

The Companies contend that, to the extent the graphic warnings go beyond the textual warnings to shame and repulse smokers and denigrate smoking as an antisocial act, the message is ideological and not informational. “[B]y effectively shouting well-understood information to consumers,” they explain, “FDA is communicating an ideological message, a point of view on how people should live their lives: that the risks from smoking outweigh the pleasure that smokers derive from it, and that smokers make bad personal decisions, and should stop smoking.”

No one doubts the government can promote smoking cessation programs; can use shock, shame, and moral opprobrium to discourage people from becoming smokers; and can use its taxing and regulatory authority to make smoking economically prohibitive and socially onerous. And the government can certainly require that consumers be fully informed about the dangers of hazardous products. But this case raises novel questions about the scope of the government’s authority to force the manufacturer of a product to go beyond making purely factual and accurate commercial disclosures and undermine its own economic interest—in this case, by making “every single pack of cigarettes in the country [a] mini billboard” for the government’s anti-smoking message.

The so-called "warning labels" are not really warning at all, the Court held, but propaganda. Some convey no relevant facts, and others might be deceptive: an image of someone smoking through a tracheotomy hole might give the inaccurate impression that a tracheotomy is a common result of smoking.

Many of the images do not convey any warning information at all, much less make an “accurate statement” about cigarettes. For example, the images of a woman crying, a small child, and the man wearing a T-shirt emblazoned with the words “I QUIT” do not offer any information about the health effects of smoking. And the “1-800-QUIT-NOW” number, when presented without any explanation about the services provided on the hotline, hardly sounds like an unbiased source of information. These inflammatory images and the provocatively-named hotline cannot rationally be viewed as pure attempts to convey information to consumers. They are unabashed attempts to evoke emotion (and perhaps embarrassment) and browbeat consumers into quitting.

I find myself saying, as often before, thank God for the First Amendment. Cigarette companies in other countries are already forced to use graphic "warning" labels. Now, if only we still had the Fourth, Fifth and Sixth Amendments...

Non-conformity is suspicious and dangerous

This seems like a point Phoebe would make/has made: encouraging people to be suspicious of strange behavior stigmatizes strange people, who are generally not terrorists. This has the effect of making social life harder for the very people for whom it is already hard! Just as so-called "behavioral analysis" at airports has the effect of making security screening harder and more traumatizing for people who are already uncomfortable and anxious about it.

The video tells viewers not to ignore their “instincts.” But do we have an instinct for detecting “sketchy” people or behavior? Given what we know about stereotyping and selective perception, the reality is that people will view behavior through their pre-existing beliefs. Their interpretations of behavior as unusual or inappropriate will be influenced by how comfortable they otherwise are with the person engaging in it, which is impacted by race/ethnicity, class, and many other social categories. A guy leaving a backpack unattended is scary if that guy has a mohawk or, you know, looks scary and stuff, but when I do it, no one bats an eye. This video basically legitimizes turning anyone who makes you at all uncomfortable in public in to the police, on the argument that you are simply following your “instinct.” When you ask every citizen to become an intelligence agent, reporting every incident they perceive as odd, the result is the increasing stigmatization and semi-criminalization of those who can’t or won’t conform to pretty narrow standards of physical appearance, dress, and behavior.

No judge and jury this time

Nothing doing. No judge and jury this time. Sometimes those trials drag on three weeks. Sometimes they even let the guy go because he’s innocent. But that isn’t going to happen this time. I’m going to get the killer, innocent or guilty, and when I do, I’m going to saw off his head, crack his ribs, jump on his neck, smash his Adam’s apple, beat in his nose, tear off his ears, pull out his hair, bend back his fingers, twist off his toenails, and shatter his kneecap. But before I do this I’m going to work him over with a rusty knife. I’m like that, Matt. I want a clean and decent America, a place where our kids can grow and sniff the good fresh air.

--Ira Wallach

Fat and class

The fact that the people at the gym are thin and the people at Walmart are fat does not show that going to the gym makes people thin or that Walmart makes people fat.

Poor people in America are fat and rich people are thin. The disgust the thin upper classes feel for the fat lower classes has nothing to do with mortality statistics, and everything to do with feelings of moral superiority engendered in thin people by the sight of fat people. Precisely because Americans are so repressed about class issues, the disgust the (relatively) poor engender in the (relatively) rich must be projected onto some other distinguishing characteristic. In 1853, an upper-class Englishman could be quite unself-conscious about the fact that the mere sight of the urban proletariat disgusted him. In 2003, any upper-class white American liberal would be horrified to imagine that the sight of, say, a lower-class Mexican-American woman going into a Walmart might somehow elicit feelings of disgust in his otherwise property sensitized soul. But the sight of a fat woman—make that an “obese” woman, better yet a “morbidly obese” woman going into Walmart, ah, that is something else again…the fact that this woman happens to be poor and non-white can be dismissed by those observers as an irrelevant coincidence.

--Paul Campos

Cornelius Gilliam

Just feeling like random quotes today.

Cornelius Gilliam, sheriff of Clay County, who had campaigned for sheriff with the slogan that he had shot more wolves than any other man in Missouri...ran the Mormons out of town.

The mother's fault

When a child dies, for whatever reason, people want to punish the mother.

In 1996, Kristin Bunch was 21, pregnant and living in a mobile home with her three year old. A sudden fire engulfed the trailer, killing her three year old. The police said it was arson and claimed she went into her son's bedroom, doused it with a liquid accelerant like kerosene or diesel fuel and set it on fire. She was charged and convicted of felony murder and arson and sentenced to 60 years in prison. Arson investigators testified at her trial that burn patterns indicated the fire was arson...There was no direct evidence at Bunch’s trial that she set multiple fires in the mobile home through use of an accelerant. No one saw her set the fire or heard her refer to setting the fire, there was no evidence she had purchased a liquid accelerant, and there was no motive offered for her to intentionally set a fire.

A similar example is the case of Hannah Overton. Her four-year-old foster son, who had physical and emotional problems and suffered from pica (according to the defense) died of salt poisoning after having consumed large amounts of salty seasoning from the pantry. But the prosecution decided that his foster mother had fed him the seasoning in order to punish him, despite the fact that there was no evidence that she had ever used such a bizarre punishment with her many other children, and that she had no record of child abuse or indeed any other criminal conduct. In this case, the prosecution practically admitted they were prosecuting her because of public feeling that when a child dies, someone has to be punished.

And this is only one of dozens of cases I've read about where mothers have been sent to prison for accidental fires, accidental poisonings, or medical conditions which caused the death of a child. Even when it is clear that a third party harmed a child, the mother is blamed. And yes, always the mother.

For instance, the disappearance of Madeline McCann, a small girl, from her English parents' room in Portugal. Still unsolved, but never any plausible theory that it was anything other than a stranger abduction. But the mother, Kate McCann, was vilified in the tabloids for having left her daughter alone in the room for a few minutes. The father did so too, but no one mentioned him. After the disappearance, the mother was stalked by paparazzi and stories were run criticizing her for such crimes as wearing earrings, brushing her hair or smiling. The fact that the mother had a prestigious job was used against her.

Or the Cleveland, Texas rape case, in which dozens of men raped an 11-year-old girl, and some of her neighbors suggested it was the mother's fault for letting her daughter out of the house.

But I think my point is clear. If your child dies, get a lawyer.

Buying healthcare is hard

I've been calling doctor's offices trying to find out the price for some relatively simple and common procedures. It's ridiculously difficult. For every three receptionists I talk to, one will act as if she has no idea what a price estimate even is. She'll offer me medical codes, but dollar amounts? You must be crazy.

Another will assume I must be uninsured, because why else would I care about the price? She'll tell me that actually they charge more for cash patients. Yes, thank you, for making it clear that you practice price discrimination which hurts the most disadvantaged patients.

Probably two will require me to laboriously explain that yes, I know the price I pay may not be the same as what they charge the insurance company.

Oh, and those price comparisons?

Procedure 1:
One office told me it would be $ 20-500 --and they refused to narrow it down any more than that.
Procedure 2:
At one office it was $70, at another $470.
Procedure 3:
I called three offices: one said $800, one $1200, and one $300. The one my primary care physician recommended was the most expensive.

I think this tells us something about why our healthcare system doesn't work.

Transsexuals

Fact is, most transsexuals agree there’s something wrong with them. The difference is they think it’s with their bodies, while unsympathetic outsiders say it’s with their heads.

Are transsexuals mentally ill? Pretty meaningless question, since there is no objective definition of mental illness. In a remarkably calm and even-handed column on a contentious topic, the author of the Straight Dope suggests that a condition which causes unhappiness in itself, rather than unhappiness as a result of social disapproval, should be considered a mental illness:

DSM-III dropped the old classification of homosexuality as a disorder because of the dawning realization that whatever gays and lesbians might be unhappy about, it wasn’t about being gay or lesbian as such — the main issue was social disapproval. In contrast, even with all the social acceptance in the world, transsexuals are still going to think they’re the wrong sex.

What ought to be measured, but has not yet been with sufficient validity, is whether sex reassignment surgery makes transsexuals happier (ideally I would think the surgery group should be compared, not only to a control group, but to a group of transsexuals getting cognitive-behavioral therapy intended to help them learn to get away from the obsessive thought of being in the wrong body.)

I know there's a certain amount of controversy over terminology here, but I don't care enough to figure out whether "transsexual" is considered the correct term. 

 

 
I highly doubt whether many people would even notice a transsexual in the locker room. But it would provide a great opportunity for unscrupulous men, wouldn't it?

I have not yet seen an explanation for why there seem to be so many more male-to-female transsexuals than the other way around. Is it because it's easier for women to wear male clothing without automatically being read as transsexual, so that they can indulge their genderbending urges without having to go all the way? Or is it that women are lower-status in our culture, so that pretending to be a male when you're not doesn't have the same transgressive edge as pretending to be female?

If you buy into the PC theories about transsexuality, you'd have to say that actually there are just as many female-to-male as the other kind, but for some reason they are not as willing to be open about it.

Questioning the conservative explanation for poverty

Bryan Caplan, the iconoclastic George Mason economist and author of Selfish Reasons to Have More Kids, is planning a book on poverty. Working title: Poverty: Who to Blame. I’m excited, but judging from his blog, he has some big blind spots when talking about poverty.

The basic truth conservatives start with, when talking about poverty, is that people who finish high school, do not commit crimes, do not have children before marriage, and find and hold a full-time minimum-wage job are very unlikely to be poor. This is true. Charles Karelis makes this point in his book, The Persistence of Poverty:

One 2003 simulation estimates that if all nonelderly and nondisabled heads of families with children worked full-time at their present wages, or at the wages they could earn based on their education and other factors, the fraction of the US population living below the poverty line would fall from 13 percent to 7.5 percent.

 

Caplan’s advice for poor women in particular is to refrain from childbearing until they find an eligible (stably employed, marriage-minded, nonabusive) man to marry. It sounds very simple. So what's the problem?

Here are some complicating questions I would expect the book to address:

1) Is it true that having children out of marriage hurts women’s economic prospects? Evidence from Kathryn Edin for one suggests that women who start out in the same economic place end up in the same place whether they become single teenage mothers or not.

2) Is it true, as he asserts, that poor people drink more and use more drugs? Actually, no. The consensus seems to be that alcohol use and income are positively correlated; richer people are more likely to drink and to drink more. Use of illegal drugs is correlated with poverty, but if Caplan thinks that substance use is one of the causes of poverty, he needs to explain why drugs and alcohol are so different here. They both cost money, carry health risks, and increase the risk of getting in trouble with the law. If the poor have lower impulse control, why are they better at controlling the impulse to drink?

3) What if there aren’t enough eligible men?

For women like me, it’s a no-brainer to wait a decade or more after puberty before having children. We know that there will be eligible men out there for us. If anything, the supply of men increases and improves over time: a 25-year-old college graduate has access to a greater variety and higher quality of men than a 15-year-old high school student.

Is this true for poor women living in poor neighborhoods? Isn’t it possible that the opposite is true for them: that the number of 18-year-old men who are marriage-minded, childless, without a criminal record and out of jail  is actually greater than the number of 25- to 30-year-olds who meet those requirements?

This is something of a speculative tangent, though. But it is true that there is a very high ratio of marriage-age women to marriage-age men in poor neighborhoods. Factor in the very high unemployment rates for young black men with no college degree, and the number of eligible men goes down further. 

Caplan rightly thinks preaching abstinence is unrealistic for most, and suggests contraception instead. But suggesting that women delay childbearing until they find an eligible man, even when this might take decades and might mean giving up the possibility of motherhood altogether, is almost as unrealistic.

4) What about the dangers of marriage? Caplan says that marriage is a good economic decision: two people living together spend less than two living apart. But it's not just about the money: what about the risk that the seemingly eligible man might lose his job, become abusive, or steal the woman’s money? Not to speak of the loss of independence.

5) What if finding full-time employment is impossible? Many minimum-wage employers deliberately avoid hiring full-time staff, because after that 40-hour-a-week threshold, they will be forced to provide more benefits. Anyone can get a job at McDonald’s, but getting 40 hours a week is a lot harder.

The largest liberal objection, of course, is that it shouldn’t matter who we blame for poverty. No one denies that the poor exist and are generally worse off than the rich. That, to me, means that they are entitled to a few of my superfluous dollars (which I probably would have spent on liquor anyway.)

Why object to the execution of the stupid?

The latest liberal outrage is the execution of a murderer, Marvin Wilson, who, according to his lawyers and one IQ test but not others, has an IQ of 61, below the threshold of 70 which Texas law takes as the minimum IQ needed to take responsibility for one’s actions.

For a while I was baffled, since many people seemed outraged by this without
 really saying why.  After some thought, I’ve decided this is not really about the death penalty.

Rather, it seems to me like a difference of opinion between those who believe judicial punishments exist to punish “guilt” (whatever that means) and those who believe the purpose of the judicial system is to protect law-abiding citizens.

If you fall into the former camp, then, if the criminal is too stupid to know what he was doing, if he is young, if he is uneducated, if he is poor, and so forth, his guilt is less. He should be punished either not at all or else the bare minimum amount. We should favor more humane prisons to promote rehabilitation. The death penalty should either not be used at all, since it precludes rehabilitation, or it should only be used for older, richer, more educated, and higher-IQ criminals (of which there are very few).

If you fall into the second camp, you will be inclined to say a murderer is a murderer is a danger to society. This danger should be eliminated regardless of hard-to-ascertain metaphysical “guilt”. The seriousness of the crime matters, but not the personal characteristics of the victim. If you favor more humane prisons, you will do so to decrease recidivism. You might favor the death penalty on grounds of efficiency, or you might oppose it because you think it does not deter.

Note, of course, that these two broad schools of thought are not correlated with opposing or supporting the death penalty. That’s a whole ‘nother issue involved in the Wilson case. I suspect that most people who think a low-IQ man should not be executed also think that no one should be executed–they focus on Wilson because he’s the easy propaganda case. (Just as most medical marijuana advocates favor legalizing all marijuana, but they focus on medical uses for the easy propaganda.)       

NB: Difference between rehabilitation and preventing recidivism. Preventing recidivism means ensuring that criminals do not reoffend–this might mean changing hearts and minds, or scaring criminals with the threat of more or worse punishment, or preventing their contact with other or worse criminals in prison, or keeping drugs off the streets, or improving economic opportunities for low-income men, and so forth. Rehabilitation focuses on changing the criminal’s personality, so that he will understand that crime is bad.

Talking about single women

Most societies fear, hate and suspect young women. Therefore, talking about young, unmarried women is linguistically problematic. This is true in several languages.

• It's especially clear  in French: garce, originally the feminine of garcon, came to mean 'slut', while garcon continued to mean simply 'boy'. After garce became contaminated, fille, the feminine of fils, came to be used. But soon fille fell victim to the same contamination. Finally jeune fille was expanded from its original meaning of 'young girl' and came to be applied to young woman, similar to the English 'girl'. Jeune personne (young person) is another euphemism used in the past to avoid facing the uncomfortable fact of a young woman.
• In English, the word 'woman' came to be used only to refer to lower-class women; the words 'lady', 'young lady' and 'girl' replaced it,and in the early 20th century English even borrowed the French 'young person' to mean an unmarried woman.
• In modern English,'lady' or 'young lady' is less often used, but the discomfort with the word 'woman' persists. A new development is the use of the word 'female', which is military and bureaucratic jargon as well as giving a helpful air of pseudo-scientificity to one's speech. When you are making unsupported allegations about the difference between men and women, it's a lot easier to call them 'males' and 'females'. It makes you sounds objective, like a farmer talking about his livestock. On the other hand, using the term 'woman/women' is so unusual it actually tends to make you sound like a feminist.
• In a Language Log post which is more comprehensive than I will do justice to, the same phenomenon is shown to appear in Chinese.
  

  
  When I started to learn Mandarin nearly half a century ago, it used to be that xiǎojiě 小姐 ("miss") was a polite way to refer to or address a young, unmarried woman. You could also extend xiǎojiě 小姐 ("miss", lit., "little elder sister") to convey other, related meanings, such as lǎo xiǎojiě 老小姐 ("old maid / miss"), xiǎojiě píqì 小姐脾气 ("petulant; flirtatious; coquettish"), and so forth. Gradually, however, xiǎojiě 小姐 ("miss") evolved to the point that it often came to be used in a jocular or facetious manner.  Furthermore, when used by itself, xiǎojiě 小姐 may be applied to prostitutes, so one must be careful when referring to someone with this word.  It seems that there is no longer a broadly accepted, relatively respectful term of address for a young, single woman.

New DSM addiction disorder criteria

Among the millions of people who will be diagnosed with an addictive disorder in the new DSM are many whose lives will be derailed by their substance use, leading to car accidents, suicide, brain damage, sexual trauma...The new criteria will allow clinicians to intervene at an earlier stage in the addiction cycle, when relatively brief and inexpensive treatments can prevent more serious problems from escalating. Psycho-education, psychotherapy and group support should be available for people who seek treatment early on. Who would argue that it’s better to wait until the substance use escalates before treatment can be initiated?

Who would argue against early intervention? I would. There are costs to substance abuse treatment: big financial ones, the cost of limiting people's autonomy, and the risks of teaching someone who may never (yet) have experienced addiction that he probably will get addicted and will be powerless to stop it. Not to mention teaching that if a person continues to use drugs or alcohol, he's no longer responsible for his behavior.

I mean, imagine a bunch of typical 20-year-old drinkers sent into AA. They probably fit the diagnostic criteria (since the definitions of "binge drinking" and "heavy drinking" keep being revised downwards!), but does anyone think that such drinkers would benefit from a treatment program? In fact, we know that most young people who use drugs or alcohol heavily will age out of such heavy use naturally. In most cases, no intervention is necessary: and treatment programs have a terrible record of success. To call for early intervention drug and alcohol treatment is like calling for surgery to treat the common cold. We know it doesn't work for most people, it's expensive, and it does serious harm to the people subjected, in many cases involuntarily, to treatment.

Oh, and ignore the first sentence. As my astute readers will have noted, horror stories are totally irrelevant when talking about early intervention. For every person who will have serious problems with a substance, there are hundreds who fit the criteria for early intervention but will never have serious problems.

Abominable women proposing marriage

The offer of herself by a woman to a man is, to us all, a thing so distasteful that we at once declare that the women must be abominable...But the man to whom the offer is made hardly sees the thing in the same light.

 --Trollope, The Eustace Diamonds

Barely 150 years since this sort of attitude was mainstream. And we already hear men complaining that women don't take enough initiative. They can't imagine any reason why a woman would be reluctant to make the first move.