There are complex legal and ethical tradeoffs involved in
using intensified regulation to bring smoking prevalence
to near-zero levels. The authors explore these tradeoffs
through a lens of health justice, paying particular
attention to the potential impact on vulnerable
populations. The ethical tradeoffs explored include the
charge that heavy regulation is paternalistic; the
potentially regressive impact of heavily taxing a product
consumed disproportionately by the poor; the simple loss
of enjoyment to heavily addicted smokers; the health
risks posed by, for example, regulating nicotine content
in cigarettes—where doing so leads to increased
consumption. Turning to legalistic concerns, the authors
explore whether endgame strategies constitute a form of
‘regulatory taking’; whether endgame strategies can be
squared with global trade/investment laws; whether free
speech rights are infringed by aggressive restrictions on
the advertisement and marketing of cigarettes.