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Profiles in Prohibitionism: Thomas Farley

New York's government is likely to continue the attempt to engineer public health behavior.

That's not just because incoming Democrat Bill de Blasio, despite disagreement with outgoing Republican Michael Bloomberg on many issues, has vowed to uphold his health-police ordinances. There is another figure, a Bloomberg appointee who will stay on after the administration departs, who has masterminded many elements of the city's project of governmental health control that bears Bloomberg's imprimatur.

Thomas Farley was brought to New York (from a Community Health professorship at Tulane in New Orleans) as the city health commissioner in 2009, when his predecessor Thomas Frieden was appointed by Obama to head the Center for Disease Control in Atlanta. During the early years of the Bloomberg administration, Frieden had already cooperated with the mayor to lay the groundwork for a plan to legislate healthy eating habits. With Frieden's departure, Farley, whose 2005 book Prescription for a Healthy Nation (co-authored with Deborah Cohen) had proposed a similar project, was a natural choice, despite Bloomberg's rejoinder that the key factor was that monogram office towels would not have to be changed. What must be changed in Farley's opinion, according to a 2010 writeup in the New York Times, is "the entire cultural landscape... to make bad choices harder and good choices easier, even if the change has to be engineered and legislated." Diet has been the primary focus, along with smoking bans.

Most of the opposition to to the Frieden-Bloomberg-Farley health-police project, outside of the predictable outcries from manufacturers of unhealthy foodstuffs and smokeables, has come from opponents of intrusive government. Libertarians claim that people have a right to make bad choices. That is a debate that is not likely to be resolved soon, indeed ever. Opposing points of view on that subject are held rather unflinchingly by their respective proponents.

The public use ban for e-cigarettes is different in kind, since the difference of opinion is not about politics but about psychology; it's about motivational strategy toward an end that everybody outside of Big Tobacco boardrooms pretty much agrees on: reducing smoking-related mortality. And prohibitionists, let's face it, don't do psychology very well.

Farley claims to be enamored of behaviorism, the school of motivational theory that shapes behavior by a subtle manipulation of carrot and stick. But the e-cig ban is all stick, having banned the carrot.

If we look over the arguments against e-cigarettes, they all embody predictions about behavior based on psychological surmises:

Vaping will re-normalize the act of smoking in public places.

Vaping will glamorize smoking.

Vaping will be mistaken for smoking by restaurant managers and so forth. Vaping will be a gateway to smoking, especially among the young.

Vaping will not help people quit smoking (despite the conviction of many thousands of ex-smokers that it is indeed helping them).

All of these are psychological projections based on guesses. How many illustrations do we need of the fact that prohibitionists are not good at psychology, and that prohibition is a terrible motivational strategy (US Prohibition of alcohol 1920-1930 and the crime wave it precipitated, the War on Drugs that swelled prisons and didn't reduce drug use, sexual abstinence training to reduce teen pregnancy, centuries of censorship in Russia and all over that made banned works intensely popular, the list could go on and on).

Maybe New York's health department should worry less about changing the entire cultural landscape, and take a tip from Psychology 101 about adding the carrot back into the equation, instead of just the stick.