What was once a concern about public goods has transformed into a social crusade with a political agenda.
http://object.cato.org/sites/cato.org/files/serials/files/regulation/2015/9/regulation-v38n3-4.pdf
This is a viewpoint of the 'big picture' of "public health" from a non-collectivist viewpoint. While there is a passage regarding ecigarettes (see below), it discusses the history and some of the philosophy of 'public health' from it's early concerns with actual 'public goods' to the paternalism of today. Not so much concerned with the safety of goods but rather a prescription for certain behaviors or lifestyles that the 'experts' in public health consider safe, or that promote public health. Long, but substantive and points to many of the things discussed here....
"Until late in the 19th century, public health
was by and large concerned with what
economists call “public goods.” ...National defense
is the most common example: it’s hard for an army to protect
only certain homes that pay a private “defense fee.” Similarly,
basic sanitation and controlling epidemics of infectious diseases
or antibiotic resistance may be examples of public goods because
they benefit everyone’s health once they are available."
Most of us would have little problem if that is what 'public health' was today.
"Public health, however, has always been tempted by authoritarian
drifts. In the 19th and early 20th century, “public hygiene”
became “racial hygiene” and “social hygiene.” A parallel development
was the eugenics movement, which aimed at preventing
people who were deemed “unfit” from passing on their genetic
defects—and sometimes simply eliminating those people altogether.
In America, both public health and eugenics flourished during
the Progressive Era. Although the two movements were not
identical, they had many similarities and shared promoters. The
founder of the U.S. Food and Drug Administration, Harvey Wiley,
figured among the supporters of a Chicago surgeon who, in the
late 1910s, “permitted or hastened the deaths of at least six infants
he diagnosed as eugenically defective,” according to University of
Michigan historian Martin Pernick."
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"Public health now encompasses noncommunicable diseases
and “lifestyle epidemics,” such as the use of tobacco and alcohol,
as well as obesity—matters that are very far removed from public
goods concerns. Also included are many conditions or forms of
behavior, such as riding a motorcycle, driving a car, owning firearms,
engaging in “substance abuse,” having imperfect access to
medical care, being poor, and so forth. Public health means health
care and everything that is related to health writ large. (my emphasis)
Moreover, “social justice” has become an essential feature of
public health: “Social justice,” writes Turnock, “is the foundation
of public health.”"
Social justice - perhaps, but it's a stretch. Individual justice - nope.
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"tobacco consumers cannot want something that
carries only costs (the purchase price of tobacco products plus the
health risks), so tobacco use must have some benefit as judged by
the consumers themselves. It won’t do for public health advocates
to respond simply that smoker demand arises from addiction, not
desire for pleasure; many smokers stop smoking and half of nonsmokers
are former smokers—so “tobacco addiction” isn’t destiny.
Moreover, everything one likes is difficult to abandon, but that
doesn’t mean people are addicted to everything they like." (original emphasis)
This aspect - the assumption of 'no benefit' (which has been brought up by Conley and Phillips?) - points to why smoking still persists, despite all the 'danger' promoted by our public health officials, and why ecigarettes lessen those dangers but will still be demand regardless of regulation.
"Another argument, at one time overexploited by the antismoking
movement, is that the consumer is incompetent at
maximizing his utility because he lacks information about the
risks of tobacco use. This line of argument was abandoned when
researchers discovered that consumers generally overestimate the
health risk of smoking. Moreover, nobody would seem more
motivated than the individual himself in obtaining optimal
information (considering the cost of information) about the
choices that affect his own life.
"Yet an individual probably remains in the best position to make choices
regarding his own life, if only because anybody else—including
politicians and bureaucrats—is subject to the same cognitive
limitations.
"In practice, public health experts and activists resemble Plato’s
philosopher kings. They reign, subsidized, in universities and
government health institutions, ostensibly knowing what is
good for society and willing to impose it by force."
This is what almost every thread here exemplifies.
The ecig citation:
"Slippery slopes are another implication. Some people don’t
believe in slippery slopes, often because they don’t understand the
logic of institutions. Government intervention calls for more intervention.
Consumers become more and more dependent on coercive
organizations like the FDA. The whole process creates and feeds
a constituency of subsidized public health experts who will make
sure that more bans and regulations are requested and enacted. A
good example is the current push for banning electronic cigarettes.
Even from the point of view of medical science, such a ban appears
about as scientific as smoking bans for parks and beaches.
Interestingly, public health itself can be seen as the product of
a slippery political slope. It is barely enumerated powers that have
allowed the federal government to enter this field. Since “health”
is not mentioned a single time in the U.S. Constitution, the federal
government’s intervention in public health has been justified by
citing the general welfare and commerce clauses."
