H/T Dick Puddlecote for this article from Boston University school of public health:
Paternalistic measures are employed in public health because public health wants a compliant population, not an informed one. When accurate labeling does not “work,” advocates move on to more coercive measures. Cigarettes have been appropriately labeled with increasingly dire warnings. The warnings have evolved from informing smokers that cigarettes “may cause cancer” to current warnings that say “cigarettes kill” and cause a variety of serious diseases and conditions. If we wished to have an informed smoking population, we would measure what smokers know about the risks of smoking. But success in labeling is not measured by what smokers know about the risks. Success is determined by the number of people who stop, or do not start, smoking. The goal is to control behavior and have people do what we think is best for them.
When informed people make choices we do not like, we increase the pressure on them to be compliant. We move from written warnings on cigarette packs, which inform, to grotesque (and misleading) pictures on cigarette packs that are meant to disgust. Or we ban smoking in parks, although there is no health justification for doing so. Recognizing that it was not possible to make a supportable argument that secondhand smoke presents a risk to non-smokers in parks, Thomas Farley, the New York City commissioner of health at the time, said that children should not be allowed to see people smoking. This is an example of the extent to which public health advocates go to deny that their acts are paternalistic and to pretend that their actions are designed to protect others. Obviously the reason Farley wants smoking bans in parks is because it give smokers less opportunity to smoke—to protect them from their “foolish” choices.
The only loser in the end is going to be Public Health. If it currently still enjoys considerable public trust, it’s because the predecessors of its current practitioners slowly built up that trust over a long period of time. The current practitioners are now busily squandering that carefully accumulated trust. One day they’re going to find that they’ve lost the trust of the public, and they won’t know how to win it back.
It’s exactly like a family business which slowly accumulates a considerable fortune over several generations, only for a spendthrift son to inherit the fortune and blow the whole lot on horses.
Public Health seems to think that it enjoys public trust as some sort of natural right that comes automatically with the job. But there exists no such natural right. It has to be earned. And once earned it needs to be continually maintained. But no-one in Public Health seems to understand this right now. Although they all will in the end.