Rhys turned up something interesting:
Moral Theater vs The Mentally Ill
The limits of the war on smoking
Pennsylvania has decided that unless you are willing to quit smoking for the duration of your treatment, you don’t deserve mental health treatment from the state
The author goes on:
This health decision is not related to treatment of the condition for which they sought help—better mental health can be achieved without quitting. The policy is not even a result of mission creep. It is seeking a new mission at the expense of the existing one.
People receiving help for addiction or mental illness are not props in a morality play. If it’s in their interest to tackle tobacco along with their other issues, then they should be encouraged to do so. But treatment cannot and should not be contingent on doing something people find extraordinarily difficult, even in optimal mental health.
Instead of seeing mental health treatment as another opportunity to modify undesired behavior, the state should focus on treating the urgent and important reasons why the patients are there.
I suppose that Tobacco Control is – and must be – solely concerned with tobacco, and with nothing else whatsoever, and that wherever it gains a foothold it will always be concerned only with stopping people smoking, and with nothing else whatsoever. And that’s why, when it takes over a new host, it gives it a new mission.
So it’s possible to imagine that if Tobacco Control were to become dominant in, say, Mediterranean holiday cruises, it would become a condition incumbent on all holiday-makers to quit smoking for the duration of their holiday in Sardinia or Greece or wherever. Equally, if Tobacco Control were to become dominant in insurance services, all insurances policies would include a condition that the insured quit smoking for the duration of their insurance. Want to borrow a book from your local library? No trouble, as long as you stop smoking for the duration that you borrow a book. And so on, as the single-minded war on smoking extends to new fields.
There was a useful word in 19th century psychiatry: monomania.
In 19th-century psychiatry, monomania (from Greek monos, one, and mania, meaning “madness” or “frenzy”) was a form of partial insanity conceived as single pathological preoccupation in an otherwise sound mind.
Tobacco Control is inherently monomaniacal: it has a single pathological preoccupation. And the antismoking zealots in Tobacco Control exhibit precisely this sort of partial insanity. They’re seemingly quite normal, except when it comes to tobacco. And they regard tobacco as far worse than anything else. The eradication of smoking has consequently become their sole aim in life. Nothing else matters.
Antismoking monomania might, however, just be one example of several modern varieties of monomania. A strong belief in the danger of Global Warming, and an accompanying fear of carbon dioxide, might also qualify as a form of monomania. And so might a pathological hatred of Donald Trump qualify as a form of monomania (Democrats in the House of Representatives immediately initiated impeachment proceedings against him).
Perhaps all these forms of monomania eventually get recognised as such, and the monomaniacs gradually get weeded out. They remain largely harmless, until large numbers of people become afflicted with the disorder.