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未成年人、道德心理学与减少伤害之争:以烟草和尼古丁为例。

Minors, Moral Psychology, and the Harm Reduction Debate: The Case of Tobacco and Nicotine.

机构信息

University at Buffalo, The State University of New York.

出版信息

J Health Polit Policy Law. 2017 Dec;42(6):1099-1112. doi: 10.1215/03616878-4193642. Epub 2017 Aug 11.

Abstract

Harm reduction debates are important in health policy. Although it has been established that morality affects policy, this article proposes that perspectives from moral psychology help to explain the challenges of developing evidence-based policy on prohibition-only versus tobacco/nicotine harm reduction for minors. Protecting youth from tobacco is critical, especially since tobacco/nicotine products are legal for adults, who usually begin using when young. Although cigarettes and other combustibles are the deadliest tobacco products, other products such as smokeless tobacco and electronic cigarettes, though unsafe, are upward of 90 percent less harmful than cigarettes. at contaminating the "purity" of youth, especially "good," low-risk youth, with any tobacco/nicotine products opposes harm reduction, as does for violating so-called community values and disrespecting authority. Support for harm reduction arises from at failing to provide reduced harm to "bad," high-risk individuals and denying them the "liberty" to decide. Fast-thinking, moral-emotional intuitions are supported by rationalizations arising from slow-thinking processes. The recognition of such moral psychological influences and the efforts to minimize their impact may help lead to amelioration and compromise. This example from tobacco control, with divided concerns for low-risk and high-risk youth, can be applied to other harm reduction versus prohibition-only policies directed at minors.

摘要

减少伤害的争论在卫生政策中很重要。虽然已经确定道德会影响政策,但本文提出,从道德心理学的角度来看,有助于解释仅禁止与烟草/尼古丁减少未成年人伤害的证据为基础的政策发展所面临的挑战。保护青少年免受烟草危害至关重要,特别是因为烟草/尼古丁产品对成年人来说是合法的,而成年人通常在年轻时就开始使用。尽管香烟和其他燃烧烟草制品是最致命的烟草制品,但其他产品,如无烟烟草和电子烟,虽然不安全,但比香烟的危害小 90%以上。将任何烟草/尼古丁产品污染青少年的“纯洁性”,特别是“好”、低风险的青少年,与减少伤害相悖,因为这违反了所谓的社区价值观,不尊重权威。支持减少伤害的原因是未能为“坏”、高风险的个人提供减少伤害,并剥夺他们“自由”来决定。快速思考、道德情感直觉得到慢思考过程中产生的合理化的支持。认识到这种道德心理影响,并努力将其影响降到最低,可能有助于改善和妥协。这一来自烟草控制的例子,涉及对低风险和高风险青少年的不同关注,可以应用于针对未成年人的其他减少伤害与仅禁止的政策。

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