Mapping the Role of Basic Rights in the Hungarian Tobacco Control: Who should be protected? By Winne Ko Submitted to Central European University Department of Political Science In Partial fulfilment of the requirements for the degree of Master of Arts Supervisor: Professor Judit Sándor Professor János Kis CEU eTD Collection Budapest, Hungary (2011) Abstracts This thesis examines the role of basic rights in the Hungarian tobacco control policy which will be effective in January 2012. The author argues that in spite of the importance of the right to health advocated in this context by non-smokers, other actors’ rights should also be protected in the process of lawmaking. The research attempts to identify the various claims of rights which are at stake with the forthcoming ban and explore the possible conflicts arise from the legal policy. Four basic rights are at the core of the discussion: the right to health, the right to health care, privacy right and the right to information. Interviews were conducted with three groups of stakeholders (healthcare workers, the public and catering businesses) to connect the legal framework of rights and the empirical relevance. Opinion collected is analysed in relation to the different notions of rights. Further scenarios of special category of non-smokers (children, women and workers) are presented with respect to violations of their rights. The thesis concludes with a discussion on the limitations of the sole reliance on legal policy as an instrument for tobacco control and calls for a combination of interventions and respecting individuals’ rights. CEU eTD Collection i Acknowledgement The completion of this thesis would not be made possible without the immense support I gained from different people throughout the short period of time. The project first emerged as a personal response to passive smoking in the city of Budapest. I would first thank my supervisors, Professor Judit Sándor and Professor János Kis. Professor Sándor offered me with encouragement and constantly brought in new inspirations for the entire course. Professor Kis helped me on clarifying a lot of the philosophical concepts. I would also like to dedicate my gratitude to my academic writing instructor, Dr. Eszter Timar who never refused to read and re-read my manuscripts and gave me valuable feedbacks. The responses collected from every interviewee are indispensable. Among the professionals are Dr. Péter Józan, Dr. Robert Úrban, Professor Amanda Amos, Mr. Neil E. Collishaw, Ms. Becky Freeman, Professor Geoffrey Fong and others. Opinion received from the local Hungarians is another central part of the thesis. They include Csaba, Fruzsina, Andi, Martin and Agota. I am very grateful for all the help I obtained from day one until the last moment of the thesis. I had learned a lot about the topic and the country as well along finishing the thesis. Lastly, a big thank you to all my friends and family who have accompanied me through all the ups and downs. CEU eTD Collection ii Table of Contents Abstracts ................................................................................................................................ i Acknowledgement................................................................................................................. ii Table of Contents................................................................................................................. iii List of Figures, Tables or Illustration ....................................................................................v List of Abbreviations.............................................................................................................vi Introduction...........................................................................................................................1 Legislative Tools of Tobacco Control.....................................................................................2 Attempts of tobacco control in Hungary ...............................................................................3 Research Question ....................................................................................................................6 Chapter 1-Theory, Methodology and Data.............................................................................6 1.1 Theoretical Framework .......................................................................................................7 1.1.1 Right to Health................................................................................................................................. 7 1.1.2 Conflicts of rights............................................................................................................................. 9 1.1.3 State and rights............................................................................................................................... 11 1.1.4 Enforcement of Legislations of rights ............................................................................................. 12 1.1.5 Paternalism .................................................................................................................................... 13 1.2 Summary..............................................................................................................................15 1.3 Methods, Collection of Sources and Processing ........................................................16 1.4 Limitations...........................................................................................................................17 Chapter 2 – Analysis of Interviews ......................................................................................19 2.1 State and Smokers’ rights ................................................................................................19 2.1.1 State and Smokers who comply with the law................................................................................... 32 2.1.2 State and Smokers who refuse to comply with the laws................................................................... 34 2.2 State and the Non-Smokers’ rights.................................................................................37 2.2.1 Special Categories of Non-smokers ................................................................................................ 43 2.2.1.1 Children................................................................................................................................... 43 2.2.1.2 Women .................................................................................................................................... 46 2.2.1.3 Workers................................................................................................................................... 49 CEU eTD Collection 2.3 Smokers, Non-smokers and Who Else?........................................................................51 Chapter 3 - Discussion.........................................................................................................55 3.1 Limits of the Legal Approach................................................................................................55 3.1.1 Sensitivity to Smokers’ Socio-economic Status ............................................................................... 55 3.1.2 Social Support in Smoking Ban ...................................................................................................... 56 3.1.3 Focus on Primary Prevention.......................................................................................................... 58 iii 3.1.4 Enforcement................................................................................................................................... 59 Chapter 4: Conclusion.........................................................................................................61 Appendices...........................................................................................................................63 Appendix A: Interview Transcripts.......................................................................................63 Interviews conducted in Budapest, Hungary............................................................................................ 63 Appendix B: Written Comments Collected.......................................................................104 Glossary.............................................................................................................................110 Bibliography ...................................................................................................................... 111 CEU eTD Collection iv List of Figures, Tables or Illustration Figure 1: Total Cigarette Consumption in Hungary (1960-2004) Table 1: Smoking Prevalence of Hungarians (2000-2009) Table 2: Proportion of Smokers and Quitters in the Visegrad Group in 2008 CEU eTD Collection v List of Abbreviations ETS – Environmental Tobacco Smoke FCTC - Framework Convention on Tobacco Control GP - General Practitioner HUF - Hungarian Forint (currency) ICCPR - International Covenant on Civil and Political Rights ICESCR - International Covenant on Economic, Social and Cultural Rights NRT - Nicotine Replacement Therapy OEP- Országos Egészségbiztosítási Pénztár (National Healthcare Fund) SHS - Secondhand Smoke UDHK - Universal Declaration of Human Rights VAT - Value-added tax VOC – Volatile Organic Compounds WHO - World Health Organization CEU eTD Collection vi Introduction This thesis