Government needs to take an ethical stand on the issue of tobacco control, thereby falling in line with the public administrators, public health advocates, and other public servants who support the passage of excise tax legislation and local ordinances that go beyond state preemption clean indoor air policy. That the excise tax will generate medical and economic benefits is unquestionable. In a similar vein, stronger local smoking bans to reduce levels of environmental tobacco smoke (ETS) will undoubtedly carry significant import for healthier work and leisure environments. What remains dubious is the degree to which the public can count on government support of anti-tobacco initiatives. A theory of administrative accountability is a significant part of assessing an issue that has ethical as well as medical and economic ramifications. This paper outlines the historical and current challenges facing public servants as they wager public health for regional economy.
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