Between Utilitarianism and Autonomy: Criminalisation of Smoking and Tobacco Products in Bhutan

Tobacco consumption is one of the main causes of noncommunicable diseases and ultimately premature deaths. Bhutan's 2010 Tobacco Control Act proscribes the sale and production of tobacco products in alignment with the WHO Framework Convention on Tobacco Control (FCTC) in an effort to tackle health risks associated to tobacco use. Despite being among the first nations to ratify the FCTC and outlaw tobacco sales, the Act resulted in the contentious imprisonment of a monk for possessing tobacco valued at USD 2.50. Amendments made in 2014 upheld punitive measures against tobacco users, but the COVID-19 pandemic and growing illicit trade were the catalysts for a temporary overturning of the law in 2020. Improving public health responses requires finding a middle ground between promoting public health initiatives and protecting individual autonomy - a balance that can be achieved through the decriminalisation of tobacco product usage.