Contemporary public health advocacy promotes a ‘fifth wave of public health’: a ‘cultural’ shift wherein the public's health becomes recognized as a common good, to be realized through concerted developments in the institutional, social, and physical environments. With reference to examples from anti‐tobacco policy, in this article I critically examine the fifth‐wave agenda in England. I explore it as an approach that, in the face of liberal individualism, works through a ‘long‐game’ method of progressive social change. Given the political context, and a predominant concern with narrow understandings of legal coercion, I explain how efforts are made to apply what are presented as less ethically contentious framings of regulatory methods, such as are provided by ‘libertarian paternalism’ (‘nudge theory’). I argue that these fail as measures of legitimacy for long‐game regulation: the philosophical foundations of public health laws require a greater – and more obviously contestable, but also more ambitious – critical depth.

中文翻译：

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无烟？公共卫生政策，强制性家长式统治和长期博弈的伦理

当代的公共卫生倡导促进了“公共卫生的第五次浪潮”：一种“文化”转变，在这种转变中，公共卫生被公认是一种共同的利益，需要通过制度，社会和自然环境的协调发展来实现。参考反烟草政策中的例子，在本文中，我将对英国的第五次浪潮议程进行严格审查。我将其作为一种面对自由主义个人主义的方法，通过渐进式社会变革的“长期博弈”方法进行研究。考虑到政治背景以及对法律强制性的狭narrow理解的主要关注，我解释了如何努力应用那些在伦理上较少引起争议的监管方法框架，例如“自由主义家长式”（“推论”）所提供的框架。 ）。