According to a news article in this week's BMJ, scientists from the German Cancer Research Centre in Heidelberg are calling for a ban on tobacco product additives because they may increase the risk of cancer and may enhance the likelihood of nicotine addiction. The article explains that cigarette additives may be used for a variety of ends, including: (1) improving the taste of cigarettes, and thereby making them more palatable for young smokers; (2) increasing the addictive strength of nicotine within cigarettes; and (3) allowing smokers to take deeper puffs, and thus inhale a greater amount of carcinogenic and toxic substances.
The Rest of the Story
The folly that characterizes the absurd regulatory approach for which U.S. public health organizations (such as the Campaign for Tobacco-Free Kids, American Cancer Society, American Heart Association, and American Lung Association) are lobbying is apparently not restricted to this country. While this cancer research center is calling for the removal of additives from cigarettes, it does not appear to be expressing any particular urgency regarding the addictive and carcinogenic potential of the cigarette itself.
This is the public health paradigm at its worst: regulate the ingredients that are added to the cigarettes, but not the addictive and carcinogenic constituents of the cigarette smoke itself. In other words, the baseline toxic qualities of tobacco products are viewed as being acceptable from the standpoint of societal policy, but not so for anything added to the products. As I pointed out with the FDA tobacco legislation now before Congress, health groups are supporting a bill that bans flavorings added to cigarettes, but does not require FDA to do anything about "naturally" present carcinogens and toxins. And the bill requires notification to consumers of any adverse health effects of substances added to cigarettes, but not of any health risks due to constituents "ordinarily present" in the product.
The underlying senselessness of federal regulation of tobacco products is that the product is inherently toxic, addictive, and carcinogenic. It is not the additives and flavorings that are responsible for the addictive, toxic, and carcinogenic effects. It is the cigarette itself. And setting performance standards to eliminate a few of the offenders is not going to address the problem. Nor is banning cigarette additives.
At this point, one may ask: Am I calling for the banning of tobacco products, or for continuation of the status quo regarding these products? The answer is: Neither.
Banning tobacco products altogether is not an acceptable option, especially based on this country's experience with prohibition of alcohol.
Neither is the status quo. However, arguing against FDA regulation of tobacco products as proposed by Philip Morris and the Campaign for Tobacco-Free Kids is not equivalent to arguing for the status quo (as suggested by the Campaign in a March 21 communication to individual tobacco control advocates). Far from it.
Those of us who are attempting to point out the irrationality of the FDA legislation are actually calling for major changes in the practice of tobacco control in this country. Most importantly, we are suggesting that the persistent, relentless, and probably futile efforts of our national organizations that are devoting substantial resources to this cause should be shifted to areas for which there is evidence of an effect on the public's health.
We agree that the status quo - with the most prominent national tobacco control organization making federal regulation a goal beyond all goals, in the context of a Congress that has almost never enacted effective tobacco control legislation and is certainly not going to start now - is completely unacceptable. We know what works in tobacco control - and that's where our resources should be directed.