In an article published recently by Kristin Billera of the United Press International, the president-elect of the American Medical Association (AMA) called low-tar cigarettes a huge hoax, arguing that cigarettes with lower tar yields are no safer than those with high tar yields.
According to the article: "Health advocates such as Dr. Ron Davis, president-elect of the American Medical Association, support its [the FDA tobacco legislation] passage. 'Passage of this legislation will end the cruel irony that cigarettes are the most important preventable cause of death and disease in the United States and one of the least regulated products in our society,' Davis said. Smoking causes 400,000 premature deaths each year, and lung cancer is the most fatal form of the disease. ... Selig [spokesperson for the American Cancer Society] is concerned that women in particular may be 'sucked in by a very misleading campaign' for products labeled 'light' or 'low-tar.' Lung-cancer numbers in U.S. women have remained steady, perhaps partially due to women switching from regular cigarettes to ones that are labeled as less harmful -- claims invalidated by the tobacco industry, she said. Most health officials agree that smoking 'low-tar' or 'low-nicotine' cigarettes are not any less hazardous than regular cigarettes, Davis said: 'It's like jumping out of the twenty-second floor of a building instead of the twenty-fourth.'"
The Rest of the Story
If the American Medical Association truly believes that low-tar yield cigarettes are no safer than high-tar yield cigarettes (and is like jumping out the 22nd floor instead of the 24th floor of a building), then what in the world is it doing supporting legislation whose basic regulatory framework is to require companies to produce lower-tar cigarettes?
Not only will smokers be jumping out of the 22nd floor of buildings, according to the AMA, but they will be doing so thinking that it is safer, by virtue of the fact that the FDA will be stringently regulating cigarettes and that the product will have an FDA stamp of approval.
It seems to me that something is awry here in the AMA's reasoning. If it is true that reducing the tar yield in cigarettes does nothing to make them safer, then why would we as physicians support legislation that asks the FDA to lower the tar yields of cigarettes? And why would we suggest to the public that by doing so, it will improve the safety of this product and save lives?
There is something magical in the thinking of the AMA. When the tobacco companies voluntarily reduce the tar yields of their cigarettes, they are not safer and there is no public health value. In fact, even calling the cigarettes lighter represents fraud.
But when the FDA requires tobacco companies to reduce their tar yields, the cigarettes are magically safer, lives will be saved, there is public health value to this approach, and there is no fraud committed on consumers by misleading them into thinking that a reduced tar yield implies a safer cigarette.
Moreover, the AMA and the ACS seem very concerned that smokers will be "sucked in by a very misleading campaign" that leads them to believe that there is some health value in low-tar cigarettes. Well if that is the case, then can you imagine how misled smokers will be when they are informed that cigarettes are strictly regulated by the FDA and the FDA has now approved the products they are using.
Smokers are going to assume that the product is safer. Who wouldn't, knowing that the FDA now strictly regulates them?
The tobacco companies are going to have an absolute field day with this. I would just love to be in the public relations department of Philip Morris after this bill passes. In fact, I already have some great statements that the company could make:
"Marlboro cigarettes are subject to strict regulation by the Food and Drug Administration. The ingredients, additives, and constituents of every cigarette are disclosed to the FDA and are approved by the FDA prior to being brought to you - our customers. We strictly adhere to FDA guidelines regarding the manufacturing process and constituents of the Marlboro product."
"Philip Morris is proud to be in full compliance with the Food and Drug Administration's regulations, which required a reduction in levels of a number of constituents in Marlboro cigarettes. We are happy to be in full compliance with the FDA regulations and to offer a cigarette that meets all FDA specifications. Together with the FDA, we are proud to be concerned about the health of our customers."
"Merit cigarettes, like all Philip Morris products, comply with all regulations established by the United States Food and Drug Administration. The FDA was given the authority to regulate our products in a way that, according to the largest national anti-smoking group, would "save countless lives." We are proud to be the only tobacco company to gladly submit to these regulations. We believe that saving countless lives is an admirable goal, and we are happy to be playing our part."
"Just as the Food and Drug Administration regulates the safety and effectiveness of all foods and drugs used by the public, the FDA now also approves cigarette products prior to their being made available to the public. You can now rest assured that the FDA has been apprised of every single one of the constituents in our products, and that the FDA has approved each and every one of them. No cigarette product is made available to you - our customers - without first having been officially approved by the FDA."
"Philip Morris is proud to be a long-time supporter of legislation that according to our fiercest opponents will "end special protection for the tobacco industry and protect our children and the nation's health instead." Ending special protections for our industry and protecting the health of our nation's children has long been a priority goal for Philip Morris. The legislation that we have championed will, according to our fiercest opponents, "save countless lives and improve health for generations to come by reducing tobacco use and its devastating consequences, which include cancer, heart disease, chronic obstructive pulmonary disease (COPD) and diseases that affect virtually every organ in the human body." We are glad to play our role in reducing cancer, reducing heart disease, reducing lung disease, and helping to reduce diseases that affect virtually every organ in the human body. We truly care not only about our customers, but about every organ in their body."
"Like every major national public health group, Philip Morris supports this legislation, that according to these groups, will 'protect our children, improve the nation’s health and save countless lives.' Saving countless lives is what Philip Morris is all about. We stand ready to do anything and everything that the FDA asks of us in order to save countless lives of Americans. We understand that some other tobacco companies have opposed this legislation. We, however, believe that the protection of our children and the nation's health and the effort to save countless lives should be a corporate priority, even if we will sacrifice profits due to our principled stand. We look forward to working with the FDA, and we are prepared to take any and all steps that the Agency asks of us in order to make our products safer."
"Marlboro, like all of our products, has been approved for sale and distribution in the United States by the Food and Drug Administration. The FDA has been provided with a comprehensive list of the constituents of this product and has given its approval for each of these constituents at the levels at which they exist in this package. The FDA has been directed by Congress to make its approval of our product based on consideration of what is "appropriate for the protection of the public's health." We are proud to be in full compliance with the FDA regulations. If you have any comments on our products, or any suggestions on how to make them safer, please write the Commissioner of the Food and Drug Administration."
There is little I have less tolerance for than speaking out of both sides of one's mouth. Here, the AMA is telling us that low-tar products are no safer than high-tar products, but that by requiring low-tar products, we can produce a safer product and save countless lives.
Which is it?
The rest of the story is that you can add the AMA to the list of anti-smoking and health organizations that are supporting what amounts to a transfer of the low-tar fraud from the cigarette companies to the government.