A report recently released by the Campaign for Tobacco-Free Kids (TFK) presents claims of the specific amount of money that will be saved because of reduced health care costs due to lowered smoking rates if the FDA tobacco legislation is enacted. The report goes so far as to estimate the specific amount of money that would be saved in each state. The Campaign for Tobacco-Free Kids is now issuing press releases in various states, making claims about how much money each state will save from reduced smoking rates due to the legislation (for example: Utah; Virginia). The report claims that exactly 2,502,000 fewer kids who are alive today will become future addicted adult smokers if the legislation is enacted, that there will be exactly 797,700 deaths prevented, and that the future health care savings will be exactly $44.4 billion. These numbers are based on a Congressional Budget Office estimate that the legislation would reduce youth smoking by 12.5% over five years.
The Rest of the Story
Before saying anything else, let me first say that in my opinion, this is the absolute worst piece of junk science I have ever seen in my entire career.
When you see a sweeping claim like this of the exact number of lives that will be saved due to a complex piece of legislation and you do not see any sensitivity analysis (meaning an estimate of the range of savings under various assumptions), you know you are dealing with complete crap.
What should tip people off that this is complete crap is are two things:
1. The fact that although the report devotes page after page to an accounting of the lives saved and reduced health care costs, it does not specify exactly what policies are going to reduce youth smoking and how they are going to accomplish that, nor does it provide any research to back up the contention that these policies will reduce youth smoking by exactly 12.5% over 5 years; and
2. The fact that the report does not take into consideration any of the potential adverse effects of the legislation, including the probable increase in cigarette consumption due to the implied FDA seal of approval for cigarettes, which would greatly undermine the public's appreciation of the health hazards of smoking.
If this were a cost-benefit analysis submitted for a class that I teach, it would receive failing marks. And I'm actually an easy grader (ask any of my students). It is exceedingly difficult to fail one of my classes, but TFK would fail, without question, if it submitted this report.
Actually, this is a highly partisan, one-sided view of the impact of the FDA tobacco legislation. It considers only the possibility that youth smoking would decline due to marketing restrictions and user fees. However, it does not even consider the possibility that smoking would increase due to a complete undermining of public health efforts for the past four decades to impress upon smokers the severity of the risks of cigarettes. It does not account for the implications of the FDA's seal of approval on cigarettes. It does not account for possible increases in cigarette consumption if nicotine levels are reduced. It does not account for cigarette company response to the legislation. It does not account for the very likely possibility that many of the marketing restrictions will be overturned by the Supreme Court. It does not account for the also likely possibility that Philip Morris will be able to greatly increase cigarette consumption by successfully marketing a reduced exposure product.
In fact, the report provides no analysis (zero) of the effects of the legislation. It simply assumes that the bill would reduce smoking by 12.5%.
Look - I could just as easily assume that the bill will increase smoking by 12.5% and come up with estimates of my own of the increased costs of this legislation. I could, but I wouldn't do that, because it is junk science.
The 12.5% estimate comes from the Congressional Budget Office (CBO) report, but that report simply assumes that youth smoking will decline by 12.5% because the intention of the legislation was to reduce youth smoking. The CBO offers absolutely no (zero) explanation for how the legislation will reduce youth smoking rates. It provides no scientific evidence to back up the assumption that this legislation will reduce youth smoking. It also fails to consider the adverse impact of the legislation, especially in terms of increased smoking due to a reduced perceived risk of smoking.
This is as low as I've ever seen the science get in the tobacco control movement.
The rest of the story is that the claims being made by the Campaign for Tobacco-Free Kids are based on junk science. The report, in my opinion, is complete crap.