A new book soon to be released by the Democracy Institute provides the most comprehensive analysis and critique of the issue of FDA regulation of tobacco products ever produced. Patrick Basham, director of the Democracy Institute, analyzes the history of the FDA tobacco legislation, the nature of the negotiations that led to the crafting of the bill currently before Congress, the interest of Philip Morris in pursuing regulation, the likely effects of the bill, the basic policy issues involved in regulation of tobacco products, and the merits of the overall regulatory scheme created by the proposed legislation.
Citation: Patrick Basham. Butt Out! How Philip Morris Burned Ted Kennedy, the FDA & the Anti-Tobacco Movement. Washington, DC: Democracy Institute, 2009. Copyright 2009 by Patrick Basham.
Order from the Democracy Institute, or email: info@democracyinstitute.org.
Basham has taught tobacco regulation and policy courses at the Johns Hopkins University and his thinking was influenced by vigorous debates in his classes, in which various sides of the issue were considered. Thus, his opinions are informed by knowledge of the interests of both the public health advocates and the tobacco executives who negotiated the bill. The book is a must-read for anyone who is interested in the tobacco issue, and I believe it should be required reading for every organization that is supporting the legislation.
From his extensive and detailed analysis of the scientific, regulatory, and policy issues, Basham concludes that "giving the FDA the authority and the responsibility for a good chunk of the U.S. tobacco file is a mistake of epic proportions."
He writes: "Handing tobacco regulation over to the FDA is tantamount to giving the keys of the regulatory store to the nation's largest cigarette manufacturer, Philip Morris. that is because the legislation on FDA tobacco regulation has been cooked up out of public sight over the last few years by a partnership of Philip Morris, certain groups from the public health establishment, and Senator Edward Kennedy and Congressman Henry Waxman."
"Kennedy, Waxman, and the public health establishment, led by the Coalition for Tobacco-Free Kids, are presenting their proposed legislation as a masterful regulatory stroke that will end tobacco marketing, prevent kids from starting to smoke, make cigarettes less enjoyable to smoke, and reduce adult smoking. But FDA regulation of tobacco will do none of these things. That is because Philip Morris skillfully hoodwinked a coalition of 'useful idiots,' including the Campaign for Tobacco-Free Kids, Senator Kennedy, and Congressman Waxman, at every turn. ... FDA regulation of tobacco will serve the interests of Philip Morris, not the interests of the anti-tobacco movement nor their sage congressional partners, and most assuredly, not the interests of the American public."
Basham defines "useful idiots" as "those members of the anti-tobacco movement whose naivete was exploited by, and to the benefit of, Philip Morris."
How we got to such a situation, how the Campaign for Tobacco-Free Kids and other anti-smoking groups were hoodwinked into negotiating with Philip Morris and supporting the resulting legislation, is the fascinating subject of the first two chapters of "Butt Out!" Basham describes how FDA regulation of tobacco products was actually part of a plan by Philip Morris to capture regulation: giving it the public appearance of being a reformed company that is willing to subject itself to strict safety standards but through carefully crafted compromises, ensuring that the true effect of the legislation would be to further the company's financial interests.
Basham reveals that the legislation was the result of a secret, carefully hidden negotiation between Philip Morris and the Campaign for Tobacco-Free Kids. These tough negotiations resulted in number of important compromises by the public health groups that severely limited FDA's regulatory authority. Worse, the Campaign for Tobacco-Free Kids never told the truth about the fact that it was negotiating with Philip Morris, a fact that it has still not disclosed.
Importantly, Basham does not dismiss the legislation simply because it was negotiated with Philip Morris. That fact leads to his giving critical scrutiny to the details of the legislation. But his condemnation of the legislation is based on a detailed analysis of the actual provisions of the bill, which is provided in Chapter 3. Basham goes through a checklist of the potential public health benefits of the legislation, and based on a review of the scientific evidence, concludes that very few of the bill's provisions will actually serve public health interests. He argues that the public health groups have indeed been outsmarted and that the bill serves the interests of Philip Morris, not those of the anti-tobacco movement.
Chapter 4 provides a detailed analysis of several of the central provisions of the legislation. The one measure which might legitimately be thought to have positive health benefits - the mandated warning labels - will likely not be effective, Basham argues, based on research into psychological reactance theory. The regulation of nicotine levels may actually be counterproductive, because lowering nicotine levels will result in greater tar exposure. Basham also offers some thoughts as to how and why the anti-tobacco groups got it so wrong.
In Chapter 5, Basham provides a more basic argument against FDA regulation of tobacco products: that the bill would burden an already troubled agency and undermine its basic mission.
Finally, in chapter 6, Basham shares his own thoughts about what a sensible, science-based, and effective national strategy for tobacco control might look like. I'll leave readers to order the book to see the approaches that Basham suggests, but one point he emphasizes is that whatever the approach, unlike the current FDA legislation, it must be transparent, guided by accurate science rather than by ideology, blind faith, or politics, and it must communicate accurate scientific information to the public.
This book is a must-read for Rest of the Story readers and anyone interested at all in tobacco control policy.
The Rest of the Story
In light of the revelations brought forward in "Butt Out," I challenge the Campaign for Tobacco-Free Kids and other anti-smoking and health groups which are supporting the FDA tobacco legislation to:
1. Publicly acknowledge that the legislation was the result of a Congressionally-mediated negotiation between the Campaign for Tobacco-Free Kids and Philip Morris.
2. Publicly acknowledge that the Campaign for Tobacco-Free Kids and other groups have been deceiving the public and their own constituents by hiding the fact that the legislation was crafted, in part, by Philip Morris, which played a major role at the negotiating table.
3. Publicly acknowledge that the many loopholes in the bill that severely limit the FDA's authority represent compromises that were made to appease the financial interests of Philip Morris, and that they do compromise public health protection in order to retain Philip Morris' support for the bill.
4. In light of the revelations and detailed analysis in "Butt Out," to renounce their support of this legislation and instead, join me in helping to craft a truly effective science-based piece of federal legislation in an open, transparent, and inclusive process -- guided by science and evidence, rather than ideology, blind faith, and politics -- that will actually result in a significant reduction in adult and youth smoking, and therefore, in substantial public health protection.
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