A study in the current issue of the Journal of Public Health Policy provides an analysis of the proposed FDA tobacco legislation supported by Philip Morris and by a coalition of public health groups, headlined by the Campaign for Tobacco-Free Kids, in light of the core principles for desired FDA legislation that Philip Morris outlined (see: Givel M. Philip Morris' FDA gambit: good for the public health? Journal of Public Health Policy 2005;26:450-468).
The study reports that the proposed FDA legislation "is compatible with almost all of Philip Morris' core principles on FDA regulation."
This result has two important implications:
First, it demonstrates that the FDA legislation, as proposed, would "ensure regulatory and economic stability in contrast to the past uncertainty of FDA regulating tobacco products as a drug and delivery device. This economic stability would have been maintained because the FDA policy and legislative approach advocated by Philip Morris and many health groups ensured that tobacco products would not be banned and that nicotine would not be removed from tobacco products ensuring a steady adult market into the foreseeable future. This approach, of course, would quite likely have also blocked any future attempts by FDA to treat tobacco products and nicotine as a drug and drug delivery device ... which would have greatly restricted the supply and marketability of tobacco products."
Second, it demonstrates that the proposed FDA legislation would "have meant that adult tobacco use including associated illnesses and deaths would have, using optimistic scenarios, been reduced to a certain extent and then stabilized and institutionalized at the federal level. This is contrary to the goals of the major health groups supporting this legislation, who generally have called for reducing tobacco use for the entire population as much as is feasible or possible ... probably for the long-term, this meant that progress toward reducing tobacco use and tobacco-related disease as much as possible through FDA regulation would have been stalled."
The author concludes that: "The crucial policy message and lesson ... is to be extremely vigilant and do not be drawn in by an apparent willingness of the industry to 'change its ways.'"
The Rest of the Story
Dr. Givel has meticulously demonstrated that the FDA legislation being supported by the Campaign for Tobacco-Free Kids and other public health groups is not compatible with the actual stated goals of these organizations, but instead, is fully compatible with the profit-making and market-dominating goals of Philip Morris, the nation's leading tobacco company.
Dr. Givel has shown, I think, that in negotiating this legislation, the Campaign for Tobacco-Free Kids conceded almost all of the critical points that Philip Morris required in order for this legislation to represent a policy that would institutionalize tobacco use and its resulting disease and death into our society, and with the sanctioning and support of the federal government.
Givel suggests that the Campaign for Tobacco-Free Kids was drawn in and fooled by the apparent willingness of the nation's leading tobacco company to change its ways, but I think it is more likely that the Campaign knew exactly what it was facing, and made a concerted decision to agree to the compromise provisions contained in the legislation because it viewed Philip Morris' support as critical to enactment of the legislation.
In other words, in order to give itself any chance of building the house, the Campaign gave away everything but the kitchen sink. Now, they are left in a position where the legislation they are supporting and claiming to be a house is nothing more than a kitchen sink.
The key effects of this legislation that Givel points out are economic and legal (litigation and legislation) stability for the industry, federal institutionalization and sanctioning of tobacco production, marketing, sale, and use, and stabilization of the tobacco market. Combined with the likelihood that Philip Morris is the best-positioned of the tobacco companies to take advantage of the liability-free reduced exposure product opportunities provided by the FDA legislation, all of this would have meant that Philip Morris would be provided with a complete market dominance.
What is surprising to me is not so much that the Campaign for Tobacco-Free Kids was willing to concede critical public health principles in negotiating this bill, but that it has been so widely successful in misleading other anti-smoking and public health groups into believing that this legislation is in the best interests of the public's health.
In many ways, the campaign is pulling the wool over the eyes of the public much more than Philip Morris is. While Philip Morris claims it is acting because of a sincere interest in social responsibility, the public is not so naive to think that any corporation would not be looking out to protect its own best interests. Their actions are not, I think, really fooling anyone.
But the Campaign for Tobacco-Free Kids, I believe, has been successful in fooling much of the public health community into believing that Philip Morris has truly changed its ways and is now supporting legislation that is in the best interests of the public's health.
In other words, Philip Morris doesn't need to conduct its own public relations anymore to improve its public image. The Campaign for Tobacco-Free Kids is doing Philip Morris' public relations for it. The Campaign is, I think, doing more to improve the public image of Philip Morris than the company could do on its own.
For that, I think Philip Morris should be credited with devising a brilliant scheme, especially in knowing that they could draw a group like the Campaign for Tobacco-Free Kids in, because of the Campaign's expressed and apparent zeal to pass federal legislation at almost any cost.
The rest of the story suggests that the FDA legislation, and even more, the promotion of that legislation by the Campaign for Tobacco-Free Kids, is truly a dream come true for the nation's leading tobacco company.
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