Tuesday, January 23, 2007

IN MY VIEW: The Big Hoax - Rising Nicotine Levels as a Reason for the Proposed FDA Tobacco Legislation

It truly is one of the biggest hoaxes I've seen in a long time. Talk about pulling the wool over people's eyes.

The Campaign for Tobacco-Free Kids (TFK) is using the Harvard report that shows increases in the nicotine yields of cigarettes over the past 8 or 9 years as supporting documentation that Congress must enact the TFK-supported FDA tobacco legislation that stalled during the past two sessions, but which has been given new life with the change in Congressional leadership.

The Campaign argues that because tobacco companies are "secretly" and deliberately manipulating nicotine levels, Congress must enact legislation so that FDA can regulate the constituents of tobacco products. The implication is that if only the TFK-supported FDA legislation were enacted, the problem of nicotine addiction would be over. In fact, TFK states as much: "The proposed legislation would grant the FDA the authority and resources to stop harmful tobacco company practices that continue to addict children."

The Rest of the Story

The chief "tobacco company practice" that continues to addict children is the addition of nicotine to cigarettes (or more properly, the failure to refrain from adding back the nicotine after it is extracted). Clearly, the Campaign is implying that if the FDA legislation is enacted, the FDA will be able to get rid of the nicotine from cigarettes so that the companies can no longer continue to addict our children.

There's just one problem with this.

The legislation that TFK supported during the past two sessions of Congress would have specifically precluded the FDA from eliminating nicotine from cigarettes.

So this turns out to be yet another example of blowing smoke. It is talking out of one side of your mouth but acting out of the other side.

On the one hand, TFK gives the public this great sound bite about how terrible it is that cigarette companies are manipulating nicotine levels and how we need the FDA tobacco legislation to stop this manipulation and to stop the addiction of our kids.

On the other hand, TFK is supporting legislation and failing to disclose to the public that the legislation does not allow the FDA to do precisely what TFK implies is the problem for which FDA regulation is needed in the first place.

Now it is possible that TFK is demanding that Senator Kennedy remove the clause from the legislation which ties FDA's hands in terms of getting rid of the nicotine, but I highly doubt it. Why? Because doing so would result in the loss of Philip Morris' support for the legislation. And I believe that TFK is more interested in getting something enacted so that they can put a feather in their cap than in making sure that legislation that is enacted does not grant special protections to the tobacco industry - protections that are not granted to any other industry regulated by the FDA.

In calling for legislation that allows the FDA to regulate tobacco products in much the same way as FDA regulates food and drugs, anti-smoking groups are full of it. The proposed legislation does not give FDA authority that is at all similar to the authority it has over food or drugs. Neither of those product manufacturers are granted special protections that tie FDA's hands in terms of the actions that it can take.

I'm not arguing here that FDA should have the same authority over tobacco products that it has over food and drugs; I'm just saying that we should call a spade a spade and not deceive the public into thinking that this is the case.

I also want to point out that attacking the cigarette companies because they "manipulate" nicotine levels is a little ridiculous. There is no way that the cigarette companies can not manipulate nicotine levels. Whatever level of nicotine they choose to put in their cigarettes is in their control. By definition, they have to manipulate the level of nicotine.

So while attacking the cigarette companies for manipulating the nicotine levels in their cigarettes creates a good sound bite, it has little meaning. There is no way that can fail to manipulate the nicotine levels.

Finally, I have to admit that from a public health policy standpoint, I fail to see what all the fuss is that anti-smoking groups are making about this nicotine report. The nicotine levels in cigarette have increased slightly. So what?

I really mean that: So what?

I simply fail to see what the significance is of the rising nicotine yields in terms of public health policy.

The implication of attacking companies for increasing nicotine levels is that if nicotine levels were falling, it would be a good thing. But lowering nicotine levels would be a public health disaster. Because of the well-recognized phenomenon of compensation, where smokers adjust their inhalation and consumption to maintain consistent nicotine dosage, any major decline in nicotine levels will result in increased cigarette consumption. If tar levels remain the same, then tar delivery will increase, resulting in a rise in lung cancer, other cancers, and chronic debilitating lung disease.

We don't want nicotine levels to decline.

In some ways, rising nicotine levels is the next best thing to eliminating the nicotine, which so far no U.S. public health group has called for. Assuming that there is no similar increase in tar levels, higher nicotine yields could actually lower cigarette consumption, which would lower tar delivery.

I have to admit that all of the brouhaha that anti-smoking groups are creating over the rising nicotine yields has me a bit mystified. It is as if the groups are simply looking for anything to make news and any excuse to attack the cigarette companies. But it is coming at the expense of focusing the public's attention on an issue that has little meaning, and perhaps even has the opposite meaning of what people are being led to believe.

Ultimately, I find the framing of this issue by the anti-smoking groups to be not only very deceptive, but very damaging. It undermines the real public health policy issues that we need to consider. It suggests the opposite of what could be a solution, or at least an effective response, to the problem.

The saddest realization for me is the apparent lack of sincerity of the major anti-smoking groups. It baffles me how an organization that is supposed to be protecting the health of kids can come out and spout lots of propaganda about how rising nicotine levels are terrible and therefore we need to enact the FDA legislation, but in the back rooms, they have negotiated a bill that does exactly the opposite: precludes the FDA from actually dealing with the problem in a definitive way.

I feel that this is a case where the health of our nation's children have truly been sold out to protect the profits of the tobacco companies.

Don't get me wrong. I'm not necessarily arguing that we should eliminate nicotine from cigarettes. I don't know that it would be a viable solution at this time. But if we're not prepared to do that, then let's cut the crap about how we're going to give FDA the power to stop the terrible, secret manipulation of nicotine that is addicting our kids. That's not going to end any time soon. And it won't end any time at all if the Campaign for Tobacco-Free Kids has its way.

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