Monday, February 12, 2007

Senator Kennedy Joins Campaign for Tobacco-Free Kids in Pulling Wool Over Eyes of American People; Integrity Impossible to Find

On January 17, Senator Edward Kennedy released a statement in response to a Harvard University School of Public Health report which concluded that nicotine yields of cigarettes have increased steadily over the past eight years. In the statement, Senator Kennedy condemned Big Tobacco for addicting millions of young smokers due to these rising nicotine levels and called it a travesty for Congress to be an accomplice to this addiction by failing to enact legislation that would allow the Food and Drug Administration (FDA) to prevent this from happening.

Senator Kennedy said: “This study is an extraordinary public service by Harvard’s School of Public Health. It’s dramatic new proof that Big Tobacco is addicted to addicting millions of young smokers into lifetimes of illness and early death. Congress has been an accomplice in the travesty because of the success of the tobacco lobby in blocking real reform. Hopefully, the study will be a wake-up call to persuade Republicans and Democrats alike to enact long overdue legislation allowing the FDA to regulate cigarettes and deal with their enormous risks.”

A day later, the Campaign for Tobacco-Free Kids issued a press release in which they argued that the increasing nicotine levels signaled the need for legislation that would grant the FDA the authority to reduce nicotine levels in order to protect the public's health by preventing companies from addicting children with their nicotine.

The Campaign stated: "A new study released today by the Harvard School of Public Health shows the critical need for Congress to enact legislation granting the U.S. Food and Drug Administration (FDA) authority over tobacco products. The Harvard study expands on and confirms an August 2006 study released by the Massachusetts Department of Public Health that found that tobacco companies have deliberately increased the levels of nicotine in cigarette smoke since 1998. The FDA legislation would require tobacco companies to disclose to the FDA changes in their products and provide FDA the authority to require them to reduce levels of constituents, like nicotine that make them more harmful or more addictive. ... These studies demonstrate that what the tobacco industry knows and what consumers don’t, can kill us. ... Legislation to allow the FDA to regulate tobacco should be given a high priority and scheduled for action early this year. The proposed legislation would grant the FDA the authority and resources to stop harmful tobacco company practices that continue to addict children, mislead consumers and devastate the nation's health."

The Rest of the Story

Today, I am revealing my opinion that Senator Kennedy's and the Campaign for Tobacco-Free Kids' statements were little other than public relations and propaganda ploys, which greatly deceive the American public into believing that the legislation which Senator Kennedy is introducing and that the Campaign for Tobacco-Free Kids is supporting would actually do something to protect our nation's youths from the addictive nature of nicotine in cigarettes.

It turns out that the addiction of millions of our nation's kids by nicotine in cigarettes is apparently not such a travesty, as Senator Kennedy and the Campaign would have us believe. Nor would the legislation that they are proposing do anything to address the problem of nicotine addiction of our nation's children.

In contrast, Senator Kennedy and the Campaign are supporting legislation that would actually institutionalize the addiction of our nation's children into law, ensuring that the Food and Drug Administration could never address the problem of nicotine addiction of our children by requiring the elimination of nicotine from cigarettes. The legislation would ensure that cigarettes always contain nicotine, and thus always maintain the potential to addict our children, regardless of whether we ever reach a point where social norms change in a way that would otherwise make feasible the FDA's gradual phasing out of nicotine from cigarettes.

According to information released by Bill Godshall, Executive Director of Smokefree Pennsylvania, Philip Morris has issued a statement confirming that the legislation to be introduced this week by Senator Kennedy would indeed preclude the FDA from eliminating the nicotine in cigarettes.

According to the tobacco company's summary of the bill to be introduced: "The product standard section explicitly provides that only Congress could ... require 'the reduction of nicotine yields of a tobacco product to zero'. ... In addition, a performance standard may not have the effect of ... reducing nicotine yields 'to zero.'"

In other words, Senator Kennedy and the Campaign for Tobacco-Free Kids were full of crap.

They told the American people one thing, but did exactly the opposite.

They deceived the American people in their public statements, which turned out to be little more than public relations propaganda to make them sound concerned about the rising nicotine levels that apparently are addicting our children.

But when it really came down to it, they were not only not willing to do anything about that problem, but they did the opposite of what needed to be done. They permanently institutionalized nicotine addiction of our nation's children into the statutes of the United States (or at least they are trying to do so - not so fast, people like me and Bill Godshall aren't going to let them get away with this quite so easily).

Now before I get criticized for calling on the elimination of nicotine from cigarettes, let me make it clear that what I view as crap is not the idea that right now, it would not be feasible for the FDA to eliminate nicotine from cigarettes and therefore that it makes sense to preclude FDA from doing just that.

That's just an opinion about an appropriate strategy for dealing with the nicotine problem, and Senator Kennedy and the Campaign are certainly welcome to their opinions. I happen to think that it is not feasible at the present time and it would not be advantageous to eliminate nicotine from cigarettes at the present time. However, my personal opinion is that it doesn't make sense to tie the FDA's hands and place decisions about this issue into the realm of politics rather than science and public policy. I think one could easily avoid the problem by simply requiring the FDA to make a determination that its regulations are feasible and to consider the potential for social disruption, black markets, etc. in promulgating any regulation that would eliminate or phase out nicotine. Thus, FDA would have the authority to take such an action if it ever made sense, but would not be required to take the action.

What is crap, however, is telling the American public that the addiction of America's children by increasing nicotine levels is a travesty that we are going to address through FDA legislation and then to go back on one's word by not addressing that problem in the legislation, but rather, doing the opposite and making sure that the specific problem you stated was the need for the legislation will be codified into the laws of the United States.

That's about as low a level of integrity that I can imagine. It's worse than simply misleading the American public by making them think you're going to do something and then not doing it. It's worse, because you are actually making the public think you're going to do something and then doing the exact opposite.

And to make matters worse, not only are you doing the opposite, but you are ensuring that the original action you said you would take can never be done.

For Congress to amend the tobacco legislation once it is enacted is almost unfathomable. Congress only enacts tobacco legislation to begin with every 30 years or so. Once this law is enacted, you can put a fork in it - we're not going to see a revision of the legislation any time soon.

It's not like I didn't make an effort to warn Senator Kennedy and the Campaign about this. In addition to contacting both of them, my op-ed published last Sunday in the New York Times exposed the problem, and made it clear that merely reducing nicotine levels would not solve the problem. It would not eliminate the addictive potential of cigarettes and in fact, it would make cigarettes potentially far more harmful: smokers compensate to make up for reduced nicotine delivery; the increased tar delivery would increase rates of cancer and chronic lung disease.

Ironically, if you want to give the FDA the power to possibly reduce the harms of cigarettes, the one thing that might actually work would be to mandate very high levels of nicotine in cigarettes.

This would have two beneficial effects: first, it would substantially reduce the intensity of smoking and levels of consumption, reducing tar delivery and lowering cancer and chronic lung disease risks.

Second, it would make cigarettes all but "unpalatable" for kids, ensuring that fewer young people would take up the habit and have it turn into an addiction. But established smokers would still be able to obtain their nicotine.

It is not actually clear yet whether the bill to be introduced by Senator Kennedy would even allow the FDA to mandate increases in nicotine levels in cigarettes. But if the legislation is similar to that introduced in the past two sessions of Congress, I do not believe it would allow this approach.

According to section 907(a)(4)(a)(i) of that legislation, the FDA could only require reductions of certain constituents in cigarettes.

In fact, in my suggested revisions to the legislation which I sent to Senator Kennedy's office, I pointed out this problem. Specifically, I suggested the following revision:

"Section 907(a)(4)(a)(i) - Tobacco Product Standards: Tobacco Product Standards: Change the word 'reduction' to 'regulation.' This would allow FDA to regulate the overall cigarette design in terms of nicotine/tar ratios, rather than just reduce the nicotine, which would lead to compensatory increases in cigarette consumption. For example, a high nicotine/low tar cigarette could provide substantially reduced risk, as cigarette consumption might fall somewhat in combination with a reduction in carcinogen intake."

It's not clear to me exactly what the most reasonable and advantageous regulatory approach would be to reduce the harms of tobacco-related disease. And I would not be criticizing Senator Kennedy so harshly had he simply introduced the bill as it is. I am not criticizing him for failing to mandate the removal of nicotine from cigarettes or even for failing to grant the authority to FDA to do this. I am criticizing him for saying one thing and doing the opposite.

While I don't necessarily call for the removal of nicotine from cigarettes, I also don't put out press releases stating what a travesty it is that Big Tobacco is increasing their nicotine levels, showing how this demonstrates a need for FDA regulation, and promising to introduce or support legislation to address this problem, and then go out and make sure, behind the public's back, that the legislation contains language that precludes the FDA from addressing the problem.

It's quite interesting that Philip Morris apparently had detailed knowledge of the provisions of the bill before any of us in the public. Philip Morris was at the negotiating table that produced this deal in the first place a couple of years ago. And apparently, their support of the legislation (i.e., assured financial stability and increased market share) is far more important to those supporting it than the integrity and honesty in public statements and the actual health protection of the public.

In summary, what's very clear to me is that those who are pretending to take the responsibility for the public's health onto their shoulders and protect us from the hazards of cigarettes do not have a clue about the real scientific and public policy issues involved with the regulation of cigarettes - something I have personally been studying for the past 21 years and think I have a little bit of expertise in.

Not only that, but in pretending to be protecting us from the travesty of the addiction of our nation's children with the use of nicotine in cigarette products, Senator Kennedy and the Campaign for Tobacco-Free Kids are pulling the wool over the eyes of the public. They are saying one thing, and doing precisely the opposite.

That's not public health protection. It's not clarity and transparency and full honesty and disclosure. But most importantly, it's not the kind of integrity that I think we deserve from our public health organizations and our policy makers - especially when those organizations and policy makers take it upon themselves to tell us that they have the very solution to the problem they are bemoaning.

When it turns out their purported solution would actually institutionalize the very problem at hand, I think it's time to do more than simply ask questions.

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