Tuesday, July 24, 2007

Senator Enzi Invites Health Agencies to Join Him in Reducing Smoking; How the Campaign for Tobacco-Free Kids Undermined the Tobacco Control Movement

In a press release issued yesterday, Senator Mike Enzi (R-WY) invited the directors of the Centers for Disease Control and Prevention (CDC), National Institutes of Health (NIH), and Food and Drug Administration (FDA) to join him in an effort to design a national plan to greatly reduce smoking rates over the next 20 years, to be spearheaded by a bill he introduced last week that would increase the cigarette tax to fund tobacco prevention and cessation programs, levy penalties on tobacco companies if smoking rates do not decrease substantially, strengthen warning labels on cigarette packages, incentivize states to spend a substantial proportion of their Master Settlement Agreement money on tobacco control programs, and give the FDA authority to eliminate nicotine from cigarettes if the demand reaches a low enough level so that this becomes practical.

According to the press release: "Last week, Enzi introduced the “Help End Addiction to Lethal Tobacco Habits Act” (HEALTH Act), S.1834, a bill to wipe out tobacco use in America through an innovative cap-and-trade program that will shrink the size of the tobacco market over the next 20 years. S.1834 is Enzi’s alternative to the Democrat tobacco bill, which has drawn wide support from Big Tobacco and some anti-smoking organizations. 'I believe my plan has the potential to radically change how we tackle tobacco use in this country,' Enzi wrote. 'I would like to invite you to meet with me to discuss my proposal and how we can work together towards our shared goal: eliminating youth smoking and tobacco product usage and significantly reducing the number of Americans dying from the use of tobacco. Your leadership is desperately needed to move this plan forward and reduce the death and disability caused by tobacco,' Enzi added. 'I welcome your input and insight and hope you will join me in working to eliminate the use of this deadly product.'"

The Rest of the Story

The rest of the story is that this turn of events reveals the way in which the Campaign for Tobacco-Free Kids has undermined the entire tobacco control movement.

This is the way that you develop a national tobacco control strategy. You bring the major health agencies and health groups together and you discuss the most effective ways to reduce tobacco use. In contrast, the Campaign for Tobacco-Free Kids, over the past few years, has basically co-opted the entire tobacco control movement, representing itself as the sole face of the movement and unilaterally negotiating with Philip Morris, through Congressional mediation, a short-sighted and misguided bill which eschews all the major proven approaches to actually reducing smoking that have been documented by scientific research.

In contrast to Senator Enzi's expression of a willingness to discuss issues and consider improvements to his legislation, the Campaign for Tobacco-Free Kids essentially signed off on a deal with Philip Morris that was never, and is still not, subject to any changes, including substantial improvements. There was no real discussion with the tobacco control movement, no consultation with many of the established experts in the tobacco control field who have important insights into the most effective national policy strategies and who have been leaders in the movement over the past two or more decades.

Instead, the Campaign for Tobacco-Free Kids appears to have decided upon its own pet legislation and forced it down the throats of everyone else in the movement.

To make matters unacceptably worse, the Campaign took it upon itself to basically represent the public health community in negotiations that were essentially conducted with Philip Morris, but without approval from the rest of the public health community.

You don't develop an effective national tobacco control policy strategy by negotiating with Philip Morris, letting the nation's leading tobacco company have a large say in what does or does not get written into the policy. That was a fatal mistake, as it simply was destined to result in an ineffective policy.

This is now a source of great embarrassment, as Senator Enzi has stolen the show from the Campaign, showing them up by proposing a real bill - one that actually uses proven, effective interventions that would actually put a substantial dent in smoking rates. A proposal that was not written by or at least tailored to meet the needs of Philip Morris.

If not for the Campaign's obsession with its misguided proposal that completely misses the mark in terms of reducing smoking and sets the nation on an unacceptable course of granting official approval to the most deadly consumer product, it is entirely possible that meaningful discussion within the tobacco control movement would have been able to take place over the past two years, resulting in a uniform coalition of groups and advocates in the movement who would now be prepared to push measures like those outlined in Senator Enzi's proposal successfully through Congress.

The tobacco control movement is woefully prepared to deal with a real proposal for a federal approach to reducing tobacco use, because it is simply not something that has been discussed over the past few years. In my opinion, the only reason it has not been on the agenda is that the agenda has been co-opted by the Campaign for Tobacco-Free Kids.

Now is the time for the other major health groups - including the American Cancer Society, American Heart Association, American Lung Association, and American Medical Association - to break themselves away from the Campaign's stronghold and put themselves on the side of a real proposal. The more quickly that we can end the Campaign's dominance over the movement, the more quickly we'll be able to start talking about some real solutions to this problem.

Now that Senator Enzi's proposal is on the table, the FDA legislation is just not going to look so appealing any more to much of the tobacco control community. Sometimes it takes seeing an alternative to convince people of the folly of a policy proposal.

The fallacy which I believe led many advocates to support the FDA approach was the straw man argument that FDA legislation is better than the status quo. What supporters of the FDA legislation failed to tell you was that this is not a decision between the FDA legislation and the status quo. It is and has always actually been a decision between the FDA legislation and a real bona fide proposal to substantially cut smoking rates using measures that we have known all along are effective.

It's no longer the FDA legislation versus the status quo. There are now two hands on the table. And the Campaign for Tobacco-Free Kids, with its health group partners, have been left holding the rag hand.

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