Wednesday, September 12, 2007

USA Today Highlights Debate Over FDA Tobacco Legislation

Today's USA Today features a point-counterpoint debate over the proposed FDA tobacco legislation. The newspaper supports the FDA legislation because, as it argues, federal regulation of tobacco products simply makes sense. In the counterpoint, Dr. Alan Blum and I oppose the legislation as representing an absurd regulatory approach and containing numerous loopholes, inserted to protect Big Tobacco, which render the legislation ineffective.

The newspaper's position is that since Cheerios are regulated by the FDA, why shouldn't tobacco products also be regulated. The proposed FDA legislation would give consumers key data, according to the paper, such as the ingredients and the constituents present in the tobacco smoke. In addition, the legislation would prevent tobacco companies from making false claims about the health advantages of tobacco products. The piece concludes by arguing that "the alternative is doing nothing — leaving a rapacious industry free to deceive the public. FDA authority would give consumers a fighting chance to learn the facts and make more informed decisions about whether to use tobacco products. If a spinach leaf is worthy of government regulation, surely a tobacco leaf deserves at least as much scrutiny."

In the counterpoint, Dr. Blum and I point out that the bill was crafted, in part, by Philip Morris. The bill represents the results of a negotiation between Philip Morris and the health groups (represented by the Campaign for Tobacco-Free Kids) and key provisions of the bill were crafted in such a way to limit the FDA's power to actually do anything meaningful that would reduce tobacco use or protect consumers. These provisions were inserted specifically to appease Big Tobacco, especially Philip Morris.

For example, while the bill bans chocolate, strawberry, and grape flavorings -- which aren't used in cigarettes anyway -- the bill exempts menthol, a flavoring which is successfully used to help entice millions of actual Americans (and especially African-Americans) to smoke or continue smoking.

While the bill purports to aim to reduce youth smoking by controlling youth access to tobacco products, it precludes the FDA from doing the two things that would result in the most meaningful access restrictions: (1) increasing the legal age of cigarette purchase; and (2) limiting the places where cigarettes may be sold.

We argue: "That the bill was written with input by Philip Morris, America's largest cigarette maker with its top-seller, Marlboro, should make us skeptical that Congress is finally standing up to Big Tobacco. Though the bill would attempt to regulate new tobacco products, it would permit Marlboro and other popular brands to stay on the market virtually untarnished, even as they cause the deaths of nearly half a million Americans each year. Although the bill would ban the use of strawberry, grape and similar candy flavorings, it wouldn't require the FDA to ban menthol (the flavored anesthetic in brands advertised to African-American and Hispanic populations) or to eliminate the more than 40 known cancer causers in cigarette smoke. The bill's loopholes make Swiss cheese look like granite: One would preclude the FDA from making cigarettes non-addictive by eliminating nicotine."

The Rest of the Story

I congratulate USA Today for highlighting this important debate and I am grateful for them giving me and Dr. Blum the opportunity to lay out our position.

I would respond to their editorial position by making the following observations:

1. I think they are exaggerating the benefits of forcing tobacco companies to disclose the cigarette smoke constituents and ingredients. We already know that cigarette smoke is toxic and carcinogenic. We have already identified over 700 ingredients in the cigarettes, more than 40 carcinogens in cigarette smoke, and more than 4,000 other toxins in the smoke. The names of these chemicals are readily available. I don't see that knowing the names of these chemicals is making any significant contribution to informing people about the risks of these products. Nor do I see how it would help for consumers to have a complete list of the chemicals, rather than the information that they already have. How is it going to help consumers to have a list of perhaps 100,000 chemicals rather than a list of 4,000 chemicals?

2. While the fact that Cheerios are regulated and tobacco products are not regulated would certainly argue for some sort of tobacco product regulation, that does not necessarily mean that this particular legislation would be an effective public health measure. If the FDA were to be given unfettered authority to regulate tobacco products, I would agree that the public health benefits could be substantial. However, that's not what this bill does. What the bill does is tie the FDA's hands in every way that it could actually make a substantial dent in smoking rates. And it does this specifically to protect Philip Morris' profits. Exactly how is that good for public health?

3. The alternative to the proposed legislation is not the status quo. The alternative is for Congress to actually do something meaningful about the problem of tobacco use. Put money, for the first time, into a serious anti-tobacco advertising campaign (like the "truth" campaign). Create or restore well-funded anti-smoking media campaigns in all 50 states. These campaigns represent the most successful intervention available to reduce tobacco use. If Congress really wanted to do something about the problem, our legislators would put their money where their mouths are. They would allocate money to fund such a program in every state.

Of note, Senator Enzi has crafted a proposal that would accomplish just this. While I think the funding mechanism needs some work (the bill would fine cigarette companies if they fail to reduce the number of smokers of their brands to prescribed levels; it would also increase federal cigarette excise taxes), I think the general idea makes sense.

If the anti-smoking groups really want to do something meaningful about addressing the tobacco epidemic in this country, they should stop wasting precious time and resources supporting the FDA legislation and instead, they should work with legislators like Senator Enzi on crafting a bill that would utilize the approaches to reducing tobacco use that are tried and true prevention strategies.

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