Thursday, June 05, 2008

Public Health Support for FDA Tobacco Legislation Crumbling; Revelation of Sell Out to Philip Morris is Destroying Coalition of Support

The support of the public health community for the FDA tobacco legislation currently before Congress continues to crumble. Last week, the National African American Tobacco Prevention Network (NAATPN) withdrew its support from the bill. Yesterday, seven former federal health secretaries wrote to every U.S. Senator, urging them to oppose the FDA legislation because of its sell out to Big Tobacco in exempting menthol from the list of flavorings banned in tobacco products.

A lead article in the New York Times today explains that the menthol exemption is a compromise agreed to by public health groups (led by the Campaign for Tobacco-Free Kids, American Heart Association, American Lung Association, American Cancer Society, and American Medical Association) in order to garner support from Philip Morris. But the former health secretaries see this compromise as a sell out to Big Tobacco and they oppose the legislation with the menthol exemption intact.

A chief sponsor of the bill - Representative Henry Waxman - admitted that the menthol exemption was a compromise of the public's health to protect the ability of adults to smoke menthol cigarettes: " the FDA the authority to ban menthol [but not banning it along with the other flavorings] is the best way to balance both public health considerations with the reality that many adults only smoke menthol cigarettes."

According to the article: "The letter reflects a growing controversy over the bill’s current exemption of menthol from a list of banned flavorings — an exemption some lawmakers said was intended to garner support from Philip Morris. ... Some antismoking advocates have said they see the menthol exemption as a necessary compromise toward getting the legislation passed, and they have said that the bill as currently drafted would give the F.D.A. the authority to limit or eliminate additives, including menthol, if they are proved to be harmful. As now written the legislation would ban cigarettes flavored with strawberry, chocolate and a number of other fruit, candy and spice flavorings. Those flavorings have occasionally been added to cigarettes in what critics say are a lure to children. But the bill specifically protects menthol from the ban, even though menthol is the most widely used flavoring."

The letter to Congress members states: "Banning flavored cigarettes, which mask the harshness of tobacco--something that can deter some first-time smokers, especially children--is a positive move. But, by failing to ban menthol, the bill caves to the financial interests of tobacco companies and discriminates against African Americans—the segment of our population at greatest risk for the killing and crippling smoking-related diseases. It sends a message that African American youngsters are valued less than white youngsters."

The Rest of the Story

In my view, this is a fatal blow to the FDA tobacco legislation for this year. The publicity that the menthol exemption is receiving and the ostentatious and definitive display of dissent from prominent and well-respected public health leaders have destroyed the chances of this legislation moving forward during the current Congressional session, which faces an abbreviated schedule because of the presidential election this fall.

Now that the bill's sellout to Big Tobacco has been placed on the front page of the New York Times, the Campaign for Tobacco-Free Kids can no longer hide the truth about the legislation, which it has attempted to do (largely with success) for the past two years.

Public opinion cannot tolerate a sellout to Big Tobacco; therefore, the bill cannot pass with the menthol exemption in place. However, to remove the menthol exemption would eliminate Philip Morris' support for the bill and detract enough legislators from supporting the legislation to spell its certain doom.

Even entertaining a menthol exemption amendment on the floor of the House and/or Senate would be a political disaster for members of Congress. Supporters of the legislation would be forced to show their hand - revealing their willingness to sell out the protection of the public's health for the protection of Big Tobacco profits. Voting against the amendment would be disastrous politically. However, voting for the amendment would essentially assure the bill's death, since Congress certainly does not have the will to stand up for the public's health over the preservation of cigarette sales and industry profits.

My guess is that supporters of the legislation will choose not to bring the bill forward to the floor during this session because of the embarrassment that would come with either failing to consider the removal of the menthol exemption, voting to retain the exemption, or having the bill fail to move forward because of the removal of the exemption. It is a lose-lose-lose proposition politically and I predict that the bill's chief sponsors in Congress will take the easy road by allowing the legislation in its current form (i.e., an ill-conceived deal between Tobacco-Free Kids and Philip Morris) to disappear via a slow and quiet death.

This, I believe, is a good thing, because it will allow the tobacco control and public health community to go back to the drawing board and actually engage in a discussion about what federal tobacco legislation would be the most effective in addressing the morbidity and mortality caused by tobacco products.

I will have more to say about that in the days to come; however, for now let me just say that placing tobacco products under the regulatory authority of the FDA is not and should not be the cornerstone of such a federal legislative approach to the tobacco problem. The sooner the tobacco control community can put to bed the notion that giving the FDA the authority to regulate tobacco products is the most effective solution to the problem, the quicker we will be able to come up with an approach that may actually be able to do something to reduce smoking and save lives.

The rest of the story is that there are a lot of enemies that the Campaign for Tobacco-Free Kids can defeat. I believe it has the resources and wherewithal to take on Big Tobacco. But there is one war that even the Campaign for Tobacco-Free Kids cannot win: a battle against the truth.

When your entire campaign is based on dishonesty and deception, secrecy and exclusion, and propaganda devoid of substance, you are eventually going to get called on it. Ultimately, what is going to end up killing the FDA legislation is nothing other than the plain old ugly truth.

No comments: