Thursday, November 06, 2008

Anti-Smoking Advocates Re-Writing History to Support FDA Tobacco Legislation

In a point-counterpoint pairing of letters published today in the New England Journal of Medicine, Dr. Joel Nitzkin of the American Association of Public Health Physicians (which opposes the FDA tobacco legislation) and Dr. Allan Brandt of Harvard University (who supports the legislation) debate the history of the current legislation.

Dr. Nitzkin asserts that the legislation "was negotiated between Matthew Myers of the Campaign for Tobacco-Free Kids and Mr. Berlind [chief legislative counsel of Philip Morris] for purposes of securing an FDA bill with full support from our nation's largest cigarette maker."

Dr. Brandt counters: "Nitzkin is wrong to claim that the currently pending bill was negotiated between Philip Morris and Matthew Myers of the Campaign for Tobacco-Free Kids. The current bill was the work of Senator Ted Kennedy (D-MA) and then-Senator Mike DeWine (R-OH), who have consistently been among Congress's strongest supporters of tobacco control."

Dr. Nitzkin further argues that the legislation "is so distorted in favor of Altria–Philip Morris that, if passed in its current form, it will do more harm than good in terms of future levels of teen smoking and future rates of tobacco-related illness and death. It can protect cigarettes or it can protect the public's health. It cannot do both."

Dr. Brandt counters: "The bill has provisions that would require serious changes in the marketing and manufacture of cigarettes in the decades ahead, including the authority for the FDA to monitor and reduce levels of dangerous additives and nicotine. The improved warning labels — just one provision of the bill — could save thousands of lives. Nitzkin is certainly entitled to oppose the legislation, but he fails to offer any evidence for his claim that the bill will lead to increases in teen smoking and tobacco-related mortality. His position conflicts with the positions of virtually all the leading public health and medical organizations that are committed to reducing the burden of disease that cigarettes generate."

The Rest of the Story

While the FDA tobacco bill was introduced into Congress this year by Senators Kennedy and DeWine, the bill is virtually identical to the bill which was introduced in previous sessions, which was the result of a negotiation between the Campaign for Tobacco-Free Kids and Philip Morris.

Thus, Dr. Nitzkin is entirely correct in his statement that this legislation was negotiated between Matthew Myers of the Campaign and Philip Morris. Dr. Brandt, on the other hand, is attempting to re-write history to vindicate the anti-smoking groups for their despicable actions.

According to an article published in Roll Call in October 2004: "Moments after lawmakers unveiled landmark legislation last spring to impose the most sweeping regulations on cigarettes in history, two of the people most closely involved in the momentous compromise bumped into each other leaving a press conference on the deal. Though they were just a few steps from each other outside the Senate's television studio, Matt Myers and Mark Berlind didn't shake hands, embrace or even say hello. ... Myers and Berlind may be the biggest winners if Congress approves the tobacco bill this week. But they're about as comfortable as boys and girls at a sixth-grade dance."

"It's easy to see why: Myers is the president of Campaign for Tobacco-Free Kids ... Berlind is the chief legislative counsel for Altria Group, the parent of Philip Morris USA, the nation's leading cigarette maker." ...

"Thanks to separate but equally calculated decisions by Philip Morris and the Campaign for Tobacco Free Kids, each has broken ranks with their typical allies, formed a secret alliance and met clandestinely to iron out key sticking points on the legislation. The talks between Philip Morris and the Campaign for Tobacco Free Kids took place on Capitol Hill even as the two sides battled over a $200 billion Justice Department lawsuit in a federal courthouse a few blocks down Pennsylvania Avenue."

"The face-to-face negotiating sessions and conference calls were so sensitive that Philip Morris and the Campaign for Tobacco Free Kids refused to tell even their closest allies."

According to Roll Call, Senator DeWine was indeed behind negotiations between these two parties: "Led by aide Abby Kral, DeWine's staff pressed Philip Morris, the Campaign for Tobacco Free Kids, national health organizations and other stakeholders to come together on a bill. ... Unbeknownst to their allies in the public health community, representatives of the Tobacco Free Kids spoke with Philip Morris lobbyists several times and met at least once to iron out language that both sides could accept. Both sides say most of the talks were arranged by DeWine's office because officials from Tobacco Free Kids and Philip Morris felt uncomfortable dealing with each other. Several times, however, Myers spoke directly to Philip Morris officials either face-to-face or by phone. 'I believe there was at least one meeting with multiple parties present where both sides were there,' said Myers." ...

Moreover, Roll Call documents that in the negotiations, the Campaign for Tobacco-Free Kids agreed to certain compromises being insisted upon by Philip Morris: "The discussions helped prompt several breakthroughs. ... Tobacco Free Kids swallowed a provision that gives Congress sole authority to ban cigarettes or to reduce nicotine levels to zero." Thus, the loopholes in the bill which I have been criticizing for months are the direct result of the Campaign for Tobacco-Free Kids caving into Philip Morris in order to maintain the company's support for the legislation.

Let me make one thing clear. Dr. Brandt has every right to support the legislation. However, anti-smoking advocates do not have the right to distort the truth and to re-write history in order to try to erase this ugly chapter. Ignoring and misrepresenting the truth does not make it go away. Moreover, re-writing history like this does a disservice to the public and to public health practitioners, because it does not allow them to make an informed decision on public health policy based on the actual facts.

I commend Dr. Nitzkin for trying to get the truth out there. It is unfortunate that anti-smoking supporters of the legislation are attempting to block the truth by distorting and re-writing history.

I understand that it is an ugly chapter in the anti-smoking movement's history -- to think that the movement allowed Philip Morris to play a pivotal role in crafting legislation to regulate.....Philip Morris. But it happened and it is unfair to the public to present a distorted version of the truth. If tobacco control practitioners want to make it go away, they ought to present their dismay to the Campaign for Tobacco-Free Kids and craft a new piece of legislation that is not written by Big Tobacco, rather than pretending that history never occurred.

I should also note that Dr. Nitzkin argues - correctly in my opinion - that the legislation would do more harm than good. By giving an FDA seal of approval to cigarettes, it would most likely increase cigarette consumption. It would provide virtual immunity to Big Tobacco and end the threat of meaningful litigation against the companies. In contrast, there is no evidence that the bill will do anything to protect the public's health. New research, in fact, suggests that even the mandated warning labels would not have any effect on smoking rates.

But instead of presenting evidence for why and how the bill will save lives, Dr. Brandt resorts to a personal attack. Instead of arguing the substance of the issue, he attacks Dr. Nitzkin for conflicting with the position of other health groups that "are committed to reducing the burden of disease that cigarettes generate." In other words, Nitzkin is nothing but a contrarian. Because he argues a position contrary to that of the mainstream organizations, he is ipso facto wrong.

That is, unfortunately, the typical response of anti-smoking groups which support the legislation. They will not enter into an actual discussion of the substance of the bill, including its weaknesses and loopholes. Instead, they attack anyone who opposes the bill as being a wacko.

The rest of the story is that supporters of the FDA tobacco legislation are attempting to re-write history to hide the truth behind the origins of this legislation.

I guess I would try to hide the truth too if I knew that the legislation was the direct result of a secret negotiation between the Campaign for Tobacco-Free Kids and Philip Morris.

Ironically, this doesn't say a lot for a movement that is trying to distinguish itself from an industry that we continually attack for dishonesty. If the movement isn't honest itself, how can it expect to hold the higher ground against the industry?

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