Monday, January 23, 2012

Federal Tobacco Policy Deliberations Continue to Focus on Products For Which There is No Evidence of Substantial Use by Youth: Dissolvable Tobacco

Last week, the FDA's Tobacco Products Scientific Advisory Committee (TPSAC) spent three days deliberating on dissolvable tobacco products - a form of smokeless tobacco that includes products such as Camel Orbs, Strips, and Sticks, Ariva, and Stonewall.

Other products which have received serious scrutiny by the FDA include electronic cigarettes (which were essentially banned by the FDA until that action was overturned by the courts).

One product has been banned: flavored cigarettes, such as the strawberry, chocolate, pineapple, grape, banana, coconut, and melon varieties.

And one product has so far received no scrutiny by the FDA: plain old, regular, tobacco cigarettes.

The Rest of the Story

One might argue that federal tobacco control efforts are doing the exact opposite of what they should be doing. Rather than focusing on the most toxic and lethal products on the market, they are instead focusing on the least hazardous products. And rather than focusing on the products which are most favored by children and adolescents, they are focusing on the products for which there is no evidence of substantial use by young people.

Dissolvable tobacco products are a perfect example. These products, while not safe, are certainly safer than cigarettes. More importantly, there is no evidence that any substantial number of youths are using these products. The same is true of electronic cigarettes.

Flavored cigarettes - like your strawberry, chocolate, pineapple, grape, banana, coconut, and melon varieties - were used by zero youths prior to their "ban" by federal legislation.

The only products which are getting a free ride are regular cigarettes, which happen to be the most toxic tobacco product on the market, as well as the one that is most popular among youths.

I find it hard to believe that the TPSAC spent three days debating a product for which there is no evidence of any substantial youth use. Would not the time have been much better spent discussing the actual problem that is afflicting millions of youths: cigarette use.

Even addressing old-fashioned smokeless tobacco use would have been a better use of time, as the old-fashioned smokeless tobacco products are being used by a significant proportion of youths.

But spending three days discussing a product that we're not even sure any youths are using makes little sense to me. What is demonstrates is a complete lack of perspective on the problem of tobacco use in the United States.

Now don't get me wrong. This is obviously not completely TPSAC's fault. The advisory committee was charged by statute with exploring the dissolvable issue. The fault is largely that of the anti-smoking groups which promoted this legislation. It is the Tobacco Act itself which ensures that federal tobacco efforts lack any kind of perspective on the problem of tobacco-related morbidity and mortality. That legislation was crafted by the anti-smoking community (a.k.a., the Campaign for Tobacco-Free Kids) to protect the market share of the most toxic tobacco products on the market at the expense of less hazardous but potentially competitive alternative products. This was done with intent; it was no accident.

The rest of the story is that thanks to misguided legislation, federal efforts on tobacco control have become largely misguided. They are focused largely on the products which are least hazardous and least used by youth, while ignoring (giving a free ride to) the most hazardous products that are most used by youth.

How does this make any sense?

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