Legislation was introduced to Congress this week by Rep Henry Waxman (D-CA) that would subject tobacco products to regulation by the FDA. This sounds like a good thing, coming from a revered public health advocate. The truth is that if cigarettes were evaluated by the same safety standards that FDA routinely applies to other products for human consumption, cigarettes would be immediately banned. That's not how things will proceed under HR 1256.
The bill represents a compromise between Philip Morris and some of the more 'reasonable' anti-tobacco groups, including Center for Tobacco-Free Kids and the American Cancer Society. These organizations have a history of promoting legislation that offers incremental progress immediately in exchange for guarantees that block more comprehensive restrictions long into the future.
Specifically, the present bill drastically limits the way that cigarettes can be regulated by FDA; at the same time, it will impose much stricter standards on nicotine gum, patches, smokeless tobacco, and other smoking-cessation aids. The American Council on Science and Health says, "the legislation offered by Chairman Waxman will, in fact, have the unintended consequence of making it harder for smokers to stop quitting."
(Background: it is not the nicotine in cigarettes that causes cancer. Ex-smokers who maintain their nicotine dose on patches or even with spit tobacco have in fact substantially reduced their risk of mortality, and, of course, they no longer impose a burden on people around them with passive tobacco smoke.)
As an alternative, Congressmen Steve Buyer (R-IN) and Mike McIntyre (D-NC) have introduced a clean tobacco control bill that offers no restrictions that will slow progress in the future.
Now that Bush is out of the White House and Congress is in Democratic hands, the tobacco industry has much to fear from a resumption of a 40-year legislative campaign to reduce tobacco use in the country and to protect non-smokers in public areas. Let's make sure that this opportunity is not squandered.
Here is a specific critique of the bill prepared by Mike Cummings:
These are very serious ... but fixable ... problems. The health community should see that these issues are resolved, then rally behind the improved bill.
* Precluding the FDA's authority to ban any class of tobacco product. Cigarettes and other combustion forms of tobacco are the real problem, and probably should be banned or at least phased out of existence.
* Precluding the FDA's authority to eliminate nicotine from tobacco products. Combustion tobacco products such as cigarettes cannot be made safer through manipulation of the tobacco or product design unless they are made nonaddictive.
* All evidence points to nicotine as the primary feature of tobacco products that cause them to be addictive and thus dangerous to use. For combustion tobacco products at the very least, the FDA ought to have the authority to remove nicotine and other design elements that make these combustion tobacco products unreasonably dangerous.
* Precluding the FDA's authority to remove additives that are nontoxic.
* The FDA ought to have full authority to remove all additives used in tobacco products regardless of their toxicity. Many addictives that are not toxic in their own right, such as menthol, contribute to the appeal of the product in ways that reinforce exposure to other toxins found in tobacco.
* Mandating tobacco industry representation on the oversight committee. This provision makes no sense. Due to an obvious conflict of interest, drug companies are precluded by the FDA in making judgments about the safety and efficacy of their drugs. Tobacco manufacturers should not be permitted to have special authority to influence the rules that the government makes about the labeling, health and safety regulations of tobacco products. This provision would also make the United States noncompliant with one of the key articles in the WHO FCTC.
* Preempting state and local regulation of tobacco products. The FDA ought to set the minimum standards for regulation and allow local and state health authorities to have the ability of implementing stronger regulations if such regulations are deemed necessary to protect the publics' health.
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