Wednesday, June 17, 2009

We've come a long way to tobacco regulation -- June 11, 2009 column


Once or twice during my freshman year in college, my roommate’s father brought me a carton of luxury British cigarettes. Thrilled by the elegant boxes, I smoked the cigarettes with gusto.

Today, that would be like someone’s dad randomly picking wild mushrooms in the woods, carrying them to the dorm and saying, “Here, these look great. They may be deadly, but eat up.”

One thing everybody agrees on in 2009: Cigarettes are poison. Smoking is the leading preventable cause of death in the United States. About 443,000 deaths a year are attributable to cigarette smoking.

While banning cigarettes is not an option in a country where 40 million people are addicted, we have agreed as a society to restrict where people can smoke, to limit cigarette sales and advertising appeals to adults and to post warning labels on cigarette packs. Still, about 1,100 kids under 18 become regular—that is, daily—smokers, according to the Centers for Disease Control and Prevention.

And that’s why Congress is poised to give the Food and Drug Administration regulatory power over tobacco. President Barack Obama likely will sign the legislation. More regulation may not end the problem of teen smoking, but it’s a step.

Interestingly, regulation isn’t happening because smoking is on the rise. It’s happening because most Americans don’t smoke, and Big Tobacco’s political clout has waned.

In the late-‘60s to mid-‘70s, the obnoxious “You’ve come a long way, baby” Virginia Slims ads linked a woman’s right to vote with a dubious right to smoke. Such an appeal today would be ludicrous. Nonsmokers demand the right to clean air, and they’re militant for good reason.

Many surgeons general have warned about the harmful effects of smoking. Congressional hearings and lengthy court cases have provided ample evidence that tobacco companies misled smokers for decades. While publicly denying that their products were addictive, the companies were controlling levels of nicotine to hook smokers and keep them hooked.

In 1965, a year after the surgeon general first reported that cigarette smoking caused lung cancer in men and was a “probable cause” of lung cancer in women, more than half the men and one in three women in America smoked. By 2008, only about one in five adults over 18 are smokers.

Americans’ relationship with tobacco remains complicated, however. We’ve segregated smokers, forcing them to engage in their habit in certain areas, yet at the same time, we rely on smokers’ tobacco excise taxes for such worthy causes as health care. Congress passed a 62-cent tobacco tax increase in February to pay for the State Children’s Health Initiative Program. If everybody were to quit smoking, we’d have to find other funding sources.

Regulation has been a long time coming. In 1994, David Kessler, then commissioner of the Food and Drug Administration, claimed jurisdiction to regulate tobacco as a drug through nicotine’s addictive properties, but the Supreme Court ruled that Congress had not intended to put tobacco under FDA control.

The new measure would mean stronger warnings, FDA oversight of cigarette ingredients and ads and such health-related claims as “light” and “mild.” The legislation doesn’t ban nicotine or menthol. Tobacco companies will pay fees based on their market share to cover regulatory costs.

Some in the health community worry that the bill doesn’t go far enough. It’s troubling that tobacco giant Philip Morris helped write the measure and backs it. Other tobacco companies oppose it, saying it’s structured to give Philip Morris a permanent business advantage by limiting competition.

But it’s a sign of how far we’ve come that usually anti-regulation Republicans back tobacco regulation. Here’s Sen. John Cornyn, R-Texas, on the Senate floor: “One might ask, as a conservative: Why would one support more regulation rather than less? Well, because of this split personality the federal government has in dealing with tobacco – recognizing it is a deadly drug, recognizing marketing often targets the most vulnerable among us, and recognizing the fact that it kills so many people and increases our health care costs not only in Medicare but in Medicaid…”

Why not just ban cigarettes? “We all know that is a slippery slope for the individual choices we make,” Cornyn said. “If we were to ban tobacco, we might as well ban fatty food; we might as well ban alcohol. Obviously, the government would become essentially the dictator of what people could and could not do and consume, and I don’t think the American people would tolerate it…”

Despite all the education about the dangers of smoking, lung cancer kills more women than any other form of cancer, including breast cancer.

I finally quit smoking for good circa 1995. No ad or cool British packaging could tempt me now. My friend Laurie wasn’t so lucky. She and I both loved smoking, and we puffed through many a late-night dorm discussion of poetry and politics. Lung cancer claimed her at 52.

Today, when I see a smoker, I see someone who just hasn’t quit yet.

(c) 2009 Marsha Mercer. All rights reserved.

No comments:

Post a Comment