What Are They Smoking?
We Need the FDA to Regulate the Tobacco Industry
SOURCE: flick.com/SuperFantastic
In Congress there is astonishingly shortsighted opposition to the obvious need for the Food and Drug Administration to police the tobacco industry.
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I recently learned that that a friend of mine has been driving his father several times a week to treatment for his smoking-related cancer, and yet there is a Marlboro Light balanced in my left hand as I type this. I hate cigarettes, and after 16 years of addiction to nicotine and countless attempts at quitting, I believe it is time for me to take drastic measures (more on that at the end of this piece).
Smoke-by-numbers
An estimated 20.8 percent of all adults (45.3 million people) smoke cigarettes in the United States.
In the United States, cigarette smoking is responsible for about one in five deaths annually, or about 438,000 deaths per year; on average, these people die 13 years younger than non-smokers.
For every person who dies of a smoking-related disease, 20 more people suffer with at least one serious illness from smoking.
Annually, cigarette smoking costs more than $167 billion, based on lost productivity ($92 billion) and health care expenditures ($75.5 billion).
In 2005, the latest year with available data, the cigarette industry spent almost $13.11 billion, or more than $36 million per day, on advertising and promotional expenses.
Each day in the United States, approximately 4,000 people between the ages of 12 and 17 years initiate cigarette smoking.
In the United States, 23 percent of high school students are current cigarette smokers.
Among adult smokers, 70 percent report that they want to quit completely, and more than 40 percent try to quit each year.
I didn’t start writing this column about my friend’s father’s cancer or my addiction. I set out to write about legislation that could finally bring parasitic tobacco companies under the control of the Food and Drug Administration and the astonishingly shortsighted opposition to placing basic health and safety regulations on products that have been proven dangerous.
Currently the FDA can regulate my mouthwash, but not the cigarettes that made my breath stink.
In 1996, the FDA actually tried to assert regulatory power over tobacco products, but the tobacco companies fought back and ultimately the Supreme Court unanimously ruled in 2001 that Congress had not granted the FDA the power to do so. Enter the Family Smoking Prevention and Tobacco Control Act, introduced last year by Senators Edward Kennedy (D-MA) and John Cornyn (R-TX) in the Senate, and Congressmen Henry Waxman (D-CA) and Thomas Davis (R-VA) in the House. The bill would reinstate the 1996 rule and expand the FDA’s power to restrict the marketing of cigarettes, to children in particular.
A superficial glance at the bill reveals that it fails the logic test by requiring an agency charged with protecting the health of Americans with regulating a deadly product without the authority to ban it outright. But the alternative, of leaving Big Tobacco to freely manipulate their product to keep me and the rest of my stinky-fingered brethren addicted, is unacceptable.
Indeed, a 2007 study by the Harvard School of Public Health [1] confirmed a previous study by the Massachusetts Department of Public Health showing cigarette companies deliberately increased the amount of nicotine in the average cigarette by 11.6 percent between 1997 and 2005. So during the time period that I and many other Americans were trying to quit smoking, Big Tobacco was bumping up nicotine levels to make it even more challenging.
Since cigarette ingredients are unregulated, they were neither required to seek approval before increasing the amount of an addictive chemical nor to inform their customers. That’s the kind of regulatory oversight the FDA could bring to this drug-peddling industry.
Cigarettes are unregulated drug delivery systems.
It’s common knowledge that cigarettes are far more than dried tobacco leaves, and that the companies that produce them have misled the public for years. But somehow we don’t think of cigarettes as highly engineered nicotine delivery systems. It is the nicotine-induced blast of dopamine and other neurotransmitters that keeps me coming back for more, so, naturally, improving the drug delivery mechanism will increase addiction. And that is the key. Cigarettes are unregulated drug delivery systems.
A recent report by several respected health organizations, including the American Heart Association and the American Lung Association, details many of the clever advances that make the modern cigarette an engineering marvel. Case in point: Philip Morris, which manufactures my brand of cigarettes, discovered that adding ammonia-based compounds to cigarettes increased the absorption of nicotine. That’s the same principle as crack cocaine. Genius!
The addition of ventilation holes in the filter paper is another brilliant bit of engineering designed to dilute the smoke so the machines that test for tar levels register lower amounts, and the cigarettes can be marketed as “light.” The problem is, smokers functionally draw on cigarettes differently than the machines to maintain nicotine levels, and there is no net health benefit, just smooth smoky goodness [2]. The best part about these companies is that they continue to innovate. A recent Wall Street Journal article detailed the many wonderful products that Phillip Morris has developed, including a high-tar, high-nicotine cigarette and shorter cigarettes for those who just need a quick fix [3].
Fear Itself
Like cigarettes marketed to minorities and children, opposition to the FDA regulating tobacco comes in a variety of flavors. Dr. Andrew von Eschenbach, the Commissioner of the FDA, told the Associated Press last year that the FDA “approve(s) products that enhance health, not destroy it,” and that if regulated the FDA could unintentionally make a decision on cigarettes that could make “the public health radically worse.” In a Senate hearing last year, von Eschenbach also expressed concern that “the public will believe that products ‘approved’ by the Agency are safe and that this will actually encourage individuals to smoke more rather than less.”
Yet the bill now in Congress does not mean the FDA will be approving cigarettes. And the public, while foolish enough to start smoking, is not so foolish as to believe that smoking is okay because the FDA regulates it.
The fear that the FDA could make things worse scares the hell out of me. Are we to believe that the FDA is incapable of making rational decisions about cigarettes, but rational ones about all other consumer products they regulate? It is also irrational to think that forcing companies to lower the amount of nicotine in cigarettes or to remove the ammonia compounds that help deliver it to the brain faster could cause people to smoke more cigarettes, especially in light of a study by the National Cancer Institute that found that gradually lowering the level of nicotine in cigarettes does not cause smokers to smoke more or inhale more.
Senator Mike Enzi (R-WY) is perhaps the most outspoken opponent of the bill in Congress, and along with eight Republican colleagues on the Senate Health Education Labor and Pensions Committee, he voted against it. Enzi has referred to the bill as a “public health disaster” because it does not allow the FDA to kill the tobacco industry completely.
He also claims that the bill is a peace offering to Big Tobacco because Philip Morris has expressed support. But the support by one of the biggest offenders is not an indication that the bill is a public health disaster and does not preclude passing additional laws that aim directly at stopping people from smoking or putting Big Tobacco out of business.
To that end, Enzi introduced the Help End Addiction to Lethal Tobacco Habits Act, which he touts as an alternative to having the FDA regulate tobacco. At its heart, the bill is a kind of cap-and-trade program that allows companies to divest from the tobacco industry over a period of 20 years. Keep in mind that Enzi’s bill is not mutually exclusive from the Kennedy-Cornyn, Waxman-Davis Family Smoking Prevention and Tobacco Control Act, which has 55 cosponsors and has passed the Senate twice before—virtually guaranteeing that it will pass when brought to a vote.
This brings up the second and perhaps more important point regarding Enzi’s alternative bill; he has failed to convince a single Senator that it is worthwhile enough to co-sponsor.
The Family Smoking Prevention and Tobacco Control Act will be considered by the House Energy and Commerce Subcommittee on Health this week, and the full committee is likely to consider it in the next couple of weeks. But ranking subcommittee member Joe Barton (R-TX) now claims that part of the bill might be out of their jurisdiction because the user fees charged to tobacco companies are adjusted for inflation over time and thus, in his view, constitute a new tax. The House parliamentarian will surly resolve this minor jurisdictional issue before next week. Then we may hear much of the same hollow and often embarrassing opposition from many in Congress, including Rep. Steve Buyer (R-IN), who invoked the slippery slope argument at a House hearing on the bill last fall, stating “What are we going to do? Outlaw Halloween, Valentine’s Day, the Easter bunny?…That gets pretty ridiculous when you think about all that.” I have and it is.
What is clear is that this brand of specious opposition will be far less decisive than the over 600 public advocacy groups that support it. With over 430,000 Americans dying of tobacco-related deaths each year, one would suppose that in most districts, more constituents have died from cigarettes over the years than would oppose the bill today.
I hate the fact that I am at the mercy of a tobacco company that has engineered their product to keep me addicted. And I hate the fact that my friend has to bring his father to chemotherapy because of cigarettes. But the fact that cowardice has prevented our government from protecting us from such manipulation makes me physically queasy.
Sen. Enzi is correct—having the FDA regulate tobacco will not get rid of cigarettes. But it sure will make it a lot harder for more dangerous products in development and currently sold abroad to make it to the United States. And if Big Tobacco has to stop developing their products for and advertising them to children, then please explain to me again how this bill is worse for us than a pack of Luckys.
Michael Stebbins is the Director of Biology Policy for the Federation of American Scientists, President of the SEA Action Fund and author of Sex, Drugs and DNA: Science’s Taboos Confronted. He quit smoking as of the publication of this piece and will donate $1000 to the American Heart Association for every cigarette he smokes from now until the end of the year. You can track his progress at SexDrugsandDNA.com.
Notes
[1] Connolly, GN, et al., Trends in Smoke Nicotine Yield and Relationship to Design Characteristics Among Popular U.S. Cigarette Brands, 1997-2005, A Report of the Tobacco Research Program Division of Public Health Practice, Harvard School of Public Health, January 2007.
[2] National Institutes of Health, Risks Associated with Smoking Cigarettes with Low Machine-Yields of Tar and Nicotine; Report of the NCI Expert Committee, National Cancer Institute, Smoking and Tobacco Control Monograph 13, October 2001.
[3] “Philip Morris Readies Aggressive Global Push,” The Wall Street Journal, January 29, 2008.
Comments on this article
Interesting post. This kind of deception frustrates the hell out of me, and you’re right: No one, most notably the government, seems to be doing much if anything about it, at least until recently. I wrote a bit about it too here and here.
March 7th, 2008 at 2:48 pmThose BASTARDS! My mother died of lung cancer after two decades of trying to quit. Why wasn’t she able to quit? Because they manipulated the product to keep her puffing away. Congress has an chance to for once do the right thing. For Christ’s sake stop the nonsense.
Tech Gurette
March 7th, 2008 at 9:11 pmI completely agree that there should be some governing body or agency over tobacco and tobacco companies, but don’t you think that the FDA in recent times has proved that they are incapeable of handeling the work they have now? (i.e. Spinich, Beef, etc.) In addition, I feel that stamping “FDA Approved” on a cigarette will only lead to a whole host of other problems.
March 10th, 2008 at 11:17 am“…I feel that stamping “FDA Approved” on a cigarette will only lead to a whole host of other problems.”
Very true. However, I think the hope here would be that the stamp would say “FDA Disapproved” instead, or that it wouldn’t even get to the stamp stage in the first place on account of frank toxicity. :)
March 10th, 2008 at 7:22 pmI’m the friend Michael refers to in this piece who has been driving his Dad to treatment for head and neck cancer. I quit smoking about 9 weeks ago, exactly a day before my Dad started chemotherapy and radiation. Sadly, I have met a lot of people over the last several weeks in chemo who have smoking related cancers.
If we allow the tobacco companies to continue to be unregulated, I promise that hospitals will have to build additional wings to house all of us who will need chemo treatment. Enough is enough.
March 11th, 2008 at 2:41 pm“If we allow the tobacco companies to continue to be unregulated, I promise that hospitals will have to build additional wings to house all of us who will need chemo treatment.”
Geoff,
They already do! Trust me. And I work in a separate wing dedicated to studying their biopsies in a research lab.
March 11th, 2008 at 4:44 pmI have smoked marijuana somewhat as a habit and, for a short while, cigarettes. I can walk away from marijuana for years (currently going on 10 years) without trouble, although I miss the social aspect of it. Cigarettes, however, nag at me constantly. I can hardly see a movie without wanting one. I have papers and high-quality tobacco stashed in the house and occasionally indulge that addiction. There is little or no satisfaction in the cigarette smoke.
As a hippie, I tried several drugs that I thought would be interesting without risking my physical or mental health to any great extent. I can say as an experience experimenter that tobacco is the most addictive substance I have tried.
March 15th, 2008 at 6:38 amRegarding the ability of the FDA to handle its current responsibilities:
This bill — section 920, specifically — gives the FDA a separate funding stream, paying for its enforcement and the establishment of a new Center for Tobacco Products — with a user fee on the tobacco companies. It will have no impact on the ability of the FDA to carry out its current functions. None.
Regarding the “stamp of approval”:
(a) the government already, in tolerating the existence of cigarettes, has given such an implied stamp. Moreover, allowing some cigarettes to call themselves “light” — which the legislation would ban, along with descriptors like “mild” and “low tar” — the government allows the companies to deceive consumers about the risks of the product.
(b) the legislation does not allow companies to put such a stamp on their products. Period. (The language is not yet available online, but was approved by the House Subcommittee on Health and the Senate HELP Committee.)
(c) Section 201 of the legislation will increase the size and prominence of warning labels — 30 percent of the front and back of the back, 17 point, bold type, white-on-black (or black-on-white, if it’s more visibile), etc. It’s the very opposite of a seal of approval.
March 17th, 2008 at 1:43 pmVery interesting article. I was especially interested in your mention of a study by the National Cancer Institute that found that gradually lowering the level of nicotine in cigarettes does not cause smokers to smoke more or inhale more. That was my experience about 10 years ago when I quit smoking. I used a method described in the book “Switch Down & Quit: What the Cigarette Companies Don’t Want You to Know About Smoking”, by Dolly D. Gahagan, published in 1987. I found that each time I switched to a slightly lighter brand, I would try to compensate for the lower nicotine level for a few days. But just as the author described, my body seemed to adjust to the lower level of nicotine and I returned to my old smoking habits within a week. Using this method, I switched from Kool Milds (about .9 mg nicotine and 11 mg tar) to Carlton Ultra-Lights (about .1 mg nicotine and 1 mg tar). There is no way that was compensating to get the same tar and nicotine out of the Carltons as I had the Kools.
What I can’t figure out is why the Federal Trade Commission stopped releasing tar and nicotine figures in 1999. According to an article at http://freegovinfo.info/archive/200608 , they continued collecting data on nicotine but have not published reports on the findings. This likely made it easier for the cigarette companies to increase the amount of nicotine in the average cigarette by 11.6 percent between 1997 and 2005 as reported in your article. Why did the FTC stop publishing the figures? I well understand that the figures are imperfect and may not accurately reflect the tar and nicotine taken in my many smokers. They could have handled this by including warnings and disclaimers as are included with other information and products. But it seems wrong to me to deny smokers the information that their very tax dollars are paying to collect. I’m just glad that I quit before the powers that be made this information generally unavailable. I’ve tried to find updated information for other smokers but have been unable to find a complete and reliable source. If you know of one, please post it here. Anyhow, thanks again for your article.
March 28th, 2008 at 1:43 am