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Tuesday, March 6, 2007

What is Teddy smoking?

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Last week the Senate began hearings on a bipartisan bill to give the Food and Drug Administration regulatory control over cigarettes and other tobacco products. The bill's proponents, including Sen. Ted Kennedy, Massachusetts Democrat, argue that FDA authority over tobacco will lead to a safer cigarette, stronger warning labels and a reduction in cigarette-related deaths.

At first blush, this sounds like great news. But tragically, the proposed legislation will have exactly the opposite effect -- and will likely increase smoking-related deaths. How could such an apparently well-meaning proposal be so insidious?

First, the bill -- which goes by the warm and fuzzy name "Family Smoking Prevention and Tobacco Control Act" -- promises to make smokes safer by removing so-called "dangerous" chemicals.

The problem is that it's not a few, or a few hundred, of the 4,000-plus "chemicals" in cigarettes are deadly: It is the inherent toxicity that results when the products of tobacco combustion are inhaled into the lungs and get into the circulation.

Worse, the legislation calls on the FDA to reduce the addictive nicotine in cigarettes -- but prohibits the agency from completely eliminating nicotine. If the nicotine is reduced, smokers will smoke "harder" to get the desired nicotine jolt -- thus taking in more of the very hazardous products of combustion. Again, it is not the nicotine itself that causes disease but inhaling the "junk" that forms when tobacco burns.

Nicotine is highly addictive -- and smokers want their "fix." Studies of "light" cigarettes reveal that while they may contain less nicotine, smokers compensate by smoking more of them, making the health risk at least equivalent to smoking "regular" cigarettes.

Another problem is the bill would mandate stronger warning labels on all tobacco products, likely giving the impression they are all equally dangerous -- and thus protect cigarette companies from the first real business challenge they have faced in decades: competition from "clean" sources of nicotine, including smokeless tobacco.

In Sweden, programs over the last 20-plus years have encouraged men to use smokeless products (known as "snus" -- a small tea-bag like pouch filled with tobacco put between gum and cheek) instead of cigarettes. The smokeless product delivers a relatively "clean" dose of nicotine -- and the result has been a substantial decline in lung cancer and other cigarette-induced diseases. This form of "harm reduction" has great potential to reduce cigarette smoking in the U.S. and reduce its associated mortality, by helping addicted smokers quit (smokeless tobacco presents minimal health risks compared to cigarette smoking).

The proposed bill, however, will mandate a severe warning on smokeless products -- a warning that totally misrepresents the relative risk of that product compared to cigarettes, thus largely removing the threat to cigarette sales that would follow if the switch to smokeless occurred here as it did in Sweden.

Finally, assigning the FDA authority over tobacco is clearly at odds with the agency's mission and opens the door for cigarettes being perceived as "FDA approved." If the industry complies with FDA mandates to remove "toxins" and lower nicotine, it can declare itself "in compliance."

The industry will imply is has an FDA "seal of approval" and must therefore be safe -- or safer. This will be a godsend to the tobacco industry in court, as they will be able to deflect liability against sick smokers' lawsuits by merely pointing to the new FDA regulation and saying they adhere to the rules. This is exactly the sort of counterproductive result of regulation that Philip Howard pointed to as evidence of "The Death of Common Sense" in his 1994 book by that name.

One has to ask our elected officials: What are you folks smoking? You propose that the agency primarily in charge of approving and regulating lifesaving pharmaceuticals and protecting us form food-borne pathogens must now oversee -- and bestow a veneer of legitimacy upon -- an industry responsible for the needless deaths of more than 400,000 Americans annually?

Dr. Elizabeth M. Whelan is the founder and president of the American Council on Science and Health.

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