Careful what you wish for

St. Louis Post-Dispatch (editorial), 08/20/2007

Under a bill expected to be voted on by the U.S. Senate next month, the Food and Drug Administration would gain the power to regulate tobacco products. FDA regulation has been a goal of public health advocates and anti-smoking groups for decades. Now, they're poised to achieve it, albeit with the help of such unlikely allies as tobacco giant Philip Morris.

Smoking kills about 440,000 Americans a year, making it the largest preventable cause of death in the United States by far. FDA regulation would make it possible to further restrict the marketing of tobacco products, a key to reducing the number of people - young people, especially - who take up the lethal addiction.

The FDA also would be in a position to crack down on the manufacturing alchemy that has produced dramatic increases in what scientists refer to as the "effective nicotine yield" of cigarettes over the past decade.

The aspect of the Senate bill that's of greatest interest to Philip Morris, however, is a provision that would allow the FDA to set standards for so-called "reduced-risk cigarettes." Because Philip Morris researchers have been working on the concept for decades, it would be in a position to influence any standards the FDA set. That, in turn, would give the company a distinct competitive advantage in getting its products onto the market.

That gives us great pause. No other industry has been more successful than Big Tobacco at turning the attacks of its opponents and attempts at regulation to its advantage. Its track record stretches back more than four decades.

Even before U.S. Surgeon General Luther Terry's landmark 1964 report on the dangers of smoking, tobacco companies knew they were selling a dangerous product. After trying - and failing - to get the report quashed, they were ready with counter-strategies based on a shrewd understanding of human psychology. "We must, in the near future, provide some answers which will give smokers a psychological crutch and a self-rationale to continue smoking," Philip Morris chief executive George Weissman wrote on Jan. 29, 1964.

Even the warnings tobacco companies eventually were forced to attach to cigarette packages ended up working to the industry's advantage: When deathly ill smokers began bringing lawsuits against tobacco companies in the 1980s and 1990s, the industry pointed to the warning labels as proof that smokers had been warned and bore the responsibility for their own illnesses.

And as massive as the 1998 tobacco industry settlement with the states was - $246 billion over 25 years - it actually is providing less money than state governments already have spent on medical care for people with tobacco-related illnesses.

So forgive us if we listen to Philip Morris' enthusiasm for FDA standards for "reduced risk cigarettes" and hear echoes of what Mr. Weissman was referring to in 1964 as a "psychological crutch" and "self-rationale."

Some of the nation's largest anti-smoking groups are backing the Senate bill. We respect their work, and we join them in hoping that FDA regulation will succeed where so many other efforts have fallen short.

At the same time, it would naive to disregard the history of supposedly sure-fire tobacco control strategies that ended up misfiring. No matter how well-conceived, they always seemed to disappear in a puff of smoke. - - -

Kicking Butt The International Jihad Against Tobacco

By William Salatan Slate August 17, 2007 http://www.slate.com/id/2172230/nav/fix/ I hate smoking. It's a filthy habit. It kills hundreds of millions of people, including bystanders. Just being around it makes me nauseous. Cities, states, and countries all over the world are banning smoking in public, and I couldn't be happier.

In fact, it's such a rout, it's getting out of hand.

The problem with tobacco all along was that politicians and the public didn't recognize it as a drug. They called it a tradition, a "crop," and a "legal product." As though coca and marijuana weren't crops. As though a product's legality should decide its morality, instead of the other way around. When it came to smoking, culture overpowered reason.

Now public opinion and governments have turned against tobacco. But the anti-smoking jihad, born of science, is beginning to outrun it. Culture is trampling reason again, this time in the other direction.

Nonsmoking areas in restaurants haven't worked too well. The smoke just drifts from one area to the other. To fix this, European countries are now isolating smokers in sealed rooms with separate ventilation. Lest any waitress encounter a toxic cloud, Holland, Slovenia, and other countries have outlawed eating in the smoking rooms. That's pretty harsh. I thought we were trying to remove smoke from eaters, not food from smokers.

Likewise, the point of recognizing tobacco as a drug was to regulate it as strictly as comparable drugs, not more so. Five months ago, a report by a British commission found that the financial health costs of alcohol and tobacco were equal. Tobacco was by far the bigger killer, but when the analysis moved beyond self-destruction to harming others, the annual death toll from alcohol-related car accidents exceeded the toll from secondhand smoke in the workplace. Drinking, unlike smoking, played a role in 78 percent of assaults and 88 percent of criminal damage. The commission concluded that if legal drugs were classified like illegal ones, alcohol would be judged more serious than tobacco. Instead, British law allows advertising of booze but not cigarettes.

The strangest thing about the current round of smoking bans is its focus on pubs. All over the world, reporters have been interviewing bar patrons about the merits of expelling tobacco. "It means I can drink and not come out [of] the bar stinking like an ash-tray," one guy in Hong Kong told Agence France-Presse after a night of partying. There's nothing more annoying than a stinking cigarette when you're trying to get stinking drunk.

Tobacco myopia isn't just a British problem. In South Korea, a university president has proposed to permit booze but "remove smoking students from our school." In Amsterdam, coffee shop patrons will soon be allowed to smoke marijuana but not tobacco, despite evidence that two joints cause as much noncancerous lung damage as five to 12 cigarettes.

In the private sector, the tobacco crusade has turned personal. According to a recent survey, 1 percent of companies refuse to hire smokers. Some use random urine or breathalyzer tests to spot nicotine. If you flunk the test or refuse to take it, you're out. Officially, the rationale is that smokers cost companies too much money in health insurance. But some policies go further. One company forced out several smokers, including at least one who wasn't on the company health plan. By her account, employees were told that the ban applied even to nicotine gum and patches, which don't produce secondhand smoke or drive up insurance premiums.

Urine tests are a warning sign that the war on smoking is morphing into a war on nicotine. The latest target is snus, a tobacco product that delivers nicotine without smoke. Despite studies showing it's far safer than cigarettes, most European countries allow smoking but prohibit snus. In the U.S., sponsors of legislation to regulate tobacco under the FDA are resisting amendments that would let companies tell consumers how much safer snus is. The president of the Campaign for Tobacco-Free Kids complains that snus will "increase the number of people who use tobacco," letting "the big companies win no matter what tobacco products people use." But the goal shouldn't be to stamp out tobacco or make companies lose. The goal should be to save lives.

The bill's opponents are no better. They'd rather stick with the idiotic current policy of letting the FDA regulate nicotine in gum and patches-its safest delivery vehicles-but not in cigarettes. They insist tobacco products can't be made safer or less addictive. That's just wrong. In addition to snus, one biotech company has already engineered tobacco plants that are almost nicotine-free.

A year ago, when a study showed an increase in cigarette nicotine levels, anti-smoking activists accused the tobacco industry of boosting its narcotic dosage to make people smoke more. But against the FDA bill, which would reduce nicotine levels, activists are making the opposite argument: that in order to get the same nicotine fix, people will be forced to smoke more cigarettes. Either way, they think manipulation is the problem. In the past, that was true. But today, manipulation is the solution.

Instead of indiscriminately vilifying tobacco, we should reengineer it. Bypass the combustion, purge the tar, dial down the nicotine-whatever serves public health. We could even use it to cure people. Two years ago, Henry Daniell, a biologist at the University of Central Florida, proved that an anthrax vaccine could be grown in genetically engineered tobacco. Tobacco was a logical vehicle, he said, because it was prolific and wouldn't end up in the food supply. Last month, he reported progress in growing a protein to prevent diabetes, but he had to do it in lettuce-a food supply risk-"due to the stigma associated with tobacco." When the war on smoking has come to this, it's time to step back and take a deep breath.