You likely know by now that the U.S. House of Representatives passed by a veto-proof margin a bill (H.R. 1108) giving the FDA power to regulate tobacco products. As the NYT notes, “The legislation was partly the result of negotiations with Philip Morris USA, the nation’s largest cigarette company, which split with other companies by endorsing it.” (NYT gives a nice summary of the bill’s provisions that I won’t repeat here.) The other tobacco companies refer to this bill as the “Marlboro Monopoly Act.”
Indeed, Philip Morris spokesman Bill Phelps plainly states that “We remain committed to securing the benefits that legislation would provide for our consumers and stockholders.”
Hmm. Could one of those legislative benefits be the huge loophole that kept menthol off the list of banned flavorings?
Could another be the opportunity for Philip Morris to claim, when making their case their case for FDA approval of “modified risk tobacco products”, that
“scientific evidence is not available and, using the best available scientific methods, cannot be made available without conducting long-term epidemiological studies for an application to meet the standards set forth in paragraph (1); and the scientific evidence that is available without conducting long-term epidemiological studies demonstrates that a measurable and substantial reduction in morbidity or mortality among individual tobacco users is reasonably likely in subsequent studies.”
Just how concerned is Philip Morris about reducing “morbidity and mortality among individual tobacco users”?
Allan Brandt notes in the NEJM that “While Altria is promoting FDA regulation, Philip Morris International is test-marketing a new high-tar, high-nicotine cigarette in Southeast Asia.”
Further, Philip Morris International (PMI) is using tricks learned in the US to addict youth overseas. Alicia Keys protested PMI sponsorship of her concert in Indonesia, including billboards promoting “A Mild cigarettes” in conjunction with the concert. PMI was not the only sponsor, but the event is billed as “A Mild Live Production” in a country where there is no minimum age law for purchasing cigarettes, about two-thirds of adult males are smokers, and PMI paid $5.2 billion in 2005 to obtain a 40% stake of HM Sampoerna (Indonesia’s largest tobacco company).
Clearly Bill Gates and NYC Mayor Michael Blumberg have their work cut out for them. Let’s hope their $500 million initiative is enough. (The Philip Morris response? They “agreed that children should be kept from smoking but thought that raising cigarette taxes promoted smuggling and counterfeiting.”)
Finally, although Congress agrees there is no question that
(50) … the major United States cigarette companies have designed their cigarettes to precisely control nicotine delivery levels and provide doses of nicotine sufficient to create and sustain addiction while also concealing much of their nicotine-related research. USA v Philip Morris, USA, Inc., et al. (Civil Action No. 99-2496 (GK), August 17, 2006).
they specifically ban the FDA from eliminating nicotine from tobacco products. In theory, the FDA could eventually reduce permitted nicotine levels to non-addictive levels, but this, like proving menthol to be a dangerous additive, could be tricky to implement, particularly if Philip Morris et al. manage to pack the Tobacco Products Scientific Advisory Committee with such unconflicted experts as their supportive University researchers in Richmond.
Indeed, Brandt cautions us that “Congressional legislation passed under the rubric of “regulation” has often come back to haunt public health advocates.” Specifically,
Once tobacco products began to sport such labels, the industry repeatedly argued in litigation, with considerable success, that its product was preempted from liability by Congressional mandate. Although there is no evidence that such legal protections were intended by earlier tobacco legislation, we now know from previously secret internal documents that the industry actually favored such legislation as a weapon in its defense against lawsuits.
The Senate will likely take up the measure in the fall, and the White House has promised a veto. Stay tuned.
Medical Writing, Editing & Grantsmanship 
Drugs, But No Smokes « Medical Writing, Editing & Grantsmanship said
[…] Tobacco “Research” Given that the Senate is a tad preoccupied with other matters just now, the Family Smoking Prevention and Tobacco Control Act may not be brought up for a vote this fall. In the meantime, though, San Francisco has passed a ban […]
Jamaal said
Reducing the nicotine in cigarettes would be anti-science and pro-Marlboro. As cigarettes are primarily a nicotine delivery system, smokers attempt to maintain a certain constant amount of nicotine in their blood, and adding a filter or reducing nicotine just increases consumption.
writedit said
As an update, as you are no doubt aware, the Senate (and the House previously) has approved the Family Smoking Prevention and Tobacco Control Act, which President Obama has promised to sign.
writedit said
JAMA has a brief synopsis of the Family Smoking Prevention and Tobacco Control Act, which President Obama did indeed sign into law on June 22, 2009. Both the Acts strengths and potential weaknesses are addressed:
writedit said
Per a recent notice, NIDA seeks research proposals addressing the clinical, population, and societal impact of the Family Smoking Prevention and Tobacco Control Act (H.R. 1256). High priority areas include: determining the impact this legislation has on population trends in smoking initiation, progression, and cessation; how it may affect desire to quit, quit attempts, relapse, and utilization of services providing treatment for nicotine dependence; changes in the effectiveness of preventive and treatment interventions; unintended consequences; and variation in these outcomes by age, race/ethnic, gender, socioeconomic status, co-morbidity, and other factors.