Sunday, February 11, 2007

Campaign for Tobacco-Free Kids' Campaign of Deception on FDA Legislation is Working; Public Has No Clue About Nicotine Policy Considerations

In the past weeks, I revealed a campaign being waged by anti-smoking groups - chiefly by the Campaign for Tobacco-Free Kids - to use data showing an increase in machine-derived nicotine yields in cigarettes over the past 8 years to indicate that tobacco companies are secretly and deliberately addicting youths with the nicotine they add to their products, that legislation is needed to address this problem, and that the FDA tobacco legislation to be introduced this week by Senator Edward Kennedy will do just that.

Here is what the Campaign for Tobacco-Free Kids said in its press release following the release of the Harvard report:

"A new study released today by the Harvard School of Public Health shows the critical need for Congress to enact legislation granting the U.S. Food and Drug Administration (FDA) authority over tobacco products. The Harvard study expands on and confirms an August 2006 study released by the Massachusetts Department of Public Health that found that tobacco companies have deliberately increased the levels of nicotine in cigarette smoke since 1998. The FDA legislation would require tobacco companies to disclose to the FDA changes in their products and provide FDA the authority to require them to reduce levels of constituents, like nicotine that make them more harmful or more addictive."

"Manufacturers of food, drugs and even pet foods are required to disclose to the FDA and the public changes in their products in order to protect the public health. Only the tobacco industry is exempt from these basic public health protections. These studies demonstrate that what the tobacco industry knows and what consumers don’t, can kill us."

"These studies add to the growing evidence that as smoking rates continue to decline, and more smokers try to quit, tobacco companies are actively trying to maintain addiction among smokers and addict a new generation of replacement smokers. The fact that the tobacco companies have been able to secretly increase nicotine levels in tobacco smoke occurred only because no federal or state agency currently has regulatory authority over cigarettes or what tobacco companies put in cigarettes. Legislation to allow the FDA to regulate tobacco should be given a high priority and scheduled for action early this year. The proposed legislation would grant the FDA the authority and resources to stop harmful tobacco company practices that continue to addict children, mislead consumers and devastate the nation's health."

OK. It sounds to me like what the Campaign for Tobacco-Free Kids is saying is that the increasing nicotine levels in cigarettes is a major public health problem that is endangering the public's health by making cigarettes more addictive and more harmful: "The FDA legislation would require tobacco companies to disclose to the FDA changes in their products and provide FDA the authority to require them to reduce levels of constituents, like nicotine that make them more harmful or more addictive."

Further, it sounds like what the Campaign for Tobacco-Free Kids is saying is that the addiction of our nation's children due to the levels of nicotine in cigarettes is a major problem, we have to do something about it, and the proposed FDA legislation would allow the FDA to take care of the problem.

There are two major problems with this kind of propaganda. First, it is deceptive with respect to the public health consequences of increased nicotine yields. In contrast to what the Campaign for Tobacco-Free Kids suggests, increasing nicotine levels do not make cigarettes more harmful, and there is little evidence that they make cigarettes more addictive. It is well-known that as nicotine yields increase, smokers smoke less and tar delivery is reduced. Increasing nicotine yields may actually have marginally positive public health benefits.

The Campaign knows very well that this is the case. In its post-trial brief in the DOJ tobacco case, the Campaign for Tobacco-Free Kids itself argued that: "the Record also demonstrates that these descriptors [e.g., "lights" and "low-nicotine"] were fraudulent. As the evidence adduced at trial overwhelmingly shows, the defendants knew and intended that “brand descriptors communicate a less hazardous cigarette than full-flavor brands,” ... the “data that have been used to justify the campaign for low nicotine cigarettes does nothing of the sort”. Therefore, tragically, smokers who switched to light and low tar mistakenly believed that doing so resulted in a real risk reduction of adverse health effects, when in fact, the perceived risk reduction was an “illusion.”"

So it seems pretty clear that the Campaign is well aware that nicotine yields in cigarettes do not correspond to the level of health hazard associated with smoking these cigarettes. In fact, the Campaign has gone so far as to argue that making any such public suggestion constitutes fraud - a criminal act if you are a tobacco company (but apparently acceptable if you are an anti-smoking group).

The second problem with this type of propaganda is that it deceives the public about the actual nature of the legislation that is being introduced this week. As a reader of this public statement, I would naturally assume that the FDA was going to be given the authority to regulate nicotine levels in cigarettes as appropriate to protect the public's health, to prevent the tobacco companies from "actively trying to maintain addiction among smokers and addict a new generation of replacement smokers," and to stop "harmful tobacco company practices that continue to addict children."

What is the most harmful tobacco company practice that continues to addict children? Without question, it's putting nicotine in the cigarettes. It's not increasing the levels. Even if levels stayed exactly where they are, cigarettes would remain a highly addictive product and would continue to addict our nation's children.

The truth, however, is that the proposed FDA legislation (according to a reliable source - Philip Morris), specifically precludes the FDA from removing the nicotine from cigarettes.

In fact, while I have yet to examine the actual legislation, it is possible that the bills actually preclude FDA from requiring an increase in nicotine levels - the only action FDA could take other than removing the nicotine that would actually improve the public's health.

Merely lowering nicotine levels - which the FDA legislation apparently intends the FDA to do - would be a public health disaster. Smokers would smoke more to obtain the same dose of nicotine, tar delivery would increase, and cancer and chronic lung disease rates would rise.

And this is what the Campaign had in mind when it told the public that the Harvard report shows the need for FDA regulation of nicotine levels? In my view, that's shameful.

The Harvard researchers themselves also seemed to be unclear at best as to the need for legislation that would give FDA the authority to regulate nicotine and why such legislation would benefit the public's health.

One co-author stated: "Policy actions today requiring the tobacco industry to disclose critical information about nicotine and product design could protect the next generation from the tragedy of addiction."

How in the world could merely disclosing the nicotine levels protect the next generation from the tragedy of addiction? Disclosing the levels - which, incidentally, are already disclosed to the Massachusetts Department of Public Health and publicly available on at least Philip Morris' website, would do nothing to prevent addiction. The only thing that would protect the next generation from the tragedy of addiction is to eliminate the nicotine. It's that simple.

I'm not calling for the elimination of nicotine, but I am suggesting that it is deceptive to suggest to the public that the solution to the problem of the "tragedy" of addiction is to require disclosure of nicotine levels. But that's about all that the FDA tobacco legislation to be introduced this week would do in terms of nicotine regulation. Unless you include requiring reductions in nicotine levels - which would be a public health disaster.

The Rest of the Story

Unfortunately, the deception about this issue from the Campaign for Tobacco-Free Kids and others has been effective in clouding the public's appreciation of the real public policy considerations involved in questions regarding the regulation of nicotine in cigarettes.

For example, an editorial published yesterday in the Online Ledger (Lakeland, Florida) argued that the Harvard report shows that legislation is needed to require companies to disclose nicotine yields to the FDA and to prohibit these companies from increasing nicotine content of their cigarettes: "Because tobacco is, essentially, an addictive drug, anti-smoking advocates have long argued that it should be regulated by the U.S. Food and Drug Administration. Presumably, FDA regulations could require companies to more precisely identify nicotine levels in their products and forbid them from steadily increasing nicotine content for the express purpose of addicting even more customers. The Senate passed such a bill in 2004, but it failed in the House. Perhaps now that Congress is under new leadership, the results of the Harvard study will provide fresh impetus for FDA regulation of what is, after all, a deadly substance."

Unfortunately, disclosure of the nicotine yields does nothing to protect anyone and forbidding companies from increasing nicotine is the last thing we would want to do. Higher nicotine to tar ratios would potentially yield a safer cigarette.

It does appear that the misleading statements by anti-smoking groups regarding the public health significance of the nicotine yields of cigarettes have resulted in a general misunderstanding among the public and the media about the real policy considerations regarding the issue of nicotine regulation.

What's so amazing to me is the way that anti-smoking groups appear to be able to twist and use information in completely opposite ways depending on their purpose. When they were trying to accuse the tobacco companies of fraud, they argued that nicotine yields are meaningless from a public health standpoint and lower nicotine does not necessarily mean a safer or less addictive cigarette.

But now that cigarette companies are increasing the nicotine levels, we seem to have forgotten all that and now all of the sudden it is a terrible public health detriment to have cigarettes with higher nicotine yields.

You can't have it both ways. Which is it?

The answer appears to be whatever way will achieve the best support for the pre-ordained agenda of the major anti-smoking groups.

No comments: