SPH prof clashes with public health orgs
By Danielle Masterson
The Food and Drug Administration will be able to strictly regulate tobacco products if legislation now before Congress is passed, say more than 50 public health organizations. But Michael Siegel, an associate professor in the School of Public Health, says the bill will result in more tobacco-related deaths.
Included in the amendment to a largely unrelated corporate tax bill, the regulations will “create a public perception that now that the FDA is regulating tobacco, cigarettes are a safer product,” says Siegel. “If the public’s perception of the risks of smoking goes down, smoking will go up.”
The amendment contains a $12 billion tobacco buyout designed to help struggling tobacco farmers switch to other crops as demand for tobacco in the United States declines. In exchange, antismoking legislators included in the amendment new FDA oversight of the industry. The amendment is sponsored by Senators Edward Kennedy (D-Mass.) and Mike DeWine (R-Ohio) and was passed by the Senate July 15. But because the House passed only the tobacco buyout and not the regulation portion of the amendment, it currently is being discussed in a conference committee.
Siegel, a physician who has researched tobacco control extensively for the past 19 years, released the first detailed report analyzing the bill last month.
According to the study, published on the SMOKEFREE Network’s Web site, the bill will create a “public perception” that “the health risk posed by ordinary tobacco products will decline as the public perceives the fact of FDA regulation as automatically meaning the product must be reasonably safe, or at least safer.”
Siegel also argues in the report that the bill will result in more tobacco-related deaths because the legislation hamstrings companies from researching, developing, introducing, or marketing less hazardous tobacco products by implementing stringent regulations.
Public health organizations say the legislation is important because it will regulate certain aspects of existing products, such as restricted marketing, disclosure of ingredients, and warning labels. The FDA does not currently regulate tobacco.
Some public health groups also champion the bill’s tobacco buyout provision. “It gives farmers the chance to use the money to transition to other crops or other ways of earning income,” says Vince Willmore, director of communications for the Campaign for Tobacco-Free Kids.
The Senate amendment requires that any new cigarette brand obtain FDA approval, while existing brands are grandfathered into the new regulatory system. But Siegel says the regulations will discourage the creation of less hazardous tobacco products.
“Existing brands can continue to be marketed and continue killing people,” he says. “But new brands must be approved by the FDA.” Any new cigarette brand that is going to be marketed as a “reduced risk” product must prove to the FDA that it lowers the risk of smoking — a feat close to impossible, he says. “It has to be done with long-term scientific studies. You can’t just find out if a new product is going to reduce cancer rates in a year or two.”
He says the legislation is flawed because “the bill completely ties the hands of the FDA in terms of complying with the very legislation that sets requirements for its action. The loopholes in the legislation are huge, and not only benefit the tobacco industry, but institutionalize tobacco and additions to tobacco products in our society.”
According to Siegel, major public health organizations made the buyout into a public health issue by forming a partnership with tobacco farmers. He says the partnership has put such groups as the Campaign for Tobacco-Free Kids, the American Cancer Society, the American Heart Association, and the American Lung Association “shoulder to shoulder” with Marlboro manufacturer Philip Morris.
“The public health organizations used the tobacco farmers as a pawn, I believe, in their political game,” says Siegel. “They formed a coalition with the farmers and said, ‘You want a buyout; we want legislation; let’s form a coalition.’
“I find it really appalling that public health groups would get together with the nation’s leading cigarette manufacturer and essentially work together to promote legislation that is going to preserve Philip Morris’ profits at the expense of the public’s health,” he adds.
Siegel says he started his analysis thinking there could be a possibility “that Philip Morris had turned over a new leaf and was, for the first time in history, supporting a bill that would protect the public health at the expense of its own profit.” But his findings show the opposite, he says: “This legislation would essentially protect the market share of Philip Morris, protect its cigarette brands, and eliminate any competition from other companies.”
Although he suggests specific changes to the bill, Siegel says federal legislation of tobacco products is not the way to go. State initiatives such as smoke-free restaurants, bars, and workplaces, as well as tobacco cessation programs, have been successful in Massachusetts and could be used to continue the effort to control and stop tobacco use.
“Public health groups should be focusing their attention where we do have power — at the state and local levels,” Siegel says, “not in this futile effort to go through Congress.”