FDA tobacco control bill is misguided

Regarding "The FDA and tobacco control: New hope for action" (Editorial, March 26): Your editorial supports the bill to entrust the Food and Drug Administration with oversight of tobacco products, in spite of the FDA commissioner's concern that such regulation will undermine the public's awareness of smoking-related dangers.

I and others have looked in vain for any evidence that the measure -- which has the strong support of the nation's dominant tobacco company, Philip Morris USA -- will save lives. The public entrusts the FDA to safeguard our food and to evaluate the safety and efficacy of medications. Promulgating "product safety" standards for cigarettes will perpetuate the myth, long fostered by cigarette manufacturers, that this inherently and irredeemably harmful product can be made safer.

Cigarettes -- as a whole, not as a collection of individual toxins -- are the problem. Manipulation of individual smoke constituents, other than possibly nicotine and menthol, has virtually no promise as a public health measure.

Although the bill would strictly regulate new, and potentially less hazardous, noncombustible tobacco products, it would not apply these standards to the most harmful form of tobacco -- cigarettes, which cause the deaths of nearly half a million Americans a year.

The bill also would purport to restrict tobacco advertising and promotion, yet most in-store promotions (which reinforce dominant brands) would persist under the First Amendment.

The words "FDA approved" might not start appearing on cigarette packs, but regulating cigarettes with food and medications inevitably implies government approval.

Arguments for and against the bill can be found on the Web site of the American Assn. of Public Health Physicians.

However well-intended, the bill is misguided. It could well be renamed the Marlboro Protection Act. And it should carry its own surgeon general's warning: "This legislation is deceptive, and it may prove devastating to public health."

Alan Blum, MD, Tuscaloosa, Ala.

Dave Cundiff, MD, MPH, Olympia, Wash.

Editor's note: Dr. Blum is a professor of family medicine and director of the University of Alabama Center for the Study of Tobacco and Society, and Dr. Cundiff is the secretary of the American Assn. of Public Health Physicians.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2007/05/14/edlt0514.htm.