The FDA and tobacco control: New hope for action

Food and Drug Administration oversight of cigarettes and other tobacco products has been a priority among tobacco control advocates for some time. What could set this year apart, though, is evidence that momentum for action finally may be building.

Exhibit A: The bipartisan legislation reintroduced last month in both the House and Senate to install such a regulatory framework.

The measure, the Family Smoking Prevention and Tobacco Control Act, would let the agency restrict the advertising and promotion of tobacco products to children, and require larger and more informative health warnings. It would force tobacco companies to disclose the contents of their products as well as research about the health effects of these products. It also would allow the agency to require changes, such as the removal of harmful ingredients or the reduction of nicotine levels. It would not give the agency power to ban tobacco.

Exhibit B: This legislation's widespread support.

Introduced in the Senate by Sens. Edward Kennedy (D, Mass.) and John Cornyn (R, Texas) and in the House by Reps. Henry Waxman (D, Calif.) and Tom Davis (R, Va.), the bill already has been the subject of a Senate hearing. It also has the backing of a range of public health organizations, including the American Medical Association, which has long-standing policy supporting FDA regulation of tobacco. Others, including the American Heart Assn., American Lung Assn., American Cancer Society Cancer Action Network and the Campaign for Tobacco-Free Kids, are among its advocates.

Exhibit C: Maybe the most compelling evidence of all -- the statistics.

Smoking continues to be the No. 1 preventable cause of death in the United States. It claims an estimated 1,200 American lives every day and more than 440,000 each year. Tobacco-related illness is responsible for an estimated $96 billion in annual health care costs.

More figures underscore why FDA controls -- especially in regard to marketing aimed at children -- are so important. Every day about 4,000 kids will try a cigarette for the first time. Another 1,000 will become new, regular daily smokers, and a third of them will die prematurely because of it.

Lastly, Exhibit D: The fact that the tobacco industry historically has faced almost no federal oversight.

No government agency has regulated the toxic ingredients included in cigarettes or had authority to challenge misleading claims such as "light," "low tar" or "mild." The AMA and these other organizations consider the lack of oversight unconscionable, especially because of the combination of smoking's health effects and nicotine's addictive properties.

Still, past efforts to build a case for change have not met with success. In 1996, the FDA took steps to regulate tobacco products, citing the authority of the Food, Drug and Cosmetic Act. But in response to a tobacco industry lawsuit, the U.S. Supreme Court ruled in 2000 that Congress had not given the agency this legal authority. And as recently as 2004, legislation similar to the current bill was passed in the Senate, but died in the House.

Fortunately, the mood this year seems different.

Supporters point to the new, Democratic-controlled Congress as reason for optimism. Others cite a growing public consensus supporting meaningful controls. Even some Big Tobacco voices have said the legislation offers potential for clearer and more predictable standards for the industry.

The enthusiasm, though, is not universal. Some public health experts, including the FDA's own acting commissioner, expressed concern that agency regulation will send a message that "safer" cigarettes are possible or will lead people to adjust their smoking habits to maintain current nicotine intake levels.

These and other issues certainly will be aired in the months ahead. But the attention will not lessen the need for action. Supporters say FDA oversight has the potential to save hundreds of thousands, even millions, of lives. Doctors, who see firsthand every day the damage done, know that meaningful steps to curb tobacco's reach are imperative.

Weighing the evidence, the verdict -- that the time is right for Congress to provide the FDA with this authority -- is quite clear. Lawmakers should not squander this opportunity.