FDA oversight means public health victory on tobacco

As recently as a few years ago, some people still were saying it never could happen. But physicians and other public health champions knew better. And they knew that the lives of many of their most vulnerable patients were just too important to back down from the fight.

That battle was for the common-sense notion that the Food and Drug Administration -- created explicitly to protect consumers from dangerous products -- should have oversight over tobacco. Now, Congress and President Obama have acted after years of disappointment on Capitol Hill and in the courtroom. For the first time, the FDA will be able to regulate the manufacture, marketing, and sale of cigarettes and other tobacco products in a way that will save lives.

This historic victory, capped by the president's June 22 signature on the tobacco regulation bill, was a long time coming.

Despite the progress that doctors and public health advocates have made in recent years, tobacco use is still the No. 1 preventable cause of death in the U.S.

Physicians struggle not only to keep patients from taking up smoking and getting them to quit if they have, but also to treat the cancer, emphysema, heart disease and other potentially life-threatening conditions caused by tobacco use. Sometimes it takes the expert hand and caring heart of a doctor who wants his or her patient to live a long, healthy and happy life. Sometimes even that is not enough.

In spite of physicians' best efforts, tobacco use still kills more than 400,000 Americans, sickens many more and costs the health system roughly $96 billion every year. That makes it a problem for all of us, not just those who choose to smoke.

That's why the federal government needed to step up and play a larger role in the battle. FDA regulation will not mean a ban on tobacco. But it will impose requirements on the industry that have the potential to convince many people that lighting up that cigarette or opening that tin of dip does not make for a healthy future.

The agency will have the authority to reduce the highly addictive nicotine content of tobacco products and require manufacturers to disclose exactly what substances go into them. It also will be able to stop the industry from using advertising with misleading claims such as "light," "low-tar" or "mild."

Most important, the government will be better able to help protect our nation's children from falling victim to Big Tobacco. New bans on tobacco ads near schools and sponsorship of sporting events will go a long way toward intercepting the roughly 1,000 kids each day who light up for the first time and become regular smokers.

President Obama acknowledged the AMA's longstanding commitment to this effort to safeguard children's health in his June 15 address to delegates at the Annual Meeting. Hundreds of other organizations with a like-minded commitment to the most vulnerable patients also lent their voices in support of the legislation and helped defeat concerted attempts to derail it once more.

Doctors need to stay vigilant in the bigger battle against tobacco, but it appears that the tide is turning when it comes to the debate over whether nicotine is a harmful drug. When this legislation first emerged a decade ago, many dismissed it as a fantasy. But thanks to the persistence of the AMA and others committed to public health, it is now a reality.