The ‘Campaign’ Girds for More Battles in the Tobacco Wars

WASHINGTON—Since its inception 5 years ago, the Campaign for Tobacco-Free Kids has become a major force in the policy wars over tobacco. Media savvy and quick to respond to news opportunities, the Campaign has been effective in publicizing the deceptive practices of the tobacco industry, its political contributions at the state and national level, and its changing advertising practices aimed at enticing youngsters into smoking.

It is supported financially by a number of public health groups, including the American Cancer Society and the American Heart Association.

Matthew L. Myers, president of the Campaign, is an attorney and former Federal Trade Commission official. He joined the organization in June 1996 as its executive vice president and general counsel, and served as the primary public health representative in the negotiations that led to the initial tobacco settlement in 1997.

In this interview with Patrick Young, ONI Washington Bureau Chief, Mr. Myers discusses the state of the tobacco wars and the Campaign’s goals and action agenda.

ONI: Are the tobacco wars over?

Mr. Myers: They are nowhere near over. All of the work over the last several years has only set the stage for the opportunity for fundamental change. Whether a meaningful change takes place in the long run is a task still in front of us.

ONI: What are your organization’s basic goals?

Mr. Myers: Our goal is to have a dramatic impact on the development, enactment, and implementation of policies that will dramatically reduce tobacco use and the harm caused by tobacco, and to help change the environment—social, political, and ethical—in which both tobacco policy decisions and individual decisions on whether to use tobacco are made.

ONI: Do you want to drive the tobacco companies out of business?

Mr. Myers: The goal isn’t to drive the tobacco companies out of business; it is to reduce the number of people who die from tobacco use.

ONI: What do you see as the important tobacco issues for the new Congress?

Mr. Myers: The extent to which the new Administration and the new Congress take on tobacco will be a test of whether the tobacco industry’s massive campaign contributions have made a major difference. We have vitally important issues facing us at the national level.

The Supreme Court decision that the FDA does not have the power to regulate tobacco [see ONI, May 2000] means that it is essential for Congress to give the FDA full authority to regulate the advertising, marketing, and manufacture of tobacco products. If this Congress doesn’t do that, it will truly not be doing the nation’s business. But there are other critical issues that Congress needs to face.

Currently, there are no uniform rules about covering tobacco cessation programs under Medicaid, and cessation is not covered under Medicare. Full coverage of tobacco cessation efforts can make a major difference in the number of people who quit.

We are also concerned about the Department of Justice’s pending lawsuit against the tobacco companies to hold them responsible for their wrongdoing and to serve as leverage for requiring future change. It is critical that that lawsuit go forward and that neither Congress nor the new Administration backs off from it.

The other critical issues relate to whether our government is going to promote the sales of tobacco products or give tax breaks for tobacco products to be sold overseas. Finally, we hope that Congress will take strong action to curtail black market smuggling of tobacco products.

ONI: Where is smuggling a problem?

Mr. Myers: Tobacco smuggling has become a worldwide problem. It is less of a problem inside the United States and more of a problem with American cigarettes, once they leave here, being smuggled into other countries. We need uniform rules to make it easier to monitor where cigarettes are going and to prevent them from disappearing into the black market once they leave American manufacturers.

ONI: Are there things that you are looking at the Administration to do?

Mr. Myers: Yes. The World Health Organization is currently engaged in negotiations over a worldwide treaty designed to reduce the harm caused by tobacco. That treaty would have a dramatic effect on smoking and death rates from tobacco across the entire world. It is critical for the United States to be a leader and not a drag on that process. Eventually, the issue will return to Congress in terms of whether we ratify the treaty. In the short run, the role we play in fashioning the treaty, as it relates to both our nation and other nations, is critical.

In addition, the Occupational Safety and Health Administration (OSHA) has been examining whether to implement rules governing environmental tobacco smoke in the workplace. The President will have a great deal to say in whether or not OSHA issues rules governing environmental tobacco smoke.

ONI: Can tobacco companies actually produce a safe cigarette?

Mr. Myers: There is no such thing as a safe cigarette. The only way a smoker can eliminate the risk of tobacco use is to quit. Certainly the tobacco companies cannot be trusted to determine whether new products are safer. The concept of a safer cigarette is an oxymoron.

ONI: Teen smoking seems to be leveling off. Are there truly any new ideas on how to drastically cut their tobacco use?

Mr. Myers: Over the last decade, we have learned a great deal about how to reduce tobacco use among both adults and teenagers. Comprehensive state tobacco prevention and cessation programs have been shown to make a major difference. The real key now is whether we have the political will to spend the money to implement the types of programs that have proven successful in Massachusetts, Florida, California, and Oregon.

ONI: What do you regard as your group’s major successes?

Mr. Myers: I would say our work, in close partnership with other members of the public health community, to make tobacco a national issue that needs to be addressed, and to prompt the states to spend more of the money they receive from the tobacco settlements on comprehensive tobacco prevention programs.

ONI: How would you rate your success so far at the state level?

Mr. Myers: We are disappointed at the number of states that have failed to allocate an adequate amount of money for tobacco prevention programs. At the same time, we believe that those states that are going to fund new tobacco programs provide a real opportunity to make a dramatic difference for millions of our children.

ONI: What new issues do you plan to pursue?

Mr. Myers: In some respect, the new issues reflect our old agenda. It is absolutely critical that the FDA be granted authority over tobacco products to protect current smokers and to discourage future smokers. Second, the job remains undone to encourage states to spend more of the tobacco settlement money for effective tobacco prevention programs.

Third, we intend to spend more of our energy encouraging the states in particular to increase the excise tax on tobacco products in order to drive down youth smoking, and to take a fresh look at the need for laws restricting where people smoke.

ONI: Do you plan to press to a greater extent on cigars and smokeless tobacco?

Mr. Myers: We already look at tobacco use as covering not just cigarettes but also cigars and smokeless tobacco and other tobacco products. We haven’t singled out either smokeless tobacco or cigars for special attention.

ONI: Do you have plans to do so?

Mr. Myers: No, I think we will continue to go the route that we are going. Whenever we urge the adoption of tobacco prevention programs, excise tax increases, or government regulation of tobacco, we make clear that each of those should apply to cigarettes, smokeless tobacco products, and cigars.

ONI: You talked about some of the international issues relative to tobacco. Does your organization plan to get involved, on an international scale, in smoking prevention and cessation?

Mr. Myers: Over the last year, we dramatically increased the amount of resources we spend on international tobacco control issues. We have taken a very active role in working to support the World Health Organization’s proposed treaty on tobacco. We are now working in close collaboration with organizations in other countries to increase tobacco prevention advocacy throughout the world.

ONI: There are so many antismoking groups. Is their effectiveness diluted because of the large number?

Mr. Myers: No, the task before us in reducing tobacco use requires a large number of organizations and a broad base of support. Working together, the multitude of organizations that are involved can have a much greater impact.

ONI: What of the future?

Mr. Myers: For the last 6 years, there has been a great deal of attention paid to the need to act strongly to reduce tobacco use. The critical question for us in the tobacco prevention and control movement is whether we will be able to translate that attention into concrete policies that will bring about a long-term change.

We are at a critical moment in terms of whether we will bring about meaningful long-term change in the resources that we devote to tobacco prevention, the policies we use to discourage the tobacco companies from encouraging people to smoke, and the regulatory authority we exert over tobacco.

What we do over the next few years is the key to whether the last 6 years was a momentary buildup or a catalyst that will dramatically change the number of people who will die from tobacco use.