New Laws Could Hurt Antitobacco Efforts

HOUSTON--Passage of the Contract with America legislation, ascurrently written, could hinder tobacco control efforts for yearsto come, a Washington, DC, attorney said at the American Societyfor Preventive Oncology (ASPO) meeting.

Conceived as a plan to "get government off the backs of individuals,"key components of the Regulatory Reform Act could hinder the abilityof federal agencies to enforce many existing health and safetyregulations, said Mathew Myers, counsel for the Coalition on Healthor Smoking and a partner with the firm of Asbill, Junkin &Myers.

He believes that such legislation could make it difficult forall but the narrowest health and safety regulations, includingproposed tobacco-related regulations, to be enacted.

The legislation also proposes to put "affected industries"on the panels of agencies charged with conducting new cost-benefitanalyses, and "would permit affected industries to sue thefederal agencies at literally every stage of the process,"he said. "Even the simplest legislation that affects a powerfulindustry could be tied up in our judicial system for years."

Smoking Is a 'Pediatric Disease'

Mr. Myers said that the weight of scientific evidence of tobacco'shealth consequences is not sufficient to keep the tobacco industryat bay. Instead, more emphasis must be placed on involvement inpublic policy development.

He suggested aggressive use of four key tools in the battle againsttobacco use (see box on page 17), and emphasized that the antitobaccocampaign must focus on teenagers and children. He said that 90%of all smokers begin before age 18, and more than a third beginbefore age 14. More than two thirds of users of smokeless tobaccobegin before age 12. "Nicotine addiction is a pediatric disease,"he said. "Educated adults are quitting; kids are still starting."

Alternative Regulatory Approaches

Current smoking regulations "make it easy to get the diseaseand difficult to get the treatment," said Jack E. Henningfield,PhD, chief of clinical pharmacology, Addiction Research Center,National Institute on Drug Abuse.

"Cigarettes are cheap and easy to obtain. They can even bebought one at a time by people who can't scrape together enoughmoney to buy a whole pack," he said. "By contrast, treatmentsfor addiction, such as nicotine patches, are in general more expensiveper day than cigarettes, require a prescription, and may be soldin quantities that require a person to write a big check."

One alternative regulatory approach would be to focus on the nicotinelevels of individual tobacco products. Regulation of controlledsubstances suggests one model that might apply to tobacco. "Underthis model, nicotine gum and possibly patches might be availableby prescription with minimal restrictions or even OTC, but anRJR Premier type delivery system (ie, cigarettes) might be regulatedmore along the lines of morphine," Dr. Henningfield said.

Another regulatory approach might be modeled on the food labelingguidelines developed by the FDA. A tobacco label might includemeaningful information about "serving size" and "dosage"of nicotine. Dr. Henningfield suggested that such labeling strategieswould also apply to smokeless tobacco products, for which nicotinedoses vary widely as a result of pH manipulation.

Four Key Tools in the Battle Against Tobacco Use

1. Dramatically increase tobacco taxes. In Canada a steeplevy on tobacco correlated with a 60% fall in smoking among youngsters.An easing of tariffs in some provinces was linked to an increasein teen smoking, Mathew Myers said at ASPO.

2. Eliminate tobacco advertising, marketing, and promotions.Specifically, he cited tobacco's link with sports and entertainmentevents.

3. Strictly limit youth access to tobacco products. Mr.Myers called for eliminating all vending machine and single cigarettesales, and stepping up enforcement of laws prohibiting sale oftobacco products to minors.

4. Isolate the tobacco industry. "This is an industrythat has demonstrated a lack of corporate responsibility and morality,"he said. "The tobacco industry knew before we did about thehealth consequences of their product. They knew 20 years beforewe did that their product was addictive. Their own documents provethat."

Last year, executives from seven tobacco companies swore underoath before Congress that there is not enough scientific evidenceto say their product causes cancer or heart disease. "It'stime we called these people what they are: liars," he said.