FDA Tobacco Bill Falls Short, Physicians Group Says

To the Editor:

In my role as Chair of the Tobacco Control Task Force of the American Association of Public Health Physicians (AAPHP), I am dismayed at what appears to be the total and unquestioning support of the Waxman FDA/Tobacco Bill by many in Congress and the addiction community.

Rather than accept the glowing description and summary of this bill as promoted by Waxman's office and the Campaign for Tobacco Free Kids, we (at the AAPHP) took the time to download and read through the full text of both last year's bill and this year's bill (no substantive changes from the bill as it stood at the end of the last Congress).

We are appalled at the degree to which the bill is out of step with what we know about how tobacco products cause illness and injury and the degree to which the bill is laced with restrictions on FDA authority that, in essence, would block FDA from promulgating any regulation not favored by Altria/Philip Morris. These and other problems with the bill (related to choice of FDA as regulatory agency and its management of the menthol issue) are so severe that this bill, if passed without major amendment, would do more harm than good in terms of future rates of teen smoking and future illness and death from tobacco products.

A properly amended bill could save the lives of 4 million of the 8 million current adult smokers in the United States who will otherwise die of a tobacco-related illness over the next 20 years. This benefit could be secured while reducing the number of teens initiating tobacco use.

With no bill at all, the influx of new (but unregulated) smokeless, modified-risk tobacco products will likely result in a significant (perhaps 200,000 to 800,000) reduction in tobacco-related deaths over the next 20 years, but with an increase in teen tobacco use.

These surprising conclusions are based on detailed analyses of the bill and literature reviews done by the Tobacco Control Task Force of the American Association of Public Health Physicians. AAPHP strongly favors effective federal regulation of the tobacco industry. The current bill does not meet that standard.

I hope Join Together and those reading this letter will join us in urging the amendments needed to to this bill to strengthen it from a public-health perspective. A current list of AAPHP's recommendations is posted on our AAPHP website, as is the bill analysis from the Tobacco Control Task Force.

Joel L. Nitzkin, MD, MPH, FACPM
Chair AAPHP Tobacco Control Task Force
New Orleans, LA