Today President Obama plans to sign the Family Smoking Prevention and Tobacco Control Act, which authorizes the Food and Drug Administration to regulate cigarettes and other tobacco products. In Friday's New York Times, business columnist Joe Nocera blows kisses at former FDA chief David Kessler, anti-smoking activist Matthew Myers, and former Philip Morris executive Steven Parrish for their roles in producing the law. Calling it "a demonstrably good thing," Nocera tells this trio of "unlikely partners" to "take a bow, fellas."
Although Nocera acknowledges "critics" who say FDA regulation will serve mainly to protect Philip Morris' market share, he assures readers they are a "small minority." Yet he does not bother to address their arguments, and his case for the law supported by Kessler, Myers, and Parrish is based almost entirely on the unexamined assumption that more regulation is always better.
Nocera says, for instance, that one "demonstrably good" aspect of the law is that "the F.D.A. will be able to mandate a reduction in nicotine levels." Why is that good? Nocera doesn't say, but one predictable result of reducing nicotine levels is that smokers will be exposed to higher level of toxins and carcinogens to get the dose of nicotine to which they are accustomed. Reducing nicotine levels therefore makes cigarettes more, not less, dangerous.
Nocera also is pleased that "new products that claim to reduce the harm from cigarettes will have to go through a rigorous scientific review process." He does not mention that manufacturers have to demonstrate that "modified risk" products will "benefit the health of the population as a whole," which means the FDA can keep indisputably safer products off the market based on fears about how they will influence nonsmokers and smokers who otherwise might have given up tobacco completely.
Nocera correctly notes that "smokeless tobacco is far less harmful than cigarettes," but he overlooks the fact that the new law prohibits manufacturers from telling consumers that without FDA approval, which is based on the same "health of the population as a whole" standard. In other words, the FDA can continue to censor potentially lifesaving information about smokeless tobacco if it worries that telling the truth will attract new tobacco users or encourage smokers to switch rather than quit. Yet Nocera implies that the law will promote awareness of smokeless tobacco's safety advantage. "Because the tobacco industry has zero credibility," he writes, "only the F.D.A. would have the moral authority to make health claims, based on real science, about smokeless products versus cigarettes." It is telling that Nocera says "moral authority" instead of "credibility," since resistance to smokeless tobacco as a harm-reducing alternative to cigarettes is based on moralism rather than science. It nevertheless may prevail at the FDA, as it has in the public health community generally.
Describing Myers' attitude toward collaborating with the largest U.S. tobacco company on a bill that will help protect it from competition, Nocera says, "All that mattered was the result: cigarettes would be regulated." The idea that regulation is an end in itself, regardless of its actual consequences, explains a lot about how Washington works.
On his tobacco policy blog, Michael Siegel notes that Kessler himself is skeptical of the idea that FDA regulation will lead to safer cigarettes, telling NPR, "I'm not sure that scientifically we're smart enough to know how to do that or that's possible when you're burning a tobacco leaf or you're inhaling all these chemicals that are very reinforcing." Recent coverage of the tobacco regulation bill here and here.