Killing Them Softly

FDA regulation of tobacco could be deadly.

Sen. Judd Gregg (R-N.H.) promises that his bill giving the Food and Drug Administration authority over tobacco products will "save lives." But it could kill people instead.

That's because the bill, which the Senate Health Committee is expected to consider soon, authorizes the FDA to block the introduction of safer tobacco products. In deciding whether to allow a new product on the market, the agency is supposed to weigh "the risks and benefits to the population as a whole." And what the FDA thinks is good for "the population as a whole" is not necessarily what's good for individual consumers.

In addition to the risk reduction offered by a new product, the FDA is supposed to consider whether its availability will discourage current users from quitting or lure new users who otherwise would not have tried tobacco. The upshot is that a demonstrably safer cigarette that smokers would welcome could be rejected because of its anticipated impact on "the population as a whole."

The same collectivist approach is reflected in a provision of the bill that prohibits risk comparisons between different kinds of tobacco products, information that a summary of the legislation calls "inherently misleading." Among other things, this restriction would prevent makers of smokeless tobacco, which is far less hazardous than cigarettes, from informing consumers of that fact.

Opponents of promoting smokeless tobacco as a safer alternative to cigarettes argue that the health benefits of such substitution would be outweighed by the health costs to new users attracted by the risk comparison and to smokers who otherwise would have decided to abstain from tobacco entirely. Given the magnitude of the risk reduction involved in switching from cigarettes to smokeless tobacco, this scenario is highly implausible.

In any case, it's wrong to insist that accurate, potentially life-saving information be withheld from consumers because they might not use it the "right" way. In a paper released last February, a leading British anti-smoking activist and five European scientists called this attitude "the health professional's authoritarian insistence that the only valid choice for smokers is to quit or die."

Another way in which Gregg's bill jeopardizes the health of smokers is by authorizing the FDA to order the reduction, or even elimination, of nicotine in cigarettes. Other things being equal, reducing nicotine content increases a smoker's exposure to the toxins and carcinogens in cigarette smoke, making the habit more dangerous.

As critics of "light" cigarettes have been pointing out for years, smokers tend to compensate for a lower nicotine yield by smoking more intensely. To get the nicotine dose they're used to, they take more puffs, inhale more deeply, hold the smoke longer, and cover ventilation holes. As a result, the "tar" intake can be substantially higher than what's indicated by the official rating, which is based on yields measured by machines.

Hence if the FDA orders nicotine reductions in an effort to prevent future smokers from "getting hooked," current smokers will be exposed to greater hazards. From a "public health" perspective, the extra deaths among current smokers would be justified by the deaths prevented because low-nicotine cigarettes attracted fewer new smokers than full-strength cigarettes would have.

All these projections are fraught with uncertainty, of course, because no one really knows how current consumers, let alone future ones, will react to new products or new information. That's one reason individuals should be allowed to decide for themselves which products they want and which information is relevant, with the government's role limited to preventing fraud.

Philip Morris, which supports Gregg's bill partly because it wants to introduce a safer cigarette with the government's blessing, is gambling that it will see eye to eye with the FDA about which products are in the best interests of "the population as a whole." The company's other major reason for supporting the bill is the desire to handicap its competitors through marketing restrictions and regulatory burdens, thereby protecting its position as the leading cigarette manufacturer.

The measure also has the backing of tobacco farmers and their representatives in Congress, because they've been promised $15 billion or so in taxpayer-funded bribes euphemistically described as crop quota "buyouts." Depending upon the final details, the legislation may even be endorsed by anti-smoking activists, who have long demanded FDA regulation of tobacco.

If so, the only people who won't get what they want (aside from Philip Morris's competitors) will be consumers. The FDA will see to that.