Some Smokers Must Die So That Others Never Exist


When David Kessler was head of the Food and Drug Administration, he was so eager to regulate tobacco products that he pretended his agency already had the statutory authority to do so. (The Supreme Court disagreed.) Now that Congress may actually give the FDA the power Kessler tried to grab, the current administrator, Andrew von Eschenbach, is noticeably less enthusiastic:

Government regulation of tobacco could backfire by inadvertently forcing smokers to light up more and inhale more deeply, the head of the Food and Drug Administration said Tuesday.

In an interview with The Associated Press, Dr. Andrew von Eschenbach said that if the FDA reduced nicotine levels in cigarettes, people would tailor their smoking habits to maintain current levels of the addictive drug.

"We could find ourselves in the conundrum of having made a decision about nicotine only to have made the public health radically worse. And that is not the position FDA is in; we approve products that enhance health, not destroy it," said von Eschenbach, a cancer surgeon….

"What I don't want to see happen is that we are in a position where we are determining that a cigarette is safe," von Eschenbach said.

Von Eschenbach is right to worry that reducing nicotine content, which the Family Smoking Prevention and Tobacco Control Act would allow the FDA to do, would make cigarettes more dangerous by encouraging "compensatory behavior." A number of studies have found that people tend to smoke more or smoke more intensely to compensate for reduced nicotine yields. The compensation is not universal or perfect, but the upshot is that exposure to toxins and carcinogens is higher than suggested by official "tar" yield. This observation is the main reason critics of the tobacco companies accuse them of committing fraud by implying that "light" cigarettes are safer than regular cigarettes. As I've noted, anti-smoking activists tend to forget this concern when they imagine government-ordered changes in cigarette yields.

But there is a "public health" rationale for cutting nicotine yields, even with the knowledge that doing so will result in more smoking-related disease over the short term. The argument is that lower nicotine levels will make cigarettes less appealing to new smokers, thereby reducing smoking-related disease over the long term. Depending on various contingencies (including the emergence of a black market in full-strength cigarettes), the net result might be fewer tobacco-related deaths. The idea is to kill more of today's smokers so fewer will die in the future. If that strikes you as a heartless, unjust policy that elevates a collectivist calculation of social welfare above the rights of individuals, you are beginning to understand the logic of "public health."

Addendum: In today's Washington Times, Elizabeth Whelan, president of the American Council on Science and Health, warns that the Family Smoking Prevention and Tobacco Control Act "will likely increase smoking-related deaths." In addition to the danger of nicotine restrictions, she notes that the bill would help maintain the myth that all tobacco products are equally dangerous, deterring cigarette smokers from switching to smokeless tobacco, which is far less hazardous. (I made similar points in a 2003 column.) Whelan also worries that the FDA seal of approval will falsely reassure smokers that cigarettes are safer than they used to be even in the absence of actual safety improvements.   

[via The Rest of the Story]