New Tobacco Regulations Aim to Reduce New Smokers

Oncologists are well acquainted with the significant toll smoking takes on health. In addition to being the cause of most lung cancers, which is the number one cause of cancer death, smoking increases the risk of heart attack and stroke. Ever since the Surgeon General warned of the dangers associated with smoking nearly 50 years ago, special interest groups have pressed Congress to grant the FDA authority to regulate or ban tobacco products.

With passage of the Family Smoking Prevention and Tobacco Control Act (HR 1256), they finally got their wish—sort of. HR 1256 contains many restrictions on the marketing of tobacco products, with the goal of reducing smoking rates in young people. According to the American Cancer Society, 90% of smokers started before age 19.

HR 1526 does not give the FDA authority to ban tobacco products or prohibit nicotine from being added to cigarettes. Nicotine is an addictive chemical that makes it harder for smokers to quit. The FDA is also prohibited from making tobacco products prescription only or prohibiting in-person sales or sales to anyone over age 18. The following are other key provisions of HR 1256:

• Cigarettes can no longer be enhanced with any flavor other than menthol, and the use of menthol will be studied further for its effects.

• Requires warning labels to cover 50% of the front and back of a cigarette package.

• Prohibits tobacco companies from sponsoring sporting and entertainment events or from giving away non-tobacco products, like t-shirts or hats, to purchasers.

• Restricts advertisements at places where cigarettes are sold to adult-only facilities.

• Restricts vending machines to adult-only facilities.

• Bans outdoor tobacco advertising within 1000 feet of schools and playgrounds.

• Requires print advertisements at purchase locations and in publications with adult readership less than 85% to be black and white text only.

• Forbids tobacco manufacturers from positioning their products as “light,” “mild,” “low tar,” or other terms that imply reduced harm to health.

• Imposes fines and other federal penalties for retailers who sell tobacco products to minors.

The law also includes provisions requiring tobacco companies to report all the ingredients of their products and the chemicals found in the smoke they produce to the Health and Human Services (HHS) secretary. HHS is tasked with notifying the public of any harmful substances in the products or smoke. Tobacco manufactures will als be required to disclose data from all health-related research they conduct to HHS and to provide market research analyses, if requested.

To implement the law, HR 1526 establishes the Center for Tobacco Products, which will be funded by levies on tobacco manufacturers. Industry analysts say these fees are likely to be passed along to consumers, further driving up the cost of smoking.

Smoking rates in adults and teens have dropped in recent years, yet 1 in 5 people in the United States still smoke. The Congressional Budget Office predicts that the new law will reduce underage smoking by 11% and adult smoking by 2% in the next decade. Other laws, such as the recent 62-cent federal tax hike on cigarettes and state laws to prohibit smoking at work or in other indoor public venues, will likely contribute to further reductions in the smoking rates.

The law is expected to eventually reduce the 400,000 smoking-related deaths that occur each year. H. Jack West, MD, Medical Director, Thoracic Oncology Program, Swedish Cancer Institute, Seattle, Washington, treats many patients who have lung cancer. On his Twitter page at http://twitter.com/DrWestGRACE, he described passage of the legislation as “a new age in DC,” and said, “As a lung cancer doctor, I’d welcome the loss of business.”

HR 1526 received wide bipartisan support, with the Senate voting 79 to 17 and the House voting 307 to 97 to pass it. Representative Steve Buyer, a Republican from Indiana, however, made a rather bizarre argument against passing the legislation. He said if people were to dry, roll, and smoke lettuce leaves, it would have the same effect on health as smoking cigarettes. “It’s not the nicotine that kills,” he said, “It’s the smoke that kills! It’s the inhalation of the smoke.” In reality, nicotine is directly linked to some of the negative health effects associated with smoking, and because lettuce does not contain nicotine, it is unlikely people would become addicted to smoking it.

Buyer, like many Congressional officials who opposed the bill, has received significant financial contributions from the tobacco industry over the years. Without the support HR 1526 received from Phillip Morris, the country’s largest tobacco company and the only cigarette maker to come out in favor of the legislation, passage could have been an uphill climb.

Some advertising lobbies and tobacco companies (including Phillip Morris) said they are considering a legal challenge to some of the law’s tough marketing restrictions. They deny any of their advertising efforts target young people, which was the government’s justification for some of the law’s strict provisions, and they claim that the broad new rules violate their first amendment rights.

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