This column was originally published in AMA eVoice on August 16, 2007. Dr. Davis is president of the American Medical Association.
Did you know that every day, about 4,000 kids in the United States will try a cigarette for the first time, and more than 1,000 will become daily smokers? Twenty-three percent of high school students in the United States are current cigarette smokers. One-third of those who continue to smoke will eventually die prematurely as a result.
In a Centers for Disease Control and Prevention (CDC) ranking of the leading "actual" causes of death—that is, the underlying risk factors for the diseases and injuries that kill the most Americans—tobacco is No. 1, responsible for 435,000 deaths each year, or 18 percent of total U.S. deaths. One of the cruelest ironies in public health is that the most important preventable cause of death in our society is also one of the most unregulated consumer products (if not the most unregulated product).
That would change with passage of the Family Smoking Prevention and Tobacco Control Act, which would give the Food and Drug Administration (FDA) the power to regulate the tobacco industry and tobacco products. This bipartisan legislation (S. 625, H.R. 1108) has been introduced in Congress by Sens. Ted Kennedy, D-Mass., and John Cornyn, R-Texas, and Reps. Henry Waxman, D-Calif., and Tom Davis, R-Va.
The bills would strengthen cigarette package warning labels, similar to the tough warnings on Canadian cigarette packs; further restrict tobacco advertising and promotion; and ban the use of terms such as "light," "mild," and "low," which falsely imply to consumers that those brands are safe or less hazardous. The legislation also would ban all cigarette flavorings except menthol, thus prohibiting tobacco companies from continuing their recent practice of introducing fruit- and candy-flavored cigarettes, which are likely to be attractive to kids.
Perhaps the most far-reaching provision would allow the FDA to reduce nicotine in cigarettes to nonaddicting levels. That policy was proposed by the AMA Council on Science and Public Health and endorsed by the AMA House of Delegates in 1998.
Fifty-three U.S. senators and 195 members of the U.S. House of Representatives are sponsoring the bills, and more than 440 health, faith-based, and other organizations (PDF, 42KB) across the country are endorsing them. On Aug. 1, the Senate Committee on Health, Education, Labor and Pensions approved S. 625, after adopting several strengthening amendments, by a vote of 13-8. Action is now needed on the floor of the Senate and in the House.
FDA authority to regulate tobacco is strongly supported by the American people. According to the results of a recent public opinion poll (PDF, 38KB) conducted by the Mellman Group for the Campaign for Tobacco-Free Kids, 70 percent of voters would like Congress to pass this legislation. That figure rises to 82 percent after respondents read details about the bill. Further, 72 percent believe passage of this bill would be an important accomplishment for Congress.
The need for this legislation couldn't be more clear. Smoking kills roughly 1,200 Americans every day—many more than the number who die from alcohol, illicit drugs, motor-vehicle crashes, fires, AIDS, homicides, and suicides combined. As physicians, we see the detrimental health effects of tobacco use daily, including the diseases commonly attributed to smoking such as cancer, heart disease, emphysema, and stroke, as well as the less well known smoking-related conditions such as cataract, hip fractures, peptic ulcer disease, adverse surgical outcomes related to wound healing, and poor pregnancy outcomes.
The AMA has been a staunch advocate for passage of legislation to give the FDA strong authority over tobacco. Please contact your U.S. senators and representative to urge them to support prompt passage of S. 625 and H.R. 1108, without weakening amendments. And please sign up to receive e-mail updates and action alerts from the Campaign for Tobacco-Free Kids.
Please send comments, questions, and replies to amaprez@ama-assn.org
Content provided by: Ronald M. Davis, MD