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Commentary: The Old Tobacco Industry Playbook and A Game That Two Can Play

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“Philip Morris believes in ‘soup to nuts regulation of the entire industry, and we think that the FDA should be involved in all of that,’ says chief legislative counsel Mark Berlind. He says the company wants to see federal oversight of cigarette ingredients, warning labels, manufacturing, and marketing—with, he adds, a few limitations.”

Slate, July 25, 2002

As we head into fall and our national attention turns en masse to the election outcomes in November, I have to admit that I’m still smarting from the huge hit our nation’s public health took in August as a result of the decision by the U.S. Court of Appeals for the D.C. Circuit on graphic warning labels. Most of the major U.S. tobacco companies challenged the U.S. Food and Drug Administration’s (FDA) regulation requiring these labels, arguing that they violate the companies’ First Amendment rights.

The Court ruled against the new warning labels despite the fact that a growing number of nations around the globe, from Canada to Australia, have successfully employed just these kinds of images to educate smokers on the harms of tobacco to decrease consumption. It was a huge opportunity lost when the Court chose to shield our public from the very real results of smoking. It could well result in more loss of life. Nonetheless, we shouldn’t be surprised and even more importantly, get derailed by it.

The landmark legislation that mandated FDA regulation of tobacco, The Family Smoking Prevention and Tobacco Control Act, has yet to become the “silver bullet” tobacco control advocates had waited so long for. Regardless, the FDA’s Center for Tobacco Products continues to hold enormous promise in the effort to safeguard the public from tobacco and save lives. But to be strategic, we need only consult the history books to predict what lies ahead. The tobacco industry – even if its leading manufacturer, Philip Morris, has made a public show of support for regulation — will continue to fight hammer and tongs as they’ve always done to overturn or delay any measures that might jeopardize their profits. These tactics are certainly not unique to the tobacco industry. Our banking industry is hard at work using this same playbook to attack and delay provisions in the Dodd–Frank Wall Street Reform and Consumer Protection Act.

As leaders in public health, it is our job to do just that, protect the consumer. Tobacco has been and remains the number one preventable cause of death for decades and we know this fight to save lives is a marathon, not a sprint. So we must keep our eye on the ball and remember all that we stand to lose if commercial interests continue to trump public health.

Research confirms what works best to drive down smoking rates – effective public education campaigns, increasing tobacco excise taxes and implementing clean indoor air initiatives. Examples of measures won and lost abound but three stand out for me.

Here at Legacy, we saw it firsthand when Lorillard Tobacco spent five long years tying us up in costly litigation in their futile attempt to shut down our social-norm changing truth® campaign, which was credited with 22 percent of the decline in youth smoking from 1999-2002.

We saw it in California earlier this year when the tobacco industry helped raise $47 million to kill Prop 29 – a proposed $1 a pack cigarette tax that would have convinced many price sensitive smokers to quit.

And we saw it happen in June in the small village of Haverstraw, New York, where a local community with the best of intentions enacted an ordinance to ban tobacco product display and pricing information in stores in an effort to decrease youth exposure to them. In response, the three leading U.S. tobacco manufacturers, Philip Morris, RJ Reynolds and Lorillard, along with other manufacturers and retailer associations, filed suit, launching an extraordinary attack on the Haverstraw town council. Their message was obvious — to send a strong message to others should they dare to consider the same.

This battle is daunting but we can’t give up the fight because there is just too much at stake. We know what works to save lives from tobacco, we just need to continue to muster the will to do them. We have a playbook too. Let’s get back to it.

Cheryl G. Healton, DrPH
President and CEO
Legacy®

8 Responses to this article

  1. Avatar of mary
    mary / November 16, 2012 at 2:23 am

    did you ever consider not everyone can afford to live a long life.when you’re homeless or working like a slave for people like you who don’t care a bit about anyone but them selves having a cigarette is a comfort it calms people down so they don’t kill themselves immediately,maybe you can stop driving your car,stop taking planes instead of trying to control everyone elses life.

  2. Elaine Keller / October 31, 2012 at 10:17 am

    Let’s consider this logically first, and then apply current research. Logically, since smokeless tobacco (ST) use does not expose the lungs to tar, carbon monoxide, particulates, and thousands of chemicals of combustion, ST use does not cause lung cancer, which accounts for 120,000 of the 443,000 of the deaths that the CDC attributes to cigarettes. An additional 103,338 deaths are attributed to respiratory diseases, as well as 49,400 deaths attributed to second-hand smoke exposure. It is simple math to add up these numbers and deduce that if all smokers switched to ST, at least 272,738 lives could be saved, each and every year.
    There is a wealth of research available on the health effects of switching from smoking to snus in Sweden, Norway, and North America. Lee’s “Summary of the epidemiological evidence relating snus to health” reveals that the relative risk (RR) for snus users of developing heart disease ranges from 0.91 to 1.12 and the RR of strokes ranges from 0.95 to 1.15. These average out to 1.01 and 1.05 respectively–nearly equal to the risks for a non-tobacco user. Thus, switching to snus would eliminate most of the 128,497 annual deaths related to cardiovascular diseases. Lee’s analysis also states, “After smoking adjustment, snus is unassociated with cancer of the oropharynx (meta-analysis RR 0.97, 95% CI 0.68-1.37), oesophagus (1.10, 0.92-1.33), stomach (0.98, 0.82-1.17), pancreas (1.20, 0.66-2.20), lung (0.71, 0.66-0.76) or other sites.”
    In a presentation to the FDA, toxicologist Dr. Neal Benowitz reviewed the research on ST and extrapolated from the RRs of snus use to determine that long-term use of Nicotine Replacement Therapy )NRT) products would be much, much safer than continued smoking. A more recent form of THR is electronic cigarettes, which have helped countless smokers who previously had been unable to quit regardless of which approved treatment product or method they tried. When surveyed about the health effects, 90% state that their lung health has improved. Many respiratory specialists are now recommending e-cigarettes to their patients who have been repeatedly unsuccessful in quitting smoking.

    Conflict of Interest Declaration: I am a volunteer director of the non-profit Consumer Advocates for Smoke-free Alternatives Association (CASAA). I receive no compensation from tobacco companies or electronic cigarette companies. I finally quit smoking on 3/27/2009 after switching to an e-cigarette.

  3. Fr. Jack Kearney / October 29, 2012 at 1:03 pm

    Happy to oblige, Steve. I have no financial connection whatsoever, except as a happy consumer of electronic cigarettes. I also gave plenty of money to to the tobacco and pharm industries, and none of their products did me any good. No, I am just a professor of addiction studies.
    BTW, electronic cigarettes are not a tobacco product, except in a bizarre legal sense.

  4. Elaine Keller / October 28, 2012 at 11:50 pm

    According to the World Health Organization (WHO) the fact that Western smokeless tobacco products are much less hazardous than smoking isn’t at all absurd:

    In 2008, a WHO report (WHO Technical Report Series report 951, 2008) stated that:

    “There is little question that, in general, smokeless tobacco products are less harmful than combusted tobacco products such as cigarettes”.

    “Among the smokeless tobacco products on the market, products with low levels of nitrosamines, such as Swedish snus, are considerably less hazardous than cigarettes, while the risks associated with some products used in Africa and Asia approach those of smoking.”

  5. Alan Selk / October 28, 2012 at 2:46 pm

    “All of your assertions are very debatable at best, with more being found about harms of smokeless tobacco all the time (and your statement ‘smoking kills, not tobacco” is simply absurd)”

    The above statement is simply a lie. In fact the science is quite clear that smokeless tobacco is dramatically less harmful then smoking. The science is so clear that at this point there is nothing debatable about it. Only a true anti-tobacco zealot would attempt to do so.

    I have to ask just what Cheryl’s agenda is that she is willing to make such obvious false statements. It certainly is not public health or getting truthful information to the public.

  6. Elaine Keller / October 28, 2012 at 10:13 am

    It is absurd is to pretend that the relative risks of developing lung disease, cardiovascular disease, and cancers are the same whether one smokes or one uses modern western smokeless tobacco (ST) products. Since ST use does not expose the lungs to tar, carbon monoxide, particulates, and thousands of chemicals of combustion, ST use does not cause lung cancer, which accounts for 120,000 of the 443,000 of the deaths that the CDC attributes to cigarettes. An additional 103,338 deaths are attributed to respiratory diseases, as well as 49,400 deaths attributed to second-hand smoke exposure. It is simple math to add up these numbers and deduce that if all smokers switched to ST, at least 272,738 lives could be saved, each and every year. There is a wealth of research available on the health effects of switching from smoking to snus in Sweden, Norway, and North America. Lee’s “Summary of the epidemiological evidence relating snus to health” reveals that the relative risk (RR) for snus users of developing heart disease ranges from 0.91 to 1.12 and the RR of strokes ranges from 0.95 to 1.15. These average out to 1.01 and 1.05 respectively–nearly equal to the risks for a non-tobacco user. Thus, switching to snus would eliminate most of the 128,497 annual deaths related to cardiovascular diseases. Lee’s analysis also states, “After smoking adjustment, snus is unassociated with cancer of the oropharynx (meta-analysis RR 0.97, 95% CI 0.68-1.37), oesophagus (1.10, 0.92-1.33), stomach (0.98, 0.82-1.17), pancreas (1.20, 0.66-2.20), lung (0.71, 0.66-0.76) or other sites.” Toxicologist Dr. Neal Benowitz has already extrapolated from the RRs of snus use to determine that long-term use of Nicotine Replacement Therapy products would be much, much safer than continued smoking. Many former smokers owe their smoke-free status to having switched to electronic cigarettes. When surveyed about the health effects, 90% state that their lung health has improved. Many respiratory specialists are now recommending e-cigarettes to their patients who have been repeatedly unsuccessful in quitting smoking.

    Conflict of Interest Declaration: I am a volunteer director of the non-profit Consumer Advocates for Smoke-free Alternatives Association (CASAA). I receive no compensation from tobacco companies or electronic cigarette companies. I did, however, finally quit smoking on 3/27/2009 after switching to an e-cigarette.

  7. Steve Heilig / October 26, 2012 at 1:54 pm

    Re Mr. Kearney’s comment:
    All of your assertions are very debatable at best, with more being found about harms of smokeless tobacco all the time (and your statement ‘smoking kills, not tobacco” is simply absurd). But for now, please disclose if you have any financial or other interests in any smokeless tobacco products, including electronic cigarettes. Thank you.

  8. Fr. Jack Kearney / October 23, 2012 at 2:12 pm

    Legacy might have more credibility if it stopped doing the same things it accuses the tobacco industry of doing: ignoring research and using half-truth advertising. Let’s be clear: it is smoking that kills, not tobacco. Research is showing that electronic cigarettes are helping people quit smoking and are much, much safer than smoking. When Legacy promotes the lie that smokeless tobacco is just as bad as smoking they are actually helping to kill smokers who think that they might as well stay smoking instead of switching to less harmful alternatives. Sorry, Legacy, sincerity is no substitute for science…..

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