Federal Control of Tobacco: A Smoldering Issue Heats Up

Should the Food and Drug Administration--which has the authority to regulate dangerous or misleading consumer products in the marketplace--have power over what health experts consider one of the most toxic items sold today: tobacco?

While tobacco companies respond with a resounding no, many anti-smoking groups, lawmakers and others believe that it should--and even insist that it already has some authority to regulate tobacco use.

“We’ve seen recent action on the part of the FDA with respect to silicone breast implants, food labeling and a host of other products,” said Scott D. Balin, of the Coalition on Smoking OR Health. “It’s time for action on tobacco products.”

The coalition does not expect federal regulators to ban tobacco, only “to get it regulated in the way that is consistent with other products,” said Joe Marx, a spokesman for the American Heart Assn. “We believe that if the crackdown is heavier, public perception will be more acute” as to its dangers, he said.

BACKGROUND: Public health officials have long complained about the dangers of smoking and in recent years have waged an unrelenting campaign that has been, by any measure, enormously successful. Societal attitudes have undergone dramatic changes toward smoking in public.

Regulation at the local level has become especially aggressive, with the widespread enactment of numerous ordinances that ban or restrict smoking in public places, such as restaurants and job sites. Nationwide, smoking has been on the decline in certain segments of the American population.

At the same time, despite its well-established risks, tobacco has been untouchable at the federal level, due to, among other things, the influence of the powerful tobacco lobby, the loyalties of congressional lawmakers from tobacco-producing states and continued consumer demand for tobacco products.

As a result, Congress and regulatory agencies have typically exercised a “hands-off” attitude toward cigarettes.

The coalition--made up of the American Heart Assn., the American Lung Assn. and the American Cancer Society--believes the FDA as well as the Federal Trade Commission, which regulates advertising claims, already have the power to do something about cigarettes but lack the will.

Recently, the coalition petitioned the FDA to use its existing authority to regulate cigarettes as “drugs” when implied health claims are made about them--for example, when a specific brand claims that it suppresses appetite and can help control weight, or that one brand is safer than another because it has less tar and nicotine.

And Rep. Mike Synar (D-Okla.) recently introduced legislation that would create a section in the Food, Drug and Cosmetic Act that would clearly give the FDA jurisdiction over cigarettes.

The tobacco industry intends to fight the legislation, as well as any attempt on the FDA’s part to regulate tobacco. Industry officials have predicted that the FDA will never move on its own against tobacco.

“It’s a terrible idea,” Walker Merryman, vice president of the Tobacco Institute, said of efforts to involve the FDA. “The coalition clearly intends to try to ban cigarettes by bringing the FDA into the picture. If the FDA asserts itself, it will end up in court.”

OUTLOOK: While federal health officials are quick to condemn cigarettes, they are reluctant to step into the politically charged issue of increasing federal regulation.

Dr. William Roper, director of the Centers for Disease Control, which runs the federal office of smoking and health, said he supports “anything that will eliminate smoking in the United States.” But he and Surgeon General Antonia C. Novello said they would defer to the FDA on this issue.

For its part, the FDA, which has become extremely aggressive under the leadership of its new commissioner, Dr. David A. Kessler, seems just as reluctant as every other federal agency to take on tobacco.

“We don’t have the resources to do what we’re supposed to do now,” one FDA official said. “We have an enormous public health responsibility--but we’re not supposed to be God.”