How Will a New Tobacco Law, Nicotine Lollipops, and E-Cigarettes Impact America's Most Dangerous Addiction?

A BUZZFLASH NEWS ANALYSIS
by Christine Bowman

"Everybody else's tobacco is poisonous. Lucky Strikes ... is toasted." -- Don Draper, ad agency executive character in Fox Network's drama, "Mad Men"

A bill placing tobacco products under the purview of the Food and Drug Administration won a cloture vote in the Senate Monday and could be voted on by the full Senate very shortly. A House version of the Family Smoking and Tobacco Control Act already has passed by a vote of 298-112, and President Obama supports the measure. Democratic leaders supporting the bill are optimistic. As Jack Reed (D,RI) said, "Passing this bill will help reduce health care costs, prevent young people from smoking, and create a healthier future for our nation."

How will the new law change the lives of individual smokers and the nation's health overall, once enacted, and is it a big deal? Although riddled with compromises, it will give the FDA some control over marketing and merchandising, hopefully thereby reducing teen smoking -- a growth area, for the tobacco industry. The proposed law allows for limits on some but not all of the more than 4,000 toxins and 60 carcinogens in tobacco smoke. It lets the FDA require lower nicotine levels, but does not let the agency mandate elimination of nicotine.

As Senator John Cornyn (R,TX) said in an interview with Politico:

It’s a less-than-perfect solution to a bad problem. Tobacco kills 400,000 people a year in this country. We’ve tried litigation, and the only thing that happened is a bunch of lawyers got rich. Ordinarily, I would not be an advocate for more government regulation. But if this is going to be a legal product, sold in America, I think this is a reasonable step.

The big picture, of course, is that public health advocates such as the American Cancer Society and American Lung Association have struggled for half a century to curtail tobacco use, but the tobacco industry inevitably fights back and rebounds. There have been labeling warning laws, class action suits over deaths, US Supreme Court challenges to regulatory efforts (2000, FDA v Brown and Williamson Tobacco Corp), numerous local statutes to restrict when and where smokers may indulge, and taxation -- most recently a 62-cent-per-pack tax to help pay for the SCHIP program.

Despite all that, the severe public health threat remains. According to the Centers for Disease control: "Smoking harms nearly every organ of the body; ... The adverse health effects from cigarette smoking account for an estimated 438,000 deaths, or nearly 1 of every 5 deaths, each year in the United States." And every day, another 6,000 kids take up smoking, or almost 800,000 annually.

Even if the new tobacco bill succeeds in bringing greater regulation of cigarettes, and reducing some health risks such as cancer, it may fail to achieve the greater goal of protecting the public, and especially children, from nicotine addiction. As cigarettes and their smoke fall under increasing controls, as ingredients become more regulated and smokers are forced to move outdoors to reduce the danger of ambient smoke to bystanders, smokeless nicotine alternatives have increasingly emerged in the marketplace. And we're not just talking about smoking cessation products like the patch or Nicorette gum.

RJ Reynolds is developing the lozenge-like Camel Orbs, as well as tasty Sticks and Strips. Phillip Morris has a similar product, the "Marlboro Snus." Star Scientific, a smaller company, markets two dissolvable products, Ariva and Stonewall. These products melt in the mouth, delivering nicotine without smoke. They also trump chewing tobacco, since they don't prompt a lot of messy spitting. Gregory Connolly of the Harvard School of Public Health warns that such products pose different dangers from smoking, since they help keep people addicted, and they're attractive to kids because they're easy to hide.

Sen. Richard Burr (R-NC) came to the defense of RJ Reynold's Orbs and criticized CNN for describing the product as candy.

BURR: But when CNN did their story. Take a guess on the angle that they took. They labeled it as candy. Candy! Even though it’s not candy flavored. They said it was candy. … No, they said it was candy. That’s where they labeled it. … They portrayed Reynolds America as being deceptive and luring children. No candy. It’s not going in the candy section. It’s in the tobacco section where smokeless and stick products is.

Yet another nicotine product emerging on the scene, but primarily coming from China, is the "e-cigarette," or electronic cigarette. These are "unapproved by the government and virtually unstudied," The New York Times reports, yet many smokers are giving them a try as a quit-smoking crutch. The Electronic Cigarette Association's spokesman says without citing scientific studies that they deliver only a mixture of nicotine and water vapor and emit “no carcinogens.” The FDA has tried, sporadically and ineffectively, to block their entry into the country.

Like the new smokeless products from the big American tobacco companies, the e-cigarette has the advantage for addicted smokers that it can be used in places where smoking is banned, and its ill-effects are limited, presumably, to the user, not harming nearby friends, family or easily irritated strangers. The odorless cigarette substitute can be used in bars and restaurants and workplaces, although it lacks the stylishness and intimacy that some smokers attribute to cigarettes -- "you look like you are holding a very unsexy Bic pen" and sharing one is "akin offering to share an asthma inhaler."

The problem remains, though, that these things deliver nicotine. They create and maintain addictions to a toxin that takes a terrible toll on the heart and affects the central nervous system like cocaine and heroin do. Nicotine is just more addictive then those two street drugs. Most nefarious is that the smokeless nicotine products seem poised to draw in the youngest users -- kids who don't want to be detected, who don't worry about long-term consequences, who may like the taste as well as the high.

So, how the public should score the latest developments in regulating nicotine and tobacco becomes a complicated question. Government and public health advocates must be congratulated for finally finding a regulatory route towards trying to contain an enormous public health problem. FDA regulation of ingredients certainly is better than nothing, and new limits on marketing might help protect American kids. E-cigarettes and nicotine lozenges might help some smokers cut down or quit. Eliminating tobacco leaves from products and smoke from lungs probably will reduce cancers (while also eliminating some US tobacco-related jobs and sending more dollars overseas, instead, to Chinese e-cigarette manufacturers).

But no one should kid themselves. No matter what happens in Washington, RJ Reynolds (opponent to the new bill) and Phillip Morris (supporter of the bill) will soldier on. And along with them, the lobbying and ad businesses will stay in the game -- just as they have for the past half century.

What it means is that public health advocates have lots more work to do, and nicotine addicts must continue to battle their own demon as best they can. Good luck in the battle.

A BUZZFLASH NEWS ANALYSIS

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