In this posting, I’ll address arguments presented in Alex Giannattasio’s posting and his rebuttal to my posting.

While the new FDA tobacco law’s greatest impact will be on manufacturers, it will also affect growers, leaf processors, wholesalers, distributors, retailers and advertisers.

The three largest cigarette manufacturers (Altria, Reynolds, Lorillard), which collectively have about 88% of the US market share, will be able to comply with the new FDA regulatory requirements at a cost of about $.02/pack. But compliance with the new law will costs hundreds of small tobacco manufacturers more than $.50/pack (with comparable compliance cost differences for small cigar, smokeless and smoking tobacco manufacturers), which almost certainly will result in most of the smaller manufacturers going out of business, with just several large manufacturers ones remaining.

As applied to cigarette manufacturers, the new FDA tobacco law would be more appropriately called the Altria Monopoly Act, as Altria’s 52% cigarette market share is likely to continue expanding at the expense of hundreds of small cigarette companies.

I strongly disagree with Mr. Giannattasio’s statement “The Act’s main goal is to dramatically limit the ability of such manufacturers to add harmful foreign substances to their tobacco products,” as there is no evidence that cigarettes made from organically grown tobacco pose fewer health risks than other cigarettes. But this myth has become increasingly popular among cigarette smokers who are vegetarians, eat organic foods and/or espouse “green” political views. The smoke emitted from the combustion of any tobacco product (or any other type of organic matter) is similarly harmful to health when inhaled.

Somewhat similar claims (made by proponents of the new FDA tobacco law) that cigarette companies put additives (especially candy flavored additives) in cigarettes to make them more addictive are also unsubstantiated by the evidence. And in fact, the additives banned by the new FDA tobacco law affects fewer than 1% of cigarettes in the US market share, with clove cigarettes from Indonesia most affected. In sharp contrast, menthol, which was exempted from the FDA laws’ cigarette additive ban, accounts for 28% of the US market share. The claim that the new FDA tobacco law would eliminate cigarette additives was yet another gross misrepresentation of fact made by proponents of the legislation to demonize cigarette manufacturers in order to gain votes of naïve members of Congress.

I also take issue with Mr. Giannattasio’s statement “It is NOT the federal government’s role to dictate nation-wide standards on what we can and cannot consume,” as that is the primary role of the FDA in regulating food, drugs and other products, and that is what Congress has just authorized the FDA to do with tobacco products. While the new law doesn’t allow the FDA to ban cigarettes, it authorizes the FDA to establish standards for specific constituents of cigarettes and cigarette smoke emissions (the latter of which would be based on inaccurate and unreliable machine tests), despite the fact that there is no evidence that increasing, decreasing or eliminating various constituents in cigarettes or cigarette smoke can make cigarettes less hazardous to health.

I partly agree with Mr. Giannattasio’s statement “If 85% of the population, as Mr. Godshall claims, are under the mistaken impression that smokefree products are as unhealthy as cigarettes, I would be tempted to point the finger of blame at overly-zealous antismoking advocates.” But “anti-tobacco”, “anti-nicotine” and “abstinence-only” are far more accurate terms than “antismoking” to describe the extremists (including the Campaign for Tobacco Free Kids, American Cancer Society, American Heart Association, American Lung Association, American Dental Association) that have demonized and grossly exaggerated the health risks of smokefree tobacco products.

These organizations adamantly oppose tobacco harm reduction (i.e. cigarette smokers switching to far less hazardous smokefree tobacco/nicotine alternatives), and instead prefer smokers to either quit all tobacco/nicotine use or continue smoking and die. The old anti-smoking movement of the past four decades has split into two distinct factions: pragmatic public health advocates whose goal is to reduce cigarette smoking, and abstinence-only anti-tobacco/nicotine extremists whose ideological goal is to eliminate all tobacco/nicotine use.

This latter group of extremists also are opportunistic prohibitionists, as CTFK, ACS, AHA, ALA joined forces with GlaxoSmithKline in 2002 to unsuccessfully petition the FDA to ban Star’s Ariva and Stonewall low nitrosamine smokeless tobacco lozenges

(that are nearly identical to GSK’s Commit nicotine lozenge, that is marketed as a smoking cessation aid). Several months ago, CTFK, ACS, AHA, ALA urged the FDA to ban recently introduced smokefree nicotine inhalers called “electronic cigarettes”, claiming that these products have not been proven to be safe or effective (as smoking cessation aids). And yet, e-cigarettes don’t emit any smoke, and are at least 99.9% less hazardous than cigarettes. Similarly, CTFK, ACS, AHA, ALA insisted that the new FDA tobacco law ban all new smokefree tobacco products (while leaving cigarettes on the market) until/unless the FDA approves the new product (which those groups almost certainly will oppose).

Mr. Giannattasio’s support for strict regulation of smokefree tobacco products (while simultaneously espousing the pleasures of cigarette smoking) indicate a selfish bias (for his tobacco product of choice) instead of product regulations based upon scientific evidence or concern for public health.

Sweden now has the lowest cigarette smoking rate (and correspondingly lowest lung cancer, COPD and heart disease death rate) in the developed world. The primary reason for Sweden’s dramatic decline in smoking (and smoking morbidity/mortality) is that a huge majority of cigarette smokers (especially males) switched to a smokefree tobacco product called snus during the past several decades. Snus now comprises 50% of all nicotine consumed in Sweden (with cigarettes now accounting for just 50%).

As I pointed out in my previous posting, smokefree tobacco/nicotine products now account for 20% of nicotine consumed in the US, up from 10% a decade ago (with cigarettes declining from 90% to 80%). A critically important public health goal (and one advocated by Smokefree Pennsylvania) should be to increase that percentage to 50% (as is the case in Sweden) in the next five or ten years, as achieving that goal also would sharply reduce cigarette consumption, diseases and deaths in the US.

Unfortunately for public health, a stated goal of CTFK, ACS, AHA, ALA, as well as the Centers for Disease Control, is to reduce the use of smokefree tobacco products, which would ensure that the overwhelming majority of nicotine consumed in the US would continue being obtained from cigarettes, and that cigarettes would remain the leading cause of disease, disability and death in the US.

Smokers have a human right to be truthfully informed that smokefree tobacco products are far less hazardous alternatives to cigarettes, and smokers have a right to legally access less hazardous alternatives to cigarettes. Unfortunately, the new FDA tobacco law tramples on those rights.

While tobacco harm reduction has the potential of sharply reducing cigarette consumption in the future, other policy changes also can/will further reduce smoking (especially cigarette tax increases and further restrictions on indoor smoking).

The examples I cited (on my previous post) of regulations that the FDA is prohibited from promulgating don’t necessarily indicate my support for those regulations (although I’ve long advocated raising the minimum age for cigarette sales above 18 years to prevent youth addiction), but rather exposed additional inaccurate and hypocritical claims made about the new law by its proponents.

In sum, the greatest potential for additional declines in cigarette consumption during the next decade won’t come from the new FDA tobacco law, but rather from other policy changes (that the new FDA tobacco law will make more difficult to achieve).

Bill Godshall

Smokefree Pennsylvania