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Jump to full article: New England Journal of Medicine (NEJM), 2008-11-06
Author: Joel L. Nitzkin, M.D., M.P.H. American Association of Public Health Physicians
Intro: In 1998, Mark Berlind, chief legislative counsel of Philip Morris, drafted specifications for regulation of tobacco products by the Food and Drug Administration (FDA) that would ensure the continuing profitability of the Marlboro brand, provide a shield against litigation, and protect cigarettes from competition from less-toxic, smokeless tobacco products.1 The current Family Smoking Prevention and Tobacco Control Act (H.R. 1108/S. 625) discussed by Brandt in his Perspective article (July 31 issue)2 was negotiated between Matthew Myers of the Campaign for Tobacco-Free Kids and Mr. Berlind3 for purposes of securing an FDA bill with full support from our nation's largest cigarette maker. The text conforms to Mr. Berlind's 1998 specifications.
Despite the optimistic wording of the summaries used to attract endorsement and sponsors, we believe that this bill is so distorted in favor of Altria-Philip Morris that, if passed in its current form, it will do more harm than good in terms of future levels of teen smoking and future rates of tobacco-related illness and death. It can protect cigarettes or it can protect the public's health. It cannot do both.
The author replies: Nitzkin is incorrect in suggesting that the current FDA bill is based on the Berlind memorandum. Philip Morris introduced such a bill in 2001, and it was broadly rejected by tobacco-control advocacy groups, including the Campaign for Tobacco-Free Kids. Furthermore, Nitzkin is wrong to claim that the currently pending bill was negotiated between Philip Morris and Matthew Myers of the Campaign for Tobacco-Free Kids. The current bill was the work of Senator Ted Kennedy (D-MA) and then-Senator Mike DeWine (R-OH), who have consistently been among Congress's strongest supporters of tobacco control.
The pending legislation differs markedly from the proposals previously put forward by Philip Morris. The bill has provisions that would require serious changes in the marketing and manufacture of cigarettes in the decades ahead, including the authority for the FDA to monitor and reduce levels of dangerous additives and nicotine. The improved warning labels -- just one provision of the bill -- could save thousands of lives.
Nitzkin is certainly entitled to oppose the legislation, but he fails to offer any evidence for his claim that the bill will lead to increases in teen smoking and tobacco-related mortality. His position conflicts with the positions of virtually all the leading public health and medical organizations that are committed to reducing the burden of disease that cigarettes generate.
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