Tobacco Bill's "Pitfalls and Possibilities"

Passage of the tobacco-regulation bill currently before Congress would represent a major step forward, Graduate School of Arts and Sciences dean Allan M. Brandt wrote in last week's New England Journal of Medicine...

Passage of the tobacco-regulation bill currently before Congress would represent a major step forward, Graduate School of Arts and Sciences dean Allan M. Brandt wrote in last week's New England Journal of Medicine. (Brandt, who is Kass professor of the history of medicine and professor of the history of science, is the author of The Cigarette Century: The Rise, Fall, and Deadly Persistence of the Product That Defined America.)

The bill would make the tobacco industry subject to regulation by the federal Food and Drug Administration (FDA). (The agency's past attempts to exert regulatory authority ended in a Supreme Court ruling that the FDA was overstepping its statutory authority, absent explicit authorization by Congress.) The bill would also force cigarette manufacturers to disclose all their products' ingredients and to disclose internal research about the physiological effects of additives; ban candy and fruit flavors used to make cigarettes more appealing to young people; strengthen restrictions around advertising and marketing tobacco products to youth; and require new warning labels with graphic images of tobacco-related illnesses such as lung cancer and oral cancer.

The bill passed the House on July 31, the publication date of Brandt's essay. The New York Times gives this prognosis for the bill's chances of becoming law:

The White House has signaled its opposition to the bill. And while the legislation has strong support in the Senate, which could take up the measure this fall, it is not clear whether the bill has a veto-proof majority there.

While voicing general support for the bill, Brandt warns that Congress, and society, should beware its unintended consequences. He notes that the tobacco industry has argued "with considerable success" that cigarette-pack warning labels release the industry from liability by shifting the burden to the consumer, and that in the wake of legislation to require those labels, the release of formerly secret internal documents revealed that the tobacco lobby assented to the legislation for precisely that reason. This, Brandt writes, has raised suspicion about the motives of Altria (the parent company of cigarette manufacturer Philip Morris USA), which supports the current bill.

The essay is available in its entirety on the NEJM website. Visitors may also watch a video interview with Brandt and a slide show of historical cigarette ads with narration by Brandt. 

Read more about Brandt and his prize-winning research in the Harvard Magazine archives.

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