The federal government and most states continued to receive mostly failing grades from the American Lung Association (ALA) for efforts to reduce tobacco use among adults and teens during 2016, despite the enactment of the long-awaited “deeming” rule giving FDA regulatory authority over all tobacco products, including e-cigarettes and cigars.
The failure to require graphic warning labels on cigarette packaging and to move toward banning menthol cigarettes earned federal administrators and lawmakers an “F” grade from the ALA for tobacco regulation, according to the group’s annual State of Tobacco Control report, released late this week.
But despite these shortcomings, anti-tobacco advocates who spoke to MedPage Today say there is no question that regulatory and other actions taken at the state and federal level during the Obama administration’s 8-year tenure helped spur the record decline in tobacco use among adults and teens.
And they expressed concern that many of these hard-fought gains will be rolled back by the new administration and Congress.
“There is no question that what government does makes a big difference,” Matthew L. Myers of Campaign for Tobacco-Free Kids told MedPage Today.
“During the last eight years we have seen tobacco advertising restricted through the FDA, there have been sustained (anti-tobacco) mass media campaigns, tobacco taxes have increased and internet sales have been curtailed. All of these things contributed to the dramatic decline in tobacco consumption,” Myers asserted.
Speaking with a group of corporate leaders on Monday, President Trump vowed to do away with 75% or more of government regulations and he repeated his campaign promise of massive tax cuts.
Myers said Trump’s views on specific tobacco regulations and taxes are not known.
“President Trump has not spoken about this, so it is still unclear what position he will personally take,” Myers said. “To date, the physical manifestation of our concern comes from the cigarette and e-cigarette industries urging Congress to curtail funding for successful mass media campaigns and critical regulatory measures.”
The ALA’s Erika Seward said two specific attempts now before Congress to weaken FDA’s regulatory authority over tobacco are of particular concern.
On Jan. 13, Rep. Bill Posey (R-Fla.) reintroduced a bill in the House to exempt premium cigars from FDA regulation. The agency’s deeming rule announced last May extended its authority to cigars, e-cigarettes, pipe tobacco, and hookah. Posey first introduced the legislation in 2015, but it failed to pass under the previous Congress.
Congress is also considering legislation to grandfather flavored e-cigarettes and other non-traditional cigarette tobacco products, which would allow them to stay on the market.
“This is especially troubling because the Surgeon General has found that these flavors are particularly attractive to kids,” Seward said, noting that flavorings are believed to be a major driver of the more than 10-fold increase in e-cigarette use among high school-age kids between 2011 and 2015.
She added that there is “real concern about what lies ahead for reducing tobacco use and, specifically, whether the FDA’s existing authority will be weakened.”
While President Trump has not yet named a new FDA director, past actions by his pick for Health and Human Services (HHS) secretary have not lessened this fear.
Rep. Tom Price, MD (R-Ga.), was one of the few members of Congress to vote against giving FDA authority over tobacco, and he also voted against continuation of the Children’s Health Insurance Program (CHIP), which is largely funded by tobacco taxes.
As head of HHS, Price would have authority over the FDA, the CDC, the National Institutes of Health, and other major health agencies.
Myers said lobbyists from the e-cigarette industry are working to convince lawmakers to effectively prevent the FDA from regulating the products, as are groups that oppose government regulation on ideological grounds.
On Jan. 17, a coalition of a dozen free-market and anti-tax activist groups opposed to e-cigarette regulation, including FreedomWorks and Campaign for Liberty, sent a letter to Congress urging that all products on the market before the regulations went into effect last August be exempt from key provisions of FDA oversight, arguing that regulation “is depriving smokers of a demonstrably safer alternative (to traditional cigarettes).”
“While everyone’s focus seems to be on the White House, the tobacco industry has made it clear that it intends to urge Congress to dramatically curtail what has been working to reduce tobacco use,” Myers said.”It may feel like we’ve been back this year for a really long time, but it’s still early.”