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Prohibitionist bill ignores life-saving strategy

The News recently published a column calling for Congress to pass the Family Smoking Prevention and Tobacco Control Act, giving the federal Food and Drug Administration regulatory authority over tobacco. Regulation of tobacco may be reasonable, but this bill is fatally flawed. It would effectively prevent the nation's 45 million smokers from learning that smokeless tobacco products are vastly safer alternatives. That message is absolutely critical to the life-saving strategy known as "tobacco harm reduction."

Harm reduction was the focus of a recent article in the prestigious medical journal Lancet, which made a compelling case that tobacco regulation based on scientific and medical principles:

* " . . . should promote complete cessation of nicotine product use as the preferred option, but also encourage existing smokers who are unable to stop smoking to adopt a less hazardous source of the drug."

* " . . . should therefore apply the levers of affordability, promotion, and availability in direct inverse relation to the hazard of the product, thus creating the most favorable market environment for the least hazardous products . . . "

The Lancet article is based on a new report by Britain's Royal College of Physicians (which published the first comprehensive study of smoking and health in 1962, two years before the U.S. Surgeon General's first report.) One of the college's key conclusions is that "low nitrosamine smokeless tobacco products may have a positive role to play in a coordinated and regulated harm reduction strategy which maximizes public health benefit . . . "

The pending congressional legislation is the polar opposite of such a rational approach to helping smokers. While the bills recognize that nicotine is powerfully addictive, they fail to acknowledge that nicotine causes none of the diseases that kill smokers.

The bills would require the FDA to all but deny smokers information about smokeless tobacco, an effective nicotine delivery vehicle that has been proven to be 98 percent safer than cigarettes.

In other words, the bills offer no effective harm reduction options for smokers, a situation that the Lancet article said is "perverse, unjust and acts against the rights and best interests of smokers and the public health."

Congress should rewrite those portions of H.R. 1108 and S. 625 that impose irrational and dangerous limitations on the communication of truthful information about smokeless tobacco and its relative risk vis-a-vis cigarettes. As written, these bills reflect tired myths and a tobacco prohibitionist bias.

In light of a wealth of published data and the profoundly illuminating Lancet article, Congress should recognize that tobacco harm reduction strategies that encourage inveterate smokers to switch to smokeless tobacco and thereby save their lives are solidly grounded in medical science and are now supported by the mainstream medical community.

Brad Rodu is a professor of medicine in the endowed chair in tobacco harm reduction research, University of Louisville.

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