Cracking down on coffin nails

Finally.

Thanks to the Democratic Congress, a burst of enlightenment in the Republican camp, and the presence of a Democratic president, the feds will finally have the power - for the first time - to regulate the chemical production and marketing of cigarettes. By a 79-17 vote yesterday, the Senate gave thumbs-up to the FDA; the House today is expected to vet the Senate move, and Barack Obama is poised to sign.

So, hey, what a concept: the Food and Drug Administration will be empowered to deal with America's top death product the same way it polices everything from cereal to dog food to lipstick. Kind of makes sense...given the fact that cigarettes are the only consumer product that kills its customers when used as directed.

It took 12 years to achieve what should have been a slam-dunk decision all along. During those 12 years of congressional dithering, nearly 5.3 million Americans died prematurely from the deleterious health effects of smoking - a Centers for Disease Control figure that includes roughly 600,000 premature deaths attributable to second-hand smoke. During those 12 years, tobacco-related health woes burdened the nation's health care system to the tune of roughly $1 trillion.

Obviously, the human and monetary toll won't be magically wiped out by the FDA. But the FDA will surely make a measurable dent; the nonpartisan Congressional Budget Office has already estimated that the law will slash youth smoking by 11 percent over the next decade (because the feds will finally be able to substantively crack down on the marketing trickery aimed at kids), and cut adult smoking over the decade by two percent. And the higher cost of smoking could be a further disincentive; the law slaps a new fee on every pack, as high as six cents, with the money specifically earmarked for the FDA oversight program.

On the national level, this is by far the most significant anti-smoking victory since the government banned smoking on commercial flights 19 years ago. There have been few such major victories during the decades since the Surgeon General conclusively linked cigarettes to lung cancer back in '64, due largely to the financial and political power the tobacco industry. So now that the FDA will finally have the authority to (among other things) order the cigarette-makers to cut their nicotine levels and actually provide details about their chemical ingredients, it's worth pondering how much the politics of tobacco has changed - for the better - these past 12 years.

I covered the politics of tobacco extensively during the late '90s, shuttling to and from Washington, and my notes and stories tell the tale:

After the FDA sought to assert authority over tobacco in 1996 (arguing that nicotine was a drug, and hence within its jurisdiction), there was a congressional push for legislation that would specifically empower the agency. The '97 Senate effort was led in part by John McCain (this was during his maverick phase), with the Clinton administration giving aid and encouragement. But the Republican-led Senate ultimately blocked it. There was much speechifying about how Big Brother should not be allowed to meddle with big tobacco, but the real deal was obvious at the time. In the 10 years between 1987 and 1997, the industry had pumped $12,965,070 into national GOP coffers - four times the amount given to Democrats.

During the spring of 1998, there was a brief flicker of conscience - with the off-year elections looming, Republicans got worried that they might be tarred as shills for the death merchants - and so, for awhile anyway, it appeared that the FDA authority language would pass. The Republicans' internal polling even showed that 82 percent of Americans supported the regulation of nicotine.

But in the end, the Republican Senate killed it again. The party's elected leaders calculated that, with respect to those '98 congressional elections, their top priority was to nurture the conservative voters who dislike government regulation. As Ethan Siegal, a Washington economist analyst tracking the politics of tobacco, told me at the time, "There is a strong group of Senate Republicans that sees this bill as the antithesis of what Republicans were elected to do - downsize government."

The stalemate continued through the George W. Bush years; even if Congress had voted to grant authority to the FDA, President Bush made it clear that he would have refused to sign it. (I know, you're shocked.) Partly because of Bush's stance, FDA authority language was stipped out of a tobacco reform bill at the eleventh hour in 2004.

But times have changed, and not just because this Congress and this White House are more amenable to cracking down on big tobacco. Philip Morris USA, the number one tobacco producer, has cleverly played the Machiavelli card, choosing to support the bill; it has calculated that its less successful, less well-heeled competitors won't be able to catch up if the FDA is breathing on their necks - whereas Philip Morris has the superior lab resources, thus enabling it to most easily meet fed directives for safer tobacco products. Moreover, Philip Morris' parent, Altria, Inc., has decided that it would be good for its image to be seen as a responsible corporate citizen.

Also, the aforementioned financial impact of tobacco on the already-stressed health care system has helped sway minds on Capitol Hill. Also, some tobacco-state lawmakers are less resistant than they used to be, because now there are fewer tobacco farmers to defend (due in part to a new federal buyout program that has encouraged tobacco farmers to switch to other crops; to Bush's credit, he signed that law).

And despite the fact that 17 senators voted No yesterday on FDA empowerment, there is finally broad philosophical agreement that government should be empowered to police cigarettes, with minimal protests that such a concept is tantamount to "socialism." (Although 16 of the 17 No votes were cast by Republicans, 23 Republican colleagues did vote Yes.) This bipartisan trend was arguably foreshadowed back in February 2007, when religious conservative leader Richard Land testified at a Senate hearing. He's hardly your typical FDA kind of guy - yet this time he argued that federal policing of cigarettes should be viewed as "a moral imperative."

Land continued: "We find it incredible that the FDA can ensure the safety of everyday items like cold medicines, cookies, and even dog food, but has no authority over tobacco, a product that causes more preventable deaths than any other...No one wants too much government regulation. What we are asking for is not overly burdensome; it would simply assure the protection of consumers, particularly our children...We are simply asking that tobacco products be subject to the same common-sense rules that apply to other products."

As Ethan Siegal warned me in May 1998, when the FDA effort tanked again in the Senate, "The whole push for reform is going to die a thousand deaths before passage. And right now, we're only at number 732." For the sake of our public health, it's a relief that we've finally closed the gap.