Bridging the Divide: A Shared Interest in a Coherent National Tobacco Policy

Abstract

In its 2000 study on the polarized nature of the debate over core tobacco policy issues, the American Council on Science and Health observed: A common feature of modern society is the convening of conferences and other forums where traditionally antipathetic parties come together to communicate in a genuine effort to understand one another and resolve lingering distrust and animosity. It is striking that the same cannot yet be said of the right and the left in the tobacco policy debate, where the opposing camps have engaged in little genuine dialogue. Three years later, the distrust and animosity persist. Important, yet reconcilable, differences on specific tobacco policy questions remain, but some in the industry and the public health community continue to focus on the differences rather than on how to resolve them. A proposal empowering the Food and Drug Administration (FDA) to regulate all aspects of the design, manufacture, and distribution of tobacco products, acknowledged by one of its critics as differing "in only about five percent" from a preferred proposal, is nonetheless excoriated by some leading tobacco control groups as "worse than having no legislation at all," "not requir[ing] any meaningful changes " in behavior by the industry, and "not even represent[ing] a starting point for further negotiations." Some in the industry lambaste the same piece of legislation as placing "the future of tobacco farmers and their families at risk, and imposing "a huge regulatory burden that would be difficult, if not impossible, for smaller manufacturers to sustain." Something here does not compute. How can a single policy option be completely meaningless and, at the same time, threaten to drive an entire industry out of business? We seem to have reached a point where the hostility and rancor developed during nearly fifty years of the so-called "tobacco wars" have reached such a fevered pitch that, even where there are policy solutions with the potential to benefit all parties to the debate, the existence of the battle itself and the desire to sustain it have become ends in themselves. My company, for one, sees no benefit in continued fighting, and would like to find common ground that will both advance public health and permit our tobacco businesses to conduct their operations in a respectful, responsible-and, yes, profitable-way. In this Commentary, I offer a view as to how the current impasse developed, and then explore the possibility of drawing back from the abyss. I first acknowledge the role that the tobacco industry has played in generating an unprecedented level of mistrust within the public health community. Then, I offer some observations about the strategy of demonizing tobacco companies. Finally, after an explanation of why I think the industry would benefit from meaningful, effective regulation of tobacco products by the FDA, I examine a specific policy question presented by the various legislative alternatives and suggest that a sensible, meaningful solution is possible.