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• BRANDT: FDA Regulation of Tobacco -- Pitfalls and Possibilities 

Given the opportunity to put tobacco control back on the federal agenda, virtually all major public health and medical specialty groups, including the American Cancer Society, the American Heart Association, the American Lung Association, and the American Medical Association, strongly support the FDA bill. Nonetheless, a few prominent tobacco-control advocates such as Stanton Glantz of the University of California, San Francisco, have expressed skepticism, arguing that Philip Morris's support indicates that the legislation would probably benefit its corporate interests. And certainly, from a historical point of view, Congressional legislation passed under the rubric of "regulation" has often come back to haunt public health advocates. . . .

Thus, it behooves public health advocates and Congress to more fully understand all the implications of FDA regulation. Some critics have referred to the inherent compromises required to enact such a bill as "dancing with the devil." In this case, the devil will be in the details. Will FDA regulation lead to interventions that further reduce the prevalence of smoking in the United States and its effect on the burden of disease? . . .

Nonetheless, despite its initial limitations, the bill offers important new federal leverage for reducing smoking-related disease, disability, and deaths.

As Congress debates the regulation of tobacco by the FDA, it would be wise to consider ways of tying serious efforts to reduce tobacco use in this country to efforts to reduce the burden of tobacco-related diseases throughout the world. Saving lives from the manifold harms of tobacco should not be viewed as a zero-sum game. Nor should FDA regulation of U.S. tobacco products be seen as offering new respectability to an industry that, as a federal judge has ruled, has been committing racketeering and fraud for more than half a century.

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