"Lost" and FDA Regulation of Tobacco

Last night I watched an excellent episode of the TV series, “Lost.” In it, a man named Ben who is the (sociopathic?) leader of one group of people trapped on a lost island, managed to get one of the members of the island’s opposing group (a man named Locke) to blow up a submarine which was apparently the only link to the outside world. The clever thing about it was that Ben managed to get Locke to do what Ben wanted--despite the fact that Locke was holding him at gunpoint, Ben was in a wheelchair, and Locke felt that it was all his idea! For those of you not familiar with this TV show, the main point here was that devious people can sometimes get what they want and yet make it seem like they have lost out and that it was all someone else’s idea.

Why am I talking about this on a forum about tobacco? Well today I’ve been thinking about parallels between that storyline and the proposed legislation to allow the US Food and Drug Administration (FDA) to regulate tobacco products. Don’t get me wrong; I strongly support the need for much tighter regulation of the tobacco industry. In fact I continue to think this bill will likely do more good than harm. But there is one big thing that bothers me. The biggest tobacco company in the country – Philip Morris (PM) – also supports the current FDA bill. So what’s that all about?

Some critics of the bill refer to it as the “Marlboro Protection Bill” because they see it as simply building bigger barriers to competition for the current leading cigarette brand, Marlboro (a Philip Morris brand). There is a particular part of the bill that refers to the introduction of new reduced harm tobacco products or claims that one product is less harmful than another. The bill correctly requires reasonable evidence that an individual using the “less harmful” product will really have lower risk of tobacco-caused harm, when the products are used in the normal way. However, the bill also requires that the product will benefit the health of the population as a whole. Now this seems to be a rather difficult standard for any new product to comply with, in the absence of a crystal ball or a massive research study involving hundreds of thousands of people and lasting decades.

So why would public health experts agree to this? Most likely, to prevent a repeat of the ”Light cigarette fiasco” in which millions of smokers switched to Lights (instead of quitting), in the false belief that light cigarettes are less harmful. So why would Philip Morris agree to it? Because they are the dominant cigarette manufacturer with by far the largest market share. New products that are much less harmful (e.g. the smokeless “snus” products that are now more popular in Sweden than cigarettes and being test-marketed in the US by competitor RJ Reynolds) have the potential to take significant market share from Marlboro. But this is much less likely if such products cannot be launched or can be prevented from making any reduced risk claims. Maybe Philip Morris is acting like Ben on "Lost," by making public health experts think they’re getting what they want, by restricting new products’ ability to make claims to be less harmful. In fact, we may just be doing PM’s dirty work by preventing less harmful competitors from entering the market and thus preserving Marlboro’s dominant position--unchallengeable by products that won’t cause lung cancer or chest diseases.

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