Are Antimicrobials the Next Cigarette?
What is the Next Cigarette?
When people learn of the similar legislative history of tobacco, lead, and asbestos… the astute audience often asks, “What is the next cigarette?” The road to law in the US is covered in pot holes and more curvy than Lombard Street. A quick look at the history of cigarette laws will illuminate only a small part of this road, but it’s a worthwhile glimpse into how laws evolve and what may lay ahead for public health protection. Are antimicrobials the next cigarette? Or is it fluorinated chemicals? Flame retardants? Plasiticizers? Time will tell.
History of Cigarette Legislation
This historical path of legislation over tobacco products is a long and ugly road. The politics, funding, unethical research, medical knowledge, lobbying, and public health impacts of this lengthy and prolonged process are completely absent from the following information gleaned from our very own Center for Disease Control (CDC).
Federal Food, Drug, and Cosmetic Act (FFDCA) of 1938
- Definition of a “drug” includes “articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in man or other animals” and “articles (other than food) intended to affect the structure or any function of the body of man or other animals”
- FDA has asserted jurisdiction in cases where the manufacturer or vendor has made medical claims
- FDA has asserted jurisdiction over alternative nicotine-delivery products
- 1984—Nicotine Polacrilex gum
- 1991—Nicotine patches
Federal Trade Commission (FTC) Act of 1914 (amended in 1938)
- Empowers the FTC to “prevent persons, partnerships, or corporations … from using unfair or deceptive acts or practices in commerce”
- 1983—FTC determines that its testing procedures may have “significantly underestimated the level of tar, nicotine, and carbon monoxide that smokers received from smoking” certain low-tar cigarettes. Prohibits Brown and Williamson Tobacco Company from using the tar rating for Barclay cigarettes in advertising, packaging or promotions because of problems with the testing methodology and consumers’ possible reliance on that information. FTC authorized revised labeling in 1986.
- 1985—FTC acts to remove the RJ Reynolds advertisements, “Of Cigarettes and Science,” in which the multiple risk factor intervention trail (MRFIT) results were misinterpreted
- 1999—FTC requires RJ Reynolds to add a label to packages and ads explaining that “no additives” does not make Winston cigarettes safer.
Federal Hazardous Substances Labeling Act (FHSA) of 1960
- Authorized FDA to regulate substances that are hazardous (either toxic, corrosive, irritant, strong sensitizers, flammable, or pressure-generating). Such substances may cause substantial personal injury or illness during or as a result of customary use.
Federal Cigarette Labeling and Advertising Act of 1965
- Required package warning label—”Caution: Cigarette Smoking May Be Hazardous to Your Health” (other health warnings prohibited)
- Required no labels on cigarette advertisements (in fact, implemented a three-year prohibition of any such labels)
- Required FTC to report to Congress annually on the effectiveness of cigarette labeling, current cigarette advertising and promotion practices, and to make recommendations for legislation
- Required Department of Health, Education, and Welfare (DHEW) to report annually to Congress on the health consequences of smoking
- More on the Federal Cigarette Labeling and Advertising Act of 1965
Public Health Cigarette Smoking Act of 1969
- Required package warning label— Warning: The Surgeon General Has Determined that Cigarette Smoking Is Dangerous to Your Health” (other health warnings prohibited)
- Temporarily preempted FTC requirement of health labels on advertisements
- Prohibited cigarette advertising on television and radio (authority to Department of Justice [DOJ])
- Prevents states or localities from regulating or prohibiting cigarette advertising or promotion for health-related reasons
Controlled Substances Act of 1970
- To prevent the abuse of drugs, narcotics, and other addictive substances
- Specifically excludes tobacco from the definition of a “controlled substance”
Consumer Product Safety Act of 1972
- Transferred authority from the FDA to regulate hazardous substances as designated by the Federal Hazardous Substances Labeling Act (FHSA) to the Consumer Product Safety Commission (CPSC)
- The term “consumer product” does not include tobacco and tobacco products
Little Cigar Act of 1973
- Bans little cigar advertisements from television and radio (authority to DOJ)
1976 Amendment to the Federal Hazardous Substances Labeling Act of 1960
- The term “hazardous substance” shall not apply to tobacco and tobacco products (passed when the American Public Health Association petitioned CPSC to set a maximum level of 21 mg. of tar in cigarettes)
Toxic Substances Control Act of 1976
- To “regulate chemical substances and mixtures which present an unreasonable risk of injury to health or the environment”
- The term “chemical substance” does not include tobacco or any tobacco products
Comprehensive Smoking Education Act of 1984
- Requires four rotating health warning labels (all listed as Surgeon General’s Warnings) on cigarette packages and advertisements (smoking causes lung cancer, heart disease and may complicate pregnancy; quitting smoking now greatly reduces serious risks to your health; smoking by pregnant women may result in fetal injury, premature birth, and low birth weight; cigarette smoke contains carbon monoxide) (preempted other package warnings)
- Requires Department of Health and Human Services (DHHS) to publish a biennial status report to Congress on smoking and health
- Creates a Federal Interagency Committee on Smoking and Health
- Requires cigarette industry to provide a confidential list of ingredients added to cigarettes manufactured in or imported into the United States (brand-specific ingredients and quantities not required)
Cigarette Safety Act of 1984
- To determine the technical and commercial feasibility of developing cigarettes and little cigars that would be less likely to ignite upholstered furniture and mattresses
Comprehensive Smokeless Tobacco Health Education Act of 1986
- Institutes three rotating health warning labels on smokeless tobacco packages and advertisements (this product may cause mouth cancer; this product may cause gum disease and tooth loss; this product is not a safe alternative to cigarettes) (preempts other health warnings on packages or advertisements [except billboards])
- Prohibits smokeless tobacco advertising on television and radio
- Requires DHHS to publish a biennial status report to Congress on smokeless tobacco
- Requires FTC to report to Congress on smokeless tobacco sales, advertising, and marketing
- Requires smokeless tobacco companies to provide a confidential list of additives and a specification of nicotine content in smokeless tobacco products
- Requires DHHS to conduct public information campaign on the health hazards of smokeless tobacco
- More on the Comprehensive Smokeless Tobacco Health Education Act of 1986
Public Law 100-202 (1987)
- Banned smoking on domestic airline flights scheduled for two hours or less
Public Law 101-164 (1989)
- Bans smoking on domestic airline flights scheduled for six hours or less
Synar Amendment to the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) Reorganization Act of 1992
- Requires all states to adopt and enforce restrictions on tobacco sales and distribution to minors
Pro-Children Act of 1994
- Requires all federally funded children’s services to become smoke-free. Expands upon 1993 law that banned smoking in Women, Infants, and Children (WIC) clinics
Family Smoking Prevention and Tobacco Control Act of 2009
- Grants the Food and Drug Administration (FDA) the authority to regulate tobacco products
Wow! You get the idea. You can imagine the millions of hours and billions of dollars ($$$) spent on developing and fine-tuning all these laws.
Themes of controlling contaminants in US
So who cares about old laws? Well, we can learn a lot from history.
When we compare the adoption of laws for tobacco, lead, and asbestos… it’s a remarkably familiar pattern.
- Anecdotal evidence suggests possible cause for concern
- Industry starts ad campaign stating opposite of anecdotal. “Don’t worry, cigarettes are actually good for health!”
- Scientific studies start to establish link (causation or correlation) between contaminant and human health problems
- Industry creates labs and hires researchers to promulgate studies showing no harm… or to raise doubt in other studies.
- More real science indicates problems.
- Usually a famous person or family member of a legislator falls victim to said toxin.
- By this point industry is dumping $millions into lobbying. Bills include protections for the industry, exemptions from past/future laws, etc.
- Public tide of opinion rises high… and pressure eventually outweighs the $millions… and a baby (compromised) law is born
- More opposition from industry. Quick – cast doubt and demonstrate damage to US jobs and economy!
- Slowly but surely more science supports the initial science, and laws are made more restrictive over time.
Another common trend is to see a cascade of laws over a predictable geography:
- Start in Europe, often Western European countries like Israel, Sweden, Germany
- Jump the pond to California
- Spread from California to rest of “blue states”
- Become federal law
The Next Cigarette is…
Can we look at the early history of these regulated substances and forecast what toxins will be regulated in the future? I believe so.
Here is a short list of ideas related to sick buildings:
- Radio Frequency (RF) radiation from WiFi, cordless phones, cellular antennas, etc.
- Low Frequency Magnetic Fields (EMF) from high voltage power lines, transformers, and wiring errors
- All of the Six Classes of Toxic Chemicals list co-developed by the Green Science Policy Institute:
“But wait,” you say, “these are ubiquitous and there’s no real science to support those claims of negative health impacts.”
Sound familiar? Like a tobacco skeptic in the 40’s?
The writing is on the wall. If you believe an once of precaution is worth a pound of cure, now is the time to practice precaution for all of the above.