US Impetus for Tobacco Restrictions Look to Europe

William B. Shultz:
We can learn from each other

S initiatives to cut cigarette smoking among young people were inspired in part by European trends. The irony is that the US has gone way beyond Europe in its onslaught on tobacco use.

William B. Shultz, assistant director at the US Food and Drug Administration (FDA) says that work on the Clinton administration's robust limits on tobacco promotion took account of similar measures carried out in Finland and France. The US government has gone much further than most European countries or the European Union, and has defined nicotine categorically as an addictive substance and cigarettes and tobacco as nicotine delivery devices.

"When we were considering what measures to adopt in the United States we looked very carefully to the programmes that have been put into effect in the various European countries. When we made the presentations to the White House, and ultimately to the President, about the measures we wanted to adopt, it was very relevant that certain European countries were taking strong measures--that Finland and France, for instance, had banned advertising. The steps taken in Europe have certainly supported the decisions that we made.

Knock-on effect

"In addition, we looked at some of the studies on advertising that had been done in European countries, and used them to support our findings that advertising influences children to begin smoking. I would imagine that the steps we have taken will have a similar effect on European countries that are considering additional tobacco control measures."

While litigation against tobacco firms is taking place in countries such as Finland, France, Britain and Italy, court cases in the US run into the hundreds. Shultz believes that the vast amount of research into the effects of smoking carried out by the tobacco industry, and either leaked or otherwise seeing the light of day because subpoenas by Congress, can be used to enhance European action to curtail tobacco use.

"We can learn from each other. The cases have been critical in revealing documents from the tobacco companies showing their strategies in terms of focusing them on children, and revealing their research, which in many cases was much more advanced than other research being done. Certainly, the documents that have been revealed will be useful to any country considering similar measures. Depending on the laws of different countries, there maybe also a lot to learn from the litigation--but of course it will depend on the extent to which the litigation is successful in the United States. The documents that have been made public in the last two years have proved to be very relevant to those law suits.

Tackling sponsorship

Shultz describes the government move on tobacco as a "sea change" for US policy. "It is a tremendous shift in policy, and a commitment by the President to invest the time and resources of the government to keeping kids from smoking. The specific proposals are also seen in some ways as dramatic. They envisage severe restrictions on advertising and sales of tobacco to children.

"Our goal in the next seven years is to reduce the numbers of kids who smoke by 50 percent. "

"We banned advertising on TV in 1970, but since then the tobacco companies have managed to get their name and logo on television through sporting events. You can turn on the TV and see six hours of a Marlboro car. This is one reason why it is so important to deal with sponsorship."

Shultz is sanguine about the strength of public support for tougher restrictions on tobacco.

"Americans love to take polls, and these suggest that this initiative has the support of 80 percent or more of people--which is about as high as it ever gets. One interesting aspect of this is that it has been popular even in the south, the area of the United States where most tobacco is grown. For example, in Virginia--which is the home of the Philip Morris company--I saw an article recently that said that when the President first announced the proposal it had the support of 45 percent of the people of that state. This year [1996] it is 55 percent. I think part of the reason for that is the emphasis on children. Nobody wants children to smoke--smokers don't want their children to smoke, and even tobacco company officials say they don't want their kids to start.

"Our goal in the next seven years is to reduce the numbers of kids who smoke by 50 percent. That is our focus. The other area that is still critical is the use of tobacco in developing countries and the issue of what responsibility the countries that export tobacco are going to take. This is an emerging issue that is going to receive more and more attention."

Interview by Mark Waller and Satu Lipponen

Half-way there

The first big question mark over the US administration's stand on tobacco came when the tobacco companies sued the FDA, arguing that the advertising restrictions violate the First Amendment to the US Constitution, on the protection of free speech. They also claimed that nicotine is not a drug, and that therefore the FDA had no right to regulate it.

In Spring 1997, the Federal District Court in Greensbro, North Carolina, upheld the FDA ruling on nicotine and the "tobacco products fit within the FDCA's [Federal Food, Drug and Cosmetic Act] defi- nitions of 'drug' and 'device'" The court also backed all restrictions involving the access of young people to tobacco products, as well as provisions that came into effect in February 1997.

These concern the prohibition on sales of cigarettes and smokeless tobacco products to young people, and the requirement that retailers check photo identification of customers who are under 27 years of age. Other FDA measures designed to keep kids away from tobacco that were to come into effect in mid-1997 were similarly upheld.

Thumbs down

As a result, billboard advertising near schools, placing cigarette vending machines where children have access to them, selling 'kiddie packs' of less than 20 cigarettes or individual smokes, and handouts of free samples are all banned.

FDA efforts to restrict the tobacco industry's advertising activities, however, were given the thumbs down by the court. It ruled that the FDA does not have the authority to regulate the advertising and promotion of tobacco products using a statutory provision of the FDCA.

The court did not make the ruling on the basis of the Fifth Amendment challenge that had been put up by the parties contesting the FDA's restrictions, among them the United States Tobacco Company and the American Advertising Federation. The advertising portion of the ruling is being appealed by the government. n

Smoke Free Europe - A Forum for Networks - 14 AUG 1997

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