Trying to kick tobacco again

Matthew Myers still doesn’t trust the tobacco industry. The president of the Campaign for Tobacco-Free Kids, who successfully fought the powerful tobacco lobby in the late 1990s, is worried that the progress he and other health advocates have made over the past two decades is being eroded amid the rise of smokeless tobacco and flavored e-cigarettes.

“The tobacco industry today continues to do what it has always done, which is to prevent the government from taking the action that everyone knows is necessary to protect the public,” Myers said during a recent interview with The Hill.

“Its rhetoric has always been one of an industry that cares about the health of effects of consumers … even while its actions do the exact opposite,” he added.

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Myers helped start the Campaign for Tobacco-Free Kids in 1996 and has been its president since 2000. The public health group works to reduce tobacco use and highlight its consequences in the United States and around the world.

Serving as an adviser to state attorneys general, Myers helped with negotiations that led to the landmark 1998 tobacco master settlement between 46 states, the District of Columbia and the five largest tobacco companies.

The 25-year, $246 billion agreement was the largest civil settlement in U.S. history. It forbade tobacco companies from directly advertising to children, among many other forms of advertising.

The settlement helped “change the world,” Myers said.

“People now recognize that the industry deliberately misled us about the health effects of its products, and deliberately undertook a decades-long campaign to prevent the government from acting,” he said.

But now Myers says the settlement also failed to “fundamentally change” the behavior of tobacco companies.

He said Congress, the administration and public health advocates all need to work together to keep the industry in check.

One of the indirect outcomes of the master settlement was the 2009 Tobacco Control Act, which gave the Food and Drug Administration (FDA) the ability to regulate all tobacco products.

That legislation “was truly the result of a decade of slow, persistent work building a bipartisan coalition to support it,” Myers said. “In the atmosphere that exists today, that’s hard to believe, but it passed the Senate with 85 votes and [conservative] members like [Texas Sen.] John Cornyn helped lead the charge.”

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But in the two decades since the Tobacco Control Act was passed, new products such as e-cigarettes have flourished in a largely unregulated marketplace.

Myers said the FDA failed to act to protect young people from getting addicted, and the public has suffered for it.

“Many of us had hoped that e-cigarette companies would behave differently, but in the absence of the government exercising its regulatory authority, we’ve learned they have behaved exactly as the tobacco companies, with truly unfortunate consequences,” he said.

Youth use of e-cigarettes has skyrocketed in the past year, driven largely by teenage customers and readily available sweet and fruit-flavored pods.

Federal statistics showed a 78 percent increase in e-cigarette use among high school students from 2017-18, and the FDA said preliminary data showed that number jumped again this year.

The most recent survey from the National Institute on Drug Abuse, released in September, showed the percentage of teenagers who are vaping has doubled in the past two years, with 25 percent of high school seniors using an e-cigarette in the past month. 

Acting FDA Commissioner Ned Sharpless acknowledged during a congressional hearing last month that the agency should have acted sooner to stop the youth epidemic. “But we’re going to catch up,” he vowed.  

Myers said the agency can’t act soon enough.

“FDA took five years to assert jurisdiction [on e-cigarettes]. That is unacceptable by any definition. Had it acted in 2012 or 2015, we’d be in a very different position.”

When the Trump administration took over in 2017, then-FDA Commissioner Scott Gottlieb enacted a plan to reduce nicotine levels in traditional cigarettes. He had hoped e-cigarettes could be a tool to help people quit.

But Myers said there’s no proof that e-cigarettes are safe, and there has been no reliable data indicating they can help people quit. Companies have been allowed to sell their products without providing any “sound scientific evidence” behind their marketing claims, Myers said.

The FDA has tried to assert its influence over e-cigarette and tobacco companies in the past, but Myers said industry lobbying convinced political officials not to enact some of the harshest measures, such as a flavor ban.

Even now, as more teenagers are getting addicted to e-cigarettes and the administration is trying to find ways to crack down, the industry is fighting back hard.

“That’s one of the reasons why FDA was so slow to act to address the issues of e-cigarettes, and one of the reasons the issue has become more partisan in Congress than it has traditionally been,” Myers said, adding that further action is needed from lawmakers as well.

“We need FDA to use the authority it was given … but it’s also a mistake to think full responsibility lies just with FDA,” Myers said.

“Congress needs to raise tobacco taxes, close the loophole for online sales and needs to ensure the e-cigarette industry is no longer allowed to market the kinds of flavors that led to this epidemic.”

In a move long sought by advocates, Congress does look likely to raise the legal smoking age to 21, and some lawmakers want much more.

Last year, the Trump administration said it would require retailers to physically separate e-cigarettes from the rest of the store. While not as strong as a complete ban on selling the products, the move was still opposed by conservatives and small business groups.

Last month, faced with new figures showing the teen vaping epidemic has not slowed, President Trump said he was instituting a total ban on all e-cigarette flavors except tobacco until the companies can clear FDA’s strict new regulatory requirements.

Myers praised the administration’s move, even though it has yet to be implemented.

“I think it’s an extraordinarily smart policy. Before the introduction of Juul, the most popular flavor was tobacco. If one is concerned about youth use of e-cigarettes, tackling the flavor issue is a priority,” Myers said. “If industry has evidence that a particular flavor helps smokers quit, there’s a pathway through FDA to evaluate that.”