Up in Smoke Notes

Up in Smoke- Notes

We are in the phony tobacco war, the quiet after the storm, the respite

before the battle is waged anew. In the years since the leading tobacco

companies and state attorneys general entered into a Master Settlement

Agreement (MSA), resolving the states’ claims against the companies,

and the Supreme Court and Congress denied the Food and Drug Administration

(FDA) jurisdiction to regulate cigarettes, tobacco policy has

withdrawn from the center stage of health policy, replaced by such issues

as prescription drug financing, medical malpractice liability reform, and

even bioterrorism.

But tobacco has not gone away. In 2002, over 22 percent of adults in

the United States smoked cigarettes (U.S. Department of Health and

Human Services 2004a: 32). In 2003, 26 percent of students in grade 12

smoked (U.S. Department of Health and Human Services 2004a: 33).

Moreover, smoking continues to kill over 400,000 Americans each year

(U.S. Department of Health and Human Services 2004b: 1). Globally the

toll is even more staggering. According to the WHO, tobacco is the second

leading cause of death on the planet, killing more than five million

people each year. “Half of the people that smoke today — that is about

650 million people — will eventually be killed by tobacco” (World Health

Organization 2005).

All this is widely known and accepted today, even by the tobacco companies.

We also know that tobacco causes numerous diseases beyond

lung cancer, that for years the tobacco companies misled the public as

to the health hazards of their product, and that governments throughout

the planet have lagged in their responsiveness to the problem. We also

now have reams of information about what causes people to smoke and

why they don’t quit (even though many want to). What we still don’t fully

appreciate, even after the MSA, and even while the federal government

Journal of Health Politics, Policy and Law, Vol. 31, No. 2, April 2006. Copyright ©...