McConnell's plan to raise the age of smoking could be a victory for tobacco companies

The urging of Senate Majority Leader Mitch McConnell to raise the legal age of smoking to 21 years seems to be a victory for public health. But anti-tobacco advocates fear that McConnell and the tobacco industry are using the bill to block other, more tried-and-tested measures aimed at curbing youth smoking.

McConnell is committed last week to introducing a bill to increase the legal age to buy tobacco from 18 to 21 years old, calling it a "top priority" when the Senate returns from vacation of audience at the end of April. This decision quickly sparked a surprising enthusiasm among cigarette and vaping manufacturers, who pledged to put their weight behind his initiative.

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But in some states, legislation aimed at increasing the age of purchase of tobacco-related products has supplanted the flavor bans, which would reduce the profits of industry giants such as "cash" and "cash". Altria and Juul. Industry-backed bills have also put an end to broader pressures to ban menthol cigarettes or to increase state taxes enough to deter potential smokers. Some may even exempt tobacco products that are not yet on the market.

"They are turning these tobacco bills into Trojan horses," said John Schachter, director of state communications at the Campaign for Tobacco-Free Children. "The industry positions tobacco 21 as the only thing to do when it comes to tobacco prevention," but "tobacco 21 must be a complement" to other measures, he said.

A spokesman for McConnell only said that his bill was still under development and would be presented next month. She did not answer the question of whether McConnell would also support higher taxes and flavor bans.

Tobacco and e-cigarette giants such as Altria have lobbied for taxes on tobacco and flavored products that are popular with teenagers to be untaxed, which according to the Centers for Disease Control would have a greater impact on reducing teen smoking and vaping.

When family medicine professor Rob Crane heard about McConnell's announcement, "the hair on my neck got up and I said," It's really terrible, "said Crane, professor at Ohio State University and president of Preventing Tobacco Addiction. Foundation.

Crane is concerned that McConnell's bill may be consistent with tobacco lobbying, which aims to amend bills by introducing weak enforcement mechanisms, banning local restrictions on flavored products and increasing taxes.

Twelve states have passed laws that elevate the legal age of tobacco to 21, but some do not know the anti-smoking measures that their advocates say are the most effective.

An Arkansas bill, for example, prevents cities and counties from adopting more stringent regulations such as the ban on electronic cigarette flavors, enforcing enforcement of the law or the raising of the age of tobacco sales.

In Virginia, Tobacco Stronghold and Altria's original state, a law to come into effect in July with general support at the Republican-controlled general assembly, did not provide funding to make respect the law and punish young people who buy cigarettes. Critics argue that this could lead to racial profiling.

Similar provisions are contained in a Texas bill that will soon pass the state legislature with broad bipartisan support.

Human rights advocates say that it is relatively rare to raise smoking by increasing the age of the consumer, but research has shown that raising taxes from barely $ 1 per pack limits purchases of cigarettes and flavored products that are particularly appealing to teens. The tastes of the electronic cigarette have led to a rise in power last year, according to CDC data.

In the state of Kentucky, McConnell's home country, state lawmakers increased the cigarette tax by 50 cents last year, the largest increase in cigarette sales. 39, state history, but lower than the demand of public health groups. The final budget bill left out a tax on electronic cigarettes.

"We had it in the bill and it mysteriously disappeared on the last day of the session," said Ben Chandler, a former congressman and current president and CEO of the Foundation for a Healthy Kentucky. "We still do not know where it went."

The bans on steamed cigarettes and menthol cigarettes, which are of interest to young consumers as well as African Americans, have sparked heated debate in countries like New York, which has adopted a package of anti-smoking measures in 2017 and voted to raise the age of purchase this month. In San Francisco, voters confirmed the strictest ban on flavors in the country, even after the industry had spent $ 12 million to oppose the referendum.

Tobacco companies "tend to be much more focused on restricting aromas than on the age of purchase," said Lisa David, President and CEO of Public Health Solutions, a non-profit organization. based in New York. "They fought the taste bans, they fought the most menthol or mint."

The problem, said Ashley Bell of the American Heart Association, is that current tobacco laws "do not cover products that are even on the market right now, let alone those that will arrive."

She was referring to Philip Morris International's IQOS system, which heats cigarette tobacco and turns it into steam but does not burn it. IQOS is being reviewed by the FDA, with a likely decision this year.

The sleek and heavy tech IQOS device has anti-smoking advocates on maximum alert. They point to a possible flaw in tobacco legislation of Rep. Robert Aderholt (R-AL) that could place IQOS in the category of vaping products, where he would benefit from looser marketing and marketing restrictions. a reduction of taxes.

At a press conference held earlier this month, McConnell gave little details other than the fact that army members would be exempted from the new age restrictions. Altria recently hired former McConnell associates and majority whip John Cornyn, the second Senate Republican, to lobby on tobacco issues.

Proponents of the bills say that they are going in the right direction, if not as far as some would like.

"I think [tobacco companies] are in agreement with the bill because it's a problem for their image, "said Virginia Rep. Christopher Stolle, a Republican who sponsored the legislation of the House. He dismissed claims that tobacco bills 21 would be a decoy. " . "

And an Altria spokesperson told POLITICO that the company was arguing for "simple tobacco bills 21 and bills offering the most viable legislative path" to raise the age of purchase.

Nevertheless, lobbying has hindered other efforts to reduce overall tobacco dependence and prevent vaping, which, according to the CDC, has erased two decades of declining nicotine teens.

FDA's more ambitious plans to limit levels of nicotine, flavored cigars and menthol cigarettes – rules that could turn off adult smokers but reduce dependency – have not been finalized when the old FDA Commissioner Scott Gottlieb left the agency this month. Republicans and industry oppose it, leaving questions about what Gottlieb's successor will do.

Philip Morris International denies that he is looking for a loophole for IQOS in the Aderholt bill. The company has submitted IQOS as a tobacco product subject to the usual restrictions of the FDA, said company spokesman Corey Henry.

PMI admits that IQOS is toxic, but claims to reduce by 90% the dangerous inhaled substances contained in tobacco. He said that it will sell directly to adults who are trying to pass.

The device has already been approved in 45 countries, but the FDA is still evaluating two PMI apps: one for IQOS as a new tobacco product and another one that would mark it as a modified risk product, stating that It is safer than other tobaccos. the market. Altria would be the American distributor of the product.

Public health officials are not so convinced that IQOS only targets adults.

"It's a beautifully crafted device," said Stanton Glantz, director of the Tobacco Control Research and Education Center at the University of California at San Francisco. "They sell them in stores that look like Apple's stores – it's like everything the industry does, saying they're for adults, but that they're selling them to people." children. "

After reviewing the IMF's IQOS application to the FDA, Glantz said that he did not think it was safer than smoking, but only that his risk profile and its effects unknown were different. Such products keep people in the market who would otherwise quit smoking, he said.

"The underlying problem here is an industry that is built around making individuals dependent on a known addictive agent – nicotine – and then getting them to be lifelong consumers of their product," he said. said Joe Thompson, president and CEO of the Arkansas Center for Health Improvement. former general surgeon of the state.

"As a country, we risk seeing another generation, if not two, follow the same path as their parents," he said.