Cornered (26 page)

“Nicotine addiction really begins as a pediatric disease,” he would begin, stretching out the syllables of
pe-di-at-ric,
for emphasis. “I mean it's not only that eleven-, twelve-, and thirteen-year-olds begin to use tobacco, it's that by the age of sixteen and seventeen they are addicted. The tobacco industry would have you believe that smoking is a free choice made by adults. They are wrong. Ask a smoker when he or she began, and you will hear”—pause—“the tale of a child.”

In rapid succession he would cite evidence and produce exhibits. “Let me show you, in their own words, what they say about children and youth. Imperial Tobacco, the Canadian affiliate of BAT in the U.K., wrote this market report. ‘If the last ten years has taught us anything it is that the industry is dominated by the companies that respond most effectively to the needs of young smokers.'

“Two documents, one called ‘Project Sixteen' and the other called ‘Project Plus, Minus,' really tell the story of who becomes a smoker. Let me read to you from Project Sixteen. Quote, ‘However intriguing smoking was at eleven, twelve, or thirteen, by the age of sixteen or seventeen many regretted their use of cigarettes for health reasons and because they feel unable to stop smoking when they want to.' Listen to these words. They are not my words. They are from the tobacco industry. ‘The fragile developing self-image of the young person needs all the support it can get … this self-image enhancement effect has traditionally been a strong theme for cigarette advertisements and should continue to be emphasized.'

“Therefore,” he continued without a pause, “we believed at the Food and Drug Administration that the best public health strategy was to intervene before people became addicted. It's not about quitting; it's about starting. If you want adults not to smoke, the best way is to have a generation grow up tobacco-free.”

Intense and animated, Kessler never stopped talking, but when he took a breath, I managed to insert a question. “Your critics in the public health community would say that by concentrating on children, you're making smoking an adult pleasure and therefore attracting children to the habit.”

“Not at all,” shot back Kessler. “What we're trying to do is reduce the positive imagery the industry has played up for so long. The tobacco industry spends $6 billion a year on advertising and promotion. They say it isn't aimed at children, but what are the three most heavily advertised brands in this country? They're Marlboro, Camel, and Newport. What are the brands that teenagers smoke the most? Marlboro, Camel, and Newport.”

At this point Kessler holds up a glossy advertisement, a folded insert from a magazine for a rock concert sponsored by R. J. Reynolds, the makers of Camel cigarettes. As he opens it, Joe Camel pops up offering tickets to the concert. “This comes from magazines that my children have in their rooms at home. What we're trying to reduce is this positive imagery.… Once you look at the evidence, once you look at what's come to light over the last several years, you can never look at a cigarette in the same way. You can never say, ‘This is just a usual commodity.'”

*   *   *

O
NE YEAR AFTER
Kessler's tobacco task force had solved the mystery of the high-nicotine plant, Y1, Kessler had found his real target, one that would eventually win over doubters in the White House and allow him to move forward with new rules to regulate the tobacco industry. The figures on youth smoking were alarming. Adult smoking had declined by 40 percent since 1965, but youth smoking had suddenly started to rise again, and no one was quite sure why. Teenagers had been using more drugs of all kinds since 1990, more marijuana, LSD and other hallucinogens, amphetamines, stimulants, and inhalants each year.

Three thousand teenagers start smoking every day and of those nearly one thousand will die prematurely, according to the Surgeon General. Among eighth-graders, the percentage of those who have smoked in the previous thirty days increased 30 percent between 1991 and 1994. Eight out of ten ninth-graders said they had no trouble buying cigarettes, even though the law says they have to be eighteen. Some estimates said as many as 255 million packs of cigarettes were sold illegally to minors each year.

Kessler blamed the industry's advertising and promotion. One study of cigarette use, commissioned by the U.S. Centers for Disease Control in Atlanta, has suggested teenage smoking is related to the amount the industry spends on promotion and advertising. The study showed that in 1980, when the tobacco companies spent $771 million on promotional giveaways, 5.4 percent of the fourteen-to-seventeen-year-olds started smoking. That figure had dropped to 4.7 percent by 1984, but then rebounded to 5.5 percent in 1989, the year the industry spent $3.2 billion on hats, T-shirts, outdoor adventure trips, coupons, and other promotional items. The highest increase in young smokers, 6.3 percent, was in 1988, the year R. J. Reynolds introduced Joe Camel.

When the anthropomorphic beast first appeared in 1988 to celebrate Camel's seventy-fifth birthday, Camels were being smoked primarily by adult men. But Joe spoke to youth. He gave dating advice called “smooth moves,” and to show he knew what he was talking about, he was joined by a whole gang of hip camels at the watering hole.

In one R. J. Reynolds internal memo about a “Young Adult Smokers'” [YAS] campaign, a divisional manager in Florida issued instructions to his cigarette salesmen on ways to increase the exposure of the new Joe Camel campaign to the young adult market [YAM]. The memo asked sales reps to identify stores within their areas that were “heavily frequented by young adult shoppers. These stores can be in close proximity to colleges [and] high schools.” Asked about the memo, the company said it was a mistake; the manager had violated company policy by targeting high school students.

Then, a second memo surfaced—this one from a divisional manager in Oklahoma. The memo advised, “The criteria for you to utilize in identifying these [YAS retail] accounts are as follows: (1) … located across from, adjacent to [or] in the general vicinity of high schools.” Isolated memos by overzealous managers, perhaps, but in fact young people started to smoke Camels. By the end of the ‘80s, Camels' share of the underage market had risen from 3 to 13 percent.

*   *   *

A
S THE
1996
ELECTION LOOMED
, President Clinton had not yet made up his mind to support Kessler. He was being sent two different messages; one from Capitol Hill sought compromise; the other from the health groups called for FDA regulation.

Politicians from Southern tobacco states warned Clinton that any move to regulate tobacco would ensure his loss there in the elections. National polls showed Clinton slightly ahead of Dole, but one in North Carolina in the summer of ‘95 had shown him twenty points behind. Clinton carried Tennessee and Kentucky in 1992 and lost by only 10,000 votes in North Carolina.

The tobacco companies were also aggressively funneling money into Republican campaigns. And in an effort to head off White House action, Philip Morris, which sold about half of the 480 billion cigarettes smoked each year, and the United States Tobacco Company, the nation's largest seller of chewing tobacco and snuff, preempted part of Kessler's campaign. They jointly proposed a ban on vending machine sales, promotional giveaways, and transit advertising as well as restrictions on billboard ads. They were also willing to create a fund of $250 million over five years to help enforce restrictions on teenage purchases of cigarettes.

Some congressmen urged Clinton to accept the industry's voluntary restrictions. Democrat Ron Wyden, of Oregon, an antitobacco congressman on Waxman's committee, and Charlie Rose, Democrat of North Carolina and an old friend of Big Tobacco, favored a negotiated settlement that would avoid FDA regulation. Wyden's argument was that any FDA proposal would be tied up in a court battle for years. “Nearly everyone understands that tobacco kills,” wrote Wyden in an Op-Ed article in
The Washington Post,
“but gridlock can kill too.… If the tobacco companies tie up FDA regulation for even three years, 3 million kids will start smoking and more than one million of them will die needlessly from tobacco.” His plan called for a “binding agreement” between the tobacco companies and the federal government to take steps to curb youth smoking. The Wyden-Rose plan was backed by Missouri Democrat and House minority leader Richard Gephardt who, with twenty current Southern Democrats, had lobbied the White House to kill Kessler's plan. Gephardt, a big recipient of tobacco industry campaign funds, told the White House that the FDA proposals would become “a critical economic factor” in many of the Southern states.

In the end, however, White House private polls told Clinton the risk was worth taking. A tough stand against tobacco might lose him North Carolina and Kentucky, but an antitobacco image would help in other, bigger states—California, New York, New Jersey. Then Kessler's campaign got help from another, unexpected front outside the cauldron of Washington politics.

*   *   *

I
N THE SUMMER
of 1995, Brown & Williamson was still trying to stop publication of the Merrell Williams papers. The company had asked the California Supreme Court to enter an emergency stay that would prevent the University of California at San Francisco from releasing the documents to the public. The court refused. On July 1, the university library put the entire set of 10,000 pages on the Internet. They could be called up on the following address:

http://www.library.ucsf.edu/tobacco

To coincide with this event, the
Journal of the American Medical Association, JAMA,
devoted its July issue to an analysis of the documents by Professor Stan Glantz and his colleagues. The analysis was accompanied by a hard-hitting editorial, which concluded that tobacco was a “drug delivery vehicle” and recommended that the industry be placed under FDA jurisdiction for “appropriate regulation as for other life-threatening drugs.” It also suggested a ban on all tobacco advertising, plus a vigorous counteradvertising campaign.

To reduce teenage smoking
JAMA
recommended further steps: an education program for physicians, the public, and policy makers; medical schools and research institutions should refuse tobacco industry grants; politicians should refuse tobacco money for their campaigns; government agencies and local communities should continue to control smoking in public; state and federal taxes on tobacco should be dramatically increased; the federal government should stop the export of tobacco to other countries; and the public should continue to use the courts to sue the companies for damages.

President Clinton would later say that the
JAMA
articles, which he had read, swayed him toward a favorable decision on the FDA proposal. The same day the issue was published, Kessler sent his proposals to the White House.

On August 10, 1995, in a midday news conference at the White House, Clinton became the first president in U.S. history to stand up to the tobacco companies and order FDA regulation governing the sale of cigarettes. While Hillary Clinton ran a “smoke-free” White House (except for the president's occasional cigar), such a move had never been contemplated when the Clintons arrived in Washington in 1992.

In giving Kessler the go-ahead, Clinton said his goal was to cut teenage smoking in half by curbing the “deadly temptations of tobacco and its skillful marketing” by the industry. The government had a responsibility to save children from “the awful dangers of tobacco,” he said. “The evidence is overwhelming and the threat is immediate. To those who produce cigarettes, I say today: Take responsibility for your actions, sell your products only to adults, draw the line on children, show by your deeds as well as your words that you recognize that it is wrong as well as illegal to hook one million children a year on tobacco.”

The proposed rules were set out in a dense 324-page section in the Federal Register. The proposal detailed how the tobacco companies had long understood, and talked freely in private about, the addictive nature of nicotine, and how they intended, by manipulation of the nicotine levels in cigarettes, to keep their customers addicted. In theory, if the FDA rules survived tobacco-industry legal challenges and the agency maintained jurisdiction, Kessler could ban tobacco outright, or he could set maximum levels of tar and nicotine in cigarettes, but that was not his plan. His proposals were aimed at eradicating smoking as a “pediatric disease.”

The proposals would prohibit sales to under-eighteen-year-olds and require photo ID for proof of age. They would ban sales through vending machines, prohibit free samples, and forbid brand-name tobacco advertising at sporting events and on products like T-shirts, tote bags, and cigarette lighters. Kessler also wanted to ban the sales of “kiddie” packs of less than twenty cigarettes and forbid billboard ads within 1,000 feet of schools. Tobacco advertising would be limited to black and white text only and manufacturers and distributors made responsible for illegal sales to those under eighteen. Finally, the proposal would require tobacco companies to create a fund of $150 million for antismoking campaigns directed at young people. The regulations would cover cigarettes and smokeless tobacco, but would not apply to pipe tobacco or cigars.

Among the studies cited in favor of the ad ban was one that found 30 percent of three-year-olds and 91 percent of six-year-olds can identify Joe Camel as a symbol of smoking. By comparison, 62 percent of six-year-olds can identify Ronald McDonald. It was a remarkable distinction, said the FDA proposal, because Ronald McDonald appears in TV commercials during children's viewing hours and there are no cigarette ads on TV. A number of industry memos included in the proposal showed how preoccupied the companies had been with youth smoking.

Clinton would turn the FDA proposals into a potent campaign theme. “When Joe Camel tells young children that smoking is cool, when billboards tell teens that smoking will lead to true romance, when Virginia Slims tells adolescents that cigarettes may make them thin and glamorous, then our children need our wisdom, our guidance, and our experience.”