Unanswered Questions for HHS Sec. Sebelius About Today's "Tobacco Control Strategic Action Plan"

Professor John Banzhaf asked the first question at this morning's announcement by HHS's Secretary Kathleen Sebelius about her agency's "Tobacco Control Action Plan, Here are more questions which might help to put her announcement into perspective.
By: Action on Smoking and Health (ASH)
Nov. 10, 2010 - PRLog -- Professor John Banzhaf of Action on Smoking (ASH) asked the first question at this morning's announcement by HHS's Secretary Kathleen Sebelius about her agency's "Tobacco Control Action Plan," including a proposal to require graphic health warnings regarding smoking.  Here are some addition questions which might help to put her announcement into perspective.

QUESTION 1: Which of the following is likely to cause more current smokers to quit, or children not to start smoking?
ANSWER 1A:  Tell them something they've heard for many years, but do it slightly better with pictures.
ANSWER 1B:  Double the number of jurisdictions - and the percentage of people in them - where smoking is prohibited in all workplaces and public places.

QUESTION 2: Which of the following is most likely to reduce the huge almost $200 billion/year cost of smoking to the American economy?
ANSWER 2A:  Tell people again that smoking causes lung cancer and heart attacks, this time with pictures.
ANSWER 2B:   Get companies to charge smokers twice as much as they are now paying for health insurance.

QUESTION 3: Since some of the proposed warning labels highlight how dangerous secondhand tobacco smoke is to children, what's the most effective way to protect them.
ANSWER 3A: Tell smokers who smoke around their children, again, that it's dangerous to the child.
ANSWER 3B:  Actively support laws to ban smoking when children are in the car, court orders prohibiting smoking in a home when children involved in custody disputes are present, and support measures by states to ban smoking when foster children are in the home.

In each case the correct answer is obviously "B," but you would not know it from today's announcement about what Sebelius called "the most significant change in more than 25 years."  The event conveniently ignored the fact that bans on smoking and financial disincentives are the two most proven and effective ways to get people to quit or not start smoking, and that virtually all of the progress in the war on smoking has been made at the state and local level.  Indeed, can anyone remember a major federal initiative which caused a significant decline in per capita cigarette consumption?

Today all HHS contracts, grants, and similar programs providing funding for most universities, states and cities, large corporations, etc. require as a condition of obtaining the grant that the institution protect Blacks and women (among others) by prohibiting discrimination.  Without the need for any new legislative authority, Sebelius could in the same way require all recipients of HHS grants, contracts, etc. to protect nonsmokers by prohibiting smoking.  Putting this one simple requirement into effect would ban smoking in tens of millions of places including workplaces, thereby providing the strongest possible incentive for smokers to quit and kids not to start.

Although HHS has ruled that smokers can be charged far more for their health insurance - a measure almost certain to persuade millions to quit - they have been very quiet about it with no educational programs or even a quiet announcement.  When Congress passed health care reform legislation - which HHS largely implements - which allows this practice to continue, HHS still remained quiet.

The irony is that during the health reform debates, Sebelius, like President Barack Obama, repeatedly stressed the need to impose personal responsibility on people for their health if there was to be fundamental reform which would hold down medical care costs.  Yet this provision - the only one adopted which would make smokers responsible for at least a portion of the huge medical care costs they impose on others - has received no support or encouragement from HHS.

Parents have been told for many years that secondhand tobacco smoke is very harmful to children, yet many millions still smoke in their presence.  Telling parents the same thing again, but this time with a picture, is unlikely to significantly change this long-standing practice.

During this time, ASH has helped persuade judges in a majority of states to issue court orders banning smoking in certain homes, to get more than a dozen states to ban smoking when foster children are in a home or car, and a growing number of jurisdictions to ban smoking when any children are in a car.  Yet HHS has done little if anything to encourage protecting the most vulnerable and defenseless nonsmokers from harm, and also thereby strongly encouraging their parents to quit, by supporting these efforts.  Instead they hope to protect children with color pictures!

In short, says Banzhaf, this much publicized announcement this morning, that the FDA is doing nothing more than exactly what Congress mandated more than a year ago, and that HHS is not going to use any of its vast powers to adopt powerful antismoking new initiatives which have been proven to be effective, and which can be done now (rather than a year later) and at no cost (compared to the hundreds of millions of dollars HHS is now spending), and without any additional legislation, is very disappointing.

Professor of Public Interest Law at GWU,
FAMRI Dr. William Cahan Distinguished Professor,
FELLOW, World Technology Network, and
Executive Director and Chief Counsel
Action on Smoking and Health (ASH)
America’s First Antismoking Organization
2013 H Street, NW
Washington, DC 20006, USA
(202) 659-4310 // (703) 527-8418
Internet: http://ash.org/
Twitter: http://twitter.com/AshOrg

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Action on Smoking and Health (ASH), America's first anti-smoking and nonsmokers' rights organization, serves as the legal action arm of the anti-smoking community. It is supported by tax-deductible contributions.
Source:Action on Smoking and Health (ASH)
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