President Trump really did issue an Executive Order, nearly a year ago, that all agencies were to use their discretion under the law in the least intrusive and most customer-friendly manner. The Food and Drug Administration seems to be exempt, as its mandate is to fight consumer choices.
The FDA announced Thursday “a historic effort Thursday to try to end cigarette addiction.” The mild goal is rosy statistics “by the end of the century” but the means of interest is to “propose rules to govern how much nicotine should be allowable in cigarettes,” using legal authority it has had since 2009.
Let us recap. Tobacco delivers a pleasurable calming effect, combined famously with the opposite effect in spades when the user tries to reduce the dosage. Nicotine, not being a normal ingredient of diet, has a few health consequences, and the usual delivery method adds tars and particulates, with substantial health consequences, including on bystanders. (The fact that there is utterly no science about health risks outdoors or in rooms ventilated to code has not stopped rulemaking by the “public health” priesthood.) E-cigarettes (vapes) solve these problems, but Commissioner Gottlieb “stopped short of endorsing” them; his announcement offered candy as a substitute.
Addiction may mean avoiding the unpleasant effect, and it may mean a personal decision to experience the pleasant effect. In any case, the decision to start smoking is as voluntary as a decision gets. Two generations into mandatory disclosure and warning labels, everyone knows the risks, and manufacturers are prohibited from most advertising and free samples. Addiction is a concept now extended to sex and gambling, activities with no inherent unpleasantness from dose reduction. This means that the sole problem with addiction is that individuals prefer to do it and we don’t approve. And somehow Gottlieb’s government of enumerated powers got the power to enforce our disapproval. (For perspective, a wiser generation of Americans realized that the original federal Prohibition was unconstitutional, and at least had the honesty to amend the Constitution (18th), and then again to cancel the ruinous experiment. Subsequent purges have been done with legislation, John McCain’s signature Comprehensive Tobacco Settlement, and now by press release.)
America is already in the throes of a voluntary experiment with dosage reduction. Many “health-conscious” Americans drink two 100-calorie Diet Beers to get the buzz we used to get with a single 150-calorie icy lager. Because drinking beer is about the buzz; few people flock to it for its taste.
And we smoke, or vape, to get the buzz as well, and despite the shakes if we should try to quit. Gottlieb’s initiative has taken aim at the buzz, though his metric is national statistics and his rationale is health effects.
It is reasonable to assume that smokers will continue to want to get the buzz, as they continued doing despite Obama’s 2009 dollar-a-pack tax increase “for children’s health” and as they will do despite gross photos on cigarette packs.
Then, when 1.7mg cigarettes are outlawed, only outlaws will have 1.7mg cigarettes. We can expect smuggling, cottage manufacture, and increasing attempts to buy off law enforcement, with increasing success as the trade becomes more lucrative: lawlessness approaching the Gangland decade a century ago, and repeated on a small scale under drug prohibition. Dosages unknown, no redress for impurities, and no way to transact safely. Bring your cash to the rest area at midnight, and hope your pusher doesn’t have a gun and the desire to leave with both the loot and the merchandise. Gottlieb himself said there might be “trade-offs” to the new Prohibition.
R.J. Reynolds and Philip Morris (Altria) gave encouraging noises, hoping for a secure franchise in healthy smokes, perhaps in exchange for showing Gottlieb they were philosophically open to an attack on their lifeblood.
Republican politicians and candidates are not a solution; they are solidly focused on the “opioid crisis” (sometimes the “opioid epidemic,” though no one has offered any theory of contagion). This crisis, like the “immigration crisis,” jumbles dissimilar phenomena; in this case, use of recreational drugs that we disfavor, versus desire for prescription painkillers in amounts and durations that someone considers unwise, now that the prescribing physician has to put you and himself into a government database as potential abusers.
Never mind. Gottlieb estimates “8 million fewer tobacco-related deaths” (in the next 81 years, knowing he will be dead before he is shown to be a liar). The FDA routinely quantifies the economic effects when a large cohort of the human herd misbehaves. We’ve got to act now. Otherwise it will be too late. Like tariffs, we have to punish individuals until the collective statistics are sufficiently pretty.
I have known several physicians, and I admire their thinking. They all value reliable information; none ever orders blood work to confirm his “hope” of remission, nor tells the technician he is seeking such a finding. All are cognizant of the fact that any prescription, any procedure, any interference with the human body, carries risks. How did they wring this culture out of Gottlieb so that he could get a policymaking job in Washington D.C.?
To paraphrase something Americans used to say around 1986: This would not be happening if Donald Trump were in charge.