SRNT Newsletter

November/December 2004, Volume 10, Number 4

President's Column

by Ken Warner

Reflections following a legislative defeat: Two days prior to my writing this column, a conference committee in Congress killed Senate legislation that would have given the Food and Drug Administration authority to regulate tobacco products. The Senate bill had received enthusiastic endorsements from numerous national health and tobacco control organizations, including the Campaign for Tobacco-Free Kids, the American Cancer Society, and the American Medical Association. It was endorsed, as well, by Philip Morris, the one cigarette company that has consistently expressed support for FDA regulation of tobacco products, although with motives that many observers suspect are not entirely altruistic. Opposing the bill, for a variety of clearly differing reasons, was an equally strange-bedfellows mix of the other tobacco companies and several prominent tobacco control advocates.

Certain to return to the legislative arena in the coming years, FDA regulation of tobacco and nicotine products, new and old, serves as a timely and superb example of how real-world tobacco control concerns call on the multiplicity of interests and talents that constitute the membership of SRNT. The issue that brought FDA regulation to the fore commonly labeled "tobacco harm reduction" demands for its resolution the creative scientific energies of the full spectrum of SRNT expertise. And it is receiving the needed attention from our members.

In 2001, after lengthy deliberations, a distinguished committee of the Institute of Medicine issued a report entitled Clearing the Smoke: Assessing the Science Base for Tobacco Harm Reduction. The report was the product, in part, of the efforts of several SRNT members who served as committee members (Gary Giovino, Dorothy Hatsukami, and Peter Shields; I served as liaison to the committee from the IOM's Board on Health Promotion and Disease Prevention). The report represented a response to growing concerns about the proliferation of novel, and completely unregulated, tobacco and nicotine products being marketed, explicitly or implicitly, as less hazardous than conventional cigarettes. The products range from cigarettes modified to reduce exposure to specific carcinogens, to pseudo-cigarettes that heat rather than burn tobacco, to low-nitrosamine smokeless tobacco products, to lozenges consisting of compressed tobacco powder.

The IOM committee called for evaluation of exposure reductions from novel products, identification and study of biomarkers and surrogates that might suggest harm reduction potential, surveillance of product use and, to the extent possible, health effects. The committee also called for product regulation in the form of governmental approval of label and marketing claims. That this agenda was a tall order was made clear in the report itself, as well as in numerous subsequent publications. A special supplement to our journal, Nicotine & Tobacco Research, published in 2002, highlighted the needs and challenges.

SRNT members have risen to the challenge. Several members have initiated intriguing and informative research efforts to evaluate consumers' exposure to toxins under real-world conditions of product consumption. Some of these researchers, as well as other Society members, are studying biomarkers in consumers of novel products. Still others are evaluating the acceptability of novel products to smokers as an alternative to smoking, using methods ranging from direct experimentation to survey research. Others have contemplated the complexity of surveillance systems that would be needed to determine product use and, ultimately, health consequences. At least one group of scientists is employing simulations to examine the possible health effects of product substitution. Still others have analyzed the specifics of product regulation that were embedded in the Senate regulation bill or that might be included in a future piece of legislation. I avoid "naming names" here only for fear of offending members whom I might overlook.

Important real-world problems rarely lend themselves to resolution through the insights of one scientific discipline. Problems like product regulation require everything from bench science to policy analysis. SRNT's membership resources are, simultaneously, extraordinarily wide and deep, and this issue illustrates vividly why each of our research domains matters, separately and together, in addressing the complicated world of humans and tobacco. Thanks to the work of the aforementioned colleagues, when FDA regulation of nicotine and tobacco products emerges again in Congress, the debate and hopefully the subsequent implementation will be far better informed than was the case in 2004. We, as scientists, benefit as well from the research needs underpinning an issue like product regulation: not only do we learn directly from our own research efforts, but as is represented in the N&TR supplement, the issue forces a very healthy interaction among scientists from very different disciplines. To my way of thinking, this is SRNT at its best.

Speaking of interacting with our scientist colleagues, planning for the annual meeting in Prague is going superbly well, thanks to the hard work of the Program Committee, chaired by Dave Drobes and co-chaired by Suzanne Colby and Robert West. They have received a record number of abstract submissions and are carefully culling through them to guarantee a most stimulating conference. Sheila Kirschbaum and her colleagues at Rees Group, Inc., are handling the logistical aspects of a sizable professional meeting with skill and aplomb. The bonus, of course, is that Prague is one of the world's most beautiful and interesting cities. I look forward to seeing you there.