The war on tobacco has turned upside down. For decades, as new information emerged about the health effects of smoking, public policy relentlessly emphasized individual decision-making. This brought real achievements -- notably, a 40 percent reduction in U.S. per capita cigarette consumption between 1975 and 1993.
Some half dozen years ago, however, the battle over tobacco entered a new phase. The focus shifted from smoking to the tobacco industry. A new view took hold. In this view, smoking is caused primarily by deceptive advertising targeted at young people, the manipulation of nicotine to maintain addiction, and the suppression of information on the harm caused by smoking. Smokers should be seen as victims of these forces. And the solution is drastic reform of the industry itself.
This new vision rapidly coalesced into policy. Several states raised tobacco taxes in order to protect smokers from their own preferences and to fund anti-smoking campaigns and research. Federal action followed, notably the attempt of the Food and Drug Administration to regulate cigarettes as nicotine-delivery devices. At the same time came an astonishing barrage of litigation, generating multi-billion-dollar settlements in Mississippi, Texas, Florida, and most recently Minnesota. A June 1997 agreement among plaintiff attorneys, state attorneys general, and the tobacco industry provided a model for comprehensive federal legislative proposals, over which debate continues to this day.
All of this activity tends to focus on a concrete goal and a specific set of tools. The goal is to reduce teen smoking rapidly by half or more, with a corresponding reduction in adult smoking as the teens get older. The tools: elimination of advertising seen by teens, price increases of up to $ 2 per pack, anti-smoking campaigns, litigation to penalize the industry financially, "look-back" penalties on the industry if teen smoking does not decrease, and FDA jurisdiction over the development of safer cigarettes.
The new approach will almost certainly fail. In fact, disturbing symptoms of failure have already begun to appear. Teen smoking has increased substantially since 1991. That has caught people's attention, but probably more alarming is a little-noticed change in the trend of overall consumption. After 15 years of sharp annual declines, per-capita cigarette consumption has hardly dropped since 1993.
Quite aside from these numbers, there are compelling reasons to believe that the central elements of the new plan cannot do what they are supposed to do. Consider prices, the single most important tool in the new thinking. Current proposals would raise federal taxes by a dollar or two -- former surgeon general C. Everett Koop and former FDA commissioner David Kessler have proposed $ 1.50. This is expected to cut teenage smoking by a third or more. The logic is that teens don't realize they will get hooked on nicotine if they smoke, but they will react strongly to higher prices. This seems most unlikely. With teen smokers consuming an average of eight cigarettes a day, there is little reason to expect an extra five or ten cents per cigarette to stop them from smoking. And in fact, the biggest drop in teenage smoking -- a nearly one-third decline in the late 1970s -- occurred when cigarette prices were also going down (by about 15 percent). On the other hand, prices have been stable or slightly rising since 1991, even as teen smoking increased. In the United Kingdom, where cigarettes already cost twice as much as in the United States, teenagers smoke at about the same rate as they do here.
What about advertising? Tell a teenager that advertising is the reason he smokes, and you will probably convince a teenager that you are out of touch with reality. Repeated statistical analyses have failed to detect a substantial effect on consumption from advertising. One may quibble about the details of individual studies, but the overall results are unmistakable. If advertising's effect on cigarette consumption were substantial, it would have been detected by now.
FDA regulation, if it comes to pass, will be institutionalized frustration. The new rules on advertising cannot reduce teen smoking, because advertising restrictions can hardly prevent what advertising never caused. Safer cigarettes (with less tar and nicotine) will be stymied, as the FDA vigorously implements policies reflecting the public-health community's hostility to safer smoking and new types of cigarettes.
There remain the anti-smoking campaigns. Often tried, they have generally had disappointing results. The people who design these campaigns tend to act on their own pet theories (they think teens are being duped by advertising) and to pursue political goals. Anti-smoking advertising, like the anti-smoking movement generally, has therefore become a vehicle for the new view that the proper target is the tobacco industry rather than smoking.
Thus in California, Massachusetts, and most recently Florida, government-funded campaigns tell kids they can't trust tobacco companies. This non-news is unlikely to cause kids to toss their cigarettes away, but it is consistent with political objectives such as new anti-smoking measures. Two anti-smoking scholars recently praised California's anti-smoking ads for challenging "the dominant view that public health problems reflect personal habits," and they noted that "it is political action and attitudes, rather than personal behavior, on which counter-ads are focused." In fact, the most effective anti-smoking ads probably come from the pharmaceutical firms that market smoking-cessation products. These firms have a financial incentive to communicate the information and strategies that will make people get serious about quitting smoking.
Why do so many well-meaning people pursue measures that cannot achieve their goals? The short answer is that they are prisoners of their own preconceptions. They reject the idea that well-informed people ever choose to smoke; they believe advertising has a power that it has never had; they are ignorant of the history of cigarette marketing; and they give unquestioning credence to economic studies of the "price elasticity" of cigarettes that are of dubious value for the purposes to which they are put.
For the fact is that there is a deep conflict between what anti-smoking campaigners want to be true and what is true. This has fostered a strategy of deception and distortion. Such a strategy can succeed in the short run because of the peculiar circumstances of the tobacco market. Anti-smoking activists learned years ago that when they stretched the facts, those who corrected them were dismissed as industry hacks. This led to the amazing discovery that those who oppose smoking can wander far beyond the boundaries of good science (even in esteemed outlets such as the Journal of the American Medical Association) and still see their words accepted and amplified by an unquestioning media. Naturally, anti-smoking campaigners have seized this opportunity, introducing numerous absurdities into the everyday thinking of scholars, regulatory officials, journalists, and politicians. Thus we have been told that cigarettes are the most advertised product in America (wrong by more than an order of magnitude), that research has finally nailed down the connection between marketing and smoking by kids, and that secret industry documents show that the problem all along has been the targeting of youth. Such misinformation is routinely accepted and repeated as if it were the truth.
Here is a concrete example. One of the most often cited FAMA studies -- in fact, the only non-governmental study the FDA cited in its regulatory initiative that actually used market data rather than surveys and the like -- claimed to demonstrate that advertising for the first women's brands, in the late 1970s, caused a surge in smoking by teenage girls. The authors used sales data (not advertising data), took their figures from an unpublished student paper, dropped the three of six brands that did not fit their thesis, mistook billion of cigarettes sold for billions of dollars worth of cigarettes sold (a forty-fold error), and concluded to much acclaim that massive advertising had fundamentally altered the market. This utterly useless study is repeatedly cited as proof that advertising causes teen smoking. This kind of thing would not happen in an ordinary intellectual environment.
Sometimes, history has been rewritten. Despite what the FDA says, the discovery that people smoke to get nicotine is not new, and neither is the fact that manufacturers strongly influence the amount of nicotine in cigarette smoke. In the late 1960s and early 1970s, maintaining adequate nicotine levels in low-tar cigarettes was widely believed to be the key to progress against the diseases caused by smoking. This belief -- which originated with public-health scholars, not the tobacco industry -- was so pervasive that Consumer Reports declared in 1972 that "efforts should be made to popularize ways of delivering frequent doses of nicotine to addicts without filling their lungs with smoke."
The National Cancer Institute and the Department of Agriculture maintained a large program devoted to developing improved strains of tobacco (containing more nicotine). A biotech firm hired by a tobacco company to cultivate one of those variants in South America (to avoid growing it in the United States) was recently accused of criminal behavior for doing so in violation of a law that was repealed in 1991. Amazingly, the FDA regarded this episode as a prime justification for regulating the tobacco industry. Again, this kind of thing would not happen in an ordinary intellectual environment.
Clearly, the new strategy of attacking the tobacco industry rather than smoking is producing little if any benefit. The costs, on the other hand, are large and growing.
First, there are costs to public health. We are abandoning the only approach to smoking-reduction that is likely to succeed: reliance on individual responsibility. This point was eloquently stated by a George Washington University physician, Larry H. Pastor, in a letter to the editor of the Journal of the American Medical Association in 1996. Describing the dubious proposition that tobacco litigation will make people quit smoking, Pastor noted that exactly the opposite could easily happen,
because some smokers will feel reinforced in externalizing blame onto "the tobacco industry" and thereby fail to take the difficult steps necessary to confront their smoking addiction. The more such personal injury litigation succeeds, the more some will comfort themselves with the rationalization that, if they develop tobacco-related illness, they can sue the cigarette makers and obtain a lucrative reward.
The strategy of blaming the industry for smoking is getting in the way of efforts to discourage smoking itself.
Second, there is the matter of who will pay the higher cigarette taxes. A hallmark of the U.S. market is that most smoking is done by people of modest means. And the idea that smokers impose financial costs on others has little foundation. To say that blue-collar smokers should pay more for their habit because they cannot protect themselves from manipulation by the tobacco companies -- and then watch them continue to smoke while the nation collects billions of dollars from their pockets to spend on other citizens -- is a sorry combination of paternalism and hypocrisy. Perhaps these smokers should simply be allowed to pursue their freely chosen course without financial penalty. At any rate, with teens buying only about 2 percent of the cigarettes sold, we know that a massive tax increase designed to stop teen smoking will be paid almost entirely by non-teens, most of them poor or lower-middle class.
The third cost of the new approach lies in the danger of creating a government stake in continued smoking. The Clinton administration wants to raise cigarette taxes so it can transfer tens of billions of dollars from smokers to its favorite domestic-policy initiatives. Far more dangerous than a mere tax-grab, this plan will work only if most smokers continue to smoke and pay the higher taxes. The public-health community should renounce any such plan. The history of the anti-smoking movement makes clear that the toughest places in which to make progress are countries like Japan, Thailand, and China -- that is, nations with a large state investment in smoking.
Fourth, as the new approach is applied to products other than tobacco, it will be hugely disruptive -- and it cannot easily be confined to tobacco. This is so for three reasons. (1) The underlying principle, that marketers are responsible for the behavior of anyone who buys their products, is indiscriminate. It is not intrinsically more relevant to tobacco than to, say, automobiles, alcohol, or red meat. (2) The tools of the new regime are too tempting. They operate by combining political opportunism with the legal means for extracting financial payments. Once launched, the process is self-perpetuating. The plaintiff attorneys who are engineering today's mass tobacco litigation honed their skills in asbestos litigation, and they are eager to move on to other arenas. (3) These methods and tools are not easily dismantled. They are greatly prized by the litigation community, advocacy groups, politicians who like to spend taxes, even academics in search of funding. Wresting such valuable tools away from those who have become accustomed to using them could be very difficult.
Finally, the new approach to tobacco carries the cost of degrading the intellectual environment. This is no trivial matter. The public-health community's power depends on information, credibility, and the consequent ability to persuade. That power can be dissipated if it is carelessly misused (as it has been), and once lost, it cannot easily be regained. As journalist Carl Cannon noted, after describing some grossly untrue statements from the White House during the debate over tobacco legislation in the Senate, "The problem is that in employing the devilishly effective -- but not always truthful -- language of political campaigns, the good guys risk losing the moral high ground." Deception is not -- at least should not be, in a free society -- a viable long-run strategy.
The time has come, then, for public policy toward tobacco to return to its roots. The only effective way of combating the harmful effects of smoking in the long run is to encourage an enduring sense of personal responsibility -- among smokers, their families, and physicians. But that's not all. Two decades of an absurd hostility to safer smoking and safer tobacco must end. We have forgotten that in the 1950s, the pronouncements of cancer researchers created a demand for cigarettes with less tar and nicotine, and the cigarette manufacturers responded with a speed that in hindsight seems miraculous. Today, instead of talking about draconian taxes and sweeping infringements on commercial speech, we should let the competitive market again serve smokers -- just as it does everyone else.
John E. Calfee, a resident scholar at the American Enterprise Institute, is the author of Fear of Persuasion: A New Perspective on Advertising and Regulation.