Regulating Tobacco in the US: An Expert's Perspective

Learn about how US regulates tobacco use with this expert guide from American Lung Association.

Regulating Tobacco in the US: An Expert's Perspective

The US Food and Drug Administration (FDA) Center for Tobacco Products is responsible for regulating the manufacture, marketing, and distribution of tobacco products to protect public health. This includes setting standards for the collection of information, as well as monitoring and enforcing compliance with these standards. The State of Tobacco Control report provides data on the progress made in each state towards reducing tobacco use. The American Lung Association has achieved several major victories and milestones in its efforts to create a smoke-free future.

To view this data, you can filter by date or topic. In December 2019, Congress approved and the president signed a law that raised the minimum age for selling tobacco to 21 years across the country. Prior to this, 19 states and DC had already passed state tobacco laws raising the minimum age to 21. The Department of Housing and Urban Development (HUD) implemented its final rule requiring all public housing agencies to have smoke-free policies in all residential units and common areas. This rule will protect nearly two million Americans, including 690,000 children, from exposure to second-hand smoke in their homes.

The Surgeon General published a report entitled Use of Electronic Cigarettes Among Young People and Young Adults, which analyzed the real and potential dangers that e-cigarettes pose to children. Key findings include that e-cigarette use among young people has become a public health problem; e-cigarette aerosol is unsafe and may contain harmful and potentially harmful components. The Patient Protection and Affordable Care Act (PPACA) was implemented on January 1, 2010, including new health insurance options and the requirements under which most private health plans must cover preventive services, including a comprehensive smoking cessation benefit. Another key component implemented was the expansion of Medicaid, which provides a comprehensive smoking cessation benefit to millions of low-income Americans.

The FDA launched its public education campaign, The Real Cost, aimed at preventing young people aged 12 to 17, including priority populations, from starting to use tobacco products. The Centers for Disease Control and Prevention (CDC) updated its best practices for comprehensive tobacco control programs, refining evidence-based recommendations for states to implement effective tobacco control programs to prevent and reduce tobacco use. The CDC also launched the federal government's first paid media advertising campaign to encourage people to quit smoking, entitled Tips from Former Smokers, featuring real people living with illnesses caused by smoking. North Dakota passed a comprehensive smoke-free law through a ballot initiative, becoming the 28th smoke-free state. President Obama signed the PPACA into law. The law includes important provisions that will expand smoking cessation benefits and establishes the Prevention and Public Health Fund, which provides funding to prevent and reduce tobacco use.

Restrictions on access and marketing of tobacco products by young people come into effect, and tobacco companies are prohibited from using light, low health descriptors and other misleading health descriptors. President Obama also signed a law that gave the FDA regulatory authority over tobacco products. Tobacco products were no longer exempt from basic oversight. The sale of flavored cigarettes was also banned, with the exception of menthol. Judge Kessler published her final judgment in the US Justice Department's lawsuit against tobacco companies. He concluded that the tobacco industry had lied for 50 years and misled the American public on issues of health and marketing aimed at children. The Surgeon General published The Health Consequences of Involuntary Exposure to Tobacco Smoke.

The report unequivocally states that the debate is over: second-hand smoke, in any form and at any level, is harmful to health. After more than a year of legal proceedings in the US Justice Department's lawsuit against tobacco companies, the Department announced that it was reducing the amount of resources it requested in the case by billions of dollars. Six major public health groups, including the American Lung Association, intervened in the lawsuit to advocate for more stringent solutions to prevent future misdeeds in the tobacco industry. The United States signed the Framework Treaty on Tobacco Control, which is the world's first tobacco control treaty and establishes international guidelines for countries to implement and control tobacco consumption and addiction. However, this treaty was never sent to Congress for ratification. As a result of advocacy work led by the American Lung Association, Delaware's state anti-smoking law came into effect. Delaware was the first state in four years to pass an anti-smoking law, which served as a catalyst for many other states to follow suit in the 2000s. The Supreme Court ruled in a 5-4 decision that the FDA could not assert its authority over tobacco products without Congress giving it explicit power to do so.

Efforts were directed towards Congress to pass legislation granting this power. The CDC published the first edition of Best Practices for Comprehensive Tobacco Control Programs. This document details how state tobacco control programs should be structured to better prevent smoking and help smokers quit smoking. It also recommends minimum levels of funding at which each state can better implement these programs. The Department of Justice announced that it was suing the tobacco industry under the RICO Act —the same law used to prosecute organized crime—alleging that the tobacco industry participated in a coordinated campaign of fraud and deception. Attorneys general from 46 states reached an historic settlement framework agreement with tobacco companies to reimburse state governments for health care costs related to tobacco. The billions of dollars were supposed to be used to prevent smoking and help people quit smoking; however, states have used most of this money for other unrelated purposes.

California became the first state in the nation to eliminate smoking in bars. This law, together with laws eliminating smoking in restaurants and most other public places, made California the first state with a comprehensive statewide smoke-free policy.

Clifton Dupriest
Clifton Dupriest

Award-winning coffee aficionado. Typical travel guru. Incurable coffee junkie. Proud music advocate. General pop culture guru.

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