[Congressional Record Volume 155, Number 50 (Tuesday, March 24, 2009)]
[House]
[Pages H3800-H3805]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




       H.R. 1216, YOUTH PREVENTION AND TOBACCO HARM REDUCTION ACT

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 6, 2009, the gentleman from Indiana (Mr. Buyer) is recognized 
for 60 minutes.
  Mr. BUYER. Mr. Speaker, it is pronounced ``Buyer.'' My family is 
Alsatian; so if you go back in my ancestry, I know the gentleman is new 
here to the Congress, it was de Buyer. So my sense is that the 
gentleman will remember it for a while.
  I come to the floor here to talk about a very pivotal issue that will 
be facing the public health of our country, and this is the issue of 
tobacco. Members of the House will be presented with a choice here 
relatively soon about which Federal regulatory structure over tobacco 
products we should use.
  Now, it is interesting, for a long time the issue was whether we 
should regulate tobacco or not regulate tobacco. There is now this 
growing concensus that the Federal Government in some way should 
regulate tobacco, and now we are trying to figure out with regard to 
who should do that regulation. Should it be the FDA under Health and 
Human Services; or, as Mr. McIntyre and I are proposing, that it be a 
separate agency under Health and Human Services, we call it a harm 
reduction agency, that will focus on reduction of the risk associated 
with many different types of tobacco products.
  So I believe that the critical issue to be considered is, how do we 
measurably and effectively reduce the disease and death associated with 
tobacco use while products remain legal and over 45 million Americans 
have not, cannot, or will not quit?
  Keeping the American tobacco consumer and the public uninformed about 
the differences in risk between smoking cigarettes and using nonburning 
forms of tobacco or other nicotine products will not help our Nation to 
overcome the death and disease attributed to tobacco use.
  Telling current tobacco smokers to ``Just Say No,'' to quit now, is 
not the most effective way to save lives. Creating a regulatory scheme 
that discourages and in fact chills the development of new, lower risk 
products is directly opposite of what many in the scientific and public 
health communities even advocate today. But those are the underlying 
tenets of what is referred to as the Waxman tobacco legislation called 
the Family Smoking Prevention and Tobacco Control Act.
  What do experts say about Mr. Waxman's approach on tobacco?
  Well, the prestigious health organization, the Royal College of 
Physicians, says, ``The current situation is perverse, unjust, and acts 
against the rights and best interests of smokers and the public health. 
Harm reduction has the potential to play a major part in preventing 
death and disability in millions of people who currently smoke and who 
either cannot or will not otherwise quit smoking. These smokers have a 
right to be able to obtain and choose from a range of safer nicotine 
products, and they have a right to accurate and unbiased information to 
guide that choice.''

[[Page H3801]]

  From the American Association of Public Health Physicians, ``In the 
judgment of AAPHA, the current bill in its form will do more harm than 
good in terms of future tobacco-related illness and death. The current 
bill,'' referring to the Waxman bill, ``with all its seemingly 
promising elements, has so many restrictions on Federal regulatory 
authority that it will be unable to effect favorable change. This bill 
is based on the false premise that cigarettes can be made safer and 
that all tobacco products are equally harmful. This bill places 
barriers to truthful communications about the relative risk of less 
hazardous smokeless tobacco products and near insurmountable barriers 
to the development of new lower risk products.''
  Now, these are two examples of organizations that have some growing 
concerns about the Waxman legislation. Now, in the face of that there 
is a growing consensus that significant harm reduction policies and 
programs, when combined with prevention and cessation, are, in my 
belief and that of Mike McIntyre, the chief cosponsor of North 
Carolina, that it is the key to a significant reduction in disease and 
death from tobacco use.
  So the Waxman legislation, despite the years of characterizations and 
representations by its proponents, does not incorporate in any 
meaningful way a comprehensive prevention, cessation, and harm 
reduction strategy. Actually, on the contrary; for a very long time, 
those of whom believe that a harm reduction strategy in fact threatens 
cessation and prevention programs. I look at this and say that they 
should all work together, that four fingers and a thumb makes a hand. 
And so, without the phalanges, do you really have a hand? So I believe 
that they all should have to work together, and that is what we are 
seeking to do here is having a harm reduction strategy that 
incorporates prevention, education, and cessation.
  I am also greatly concerned that the Waxman legislation continues to 
ignore the evolution of opinion in the scientific and public health 
communities, and relies on tactics taught and thought that were 
effective in the early 1990s, such as it includes provisions that the 
Supreme Court had thrown out with regard to restrictions on First 
Amendment on advertising these issues. I was really concerned about it, 
and Mr. Waxman believes it is okay. I have great, great concern here.
  Congressman Mike McIntyre and I have introduced H.R. 1216, the Youth 
Prevention and Tobacco Harm Reduction Act. This legislation imposes 
significant regulatory oversight within the Department of Health and 
Human Services over tobacco products, and incorporates many of the 
provisions included in Henry Waxman's legislation.
  It includes serious policy and programs of prevention, cessation, and 
harm reduction, which we believe will lead to saving thousands of lives 
over the next decades. It will squarely address the issue of tobacco 
use by minors through additional resources and enforcement at the State 
levels.
  In fact, Mr. McIntyre's and my legislation is even stronger in the 
protections for minors on two points. Number one, we say unto the 
States that with regard to the Master Settlement Agreement and monies 
that were supposed to be spent by the States on tobacco cessation and 
education and prevention programs, at the end of the Master Settlement 
before it was signed there was this last-moment agreement. Rather than 
dictating unto States on what percentage of the monies are to be spent 
on tobacco prevention and cessation programs they said, well, we will 
just leave it to the discretion of the States. The CDC then every year 
publishes a report with regard to what the percentage that States 
should be spending, States are not spending on those programs. So Mr. 
McIntyre and I come in, and we are dictating unto the States that they 
are to spend their Master Settlement Tobacco Agreement on programs to 
help children.
  The other point that Mr. McIntyre of North Carolina and I have is on 
protecting children. We are also saying to the States that we want you 
to treat tobacco like alcohol. So where it is illegal for a minor to 
possess alcohol, we also say: States, you should make it illegal for 
minors to possess tobacco.
  With that, let me yield to a major cosponsor of this legislation. 
This is bipartisan legislation. It is an alternative to Mr. Waxman. 
And, actually, what Mr. McIntyre and I were really hopeful is that our 
bill here would have been adopted in the Energy and Commerce Committee 
as a substitute. If we could have combined our effort with that of Mr. 
Waxman's, we would have 435 votes here on the floor, and we could make 
this a reality and make our society a healthier and safer place.
  I want to thank the gentleman for his efforts. He is a strong 
advocate of our agricultural policies and is very concerned with regard 
to ensuring that the Federal regulatory oversight from Health and Human 
Services does not interrupt with growing practices by our farmers.
  Mr. McINTYRE. I would like to thank Mr. Buyer, who is the principal 
sponsor of this responsible tobacco regulation legislation. I was 
pleased to be the original cosponsor with him.
  In our legislation, we certainly want to make sure that this is an 
issue of fundamental fairness. This is not an anti-public health 
alternative. In fact, as Mr. Buyer was just saying and as we were just 
discussing in our interchange a few moments ago, in fact we have even 
stronger regulation to prevent youth smoking.
  I have a son. When he was in high school, and he was now in law 
school, but who actually served on the Campaign for Tobacco Free Kids. 
So we understand that, and this is a strong statement, even stronger 
than Mr. Waxman's proposal against youth smoking. But it also 
recognizes that the FDA is understaffed and underfunded and overworked 
right now, and we are not in a situation where we need the FDA to come 
out on the farm and start regulating farmers. And, from that 
perspective, I wanted to principally speak in the next few moments as 
chairman of the Subcommittee on Rural Development, Biotechnology, 
Specialty Crops and Foreign Agriculture. The specialty crops over which 
our subcommittee has jurisdiction include tobacco.
  Now, we may soon see H.R. 1256, which is Representative Waxman's bill 
to implement FDA regulation of tobacco products and leaf scheduled for 
consideration under suspensions of the rules on the House floor. This 
process will allow for no amendments or alternatives to be presented on 
this incredibly important and complex issue of tobacco regulation.
  I urge my fellow Members to vote against the Waxman bill when it 
comes up on suspension so that we may consider an alternative bill, so 
that we may be able to consider the bill that Mr. Buyer and I are 
discussing tonight that does even more than Mr. Waxman's bill while 
preserving a vital economic engine for many communities throughout the 
United States, including my district in Southeastern North Carolina.
  H.R. 1261 is the Youth Prevention and Tobacco Harm Reduction Act that 
we have introduced together, and is actually a better approach to 
regulating tobacco and preventing minors from using tobacco products 
than the Waxman bill.
  The Waxman bill will grant the FDA, the Food and Drug Administration, 
wide authority to dictate to manufacturers and growers dramatic changes 
in product design and leaf cultivation.
  The tobacco industry contributes over $36 billion each year to the 
U.S. economy, employing over 19,000 individuals nationwide. This is not 
exactly the time to cause even thousands more of our fellow citizens to 
lose their jobs or to yet cause another problem with our Nation's 
economy. In my home State of North Carolina, over 8,600 people are 
employed by the industry, with a Statewide economic impact of nearly 
$24 billion. Mr. Waxman's manufacturing and FDA on the farm provisions 
will put many companies and growers out of business, and we absolutely 
cannot afford to lose any more jobs.
  Our bill, H.R. 1261, specifically protects growers by preventing any 
government agency from requiring changes to traditional farming 
practices, including standard cultivation practices, curing processes, 
seed composition, tobacco type, fertilization, soil, recordkeeping, and 
any other requirements that affect farming practices. The last thing 
that our farmers want to see is another government bureaucrat coming 
out on the farm walking around, snooping around about the soil and how 
he is growing his crops.

[[Page H3802]]

  In addition, our bill does more to protect public health and prevent 
minors from smoking even than the Waxman bill does. H.R. 1261 considers 
cutting-edge scientific research by promoting a harm reduction strategy 
to move smokers to less harmful tobacco products.
  According to applied economics, the use of these reduced harm tobacco 
products increases the average probability of smoke cessation by over 
10 percent; and I am sure my colleague will be speaking more to that 
aspect of this bill.

                              {time}  1800

  H.R. 1261 specifically addresses youth tobacco by encouraging States 
to penalize minors for purchasing and possessing tobacco products. 
Under current law, retailers are prohibited from selling products to 
minors. But unlike with the purchase of alcohol, minors are not 
penalized for underage purchase and possession of tobacco products. And 
our bill clears that up and also allows for penalties in that regard.
  The bill also calls upon States to increase their percentage of the 
Master Settlement Agreement dollars to fund tobacco cessation and 
public health programs. In the past 10 years, States have spent just 
3.2 percent of their total tobacco-generated revenue on tobacco 
prevention and cessation programs. Our bill would allow that to be 
increased.
  H.R. 1261 is a commonsense approach to tobacco regulation that will 
both protect the public health and protect the jobs in our vital sector 
of the tobacco economy. I urge my colleagues to vote note ``no'' on 
Waxman and give yourself a chance to consider a more viable and 
reasonable economic alternative that does even more to protect our 
youth.
  In closing to my colleague, I will say for our colleagues who may be 
in their offices or their staff that may still be in their offices this 
evening, we do have a chart that compares both bills. If we want to 
talk about, all right, what are the reasonable alternatives, one by one 
we go through the different segments of the bill to explain so that a 
real comparative analysis can be done. And that is what this is about. 
It is fundamental fairness in how we pass legislation so it is not just 
rushed through under suspension but we get a chance to actually analyze 
and compare these two bills, and that we do it in a way that will best 
achieve the goal here of protecting the public health, particularly of 
our young people, and protect jobs and not cost our economy any more 
jobs than our country, unfortunately, has already lost.
  And with that, I yield back to my colleague. And thank you for your 
great work on this bill.
  Mr. BUYER. I thank the gentleman for his help and his support on the 
bill. This is an issue about the public health of our country and the 
fact that we have a bipartisan approach here, a bill that we seek to 
decrease the mortality and morbidity rates is extremely important. 
There are over 100 nations around the world that are struggling with 
this issue. Tobacco is a legal product. It is the smoking that really 
hurts and harms and kills people. It is not the nicotine. And so what 
we are trying to do is to migrate people from smoking products to 
smokeless products. The very large risk differential, it is the 
difference between combustion and noncombustion products.
  The gentleman understands that. And he is embracing the harm 
reduction strategy from a public health perspective. And he also wants 
to make sure that we work in concert with our growers, that we have 
very sound export policies with regard to our trading partners around 
the world so we don't have any World Trade Organization violations, 
while at the same time we are cognizant of illicit trade issues. The 
gentleman is an expert in these areas. And I welcome his support. And I 
thank him for being here tonight.
  What I would like to do is I'm going to share a chart that the world 
has never seen. And I am hopeful that here in the United States we can 
continue to lead the world and to make the world a healthier place. And 
so what I'm going to do here is I want to talk about our harm reduction 
strategy and to talk about the risk differential among a continuum of 
risks. So the best way for me to do this is to put a chart up so all 
the Members can have a look at this. And I will talk about it here for 
a second.
  I have continuum of risk here at the top, along then with the 
relative risk of chronic disease here on the side. And what I have done 
is what is not on the chart, I don't put cigars or pipe tobacco in 
here. That is outside of the regulation of not only our bill but also 
of Mr. Waxman's bill. But pipe and cigar is the most toxic. If I were 
to go on this chart, what I put on this chart listing 100 percent as 
the most toxic, under that which of tobacco products are to be 
regulated by our bill would be your nonfiltered cigarettes, so that 
would be your roll-your-own cigarettes or a Lucky Strike or other forms 
of generic cigarettes that are nonfiltered.
  So I think common sense is going to tell you if there is not a filter 
on it, you're going to smoke it, you're going to inhale a lot of toxic 
substances and carcinogens deep into your lungs.
  The next, as we look at continuum of risk, among available products 
that are on the marketplace here in the United States in North America, 
so you have your nonfiltered cigarettes. Next are your filtered 
cigarettes. That kind of makes sense. If I'm going to put a filter on 
it, I'm going to reduce the risk between those two types of instruments 
that deliver nicotine. So that is what the key here is. People want 
access to their nicotine. And it is the smoking that harms them. And so 
how do you reduce the harm? And so what drives some people a little 
crazy here is that can you really say that there is a safer type of 
cigarette? Well, if you want to take a science-based approach, you 
really have to be very honest about this and say, well, among the types 
of cigarettes, there are different types of cigarettes as a delivery 
device of nicotine that are safer than others. But they are all not 
entirely safe. But there is a risk differential. And it should be 
discussed. So we have from nonfiltered to filtered cigarettes.
  What I don't have here, which sort of comes up next, is you actually 
have vented filtered cigarettes. But what we are finding out from the 
science-based approach is that if you put vents into the filters, even 
though you're trying to reduce the smoke and a lot of the bad, toxic 
substances, people will draw on that cigarette a little harder, and so 
they are sucking it deeper in their lungs. And that is not a good 
thing.
  Next we have our tobacco-heated cigarettes and electronic cigarettes. 
The reason I put question marks with regard to both of these types of 
nicotine delivery devices is that with regard to tobacco-heated 
cigarettes there are a couple of products that are out on the market. 
Philip Morris has the Accord and Reynolds American has the Eclipse. So 
these are out on the marketplace. We do know that these types of 
nicotine delivery systems are a much less riskier product than say your 
strictly just filtered cigarette or your nonfiltered cigarette. But 
where do they fall on the chart? There isn't enough science to tell us 
exactly where. We know it is better. It is not completely safe, but it 
is better. And we don't know exactly where, but we know it is falling 
downward on the continuum of risk chart. So we really do need some 
science here to tell us where the electronic cigarette and tobacco-
heated cigarettes fall on that.
  So that is part of the reason we want to create, under Health and 
Human Services, a separate agency that will focus our Nation's 
expertise on tobacco. And I want to be able to do that without people 
believing that, well, if FDA is regulating tobacco, that somehow that 
it is an okay product. No. This is a high-risk product. And what is 
important is that somehow we get to the American people they get 
informed, they can make an informed choice among an array of products 
along the continuum of risk.

  So after electronic cigarettes, if we can truly move an individual 
out of smoking, if they are looking on how I can gain my access to 
nicotine, I think people know that, hey, the surgeon general is right. 
There is some risk that will accord anything that has to do with smoke. 
If you can transition, or migrate, a population from smoking to a 
smokeless product, I assure you, we can take out up to around 80 
percent, based on the science, almost 80 to 90 percent of the health 
risk can be taken away.
  Now the American public needs to know that. So you say, okay, what's

[[Page H3803]]

the difference between a U.S. smokeless product and Swedish Snus? Well, 
the difference is the U.S. smokeless product is fermented, and the 
Swedish Snus is pasteurized. So if you can actually move to the Swedish 
Snus, you can eliminate about 98 percent. Think about this. Ninety-
eight percent of the health risks can be taken away, yet people can 
still gain access to nicotine.
  Now, if you wanted to go on a little bit further, there are 
dissolvables of tobacco that have no nitrosamines. That is the really 
bad stuff, and you can remove that and you can still gain access to 
your nicotine. And these dissolvable products that are just being 
introduced and tested in the marketplace are these Orbs or a tobacco 
stick or a strip that you can lay on your tongue and you can gain 
access to the nicotine.
  Now, I assure you, you don't gain as quickly the access to the 
nicotine and get the sensation upon the brain as you would smoking the 
cigarette. But you can gain access to the nicotine, and people then can 
make an informed choice, gosh, I can gain access to my nicotine, I 
don't get it as quickly, I can get it, but, gee, maybe it is worth it 
for me to live a few more years and enjoy my family. I can enjoy my 
nicotine and, gee, I'm not going to die from smoking. You see, that is 
extremely important. And as we move people and then migrate them down 
from this continuum, you can move then to therapeutic, there are 
therapeutic methods to gain access to nicotine, through the gum, the 
patch, the lozenges, and then for the individuals who seek to quit.
  And that is part of the process of what we are doing here is we want 
to incorporate a harm-reduction strategy to inform a population that if 
you want to gain access to your nicotine, it is the smoke that is 
really going to kill you. So if you can get them off of smoking and 
move them to smokeless products and then move them from there to 
therapeutic and then pharmaceutical to eventually cessation and 
quitting.
  Now, that is part of the harm reduction strategy. And what I believe 
is extremely important is when we have this as a strategy, you have 
about 40 million smokers over here on this end of the chart, and you 
only have about 2 million down here that are actually trying to quit. 
In the meantime, of the filtered cigarettes, about 80 to 85 percent of 
the individuals who are smoking the cigarettes are smoking lights or 
ultralights. Now why are they buying lights or ultralights? Because 
somehow they believe that if they smoke a light or ultralight that it 
will be less harmful for them. You see, people are trying to make an 
informed decision, and they think it will be less harmful for them. The 
reality is these are products that are going to be harmful to you. I 
think people need to know and understand that.
  So what we are hopeful here is that in our legislation, we create 
this Harm Reduction Center under Health and Human Services where we 
take our great minds and we do science. We do science on the entire 
array of products along a continuum of risk, and we inform the public 
so that the public, when they buy these products, that we can actually 
migrate our population from combustion to noncombustion products and 
hopefully quitting, while at the same time, we want to make our 
investments in education and prevention programs, not just for children 
and minors, but also for adults.
  What is important here, what we are finding, is that when people 
migrate from smoking to smokeless, some fear that, wow, if somebody 
starts here, the smokeless product, will they actually migrate this 
direction on the chart, headed up the chart? The reality is it is not 
what is happening in the marketplace. So that is why we have created an 
alternative public health position for tobacco.
  My good friend, Mr. Waxman, I applaud his perseverance over the years 
and his persistence. His legislation has sort of an abstinence-only 
approach on tobacco. I respect Mr. Waxman. We have had a good working 
relationship over the years. And I really was hopeful that he would 
incorporate this harm reduction in his bill. Now, he said, ``Steve, I 
have got harm reduction in my bill.'' I said, ``well, Henry, you may 
have it in the bill.'' But what he has are unrealistic standards that 
products that may gain access to the marketplace. He has a two-tiered, 
a two-pronged tiered test, one that will test at the individual and one 
at the public with regard to the impact of a particular product. It 
will almost be impossible for new products to gain access to the 
market.
  If we truly wanted to make our society healthier, what we should be 
doing is encouraging people to move from combustion to noncombustion 
products. And we can do that, if I can take out 80 percent of the 
health risk, we are making our country healthier and hopefully then 
move to cessation.
  That is why I call this the continuum of risk chart. And it is open 
and free to the world to use this chart, to scrutinize the chart. And 
I'm hopeful that other legislative bodies around the world will 
incorporate harm reduction as a strategy for a nation for them to be 
healthier.
  The harm reduction policies advocated in H.R. 1261 are an important 
method to figure out how we can satisfy the nicotine cravings among all 
of these legal type products.
  What I would like to share are what some of the scientists actually 
say about tobacco harm reduction as a public health strategy. From the 
American Association of Public Health Physicians, dated 2008, ``tobacco 
harm reduction is taken to mean encouraging and enabling smokers to 
reduce their risk of tobacco-related illness and death by switching to 
less hazardous smokeless tobacco products.''

                              {time}  1815

  You see, the reason I don't have advertising restrictions in my bill 
is I think it is extremely important. Mr. McIntyre and I created this 
bipartisan piece of legislation for a purpose. We want to make sure 
that people are informed with regard to their entire array of products, 
tobacco products. And you need to be able to inform them as to what 
products have the higher risk, which ones have less risk.
  And what really concerns me is, if you make, let the FDA do this, of 
which the FDA it is counter to their culture, even, to somehow say that 
one cigarette, this is a safer cigarette among an array of cigarettes 
that are harmful. That is a very, very challenging endeavor for them. 
And so it is why some in the public health community are a little 
concerned.
  The International Journal for Drug Policy, their quote, ``Numerous 
alternative systems for nicotine delivery exist, many of them far safer 
than smoking. A pragmatic public health approach to tobacco control 
would recognize a continuum of risk and encourage nicotine users to 
move themselves down the risk spectrum by choosing safer alternatives 
to smoking without demanding abstinence.'' That is the International 
Journal of Drug Policy, and that is exactly what we are trying to do 
here.
  There is another quote from the American Association of Public Health 
Physicians, ``In practical terms, enhancement of current policies, 
based on the premise that all tobacco products are equally risky, will 
yield only small or barely measurable reductions in tobacco-related 
illnesses and death. Addition of a harm reduction component, however, 
could yield a 50 to 80 percent reduction in tobacco-related illness and 
death over the first 10 years, and likely a reduction of up to 90 
percent within 20 years.''
  Now you see why Mr. McIntyre and I are so excited about this 
alternative approach, because abstinence only does not achieve the 
goals to make a society healthier with regard to tobacco. And this is 
exactly what we are trying to achieve, that is also being endorsed here 
by the American Association of Public Health Physicians.
  The Royal College of Physicians in 2007 stated, ``Harm reduction is a 
fundamental component of many aspects of the medicine and, indeed, 
everyday, life, yet for some reason, effective harm reduction 
principles have not been applied to tobacco smoking. It is very clear 
that for most of the major health effects of tobacco, smoking is many 
times more dangerous than smokeless tobacco use.''
  The American Council on Science and Health stated, ``The American 
Council on Science and Health believes that strong support of tobacco 
harm reduction is fully consistent with its mission to promote sound 
science in regulation and in public policy, and to assist consumers in 
distinguishing real

[[Page H3804]]

health threats from spurious health claims. As this report documents, 
there is a strong scientific and medical foundation for tobacco harm 
reduction, which shows a great potential as a public health strategy to 
help millions of smokers.''
  With regard to--here is another one from SmokeFree Pennsylvania. 
``Although smokeless tobacco is just as addictive as cigarettes and 
should not be used by those who are not addicted to nicotine, 
cigarettes are about 100 times deadlier than smokeless tobacco 
products.''
  Here is a quote from Britton and Edwards, The Lancet, in 2007. ``The 
risk of adverse effects associated with snus,'' now snus is pasteurized 
product, Swedish snus, ``is lower than that associated with smoking, 
overall by an estimated 90 percent. Whatever the true overall hazard, 
use of low nitrosamine smokeless products is clearly substantially less 
harmful than tobacco smoking.''
  Why am I pulling out these quotes? I am pulling out these quotes 
because what has been talked about as those who support the Waxman 
legislation is that somehow all of these products are equally harmful. 
That is false. That is what I want to convey to everyone. They are not 
equally harmful. And it is extremely important that the public be 
informed about all that these types of products, along a continuum of 
risk, so people can make informed choices. We do that every day. We 
make decisions on what kind of automobile we want to drive. We do the 
continuum of risk. How about what we eat, what we drink? We make 
choices and decisions every day. Should I put on my seatbelt, should I 
wear a helmet. All kind of things. We make judgments.
  When I look at the farmers, my gosh, there are all types of risk out 
on the farm, and a lot of judgments are made along a continuum of risk 
along with the farm machinery.
  We make these judgments. Why don't we do that as a public health 
strategy for tobacco? It only makes sense. And what I am really hopeful 
here--I had a really good discussion last week with Mr. Waxman about 
some tweaks on amendments, some of which he didn't agree to of which I 
was hopeful.
  I really appeal to my good friend from California because we could 
combine, and I shared this with him. We could combine our efforts here. 
If he would endorse this harm reduction strategy with his bill, we 
could get this to the President's desk. I really believe that this 
could pass in a very large number.
  I remember years ago when Joe Kennedy and I combined our efforts 
together, and when we would come to the floor it would pass 435 to 
nothing. And I was really hopeful, I had an earnest effort here, good 
discussions with Mr. Waxman, and I told him I would take a good hard 
look at his bill and I would recommend some changes, and I was really 
hopeful that he would combine a harm reduction strategy with his 
abstinence only approach, and we would truly have the four fingers, a 
thumb that will make a hand. But without this, he is only going to 
have, I don't know what you call it, a thumb and a palm. I guess he is 
only going to have a palm. And that is really not going to be good. So 
I want to build a hand and not just a palm to help our country.
  The other point I have is, Madam Speaker, I would submit for the 
Record a letter from the American Council on Science and Health from 
Dr. Elizabeth Whelan dated March 12, 2009, and, dated October 18, 2008, 
the AAPHP Tobacco Harm Reduction Resolution, titled Resolution on 
Tobacco Harm Reduction.
                                                  American Council


                                        on Science and Health,

                                     New York, NY, March 12, 2009.
     Hon. Steve Buyer,
     Rayburn House Office Building,
     Washington, DC.

     Hon. Mike McIntyre,
     Rayburn House Office Building,
     Washington, DC.
       Dear Representative Buyer and Representative McIntyre: On 
     behalf of the more than 400 scientists who advise our 
     organization, and the hundreds of thousands of consumers we 
     represent, thank you for your work on H.R. 1261. Our 
     scientists understand the urgent need to reduce the dreadful 
     toll of cigarettes on the American people--with over 400,000 
     smoking-related deaths each and every year in our country. 
     Your bill is a tougher, science-based alternative to Rep. 
     Waxman's HR 1256.
       H.R. 1256 will not only fail to reduce the ravages of 
     cigarette-induced disease and death--it will likely worsen 
     it. The new regulation of tobacco ``additives'' will not 
     lower the toxic and carcinogenic mixture induced by the 
     combustion and inhalation of cigarette smoke. The enhanced 
     restrictions on lower-risk tobacco products, such as 
     smokeless tobacco and ``clean'' nicotine--which have been 
     shown to assist addicted smokers in quitting--will condemn 
     the over 40 million addicted smokers to the same old ``quit 
     or die'' pair of options.
       Successful quit rates are under 20% utilizing the 
     currently-approved remedies. The Waxman legislation would 
     codify this failed policy into law.
       Perhaps the worst aspect of this Waxman approach is that it 
     gives FDA responsibility for overseeing tobacco issues. This 
     will allow the cigarette makers to cloak themselves in the 
     mantle of being ``FDA Approved,'' shielding them from 
     liability for their irresponsible marketing schemes and 
     manipulation of cigarettes' addiction capabilities.
       Your bill--H.R. 1261--will obviate most of the detrimental 
     and counterproductive effects of the Waxman bill. Truthfully 
     telling the American consumer about lower-risk tobacco 
     products--harm reduction rather than ``quit or die''--along 
     with stringent marketing restrictions and attention-getting 
     warning labels, and the establishment of a tobacco-regulation 
     section in the Department of Health and Human Services--not 
     the FDA--will all be of major benefit in reducing the toll of 
     cigarettes in America.
           Sincerely,
                                          Dr. Elizabeth M. Whelan,
     President.
                                  ____



                  resolution on tobacco harm reduction

       Whereas there is substantial scientific evidence that 
     selected smokeless tobacco (ST) products can satisfy the 
     nicotine addiction of inveterate smokers while eliminating 
     most, if not all, risk of pulmonary and cardiovascular 
     complications of smoking and while reducing the risk of 
     cancer by more than 95% and
       Whereas transitioning smokers to selected ST products will 
     eliminate environmental tobacco smoke and fire-related 
     hazards and
       Whereas current ``abstain, quit, or die'' tobacco control 
     policies in the United States may have reached their maximum 
     possible public health benefit because of the large number of 
     cigarette smokers either unwilling or unable to discontinue 
     their addiction to nicotine, and
       Whereas there is evidence that harm reduction works and can 
     be accomplished in a way that will not increase initiation or 
     impede smoking cessation and
       Whereas health-related agencies and organizations, both 
     within the United States and Abroad have already gone on 
     record endorsing Harm Reduction as an approach to further 
     reducing tobacco related illness and death, and
       Whereas current federal policy requires tobacco product 
     labeling that leaves the incorrect impression that all 
     tobacco product present equal risk; and
       Whereas certain tax policies put ST products at a 
     competitive disadvantage, compared to cigarettes; and
       Whereas harm reduction approaches to reducing tobacco 
     related illness and death promise to be more politically and 
     financially viable than alternative approaches because harm 
     reduction approaches can secure the support of many tobacco-
     industry-related stakeholders.
       Be it Therefore Resolved that the American Association of 
     Public Health Physicians go on record as favoring Harm 
     Reduction as a central component of public health efforts to 
     reduce tobacco-related illness and death and
       Be it further Resolved that such efforts shall encourage 
     the following approaches:
       1. Product labeling to inform consumers of the relative 
     risk profiles of the various classes of tobacco products.
       2. Governmental and health-organization sponsored health 
     education to educate consumers to the risk profiles of the 
     various classes of tobacco products
       3. Revision of taxation schemes at federal, state, and 
     local levels to reflect risk profiles and costs to society of 
     the various classes of tobacco products
       4. Regulation of the manufacturing and marketing of the 
     various classes of tobacco products reflective of their 
     respective risk profiles and costs to society
       Be it further Resolved that funds be established through 
     taxation of tobacco products to facilitate government-
     sponsored (as opposed to tobacco company sponsored) research 
     and program evaluation to refine our understanding of the 
     relative risk profiles of the various classes of tobacco 
     products, market trends, and the impact of governmental 
     policy and programming on tobacco product consumption.

  The last point I would like to make is the appeal that my good 
friend, Mike McIntyre, made to the Members. And the appeal is that we 
have a choice before us. The choice before us is to take an abstinence 
only approach to tobacco, or do we really combine forces and use a harm 
reduction strategy, coupled with cessation prevention education 
efforts. It should all be together.
  And I asked the chairman of the Energy and Commerce Committee, if he 
would protect the right that this substitute be heard here on the 
floor, just as he permitted this substitute to be

[[Page H3805]]

made in the Energy and Commerce Committee. He said that his intent was 
to bring his tobacco bill to the floor under suspension. I appealed to 
my good friend not to do that. Allow Congress to work its will, just as 
you did at the committee.
  When this bill came before the committee, it was all Republicans 
voted for it and all Democrats voted against it. I was surprised by 
that. I was surprised by that because we, Mr. McIntyre and I, looked at 
this from a bipartisan perspective, and we were seeking to improve 
public health. And when you try to work to improve public health from 
this perspective this isn't one of these fights about socializing 
medicine or something that defines political parties. This one really 
surprised me that within the committee, that there was a partisan vote. 
That should have never, ever have happened at the committee.
  And what I am hopeful here is that Mr. Waxman, when he makes his 
appeal to the Speaker for his legislation to come to the floor, that he 
actually goes through regular order, that he goes to the Rules 
Committee, and that Mr. McIntyre and I be permitted to have our 
bipartisan substitute be debated here on the House floor.
  And please, do not bring--this is too important of a public health 
position to come up on suspension. This is a bipartisan bill. And to 
bring it up on suspension denies the rights of a lot of Members for 
this public, harm reduction strategy in which we seek to improve public 
health.
  So, if, in fact, if Mr. Waxman brings his tobacco bill to the floor, 
my appeal would be to all Members to vote against the suspension. Now, 
the purpose of voting against the suspension isn't necessarily on the 
substance of the bill itself. It is about the process. We have got the 
process and procedure and you have substance. To bring a bill this 
important on public health under suspension and denying the right of a 
substitute, now we have a process issue. And Mr. McIntyre and I will be 
appealing to Members to vote ``no'' on suspension. We shouldn't be 
suspending the rules and denying amendments and the substitute here on 
this floor. The Congress should work the will of the American people, 
and that is, that all views and opinions and amendments and substitutes 
should be made in order here. And what this has really been done now it 
is narrowed down to two positions.
  And since Mr. Waxman will not incorporate this, the least we can do 
is have this issue heard here on the floor. And that is my appeal.
  So let me conclude with this. Mr. Waxman, I appeal to my good friend, 
allow this to come to the floor. Do not put your bill on suspension. If 
your bill comes to the floor on suspension, then Mr. McIntyre and I are 
asking for all Members to vote against the suspension and for the clear 
purpose that our right to be heard.
  I will yield back.

                          ____________________