[Congressional Record (Bound Edition), Volume 155 (2009), Part 11]
[Senate]
[Pages 14280-14281]
[From the U.S. Government Publishing Office, www.gpo.gov]




           FAMILY SMOKING PREVENTION AND TOBACCO CONTROL ACT

  Mr. CORNYN. Actually, Madam President, I intend to speak on the 
underlying bill. But because the bill manager is not here, I think my 
remarks are just as appropriate in morning business.
  I rise to offer my support as a cosponsor of the Family Smoking 
Prevention and Tobacco Control Act, the so-called FDA regulation of the 
tobacco bill that is currently before the Senate.
  This is a rarity these days in Washington. It is actually a 
bipartisan bill--people of both parties working together to try to 
solve a real problem--and I want to particularly thank Senator Kennedy 
and Senator Dodd for their leadership on the bill. I also want to thank 
the Campaign for Tobacco-Free Kids for organizing more than 1,000 
public health groups, faith-based organizations, medical associations, 
and other partners to support this legislation.
  The House, as we know, passed the bill in April on a bipartisan 
basis, and now it is time for the Senate to do its job this week.
  This comes to us in a rather unusual historical and regulatory 
posture. The fact is, we know tobacco is a killer. It is a killer. It 
kills 400,000 Americans each year in the United States, including 90 
percent of all deaths from lung cancer, one out of every three deaths 
from other types of cancer, and one out of every five deaths for 
cardiovascular disease.
  The real tragedy is not just that adults choose to smoke and harm 
their health--and many of whom, unfortunately, die premature deaths as 
a result--it is that many smokers begin their addiction to tobacco--the 
nicotine, which is the addictive substance within tobacco--when they 
are young, before they are able to make intelligent choices about what 
to do with their bodies and their health.
  Every day about 1,000 children become regular daily smokers. Medical 
professionals project that about one-third of these children will 
eventually die prematurely from a tobacco-related disease.
  Not surprisingly, at a time when we are contemplating health care 
reform in this country, the huge expense of health care and the fiscal 
unsustainability of the Medicare program, it is also important to point 
out that tobacco directly increases the cost of health care in our 
country. More than $100 billion is spent every year to treat tobacco-
related diseases--$100 billion of taxpayer money--and about $30 billion 
of that is spent through our Medicaid Program.
  America has a love-hate relationship with tobacco, and Congress, I 
should say, and State government does as well. My colleagues will 
recall that tobacco actually presents a revenue source for the State 
and Federal Government. One of the most recent instances is when 
Congress passed a 60-cent-plus additional tax on tobacco in order to 
fund an expansion of the State Children's Health Insurance Program. So 
government has become addicted to tobacco, too, because of the revenue 
stream it presents, and that is true at the Federal level and at the 
State level.
  However, because of the political clout of tobacco companies years 
back, when the FDA regulation statute was passed, tobacco was 
specifically left out of the power of the FDA to regulate this drug. 
The active ingredient I mentioned is nicotine, which was not 
acknowledged to be an addictive drug for many years until finally the 
Surgeon General did identify it for what it was: an addictive drug that 
makes it harder for people, once they start smoking, to quit.
  Then, of course, we tried litigation to control tobacco and the 
spread of marketing tobacco to children and addicting them to this 
deadly drug, which it is. Then, we found out it had basically no 
impact, that massive national litigation through the attorneys general 
in the States. Basically, the only thing that happened as a result of 
that is lawyers got rich, but it didn't do anything to deal with the 
problem of marketing tobacco to children.
  One might ask, as a conservative: Why would one support more 
regulation rather than less? Well, because of this split personality 
the Federal Government has in dealing with tobacco--recognizing it is a 
deadly drug, recognizing marketing often targets the most vulnerable 
among us, and recognizing the fact that it kills so many people and 
increases our health care costs not only in Medicare but in Medicaid--
why in the world wouldn't we ban it? I know the Senator from Oklahoma 
has said maybe the world would be a better place if tobacco wasn't 
legal. Well, we all know that is a slippery slope for the individual 
choices we make. If we were to ban tobacco, we might as well ban fatty 
food; we might as well ban alcohol. Obviously, the government would 
become essentially the dictator of what people could and could not do 
and consume, and I don't think the American people would tolerate it 
and I think with some good reason.
  We have to accept individual responsibility for our choices. But, 
again, when you target a deadly drug such as tobacco and nicotine--this 
addictive component of tobacco to children--that, to me, crosses the 
line where we ought to say the Federal Government does have a 
responsibility to allow this legal product, if it is going to remain 
legal, to be used but under a regulatory regime that will protect the 
most vulnerable among us.
  Many States have effective ways to deal with underage use of tobacco. 
I think the regime in my State of Texas works pretty well, but it is 
spotty and not uniform across the country; thus, I think, necessitating 
a Federal response.
  This bill--which, as I say, should be our last resort, and in many 
ways it is--increases Federal regulation, I believe, in a responsible 
way, under an imperfect situation, where this legal but deadly drug is 
used by so many people in our country.
  This bill gives the Food and Drug Administration the authority to 
regulate the manufacturing, marketing, and sale of tobacco products. It 
would restrict marketing and sales to our young people. It would 
require tobacco companies to disclose all the ingredients in their 
products to the FDA. There have been various revelations over time that 
there were actually efforts made by tobacco companies to

[[Page 14281]]

provide an extra dose of the addictive component of tobacco, which is 
nicotine, in order to hook people at a younger age. I think by 
providing for disclosure of all the ingredients of these products to 
the FDA, and thus to the American people, we can give people at least 
as much information as we possibly can to make wise choices with regard 
to their use of tobacco, or not, preferably. It would require larger 
and stronger health warnings on tobacco products.
  This bill would also protect our young people and taxpayers as well. 
Smokers will pay for the enforcement of these regulations through user 
fees on manufacturers of cigarettes, cigarette tobacco, and smokeless 
tobacco products. Nonsmokers will not have to pay any additional taxes 
or fees as a result of this bill.
  I hope this bill does some good. I think it will. But the key to 
reducing smoking is for individuals to make better choices and for our 
culture to change, as it has already changed, when it comes to 
consumption of tobacco products. I think about other examples over time 
where our culture has changed to where we now do things that are safer 
and better today than we used to when I was growing up. For example, 
when I was growing up, seatbelt use was very sparse. As a matter of 
fact, you could buy a car, and if you wanted a seatbelt, you would have 
to have somebody install it for you because it didn't come as original, 
manufactured equipment. Today we know seatbelt use is not only much 
broader and more widely spread, but you can't get into a car and turn 
it on without being dinged to death or otherwise reminded that you need 
to put your seatbelt on. The truth is it has made driving in cars a lot 
safer. It has kept people healthier, even in spite of accidents they 
have been involved in, and it has--not coincidentally--helped reduce 
medical admissions and medical expenses as well.
  We know there is also today a greater societal stigma against drunk 
driving. That was not always the case. As a matter of fact, as a result 
of many years of public education and stricter law enforcement, now 
people take a much smarter and well-informed view of drinking and 
particularly the risks of drinking and driving. We know also that many 
Americans, in dealing with energy, are dealing more responsibly by 
recycling and conserving energy. Of course, millions of Americans are 
trying to do better when it comes to eating right and exercising more 
frequently so they can protect their own health and engage in 
preventive medicine, so to speak.
  Government can't do it all because, as I said earlier, I think 
individuals bear a responsibility to make good choices. One thing 
government can do is help inform those choices. I think this regulation 
bill will help smokers make better decisions by knowing what is in the 
tobacco product and allowing the FDA to regulate this drug.
  I believe the real drivers of change, though, are not just the 
government, not the nanny State that will tell us what we can and 
cannot do, but cultural influences and, indeed, economic incentives 
which are more powerful than government regulations in influencing 
individual behavior.
  Some have said: Why in the world would we give tobacco regulation to 
the Food and Drug Administration, a Federal agency with the primary job 
of determining safety of food and drugs and medical devices as well as 
efficacy. As a matter of fact, many people have been tempted to buy 
prescription drugs, let's say, over the Internet but not knowing where 
they were actually manufactured, whether they were actually counterfeit 
drugs. So there is not only the question of safety--in other words, if 
you put it in your mouth, is it going to poison you--but it is also if 
you put it in your mouth and you take it expecting it actually to be 
effective against the medical condition you want to treat. The FDA is a 
regulatory agency that is supposed to determine not only safety of food 
and drugs but also their efficacy.
  There is a certain anomaly in giving the FDA regulatory authority for 
something we know will kill people--and does, in fact, kill hundreds of 
thousands of people--when used as intended by the manufacturer, but I 
think this is a step in the right direction. I think the world would be 
a better place--we would all certainly be healthier--if people chose 
not to use tobacco, and many have made that choice due to the cultural 
influences we have mentioned, as well as some of the economic 
incentives that are provided by employers.
  As we undertake the task of reforming our health system in America, 
something that comprises 17 percent of our gross domestic product, I 
think we could well learn from some of the successful experiences and 
experiments some employers have used and some workers have used when it 
comes to drugs such as tobacco. For example, one large grocery company 
headquartered out in California--Safeway--which also has many employees 
in Texas, as an employer, they noticed that 70 percent of their health 
care costs were related to individual behavior, things such as diet, 
exercise, and, yes, indeed, smoking. They recognized that if they could 
encourage their employees to get age-appropriate diagnostic procedures 
for cancer--colon cancer, for example--if they could encourage their 
employees to quit smoking, if they could encourage their employees to 
watch their weight and get exercise and to watch their blood pressure 
and take blood pressure medication where indicated, where they could 
encourage them to take cholesterol-lowering medication, if they had 
high cholesterol, that they could not only have healthier, more 
productive employees, they could actually bring down the costs of 
health care for their employees as well as their own costs. I think 
Safeway is just one example of many successful innovators across this 
country, where people are encouraged to do the right thing for 
themselves and for their employers and for their families. I think 
these are the kinds of issues that ought to guide us as we debate 
health care reform during the coming weeks.
  I believe this legislation fills the necessary gap in FDA's 
regulatory authority, an agency that regulates everything from food to 
prescription drugs, to medical devices. The only reason tobacco was 
left out of it is because of the political clout of tobacco years ago. 
This legislation fills that gap and I think presents the most pragmatic 
approach to try to deal with the scourge of underage smoking and 
marketing to children, as well as informing consumers of what they need 
to know in order to make smart choices for their own health and for the 
health of their family.
  I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mrs. BOXER. Madam President, I ask unanimous consent that the order 
for the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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