"The American Cancer Society supports the right settlement-- but this is not that settlement," said ACS Chairman George Dessart. "While we believe the comprehensive legislation which will result from the settlement discussions has more potential for advancing public health than the uncertain outcome of lengthy continued litigation or piecemeal legislation, we do have concerns. There are major elements of the current settlement proposal that will require substantial revisions for the agreement to succeed in its more important potential benefit to public health-- reducing tobacco use and therefore tobacco-caused disease and death."

"The ACS is committed to reducing cancer deaths due to tobacco use," said John Seffrin, chief executive officer. "We believe the proposed settlement provides a rare opportunity to make substantial inroads in combating tobacco related illnesses -- the largest cause of death and disease in the United States."

When the settlement proposal was released, ACS began a three stage comprehensive review and analysis process of the settlement document which included a review by staff and volunteer executive leadership, a specially-convened panel of outside legal, economic and health policy experts, and participation in the evaluation process by Advisory Committee on Tobacco Policy and Public Health, which was chaired by former FDA commissioner David Kessler and former Surgeon General C. Everett Koop, and appointed by select members of Congress. Dr. Seffrin chaired the panel on FDA regulation of tobacco products for the Koop/Kessler committee.

Areas the ACS thinks need revision include:

Industry Payments

The amount of the required industry payments may be too small to produce significant reductions in youth smoking. The present discounted value of the required $368.5 billion payments is actually only $194.5 billion. The payments would produce a 41 cents per pack increase in the price of cigarettes in Year 1, and eventually grow to 62 cents per pack by Year 5. No other public health strategy would exhibit the speed and cost-effectiveness of impact achieved by increasing the price of tobacco products. ACS proposes:

• Raise the federal tobacco excise tax to $2 per pack of cigarettes with a proportional increase on smokeless tobacco products.

FDA Regulation of Nicotine and Other Tobacco Constituents

The procedural hurdles are wholly unjustified. The ACS recommends:

• Authorize FDA to develop performance standards designed to reduce or eliminate any constituent, including nicotine;

• Delete 12 year provision and apply a single standard that applies from the effective date of the Act;

• Eliminate proposed heightened standard of proof and allow traditional administrative law to apply;

• Delete requirements that FDA demonstrate that modifications in tobacco products will not result in significant contraband; and

• Include regulation of cigars and pipe tobacco.

Preemption

State and local governments have undertaken significant efforts to control underage use of tobacco, through imposing excise taxes, restrictions on sales to minors, labeling and disclosure requirements and policies protecting citizens from secondhand smoke.

• ACS believes states and localities should be authorized to enact laws that are more stringent than, federal tobacco control laws.

Public Disclosure of Industry Documents

It is clear that the tobacco industry did not disclose what it knew about the dangers and addictive properties of cigarettes. ACS recommends:

• The industry be required to release to the FDA any and all information -- including research and marketing documents-that are relevant to public health, safety, and the development of less hazardous tobacco products.

Reducing Underage Tobacco Consumption and 'Look Back' Provisions

There is no economic incentive to ensure the industry will meet the targets. The ACS recommends:

• Raise the targets for smokeless tobacco to same level as cigarettes;
• Impose a surcharge on each tobacco company based on brand-specific youth consumption;
• Eliminate the rebate provision to avoid undermining the intent and effectiveness of the "look-back'"provision;
• Add language to explicitly authorize state and local governments to use minors in compliance checks;
• Require sales data, by brand, in order to evaluate performance by individual companies; and
• Eliminate the $2 billion cap.

Disclosure and Regulation of Non-Tobacco Ingredients & Reduced Risk Products

We embrace the requirement that manufacturers be required to provide FDA a list of non-tobacco ingredients, however, ACS recommends:

• "Ingredients" must include all additives and other substances derived from tobacco, as well as non-tobacco ingredients;
• Legislation should specifically provide FDA with the authority and responsibility to establish safety standards to serve as the basis for the safety assessment; and
• Legislation should make clear that a safety assessment must include an evaluation of ingredients used in combination with each other, as well as the fact that ingredients are altered through burning.
• The FDA be provided the authority, and the resources, to establish an appropriate means of measuring risk, and determining reduced risk in development and approval of a "reduced risk" (safer cigarette) product.

ACS released the results of nationwide polling that looked at public support for the tobacco settlement. Polling was performed by The Mellman Group in June. Seven of the questions included:

• 69% support FDA Regulation of tobacco products;
• 84% favor disclosure of tobacco industry documents;
• 68% favor state and local ability to enact tougher laws;
• 89% support fines and license revocation for those who sell to kids;
• 78% favor licensing requirements of retailers;
• 76% support a ban on vending machines.

"Smoking is a pediatric disease and 3,000 young people begin smoking every day," said ACS President Myles Cunningham, M.D. "We must combat this problem from all sides, because tobacco is not a partisan issue. ACS will work with Congress and the public health community to ensure that a carefully crafted piece of legislation gets developed that will end the tobacco epidemic."

The 200+ page document, which was delivered to Congress, includes a thorough evaluation of the original FDA rule, information on the regulation of nicotine as a drug, facts on the health aspects of smoking and state specific tobacco and health issues. The press conference today released the Society's official position and the organization's recommendations for developing legislation to achieve the goals of truly comprehensive national tobacco policy drive by the public health agenda. And in a few days we will release a complete analysis of the legal and constitutional ramifications of the settlement.

"As the settlement proposal goes through Congress, the American Cancer Society will monitor the process closely, and will work actively with our partners in the public health community to ensure the elements affecting public health are sustained and supported, and the tobacco industry is controlled," said Seffrin. "Today, I call on my friends in the public health community, many of whom I worked with on the Koop/Kessler Committee, to join the American Cancer Society, as we monitor the progress of the tobacco settlement as it moves through Congress."