Monday, June 15, 2009

Is the FDA’s oversight of tobacco a good idea?

The newly enacted law giving the Food and Drug Administration the authority to regulate tobacco has generated a lot of strong opinion. On the one hand, nicotine is a pharmacologically active substance and highly addictive, so it is hard to refute the logic that it should be regulated; and clearly there can be no dispute as to the enormous toll that tobacco use has taken in terms of life and health. Others see it as big government meddling in matters of personal choice, pointing out that our health and well-being is ultimately our own responsibility. I see it as naïve political posturing.
Here’s why: In the words of one of the senators who advocated for the law, the new authority will be used to immediately require larger warning labels, so that smokers will have to pause and reconsider before lighting up. The problem is that warning labels don’t work; it’s not like the ones that are there now are invisible. Smokers see them now just as they will when the warnings are larger. So what is really going on in the minds of people who consume a product labeled as likely to be deadly when used as intended? Understanding that is the key to understanding the decision to smoke, and to effective public health measures.
There is some information on this thanks to a technology called functional MRI (magnetic resonance imaging), or fMRI. This captures what is going on in the brain in real time. Martin Lindstrom, in his book Buyology: Truth and Lies About Why We Buy reports using fMRI to study the issue of warning labels and other factors related to decision-making. (The field of study is called “neuromarketing.”) Lindstrom was able to definitively show that warning labels have no effect on smoking cravings. This was true even if the subjects answered in an interview that the labels were a deterrent.
There are a number of potential reasons for this, but the point is that the science is way ahead of the policy-making process here, as with so many other topics. Requiring calories and fat content to be displayed on restaurant and fast-food menus seems equally unlikely to stem the tide of obesity, or admonishments on liquor bottles to prevent drunk driving.

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