Tobacco
Case Studies: Two efforts to reduce the morbidity and mortality related to tobacco and
a description of the evolution of the tobacco industry.





(1) To limit advertising promoting tobacco and to alert the public to the dangers of tobacco: Luther Terry, MD.

 What might you (as Surgeon General) do if an unexpected question at a press conference left President Kennedy in a box?

Smoking & Politics, Policy Making and the Federal Bureaucracy.
By A Lee Fritschler.

See outline of this book, below.





(2) To hold tobacco industry accountable for willful damage: David Kessler, MD.

 What might you (as Commissioner of the Food and Drug Administration) do if tobacco remained a major industry and killer?

A Question of Intent, A Great American Battle With a Deadly Industry.
By David Kessler.





(3) The tobacco industry:

 How do the circumstances of an industry determine the skills and perspectives that guide that industry?

Ashes to Ashes: America’s Hundred-Year Cigarette War, the Public Health, and the Unabashed Triumph of Philip Morris
By Richard Kluger (1997 Pulitzer Prize for General Nonfiction).
 
 
 
 
 
 
 
 
 
 
 

Fritschler, A. Lee, and Hoefler, James M. 1996. Smoking & Politics (5th ed). Upper Saddle River, NJ: Prentice Hall.
 

Powers of a regulatory agency [pp. 64-65]

Formal Powers Informal Powers
Adjudicatory (quasi-judicial)
Rule-making (quasi-legislative)
Advisory Opinion
Trade Practices Conference
Consent Order

Determinants of success in influencing policy
Influencing policy requires Persistence, Skill, and Luck
"Those who want to initiate change in policy have come to recognize that their cause will succeed only with hard work, careful strategy, and large portions of luck." p. 37

Skill of Surgeon General
Recognized opportunity; selected and charged advisory committee for skill, legitimacy, and objectivity; programmed public interest.

Preparation by regulatory agencies
Setting precedence for rule-making.
Favored by the general broadly accepted "delegation doctrine.".

Skill of tobacco interests
Respected and skilled lobbyist; Consolidating their efforts and accepting compromise; questioning the science; moving action to Congress (the political, rather than the legal, arena).
Use of preemptive legislation and threats of restricting the regulatory agencies' budgetary and regulatory resources.

Problem of the public health interests
Failure to consolidate efforts; taking absolute positions.

Success?
Breaking of the iron triangle
Incidence of smoking

A final question
Would the public health interests have made more progress if they had concentrated upon tort law?