Tobacco regulation is an important and challenging policy topic that must balance the health and interests of smokers. The purpose of this analysis is to focus on the impact of tobacco regulation on public and social health. It is significant because tobacco and smoking are strong risk factors for several serious conditions including cancers, heart disease, lung diseases, and COPD, both for the smoker and for the general population that may be exposed to secondhand smoke. The policy analysis will seek to answer questions on whether current policy is adequate at maintaining public health and what further policy strategies can be undertaken to reduce the rate of tobacco use in the population.
Background
Tobacco products are universally considered a threat to public health and safety by medical professionals and the FDA. More than 16 million people in the U.S. have a disease caused by smoking. Secondhand smoke contributes to 41,000 death annually, causing similar conditions as smokers themselves may experience such as lung cancer and heart disease (CDC, 2016). Tobacco use is the leading cause of preventable death in the United States, with at least 480,000 lives lost each year due to cigarette-related illness.
Although the incidence of smoking is declining, more than 34.4 million Americans smoke daily, with 1.4 million being underage. Electronic tobacco products (e-cigarettes) are also gaining popularity, often marketed and perceived as safer alternatives to regular smoking, but that is not commonly the case. E-tobacco products are used by 6.9 million adults and 3.6 million youth (Green, 2019). The health risks, particularly for infants and children are high, making tobacco use a vital public health concern.
The most significant piece of federal policy on tobacco regulation in modern times is the Family Smoking Prevention and Tobacco Control Act signed into law by President Obama in 2009. It provides the Food and Drug Administration with comprehensive and overarching authority to regulate the tobacco industry in manufacturing, marketing, and sale. The law helps manage the image that the tobacco industry presents, requiring identification of risks, health claims, and components of such products offer, as well as visible health warning labels.
Furthermore, the act takes steps in reducing the exposure of products to minors under the age of 18. New tobacco products must be approved as with medicines before introduced to the market (Public Health Law Center, 2019). In terms of public usage, local laws often focus on this by limiting places in public where smoking is allowed, especially limiting such in contexts of highly public places and events or near families and children.
The strengths of the current policy include that it can regulate the market to some extent by limiting the advertising and access of tobacco products as well as oversee quality. It is much harder to see any type of tobacco product advertising in the modern-day, and if it is present, it has explicit warning labels. The shortcomings of the policy are that it does not address the public health effects directly as anyone over the age of 18 can still easily purchase cigarettes, and smoke in many places where public exposure to secondhand smoke is imminent.
There is no federal policy targeting this, nor are people who smoke well-educated regarding real impacts on health as the public health campaign against tobacco largely fell off in recent years. Key stakeholders in the policy topic include tobacco industry companies, government and public health agencies, and the population, divided by those who smoke and those who are opposed to it.
Analysis
A realistic alternative policy would be a widespread anti-tobacco education initiative, producing a mass media information campaign about the dangers of tobacco products and instituting funded educational programs in schools and communities to promote anti-smoking. Limited education campaigns run by the FDA have shown to be effective at discouraging smoking, particularly in youth who were susceptible. The penetration rate of such a campaign was 89% and positive reactions combined with the high level of awareness can lead to potential shifts in population-level cognition and lifestyle choices (Duke, 2015). Criteria to evaluate policy can be based on its effectiveness, reception by the population, cost, and public health benefits.
An education campaign is a viable option, helping to prevent new users from trying tobacco products and encouraging others to stop. It is effective at targeting certain vulnerable population groups such as youth who are most at risk from negative health effects of tobacco. New cases of tobacco use may decrease eventually leading to a reduction in public health cases concerning the product. Meanwhile, the original policy of market regulation is vital to monitor producers, ensuring they do not use deceptive methods of advertisement, disclose all risks, and maintain the quality of products. Arguably, from a public health perspective, this offers more impact by focusing on the root of the issue and establishing highly necessary regulation.
Patient outcomes may become worse with a lack of quality and advertisement regulation, with smoking being a widespread and social activity. Both policies give up essential means of combatting smoking. Market regulation does not provide adequate levels of public education needed to promote the dangers of smoking as risk labels are commonly not enough. Meanwhile, education policy lacks the proper market influence and it would simply be a matter of which public information campaign is more effective, government-promoted health or ones used by tobacco companies.
Recommendations
The best policy moving forward would be to implement stricter regulation of the tobacco market. Limiting options where products can be sold, implementing strict guidelines on new products (e-cigarettes), implementing taxes, and potentially raising the age of legal purchase to 21. Most individuals understand to some extent the dangers of smoking but continue to do so because it is either social or an addiction.
Directly creating limitations of various kinds to purchasing such products and advertising, will eventually see a decrease in smokers. Strategies to implement such policy would be to continue working with the FDA and include other government agencies as well as Congress to pass anti-tobacco legislation. Establishing strict regulations using evidence of tobacco danger can be effective. Barriers to such implementation would be heavy tobacco industry lobbying, claiming that risks are overstated and their investments into e-cigarettes which are publicly perceived to be safer. People may also criticize strict regulation as a violation of personal choices and rights. Evaluation of policy will need to occur over years to see the rate of smoking, tobacco purchases, and smoking-related diseases.
Discussion
The analysis of the question of whether current policy is adequate suggests that it is a step in the right direction, but further regulation and pressure on the tobacco market is necessary to have a profound impact on reducing smoking rates. Further policy strategies of introducing education initiatives, at least on a small scale can be beneficial to positively influencing a vulnerable population.
The limitations of this policy analysis are that the process of producing health policy is often highly partisan and challenging, and it is difficult to predict long-term contexts and consequences. In terms of policymaking and practice, the anti-tobacco policy has been evaluated continuously since the beginning of the century. It is important to discuss and analyze the concepts because different types of policies play an important role in reducing smoking prevalence. Effects of different policies vary, but a larger base of evidence supports regulation of the market in terms of advertising restrictions and health warnings (Levy et al., 2018).
Conclusion
Tobacco use is very impactful and dangerous for public health, directly and through second-hand smoke, causing several diseases. Current FDA policy focuses on monitoring tobacco product producers and the market. An alternative policy would be to focus on an education campaign. However, in reality, maintaining regulation of the tobacco industry would be most effective currently in terms of public health. The regulation should be stricter, and policy should move further to limit access of the population to tobacco products.
References
CDC. (2016). Health effects.
Duke, J. C., Alexander, T. N., Zhao, X., Delahanty, J. C., Allen, J. A., MacMonegle, A. J., & Farrelly, M. C. (2015). Youth’s awareness of and reactions to the real cost national tobacco public education campaign. PLOS ONE, 10(12), e0144827. Web.
Green, V. R. (2019). FDA regulation of tobacco products.
Levy, D. T., Tam, J., Kuo, C., Fong, G. T., & Chaloupka, F. (2018). The Impact of Implementing Tobacco Control Policies. Journal of Public Health Management and Practice, 24(5), 448-457. Web.
Public Health Law Center. (2019). Federal regulation of tobacco: A summary. Web.