Benefits and risks in ending regulatory exceptionalism for tobacco

It has often been noted that the tobacco industry is cosseted by regulatory exceptionalism. Unlike food, drink and pharmaceuticals that are taken into the body, and doctors, dentists, podiatrists, tattooists, body piercers and even brothels whose work involves various gradations of body penetration, tobacco remains the only commercial product or service intended to be taken into the body which is not commonly subject to safety regulation standards. Those wanting to do things to other's bodies have to be qualified, trained, inspected, tested and risk losing their rights to practice if breaching legislated standards. Drugs designed to save lives and enhance health are subject to elaborate regulatory controls and those selling them required to undertake degrees in pharmacy or medicine. In most nations, tobacco, which causes stratospheric death estimated to reach a billion this century, can be sold by anyone. Manufacturers are free to add any licit additive for whatever purpose they please.

Very few in tobacco control appear to believe this situation should continue, with most futurists now routinely calling on tobacco to be "regulated". But beyond the glib catchcry, what would regulating tobacco - the product - actually involve?

Legislated performance standards are now in place in Canada and several US states for reduced ignition propensity (RIP) cigarettes and have played a vanguard role in regulating tobacco. The work of the TobReg committee and its latest report is the first attempt in the wake of highly criticised and ultimately dangerously misleading standards based on tar levels as measures of risk to begin to spell out exactly how the product itself should be regulated. TobReg's recent work is therefore a landmark in the history of tobacco control.

The latest report has two core proposals. First, it calls for a legislated program of eventually reducing to the maximum extent technologically possible toxic substances present in cigarette smoke. Essentially, this is a recommendation driven by the precautionary principle that there is no sensible reason for known human carcinogens and other toxicants to be allowed to be at any higher level than the lowest levels known to be already on the market. Global differences within brands show what is currently possible and TobReg argues that maximum standards should be based on median values. Importantly here, TobReg acknowledges that "Existing science has not established that reduction of any individual toxicants in machine measured cigarette smoke. will reduce actual human exposure or disease risks... Mandating levels and removing from the market some brands with higher levels is not a statement that the remaining brands are safe or less hazardous than the brands removed...".

We will not know whether emission regulated tobacco products in fact do reduce risk until large cohorts consume them for several decades. But the corollary of rejecting the precautionary principle is to allow the absurd regulatory exceptionalism granted to tobacco to continue, thereby effectively giving carte blanche to the industry remain comfortably unaccountable to even the most basic rudiments of product safety. In the meantime, while this proposed program of regulation slowly rolls out, toxicant by toxicant, comprehensive tobacco control will continue to erode and denormalise smoking.