Big Tobacco: Trust, But Regulate.

Cigarettes are a potent delivery device for the drug nicotine. But unlike most other drugs in widespread use, nicotine isn't regulated by the U.S. Food and Drug Administration.

This week, the Senate began debating a bill that would change that. It would give the FDA authority over the production, packaging and marketing of cigarettes.

The House already has approved similar legislation. Senators should quickly follow suit.

A decade ago, then-FDA Commissioner David Kessler tried to assert regulatory control over tobacco companies. But the U.S. Supreme Court rejected his bid, ruling that congressional authority was required.

More than 4.4 million Americans have died from tobacco-related causes since then, an average of 443,000 a year.

For each one of them, 20 suffer at least one serious tobacco-related illness. The direct medical cost of treating those illnesses is estimated at $96 billion a year.

Regulating Big Tobacco would help by curbing the industry's heavy marketing, much of it aimed at teenagers and kids. It would prevent the purposeful manipulation of nicotine levels in cigarettes. And most important, it would prevent Big Tobacco's fraudulent — and fraudulent is precisely the right word — marketing techniques.

On May 22, the U.S. Court of Appeals in the District of Columbia upheld a ruling that cigarette makers had lied for decades about the dangers of smoking and secondhand smoke; that they conspired to mislead the public and that they marketed their products to people under 21.

The three-judge panel ruled that tobacco companies knew "that cigarette smoking causes disease, that nicotine is addictive, that light cigarettes do not present lower health risks than regular cigarettes ...

and that secondhand smoke is hazardous to health." Yet they continued publicly to insist otherwise.

Tobacco companies say they've turned over a new leaf since the bad old days when they used to insist the science on smoking's health effects was "unsettled."

The truth is that tobacco companies have turned over enough new leaves to make a million cigarettes, yet they keep getting caught at their old tricks.

Industry documents show that cigarette companies paid to establish and sustain so-called "smokers' rights" groups in the 1990s when the first indoor smoking bans were proposed. The industry coordinated "grass-roots" opposition to those bans.

Arguments first orchestrated by industry groups more than a decade ago — years after they first became aware of the health effects of secondhand smoke — still are being aired by smokers rights groups in Missouri, where the City of Clayton's Board of Aldermen is considering a clean indoor air bill, and on the commentary page of this newspaper.

Regulation would add to the workload at the FDA, which is underfunded, understaffed and overstretched. Lawmakers want to pay for a new tobacco division at the FDA by imposing a fee on tobacco companies.

Similar funding arrangements with drug companies are used to pay for FDA safety reviews of new drugs, an arrangement critics say makes the agency overly reliant on an industry it regulates. The fact that Philip Morris, the nation's largest cigarette maker, supports FDA regulation worries many long-time public health advocates.

They're right to be suspicious. To paraphrase former President Ronald Reagan, lawmakers should trust, but regulate, Big Tobacco.

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