Surgeon General Richard H. Carmona said yesterday that he supports the banning of tobacco products -- the first time that the government's top doctor and public health advocate has made such a strong statement about the historically contentious subject.
Testifying at a House Energy and Commerce subcommittee hearing on smokeless tobacco and "reduced risk" tobacco products, Carmona was asked if he would "support the abolition of all tobacco products."
"I would at this point, yes," he replied.
He declined to state whether he would support a law to ban tobacco -- saying "legislation is not my field" -- but did say that he "would support banning or abolishing tobacco products."
"If Congress chose to go that way, that would be up to them," he said. "But I see no need for any tobacco products in society."
Carmona's comments, made in answer to questions from Rep. Ed Whitfield (R-Ky.), were received without much immediate response from the committee. But representatives from tobacco states later said they were startled.
"It just came out of the blue," Whitfield said after the hearing. "I've never heard anything like that from any public official -- and even from the advocates against tobacco. I was pretty disappointed and surprised, and quite shocked."
Bush administration officials quickly distanced themselves from the comments, saying that they represented Carmona's views as a doctor rather than the position of the administration.
"That is not the policy of the administration," White House spokesman Scott McClellan said. "The president supports efforts to crack down on youth smoking, and we can do more as a society to keep tobacco away from kids. That's our focus."
But the comments yesterday also reflected how far medical, and to some extent public, views about tobacco have swung. While Carmona's comments were the most dramatic during yesterday's hearing, those in the room -- from conservative Republican lawmakers to liberal Democrats -- voiced a consensus that tobacco is a killer, is addictive, has sometimes been sold through questionable practices to consumers and has to be controlled.
The willingness to voice objections to tobacco in ways that would have been considered controversial not long ago is striking, especially in light of the millions of dollars in campaign donations the tobacco industry gives to politicians, especially to President Bush and Republicans in Congress.
Although surgeons general have little authority in policymaking, they have always had an influential role as chief spokesman for the nation's health. Particularly on the subject of tobacco's dangers and efforts to control them, surgeons general have played a leading role since the 1960s and have often led the way to legislation.
But while surgeons general have been increasingly aggressive in advocating efforts to control tobacco use, none made the kind of comments that Carmona did yesterday. C. Everett Koop, when he was surgeon general in the mid-1980s, put himself at odds with the Reagan White House by saying that he supported a bill banning cigarette advertising and promotion, but he didn't support abolishing tobacco sales while in office.
Carmona, whose appointment was approved by the Senate last August, is a former Green Beret and trauma surgeon known for his sometimes swashbuckling exploits. Raised in Harlem, he was a poor high school dropout who earned a reputation for his talents, daring and energy as a soldier, doctor and deputy sheriff in Arizona, and as the founder of the state's emergency medical system.
Throughout his testimony yesterday, Carmona showed himself to be a staunch critic of tobacco products -- which federal officials estimate kill more than 400,000 Americans each year. He was adamant in saying there is no evidence that smokeless tobacco causes less harm than cigarettes, a message that some Republican members of the committee were clearly unhappy to hear.
The morning hearing, before the House Energy and Commerce Committee, was called to discuss efforts by U.S. Smokeless Tobacco Co. to have its products, such as chewing tobacco and snuff, recognized and marketed as less harmful than cigarettes. An afternoon hearing before the House Government Reform Committee dealt more broadly with the question of "risk reduction" in smoking and how tobacco products should be regulated in the future.
Tobacco companies have aggressively attacked any congressional or regulatory efforts that they believe might allow for a ban. The industry fought Clinton administration efforts to give the Food and Drug Administration authority to regulate tobacco by contending, among other things, that the FDA might ban tobacco since it can never be either safe or effective -- the standard for approving medicinal drugs.
The largest tobacco company, Philip Morris USA, strongly supports a bill introduced last year by Rep. Thomas M. Davis III (R-Va.) that would forbid a regulatory agency from banning tobacco, saying that such a decision should be left up to Congress. Philip Morris and other companies oppose another bill sponsored by Sens. Edward M. Kennedy (D-Mass.) and Mike DeWine (R-Ohio) in part because it is ambiguous on the issue.
Responding to yesterday's comments by Carmona, Philip Morris spokesman Michael Pfeil said prohibiting tobacco is bad policy and would be counterproductive.
"We were surprised, because over the course of the years there have been very few people advocating a ban on tobacco products," Pfeil said. "It's just not a very effective way to deal with the problem."
Joel Spivak, spokesman for the Campaign for Tobacco-Free Kids, agreed. "We would all like to see a tobacco-free world," he said. "But the reality is that there are 45 million Americans who are smokers, and we can't just take away their tobacco."
