Despite months of anti-tobacco rhetoric from our nation's leading health officials, it seems that in the eyes of the Bush administration, a death overseas from smoking cigarettes means less than a death in the United States.

The U.S. position on the health impact of tobacco exports reflects an abrupt policy shift for anti-tobacco crusader Secretary of Health and Human Services Louis Sullivan. The change of heart came just over a month after Dr. Sullivan's assistant secretary for health, Dr. James Mason, told delegates to the Seventh World Conference on Smoking and Health in Perth, Australia, "It is indeed offensive that cigarette makers can peddle more than five trillion of their pernicious products a year around the world."

Strong words and an appropriate sentiment for a U.S. health official. Upon his return from Australia, Dr. Mason was invited to testify at a congressional hearing addressing the health effects of U.S. tobacco exports. At issue was a General Accounting Office report pointing out the obvious inconsistency of a U.S. health policy that asks people not to smoke and a trade policy that says please do.

Dr. Mason had accepted the subcommittee's invitation to appear with a representative of the U.S. Trade Office. But two days before the hearing, we were informed that the administration would not allow the assistant secretary for health to testify. In response to a letter requesting an explanation for this unusual action, Dr. Sullivan told the subcommittee that "our message on smoking remains strong and unaltered" and that the department would be pleased to testify in the future "to address the health concerns of smoking on our citizens" (emphasis added).

Dr. Sullivan has rightfully criticized U.S. tobacco companies for outrageous conduct in the targeting of cigarette advertising at blacks and women. Yet when these same companies use television advertising and other marketing gimmicks to target blacks and women overseas, the secretary and his department are strangely silent.

U.S. consumption of cigarettes is declining. That's the good news. The bad news is that U.S. tobacco manufacturers are responding to the decline by expanding markets overseas. For every smoker who quits in Boston or Baltimore, new smokers are being aggressively targeted and recruited by U.S. tobacco companies in Bangkok and Beijing.

Every year, cigarettes are responsible for 400,000 deaths in the United States and 2.5 million worldwide. The World Health Organization estimates that if current smoking trends continue, worldwide deaths from smoking will exceed 10 million by the first quarter of the 21st century. A disproportionate number of these deaths will take place in the developing nations of Asia, Africa and South America.

But cigarettes are a profitable export for the United States. Last year tobacco exports were responsible for a trade surplus of over $4 billion. It is repugnant that the solution to the U.S. trade deficit is to export more tobacco. We should be fighting harder to sell positive commodities such as automobiles, satellite technology and aviation equipment. With this year's trade deficit projected to exceed $100 billion, the contribution of tobacco is hardly worth the moral price such exports exact.

Tobacco supporters in Congress and the industry argue that tobacco should be treated like any other U.S. commodity. If we don't sell U.S. tobacco to Asians, Asian tobacco companies will get the market. U.S. exports don't cause smoking, they say.

Secretary Sullivan should not have heeded these arguments. They come from the same people he has condemned for its sale of tobacco to American children. The question he should have asked, and the one Dr. Mason so eloquently answered, is whether we should vigorously push the export and sale of tobacco overseas simply because there are people willing to buy it.

In 1836, the British government worried about the economic risk of a negative trade balance with China, and its 19th century solution has a deadly parallel to the tobacco trade solution of today. The British sold the Chinese opium in exchange for silk and tea. And so opium became, in historian Immanuel C. Y. Hsu's words, "the economic panacea for the British trade doldrums."

Our tobacco export policies are no less morally offensive today.

Rep. Waxman (D-Calif.) is chairman of the subcommittee on health and the environment.