by John McCain , Robert A. Levy

The measure was developed in cooperation with the attorneys general, representatives of the public -health sector and the Clinton administration. It contains the six major initiatives experts say must be jointly undertaken if we are to cure the pediatric epidemic of tobacco use. These elements include: (1) advertising restrictions to eliminate marketing appeals to youth; (2) higher cigarette prices to deter underage consumption; (3) aggressive youth-smoking reduction targets and industry penalties for nonattainment; (4) stronger enforcement of youth tobacco-access rules; (5) public disclosure, oversight and regulation of cigarette ingredients; and (6) industry payments to compensate for smoking-related medical costs and to finance smoking prevention, cessation and medical-research programs.

First, marketing and advertising. Documents disclosed in courts and Congress prove that tobacco companies have targeted and groomed the youth market to replace the 400,000 customers they “lose” each year. Studies show that young people are particularly susceptible to the industry’s marketing pitches. So effective have these companies been at appealing to youth, that many children can identify Joe Camel as readily as they do Barney or cartoon characters.

The bill would place vast advertising and marketing restrictions on the tobacco industry, including a ban on billboards and outdoor advertising at sports arenas, as well as a prohibition of color ads and the use of human and animal figures. It would restrict point-of-sale advertising to ensure that cigarette pitches aren’t directed at children and would require bold, new warning labels on cigarette packaging. And, the tobacco industry would not be permitted to pay Hollywood to have its products featured in entertainment media.

Second higher cigarette prices. Experts say the most important step to deter youth consumption is to hike the price of tobacco products. Health studies show that consumption of only a modest number of cigarettes can result in clinical addiction, and that higher pricing is essential to deter underage use. Accordingly, the bill would increase the price per pack of cigarettes by a minimum of $1.10 over five years. The Clinton administration believes that this hike, included in the president’s budget request, could cut youth consumption in half.

Third, youth smoking-reduction targets. Four-and-one-half million underage Americans use tobacco, and the number is growing.

The bill calls for a 60 percent reduction in youth consumption within 10 years and levies hefty financial penalties on the tobacco industry for failing to achieve them.

Fourth, stronger enforcement of rules for youth access to tobacco products. While smoking by minors is prohibited in every state, youths continue to buy tobacco. The bill would require that tobacco products be stored in areas inaccessible to youths and required retailers to “card” tobacco purchasers in the same manner as alcohol buyers. In addition, the bill would ban vending machines, except in adult facilities, and require face-to-face transactions where teens are present.

Fifth, cigarette-ingredient regulation. Cigarettes contain numerous active ingredients harmful to health, including nicotine, tar and ammonia. Evidence suggests that the tobacco industry has manipulated these ingredients to enhance their addictive qualities and, in some instances, added benign substances such as molasses to sweeten the taste for introductory users–our children.

The bill would permit the FDA to oversee and regulate tobacco products in order to protect public health and promote the development of safer cigarettes. However, any ban on nicotine, tobacco products or retail sales of tobacco could not go into effect for two years, enabling Congress time to act. Moreover, the FDA would have to consider the black-market potential of any modification to cigarettes that would push uses to seek contraband products.

Sixth, industry payments. Smoking-related health-care costs exceed a whopping $45 billion per year! The bill would require the industry to pay $516 billion during the next 25 years to reimburse taxpayers for costs to Medicare and state healthcare programs. These funds also would be employed to finance smoking-related health research, prevention and cessation activities, as well as to help innocent tobacco farmers and rural communities affected by changes in the industry.

Finally, the bill would place a cap on the tobacco industry’s exposure to legal liability without barring any individual or group’s ability to sue or receive compensation. The tobacco industry has successfully fended off lawsuits for years. However, should trends change and massive new judgments be awarded against the tobacco industry, bankruptcy is always a possibility.

Experts agree that bankruptcy is an undesirable outcome for the nation economically, legally and medically. Involving bankruptcy would permit the industry to shield itself from its financial responsibilities, including compensation to victims. When the asbestos companies went bankrupt and left the financial and legal mess that it still with us, only the lawyers made out. Moreover, the extinction of domestic manufacturers would simply push tobacco users to purchase foreign brands or unregulated contraband which would lead to a public-health crisis.

We have heard many opinions about whether the industry — at the end of the day — will submit to this legislation. Legal challenges, of course, would delay reforms, so industry cooperation would be advantageous. While public-health authorities insist that price hikes are the key to cutting underage smoking, they alone won’t do the job.

The proposed advertising restrictions and youth-usage penalties, which the industry is threatening to challenge, are essential pieces of the puzzle.

The National Tobacco Policy and Youth Smoking Reduction Act, however, was never intended to be a “deal” with the tobacco industry. Our mission was to pass the best possible legislation to stop youth smoking. That’s what the public has demanded and, with that goal in mind, the bill will be considered by the full Senate, where it will be further refined.

Tobacco is a legal products and the decision to use it, though risky, is a choice for adults to make. Nevertheless, the nation requires that the tobacco industry join us in the fight to protect our children. If they choose not to, the American people will respond accordingly. Congress will act, and the states will resume their lawsuits to extract in court what we might more efficiently achieve through cooperation.

The real bottom line for tobacco legislation is not about the industry’s finances but rather, the health of our children.