To the Editor:
Dr. Kessler, in his analysis of the tobacco settlement (Oct. 9 issue), (1) does not mention that the contingency fee for the private trial lawyers involved in this government-sponsored settlement could amount to more than $100 billion. This represents a huge transfer of wealth to a small but politically active and powerful segment of our society. It is wrong to take this public settlement and use it for private gain. Instead, the monetary award should be used to help defray the past, present, and future medical costs of smoking. It should also be used for research and public education and to provide activities so that our young people do not feel the need to smoke their first cigarette.
Richard Tillotson
17 Park St.
Buffalo, NY 14201
References
1.
Kessler DA. The tobacco settlement. N Engl J Med 1997;337:1082-3.
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We agree with Dr. Kessler that the tobacco settlement is far from beneficial to the health of the United States. Our main objection to his article is that it hardly takes into account the smoking epidemic in the rest of the world. Multinational tobacco companies have already spread their tentacles into the developing world (1,2) and are now tightening their grip. No settlement with these global companies can be limited to a single nation. It would be very wrong for the U.S. government to allow the tobacco industry to bypass U.S. laws and make money in less privileged countries.
Jayant S. Vaidya, M.S.(Surg.)
University College London
London W1P 7LD, United Kingdom
Sharad G. Vaidya, M.S.(Surg.)
National Organisation for Tobacco Eradication
Panaji, Goa 403001, India
References
1.
Vaidya SG, Naik UD, Vaidya JS. Effect of sports sponsorship by tobacco companies on children's experimentation with tobacco. BMJ 1996;313:400.
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2.
Mackay J. Battling upstream against the tobacco epidemic in China. Tobacco Control 1997;6(1):9-10.
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If we are really serious about preventing tobacco addiction, we may need to do more than increase the price of cigarettes. We may need to treat tobacco as the addicting drug it is and distribute tobacco products like prescription drugs. I propose that adult smokers register the number of cigarettes needed each day in a national but confidential data base. Registration would allow the smoker to purchase any brand of cigarette by mail (the way prescription drugs are purchased from prescription-warehouse services) or at special tobacco outlets. It would, in effect, be a permanently refillable prescription.
Users would be permitted only their average daily doses. Special arrangements could be made for travelers and tourists, who could purchase tobacco products by showing their travel documents and proof of age. Cigarette packages would come with identifying numbers printed throughout the wrapping, so that packages found in the possession of a minor could be traced to the original purchaser. Public advertising could be prohibited. Smokers who wished to receive advertising would be on a national mailing list made available to tobacco companies. Naturally, all of this would be paid for by a distribution tax on cigarettes.
The approach would severely limit the access of teens to tobacco and prevent advertising to nonusers. Because adult addicts would continue to have unimpeded access to tobacco products, the market for illegal distribution of cigarettes would remain small and unprofitable. Over the course of one generation, we could become a nation of nonsmokers.
Robert Pohl, M.D.
Wayne State University
Detroit, MI 48207