Where There’s Smoke … There’s Health Research

You know that tobacco settlement everybody’s all fired up about? Well, we want you to get in the habit of paying attention to what happens, because it could mean a couple of billion dollars for health research — a good portion of which could go to behavioral research.

Congress took the first step down Tobacco Road in April when the Senate Commerce Committee approved legislation to change how tobacco is regulated and to require tobacco companies to pay billions for past harm. Among other things, money from the settlement would fund an enormous increase for the National Institutes of Health (NIH) in FY 99 (see the March 1998 Observer for details).

The Commerce Committee bill, which was sponsored by its chair, Sen. John McCain (R-AZ), provides $2.5 billion a year for NIH research. A third of that money would be devoted to “epidemiological, behavioral, and social science research” specifically related to smoking and health, and the remaining two thirds would filter out to NIH research more generally but still loosely tied to smoking diseases. This two-thirds would also specifically include behavioral research. So as it stands now, there would be two streams of money going to NIH from the tobacco settlement: one for NIH generally, and one for behavioral and social science research on smoking and health.

We’re pleased to report that APS was instrumental in making sure that behavioral research is included in a couple of ways. The “smoking and health” portion of the McCain bill includes a provision that APS helped develop in conjunction with the Campaign for Tobacco-Free Kids. Specifically, the language includes a definition of behavioral research designed to establish a limit on what is and isn’t behavioral science. Research in which “the behavior of an organism is observed for the purpose of determining activity at the cellular or molecular level” will not be appropriate under the smoking and health one-third, language reminiscent to what APS initiated in the legislation that created the NIH Office of Behavioral and Social Sciences Research. In addition, APS helped ensure that behavioral research was inserted both in the portion pertaining to NIH more generally and in the smoking and health portion.

Waiting to Exhale
But don’t be spending that money yet. You might get burned. The tobacco bill is huge, complicated, and packed with controversial provisions. Although the NIH section is just a small part, it is subject to the same political dynamics that are affecting the bill as a whole.

While the Commerce Committee’s approval of the McCain bill is an enormous first step, the bill must clear many more hurdles before NIH actually sees the money. There are procedural obstacles, such as limits on government spending that were put in place during the deficit-reduction era that must be changed to accommodate the influx of money. Of greater significance are the political obstacles stemming from the much-publicized resistance from the tobacco industry and its supporters in Congress, and even from public health advocates who want the bill to go even farther. And we are told that NIH is not too pleased with our focusing at least some of the bill exclusively on behavior.

The only sure thing is that with all these potential roadblocks, the tobacco settlement will drag on for some time. When you have the President and the Speaker of the House bickering over whether Joe Camel or Leonardo DiCaprio in Titanic are more influential in teens’ smoking, you know the settlement isn’t going to happen tomorrow. One scenario wafting around Capitol Hill these days is that Congress will pass a simple tax on cigarettes this year, with the majority of the bill deferred until next year—sort of a one-pack-at-a-time strategy. But even that should signal how some of the larger issues are going to be dealt with if and when the whole carton comes up for sale.