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BMJ No 7106 Volume 315 News Saturday 23 August 1997 The campaigner who dreams of a tobacco free world Matthew Myers was the only public health advocate to sit down with tobacco companies in the United States earlier this year to broker the historic $300bn (£188bn) deal. He tells Terri Rutter that the battle against smoking is far from over This week doctors, tobacco control activists, and public health officials gather at the 10th world conference on tobacco or health in Beijing. Matthew Myers, executive vice president of the National Center for Tobacco-Free Kids, will be among them. The venue for the meeting is appropriate, he says, as more people will die in China from tobacco related illness than anywhere else in the world. Mr Myers has a mission to stop what he passionately believes is indiscriminate murder carried out by tobacco companies. "This is an industry responsible for killing more people than any other," he says. Set up a year ago, the National Center for Tobacco-Free Kids counts among its member organisations (over 120) the American Cancer Society, the American Medical Association, and the American Public Health Association. Mr Myers, a long time tobacco control advocate, was responsible for demanding that warning labels on cigarette packages be printed in bold type and prominently placed - a law he wrote in conjunction with the American vice president Al Gore - and he successfully lobbied Congress to double the tax on cigarettes. In April this year, when representatives from the five largest tobacco companies in the United States sat down with state attorneys general to try to reach a mutually amenable settlement, Mr Myers was the only public health advocate to join them (26 April, p 1217). He worked for the provision in the settlement that calls for the industry to pay heavy fines if smoking among young people does not dramatically decrease. Mr Myers fosters a long bred enmity towards the tobacco industry, which underscores his speech and his work. "This industry has made its livelihood out of exploiting children," he said. "They use nicotine to addict new consumers, knowing that their products kill." But for all his strong words and his widely acknowledged influence in more than a decade of antitobacco work, not everyone supported his efforts in the settlement talks. While he had his proponents - including the Clinton administration and Richard Scruggs, a lawyer who represented 20 states in the talks and who called Matthew Myers the single most important player in the negotiations - he also had his critics. "The National Center for Tobacco-Free Kids is performing exactly the wrong role," representative Henry Waxman, an antitobacco campaigner, told the New York Times while the talks were taking place. "They seem to have forgotten that their original mission was to be advocates, not backroom negotiators." Mr Myers was not surprised: "Some believe that no one should sit down with the tobacco industry, given their decades of wrongdoing. But if there is an opportunity to bring about fundamental change then it would be irresponsible not to." Aged 50, he had come a long way to get to that negotiating table. As a law graduate, in 1980 he went to work at the Federal Trade Commission in the division of advertising practices, where he oversaw advertisements produced by tobacco companies. "Three secretaries quit smoking in response to the work we did," he said. "The more you learn about the industry, the more you recognise how reprehensible their behaviour has been." In 1981 he opened a law firm in Washington, DC, and began representing the Coalition on Smoking or Health, an organisation comprising the American Cancer Society, the American Lung Association, and the American Heart Association. Last year this became the National Center for Tobacco-Free Kids. Mr Myers said that after years of work he is finally seeing a sea change in attitude towards smoking. Although doctors have been issuing warnings that smoking can cause disease since at least the 1960s, it was only last year that the Food and Drug Administration declared that nicotine is an addictive drug and, under its commissioner Dr David Kessler, that smoking is a paediatric disease. "The tobacco industry has always been treated as any other industry selling a legal product," said Mr Myers. "But this is the only product that kills when it is used as intended." Much more work will be needed, however, for his ultimate goal - "to have no one smoke" - to be achieved. The proposed $300bn (£188bn) settlement with the tobacco companies that Mr Myers helped to craft is likely to require more toiling over its fine points before it meets public health demands. The Advisory Committee on Tobacco Policy and Public Health, the group that is reviewing the settlement to advise Congress and which includes Dr Kessler and the former Surgeon General Everett Koop, announced that the settlement was unacceptable. The committee was particularly concerned that the Food and Drug Administration would not be given enough authority to regulate nicotine. Mr Myers is also not satisfied with its terms. "I think the settlement offers a historic opportunity to bring about public policy change, but only if critical improvements are made," he said. He also points to the necessity for no restrictions to be placed on the Food and Drug Administration, as well as to the issues surrounding the tobacco industry's responsibility to curb smoking in young people. Although increasing numbers of adults are stopping smoking, the number of teenagers who smoke in the United States is the highest it has been in 16 years. "The most important war is not being won," he said. It is no coincidence that in 1993 - the year that saw a sharp increase in the number of teenagers who started smoking - tobacco companies lowered the price by 40 cents on the three brands that young people predominantly smoke, he said. He hopes that his centre's aggressive public education campaign will go some way to counter that trend (see Editorials pp 439, 440). Home | Current issue | Past issues | Classified ads | Career Focus | Feedback Collections | About this site | About the BMJ | BMA | Medline