A Pack or Two a Day, a Future of Health Problems: FDA Issues New Warning Label on Cigarettes

For young people who may be considering taking up smoking, Joe Meeks, from Muncie, Indiana, has a somber warning.

“I don’t recommend dying as a way to quit, but it worked for me,” Meeks, 62, says with a slight chuckle.

Meeks was diagnosed with chronic obstructive pulmonary disease in 2005.

“I had a heart attack and I died,” Meeks says. “And they shocked me in the parking lot of the emergency room and brought me back. Then I went into the ER, and they lost me again.”

Meeks says he was shocked back to life a second time before slipping into a coma for four days.

“When I woke up,” he says, “I woke up a non-smoker. I did not even want a cigarette, nor have I wanted one since.”

Meeks had been a smoker for 39 years. In 1966, when he joined the Air Force, he says the service distributed cigarettes to its soldiers.

“They were in our rations and it was encouraged,” he says.

Meeks smoked from his enlistment into the military until 2005, averaging two packs a day. He says he tried to quit a “million times.”

Meeks suffered his heart attack on February 9^th, 2005. After having finished work for the day as a warehouse manager, Meeks stopped at a local truck stop. He says he was talking to the restaurant manager when he complained of chest pains. She drove him to a nearby hospital.

“On the way—which was about a 7-mile drive—I went out and she drove in the pouring rain, beating on my chest [at the same time], and talking to the emergency room as she was driving the last mile,” he says.

After the heart attack and the diagnosis of COPD, Meeks was unable to work and had to go on disability. Since he could not afford COBRA [The Consolidated Omnibus Budget Reconciliation Act] insurance—it would cost him $600 per month and his own health insurance ran out six months after his heart attack, he spent a year and a half without health insurance.

To qualify for Medicare, a person needs to be considered disabled for two full years.

“Yes, I needed care, but I did it. I was able to work through [those] two years,” Meeks says. “My doctors loaded me up on samples, and there weren’t a whole lot of tests, and my oxygen company was very nice as far as allowing a reduced rate, so that helped.”

Now a volunteer for three years for the COPD Foundation, Meeks says it is imperative to educate young people of the effects of smoking before they ever light up.

“We have to stop it from starting,” Meeks says. “I always tell a kid . . . this is what smoking will do to you. It’s important kids know this is what happens. It’s not cool.”

Prevention was one of the main facets of national legislation passed last month. The Family Smoking Prevention and Tobacco Control Act gave the Food and Drug Administration power to regulate the manufacturing, marketing and sale of tobacco.

The bill was signed into law by President Barack Obama June 22^nd this year, after having passed through the Senate with 79 in favor, and 17 voting against. Only one Democrat, Sen. Kay Hagan from the leading tobacco-growing state of North Carolina, opposed it.

Under the new law, the FDA is now allowed to restrict the marketing of tobacco, ban candy-flavored cigarettes, regulate nicotine and other ingredient levels, require the posting of larger labels on tobacco products and ban tobacco companies from using the words “mild” or “low tar” while making them also disclose the contents of their products.

The legislation comes 45 years after then-U.S. Surgeon General Luther Terry announced that smoking causes cancer. There are 400,000 annual deaths related to tobacco and tobacco-related health care costs exceed $100 billion every year.

Katherine Klem, the Grassroots Advocacy Coordinator for the American Cancer Society in New Hampshire, says this bill is “absolutely one of the most critical advances for this country.”

“It essentially will allow the FDA to crack down on marketing to kids and stop tobacco companies from manipulating the level of nicotine in their products [and] force out some of their toxins,” Klem, who has been working on the legislation since 2001, says. “Companies finally have to be truthful about what’s in these products and how the products affect people.

“Between cracking down and being able to reduce the level of nicotine and carcinogens and force tobacco companies to release their ingredients by having the FDA scientists evaluate claims, we’re going to save lives,” she says. Klem added that the Congressional Budget Office estimated the new law would reduce youth smoking by 11 percent and adult smoking by two percent over the next decade.

“It translates into generations of lives saved,” she says.

The bill is not without its detractors. Michael Siegel, the Associate Chairman of the Community Health Sciences Department at Boston University, says the legislature is detrimental.

“Essentially, what it does is puts an FDA seal of approval on cigarettes. [It’s] an absurd notion,” he says.

Siegel is a researcher in the tobacco control area and has been following the progress of the smoking issue for a decade. He says the bill undercuts the FDA’s primary use by “institutionalizing cigarette addiction.”

“Basically, the thing I think people need to know is that it was crafted by Philip Morris,” Siegel says. “In reality, how can any bill crafted by Philip Morris be good for public health?”

Philip Morris is owned by Altria Group, the nation’s biggest tobacco company and the only tobacco company to support the legislation.

“What Philip Morris did was they got the best of both worlds,” Siegel says. “On one hand, they’re able to say they support public health . . . but on the other hand, there’s enough loopholes in the bill that wouldn’t do anything seriously to put a threat to their cigarette profits.”

Jonathan Emerson Kohler, a research fellow and surgical resident at Brigham & Women’s Hospital in Boston, says it remains to be seen if the legislation will serve as an effective way to curb people’s smoking.

“Will it have an effect on COPD? It certainly will,” Kohler says. “COPD as a global [problem] is the single most common health affect of smoking—more common than lung cancer. But that’s where we’ll see—in terms of overall benefits—the reduction in COPD.”

Kohler, who has performed surgeries on patients who have been long-term smokers, says any legislation that seeks to curb tobacco usage is helpful.

“They can’t regulate the same way they regulate drugs,” Kohler says. “If tobacco or nicotine had to pass through the same stringent safeguards that drugs do, they’d never be approved, but it gives them [the FDA] some foothold in trying to improve public health.”

Although the legislation may be trying to improve public health, Siegel says it still does not do anything to prevent tobacco use.

“There’s nothing in the bill that’s going to decrease smoking,” he says. “Warning labels, well, people pay attention to warning labels for three days, then they get used to it.”

Maggie Borger, 59, who has severe COPD, says although she supports the bill, she is not sure if parts of it—such as implementing larger warning labels—will be effective in turning people off from smoking.

“They put the surgeon general’s warning on it [cigarettes] when I was smoking, did it make an impact on me? No,” Borger says. “I was a smoker. I bought my cigarettes, and I smoked them. The FDA is going to have to take stronger action. Although, I support them having control [because] I think they’re the only federal agency that can possibly make tobacco inaccessible.”

Borger, a resident of Glen Ellyn, Illinois, is a volunteer for the COPD Foundation. She smoked two packs a day from the age of 16 until she collapsed in December of 2004.

After her collapse, Borger spent 10 days in an intensive care unit at a cost of $24,000. Luckily for Borger, she is covered under her husband Peter’s insurance company, Humana.

But when her husband tried to switch jobs, the new insurance carrier deemed Borger uninsurable. Peter had to stay at his current job as an information systems manager for the Pacific Phoenix Group.

“If he leaves that job I lose my health insurance entirely,” Borger says.

Borger estimated her medical care—including lab tests, doctor appointments, x-rays, etc. —since diagnosis to be around $80,000, all of which she would have had to pay out of pocket if she was not covered under her husband’s insurance.

As for Meeks, he says the bill may prevent people from starting to smoke, which will perhaps eliminate COPD from continuing to develop in the coming generations.

“I hope it will. That’s the key to wiping out COPD,” he says. “To stop people from smoking . . . I’m sure of it, and then we could put money towards finding a cure for the rest of the issues.”