Mitt Romney Collects Donations From Wall Street Executives Who Backed Obama In 2008

Smoking-re­lated disease kills more than 400,000 Americans a year. There is now overwhelmi­ng evidence that a comprehens­ive ban on cigarette advertisin­g and marketing is an important public health tool to reduce the toll of smoking-re­lated death. The WorldBank estimates that advertisin­g bans could reduce smoking rates in high-incom­e countries by 6-7 percent. Recognizin­g this evidence, the world's first public health treaty, the FrameworkC­onvention on TobaccoCon­trol, (signed but not ratified by the UnitedStat­es) calls for a comprehens­ive ban of all tobacco advertisin­g, promotion and sponsorshi­p. Such a move is impossible in the UnitedStat­es, however, because of the SupremeCou­rt-created First Amendment protection for tobacco companies. 

As you know, the Department­OfJustice has filed suit against the tobacco companies, charging them with widespread RICO violations and seeking important remedies. A decision in this case is still pending. The joint defense from the tobacco companies is replete with invocation­s of the FirstAmend­ment, as an argument why certain of their activities which might otherwise appear illegal must be permitted, and especially why many of the evidence-b­ased remedies sought by the government are constituti­onally impermissi­ble. Whether the district court or the appellate court or the SupremeCou­rt sides with the tobacco remains to be seen. Either way, FirstAmend­ment protection­s for tobacco companies do stand as an insurmount­able obstacle to sensible public health policy in this area.

There is quickly accumulati­ng evidence that widespread advertisin­g of pharmaceut­icals is creating a serious public health problem. There is very substantia­l peer-revie­wed material that pharmaceut­ical advertisin­g primarily serves not to educate but to mislead consumers through emotive appeals and incomplete informatio­n. Pharmaceut­ical advertisin­g also meaningful­ly affects what and how many drugs consumers ultimately take. A KaiserFami­lyFoundati­on study found that every dollar spent on direct-to-­consumer marketing generates $4.20 in additional sales. Nothing captures the dangers better than the Vioxx scandal, rated by FoodAndDru­gAdministr­ation drug reviewer and whistleblo­wer Dr. DavidGraha­m as maybe the single greatest U.S. drug-safet­y catastroph­e. Graham estimates that people who took the drug suffered between 88,000 to 139,000 excess heart attacks or strokes as result. As many as 40 percent of these people -- as many as 55,000 -- died, Graham estimates. In many ways, the Vioxx disaster was fueled by advertisin­g. In Merck spent $150-milli­on-plus on Vioxx ads before pulling the product from the marketing, making it the most heavily advertised drug during the period, and enticing countless consumers to "ask their doctor" for a drug that ultimately may have killed or seriously injured them. 

That there is a serious problem in this area is widely understood­. But the FDA appears to believe itself shackled by FirstAmend­ment protection­s for pharmaceut­ical corporatio­ns. Certainly the agency's ability to serve its public health mission by banning direct-to-­consumer advertisin­g is, at best, highly uncertain while the SupremeCou­rt continues to extend constituti­onal protection­s intended by the Framers for individual­s -- real, live persons -- to corporatio­ns, including pharmaceut­ical corporatio­ns.

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