Pallone, Vitale attend forum at Robert Wood FDA legislation hot topic at Tobacco and Health Forum BY KATHY CHANG Staff Writer Fifty-seven-year-old Gerry Schwab, of Medford, said his decision to start smoking as a teenager nearly cost him his life at the age of 34. "I suffered a major myocardial infarction [death to a certain segment of the heart muscle]," said Schwab, who was named the 2007 Survivor-Advocate of the Year for the American Heart Association. "I had to be medevacked to Boston, where I had additional cardiac procedures." The AHA Survivor Advocate of the Year award is given to one heart disease or stroke survivor nationally who has made an exceptional commitment to the AHA and its division, the American Stroke Association, in advocating for federal and state policy priorities. "I lost nearly 30 percent of my heart muscle," said Schwab. "The drag of smoke constricted my arteries, causing damage and more danger that nearly killed me. I had to end my promising career as a senior executive in the financial services industry and had to retire by the age of 46. Now, every day, I have to avoid secondhand smoke. Once I smell smoke, I have to leave." Since 1995, Schwab has lived with an implanted defibrillator. He also underwent an emergency angioplasty and stent procedure in 1997 and has experienced numerous episodes of atrial fibrillation and ventricular tachycardia and has undergone four cardiac catheterizations. Schwab was one of seven speakers at the Tobacco and Health forum with Congressman Frank Pallone [D-6] held at the Robert Wood Johnson University Hospital Schwartzman Courtyard in New Brunswick. The other speakers included Deb Brown of the American Lung Association, Steve Jones, interim president and CEO of Robert Wood Johnson University Hospital, state Sen. Joseph Vitale [D-19], Dr. Michael Steinberg of UMDNJ, and Dr. Mary Todd, CEO at the Cancer Institute of New Jersey. "Tobacco is the number-one preventable cause of death in the U.S.," said Jones. "Billions of dollars are spent on health care costs due to diseases from tobacco." More than 440,000 Americans die each year from tobacco-related disease, with heart disease, stroke and other cardiovascular diseases accounting for more than one-third of these deaths, according to the AHA. "I find it shocking that tobacco use kills more people than alcohol, AIDS, car accidents, illegal drugs, murders, and suicides combined," said Todd. Pallone is the chairman of the Congressional Health, Energy and Commerce Committee, which has jurisdiction over issues pertaining to energy, environment, health care, commerce and telecommunications. In January 2007, Pallone was chosen by his colleagues on the Energy and Commerce Committee to chair the powerful subcommittee on health. The subcommittee has sole jurisdiction over Medicaid, the Food and Drug Administration [FDA], the National Institutes of Health [NIH] and the Centers for Disease Control [CDC], and shares jurisdiction of Medicare with the Ways and Means Committee. It oversees public health, biomedical programs, food and drug safety, mental health and research, hospital construction, and all health-care homeland security-related concerns. In February 2007, two new bills were introduced in the U.S. Congress designed to give the FDA authority to regulate tobacco products: HR-1108, sponsored by Rep. Henry Waxman [D-Calif.] and Tom Davis [R-Va.]; and S-625, sponsored by Sen. Edward Kennedy [D-Mass.] and Jon Cornyn [R-Texas]. "In the next two months, we hope to push a bill to grant the FDA the authority to regulate tobacco products," said Pallone. In June 2000, the U.S. Supreme Court ruled that Congress had not expressly given the FDA legal authority to regulate the tobacco industry and that Congress must specifically enact legislation to allow the FDA to regulate tobacco. "For a young teenager who starts smoking Camels, you probably know that person will probably smoke for the rest of their life," said Pallone. "That is why this piece of legislation is so valuable," he said. "The young are more susceptible to pay attention to advertising." The FDA legislation would grant the FDA the same broad authority regarding the sale and distribution of tobacco products. The FDA could also take further action to ensure that tobacco products are not illegally sold to children. The FDA legislation would require that one month after enactment, the FDA republish the 1996 regulations, which restrict marketing that targets children and youth access to tobacco products. Vitale said there needs to be regulation of the promotion of sale. "They are selling flavored cigarettes like bubble gum and strawberry that market to 16-year-olds," he said. "This doesn't tell kids how bad it is to smoke." The FDA legislation would require the tobacco companies to submit, within six months of the legislation enactment, a listing of all tobacco ingredients and additives to tobacco. The legislation would require the FDA to determine whether an action regarding a tobacco product will "protect the public health." The legislation would revise the health warning and issue performance standards on both cigarettes and smokeless tobacco products and grant the FDA the authority to further revise and add health warnings and to alter their format, including, but not limited to, changing their size, location and color. Also under FDA authority, they would be able to prohibit claims such as "All of the taste … less of the toxins," "reduced carcinogens," and "premium taste." The FDA legislation would expand state authority over tobacco marketing. Currently, individual states do not have the right to regulate cigarette marketing. In the last session of the U.S. Congress, the legislation passed through the Senate but not the House of Representatives. "About 10 years ago, the former FDA commissioner pushed to have tobacco regulated by the FDA, but nothing ever came of it," said Suzanne Ffolkes, spokesperson for the American Heart Association. "For too long, tobacco companies have tried to play by their own rules, escaping much-needed federal oversight," she said. "We are lucky that Representative Pallone is behind this bill, and hopefully we can push this through." In 1996, the FDA asserted jurisdiction over tobacco products under the Food, Drug, and Cosmetics Act. These regulations were designed to regulate tobacco advertising and promotional campaigns as well as labeling and purchasing restrictions. The tobacco industry sued the federal government, arguing that the FDA lacked legal authority to regulate tobacco products. The tobacco industry, Pallone said, has its roots in the founding of this country. "People have to understand that the tobacco industry was founded in the Jamestown Settlement in Virginia," said Pallone. "They just celebrated their 400th anniversary, and the American system will never forget that. The tobacco industry is very powerful." Vitale said tobacco has evolved in society. "In World War II, every GI was given cigarettes in their kit," he said. "We went from 100,000 GIs who did not smoke to 100,000 who did. I remember Johnny Carson used to smoke on the set. It was all part of the culture, but we knew all along that smoking was harmful." Pallone said psychology plays a major part in tobacco advertising. "As a kid, you look at advertisements and your peers," said Pallone. "According to the advertisements, it's sexy to drink alcohol and it's cool to smoke." As for Schwab, he has been an instrumental component of the American Heart Association's Advocacy Department's strategic plan to pursue a statewide smoking ban in all public workplaces. He has focused his valuable time and energy on closing the final loophole of the New Jersey Smoke Free Air Act (approved in January 2006), which would implement a smoke-free work environment for the gaming floors of Atlantic City. "My cardiologist has told me numerous times that he has no idea how I'm still alive," said Schwab. "I have to avoid smoke everywhere I go because my doctors told me that I will not be able to survive another heart attack, and I believe them," he said. "As a teenager, I ignored the danger signs because I thought I was young and it wouldn't happen to me. And believe it or not, at the age of 34, I thought the same thing." Schwab said living this disease has been "tragic and horrific." "There's nothing pleasant about this disease," he said. "There's no better message to reach out to the nation's youth - don't smoke and don't start. I don't want anybody to go through what I have gone through."