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Huge health risk ignored

One big problem with breast implants is that they don't grow on farms in Kentucky and North Carolina.

At least, a cynic might reach that conclusion after three days of hearings into the safety of the devices. The Food and Drug Administration (FDA) is now deciding how to limit the use of silicone gel implants until doctors know more about their risks.

Meanwhile, the federal government puts almost no restrictions on the sale of another product whose health risks are clearly known and far more serious _ tobacco. In fact, Congress has specifically excluded cigarettes and other tobacco products from the FDA's authority.

Cigarette makers "just have a huge amount of political clout in Washington, and they have been able to skirt many if not all of the meaningful health care debates," said Rep. Richard Durbin, D-Ill. He sponsored the bill that banned smoking on domestic airline flights. His father died of lung cancer when Durbin was 14.

Although they may argue about what the evidence shows, almost everybody in the breast implant controversy agrees that it's a good idea for the FDA to get more information about how safe the implants are. A panel of experts recommended Thursday that the FDA more tightly control the use of implants while more studies are done.

As many as 1-million women have had implants, and there is some evidence of major complications, especially when silicone gel leaks into the body. Disorders of the immune system are a particular worry.

Serious though the risks may be, the potential hazards of breast implants pale in comparison with the known danger of cigarettes. Every year, according to the Centers for Disease Control, about 400,000 Americans die early deaths because they were smokers.

And though the percentage of Americans who do smoke keeps declining _ it's somewhere between 25 and 30 percent _ there are some disquieting signs. In a small survey of preschool children in Georgia, 90 percent of six-year-olds recognized the "Old Joe" cartoon camel promoting cigarettes.

In 1990, the latest figures available, American tobacco companies sold 527-billion cigarettes in this country, according to the Tobacco Institute, an industry trade group. The American tobacco market was worth $43.8-billion that year, and the tobacco industry jealously guards its access.

Members of Congress receive more than $1-million a year in campaign contributions from the tobacco industry, according to the National Library on Money & Politics, a Washington outfit that tracks political donations. Of late, the industry has been especially kind to several southern senators, and to Rep. Dan Rostenkowski, chairman of the House committee that writes tax laws.

Before Congress agreed to stop taking them, cigarette companies and their trade group also were generous with public speaking fees. In 1989, the Tobacco Institute, Philip Morris and RJR/Nabisco spent more $305,000 on "honoraria" for lawmakers.

The shift in public attitudes about smoking has diminished the power of the tobacco lobby somewhat. Congress did pass the airline smoking ban, and some members are preparing legislation to give the FDA some limited authority over cigarette content and advertising.

"The tobacco industry has tried at all costs not to be covered by any federal agency's authority," said Rep. Mike Synar, D-Okla. The law he proposes would give the FDA only limited control over cigarettes, he acknowledged, but that would be a start toward greater regulation.

"Breast implants are a serious problem," Synar said, "but tobacco is even a more serious problem that deserves more regulation."

Even with that legislation, which faces a difficult political battle, it would be easier for women to buy a product that causes cancer than a product that can help repair the damage that cancer causes. Go figure.

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