There's one vice RFK Jr. isn't talking about

Politico

a day ago

Robert F. Kennedy Jr. has made it his mission to remind Americans that they need to get off the couch and lay off the junk food. But there's one vice he's not talking about: smoking.
That's troubled anti-smoking activists, researchers who focus on the diseases tobacco causes and Democrats in Congress who point out that smoking, despite a marked decline in recent years, still leads to more preventable deaths than anything else.
Even so, Kennedy didn't mention the health impacts of smoking once in last month's Make America Healthy Again report assessing the biggest threats to Americans' health. That marks a turning point from the priorities of public health officials going back decades, including the Biden administration's, which targeted smoking as part of a moonshot plan to halve cancer death rates. Anti-tobacco advocates fear deemphasizing the dangers of tobacco could slow or even halt progress in driving down smoking rates.
'Attempting to combat chronic disease without tobacco control is like attempting a triathlon without a bicycle,' said Brian King, whom Kennedy pushed out of his job as the Food and Drug Administration's top tobacco regulator in April. 'You're destined for failure before leaving the starting line.'
Since President Donald Trump's inauguration, his health agencies appear to have shelved two moves King planned to combat smoking, banning the last remaining legal cigarette flavoring, menthol, and requiring companies to reduce the amount of nicotine in their products. Nicotine is what makes cigarettes addictive.
But an HHS spokesperson said the department 'remains steadfast in its mission to protect and promote public health,' adding that the MAHA report is not an 'exhaustive inventory of every HHS program or public health challenge.'
'HHS agencies continue to carry out their responsibilities, including work on tobacco control, with the highest level of integrity and commitment to the American public,' the spokesperson said.
A sustained public health campaign to educate Americans about smoking's risks over decades has driven a huge decrease in use. In the 1960s, more than 4 in 10 adults smoked cigarettes. Now it's fewer than 1 in 8. And the public health success among kids is even starker. Fewer than 1 in 26 now smoke cigarettes, according to an analysis of federal data.
The negative health impacts of tobacco use are well-studied and vast. For years it has been the top preventable cause of death in the United States, contributing to cancer, heart disease and stroke.
But when Sen. Dick Durbin (D-Ill.) quizzed Kennedy about that during a budget hearing last month, asking him to name the 'No. 1 cause of preventable death in America today,' Kennedy was stumped.
'I'm not sure what you're talking about,' he said.
Kennedy's apparent lack of interest in combating smoking — the word 'tobacco' appears in the MAHA report only within the context of his concerns about food marketing while 'smoking' and 'cigarettes' are never mentioned — also suggests this Trump administration won't be like the first.
Then, Trump's FDA commissioner, Scott Gottlieb, put the menthol ban and the limits on nicotine on the table, drawing applause from anti-smoking activists.
Congress permitted the agency to make those moves in a 2009 law. That law banned flavorings except menthol — which is a cash cow for Marlboro cigarette maker Philip Morris, whose support helped get the law passed — but gave the FDA the power to decide whether to ban it. It also gave the agency the power to force cigarette companies to reduce nicotine levels.
The Obama administration didn't do so. President Joe Biden proposed limiting nicotine levels after the 2024 election but never finalized the rule. A Biden plan to ban menthol cigarettes in 2022 was also not finalized.
Menthol is popular among Black smokers and some Democrats feared a ban could alienate crucial voters in a presidential election year.
Jerome Adams, who was surgeon general during the first Trump term, said he wants Kennedy to prioritize the tobacco regulations laid out in Gottlieb's tobacco regulation plan — an effort he said would benefit youth and marginalized communities that are disproportionately impacted by menthol cigarettes.
'These proposed regulations align with the MAHA movement's focus on preventing chronic diseases,' Adams said.
The tobacco industry spent heavily on Trump's 2024 campaign — and already has a lot to show for it.
Trump pledged to 'save' vaping on his social media site, Truth Social, in September after meeting with Vapor Technology Association Executive Director Tony Abboud.
The Trump administration pushed King — whom the tobacco industry had criticized for years — out of his job leading the FDA's Center for Tobacco Products. Job dismissals led by Trump's Department of Government Efficiency also gutted the CDC Office on Smoking and Health, which oversees federal smoking cessation programs and studies.
The Trump administration also slashed funds the National Institutes of Health disburses to research facilities, which scientists say could imperil tobacco smoking studies.
Asked about the industry's contributions to the Trump campaign, White House spokesperson Kush Desai wrote in an email, 'the only special interest guiding the Administration's decision-making is the best interest of the American people.'
Tobacco-control advocates say Trump's early moves could undermine the country's progress diminishing smoking and the diseases it causes.
'These levels are decreasing because we have made such a commitment over the past few decades to enact things to work to get these levels down,' said Catharine Young, a Biden administration official who worked on his cancer moonshot initiative. 'But if you stop that or if you don't increase that effort, they're not going to continue to go down. They're either going to flat line, or they're going to start rising again.'
Both Democratic and Republican administrations have hesitated to use all the regulatory authorities the 2009 law granted them.
After Gottlieb resigned in March 2019, the agency's efforts to advance his 2017 tobacco plan were snuffed out.
'With his resignation, we lost the champion for the 2017 plan, and some months after he resigned, I was literally ordered by political appointees at FDA to stop talking publicly about menthol and nicotine,' said Mitch Zeller, who led the FDA's Center for Tobacco Products before King.
Ultimately, Zeller wasn't able to implement a menthol ban or nicotine limits during any of the three administrations he served.
During Biden's administration, then-FDA Commissioner Robert Califf enlisted allies outside the government to lobby the White House after agency efforts to ban menthol cigarettes were held up at the Office of Management and Budget. But the final rule was not published before Biden left office.
'They caved to political pressure from cigarette companies,' Zeller said.
The FDA estimated the plan to limit nicotine levels in cigarettes proposed during the Biden administration would avert 4.3 million deaths and prevent 48 million youth and young adults from starting habitual cigarette smoking by the end of the century if implemented. And banning menthol cigarettes in the U.S. would cut 324,000 to 654,000 smoking-attributable deaths by 2060, according to modeling studies cited in the 2022 proposal.
Luis Pinto, a spokesperson for Reynolds American, the maker of Lucky Strike, Camel and Newport cigarettes, said the company has not yet met with Trump's FDA commissioner, Marty Makary.
Pinto said the company is opposed to a menthol cigarette ban because it believes there are 'more effective and sustainable ways to help adult smokers transition away from combustible cigarettes.'
'Rather than setting a nicotine standard, the focus should be on expanding access to a diverse and innovative portfolio of potentially reduced-risk products,' Pinto said. 'Tobacco harm reduction, not prohibition, is the most effective path forward in reducing the health impacts of smoking.'
On Capitol Hill, Kennedy has rarely discussed tobacco despite his focus on preventing chronic disease, disappointing lawmakers like Durbin, the second ranking Democrat in the Senate.
In an interview with POLITICO, Durbin emphasized the tobacco industry is still a threat to public health, especially as it markets more novel forms of nicotine exposure like vaping, which has become popular among younger Americans.
'The tobacco companies have not given up. Their basic approach is to addict children to their product, and so now they're using vaping and [other] devices to get … high schoolers in America addicted to forms of nicotine,' Durbin said, referring to Gottlieb as a hero. 'I just don't think you can credibly say you're addressing public health in America and ignore tobacco and vaping.'
King, who's now with the Campaign for Tobacco-Free Kids, an anti-smoking group, is still hoping to convince Trump officials that going after tobacco needs to be part of the MAHA agenda. And he says he sees hope in the FDA's crackdown on illegal e-cigarettes, which he interprets as a sign the government is looking to snuff out unapproved vaping products.
'We have seen the decimation of tobacco control infrastructure,' King said. 'It's important you have the resources and the people.'