I'm going to tell you a story. I'm going to tell you a story about how the deadliest consumer product imaginable came to be. It's the cigarette. The cigarette is the only consumer product that, when used as intended, will kill half of all long-term users prematurely, later in life. But this is also a story about the work that we're doing at the Food and Drug Administration, and specifically, the work that we're doing to create the cigarette of the future, that is no longer capable of creating or sustaining addiction.
Ispričaću vam priču. Ispričaću vam priču o tome kako je nastao najsmrtonosniji proizvod koji se može zamisliti. U pitanju su cigarete. Cigareta je jedini tržišni proizvod koji, kada se koristi kako je predviđeno, prevremeno ubije polovinu dugoročnih korisnika, kasnije u životu. Ali ovo je takođe priča o tome šta mi preduzimamo u Upravi za hranu i lekove, i konkretno o tome šta radimo da bismo stvorili cigaretu budućnosti koja više neće moći da stvori i održava zavisnost.
A lot of people think that the tobacco problem or the smoking problem has been solved in the United States because of the great progress that's been made over the last 40, 50 years, when it comes to both consumption and prevalence. And it's true; smoking rates are at historic lows. It's true for both adults and for kids. And it's true that those who continue to smoke are smoking far fewer cigarettes per day than at any time in history.
Mnogi misle da je problem sa duvanom ili sa pušenjem rešen u Sjedinjenim Državama zbog velikog napretka koji je ostvaren tokom proteklih 40-50 godina, što se tiče korišćenja i rasprostranjenosti. To jeste istina; stopa pušenja nikada nije bila niža u istoriji. To važi i za odrasle i za decu. Takođe je tačno da oni koji nastave sa pušenjem puše znatno manje cigareta dnevno nego ikada pre u istoriji.
But what if I told you that tobacco use, primarily because of firsthand and secondhand exposure to the smoke in cigarettes, remains the leading cause of completely preventable disease and death in this country? Well, that's true. And what if I told you that it's actually killing more people than we thought to be the case ever before? That's true, too. Smoking kills more people each year than alcohol, AIDS, car accidents, illegal drugs, murders and suicides combined. Year in and year out.
Ali šta ako bih vam rekao da upotreba duvana, pre svega zbog direktne i pasivne izloženosti dimu cigarete, ostaje vodeći uzrok potpuno sprečivih bolesti i smrti u ovoj zemlji? Pa, to je istina. I šta ako bih vam rekao da zapravo ubija više ljudi nego što smo ikada ranije mislili? To je takođe istinito. Pušenje svake godine ubije više ljudi od alkohola, side, saobraćajnih nesreća, ilegalnih droga, ubistava i samoubistava zajedno. Iz godine u godinu.
In 2014, Dr. Adams's predecessor released the 50th anniversary Surgeon General's report on smoking and health. And that report upped the annual death toll from smoking, because the list of smoking-related illnesses got bigger. And so it is now conservatively estimated that smoking kills 480,000 Americans every year. These are completely preventable deaths.
Godine 2014, prethodnik dr Adamsa objavio je izveštaj autoriteta za javno zdravlje, povodom 50. godišnjice, u vezi sa pušenjem i zdravljem. A taj izveštaj je izneo veći broj smrtnih slučajeva od pušenja godišnje, jer se povećao spisak bolesti koje su povezane sa pušenjem. Tako da se sada sa oprezom procenjuje da pušenje svake godine ubije 480 000 Amerikanaca. To su potpuno sprečivi smrtni slučajevi.
How do we wrap our heads around a statistic like this? So much of what we've heard at this conference is about individual experiences and personal experiences. How do we deal with this at a population level, when there are 480,000 moms, dads, sisters, brothers, aunts and uncles dying unnecessary deaths every year from tobacco?
Kako da shvatimo ovakve statističke podatke? Dobar deo onoga što smo čuli na ovoj konferenciji tiče se pojedinačnih i ličnih iskustava. Kako da se pozabavimo ovim na nivou stanovništva, kada postoji 480 000 majki, očeva, sestara, braće, tetki i teča koji svake godine umiru od duvana nepotrebnom smrću?
And then what happens when you think about this trajectory for the future? And just do the simple math: from the time of the 50th anniversary Surgeon General's report five years ago, when this horrible statistic was raised, just through mid-century -- that's more than 17 million avoidable deaths in the United States from tobacco use, primarily because of cigarettes. The Surgeon General concluded that 5.6 million children alive in the United States in 2014 will die prematurely later in life because of cigarettes. Five point six million children.
A šta se dešava kada razmislite o ovoj tendenciji u budućnosti? Samo primenite prostu matematiku: od 50. godišnjice izveštaja o javnom zdravlju pre pet godina, kada su objavljeni ti užasni statistički podaci, tek sredinom veka - to je više od 17 miliona sprečivih smrtnih slučajeva u SAD-u usled korišćenja duvana, prvenstveno zbog cigareta. Portparol za javno zdravlje je zaključio da će 5,6 miliona dece koja žive u SAD-u 2014. godine kasnije u životu umreti prevremeno zbog cigareta. Pet zarez šest miliona dece.
So this is an enormous public health problem for all of us but especially for us as regulators at the Food and Drug Administration and the Center for Tobacco Products. What can we do about it? What can we do to reverse this trajectory of disease and death?
Dakle, ovo je ogroman problem javnog zdravlja za sve nas, ali naročito za nas regulatore u Upravi za hranu i lekove i Centru za duvanske proizvode. Šta možemo da uradimo povodom toga? Šta možemo učiniti da preokrenemo ovu putanju bolesti i smrti?
Well, we have an interesting guide to help unravel issues like: How did the cigarette as we know it come to be? What is the true nature of the tobacco and cigarette business? How did the industry behave in the historically unregulated marketplace? And our guide is previously secret internal documents from the tobacco industry. Come with me in a tobacco industry document time machine.
Pa, imamo zanimljiv vodič za pomoć u rešavanju problema kao što su: kako su nastale cigarete kakvim ih znamo? Koja je prava priroda poslovanja sa duvanom i cigaretama? Kako se ova industrija ponašala na ranije neregulisanom tržištu? Naš vodič predstavljaju prvobitno tajna unutrašnja dokumenta iz duvanske industrije. Pođite sa mnom u vremensku mašinu dokumenata duvanske industrije.
Nineteen sixty-three was 25 years before the Surgeon General was finally able to conclude that the nicotine and cigarettes was addictive. That did not happen until the Surgeon General's report in 1998. Nineteen sixty-three was one year before the first-ever Surgeon General's report in 1964.
Godina 1963. bila je 25 godina pre nego što je portparol za javno zdravlje konačno zaključio da nikotin i cigarete stvaraju zavisnost. To se nije dogodilo do izveštaja iz 1998. godine. Godina 1963. bila je godina pre prvog izveštaja portparola za javno zdravlje iz 1964. god.
I remember 1964. I don't remember the Surgeon General's report, but I remember 1964. I was a kid growing up in Brooklyn, New York. This was at a time when almost one in two adults in the United States smoked. Both of my parents were heavy smokers at the time. Tobacco use was so incredibly normalized that -- and this wasn't North Carolina, Virginia or Kentucky, this was Brooklyn -- we made ashtrays for our parents in arts and crafts class.
Sećam se 1964. godine. Ne sećam se izveštaja o javnom zdravlju, ali sećam se 1964. godine. Bio sam dečak koji je odrastao u Bruklinu u Njujorku. To je bilo u vreme kada je skoro jedna od dve odrasle osobe u Sjedinjenim Državama pušila. Oba moja roditelja bili su strastveni pušači u to vreme. Upotreba duvana je bila tako neverovatno normalizovana da smo - a ovo nije bila Severna Karolina, Virdžinija ili Kentaki, ovo je bio Bruklin - pravili pepeljare za roditelje na časovima likovnog.
(Laughter)
(Smeh)
The ashtrays I made were pretty awful, but they were ashtrays.
Pepeljare koje sam pravio su bile grozne, ali bile su pepeljare.
(Laughter)
(Smeh)
So normalized that I remember seeing a bowl of loose cigarettes in the foyer of our house and other houses as a welcoming gesture when friends came over for a visit.
Toliko je to bilo normalno da se sećam da sam viđao činije sa otpakovanim cigaretama u hodniku naše kuće i drugih kuća kao gest dobrodošlice kada bi prijatelji došli u posetu.
OK, we're back in 1963. The top lawyer for Brown and Williamson, which was then the third-largest cigarette company in the United States, wrote the following: "Nicotine is addictive. We are, then, in the business of selling nicotine -- an addictive drug." It's a remarkable statement, as much for what it doesn't say as for what it does say. He didn't say they were in the cigarette business. He didn't say they were in the tobacco business. He said they were in the business of selling nicotine.
U redu, vraćamo se u 1963. godinu. Glavni advokat koji je radio za Braun i Vilijamson, tada treću najveću kompaniju cigareta u Sjedinjenim Državama, napisao je sledeće: „Nikotin stvara zavisnost. Mi smo, prema tome, u poslu prodaje nikotina - droge koja izaziva zavisnost.“ To je izuzetna izjava, zbog onoga što ne kaže, kao i zbog onoga što kaže. Nije rekao da se bave poslom sa cigaretama. Nije rekao da se bave poslom sa duvanom. Rekao je da su u poslu prodaje nikotina.
Philip Morris in 1972: "The cigarette isn't a product, it's a package. The product is nicotine. The pack is a storage container for a day's supply of nicotine. The cigarette, a dispenser for a dose unit of nicotine." We'll come back to this dose unit notion later.
Filip Moris 1972. godine: „Cigareta nije proizvod, to je pakovanje. Proizvod je nikotin. Pakla je kutija za skladištenje dnevne doze nikotina. Cigareta je sredstvo za dostavljanje doze nikotina.“ Vratićemo se tom pojmu doze kasnije.
And R.J. Reynolds in 1972: "In a sense, the tobacco industry may be thought of as being a specialized, highly ritualized and stylized segment of the pharmaceutical industry. Tobacco products uniquely contain and deliver nicotine, a potent drug with a variety of physiological effects."
R. Dž. Rejnolds 1972. godine: „Na neki način, duvanska industrija se može smatrati specijalizovanim, vrlo ritualizovanim i stilizovanim segmentom farmaceutske industrije. Duvanski proizvodi na jedinstven način sadrže i oslobađaju nikotin, snažnu drogu sa raznim fiziološkim efektima.“
At the time, and for many decades, publicly, the industry completely denied addiction and completely denied causality. But they knew the true nature of their business. And from time to time, there have been health scares made public about cigarettes, going back many decades. How did the industry respond? And how did they respond in this historically unregulated marketplace?
U to vreme i decenijama pre je, u javnosti, industrija u potpunosti negirala zavisnost i sasvim poricala uzročnost. Ali znali su pravu prirodu svog posla. S vremena na vreme, u javnosti bi se javila zabrinutost u vezi sa uticajem cigareta na zdravlje, mnogo decenija unazad. Kako je industrija reagovala? I kako su reagovali na ovom prethodno neregulisanom tržištu?
Going back to the 1930s, it was with advertising that heavily featured imagery of doctors and other health care professionals sending messages of reassurance. This is an ad for Lucky Strikes, the popular cigarette of the time in the '30s:
Ako se vratimo u 1930-e, odgovor su bile reklame sa vrlo istaknutim slikama doktora i drugih zdravstvenih radnika koje su slale poruke razuveravanja. Ovo je reklama za Laki strajk, popularne cigarete u to vreme, '30-ih godina.
[20,679 physicians say "Luckies are less irritating." Your throat protection against irritation, against cough.]
[20 679 lekara kaže da „Laki manje iritira“. Zaštita grla od iritacije, protiv kašlja.]
(Laughter)
(Smeh)
We laugh, but this was the kind of advertising that was there to send a health message of reassurance.
Smejemo se, ali to je bilo reklamiranje radi slanja poruke razuveravanja o posledicama po zdravlje.
Fast-forward to 1950s, '60s and '70s. And here, again, in the absence of regulation, what we're going to see is modifications to the product and product design to respond to the health concerns of the day.
Premotajmo film na 1950-e, '60-e i '70-e. I ovde, opet, u nedostatku propisa, videćemo izmene proizvoda i dizajna proizvoda da bi odgovorio na tadašnje brige u vezi sa zdravljem.
This is the Kent Micronite filter. And here, the innovation, if you will, was the filtered cigarette.
Ovo je filter Kent majkronajt. A ovde je inovacija, može se reći, bila cigareta sa filterom.
[Full smoking pleasure ... plus proof of the greatest health protection ever.]
[Potpuno pušačko zadovoljstvo... plus dokazano najbolja zaštita za zdravlje do sada.]
What the smoker of this product didn't know, what their doctor didn't know, what the government didn't know, is that this was a filter that was lined with asbestos --
Ono što pušač ovog proizvoda nije znao, ono što njegov doktor nije znao, ono što vlada nije znala je da je ovaj filter bio obložen azbestom -
(Gasps) so that when smokers were smoking this filtered cigarette and still inhaling the chemicals and smoke that we know are associated with cancer and lung disease and heart disease, they were also sucking down asbestos fibers. (Gasps)
(Uzdah) tako da kada su pušači pušili tu cigaretu sa filterom i i dalje udisali hemikalije i dim za koje znamo da su povezani sa rakom, bolestima pluća i srčanim oboljenjima, takođe su usisavali vlakna azbesta. (Uzdah)
In the 1960s and the 1970s, the so-called innovation was the light cigarette. This is a typical brand of the day called True. And this is after the Surgeon General's reports have started coming out. And you see the look of concern on her face.
Tokom 1960-ih i 1970-ih, takozvana inovacija bila je „lajt“ cigareta. Ovo je tipičan tadašnji brend zvani True. Ovo je nakon što su počeli da izlaze zvanični izveštaji o javnom zdravlju. Vidite njen zabrinuti izraz lica.
[Considering all I'd heard, I decided to either quit or smoke True. I smoke True.]
[S obzirom na sve što sam čula, rešila sam da ili prestanem da pušim, ili da pušim True. Pušim True.]
(Laughter)
(Smeh)
[The low tar, low nicotine cigarette.] And then it says, "Think about it." And then even below that in the small print are tar numbers and nicotine numbers. What was a light cigarette? How did it work?
[Cigarete sa malom količinom katrana i nikotina.] A onda kaže: „Razmislite o tome.“ Onda ispod toga sitnim slovima stoje brojke vezane za količinu katrana i nikotina. Šta su bile lajt cigarete? Kako je to funkcionisalo?
This is an illustration of the product modification known as "filter ventilation." That's not a real filter blown up. That's just a picture so that you could see the rows of laser-perforated ventilation holes that were put on the filter. When you look at a real cigarette, it's harder to see. Every patent for this product shows that the ventilation holes should be 12 millimeters from the lip end of the filter. How did it work?
Ovo je ilustracija izmene proizvoda poznata kao „ventilacija filtera“. Ovo nije uvećana slika pravog filtera. To je samo slika da možete da vidite linije laserski izbušenih otvora za ventilaciju koji su stavljani na filter. Kada pogledate pravu cigaretu, to je teže videti. Svaki patent za ovaj proizvod pokazuje da ventilacioni otvori treba da budu 12 milimetara od kraja filtera koji ide na usnu. Kako je to funkcionisalo?
The cigarette got stuck into a machine. The machine started puffing away on the cigarette and recording tar and nicotine levels. As the machine smoked, outside air came through those ventilation holes and diluted the amount of smoke that was coming through the cigarette. So as the machine smoked, there really was less tar and nicotine being delivered compared to a regular cigarette. What the tobacco industry knew was that human beings don't smoke like machines. How do human beings smoke this? Where do the fingers go?
Cigaretu bi zaboli u mašinu. Mašina bi počela da povlači dim iz cigarete i da beleži nivo katrana i nikotina. Dok bi mašina pušila, spoljni vazduh bi prolazio kroz te ventilacione otvore i razblaživao količinu dima koji je prolazio kroz cigaretu. Tako da, dok je mašina pušila, zaista je oslobađano manje katrana i nikotina u poređenju sa običnom cigaretom. Duvanska industrija je ipak znala da ljudska bića ne puše kao mašine. Kako ljudi to rade? Gde idu prsti?
(Murmurs)
(Mrmljanje)
Where do the lips go? I told you that the patent said that the holes are 12 millimeters from the lip end. The smoker didn't even know they were there, but between fingers and lips, the holes get blocked. And when the holes get blocked, it's no longer a light cigarette. Turns out that there's actually basically as much nicotine inside a light cigarette as a regular cigarette. The difference was what's on the outside. But once you block what's on the outside, it's a regular cigarette.
Gde idu usne? Rekao sam vam da patent nalaže da otvori budu 12 milimetara od kraja za usnu. Pušači nisu ni znali da su tu, ali između prstiju i usana, otvori se blokiraju. A kada se otvori blokiraju, to više nije lajt cigareta. Ispostavilo se da zapravo postoji praktično ista količina nikotina u lajt cigaretama kao i u običnim. Razlika je bila samo u onome što je spolja. Ali kada blokirate to što je spolja, to je obična cigareta.
Congress put FDA in the business of regulating tobacco products 10 years ago this June. So you heard the statistics at the beginning about the extraordinary contribution to disease and death that cigarettes make. We've also been paying a lot of attention to how the cigarette works as a drug-delivery device and the remarkable efficiency with which it delivers nicotine. So let's take a look. When the smoker puffs on the cigarette, the nicotine from that puff gets up into the brain in less than 10 seconds. Less than 10 seconds. Up in the brain, there are these things called "nicotinic receptors." They're there ... waiting. They're waiting for, in the words of that Philip Morris document, the next "dose unit of nicotine."
Ovog juna će biti 10 godina otkad je Kongres Upravi za hranu i lekove poverio regulisanje duvanskih proizvoda. Čuli ste na početku statističke podatke o neverovatnom doprinosu cigareta bolestima i smrtnom ishodu. Takođe smo dosta pažnje posvećivali tome kako cigarete funkcionišu kao sredstvo snabdevanja drogom i izuzetnoj efikasnosti u dostavljanju nikotina. Pogledajmo kako to izgleda. Kada pušač povuče dim cigarete, nikotin iz tog dima stiže do mozga za manje od 10 sekundi. Manje od 10 sekundi. Gore u mozgu postoji nešto što se zove „nikotinski receptori“. Oni tamo... čekaju. Čekaju, prema rečima iz tog dokumenta Filipa Morisa, sledeću „dozu nikotina“.
The smoker that you see outside, huddled with other smokers, in the cold, in the wind, in the rain, is experiencing craving and may be experiencing the symptoms of withdrawal. Those symptoms of withdrawal are a chemical message that these receptors are sending to the body, saying, "Feed me!" And a product that can deliver the drug in less than 10 seconds turns out to be an incredibly efficient and incredibly addictive product. We've spoken to so many addiction treatment experts over the years. And the story I hear is the same over and over again: "Long after I was able to get somebody off of heroin or cocaine or crack cocaine, I can't get them to quit cigarettes." A large part of the explanation is the 10-second thing.
Pušač kojeg viđate napolju, na gomili sa drugim pušačima, na hladnoći, na vetru, na kiši, doživljava snažnu želju za pušenjem i može prolaziti kroz apstinencijalne simptome. Ti apstinencijalni simptomi su hemijska poruka koju ti receptori šalju telu, poručujući: „Nahrani me!“ Za proizvod koji može da dostavi drogu za manje od 10 sekundi ispostavilo se da je neverovatno efikasan i da neverovatno stvara zavisnost. Razgovarali smo sa toliko stručnjaka za lečenje bolesti zavisnosti proteklih godina. Priča koju slušam je uvek ista, iznova i iznova: „Mnogo nakon što uspem da nekog skinem sa heroina, kokaina ili kreka, i dalje ne mogu da postignem da prestanu da puše cigarete.“ Veliki deo objašnjenja za to jeste ono što sam govorio o 10 sekundi.
FDA has it within its regulatory reach to use the tools of product regulation to render cigarettes as we know them minimally or nonaddictive. We're working on this. And this could have a profound impact at a population level from this one policy. We did dynamic population-level modeling a year ago, and we published the results in "The New England Journal." And because of the generational effect of this policy, which I'll explain in a minute, here's what we project out through the end of the century: more than 33 million people who would otherwise have gone on to become regular smokers won't, because the cigarette that they'll be experimenting with can't create or sustain addiction. This would drive the adult smoking rate down to less than one and a half percent. And these two things combined would result in the saving of more than eight million cigarette-related deaths that would otherwise have occurred from the generational impact of this.
Uprava za hranu i lekove u cilju regulacije ima na raspolaganju sredstva za regulisanje proizvoda da bi postigla da cigarete kakve znamo ne stvaraju ili minimalno stvaraju zavisnost. Radimo na tome. To bi moglo da ima ogroman uticaj na nivou populacije, samo jedan takav propis. Pre godinu dana smo sproveli dinamično modeliranje na nivou populacije, i objavili smo rezultate u „Časopisu Nove Engleske“. Zbog generacijskog dejstva ove strategije, što ću objasniti za minut, evo šta predviđamo do kraja veka: više od 33 miliona ljudi koji bi inače bili svakodnevni pušači to neće postati, jer cigarete sa kojima će eksperimentisati neće stvarati i održavati zavisnost. To bi smanjilo stopu pušenja kod odraslih na manje od jednog i po procenta. Te dve svari zajedno bi kao rezultat imale sprečavanje više od osam miliona smrti povezanih sa pušenjem koje bi se inače dogodile usled generacijskog uticaja ovoga.
Now, why am I saying "generational"? It's about kids. Ninety percent of adult smokers started smoking when they were kids. Half of them became regular smokers before they were legally old enough to buy a pack of cigarettes. Half of them became regular smokers before they were 18 years old. Experimentation. Regular smoking. Addiction. Decades of smoking. And then the illness, and that's why we're talking about a product that will kill half of all long-term users prematurely later in life. The generational impact of this nicotine-reduction policy is profound. Those old industry documents had a word for young people. They were described as "the replacement smokers." The replacement smokers for addicted adult smokers who died or quit.
Zašto kažem „generacijskog“? Radi se o deci. Devedeset posto odraslih pušača počelo je da puši kada su bili deca. Polovina njih postanu stalni pušači pre nego što dostignu starost da zakonski mogu da kupe paklu cigareta. Polovina njih postanu pušači pre nego što napune 18 godina. Eksperimentisanje. Svakodnevno pušenje. Zavisnost. Decenije pušenja. I zatim sledi bolest, i zato govorimo o proizvodu koji će kasnije u životu prevremeno ubiti polovinu dugoročnih korisnika. Generacijski uticaj ove strategije smanjenja nikotina je ogroman. U tim starim dokumentima industrije postojao je termin za mlade. Opisivani su kao „zamenski pušači“. Zamenski pušači za odrasle pušače zavisnike koji su umrli ili prestali da puše.
Future generations of kids, especially teens, are going to engage in risky behavior. We can't stop that. But what if the only cigarette that they could get their hands on could no longer create or sustain addiction? That's the public health return on investment at a population level over time.
Buduće generacije dece, a naročito tinejdžeri, ulaziće u rizične aktivnosti. To ne možemo da zaustavimo. Ali šta bi bilo kada jedine cigarete kojih bi mogli da se domognu ne bi više mogle da stvore i održavaju zavisnost? To je povraćaj ulaganja javnog zdravlja koji se vremenom ostvaruje na nivou stanovništva.
Haven't said anything about e-cigarettes. But I have to say something about e-cigarettes.
Ništa nisam rekao o elektronskim cigaretama. Ali moram da kažem nešto o elektronskim cigaretama.
(Laughter)
(Smeh)
We are dealing with an epidemic of kids' use of e-cigarettes. And what troubles us the most, in combination with the rising numbers when it comes to prevalence, is frequency. Not only are more kids using e-cigarettes, but more kids are using e-cigarettes 20 or more days in the past 30 days than at any time since e-cigarettes came onto the market. And at FDA, we're doing everything that we can using program and policy, first to get the word out to kids that this is not a harmless product and to make sure that kids aren't initiating and experimenting on any tobacco product, whether combustion is present or not. But think about e-cigarettes in a properly regulated marketplace as something that could be of benefit to addicted adult cigarette smokers who are trying to transition away from cigarettes.
Suočavamo se sa epidemijom upotrebe elektronskih cigareta kod dece. Ono što nas najviše od svega muči, u kombinaciji sa povećanjem brojeva kada se radi o rasprostranjenost, je učestalost. Ne samo da sve više dece koristi elektronske cigarete, već više dece koristi elektronske cigarete 20 ili više dana u mesecu otkad su se elektronske cigarete pojavile na tržištu. U Upravi za hranu i lekove činimo sve što možemo koristeći program i zakone, najpre da bismo doprli do dece sa porukom da to nije bezopasan proizvod, i da bismo se postarali da deca ne započinju eksperimentisanje sa duvanskim proizvodima, bilo da je sagorevanje tu prisutno ili ne. Ali razmislite o elektronskim cigaretama na pravilno regulisanom tržištu kao o nečemu što bi moglo koristiti odraslim pušačima zavisnim od cigareta koji pokušavaju da tako ostvare prelaz.
So, I'll leave you with this vision: imagine a world where the only cigarette that future generations of kids could experiment with could no longer create or sustain addiction because of a single policy. Imagine a world where health-concerned cigarette smokers, especially if a policy goes into effect that takes the nicotine levels down to minimally or nonaddictive levels, could transition to alternative and less harmful forms of nicotine delivery, starting with FDA-approved nicotine medications, like the gum, patch and lozenge.
Zaključiću ovom vizijom: zamislite svet u kome jedine cigarete sa kojima bi buduće generacije dece mogle da eksperimentišu ne bi više mogle da stvaraju niti održavaju zavisnot zbog jednog jedinog propisa. Zamislite svet u kome bi pušači zabrinuti za zdravlje, naročito ako stupi na snagu propis koji smanjuje nikotina na nivo koji ne stvara ili minimalno stvara zavisnost, mogli da pređu na alternativne i manje štetne oblike snabdevanja nikotinom, počevši od nikotinskih lekova odobrenih od strane Uprave, kao što su žvake, flasteri i pastile.
And finally, imagine a world and a properly regulated marketplace, whether it's e-cigarettes or whatever the technology of the day, it's not the product developers and the marketers who decide which products come to market and what claims get made for them, it's review scientists at FDA, who look at applications and decide, using the standard that Congress has entrusted us to implement and enforce, whether a particular product should come to market, because the marketing of that product and the words of our law would be appropriate for the protection of the public health. These are the kinds of powerful regulatory tools that are within our reach to deal with what remains the leading cause of completely preventable disease and death in the country. If we get this right, that trajectory, those 5.6 million kids, is breakable.
I najzad, zamislite u svetu valjano regulisano tržište gde, bilo da se radi o elektronskim cigaretama ili koja god da je to nova tehnologija, nisu pronalazači proizvoda i prodavci ti koji odlučuju koji proizvodi stupaju na tržište i šta se tvrdi o njima, već su to naučnici Uprave zaduženi za kontrolu, koji pregledaju prijave i odlučuju, koristeći pri tome standarde koja nam je Kongres poverio da ih sprovodimo i primenjujemo, o tome da li određeni proizvod treba da se pojavi na tržištu, da bi marketing tog proizvoda i slova naših zakona bili prikladni za zaštitu javnog zdravlja. To su moćna regulatorna sredstva koja su nam unutar dometa za borbu sa onim što je još uvek vodeći uzrok sasvim sprečivih bolesti i smrtnih slučajeva u zemlji. Ako ovo uradimo ako treba, ona putanja, onih 5,6 miliona dece, može se narušiti.
Thank you.
Hvala.
(Applause)
(Aplauz)