Policy News Roundup: December 5, 2024

Supreme Court upholds graphic cigarette warnings

The news: A rule requiring warnings on cigarette packs that graphically illustrate the health risks of smoking will go into effect after the Supreme Court declined to hear an appeal of a case from tobacco companies arguing that the rule violates their free speech rights.

The backstory:

• The rule requiring the warnings was adopted by the Food and Drug Administration (FDA) in 2020 during Trump’s first term. It required warnings about the risks of smoking to occupy the top 50% of cigarette packs and top 20% of ads.
• Tobacco companies sued in 2020, claiming the rule violated their free speech rights by compelling them to endorse the government’s anti-smoking message through images they said misrepresented or exaggerated health consequences of smoking.
• A district court judge blocked the regulation in 2022, finding the warnings violated First Amendment protections, but the 5th U.S. Circuit Court of Appeals in March found that the warnings were “factual and uncontroversial,” satisfying the legal standard under the First Amendment.
• The tobacco companies appealed to the Supreme Court, but the justices declined to hear the case.

Why it’s important: Requiring such warnings on tobacco product packaging can help prevent use, particularly among youth. The tobacco industry has long tried to downplay the risks of smoking.

Source: US Supreme Court rejects tobacco firms’ appeal over graphic warnings (Reuters)

November was National Family Caregivers Month, and this week (December 2-8) is the inaugural National Grief Awareness Week.

The numbers: It is estimated that 53 million American family caregivers are providing care to a loved one. The number of individuals reporting grief and bereavement has increased in recent years due to COVID, the overdose crisis and elevated rates of suicide.

• Family caregivers are defined as family members or someone identified as “family” who provide assistance and support to individuals with a chronic health condition, including mental health and substance use conditions.

Why it’s important: Caregiving and grief can impact physical and mental health.

The Substance Abuse and Mental Health Services Administration’s (SAMHSA) family caregiving resources:

• SAMHSA’s support for caregivers includes the Statewide Family Network, National Family Support Technical Assistance Center, SSI Eligibility for Parents/Caregivers, the “Talk. They Hear You.” campaign, the Family Psychoeducation EBP Toolkit, Resources for Families Coping with Mental and Substance Use Disorders and Help for Service Members and their Families.
• SAMHSA’s Program to Advance Recovery Knowledge (SPARK) has convened policy and practice meetings to improve caregiving supports, conducted training webinars on family supports and encouraged the meaningful involvement of families in policy and practice improvements.

SAMHSA’s grief resources:

• New webpage and social media toolkit with resources on bereavement and grief.
• Two informational webinars this week – one on the universality of grief and the sociocultural differences, and one on the experience, impact and supports available for different types of grief.
• Systematic review and technical expert panel to understand what high-quality bereavement care consists of and assess the feasibility of developing standards for this care.
• Report on grief and bereavement supports currently available in the U.S.

Source: National Family Caregivers Month; Shining a Light on Bereavement and Grief: SAMHSA Recognizes National Grief Awareness Week (Substance Abuse and Mental Health Services Administration)

President-elect Donald Trump said he will issue an Executive Order to impose an additional 10% tariff on Chinese products and a 25% tariff on Canada and Mexico for the countries’ purported inaction to stop fentanyl from coming into the U.S.

The broader plan: The tariffs are part a plan by advisers to the Trump transition team to take aggressive action on fentanyl.

• A preliminary plan circulating in Trump transition circles calls for a whole-of-government task force incorporating all aspects of U.S. diplomatic, law enforcement and financial power to address the crisis.
• The plan calls for criminal indictments of major Chinese and Mexican financial institutions allegedly laundering money for cartels; mass sanctions on Chinese companies and people implicated in the fentanyl trade; beefed-up bounties on most-wanted traffickers; cyber warfare against Mexican cartels; and a U.S. intelligence agency focus on fentanyl that is commensurate with the war on terrorist organizations.

But:

• Cooperation on fentanyl between the U.S. and China has already been happening to some degree. In September, Chinese officials expanded the list of precursor chemicals, imposing more oversight. The move was the result of bilateral talks on narcotics that started after Presidents Joe Biden and Xi Jinping met a year ago.
• Federal data does not support the claim that drugs are coming in through illegal border crossings. Most fentanyl is smuggled in through official border crossings by U.S. citizens, not by people crossing illegally.
• There is little evidence that traffickers are smuggling fentanyl across the northern border in significant quantities.

The response:

• Experts say that Chinese and U.S. law enforcement officials need to work together more closely, and that China needs to provide the U.S. with more support in anti-money laundering efforts. Some analysts were concerned that tariffs might hurt that effort more than help it.
• The Chinese Embassy warned that China would respond if the U.S. takes a more combative posture. China’s state media warned Trump not to make China a “scapegoat” for the U.S. fentanyl crisis or “take China’s goodwill for granted regarding anti-drug cooperation.”
• Mexican President Claudia Sheinbaum warned against connecting immigration and fentanyl to tariffs in a letter to Trump last week. She said that “migration and drug consumption in the United States cannot be addressed through threats or tariffs,” and that the countries need “cooperation and mutual understanding to tackle these significant challenges.”
• Canadian Prime Minister Justin Trudeau visited Trump last week to discuss the tariff proposals, which Trudeau said would be bad for both countries.

Source: Fentanyl Rises Again, This Time as Trump’s Diplomatic Weapon Against China (The New York Times); Trump tied migrant entries and fentanyl to tariffs. Here are the facts. (The Washington Post); Trump camp says China is ‘attacking’ U.S. with fentanyl. They aim to fight back (Reuters); China state media warn Trump against mutually destructive tariff war (Reuters)

President-elect Donald Trump has nominated several more people to lead agencies that oversee issues related to substance use and addiction.

National Institutes of Health (NIH): Jay Bhattacharya (Stanford University professor)

• Bhattacharya has called for overhauling the NIH and limiting the power of civil servants, who, he believes, played too prominent a role in shaping federal policy during the pandemic. Bhattacharya met last week with Robert F. Kennedy Jr., Trump’s nominee to lead the Department of Health and Human Services (HHS), and impressed him with his ideas to overhaul the NIH.
• Bhattacharya is a health policy professor who has published research on health economics. He is a somewhat unconventional pick not only in that he has railed against the agency he is set to lead but also in that he does not work in the “hard sciences.”
• Next step: The Senate has to confirm Bhattacharya for the role.

Department of Health and Human Services (Deputy Secretary): Jim O’Neill (biotech investor)

• O’Neill is close to billionaire Peter Thiel, co-founding the Thiel Fellowship and serving as managing director of his investment firm, which also employed Vice President-elect J.D. Vance. Earlier in his career, O’Neill worked as a speechwriter and policy adviser at HHS during the George W. Bush administration. At HHS, he worked on pandemic preparedness, Food and Drug Administration (FDA) reform, public health and other projects.
• The HHS deputy secretary oversees the day-to-day operations of all sub-agencies (including the Substance Abuse and Mental Health Services Administration), as well as the development and clearance of HHS regulations.
• Next step: The Senate has to confirm O’Neill for the role. He may have an easier time getting confirmed given his prior government experience. If it takes Kennedy a while to win over Congress next year, O’Neill could serve as acting secretary.

U.S. Trade Representative: Jamieson Greer (trade litigator)

• Greer served as chief of staff to the trade representative in the last Trump administration.
• U.S. trade representative is expected to be one of the most important posts in the incoming administration. Given Trump’s recent promises to impose additional tariffs on Mexico, Canada and China as a means of pushing action on fentanyl trafficking (see above), this position could prove important to the addiction field.
• Next step: The Senate has to confirm Greer for the role.

Some news from the Surgeon General nominee: Janette Nesheiwat called for banning social media for youth in a July TV appearance and repeatedly assailed social media’s impact on youth in her Fox News appearances.

• Nesheiwat has linked social media use to feelings of loneliness and hostility among young people and said “tackling” social media was key to countering the opioid epidemic. She praised Florida’s law banning children 13 and under from setting up social media accounts for helping to protect children from “life-threatening” risks online, including drug sales, sexual predators and cyberbullying.

Read about RFK Jr.’s history of addiction: Kennedy’s Inheritance: How Addiction and Trauma Shaped a Turbulent Life

Source: Trump Picks Stanford Doctor Who Opposed Lockdowns to Head N.I.H. (The New York Times); Trump picks Jay Bhattacharya to lead NIH, overseeing scientific research (The Washington Post); Trump picks Stanford’s Jay Bhattacharya to lead NIH (STAT); Trump taps biotech investor Jim O’Neill for HHS deputy secretary (STAT); Trump picks Lighthizer acolyte to be his trade chief (Politico); Trump’s surgeon general pick called for banning social media for teens (The Washington Post)