Steve Buyer

Mr. BUYER

Mr. BUYER. I yield 3 minutes to the gentleman from Texas, Dr. Burgess.

Mr. BUYER. I want to thank both gentlemen--Mr. Platts and the chairman--for his bill. As I've said, I complimented you earlier about your persistence and about your tenacity, about your drive and your sincerity. I don't question it at all. I have a different approach on how we can improve public policy, and this has been a good debate. I want to thank the chairman for allowing this debate to occur. It was a healthy debate at the committee during the markup. I think it's a healthy debate for us to have. Over 100 countries around the world are struggling with how they answer these public health questions on how to deal with individuals who become addicted to nicotine. When you look at this approach of, ``Well, let's just quit. Stop smoking and just quit,'' I just take a simple look at this. I say there are 45 million smokers, and then there are 2 million who are trying to stop smoking. Yet there's only a 7 percent success rate. Something is not working. To me, that's a rate of failure. So that's why Mr. McIntyre and I came up with a different approach. We came up with a harm-reduction approach, and what we seek to do is to put our arms around everything. Not only are we trying to accomplish some of the similar goals of Mr. Waxman and Mr. Platts and of others who support Mr. Waxman's approach, but we wanted to include everything. We could include abstinence. We could include cessation programs and prevention and education. We seek to do that because we have a harm- reduction strategy to do that, and we want to move people down a continuum of risk. When you look at the 45 million smokers, 85 percent of them are smoking light or ultralight cigarettes. Now, the reason they do that is they make a subconscious decision that somehow it's a healthier or a safer cigarette. The reality is it's not. It's not. So Mr. Platts is absolutely correct, but what we seek to do in the substitute is we want to regulate tobacco. That's what Mr. McIntyre and I seek to do. We want to regulate tobacco. We don't want to do it under the FDA. We want to do it in a harm-reduction center, and we want the tobacco companies to come forward. We'll regulate that tobacco, but we want to migrate smokers into other forms of products. I'm going to talk about that in greater detail on the substitute. At this point, Mr. Waxman, I don't have any other speakers, so we can proceed to the substitute.

Mr. BUYER. I yield back the balance of my time.

Mr. BUYER. Mr. Speaker, I have an amendment at the desk.

Mr. BUYER. Thank you. Mr. Speaker, I have a parliamentary inquiry: Because this is my substitute, do I speak last on the substitute?

Mr. BUYER. Thank you. With that, I will yield to the cosponsor of this bipartisan substitute, Mr. McIntyre of North Carolina.

Mr. BUYER. I would say to the gentlelady who just spoke in the well that Mr. Waxman's bill was drafted years ago, and it was drafted prior to the Master Settlement Agreement. And it is the Master Settlement Agreement itself that has great restrictions upon advertisers. So there is a reason that I don't have it--I say to the gentlelady, there is a reason I don't have that part in the bill because the Master Settlement Agreement that is now administered by the attorneys general in 46 States, including the District of Columbia, who work in concert not only with the FDA but also with the Federal Trade Commission. These tobacco companies are not even advertising today in these types of magazines. But one of the reasons I didn't go further in advertising is that when we work in concert with the Harm Reduction Center under Health and Human Services, what we seek to do is to inform the public with regard to the relative risks among different types of tobacco product, and that's what we seek to do. We seek to migrate people from the smoking to other types of products. If I could, I would like to show exactly what I am about to share. What I would like to share here with you is a chart, and what is important about this chart is about the continuum of risk and about all of the different types of products that are available in the marketplace today. So when you think about this and you think about the continuum of risk, what I did is I sought to say, All right. Let's think about the products that are presently available out there. So when you think about that, we have non-filtered cigarettes. That's the worse. I mean, you get those toxins. You get them right into your body and substance, and that's really bad. Non-filtered cigarettes. Then you've got filtered cigarettes. We know that's a little bit better--all of these tobacco products are harmful. So we go from non- filtered cigarettes to a filtered cigarette. Then I have a vented filtered cigarette, but those are really bad, too, because people try to gain access to that nicotine so they suck a little harder on that cigarette and they draw it deeper into their lungs. That's not a good thing. Then we have tobacco-heated cigarettes like the Accord. Now, we know that that reduces a lot of the toxic substances, but we're really not sure where on the continuum of risk does it lie along with the electronic cigarette because there isn't sufficient science yet to back that up. And these are products that--innovation that is coming out in the marketplace because people every day are making conscious decisions about what we eat, what we drink on a risk assessment, and that's what we are trying to do here in the statute. So after electronic cigarettes, we have smokeless tobacco products. Now, when I think about this, we can go from a non-filtered cigarette and go all the way down 90 percent down the health risk chart, 90 percent, to get to a U.S. smokeless product. Let's talk about the difference between a U.S. smokeless product and a Swedish Snus. The U.S. smokeless tobacco product is fermented. So through that fermentation and the natural processing of tobacco and the nitrosamines, you still have some serious carcinogens and some toxic substances. But it is still scientifically shown to be a much better and safer tobacco product than that of smoking. You see, it is not the nicotine that is killing people. It's the smoke. It's the smoke. It's the smoke. That's killing people. So to get away from that--I heard somebody coughing. It was the smoke, I am telling you. If we can pull them away from the smoke and move them down the continuum of risk chart--actually if we could get them into a Swedish snus, get them into a pasteurized product, we take away 98 percent of the health risk. And then if we can get them to--actually they are now called dissolvable tobacco products. These are orbs or strips that you can lay on your tongue or a stick that's a little like an oversized toothpick that you can stick in your mouth. These are tobacco products that contain no nitrosamines, and you can eliminate 99 percent of the health risk, but an individual can still gain their access to nicotine if they like. And what we're trying to do, though, is move then down the continuum of risk, make informed decisions in order for them to be healthier but still gain access to their nicotine. Then you have therapeutic nicotine devices, which are your gum, your patches, your lozenges. And then we have pharmaceuticals. We want people to quit smoking. But in order to do this, what we've done--not only Mr. McIntyre but Mr. Shuler and others here in a bipartisan effort--is to create a harm- reduction strategy. And we embrace--so not only the goals of Mr. Waxman on abstinence, but we also embrace the goals of education, prevention and cessation activities as we try to move people and make informed choices along this continuum of risk. Now, what is so, to me, unconscionable is that if, in fact, Mr. Waxman's bills were to pass, is that these new innovative types of nicotine delivery devices could not make their access to the market. Now as I said--I will say it for the umpteenth time--I respect Mr. Waxman and his desire to try to get people to eliminate smoking. We just recognized that today only 7 percent success rate with regard to these type of nicotine replacement therapies, and that's a failure rate, and we shouldn't do that. I reserve the balance of my time.

Mr. BUYER. Mr. Speaker, I would yield to one of the cosponsors of this substitute, Mr. Shuler of North Carolina, for as much time as he might consume.

Mr. BUYER. Mr. Speaker, I yield 3 minutes to the gentlewoman from Tennessee (Mrs. Blackburn).

Mr. BUYER. I yield myself such time as I may consume. According to the Journal of Health Care Law and Policy, dated 2008, ``There is a very strong basis in science for believing that the harm caused by current cigarettes can be massively reduced by alternative nicotine delivery systems. Anti-tobacco campaigners who refuse to discuss harm reduction will merely be ensuring that they are not part of the ongoing dialogue that will shape this key area of policy.'' I also would like to cite Britton and Edwards in The Lancet, 2007. ``The risk of adverse effects associated with Snus use is lower than that associated with smoking, overall by an estimated 90 percent. Whatever the true overall hazard, use of low nitrosamine smokeless products is clearly substantially less harmful than tobacco smoking.'' Also citing the Scientific Committee on Emerging and Newly Identified Health Risks, dated 2007, ``The magnitude of the overall reduction in hazard,'' meaning switching from cigarettes to smokeless, ``is difficult to estimate.'' But as outlined in their paper, for cardiovascular disease, it is at least a 50 percent reduction; for pancreatic cancer, it is at least 30 percent; for oral and other GI cancer, it is at least 50 percent reduction and probably more; and for lung cancer and chronic obstructive pulmonary disease, it's possibly even 100 percent. Now, what I'm hopeful is that at some point, I'm going to make this quest that Mr. Waxman and I can somehow come together, because according to CBO the reduction in the rates of smoking in the Waxman bill is two-tenths of 1 percent per year. So we're going to take over $6 billion to reduce smoking rates under Mr. Waxman's approach by two- tenths of 1 percent per year. Which means over a 10-year time frame, the total that we're going to reduce for smoking in the entire country is 2 percent. We are going to reduce smoking rates in the country under Mr. Waxman by 2 percent. We can do much better than that, and that's why we have this substitute is that we want to move people from smoking down the continuum of risk to eventually quitting, and I think that's exactly what the chairman embraces. Please support the substitute.

Mr. BUYER

Mr. BUYER. Further parliamentary inquiry.

Mr. BUYER. Mr. Speaker, I have a parliamentary inquiry.

Mr. BUYER. Why was I not given the opportunity to ask for the yeas and nays and it's reserved for tomorrow? Do I have to be present tomorrow to ask for the yeas and nays? I know you said further proceedings are extended.

Mr. BUYER

Mr. BUYER. Madam Speaker, consistent with the Republican Leadership's policy on earmarks, I hereby certify that my Substitute Amendment to H.R. 1256 does not contain any earmarks.

Mr. BUYER

Mr. BUYER. Madam Speaker, I rise today in support of H.R. 1171, as amended, the Homeless Veterans Reintegration Program Reauthorization Act of 2009. Ranking Member John Boozman of the Subcommittee on Economic Opportunity introduced this bill to extend the Homeless Veteran Reintegration Program (HVRP) through fiscal year 2014, and I am proud to join him as an original cosponsor. I would also like to thank Chairwoman Herseth Sandlin of the Subcommittee on Economic Opportunity and Chairman Filner of the Full Committee on Veterans' Affairs for moving this important measure with our first group of authorizing bills. Madam Speaker, I am also proud that H.R. 1171, as amended, also includes an amendment that I offered in the full committee markup. My amendment is similar to H.R. 293, The Homeless Women Veterans and Veterans with Children Act of 2009, or what I refer to as HVRP-W. H.R. 293 was one of several bills I suggested that House Leadership include in the original stimulus package and is part of what I call the Noble Warrior Initiative which has received widespread support from the VSO community. My amendment adds the provisions of H.R. 293 to H.R. 1171, as amended, to create a new grant program that complements the current HVRP program with a focus on homeless women veterans and homeless veterans with children. As amended, H.R. 1171 authorizes a separate appropriation of $10 million to fund grants to community organizations that provide services to homeless women veterans and homeless veterans with children. Today, VA estimates there are about 154,000 veterans counted among the homeless. With women comprising a larger percentage of our military, in addition to sexual trauma, women are increasingly exposed to the same stressors and dangers as the men and we are now seeing more women in need of homeless services including the training and employment services offered through HVRP. Therefore, I believe we need to add the focus of the HVRP-W to make sure that job skill services are being provided to homeless women veterans and veterans with children. These two groups have separate and unique needs and wants from those of what we think of as the traditional homeless veteran population. Here are a few facts from VA regarding homeless women veterans and homeless veterans with children: VA's March 2007 Northeast Program Evaluation Center (NEPEC) contacted 38,667 homeless veterans. About 4 percent were women. In 2008 VA and communities held 157 Stand Downs and aided 2,347 homeless women veterans and 1,327 children. Last year VA's community based Homeless Grant and Per Diem program served 19,345 veterans including 1,277 women veterans. VA's Domiciliary Care for Homeless Veterans treated 5,905 veterans including 242 female veterans. The HUD-VASH housing voucher program for homeless veterans referred 8,000 veterans of whom 880 were women. 1040 veterans (male and female) housed through HUD-VASH had dependent children. Madam Speaker as you may know, despite the headway in reducing the number of homeless veterans, there is still much more work ahead of us to end homelessness among our nation's heroes. I believe H.R. 1171, as amended, will go a long way towards this goal and I urge my colleagues to support the bill.

Mr. BUYER

Mr. BUYER. I would ask of the gentleman, representing the views of the minority leadership of the Energy and Commerce Committee and the House Armed Services Committee, that there are some outstanding issues and that the dynamic has, in fact, changed, that there are bipartisan alternatives to Mr. Waxman's legislatkion. And so what we are asking is for there to be regular order for the House to be able to work its will. This bipartisan legislation is a completely different type of alternative approach to public health policy with tobacco. So while the gentleman was active with regard to what occurred in the last Congress, this is a very different Congress. So we are asking for regular order. And there is a particular issue that is highly sensitive to the House Armed Services Committee because the Waxman legislation mandates the inclusion of the military in the Roth program. So what we have is, the Energy and Commerce Committee is dictating military personnel policy. In order to protect this about 160 million over a 10-year, for that to remain in the personnel budget of the Armed Services Committee, the Armed Services Committee would need to have an amendment that goes through the Rules Committee. You see, if, in fact, you allow it to come on suspension, the suspension then denies the House Armed Services Committee's ability to fence off those dollars for it to remain in the personnel budget. It would also deny the bipartisan substitute and would also deny Dr. Burgess his amendments. So the dynamic, I just want to inform the majority, has changed. And we are very hopeful that you will take that under advisement and that that bill will be brought to the floor under a rule.

Mr. BUYER. We have been working very hard. And I would place the majority on notice that please do not bring this on suspension, because we have the votes to bring it down.

Mr. BUYER

Mr. BUYER. Mr. Speaker, it is pronounced ``Buyer.'' My family is Alsatian; so if you go back in my ancestry, I know the gentleman is new here to the Congress, it was de Buyer. So my sense is that the gentleman will remember it for a while. I come to the floor here to talk about a very pivotal issue that will be facing the public health of our country, and this is the issue of tobacco. Members of the House will be presented with a choice here relatively soon about which Federal regulatory structure over tobacco products we should use. Now, it is interesting, for a long time the issue was whether we should regulate tobacco or not regulate tobacco. There is now this growing concensus that the Federal Government in some way should regulate tobacco, and now we are trying to figure out with regard to who should do that regulation. Should it be the FDA under Health and Human Services; or, as Mr. McIntyre and I are proposing, that it be a separate agency under Health and Human Services, we call it a harm reduction agency, that will focus on reduction of the risk associated with many different types of tobacco products. So I believe that the critical issue to be considered is, how do we measurably and effectively reduce the disease and death associated with tobacco use while products remain legal and over 45 million Americans have not, cannot, or will not quit? Keeping the American tobacco consumer and the public uninformed about the differences in risk between smoking cigarettes and using nonburning forms of tobacco or other nicotine products will not help our Nation to overcome the death and disease attributed to tobacco use. Telling current tobacco smokers to ``Just Say No,'' to quit now, is not the most effective way to save lives. Creating a regulatory scheme that discourages and in fact chills the development of new, lower risk products is directly opposite of what many in the scientific and public health communities even advocate today. But those are the underlying tenets of what is referred to as the Waxman tobacco legislation called the Family Smoking Prevention and Tobacco Control Act. What do experts say about Mr. Waxman's approach on tobacco? Well, the prestigious health organization, the Royal College of Physicians, says, ``The current situation is perverse, unjust, and acts against the rights and best interests of smokers and the public health. Harm reduction has the potential to play a major part in preventing death and disability in millions of people who currently smoke and who either cannot or will not otherwise quit smoking. These smokers have a right to be able to obtain and choose from a range of safer nicotine products, and they have a right to accurate and unbiased information to guide that choice.'' From the American Association of Public Health Physicians, ``In the judgment of AAPHA, the current bill in its form will do more harm than good in terms of future tobacco-related illness and death. The current bill,'' referring to the Waxman bill, ``with all its seemingly promising elements, has so many restrictions on Federal regulatory authority that it will be unable to effect favorable change. This bill is based on the false premise that cigarettes can be made safer and that all tobacco products are equally harmful. This bill places barriers to truthful communications about the relative risk of less hazardous smokeless tobacco products and near insurmountable barriers to the development of new lower risk products.'' Now, these are two examples of organizations that have some growing concerns about the Waxman legislation. Now, in the face of that there is a growing consensus that significant harm reduction policies and programs, when combined with prevention and cessation, are, in my belief and that of Mike McIntyre, the chief cosponsor of North Carolina, that it is the key to a significant reduction in disease and death from tobacco use. So the Waxman legislation, despite the years of characterizations and representations by its proponents, does not incorporate in any meaningful way a comprehensive prevention, cessation, and harm reduction strategy. Actually, on the contrary; for a very long time, those of whom believe that a harm reduction strategy in fact threatens cessation and prevention programs. I look at this and say that they should all work together, that four fingers and a thumb makes a hand. And so, without the phalanges, do you really have a hand? So I believe that they all should have to work together, and that is what we are seeking to do here is having a harm reduction strategy that incorporates prevention, education, and cessation. I am also greatly concerned that the Waxman legislation continues to ignore the evolution of opinion in the scientific and public health communities, and relies on tactics taught and thought that were effective in the early 1990s, such as it includes provisions that the Supreme Court had thrown out with regard to restrictions on First Amendment on advertising these issues. I was really concerned about it, and Mr. Waxman believes it is okay. I have great, great concern here. Congressman Mike McIntyre and I have introduced H.R. 1216, the Youth Prevention and Tobacco Harm Reduction Act. This legislation imposes significant regulatory oversight within the Department of Health and Human Services over tobacco products, and incorporates many of the provisions included in Henry Waxman's legislation. It includes serious policy and programs of prevention, cessation, and harm reduction, which we believe will lead to saving thousands of lives over the next decades. It will squarely address the issue of tobacco use by minors through additional resources and enforcement at the State levels. In fact, Mr. McIntyre's and my legislation is even stronger in the protections for minors on two points. Number one, we say unto the States that with regard to the Master Settlement Agreement and monies that were supposed to be spent by the States on tobacco cessation and education and prevention programs, at the end of the Master Settlement before it was signed there was this last-moment agreement. Rather than dictating unto States on what percentage of the monies are to be spent on tobacco prevention and cessation programs they said, well, we will just leave it to the discretion of the States. The CDC then every year publishes a report with regard to what the percentage that States should be spending, States are not spending on those programs. So Mr. McIntyre and I come in, and we are dictating unto the States that they are to spend their Master Settlement Tobacco Agreement on programs to help children. The other point that Mr. McIntyre of North Carolina and I have is on protecting children. We are also saying to the States that we want you to treat tobacco like alcohol. So where it is illegal for a minor to possess alcohol, we also say: States, you should make it illegal for minors to possess tobacco. With that, let me yield to a major cosponsor of this legislation. This is bipartisan legislation. It is an alternative to Mr. Waxman. And, actually, what Mr. McIntyre and I were really hopeful is that our bill here would have been adopted in the Energy and Commerce Committee as a substitute. If we could have combined our effort with that of Mr. Waxman's, we would have 435 votes here on the floor, and we could make this a reality and make our society a healthier and safer place. I want to thank the gentleman for his efforts. He is a strong advocate of our agricultural policies and is very concerned with regard to ensuring that the Federal regulatory oversight from Health and Human Services does not interrupt with growing practices by our farmers.

Mr. BUYER. I thank the gentleman for his help and his support on the bill. This is an issue about the public health of our country and the fact that we have a bipartisan approach here, a bill that we seek to decrease the mortality and morbidity rates is extremely important. There are over 100 nations around the world that are struggling with this issue. Tobacco is a legal product. It is the smoking that really hurts and harms and kills people. It is not the nicotine. And so what we are trying to do is to migrate people from smoking products to smokeless products. The very large risk differential, it is the difference between combustion and noncombustion products. The gentleman understands that. And he is embracing the harm reduction strategy from a public health perspective. And he also wants to make sure that we work in concert with our growers, that we have very sound export policies with regard to our trading partners around the world so we don't have any World Trade Organization violations, while at the same time we are cognizant of illicit trade issues. The gentleman is an expert in these areas. And I welcome his support. And I thank him for being here tonight. What I would like to do is I'm going to share a chart that the world has never seen. And I am hopeful that here in the United States we can continue to lead the world and to make the world a healthier place. And so what I'm going to do here is I want to talk about our harm reduction strategy and to talk about the risk differential among a continuum of risks. So the best way for me to do this is to put a chart up so all the Members can have a look at this. And I will talk about it here for a second. I have continuum of risk here at the top, along then with the relative risk of chronic disease here on the side. And what I have done is what is not on the chart, I don't put cigars or pipe tobacco in here. That is outside of the regulation of not only our bill but also of Mr. Waxman's bill. But pipe and cigar is the most toxic. If I were to go on this chart, what I put on this chart listing 100 percent as the most toxic, under that which of tobacco products are to be regulated by our bill would be your nonfiltered cigarettes, so that would be your roll-your-own cigarettes or a Lucky Strike or other forms of generic cigarettes that are nonfiltered. So I think common sense is going to tell you if there is not a filter on it, you're going to smoke it, you're going to inhale a lot of toxic substances and carcinogens deep into your lungs. The next, as we look at continuum of risk, among available products that are on the marketplace here in the United States in North America, so you have your nonfiltered cigarettes. Next are your filtered cigarettes. That kind of makes sense. If I'm going to put a filter on it, I'm going to reduce the risk between those two types of instruments that deliver nicotine. So that is what the key here is. People want access to their nicotine. And it is the smoking that harms them. And so how do you reduce the harm? And so what drives some people a little crazy here is that can you really say that there is a safer type of cigarette? Well, if you want to take a science-based approach, you really have to be very honest about this and say, well, among the types of cigarettes, there are different types of cigarettes as a delivery device of nicotine that are safer than others. But they are all not entirely safe. But there is a risk differential. And it should be discussed. So we have from nonfiltered to filtered cigarettes. What I don't have here, which sort of comes up next, is you actually have vented filtered cigarettes. But what we are finding out from the science-based approach is that if you put vents into the filters, even though you're trying to reduce the smoke and a lot of the bad, toxic substances, people will draw on that cigarette a little harder, and so they are sucking it deeper in their lungs. And that is not a good thing. Next we have our tobacco-heated cigarettes and electronic cigarettes. The reason I put question marks with regard to both of these types of nicotine delivery devices is that with regard to tobacco-heated cigarettes there are a couple of products that are out on the market. Philip Morris has the Accord and Reynolds American has the Eclipse. So these are out on the marketplace. We do know that these types of nicotine delivery systems are a much less riskier product than say your strictly just filtered cigarette or your nonfiltered cigarette. But where do they fall on the chart? There isn't enough science to tell us exactly where. We know it is better. It is not completely safe, but it is better. And we don't know exactly where, but we know it is falling downward on the continuum of risk chart. So we really do need some science here to tell us where the electronic cigarette and tobacco- heated cigarettes fall on that. So that is part of the reason we want to create, under Health and Human Services, a separate agency that will focus our Nation's expertise on tobacco. And I want to be able to do that without people believing that, well, if FDA is regulating tobacco, that somehow that it is an okay product. No. This is a high-risk product. And what is important is that somehow we get to the American people they get informed, they can make an informed choice among an array of products along the continuum of risk. So after electronic cigarettes, if we can truly move an individual out of smoking, if they are looking on how I can gain my access to nicotine, I think people know that, hey, the surgeon general is right. There is some risk that will accord anything that has to do with smoke. If you can transition, or migrate, a population from smoking to a smokeless product, I assure you, we can take out up to around 80 percent, based on the science, almost 80 to 90 percent of the health risk can be taken away. Now the American public needs to know that. So you say, okay, what's the difference between a U.S. smokeless product and Swedish Snus? Well, the difference is the U.S. smokeless product is fermented, and the Swedish Snus is pasteurized. So if you can actually move to the Swedish Snus, you can eliminate about 98 percent. Think about this. Ninety- eight percent of the health risks can be taken away, yet people can still gain access to nicotine. Now, if you wanted to go on a little bit further, there are dissolvables of tobacco that have no nitrosamines. That is the really bad stuff, and you can remove that and you can still gain access to your nicotine. And these dissolvable products that are just being introduced and tested in the marketplace are these Orbs or a tobacco stick or a strip that you can lay on your tongue and you can gain access to the nicotine. Now, I assure you, you don't gain as quickly the access to the nicotine and get the sensation upon the brain as you would smoking the cigarette. But you can gain access to the nicotine, and people then can make an informed choice, gosh, I can gain access to my nicotine, I don't get it as quickly, I can get it, but, gee, maybe it is worth it for me to live a few more years and enjoy my family. I can enjoy my nicotine and, gee, I'm not going to die from smoking. You see, that is extremely important. And as we move people and then migrate them down from this continuum, you can move then to therapeutic, there are therapeutic methods to gain access to nicotine, through the gum, the patch, the lozenges, and then for the individuals who seek to quit. And that is part of the process of what we are doing here is we want to incorporate a harm-reduction strategy to inform a population that if you want to gain access to your nicotine, it is the smoke that is really going to kill you. So if you can get them off of smoking and move them to smokeless products and then move them from there to therapeutic and then pharmaceutical to eventually cessation and quitting. Now, that is part of the harm reduction strategy. And what I believe is extremely important is when we have this as a strategy, you have about 40 million smokers over here on this end of the chart, and you only have about 2 million down here that are actually trying to quit. In the meantime, of the filtered cigarettes, about 80 to 85 percent of the individuals who are smoking the cigarettes are smoking lights or ultralights. Now why are they buying lights or ultralights? Because somehow they believe that if they smoke a light or ultralight that it will be less harmful for them. You see, people are trying to make an informed decision, and they think it will be less harmful for them. The reality is these are products that are going to be harmful to you. I think people need to know and understand that. So what we are hopeful here is that in our legislation, we create this Harm Reduction Center under Health and Human Services where we take our great minds and we do science. We do science on the entire array of products along a continuum of risk, and we inform the public so that the public, when they buy these products, that we can actually migrate our population from combustion to noncombustion products and hopefully quitting, while at the same time, we want to make our investments in education and prevention programs, not just for children and minors, but also for adults. What is important here, what we are finding, is that when people migrate from smoking to smokeless, some fear that, wow, if somebody starts here, the smokeless product, will they actually migrate this direction on the chart, headed up the chart? The reality is it is not what is happening in the marketplace. So that is why we have created an alternative public health position for tobacco. My good friend, Mr. Waxman, I applaud his perseverance over the years and his persistence. His legislation has sort of an abstinence-only approach on tobacco. I respect Mr. Waxman. We have had a good working relationship over the years. And I really was hopeful that he would incorporate this harm reduction in his bill. Now, he said, ``Steve, I have got harm reduction in my bill.'' I said, ``well, Henry, you may have it in the bill.'' But what he has are unrealistic standards that products that may gain access to the marketplace. He has a two-tiered, a two-pronged tiered test, one that will test at the individual and one at the public with regard to the impact of a particular product. It will almost be impossible for new products to gain access to the market. If we truly wanted to make our society healthier, what we should be doing is encouraging people to move from combustion to noncombustion products. And we can do that, if I can take out 80 percent of the health risk, we are making our country healthier and hopefully then move to cessation. That is why I call this the continuum of risk chart. And it is open and free to the world to use this chart, to scrutinize the chart. And I'm hopeful that other legislative bodies around the world will incorporate harm reduction as a strategy for a nation for them to be healthier. The harm reduction policies advocated in H.R. 1261 are an important method to figure out how we can satisfy the nicotine cravings among all of these legal type products. What I would like to share are what some of the scientists actually say about tobacco harm reduction as a public health strategy. From the American Association of Public Health Physicians, dated 2008, ``tobacco harm reduction is taken to mean encouraging and enabling smokers to reduce their risk of tobacco-related illness and death by switching to less hazardous smokeless tobacco products.'' You see, the reason I don't have advertising restrictions in my bill is I think it is extremely important. Mr. McIntyre and I created this bipartisan piece of legislation for a purpose. We want to make sure that people are informed with regard to their entire array of products, tobacco products. And you need to be able to inform them as to what products have the higher risk, which ones have less risk. And what really concerns me is, if you make, let the FDA do this, of which the FDA it is counter to their culture, even, to somehow say that one cigarette, this is a safer cigarette among an array of cigarettes that are harmful. That is a very, very challenging endeavor for them. And so it is why some in the public health community are a little concerned. The International Journal for Drug Policy, their quote, ``Numerous alternative systems for nicotine delivery exist, many of them far safer than smoking. A pragmatic public health approach to tobacco control would recognize a continuum of risk and encourage nicotine users to move themselves down the risk spectrum by choosing safer alternatives to smoking without demanding abstinence.'' That is the International Journal of Drug Policy, and that is exactly what we are trying to do here. There is another quote from the American Association of Public Health Physicians, ``In practical terms, enhancement of current policies, based on the premise that all tobacco products are equally risky, will yield only small or barely measurable reductions in tobacco-related illnesses and death. Addition of a harm reduction component, however, could yield a 50 to 80 percent reduction in tobacco-related illness and death over the first 10 years, and likely a reduction of up to 90 percent within 20 years.'' Now you see why Mr. McIntyre and I are so excited about this alternative approach, because abstinence only does not achieve the goals to make a society healthier with regard to tobacco. And this is exactly what we are trying to achieve, that is also being endorsed here by the American Association of Public Health Physicians. The Royal College of Physicians in 2007 stated, ``Harm reduction is a fundamental component of many aspects of the medicine and, indeed, everyday, life, yet for some reason, effective harm reduction principles have not been applied to tobacco smoking. It is very clear that for most of the major health effects of tobacco, smoking is many times more dangerous than smokeless tobacco use.'' The American Council on Science and Health stated, ``The American Council on Science and Health believes that strong support of tobacco harm reduction is fully consistent with its mission to promote sound science in regulation and in public policy, and to assist consumers in distinguishing real health threats from spurious health claims. As this report documents, there is a strong scientific and medical foundation for tobacco harm reduction, which shows a great potential as a public health strategy to help millions of smokers.'' With regard to--here is another one from SmokeFree Pennsylvania. ``Although smokeless tobacco is just as addictive as cigarettes and should not be used by those who are not addicted to nicotine, cigarettes are about 100 times deadlier than smokeless tobacco products.'' Here is a quote from Britton and Edwards, The Lancet, in 2007. ``The risk of adverse effects associated with snus,'' now snus is pasteurized product, Swedish snus, ``is lower than that associated with smoking, overall by an estimated 90 percent. Whatever the true overall hazard, use of low nitrosamine smokeless products is clearly substantially less harmful than tobacco smoking.'' Why am I pulling out these quotes? I am pulling out these quotes because what has been talked about as those who support the Waxman legislation is that somehow all of these products are equally harmful. That is false. That is what I want to convey to everyone. They are not equally harmful. And it is extremely important that the public be informed about all that these types of products, along a continuum of risk, so people can make informed choices. We do that every day. We make decisions on what kind of automobile we want to drive. We do the continuum of risk. How about what we eat, what we drink? We make choices and decisions every day. Should I put on my seatbelt, should I wear a helmet. All kind of things. We make judgments. When I look at the farmers, my gosh, there are all types of risk out on the farm, and a lot of judgments are made along a continuum of risk along with the farm machinery. We make these judgments. Why don't we do that as a public health strategy for tobacco? It only makes sense. And what I am really hopeful here--I had a really good discussion last week with Mr. Waxman about some tweaks on amendments, some of which he didn't agree to of which I was hopeful. I really appeal to my good friend from California because we could combine, and I shared this with him. We could combine our efforts here. If he would endorse this harm reduction strategy with his bill, we could get this to the President's desk. I really believe that this could pass in a very large number. I remember years ago when Joe Kennedy and I combined our efforts together, and when we would come to the floor it would pass 435 to nothing. And I was really hopeful, I had an earnest effort here, good discussions with Mr. Waxman, and I told him I would take a good hard look at his bill and I would recommend some changes, and I was really hopeful that he would combine a harm reduction strategy with his abstinence only approach, and we would truly have the four fingers, a thumb that will make a hand. But without this, he is only going to have, I don't know what you call it, a thumb and a palm. I guess he is only going to have a palm. And that is really not going to be good. So I want to build a hand and not just a palm to help our country. The other point I have is, Madam Speaker, I would submit for the Record a letter from the American Council on Science and Health from Dr. Elizabeth Whelan dated March 12, 2009, and, dated October 18, 2008, the AAPHP Tobacco Harm Reduction Resolution, titled Resolution on Tobacco Harm Reduction. American Council on Science and Health, New York, NY, March 12, 2009. Hon. Steve Buyer, Rayburn House Office Building, Washington, DC. Hon. Mike McIntyre, Rayburn House Office Building, Washington, DC. Dear Representative Buyer and Representative McIntyre: On behalf of the more than 400 scientists who advise our organization, and the hundreds of thousands of consumers we represent, thank you for your work on H.R. 1261. Our scientists understand the urgent need to reduce the dreadful toll of cigarettes on the American people--with over 400,000 smoking-related deaths each and every year in our country. Your bill is a tougher, science-based alternative to Rep. Waxman's HR 1256. H.R. 1256 will not only fail to reduce the ravages of cigarette-induced disease and death--it will likely worsen it. The new regulation of tobacco ``additives'' will not lower the toxic and carcinogenic mixture induced by the combustion and inhalation of cigarette smoke. The enhanced restrictions on lower-risk tobacco products, such as smokeless tobacco and ``clean'' nicotine--which have been shown to assist addicted smokers in quitting--will condemn the over 40 million addicted smokers to the same old ``quit or die'' pair of options. Successful quit rates are under 20% utilizing the currently-approved remedies. The Waxman legislation would codify this failed policy into law. Perhaps the worst aspect of this Waxman approach is that it gives FDA responsibility for overseeing tobacco issues. This will allow the cigarette makers to cloak themselves in the mantle of being ``FDA Approved,'' shielding them from liability for their irresponsible marketing schemes and manipulation of cigarettes' addiction capabilities. Your bill--H.R. 1261--will obviate most of the detrimental and counterproductive effects of the Waxman bill. Truthfully telling the American consumer about lower-risk tobacco products--harm reduction rather than ``quit or die''--along with stringent marketing restrictions and attention-getting warning labels, and the establishment of a tobacco-regulation section in the Department of Health and Human Services--not the FDA--will all be of major benefit in reducing the toll of cigarettes in America. Sincerely, Dr. Elizabeth M. Whelan, President.

Mr. BUYER

Mr. BUYER. Madam Speaker, I am pleased to introduce a bill to provide an increase in the amount payable to disabled veterans under the Department of Veterans Affairs (VA) Home Improvement and Structural Alteration Program. Known as the HISA program, this important VA benefit provides grants to seriously disabled veterans who require home adaptations to provide access to in-home medical care. Typically, HISA grants are used for such things as widening doors; putting in handrails or special lighting; making kitchens, bathrooms, windows, or electrical outlets and switches more accessible; building ramps or improving entrance paths and driveways. The benefit is paid from the medical care appropriation and is available to both veterans with service-connected and non-service connected disabilities. A service-connected veteran can receive a HISA grant in addition to other home adaptations grants available through the Veterans Benefits Administration. Congress first authorized VA to establish the HISA program as part of outpatient care for home health services in 1973. We have been engaged in the Global War on Terror for nearly eight years and are seeing an increasing number of servicemembers returning from Iraq and Afghanistan utilizing VA health care. It is especially important that this program remains relevant and can meet the needs of our newest generation of veterans. The current maximum amount of a HISA grant is $4,100 for service- connected veterans and $1,200 for non-service connected veterans. This amount was established by Congress in 1992 and has not been raised in seventeen years. My bill would increase the maximum amount of the grants to $6,800 for service-connected veterans and $2,000 for non-service connected veterans. This recommended increase reflects a three percent increase for each year since 1992. It accounts for inflation and the increased cost of home modifications. I urge my colleagues to join me in cosponsoring this legislation. It would have a direct and immediate impact on improving health care and the quality of life for our disabled veterans.

Mr. BUYER

Mr. BUYER. Madam Speaker, pursuant to the House Republican standards on earmarks, I am submitting the following information for publication in the Congressional Record regarding earmarks I received as part of H.R. 1105, the Fiscal Year 2009 Omnibus Appropriations Act. Requesting Member: Congressman Steve Buyer Bill Number: H.R. 1105 Account: COPS Law Enforcement Technology Legal Name of Requesting Entity: Johnson County, Indiana Address of Requesting Entity: Johnson County, 86 West Court Street, Franklin, Indiana, 46131 Description of Request: Provide an earmark of $850,000 to allow Johnson County to install an additional radio tower for its public safety communications system, thereby eliminating areas of the County without coverage. The funding will also provide for the upgrading of the public communications system to allow for simultaneous communications among public safety officials. Requesting Member: Congressman Steve Buyer Bill Number: H.R. 1105 Account: OJP--Juvenile Justice Legal Name of Requesting Entity: Indiana Teen Challenge Address of Requesting Entity: Indiana Teen Challenge, 1015 North Lebanon Street, Post Office Box 564, Lebanon, Indiana, 46052 Description of Request: Provide an earmark of $50,000 to Indiana Teen Challenge to be used to expand the organization's substance abuse prevention outreach program in Lebanon, Indiana. The funding will be used to expand the program into a full-time effort for a dedicated staff member who would nearly quadruple the organization's outreach in the community. The goal of the program is to prevent experimentation and use of drugs before adolescents need treatment. Requesting Member: Congressman Steve Buyer Bill Number: H.R. 1105 Account: Health Resources and Services Administration (HRSA)--Health Facilities and Services Legal Name of Requesting Entity: Clarian Health Partners, Inc. Address of Requesting Entity: Clarian Healthcare, 1701 North Senate Boulevard, Executive Office-B107, Indianapolis, IN 46202 Description of Request: Provide an earmark of $381,000 to expand and renovate the thirty year old children's burn unit. The expanded unit will offer private patient rooms, a family waiting area, and additional support and storage areas for supplies and equipment. The burn unit serves the entire State of Indiana. Bill Number: H.R. 1105 Account: Health Resources and Services Administration (HRSA)--Health Facilities and Services Legal Name of Requesting Entity: St. Elizabeth Regional Health Address of Requesting Entity: St. Elizabeth Regional Health, 1501 Hartford Street, Lafayette, IN 47904 Description of Request: Provide an earmark of $143,000 to renovate hospital space originally designed for an acute inpatient unit to accommodate a new psychiatry services unit. The new unit will provide twenty patient beds, and renovations are necessary to ensure the safety and security of the patients and staff within the facility. Bill Number: H.R. 1105 Account: Substance Abuse and Mental Health Services Administration (SAMHSA)-Substance Abuse Treatment Legal Name of Requesting Entity: Indiana Teen Challenge Address of Requesting Entity: Indiana Teen Challenge, 1015 North Lebanon Street, Post Office Box 564, Lebanon, IN, 46052 Description of Request: Provide an earmark of $143,000 to offset Indiana Teen Challenge's costs in providing addiction treatment services to adolescent girls aged thirteen to seventeen at no cost or discounted rates. The funding will be applied toward salaries and benefits, supplies, equipment, travel, contractual, and other costs. Requesting Member: Congressman Steve Buyer Bill Number: H.R. 1105 Account: Employment and Training Administration (ETA)--Training and Employment Services (TES) Legal Name of Requesting Entity: Indiana State University Address of Requesting Entity: Indiana State University, Office of the President, Condit House, Terre Haute, IN 47809 Description of Request: Provide an earmark of $190,000 to the Indiana State University in order to expanding the Lawrence County Sycamore Community Learning Center to meet the needs of the community by providing additional education and training services that will afford more local citizens the skills and credentials valued in the local labor market. Requesting Member: Congressman Steve Buyer Bill Number: H.R. 1105 Account: United States Army Corps of Engineers General Investigations Legal Name of Requesting Entity: Tippecanoe County, Indiana Address of Requesting Entity: 200 North 2nd Street Lafayette, Indiana 47901 Description of Request: Provide an earmark of $96,000 to conduct a reconnaissance study of the Wabash River Corridor in Tippecanoe County, IN. The project will incorporate information and data from ACOE- PAS FY 06 and 07 Wabash River Hydraulic Study and the in-progress PAS FY 08 corridor master plan project to develop an overall corridor master plan to guide future growth in Lafayette-West Lafayette, Tippecanoe County. The Project will examine the level of federal interest in participating in a project to implement flood reduction management, initiate ecosystem restoration, and enhance recreation. Requesting Member: Congressman Steve Buyer Bill Number: H.R. 1105 Account: Federal Transit Administration Sec. 5309 Legal Name of Requesting Entity: Greater Lafayette Public Transportation Corp. (GLPTC, CityBus) Address of Requesting Entity: 1250 Canal Rd., P.O. Box 588 Lafayette, IN 47902 Description of Request: Provide an earmark of $2,945,000 from the FTA section 5309 account. City Bus will provide a 20% match totaling $525,000. The funds will be spent towards increasing the hybrid bus fleet. The engines are manufactured in Indiana (Cummins and GM Allison Transmission). Requesting Member: Congressman Steve Buyer Bill Number: H.R. 1105 Account: Transportation Community and System Preservation Legal Name of Requesting Entity: Boone County, IN Address of Requesting Entity: 212 Courthouse Square, Lebanon IN 46052 Description of Request: Provide an earmark of $855,000 for the extension of the 146th Street Corridor. As part of an overall highway plan involving four project centered on the I-65/SR267 interchange in Boone County, the County is pursuing the extension of the 146th Street Corridor from the Hamilton County line to 1-65. Hamilton County has begun the design of their portion of 146th Street, and will ultimately result in a four lane parkway from the Boone County line to Spring Mill Road. Requesting Member: Congressman Steve Buyer Bill Number: H.R. 1105 Account: Transportation Community and System Preservation Legal Name of Requesting Entity: Hendricks County, IN Address of Requesting Entity: 355 S. Washington Street Danville, IN 46122 Description of Request: Provide an earmark of $570,000 to continue the Ronald Reagan Parkway construction, which ultimately connects 1-70 and the Indianapolis International Airport to 1-65 in Boone County, Indiana. With the original northern and southern segments of the project completed or underway, this project will focus on the construction of the middle segment from US 36 to CR100S over the Avon CSX rail yards, and the design of the adjoining segment from CR100S to CR200S, completing the southern linkage of the road. Requesting Member: Congressman Steve Buyer Bill Number: H.R. 1105 Account: Transportation and Community and System Preservation Program Legal Name of Requesting Entity: Johnson County, IN Address of Requesting Entity: 86 West Court Street, Franklin, IN 46131 Description of Request: Provide an earmark of $237,500 for construction of an interchange at the intersection of 1-65 and County Road 750 North (a.k.a. Worthsville Road) in Johnson County, Indiana. This Project will ultimately increase connectivity between major north- south corridors on the south-side of Indianapolis by providing a specific route for through-traffic traveling between these north-south roads.

Mr. BUYER

Mr. BUYER. Mr. Speaker, I came to the institution of Congress as a very young man--not as young as you were, John, perhaps--I was 32 years old. I was a fresh, young captain right out of the first gulf war, and I came to the institution of Congress because I wanted to serve my country in another capacity; and I was very upset having seen what men and women do in the name of liberty on a distant battlefield and then to see what had happened to Congress. To my friend John Dingell, your party controlled for 40 years, and then the institution became dark and mismanaged, unorganized. There were some bad things that were going on. That propelled me to come to Congress. And when I came to Congress, I then looked upon my mentors. As a young man, I had great respect because I grew up in an American Legion family, and those guys that would be out in the alley at the fish fries and shooing me out of the way because they were drinking a beer while they were telling stories and war stories, they were the World War II generation. And I come here to Congress and I got to serve, then, with some of the remaining World War II generation. And upon my reflection, John, as you reflect upon your 50 years-plus of being here in Congress, I think about what a joy it must have been to have served here in Congress in the 1950s and the 1960s when there were so many individuals here in Congress that were of the product of World War II and Korea. Because these were individuals who had truly crossed over and had seen the world in a different dimension and didn't have time for the political games; what were the great interests that could help our country move forward; Republicans and Democrats working together, building bridges across any of those divides of which individuals who didn't understand that type of dimension or reasoning or the bridge builders of those policies were the products of World War II and Korea. And I kind of look back to your career and say, you know, it would have been a real joy to serve here in Congress during those two decades. And I got to see the end of that when I was here, and it was Bob Stump and Sonny Montgomery and others.

Mr. BUYER. And I think about what a real joy. And then I watched you, not only as the great John Dingell, as what you were referred to here in the town as you led the Energy and Commerce Committee, and then how you also then served in the minority. You are a man who believes in the institution, and by that way you teach a lot of us on how to act, our deportment, our demeanor, our tone, and our tenor; but you also respect the institution. And when you respect the institution, that means you respect each other. And right now, Lady Liberty is weeping. And the reason Lady Liberty is weeping is because we take one of the great men of this institution, and the Democrat leadership moved you out. And they moved you out, John, because you were an institutional man. You're a man that respects open deliberation and debate, and that's who you are. But if you're an individual who believes that no, it's my way or the highway and I'm going to do it my way, an individual who permits open debate and deliberation of all individuals--everyone here was elected to represent their districts. So we are in equal capacity. But your leadership, John, moved you out, and that was unfortunate. And that's why I said Lady Liberty is weeping today because right now, we're voting on bills that did not go through particular markups. You know, the Speaker, we spend that 10 hours in the Energy and Commerce Committee and do amendments, and she takes her own bill on up to the Rules Committee, brings it to floor, don't even do amendments so we don't even get to participate in the process. The reason you can do that is because you move someone out like John Dingell. This is a man that everyone in the institution respects, and so when I will reflect upon my tenure in Congress, I will say that I got to serve with some great men and women. In particular, when I think of Henry Hyde, I will put him in the same arena as Daniel Webster and Henry Clay, the great orators. And I will put you in the same category as Sam Rayburn and some of those great individuals that have served this country, John. I am proud to have served here with you.

Mr. BUYER

Mr. BUYER. Mr. Chairman, in December as then President-elect Obama was putting together his transition team, I turned to the staff on the House Veterans' Affairs Committee on the Republican side and said I do appreciate Mr. Obama's tone for bipartisanship, and I instructed the staff to look at all of the construction projects and work with the Bush administration. We sent a letter then to not only Speaker Pelosi but also President-elect Obama. We asked for two things, in essence. What I sought to do was complement then President-elect Obama with regard to the extension of his hand in bipartisanship. My letter asked to include veterans in the stimulus plan, and to do two things. Since my Democrat colleagues love to do public works, we would do that for them. We would do public works, and we will also do job creation and entrepreneurship to satisfy Republicans. We would be bipartisan in regard to our letter to the transition team and to the Speaker of the House. Well, what do you think happened? My gesture was half met. So as the ranking Republican on Veterans' Affairs, I asked for a billion dollars with regard to $950 million for hospital nonrecurring maintenance, i.e. construction, and then $500 million for cemeteries, recurring maintenance, and then a billion dollars for small business loan guarantees. Oh, we are not going to take creation of jobs and entrepreneurship. That was rejected. What they took were the public works side. Let's create jobs. Well, excuse me, strike that. We are going to create work. See, there is a difference between creation of work and creation of a job. So what I am hopeful is here, I have gone to the Rules Committee and I have offered four amendments to the Rules Committee, and I am hopeful that they will adopt this. Entrepreneurship is important.

Mr. BUYER. Mr. Chair, the balance of my remarks I submit for the Record. Mr. Chair, today, the headline in the State's largest newspaper noted an additional 50,000 job losses across the country. Indiana's unemployment rate jumped a full 1% last month to 8.2%. Hoosiers are worried about their economic future, wondering if they can afford to send their kids to college or afford retirement. The stimulus bill being rammed through Congress is not the medicine to meet the economic challenges we face in the short term or the long term. Business owners, workers and employers tell me they believe we need a short term stimulus to get the economy moving again, real tools to help them stay solvent. However, the bill before us is a political tool geared more toward 2012 than 2009. Very little of this stimulus bill will do anything to grow the economy or expand our job base. Not to mention the cost on future generations. According to the Congressional Budget Office (CBO), the federal deficit will rise to a record $1.2 trillion in 2009, and that does not even include the near $1 trillion included in this massive spending bill. Most of the discretionary spending in this bill will not actually be spent until after 2010--only 8% of the spending will take place this year. This legislation alone increases the national debt by $6,700 for every American household. It doles out enough money to give every man, woman and child in the nation $2,700 each. How can I explain that as responsible and rational government spending to the Hoosiers that I represent back home in Indiana? This is only the first shot. Watch out America. The increased debt caused by this legislation will be used as a further rationale for raising taxes and continued government spending in the future. The Federal Government cannot spend its way out of this recession. History tells us that to expand the economy the private sector must grow. We need to pass policies that promote growth and economic expansion, not policies that give handouts. Instead of a handout, we must give Americans a hand through short-term stimulus and long-term tax policies which will allow the real job makers--the private sector-- to grow our economy. This legislation is not the appropriate means to revitalize the economy. Instead of creating higher taxes for American families by increasing government spending, we should make permanent the 2001 and 2003 tax reductions and reduce individual, small business and corporate taxes. Extending these tax cuts and further reducing taxes would stimulate long-term job production and increase the gross domestic product, thereby improving our economy and shortening the length of the recession. This bill creates a lot of work, not the desperately needed jobs that help bolster the long term growth of this Nation's economy.