After more than a decade of debate, Congress is poised to approve the most sweeping effort ever to regulate tobacco products.
The Senate could pass a bipartisan bill as early as today that would require larger health warnings on cigarette packs, ban candy flavorings, ban the use of claims such as "light," "mild" and "low tar," and further restrict tobacco advertising.
On Monday, the Senate voted to end debate, a crucial step toward passage. In April, the House approved a similar bill giving the Food and Drug Administration (FDA) the authority to regulate tobacco. President Obama, who has struggled to quit smoking, has said he'll sign the legislation.
"It's historic in that we're finally saying tobacco needs to be regulated," said Democratic Sen. Dick Durbin of Illinois, who co-authored a bill in 1990 to ban smoking on airplanes. He said the bill will save millions of lives and protect children, but he lamented that "it breaks my heart it took us 20 years."
In 1998, Republican Sen. John McCain of Arizona pushed a bill to give the FDA such authority, but he was thwarted by a well-financed tobacco lobby.
The powerful tobacco industry has long resisted regulation, but its grip has been weakening, said co-author Rep. Henry Waxman, a California Democrat, who first sought such a step in the 1980s. Since 1994, when tobacco executives told his Energy and Commerce Committee that nicotine was not addictive, public attitudes and laws have changed dramatically, he said.
More than two dozen states have passed comprehensive laws to ban smoking in public places and most have raised tobacco taxes.
Philip Morris USA, the nation's largest cigarette maker, embraced regulation. Spokesman Bill Phelps said the company, maker of Marlboros, hopes it will be a "framework to pursue tobacco products that are less harmful than conventional cigarettes."
The second and third largest tobacco makers, R.J. Reynolds and Lorillard, oppose the bill. They argue that its advertising restrictions will lock in Philip Morris' market advantage.
"It will have competitive consequences," said Tommy Payne, executive vice president of R.J. Reynolds, maker of Camels.
North Carolina's senators, Republican Richard Burr and Democrat Kay Hagan, oppose the bill. They say it would burden the FDA and hurt farmers in their state, who grow the most tobacco in the nation.
More senators spoke in the bill's favor, as some talked about deceased parents or showed posters of cancer patients.
Democratic Sen. Frank Lautenberg of New Jersey recalled his own turning point.
"One night after dinner, my third daughter, who was about 7 or 8, said, 'Daddy, why are you smoking?' I said, 'Well, because it makes me feel relaxed.' "
His daughter said she learned in school that smoking leads to a "black box in your throat." Within days, he said, he smoked his last cigarette.
Major health groups back the bill, including the American Lung Association, the American Heart Association and the American Cancer Society.
The Campaign for Tobacco-Free Kids says tobacco use remains the nation's top cause of preventable death, killing more than 400,000 Americans and costing $96 million in health care bills each year.
"We're a long way from solving the problem," said Matt Myers, the group's president. He said that although a much smaller share of Americans are smoking now than in 1965, when the surgeon general issued a report linking smoking to lung cancer, the number dying from tobacco use hasn't changed.
The Family Smoking and Tobacco Control Act will require tobacco companies to disclose detailed information about their products' ingredients and will allow the FDA to require changes to protect public health.
"If done right," the bill could save millions of lives, said Greg Connolly of Harvard University's School of Public Health. He supports it but has "very, very serious concerns." He fears the FDA may do Philip Morris' bidding and focus on finding a "safer cigarette." Instead, he said, it should focus on reducing tobacco use.
"The critical issue," he said, "is what route the FDA will take."