Eradicate the Tobacco Industry?

The group Airspace ASH has been doing one of these informal online polls, "Should the tobacco industry be eradicated?" My reply of course is Absolutely! Or if I may restrain my enthusiasm suggest that removing the opportunity for massive profit could accomplish the same. The tobacco industry is an historical anomaly. No industry receives such freedom from regulation and none causes as much inherent disease, death, and correlate health care cost. None. None accidentally. None incidentally. None.

Yet the tobacco industry retains blue chip status in stock markets around the globe.

The challenge to tobacco must include opposition to the bizarre economics of permissive tobacco policies subsidizing the rogue capitalism and complexity of nicotine addiction. That is why incremental approaches to de-normalizing tobacco, (taxes, tobacco free space, market reform) are considered effective. Prohibition is not effective prevention. But prohibiting means of profitably marketing nicotine may well be. Hence, the increments.

In an age of transnational corporations it is perhaps oversimplified to call for the eradication of the tobacco industry. They have a tendency to morph and are as aggressive as the most pernicious cancer in pursuing profit. But it is most certainly a worthy goal to remove the profit for which these corporations exist. It is this predatory profit that drives the pandemic.

I do take issue with those that suggest more accessible nicotine is an appropriate response. One need not eradicate tobacco to de-normalize the popularity of nicotine addiction. But it may well be possible to regulate nicotine delivery, access, marketing, etc. to the point where tobacco use is much less desirable or socially acceptable.

Tobacco corporations are archetypical in their amorality. As we slowly inch our way toward a tobacco free society in more developed nations they open new markets on the Pacific Rim and in Africa. Talking about snus and nicotine vapor is counterproductive when transnational corporations are recruiting share croppers and new markets in the rest of the world. We will be successful in our challenge to tobacco someday but it will not be expedited by ignoring the global accommodation and predation for which the tobacco industry continues to distinguish itself.

Industry collaboration

“We cannot continue allowing hatred and disdain towards tobacco companies to interfere with and trump efforts to achieve our fundamental goal of rapidly reducing the leading cause of disease, disability and death (i.e. cigarettes). Its daily cigarette smoking that is killing millions of people, not nicotine, tobacco, or tobacco companies.”

Bill Godshall, Pennsylvania

Mr. Godshall’s exemplary missive conveniently ignores the fact that daily cigarette smoking would not occur were it not for addictive nicotine. Nicotine is inherent to tobacco. Tobacco use would not be prevalent were it not for tobacco companies, and tobacco companies would not market nicotine were it not for the profit.

Our esteemed colleague, Dr. K. H. Ginzel has noted that harm reduction is analogous to Allied forces negotiating w Hitler on the beaches of Normandy for how many lives we can accommodate for the Nazis to remain in power. Collaboration, whether complicit or duplicate, is still culpable.

It most certainly is the tobacco companies that are killing people. Tobacco has not been a benign weed on the side of the road for 400 years. Without the predatory capitalist promotion of an addictive deadly product there would be no pandemic. To assume that tobacco companies are going to rectify this with new nicotine products is ludicrous.

We already have ‘harm reduction’ policies proven to reduce the harm of prevalent use: taxes, tobacco free space, and marketing reform. And criminal proceedings for corporate executives seems promising. The best we can hope for with Reynolds, or any tobacco company, in producing NRT products is a perpetuation of the misdirection that warranted a federal conviction in a U.S. court for fraud and racketeering. A corporations’ only obligation is to profit and the tobacco industry’s profit is incompatible with the public health.

One of the best gauges of the effectiveness of tobacco free advocacy is how the industry behaves. This dubious flirtation with NRT and the incredibly overhyped E cigarette should do little more than question the efficacy of either to actually reduce use. The tobacco industry has had decades to reduce the harm they cause and have responded with fraud, smuggling, endless litigation, manipulation of policies and politicians, and an ever increasing mortality rate in the developing world.

An alliance with the tobacco industry is just that. Don’t expect any applause.

harm reduction or criminal distraction

The recent acquisition of cessation products manufacturer Niconovum by Reynolds American International reveals much in the way prevention advocates should treat a harm reduction perspective and provide greater emphasis on challenging the rogue capitalists that market nicotine. Mr. Ezekwesiri Eluchie has quite astutely pointed out that the industry is once again setting the agenda within which tobacco control advocates find themselves.

The acquisition of Niconovum displays just how much harm reduction is of necessity product centered and by definition unconcerned w the corporations that profit from the spread of nicotine addiction. Harm reduction advocates do little more than collaborate with sophisticated marketing strategies that subtly shift the onus of addiction back to the user. Until advocates can unite in recognition that it is not merely tobacco, but the rogue capitalism practiced by nicotine profiteers we must challenge, they will continue to set the agenda.

As well this casts umbrage on those that profit from NRT and pharmacological solutions to nicotine addiction and unfortunately raises questions about funding from these companies for tobacco control. Given how woefully and comparably underfunded advocates are I have no immediate solution. But Mr. Eluchie’s suggestion that we fully acknowledge the magnitude of death and disease from tobacco as simply criminal seems a very good place to start.

Effective, Evidence Based Messaging

The December edition of the journal Adolescent Health includes an important study regarding effective messaging for tobacco initiation. The paper, The Perception of Secondhand Smoke Risks Predict Future Adolescent Smoking Initiation , concludes that “perceptions of personal second-hand smoke risks and parental second-hand smoke risks significantly deterred adolescent smoking initiation”. This current research may not be novel but it is impressive in showing that perceptions about the dangers of secondhand smoke have triple the effect on smoking initiation among youth compared to peers’ smoking. And this conclusion is revealing because focusing on peer pressure is a mainstay of industry funded campaigns ostensibly aimed at reducing youth addiction to nicotine. The 2007 CDC Best Practices on Health Communication Interventions cites research showing that these campaigns not only are ineffective they actually can increase youth initiation (p 32). The Best Practices also notes that the most effective media campaigns created a negative reaction to the tobacco industry itself (p 34).

Those campaigns reliant on no evidence base will not be interested in this. But sincere efforts at reducing smoking prevalence in Arkansas can take advantage of this research to fashion campaigns that will not only be effective but also can be crafted to work toward rectifying seriously flawed clean indoor air laws.

Currently Arkansas’ Stamp Out Smoking tobacco prevention media is capitalizing on the recent state and federal tobacco tax increases to promote the 1-800 QUIT NOW cessation services. This may well be justified for a time but should not miss opportunities for long term effective tobacco prevention policies.

Cranford Johnson Robinson Woods, the firm that holds the SOS account, has in the past cited market research showing a high degree of brand recognition as evidence of a successful campaign. In 2008 CJRW announced it was becoming an affiliate of the PR monolith Burson Marsteller. With longtime ties to the tobacco industry, BM is responsible for creating the National Smokers’ Alliance and the Accommodation Program as front groups to oppose tobacco taxes and clean indoor air laws.

This tremendous conflict of interest becomes most suspicious when media campaigns do not take advantage of evidence based research for effective prevention. At some point attention should be given to the differences between effective branding and effectively reducing the influences of the tobacco industry on our communities.

Gambling Addiction

Oregon Lottery addicted to big losses of gambling addicts

"Addictions," says Joseph Frascella, director of the division of clinical neuroscience at the National Institute on Drug Abuse (NIDA), "are repetitive behaviors in the face of negative consequences, the desire to continue something you know is bad for you."

http://www.time.com/time/magazine/article/0,9171,1640436,00.html

It is intriguing that researchers have actually found that gambling excites the same dopamine activity that other behaviors, or substances, do in the brain. MRI work at Cal Tech in 2006 surprised a lot of folks and of course the DSM IV has criteria distinguishing gambling addiction. The point is that there are actual physiological differences between an addiction and a habit, like how you like your eggs, etc.

Now what interests me is of course related to nicotine addiction and genetics. Ever wonder why some people find it easy to quit smoking and some go to their grave clutching a fag? Well an important part of that is how the body metabolizes nicotine in the liver and that enzyme is inherited.

I don’t really have a dog in this hunt but, if problem gambling is inherited and the government is exploiting that genetic makeup to fund the bulk of whatever it is they fund w a lottery, an ethical quandary comes into play. It seems analogous to taxing redheads for no other reason than the color of their hair. This is one reason the article interested me.

A fellow at UAMS, Warren Bickel just got a couple of million $ from NIH I believe to study what he’s calling behavioral economics and meth addiction. I heard him speak a few years ago and the short of it is that addicts don’t have the same concept of long term and short term rewards. You and i may contribute to an IRA for long term goals but an addict my think of a long term goals as scoring tomorrow’s fix today. That’s over simplified but not much. ( This comes into play w nicotine addiction and children. Kids just do not recognize long term health benefits. We were all immortal once.)

Anyway, that’s a little bit about the difference and similarity between being unable to stop smoking, or feeding the ponies at the race track, and how you like your eggs.

E cigarettes, NRT, and Distraction

The Wall Street Journal reports that tobacco giant Reynolds American International is involved in talks to purchase Niconovum the Swedish manufacturer of Nicotine Replacement Therapy products. NRT is of course a popular method for tobacco cessation. At first blush this seems a truly strange union. Is RJR trying to sabotage tobacco cessation efforts? Or is this simply revealing what we have known all along about tobacco marketing? It is nicotine dependent.

"We are, then in the business of selling nicotine, an addictive drug effective in the relief of stress mechanisms." RJR July 17, 1963. Bates 1802.05

And if we suspect Niconovum’s/RJR’s nicotine products why then should we not be suspicious of others that profit from the sale of nicotine like Pfizer et al. Is it because we question RJR’s intent and not the drug companies that have made a huge business out of cessation products?

E cigarettes are being promoted as smoking cessation devices by everyone except the E cigarette companies. That classification would give the FDA more authority to regulate the devices, the nicotine. More than anecdotal evidence is required to show that nicotine delivery in this fashion is harmless or effective.

The best evidence that E cigarettes pose no competitive threat is demonstrated by a lack of opposition from the tobacco cartel. If tobacco companies thought nicotine vapor threatened their profit, we’d know because they would swoop down and buy the tiny businesses that are producing these vaporizers. And they may yet just as RJR is eyeballing NRT manufacturer Niconovum. In the meanwhile big tobacco is content to let E cigarettes play the spoiler for the myth of a safe cigarette. The poor will never get their fix as cheaply as the traditional cigarette and the few who can afford to switch to taking their nicotine in a vapor will reaffirm nicotine addiction as a normal part of the day. But at the end of the day as long as it contains nicotine big tobacco has nothing to lose.

e cigs, advocacy, and prevention

While I appreciate the serious discussion of e-cigarettes, on a global scale it is probably fairly academic. Those most likely to become addicted to nicotine, the poor and undereducated, are unlikely to find nicotine vapor or low emission devices a real option. (if you don't like butts imagine the environmental impact of these latest delivery devices!) Individuals should decide whether they are public health advocates or tobacco prevention advocates working in the realm of public health. The relative harm from spit, low emission, or e-cigarette effluent is rather immaterial if either is not proven to reduce the prevalence of nicotine addiction.

Tobacco free spaces are not ends in themselves but tools for challenging those culpable and profiting from the leading cause of death and disease on the planet.

Recall that harm reduction involving tobacco companies originated with the mirage of the filter tip and the low tar cigarette. Arbitrarily deciding that a certain level of risk is acceptable only serves to collaborate with an industry that could care less.

Bookstore Sells Toy Cigarettes

Handsel Art

22 October 2009

FOR IMMEDIATE RELEASE

contact J.R. Few

handselart@marioncounty.com

or 870-427-1365

Advocates Object to Toy Cigarettes

The tobacco industry spends $12.8 billion marketing annually in the U.S. but sometimes the least expensive marketing opportunities come from unlikely sources. Hollie Pierce, Coordinator for Tobacco Free Boone County in north central Arkansas, never imagined that her local book store would be glamorizing tobacco with toy cigarettes (pictured). But that is exactly what she found in the novelty pen section at the Books A Million store in Branson, MO recently.

“Marketing novelty cigarette pens just feet from the children’s book section sends a truly irresponsible message. The greatest part of our public health challenge is to de-normalize tobacco use,” says Pierce. 90% of the over 440,000 Americans who die from tobacco use started as children.

Knowing that children want to emulate adult behavior and making tobacco less appealing to youth are major steps in preventing addiction to nicotine.

Pierce is encouraging her colleagues in tobacco prevention and anyone to express their dismay for such thoughtless marketing by contacting Books A Million at feedback@booksamillion.com. She notes that retailers often just never realize the potential harm but, “What we may think of as a simple ink pen, may actually encourage youth and adults to smoke.”

Books A Million is the country’s third largest book retailer and operates over 200 stores in the Midwest and Southeast.

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public health v tobacco prevention

public health v tobacco prevention

There seems to be a certain difficulty for advocates dealing with tobacco to get from the evidence of harm in the public health and the effective reduction of this harm within the realm of social norm change. Many of those involved in tobacco control are actually working within the health care community. This is to be expected. The relationship between tobacco and disease is what prompts our interest.

The traditional dichotomy is a matter of treating the addiction to nicotine and the matter of preventing the onset of addiction. Both motivated by the prevalence of tobacco related disease. But the difficulties are not merely between these perspectives but also in the reluctance of advocates from all perspectives to recognize the culpability of those that profit from tobacco.

choice

The tobacco industry claims that tobacco marketing is a matter of enticing adult smokers to particular brands. The concept of addiction is underplayed regardless of the evidence of the tremendous power of nicotine to addict. While brand promotion is most certainly an aspect of their focus further deconstruction reveals a distinct diversion of the blame for tobacco related disease to the user. 9 of 10 tobacco users are addicted before the age of consent. Locally and globally the poor and uneducated are more likely to become addicted to nicotine.

Are tobacco users without autonomy? Of course not, but that autonomy is most certainly colored by nicotine and the tremendous and sophisticated marketing budget tobacco companies expend.

Somewhere in the mix of ostensible tobacco free advocacy is a confusion about the cause of tobacco related disease. Tobacco hasn’t been a benign weed for nearly 400 years. The historical weed is rather incidental to those that profit from contemporary nicotine addiction.

Until tobacco control advocates recognize that the harm from tobacco is profit driven, and of a magnitude without precedent, we miss the opportunity for real prevention.

Handsel Art

7 October 2009

FOR IMMEDIATE RELEASE

contact J.R. Few

handselart@marioncounty.com

or 870-427-1365

Local Advocate Speaks in Wales

Tobacco prevention in Marion County, Arkansas acquired international note last week with local activist, J.R. Few’s presentation at the second annual ASH Wales’ Communicate, Collaborate, Celebrate Conference in Cardiff, Wales October 5 & 6. Speaking during the “Engaging Smokers” workshop, Few shared insight and successes from work as volunteer media coordinator for Tobacco Free Marion County between 2002 until 2009.

“It was an honor and a privilege to be invited to this event. The challenges to the tobacco industry are truly global. We get caught up in our own local mediocrity and often forget that the world at large is where the tobacco industry profits most.”

Few is creative director for his family’s business, Handsel Art and Advertising. Handsel Art has offered to the public quality art, advertising, public relations, and photography since 1971 and currently works to challenge a predatory rogue industry with tobacco prevention activists in Arkansas and around the globe.

###

The primary sponsors for the event were Pfizer and McNeil and because of this the conference is subject to the same critique the World Conference on Smoking or Health in Mumbai received. The fashion in which we engage the tobacco pandemic should be evidence based. But the slippery aspect of saying something like that is that the paradigm from which one begins shapes the questions and evidence one seeks. It is a very good question to ask if having these corporate sponsors determines the flavor of a conference. And these particular sponsors are involved quite directly with profit from using their products to treat nicotine addiction, not control and prevent the prevalence and spread of nicotine.

That said, the gathering was certainly a cessation based perspective but with a serious effort at broadening the scope. I got the impression that tobacco prevention advocates were beginning to feel the frustrations that they may have maxed out the utility of a certain direction of effort.

The challenge to tobacco in the UK has been a decade of the National Health Service focusing on cessation. This of course couldn't make the industry any happier because they are more aware than anyone how difficult, even impossible, overcoming nicotine addiction can be. However, this seems to be on the cusp of change. It made my presentation about adhering to best practices and strict media tie in very appropriate. They are only now getting the knack of their foe being the industry itself. John Tilley, speaking for NHS, noted that a new national tobacco policy was imminent. The last session we attended outlined the 2008 report of the Tobacco Control National Support Team suggesting an evidence based approach much like the CDC Best Practices for engaging the industry. Wales itself is seeking a unified national tobacco policy. This conference, only the second for ASH Wales I believe, is part of that effort. In many ways Arkansas is far ahead of the game, especially for Wales. And even the UK too.

My gig actually went over pretty well. I'm large and loud and had lots of colorful slides. Additionally my "Kill 'em all, let god sort it out" approach to the tobacco industry was fairly novel for much of the audience. And the numbers I was able to bring from our efforts in Marion County were a pretty straight forward approach to successful tobacco control. But we know from experience in Arkansas that doesn't mean anybody is listening. Additionally, the English have the same difficulties w ignorant politicians pandering to the lowest common denominator and eating out of the hands of the industry whether they know it or not.

It truly was an enlightening honor and privilege to attend the ASH Wales Conference and speak to so many dedicated advocates. I believe we made some friends with whom collaboration and communication will have a positive challenge to the tobacco industry. Might be a little early to celebrate.

Tobacco Free Spaces

I posted this on Globalink, so why not here, right?

I respectfully take issue with the perspective that tobacco free advocates are being “absolutist” about smoke free public space. Strict adherence to tobacco free space is simply consistent with what we know to be evidence based to effectively reduce tobacco use and nicotine adduction. Saying that outdoor tobacco policies need be “reasonable and fair” is little more than the accommodation argument the industry uses to delay clean indoor air in bars and restaurants. We are accommodating the tobacco industry not nicotine addicts. One reason that so many have quit using tobacco is because there have been regulations in place that make smoking less convenient; quitting easier. Enabling smokers is doing no one but those that profit from the sale and prevalence of nicotine a favor.

Are there limits to which we should regulate public nicotine addiction? Perhaps. But given the present almost unbelievable mortality and disease associated with the products the industry purveys that time is not yet here. We have evidence based incremental approaches to de-normalizing the tobacco pandemic: market reform, significant increases in the price, tobacco free space, and inclusive of the first three, support for cessation. Saying that regulating tobacco out of doors is unreasonable neglects the tragic subsidy we allow Big Tobacco when they foul our air, litter our public spaces, and prey on our youth.

Advocates should challenge the tobacco industry not collaborate. I see little reason to accommodate the tobacco industry. Communities have a justifiable and compelling interest in regulating rogue capitalists right out of town.

CTFA state conference

Not a bad way to spend a day listening to the likes of former Justice Department attorney Sharon Eubanks talk about how the Bush administration thwarted efforts at a RICO conviction for big tobacco.

Another note; if you ever get a chance to hear Ms. LaTanisha Wright speak, run, do not walk, to see her presentation. She is a former Brown and Williamson employee and now a member of the National African American Tobacco Prevention Network. She is a sharp, effective speaker.

Handsel Art

19 September 2009

FOR IMMEDIATE RELEASE

contact J.R. Few

handselart@marioncounty.com

or 870-427-1365

Advocates Hold State Conference

Advocates from across Arkansas gathered to challenge the tobacco industry at the 7th annual Coalition for a Tobacco Free Arkansas’ Striking Out Tobacco in Arkansas Conference at the Wyndham-Riverfront Hotel in North Little Rock September 17th.

After a welcome from CTFA Executive Director Katherine Donald And CTFA Board Chair Carla Sparks, the audience enjoyed a panel discussion: The Past Present and Future of Tobacco Control in Arkansas. Panelists ranged from attorney Tim Gauger, who worked with then Attorney General Winston Bryant to secure Arkansas’ Master Settlement funds in the late 90s, to the current Tobacco Prevention and Cessation Branch Chief for the Arkansas’ Department of Health, Dr Carolyn Dresler. Speaking for the American Heart Association, Barbara Kumpe reminded that Arkansas’s distinctive use of MSA dollars for health related issues was the result of a 64% voter mandate in 2000.

Former Department of Justice attorney Sharon Eubanks gave the Luncheon Plenary as an overview of her successful prosecution of the tobacco industry as lead attorney for racketeering and fraud charges in 2006. A career government lawyer, Eubanks recounted how Bush Administration appointees, when it became apparent the case would succeed, directed her to drop a $130 billion remedy that included a national tobacco cessation program and even attempted to get witnesses to change their testimony just days before the final hearing. She resigned from the Justice Department as the result of this politically motivated interference. An appellate court upheld the racketeering decision earlier this year.

Briefing the audience on the recent law giving the FDA limited authority over tobacco, she noted that this bill was written 10 years ago. “And we have learned much more about the industry and tobacco since then.” She went on to suggest that certain commercial speech restrictions may not stand the scrutiny of litigation.

Mr. Joe Arnold was recognized with the Trail Blazer Award for his persistent and successful efforts to enact a tobacco free policy for all Little Rock city parks, including Riverfront Park.

Conference participants were given a wide choice of workshop topics including tobacco in the gay and lesbian community, tobacco in the Coordinated School Health programs, recent laws in Arkansas involving tobacco, and a media and counter-marketing workshop by local activist J.R. Few.

Perhaps the highpoint of the day was the closing presentation by La Tanisha Wright with the National African American Tobacco Prevention Network. A former Brown and Williamson employee, Ms. Wright gave an eloquent, informative, and emotional insider’s overview of the history of tobacco and slavery and how marketing tactics continue to target and enslave African Americans today.

Local advocates Harry Meyer and his daughter Ida attended the CTFA event. “Ida talked about the last speaker all the way home and is still talking about it,” says Meyer. “That woman made a huge impression on her, me too for that matter. The conference was a tremendous learning opportunity for anyone.”

###

FDA Litigation Begins

The first lawsuit challenging the limited authority of the FDA to regulate tobacco advertising was filed in U.S. District Court in Kentucky today. Their complaint is that restrictions on advertising are an infringement of First Amendment rights.

This intriguing distinction in the U.S. that places advertisements under speech doctrines rather than trade is fairly recent. In 1980 the court established the Central Hudson test for “commercial speech” that disallows First Amendment protection only if the advertisement is false or misleading or the government has a substantial, reasonable, interest in regulation. But it wasn’t until 2001 that Lorrilard vs. Reilly struck down Massachusetts restrictions on tobacco advertising saying the state did not prove that these restrictions would reduce underage smoking.

Today’s suit claims,that marketing aspects of the law, "severely restrict the few remaining channels we have to communicate with adult tobacco consumers."

My concern is not that tobacco companies will be allowed to communicate with adult tobacco consumers but that reinforcing the “adults only” cachet will enhance longstanding marketing strategies for attracting youth. The tobacco companies can’t lose.

The success or failure of this litigation will no doubt take years. In fact, this aspect of the new law is not scheduled to take effect for three years anyway. But already we are learning of the troubling nature of institutionalizing contemporary tobacco use under the auspices of the Food and Drug Administration. Note that Philip Morris, a leading collaborator on the bill, is letting the competitors initiate this litigation.

Arkansas Clean Indoor Air, needs work yesterday

Most recently a glaring example of how poor the Arkansas Clean Indoor Air law is occured. Sportsfans will remember that this was then Governor Huckabee’s effort at leaving Arkansas to campaign for president as the health care candidate w a minimum of tobacco prevention. It wouldn’t do for his record of collaboration with the tobacco industry without some lip service of a clean air act to survive. That is what the ACIA is, lip service badly in need of repair.

Adding insult to this are serious questions about enforcement from the Arkansas Department of Health today.

One saturday in late July my friend Harry stops in the Goldpan Cafe in Lakeview AR for breakfast on his way to help his brother lay a foundation. Harry is retired, got time on his hands, and the Goldpan is open. He also is the parent of a middle schooler avid on tobacco prevention. So he knows that the half a dozen kids he sees shouldn’t be sitting in the smoking section. Smoking Section? Arkansas law protects them from secondhand smoke in all businesses. They shouldn’t be inside the building!

So he files a complaint w the Arkansas Department of Health at the Breatheasy site. Done. Until a few days later he gets a call, and a hang-up. Then immediately after a call and verbal abuse for making his report of noncompliance. When he notices his answering machine has 3 more ‘messages’ later in the week from apparently Goldpan patrons, all abusive. He starts to reconsider his decision to ignore the first call. The ACIA contains a ‘non retaliation’ clause ostensibly intended for employee protection, and according to the ADH lawyer, never tested in this kind of case.

To synopsize, the ADH lawyer says that there is no official procedure under Arkansas’ Freedom of Information Act to get Harry’s name and apparently the ADH investigator provided this information at the time of the visit. One can file a non-compliance report anonymously.

I drove by the Goldpan today and took this photo. Came home and filed a a report of noncompliance stating:

"In attempting to enter the business, which has been granted an exemption and is a smoking establshment, I noticed that the business had no signs conforming to Section VI of the Rules for Arkansas Clean Indoor Air law http://www.arcleanair.com/pdf/clean_indoor_air_act_rule_2006.pdf . The only signage visible at the entrance was a crude paper sign saying, "No one under 21 allowed in, 7,28,09." I fled."

Investigators from ADH had time to give out my friend’s name and contact info yet not enough to rectify simple signage requirements? It would be easy to fault the local ADH tobacco prevention coalition grantee, and probably should. But not all counties have a coalition and how many businesses remain noncompliant simply because no one informed enough about the law has entered the business? A complaint driven public health and safety law is ridiculous enough without lacking sincere efforts at enforcement.

Policy makers need to know how badly flawed this legislation is. There is no safe exposure to secondhand smoke and no room for second tier enforcement of a public hazard that kills 5,000 Arkansans annually.

Reducing harm or manipulating libertarians?

Harm reduction makes a primary goal an effort at reducing the harm of risk taking behaviors. Libertarians take risk taking behaviors as a primary right and harm reduction as a means of justification.

The tobacco industry has been quite successful in not only confusing this distinction but also recruiting advocates to perpetuate this misconception. Regrettably, this has worked to divide public health challenges to rogue capitalist goals.

Harm redux/ FDA's limited authority

It is unfortunate to see ostensible tobacco prevention advocates carrying water for the tobacco companies under the banner of harm reduction. The term harm reduction was coined as a means of dealing in a compassionate manner with drug use and sexual behaviors that put one at risk of harm or disease. Needle exchanges and free condoms are tactics to protect individuals, and therefore the community, from the worst results of risk taking behaviors. Using the term in this manner there is no tacit approval, or disapproval, of the addiction but a means that an individual's behavior can reduce harm. The perversion of the concept toward tobacco is not behavior modification but product modification and hence implicit approval of nicotine addiction. Simply calling oneself smoke free does not address the real need to challenge the rogue capitalism behind the tobacco pandemic.

The linked article from Glantz, Barnes, and Eubanks is just about a must read for sincere tobacco free advocates. The question remains why so many public health advocates could support such poor, even detrimental, legislation. My first assumption is that while public health groups out of necessity must deal with tobacco related disease they are not primarily focused on what it takes to challenge tobacco.

My experience in tobacco prevention is minimal but an overwhelming awareness has been that not everyone who claims to be a tobacco free advocate is. This unfortunately includes everyone from ADH grantees, employees, and even major public health group lobbyists.

This sounds like an old saw to me now but I once heard Dr. Tom Houston remark that 100 years ago, when infectious disease was the leading cause of death, there were no transnational corporations challenging the public health. In 2006 Dr. Houston's words curiously came to fruition with a federal conviction for fraud and racketeering in U.S. versus Philip Morris. Philip Morris was the lone supporter among tobacco companies of the FDA's limited authority over tobacco. Be sure that it will not be alone in the inevitable litigation the tobacco industry will throw into the gears of curiously suspect legislation. Enjoy the article!

http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000118

big tobacco is really really big.

Mr. Hemant Goswami with the Burning Brain Society forwarded this article in Time. It's a fine lesson that those of us in tobacco prevention must be long sighted and seriously political. E cigs, strawberry flavored cigars, spit you swallow, and even litigation, are all stalling tactics for the growth market overseas. In this case, Africa.

http://www.time.com/time/health/article/0,8599,1911796-1,00.html

An open letter to the new Miss Arkansas, Sarah Slocum

Congratulations, Ms. Slocum! 

Soon you will be approached by all manner of sponsors wanting to get a piece of the crown and publicity.  One of these sponsors will be RJ Reynolds maker of Camel #9s, in the sleek pink and black packaging and promotion targeting young women.  

RJR will offer you large dollars to promote in schools a program they fund that is ostensibly a tobacco prevention program directed toward youth.  If you find it odd that a tobacco company would support effective tobacco prevention you would be right.  The Centers for Disease Control cites research showing that tobacco company funded programs to reduce youth use not only are ineffective but may increase youth initiation to tobacco.  

This particular program, 'Right Decisions, Right Now', by focusing on telling young people to resist peer pressure, infers that tobacco use is somehow more popular than they realized. Research has shown young people are twice as likely to smoke because of tobacco advertising than peer pressure.   Additionally,  this program portrays smoking as an activity only adults should choose.  Can you think of a better way to get kids to want to smoke? 

Miss Slocum, Miss Arkansas, I encourage you to take the high road and refuse to be the pawn of an industry that calls kids, “replacement smokers.”  Your status and role model are so important to so many people.  Please use it intelligently.

Thank you and good luck.  

p.s. you can learn more about tobacco industry tactics here:  http://no-smoke.org/document.php?id=276

Tobacco prevention funding coveted and threatened

It is no accident that the Arkansas Department of Health announced that smoking rates, since the 2002 inception of the state’s tobacco prevention program, have dropped by nearly 100,000 smokers.  There is little doubt that this is monumental and will save countless lives and dollars. The impetus for releasing these stats is more than likely the Arkansas legislature’s perennial targeting of the Master Settlement Agreement funding for these programs is a little louder than usual.  

It is almost baffling that some legislators cannot understand that tobacco use is the leading cause of death and disease, number one, most, more than the top five, combined.  Almost baffling because the limited lobbying ability of publicly funded or un-funded tobacco free advocates is dwarfed by the full time lobbying effort of an industry convicted of fraud and racketeering in Federal court.  The resilience of Arkansas legislators to the facts of challenging  tobacco unfortunately leads to serious concerns about the intellect of some of our solons.

Additionally, questions surround the recent SB922 that would have decimated tobacco prevention specifically.  This bill had sponsorship enough in both the house and senate to pass but mysteriously was pulled by the bill's main sponsor.

Justification for raiding Initiated Act 1 of 2000, that delegates Arkansas’ MSA funds for “health related issues” is far from clear.  This act has actually really distinguished Arkansas’ spending of these monies.  Nationally only about 3% of states’ MSA is spent challenging tobacco.  Only a little less than a third, $12-15 million annually, are spent on actual tobacco prevention and cessation programs in Arkansas.  Still, there are those that resent any opposition to the status quo subsidy the tobacco industry enjoys.

We should certainly demand results and oversight of these funds.  I will not defend all uses that have evolved with this voter mandated legislation. But 100,000 fewer smokers and going from 6th highest adult use to 10th is a dramatically significant social change.  Just as certainly should the funding for evaluation be the very last budget compromised.

Legislators should protect and enlarge tobacco prevention spending in Arkansas. None of Arkansas’ recently increased tobacco tax goes toward prevention.  The actual increased tax should continue to significantly impact reduced smoking prevalence but the most cost effective tobacco prevention is still comprehensive clean indoor air legislation.  

I said I wouldn’t defend all of the tobacco prevention funds and a particular emphasis on cessation over creating tobacco free space is a problem.  In fact, research published in the American Journal of Public Health says,  

“Smoke-free work-place policies are about 9 times more cost-effective per new nonsmoker than free NRT programs are. Smoke-free workplace policies should be a public health funding priority, even when the primary goal is to promote individual smoking cessation.”  AJPH 2005 Jun;95(6):969-75. (07-17-2009)

Cessation is almost a natural fit for a department of health program but it is not tobacco prevention. It is treatment, treatment for nicotine addiction. ( The efficacy of NRT and pharmacology is a huge discussion) And treatment for nicotine addiction is not the most cost effective use of funds. It is part of an effective comprehensive evidence based plan to reduce tobacco use but it is not the primary means to de-normalizing tobacco use. ( Remember: taxes, tobacco free space, marketing reform)

Regardless, if legislators are interested in affecting the $812 million in annual tobacco related health care cost or the $1.3 billion in lost productivity, tampering with Act 1 is not the way to go.   Even with the new taxes, tobacco will not begin to cover the cost to the community.  Permissive tobacco policies are de facto subsidies for the tobacco industry; an industry whose return to the state is limited and debatable indeed.  

 

100,000 fewer smokers is huge for Arkansas.  Before hampering these results the legislature has a clear need to rectify the exemptions and lack of enforcement for Arkansas Clean Indoor Air act and Act 13 protecting children from SHS in cars and take seriously challenging the subsidy for the rogue capitalists that profit from tobacco. 

El Dorado works for smoke free bars

Just a note from the southern end of the state tonight.

Handsel Art

12 July 2009

FOR IMMEDIATE RELEASE

contact J.R. Few

handselart@marioncounty.com

or 870-427-1365

Community Supports Smoke Free Bars.

Tobacco free activists marshaled nearly three dozen advocates to amend their city’s clean air ordinance to include bars at the El Dorado City Council meeting in Union County July 9th.  Led by Pride Youth Program’s executive director Deb Crawford, the Union County Tobacco Free Coalition’s presence dwarfed a minority of pro tobacco voices.  

Championing the amendment is Alderperson Vertis Mason. (pictured) 

El Dorado’s smoke free ordinance was enacted in 2006 before the Arkansas’ Clean Indoor Air act. This local ordinance includes much needed buffer zones around entrances and exits.   Arkansas’ Clean Indoor Air act specifically neglects protection from any smoke out of doors and adds exemptions for businesses that restrict anyone under 21.

Speaking in favor of the amendment,  north Arkansas activist J.R. Few praised the Council’s foresight in correcting a flaw in Arkansas’ law because, “We do not lose the right to breathe at 21.”

Executive director for the Coalition for a Tobacco Free Arkansas, Katherine Donald, noted that the whole state is watching El Dorado set the curve for smoke free air in Arkansas.    The El Dorado City Council is expected to take up a third and final reading of the amendment on July 23.

###

Contact Deb Crawford at  Deb@prideyouthprograms.org for information on how to assist their efforts to extend their smoke free ordinance to bars.

Arkansas Clean Indoor Air, needs work now

This morning KUAR, the public radio station in Little Rock, ran this story on the 3rd anniversary of Arkansas Clean Indoor Air act.  http://tinyurl.com/lxwlqt  

The statement is made that the law went into effect 3 years ago but fails to mention that the state only began enforcement  2 years ago.  The inside scoop here is that when the environmental branch of ADH was planning to enforce the law the tobacco prevention branch was not invited to these meetings.  As recently as September of 2007 ADH was telling businesses that secondhand smoke could not drift back inside a building when, in fact, the law specifically does not regulate any outside smoking.

Dr. Gary Wheeler is quoted in saying that Arkansas has not seen an expected reduction in heart attacks yet and there may be due to other variables unique to Arkansas.  He goes on to suggest that confusion about the law could be rectified by removing the exemptions.  Dr. Wheeler is right on both counts.

The Arkansas variable that may be most important is the fact that the ACIA is not comprehensive protection from tobacco smoke.

Celebrated advocate, UCSF’s Dr. Stanton Glantz, during a presentation at Pulaski Tech in NLR last year, specified that heart attack rates only go down when clean indoor air laws have no exemptions, like bars.  http://tinyurl.com/ktd39n

Arkansas clean air law may have numerically increased the number of smoke free businesses in what seems a dramatic fashion. But the large exemptions, like the over 21 loophole, probably did not decrease anywhere near as dramatically the amount of secondhand smoke to which people were exposed.  And to stretch the argument further those individuals still enduring heavy exposure to SHS, bar patrons and employees, may well also be those at the greatest risk for heart disease; poor health habits, little health care, etc.  

Arkansas Clean Indoor Air act needs a tremendous overhaul.  This is made most urgent given that we are now discovering the new lottery legislation opens the door for potential gambling parlors.  These parlors as well as the racinos will no doubt include restrictions for minors and a carte blanch ‘adults only’ cachet for the tobacco industry.

Smokefree Rights

One of the more important in tobacco prevention documents written in recent history is Samantha Graf’s There is No Constitutional Right to Smoke .  Published and updated in 2008 by the Tobacco Control Legal Consortium, the paper clarifies that due process and equal protection claims  to a right to smoke have been consistently denied by the courts.  If you haven’t enjoyed this paper yet it is highly recommended.

The confusion about a right to smoke is not an accident but the result of decades of tobacco industry deceit to the point of a 2006 conviction for racketeering and fraud under Federal statutes typically reserved for organized crime.  

A couple of years ago I had the pleasure of attending a local city council meeting where a smoke free skate park policy was being discussed.  The attitude was generally negative with one council person practically throwing a fit that his civil rights were being violated.  As an aside, the council person neither smoked nor skated.

Civil rights pertain to people not behavior.  The courts have been quite clear that there is no more civil right to smoke than there is to run naked in public or drive drunk.  Tobacco free policies are not about you but about children and the public health. 

Most recently it was learned the Little Rock City City Attorney’s office was in opposition to the policy over a concern for freedom of speech claims against tobacco free parks policies. This is specious to the point of absurdity. 

No one ever heard of a right to smoke until a couple of decades ago when public relations monolith Burson Marsteller started funding  and founding smokers’ rights front groups to challenge a growing trend for tobacco free public space and tobacco taxes. 

But what this shows is how successful the industry has been in its public relation’s measure, and in its fraud. Smokers are not a protected class nor is tobacco free space  an unreasonable reaction to regulating  hazardous conduct. 

Permissive tobacco policies are essentially a subsidy for tobacco companies and only serve to confuse corporate responsibility with personal rights, the right to protection from rogue capitalists.  We have a right to a  tobacco free environment, a human right...