FDA Releases Selection of Graphic Warnings

The FDA released Tuesday their final selection of 9 graphic warnings to be placed on all cigarette packaging and advertising by September 2012. These warnings will replace the ubiquitous black and white labels that have been in use for the past 25 years. The Federal Trade Commission found in 1981 that they had little deterrent effect. The new warnings will cover 50% of packaging and 20% of advertising.

CDC research conducted in 14 foreign nations has shown that graphic warnings spur smokers to think about quitting. However, there remains question as to the efficacy in a society as literate as the U.S. Are there really individuals that do not know tobacco will kill you? One of the critiques of youth focused prevention is that young persons do not grasp the same concept of long term health risk. Will these graphic warnings actually penetrate this worldview and prevent initiation?

One of the most unique criticisms of graphic warning labels comes from Martin Lindstrom author of the book Buyology. Lindstrom’s book is an analysis of the effectiveness of marketing tactics involving MRI and EEG brain scanning technologies called nueromarketing. His findings were that graphic warnings on cigarette packaging did little to inhibit craving and promote cessation. In an interview on NBC’s Today show in 2008 he remarked,

“We couldn’t help but conclude that those same cigarette warning labels intended to reduce smoking, curb cancer, and save lives had instead become a killer marketing tool for the tobacco industry.” The crux of his argument is that visual stimuli, like the graphic warnings, over time becomes associated with cigarettes as effectively as any overt branding.

None of the marketing reforms called for in the Family Smoking Prevention and Tobacco Control Act go to the lengths of eliminating branding and advertising called for in the WHO’s Framework Convention on Tobacco Control. Limiting advertising to black on white as well as a preclusion from claiming that a tobacco product was FDA approved were almost immediately held up by litigation. The judicial history of commercial speech in the U.S. may place significant obstacles to ratification in this country.

Perhaps the most positive aspect of these new warnings is the inclusion of the 1-800 QUIT NOW national quit line number. Getting a minimum of social support and counseling to smokers can only act as a prompt for cessation that did not exist previously.

Fayetteville Battles On

On June 7 the Fayetteville City Council failed to pass a comprehensive clean indoor air ordinance that would have protected bartenders, servers, and musicians from secondhand smoke. The vote required a super majority because it amended a popular vote in 2003.5 voted positively with 3 siding with the tobacco industry. And in this is the real story. The expected 6th vote to pass would have come from a former board member for the American Lung Association. Alderman Mark Kinion failed the people of Fayetteville and embarrassed himself and the Lung Association. This is reprehensible. Yet again evidence of the tremendous influence of the tobacco industry in Arkansas.

For your amusement, my presentation to the City Council is below.

Handsel Art

7 June 2011

contact J.R. Few

handselart@marioncounty.com

http://handselart.blogspot.com/

or 870-427-1365

ADDRESS TO THE FAYETTEVILLE, AR CITY COUNCIL

Thank you for the opportunity to speak this evening.

My name is J.R. Pinky Few. I’m Creative Director for Handsel Art and Advertising. I’ve been a tobacco free advocate for about a decade. In 2006 I was recognized by the Coalition for a Tobacco Free Arkansas with the Trailblazer Award. The National Public Health Information Coalition cited my work in print media w gold and silver medals in 2007. In 2009 I was invited to speak on effective rural media at the ASH Wales conference in Cardiff, Wales. I currently work as a volunteer w the Arkansas Cancer Coalition on the Communications Committee and act as co-chair of the Lung Cancer Work Group.

I have to ask why a public health issue as evidence based as smoke free air is even being debated. The Surgeon General Richard Carmona’s report in 2006 stated that there was unequivocally no safe exposure to secondhand smoke. Surgeon General Regina Benjamin’s 2010 report, “explains beyond a shadow of a doubt how tobacco smoke causes disease, validates earlier findings, and expands and strengthens the science base.” She adds,” Armed with this irrefutable data, the time has come to mount a full-scale assault on the tobacco epidemic”. So why are we here?

George Santayana is quoted that those who do not learn from history are doomed to repeat it.

In 1954, responding to growing epidemiological evidence relating tobacco to disease, the tobacco industry took out a full page ad in 400 of the largest newspapers in the country. Titled a “Frank statement to cigarette smokers”, it promised to work closely with public health officials to understand the ‘speculation’ about tobacco and disease. This spawned the creation of the Tobacco Industry Research Committee. That developed into the American Tobacco Institute and marks the beginning of decades of deceit, pseudoscience, and manipulation of our laws and public opinion. In 2006 a Federal Court convicted the tobacco industry of Racketeering and Fraud. In her final opinion Judge Gladys Kessler notes,

“These public promises were intended to deceive the American public into believing that there was no risk associated with passive smoking and that Defendants would fund objective research to find definitive answers. Instead, over the decades that followed, Defendants took steps to undermine independent research, to fund research designed and controlled to generate industry favorable results, and to suppress adverse research results.”

We are here because this historic fraud was, and continues to be, so very successful. The industry created, funds, and manipulates hospitality groups and smokers clubs to create the illusion that there was any question about the science or rights behind clean indoor air. Smoking is a privilege. Breathing is a right.

We hear concerns about lost business revenue when there are no legitimate, peer reviewed studies of tax receipts that do not show clean indoor air to be revenue neutral or advantageous to smoke free businesses. The only business that loses money with clean indoor air is the tobacco business.

I’ll warrant you’re hearing the same pro tobacco arguments today that you heard in 2003. The forecast economic doom didn’t happen then either. And in fact since 2003 research has shown that comprehensive smoke free space significantly reduces deaths from cardiovascular disease. In 2003 the study in Helena, Montana showed a 42% reduction in area heart attacks after a comprehensive law. This was replicated in Pueblo NM, in CA, in NY, in Italy. The National Academy of Sciences concluded from 11 key studies that comprehensive smoke free air in public spaces reduced heart attacks from 6% to 47% . These results were often seen almost immediately. This makes sense because we know that even brief exposure to secondhand smoke compromises the cardiovascular system.

Because of the lag time between exposure and the onset of cancers we have not seen the reduction among cancer deaths caused by tobacco smoke yet. However, the California EPA has classified secondhand smoke as a Toxic Air Contaminant and as such subject to regulation even out of doors. This finding was the result of research showing a causal relationship between adult asthma, pre-term deliveries, and a significantly increased risk of breast cancer among primarily younger pre-menopausal women. This is pertinent today because so many young women work in bars before they start a family.

The risk of death from heart disease or cancer should never be a condition of employment or patronage.

100 years ago infectious disease was the leading cause of death. Simple sanitation, clean water and hand washing, saved millions of lives. Today tobacco is the leading cause of death and second hand smoke is the third leading cause. 100 years ago we did not have multinational corporations hiding behind rhetoric minimizing the risks to public health and claiming personal liberties. Today we do. We don’t force this rhetoric on sanitation or hand washing requirements. We don’t carefully weigh an individual’s right to build unsafely, to drive drunk or faster than the speed limit. Why should we phrase the question about clean indoor air as one of personal liberties? The fact is we shouldn’t. Smoke free air is a matter of public health. The only place that rights come into play is a human right to every opportunity for health and safety.

Clean indoor air requirements are simple and will save lives. Smoke free air protects nonsmokers, helps smokers quit, and is the example to young people that tobacco is never appropriate, desirable, or normal.

The data and ethics are straightforward and clear. It is well past time for a comprehensive clean indoor air ordinance. That is why we are here.

Thank you.

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Menthol? What Menthol?

Earlier this year the FDA Tobacco Products Scientific Advisory Committee , entrusted with investigating menthol in cigarettes, stopped just short of a recommendation that menthol be banned. The report noted that, “removal of menthol cigarettes from the marketplace would benefit public health in the United States.” This diplomatic missive, or cowardly depending on your perspective, recognized that menthol may not actually be harmful. But in cigarettes certainly causes harm.

Last week Congress threw another variable into the works when Montana Republican Denny Rehberg’s amendment to an appropriations bill was approved by the House Appropriations Committee. The amendment, in short, would preclude “consumer behavior” as a variable in determining whether a product was safe. Hence the fact that the Advisory Committee had noted that even though menthol played an integral part in the ease of youth initiation to nicotine addiction, and difficulties in cessation, it could not play a role in the decision on whether or not to ban menthol in cigarettes.

A release from Tobacco Free Kids, and others, notes that of the 29 to 20 committee vote, those voting in favor received 20 times the campaign contributions from tobacco companies than those opposing the amendment.

The moral here is a brief lesson in just how bad the passage of the Family Smoking Prevention and Tobacco Control Act was.

It is no secret that the major public health groups, led by the Campaign for Tobacco Free Kids, snuggled up with Phillip Morris to pass the FSPTC. Having the majority market share in the U.S. PM knew they had a good chance that the other tobacco companies would immediately file suit to block any problematic marketing reform. (They did, blocking black and white advertising and restrictions on claiming FDA approval of cigarettes, almost immediately.) While the Act did remove fruit and candy flavored cigarettes,( small cigars and spit tobacco were unaffected). Menthol was the deal breaker for PM because, some menthol is in all tobacco, and they knew they had legislators already paid for in Congress.

The first guiding principle for the World Health Organization's Framework Convention on Tobacco Control is that the interests of the tobacco industry and the public health are incompatible. In the U.S. some of us are learning hard lessons about the veracity of this guideline. Unfortunately, the rest of us will pay for it.