Maybe there's a reason ADH has tobacco prevention in the basement.

I really don’t keep up w too much of ADH politics for a couple of reasons.  One is because I no longer volunteer for a local community tobacco prevention coalition.  The other is because it fairly typically makes me ill.

Such is the case learning that the 2015 RFPs for tobacco prevention have tweaked themselves to not only demand ownership of all work product and materials, (That really grates on an unpaid media volunteer) but also has dismissed the Coalition for a Tobacco Free Arkansas and the youth YES teams to find some party they can control as one entity. 

First, for as long as I have had any understanding of the MSA funding for which pittance is still left for actual tobacco prevention there has been a need for a distinct legal separation between lobbying and advocacy. It has always been the tactic, in Arkansas since ethics complaints in Fayetteville in 2004, for pro- tobacco forces to claim state funds were used to lobby for policy change.  Since then tobacco free challenges have made great effort to distance advocacy from lobbying.  I was there in Fayetteville when Dr. David Bourne suggested that advocates abridge their freedom to speak when Huckabee was threatening to pull ADH funding for tobacco prevention. This is the point of having a statewide coalition keeping accounting that distinguish lobbying efforts from any ADH funding. That degree of separation is integral to making policy change efforts immune to industry, and significantly legislative complaints, that public money was used to lobby. Policy change is essential to actual population based measured tobacco free change.

Like I said, I dunno what is going on within TPCP but it does not portend much tobacco free success and has the potential of discarding years of sincere educated and sophisticated advocacy protecting Arkansas’ dedication of MSA dollars. Micro managing organizations that have worked hand in glove with previous TPCP bureacrats neglects a tremendous learning curve that the tobacco industry depends on.

We expect more from the Arkansas Department of Health than petty politics but unfortunately, at least when it concerns tobacco, that has not been the case.

ADH Insults Tobacco Prevention Advocacy

I’ve had issues w the Arkansas Department of Health for about as long as I’ve known anyone associated. I’ve met some of the most insincere and self serving bureaucrats known to humanity working, ostensibly, toward tobacco prevention. That said, I’ve also known some of the most dedicated and committed individuals you could imagine.  The Tobacco Prevention and Cessation Program, with a few notable exceptions, has enjoyed talent and sincere advocacy.  Somehow they seem to move right along to other issues with too much frequency. 

Tobacco use is the leading cause of preventable death in the U.S. and in Arkansas.  The tobacco industry is responsible for the leading risk factors for heart disease, stroke, and lung disease. 90% of lung cancer is due to cigarette smoking killing more than the next top three cancer killers combined.  Tobacco kills.  Got that?

This week, I had the unfortunate opportunity to visit the Tobacco Prevention and Cessation Program’s offices. I had proposed to the Arkansas Cancer Coalition and was funded for a small grant to do air quality monitoring for a couple of the significant exemptions to Arkansas’ Clean Indoor Air Act of 2006. This was dependent on collaboration w the use of TPCP’s SidePak pm2.5 air monitors and damned if the device, that was actually purchased new for this venture, failed to work properly. Much to my disappointment I had to touch base w Debbie Rushing and lay the repair or replacement of this device on her table.  I have to say that she and Dr. Gary Wheeler have been more than supportive for my proposed activity.  Advocates need this kind of data to rectify our lame assed clean indoor air law.  And Gary and Debbie are both savvy and honest enough to admit it.

Enough about my complaining.  I had to return the SidePak.  This was my heuristic experience.  The last time I’d been to the TPCP offices was to meet Michael Johnson with the Rand Institute upstairs to discuss grantee evaluation about 2004.  The office was bustling with folks upstairs a in corner office space filled with windows.  Brochures and educational materials, were stacked in the hallways. 

On Monday I limped to the top of the exterior stairs to the main ADH security desk to return the SidePak.  The guard had to look up on his computer to discover where the TPCP offices were. “They are in the basement,” he said.  I took the elevator down into a short corridor with janitorial offices.  I could see stacks of paper towels in door windows.  I went back upstairs and a new police guy said I had to go through the double doors marked “No Admittance.”  I went back down and fortunately caught some gentleman to ask how to find the Tobacco Prevention offices and let me through.  He told me to follow him through the double door onto a loading dock and out through another.  He said the Tobacco Prevention office was down the hall and to the left.  I thanked him.  Stumbling down the hallway I found the TPCP sign on a door.  Inside, was a relatively empty roomful of cubicles, no reception.  Making my way to Ms. Rushing’s office I heard what makes her my hero for today speaking to the TSI SidePak people on the phone.  “And so, as a good customer service representative, what are you going to do for me?”  This after the failure of an unused, expensive, device.

Debbie, I apologize for adding to your workload.

My issue is that the Arkansas Department of Health literally has buried the people burdened with challenging the leading cause of death and disease in the basement. 

But wait there’s more!  I left Debbie on the phone with whatever cretin at TSI who may or may not make things right.  They sure won’t make the three days right I sat in smoke filled space at a horse track to get data. The notable thing here is that the Arkansas Department of Health does not really give a shit about the leading cause of death in Arkansas.

I left the TPCP offices and went through the double doors at the loading dock.  A young lady actually held the door for me.  Unfortunately, the doors on the other side, and that side too, were locked.  The door buzzer for assistance on my return went unheeded leaving me locked outside. I was starting to hike around the building when I saw a pair of women pushing a mail cart. She asked me if I was trying to get into the building and told me I was not supposed to be there.  I thanked her and took the elevator to give the young police guy my visitor’s sticker. (He was probably the most sympathetic and helpful individual I met with the exception of Ms. Rushing.)

The whole point of this missive despite my whining was to note that the Arkansas Department of Health and in consort with the Department of Human Services has done their very level best to hide the individuals charged with challenging the leading cause of preventable death in offices behind the janitors, a loading dock, and the mail room, w two doors that lock behind you.  This sucks.

If the state of Arkansas had any sincere ambition to protect the public health the political figureheads would do more than pay lip service to tobacco prevention.  And the actual individuals charged with the actual work would get better treatment than they do now.  I knew that the powers that be had abused and driven away a celebrated thoracic surgeon and one of the leading tobacco prevention advocates on the planet in Dr. Carolyn Dresler.  I did not know how far they had gone to discourage anyone of merit to make any habit of challenging the tobacco industry.  

Just in case anyone in Arkansas had any optimism about the political courage our policy makers have for tobacco prevention you should make more of an effort to thank the TPCP people who continue to work in Little Rock. The folks that run the Department of Health would rather we don't find the tobacco prevention branch.

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The Right Message

Here is the link to the previously mentioned presentation: The Right Message. Why not, Why, and How.  I was encouraged reading in the new 2014 Best Practices for Tobacco Control the emphasis on Mass Reach health Communication.  The tobacco industry is pretty clear in their goal of selling a profitable product.  Public health on the other hand has been divided in its efforts and less than honest about actually saying what it should be doing is making that product unprofitable.  This is one reason I tend to try and recognize tobacco free space as not merely the clean indoor air but also the parking lot free of signage or the counter top free of product.  It is not merely that tobacco is a health risk.  The tobacco industry is a health risk.

Anyway, here is the link to the video again.

TPCP, Using Media, and Lobbying

I’m bad about keeping a blog. Since no one reads it anyway it becomes little more than a journal.  But I need to follow up on an opportunity I was given presenting a short bit to the current Arkansas Department of Health Tobacco Prevention and Cessation Program (TPCP) Grantees at their Quarterly meeting at Pulaski Tech recently. The bulk of the day was an Americans for Nonsmokers’ Rights training by their Southern States Regional Consultant, Onjewel Smith.  

My presentation was little more than a combination of a perspective of how public health has always been short sighted, when it came to dealing with the tobacco industry from as far back as the Frank Statement, and a synopsis of a paper I delivered at the 2009 ASH Wales Conference in Cardiff, Wales.  The Cardiff presentation was an overview of successes Tobacco Free Marion County had in reducing BRFSS adult smoking rate numbers making use of a coordinated and comprehensive public relations campaign.  CTFA’s Katherine Donald suggested that since my gig came while everyone was eating their boxed lunches I was the Keynote Speaker.  I told her that if I ever got around to writing a C.V. it would be.

Dr. Gary Wheeler, acting medical head of TPCP and an inaugural graduate of the Clinton School of Public Service, I cannot brag on Gary enough, helped clarify my language about a Fayetteville bar owner’s complaint to the state Ethics Board.  Gary shared that calling attention to using public funds to lobby was a tobacco industry ploy  used against federal tobacco free efforts in the 90s.  Regardless, it was Huckabee in 2003 who said he wanted tobacco grantees to comply with the “letter as well as the spirit of the law” regarding tobacco prevention.  I quote this because he used the same language not 3 weeks later complaining about the legislature recessing rather than adjourning. Huckabee’s actions easily checked progress in tobacco prevention in Arkansas to this day, not excluding his 2006 exemption riddled Arkansas Clean Indoor Air Law. It really is an embarrassment that Huckabee has any kind of national stage in the media today much less a political voice.

But it does explain the murmured response among grant administrators and grantees when I assured them that they could lobby within semantics.  Hell, I encouraged them to lobby.  CDC Best Practices are all about policy change.  And my emphasis on semantics was exactly the same advice Lynda Lehing gave grantees in 2003.  There has to be some government employee/ bureaucrat mantra about safety in ignorance. At any rate it was Huckabee’s 2003 call to inaction that was the major prompt for me to speak out and use what I knew about public relations and the media as a voice once removed from Tobacco Free Marion County.  And like Ms. Smith inferred, tobacco prevention advocates often find themselves alone in the wilderness.  TFMC was no exception.  Using the media was a way of making the coalition seem much larger than it actually was.  And it can be for any tobacco prevention advocacy today as well. 

At some point in the near future I’ll put audio to my presentation and put it on line.