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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Pinky, sadly, Arkansas is far from alone in pretending concern about every state's leading cause of preventable death. As you know, what's most troubling to me is that after 30 years and billions spent marketing replacement nicotine and other approved quitting products that, as shown by the July 2013 Gallup Poll, pharma's "double your chances" campaign is a massive and deadly lie (the Poll found that 92% of successful quitters quit without approved products, with only 1 in 100 ex-smokers crediting nicotine gum).
ReplyDeleteI suspect that as here in South Carolina, there is zero concern in Arkansas about the fact that all population level findings over the past decade indicate that replacement nicotine is actually undercutting cessation and ultimately costing lives.
I keep wanting to blame ignorance or apathy, but as with monitoring air quality, how hard or expensive would it be to conduct random long-term (>6 months) urine cotinine tests of those given free replacement nicotine when the unit testing cost per 1000 is $1.22 per test (Craig Medical)?
Truth is, state health departments already know that free replacement nicotine undermines successful quitting. At some point we need to begin asking, whose team is government on? What's more important, nicotine sales jobs and the tax revenue stream addicts generate, or helping the enslaved addict break free?
With the minimum wage earning mom forced to pick between the $4.00 needed daily to feed her addiction and a $4.00 gallon of milk for her child, you'd think that health officials in Arkansas and South Carolina would get curious as to how 92 percent of ex-smokers are succeeding.
You'd think some health official somewhere would get curious as to why approved products prevail over placebo inside clinical trials yet get clobbered just as badly by cold turkey quitters under real-world conditions.
It's as if our top health officials are wearing blinders, as if 2014's tobacco death toll is a done deal and acceptable, as if there's a massive financial conflict of interest in getting serious about saving lives.
Spot on, John. Clinical guidelines and free NRT w the QuitLine are the party line here. A couple of years ago Alan Blum spoke at the Clearing the Air in Communities of Color conference and one of the upper level DHS functionaries actually wanted to argue w him about pharma and NRT. He, by the way, plugged your site that day. Bidness as usual.
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