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.

Tobacco Free Activists Recognized by National Group

Handsel Art

19 November 2013

FOR IMMEDIATE RELEASE

contact J.R. Few

handselart@gmail.com

or 870-427-1365

Tobacco industry marketing tactics, like product placement, make nicotine addiction seem normal 

and harmless and are often subtle and deceptive. 

Two Arkansas photographers have been recognized in a national tobacco prevention photography contest hosted by Countertobacco.org.  Ashley Richter, a tobacco free advocate attending North Arkansas College, was a winner in the Youth Appeal category with a photo of  an electronic cigarette advertisement adjacent to candies at a convenience store counter.  An Honorable Mention in the same category was awarded to J.R. Few of rural Marion County for a photo showing product placement of flavored cigars next to bubble gum and hard candies. Photos like these, showing nicotine products and ads in proximities to candies or foodstuffs, display the unfortunate and false subliminal message that they are harmless and normal.

Countertobacco.org is the first comprehensive resource for groups working to challenge tobacco at point of sale. The tobacco industry has a history of sophisticated and successful marketing that, in addition to a federal conviction for fraud in 2006, addicts and kills over 400,000 Americans annually. Currently, the major focus of tobacco industry marketing is the retail environment where tobacco is sold. Not coincidentally, research shows that convenience stores selling tobacco are where youth most frequent.

Few, a volunteer with the Arkansas Cancer Coalition and the Coalition for a Tobacco Free Arkansas notes, “Ms. Richter’s photo is topical and important because the industry is taking advantage of a loophole in federal and state regulations for tobacco products to market the electronic cigarette. These devices are not a tool to help people overcome their nicotine addiction. They are a marketing strategy to prevent just that.”  Public health research has shown that rather than helping people quit smoking, electronic cigarettes prompt a dual use of nicotine delivery with no real net health benefit.  

The American Cancer Society holds the annual Great American SmokeOut on the third Thursday of November. The ‘SmokeOut’ is designated as a day nicotine addicts can take a day off and perhaps extend a tobacco free life.  If we pay attention to groups like Countertobacco.org it may also be an opportunity to understand how the tobacco industry continues to market a deadly addictive drug. 

The Arkansas Department of Health offers free counseling for nicotine addiction at 1-800-QUIT NOW.

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A current thought on harm reduction

 Harm reduction was a term coined in response to diseases and maladies encountered by homosexual men and by intravenous drug users in the face of the tremendous onset of the AIDS epidemic in the late 80s.  Clean needles and condoms were seen as a way to offset the worst effects of a public health crisis until an actual cure or remedy for the diseases that were killing people was found. 

Since then the term ‘harm reduction’ has been bastardized by the tobacco industry as not a way to reduce harm until a remedy for tobacco related disease is found but a way to perpetuate tobacco industry profit under the guise of public health.  This is so very evident after we see that the same arguments for the ‘harm reduction’ of spit tobacco are the same used for the novelty of electronic nicotine delivery.  There is disease related to intravenous drug use and some sexual behaviors.  There is disease related to tobacco use.  One use of the term ‘harm reduction’ wants to find a remedy for disease.  The latter uses the term as a means of continuing tobacco industry profit.  The crux is that there may be a human inclination toward intoxication and certain sexual behaviors but that does not necessarily include nicotine.

Focusing public health efforts on safe sex and clean needles responds to modified and alternative behaviors as remedial. Focusing efforts on changing nicotine delivery responds to alternative nicotine delivery as the remedy.  The first is a public health strategy. The latter is a marketing strategy.  As the multinational tobacco corporations ease their way into electronic cigarettes we see more and more of the same arguments for ignoring actual data concerning dual use and disease.  Electronic nicotine provides no significant pubic health benefit.

One must look closely to see the tobacco industry’s subtle diversion of blame and rights with harm reduction. The original use of the term regarding drug use and sexual behavior wants to see individuals change their behavior.  The tobacco industry wants to see harm reduction confuse behavior with a choice of nicotine delivery. 

The tobacco industry is not concerned with rights, but profit.

Addiction Incorporated

On August 7 at the North Little Rock Riverfront Wyndham, the Arkansas Department of Health Tobacco Prevention and Cessation Program, in partnership with the Coalition for a Tobacco Free Arkansas, presented a viewing of the documentary Addiction Incorporated. Using an overview biography of industry whistle blower and tobacco free advocate, Victor DeNoble, the film outlined the challenges and industry subterfuge around the scientific discoveries demonstrating the addictive nature of nicotine.

The film begins with a background of DeNoble as a naive working class lad finding himself as  a post doc fellow with a job offer from Phillip Morris. His work for PM involved research on alternatives to nicotine that might reduce cardiovascular risks.  Studies on lab rats led to the conclusion that nicotine was in fact a very addictive substance. Phillip Morris shut down the research and fired DeNoble. Bound by a nondisclosure clause, it was only a decade later that this research was revealed in testimony before a congressional panel investigating the tobacco industry. Using interviews with lawyers, industry executives, and public health advocates the film follows litigation, the first efforts at FDA regulation, the MSA, the Family Smoking and Tobacco Prevention Act, and the RICO conviction of the tobacco industry in U.S. v Phillip Morris et al.  At a certain point in this journey DeNoble decides to dedicate his advocacy to educating children about addiction and tobacco.

Previous to the viewing a couple sitting behind me identified themselves as novices to tobacco prevention asking what they could expect.  I told them I hoped that the film would help direct advocates to recognizing the necessity of challenging the tobacco industry.  Without understanding the vector of the industry tobacco control at best is masturbation. 

The film did a fine job of documenting the last 30 years of public health’s dealings with the tobacco industry.  Where it failed was in noting that what passed for public health victories were actually successful long term industry strategies.  The adult smoking rate may have fallen from around 60% in the late 50s to 20% today but morbidity from tobacco related disease still tops 400,000 Americans annually.  The litigation of the late 90’s spawned the Master Settlement Agreement with the states. But of those settled funds only about 2% are spent on tobacco prevention today.  The first efforts in the 90s at allowing the FDA regulatory control over tobacco were thwarted by the Supreme Court’s ruling that for the  FDA to retain it’s guarantee for health and safety it would have no choice but to ban tobacco.  Congress had not given the FDA that authority.  The 2009 Family Smoking and Tobacco Prevention Act was a law written by Phillip Morris allowing FDA limited regulation and compromising that guarantee and the integrity of the FDA.  And even the significant RICO conviction carried no meaningful punitive measures. To many of us the film was ancient history just scratching the surface of tobacco industry subterfuge and deceit.  But judging from the crowd reaction it was news to quite a few.

The documentary left the impression that the tobacco pandemic could be resolved if we could just keep young people from ever starting.  That, in itself, is  part of industry strategies to blame the victims for tobacco related disease while omitting their own culpability.  Nowhere was it mentioned the numerous youth tobacco prevention programs the industry funds that have been shown to be ineffective and can actually increase youth initiation by depicting smoking as a choice only an adult should make.  The film neglects the complicity that industry funding makes of otherwise well intentioned groups like the Boys and Girls Clubs and 4H Clubs.  We don’t see how Keep America Beautiful is hijacked into providing public ashtrays that not only distract the blame for litter from tobacco companies but actually encourage public smoking. We don’t learn in the film that the growth market for tobacco is in the lowest socio economic class in this country and in underdeveloped nations. Unmentioned are the millions the tobacco industry spends in a token effort to make themselves appear to be good corporate citizens while profiting from a product that is by far the leading cause of death and disease on the planet.  We don’t hear of the political funding opposing tobacco taxes and tobacco free spaces. Or of the friendly politicians bought by the pallet load. 

Addiction Incorporated is a film we all should see.  But it should be viewed with the awareness that the tobacco industry is actually much much more amoral. The documentary is good as long as we realize it is but a starting place in challenging tobacco.

One Remedy from US v Phillip Morris

Handsel Art

FOR IMMEDIATE RELEASE

2 December 2012

contact J.R. Few

handselart@gmail.com

or 870-427-1365

Tobacco Companies to Issue Corrective Statements

On November 27, 2012 Judge Gladys Kessler clarified remedies of her 2006 ruling  in U.S. v Phillip Morris that found the tobacco industry guilty of racketeering and fraud.  Tobacco companies must publish corrective statements that they lied about the dangers of smoking and manipulation of nicotine addiction,  the hazards of secondhand smoke, and the misconception of allegedly safer “light” and “low tar” cigarettes.   This remedy promises to be the most significant action the government has taken against the tobacco industry in nearly 45 years. 

In 1999 the Department of Justice (DOJ) filed suit under RICO statutes for a decades long conspiracy by the tobacco industry to deceive the American people.  In 2005 a D.C. appellate court denied the original remedies proposed to disgorge $280 billion from tobacco companies as illegal profit. This prompted the DOJ to  reassess remedies and highlight a 25 year $130 billion national tobacco cessation program.  This was a significant setback, though not the last in the DOJ’s case.  

Begun during the Clinton Administration, many involved were surprised when the Bush administration continued the suit.  Yet just days before going to the judge, a Bush political appointee, Robert McCallum, ordered lead counsel and DOJ career lawyer, Sharon Eubanks, to reduce requested remedies for the cessation program to just $10 billion.  McCallum was subsequently rewarded for his work in the DOJ with an ambassadorship to Australia.  (The litany of political interference in this case has been well documented by Ms. Eubanks in her book, Bad Acts.) Judge Kessler’s final order in favor of the DOJ involved 4 major remedies including: disjunctive remedies designed to prevent future RICO violations, eliminating deceptive “light” and “low tar” brand descriptors, disclosure of documents and marketing data, and corrective statements financed by the industry. 

The 2007 Best Practices for Tobacco Control, Health Communications Interventions notes that, “Aggressive state and national counter-marketing campaigns that have more directly confronted the tobacco industry’s marketing tactics have also demonstrated effectiveness but have often become targets for budget cuts.”  Requiring tobacco companies to admit criminal deceit, on their own dime, takes prevention to another and hopefully more effective level.  

The  tobacco industry has a history of manipulating public policy and serious oversight should be given.  But these statements have a timely potential.  An unfortunate aspect of tobacco prevention seeks a solution in making addicts quit and preventing youth initiation while ignoring the industry. The FDA’s recent introduction of 8 Tips for Talking with Youth about Tobacco and the DHHS’  new site BeTobaccoFree.gov  are packed with information about the health effects of tobacco use and nicotine addiction.  But both sites behave as if tobacco use were simply an accident of nature and completely omit the culpability of the tobacco industry in promoting a deadly product.  This promotion, not coincidentally, resulted in a criminal conviction for which these corrective statements hope to begin to remedy.  The terrible pandemic of tobacco related disease will not be resolved on the backs of the victims but on the rogue capitalists who profit from tobacco. This remedy from U.S. v Phillip Morris is a constructive step in that direction.

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New Surgeon General's report: No Safe Exposure

Click title for link to report.

subsidy

Subsidizing the tobacco industry is not dissimilar to subsidizing any industry in a capitalist community. Industry is offered tax breaks, incentives, and opportunity for conducting business in a community as an opportunity for employment and improving commerce. We provide tax breaks in return for a positive economic impact. The unfortunate difference is that the tobacco business is an economic drain. The American Lung Association has estimated that a pack of cigarettes should cost $16.66 to simply break even for the cost to the public health.

While honest work, jobs dependent on selling cigarettes are a poor trade for $812 million in tobacco related health care costs annually in Arkansas, the litter. or the lives.

Fed's Latest Effort

Handsel Art

17 November 2010

FOR IMMEDIATE RELEASE

contact J.R. Few

handselart@marioncounty.com

or 870-427-1365

HHS Announces Tobacco Strategy

Earlier this month the Director of the U.S. Department of Health and Human Services, Kathleen Sebelius, announced the federal government’s latest strategy to control the leading cause of preventable death, tobacco. Headlining the announcement were the new graphic pack and ad warnings required by the Family Smoking Prevention and Tobacco Control Act giving limited authority over tobacco to the Food and Drug Administration. These 9 graphic warnings will cover 50% of any pack and 20% of advertising. In 1965 the tobacco lobby was successful in minimizing Surgeon General Luther Terry’s report that smoking caused cancer to the ubiquitous: “Smoking may be hazardous to your health.” Arguably, tobacco lobbyists still manipulate public policy.

Today 38 nations require similar or stronger warnings. Australia has required that all cigarettes be sold in plain packaging by 2012. Other nations‘ graphic pack warnings are a facet of the World Health Organizations Framework Convention on Tobacco Control. Ironically, the U.S. law requiring graphic warnings also inhibits this country’s compliance with the global treaty by including the tobacco industry on an FDA scientific advisory panel.

Requirements in the new legislation to quit using deceptive “light” and “low tar” packaging had been anticipated by the industry changing the actual language to suggestive lighter colored packaging. Actually, the elimination of the words “light” and “low tar” had been ordered by Judge Gladys Kessler in 2006 as part of her finding against the tobacco industry as racketeers. Restricting advertisements to black on white messaging were almost immediately struck down by the courts.

While the bill was supported by major public health groups, and global tobacco giant Philip Morris, not all advocates consider giving the FDA limited authority over tobacco a good idea. Dr. Heinz Ginzel, Emeritus Professor of Pharmacology and Toxicology at the University of Arkansas for Medical Sciences says, “ Any regulatory actions concerning tobacco taken under the auspices of the FDA are jeopardizing, contaminating, degrading and corrupting the declared original mission of the FDA.”

Other advocates like the National African American Tobacco Prevention Network object to a failure to include menthol flavoring while banning fruit and candy flavors. A recent press release from NAATPN states, “Our organizational stance is and has always been steeped in the historic exploitation and targeting of Black communities by the tobacco industry which began in the 1950’s when only 5% of our community smoked mentholated tobacco, and continues today because now nearly 83% of all tobacco consumed by Blacks is mentholated.” The FDA scientific advisory panel has until 2011 to determine how to regulate, if at all, menthol flavoring in tobacco.

One positive aspect of the new law is the removal of federal preemption for state and local governments to regulate point of purchase marketing. Currently the only signage or advertising mandates are legal age requirements. These are most often produced by the tobacco industry. Arkansans could now require the Quit Line be placed at point of purchase, regulate signage, or enhance any federal health warnings.

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Riverfest Smoke Free?

In July of last year, after much ado and the hard work of many of us, City Manager Bruce Moore signed the Little Rock Parks Commission recommended policy that Little Rock City Parks be tobacco free. The policy went into effect in October.

Now as Riverfest approaches it is questionable if the organizers of the event are going to respect this policy or continue their subsidy for the tobacco industry at the expense of the community. A quick glance at the Riverfest website cites only Arkansas clean indoor air laws with no recognition of the Parks Commission’s tobacco free policy at all.

Will we once again suffer the drifting smoke, pay for collecting the cigarette litter, and finance the corporate welfare for a rogue industry? The organizers of Riverfest may not care about the community and the entertainers but I bet their sponsors do. You can find them here. Contact the city manager’s office too. Demand not merely simple courtesy but evidence based public health policies.

It’s your air and your music, don’t share any more of it with the tobacco industry.

Tobacco Leaves on a Dollar

Dr.s Simon Chapman and Ross MacKenzie’s 2010 paper, The Global Research Neglect of Unassisted Smoking Cessation: Causes and Consequences, and more recently Chapman’s op ed on the marketing and promotion of NRT and pharmacopeia for tobacco cessation may well be the key to the next paradigm for effective tobacco control.

Recently there has been much attention given the ostensible “inveterate smoker”, the smoker who does not quit. It has been felt that after we raise the cost of tobacco, create tobacco free space, and eliminate tobacco marketing there still are going to be people who will not or cannot quit. This alleged population has been much of the motivation for those referring to themselves as harm reduction advocates, encouraging the promotion of forms of nicotine delivery allegedly less harmful than smoking. Chapman and Mackenzie’s work here calls into question whether that population exists at all and the validity of research funded by those marketing NRT or pharmacopeia.

He make 3 structural points: Most research is done by those interested in interventions and because of that primarily are testing their own means. In a capitalist society there is the tendency for medical means to become commodities. And lastly that these interventions are based on the erroneous assumption that there are some individuals who have an impenetrable addiction that warrants the interventions.

Yet 3/4 of all ex-smokers quit with no assistance at all. Cold turkey quitters outnumber all cessation methods combined. Studies have shown that most successful nicotine addiction was overcome with no preparation at all, that certain environmental cues prompted cessation and abstinence.

Recent genetic discoveries have suggested that there are predispositions to nicotine addiction and has been a facet of the thesis of the inveterate addict. This should not be underestimated in evaluating the risks of ever starting to use nicotine. But Chapman and Mackenzie’s research sheds light on the need to shift our perspectives toward modifying the environment beyond increased pricing, tobacco free spaces, and marketing reform. What we have been calling cessation support perhaps should not take as strong an active, or pharmaceutically interventionist, role as it does a further reformation of the environment.

The theory that some people cannot quit without intervention becomes a self fulfilling prophecy when seen with the enormous amounts spent by pharmaceutical companies, and others, advertising cessation assistance and funding research to test their products. We know that youth are more likely to start smoking if they believe quitting will be easy. Are we not re-enforcing the myth that quitting is difficult with our capitalist emphasis on marketing cessation support?

The under publicized figures surrounding cold turkey cessation point to rogue capitalism as a major factor in challenging tobacco perhaps no less than that of the tobacco industry. Somewhere in the evolution of dealing with nicotine addiction the emphasis on changing people’s perspectives on tobacco use from a social issue to a medically treatable problem a step was missed. There is little doubt that if there weren’t a dollar to be made it would not have happened.

Dr. Chapman points out that for the developing world, the growth market for tobacco companies, NRT and pharmacopeia is not a viable economic or realistic option. His paper suggests that we are far from optimizing the environmental and behavioral cues that enhance cessation and should not be dissuaded by the drive to profit in our capitalist society.

This also helps clarify where the harm reductive E cigarette clamor is coming from. Right now E cigarettes can’t decide whether they are cessation devices or that fairy tale of a safe tobacco habit. Emphasizing the fact that most people overcome nicotine without NRT shows how unwarranted another nicotine delivery device is.

400 years ago European colonial efforts to export tobacco co-opted an entheogenic plant from aboriginal Americans. In short order the plantation economy spawned the genocide of native peoples and the importation of an enslaved African population. As the leading cause of death and disease today is the capitalism surrounding tobacco today significantly different? The profit certainly isn’t.

Dismantling FDA Authority for Tobacco Begins

A Federal court in Kentucky overturned the first advertising regulations of the Philip Morris FDA bill this week. While leaving in aspects for larger health warnings and prohibiting event sponsorships, two key parts of the marketing restrictions were tossed. The bill had stipulated that only black and white advertising in mediums where children were likely to view would be allowed. This was thrown out as overly broad. You think?

Tobacco companies can continue to use their color graphics and imagery in advertising which are integral to branding and normalization of tobacco promotion.

Additionally, restricting tobacco company language claiming that FDA regulation made their product safer was tossed. This was one of the more telling and foolish parts of the bill. Detractors began much of their criticism of this legislation saying that industry marketing would take advantage of giving regulatory authority to the agency that supposedly guaranteed the health and safety of our food and drugs. In response, this ridiculous and obviously unconstitutional restriction was tacked onto the bill. “No you can’t claim that an FDA regulated cigarette is safer!” Apparently, yes you can. So why have we ruined the tenable integrity of the FDA anyway?

Philip Morris wrote this legislation. Other tobacco company lawyers cued up almost immediately to help dismantle the most potentially effective regulatory authority and thus far are successful. One can only imagine what the current Supreme Court will do for them as the suits creep upstream. What is not left to the imagination is that when all is said and done Philip Morris will have gotten almost everything it wanted without ever filing a brief.

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.

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 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.

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.

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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 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. 

CTFA thanks benefactors

Handsel Art

28 June 2009

FOR IMMEDIATE RELEASE

contact J.R. Few

handselart@marioncounty.com

or 870-427-1365

Tobacco Prevention Advocates Thanked

Local advocates from around the state joined in attending the first annual Coalition for a Tobacco Free Arkansas’ Benefactors Luncheon at the UAMS Fay Boozman College of Public Health June 26.  Styled as an opportunity to thank individuals who aided CTFA’s mission to promote a tobacco free state, the audience was welcomed by Board Chair Carla Sparks and Executive Director Katherine Donald expressing gratitude for services provided in the past and thanks in advance for the future.

Ms. Idonia Trotter (pictured) made her first appearance as  Executive Director of Arkansas’ Minority Health Commission sharing her experiences working with CTFA and the willingness of the Coalition to place a tobacco free mission ahead of taking credit for success.  Ms. Trotter was the first concurrent Clinton School of Public Service  and Bowen School of Law graduate in May.

Local advocate and CTFA partner J.R. Few spoke about the importance of CTFA’s status as the only coalition in the state that specifically challenges the tobacco industry. 

“Other public health groups may, out of necessity, focus on illness caused by tobacco but they have their own agenda, unfortunately often shaped by their national offices. CTFA’s goals are unique to Arkansas,“ he said.

Individuals interested in tobacco prevention in Arkansas can contact CTFA at 501- 687-0345 or visit www.arfreshair.com.

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Post One

By way of welcome, this is an experiment; another autodidactic adventure in posting art, angina, and activism.  I'm not sure I can tell them apart at all.