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.

Tobacco Free Activists Recognized by National Group

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19 November 2013

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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.

Using grammar to challenge electronic cigarette marketing

Early electronic cigarette marketing.

Seeing the growth of the popularity of electronic cigarettes I wanted to note the importance of tobacco free advocates making a collective effort at getting our language together. ANR has a presentation ice breaker where the audience is asked to say, “smoking ban.”  The presenter then congratulates them for getting that out of the way so that they never have to utter that phrase again.  We work for tobacco free spaces, clean indoor air, and safe smoke free workplaces and public space. We try to avoid saying anything about “anti tobacco” and recognize that “environmental tobacco smoke” is a polite industry way of talking about secondhand smoke. We need to make sure that we do not address the industry challenges from electronic cigarettes with their language. 

It is with this spirit that I suggest that advocates drop, as is conversationally convenient, the use of terms like “vaping” and “E vapor.”  Even the term “E cig” has the short harmless aspect of a nickname.  We might do well to consider the discipline of always using a full description of “electronic cigarettes” as another “nicotine delivery device.”  We can refer to the effluent as just that, “effluent.”  And make note to point out the “fine particulate” included in the “aerosol contamination.” 

The stakes are too high to allow the tobacco industry to define our terms.

CTFA Holds Annual Conference

The Coalition for a Tobacco Free Arkansas (CTFA) held its 11th annual Striking Out Tobacco in Arkansas Conference at the Riverfront Wyndham in North Little Rock September 12th.  Attended by advocates from around the state, the conference featured such prominent speakers as Dr. Valerie Yerger from the University of California, San Francisco(UCSF) and the noted tobacco industry whistle blower, Dr Victor DeNoble.

Dr. Yerger, an Associate Professor of Health Policy at UCSF, is probably best known for her involvement w the Legacy Tobacco Documents Library. But for this presentation she donned her credentials as a licensed naturopathic doctor to talk about menthol in tobacco. The Family Smoking Prevention and Tobacco Control Act, that gave the FDA limited authority over tobacco, banned fruit and candy flavors in cigarettes but neglected menthol.  Yerger noted that menthol’s medicinal application was not merely a benign flavoring.  As a natural anesthetic it not only masks the harshness of tobacco smoke but also enhances drug delivery. This encourages addiction and makes cessation more difficult.  She pointed out the importance of seeing that 80% of African Americans, who smoke, smoke menthol. Challenging tobacco, challenging menthol in tobacco, is a matter of social justice.

  

Ritney Castine, representing the Campaign for Tobacco Free Kids, gave a lively overview of modern tobacco control and the value of youth involvement in policy change.  Noting that many only wanted young people to be cute, he emphasized,  “Cute isn’t effective.” Castine added that young people are essential to any great change but could only be that as fully vetted participants.

A knowledgable review and refutations of the myths surrounding of the Affordable Care Act was provided by consumer assistance specialist from the Arkansas Insurance Department, Sandra Cook.

Karin Rudolph, with the FDA’s Center for Tobacco Products, presented a well scripted party line account of the FDA’s  limited authority over cigarettes under the Family Smoking Prevention and Tobacco Control Act. This law, passed in 2009, was supported by many major public health groups, and tobacco giant Phillip Morris.

The day culminated with former Phillip Morris scientist, Dr. Victor DeNoble.  Dr. DeNoble recounted animal research proving that, contrary to industry claims, nicotine was a very addictive substance. He was kept silent for a decade by a confidentiality agreement with Phillip Morris. It was only his 1994 testimony before Congress that allowed him to speak out.  Echoing previous remarks and questions about the burgeoning E-cigarette market he noted that the device was not  a safe alternative to smoking but designed to enable continued addiction.

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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

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2 December 2012

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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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A National Disgrace

I was coincidentally looking through the TTAC newsletter when Katherine Donald shared the link w her Coalition for a Tobacco Free Arkansas mailing list.  What I happened to fall upon in the table of contents was the link to the FDA Tobacco Products page and 8 Tips for talking to youth about tobacco. I get the FDA updates but don’t always follow up.  This is one reason why.

The CDC 2007 Best Practices for  Comprehensive Tobacco Control Health Communications Interventions makes the statement:

“Adolescents and young adults are very sensitive to perceived social norms and media presentations of smoking behavior. Nonsmoking adolescents exposed to tobacco advertising and promotional campaigns are significantly more likely to become young adult smokers. Because adolescents and young adults have been and continue to be so heavily exposed to images of smoking in the media, tobacco advertising, and promotional campaigns, public health counter-marketing campaigns are needed to focus on preventing initiation and promoting cessation.”

Nowhere in the FDA ‘tips’ for talking to youth is there any mention of tobacco advertising, tobacco promotion, marketing, or even the words “tobacco industry.” Instead, it focuses on how the young individual must decide, regardless if they are 11 years old or not, if they will become a nicotine addict.  This is just another example of how and why the Family Smoking Prevention and Tobacco Control Act is a national disgrace.

How is it that the Campaign for Tobacco Free Kids, the American Cancer Society, the American Heart Association, the American Lung Association, and a wealth of popular public health groups, not including the National African American Tobacco Control Network and Americans for Nonsmokers’ Rights, could support such a terribly flawed bill?

That is a huge question. How, or will, these groups rectify and apologize for their misspent support?  The greater issue is: how will the rest of us redeem a federal law that institutionalizes tobacco unlike never before?

SOS launches another youth activity, yawn.

A major aspect the tobacco industry uses to justify marketing and promotion of a deadly addictive drug is that consumers make a responsible adult choice.  In litigation, when victims have sued, almost invariably the argument industry takes is that you can’t be sure tobacco killed you and even if it did you knew better and chose to smoke.  I mean we’ve had this warning on the pack since 1965.  What were you thinking?

Phillip Morris funds ostensible tobacco prevention programs to keep kids from starting to smoke with the message that smoking is a choice only an adult should make.  Can you think of a better way to get kids to smoke?  It’s an adult choice.  So what if most smokers make that choice a few years early?  The tremendous capacity for nicotine to addict is fairly much a neglected aspect of the product.  It’s all about choosing.

And along comes the latest Stamp Out Smoking essay contest.  The theme this year is My Reason to Write.  Students are encouraged to write a letter thanking someone for their smoke free example or encouraging someone to quit.  Notice anything?  It’s all about choosing. In fact, the heading of the page says “We can all say NO to tobacco.” 

Undoubtedly we’ll see the same tired pleadings to addicted family members and blustering pledges to never start so they can make the team.  In fact one of the suggestions is to organize a pledge drive.  (I would welcome any legitimate research able to show that no smoking pledges are worth any more than the paper they are printed on.)  In the first case the focus is on a role model in their lives.  They may be an addict but they are still role models so something must be OK about nicotine.  In the second instance, the industry line about choice being the significant aspect of smoking is parroted.  Success with youth focused tobacco control programs are often frustratingly short term.  With efforts like this it is no wonder.

I am fond of saying that tobacco has not been a benign weed by the side of the road for 400 years.  But this is what is depicted when young people are told that the individual's choice to be tobacco free will make the difference.  In the tips for parents and teachers on how to talk to kids about tobacco nowhere is the tobacco industry mentioned.  Nowhere does it say that tobacco marketing, promotion, and public use are the result of multi-national corporations’ demand for profit. Instead these talking points would have us believe that being tobacco free was like choosing one cereal over the other for breakfast.  Characterizing the issue like this makes it seem that smoking is a normal part of their day, they shouldn’t do it, but it's normal.  When the very opposite should be our message.

In 1996 Dr. Stanton Glantz wrote in the American Journal of Public Health, 

“Finally, the public health community should realize that the best way to keep kids from smoking is to reduce tobacco consumption among every one.  The message should not be “we don’t want kids to smoke”; it should be “we want a smoke-free society.”  As the tobacco industry knows well kids want to be like adults, and reducing smoking sends a strong message to kids about social norms.”

That was 16 years ago.  Dr. Glantz spoke at the CTFA conference just last week.  Was anybody  responsible for this campaign there?  Have they ever been?  It is bad enough to have Burson Marsteller’s only U.S. based affiliate paid to run campaigns like this. The revolving door of personnel without actual tobacco control experience in the TPCP program makes ineffective messaging like this even more unfortunate.

CTFA Holds Successful 10th Anniversary Conference

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16 September 2012

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CTFA Holds Successful 10th Anniversary Conference

Dr. Stanton Glantz

Over 160 advocates from around the state celebrating public health successes from the past decade gathered for the Coalition for a Tobacco Free Arkansas’ 10th annual Striking Out Tobacco in Arkansas conference in North Little Rock September 13th, 2012.  Attendees were treated with presentations from some of the most distinguished tobacco control authorities in the nation.

Dr. Greg Connelly, from the Harvard School of Public Health, was influential in getting the Family Smoking Prevention and Tobacco Control Act passed in 2009. This law gave limited authority over cigarettes to the Food and Drug Administration. An original member of the FDA’s Tobacco Products Scientific Advisory Committee, Connolly has since resigned and had little to recommend about the law today. He encouraged the audience to put pressure on the FDA to act more quickly regarding a decision about menthol.  The original bill banned characterizing fruit and candy flavors in cigarettes but neglected to include menthol in these restrictions.  The Committee concluded that menthol in cigarettes made initiation of nicotine addiction easier and quitting more difficult. Their March 23rd 2011 report stated, “removal of menthol cigarettes from the marketplace would benefit public health in the United States”.  The FDA’s final decision was due 90 days after the submission of the report but has not acted.  80% of African American smokers consume menthol cigarettes.

Keynote speaker, Dr. Stanton Glantz, a founding member of the group Americans for Non Smokers’ Rights and Director of the Center for Tobacco Control and Research at the University of California at San Francisco, recounted how the tobacco free movement had evolved in California.  He called attention to the statewide media campaign emphasizing that nicotine was addictive, secondhand smoke will kill you, and the tobacco industry lies. He noted that focusing on a corrupt industry creates a ‘social un-acceptability‘ quotient  that could be as effective as tobacco taxes in decreasing use.

Glantz pointed out that he and Dr. Connolly had been on opposite sides of the law giving the FDA authority over cigarettes. Noting that the industry was now offering soluble nicotine products to sidestep smoke free laws and keep people addicted he added, “One thing I think we should be pressing for at the FDA,  if they should ever grow a back bone, which is unlikely, but if they should they should prohibit co-branding of these non cigarette products, so they can’t say Use Marlboro snus on the plane and smoke Marlboro cigarettes when you can.” 

He concluded that tobacco control efforts really do work.  Over 15 years the California  tobacco control program cost $1.4 billion.  But health care costs from an almost immediate reduction of heart disease deaths and asthma attacks, and 14% decreased incidence of lung cancers over a decade, saved the state $86 billion.  “So when politicians say we don’t have enough money for tobacco control, everything they cut from that, they are paying over and above that in health care costs and it’s not 20 years from now.”

Recognizing  Arkansas’ deeply flawed clean indoor air law, Glantz suggested that activists work locally to rectify exemptions.  He complimented advocates for a 30% drop over the last 3 years in cigarette sales in Arkansas.  “You’ve got to realize that every little success you have is dollars out of a multi national corporation’s pocket, and they don’t like that,  and are going to do everything in their power to stop that.”

Additional speakers included representatives from the National Latino Tobacco Control Network, the American Lung Association, and the University of Wisconsin. “CTFA always does a great job addressing disparities,” says Julie Andersen from Marion County.   “This year was no different with speakers focusing on Latinos, the LGBT community, and nicotine dependence among those living with a mental illness. Excellent conference!”

The Coalition for a Tobacco Free Arkansas is a statewide network of organizations with a shared mission to challenge the tobacco industry.  More information can be found at www.arfreshair.com 

Renowned Speakers to Address CTFA Conference

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19 August 2012

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Renowned Speakers to Address CTFA Conference

In 2003, when the Coalition for a Tobacco Free Arkansas (CTFA) held the first Striking Out Tobacco in Arkansas conference, it was for many of the statewide group of advocates their first opportunity for tobacco prevention education.  While the conference is only a facet of the advocacy CTFA offers, the 2012 event, September 13th at the Wyndham Riverfront in North Little Rock, will include a collection of some of the most respected tobacco control advocates ever gathered in Arkansas.  Featured speakers include two of the most influential tobacco free advocates in the world, Dr. Stanton Glantz and Dr. Gregory Connolly.

Glantz, Director of the Center for Tobacco Control and Research at the University  of California at San Francisco, has been involved in tobacco control since 1978.  A founding member for the advocacy group, Americans for Nonsmokers’ Rights, he has been a leader in helping establish the most effective means to challenge the industry at all levels of policy. His research covers a wide range of issues including the effects of secondhand smoke on the cardiovascular system and the public health benefits of smoke free legislation.  Additionally, Glantz has been instrumental in establishing the Legacy Tobacco Documents Library making 50 million pages of previously secret industry documents available to the public. 

Dr. Connolly is the Director of the Center for Global Tobacco Control at the Harvard School of Public Health.  Originally trained as a dentist, Connolly is an appointee to the World Health Organization’s panel on Smoking and Health and led the highly successful Massachusetts Tobacco Control Program for nearly 2 decades  His work in tobacco control is internationally recognized and has included research on tobacco product design, reduced risk products, tobacco interventions and prevention of tobacco related disease.

These speakers alone would be significant for any conference.  However, CTFA has also secured Dr. Bruce Christiansen from the University of Wisconsin, an authority on treating tobacco dependence,  National Director of the National Latino Tobacco Control Network,  Dr. Jeanette Noltenius,  and Linda Cullers, Senior Director of Health Promotions, American Lung Association for the Plains-Gulf Region. 

Katherine Donald, Executive Director for CTFA says, “Tobacco free advocates know that education is one of our greatest assets.  This promises to be a tremendous opportunity for public health advocates, activists, teachers, parents, policy makers, or anyone concerned with tobacco prevention in Arkansas.”

Tobacco continues to be the leading cause of death in Arkansas, and secondhand smoke, the third leading preventable cause, kills over 500 of our neighbors annually. Unfortunately, prevention funding is at a 10 year low while the tobacco industry spends $129.5 million marketing each year in Arkansas alone.

Registration is $50 per person. Forms and information are available at www.arfreshair.com .  As a special incentive, registration fees will be waved for any policy maker or candidate for public office.  This is one event you do not want to miss.

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Dr. Stanton Glantz, the American Legacy Foundation Distinguished Professor of Tobacco Control at the University of California, San Francisco will be one of several prestigious speakers at the Coalition for a Tobacco Free Arkansas’ Striking out Tobacco in Arkansas conference at the Wyndham Riverfront in North Little Rock September 13.

Cigars, Candy, Litigation, and Laws

Cigars, Candy, Litigation, and Laws

In 2009 Congress passed the Family Smoking Prevention and Tobacco Control Act with support from major public health groups, and tobacco giant Philip Morris. Lauded by supporters as a landmark, the bill gave the Food and Drug Administration limited authority over tobacco.  But three years after passage, the bulk of the FSPTCA has been delayed or repealed by tobacco industry litigation.  Requirements that tobacco advertisement near where children are present be limited to black on white has been struck down.  Large graphic package warnings, scheduled to go in effect in 2012, are still delayed.  And most recently authority preempting local control over point of sale warnings has been delivered a setback in a New York appellate court.

While many consider the omission of menthol in the list of restricted cigarette flavorings a serious flaw in the FSPTCA, banning fruit and candy flavors have not been thwarted in the courts.  Unfortunately, pro tobacco forces in Congress have introduced a serious challenge in the Traditional Cigar Manufacturing and Small Business Jobs Preservation Act of 2011.  Purportedly focused on high end cigar products, this bill would remove cigars from FDA regulatory authority.  However, that includes the smaller candy and fruit flavored cigars that are a significant feature of the tobacco cartel’s growth market.  These small cigars are more accessible to youth not only because they are sold in flavors but they are also sold individually and often the most inexpensive tobacco product available.  The 2012 Surgeon General’s Report on Youth and Young Adult Tobacco Use notes that 1 in 5 white male high school seniors is a current cigar smoker and that most typically consume more than one type of tobacco product. 

This proposed legislation should alarm local tobacco free advocates because 3 of Arkansas’ Representatives are co-sponsors.  Additionally, retailers in Arkansas are not yet required to place all tobacco products behind the counter. Product placement, like placing small cigars next to bubble gum, has long been a tactic in a sophisticated strategy making tobacco seem normal and desirable in stores where youth frequent.  

For all its flaws, the FSTPCA may show most promise in the potential for point of sale regulation. The new law allows state and local restrictions on the “time, place, and manner” but not “content”  of tobacco marketing. One locality, Haverstraw, NY, has become the first U.S. municipality to restrict tobacco displays, mimicking tactics public health advocates have employed in other countries.   

Protecting the marketing and promotion of inexpensive candy flavored tobacco with bill titles like “Small Business Jobs Preservation” would be silly if the cost to public health were not so tragic.  The Surgeon General’s Report  notes that 80% of high school smokers will go on to smoke into adulthood.  Half will die prematurely.  It is this compelling interest that should drive policy makers to recognize the tobacco cartel’s continued profit at the public’s expense, and end it.  

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World No Tobacco Day 2012

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13 April 2012

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World No Tobacco Day 2012

In 2003 the World Health Organization (WHO) adopted the Framework Convention on Tobacco Control (FCTC), recognizing tobacco as the leading global cause of death and disease. To date there are 170 parties to the treaty focusing on key tobacco prevention strategies including: adopting tax increases to reduce prevalence, banning tobacco advertising, creating tobacco free spaces, placing prominent warnings on packaging, and combating tobacco smuggling. Responding to a growing tobacco pandemic, the FCTC represents the world’s first global health treaty and affirms the right of all people to the highest standard of health. That has not prevented the tobacco industry from aggressively trying to undermine the efforts of the FCTC. The WHO has selected “Tobacco Industry Interference” in the FCTC as the theme for this year’s World No Tobacco Day, May 31_st.

In this country, 50 years of the tobacco industry’s sophisticated efforts opposing the public health gained a federal court conviction for racketeering and fraud in 2006. Today, the growth market for tobacco extends beyond our borders but industry efforts are no less deceitful and manipulative. Front groups and public relation firms have promoted the same pseudo-science regarding secondhand smoke and tobacco globally. Internal documents have shown the industry makes extensive use of media to manipulate research and public opinion to oppose tobacco taxes, marketing reform, and tobacco free space all over the world. One of the most infamous evidences of industry interference was a 1999 paper, commissioned by Philip Morris, stating that in Czechoslovakia smoking was actually beneficial because a decreased lifespan saved pension funding.

Litigation continues to be one of the tobacco industry’s strengths. In countries from Uruguay to Germany, tobacco industry lawyers have hindered and thwarted challenges to tobacco prevalence. Graphic warnings in the U.S., plain packaging in Australia, and regulating displays in the U.K. are all being challenged in their respective courts.

Perhaps the most heinous industry tactic is the infiltration and manipulation of otherwise well intentioned advocate groups. Youth tobacco education programs, funded by the tobacco industry, employed all over the world, show little success in preventing initiation and can actually enhance tobacco use. Project Sunrise, revealed by industry documents, exposes a plan to collaborate with, and manipulate, public health groups, legislation, and individuals to compromise and weaken tobacco free efforts.

The lengths to which the tobacco industry will go is perhaps limitless. The message of World No Tobacco Day 2012 is that challenging tobacco necessitates that public health advocates understand a paradigm shift recognizing a profit driven pandemic unlike any the world has ever known.

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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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