Tobacco-free policy

The Cancer Prevention and Research Institute in Texas announced earlier this month, a new tobacco-free policy for all current and future grants, which includes Texas and Texas Tech University Health Sciences Center.
Smoking is prohibited within 20 feet of the entrances to the buildings on campus.
Texas Tech
Taylor Eighmy, Vice President for Research at Texas, said the university received about $ 1 million from the institute since it was found, and hoped to get so much more.
“You can certainly understand why CPRIT would do something like this. Cancer is a terrible disease and it affects so many people. Relations between tobacco and cancer are very clear,” said Eighmy. “It’s probably not the first time (s), such as CPRIT, which distributes research dollars to help the fight against this disease in the implementation of these kinds of rules. We understand this and we will abide by this rule. It does not surprise us “.
Texas voters approved a constitutional amendment in 2007, the creation of CPRIT and authorizing the state provides $ 3 billion in bonds to fund innovative cancer research and prevention programs and services in Texas.
CPRIT has funded 364 awards for cancer research, commercialization and prevention since 2010, according to its website. Recipients CPRIT awards include 66 academic institutions, nonprofit organizations and private companies, all located in Texas.
The new policy applies to all institutions, organizations or companies that receive grants from CPRIT equal to or greater than $ 25,000 during the fiscal year. Tobacco-free policy covers all types of tobacco, including cigarettes, cigars, pipes, hookahs, electronic cigarettes, smokeless tobacco, snuff and chewing tobacco.
This rule requires the prohibition of tobacco products to employees and visitors to buildings and structures, where the CPRIT-funded projects will be held, as well as sidewalks, parking lots, walkways and parking structures attached in close proximity to the degree of CPRIT-funded Company owns leases or controls.
Texas Tech should be a review of current policy work, which requires the approval of Texas Tech University System Board of Regents, Eighmy said.
Tobacco-free policy will affect only the buildings, which conducts research funding CPRIT. Eighmy said the five buildings will be free of tobacco, including civil engineering, human sciences, agriculture and experimental sciences.
Details of compliance policies can not be made public until they are completed after the Board of Regents meets in March, Eighmy said.
Eighmy said the ban on tobacco town wide is a hot topic, but for now, the University pays special attention to this policy.
“I think it’s obvious that people can think and talk,” he said. At the moment … I think we will use it more than the entire scene mode. We are going to meet your specific requirements, which allow us to meet CPRIT (policy). ”
Student response to
Clint Elliott, a senior non-smoker, said that tobacco-free policy sounded good to him, until he realized policy include smokeless tobacco.
“I think it’s kind of dumb. Smokeless tobacco is not doing anything. I think it gives you a gum cancer, but it’s rare,” he said. “I think I’ll stay away from these buildings.”
Nelly Vanderhagen, a freshman who does not use tobacco products, said she believes that the new policy is a sound idea, but said she does not necessarily agree with him.
“Passive smoking is not good. I do not want to be around smokers. It’s a good idea for the environment and health…. I think they have the freedom to smoke (where they choose) within certain limits. Doors limit is good idea, but it should not change just because (Tech) receives funding. ”
Shely Miller, Senior Tech, said she had been smoking for almost three years. She said that CPRIT policy makes sense, and she has no problems with the rules. Before she became a smoker, it is annoying when people walk on it and blew into her face, she said.
It is not that the other student smokers will feel the same.
“The Human Sciences building, I do not think it will fly there,” she said. “There are a lot of smokers out there. They are always in front of the building. This is sort of their own culture. I guarantee many of these people will be upset.”
Howard Monsour, a senior who smoked outside the Arts Building on Thursday, said smoking since he was 13 years old.
Monsour said he believes he has the right to do what he wants and he should be able to smoke where he wants, but he understands the reasons for the new policy. However, he did not believe all smokers will comply.
“I think, frankly, people are smoking (in the tobacco-free areas). People who want to smoke in any case,” said Monsour. “We have laws, and there are always people who violate them.”
Doug STOCCO, executive vice president of research for the Texas Tech Health Sciences Center, said CPRIT awarded the HSC agencies more than $ 16.2 million since its inception, but the HSC will not depend on the new policy.
TTUHSC first issue of smoke free policies in all owned / managed buildings in September 1989. In September 2000, a change in policy was published, which makes building a tobacco-free environment since January 1, 2001. This policy prohibited the use of tobacco in TTUHSC facilities and in any place in any TTUHSC campus.
“CPRIT announcement was not a problem for us. We have been in compliance for at least 10 years,” said STOCCO. “People thought that agriculture should not prevent the promotion of healthy things.”
The current policy of HSC will be presented to the Board of Regents for approval at the next meeting, in accordance with the requirements of CPRIT, he added.
“We’re still ahead of the curve on all this. We really,” STOCCO said. “The reason is that in the late ’90s and early 2000s, we were very, very vibrant group here that was anti-smoking”.
Donna Bacchi, Lubbock doctor and wife of former Chancellor of Technology, David Smith, at the head of the center of HSC to prevent smoking, STOCCO said. The group is responsible for the smoking ban by many local restaurants, he said.
Another requirement of the new instrument of policy CPRIT funded are required to provide or refer to the use of tobacco cessation services to employees.
Eighmy said Tech employees who are interested in stopping the service can contact the staff to get directions.
STOCCO said Bacchi and her team also put in place HSC tobacco intervention program, services provided to individuals who want to quit smoking.
Because nicotine is addictive, like other drugs, those who try to quit smoking should have a plan and procedures for removing dependence, STOCCO said. Intervention program gives people that plan, he said.
“I 100 percent agree with the new policy ….” STOCCO said. “I do not think (CPRIT) uses it as a strong arm tactic, but looking at him any group of research and work to prevent cancer should have a policy, because we know the dangers of cigarettes and cancer. I welcome their efforts, and I think they’re right on the money. ”

Doctors hawked cigarettes are healthy for consumers

Despite its stated mission, “To promote the art and science of medicine and the betterment of public health,” the American Medical Association (AMA) has taken many missteps in protecting the health of the American people. One of the most striking examples is the AMA’s long-term relationship with the tobacco industry.

Both the AMA and individual doctors sided with big tobacco for decades after the deleterious effects of smoking were proven. Medical historians have tracked this relationship in great detail, examining internal documents from tobacco companies and their legal counsel and public relations advisers. The overarching theme of big tobacco’s efforts was to keep alive the appearance of a “debate” or “controversy” of the health effects of cigarette smoking.
The first research to make a statistical correlation between cancer and smoking was published in 1930 in Cologne, Germany. In 1938, Dr. Raymond Pearl of Johns Hopkins University reported that smokers do not live as long as non-smokers. The tobacco industry dismissed these early findings as anecdotal — but at the same time recruited doctors to endorse cigarettes.

JAMA kicks off two decades of cigarette advertising

The Journal of the American Medical Association (JAMA) published its first cigarette advertisement in 1933, stating that it had done so only “after careful consideration of the extent to which cigarettes were used by physicians in practice.” These advertisements continued for 20 years. The same year, Chesterfield began running ads in the New York State Journal of Medicine, with the claim that its cigarettes were “Just as pure as the water you drink… and practically untouched by human hands.”
In medical journals and in the popular media, one of the most infamous cigarette advertising slogans was associated with the Camel brand: “More doctors smoke Camels than any other cigarette.” The campaign began in 1946 and ran for eight years in magazines and on the radio. The ads included this message:
“Family physicians, surgeons, diagnosticians, nose and throat specialists, doctors in every branch of medicine… a total of 113,597 doctors… were asked the question: ‘What cigarette do you smoke?’ And more of them named Camel as their smoke than any other cigarette! Three independent research groups found this to be a fact. You see, doctors too smoke for pleasure. That full Camel flavor is just as appealing to a doctor’s taste as to yours… that marvelous Camel mildness means just as much to his throat as to yours.”

Big Tobacco’s suppression of scientific evidence

At the same time that JAMA ran cigarette ads, it published in 1950 the first major study to causally link smoking to lung cancer. Morton Levin, then director of Cancer Control for the New York State Department of Health, surveyed patients in Buffalo, N.Y., from 1938 to 1950 and found that smokers were twice as likely to develop lung cancer as non-smokers.

Cigarette producers may have hoped that the public would remain unaware of studies published in medical journals. However, the dangers of smoking became widely known in 1952 when Reader’s Digest published “Cancer by the Carton,” detailing the dangers of cigarettes. Within a year cigarette sales fell for the first time in more than two decades.

The tobacco industry responded swiftly, engaging the medical community in its efforts. The Tobacco Industry Research Committee (TIRC) was formed by U.S. tobacco companies in 1954. By sponsoring “independent” scientific research, the TIRC attempted to keep alive a debate about whether or not cigarettes were harmful.

The industry announced the formation of the TIRC in an advertisement that appeared in The New York Times and 447 other newspapers reaching more than 43 million Americans. The advertisement, titled “A Frank Statement to Cigarette Smokers,” read:
“RECENT REPORTS on experiments with mice have given wide publicity to a theory that cigarette smoking is in some way linked with lung cancer in human beings.

Although conducted by doctors of professional standing, these experiments are not regarded as conclusive in the field of cancer research. However, we do not believe that any serious medical research, even though its results are inconclusive should be disregarded or lightly dismissed.
At the same time, we feel it is in the public interest to call attention to the fact that eminent doctors and research scientists have publicly questioned the claimed significance of these experiments.

Distinguished authorities point out:
1. That medical research of recent years indicates many possible causes of lung cancer.
2. That there is no agreement among the authorities regarding what the cause is.
3. That there is no proof that cigarette smoking is one of the causes.
4. Those statistics purporting to link cigarette smoking with the disease could apply with equal force to any one of many other aspects of modern life. Indeed the validity of the statistics themselves is questioned by numerous scientists.
We accept an interest in people’s health as a basic responsibility, paramount to every other consideration in our business.

We believe the products we make are not injurious to health.
We always have and always will cooperate closely with those whose task it is to safeguard the public health. For more than 300 years tobacco has given solace, relaxation, and enjoyment to mankind. At one time or another during those years, critics have held it responsible for practically every disease of the human body. One by one these charges has been abandoned for lack of evidence.

Regardless of the record of the past, the fact that cigarette smoking today should even be suspected as a cause of a serious disease is a matter of deep concern to us.

Many people have asked us what we are doing to meet the public’s concern aroused by the recent reports. Here is the answer:

1. We are pledging aid and assistance to the research effort into all phases of tobacco use and health. This joint financial aid will, of course, be in addition to what is already being contributed by individual companies.
2. For this purpose, we are establishing a joint industry group consisting initially of the undersigned. This group will be known as TOBACCO INDUSTRY RESEARCH COMMITTEE.
3. In charge of the research activities of the Committee will be a scientist of unimpeachable integrity and national repute. In addition, there will be an Advisory Board of scientists disinterested in the cigarette industry. A group of distinguished men from medicine, science, and education will be invited to serve on this Board. These scientists will advise the Committee on its research activities.
This statement is being issued because we believe the people are entitled to know where we stand on this matter and what we intend to do about it.”

Doctors’ involvement in the tobacco deception

The statement — signed by presidents of major tobacco interests including Phillip Morris, Brown & Williamson, and R.J. Reynolds — was designed to launch the “controversy” which I mentioned earlier. In fact, there was no controversy. The research results were clear: smoking had been proven harmful — not just to mice, but to people who had for years been advised that smoking offered health benefits.

The TIRC promised to convene “a group of distinguished men from medicine, science, and education” and it did so. Early members of the TIRC’s Scientific Advisory Board (SAB) included: McKeen Cattell, PhD, MD, professor of pharmacology from Cornell University Medical College; Julius H. Comroe, Jr., MD, director of the University of California Medical Center’s cardiovascular research institute and chairman of University of Pennsylvania Graduate School of Medicine; and Edwin B. Wilson, PhD, LLD, professor of vital statistics, Harvard University.

According to the New York State Archives, the TIRC’s functions “included both the funding of research and carrying out public relations activities relating to tobacco and health.” Faced with mounting evidence that smoking was harmful, “it became evident that this was not a short-term endeavor, and that it was difficult to manage both scientific research and public relations in one organization. As a result, the Tobacco Institute was formed to assume the public relations functions, and the Council for Tobacco Research (CTR) was formed and incorporated to provide funding for scientific research.”
Whether or not individual doctors supported smoking, lending their names to the TIRC gave it credibility. The Center for Media and Democracy has reported that many of the scientists who were members of the Scientific Advisory Board privately “disagreed with the tobacco industry’s party line.” According to the center’s website: “In 1987, Dr. Kenneth Warner polled the SAB’s 13 current members, asking, ‘Do you believe that cigarette smoking causes lung cancer?’ Seven of the SAB members refused to answer the question, even after Warner promised individual anonymity. The other six all answered in the affirmative. ‘I don’t think there’s a guy on the [Board] who doesn’t believe that cigarette smoking contributes to an increased risk of lung cancer,’ one said, adding that the SAB’s members were ‘terrified’ to say so publicly out of fear of involvement in tobacco product liability lawsuits.”

If it was fear that kept doctors on board with the TIRC and its renamed version, CTR, it did not stop them from handing out research grants. The Center for Media and Democracy describes some of the early grants: “Research projects attempted to show that both lung cancer and smoking were caused by some other ‘third factor,’ such as a person’s psychological makeup, religion, war experiences or genetic susceptibility. One research project asked whether the handwriting of lung cancer patients can reveal characteristics associated with lung cancer. Another looked for enzyme markers predicting susceptibility to lung cancer.”

After three decades, the AMA finally admits smoking is harmful

After the 1964 Surgeon General’s landmark report on the dangers of cigarettes, the CTR stepped up its work, providing materials to defend the tobacco industry against litigation. The same year — three decades after medical research demonstrated the dangers of cigarettes — the American Medical Association finally issued a statement on smoking, calling it “a serious health hazard.” It was not until 1998 that the CTR was shut down — and only after the tobacco industry lost a major court case brought forward by states across the country.

Allan M. Brandt, a medical historian at Harvard, writes about the role that medical research played on both sides of the smoking debate in his new book, The Cigarette Century: The Rise, Fall and Deadly Persistence of the Product that Defined America. After reviewing research, court transcripts and previously restricted memoranda from tobacco companies, Brandt summed up the misleading nature of “expert” medical testimony in tobacco litigation: “I was appalled by what the tobacco expert witnesses had written. By asking narrow questions and responding to them with narrow research, they provided precisely the cover the industry sought.”

In a recent interview with The New York Times, Brandt acknowledged that his research is a combination of scholarship and health advocacy — pointing out the means by which the American public was intentionally misled for most of the twentieth century. As Brandt stated, “The stakes are high, and there is much work to be done.”

The medical conspiracy continues today

It is my belief that just as private industry and the medical community conspired to deceive the public on tobacco (and thereby profit from the public’s ignorance of tobacco’s extreme health hazard), the same story is repeating itself today in the cancer industry, the sunscreen industry, and the pharmaceutical industry. In each case, so-called “authoritative” doctors insist that whatever they’re pushing is safe for human consumption and that the public should buy their products without any concern about safety.

And yet these industries are much like the tobacco industry in the fact that they primarily seek profits, not health. Medicine today is in the business of making money, and that goal is achieved by selling chemical products to consumers regardless of their safety or efficacy. Big Medicine is the modern version of Big Tobacco, and over the last several decades, the American Medical Association has proudly supported both cigarettes and pharmaceuticals. In my opinion, the AMA is indirectly responsible for the deaths of millions of Americans — not just from pushing cigarettes but also for continuing to push dangerous pharmaceuticals while discrediting nearly everything in natural medicine or alternative medicine. The AMA is a truly evil organization, in my opinion, that I believe has directly and knowingly contributed to the suffering and death of Americans for more than 75 years. Read my story, What the AMA hopes you never learn about its true history to learn more. In a just society, AMA leaders would be arrested and tried for their crimes against humanity, just as top FDA officials should be.

The cancer industry, similarly, is extremely dangerous to the health and safety of Americans thanks to its outright refusal to support anti-cancer nutrition (vitamin D, broccoli sprouts, spirulina, rainforest herbs, etc.) as well as its refusal to fight for the removal of toxic chemicals from consumer products and the workplace.

In studying the history of product commercialization by medical groups, what we consistently find is a series of cons perpetrated against consumers, masterminded by profit-seeing medical groups that conspire with corporations to maximize profits at the expense of public health. Nothing has changed today, either. The AMA isn’t pushing cigarettes anymore, but it’s still pushing deadly pharmaceuticals that will one day be regarded as just as senseless as smoking. Let’s face it: pharmaceutical medicine is hopelessly outdated, ineffective and dangerous. Nobody intelligent today actually believes that pharmaceuticals help people heal. In fact, the more drugs people take, the worse their health becomes! Modern medicine is actually harmful to patients!

Medical science is slow to change and slow to give up its closely-guarded (false) beliefs. In time, however, virtually everything now supported by the medical industry (the FDA, AMA, ACS, etc.) will be regarded as insanely harmful to human health. One day, future scientists will look back on medicine today and wonder just how such an industry of evil and greed could have gained so much power and authority. The answer is found in “groupthink” and the strange knack for humans to defer to anyone in an apparent position of authority, regardless of whether such authority is warranted.
By Mike Adams

The “Million Hearts” Initiative – Preventing Heart Attacks and Strokes

Each year, more than 2 million Americans have a heart attack or stroke, and more than 800,000 of them die; cardiovascular disease is the leading cause of death in the United States and the largest cause of lower life expectancy among blacks. Related medical costs and productivity losses approach $450 billion annually, and inflation-adjusted direct medical costs are projected to triple over the next two decades if present trends continue.
To reduce this burden, the Department of Health and Human Services (DHHS), other federal, state, and local government agencies, and a broad range of private-sector partners are today launching a “Million Hearts” initiative to prevent 1 million heart attacks and strokes over the next 5 years by implementing proven, effective, inexpensive interventions.
hearts program
Cardiovascular prevention works in two realms: the clinic and the community. Clinical and community interventions each contributed about equally to the 50% reduction in U.S. mortality due to heart attacks between 1980 and 2000. If used consistently, proven interventions could prevent more than half of heart attacks and strokes. It’s time to take the next big step.
In the clinical realm, Million Hearts will improve management of the “ABCS” — aspirin for high-risk patients, blood-pressure control, cholesterol management, and smoking cessation. As for community-based prevention, the initiative will encourage efforts to reduce smoking, improve nutrition, and reduce blood pressure. It will implement the cardiovascular-disease–prevention priorities of the National Quality and National Prevention Strategies and help in meeting targets set by Healthy People 2020.
Improving management of the ABCS can prevent more deaths than other clinical preventive services. Patients reduce their risk of heart attack or stroke by taking aspirin as appropriate. Treating high blood pressure and high cholesterol substantially and quickly reduces mortality among high-risk patients. Even brief smoking-cessation advice from clinicians doubles the likelihood of a successful quit attempt, and the use of medications increases quit rates further.
Currently, less than half of people with ischemic heart disease take daily aspirin or another antiplatelet agent; less than half with hypertension have it adequately controlled; only a third with hyperlipidemia have adequate treatment; and less than a quarter of smokers who try to quit get counseling or medications. As a result, more than 100 million people — half of American adults — smoke or have uncontrolled high blood pressure or cholesterol; many have more than one of these cardiovascular risk factors. Increasing utilization of these simple interventions could save more than 100,000 lives a year. Measuring and monitoring can encourage providers to improve preventive care.
Improving care is particularly critical in light of increases in the prevalence of obesity and diabetes. Obesity and physical activity are currently being addressed by complementary efforts designed to improve understanding, implement pilot or community-based programs, and evaluate outcomes. The First Lady’s “Let’s Move” campaign is a comprehensive initiative with the goal of ending childhood obesity — a precursor to cardiovascular disease — within a generation by fostering environments that support increased physical activity and improved nutrition for children and families. And public and private partners are working to expand the Diabetes Prevention Program, which promotes weight loss, improved nutrition, and increased physical activity among people at highest risk.
The Affordable Care Act (ACA) provides a strong foundation for Million Hearts by increasing coverage and facilitating improved care. It waives patient cost sharing for preventive services, including blood-pressure and cholesterol screening and smoking-cessation counseling and treatment, for enrollees in new private insurance plans. The new annual wellness visit for Medicare beneficiaries will help physicians focus on reducing cardiovascular risk and target interventions appropriately. Eliminating Medicare’s “doughnut hole” in prescription-drug coverage will increase access to blood-pressure, cholesterol-lowering, and smoking-cessation medications. Covering 32 million currently uninsured Americans will reduce financial barriers to preventive care, and expanding community health centers will increase access to care and reduce health disparities. In addition, electronic health records (EHRs) will support improved clinical decision making.
Additional means of increasing control of the ABCS include reducing or eliminating copayments for medications, once-a-day dosing, team-based care approaches, stepwise care management, and new forms of payment and delivery for higher-quality, higher-value, and coordinated care, such as those envisioned for accountable care organizations.
Expanding use of prevention-oriented EHRs will enable providers and health systems to track and improve management of the ABCS. Incorporating core ABCS-related quality measures and decision-support tools into the 2013–2014 criteria for “meaningful use” of information technology and providing technical assistance through quality-improvement organizations in all states, the 62 Health Information Technology Regional Extension Centers (which reach nearly 100,000 primary care doctors), and Beacon Communities will reach more than 100 million patients within the next few years.
Million Hearts will work to standardize core ABCS indicators across medical practices, insurers, institutional providers, and systems in public and nonpublic settings. Standardization will facilitate public reporting and identification and diffusion of best practices and will reduce providers’ burden by streamlining quality measurement and improvement. The initiative will be linked to quality-recognition programs (e.g., the Physician Quality Reporting System and star ratings for Medicare Part D and Medicare Advantage plans) and may eventually support approaches in which providers are paid more for better preventive care.
Community-based prevention works by facilitating healthy choices. Important community-based prevention initiatives include those funded by the American Recovery and Reinvestment Act’s Communities Putting Prevention to Work program and programs supported by the ACA’s Prevention and Public Health Fund, including Community Transformation Grants, initiatives for tobacco control and chronic-disease prevention and control, many National Prevention Strategy initiatives, and state and local actions addressing tobacco use, nutrition, and the linkage between clinical and community-based prevention.
Reductions in smoking, sodium consumption, and trans fat consumption can substantially and rapidly improve cardiovascular health. Warning people about the harms of tobacco use through mass media and other measures, as well as package labeling as enabled by the Family Smoking Prevention and Tobacco Control Act, and creating smoke-free public places and workplaces, as detailed in the National Prevention Strategy and facilitated through ACA-funded community grants, should further reduce smoking rates by discouraging smoking initiation and encouraging cessation.
Reducing sodium intake, another key National Prevention Strategy intervention, reduces risks of hypertension and cardiovascular disease. Because most dietary sodium comes from processed and restaurant foods, it’s difficult for Americans to limit their sodium consumption. Procurement guidelines from the DHHS and the General Services Administration and proposed school-food standards from the Department of Agriculture include a focus on sodium reduction. Menu-labeling requirements in chain restaurants will help people make more informed choices. The Centers for Disease Control and Prevention (CDC) is increasing public and professional education regarding sodium, and the CDC’s National Health and Nutrition Examination Survey (NHANES) will begin collecting information on sodium consumption.
Consumption of artificial trans fat increases the risk of cardiovascular disease by raising low-density lipoprotein (LDL) cholesterol levels and lowering high-density lipoprotein (HDL) cholesterol levels. Replacing artificial trans fat with heart-healthy oils is feasible and does not increase the cost or change the flavor or texture of foods. Since the Food and Drug Administration began requiring listing of trans fat content on food labels, the industry has voluntarily reformulated foods, and according to CDC data, Americans’ trans fat consumption has decreased by at least half. Elimination of such consumption could prevent 50,000 deaths per year.5
Million Hearts will leverage, focus, and align existing investments and generally not require new public spending. Voluntary initiatives will simplify, harmonize, and automate clinicians’ reporting requirements, decrease administrative burden, improve the quality of prevention and care, and inform the public more fully. Improvements in control of the ABCS, nutrition, and smoking are projected to prevent more than a million heart attacks and strokes over the initiative’s first 5 years. By focusing our initial efforts where they will save the most lives, we aim to make progress toward a health system that will serve Americans’ needs in the 21st century.
Source Information
Dr. Frieden is the director of the Centers for Disease Control and Prevention, Atlanta; Dr. Berwick is the administrator of the Centers for Medicare and Medicaid Services, Baltimore.

University of Kentucky adopted tobacco-free policies

This summer, a group of University of Kentucky students and staff has been patrolling campus grounds – scouting out any student, employee or visitor lighting a cigarette.
Unlike hall monitors who cite students for bad behavior, the Tobacco-free Take Action! volunteers approach smokers, respectfully ask them to dispose of the cigarette and provide information about quit-smoking resources available on campus.
The University of Kentucky is one of more than 500 college campuses across the country that have enacted 100% smoke-free or tobacco-free policies as of July 1. Although policy enforcement varies from school to school, most prohibit smoking on all campus grounds, including athletic stadiums, restaurants and parking lots.
An increasing number of colleges adopted smoke-free or tobacco-free policies in the past few years, according to American Nonsmokers’ Rights Foundation Project Manager Liz Williams. In the past year alone, 120 campuses were added to the smoke-free list.
The most successful policies have been grass-roots efforts driven by students and campus employees.
“They typically come about because students and faculty are questioning the role of tobacco in an educational setting and deciding to discourage its use and exposure,” Williams said.
About 46 million Americans age 18 and older smoke cigarettes, according to the Centers for Disease Control and Prevention. A 2010 American College Health Association report found that out of 30,093 students surveyed at 39 colleges, 4.4% had smoked every day in the past 30 days.
Since the first surgeon general report declaring the negative effects of smoking in 1964, smoking has become “socially less acceptable” among people of all ages, especially college students, says Laura Talbott-Forbes, chairwoman of the health association’s Alcohol, Tobacco and Other Drugs Coalition.
“There’s a very health-conscious, socially aware student that we have on campus these days,” she said.
The smoke-free spree
It wasn’t until the early 2000s that 100% smoke-free campuses began popping up across the United States.
Ty Patterson, the former vice president of Student Affairs at Ozarks Technical Community College in Springfield, Missouri, says he started the first smoke-free campus in 2003, but the idea was planted in 1999.
“The president came to me and said, ‘Ty, we’ve got problems. You can’t get in and out of doorways without going through a corridor of smoke,’ ” Patterson recalled.
Patterson, who had quit smoking two years prior, set out to find a higher education institution that had managed to eliminate tobacco on campus. To Patterson’s dismay, there weren’t any.
“When I explained to (schools) what we were thinking about doing, they said … ‘We’d love to be able to do that, but we don’t know how,’ ” he said.
Over the next four years, Patterson developed a policy in which trained staff members held polite conversations with students and faculty who violated the smoking rules. The first violation is a warning. The second and third result in $15 fines or two hours spent picking up tobacco litter. For any further violations, the offender is placed on probation or asked to leave the school.
Although some employees vehemently opposed the policy, Patterson says, no staff member ever reached the third violation, and only two students were placed on probation from the time the school enforced the policy in October 2004.
Ozarks Technical spent more than 3½ years developing the initiative and educating students and staff about the forthcoming policy. However, Patterson — who has now helped more than 500 schools, hospitals and businesses implement smoking bans as the director of the National Center for Tobacco Policy — says most campuses today can effectively institute a policy in one year since there’s less resistance to the concept than in 2003.
It really works
The University of Michigan enacted a smoke-free policy on July 1. Campus officials spent three years researching policies and forming focus groups, committees and surveys to seek student and faculty input.
Since the ban was implemented, school Chief Health Officer Dr. Robert Winfield says, it’s uncommon to see smokers anywhere but along city of Ann Arbor sidewalks — where smoking is permitted. He cited one entrance to the Michigan Union known as a smoker hot spot. When he visited the area recently, he noted, “there wasn’t a smoker in sight.”
In 2009, the state of Kentucky had one of the highest smoking rates at 25.6%, according to the CDC.
Since the University of Kentucky turned smoke-free in November that year, an increasing number of people have sought tobacco treatment services. In 2008, 33 people enrolled in a tobacco cessation program. After the policy’s first year, enrollment rose to 146 people, according to Ellen Hahn, director of UK’s Tobacco Policy Research Program. The number of nicotine replacement coupons redeemed by students and faculty also increased from 124 to 470 in the same period.
For smokers visiting the campus, UK offers nicotine cessation products, such as gum or patches, for $5 at several locations.
“We’re trying to make it comfortable for people so they don’t feel like they have to light up and violate the policy,” Hahn said.
Secondhand smoke boosts kids’ ADHD, learning disability risks
Policy patrol
During the first semester of a smoking ban, Patterson recommends that universities not come down with a heavy fist and instead educate the community about the policy and the negative effects of tobacco.
Nearly two years later, the University of Kentucky still doesn’t exercise strict enforcement. “We certainly don’t have smoking police,” Hahn said.
Instead, smoke-free supporters like senior Melissa McCann, a Tobacco-free Take Action! volunteer, remind smokers of the ban. McCann said the 10 smokers she asked to extinguish their cigarettes this summer all complied.
“In a tobacco state, you might think we’d have more backlash and opposition than we did,” said Hahn, explaining that only a few students held a protest the day the policy launched.
Regardless of the health benefits, opponents argue that smoke-free policies infringe on people’s rights. Michigan senior Graham Kozak, president of the College Libertarians, says smoking is a “personal choice.”
“It’s not within the scope of the university’s responsibilities to decide that smoking is an activity that we as adults shouldn’t engage in,” he said.
Jonathan Sternberg, an attorney currently fighting a citywide smoking ban in Springfield, Missouri, says smoking bans “just don’t really make sense.”
“Any time you tell (people) that they can’t do something they want to do, really they’re just going to do it anyway. … All you’re doing is encouraging disrespect for authority,” Sternberg said.
Smoking in pregnancy linked to serious birth defects
A smoke-free future
The University of Florida went tobacco-free in July 2010, and Valencia College in Orlando plans to adopt the policy in 2012. This spurred students at Seminole State College of Florida to talk with administrators about following their lead, says Student Government Association President Krizia Capeles.
In response, the association plans to distribute a ballot this fall, in which students will vote for or against a smoking ban.
Patterson predicts that nearly all college campuses in the United States will be 100% smoke-free in 10 years. Talbott-Forbes, too, says it’s a possibility — mentioning how professors once smoked in their offices but can’t today.
“We’ve gone from pushing smoking out of the building … to now trying to push smoking totally off campus,” she said.
Although it may take time to sink in, Hahn said, people eventually “get it.”
“They get the idea that tobacco use just isn’t accepted here.”

WHO welcomes Sochi 2014's decision to make next Winter Olympic Games smoke-free

The World Health Organization has welcomed Sochi 2014’s decision to support the non-smoking policy during the next Winter Olympic Games. It will make the Sochi Olympics the twelfth Olympic Games to be free from tobacco smoke, with a blanket ban that will protect over 155,000 athletes, sports delegation representatives and volunteers from the harmful effects of smoking. The best lessons learned from other international events were recently discussed at a working meeting in the city of Sochi, attended by representatives of the World Health Organization (WHO), international non smoking foundations, the Administration of Sochi and Krasnodar region, and the Sochi 2014 Organizing Committee.
During the working meeting, those present assessed the efforts of Organizing Committees from past Games in the fight again smoking. In particular they looked at the example of Beijing, where, during the Summer Olympic Games of 2008 smoking was banned in restaurants and hotels connected to the Olympics, with hundreds of other sites voluntarily becoming no-smoking areas. A ban on smoking in taxis was also brought in especially for the Beijing Games, and came into effect in 2007. The organizers of the 2008 Games invested substantially into a public advertising campaign on the harm caused by passive smoking. The adverts were put up at bus-stops, in the metro and at airports. These measures were all seen to be successful and within a year after the Olympic Games, the level of tobacco consumption in Beijing had fallen by 1.5%.
The meeting set out a framework which states that all the Olympic venues in Sochi during the Games and all public areas without exception will become non-smoking territory. The only place that smoking will be permitted during the Games is in specially marked areas outside the Olympic and Paralympic venues, which have been designed to minimise the impact on those who do not smoke. There will also be a ban on smoking in the bars and restaurants situated in the Olympic Park. Visitors will be unable to purchase cigarettes in any of the Olympic venues, whilst during events the message of the Organizing Committee’s anti-smoking policy will be broadcast on the scoreboard and over the radio. In addition, there will be a telephone number available for people to call if they wish to complain about people smoking in designated non-smoking areas.
The participants of the meeting highlighted that although Russia joined the International Anti-Tobacco Convention in 1998, smoking is still a serious issue in a country with one of the world’s highest percentages of smokers, currently 44 million people. It has been reported that each year approximately 500,000 people die from smoking-related illnesses in Russia.
The Sochi 2014 Organizing Committee continues to work hard in ensuring that it hosts a Games in accordance with the sustainable development policy. They have focused on six key aspects, the foremost of which is a healthy lifestyle. To bring this to life, the Sochi 2014 Organizing Committee have sought ways to popularize healthy lifestyles which would not be possible without a non-smoking policy.
Sochi 2014 CEO and President, Dmitry Chernyshenko commented:
“It is very important that The World Health Organization has welcomed Sochi 2014’s decision to support the non-smoking policy during the next Winter Olympic Games. There is a well known rhyme in Russia which says ‘stop smoking, go skiing’ and I would like this philosophy to be adopted during the Sochi 2014 Winter Games. Our aim for these Games is not only to create a long lasting legacy in Russia that promotes the benefits of sport, but also to encourage citizens to live a healthy lifestyle and change their lives for the better.
If as a result of this anti-smoking drive we can significantly reduce the number of Russians who smoke, then I will feel that Sochi 2014 will have made yet another vital contribution to bringing about transformative social change in our country.”

For more information, contact: Xenia Reizhevskaya, Sochi 2014 Head of Press Office, +7 925 999 2551

The FDA's Cigarette Pack Anti-Smoking Billboards

The new FDA regulations for cigarette packaging raises additional First Amendment issues to the extent that it is a case of compelledFDA cigarettes packs speech, as opposed to being one of prohibited speech. The case precedents in this area go back to the 1940s in purely political contexts as opposed to commercial speech.
In Minersville School District v. Gobitis, 310 U.S. 586 (1940), the Court upheld a school administrator’s decision to expel Jehovah’s Witness students who refused to salute the flag. Then, after a large public outcry, and the addition of two new Justices, the Court reversed that ruling in West Virginia v. Barnette, 319 U.S.624 (1943), with three of the Minersville majority reversing themselves. The Barnette ruling, however, did not go any further than finding an inconsistency between recognizing a right to speak one’s own mind and allowing public authorities to compel an individual to say what he does not believe.
Thirty-four years later, in Maynards v. New Hampshire, 430 U.S. 705(1977) the Court overturned the conviction of Jehovah’s witnesses who had covered over the state motto “Live free or die” on their license plates. Chief Justice Burger’s opinion chastised the state for compelling individuals to be “couriers for ideological messages” and “mobile billboards” for the state’s politically charged motto.
The First Amendment thus unquestionably prohibits the government from compelling any person to speak against their beliefs or interests as well as prohibiting the suppression of speech. Barnette and Maynards, however, involved purely political messages, but what about compelling commercial speech via regulation?
In R.J. Reynolds Tobacco Co. v. Shewry, 423 F.3rd 906 (2005),the Ninth Circuit Court of Appeals upheld a California statute that applied specific revenues obtained from the tobacco industry through a 25 cent per pack cigarette tax to fund anti-smoking advertisements that vilified the industry. The Court rejected Reynolds’ argument that this was unconstitutional as it compelled the company to speak against its interests by funding a message with which it strongly disagreed.
The Court of Appeals opinion in the R.J. Reynolds case relied on recent Supreme Court rulings that give broad discretion to the states as to how they spend tax revenues, including public information campaigns that target specific industries. The Supreme Court denied certiorari in 2006, thus letting the Ninth Circuit ruling stand. R.J. Reynolds Tobacco Co. v. Shewry, No. 05-867 (Feb. 21, 2006).
In R.J. Reynolds, the Court of Appeals tacitly recognized that spending money on advertising or public service messages was a form of protected speech, as has been made explicit by the Supreme Court’s 2010 ruling in Citizens United v. Federal Elections Commission, that upheld the right of corporate free speech in the form of spending money to influence public opinion and voters on political issues. The ruling in Citizens United has proven to be highly controversial in large measure because corporate “speech” via spending money can be done anonymously in political campaigns, a factor which by definition is not present in context of corporate packaging and advertising to sell products.
In the context of tobacco products, restrictions on advertising over broadcast media have been in place for decades. In Capitol Broadcasting Co. v. Mitchell, 404 U.S. 1000 (1972), the Supreme Court affirmed per curiam a ruling by the D.C. District Court, 333 F. Supp. 582 (1971) upholding a federal law, 15 U.S.C. Sect. 1335, that barred cigarette ads on television. In a later case, Pittsburgh Press co. v. Pittsburgh Commission on Human Relations, 413 U.s. 376 (1973), a case involving censorship of print media, Justice Powell’s majority opinion distinguished the Court’s summary ruling in Capitol Broadcasting on the basis that it applied only to restricting commercial messages on broadcast media, not in print media..
Similarly, health warning labels on cigarette packages have been required since 1965 under the Cigarette Label and Warning Act. The tobacco industry did not appeal from that legislation at the time, deciding instead to accept the modest factual message about health risks that the law required on all cigarette packs. They were confident, to be sure, that the warnings would not deter many of their older existing customers, hard core nicotine addicts, while they just might insulate the industry from liability for smoking related diseases to people who took up the habit after the warnings were printed on the packages.
Not all inroads on the tobacco industry’s commercial free speech rights have been upheld under the First Amendment or acquiesed to by the manufacturers. In Lorillard Tobacco Co. v. Reilly, 533 U.S. 525 (2001), the Supreme Court struck down a series of Massachusetts regulations that restricted the advertising of tobacco products. A threshold issue under the Supremacy Clause of Article VI might have sufficed to render the state regulations invalid, as against exclusive federal jurisdiction under statute, but the Court went on to analyze the regulations as limiting commercial speech under the First Amendment as well.
On the First Amendment issue, the Court in Lorillard held that the Commonwealth failed to meet its burden to show that a ban on outdoor advertisement of smokeless tobacco and cigars was not more extensive than necessary to advance the admittedly valid state interest in curbing underage tobacco use. That ruling thus turned on the fourth criterion of Central Hudson, where the ads in question promoted a lawful activity and were not misleading, while the state’s interest was admittedly substantial and the regulation would directly advance that interest.
That same criterion will be the crux of any appeal by the tobacco industry from the FDA’s new requirement for more prominent and more graphic labels on cigarette packs. The rationale for the 1965 law was that tobacco advertisements showing healthy vigorous people smoking cigarettes was deceptive, which would trigger the first criterion under Central Hudson, and the health warning labels were conceived as a legitimate way to achieve a more balanced presentation to the consumer.
The presentation became even more balanced in 1971 when 15 U.S.C. Sect. 1335 took effect, banning cigarette ads on broadcast media. Still cigarettes and other tobacco products remained legal, while public awareness of the serious health hazards of smoking has steadily increased. Nobody today would buy into the Old Gold cigarettes slogan “Not a cough in a carload,” even if the tobacco companies had the effrontery to resume that kind of overtly deceptive advertising.
So, the question again devolves to the fourth criterion under Central Hudson, whether the new FDA regulations that compel cigarette manufacturers to put graphic images on their product at the point of sale are valid under the First Amendment, or whether they substantially exceed what is reasonable and necessary to serve the government’s interest in the issue. That question requires a closer look at what the government’s interest is in this context.
The specific rationale for the Cigarette Label & Warning Act of 1965 was to counter what was, with good reason, then considered to be deceptive advertisement by the tobacco industry. Today, however, cigarette advertising has been severely restricted to print media, and the content is not overtly deceptive as some of the older ads which made claims like “more doctors recommend smoking Camels than any other cigarette.”
There is a real public health issue involved with both smoking and smokeless tobacco use, but if the government’s purpose is to coerce or scare people into quitting cigarettes, a simpler way would be to ban cigarettes and tobacco products outright, without getting into any thorny free speech issues under the First Amendment.
There are, beyond any doubt, serious health issues involved with smoking, but despite widespread if not universal recognition of those issues, many people continue to smoke cigarettes. Many of them are addicted, and many others smoke for reasons of vanity, to create and maintain for themselves an image of presumed sophistication or glamour that current cigarette ads in print seek to foster.
That kind of image appeal, however, is materially different from the blatantly deceptive health claims of older cigarette advertising. In the first place, purely subjective considerations of beauty, glamour and sophistication are in the eye of the beholder, in marked contrast with objectively diagnosed medical conditions like lung cancer, emphysema or heart disease. If a significant number of consumers believe smoking is hip, glamorous, macho or sophisticated, even with the help of cigarette ads in addition to Hollywood product placements, then it is in fact hip and glamorous despite the very real health concerns that obtain. For this reason, cigarette ads based on that kind of imagery cannnot be considered deceptive, especially where the packaging already contains accurate textual information about the health risks.
Again, everyone with a functioning brain in today’s America already knows that cigarettes cause cancer and other serious health problems, but despite such knowledge many of our fellow citizens continue to smoke. Nobody today is really being deceived by cigarette ads on any health issues, and therefore the pending regulations that require cigarette manufacturers to place graphic and grotesque imagery on their packaging is clearly excessive as a means to counter deceptive advertising or to promote any other govenmental interests sufficient to override the manufacturer’s right of free speech.
There is also the consumer’s right of free expression to be considered here. Many smokers have strong brand loyalties, and they willingly display the brightly colored packs as an element of their own public image and self-expression. The common image of a biker in white tee shirt with a box of Marlboro’s twisted into one of the sleeves as a macho man gesture is one example of this phenomenon. Individual smokers, the consumers being targeted by the FDA’s new regs, derive gratification from this that will clearly be impaired by being forced to carry the new grotesquely graphic packs or, in the alternative, quit smoking which is in fact the FDA’s actual agenda, as opposed to just providing full disclosure of health risks.
Here, too, many consumers will simply purchase metal cigarette boxes and discard the new packaging, or they will use plastic slip-on covers to conceal the new graphic packaging which they will find highly offensive rather than simply informational. The tobacco companies might also just look the othe way as plastic novelty manufacturers replicate older, Classic brand cigarettes to fit over and hide the new packaging, which would defeat the FDA’s purpose entirely. In that event, what will the smoke police do -enforce the tobacco companies’ trademark rights? Or will they arrest the smoker for covering up the new graphic cigarette pack with a legally purchased plastic replica of the old pack?
The FDA is undoubtedly concerned about younger people taking up smoking, in part based on printed cigarette ads that target them, e.g. Newport’s “alive with pleasure” slogan, but that is not deceptive where many people do find pleasure in smoking cigarettes. Besides, both parental smoking and peer pressure are equally strong if not stronger influences on teenage smoking than the printed cigarette ads per se. This is especially true where younger Americans are less likely to be reading magazines today as opposed to watching television where all tobacco advertising is banned.
There’s another factor that enters ironically into young people taking up the habit, and that is marijuana. Many young people today who smoke marijuana also take up cigarettes, not to appear macho, sophisticated or glamorous, but simply to provide cover for their pot smoking. The aroma of cigarette smoke is used to conceal or mask the smell of pot, especially the more aromatic cigarette brands that many younger people favor, and carrying a pack of cigarettes around provides cover for their carrying the matches or lighter they use for marijuana.
So, yes, it’s clear beyond any doubt that cigarette smoking causes serious health problems, but the same can be said of many other common practices, like drinking alcohol, driving automobiles, eating fatty foods and, most assuredly, enlisting in the armed services. Meanwhile, the government has not found it necessary to require breweries to put pictures of someone puking on every beer can, or require distillers to put pictures of a cirrhotic liver on every bottle of vodka.
Personally, I’d love to see Congress mandate that pictures of dead soldiers with heads blown off be prominently displayed on every Army recruiting poster in every post office all across America -which would really be truth in advertising. Seriously, though, to require that kind of graphic imagery on cigarette packs, but not on beer cans or automobile speedometers, raises an issue of equal protection under the 14th Amendment, as well as free speech under the First Amendment.
Just this past week, in Pliva v. Mensing, the Court held that generic drug manufacturers cannot be sued for failing to provide a stronger health risk warning on their packaging than is required for the equivalent brand-name product. The Pliva ruling was focused narrowly on the basis of pre-emption under the Article VI Supremacy Clause, and did not directly address the equal protection issue, but it clearly raises questions of equal protection and subsantive due process.
There are many products that, like cigarettes, carry a risk of causing serious illness or injury to consumers and/or the general public, and the government does indeed require printed warning labels on everything from beer to chain saws, but there’s been no talk of requiring graphic warnings like, say, gory pictures of lost limbs on every chain saw. So unless and until the government starts requiring graphic, repulsive imagery as part of the required warnings on all products that pose a danger of illness or injury, the new FDA cigarette warnings clearly do not meet the fourth criterion under Central Hudson, where the new cigarette labeling requirements are clearly excessive for the legitimate governmental purpose of providing information to assist the consumer in making an informed choice of whether to purchase the product.
The fact that such graphic warnings of well known health risks are not required on alcoholic beverages or, say, sugar products, is a tacit acknowledgment that the existing textual warnings are sufficient to the legitimate purpose of conveying information about the serious health risks involved with consuming alcohol or sugar, so the same must be true for smoking. Beer and candy ads are at least as “deceptive” as cigarette ads insofar as consumers are portrayed as vigorous and healthy young people, smiling and laughing as they enjoy the product. The extremely graphic imagery required on cigarette packs by the new regulations thus goes far beyond what is legitimately necessary for purely informational purposes, and enter the realm of social engineering -a blatant attempt to dissuade smokers from purchasing the product as opposed to merely providing accurate information as to the risks and then letting the individual decide.
Again, if the government wants people to stop smoking, Congress can pass a law prohibiting the sale and use of all tobacco products, based on clear and important considerations of public health. That, of course, would be utter folly, as was shown with Prohibition and is now playing out with Nixon’s interminable “War on Drugs.” The government also has every right to continue funding anti-smoking campaigns, even using cigarette tax money to do so as held in the R.J. Reynolds case.
But the new FDA rules go far beyond being an exercise of government discretion on how to spend tax revenues or providing meaningful product information to the consumer, and instead get into an area of coerced speech whereby the tobacco companies are required to carry the government’s anti-smoking message on their point of sale packaging. That is no different in principle from Justice Burger’s observation in the Maynard case that the state cannot compel anyone to create a billboard to carry the government’s ideological message.
This is where the new FDA regulations clearly violate the cigarette manufacturer’s First Amendment right of commercial free speech, and raise thorny issue of equal protection and substantive due process as well. The tobacco industry is being singled out for onerous regulation while other industries whose products create equally significant health or safety risks are not subjected to similar regulation.
Again, as held in the 44 Liquormart case, the government cannot single out the tobacco industry on the basis of relative social utility, simply because smoking is viewed by many as a “vice” in addition to being a health problem. Given the fact that such extremely graphic packaging images are not required for other products that pose serious health risks, the new FDA cigarette packaging regulations go far beyond the narrow informational purpose for which health and safety warnings are legitimately and reasonably imposed on a wide variety of consumer products across the board. Those new regulations are therefore excessive under the Central Hudson criteria, and thus violate the tobacco companies’ First Amendment right of commercial free speech.

Snus Maker Sets Its Sights on U.S.

Smokeless-tobacco giant Swedish Match AB, the dominant maker of snus in Scandinavia, plans to begin a major push into the snuscategory in the U.S. in the coming months.
The company, which to date has only dipped its toes into the small-but-growing segment of the U.S. smokeless-tobacco industry, is unveiling two new versions of its General brand for American consumers and sharply expanding retail distribution starting this month. Initial markets will be Chicago, Dallas and Philadelphia, executives said in an interview Thursday.
The effort underscores tobacco makers’ rising interest in expanding a product style that is popular in Sweden and Norway but relatively new in North America. Snus—a type of oral tobacco that comes in small pouches and requires no spitting—accounts for about 2.5% of smokeless-tobacco sales in the U.S., up from virtually no sales just a few years ago, according to Swedish Match.
The Stockholm concern hopes to grab market share from category leaders Reynolds American Inc., which sells Camel Snus, and Altria Group Inc., which markets Marlboro Snus and Skoal Snus.
Swedish Match said it intends to emphasize to consumers that General is an authentic Swedish snus that has been made in Sweden for more than 150 years. The new Nordic Mint and Classic brand cigarettesvarieties will sell at a slight premium to Camel Snus, the market leader in the U.S.
“We think snus in the U.S. is going to be a big category,” said Clark Darrah, vice president for next-generation products for Swedish Match’s U.S. division. “Globally, this is the biggest opportunity that we have.”
The rising demand for snus is part of an upswing in overall sales of smokeless tobacco in the U.S. The category’s growth of roughly 6% to 7% by volume in recent years stems in part from an increase in bans on smoking in public places and higher cigarette taxes, which have prompted some smokers to seek alternatives. U.S. cigarette sales volumes have been declining for years.
Rising sales of smokeless-tobacco products have raised concerns among some major anti-smoking groups, including the Campaign for Tobacco-Free Kids, which worry that such products will keep smokers from quitting tobacco altogether. Other public-health advocates, pointing to the difficulty of quitting smoking, argue that smokeless tobacco could play a role in reducing tobacco-related disease in the U.S.
Research has shown that snus is substantially safer than cigarettes. However, companies can’t make such health claims under a 2009 U.S. tobacco law unless they meet a series of high standards using scientific evidence. Swedish Match said it is looking into the possibility of filing an application with the U.S. Food and Drug Administration to have its snus products designated as “modified risk.” The rules and process for such applications are still being worked out by the FDA.
Swedish Match controls about 85% of the snus market in Sweden and about 70% of the market in Norway. More men consume snus than smoke cigarettes in Sweden, the company noted.
Mr. Darrah acknowledged that the company faces a significant challenge in trying to gain retail-shelf space in the U.S., where Altria and Reynolds dominate the cigarette and smokeless categories. “What we need to do is sell the opportunity to the retailer,” he said.
The company began selling General in the U.S. about five years ago, but sales primarily have been limited to tobacco shops. The company also focused initially on Swedish-American consumers.
Swedish Match will expand distribution into major convenience-store chains in the coming months. Mr. Darrah said the Nordic Mint variety that the company is introducing is designed to appeal to Americans’ interest in flavored snus products.
Mr. Darrah said the increasing anti-smoking regulations and declining societal acceptance of cigarettes in the U.S. have created an environment similar to the one in Sweden more than 30 years ago that helped foster the rise in snus consumption.
Swedish Match also sells mass-market cigars, matches and cigarette lighters. The company controls about 12% of the moist-snuff market in the U.S. with brands such as Longhorn and Timber Wolf. The leaders in that category are Altria, which sells Copenhagen and Skoal, and Reynolds, which markets Grizzly, the top-selling moist snuff.
By David Kesmodel

A Social Networking Device for Smokers

Companies have started adding the ability to communicate wirelessly to an increasing range of devices, like tablet computers, cars and refrigerators.
Now they are doing it with cigarettes.
Blu, the maker of electronic cigarettes that release a nicotine-laden vapor instead of smoke, has developed packs of e-cigarettes with sensors that will let users know when other e-smokers are nearby.
Think of it as social smoking for the social networking era.
“You’ll meet more people than ever, just because of the wow factor,” said Jason Healy, the founder of Blu, who did not appear to be making friends as he exhaled the odorless vapor of an e-cigarette at a coffee shop in Midtown Manhattan recently. “It’s like with any new technology.”
E-cigarettes have several obvious advantages to their traditional counterparts. They allow users to avoid bans on smoking in public places because they release only water vapor. Mr. Healy and other e-cigarette manufacturers also claim that they have practically no negative health effects — an assertion that draws skepticism in many quarters. But the devices are also, in their own way, gadgets.
The new “smart packs,” which will go on sale next month for $80 for five e-cigarettes, are equipped with devices that emit and search for the radio signals of other packs. When they get within 50 feet of one another, the packs vibrate and flash a blue light.
The reusable packs, which serve as a charger for the cigarettes, can be set to exchange information about their owners, like contact information on social networking sites, that can be downloaded onto personal computers.
The packs also conveniently vibrate when a smoker nears a retail outlet that sells Blu cigarettes.
Later versions will be tethered to a smartphone through an app, allowing more options for real-time communication, Mr. Healy said. The company also plans to develop a system through which the packs will monitor how much people are smoking and report back to them — or to their doctors.
Marketers think people want more devices to link to each other. More than 105 million adult Americans have at least two types of connected devices, and 37 million have five or more, according to Forrester Research.
Nintendo’s new hand-held gaming systems, the 3DS, communicate with one another when brought into close proximity. A smartphone app called Color allows users to take photographs that are then automatically shared with anyone nearby who has also downloaded the app. It recently raised $41 million from venture capitalists.
But Charles S. Golvin, an analyst at Forrester Research who has studied connected devices, said that ideas like Blu’s connected cigarettes or Color show that digital connections can get ahead of the reasons for doing so.
“The way that groups of affinity are conferred just by physical proximity makes a bit of sense,” he said. “If someone walks by with a Nintendo, great, I share a common interest. The fact that I walk by a smoker? Seems like a weak link.”
Mr. Healy says he thinks the connected packs would be most useful in nightclubs, where people are interested in striking up conversations and want to smoke without being forced outside.
Adam Alfandary, 24, a Brooklyn resident who works for a technology start-up, was skeptical. He said that the social aspects of smoking were a part of the reason he continued to light up, but he scoffed at the idea of a cigarette that would do the social part for him. “I think that’s the dumbest thing I’ve ever heard in my life,” he said.
“And I’m saying that in full acknowledgment that smoking is one of the dumbest things I can do.”
The New York Times

Asthma rates increasing in U.S., despite less smoking and decreased air pollution

About one in 12 people in the United States now has asthma, a total of 24.6 million people and an increase of 4.3 million since 2001, the Centers for Disease Control and Prevention said Tuesday. The costs of medical care for these patients increased by about 6% between 2002 and 2007, totaling $56 billion in the latter year, according to information in the CDC’s Morbidity and Mortality Weekly Report. The increases come, surprisingly, despite improved air quality throughout most of the country and widespread decreases in smoking. “We don’t know exactly why the rate is going up,” Ileana Arias, principal deputy director of the CDC, said in a news conference. “But measures can be taken to control asthma symptoms, and exacerbations and many asthma attacks can be prevented,” she said.
Asthma is a chronic disease that is marked by wheezing, breathlessness, chest tightness and nighttime and early morning coughing. Common triggers include tobacco smoke, mold, air pollution and infections such as influenza and colds. The disease is generally treated with two classes of medications: beta-agonists to provide quick relief when patients are having symptoms, and inhaled corticosteroids or a combination of steroids and long-acting beta-agonists to control persistent asthma.
Researchers have changed the way they measure the incidence of asthma in the population, so direct comparison to rates in the 1990s is not possible, said Paul Garbe, chief of the CDC’s air pollution and respiratory health branch. But there has been a continuing increase in the incidence over the last several decades, he said. “The trends are going up,” he noted. But one trend, however, has changed, he added. In the 1980s and 1990s, there was a dramatic increase in the number of people who died from asthma, but the numbers have been declining. In 2007, there were 3,447 deaths attributable to asthma, about nine every day. “That [decrease] is the one bright spot.”
[Updated at 1:20 pm.: The number of asthma deaths rose from about 3,000 in 1980 to a high of 5,500 in 1996, according to Garbe. A decline in the death rate then began in 1999, even though the asthma rate continued to grow. He attributed the decline to better medical care of asthma patients and better diagnosis, which allowed more people to be treated.]
Asthma is more common in children, with about 9.6% reporting the disease, compared to 7.7% of adults. Boys were particularly affected, with 11.3% of them having the disease. The biggest increase in asthma rates was among black children, an almost 50% increase between 2001 and 2009. Seventeen percent of black children now have the disease.
Average annual asthma costs in the nation were $3,300 per person over the course of the decade, according to the report. About 90% of those with asthma said they had health insurance, but 11% of those said they still could not afford their asthma medications. About 40% of those without insurance said they could not afford their medications.
One of the key measures in treating asthma is for physicians to prepare a written asthma action plan to teach patients how to manage their symptoms, including how to avoid asthma triggers and how to take their medications properly. Many physicians do not prepare such written plans, Garbe said, perhaps because they feel they do not have sufficient time to do so. Many states are now also developing plans for home environmental assessments and educational sessions to help patients manage their disease. Work in some states has shown that these efforts reduce visits to the emergency room significantly. But severe budget deficits in states and the federal government may impair such efforts in the future, according to the American Lung Assn. The president’s proposed budget, the association said, would reduce funding for in-home visits and other asthma programs by as much as 50% and reduce the number of states funded by the National Asthma Control Program from 36 to 15. At least half of the CDC-funded school-based asthma programs would also be eliminated, the group said.
By Thomas H. Maugh II, Los Angeles Times

State Smoke-Free Laws for Worksites, Restaurants, and Bars

Secondhand smoke (SHS) exposure causes lung cancer and cardiovascular and respiratory diseases in nonsmoking adults and children, resulting in an estimated 46,000 heart disease deaths and 3,400 lung cancer deaths among U.S. nonsmoking adults each year (1). Smoke-free laws that prohibit smoking in all indoor areas of a venue fully protect nonsmokers from involuntary exposure to SHS indoors (1). A Healthy People 2010 objective (27-13) called for enacting laws eliminating smoking in public places and worksites in all 50 states and the District of Columbia (DC); because this objective was not met by 2010, it was retained for Healthy People 2020 (renumbered as TU-13). To assess progress toward meeting this objective, CDC reviewed state laws restricting smoking in effect as of December 31, 2010. This report summarizes the changes in state smoking restrictions for private-sector worksites, restaurants, and bars that occurred from December 31, 2000 to December 31, 2010. The number of states (including DC) with laws that prohibit smoking in indoor areas of worksites, restaurants, and bars increased from zero in 2000 to 26 in 2010. However, regional disparities remain in policy adoption, with no southern state having adopted a smoke-free law that prohibits smoking in all three venues. The Healthy People 2020 target on this topic is achievable if current activity in smoke-free policy adoption is sustained nationally and intensified in certain regions, particularly the South.
This report focuses on laws that completely prohibit smoking in private-sector worksites, restaurants, and bars. These three venues were selected because they are a major source of SHS exposure for nonsmoking employees and the public (1). CDC considers a state smoke-free law to be comprehensive if it prohibits smoking in these three venues. Some states have enacted laws with less stringent smoking restrictions (e.g., provisions restricting smoking to designated areas or to separately ventilated areas); however, these laws are not effective in eliminating SHS exposure. The Surgeon General has concluded that the only way to fully protect nonsmokers from SHS exposure is to prohibit smoking in all indoor areas, and that separating smokers from nonsmokers, cleaning the air, and ventilating buildings cannot eliminate SHS exposure (1).
Data on state smoking restrictions for this report were obtained from CDC’s State Tobacco Activities Tracking and Evaluation (STATE) System database, which contains tobacco-related epidemiologic and economic data and information on state tobacco-related legislation.* State legislation is collected quarterly from an online legal research database of state laws and is analyzed, coded, and entered into the STATE System. The STATE System contains information on state tobacco-related laws, including smoke-free policies, in effect since the fourth quarter of 1995. In addition to information on state smoking restrictions in worksites, restaurants, and bars, the STATE System contains information on state smoking restrictions in other venues, including government worksites, commercial and home-based child care centers, multiunit housing, vehicles, hospitals, prisons, and hotels and motels.
The number of states with comprehensive smoke-free laws in effect increased from zero on December 31, 2000, to 26 states on December 31, 2010 (Table 1). In 2002, Delaware became the first state to implement a comprehensive smoke-free law, followed by New York in 2003, Massachusetts in 2004, and Rhode Island and Washington in 2005. In 2006, comprehensive smoke-free laws went into effect in Colorado, Hawaii, New Jersey, and Ohio, followed by Arizona, DC, Minnesota, and New Mexico in 2007; Illinois, Iowa, and Maryland in 2008; Maine, Montana, Nebraska, Oregon, Utah, and Vermont in 2009; and Kansas, Michigan, South Dakota, and Wisconsin in 2010. The years listed are the years in which the laws took effect; in some cases the laws were enacted in a preceding year. Some state laws were expanded gradually or phased in; in these cases, the year provided is the year when the law first applied to all three of the settings considered in this study. Additionally, while most of these laws were enacted through the state legislative process, Arizona, Ohio, South Dakota, and Washington enacted their laws through ballot measures.
As of December 31, 2010, in addition to the 26 states with comprehensive smoke-free laws, 10 states had enacted laws that prohibit smoking in one or two, but not all three, of the venues included in this study (Table 2). Additionally, eight states had passed less restrictive laws (e.g., laws allowing smoking in designated areas or areas with separate ventilation). Finally, seven states have no statewide smoking restrictions in place for private worksites, restaurants, or bars (Table 2). Of note, only three southern states (Florida, Louisiana, and North Carolina) have laws that prohibit smoking in any two of the three venues examined in this report, and no southern state has a comprehensive state smoke-free law in effect (Figure).
Reported by
M Tynan,* S Babb, MPH, A MacNeil, MPH, M Griffin, MPH, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. *Corresponding contributor: Michael Tynan, CDC, 770-488-5286,

TABLE 1. Effective dates of state comprehensive smoke-free laws — United States, 2002–2010
State Effective date
Delaware 12/1/2002
New York 7/24/2003
Massachusetts 7/5/2004
Rhode Island 3/1/2005
Washington 12/8/2005
New Jersey 4/15/2006
Colorado 7/1/2006
Hawaii 11/16/2006
Ohio 12/7/2006
District of Columbia 1/1/2007
Arizona 5/1/2007
New Mexico 6/15/2007
Minnesota 10/1/2007
Illinois 1/1/2008
Maryland 2/1/2008
Iowa 7/1/2008
Oregon 1/1/2009
Utah 1/1/2009
Nebraska 6/1/2009
Vermont 7/1/2009
Maine 9/11/2009
Montana 10/1/2009
Michigan 5/1/2010
Kansas 7/1/2010
Wisconsin 7/5/2010
South Dakota 11/10/2010
Source: State Tobacco Activities Tracking and Evaluation System, Office on Smoking and Health, CDC.
TABLE 2. State smoking restrictions for worksites, restaurants, and bars in 25 states that do not have a comprehensive smoke-free law — United States, December 31, 2010
State Smoking restriction by location
Worksites Restaurants Bars
Smoke-free in two locations
Florida Smoke-free Smoke-free
Louisiana Smoke-free Smoke-free
Nevada Smoke-free Smoke-free
North Carolina Smoke-free Smoke-free
Smoke-free in one location
Arkansas Smoke-free Designated§
Idaho Designated Smoke-free
New Hampshire Designated Smoke-free
North Dakota Smoke-free Designated
Pennsylvania Smoke-free Ventilated
Tennessee Smoke-free Designated§
Other restrictions
Alabama Designated
Alaska Designated
California Ventilated Ventilated Ventilated
Connecticut Ventilated Ventilated Ventilated
Georgia Designated Designated§ Designated§
Missouri Designated Designated Designated
Oklahoma Designated Ventilated
Virginia Ventilated Ventilated
No smoking restrictions
South Carolina
West Virginia
Source: State Tobacco Activities Tracking and Evaluation System, Office on Smoking and Health, CDC.
FIGURE. State smoke-free indoor air laws in effect for private worksites, restaurants, and bars — United States, December 31, 2010
smoke free states 2010
Source: State Tobacco Activities Tracking and Evaluation System, Office on Smoking and Health, CDC.