Presentation on theme: "Tobacco Control – Yesterday, Today and Tomorrow"— Presentation transcript:
1Tobacco Control – Yesterday, Today and Tomorrow Christopher SquierCommission on Tobacco Use Prevention and ControlAmerican Cancer Society (ACS)Clean Air for Everyone (CAFÉ)
2In the Beginning……… Iowa Cigarette Control Law—1897 In Iowa banned the manufacture, sale, exchange, and disposition of cigarettes and cigarette paper.The ban was repealed after the 1st World War but in 1921 Iowa became the first state to impose a cigarette tax!
3In the Beginning……… Strange Bedfellows – Henry Ford and Adolf Hitler In 1941, Hitler introduced a comprehensive public health program to restrict smoking and limit advertising1914
41930’s and 1940’s -the Age of Innocence? Physicians selling cigarettes!
6The 1950’s - the Health Context -cruel realities; tobacco can kill you the 1st Surgeon General’s Reportlinked smoking and lung cancerBut in 1961 Philip Morris had already identified 42 carcinogens in tobacco smoke!
7The Health Context -cruel realities; tobacco can kill you 1966 Health warnings beginon cigarette packsCaution--cigarette smoking maybe hazardous to your health1971 Cigarette advertisementsare taken off TV and radio
8The Response of Big Tobacco – lies and prevarication The filtered fifties and the low tarsixties – cruel hoaxesApril 14, 1994; the chief executive officers of the 7 major tobacco companies testified before Congress that they did not believe nicotine was addictive.
9Tobacco Control ? ‘Education’ and just say ‘no’ An ‘adult habit’ Website funded by R J Reynolds to promote ‘adult choice’
10The Litigous Nineties and the 1998 Master Settlement Agreement Q: ‘Could you please explainthe recent historic tobacco settlement?’A:’ Sure. Basically, the tobacco industryhas admitted that it is killing people by the millions, and has agreed thatfrom now on it will do this under the strict supervision of the federal government’.Dave Barry
11The Attorneys General Master Settlement Agreement In 1998 the tobacco industry agreed to pay 46 states $206b over 25 years:the agreement included provisions to:refrain from targeting youthto limit brand name sponsorshipreduce outside advertising (billboards and transit)refrain from opposing state or local laws intended to protect youthcease to sell merchandise with tobacco brand names
13Comprehensive Tobacco Control Programs Work CDC showed:Dose response relationship between levels of spending and program effectIncrease in spending per capita associated with larger tobacco control program effectIncreased efficiency from lessons learned
14Tobacco Control in Iowa Iowa Code AnnotatedChapter 142A. Tobacco Use Prevention and ControlEstablishment of a Division of Tobacco Use Prevention and Control with a full time DirectorEstablishment of a Commission to develop policy and provide directionEstablish youth programs that are directed by youth participants for youth.Establish community partnerships
15What Happened in Iowa?- an unprecedented decrease in smoking prevalence!
16What happened in Iowa?A relationship between tobacco control spending and outcomes
17What happened in Iowa? A successful youth program (JEL) and a reduction in youth smoking A greater reduction in youth smoking in Iowa than nationally
18What happened in Iowa? A decrease in hospital admissions for diseases related to secondhand smoke exposure
19Tobacco Control - what is happening now in Iowa Tobacco Control - what is happening now in Iowa? Snatching Disaster from the Jaws of SuccessSince 2009 we have seen continual cuts in the budget of the Division of Tobacco ControlThis culminated in a halving of the current years budget!
20Tobacco Control - what is happening in Iowa Tobacco Control - what is happening in Iowa? Snatching Disaster from the Jaws of SuccessDevastating budget cuts are having predictable effectsIowa smoking rates have gone up to 16% in 2010 (Iowa Adult Tobacco Survey)O
21Tobacco Control - what is happening in Iowa Tobacco Control - what is happening in Iowa? Snatching Disaster from the Jaws of SuccessBut there is no shortage of funding!Tobacco settlement and tax income is almost one hundred times greater than the appropriations to tobacco controlMeanwhile, the tobacco industry spends $102M a year promoting its products in Iowa!
22Tobacco Control - what is happening in Iowa? We have a Governor who claims that Iowa will be the healthiest state in the nationBut actions speak louder than words!Tobacco funding has been halvedThe Director was dismissed and the Division of Tobacco Control is threatened with elimination!
23Is there a tomorrow? An end game for tobacco? A global view As smoking rates decrease, how do we finally eliminate a lethal but addictive product?
24Framework convention on tobacco control The treaty sets an international floor for tobacco control with provisions on advertising and sponsorship, tax and price increases, labeling, illicit trade and secondhand smoke.
25How effective are these strategies? The USA has not ratified the Convention!
26Tobacco Free New Zealand 2020 Tupeka Kore Aotearoa 2020VisionFuture generations of New Zealand children will be free from exposure to tobacco and will enjoy smokefree livesStrategiesTobacco retail displays will be bannedPlain packaging and graphic warnings will replace brand imageryTobacco retail prices will increase systematically and significantly (20% per year)The supply and sale of tobacco products will be controlled –retailers licensed and number of licenses decreased annually
31Tobacco Control - what is to be done in Iowa? 30% of all cancers are related to tobacco use80% of lung and oral cancers are related to tobacco use4,400 Iowa adults die each year from tobacco useBut there is an industry that lobbies against the actions that are necessary to prevent or reduce tobacco related diseases!
32Tobacco Control - what is to be done in Iowa Tobacco Control - what is to be done in Iowa? There are new challenges; smokeless tobacco products -dissolvablesThere are a variety of flavored, soluble tobacco products being promoted in the US, some with a great similarity to candy!Attempts to regulate these have been resisted!
33Tobacco Control - what is to be done in Iowa Tobacco Control - what is to be done in Iowa? New challenges; snuff, snus and cross-brandingSnus is a form of smokeless tobacco manufactured in Sweden that has much lower levels of carcinogens (nitrosamines) than are found in US snuff.‘Snus’ has recently been marketed in the US but there is no information on the level of carcinogens or its health effects. Some is sold under cigarette brand names, suggesting it is intended to supplement smoking, not replace it!
34Tobacco Control - what is to be done in Iowa? Education – we have an administration and legislature that needs a lot of helpWe must advocate and where necessary apply political pressure – follow the money!Grassroot and grasstop support is essential – that means you!4,400 Iowa adults die each year from tobacco use