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Supreme Court refuses to hear appeal by cigarette manufacturer

May 5th, 2016
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http://montrealgazette.com/news/local-news/supreme-court-refuses-to-hear-appeal-by-cigarette-manufacturer

A Quebec law that was adopted to facilitate the recovery of the costs of medical treatment to smokers has stood up to a cigarette manufacturer’s attempts to invalidate it.

On Thursday, the Supreme Court of Canada refused to hear an appeal by JTI-MacDonald, which was the company’s last recourse to invalidate the law. As is usual in such cases, the top court did not provide grounds for its refusal.

The Tobacco-related Damages and Health Care Costs Recovery Act was sanctioned in June 2009 and its purpose is to establish special rules for the recovery of tobacco-related health care costs that are attributable to a wrong committed by one or more tobacco product manufacturers and for the recovery of damages for a tobacco-related injury.

Quebec Superior Court declared the law constitutional in 2014, and its decision was upheld by the Quebec Court of Appeal in 2015

JTI-MacDonald claims the law infringes the protection that is conferred by Section 23 of the Quebec charter of human rights and freedoms, which provides for the right to a full and equal, public and fair hearing by an independent and impartial tribunal.

The company argues the law has the effect of placing tobacco product manufacturers at a substantial disadvantage compared to government and private litigants because of the “cumulative effect” of the special rules foreseen in the law.

The manufacturers claim they are “handcuffed” and not in a situation to fully defend themselves.

The justices of the Court of Appeal didn’t agree with the manufacturers’ arguments.

However, Justice Geneviève Marcotte, speaking in her name and of those of her colleagues on the bench, called the law “particularly severe” towards cigarette manufacturers and said it “significantly reduces” the government’s burden of proof. The judge also talks in the ruling about “hefty” means in terms of civil responsibility.

Despite the finding, Marcotte declared it’s not for the Court of Appeal to question the choices made by the legislator nor the opportunity for a law.

In June 2012, with the help of the law, Quebec filed a C$60-million claim for damages and interest against JTI-MacDonald and other tobacco manufacturers.

Other provinces in Canada have adopted similar laws to recover health care costs

Liability: untapped potential in the Framework Convention on Tobacco Control

Apr 11th, 2016
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http://blogs.bmj.com/tc/2016/04/11/liability-untapped-potential-in-the-framework-convention-on-tobacco-control/?q=w_tc_blog_sidetab

The history of the Framework Convention on Tobacco Control (FCTC) is filled with one unprecedented victory after another (see page 21). The next milestone for the treaty can—and should— tap the potential of Article 19 to hold the industry liable. Though the implementation of measures in line with Articles 5.3 and 13 has dramatically shifted the way the tobacco industry can operate globally, Article 19 has similar—if not greater—potential to curb the operations of the industry, and therefore the tobacco epidemic. As we look to the next Conference of the Parties (COP) in November, Parties should be looking to make sure that Article 19 achieves its potential.

For many who participated in the drafting of the FCTC, Article 5.3 (protecting public health policies from the tobacco industry) and Article 13 (banning tobacco advertising, promotion and sponsorship) seemed too visionary. Many thought these articles would be politically and technically impossible to implement. But a decade later, Parties are prioritizing these articles— and the effects are startling. Today, tobacco industry marketing is being rolled back across the globe. And dozens of countries have barred the industry from the policymaking table, creating space for effective policies to take hold.

But still the industry continues to be enormously profitable, with the top six corporations raking in $44 billion of profits in 2013. This, in part, because it breaks national laws and is not held accountable for what its products cost society. Governments pay billions of dollars in healthcare costs due to the tobacco epidemic. And evidence continues to mount of the tobacco industry’s illegal activities, which it currently appears to engage in with relative impunity—from illicit trade to widespread and systematic bribery.

To take the next big step in reducing the industry-driven tobacco epidemic, we must be able to hold the industry civilly and criminally liable. We must appreciate the visionary potential in Article 19. And we must take bold, courageous action to realize the world that Article 19 can make possible.

A vast ocean of possibility

Successful civil liability litigation in the U.S. and Canada has proven this tactic has great, global potential. It can provide an avenue for governments to hold the industry accountable for breaking laws, whether it be illegal marketing practices or illicit trade. Financially, it can shift the cost of the tobacco epidemic to the industry, where it belongs, raise the price of tobacco products (which reduces consumption), and provide funds for tobacco control campaigns. And finally, civil liability suits can expose internal industry documents, which provide invaluable insight into the industry’s tactics and help pave the way for even more effective legislation and litigation.

Holding the tobacco industry criminally liable, on the other hand, is admittedly venturing into less tested waters. But the ocean of possibility is vast.

Research on criminal liability provides cause for hope. A successful criminal prosecution would dramatically change the landscape for the tobacco industry. Tobacco executives could face potential prison time for violating tobacco control laws or for misleading people about the lethality of their products. The negative publicity generated with such charges would go far in denormalizing the tobacco industry and would chill the recruitment of talent.

Moral and financial imperative

To be sure, successful implementation of liability measures will prove to be challenging. And it will look different in each country given the range of legal systems across Parties. But the moral and financial imperatives are clear. Parties in the Global South, such as those recently targeted by British American Tobacco’s bribery, are now calling for tools to advance Article 19. These are some of the same Parties who championed Articles 5.3 and 13 during the FCTC negotiations.

We can and must follow these Parties’ visionary lead once again. During COP7, Parties should adopt strong guiding principles to advance implementation of Article 19. These include principles for developing and reforming legislation, and best practices for litigating in civil and criminal liability regimes in both civil and common law jurisdictions and systems.

Without a doubt, litigating against the tobacco industry is costly and intimidating. But many governments are already locked in defensive legal battles with the industry as it turns to litigation more and more to undermine strong tobacco control policies around the world. If governments are going to be in court with the industry, they should be doing it on their terms, proactively holding the industry liable for its myriad of abuses. And to do so, they need tools and guidance for implementation of Article 19 from the treaty, the Secretariat, and the COP. We have the ability to bring the untapped potential of Article 19 into fruition and to rein in the tobacco industry as we have never seen before. We have no time to lose. We must act, as a global community, now.

Chris Bostic is Deputy Director for Policy at Action on Smoking and Health (Twitter: @AshOrg). Richard Daynard is University Distinguished Professor of Law at Northeastern University and President of the Public Health Advocacy Institute . Tamar Lawrence-Samuel is Associate Research Director at Corporate Accountability International. (Twitter: @StopCorpAbuse)

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Texas Supreme Court Upholds Tax On Small Tobacco Companies For Healthcare Costs

Apr 4th, 2016
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http://healthcare.dmagazine.com/2016/04/04/texas-supreme-court-upholds-tax-on-small-tobacco-companies-for-healthcare-costs/

The Texas Supreme Court on Friday upheld a $500 million tax on small tobacco companies that goes toward offsetting the healthcare costs associated with using tobacco.

A lower court had spiked the state tax, which was adopted in 2013. The state appealed further, getting the case in front of the Texas Supreme Court. The tax levies a 55-cent fee on each pack of cigarettes that is produced by a small manufacturer. These small companies filed suit, arguing that it breaks the state law because large companies are exempt. Texas has what’s known as an “Equal and Uniform Clause” which mandates that taxes on like items must be the same across the board.

Justice Don Willett didn’t find that to be the case here, as the tax is targeted at the companies and not the product. And besides, the larger tobacco companies were ordered to pay $500 million to Texas each year for not presenting the true health risk associated with cigarettes as well as targeting minors.

Combustible cigarettes cost less to use than e-cigarettes

Mar 28th, 2016
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Global evidence and tax policy implications

http://tobaccocontrol.bmj.com/content/early/2016/03/16/tobaccocontrol-2015-052874.short?g=w_tobaccocontrol_ahead_tab

Abstract

Background

Some scholars suggest that price differences between combustible cigarettes and e-cigarettes could be effective in moving current combustible smokers to e-cigarettes, which could reduce tobacco-related death and disease. Currently, in most jurisdictions, e-cigarettes are not subject to the same excise taxes as combustible cigarettes, potentially providing the category with a price advantage over combustible cigarettes. This paper tests whether e-cigarettes tax advantage has translated into a price advantage.

Methods

In a sample of 45 countries, the price of combustible cigarettes, disposable e-cigarettes and rechargeable cigarettes were compared.

Results

Comparable units of combustible cigarettes cost less than disposable e-cigarettes in almost every country in the sample. While the e-liquids consumed in rechargeable e-cigarettes might cost less per comparable unit than combustible cigarettes, the initial cost to purchase a rechargeable e-cigarette presents a significant cost barrier to switching from smoking to vaping.

Discussion

Existing prices of e-cigarettes are generally much higher than of combustible cigarettes. If policymakers wish to tax e-cigarettes less than combustibles, forceful policy action—almost certainly through excise taxation—must raise the price of combustible cigarettes beyond the price of using e-cigarettes.

Smoking results in staggering costs over a lifetime

Feb 6th, 2016
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http://www.times-standard.com/health/20160206/smoking-results-in-staggering-costs-over-a-lifetime

The average California tobacco smoker will lose more than US$1.5 million over a lifetime, including the cumulative cost of a pack per day, health care expenditures, income losses and other costs, according to an analysis by the personal finance website WalletHub.

“The loss of life, the cost of medical care, the loss of productivity is enormous,” Humboldt County Public Health Officer Dr. Donald Baird said.

Each year, WalletHub reports the True Cost of Smoking by State, tallying the societal and economic impacts that total more than $320 billion a year involving some 66 million tobacco users in the U.S.

The states ranged from Louisiana at the lowest with $1.23 million total cost per smoker to New York at $2.45 million lost over a lifetime. California was right in the middle at $1,512,519.

The American Lung Association, meanwhile, last week released its State of Tobacco Control, a yearly report card the federal government and all 50 states on key tobacco control policies.

The group gave the state mostly failing grades because elected officials are doing too little to reduce tobacco use and exposure to secondhand smoke.

Anti-smoking activists want the tobacco tax increased by $2 per pack and the extra money earmarked for funding for tobacco prevention and control, and tobacco-related disease research and treatments. They also want to increase the purchase age of tobacco from 18 to 21 and have restrictions on the sale of electronic cigarettes and flavored tobacco products. And they want to expand access and coverage of tobacco cessation treatments and services for all Medi-Cal recipients.

Many resources and support services are available in Humboldt County for smokers who want to kick the habit, Baird said. In addition to county public health clinics, free Quit Kits are available at the College of the Redwoods and Humboldt State University student health centers from the American Cancer Society and through the Open Door Health clinics.

The most effective way for people to quit smoking combines cessation counseling with nicotine replacement therapy or medications, which can help people fight the craving for tobacco, ease withdrawal symptoms and keep people from using tobacco again.

“Scare tactics don’t work in helping people quit. People need support,” Baird said. “No. 1, the person has to want to quit.”

Dr. Elie Richa, an oncologist with Humboldt Medical Specialists, said smoking causes more than lung cancer. Other cancers related to smoking affect the head, neck, kidneys and bladder because that’s where all of those cancer-causing substances collect before being excreted from the body.

People using electronic cigarettes still are exposing themselves to nicotine, heated and aerosolized propylene glycol and glycerol, Richa said.

The long-term health consequences of e-cigarette use are unknown, Richa said. The toxicity of chronic exposure to those components and other elements in e-cigarettes is uncertain, he said.

Wallethub’s calculations are based on an adult who smokes one pack of cigarettes per day beginning at age 18, when a person can legally purchase tobacco products. The analysis assumes a lifespan of an additional 51 years because 69 is the average age at which a smoker dies.

Out-of-pocket costs are the average cost of a pack of cigarettes per state, multiplied by the total number of days in 51 years. Financial opportunity lost is determined by the amount of return a person would have earned by investing that money in the stock market. Health care cost per smoker are direct medical costs to treat smoking-related health complications based on state-level data from the U.S. Centers for Disease Control and Prevention.

Studies show smoking can lead to loss of income from absenteeism, workplace bias or lower productivity because of smoking-induced health problems.

Nonsmokers are generally entitled to a homeowner’s insurance credit of 5 percent to 15 percent, according to the Independent Insurance Agents & Brokers of America.

When he was 14 years old, Baird used a financial tactic to get his father, an accountant, to quit. Baird wanted a ski boat, and he calculated how long it would take if his father quit smoking to accrue the money needed to buy the boat.

“I was appealing to the way he thought,” Baird said.

Baird had his share to contribute to the boat fund, but a year later, they reached their goal. Most importantly, his father kicked the habit, and he made his son make one other vow.

“He made me promise that I would never smoke myself,” Baird said. “It’s the best deal I ever made in my lifetime.”

The economic burden of lung disease

Feb 5th, 2016
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The Tobacco Industry should pay for damage it causes – and you can help make that happen

Jan 26th, 2016
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http://scienceblog.cancerresearchuk.org/2016/01/26/the-tobacco-industry-should-pay-for-damage-it-causes-and-you-can-help-make-that-happen/

When Andrew was diagnosed with a rare type of blood cancer, he was a 40-a-day smoker.

Now, two years on, his cancer is under control. And he’s ditched the cigarettes.

“The moment I received that diagnosis, I knew I had to stop smoking,” he tells us. And it was NHS Stop Smoking Services that helped Andrew get there.

But these vital services are under threat. Cuts to local public health budgets mean that Stop Smoking Services – the most effective method for helping people quit – might soon be a thing of the past.

But we have a solution. The tobacco industry makes more than £4,000 in profits for every death caused by smoking. And we think that by holding it to account for this financially, Stop Smoking Services can be given the investment they need, to make sure everyone who wants to use them, can do so.

So today we’re launching a new campaign, asking the Government to make Big Tobacco Cough Up and pay for the damage it causes.

And you can help us by signing our petition and making sure your voice is heard.

But why is this so important?

Why should we protect Stop Smoking Services?

Stop Smoking Services provide both prescription medication (including nicotine replacement therapy (NRT)) and specialist behavioural support. This combined approach roughly triples smokers’ chances of successfully stopping compared to going it alone. And research has shown these services are the most effective way of ditching the habit for good.

“My GP helped put me in touch with my local Stop Smoking Services and they were absolutely brilliant,” says Andrew.

“I signed up for 12 weeks and saw a really helpful lady, face-to-face, every week. I stopped smoking two weeks into the sessions and have never looked back.

“I can really notice the difference since quitting – and that was two years ago.”

Saving money and promoting a healthier life

Andrew’s story is just one of thousands illustrating the transformative effect Stop Smoking Services can have on peoples’ lives. But they are also extremely cost-effective.

Evidence shows that every £1 spent on these services saves around £10 in healthcare costs and health gains in the long term. This is because the NHS won’t have to spend as much treating tobacco-related illnesses’, and fewer people will suffer from smoking-related illness’, leading to fewer smoking-related sick days and lost productivity.

But it also costs money to help people quit. And it isn’t just about services.

Advertising campaigns like Stoptober are really successful at encouraging people to quit. Public Health England, which is responsible for running campaigns like Stoptober, has had its funding for mass media campaigns cut by central government. And while the quality has remained consistent, we think the number of tobacco media campaigns is not at an acceptable level.

Evidence shows that advertising campaigns are only effective if they are well-funded, but the UK is currently spending eight times less than the recommended amount.

We can’t allow this trend to continue.

And that’s why we also think that tobacco companies should be footing this bill too.

So what can we do to protect these services?

The tobacco industry makes billions in profits every year from its deadly products. By simply charging the industry around 1p per cigarette they sell in the UK, this could inject an extra £500m into public health services and mass media quit campaigns to help save thousands of lives.

In March, as part of the Budget, the Treasury will decide how the Government will spend its money for the next year. From today, we’re asking our supporters to sign a petition to ask Chancellor George Osborne to pass a law to make the tobacco industry pay for Stop Smoking Services and advertising campaigns to help people quit, meaning people like Andrew can access the help they want.

How you can help

The Government listens to us when we speak as one. And we know that petition campaigns work. Last year nearly 25,000 of you asked the Government to invest in services for diagnosing cancer earlier. And they responded with a commitment to invest £300m each year up to 2020.

So here’s how you can tell the Government you want to see Big Tobacco Cough Up:

1. Take two minutes to add your name to our petition
2. Ask your friends, family and colleagues to sign up too
3. Spread the word on social media using our campaign hashtag #BigTobaccoCoughUp

The more signatures we get, the more pressure there is on Government to make the tobacco industry pay for the damage they cause.

“I smoked for most of my adult life and didn’t think I’d ever give up, but thanks to Stop Smoking service I did. I’m pretty sure I would not have been able to do it on my own,” says Andrew.

“These services are vital and I’m fully behind Cancer Research UK’s campaign to get the tobacco industry to cough up.”

Will you join him in making a stand?

Katy Ashford is a campaigning officer at Cancer Research UK

Sri Lankan President to forgo income from drug and tobacco to save country from drug menace

Jan 19th, 2016
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http://www.colombopage.com/archive_16A/Jan19_1453219903CH.php

Sri Lankan President Maithripala Sirisena says he is ready to relinquish the income received by the government from the sale of drug and tobacco to save the country and the people from the drug menace.

Speaking at the concluding ceremony of the series of the programs of the 4th phase of the “Drug Free Country”, the National Program for Drug Prevention held Tuesday at the National Youth Services Council in Maharagama, the President said it is essential to prevent drug menace to build a disciplined country with a better economy.

“The government is working to face that challenge with the help of everybody,” the President said.

He said the instructions have been given to establish separate units in all government institutions for the prevention and control of drug and these units should have meetings once in three months.

“They should fulfill the responsibility to convey a message to the society to prevent people from drug use,” the President said.

The President further said that the existence of legal drugs, for which the government has granted licenses, and the illegal drugs pose a major challenge to the government as it is a social problem. He added that whether it’s legal or illegal, drug abuse does a great harm to human lives.

The Colombo district action plan for the prevention of drug abuse was presented to the President by the Colombo District Secretary Sunil Kannangara. The events of today’s program were based on Colombo District.

The President also presented awards to individuals for their commitment to eliminate the drug menace from the country.

Mr. Edward Mallawarachchi presented three books written by him regarding the chronic kidney disease and drug addiction, to the President at the event.

The Maha Sangha including Most Venerable Ittapane Dhammalankara Thera, Pathberiye Wimalagana Nayaka Thero, Minister Susil Premajayantha, MPs Jagath Pushpakumara, Eric Weerawardena, Western Provincial Councilor Gamini Thilakasiri and the others participated in the event.

Raise tobacco tax to save lives in China

Dec 25th, 2015
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From June 1 it has begun to feel like public health might be starting to win out in the battle against tobacco in Beijing. The Beijing smoke-free law now makes it illegal to light up in workplaces, restaurants, hotels and other public spaces across the city. But the battle against tobacco is far from over. Tobacco products still kill thousands of Chinese people every day.

http://usa.chinadaily.com.cn/opinion/2015-12/25/content_22803178.htm

There is a way to combat this, though: tobacco tax. Quite simply, a big enough tax increase could save millions of lives in the next decade.

Tobacco use significantly contributes to a fast growing epidemic in China: non-communicable diseases such as heart attacks, strokes, cancer and chronic pulmonary diseases. These conditions are now the leading causes of premature death, ill health and disability in China, accounting for more than 80 percent of total annual deaths. If tobacco use is not significantly reduced, it will aggravate the economic and social impact of an aging population, increasing the odds of a future economic slowdown, which in turn will pose a significant social challenge.

Experience from many other countries shows that not only is tobacco tax an effective means to reduce tobacco consumption and associated healthcare costs, it can also provide significant revenue which can be reinvested into other priorities.

The Philippines is a great example of how tobacco taxes are “win-win”. The 2012 Philippines “Sin Tax” Law has raised and simplified tobacco and alcohol excises, increased government revenues and reduced smoking. Retail prices of cigarettes increased significantly, with early data suggesting a decline in smoking prevalence.

Despite the decline in volume, revenue still increased – nearly doubling the Philippines’ Department of Health’s budget. This enabled fully subsidized health insurance to be provided to the poorest 40 percent of the population – 14 million families, or approximately 45 million people.

In May 2015, China’s Ministry of Finance announced an increase in tobacco taxation, of 0.005 renminbi per individual cigarette, alongside an increase in the wholesale tax rate. Importantly, this tax increase is flowing onto retail prices – making cigarettes a little more expensive across China as a result.

This tax increase adopted by the government of China, in line with its commitment to the World Health Organization’s Framework Convention on Tobacco Control, is an important step in the right direction. However, it is only one step. As the recently released 2015 WHO Report on the Global Tobacco Epidemic points out, tobacco taxes must be increased regularly in order to reduce tobacco use. Otherwise, if incomes rise more quickly than inflation, the relative cost of tobacco products can actually decrease over time.

This has been the case in China over the last decade as the economy has grown, incomes have increased, and tobacco products have become more affordable. Compared with the progress made in other BRICS (Brazil, Russia, India, China and South Africa) countries, China is lagging behind in raising tobacco taxes.

Higher tobacco taxes not only help smokers quit, but crucially they also prevent the next generation from taking up smoking in the first place. The vast majority of smokers start smoking when they are young. Higher tobacco taxes make cigarettes much less affordable for teenagers, helping to protect the coming generations from tobacco disease and death.

If tobacco control measures are not strengthened with steeper tobacco tax increases, China’s non-communicable disease epidemic will continue to explode over the next 20 years. This really has the potential to undermine the Chinese government’s agenda for harmonious and human-centred development, particularly by aggravating health inequities.

The WHO and the World Bank Group stand ready to support the government of China in advancing the tobacco taxation agenda. A healthy future for China depends on it.

Bernhard Schwartlander is WHO China representative, and Bert Hofman is World Bank’s country director for China, Mongolia and South Korea.

Running away from “Tobacco Road”

Dec 15th, 2015
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Earlier this fall, my oldest son invited me to watch him run his first half marathon in Durham, North Carolina. While standing at the starting line, facing hundreds of runners of different ages, I could not help but be amazed by the irony of the situation: In the midst of a region in the United States known as “tobacco road,” there was tangible evidence of a significant, healthier turn in people’s norms and behaviors.

http://blogs.worldbank.org/health/running-away-tobacco-road

Why the irony, you may ask? After the U.S. Civil War in the 19th century, the tobacco industry became the backbone of North Carolina’s economy, and the city of Durham developed rapidly as a tobacco manufacturing center. Although cigarettes are no longer manufactured there, its historic district, where the race took place, still preserves the physical legacy of tobacco factories, which have now been converted into upscale apartment buildings and retail spaces.

While North Carolina is still the top tobacco-producing area in the United States, over the past two decades, tobacco employment, and the number of tobacco farming, processing and manufacturing establishments have declined steadily across all segments of the tobacco value chain in the U.S. In 1992, the U.S. tobacco industry employed over 80,762 people in 2,144 establishments. By 2012, this number had dropped to 42,531 workers in 1,955 establishments, a decline of 47.3% and 8.8%, respectively.

The continuous decline in the relative economic importance of the U.S. tobacco industry is due in large measure to the translation of medical and public health evidence, and knowledge about the negative health effects of tobacco use, into effective public policy measures, such as smoke-free laws and tobacco tax increases, which make these products unaffordable. Education campaigns and cessation programs have also helped to reduce the social acceptability of smoking and have changed consumption patterns. And funding from the 1998 Master Settlement Agreement–an accord between the state Attorneys General of 46 states, five U.S. territories, the District of Columbia, and the five largest U.S. tobacco companies, which requires the tobacco industry to pay the states approximately US$10 billion annually for the cost of health care for tobacco-related illnesses — is being used to support crop diversification away from tobacco.

Beginning with the first U.S. Surgeon General’s report on tobacco released in 1964, a broad consensus now exists that tobacco use is the single-most preventable cause of death and disease in the United States. As documented in the Healthy People 2020 report, for every person who dies from tobacco use in the United States, 20 more people suffer with at least one serious tobacco-related illness. Overall, smoking in the United States kills about 480,000 Americans a year and costs nearly $280 billion a year in health care costs and lost productivity.

Thanks to widespread application of anti-tobacco policy measures, smoking rates have declined significantly. Survey data from the U.S. Centers for Disease Control and Prevention (CDC) show a significant downward trend in current cigarette smoking among adults in the U.S.: from 42% in 1965 to 19% in 2011.

In spite of the significant progress achieved over the past 50 years, the 2014 Surgeon General’s report warns against complacency. The list of illnesses caused by smoking has grown, and smokers today have a greater risk of developing lung cancer than they did in 1964, even though they smoke fewer cigarettes, due to changes in the design and composition of cigarettes that raise health risks. It is notable that, for the first time, women are as likely as men to die from many of the diseases caused by smoking.

As the tobacco industry and tobacco use in the United States gradually but inexorably continue to fade away, there are other deep-seated and far-reaching changes taking place in social and cultural norms, attitudes and behaviors that have had an impact on the population’s health.

Scientific evidence and knowledge about the health benefits of regular physical activity, for example, are influencing youth and adults alike to participate in moderate and vigorous physical activities, such as running. Events such as the Durham Half Marathon reflect the “running/jogging/walking boom” that has grown over the past decade. Since 2004, Americans’ estimated total running/jogging participation (6+days/year) has increased 70% to a record of nearly 42 million people, across both genders.

Public health warnings and advice on effective ways to deal with the growing U.S. obesity and diabetes epidemic are also making more people cognizant about the food they eat. CDC data show that improvement in eating habits, including reductions in the average number of daily calories children and adults consume; a decline in the amount of soda Americans drink by about one-quarter since the late 1990s; and a rise in physical activity, have all contributed to the fall in the rate of new diabetes cases by about one-fifth, from 2008 to 2014.

On the trip back home from Durham, I concluded that all of us who are involved in supporting the realization of universal health coverage across the world now have a tremendous opportunity to contribute to the attainment of longer lives, free of preventable disease, disability, injury, and premature death. But to do so effectively in today’s era of competitive priorities and vested commercial interests, we need to advocate and support sound policymaking by disseminating and adapting to specific country contexts, good practices such as the ones observed in the United States. We also must bring evidence to bear on the broad social and economic benefits of public health action, as well as the costs of inaction.

We have a ways to go, but “running away from tobacco road” is a step in the right direction.

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