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Increases in Secondhand Smoke After Going Smoke-Free

An Assessment of the Impact of a Mandated Smoke-Free Housing Policy

https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntaa040/5742114?redirectedFrom=fulltext

Abstract

Objective

The 12-month impact of federally mandated smoke-free housing (SFH) policy adoption (July 2018) was assessed using two markers of ambient secondhand smoke (SHS): airborne nicotine and particulate matter at the 2.5-micrometer threshold (PM2.5).

Methods

We measured markers of SHS in Norfolk, VA from December 2017 to December 2018 in six federally subsidized multi-unit public housing buildings. Multi-level regression was used to model the following comparisons: (1) the month immediately before SFH implementation versus the month immediately after, and (2) December 2017 versus December 2018.

Results

There was a 27% reduction in indoor PM2.5 and a 32% reduction in airborne nicotine in the first month after SFH adoption, compared to the month prior to adoption. However, there was a 33% increase in PM2.5 and a 25% increase in airborne nicotine after 12 months.

Conclusions

US Department of Housing and Urban Development (HUD)-mandated SFH can reduce SHS in multi-unit housing. However, SFH could also plausibly increase indoor smoking. Policy approaches adopted by individual properties or housing authorities—for example, property-wide bans versus allowing designated smoking areas—could be driving this potential unintended consequence.

Implications

Successful implementation of SFH by public housing authorities in response to the HUD rule requires ongoing attention to implementation strategies. In this sense, SFH likely differs from other policies that might be seen as less intrusive. Long-term success of SFH will depend on careful policy implementation, including plans to educate and support housing authority staff, inform and engage residents, and build effective partnerships with community agencies.

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Commentary on the launch of the Foundation for a Smoke-Free World

September 2017 saw the launch of the Foundation for a Smoke-Free World, which describes itself as “an independent, non-profit organization created to accelerate global efforts to reduce health impacts and deaths from smoking, with the goal of ultimately eliminating smoking worldwide”.

http://blogs.bmj.com/tc/2017/10/13/commentary-on-the-launch-of-the-foundation-for-a-smoke-free-world/

The creation of such an organization would usually be a matter for celebration among the tobacco control community and especially for the WHO Framework Convention on Tobacco Control (WHO FCTC), the United Nations tobacco control treaty, whose Secretariat I lead.

And yet this is not good news. The Foundation is currently 100% funded by Philip Morris International (PMI). The company has already pledged around US$1 billion for the period of 12 years or around US$80 million a year. To put that in context, this is more than eight times greater than the entire WHO FCTC annual budget.

The Foundation claims that its funding source doesn’t matter, since its bylaws prohibit tobacco industry interference, and safeguard against conflicts of interest, thereby guaranteeing its independence. We are asked to believe that this industry-funded organization will simply ignore the commercial interests of its paymaster. We are asked to believe this where the organization is established to work on specific issues of interest to PMI, where that work may promote other products that contain nicotine and have the ability to sustain addiction, and where the paymaster can decide not to continue funding the organization from one year to another. How can masters of this Foundation that claim to be independent be unaware of PMI’s lobbying strategies, and ensure that their Foundation is not inadvertently supporting bad public health policy?

The establishment of the Foundation ties into a broader PMI strategy to ensure that there is little or no regulation on new tobacco products PMI is producing. It also fits into the tobacco industry’s corporate social responsibility schemes. Such projects are designed to mislead or confuse public opinion. They are the anti-truth.

How do we know? Reams of research and legal documents on tobacco industry behaviour confirm that the Foundation’s public statements fit seamlessly into the tobacco industry’s strategy, which is to sell new products while continuing to sell cigarettes. Over decades, tobacco industry dollars have funded influence buying, covert activities and scientific misrepresentation. Industry money has never advanced the cause of public health, as is made clear in excruciating detail by the millions of tobacco industry documents. These reveal, for example, that firms have “sought to influence debate by buying up scientists on a spectacular scale.”

PMI recently rejected an appeal from 120 Organisations asking it to halt the production of cigarettes. To make it plain, if the company were serious about making the world smoke-free they should immediately stop fighting, in several countries, tobacco control measures to implement the Framework Convention.

This Foundation fits within a broader strategy of PMI attempting to present itself as a “stakeholder” in tobacco control. Some examples of these initiatives include PMI Impact,which claims to counter the illicit trade in tobacco products but in fact serves to slow and disrupt the entry into force of the Protocol to Eliminate Illicit Trade in Tobacco Products. Another tobacco industry initiative, which PMI co-funds, is the Eliminating Child Labour in Tobacco Growing Foundation (ECLT). With little impact on reducing child labour on tobacco in low and middle income countries, this Foundation detracts from implementation of Article 17 of the WHO FCTC, which calls upon governments to support tobacco workers and growers to switch to alternative sustainable livelihoods.

Taken as a whole, the tobacco industry’s corporate social responsibility programmes are an abomination, which seek to give the impression of action on important issues, while boosting its own profits and hiding its own role in creating problems.

Parties to the WHO FCTC have pledged, through Article 5.3 of the treaty, to resist tobacco industry interference. In a 2016 ruling against the tobacco industry, a senior English judge accurately summarised this key Article and its Guidelines : “[T]he tobacco industry should be treated as having adopted a deliberate policy of subverting public health policy through, inter alia, the deployment of its substantial capital and organisational resources to generate evidence designed to contradict the established policy consensus… that this evidence is unreliable, i.e. false.”

WHO FCTC Parties should therefore adopt legislation or rules to implement Article 5.3 and ensure they do not promote, participate in or endorse tobacco industry involvement, directly or through these “foundations”, in initiatives related to tobacco control. No government and no reputable academic, research or public health organisation should partner with PMI’s new foundation.

It is already clear that this tobacco industry-funded Foundation fits a long-established and sinister pattern of corporate chicanery. The industry’s aim, after all, is not to help its customers but to profit from them.

The tobacco industry’s new “partnerships” with supposedly independent organizations do constitute a serious threat, but we have a response to hand.

It’s called the WHO FCTC, and it’s the true foundation for a smoke-free world.

Dr Da Costa e Silva is the Head of the WHO FCTC Secretariat.

Wellcome statement: corporate event hire cancellation

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