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March, 2017:

Re-energizing tobacco control with evidence-based findings

The accumulated evidence over the past half century on the causal relationship between smoking and harm to health provides us with a robust scientific foundation to inform policy design and action.

http://blogs.worldbank.org/health/re-energizing-tobacco-control-evidence-based-findings

Tobacco use is a leading cause of death worldwide, killing close to 6 million people each year. This enormous loss of life and its social and economic impacts undermine development across countries.

While progress has been made in global tobacco control since 2005, when the World Health Organization’s Framework Convention on Tobacco Control (WHO’s FCTC) came into force, renewed effort is needed across low-and middle-income countries, led by national governments, to halt this human-made health scourge once and for all.

In an era, where many question the power of scientific evidence to influence human behavior: whether at the level of individual lifestyle choices, or of public policy, I believe that faith and reason remain the essential guideposts for charting human progress.

The rational case for tobacco control is that it aligns individual self-interest, in terms of preserving health and avoiding suffering, with governments’ economic interests in reducing expenditures, increasing revenue, and maximizing social welfare. Indeed, individual self-preservation, domestic revenue generation, and improvement of overall social well-being is a powerful combination of motivators!

To make this combination work, policy formulation should be informed by a clear understanding of the biological and behavioral mechanisms that lead to the onset of tobacco-related diseases and their adverse health and economic effects. By using country-specific data, we can target policy makers, government officials, and health services personnel, particularly those working at the community level, to raise awareness of the dangers of tobacco for patients, families, and the general population.

The message has to be stark and unapologetic: both active smoking and exposure to secondhand smoke cause disease and kill prematurely. Indeed, accumulated evidence shows that nicotine (a chemical in tobacco): 1) Is a highly addictive stimulant that at high levels produces acute toxicity; 2) activates multiple biological pathways through which smoking increases risk for disease; 3) adversely affects maternal and fetal health during pregnancy, contributing to adverse outcomes such as preterm delivery and stillbirth, as well as congenital malformations (e.g., orofacial clefts); and 4) during fetal development and adolescence has lasting adverse consequences for brain development. It also shows that tar, the resinous, partially combusted particulate matter produced by the burning of tobacco, is toxic. It damages the smoker’s lungs over time. Carbon monoxide, a colorless, odorless gas produced from the incomplete burning of tobacco, accumulates indoors, and reduces the oxygen-carrying capacity of the blood.

We have to hammer home that cigarette smoking is causally linked to diseases of nearly all organs of the body. The evidence is sufficient to conclude that the risk of developing lung cancer from cigarette smoking has actually increased since the 1950s, due to changes in the design and composition of cigarettes. We have to explain that there is evidence for a causal relationship between smoking and several types of cancer, including liver and colorectal cancers, and prostate cancer. Smoking is the dominant cause of chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis; and smoking increases the risk of tuberculosis. We have to show that research continues to identify diseases caused by smoking, including such common diseases as diabetes. Scientists now know that the risk of developing diabetes is 30–40 percent higher for active smokers than nonsmokers.

Crucially, we need to link health arguments with the economic case for tobacco control. That case is powerful, as confirmed by recent studies demonstrating huge smoking-attributable economic costs in the United States and other countries. We can prove that the health benefits of tobacco taxes and other regulatory and control measures far exceed any required increase in taxes and prices, while disproportionately benefiting low-income households, as shown in a recent study in Chile and by results of the 2012 “sin tax reform” in the Philippines. Modeling work, as recently done in countries such as Armenia, Colombia, Lesotho, Moldova, Nigeria, and Ukraine, can inform policy making by reliably quantifying the likely impact of tobacco tax increases on prices, consumption, and domestic revenue mobilization. And related work in Ukraine, shows the estimated positive long-term health and cost-avoided impact of tobacco taxation and other control measures.

As we move into the third decade of the 21st Century, the achievement of smoke-free societies should be a critical marker of sustainable development. Globally, Finland, is paving the way. It has become the first country to set the goal of making itself tobacco-free by 2040. But to realize that vision, saving our children and their children from tobacco addiction, disease, and early death, we have to move from declaration of good intentions to committed, measurable, and sustained action over the medium term that is informed by quantifiable public health and economic evidence.

Cancer group renews push to increase tobacco purchase age to 21

Cancer prevention advocates are renewing their push to raise the statewide smoking age from 18 to 21.

The issue has been raised before, as a growing number of cities and towns increase the age for purchasing tobacco. A bill to raise the statewide tobacco purchase age to 21 passed the Senate last year on a vote of 32-2. But the bill never made it through the House.

Carol Clark, a volunteer with the American Cancer Society Cancer Action Network from Gloucester, survived cancer herself. She has two friends currently battling lung cancer caused by smoking. She lost her grandmother to smoking-related emphysema. She plans to come to the Statehouse to lobby for the bill.

“I think kids have too much access (to tobacco),” Clark said. “They start smoking at a young age. It does major damage.”

Clark said she does not understand why so many teenagers start to smoke given the information available today about its health risks. Clark, 61, said she wishes that information was available when her generation and her parents’ generation were growing up.

“I don’t want to see the next generation go through what mine are going through right now,” she said.

According to the American Cancer Society, 95 percent of smokers start smoking before age 21. Supporters of the bill see it as a way to protect children and teenagers and avoid negative public health impacts, including an increase in cancer rates, later on. It would also create uniform rules across the state, as opposed to a patchwork of local ordinances.

Opponents of the bill have argued that 18-year-olds are adults and should be allowed to make their own decisions. And raising the age could negatively affect businesses that sell tobacco.

The penalties for violating the law would be on retailers, not smokers.

Other sections of the bill would ban the sale of tobacco in pharmacies and ban the smoking of e-cigarettes in schools, restaurants and workplaces.

The American Cancer Society Cancer Action Network will be advocating for the bill as part of its annual lobbying day at the Statehouse on Wednesday. The group expects more than 100 people at the event.

The legislation, S.1218/H.2864, is sponsored by Sen. Jason Lewis, D-Winchester, and Rep. Paul McMurtry, D-Dedham. It has approximately 140 co-sponsors.

How Trump Ally Myron Ebell Spread Misinformation for Big Tobacco and Big Oil

The former head of President Trump’s EPA transition team played a central role in the corporate-led attack on public perceptions about tobacco and climate change.

http://www.alternet.org/environment/how-trump-ally-myron-ebell-spread-misinformation-big-tobacco-and-big-oil

“Frontiers will [change] the debate from one about teenage smoking and industry practices to one about massive tax increases, bigger government and loss of individual freedom.” — Frontiers of Freedom funding proposal to Philip Morris

When Phillip Morris didn’t like new FDA regulations that targeted cigarette sales to children and teens, Myron Ebell—who recently served as the head of President Trump’s EPA transition team—was there to “change the debate” to fit the tobacco giant’s agenda.

The FDA’s proposed regulations included prohibiting outdoor advertising of any tobacco products near schools or playgrounds, strictly regulating labeling and prohibiting tobacco company sponsorships of public events. To fight the new restrictions, tobacco-industry-funded Frontiers for Freedom started a campaign to cast doubt on the validity of the new regulations.

Frontiers, a conservative “educational foundation,” hired Ebell as policy director to help run the campaign, even using his name to raise money for the project. In a fundraising letter to Philip Morris in 1998, Frontiers highlighted Ebell as an example of why more funding was needed to run an organized push to make regulating the tobacco industry “politically unpalatable.”

The Frontiers campaign was pure spin. The tobacco companies’ First Amendment rights were being trampled on, it claimed—more Big Government overreach. From pushing the dubious claim that rules infringed on smokers’ and tobacco companies’ rights to blaming smokers themselves, Ebell oversaw Frontier’s tobacco-industry-funded drive to fight regulation. It took a fourteen-year battle for Congress to pass the regulations and make them stick. In the end, the tobacco advertising regulations made significant progress in curbing teen smoking. No thanks to Ebell and Frontiers for Freedom.

In April of 1998, Ebell and a handful of other marketing experts sat around a table with some of the largest U.S. fossil fuel companies to discuss a plan for a similar attack on climate science. Representatives from Exxon, Chevron, utility giant Southern Company and the American Petroleum Institute worked with operatives from established conservative think tanks and public relations wonks to draft a program designed to attack public and political perceptions about climate change. They dubbed it “The Global Climate Science Communications Plan.”

The plan’s strategy was similar to Frontier’s anti-regulation tobacco campaign. This time the goal was to make climate-change-related regulation politically unpalatable.

The foundation of the plan was to sow doubt about the scientific validity of action on climate change, even though in 1998 the science was already solid. Of the ninety-six papers published on global warming that year, just one disagreed about man’s activities driving warming. That truth about the state of the science was replaced with a push to convince “a majority of the American public” that “significant uncertainties exist in climate science.”

The seven-page directive boldly stated that “victory will be achieved when” the uncertainties about climate science are part of “common knowledge,” when media recognizes and covers those uncertainties and when those promoting action on climate science appear out of touch.

Strategies and tactics of the plan included:

• Recruit and train a team of scientists for media outreach
• Produce a steady stream of op-eds written by these scientists
• Organize and teach conservative grassroots groups
• Become a one-stop-shop for members of Congress, state leaders and teachers looking for information about climate change
• Distribute materials directly to schools and convince a national TV journalist to produce a TV program outlining the supposed uncertainties

It worked.

In 2007, television journalist John Stossel did a bang-up job promoting climate confusion with his special, “Myths, Lies and Downright Stupidity,” for a special edition of “20/20.” By 2016, a Pew poll found only 9 percent of conservative Republicans believed that climate research reflects the best available evidence, while 57 percent of that same group felt that climate research is influenced not by valid science, but by scientists’ desire to advance their careers.

In 1999, Ebell moved to Competitive Enterprise Institute, a libertarian think tank funded by many of the same oil companies he’d sat around the table with the year before to hatch the plan to misinform the American public. From 1998 to 2005, ExxonMobil provided CEI with over $2 million dollars of funding. As director of CEI’s Center for Energy and Environment, Ebell put the plan to work.

Impacting the voice of elected officials was another key aspect of “victory” named in the 1998 disinformation plan. By that measure success was swift in coming. Just two years after the plan was hatched, CEI joined with conservative Senator James Inhofe as co-plaintiff in a lawsuit over the National Assessment, a federal report on climate change’s impacts on the United State.

The lawsuit was designed to suppress publication and distribution of recent climate science findings. In 2003, CEI sued the U.S. government directly, demanding the National Assessment not be disseminated. In 2005, Senator Inhofe joined with Ebell and other climate science deniers on a speaker’s panel for a CEI panel to discuss the Future of International and U.S. Climate Policy. By 2012, Ebell was bragging on his blog about Inhofe’s legislation to block EPA regulations. It was a victory: Climate-change-related regulation had become politically unpalatable.

Opposition to the validity of climate science skyrocketed among conservative politicians after 1998. Fighting all government action on global warming is now a bullet point on the GOP’s purity test. Over that same period, oil industry financial support for political campaigns and lobbying efforts have overwhelmingly gone to Republicans.

The election of Donald Trump was icing on the climate science denial cake. Ebell was tapped to head Trump’s EPA transition team. Eighteen years of work deceiving the public finally paid off for Ebell. His dream of drastically reducing the power of the EPA is being realized. Ebell headed Trump’s EPA transition team. He oversaw the writing of a policy paper—not available to the public—that will steer fellow climate science denier and EPA antagonist-turned-EPA head Scott Pruitt. Under Pruitt’s leadership, climate-change-related regulations will be rolled back and the EPA’s budget will be cut by 24percent.

Ebell has no background in science. He studied philosophy and has a master’s degree in political theory. His understanding of modern climate science sounds like this:

The models say that much of the warming will occur in the upper latitudes and in the winter. At the risk of further ridicule in kooky blogs in England, where global warming alarmism is now a religion, that sounds pretty good to me. Fewer people will die from the cold.

Fossil fuel industries got what they wanted. Conservative politicians got what they wanted. CEI got what it wanted. Ebell got what he wanted. All at the expense of the environment, public health and the stability of future generations.

Hope Forpeace is a short film producer with AK Productions. She spoke before the EPA’s Scientific Advisory in 2015 and coordinated the effort to have EPA’s fracking study include known cases of water contamination. She has traveled across the country for several years investigating cases of fracking-related pollution.

California targets candy-flavored tobacco as teen ‘gateway’ to cigarette smoking

More teens are turning to fruit- and candy-flavored tobacco, raising concerns that sweetened e-cigarettes and cigarillos are a gateway to nicotine addiction. A California anti-tobacco campaign targeting teens has ramped up in high schools and at a recent state Capitol rally on Kick Butts Day. Claudia Buck cbuck@sacbee.com

http://www.sacbee.com/news/local/health-and-medicine/article140622513.html

At the checkout counter, the flavors are sweet and enticing: Banana Smash. Twisted Berry. Berry Honey. Cherry Dynamite.

They aren’t in the candy aisle but on the tobacco shelf, often sold in 99-cent two-pack mini-cigars or liquid cartridges for e-cigarettes.

While fewer young Americans are puffing on cigarettes, more teens are using flavored tobacco, typically by vaping with electronic cigarettes or smoking tiny cigars known as cigarillos.

This year, there’s a renewed push to banish flavored tobacco products, which health officials and others fear are luring the next generation of nicotine addicts by targeting teens and kids.

The sweetened flavors are “a gateway to traditional cigarette smoking,” said Scott Gerber, a wellness program director with the Alameda County Office of Education, who attended a recent anti-tobacco state Capitol rally with a handful of high school students from Berkeley and Fremont. Tobacco companies, he said, “are targeting young people with cherry, strawberry, piña colada flavors. … Gummi bears? That’s a youth-friendly flavor, not an adult-friendly flavor.”

Gerber was among about 250 high school students and chaperones who attended the anti-tobacco rally, chanting slogans and carrying signs with messages such as “We want to see a new light, not a lighter” and “We want 7,700 flavors of ice cream, not tobacco!” The rally was part of national Kick Butts Day, co-sponsored by the California Youth Advocacy Network and the Campaign for Tobacco-Free Kids.

In 2014, 73 percent of high school students and 56 percent of middle school students who used tobacco products in the past 30 days reported using a flavored tobacco product, according to the federal Centers for Disease Control and Prevention.

Wheatland High School student Angelina Hom, 15, who belongs to a campus group called SOWHAT (Students Of Wheatland High Against Tobacco), said she’s seen the negative impacts of tobacco firsthand in family members and hopes more of her peers get the message to avoid tobacco.

Convenience stores near her Northern California school have prominent displays of brightly colored, fruity-flavored tobacco products positioned close to the checkout counter, she said. “You go to pay for your food and there’s a wall full of of tobacco and cigarettes. It targets kids into thinking it’s cool.”

E-cigarettes are the most commonly used tobacco product among middle and high school teens in California. An estimated 217,000 Californians between the ages of 12 and 17 currently smoke traditional cigarettes or e-cigarettes, according to state health officials.

In stores, although tobacco products by law must be behind glass, it’s not unusual to find Swisher Sweets, candy-flavored cigarillos sold in two-packs for less than a dollar, sitting near candy bars and snacks, at eye level of young customers.

“Having it advertised as candy unlocks the door to the world of addiction,” said shopper Jenni Richardson, 24, in a midtown Sacramento convenience store where Swisher Sweets sit directly above the ice cream freezer case. A self-described recovering heroin addict, Richardson said tobacco products are dangerously addictive, noting it was far easier for her to quit narcotics than nicotine.

Last summer, the growth in e-cigarette use helped prompt California to toughen state tobacco laws, raising the minimum age for legally buying cigarettes and cigars from 18 to 21, the first change since tobacco control laws went into effect 144 years ago. Also for the first time, those laws now apply to e-cigarettes, which have become hugely popular for their myriad fruit and candy-scented flavors, with names such as Watermelon Krush, Apple Pie a la Mode and Blueberry Cotton Candy.

Some counties have banned all sales of flavored tobacco, including Yolo County, which prohibits sales in the county’s unincorporated areas, starting May 1. The intent was to deter use by youths, said Keri Hess, the county’s tobacco prevention youth coordinator.

“Lots of kids who use e-cigarettes would never dream of trying a regular cigarette because they say it tastes gross. They know the hazards of regular cigarettes and tobacco, but they don’t recognize the health hazards of e-cigarettes,” Hess said.

In Yolo County, 73 percent of stores carried e-cigarettes last year compared with 46 percent in 2013.

The state’s crackdown came as illegal sales of tobacco to minors were up last year by more than a third from 2015, according to the state Department of Public Health’s annual survey, which took place before the legal age was changed. Using teenage decoys trying to buy smokes, the annual survey found that 10.3 percent of 793 stores sold tobacco to underage buyers, the highest rate in eight years.

Citing research that shows brain development continues until around age 25, state health officials say nicotine is a “highly addictive neurotoxin” that can permanently damage adolescent and young adult brains.

“The younger people are when they start smoking or using nicotine, the more likely they are to become addicted,” said State Public Health Officer Dr. Karen Smith during a news conference last summer. Every year in California, she noted, 34,000 people die of tobacco-related diseases.

She said the surge of teens vaping with e-cigarettes is no accident, given the “aggressive marketing” and the proliferation of gadgets and flavors by tobacco companies. Calling them “enticing gateway products,” Smith said e-cigarettes are “fueling the addiction” to nicotine.

Since 2009, the U.S. Food and Drug Administration has banned the sale of cigarettes with fruit and candy flavors, part of federal efforts to reduce tobacco addiction among youths. More recently, the FDA is focusing on cigars and cigarillos (mini-cigars). In December, it issued warning letters to four tobacco companies, including Swisher International Inc., maker of Swisher Sweets, for selling cigars in “youth-appealing” flavors, such as grape, wild cherry and strawberry.

If the companies don’t take action, they could face civil penalties, criminal prosecution and seizure of products, according to the FDA.

“Flavored cigarettes appeal to kids and disguise the bad taste of tobacco, but they are just as addictive as regular tobacco products and have the same harmful health effects,” said Mitch Zeller, director of the FDA’s Center for Tobacco Products, in a statement. He said continued bans on flavored tobacco are essential to “protect future generations from a lifetime of addiction.”

To students at the recent state Capitol rally, the brightly colored packaging and sweetened flavors are “like candy,” enticing teens and kids to get hooked on nicotine at an early age, said Naphatsorn Kaewwanna, 18, a high school senior with the Asian American Drug Abuse Program in Los Angeles County.

“We should put a stop to it,” she said.

 

Cancer Activists Push Bill to Hike Legal Age to Buy Tobacco

Over 100 cancer patients, survivors and their families from across Massachusetts are planning to gather at the Statehouse to press lawmakers to support efforts to protect young people from nicotine addiction.

http://www.capecod.com/newscenter/cancer-activists-push-bill-to-hike-legal-age-to-buy-tobacco/

At the top of the agenda is a bill that would increase the legal age to buy tobacco products from 18 to 21.

The legislation would also include e-cigarettes in the smoke-free workplace law and ban the sale of tobacco products in facilities that provide health care, such as pharmacies.

About 95 percent of adults who smoke started by age 21.

More than 140 communities in the Commonwealth have passed regulations raising the purchase age from 18 to 21, including Falmouth, Mashpee, Yarmouth, Brewster, Orleans, Eastham and Provincetown.

The Board of Health in Harwich will hold a public hearing April 11 to discuss a proposed regulation change to increase the legal age to 21. The board could vote on the measure that night.

Wednesday’s visit to Beacon Hill is part of the American Cancer Society Cancer Action Network’s annual lobby day.

This year, an estimated 37,000 Massachusetts residents will be diagnosed with cancer. An estimated 12,600 will die from the disease.

Graphical health warnings on cigarette packs found effective

A recently completed sample based study done in Bangladesh claims that the health warning labels describing the harmful effects of tobacco products using text and/or pictures are found to be effective.

Health warnings on cigarette packages are among the most prominent sources of information about the harms of smoking and tobacco use.

Indeed, even in high-income countries where millions of dollars are spent on anti-tobacco mass media campaigns, smokers still report getting information about the risks of smoking from cigarette packages almost as much as from television, and much more than from other sources such as print media.

Therefore, in a country such as Bangladesh, where very little information about the harms of tobacco use appears on television and other broadcast media, warning labels on tobacco packages represent an even more important opportunity for informing the public about the harms of tobacco. Given their tremendous reach and frequency of exposure, health warnings are an extremely cost-effective public health intervention compared to other tobacco prevention efforts such as paid mass media advertising – these came out of a sample-based survey.

Findings from the survey revealed, 98.1% of the respondents opined that they supported the current practice of bothside for pictorial/graphical health warnings (GHW) and 77.5% respondent informed that they thought that the current use of GHW of 50% of the cigarette pack for warnings was good enough to demotivate and reduce the use of tobacco products. Considering up to 50% of the cigarette pack, around 89% were supporting this.

The findings revealed – about 72.7% of the respondents reported that they felt very unpleasant to see the pictorial warning on the tobacco packets (74.1% in urban and 72.7% in rural areas). The survey also reported that the pictorial warning was very realistic to 65.6% of the respondents and extremely realistic to 17.0% respondent (18.8% in rural and 15.3% in urban areas).

The psychological impact of GHW on the respondents was also examined. 13.9% of the respondents were extremely worried and 61.7% were very worried to see the pictorial warning on the cigarette package.

In summary, the study found that the graphical health warnings (GHW) were realistic to provide health-related information and are very effective in creating an unpleasant feeling and sense of worriedness among the smokers to aware them regarding the harmful effects of smoking.

A good news that the study uncovered was 75.8% respondents tried to reduce or quit smoking after seeing the pictorial warning on the cigarette packet. The rate is 76.3% in rural and 75.3% in urban areas. 83.5% respondents reported that they tried to reduce or quit smoking habit to see the pictorial warning. 74.8% recommended to include
GHW in Biri, Gul and Jorda.

Moreover, 64.2% respondents recommended that government should take initiative for mass awareness and 85.5% recommended for more visual media (TV) coverage.

Progress against ‘global tobacco epidemic’ made but not enough

Tobacco treaty has helped cut smoking rates, yet more work is needed

http://www.timesofmalta.com/articles/view/20170325/health-fitness/Progress-against-global-tobacco-epidemic-made-but-not-enough.643389

The WHO warns against tobacco use which kills about six million people a year globally and imposes a huge burden on the world economy.

A global tobacco treaty put in place in 2005 has helped reduce smoking rates by 2.5 per cent worldwide in 10 years, researchers said, but use of deadly tobacco products could be cut even further with more work on anti-smoking policies.

In a study published in the Lancet Public Health journal, researchers from Canada’s University of Waterloo and the World Health Organisation (WHO) found that while progress against what they called the “global tobacco epidemic” has been substantial, it has still fallen short of the pace called for by the treaty.

The WHO Framework Convention on Tobacco Control (FCTC), which came into effect in 2005, obliges the 180 countries signed up to have high tobacco taxes, smoke-free public spaces, warning labels, comprehensive advertising bans and support for stop-smoking services.

Smoking causes lung cancer and is a major risk factor for cardiovascular illnesses such as heart disease and strokes, which kill more people than any other diseases.

The WHO says tobacco kills about six million people a year globally and imposes a huge burden on the world economy. Annual healthcare and lost productivity costs for those made ill from smoking are estimated at around $1 trillion.

The study analysed WHO data from 126 countries – 116 of which are signatories to the FCTC – and tracked and compared the implementation of the five key measures from 2007 to 2014 to look at links between strong policies and smoking rates.

It found that, on average, smoking rates dropped to 22.2 per cent in 2015 from 24.7 a decade earlier. But the trends varied, with rates falling in 90 countries, rising in 24 and remaining steady in 12.

Countries that fully implemented more FCTC measures saw significantly greater reductions in smoking rates, the study found. Overall, each additional measure was linked with a drop in smoking rates of 1.57 percentage points – corresponding to 7.1 per cent fewer smokers in 2015 compared with in 2005.

The study was not a full global analysis, since only 65 per cent of countries had the data needed, but it did include countries from all income levels and regions. The researchers also noted that the lower smoking rates could be influenced by factors other than FCTC policy recommendations.

“The data did not allow a detailed analysis of the impact of individual policies,” said Geoffrey Fong of Waterloo University, who co-led the work.

He called for more studies that are specifically designed to evaluate the impact of all FCTC policies and would “help provide guidance to countries about what policies may offer the greatest benefits”.

ACT Welcomes Tobacco Tax Hike In Federal Budget

The Alliance for the Control of Tobacco welcomes a hike in the federal tobacco tax announced this week by the Trudeau government.

http://vocm.com/news/act-welcomes-tobacco-tax-hike-in-federal-budget/

Executive Director Kevin Coady says they welcome anything to discourage smoking.

He says the surtax the tobacco manufacturer was paying has been removed, and the consumer tax increased, but it should discourage people from picking up the habit, or force them to cut back.

Statistics Canada earlier this week released numbers showing that this province has the highest rate of tobacco use in the country at 24.4 per cent, and marked increase from the previous survey.

Inside Big Tobacco’s Academy of Lies, the Inventor of ‘Alternative Facts’

Don’t like the science? Then invent one you do like. It was one of America’s greatest snow jobs, costing millions of lives. And it’s happening again with climate change and this time billions of lives are at stake.

http://www.thedailybeast.com/articles/2017/03/25/inside-big-tobacco-s-academy-of-lies-the-inventor-of-alternative-facts.html

The world is warmer than it’s ever been since records began to be kept in 1880. The Antarctic ice sheet is melting so fast it alone is responsible for 10 percent of the global rise in sea levels. The coral bleaching of Australia’s Great Barrier Reef, a direct result of global warming, is now virtually irreversible.

All this as the Trump administration abandons measures to combat climate change and gives climate change deniers full powers to put the brake on any scientific research devoted to establishing a link between climate change and human activity. Goodbye Planet Earth.

This is the willful corruption of science in the cause of ideology. But we’ve been here before. To understand how this game is played, we can go back to what you could call the foundation of the Liars’ Academy, the professionalization of the crafting of alternative scientific facts.

It’s generally thought that the turning point in establishing a direct link between smoking and cancer came with the U.S. surgeon general’s report of 1964. Drawing on 7,000 scientific studies and the work of 150 consultants, the report demonstrated that the death rate among smokers was 70 percent higher than among non-smokers.

In fact, the first really authoritative warning about smoking came in 1953, when Alton Ochsner, president of the American Cancer Society and the American College of Surgeons, predicted that the male population would be decimated unless steps were taken to reduce the cancer producing content of cigarettes.

At this point any link between smoking and cancer had not been acknowledged by the National Cancer Institute or the U.S. Public Health Service or most of the medical establishment. (As late as 1958 a Gallup survey showed that only 44 percent of Americans believed smoking caused cancer.)

A top R.J. Reynolds executive, Claude Teague, had reviewed the same evidence as Ochsner and reported, “Studies of clinical data tend to confirm the relationship between heavy and prolonged tobacco smoking and incidence of cancer of the lung.”

All copies of Teague’s report were collected and destroyed, and a week after Oschner’s speech six tobacco company presidents met to take stock of the threat now facing them. As a result, they called in John Hill, founder of the public relations firm Hill & Knowlton. What followed was a strategy described by a lawyer as “the industry’s ultimate public relations sham.”

Hill & Knowlton advised the companies:

“There is only one problem—confidence and how to establish it; public assurance and how to create it—in a perhaps long interim when scientific doubts must remain. And, most important, how to free millions of Americans from the guilty fear that is going to arise deep in their biological depths—regardless of any pooh-poohing logic—every time they light a cigarette.”

This marked the beginning of what became, literally, an industrial scale exercise in the promotion of an alternative scientific reality. It involved not just alternative facts but an entire body of false scientific argument to deny that smoking caused cancer. This was the work of an unholy alliance of tobacco company executives, public relations flacks, corporate lawyers, scientists, politicians, and gullible media.

The full extent of the conspiracy was revealed only in 2001, when David Kessler, the former commissioner of the Food and Drug Administration, and relentless foe of the tobacco industry, published his memoir, A Question of Intent.

(Personal disclosure: I was one of a team of researchers who worked with Kessler on the book.)

It is timely to revisit this story because, among other things, it demonstrates that the daily flood of alternative facts from the White House builds on the foundation of Big Tobacco’s model of disinformation. There is no need to compare this with the propaganda machine of Nazi Germany or of any totalitarian state. In its reach and sophistication it is a wholly American achievement.

For more than four decades Big Tobacco had one objective: to maintain the pretense that the link between smoking and cancer remained unproven. In that method it anticipated the entire strategy of climate change deniers, to argue that even if the earth was warming up there was no link between that and human activity. In order to pursue their disinformation campaign the tobacco industry had to produce its own alternative facts—or alternative science.

Hill & Knowlton outlined a four-point strategy to deal with scientific critics: “(a) smearing or belittling them (b) trying to overwhelm them with mass publication of the opposed viewpoints of other specialties (c) debating them in the public arena; or (d) we can determine to raise the issue far above them, so they are hardly even mentioned, and then we can make our case.”

The first step in pursuing this strategy was to set up a body that looked and sounded like an authoritative scientific enterprise, then to staff it with scientists prepared to sell themselves to the mission. It was named the Council for Scientific Research, CTR, and its director was a Harvard-educated cancer researcher of international renown, Clarence Cook Little. He, in turn, recruited similarly illustrious peers to the cause.

All of these supposed experts were satisfied that they could rest their reputations securely on the narrow premise on the “unproven” link. In this they were abetted by lawyers who discovered that when cases against the tobacco industry came to court juries were inclined to believe that smoking was a personal choice. So-called scientific witnesses supported attorneys who argued that “association cannot prove causation.”

“Everyone was molded according to the script,” one industry official told Kessler later as he investigated the record.

Kessler, respectful of C.C. Little’s reputation, could not understand how he could have gone along with the CTR’s strategy. He went through Little’s private papers and found no answer. He did, however, find a letter to Little from Charles Huggins, a Nobel laureate cancer researcher at the University of Chicago. Huggins pleaded with Little: “Please leave the tobacco industry to stew in its own juice…[it] is criminal to promote smoking. It is dastardly. This is the Age of the Hollow Man. Let it not be known as the age when our finest thinkers sell out.”

Eventually the industry decided that the CTR was not as effective as it should have been. In 1964, following the surgeon general’s report, the alternative facts campaign had another instrument, Special Projects. This had no official address, no incorporation papers, no board of directors, no by-laws and no accountability.

In fact, Special Projects marked the ascendancy of lawyers. David Hardy, of the law firm Shook, Hardy & Bacon, began looking for scientists and physicians prepared to testify against the surgeon general’s report before Congress. Special Projects was run by the general counsels of the tobacco companies, supported by Shook, Hardy and the Washington, D.C. law firm Covington & Butling.

Kessler discovered that every decision, every research project, every public presentation, went through lawyers who had one prevailing concern: liability.

Kessler found an industry source who was prepared to talk as long he remained identified only as “Veritas.” Discussing the lawyers involved in Special Projects, Kessler asked, “Where did they cross the line?”

“When you commission the research and know the outcome, that’s fraudulent. When you market that as the truth, that’s evil,” Veritas replied.

The cynicism of the operation could sometimes catch a rooky lawyer unawares. One recent law school graduate working for another law firm, Wachell, Lipton, involved with Big Tobacco pointed out that the industry money flowing to the firm was being “used to purchase favorable judicial or legislative testimony, thereby perpetrating a fraud on the public.”

He asked for guidance from more senior colleagues. There was no record of the response. We are fond of describing America as a nation of laws. Maybe so, but we are also a nation of lawyers, and you get what you can pay for.

Although the industry’s main effort was directed at squashing litigation, there was a more subtle program of “managing the social climate for tobacco use.” The industry always worked hard to recruit young smokers—after all, the market had always to replace the people being killed off by smoking with another generation of initiates. They noticed that anti-smoking campaigns were beginning to work among teens. In response they branded public health advocates as the enforcers of political correctness, even commissioning a theater group to satirize “the new puritanism.”

Kessler discovered that at Philip Morris successful manipulation of the story wasn’t thought to be enough. Part of a top secret plan called Operation Rainmaker was that they should not only shape the story but own the means of delivering it. Notes for a meeting in 1990 said, “If we are to truly influence the public policy agenda and the information flow to the populace, we must be the media…the only way to do this is to own a major media outlet.”

The proposed targets included the Knight-Ridder newspaper chain; the Copley News Service, United Press International and U.S. News & World Report.

This plot never came to pass. But in some cases Big Tobacco didn’t need to buy the media because the media gave them a pass. Perhaps the most egregious example of this was in a surprising place: the newsroom of The New York Times.

For years some of the most rigorously sustained reporting on Big Tobacco had been the work of Philip Hilts in the Washington bureau of the Times. Hilts had a deep grasp of scientific detail and a passion for pursuing the secrets of how the ingredients of cigarettes were manipulated to create addiction. After a lot of digging Hilts discovered that in Philip Morris’s Benson & Hedges brand there had been a significant rise in the levels of nicotine. Company research had described these levels as “optimum.”

Following publication of the Benson & Hedges story, Philip Morris executives went ballistic and demanded that the paper print a correction. The editors refused, saying that no error had been made.

However, in the Times newsroom some editors had developed a “not another tobacco story” resistance, feeling apparently that there was little left that could surprise. And a week later, Soma Golden Behr, assistant managing editor for national news, called Hilts to New York. Over lunch Behr told Hilts that his tobacco beat was finished and he was reassigned. For two years, until 1999, the Times basically dropped the story.

In that period Alix Freedman of The Wall Street Journal won a Pulitzer for her coverage of Big Tobacco.

Kessler thought Hilts’s reporting had been invaluable and later sought to find out why he had been pulled from the story. He decided that it wasn’t directly a result of the Philip Morris intervention. It was more a dumb misjudgment by editors who thought that the reporter had become too committed to one story.

There is a moral to this, and one I know well from personal experience. Obsession can be the difference between a reporter who sees no further than the news cycle and one who implicitly understands where a story is really going and will stick with it until it gets there. Obsession is good. And when you’re up against alternative facts it’s indispensable.

In his time as FDA Commissioner, under presidents Bush and Clinton, from 1990 to 1997, Kessler was the most formidable opponent ever faced by Big Tobacco. The Supreme Court ultimately refused to accept his case that tobacco should be classified as a drug and therefore that it should be regulated by the agency.

Nonetheless his agency’s investigations finally exposed the lethal secret that the industry had hidden beneath its mountain of alternative facts: cigarettes were, basically, a nicotine delivery system, nicotine led to addiction, everything that could be done to strengthen the dose of nicotine was done, and nicotine addiction killed.

Kessler also proved in chilling detail that the public good can suffer grievous harm as a result of a deliberate and sustained campaign to corrupt science and defer for generations the acceptance of scientific fact. Climate change is a far greater threat than smoking ever was. The ethic of the Liars’ Academy has now been incorporated into main stream politics: the methods of denial haven’t changed, but the stakes are now so much higher. And, as with smoking, there is no concern for future generations, just a greedy defense of the indefensible.

Guam raises tobacco age to 21 come 2018

The legal smoking age in Guam will be 21 next year.

http://www.dailymail.co.uk/wires/ap/article-4346104/Guam-raises-tobacco-age-21-come-2018.html

The Pacific Daily News reports (http://bit.ly/2nPFaIb ) that a measure lapsed into law this week raising the legal age to use or purchase tobacco products from 18 to 21 stating Jan. 1, 2018. Lawmakers unanimously passed the measure on March 9 and the governor took no action, meaning the measure automatically became law.

Last year, the Legislature passed a similar bill to raise the legal tobacco age to 21 but Gov. Eddie Calvo vetoed it, saying the bill didn’t give residents the freedom to choose.

According to the American Cancer Society, smoking rates on Guam have declined in recent years to 27.4 percent, but still remain higher than the national average of 17.5 percent.