Lessons from the Tobacco Control Movement

Similar documents
If We Want More Evidence-Based Practice, We Need More Practice-Based Evidence

Prevention and Control of Obesity in the US: A Challenging Problem

Tobacco use is Wisconsin s

Progress and Challenges in the Prevention and Control of Obesity

CDC s Best Practices for Tobacco Control Programs

Tobacco Surveillance in the United States

Social and Policy Perspective on Tobacco Use

Tobacco Surveillance in the United States

5,000. Number of cigarettes 4,000 3,000 2,000 1,000

Executive Summary. Overall conclusions of this report include:

Effective Strategies for Reaching Local Policy Makers to Implement Policy Change

New Jersey s Comprehensive Tobacco Control Program: Importance of Sustained Funding

Update on the Current Epidemiology of Obesity in the United States. William H. Dietz MD, PhD Consultant Institute of Medicine

Submission to the World Health Organization on the Global Tobacco Control Committee

COMPREHENSIVE TOBACCO PREVENTION AND CESSATION PROGRAMS EFFECTIVELY REDUCE TOBACCO USE

COMPREHENSIVE TOBACCO PREVENTION AND CESSATION PROGRAMS EFFECTIVELY REDUCE TOBACCO USE

Save Lives and Save Money

OTPC executive committee is comprised of volunteers representing various community sectors within Oklahoma. The Oklahoma Turning Point Council

Tobacco Control Program Funding in Indiana: A Critical Assessment. Final Report to the Richard M. Fairbanks Foundation

Oklahoma Turning Point Council (OTPC)

National health-care expenditures are projected to rise to $5.2 trillion by 2023

What Explains the Recent Declines in Childhood Obesity?

UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA

Puffs and Pounds: Lessons from Tobacco Control for Combating the Obesity Epidemic. Kenneth E. Warner Dean, Univ. of Michigan School of Public Health

Tobacco: A Critical Element in Addressing Cancer Disparities. Athena Ramos, PhD, MBA, MS, CPM

Fast Facts. Morbidity and Mortality (Related to Tobacco Use)

Tobacco Control in Los Angeles County: Lessons Learned

Get the Facts: Minnesota s 2013 Tobacco Tax Increase is Improving Health

Advertising, Promotion, Countermarketing, and Tobacco Use. Frank J. Chaloupka University of Illinois at Chicago

TOBACCO CONTROL IN SOUTHERN NEVADA

LIVE HEALTHY. Disclosure. Learning Objectives. University of Texas Health Science Center at San Antonio, Texas. Pediatrics Grand Rounds 28 June 2013

Tobacco-Control Policy Workshop:

The Global Tobacco Problem

The Devastating Toll of Tobacco

RE: FR-5597-N-01 Request for Information on Adopting Smoke-Free Policies in PHAs and Multifamily Housing

Impact of excise tax on price, consumption and revenue

Pulaski County Health Improvement Plan

Tobacco Cessation Program Planning, Implementation and Evolution

Progress toward quitting. The cessation environment in New York

Tobacco Data, Prevention Spending, and the Toll of Tobacco Use in North Carolina

Public Health Association of Australia: Policy-at-a-glance Prevention and Management of Overweight and Obesity in Australia Policy

SUGAR, OBESITY AND DIABETES THE OTHER GLOBAL FOOD CRISIS

Community Capacity Building: Community Driven Efforts that Combat Tobacco Transnationals in our Communities and Abroad. Case Study

Comprehensive Tobacco Control Programs: Economic Review. Page 1 of 26. Study Info Intervention Characteristics Population Characteristics

STATE TOBACCO TAX INCREASES: EXPLANATIONS AND SOURCES FOR PROJECTIONS OF NEW REVENUES & BENEFITS

Where We Are: State of Tobacco Control and Prevention

Americans for Nonsmokers Rights

Epidemiology of Tobacco-Related Health Disparities

Tobacco Control: Big Fast Benefits. Stanton A. Glantz, PhD Professor of Medicine University of California San Francisco

The facts are in: Minnesota's 2013 tobacco tax increase is improving health

INTRODUCTION TO POLICIES THAT GOVERN ADOLESCENT HEALTH IN KENYA DR. JOHN TOLE AGA KHAN UNIVERSITY 25 TH APRIL 2018

Centers for Disease Control and Prevention

ELEVEN REASONS WHY S IS BAD PUBLIC POLICY. Clinton Admin. FY00 budget request for FDA tobacco regulation was $34 million.

TOBACCO CONTROL PROGRAM COMMUNITY GRANT. REQUEST FOR PROPOSALS- Release Date: October 2, 2018 Application Deadline: October 19, 2018 at 5:00 PM

The new PH landscape Opportunities for collaboration

RHODE ISLAND CANCER PREVENTION AND CONTROL

Building Capacity for Tobacco Dependence Treatment in Japan. Request for Proposals (RFP) - Background and Rationale

6/14/2016. Disclaimer. A Shift to Prevention and Wellness Can We Do It?

Healthy People, Healthy Communities

The Health Consequences of Involuntary Exposure to Tobacco Smoke

7Florida Health Performs

FDA s Action Agenda to Reduce Tobacco Related-Cancer Incidence and Mortality

Youth Smoking. An assessment of trends in youth smoking through Wisconsin Department of Health and Family Services. Percent.

Executive Summary: Toi Te Ora s Childhood Obesity Prevention Strategy ( )

CDC and Bridging the Gap: Introducing New State Appropriation, Grants, and Expenditure Data in the STATE System

Tobacco Control Policy at the State Level. Progress and Challenges. Danny McGoldrick Institute of Medicine Washington, DC June 11, 2012

THE ROME ACCORD ICN2 zero draft political outcome document for 19 November 2014

Cannabis use carries significant health risks, especially for people who use it frequently and or/begin to use it at an early age.

The New England Journal of Medicine. Special Article

SUNSET Russian Tobacco Education Project

ADVOCATING FOR PATIENTS WITH DIABETES

I N C R E A S I N G C I G A R E T T E E X C I S E T A X I S BAD POLICY FOR OREGON

Adult Smoking Rate Declines in Wyoming

Environmental Prevention Practices

SECOND INTERNATIONAL CONFERENCE ON NUTRITION

September 20th

The Kirwan Institute is entering its second decade of working to create a just and inclusive

Ministerial Round Table: Accelerating implementation of WHO FCTC in SEAR

The English experience in a European regulatory context. E-cigarette summit Washington DC 1 st May 2018 Deborah Arnott Chief Executive ASH (UK)

Price, Food Consumption, and Obesity

Are State Legislatures Responding To Public Opinion When Allocating Funds For Tobacco Control Programs?

RNAO response to proposed regulation under Smoke-Free Ontario Act, 2017

The Burden of Tobacco, Tobacco Control, and Advocacy: Policy Strategies for Oral Health. Robert McMillen, PhD

GATS Highlights. GATS Objectives. GATS Methodology

TAG! YOU'RE IT: HOW BIG TOBACCO SHIFTS BLAME BACK ONTO THE PUBLIC

Atlanta Declaration for the Advancement of Women s Right of Access to Information

Alcohol and Public Health: burden and global response. Maristela G Monteiro, MD PhD Senior Advisor on Alcohol and Substance Abuse

Fumo, riduzione del danno e rischio oncologico

PREVENTION. Category: Initiation of Tobacco Use. Strategies to Reduce tobacco use initiation. used smokeless tobacco on one or more of the

GMPOWER- Radically Reducing Smoking by One Third by 2020 Draft Plans Andrea Crossfield, CE, Healthier Futures 1

The Community Guide Task Force Recommendations and Winnable Battles

- Decree nº (January 2 nd, 2006) Promulgates the Framework Convention on Tobacco Control

Evaluation of Tobacco Control Programs: ASSIST

New Delhi Declaration

Health Literacy for NCD prevention, management and prompting equality

Taskforce on Childhood Obesity. Hank Cardello February 23, 2010

Burkina Faso. Report card on the WHO Framework Convention on Tobacco Control. 29 October Contents. Introduction

An Overview of the Government of Canada s Approach to Legalize, Regulate and Restrict Access to Cannabis. February 2018

Magyar Nemzeti Szívalapítvány Hungarian National Heart Foundation

The National perspective Public Health England s vision, mission and priorities

Transcription:

Lessons from the Tobacco Control Movement Behavior, Energy and Climate Change Conference November 17, 2008 Michael P. Eriksen, Sc.D. Institute of Public Health Georgia State University Atlanta, Georgia meriksen@gsu.edu

Lessons from the Tobacco Control Movement Science Advocacy Leadership Action

The Committee s Judgment in Brief On the basis of prolonged study and evaluation of many lines of converging evidence, the committee makes the following judgment: Cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action. (USDHEW, 1964, PHS Pub No. 1103, page 33)

Adult Per Capita Cigarette Consumption and Major Smoking and Health Events United States, 1900-2004 5,000 4,000 End of WW II 1st Surgeon General s Report Broadcast Ad Ban Number of Cigarettes 3,000 2,000 1,000 Great Depression 1st Smoking- Cancer Concern Fairness Doctrine Messages on TV and Radio Nonsmokers Rights Movement Begins Federal Cigarette Tax Doubles Master Settlement Agreement 0 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 Source: USDA Tobacco & Situation Outlook report, 2004 ;1986-2000 Surgeon General's Reports TM

Question for the Energy and Climate Control Community What is the strength of the evidence of the harm caused? What is the strength of the evidence that there are effective interventions?

Lessons from the Tobacco Control Movement Science Advocacy Leadership Action

The Bridge Between Science and Advocacy: Externalities Externalities when your behavior has an effect, either positive or negative, on others. When there are negative externalities, government or public intervention is needed. Citizen action can stimulate government action, or replace it. For tobacco control, negative externalities led to lasting social change.

Externalities: Secondhand Smoke You can see it, smell it and taste it. Strong scientific evidence as to harm Asking nonsmokers to assume an involuntary risk they chose not to smoke, but there health is at risk due to the behavior of others.

1978 Roper Report for The Tobacco Institute Nearly six out of ten believe that smoking is hazardous to the nonsmoker's health, up sharply over the last four years. More than two-thirds of non smokers believe it and nearly onehalf of all smokers believe it. This we see as the most dangerous development to the viability of the tobacco industry that has yet occurred. (emphasis added)

Society of Actuaries 2005 Report Total Annual Medical Costs for Selected Diseases Behan D, Eriksen M and Lin Y. Medical and Indirect Costs of Secondhand Smoke Exposure, Society of Actuaries, Schaumburg, Illinois 2005.

Question for the Energy and Climate Control Community What are your externalities, e.g., what behaviors do some engage in that harm others? How can you make these externalities more real, immediate and salient to the public? What strategies can be implemented to mitigate the harm caused by these externalities?

Lessons from the Tobacco Control Movement Science Advocacy Leadership Action

The Vector

1994 Waxman Tobacco Hearings

The cigarette industry is peddling a deadly weapon. It is dealing in people s lives for financial gain The industry we seek to regulate is powerful and resourceful. Each new effort to regulate will bring new ways to evade Still, we must be equal to the task. For the stakes involved are nothing less than the lives and health of millions all over the world. But this is a battle which can be won I know it is a battle which must be won.

Robert F. Kennedy September 1967 Video.mp4

Robert F. Kennedy September 1967 http://video.google.com/videoplay?doci d=-2501590901254616694

Question for the Energy and Climate Control Community Who are your leaders? How can your leaders help increase the sustainability of the issue in the publics eye? Do you have an opponent that can be the focus of public attention (or even animosity)? Even if you do, could you achieve more through partnerships than confrontation?

Lessons from the Tobacco Control Movement Science Advocacy Leadership Action

Trends in per capita cigarette consumption for selected states and the average consumption across all states, 1980-2003 140 120 Per Capita Sales (# of Packs) 100 80 60 40 California United States Massachusetts 20 0 1980 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 Year Data from: Orzechowski W, Walker RC. The tax burden on tobacco: historical compilation 2003: Volume 36. Arlington (VA): Orzechowski and Walker; 2003.

Figure 3. Savings in California Personal Health Care Expenditures Lightwood JM, Dinno A, Glantz SA PLoS Medicine Vol. 5, No. 8, e178 doi:10.1371/journal.pmed.00501 78 Lightwood JM, Dinno A, Glantz SA (2008) Effect of the California Tobacco Control Program on Personal Health Care Expenditures. PLoS Med 5(8): e178

Median (50th Percentile) Cotinine Levels

Factors Associated with Successful Health-related Social Change Efforts A persuasive science base documenting a socially and scientifically credible threat to the public health with important economic implications; A supportive partnership with the media; Strategic leadership and a prominent champion; A diverse constituency of highly effective advocates; and Enabling and reinforcing laws, regulations and policies Eriksen MP: Lessons learned from public health efforts and their relevance in preventing childhood obesity. In: Preventing Childhood Obesity, Institute of Medicine, 2005.

How Did Smoking Go From Being the Norm to Becoming Socially Unacceptable? Externalities documented by personal experience and scientific evidence. Citizen action, particularly among opinion leaders, innovators and early adopters. Changing social norms and decreasing social acceptability of the status quo. Institutional change among early majority reflected by laws and policies. Litigation to address failure in public policy and to move laggards.

Summary of Tobacco Lessons With tobacco, social change has taken decades. The challenge is to accelerate social change for energy and climate change behaviors so that it takes years, not decades.

When I look back at the processes of history, when I survey the genesis of America, I see this written over every page: that the nations are renewed from the bottom, not from the top; that the genius that springs up from the ranks of unknown men is the genius which renews the youth and energy of the people. Woodrow Wilson, The New Freedom: A Call for the Emancipation of the Generous Energies of a People, Doubleday, Page and Company, 1913

Take Home Messages: Possible Solutions The public is ambivalent about the appropriateness and effectiveness of certain interventions. Part of this is due to concerns about frivolous lawsuits, the appropriate role of government and an increasing emphasis on personal responsibility. While we don t know all the answers, we know enough now to begin to reduce the problem. Positive change will require small steps, sustained over time. We did not get here overnight, and success will take time. Effective solutions will require the involvement of all sectors of society.

Framework for Addressing Obesity Home School Community Work Site Genetics Psychosocial Other Personal Factors Food and Beverage Intake Social Norms and Values Sectors of Influence Behavioral Settings Individual and Family Factors Physical Activity Food and Beverage Industry Agriculture Education Media Government Public Health Healthcare Employers Land Use and Transportation Leisure Recreation Energy Intake Energy Expenditure Energy Balance Prevention of Overweight and Obesity Among Children, Youth, and Adults Note: Adapted from Preventing Childhood Obesity. Institute of Medicine, 2005.

An Organizing Framework for Public Health Interventions The Information Environment Access and Opportunity Economic Factors The Legal and Regulatory Environment Prevention and Treatment Programs The Social Environment

Figure 2 Relations between climate change, social determinants, and health inequity Solid lines denote causal pathways, dotted lines indicate effect modifiers. Friel S, Marmot M, McMichael A et al. Global health equity and climate stabilisation: a common agenda. Lancet 372 (9650): 1677-1683, 8 November 2008.

Figure 1 Deaths attributable to anthropogenic climate change between 1970 and 2000, density-equalling cartogram Friel S, Marmot M, McMichael A et al. Global health equity and climate stabilisation: a common agenda. Lancet 372 (9650): 1677-1683, 8 November 2008.

Public Health Interventions Effective for Multiple Health Behaviors and Conditions Community-wide Campaigns School-based Interventions Mass Media Strategies Laws and Regulations From Community Guide for Preventive Services

The significant problems we face cannot be solved at the same level of thinking we were at when we created them. Albert Einstein