Changing Laws And Attitudes About Smoking
How has the tobacco industry influenced American culture?
The tobacco industry is out to sell a product. That product is only going to be viable if they recruit new smokers. So their primary purpose in their marketing is to recruit people to think positively about their product and to begin to experiment with it and use it. The tobacco industry has sponsored youth events: rock concerts, college events, art events, cultural and ethnic groups, who otherwise would not have access to easy money to support their events. The tobacco industry has gone in specifically marketing to Hispanics and the African-American cultures, trying to work on women and smoking. That's been a big emphasis of the tobacco industry. They also have influenced, probably, children because of the use of cartoon characters in the past, such as Joe Camel. They were required to stop using that promotion, at least in the U.S., during the Master Settlement Agreement. At that time Joe Camel was more recognizable than Mickey Mouse to children at the age of five. So we know that their promotion and marketing strategies has changed the views of, not only children, but adolescents through their marketing and movies. They aren't allowed to specifically market on TV anymore. But if you open up almost any magazine for an adolescent or a youth, race car driving, they sponsor race cars. They sponsor all sorts of events that seem cultural, sexy, racy. They create an image, like the old Camel man, the Marlboro man, the Marlboro ranch. All of these events, getting Camel bucks, and turning those in, people know about these. Promotional items like baseball caps, t-shirts, free give-aways. All of those things make the tobacco industry seem like the good guys, and encourage people to use their products and think of them in a positive way, instead of being honest about these products actually killing more people in America than any other single source.
How did the 1964 US Surgeon General's report impact the tobacco industry?
In the 1940s and 1950s, reports were coming out about new epidemiological and pathological findings that cigarette smoking was linked to an epidemic of new occurrences of diseases that were not seen in the 1800s. In 1964, the Surgeon General Dr. Luther Terry created a group of people heavily influenced by the tobacco industry and their lobby to create a document that embodied, at that time, what we knew about the effect of smoking. That document came out saying cigarette smoking is dangerous, that it increases the risk of heart disease, and is probably associated with cancer and lung disease. Since 1964, there have been at least 40 years of continued Surgeon General's reports where that office of the US government has taken on the issue, especially during the time of Dr. C. Everett Coop and the Reagan and Clinton era when the government supported active advertising against tobacco. I think that that landmark case in 1964 got the attention of the Americans. Men quit smoking right about that time in the early 60s and the rates began to decline. When you look at the rates of women, it was increasing right up until 1964 and the rate of smoking in women began to decline at that point in time. In the United States, at least, that really made an impact on the listening public that said "Hmm, maybe this is not just a fun thing to do, maybe this is not just a pleasurable habit?". The doctors, the government, and everyone is saying that this is risky behavior. Americans have been listening ever since.
How are tobacco control laws changing American culture?
In most states, following the 1989 passage of Prop 99 in the state of California legislation that influences clean indoor air, prevention of second-hand smoke in workplaces, prevention of exposure to children, increasing taxation on cigarettes, and anti-tobacco campaigns on TV, radio, newspaper print in a state, and provision of smoking cessation services have really started in California and going with multiple states who have followed this model have really got the attention of the population and begun a rapid decline in smoking in those states. States that have not had anti-smoking legislation have not seen their smoking rates fall. In fact, in many of those states the smoking rate has continued to rise.
Which states have the most stringent smoking laws?
There are probably five states that have aggressively used tobacco taxation to fund anti-tobacco messaging, treatment, and clean indoor air legislation throughout their states. California was the first. California's smoking rate dropped faster than any other state, beginning in 1989 when their first legislation was passed. Arizona followed very quickly, along with Massachusetts and Connecticut. Utah had a lower smoking rate than any other state to begin with, because a larger proportion of their population doesn't smoke for religious reasons. Oregon also followed. Washington has had a decline as a result of their anti-smoking campaign. It's been very clear when a state health department, their governor and their legislature work together to create anti-smoking messages to the state, incentives, research, and clean indoor air laws in legislation. The population then listens and begins to change their behavior, seeking treatment and choosing to live smoke free lives. In fact, in the state where I live, in California, only nine percent of women still smoke. It's the lowest state in the union because California has had a massive anti-smoking campaign for 20 years.
Why are US tobacco control laws necessary?
In the last 40 years since the first surgeon general's report, when they have done public health research about what makes the biggest difference in a population of people to get people to: be aware, change their behaviors, stop smoking and not affect other people, just telling people to quit doesn't have the same impact as legislation that protects everyone from second hand smoke. So, protection of clean indoor air or second hand smoke prevention; A) protects people who otherwise would be exposed to second hand smoke and have those effects, B) gets the attention of the cigarette smokers so that they realize: “Hmm, my smoking is not safe for the person sitting next to me. It's not safe for me!” and it creates the attitude within the community that cigarette smoking is something all of us need to ask smokers to be responsible about. To not increase the risk for innocent—for example innocent parties or children who are in a restaurant, if a child comes who has asthma and has to sit next to the table of someone who is smoking, why do they have a right for their smoking to make that child have to land in an emergency room that night wheezing. So when you really look up the effects of second hand smoke, the legislations, the lack of control over sales to minors, all of the things that are attempted have their little piece to play in an overall comprehensive plan to make a population realize this is not a safe behavior.
Are cigarettes and tobacco products regulated by the FDA?
When the FDA was originally drafted with their rules and regulations, the tobacco industry specifically lobbied to have tobacco products excluded from all of their jurisdiction. We're talking a long time ago, because tobacco was said to not be a food, and not be a drug. Now we know it clearly is a drug. They knew that at the time, but because of that initial legislation, tobacco and all tobacco products are excluded from any of the government regulation or control. Their products, the exhaust, for example from a car, compared to the smoke from a cigarette, or cigar or a pipe. A car is much more regulated and it is safer to breathe exhaust from the engine of a car than it is to breathe the exhaust and fumes from a cigarette. That is absolutely true, but that's what happens when you have an industry that is unregulated and doesn't operate in an ethical manner with the products that they make commercially available to anyone who buys them.
What is the 'Framework Convention on Tobacco Control' or 'FCTC'?
The 'Framework Convention on Tobacco Control,' or FCTC, is a global treaty that the World Health Organization, along with many partner organizations, have encouraged all of their member nations to endorse, to ratify, and to enforce with legislation in each member country that will limit the advertising and promotion of tobacco, secondhand smoke legislation, taxation of weighting, smuggling, and on and on. There's about 15 categories that they encourage every member nation to address appropriately in their country. In 2006, it had received enough support from all their member nations to go into effect, and what we are hoping is that countries that otherwise would not have the public health support rallies within the expertise of their country will be able to follow this wave of global control over the tobacco industries' influence over government so that passive smoking, cost of cigarettes, marketing to children and all of those strategies used by the tobacco industry will not have the same long-term impact 10, 20, 30 years from now that we were anticipating. It's been a tremendous public health success, and in fact it's the first global health treaty that was ever passed by the World Health Organization. It's appropriate because tobacco use is the #1 killer in the world.