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Smoking Bans And Car-Seat Bribes: Five Lessons From The 50-Year Effort To Reduce Smoking And Save Lives

Smoking Bans And Car-Seat Bribes: Five Lessons From The 50-Year Effort To Reduce Smoking And Save Lives

Jan 10 2014, 10:41am CST | by

with Larry Cohen On the occasion of the 50th anniversary of the Surgeon General’s Report on Smoking and Health, I wrote this blog with my colleague Larry Cohen, Prevention Institute’s executive...

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28 weeks ago

Smoking Bans And Car-Seat Bribes: Five Lessons From The 50-Year Effort To Reduce Smoking And Save Lives

Jan 10 2014, 10:41am CST | by

with Larry Cohen

On the occasion of the 50th anniversary of the Surgeon General’s Report on Smoking and Health, I wrote this blog with my colleague Larry Cohen, Prevention Institute’s executive director and a longtime leader in the fight against smoking.

Fifty years ago this week, Surgeon General Luther Terry released perhaps the most important public health document in U.S. history, the now-famous first Surgeon General’s Report on Smoking and Health. It made explicit and public what virtually every scientist not on the payroll of the tobacco companies knew and acknowledged: that smoking cigarettes was deadly.

At the time, cigarettes cost about 35 cents a pack, 42 percent of American adults smoked and people lit up just about everywhere—on airplanes, in restaurants and bars, even in doctor’s waiting rooms. And more than 300,000 Americans were dying of lung cancer and other tobacco-related causes each year.

Flash forward 50 years and the landscape has changed dramatically. The percentage of adults who smoke has dropped by more than half, to 19 percent. The average cost of a pack of cigarettes is more than $5.60. And the rate of deaths has dropped dramatically.

New research just released in the Journal of the American Medical Association finds that tobacco-control efforts since 1964 kept 8 million people from dying prematurely. The decline in smoking has added 2.3 years to the average lifespan of American men and 1.6 years to the lifespan of American women. If those number sound modest, consider this: Each of the 8 million people spared a premature death because they never smoked, or quit smoking early, gained, on average, almost 20 years of life.

The anniversary of the Surgeon General’s report is generating lots of media coverage tracking these changes, trends that are worth celebrating and understanding more deeply. But it’s also important to note that these changes didn’t happen solely as a result of the report itself, or the education efforts that came in its wake. It took policy changes, first small ones in a few places, then bigger ones in more places, to finally produce a groundswell.

In the early 1980s, I worked on the first multi-city no-smoking laws in the U.S., as director of prevention for the health department of Contra Costa, a politically moderate county east of San Francisco. We knew tobacco was a major cause of chronic disease and formed a local coalition that included the American Cancer Society, American Heart Association and American Lung Association, highly credible organizations whose boards included influential doctors and donors. This was Lesson 1—the importance of building coalitions.

When we launched our efforts to ban smoking, many people said it would be impossible. Smoking was the norm, both acceptable and unrestricted. Many considered the tobacco industry too big to fight. Yet we were determined to influence smoking habits and believed that altering policy was the key.

Our initial goal was modest: to ban smoking in 40 percent of the seating in restaurants. By itself, of course, that wouldn’t end lung cancer, heart disease, or emphysema. Yet it had a huge impact because each modest victory changed the status quo and spurred efforts for more sweeping change. Soon, communities across the country were passing laws that banned smoking in 50 percent of each restaurant, then 80 percent, then 100 percent. Next, we were regulating smoking on airplanes, in public buildings, and eventually in bars and on beaches. This is Lesson 2—the importance of policy change. 

These local smoking-control ordinances were combined with state and federal efforts to increase tobacco taxes. The taxes not only made cigarettes more expensive, dampening demand, they helped fund advertising campaigns warning people of the dangers of cigarettes and supported smoking quitlines. Together, this multipronged effort to change policy, backed by a powerful communications and educational strategy, created a snowball of change that transformed norms and expectations around smoking. Lesson 3—create campaigns that are multifaceted.

At every step, we faced the determined and deep-pocketed resistance of Big Tobacco— just as advocates working today to pass taxes or marketing restrictions on soda and junk food face powerful, high-budget opposition from the food and beverage industries. Of course, one tactic always used by industry in opposing policy change is to coopt its leaders. In my case, that moment came at a lunch meeting I cautiously accepted with the state’s top tobacco lobbyist, who offered to supply our county with all the child-safety car seats we wanted if we dropped our tobacco policy work. Lesson 4—expect and beware of efforts to coopt.

As we consider and celebrate these victories, we must also remember how far we have to go. Today, while the rate of smoking has dropped, it remains the leading cause of preventable death, claiming the lives of 440,000 Americans each year. Eight million Americans live with at least one serious chronic disease from smoking, and people of color and with lower incomes remain at higher risk. The cost to the U.S economy is $193 billion a year, half of it in direct medical costs. Tobacco companies continue to market their deadly products, focusing on the most vulnerable by pitching menthol cigarettes to African Americans, using flavored e-cigarettes to hook young people, and unconscionably trying to hold back attempts at regulation in the countries of the developing world. And that leads to Lesson 5—keep up the fight (and we’ve only just begun).

Source: Forbes Business

 
Update
10

7 weeks ago

RM47mil KWSG contributions still unclaimed

Jun 9 2014 7:54am CDT | Source: Business Times Malaysia

KUALA LUMPUR: About RM47 million of contributions in the Teachers Provident Fund (KWSG) still remain unclaimed, the Dewan Rakya ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
9

7 weeks ago

Gold shop lost almost RM1mil

Jun 9 2014 3:50am CDT | Source: Business Times Malaysia

KANGAR: A gold shop owner lost almost RM1 million after after the safe on in his shop was broken into by robb ...
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Update
8

7 weeks ago

Motion to debate MAS losses in Dewan Rakyat rejected

Jun 9 2014 3:39am CDT | Source: Business Times Malaysia

KUALA LUMPUR: AN emergency motion to debate the losses incurred by Malaysia Airlines last year, amounting to RM1.2 billion was rejected by the Dewan R ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
7

7 weeks ago

MH370 Tragedy: Hisham: RM27.6 mil spent on 1st phase of SAR

Jun 9 2014 2:11am CDT | Source: Business Times Malaysia

KUALA LUMPUR: Malaysia spent some RM27.6 million in its first phase of the search operations for missing Malaysia Airline flight MH370, said Acting Transport Minister, Datuk Seri Hishammuddin Hussei ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
6

7 weeks ago

9.1m litres of diesel seized in a month

Jun 8 2014 1:11am CDT | Source: Business Times Malaysia

PUTRAJAYA: The Domestic Trade, Cooperatives, and Consumerism ministry has seized some 9.1 million litres of diesel and property worth RM58 million since mounting ‘Operasi Diesel Selatan’ in the sou ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
5

7 weeks ago

Girl, 9, awarded RM2.78m compensation for medical negligence

Jun 6 2014 4:56am CDT | Source: Business Times Malaysia

KUALA LUMPUR: A nine-year-old girl who suffered brain damage during her birth at a government hospital was awarded over RM2.78 million ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
4

7 weeks ago

Malaysia's total trade in April up 12pc

Jun 5 2014 11:52pm CDT | Source: Business Times Malaysia

KUALA LUMPUR: Malaysia's total trade in April 2014 rose by 12 per cent from a year ago to RM123.86 billion due to growing trading activities, International Trade and Industry Minister Datuk Seri Mustapa Mohamed sai ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
3

7 weeks ago

Works Ministry to spend RM20m for upgrading works at 50 accident black spots

Jun 4 2014 11:35pm CDT | Source: Business Times Malaysia

JOHOR BARU: The Works Ministry will implement upgrading works at 50 accident prone locations in the country that have been identified this year involving an allocation ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
2

7 weeks ago

Najib launches loan scheme for Ramadan traders

Jun 4 2014 10:24pm CDT | Source: Business Times Malaysia

PUTRAJAYA: Prime Minister Datuk Seri Najib Razak today launches RM45 million Ramadan Bazaar S ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 
Update
1

8 weeks ago

Residents bring up objection against Kidex to Suhakam

Jun 4 2014 4:49am CDT | Source: Business Times Malaysia

PETALING JAYA: A group of 20 Petaling Jaya residents held a meeting with the Human Rights Commission of Malaysia (Suhakam) over their objection against the proposed RM2.2 billion Kinrara Damansara Skyway (Kidex) today. ...
Source: Business Times Malaysia   Full article at: Business Times Malaysia
 

 

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