tobacco

On October 1, 2008, the city of San Francisco put a law into effect that prohibits the sale of cigarettes in pharmacies. Walgreens drug store chain and Altria/Philip Morris have filed lawsuits against the city over the measure. In a September 30, 2008 statement about the new law, San Francisco Mayor Gavin Newsom related the city's simple rationale: "Pharmacies should be places where people go to get better, not where people go to get cancer."

Familiar corner drug store chains like Rite Aid and Walgreens have long cultivated an image of being all about health. Their web sites feature photos of friendly-looking pharmacists in white coats ready to help us with our health care needs. The Rite Aid company Web site tells us they are "committed to the healthcare needs of our customers." CVS says its vision is to "strive to improve the quality of human life" by making "high-quality health and pharmacy services safe" and easy to access. Walgreens says it stands ready to help people by supplying "health and wellness products" and health information. If all this makes you feel that these drugstore chains have your best interests at heart, it's certainly by design. But don't be don't be taken in too easily.

Germany's Federal Medical Society is proposing to classify nicotine addiction as an illness, saying doctors should evaluate and treat heavily addicted smokers the same way they do patients suffering from physical illness. They hope that labeling smokers as being sick will pressure more of them to seek professional help to overcome their addiction. The label may be more than just a strategy, though. In June 1998, the Director of the U.S. National Institute on Drug Abuse, Alan I. Leshner, Ph.D., testified before a Congressional panel that addiction, including nicotine addiction, is now considered to be a chronic, recurring brain disease. German health insurance companies fear the Medical Society's proposal will lead to a spike in smoking-related claims, and are unenthusiastic about paying for medical treatment for something they consider to be a "self-inflicted addiction." About 140,000 German citizens die annually from smoking-related illnesses.

"We do not want children to smoke," British American Tobacco (BAT) declares on its website. But the company that describes itself as the "world's most international tobacco group" routinely violates its own voluntary international marketing and advertising standards, according to a July 1, 2008 BBC-TV This World investigation. BAT was caught in Malawi, Mauritius and Nigeria using marketing tactics that are well-known to appeal to youth: advertising and selling single cigarettes, and sponsoring non-age-restricted, product-branded musical entertainment. (See also "Playing with Children's Lives: Big Tobacco in Malawi.")

When a company adopts and prominently touts its voluntary behavior codes, only to end up violating them, people start asking questions: What are the real reasons for these codes? Are they just for public relations (PR) purposes? To, as they say, 'cover your a*s' (CYA)? How did they arise? What, if any, value do they have?

Tobacco manufacturers discovered over 40 years ago that radioactive polonium-210 exists in cigarettes and tobacco smoke, and spent decades working to remove it, according to a new study published in the American Journal of Public Health. The companies tried to remove polonium -- a naturally-occurring, alpha particle-emitting constituent of the fertilizers and soil used to grow tobacco -- by creating special filters, washing the tobacco leaf and genetically altering tobacco plants, but ultimately failed. Instead of coming clean, the companies kept their internal research on polonium and information about their unsuccessful efforts to remove it secret. They didn't want to heighten public awareness of polonium in cigarettes. Polonium-210 is the lethal radioactive substance that was used to poison Russian dissident Alexander Litvinenko in London in 2006.

Cigarette ads and smoking in the movies influence kids to smokePhilip Morris and the tobacco industry in general have long insisted that cigarette advertising has no influence whatsoever in getting people to start smoking, claiming it only influences existing adult smokers to change brands. But this week the National Cancer Institute published an extensive, 684-page monograph that evaluates current evidence regarding the power of the media to both encourage and discourage tobacco use. NCI found that "The total weight of evidence -- from multiple studies, conducted by investigators from different disciplines, and using data from many countries -- demonstrates a causal relationship between tobacco advertising and promotion and increased tobacco use." NCI further concluded that smoking in the movies causes more children to start smoking, saying "the depiction of cigarette smoking in movies is pervasive" and "the total weight of evidence ... indicates a causal relationship between exposure to depictions of smoking in movies and youth initiation."

Last month, when pop singer Alicia Keys protested Philip Morris International's (PMI) sponsorship of her concert in Jakarta, Indonesia, PMI was forced to pull down posters and billboards that promoted the event. That debacle was hardly over when health advocates started pushing for PMI to end its involvement in yet another concert, the August 30 reunion of the Filipino group Eraserheads, a band so popular in this part of the world that it has been dubbed the "Beatles of the Philippines." People seeking tickets to the free concert are directed to www.marlboro.ph, a Web site run by PMI's Philippine subsidiary. To obtain tickets and information, visitors must provide personal contact information that allows PMI to send them promotional materials for cigarettes. The Eraserheads concert is generating tremendous buzz on the Internet that often mentions the Marlboro web site and brand name, conferring substantial positive publicity upon PMI and its best-selling cigarette brand. But last week, the Philippines Department of Health warned PMI that it is violating the country's tobacco regulation law, which, as of July 1, 2008 prohibits all forms of tobacco advertising in mass media, including the Internet, places strict restrictions on other tobacco promotional activities and bans tobacco company sponsorship of concerts and other events.

Daniel Troy served as chief counsel for the U.S. Food and Drug Administration from 2001 to 2004. Starting September 2, 2008, he will be head counsel for the pharmaceutical company GlaxoSmithKline. Before his stint at the FDA, Troy "fought the agency on behalf of the right to use medical-journal articles to suggest off-label uses for drugs and medical devices." He was also an active litigator who worked against consumer interests. "Representing the Washington Legal Foundation, an industry-supported business think tank, Mr. Troy argued for the protection of commercial speech. ... He was also part of the winning team representing Brown & Williamson in a suit against the FDA regarding tobacco advertising." At the FDA, he was known as a loyal friend of the very industries the regulatory agency is charged with monitoring. "Under Mr. Troy, the agency began filing amicus briefs opposing lawsuits against drug and medical-device makers, saying that having met the FDA's approval and labeling standards, manufacturers should be protected from state-based suits for damages." His move to GSK is another example of the revolving door between government and industry. GSK said of Troy, "His wealth of experience in the regulatory legislative area will be of enormous benefit to us, and ultimately to patients."

Smoking was officially banned July 1 in Dutch bars and cafes. Since then, smokers have started flocking to a new religious movement in the Netherlands known as the "The Only and Universal Smokers Church of God," or the "Smokers Church." Michiel Eijsbouts, who founded the church in 2001, insists that the new smoking law does not apply to members of the Smokers Church. He says church members have a right to express their religion and they do it through smoking. Members of the Smokers Church profess to believe in a trinity of smoke, fire and ash, and their holy rite to their god is honored by smoking. People who sign up to join the church pay three British pounds and get a card that proves their religious affiliation to authorities. So far, the church boasts over 2,000 members, and over 100 bars and cafes have recently applied to the church to be considered "religious institutions." Mr. Eijsbouts said, "Converting people was not easy until the smoking ban, but now people are flocking to the church."

Kool Menthol Ad c. 1975: "The longer you smoke, the more you'll like Kool Super Longs"Harvard School of Public Health researchers combed through tobacco industry documents to find out why the industry adds menthol to cigarettes, and why cigarette brands have differing levels of menthol. Researchers found that tobacco companies use menthol's anesthetic effect to mask the harshness of the smoke and ease throat pain for beginning smokers. Once smokers are addicted, according to documents, they seek cigarettes with increasing levels of menthol to maintain the sensory effects. Tobacco companies respond by making cigarette brands with low levels of menthol for starters, and brands with higher menthol levels for veteran smokers. R.J. Reynolds calls the Harvard study propaganda, and says it is aimed at promoting a federal ban on menthol. The study was published online ahead of print at the Web site of the American Journal of Public Health.

FTC smoking machineThe U.S. Federal Trade Commission (FTC) is considering stopping use of the "FTC Method" to determine the amounts of tar and nicotine in cigarettes, a test that tobacco companies have touted on cigarette packs for over 40 years and have long used to market "light," "ultralight" and "low tar" cigarettes. The FTC started using the "Cambridge Filter Method" to test for tar and nicotine in 1966, when public health authorities believed that reducing the amount of tar in cigarettes would reduce the risk of lung cancer. In recent years, evidence has proven the test meaningless because it was found that smokers "compensate," or adjust how they smoke, to get the amount of nicotine they need from a cigarette, regardless of nicotine content. Senators Frank Lautenberg (D-New Jersey) and Olympia Snowe (R-Maine) have introduced a bill to stop cigarette companies from using the "FTC Method" to measure tar and nicotine. "For years, Big Tobacco has relied on the FTC's flawed testing method to mislead smokers into thinking these ['light' and 'low tar'] cigarettes deliver less tar and nicotine...In reality, some so-called 'light' and 'low tar' cigarettes can actually be more harmful for smokers," Lautenberg said.