Where there s smoke there s money
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Where there’s smoke there’s money:. Campaign contributions and U.S. government efforts to derail the Global Tobacco Treaty Martin Donohoe. Tobacco – Weapon of Mass Destruction. 1.3 billion smokers 84% in developing countries 43 million (19% of adults) in U.S.

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Where there s smoke there s money

Where there’s smoke there’s money:

Campaign contributions and U.S. government efforts to derail the Global Tobacco Treaty

Martin Donohoe


Tobacco weapon of mass destruction

Tobacco – Weapon of Mass Destruction

  • 1.3 billion smokers

    • 84% in developing countries

    • 43 million (19% of adults) in U.S.

  • 5.7 trillion cigarettes smoked/yr worldwide


Tobacco weapon of mass destruction1

Tobacco – Weapon of Mass Destruction

  • Nearly 6 million deaths/yr worldwide (1/10 deaths) – 600,000 from passive smoking

    • Estimated 8-10 million by 2030

    • Only 7% of the world’s population lives in jurisdictions with comprehensive smoke-free laws, and enforcement of these laws is robust in only a few


Tobacco weapon of mass destruction2

Tobacco – Weapon of Mass Destruction

  • Leading cause of death in U.S.

    • 443,000 deaths/yr from smoking

    • 50,000 from environmental tobacco smoke (ETS)


Tobacco weapon of mass destruction3

Tobacco – Weapon of Mass Destruction

  • Numerous health consequences

  • Tobacco smoke contains numerous toxins, carcinogens, and radioactive pollonium

  • Heavily pesticide-dependent crop

    • Tobacco industry has lobbied to weaken environmental regulations


Cigarette litter

Cigarette Litter

  • Nearly billion pounds of cigarette butts littered per year

    • 4.5 trillion butts

    • Comprised largely of filters made from cellulose acetate, a non-biodegradable plastic

    • Filters trap toxins, heavy metals which can leach into environment

  • The most littered item in the world


Tobacco weapon of mass destruction4

Tobacco – Weapon of Mass Destruction

  • Direct medical costs = $100 billion/yr

  • Lost productivity = $97 billion/yr

  • Medical care and lost productivity due to tobacco use costs each U.S. citizen approximately $600/yr


Smoking prevention and cessation

Smoking Prevention and Cessation

  • Over the last 10 years, only 3.2% of state revenues from tobacco taxes and settlement money spent on prevention and cessation

    • Average state tax = $1.44 per pack (7¢/pack SC to 2.75¢/pack NY

    • Federal tax = $2.21/pack

  • Society saves $3 in medical costs for every $1 spent to prevent smoking; $50 per $1 in CA per 2008 study


Smoke free legislation

Smoke-Free Legislation

1975: Minnesota passes first clean indoor air law

1999: All 50 states and D.C. have some public smoking restrictions


Smokescreen

Smokescreen

  • Cigarettes most marketed products in the world

    • $2 billion/year in the U.S.

    • $10.5 billion/year worldwide

  • 3 largest companies have combined annual revenues exceeding $121 billion (2007)

  • U.S. leading exporter of cigarettes

  • U.S. tax money used to assist corporations in their marketing efforts overseas


Smokescreen1

Smokescreen

  • Tobacco manufacturers pay governments U.S. $133 billion/yr, but less than $1 billion/yr spent on tobacco control (and only 3% of this spent on low- and middle-income countries)

  • Tobacco companies spend $23 on marketing for every $1 that states spend to fight tobacco use

    • States spend less than 2% of tobacco revenue to fight tobacco use

    • Recent state funding cuts


Who framework convention on tobacco control treaty

WHO Framework Convention on Tobacco Control Treaty

  • Finalized 2/27/05

  • Ratified by 174 nations (as of end of 2011)

    • Including Russia, Canada, Australia, Mexico, and the UK

    • Another 8 have signed but not yet ratified/approved


Who framework convention on tobacco control treaty1

WHO Framework Convention on Tobacco Control Treaty

  • Exempts tobacco control from free trade challenges

  • Limits tobacco advertising

  • Cracks down on tobacco smuggling

  • Bans tobacco sales to and by minors


Who framework convention on tobacco control treaty2

WHO Framework Convention on Tobacco Control Treaty

  • Promotes agricultural diversification and alternative livelihoods for tobacco farmers

  • Standardizes packaging

    • Bans deceptive terms such as “light” and “mild”

    • Improves warning labels


U s efforts to undermine the treaty

U.S. Efforts to Undermine the Treaty

  • Despite overwhelming U.S. and international public support for the goals of the treaty…

  • U.S. government attempted to scuttle the treaty in the name of free trade and free speech

  • Tobacco industry documents show attempt to create alternative through Project Cerberus


U s efforts to undermine the treaty1

U.S. Efforts to Undermine the Treaty

  • Original U.S. negotiator Thomas Novotny resigned after the Bush administration pressured him to lobby for the deletion of 10 of 11 treaty provisions, as outlined in a Phillip Morris memo


Phillip morris and altria

Phillip Morris and Altria

  • Phillip Morris = world’s largest tobacco company

    • Parent company = Altria (also owns 85% of Kraft Foods and 28 % of Miller Brewing)

    • 2008: Phillip Morris International becomes independent company, separates from Phillip Morris USA and Altria


U s efforts to undermine the treaty2

U.S. Efforts to Undermine the Treaty

  • U.S. Belatedly signed on 5/3/05

  • Senate must ratify AND President must sign

    • Administration has not submitted treaty to Congress – “studying it”


Bush administration ties to the tobacco industry

Bush Administration Ties to the Tobacco Industry

  • Karl Rove (Deputy Chief of Staff and Senior Advisor) – lobbyist/strategist for PM

  • Kirk Blalock (White House liaison to the business community) – PM public relations official


Bush administration ties to the tobacco industry1

Bush Administration Ties to the Tobacco Industry

  • Charles Black (informal advisor to Bush during 2000 campaign) – PM lobbyist

  • Daniel Troy (former FDA Chief Counsel) – represented tobacco industry when it sued the FDA over tobacco ad regulation


Bush administration ties to the tobacco industry2

Bush Administration Ties to the Tobacco Industry

  • Tommy Thompson (HHS Secretary)

    • received $72,000 in campaign contributions from PM executives when he was governor of Wisconsin

    • advisor for the primary tobacco lobbying firm in D.C.

    • Rejected his own advisory panel’s recommendation to increase federal tobacco tax


Bush administration ties to the tobacco industry3

Bush Administration Ties to the Tobacco Industry

  • British American Tobacco PLC’s Brown and Williamson unit and RJ Reynolds Tobacco Holdings, Inc. represented by Barbour, Griffith and Rogers

    • Lobbying firm stocked with Republican operatives, including:

      • Haley Barbour – former GOP Chairman, MS governor

      • Lanny Griffith – White House aide to GHW Bush


Obama administration ties to the tobacco industry

Obama Administration Ties to the Tobacco Industry

  • US Trade Representative Ronald Kirk

    • Former PM lobbyist

    • Opposed smoking ban at Dallas airport when mayor of Dallas in early 1990s

    • Has opposed federal excise tax on tobacco


Campaign contributions

Campaign Contributions

  • $3.5 million (through individual contributions and PACs) in 2004

    • 74% to Republicans

  • $20 million to Republican candidates for federal office since 1997

  • PM – leading overall campaign contributor to Republicans since 1989


U s non cooperation on international treaties

U.S. Non-Cooperation on International Treaties

  • Failure to sign or approve:

    • Kyoto Protocol on Climate Change

    • Convention on the Prohibition of Anti-Personnel Land Mines

    • Cluster Bomb Ban

    • Comprehensive Nuclear Test Ban Treaty

    • Convention on the Rights of the Child


U s non cooperation on international treaties1

U.S. Non-Cooperation on International Treaties

  • Failure to sign or approve:

    • Convention on the Elimination of Discrimination Against Women

    • Convention on Economic, Social and Cultural Rights

    • Convention for the Suppression of Traffic in Persons

  • Failure to pay full U.N. dues

  • Opposition to International Criminal Court


Health care organizations and medical schools

Health Care Organizations and Medical Schools

  • As of 2009: insurers (including some of the largest owners of HMOs) and mutual funds heavily invested in tobacco stocks

    • Prudential - $1.4 billion; Sun Life - $1 billion; Standard Life - $950 million

    • TIAA-CREF (whose mutual funds are owned by many health professionals) owns over $700 million in Phillip Morris stock.


Health care organizations and medical schools1

Health Care Organizations and Medical Schools

  • 1996-1998: PM and Cigna collaborated to censor accurate information on the harms of smoking and ETS from health newsletters

  • Tobacco companies sponsored “research” to refute links between tobacco and disease


Health care organizations and medical schools2

Health Care Organizations and Medical Schools

  • Tobacco industry has “white-coated” itself since the 1940s

    • Borrowing from medicine’s prestige and public esteem in ads featuring smoking doctors


Tobacco company harrassment of academics

Tobacco Company Harrassment of Academics

  • Threatened litigation against historians who have testified on behalf of plaintiffs

  • Hired graduate students to do “research”

    • Some unwittingly


Health care organizations and medical schools3

Health Care Organizations and Medical Schools

  • As of late 2004, despite a decade’s old plea from the AMA for medical schools to divest their tobacco holdings, some of the nation’s leading medical schools had failed to do so:

    • Cornell, Duke, Washington University, Yale, and possibly Penn (refused to answer requests)

    • Columbia is said to have divested, but could not provide details to confirm


Smokefree hospitals

Smokefree Hospitals

1993: JCAHO mandates that all hospitals seeking accreditation adopt smokefree indoor work policies

Over 45% of US hospitals have smokefree policies by the end of 2008 (>50% expected by end of 2009)

2/3 of Oregon hospitals smokefree

Higher quit rates, faster quitting, less second hand smoke exposure at smokefree hospitals


Conclusions

Conclusions

  • U.S. resistance to / attempts to scuttle global tobacco treaty squanders opportunity for U.S. to take lead on important international public health issue

  • Represents callous disregard for human health and world economy


Conclusions1

Conclusions

  • Some health care organizations and medical schools have failed to provide ethical and moral leadership in anti-tobacco crusade

  • Government / health care community’s obstructionism and failure to lead likely due to influence of campaign contributions / research funding


Recommendations

Recommendations

  • President should send Treaty to U.S. Senate, which should immediately ratify, and President sign

  • Campaign finance reform

  • Strengthen smoke-free legislation


Recommendations1

Recommendations

  • Medical schools and health care organizations should immediately divest all tobacco holdings

  • Health care professionals should lobby their institutions and legislators to take the lead in the war on tobacco

    • Increase tobacco taxes, spend more on prevention and cessation programs


Recommendations2

Recommendations

  • Media should more aggressively expose tobacco industry machinations

  • Ban public smoking

    • Majority of public supports

    • 25 states + D.C. currently prohibit smoking in indoor areas (worksites, restaurants, bars)

  • Ban tobacco sales in pharmacies


Family smoking prevention and tobacco control act of 2009

Family Smoking Prevention and Tobacco Control Act of 2009

  • Tobacco companies must provide ingredients to govt.; govt. will regulate harmful ingredients

  • Govt. cannot ban cigarettes, reduce nicotine content to zero

  • Age limit of 18 to purchase cigarettes and smokeless tobacco


Family smoking prevention and tobacco control act of 20091

Family Smoking Prevention and Tobacco Control Act of 2009

  • Minimum cigarette pack size of 20

  • Bans “light” and “low tar” labels, fruit- and candy- flavored cigarettes; menthol flavoring still allowed

  • New, larger set of warning labels (50% of pack / 20% of ads by 2012; quit line number also included)

    • As in at least 43 other countries

    • Canada – covers 75% of pack


Family smoking prevention and tobacco control act of 20092

Family Smoking Prevention and Tobacco Control Act of 2009

Limits on public advertising in publications with high numbers of young readers

Bans sponsorships of sports and entertainment events

Restricts vending machines to adult-only venues

Bans free samples


Family smoking prevention and tobacco control act of 20093

Family Smoking Prevention and Tobacco Control Act of 2009

  • Supported by Phillip Morris

    • Possibly to solidify its dominant market position

  • May mitigate the legal liabilities of tobacco companies


Family smoking prevention and tobacco control act of 20094

Family Smoking Prevention and Tobacco Control Act of 2009

  • U.S. District Court judge has blocked implementation of ad regulations (in lawsuit brought by tobacco companies)

    • Justice Dept. will likely appeal

  • WTO has ruled against measures designed to decrease teen smoking

    • U.S. unlikely to abide by ruling


The future

The Future

  • Late 2010: EPA proposes new, larger, more visual warning labels (required by 2010 under FSPTCA

  • 2011: FDA to regulate electronic nicotine delivery devices (ENDS, aka e-cigarettes) as tobacco products


Tobacco taxes

Tobacco Taxes

Federal excise tax = $2.21 per pack

Average state excise tax = $1.44 per pack


For references see

For references, see:

Donohoe MT. Cigarettes: The other weapons of mass destruction. Medscape Ob/Gyn and Women’s Health 2005;10(1): posted 4/5/05. Available at http://www.medscape.com/viewarticle/501586


Contact information

Contact Information

Public Health and Social Justice Website

http://www.phsj.org

[email protected]


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