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Clearing the Smoke: Realities & Myths about the Tobacco Epidemic. Clifford E. Douglas, J.D. Director, University of Michigan Tobacco Research Network Lecturer, University of Michigan School of Public Health. Student National Pharmacy Association Webinar February 25, 2014. Topics.
Realities & Myths
about the Tobacco Epidemic
Clifford E. Douglas, J.D.
Director, University of Michigan Tobacco Research Network
Lecturer, University of Michigan School of Public Health
Student National Pharmacy Association Webinar
February 25, 2014
The Persistent Epidemic
Source: Theodore R. Holford, et al., Tobacco Control and the Reduction in Smoking-Related Premature Deaths in the United States, 1964-2012, JAMA 2014;311:164-171.
Robert Proctor, Ph.D., Stanford University
Historian of Science, author of Golden
Holocaust: Origins of the Cigarette
Catastrophe and the Case for Abolition (2011)
20th Century: 100 million deaths
21st Century: 1 billion deaths (projected)
Acetone(solvent and paint stripper)
Ammonia(poisonous gas and toilet bowl cleaner)
Arsenic(potent ant poison)
Butane(flammable chemical in lighter fluid)
Cadmium(carcinogenic chemical in batteries; lung & intestinal irritant)
Carbon monoxide (poisonous
gas in auto exhaust)
Formaldehyde(dead frogs love it)
Hydrogen cyanide (deadly ingredient in rat poison)
Methanol(jet engine and rocket fuel)
Polonium-210(radioactive element and spy-killer)
Toluene(poisonous industrial solvent)
2014 SGR: “Tobacco industry advertising and promotional activities cause youth and young adults to start smoking, and nicotine addiction keeps people smoking past those ages.”
Q. Do you believe that cigarette smoking is addictive?
A. Pharmacologically, my answer is no. If they are behaviorally addictive or habit forming, they are much more like caffeine, or in my case, Gummy Bears. I love Gummy Bears ... and I want Gummy Bears, and I like Gummy Bears, and I eat Gummy Bears, and I don't like it when I don't eat my Gummy Bears, but I'm certainly not addicted to them.
“The primary incentive to cigarette smoking is the immediate salutory effect of inhaled smoke upon bodily function … The physiological effect serves as the primary incentive; all other incentives are secondary. …
be no smoking. … No one has
ever become a cigarette smoker by smoking cigarettes without nicotine. …
The physiological response to nicotine
can readily be elicited by cigarettes delivering in the range of 1 mg. of nicotine. …
not as a product but as a package.
The product is nicotine. The
cigarette is but one of many package
of nicotine. …
for a dose unit of nicotine. …
vehicle of nicotine. …
and the cigarette the most optimized dispenser of smoke.”William L. Dunn, Ph.D., chief of the Behavioral
Research Group at Philip Morris, “Motives and
Incentives in Cigarette Smoking,” paper presented
at secret tobacco industry conference sponsored
by Council for Tobacco Research on St. Martin,
in the business of selling nicotine,
an addictive drug effective in the
relief of stress mechanisms.”Brown & Williamson general counsel
Addison Yeaman in an internal memorandum,
July 17, 1963
may be thought of as being a
specialized, highly ritualized,
and stylized segment of the
pharmaceutical industry.”Claude Teague, R.J. Reynolds Tobacco
Co., “Research Planning Memorandum on
the Nature of the Tobacco Business and
the Central Role of Nicotine Therein,”
April 14, 1972.
Who is Harmed?
to develop lung cancer than white men
Tobacco companies have carefully studied the attitudes and behaviors of young people, particularly as they go through life transitions, such as attending college.
“If young people don’t start using tobacco by age 26, they almost certainly will never start.”
- Surgeon General Regina Benjamin
“If you think you’re too small to be effective, you have never been in bed with a mosquito.”
To combat the tobacco epidemic, we use several evidence-based
Widespread expansion of tobacco-free policies to institutions of higher learning across the U.S.
Please visit http://tobaccofreecampus.org!
Foster a collaborative, cooperative effort among academic institutions and community public health partners
Expand awareness in academia and among the public of the need for and benefits of such policies
Facilitate information flow and access to technical assistance
Source: Americans for Nonsmokers’ Rights Foundation,
Family Smoking Prevention and Tobacco Control Act, enacted June 2009
FDA regulation of tobacco products and tobacco marketing is necessary to control industry behavior and protect public health
Before June 2009, tobacco products
were not regulated for health
Source: Tax Burden on Tobacco, 2010, and author’s calculations
Norm Change and Help Smokers Quit
The 2014 SGR’s Closing Words
“This nation’s decades-long battle against the tobacco epidemic has successfully prevented millions of premature deaths that would otherwise have occurred – an historic achievement by any measure. On the fiftieth anniversary of the landmark 1964 Surgeon General’s report, this nation must rededicate itself not only to carrying forward the successful tobacco control efforts that have long been under way, but also to expanding and accelerating those efforts in full recognition of the challenge that remains.” (p. 875)