Campaign for Tobacco Free Kids

FDA Clears First Tobacco Product for Marketing

For the first time since it was given the power to regulate tobacco, the US Food and Drug Administration (FDA) has authorized marketing of a new product.

The agency said that eight new smokeless snus products, to be sold in the United States under the “General” brand name by Stockholm-based Swedish Match AB, are now authorized under the premarket tobacco application pathway, which was established by the 2009 Family Smoking Prevention and Tobacco Control Act. Snus cannot be marketed as “FDA-approved,” however.

“Today’s action demonstrates that the premarket tobacco application process is a viable pathway under which products can be marketed, as long as the public health can be protected,” said Mitch Zeller, director of the FDA’s Center for Tobacco Products, in a statement.

This is the first time any tobacco maker has completed the rigorous premarket tobacco application review process at the agency; others have had products approved by proving they are substantially equivalent to what is already on the market.

The agency said that Swedish Match provided evidence that “these products would likely provide less toxic options if current adult smokeless tobacco users used them exclusively.” The agency also agreed with the company that snus’ availability would not result in substantial new use, delay quit attempts, or attract ex-smokers.

Swedish Match had been seeking separately to remove warnings that snus is harmful, but the agency has not yet ruled on that request.

In that separate application, Swedish Match was seeking to have the 10 types of snus it already sells in the United States designated as modified-risk tobacco products. The agency accepted the company’s application in August 2014 and held a meeting of its advisory panel to review the evidence in April 2015.

The company wanted to remove warnings that snus could cause gum disease and tooth loss or mouth cancer. It also sought to label its products with the statement that reads, “No tobacco product is safe, but this product presents substantially lower risks to health than cigarettes.” The advisory committee could not reach consensus on whether snus was a safer alternative to smoking, and also was not convinced that the product would not attract new users. At that meeting, Dennis Henigan, director of legal and policy analysis for the Campaign for Tobacco-Free Kids, said Swedish Match had failed to show that users would not use both cigarettes and snus, or that young people would not initiate use.

Snus, which is ground tobacco, salt, and water, comes in a pouch that users place under their upper lip. It can be used for up to 30 minutes, according to the company. It is popular in Sweden, but less so in the United States. Swedish Match says its General brand accounts for 11% of American convenience store snus sales. The 60 million cans it sells annually in the United States are dwarfed by the billion cans of smokeless tobacco sold.

The Centers for Disease Control and Prevention estimates that less than 4% of adults use smokeless tobacco, with rates highest among men aged 18 to 25 years (10%). A 2014 Centers for Disease Control and Prevention survey of high school students found that 5.5% of overall used smokeless tobacco, and an additional 1.9% reported current use of snus.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

November, 2015|Oral Cancer News|

Boston votes to ban chewing tobacco from ballparks, including Fenway

Author: Marissa Payne


Baseball in Boston is about to change. On Wednesday, the City Council voted unanimously to make its baseball parks and stadiums, including historic Fenway, tobacco-free zones. And yes, the ordinance covers the kind of tobacco you chew, a longtime favorite of many MLB players.

“This action will save lives by reducing the number of young people who begin to use smokeless tobacco because they followed the example of the Major Leaguers they idolize,” Matthew Myers, president of the Campaign for Tobacco-Free Kids said in a statement sent to The Washington Post. “We thank Mayor Marty Walsh, the City Council and Boston’s health community for their leadership on this important issue.”

Red Sox owner John Henry was also supportive of the legislation.

“It’s a great thing,” Henry said (via when Mayor Walsh first proposed the legislation last month. “I’m very supportive.”

The ban doesn’t just apply to players, but also fans, and it covers all stadiums from major-league to organized amateur games. Those found in violation of the ordinance face a $250 fine, Boston’s Fox affiliate reports.

Boston is now the second major U.S. city to ban tobacco at its baseball stadiums. San Francisco, which banned the substance in April, was the first. Both cities had very good reasons to nix the chew.

Smokeless tobacco, like cigarettes, contains the addictive substance nicotine and its users can become more at-risk for illnesses such as cancer, gum disease and heart disease, according to the Mayo Clinic.

“You can call chewing tobacco by whatever name you want — smokeless tobacco, spit tobacco, chew, snuff, pinch or dip — but don’t call it harmless,” a Mayo Clinic brochure says.

The most dangerous side effects of chewing tobacco rose to fame last year when two former major league players connected their cancers to the habit.

“I do believe without a doubt, unquestionably, that chewing is what gave me cancer,” former MLB pitcher Curt Schilling said at the WEEI/NESN Jimmy Fund Radio Telethon last year. “I did [it] for about 30 years. It was an addictive habit. … I lost my sense of smell, my taste buds for the most part. I had gum issues, they bled, all this other stuff. None of it was enough to ever make me quit. The pain that I was in going through this treatment, the second or third day it was the only thing in my life that … I wish I could go back and never have dipped. Not once. It was so painful.”

An even more dire warning came from the experience of San Diego Padres slugger Tony Gwynn. His cancer of the mouth and salivary glands killed him last year at the age of 54. Before his death, he too blamed his disease on smokeless tobacco.

“Of course, it caused it,” Gwynn once said. “I always dipped on my right side.”

Despite the health concerns, however, many MLB players, including several Red Sox players, continued to use chewing tobacco.

An informal Boston Globe survey last month found that 21 of the 58 Red Sox players who were invited to spring training last year indicated they used smokeless tobacco. This is despite the team already discouraging the substance’s use by offering players other things to chew on, including gum and sunflower seeds.

With the new ordinance, however, those players will now be forced to find new, possibly safer habits, which the Boston City Council and tobacco-free advocates hope trickle down to their young fans.

While cigarette use among youths in the United States is declining, smokeless tobacco use has remained steady. According to the Centers for Disease Control and Prevention, more than five out of every 100 high school students reported using smokeless tobacco in 2014. Nearly two out of ever 100 middle schoolers said they used the substance.

Boston and San Francisco aren’t the only city’s that see a problem either.

In June, a member of the Los Angeles City Council proposed legislation to also ban tobacco at area baseball stadiums.

“It’s about protecting the health of our players and the health of our kids,” Councilman Jose Huizar told the Los Angeles Times. “America has a great pastime, but chewing smokeless tobacco shouldn’t be part of that.”

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

September, 2015|Oral Cancer News|

FDA Efforts to Reduce Youth Smoking

Source: USA Today
Published: February 4, 2014


WASHINGTON — The Food and Drug Administration is launching the government’s largest effort yet to curb tobacco use among at-risk teens.

The $115 million media campaign stems from the FDA’s new authority to regulate tobacco, granted by a 2009 law, says commissioner Margaret Hamburg. The ads will target the roughly 10 million American teens who are open to smoking or are already experimenting with cigarettes, she says.

That investment “is one of the most important efforts in recent times in the effort to reduce youth smoking,” says Matthew Myers, president of the Campaign for Tobacco-Free Kids. “The FDA has carefully researched which ads will have the greatest impact on at-risk youth. These were designed with the same scientific rigor that Madison Avenue uses to market its products.”

Many “at-risk” kids see smoking as a temporary coping mechanism to help them deal with the “chaos” caused by poverty, violence or family turmoil, said Mitch Zeller, director of the FDA’s Center for Tobacco Products.

“We are not talking about happy-go-lucky kids,” Zeller said. “They don’t see themselves as smokers. They think they will be able to quit.”

Although the first round of ads will aim for a broad audience, later campaigns will target specific groups, such as gay teens and Native Americans, Zeller said. Ads from the campaign, called “The Real Cost,” will run on MTV, in Teen Vogue, on YouTube and other social media.

The ads are based on studies that show teens are often more worried about their appearance today than their long-term risk of cancer, Zeller said.

One of the videos features a girl trying to buy cigarettes at a convenience store. When a clerk tells her that she doesn’t have enough money, the girl reluctantly scrapes off part of her cheek, revealing ugly wrinkles beneath, then hands her youthful skin to the clerk.

The campaign comes on the heels of a new surgeon general report, released last month, which calculated that 5.6 million American children will die from tobacco-related illness, unless the country takes immediate action to lower smoking rates. About 3,200 teens try their first cigarette each day and 700 become life-long smokers, Hamburg says

The educational effort stems from the FDA’s expanded authority to regulate tobacco, provided by the Family Smoking Prevention and Tobacco Control Act of 2009.

The FDA cited the 2009 law when it created graphic warning labels for cigarette packs. A federal appeals court struck down those warning labels in 2012.

Although the FDA has asserted its intention to regulate electronic cigarettes, the ads won’t mention them. The agency has not yet issued regulations for e-cigarettes, which contain nicotine but no tobacco.

The media campaign is one of three major anti-smoking efforts this year.

The Centers for Disease Control and Prevention this week relaunched its “Tips from Former Smokers” campaign, which began in 2012. That effort, costing $48 million to $60 million each year, has been credited with helping 100,000 Americans quit smoking.

The “truth” campaign — run by the anti-smoking group Legacy — will also launch a media campaign this summer, said Robin Koval, the group’s president and CEO. The truth campaign — funded by the Master Settlement Agreement between tobacco companies and the states – has been credited with preventing 450,000 young people from smoking from 2000 to 2004 can find on this page.

Yet Myers said these efforts are dwarfed by the tobacco industry, which spends more than $8 billion a year on marketing.


* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.


February, 2014|Oral Cancer News|

Fifteen Years after Tobacco Settlement, States Falling Short in Funding Tobacco Prevention: Q&A with Danny McGoldrick

Source: Robert Wood Johnson Foundation 
Published: December 10, 2013
By: Danny McGoldrick


On November 23, 1998, 46 states settled their lawsuits against the nation’s major tobacco companies to recover tobacco-related health care costs, joining four states—Mississippi, Texas, Florida and Minnesota—that had reached earlier, individual settlements.

These settlements require the tobacco companies to make annual payments to the states in perpetuity, with total payments estimated at $246 billion over the first 25 years.

Yesterday a coalition of health advocacy groups released the latest edition of A Broken Promise to Our Kids, an annual report on state use of tobacco funds for tobacco prevention and cessation efforts. As in years past, the report finds that most states fall short in the amount of money they allocate to prevent kids from smoking and to help current smokers quit.

The groups that jointly issued the report include the Campaign for Tobacco-Free Kids, the American Heart Association, American Cancer Society Cancer Action Network, the American Lung Association, the Robert Wood Johnson Foundation and Americans for Nonsmokers’ Rights.

Key findings of the 2013 report include:

• Over the past 15 years, states have spent just 2.3 percent of their total tobacco-generated revenue on tobacco preventionand cessation programs.


• The states this year will collect $25 billion from the tobacco settlement  and tobacco taxes, but will spend just 1.9 percent of it—$481.2 million—on tobacco prevention programs. This means the states are spending less than two cents of every dollar in tobacco revenue to fight tobacco use.

• States are falling short of the U.S. Centers for Disease Control and Prevention’s (CDC) recommended funding levels for tobacco prevention programs. Altogether, the states have budgeted just 13 percent of the $3.7 billion the CDC recommends.

• Only two states—Alaska and North Dakota—currently fund tobacco prevention programs at the CDC-recommended level.

To discuss the ramifications of the latest edition of the Broken Promises report, NewPublicHealth recently spoke with Danny McGoldrick, vice president of research at the Campaign for Tobacco-Free Kids.PH3

NewPublicHealth: Can you give us some background on the Tobacco Master Settlement Agreement?

Danny McGoldrick: This is the 15th anniversary of the Tobacco Master Settlement Agreement, when 46 states and the District of Columbia settled their lawsuits against the tobacco companies mostly to recover the costs that they’d incurred treating smoking-caused disease in their states. Four other states had settled individually with the tobacco companies prior to the Master Settlement Agreement, and so this provided for some restrictions on tobacco company marketing; they promised never to market to kids again, which is ironic, but it also resulted in the tobacco companies sending about $250 billion over just the first 25 years of the settlement for the states to spend as they saw fit. They left that to the province of the state legislators and governors to decide how those funds should be spent.

 NPH: Why do states do with the funds not used on tobacco prevention and cessation efforts?

McGoldrick: States have used a portion of the funds to deal with budget deficits as well as a number of other things, some worthy programs. But what they haven’t done is fund tobacco prevention programs at anywhere near the levels recommended by the U.S. Centers for Disease Control and Prevention, which provides guidance not only on the amount of money the state should spend for these lifesaving and moneysaving programs, but also the science behind exactly what kind of programs to run.

These are science-based interventions that we know work when funded and implemented properly. They consist of hard-hitting media campaigns that get the word out about the dangers of tobacco use in ways that resonate with kids and with smokers to encourage them to quit. They include community-based programs that reach people where they live, work, play, and learn with messages about tobacco use, again preventing kids from starting and encouraging smokers to quit and involving young people in talking to each other about not only the harms of tobacco, but the role of tobacco companies in targeting them. And finally, they include help for smokers who want to quit. And there’s a science behind each of these interventions, but when we put them together in a comprehensive program we know they work through reduced tobacco use among both kids and adults.

NPH: On average, what percentage do the states use? Is that a good number? Does that really tell us that most states tend to use the same percentage of funds?

McGoldrick: It really varies because states are different sizes and they spend the money in different ways. What we look at is how states are spending relative to what the CDC recommends, and it’s a pretty dismal picture. Overall, states are spending only about 2 percent of the $25 billion they received in the most recent fiscal year from their master settlement payments and their tobacco taxes. This is just a travesty. Only two states are funding at the level the CDC recommends—those are North Dakota and Alaska—and only four more at spending at even half the level that the CDC recommends—those are Delaware, Wyoming, Hawaii and Oklahoma. So almost half the states, 24 states, are spending less than 10 percent of what the CDC recommends for these programs that we know work and that they have the money for. Three states are spending less than 1 percent of what the CDC recommends—New Hampshire, Alabama and Missouri. New Jersey is spending no state dollars on tobacco prevention.

So, when you look at it in terms of what the CDC recommends, when you look at it in terms of what the states are getting in terms of all of this revenue, when you look at it compared to what the tobacco companies are spending to get people to smoke and when you look at it compared to what we’re spending treating tobacco-caused disease, it just makes no sense that states aren’t doing a better job keeping the promise of the tobacco settlement.

NPH: What are the key recommendations for what states should be doing?

McGoldrick: We know that states have a lot of issues that they’re dealing with and programs that they need to fund, but it would only take about 15 percent of the revenue that states are taking in from their master settlent payments or their settlement payments and their tobacco taxes to fund these programs. So that should be priority one and would still leave tens of billions of dollars to fund other important programs in the state.

It really is penny wise and pound foolish not to invest this money because we know that states not only save lives by investing in these programs, but they save health care dollars. Tobacco-caused diseases are a big reason for the health care crisis in our states. We spend almost $100 billion every year treating tobacco-caused disease in this country, all of that absolutely and completely preventable. So when you invest in these programs, you not only save lives, you not only save kids a lifetime of addiction and premature death, but you actually reduce your healthcare costs so these programs pay for themselves. Our governors and legislators are not only not doing the right thing with the money—they’re not doing the smart thing for their own budgets. It’s really unbelievable that they could not only save lives but actually save money in the long run by investing in these programs, and they’re just making shortsighted and foolish decisions.

* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

December, 2013|Oral Cancer News|

Most youth who use smokeless tobacco are smokers, too

By Anne Harding
NEW YORK | Thu Aug 8, 2013 5:17pm EDT
SOURCE: Pediatrics, online August 5, 2013.


(Reuters Health) – Most young people in the U.S. who use newer smokeless tobacco products are smoking cigarettes too, according to new research.

“These findings are troubling, but not surprising, as tobacco companies spend huge sums to market smokeless tobacco in ways that entice kids to start and encourage dual use of cigarettes and smokeless tobacco,” Vince Willmore, vice president of communications at the Campaign for Tobacco-Free Kids, a Washington, D.C.-based advocacy organization, told Reuters Health in an email.

“From 1998 to 2011, total marketing expenditures for smokeless tobacco increased by 210 percent – from $145.5 million to $451.7 million a year, according to the Federal Trade Commission,” he added.

Swedish-style “snus,” introduced to the U.S. in 2006, and dissolvable tobacco products, introduced in 2008, are arguably less harmful than conventional chewing tobacco because they contain fewer nitrosamines, and have been promoted as safer alternatives.

But public health experts have been concerned that these products could serve as a “gateway drug” to use of conventional smokeless tobacco and to cigarette smoking.

To better understand the prevalence of smokeless tobacco use among young people, Dr. Gregory Connolly of the Harvard School of Public Health in Boston and his colleagues looked at data from the 2011 National Youth Tobacco Survey, which included nearly 19,000 sixth- to 12th-graders from across the country.

Overall, the researchers found, 5.6 percent of young people reported using any type of smokeless tobacco. Five percent used chewing tobacco, snuff or dip, just under two percent used snus and 0.3 percent used dissolvable products.

Among young people who were current smokeless tobacco users, about 72 percent reported smoking cigarettes too, while almost 81 percent of young people who used only snus or dissolvables were also smoking cigarettes.

Just 40 percent of smokeless tobacco users said they had plans to quit using tobacco, according to findings published in Pediatrics.

“We found higher current use than we expected. It’s just not experimentation, it looks like it’s taken hold among adolescents,” Connolly told Reuters Health.

“The most distressing finding was that this is not resulting in children or in young adolescents switching from smoking to these new products that may or may not be safer when used alone. They’re using both in very high numbers.”

Little information had been available on trends in the use of novel smokeless tobacco products, so studies like this one are important, Dr. Neal Benowitz, who has studied the health effects of smokeless tobacco at the University of California, San Francisco, told Reuters Health.

“To me the fact that 72 percent of users concurrently smoke cigarettes is a serious issue,” he said. “These would be safer alternatives only if people used them exclusively, and as soon as you’re talking about dual use you virtually negate any reduction of harm.”

Benowitz, who was not involved in the current research, noted that studies have shown use of smokeless tobacco among U.S. youth can indeed be a gateway to cigarette smoking.

“The most disturbing finding is that a huge percentage of youth smokeless tobacco users also smoke cigarettes,” Willmore said.

“This indicates that smokeless tobacco compounds the problem of overall tobacco use in the United States, rather than helping to solve it as some tobacco companies claim.”

RJ Reynolds, which makes Camel Snus and dissolvable tobacco products including Camel Orbs, Sticks and Strips, did not respond to a request for comment by press time.

“The tobacco industry is facing the 21st century with a whole new strategy, and that is to bring in new products that they claim to be safer,” Connolly told Reuters Health.

He pointed out that under the Family Smoking Prevention and Tobacco Control Act, passed in 2009, the U.S. Food and Drug Administration is charged with regulating tobacco products, including smokeless tobacco.

“When we look at this data I think it is very disturbing to realize that the law has not kept them out, and at least in this data set they’re gaining traction among young people,” Connolly said.


*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.


August, 2013|Oral Cancer News|

Big Tobacco Spending More Than a Super PAC to Defeat Cancer Research


My job requires me to be online all day keeping an ear to the ground on major issues related to cancer. I knew the Prop 29 fight in California was going to be fought against Big Tobacco, but I didn’t realize the scale of their funding machine.

Why are LIVESTRONG, American Cancer Society, Campaign for Tobacco Free Kids, American Heart Association, American Lung Association and many other health organizations for this proposition? Because it keeps kids from smoking, funds much needed cancer research and prevention programs. So it won’t surprise you that Big Tobacco is the driving force against the cancer research prop. Although it is not surprising, the amount of money they are pumping into California is unreal. To date, Big Tobacco has funneled 40 million dollars into their anti cancer research initiative compared to Yes on 29 Coalition’s 8 million raised.

What I find most telling is when it comes to where these funds are from. Check out this visualization from – a nonprofit, nonpartisan research organization that reveals money’s influence on politics.

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

May, 2012|Oral Cancer News|

New Report: States Slash Tobacco Prevention Funding by 36%, Spend Less than 2 Cents of Every Tobacco Dollar to Fight Tobacco Use


WASHINGTON, DC – States have slashed funding for programs to reduce tobacco use by 12 percent in the past year and by 36 percent over the past four years, threatening the nation’s progress against tobacco, according to a report released today by a coalition of public health organizations.

The states this year (Fiscal Year 2012) will collect a near-record $25.6 billion in revenue from the 1998 state tobacco settlement and tobacco taxes, but will spend only 1.8 percent of it – $456.7 million – on programs to prevent kids from smoking and help smokers quit. This means the states are spending less than two cents of every dollar in tobacco revenue to fight tobacco use.

Both the total amounts states are spending on tobacco prevention programs and the percentage of tobacco revenue spent on these programs are the lowest since 1999, when the states first received significant tobacco settlement funds. With nearly 20 percent of Americans still smoking, the report warns that continued progress against tobacco use – the nation’s number one cause of preventable death – is at risk unless states increase funding for tobacco prevention and cessation programs. The report also calls on states to increase tobacco taxes and, for states that have yet to do so, to enact strong smoke-free laws that apply to all workplaces, restaurants and bars.

The report further calls on the federal government to launch a national tobacco prevention and cessation campaign, including a mass-media campaign and support for telephone quitlines, as the Obama Administration proposed in its Tobacco Control Strategic Action Plan. It also calls for preservation of the Prevention and Public Health Fund, created by the health care reform law to support such disease prevention initiatives.

The report, titled “A Broken Promise to Our Children: The 1998 State Tobacco Settlement 13 Years Later,” was released by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society Cancer Action Network, American Lung Association, Robert Wood Johnson Foundation and Americans for Nonsmokers’ Rights. Issued annually, the report assesses whether states have kept their promise to use tobacco settlement funds – expected to total $246 billion over the first 25 years – to fight tobacco use.

“More than ever, this report shows that the states have squandered the opportunity presented by the tobacco settlement to significantly reduce tobacco use and its devastating toll on our nation,” said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. “It’s no coincidence that progress against tobacco has slowed at the same time that states have slashed tobacco prevention funds. We cannot win the fight against tobacco unless elected officials at all levels step up efforts to implement proven solutions.”

Key Findings

Other findings of this year’s report include:

  • Most states are falling far short of recommended funding levels for tobacco prevention programs set by the U.S. Centers for Disease Control and Prevention (CDC). The $456.7 million the states have budgeted is just 12 percent of the $3.7 billion the CDC recommends for all the states combined. It would take less than 15 percent of total state tobacco revenues to fully fund tobacco prevention programs in every state.
  • States have cut funding for tobacco prevention and cessation programs by $61.2 million (12 percent) in the past year and by $260.5 million (36 percent) in the past four years.
  • Counting both state funds and federal grants, only Alaska and North Dakota currently fund tobacco prevention programs at CDC-recommended levels. Only four other states provide even half the recommended funding, while 33 states and Washington, DC, provide less than a quarter. Four states – Connecticut, Nevada, New Hampshire and Ohio – and DC have budgeted zero state funds for tobacco prevention this year.
  • Tobacco companies spend $23 to market tobacco products for every $1 the states spend to fight tobacco use. According to the latest data from the Federal Trade Commission, tobacco companies spend $10.5 billion a year on marketing.
  • Federal grants have helped to cushion the impact of state funding cuts, but some of that funding is temporary and will run out this year. In fiscal year 2012, the federal government is providing $91.2 million in state and community grants to reduce tobacco use. States have also received $196.4 million in stimulus funds for tobacco prevention, some of which will be spent this year.

The report comes as recent surveys have found that smoking declines in the United States have slowed. The CDC recently reported that the adult smoking rate in 2010 was 19.3 percent — only a small decline since 2004 when 20.9 percent smoked. While smoking among high school students has declined by 46 percent from a high of 36.4 percent in 1997, 19.5 percent still smoke.

“It is truly penny-wise and pound-foolish for the states to cut funding for tobacco prevention and cessation programs,” said Nancy Brown, CEO of the American Heart Association. “These programs not only reduce smoking, but also lower tobacco-related health care costs that total nearly $100 billion annually. Tobacco prevention programs are smart investments that save lives and money.”

“Tobacco prevention and cessation programs are a great example that when we invest in prevention and public health, we save lives, improve health and reduce health care costs. For example, we know that smoke-free workplaces and funding programs to help smokers quit are a win for business, worker productivity and a healthier community,” said Risa Lavizzo-Mourey, M.D., M.B.A., President and CEO of the Robert Wood Johnson Foundation.

“We know that the most effective way to curb the tobacco epidemic in this country is through regularly and significantly increasing tobacco taxes, enacting comprehensive smoke-free laws and fully funding tobacco prevention and cessation programs,” said John R. Seffrin, PhD, chief executive officer, American Cancer Society Cancer Action Network, the advocacy affiliate of the American Cancer Society. “States are putting lives at risk and leaving potential state revenue on the table when they fall short of implementing strong tobacco control policies.”

“The continued devastating cuts in tobacco prevention spending in 2011 are unfortunately part of a broader pattern of states backsliding on putting in place policies and making investments to fight tobacco use,” said American Lung Association President and CEO Charles D. Connor. “States are missing a key opportunity to save lives and money.”

“Comprehensive tobacco control programs not only reduce smoking, but they also prevent a new generation of young smokers and lead to policies that protect workers from exposure to secondhand smoke in public places and workplaces,” said Cynthia Hallett, MPH, Executive Director of Americans for Nonsmokers’ Rights. “It is a tragedy that less that 2 percent of tobacco revenue goes to evidence-based tobacco prevention programs. States should be advocating for public health and not toeing the line for the tobacco industry.”

Tobacco use kills more than 400,000 people in the United States each year and costs the nation $96 billion in health care bills. Every day, another 1,000 kids become regular smokers — one-third of them will die prematurely as a result.

(NOTE: Alabama’s tobacco prevention program budget for FY2012 was not available when this report went to press. Alabama historically has provided minimal funding for tobacco prevention. In FY 2011, Alabama budgeted $860,000, which is just 1.5 percent of the CDC’s recommendation.)

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

December, 2011|Oral Cancer News|

Kentucky Cancer Center Urges Smokers to Switch to Smoke-Free Tobacco. But is it Really a Better Option?


In the smoker-heavy state of Kentucky, a cancer center is suggesting something that most health experts won’t and the tobacco industry can’t: If you really want to quit, switch to smoke-free tobacco.

The James Graham Brown Cancer Center and the University of Louisville are aiming their “Switch and Quit” campaign at the city of Owensboro. It uses print, radio, billboard and other advertising to urge smokers to swap their cigarettes for smokeless tobacco and other products that do not deliver nicotine by smoke.

Supporters say smokers who switch are more likely to give up cigarettes than those who use other methods such as nicotine patches, and that smokeless tobacco carries less risk of disease than cigarettes do.

“We need something that works better than what we have,” said Dr. Donald Miller, an oncologist and director of the James Graham Brown Cancer Center, which supports the effort along with the University of Louisville. “This is as reasonable a scientific hypothesis as anybody has come up with and it needs to be tried.”

The campaign runs counter to the prevailing opinion of the public health community, which holds that there is no safe way to use tobacco. Federal researchers, however, have begun to at least consider the idea that smokers might be better off going smokeless.

The National Cancer Institute at the National Institutes of Health says on its website that the use of all tobacco products “should be strongly discouraged,” and that there is “no scientific evidence that using smokeless tobacco can help a person quit smoking.” But this year it approved funding for a study that might provide some of that very evidence.

“Switch and Quit” is directed by Brad Rodu, a professor of medicine at the University of Louisville. He analyzed the 2000 National Health Interview Survey and found that male smokers who switched to smokeless tobacco were more likely to quit smoking than those who used nicotine patches or gum.

“Americans are largely misinformed about the relative risks. … They think smokeless tobacco is just as dangerous,” Rodu said. “This level of misinformation is an enormous barrier to actually accomplishing tobacco-harm reduction because if people believe that the products have equal risk, there’s not a real incentive.”

The program is funded through Rodu’s research money, which includes grants from the tobacco industry. Grants through the University of Louisville are unrestricted, which the program says “ensures the scientific independence and integrity of research projects and activities.”

“There’s absolutely no influence whatsoever,” Rodu said. “I decide, along with my colleagues, how we use the money, for what projects, and this is entirely the case. I would not have a situation where there was some control over the kind of projects I undertake.”

Tobacco companies want to market more smokeless tobacco and other cigarette alternatives to make up for falling cigarette sales. Some have introduced “snus” — small pouches like tea bags that users stick between the cheek and gum — and dissolvable tobacco — finely milled tobacco shaped into orbs, sticks and strips.

But they’re barred by federal law from explicitly marketing them as less risky than cigarettes — at least for now. That means the “Switch and Quit” program can do something the tobacco industry itself cannot: claim that smokeless tobacco has a health benefit when compared to smoking.

The program says smoking kills about 220 adults a year in and around Owensboro. The state of Kentucky, a leading tobacco grower, has the nation’s highest smoking and lung cancer rates.

Owensboro and the surrounding area consume about 3 million cigarettes a week, according to the program. That amounts to well over a pack for every man, woman and child in the community of about 115,000 people.

Owensboro resident Vernon Goode had smoked for about 10 years before he recently traded his Marlboros for dissolvable tobacco tablets. The campaign didn’t inspire him to quit, but he said he thought it was a good idea.

“I was just wanting to quit because, you know, I could feel it in my lungs,” Goode said. “I’ll smoke a cigarette every once in a while, but not very often. I want to quit altogether and I’m just using this right here as I guess what you’d call a stepping stone.”

The Owensboro program has raised concerns among some in the public health community who say organizers are claiming smokeless tobacco is a healthier alternative to smoking without approval from the Food and Drug Administration.

A 2009 law gives the FDA authority to evaluate health risks of tobacco products and approve those that could be marketed as safer than what’s currently for sale. None have been given the OK yet. The FDA also plans to regulate electronic cigarettes, battery-powered plastic and metal devices that heat a liquid nicotine solution in a disposable cartridge, creating vapor that users inhale.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, called the program “a giant experiment with the people of Owensboro without rules or guidance designed to protect individuals from experimental medicine.”

Smokeless tobacco isn’t a safe alternative to cigarettes, according to the Centers for Disease Control and Prevention. Health warnings on the products required by the FDA state the same thing.

However, some studies, including a 2007 report from the Royal College of Physicians in London titled “Harm Reduction in Nicotine Addiction,” suggest that some smokeless tobacco products are about 90 percent less harmful than cigarettes.

“The worst that you can say about smokeless tobacco is that it’s the lesser of two evils,” said Dr. Randall Thomas, an oncologist with the Owensboro Medical Health System. The health system, the community’s largest employer, is going smoke-free in 2013 and is offering Rodu’s program as one of a variety of quit-smoking tools for its employees.

“I don’t think we have any problem in telling a person that drinks a six-pack a day that if they could cut it back to two beers a day or two drinks a day that their health risks are greatly reduced,” Thomas said. “Finding a way to let people have their nicotine that carries less risk, it’s the realistic solution.”

The Owensboro program doesn’t suggest pharmaceutical nicotine replacement gum or patches. That’s because they are regulated to provide very small doses of nicotine and are recommended for only a short period of time, while smokeless tobacco can be used as long as a smoker needs, Rodu said.

Myers, of the Campaign for Tobacco-Free Kids, said more research is needed before anyone should suggest that the nation’s 46 million smokers would be better off using smokeless tobacco. In the meantime, he said, there are a host of FDA-approved products that can help people give up smoking.

“There’s a right way and a wrong way to determine whether smokeless tobacco can and should be marketed as a way to help people quit,” Myers said.

The National Cancer Institute approved funding earlier this year for a nationwide 1,250-person study to look at whether being given a snus product changes the habits of smokers who are not motivated to quit.

The tobacco industry sees smokeless tobacco as its future, said Matthew J. Carpenter, a psychology professor at the Medical University of South Carolina who is conducting the yearlong study.

Carpenter said the snus study will examine what smokers do when given smokeless tobacco. He won’t look at the health effects, or advise smokers to use the snus to quit.

“They are probably safer than conventional cigarettes, if for no other reason than you’re not burning anything, you’re not smoking anything, you’re not inhaling any smoke,” he said.

“If you compare it to conventional cigarettes, they’re probably a little bit better. If you compare it to quitting, they’re absolutely worse.”

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

October, 2011|Oral Cancer News|

New Study Indicates Tobacco Industry Was Aware of Their Own Products Dangers

Source: USA Today

A new study says tobacco companies knew for decades that cigarette smoke was radioactive and potentially carcinogenic.

Tobacco companies knew for decades that cigarette smoke was radioactive and potentially carcinogenic but kept that information from the public, according to a new study.

The tobacco industry began investigations into the possible effects of these radioactive particles, identified as polonium-210, on smokers as early as the 1960s, says the study by UCLA researchers who analyzed dozens of previously unexamined industry documents.

“I’ve not seen a document before that’s specifically cited the industry’s own internal research finding that sufficient levels of polonium-210 can cause cancer,” says Matt Myers of the Campaign for Tobacco-Free Kids. He says the study reinforces the need for the U.S. Food and Drug Administration to scrutinize tobacco products. This week, the FDA began requiring tobacco companies to disclose detailed information about new products and changes to existing ones. The study, published in the peer-reviewed journal Nicotine & Tobacco Research, suggests the FDA make removal of the radioative particles from tobacco products a top priority. “We used to think that only the chemicals in the cigarettes were causing lung cancer,” said Hrayr S. Karagueuzian, lead author of the study. Now, Karagueuzian said, the industry’s own research shows that polonium-210, absorbed by tobacco leaves and inhaled by smokers, is dangerous. He said UCLA researchers found that the radioactivity could cause 120 to 138 deaths for every 1,000 regular smokers over a 25-year period. Karagueuzian said tobacco companies have declined techniques that could help eliminate polonium-210 from tobacco because of concern that smokers might lose the “instant nicotine rush” that fuels their addiction. David Sutton, spokesman for Philip Morris USA, the largest U.S. tobacco manufacturer, said the company does not add polonium-210 to its products. He said it’s a “naturally occurring element in the air” and has been widely discussed by the public health community for years. Industry critic Greg Connolly, who directs Harvard University’s Center for Global Tobacco Control, agrees that polonium-210’s risks have long been known. He said the study, however, reinforces the need for the FDA to regulate tobacco companies, adding, “The $64,000 question is: have they changed?”

This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

September, 2011|Oral Cancer News|

Stephen Strasburg attempts to quit smokeless tobacco

Author: Adam Kilgore

Like any other high school kid, Stephen Strasburg wanted to emulate the major league baseball players he watched on television. He mimicked their actions down to the last detail. He rolled his pants up to reveal high socks, wore wristbands at the plate and, during downtime, opened tins of chewing tobacco and pinched some in his lower lip.

Years later, having developed a powerful addiction, Strasburg regrets ever trying smokeless tobacco. Last fall, Tony Gwynn – his college coach at San Diego State and one of those players he grew up idolizing – began radiation treatments for parotid cancer, a diagnosis Gwynn blamed on using smokeless tobacco.

In the wake of Gwynn’s cancer diagnosis, Strasburg has resolved to quit smokeless tobacco while he recuperates from Tommy John surgery. He doesn’t want to face the myriad health risks borne from tobacco use, and he doesn’t want kids who want to be like him to see him with a packed lower lip. Strasburg conflates many activities with dipping, and he has yet to eradicate the habit. But he is determined he will.

“I’m still in the process of quitting,” Strasburg, 22, said. “I’ve made a lot of strides, stopped being so compulsive with it. I’m hoping I’m going to be clean for spring training. It’s going to be hard, because it’s something that’s embedded in the game.”

Smokeless tobacco has long been entrenched in baseball. In the 1980s, wads of it bulged in batters’ cheeks. More recently, tins of what players call “dip” form circular outlines on players’ back pockets. Managers, players and coaches use it occupy time during the lulls of a game and to feel the rush of nicotine it provides, a momentary buzz of energy that many come to believe – erroneously – benefits their performance.

The habit carries a steep risk. Smokeless tobacco can lead to several forms of mouth cancer that require a series of disfiguring surgeries; many patients have their entire jaw removed. The juices swallowed contain heavy metals and can lead to esophageal and pancreatic cancer, two of the direst cancers to treat. White, precancerous lesions appear on the lips. Gums recede. Teeth become discolored and loosen.

“It’s nasty stuff,” said Gregory Connolly, a Harvard professor who has lectured major league players and testified before Congress on the ills of smokeless tobacco. “There’s no other way to look at it.”

For two decades, there has been a fight to educate players on the danger and eradicate smokeless tobacco from baseball, both for the health of players and for the health of children who watch and idolize them. Several congressional hearings, including one last April, have addressed the issue. Major League Baseball has urged players to not use it when on camera. Since 1993, all tobacco products have been banned in the minor leagues on fields, in clubhouses and during team travel. It’s also banned in college and in every significant amateur association.

And yet, experts say, the usage among major league players has remained steady. Roughly 33 percent of major league players, Connolly said, use some form of smokeless tobacco, a rate that has remained stagnant. More dispiriting, its use has risen among young males. The only significant increase of any tobacco product over the last five years, according to Connolly and other advocates, has been the use of smokeless among youths. It has increased to 25 percent, compared with 16 percent of the general population.

“It hasn’t changed that much,” says Joe Garagiola, his voice dripping with a frustration bordering on depression. Garagiola, a former player and major league executive, chewed himself as a player in the ’40s, believing, as so many players still do, that chewing tobacco is a rite of passage. He quit after his daughter asked if he was going to die. Later in life, he watched his friend Bill Tuttle, a former major leaguer, lose his jaw and then succumb to cancer caused by spit tobacco.

For two decades, Garagiola campaigned against smokeless tobacco in baseball. He gave speeches during spring training. He testified before Congress. At his home in Arizona, he keeps a box full of newspaper stories, fact sheets and advertisements for smokeless tobacco.

He still pleads with players to not put tins in their back pocket, a possible example for kids. The dearth of progress is difficult for him to bear.

“I’m to the point where you’re ready to put up the flag and say, ‘You win,’ ” Garagiola said. “The frustration is so deep. There’s nothing I can do about it. It hurts me. It really does. If baseball would just simply say we are banning tobacco from the field – but no. It’s a collective bargaining piece.”

Ban would mean bargain
Tobacco has not been banned in the majors, Garagiola and other experts say, because MLB and the players’ union view smokeless tobacco as a collective bargaining issue rather than a health issue. The players’ association will not yield to a ban without a concession, and the league has been unwilling to cede anything to implement a ban.

The next round of collective bargaining will take place this year, before the current Basic Agreement expires Dec. 11. Some momentum for a ban has gathered. During a House Energy and Commerce Committee Hearing, Rep. Henry Waxman (D-Calif.) called for baseball to ban all tobacco at the park. “Millions of young fans are exposed on a daily basis to the use of smokeless tobacco by their heroes,” Waxman said during the hearing.

In November, 10 anti-tobacco organizations, including the American Cancer Society and the Campaign for Tobacco-Free Kids, sent a letter to Commissioner Bud Selig and MLB Players Association head Michael Weiner urging a ban. “There is an unmistakable urgency for the players and team management to address this issue now,” the letter read.

“As a matter of policy, we don’t speak publicly about what we’re going to propose at the negotiating table,” MLB Executive Vice President Rob Manfred said. “What I will tell you is that smokeless tobacco remains a significant concern to Major League Baseball. Generally, our minor league policy reflects where we’re we’d like to be.”

“Despite its long-standing use throughout the history of the game, the union discourages the use of smokeless tobacco and has worked with the Commissioner’s Office to help make players aware of the health risks associated with these products,” Weiner said in a statement. “We have discussed this issue with players in anticipation of our upcoming collective bargaining negotiations.”

Weiner declined to address follow-up questions through a spokesman, not wanting to elaborate on a bargaining position.

Connolly drew a parallel between steroid testing and banning tobacco. Immense public scorn eventually pressured the players’ association into accepting tests for performance-enhancing drugs. Smokeless tobacco, meanwhile, has been left largely unregulated at the major league level. Connolly recalls reading a cover of Sports Illustrated decrying the use of steroids in baseball. On the back cover was an advertisement for a smokeless tobacco company.

“I looked at it and said, ‘This is insane,’ ” Connolly said. “If you’re looking at drugs, what is the most-abused drug by major league baseball players? It’s smokeless tobacco. There’s no question. What has the potential to do more harm to American kids in terms of addiction? It’s smokeless tobacco. It’s not steroids.”

Quitting has side effects
Smokeless tobacco use in baseball persists, in part, because of its powerful addictive quality. The rush or buzz players feel, studies have shown, is not actually a burst of energy, but rather a means to ease withdrawal symptoms.

Spit tobacco uses a different delivery system than cigarettes. Its high concentration of nicotine reaches the brain through mucous membranes in the mouth. In level of addiction, smokeless tobacco is more similar to cocaine than cigarettes, experts say.

And so quitting leads to a battery of side effects – sleep disruption, upset stomach, depression, headaches, lack of concentration. It is nearly impossible to play baseball under such conditions, which makes quitting during the season untenable and strengthens tobacco’s grip on players. Using may not help performance, but quitting certainly hurts.

“When they use again, they feel better and their performance is better,” said Thomas Glynn, an expert with the American Cancer Society. “But it’s not the smokeless that is helping. It’s the absence of withdrawal symptoms.”

Strasburg, then, has chosen the right time to quit. He will not have to worry about his performance for the Washington Nationals until the very end of 2011 at the earliest, and more likely until 2012. “He’s in a good position right now,” Glynn said. “If he can use this time to quit, it’s a good opportunity for him – and for any people who admire him.”

Strasburg has decided to quit as much for himself as for the countless kids who have watched him become one of baseball’s most recognizable players.

“I was one of those kids that picked it up based on seeing ballplayers do it,” Strasburg said. “It’s not a good thing, and I don’t want to represent myself like that. That’s one of the big reasons. Another reason is, when I do have kids, I don’t want my kids to be like that, too.”

Strasburg stressed that his decision to quit is an individual choice. He wants to set a good example for children who watch baseball, not necessarily set a directive for teammates.

“I’m not going to sit here and be the spokesperson for quitting dipping,” Strasburg said. “I’m doing it for myself. I’m not saying anything about anybody else – it’s their personal choice. For me, it’s the best decision.”

January, 2011|Oral Cancer News|