where there’s smoke there’s money:
DESCRIPTION
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. - PowerPoint PPT PresentationTRANSCRIPT
Where there’s smoke Where there’s smoke there’s money:there’s money:
Campaign contributions and U.S. Campaign contributions and U.S. government efforts to derail the government efforts to derail the
Global Tobacco TreatyGlobal Tobacco Treaty
Martin DonohoeMartin Donohoe
Tobacco – Weapon of Mass Tobacco – Weapon of Mass DestructionDestruction
1.3 billion smokers1.3 billion smokers 84% in developing countries84% in developing countries 43 million (19% of adults) in 43 million (19% of adults) in
U.S.U.S.5.7 trillion cigarettes smoked/yr 5.7 trillion cigarettes smoked/yr worldwideworldwide
Tobacco – Weapon of Mass Tobacco – Weapon of Mass DestructionDestruction
Nearly 6 million deaths/yr worldwide Nearly 6 million deaths/yr worldwide (1/10 deaths) – 600,000 from passive (1/10 deaths) – 600,000 from passive smokingsmoking Estimated 8-10 million by 2030Estimated 8-10 million by 2030 Only 7% of the world’s population lives Only 7% of the world’s population lives
in jurisdictions with comprehensive in jurisdictions with comprehensive smoke-free laws, and enforcement of smoke-free laws, and enforcement of these laws is robust in only a fewthese laws is robust in only a few
Tobacco – Weapon of Mass Tobacco – Weapon of Mass DestructionDestruction
Leading cause of death in U.S.Leading cause of death in U.S. 443,000 deaths/yr from smoking443,000 deaths/yr from smoking 50,000 from environmental tobacco 50,000 from environmental tobacco
smoke (ETS)smoke (ETS)
Tobacco – Weapon of Mass Tobacco – Weapon of Mass DestructionDestruction
Numerous health consequencesNumerous health consequences
Tobacco smoke contains numerous Tobacco smoke contains numerous toxins, carcinogens, and radioactive toxins, carcinogens, and radioactive polloniumpollonium
Heavily pesticide-dependent cropHeavily pesticide-dependent crop Tobacco industry has lobbied to Tobacco industry has lobbied to
weaken environmental regulationsweaken environmental regulations
Cigarette LitterCigarette Litter
Nearly billion pounds of cigarette butts littered Nearly billion pounds of cigarette butts littered per yearper year 4.5 trillion butts4.5 trillion butts Comprised largely of filters made from Comprised largely of filters made from
cellulose acetate, a non-biodegradable plasticcellulose acetate, a non-biodegradable plastic Filters trap toxins, heavy metals which can Filters trap toxins, heavy metals which can
leach into environmentleach into environment
The most littered item in the worldThe most littered item in the world
Tobacco – Weapon of Mass Tobacco – Weapon of Mass DestructionDestruction
Direct medical costs = $100 billion/yr Direct medical costs = $100 billion/yr
Lost productivity = $97 billion/yrLost productivity = $97 billion/yr
Medical care and lost productivity due Medical care and lost productivity due to tobacco use costs each U.S. to tobacco use costs each U.S. citizen approximately $600/yrcitizen approximately $600/yr
Smoking Prevention and Smoking Prevention and CessationCessation
Over the last 10 years, only 3.2% of state Over the last 10 years, only 3.2% of state revenues from tobacco taxes and settlement revenues from tobacco taxes and settlement money spent on prevention and cessationmoney spent on prevention and cessation Average state tax = $1.44 per pack Average state tax = $1.44 per pack (7(7¢¢/pack /pack
SC to 2.75¢/pack NYSC to 2.75¢/pack NY Federal tax = $2.21/packFederal tax = $2.21/pack
Society saves $3 in medical costs for every $1 Society saves $3 in medical costs for every $1 spent to prevent smoking; $50 per $1 in CA per spent to prevent smoking; $50 per $1 in CA per 2008 study2008 study
Smoke-Free LegislationSmoke-Free Legislation
1975: Minnesota passes first clean indoor 1975: Minnesota passes first clean indoor air lawair law
1999: All 50 states and D.C. have some 1999: All 50 states and D.C. have some public smoking restrictionspublic smoking restrictions
SmokescreenSmokescreen
Cigarettes most marketed products in the worldCigarettes most marketed products in the world $2 billion/year in the U.S.$2 billion/year in the U.S. $10.5 billion/year worldwide$10.5 billion/year worldwide
3 largest companies have combined annual 3 largest companies have combined annual revenues exceeding $121 billion (2007)revenues exceeding $121 billion (2007)
U.S. leading exporter of cigarettesU.S. leading exporter of cigarettes
U.S. tax money used to assist corporations in U.S. tax money used to assist corporations in their marketing efforts overseastheir marketing efforts overseas
SmokescreenSmokescreen
Tobacco manufacturers pay governments U.S. Tobacco manufacturers pay governments U.S. $133 billion/yr, but less than $1 billion/yr spent $133 billion/yr, but less than $1 billion/yr spent on tobacco control (and only 3% of this spent on on tobacco control (and only 3% of this spent on low- and middle-income countries)low- and middle-income countries)
Tobacco companies spend $23 on marketing for Tobacco companies spend $23 on marketing for every $1 that states spend to fight tobacco useevery $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 WHO Framework Convention on Tobacco Control TreatyTobacco Control Treaty
Finalized 2/27/05Finalized 2/27/05
Ratified by 174 nations (as of end of Ratified by 174 nations (as of end of 2011)2011) Including Russia, Canada, Including Russia, Canada,
Australia, Mexico, and the UKAustralia, Mexico, and the UK Another 8 have signed but not yet Another 8 have signed but not yet
ratified/approvedratified/approved
WHO Framework Convention on WHO Framework Convention on Tobacco Control TreatyTobacco Control Treaty
Exempts tobacco control from free Exempts tobacco control from free trade challengestrade challenges
Limits tobacco advertisingLimits tobacco advertising
Cracks down on tobacco smugglingCracks down on tobacco smuggling
Bans tobacco sales to and by minorsBans tobacco sales to and by minors
WHO Framework Convention on WHO Framework Convention on Tobacco Control TreatyTobacco Control Treaty
Promotes agricultural diversification Promotes agricultural diversification and alternative livelihoods for tobacco and alternative livelihoods for tobacco farmersfarmers
Standardizes packagingStandardizes packaging Bans deceptive terms such as Bans deceptive terms such as
“light” and “mild”“light” and “mild” Improves warning labelsImproves warning labels
U.S. Efforts to Undermine the U.S. Efforts to Undermine the TreatyTreaty
Despite overwhelming U.S. and Despite overwhelming U.S. and international public support for the international public support for the goals of the treaty…goals of the treaty…U.S. government attempted to scuttle U.S. government attempted to scuttle the treaty in the name of free trade the treaty in the name of free trade and free speechand free speechTobacco industry documents show Tobacco industry documents show attempt to create alternative through attempt to create alternative through Project CerberusProject Cerberus
U.S. Efforts to Undermine the U.S. Efforts to Undermine the TreatyTreaty
Original U.S. negotiator Thomas Original U.S. negotiator Thomas Novotny resigned after the Bush Novotny resigned after the Bush administration pressured him to lobby administration pressured him to lobby for the deletion of 10 of 11 treaty for the deletion of 10 of 11 treaty provisions, as outlined in a Phillip provisions, as outlined in a Phillip Morris memoMorris memo
Phillip Morris and AltriaPhillip Morris and Altria
Phillip Morris = world’s largest Phillip Morris = world’s largest tobacco companytobacco company Parent company = Altria (also owns Parent company = Altria (also owns
85% of Kraft Foods and 28 % of Miller 85% of Kraft Foods and 28 % of Miller Brewing)Brewing)
2008: Phillip Morris International 2008: Phillip Morris International becomes independent company, becomes independent company, separates from Phillip Morris USA and separates from Phillip Morris USA and AltriaAltria
U.S. Efforts to Undermine the U.S. Efforts to Undermine the TreatyTreaty
U.S. Belatedly signed on 5/3/05U.S. Belatedly signed on 5/3/05
Senate must ratify AND President Senate must ratify AND President must signmust sign Administration has not submitted Administration has not submitted
treaty to Congress – “studying it”treaty to Congress – “studying it”
Bush Administration Ties to the Bush Administration Ties to the Tobacco IndustryTobacco Industry
Karl Rove (Deputy Chief of Staff Karl Rove (Deputy Chief of Staff and Senior Advisor) – and Senior Advisor) – lobbyist/strategist for PMlobbyist/strategist for PM
Kirk Blalock (White House liaison Kirk Blalock (White House liaison to the business community) – PM to the business community) – PM public relations officialpublic relations official
Bush Administration Ties to the Bush Administration Ties to the Tobacco IndustryTobacco Industry
Charles Black (informal advisor to Charles Black (informal advisor to Bush during 2000 campaign) – Bush during 2000 campaign) – PM lobbyistPM lobbyist
Daniel Troy (former FDA Chief Daniel Troy (former FDA Chief Counsel) – represented tobacco Counsel) – represented tobacco industry when it sued the FDA industry when it sued the FDA over tobacco ad regulationover tobacco ad regulation
Bush Administration Ties to the Bush Administration Ties to the Tobacco IndustryTobacco Industry
Tommy Thompson (HHS Secretary)Tommy Thompson (HHS Secretary) received $72,000 in campaign contributions received $72,000 in campaign contributions
from PM executives when he was governor of from PM executives when he was governor of WisconsinWisconsin
advisor for the primary tobacco lobbying firm advisor for the primary tobacco lobbying firm in D.C.in D.C.
Rejected his own advisory panel’s Rejected his own advisory panel’s recommendation to increase federal tobacco recommendation to increase federal tobacco taxtax
Bush Administration Ties to the Bush Administration Ties to the Tobacco IndustryTobacco Industry
British American Tobacco PLC’s Brown British American Tobacco PLC’s Brown and Williamson unit and RJ Reynolds and Williamson unit and RJ Reynolds Tobacco Holdings, Inc. represented by Tobacco Holdings, Inc. represented by Barbour, Griffith and RogersBarbour, Griffith and Rogers Lobbying firm stocked with Republican Lobbying firm stocked with Republican
operatives, including:operatives, including:Haley Barbour – former GOP Chairman, MS Haley Barbour – former GOP Chairman, MS governorgovernor
Lanny Griffith – White House aide to GHW BushLanny Griffith – White House aide to GHW Bush
Obama Administration Ties to Obama Administration Ties to the Tobacco Industrythe Tobacco Industry
US Trade Representative Ronald KirkUS Trade Representative Ronald Kirk Former PM lobbyistFormer PM lobbyist Opposed smoking ban at Dallas airport Opposed smoking ban at Dallas airport
when mayor of Dallas in early 1990swhen mayor of Dallas in early 1990s Has opposed federal excise tax on Has opposed federal excise tax on
tobaccotobacco
Campaign ContributionsCampaign Contributions
$3.5 million (through individual $3.5 million (through individual contributions and PACs) in 2004contributions and PACs) in 2004 74% to Republicans74% to Republicans
$20 million to Republican candidates for $20 million to Republican candidates for federal office since 1997federal office since 1997
PM – leading overall campaign contributor PM – leading overall campaign contributor to Republicans since 1989to Republicans since 1989
U.S. Non-Cooperation on U.S. Non-Cooperation on International TreatiesInternational Treaties
Failure to sign or approve:Failure to sign or approve: Kyoto Protocol on Climate ChangeKyoto Protocol on Climate Change Convention on the Prohibition of Anti-Convention on the Prohibition of Anti-
Personnel Land MinesPersonnel Land Mines Cluster Bomb BanCluster Bomb Ban Comprehensive Nuclear Test Ban TreatyComprehensive Nuclear Test Ban Treaty Convention on the Rights of the ChildConvention on the Rights of the Child
U.S. Non-Cooperation on U.S. Non-Cooperation on International TreatiesInternational Treaties
Failure to sign or approve:Failure to sign or approve: Convention on the Elimination of Convention on the Elimination of
Discrimination Against WomenDiscrimination Against Women Convention on Economic, Social and Cultural Convention on Economic, Social and Cultural
RightsRights Convention for the Suppression of Traffic in Convention for the Suppression of Traffic in
PersonsPersons
Failure to pay full U.N. duesFailure to pay full U.N. dues
Opposition to International Criminal CourtOpposition to International Criminal Court
Health Care Organizations and Health Care Organizations and Medical SchoolsMedical Schools
As of 2009: insurers (including some of the As of 2009: insurers (including some of the largest owners of HMOs) and mutual largest owners of HMOs) and mutual funds heavily invested in tobacco stocksfunds heavily invested in tobacco stocks Prudential - $1.4 billion; Sun Life - $1 billion; Prudential - $1.4 billion; Sun Life - $1 billion;
Standard Life - $950 millionStandard Life - $950 million TIAA-CREF (whose mutual funds are owned TIAA-CREF (whose mutual funds are owned
by many health professionals) owns over by many health professionals) owns over $700 million in Phillip Morris stock.$700 million in Phillip Morris stock.
Health Care Organizations and Health Care Organizations and Medical SchoolsMedical Schools
1996-1998: PM and Cigna collaborated to 1996-1998: PM and Cigna collaborated to censor accurate information on the harms censor accurate information on the harms of smoking and ETS from health of smoking and ETS from health newslettersnewsletters
Tobacco companies sponsored “research” Tobacco companies sponsored “research” to refute links between tobacco and to refute links between tobacco and diseasedisease
Health Care Organizations and Health Care Organizations and Medical SchoolsMedical Schools
Tobacco industry has “white-Tobacco industry has “white-coated” itself since the 1940scoated” itself since the 1940s Borrowing from medicine’s Borrowing from medicine’s
prestige and public esteem in prestige and public esteem in ads featuring smoking doctorsads featuring smoking doctors
Tobacco Company Harrassment of Tobacco Company Harrassment of AcademicsAcademics
Threatened litigation against Threatened litigation against historians who have testified on historians who have testified on behalf of plaintiffsbehalf of plaintiffs
Hired graduate students to do Hired graduate students to do “research”“research” Some unwittinglySome unwittingly
Health Care Organizations and Health Care Organizations and Medical SchoolsMedical Schools
As of late 2004, despite a decade’s old As of late 2004, despite a decade’s old plea from the AMA for medical schools to plea from the AMA for medical schools to divest their tobacco holdings, some of the divest their tobacco holdings, some of the nation’s leading medical schools had failed nation’s leading medical schools had failed to do so:to do so: Cornell, Duke, Washington University, Yale, Cornell, Duke, Washington University, Yale,
and possibly Penn (refused to answer and possibly Penn (refused to answer requests)requests)
Columbia is said to have divested, but could Columbia is said to have divested, but could not provide details to confirmnot provide details to confirm
Smokefree HospitalsSmokefree Hospitals
1993: JCAHO mandates that all hospitals 1993: JCAHO mandates that all hospitals seeking accreditation adopt smokefree indoor seeking accreditation adopt smokefree indoor work policieswork policies
Over 45% of US hospitals have smokefree Over 45% of US hospitals have smokefree policies by the end of 2008 (policies by the end of 2008 (>50% expected by >50% expected by end of end of 2009)2009)
2/3 of Oregon hospitals smokefree2/3 of Oregon hospitals smokefree
Higher quit rates, faster quitting, less second Higher quit rates, faster quitting, less second hand smoke exposure at smokefree hospitalshand smoke exposure at smokefree hospitals
ConclusionsConclusions
U.S. resistance to / attempts to scuttle U.S. resistance to / attempts to scuttle global tobacco treaty squanders global tobacco treaty squanders opportunity for U.S. to take lead on opportunity for U.S. to take lead on important international public health important international public health issueissue
Represents callous disregard for Represents callous disregard for human health and world economyhuman health and world economy
ConclusionsConclusions
Some health care organizations and Some health care organizations and medical schools have failed to provide medical schools have failed to provide ethical and moral leadership in anti-ethical and moral leadership in anti-tobacco crusadetobacco crusade
Government / health care community’s Government / health care community’s obstructionism and failure to lead likely obstructionism and failure to lead likely due to influence of campaign contributions due to influence of campaign contributions / research funding/ research funding
RecommendationsRecommendations
President should send Treaty to U.S. President should send Treaty to U.S. Senate, which should immediately Senate, which should immediately ratify, and President signratify, and President sign
Campaign finance reformCampaign finance reform
Strengthen smoke-free legislationStrengthen smoke-free legislation
RecommendationsRecommendations
Medical schools and health care Medical schools and health care organizations should immediately organizations should immediately divest all tobacco holdingsdivest all tobacco holdings
Health care professionals should Health care professionals should lobby their institutions and legislators lobby their institutions and legislators to take the lead in the war on tobaccoto take the lead in the war on tobacco Increase tobacco taxes, spend more on Increase tobacco taxes, spend more on
prevention and cessation programsprevention and cessation programs
RecommendationsRecommendations
Media should more aggressively expose Media should more aggressively expose tobacco industry machinationstobacco industry machinations
Ban public smokingBan public smoking Majority of public supportsMajority of public supports 25 states + D.C. currently prohibit 25 states + D.C. currently prohibit
smoking in indoor areas (worksites, smoking in indoor areas (worksites, restaurants, bars)restaurants, bars)
Ban tobacco sales in pharmaciesBan tobacco sales in pharmacies
Family Smoking Prevention and Family Smoking Prevention and Tobacco Control Act of 2009Tobacco Control Act of 2009
Tobacco companies must provide Tobacco companies must provide ingredients to govt.; govt. will regulate ingredients to govt.; govt. will regulate harmful ingredientsharmful ingredients
Govt. cannot ban cigarettes, reduce Govt. cannot ban cigarettes, reduce nicotine content to zeronicotine content to zero
Age limit of 18 to purchase cigarettes and Age limit of 18 to purchase cigarettes and smokeless tobaccosmokeless tobacco
Family Smoking Prevention and Family Smoking Prevention and Tobacco Control Act of 2009Tobacco Control Act of 2009
Minimum cigarette pack size of 20Minimum cigarette pack size of 20
Bans “light” and “low tar” labels, fruit- and candy- Bans “light” and “low tar” labels, fruit- and candy- flavored cigarettes; menthol flavoring still flavored cigarettes; menthol flavoring still allowedallowed
New, larger set of warning labels (50% of pack / New, larger set of warning labels (50% of pack / 20% of ads by 2012; quit line number also 20% of ads by 2012; quit line number also included)included) As in at least 43 other countriesAs in at least 43 other countries Canada – covers 75% of packCanada – covers 75% of pack
Family Smoking Prevention and Family Smoking Prevention and Tobacco Control Act of 2009Tobacco Control Act of 2009
Limits on public advertising in publications Limits on public advertising in publications with high numbers of young readerswith high numbers of young readers
Bans sponsorships of sports and Bans sponsorships of sports and entertainment eventsentertainment events
Restricts vending machines to adult-only Restricts vending machines to adult-only venuesvenues
Bans free samplesBans free samples
Family Smoking Prevention and Family Smoking Prevention and Tobacco Control Act of 2009Tobacco Control Act of 2009
Supported by Phillip MorrisSupported by Phillip Morris Possibly to solidify its dominant market Possibly to solidify its dominant market
positionposition
May mitigate the legal liabilities of tobacco May mitigate the legal liabilities of tobacco companiescompanies
Family Smoking Prevention and Family Smoking Prevention and Tobacco Control Act of 2009Tobacco Control Act of 2009
U.S. District Court judge has blocked U.S. District Court judge has blocked implementation of ad regulations (in implementation of ad regulations (in lawsuit brought by tobacco companies)lawsuit brought by tobacco companies) Justice Dept. will likely appealJustice Dept. will likely appeal
WTO has ruled against measures WTO has ruled against measures designed to decrease teen smokingdesigned to decrease teen smoking U.S. unlikely to abide by rulingU.S. unlikely to abide by ruling
The Future
Late 2010: EPA proposes new, larger, Late 2010: EPA proposes new, larger, more visual warning labels (required by more visual warning labels (required by 2010 under FSPTCA2010 under FSPTCA
2011: FDA to regulate electronic nicotine 2011: FDA to regulate electronic nicotine delivery devices (ENDS, aka e-cigarettes) delivery devices (ENDS, aka e-cigarettes) as tobacco productsas tobacco products
Tobacco TaxesTobacco Taxes
Federal excise tax = $2.21 per packFederal excise tax = $2.21 per pack
Average state excise tax = $1.44 per Average state excise tax = $1.44 per packpack
For references, see:For references, see:
Donohoe MT. Cigarettes: The other Donohoe MT. Cigarettes: The other weapons of mass destruction. weapons of mass destruction. Medscape Ob/Gyn and Women’s Medscape Ob/Gyn and Women’s Health 2005;10(1): posted 4/5/05. Health 2005;10(1): posted 4/5/05. Available at Available at http://www.medscape.com/viewarticlehttp://www.medscape.com/viewarticle/501586/501586
Contact InformationContact Information
Public Health and Social Justice Public Health and Social Justice WebsiteWebsite
http://www.phsj.orghttp://www.phsj.org
[email protected]@phsj.org