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Grand Forks Herald: Report: North Dakota only state spending enough on tobacco prevention

By John Hageman, Grand Forks Herald
A report released this week argues almost every state in the country is not spending enough money on tobacco prevention and cessation programs—every state, that is, except for North Dakota.
The report, released by the Campaign for Tobacco-Free Kids, focuses in part on the billions of dollars states have received since they settled lawsuits against major tobacco companies in 1998. With $10 million set aside for fiscal year 2016, North Dakota is the only state to spend at levels recommended by the Centers for Disease Control and Prevention and was one of five states to spend at least 50 percent of what the CDC recommends.
 
“It’s so frustrating because it’s such a critical investment, and we’re talking about such a small amount of money,” said John Schachter, director of state communications for the Campaign for Tobacco-Free Kids. “When there’s a pot from which to draw from logically—tobacco taxes and the settlement—as we say, it’s a no-brainer.”
States spent as much as $717.2 million on tobacco prevention programs in fiscal year 2008, but that dropped during the recession and bottomed out at $459.5 million in 2013, according to the campaign’s report. Spending will reach $468 million in fiscal year 2016, a fraction of the estimated $25.8 billion they will collect in settlement funds and tobacco taxes, though the budgets for two states were not yet available.
Tobacco companies spend about $9.6 billion a year on marketing, according to the campaign’s report.
“We believe states should use (settlement) payments to fund tobacco cessation and underage tobacco prevention programs at levels recommended by the Centers for Disease Control,” Brian May, a spokesman for tobacco giant Philip Morris, wrote in an email to the Herald.
While tobacco companies cannot advertise on television or the radio, Schacter said “it’s pretty clear the industry is out there in force.” He said the industry spends most of its marketing dollars at “point of sale,” such as displays at convenience stores and gas stations.
“The states still know it’s an issue, but for whatever reason, they’re deciding to spend the money elsewhere,” Schachter said.

N.D. in the lead

The campaign’s report highlights North Dakota as an example for the rest of the states to follow, citing a drop in high school student smoking rates in recent years.
But North Dakota hasn’t always been a leader in tobacco prevention spending. In fiscal year 2009, it spent just $3.1 million on those programs, or one-third of CDC-recommended funding. That changed with the passing of a measure in 2008 requiring a portion of the settlement dollars be used to reduce tobacco use.
“The settlement did not dictate how the money from the settlement was spent, but it did point out that the settlement was entered into because of the unacceptable behavior of the tobacco industry,” said Jeanne Prom, executive director of the North Dakota Center for Tobacco Prevention and Control Policy.
North Dakota’s tobacco tax revenue is not used for prevention efforts, she said.
Minnesota will receive $791.7 million in total tobacco revenue in fiscal year 2016 but will spend only $21.5 million on prevention programs, less than half of what the CDC recommends, according to the campaign’s report.
Laura Oliven, the tobacco control manager at the Minnesota Department of Health, called the CDC recommendations “aspirational.” She also pointed out the campaign’s figures don’t capture Blue Cross Blue Shield’s Center for Prevention in Minnesota.
Minnesota’s adult smoking rate has dropped to 14.4 percent, the lowest it has ever recorded, the health department announced in January.
“We do a lot to maximize the funds we have,” Oliven said. “I guess the theme here really is that while we’ve made a lot of great strides, there’s still considerable work to be done.”

Local outcomes

Haley Thorson, a tobacco prevention coordinator at the Grand Forks Public Health Department, said tobacco settlement dollars helped fund a study asking residents about second-hand smoke. She called that a “pivotal piece of information” in Grand Forks passing a law in 2010 that outlawed smoking in bars, casinos and truck stops.
“That policy was passed by the City Council because we really did have the pulse of how the community supported that policy,” she said.
North Dakota passed a similar statewide law in 2012.
The health department receives about $300,000 annually from the Center for Tobacco Prevention and Control Policy, or BreatheND. Thorson said it focuses much of its efforts on tobacco-related policies.
“We used to go into schools and educate kids on the harms of tobacco use, but the better bang for our buck is to establish a comprehensive tobacco-free school policy that allows them to be educated in an environment where they’re not exposed to tobacco use,” she said.
Those efforts appear to be working.
The percentage of North Dakota high school students who smoked at least once in the past month plunged to 11.7 percent this year after hovering around 20 percent for the eight previous years, according to survey results provided by Thorson.
“For the states that aren’t spending anything or next to nothing, they need to see results like these,” Thorson said.
http://www.grandforksherald.com/news/region/3900310-report-north-dakota-only-state-spending-enough-tobacco-prevention

States Most Impacted by Tobacco Do Least to Reduce Smoking’s Toll

From Parnership for Drug-Free Kids
States most impacted by tobacco use often do the least to reduce the toll of smoking, according to an analysis by USA Today. Kentucky, Tennessee, Missouri, West Virginia and Mississippi are doing the worst job in terms of tobacco control, the newspaper found.
USA Today found big tobacco-growing states, including Kentucky, Georgia and Tennessee, have the poorest and sickest residents, but spend less than one-fifth of the federal government’s recommended minimum for tobacco education and enforcement.
States hardest hit by tobacco use are the least likely to restrict smoking in restaurants and workplaces, the analysis found. These states impose penalties of $100 or less on businesses that sell tobacco to children, compared with $10,000 in states with the most aggressive enforcement.
Tobacco taxes in states with the most smokers are 60 cents or less, compared with $4.35 in New York and $3.75 in Rhode Island, the newspaper found.
USA Today created two scores for states. States’ “impact score” combined youth and adult smoking rates with public perception about the risks of smoking. States’ “aggressiveness score” combined cigarette taxes, smoking bans, how state spending compares with federal recommendations, ad restrictions, and penalties on cigarette sales to young people.
The states that scored high on aggressiveness and low on tobacco impact included Hawaii, New York and Utah. States scoring low on aggressiveness and high on tobacco impact included Kentucky, Tennessee, Missouri, West Virginia and Mississippi.
According to Brian King, a Deputy Director in the Centers for Disease Control and Prevention’s Office of Smoking and Health, the most effective ways to reduce smoking are to regulate it, increase cigarette taxes, run powerful anti-tobacco campaigns and adequately fund tobacco control efforts. He notes that government anti-smoking efforts are “outgunned” by the tobacco industry, which spends about $1 million an hour advertising tobacco.
http://www.drugfree.org/join-together/states-impacted-tobacco-least-reduce-smokings-toll/

Stateline: Should the Smoking Age Be 21? Some Legislators Say Yes

By Jenni Bergal, Stateline | Pew Charitable Trust
While a growing number of states have turned their attention to marijuana legalization, another proposal has been quietly catching fire among some legislators—raising the legal age to buy cigarettes.
This summer, Hawaii became the first state to approve increasing the smoking age from 18 to 21 starting Jan 1. A similar measure passed the California Senate, but stalled in the Assembly. And nearly a dozen other states have considered bills this year to boost the legal age for buying tobacco products.
“It really is about good public health,” said Democratic Hawaii state Sen. Rosalyn Baker, who sponsored the legislation. “If you can keep individuals from beginning to smoke until they’re at least 21, then you have a much greater chance of them never becoming lifelong smokers.”
Supporters say hiking the legal age to 21 not only will save lives but will cut medical costs for states. But opponents say it would hurt small businesses, reduce tax revenue and violate the personal freedom of young adults who are legally able to vote and join the military.
Measures to raise the smoking age to 21 also were introduced this year in Massachusetts, New York, Oregon, Rhode Island, Utah, Vermont, Washington and the District of Columbia, according to the Preventing Tobacco Addiction Foundation, an advocacy group aimed at keeping young people from starting to smoke. Iowa and Texas considered measures to increase the legal age to 19. None of those bills passed. And just last week, a Pennsylvania legislator introduced a bill to up the minimum age there to 21.

Cities Act First

In almost every state, the legal age to buy tobacco products is 18. Four states—Alabama, Alaska, New Jersey and Utah—have set the minimum at 19.
Anti-tobacco and health care advocates say that hiking the smoking age to 21 is a fairly new approach in their effort to reduce young people’s tobacco use. Until recently, research on the topic has been somewhat limited, they say.
That hasn’t stopped a growing number of local governments from taking action on their own in the last few years. As of late September, at least 94 cities and counties, including New York City, Evanston, Illinois, and Columbia, Missouri, had passed measures raising the smoking age to 21, according to the Campaign for Tobacco-Free Kids, an advocacy group that promotes reducing tobacco use.
One of those communities is Hawaii County, the so-called “Big Island” of Hawaii, where the law changed last year after a grassroots effort by health care advocates, anti-smoking groups and local high school students. That coalition, joined by teens from across Hawaii, continued its fight at the state level, and legislators heard the message, said Sen. Baker, whose bill also included e-cigarettes, battery-powered devices that deliver vaporized nicotine, which have become popular among young people.
Supporters of raising the smoking age to 21 say that a turning point was a March report by the Institute of Medicine, the health arm of the National Academies of Sciences, Engineering and Medicine, which predicted that raising the age to 21 would cut smoking by 12 percent by the time today’s teenagers are adults. It also would result in about 223,000 fewer premature deaths.
The institute’s report also supported health care advocates’ argument that preventing or delaying teens and young adults from experimenting with smoking would stop many of them from ever taking up the habit. About 90 percent of adults who become daily smokers say they started before they were 19, according to the report.
“Raising the age to 21 will keep tobacco out of high schools, where younger kids often get it from older students,” said John Schachter, state communications director for the Campaign for Tobacco-Free Kids. “If you can cut that pipeline off, you’re making great strides.”
California state Sen. Ed Hernandez, a Democrat who sponsored a measure to raise the smoking age, said it’s good public policy.
“If we make it a law to drive with your seatbelt on to protect the consumer, or to require helmets for people on motorcycles, why can’t we raise the smoking age to protect young adults from becoming addicted to tobacco?” he said.
Supporters also point out that 21 became the national legal drinking age after President Ronald Reagan signed legislation in 1984 that forced states to comply or risk losing millions of dollars in federal highway funds. That has resulted in reduced alcohol consumption among young people and fewer alcohol-related crashes, national studies have found.
“President Reagan thought young people were not ready to make this decision to drink or to drink and drive before they turned 21,” said Rob Crane, president of the Preventing Tobacco Addiction Foundation. “Smoking kills more than six times as many people as drinking.”

Personal Choice

Opponents say that raising the smoking age to 21 would have negative consequences for businesses, taxpayers, and 18-year-olds who should be free to make a personal choice about whether they want to smoke.
Smokers’ rights groups, retailers and veterans’ organizations are among those who’ve opposed such legislation.
“If you’re old enough to fight and die for your country at age 18, you ought to be able to make the choice of whether you want to purchase a legal product or not,” said Pete Conaty, a lobbyist for numerous veterans groups who testified against the California bill. “You could enlist in the military, go to six months of training, be sent over to Iraq or Afghanistan and come back at age 19½ to California and not be able to buy a cigarette. It just doesn’t seem fair.”
Opponents say it’s wrong to compare cigarettes with alcohol. “If you smoke one or two cigarettes and get behind the wheel of a car, you’re not driving impaired,” Conaty said.
Opponents also say taxpayers would take a financial hit if the smoking age is raised because it would mean less revenue from cigarette taxes.
In New Jersey, where a bill to hike the smoking age to 21 passed the Senate last year and remains in an Assembly committee, a legislative agency estimated that tax revenue would be reduced by about $19 million a year.
In California, a fiscal analysis by the Senate appropriations committee estimated that raising the age to 21 would cut tobacco and sales tax revenue by $68 million a year. That would be offset by what the analysis said could be “significant” health care cost savings to taxpayers—reaching as much as $2 billion a year.
Stores that sell tobacco products and e-cigarettes also fear the effect. The Hawaii Chamber of Commerce opposed the measure there.  And Bill Dombrowski, president of the California Retailers Association, suggested that raising the smoking age would simply drive young people to the black market.
“If you raise the age, people under 21 will find the cigarettes somewhere else,” he said.

Health Care Savings

Cigarette smoking is the leading cause of preventable death in the U.S. and is responsible for more than 480,000 deaths a year, according to a 2014 U.S. Surgeon General report, which said the direct medical costs of smoking are at least $130 billion a year.
Supporters of the 21 smoking age say that the savings in health care costs, especially through Medicaid, the federal-state health insurance program for the poor and disabled, will far outweigh any loss in tax revenue for states.
Schachter and other advocates say Hawaii’s action, along with that of dozens of cities, will help spark legislation in other states and create a new standard for when young people take their first puff.
“There is momentum on this issue, and I think you’re going to see more and more states and cities moving in that direction,” Schachter said.
http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2015/10/14/should-the-smoking-age-be-21-some-legislators-say-yes

LA Times: $2 more for cigarettes? California tobacco tax proposal revived in special session

A proposal to raise the tobacco tax by $2 per pack of cigarettes in California was given new life Wednesday when legislation was announced as part of a special session on healthcare.
Supporters say the new bill has a better chance of passing than one that stalled in the regular session because the $1.5 billion raised by such a tax could help the state pay for healthcare costs for low-income residents, a key goal of the special session.
Sen. Richard Pan (D-Sacramento) said he will introduce the tobacco tax, noting that California’s current 87-cent-per-pack tobacco tax makes the state 33rd in the nation, far below New York, which charges a tax of $4.35 a pack. There is also a $1.01 federal tax on cigarettes.
A rally for the proposal was held Wednesday next to the Capitol by the Save Lives California coalition, made up of groups including the California Medical Assn., the American Cancer Society, the American Lung Assn. and the Service Employees International Union.
The coalition said that if the Legislature fails to muster the two-thirds vote to pass the tax, it will put the tax proposal on the 2016 ballot.
“We know raising the tobacco tax has been proven to prevent and reduce smoking, especially among young people,” Pan told the nearly 100 people at the rally. He said 40,000 people die each year in California from tobacco-related diseases, and treating such illnesses costs taxpayers $18.1 billion annually.
A Field Poll released Wednesday indicates a $2 tobacco tax to pay for healthcare costs is supported by 67% of Californians.
The tax is one of several anti-tobacco bills being considered during the special session, including one raising the smoking age to 21 and another restricting the use of electronic cigarettes in public.
“The special session is an opportunity for lawmakers to take long-overdue action to prevent young people from falling prey to the No. 1 cause of preventable death in California: tobacco addiction,” said Claudia Alvarez, an SEIU delegate and family medicine resident at Harbor-UCLA Medical Center.
Those in the audience at the rally included Jennifer Kent, the governor’s appointee as director of the California Department of Health Care Services.
“To the extent we have an ongoing need for revenues we’re obviously willing to consider both this tax and any other revenue sources,” Kent said in an interview afterward. “We’re here and interested and willing and able to partner” with the coalition.
She said there is a strong link between tobacco use and illnesses covered by Medi-Cal.
The regular-session tobacco tax bill was opposed by groups including the Cigar Assn. of America and the Howard Jarvis Taxpayers Assn., which argued it creates a regressive tax on a declining revenue source.
“At a time when state revenue has recovered and the governor says there is even a surplus, there is no reason for a tax increase,” said Jon Coupal, president of the taxpayers group.
Proponents of the bill estimate 295,000 smokers will kick the habit the first year if the tax goes up $2 per pack, and many others will not start smoking to begin with.
http://www.latimes.com/local/political/la-me-pc-california-tobacco-tax-proposal-revived-for-special-session-20150826-story.html

Opinion: Chamber's tobacco tax stance flawed

By John LaChance from Fargo

I used to believe smoking was just a part of life. My parents, grandparents, uncles, aunts, cousins, neighbors, doctors, nurses, teachers, etc. all smoked around me as I was growing up.
For years, I worked in bars and restaurants where people smoked. The more they smoked, the more they drank. The more they drank, the more they spent. The more they spent, the more I made. Simple.
I even participated in a public service announcement urging people to vote against banning smoking in bars in restaurants many years ago. I would be a hypocrite if I did not disclose that information.
I was dead wrong.
State Chamber executive Andy Peterson’s opinion piece in The Forum (Sunday, July 12) offering a rationale that it’s “free enterprise” for the Greater ND Chamber of Commerce’s stance on lobbying against a cigarette tax increase prompted me to research what this stance may be costing his members.
North Dakota has the sixth-lowest cigarette tax per pack in the United States, $0.44 per pack. Montana, $1.70 per pack. South Dakota, $1.53 per pack. Minnesota, $2.90 per pack. Canada, $2.80 per pack.
Statistically, there are more than 440,000 workers in North Dakota (Bureau of Labor Statistics, U.S. Department of Labor).
I couldn’t find exact numbers but let’s say, conservatively, half of those workers, 220,000, work for the 1,037 member businesses listed on the Chamber’s website. Four of the top five largest employers in the state are also members of the Greater ND Chamber of Commerce. The fifth employer was not disclosed.
The average cost to a business per employee who smokes is $5,816 a year, per a 2013 Ohio State University study. A Gallup poll from 2013, “estimates that 19 percent of workers still smoke and that workers who smoke cost the U.S. economy $278 billion annually in lost productivity due to absenteeism and extra health care costs. This figure is based on an analysis of the cost of extra missed workdays due to poor health, partial absenteeism due to smoke breaks, and additional health care costs compared with workers who do not smoke.”
So let’s say, conservatively, 41,800 workers (220,000 x 19 percent) employed by the Greater ND Chamber businesses still smoke. That is potentially costing these member businesses $243,108,800 ($5,816 x 41,800).
The most recent revenue numbers I could find from cigarette sales in North Dakota was $68,951,521 for 2009.
Hmm?
Now I’m just beginning my graduate studies in business, but it appears it would be in the Greater ND Chamber’s best interest to encourage a cigarette tax increase.
Not only would an increase in the cigarette tax raise revenue for some of Peterson’s members, it would decrease the amount of money most if not all of his member businesses are losing out on paying for smoking- related costs.
Simple.
http://www.inforum.com/letters/3799718-letter-chambers-tobacco-tax-stance-flawed

Opinion: Does the ND State Chamber side with the U.S. Chamber on Opposing Tobacco Prevention?

By: Dr. Eric Johnson, Grand Forks
President, Tobacco Free North Dakota
If you have not read the June 30, 2015 New York Times article titled, “U.S. Chamber of Commerce Works Globally to Fight Antismoking Measures”, please do so. While we acknowledge there is, at times, a disconnect between national, state and local organizations such as the Chambers of Commerce organizations, I couldn’t help but recognize some similarities between Chamber international efforts as detailed in the article referenced above and the actions of the Greater North Dakota Chamber here in our state.
Even as an active member of the Healthy North Dakota Summit, a public health initiative established by then-Governor John Hoeven and whose statewide plan identifies strategies to “support North Dakotans who make healthy choices – in schools, workplaces, senior centers, homes and anywhere people live, learn, work and play,” the GNDC has not only been absent in supporting tobacco prevention efforts in our state, it has actively opposed them.
With the goal to “reduce tobacco use in North Dakota” on paper in their statewide plan and in mind, we are troubled to see efforts of the Chambers of Commerce – whether internationally or here at the state level – combat proven prevention strategies that save both lives and money.
We call on North Dakotans to demand better and challenge the GNDC to accept what the numbers have long confirmed – that comprehensive tobacco prevention practices are fiscally responsible to taxpayers, health care systems, and ultimately, our workforce and employers in the business community.
——-
Click here to read Mr. Andy Peterson’s letter to the editor in response.
And click here to read Dr. Eric Johnson’s corrections to the inaccuracies of Mr. Peterson’s letter.

TFND calls on GNDC to support tobacco prevention

Upon reading the New York Times article entitled, “US Chamber works globally to fight antismoking measurers”, TFND communicated its disappointment with the Greater North Dakota Chamber’s work in our state alongside Big Tobacco.
In doing so, we sent this letter: TFND Letter to GNDC – 7.1.15.

GNDC responded: GNDC – TFND Letter – 7.2.15

And our final communication back to GNDC: TFND response to GNDC – 7.2.15

New York Times: U.S. Chamber of Commerce Works Globally to Fight Antismoking Measures

By DANNY HAKIM

KIEV, Ukraine — A parliamentary hearing was convened here in March to consider an odd remnant of Ukraine’s corrupt, pre-revolutionary government.

Three years ago, Ukraine filed an international legal challenge against Australia, over Australia’s right to enact antismoking laws on its own soil. To a number of lawmakers, the case seemed absurd, and they wanted to investigate why it was even being pursued.

When it came time to defend the tobacco industry, a man named Taras Kachka spoke up. He argued that several “fantastic tobacco companies” had bought up Soviet-era factories and modernized them, and now they were exporting tobacco to many other countries. It was in Ukraine’s national interest, he said, to support investors in the country, even though they do not sell tobacco to Australia.

Mr. Kachka was not a tobacco lobbyist or farmer or factory owner. He was the head of a Ukrainian affiliate of the U.S. Chamber of Commerce, America’s largest trade group.

From Ukraine to Uruguay, Moldova to the Philippines, the U.S. Chamber of Commerce and its foreign affiliates have become the hammer for the tobacco industry, engaging in a worldwide effort to fight antismoking laws of all kinds, according to interviews with government ministers, lobbyists, lawmakers and public health groups in Asia, Europe, Latin America and the United States.

The U.S. Chamber’s work in support of the tobacco industry in recent years has emerged as a priority at the same time the industry has faced one of the most serious threats in its history. A global treaty, negotiated through the World Health Organization, mandates anti-smoking measures and also seeks to curb the influence of the tobacco industry in policy making. The treaty, which took effect in 2005, has been ratified by 179 countries; holdouts include Cuba, Haiti and the United States.

Facing a wave of new legislation around the world, the tobacco lobby has turned for help to the U.S. Chamber of Commerce, with the weight of American business behind it. While the chamber’s global tobacco lobbying has been largely hidden from public view, its influence has been widely felt.

Letters, emails and other documents from foreign governments, the chamber’s affiliates and antismoking groups, which were reviewed by The New York Times, show how the chamber has embraced the challenge, undertaking a three-pronged strategy in its global campaign to advance the interests of the tobacco industry.

In the capitals of far-flung nations, the chamber lobbies alongside its foreign affiliates to beat back antismoking laws.

In trade forums, the chamber pits countries against one another. The Ukrainian prime minister, Arseniy Yatsenyuk, recently revealed that his country’s case against Australia was prompted by a complaint from the U.S. Chamber.

And in Washington, Thomas J. Donohue, the chief executive of the chamber, has personally taken part in lobbying to defend the ability of the tobacco industry to sue under future international treaties, notably the Trans-Pacific Partnership, a trade agreement being negotiated between the United States and several Pacific Rim nations.

“They represent the interests of the tobacco industry,” said Dr. Vera Luiza da Costa e Silva, the head of the Secretariat that oversees the W.H.O treaty, called the Framework Convention on Tobacco Control. “They are putting their feet everywhere where there are stronger regulations coming up.”

The increasing global advocacy highlights the chamber’s enduring ties to the tobacco industry, which in years past centered on American regulation of cigarettes. A top executive at the tobacco giant Altria Group serves on the chamber’s board. Philip Morris International plays a leading role in the global campaign; one executive drafted a position paper used by a chamber affiliate in Brussels, while another accompanied a chamber executive to a meeting with the Philippine ambassador in Washington to lobby against a cigarette-tax increase. The cigarette makers’ payments to the chamber are not disclosed.

It is not clear how the chamber’s campaign reflects the interests of its broader membership, which includes technology companies like Google, pharmaceutical giants like Pfizer and health insurers like Anthem. And the chamber’s record in its tobacco fight is mixed, often leaving American business as the face of a losing cause, pushing a well-known toxin on poor populations whose leaders are determined to curb smoking.

The U.S. Chamber issued brief statements in response to inquiries. “The Chamber regularly reaches out to governments around the world to urge them to avoid measures that discriminate against particular companies or industries, undermine their trademarks or brands, or destroy their intellectual property,” the statement said, adding, “we’ve worked with a broad array of business organizations at home and abroad to defend these principles.”

The chamber declined to say if it supported any measures to curb smoking.

The chamber, a private nonprofit that has more than three million members and annual revenue of $165 million, spends more on lobbying than any other interest group in America. For decades, it has taken positions aimed at bolstering its members’ fortunes.

While the chamber has local outposts across the United States, it also has more than 100 affiliates around the world. Foreign branches pay dues and typically hew to the U.S. Chamber’s strategy, often advancing it on the ground. Members include both American and foreign businesses, a symbiotic relationship that magnifies the chamber’s clout.

For foreign companies, membership comes with “access to the U.S. Embassy” according to the Cambodian branch, and entree to “the U.S. government,” according to the Azerbaijan branch. Members in Hanoi get an invitation to an annual trip to “lobby Congress and the administration” in Washington.

Since Mr. Donohue took over in 1997, he has steered the chamber into positions that have alienated some members. In 2009, the chamber threatened to sue if the Environmental Protection Agency regulated greenhouse gas emissions, disputing its authority to act on climate change. That led Nike to step down from the chamber’s board, and to Apple’s departure from the group. In 2013, the American arm of the Swedish construction giant Skanska resigned, protesting the chamber’s support for what Skanska called a “chemical industry-led initiative” to lobby against green building codes.

The chamber’s tobacco lobbying has led to confusion for many countries, Dr. da Costa e Silva said, adding “there is a misconception that the American chamber of commerce represents the government of the U.S.” In some places like Estonia, the lines are blurred. The United States ambassador there, Jeffrey Levine, serves as honorary president of the chamber’s local affiliate; the affiliate quoted Philip Morris in a publication outlining its priorities.

The tobacco industry has increasingly turned to international courts to challenge antismoking laws that countries have enacted after the passage of the W.H.O. treaty. Early this year, Michael R. Bloomberg and Bill Gates set up an international fund to fight such suits. Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, an advocacy group that administers the fund, called the chamber “the tobacco industry’s most formidable front group,” adding, “it pops up everywhere.”

In Ukraine, the chamber’s involvement was no surprise to Hanna Hopko, the lawmaker who led the hearing in Parliament. She said the chamber there had fought against antismoking laws for years.

“They were against the tobacco tax increase, they were against placing warning labels on cigarettes,” she said. “This is just business as usual for them.”

Country-by-Country Strategy

More than 3,000 miles away, in Nepal, the health ministry proposed a law last year to increase the size of graphic warning labels from covering three-fourths of a cigarette pack to 90 percent. Countries like Nepal that have ratified the W.H.O. treaty are supposed to take steps to make cigarette packs less appealing.

Not long afterward, one of Nepal’s top officials, Lilamani Poudel, said he received an email from a representative of the chamber’s local affiliate in the country, warning that the proposal “would negate foreign investment” and “invite instability.”

In January, the U.S. Chamber itself weighed in. In a letter to Nepal’s deputy prime minister, a senior vice president at the chamber, Tami Overby, wrote that she was “not aware of any science-based evidence” that larger warning labels “will have any discernible impact on reducing or discouraging tobacco use.”

A 2013 Harvard study found that graphic warning labels “play a lifesaving role in highlighting the dangers of smoking and encouraging smokers to quit.”

While Nepal eventually mandated the change in warning labels, cigarette companies filed for an extension and compliance has stalled.

“Since we have to focus on responding to the devastating earthquake, we have not been able to monitor the state of law enforcement effectively,” said Shanta Bahadur Shrestha, a senior health ministry official.

The episode reflects the chamber’s country-by-country lobbying strategy. A pattern emerged in letters to seven nations: Written by either the chamber’s top international executive, Myron Brilliant, or his deputies, they introduced the chamber as “the world’s largest business federation.”

Then the letters mention a matter “of concern.” In Jamaica and Nepal, it was graphic health warnings on packages. In Uruguay, it was a plan to bar cigarettes from being displayed by retailers. The Moldovan president was warned against “extreme measures” in his country, though they included common steps like restricting smoking in public places and banning advertising where cigarettes are sold.

A proposal to raise cigarette taxes in the Philippines would open the floodgates to smugglers, the government there was told. Tax revenue has increased since the proposal became law.

“We are not cowed by them,” said Jeremias Paul, the country’s under secretary of finance. “We meet with these guys when we’re trying to encourage investment in the Philippines, so clearly they are very influential, but that doesn’t mean they will dictate their ways.”

Protecting tobacco companies is portrayed by the chamber as vital for a nation’s economic health. Uruguay’s president is warned that antismoking laws will “have a disruptive effect on the formal economy.” El Salvador’s vice president is told that “arbitrary actions” like requiring graphic health warnings in advertisements undermine “investment and economic growth.”

On the ground, the chamber’s local affiliates use hands-on tactics.

After Moldova’s health ministry proposed measures in 2013, Serghei Toncu, the head of the American Chamber of Commerce in Moldova, laid out his objections in a series of meetings held by a regulatory review panel.

“The consumption of alcohol and cigarettes is at the discretion of each person,” Mr. Toncu said at one meeting, adding that the discussion should not be about “whether smoking is harmful.”

“You do not respect us,” he told the health ministry at another.

At a third, he called the ministry’s research “flawed from the start.”

His objections were not merely plaintive cries. The American chamber has a seat on Moldova’s regulatory review panel giving it direct influence over policy making in the small country.

“The American Chamber of Commerce is a very powerful and active organization,” said Oleg Chelaru, a team leader on the staff that assists the review panel. “They played a very crucial role in analyzing and giving an opinion on this initiative.”

Mr. Toncu, who has since left the chamber, declined to comment. Mila Malairau, the chamber’s executive director, said its main objective was to make sure the industry “was consulted” in “a transparent and predictable manner.”

After recently passing in Parliament, the long-stalled measures were subject to fresh objections from the chamber and others, and have not yet been enacted.

Fighting a Trade Exception

In Washington, the U.S. Chamber’s tobacco lobbying has been visible in the negotiations over the Trans-Pacific Partnership, a priority of the Obama administration that recently received critical backing in Congress.

One of the more controversial proposals would expand the power of companies to sue countries if they violate trade rules. The U.S. Chamber has openly opposed plans to withhold such powers from tobacco companies, curbing their ability to challenge national antismoking laws. The chamber says on its website that “singling out tobacco” will “open a Pandora’s box as other governments go after their particular bêtes noires.”

The issue is still unresolved. A spokesman for the United States trade representative said negotiators would ensure that governments “can implement regulations to protect public health” while also “ensuring that our farmers are not discriminated against.”

Email traffic shows that Mr. Donohue, the chamber’s head, sought to raise the issue in 2012 directly with Ron Kirk, who was then the United States trade representative. In email exchanges between staff members of the two, Mr. Donohue specifically sought to discuss the role of tobacco in the trade agreement.

“Tom had a couple of things to raise, including urging that the tobacco text not be submitted at this round,” one of Mr. Donohue’s staff members wrote to Mr. Kirk’s staff. The emails were produced in response to a Freedom of Information request filed by the Campaign for Tobacco-Free Kids, which provided them to The Times.

Mr. Kirk is now a senior lawyer at Gibson, Dunn, a firm that counts the tobacco industry as a client. He said in an interview that during his tenure as trade representative, he met periodically with Mr. Donohue but could not recall a specific conversation on tobacco.

He said trade groups were generally concerned about “treating one industry different than you would treat anyone else, more so than doing tobacco’s bidding.”

The chamber declined to make Mr. Donohue available for an interview.

A Face-Saving Measure

In Ukraine, it was Valeriy Pyatnytskiy who signed off on the complaint against Australia in 2012, which was filed with the World Trade Organization. At the time, he was Ukraine’s chief negotiator to the W.T.O. His political career has survived the revolution and he is now an adviser to the Ukrainian prime minister, Mr. Yatsenyuk.

In a recent interview, he said that for Ukraine, the case was a matter of principle. It was about respecting the rules.

He offered a hypothetical: If Ukraine allowed Australia to use plain packaging on cigarettes, what would stop Ukraine from introducing plain packaging for wine? Then Ukrainian winemakers could better compete with French wines, because they would all be in plain bags marked red or white.

“We had this in the Soviet times,” he said. “It was absolutely plain packaging everywhere.”

Some Ukrainian officials have long been troubled by the case.

“It has nothing to do with trade laws,” said Pavlo Sheremeta, who briefly served as Ukraine’s economic minister after the revolution. “We have zero exports of tobacco to Australia, so what do we have to do with this?”

Last year, he urged the American Chamber in Kiev to reconsider.

“I wrote a formal letter, asking them, ‘Do you still keep the same position?’ ” Mr. Sheremeta said. “Basically I was suggesting a face-saving way out of this.” But when he met with chamber officials, the plain packaging case was outlined as a top priority.

They refused to back down. After Mr. Pyatnytskiy, a tobacco ally, was installed as his deputy, Mr. Sheremeta resigned.

“The world was laughing at us,” he said of the case.

Shortly after The Times discussed the case with Ukrainian government officials, there were new protests from activists. Mr. Yatsenyuk called for a review of the matter. Ukraine has since suspended its involvement, but other countries including Cuba and Honduras are continuing to pursue the case against Australia.

Andy Hunder, who took over as president of the American Chamber of Commerce in Kiev in April, said the organization was moving on, adding, “We are looking forward now.”

Sofiia Kochmar contributed reporting from Kiev, Bhadra Sharma from Kathmandu and Palko Karasz from London.

http://www.nytimes.com/2015/07/01/business/international/us-chamber-works-globally-to-fight-antismoking-measures.html?hp&action=click&pgtype=Homepage&module=first-column-region®ion=top-news&WT.nav=top-news&_r=1

Upon reading this article, TFND communicated its disappointment with the Greater North Dakota Chamber’s work in our state alongside Big Tobacco. In doing so, we sent this letter: TFND Letter to GNDC – 7.1.15.

GNDC responded: GNDC – TFND Letter – 7.2.15

And our final communication back to GNDC: TFND response to GNDC – 7.2.15

The Dickinson Press: Several businesses caught selling tobacco to minors

By Andrew Haffner

The Southwestern District Unit Health caught six Dickinson businesses selling tobacco to a minor Monday in a quarterly compliance check of 25 city retailers.

The businesses that failed the check are M & H Gas Station, Cenex Convenience Store on Villard Street, Simonson’s Store on Villard Street, Rosie’s Food & Gas, and Family Fare supermarkets at both 18th Street West and Roughrider Boulevard.

Tobacco Treatment Specialist Jennifer Schaeffer said in a release that compliance checks are conducted with a trained minor student with a police officer present. Dickinson municipal code prohibits selling tobacco to minors, with punishments tiered to the persistence of retailer offenses.

First-time offenders can face a fine of $100, while those who sell illegally three times within two years may receive a $500 fine and tobacco license revocation.

Schaeffer said in the release that the Southwestern District Unit Health offered a training course for tobacco retailers to prepare them for subsequent compliance checks.

“We are trying to educate them and the public that this is an important issue in keeping our children safe,” she said in the release.

http://www.thedickinsonpress.com/news/local/3777389-several-businesses-caught-selling-tobacco-minors

HealthlineNews: Is 18 Too Young to Buy Tobacco Products? Some States Think So.

California is on the verge of joining other states in raising the minimum age to purchase tobacco, sparking more debate about what privileges and responsibilities fall on young adults.

How old should you be to purchase tobacco?

Some legislative leaders in the United States apparently think 18 is too young.

On Friday, Hawaii’s governor signed a bill raising the minimum age to buy tobacco to 21. The law takes effect next year.

Four states — Alabama, Alaska, New Jersey, and Utah — have raised the minimum age to buy tobacco to 19, while some local municipalities have raised it to 21.

And, earlier this month, the California State Senate overwhelmingly voted to increase the age at which a person can buy tobacco products from 18 to 21. The bill still needs Assembly approval and the governor’s signature.

The goal is to further limit access to tobacco products to young smokers. The move is backed by several health groups, including the American Cancer Society and the California Medical Association.

Dr. Jack Jacoub, an oncologist and director of thoracic oncology at the Memorial Care Cancer Institute at Orange Coast Memorial Medical Center in Fountain Valley, California, says with decades of data available, it’s clear the age increase is a sound move to prevent people from starting lifelong habits.

“It’s still a risk factor for a host of different cancers, not just lung cancer,” he said. “If you separate the legal aspect of it, it makes the most sense to raise the minimum age to 21.”

A Measure Aimed at Delaying the Start

A study by the Institute of Medicine (IOM) published in March found that increasing the minimum legal age to 21 would likely prevent or delay when people would begin smoking, specifically children aged 15 to 17.

About 90 percent of smokers now start before 19 years old, so the argument is the 21-year minimum would reduce teens’ access to tobacco because it’s unlikely they would be in the same social circle as people old enough to purchase tobacco.

The U.S. Food and Drug Administration (FDA) doesn’t have the authority to raise the legal smoking age to 21, so it’s an issue that must be dealt with at the state level. The federal government, however, does have a law that withholds federal highway funds to states that don’t have their minimum drinking age at 21.

The town of Needham, Massachusetts, raised its smoking age to 21 in 2005. Over the next decade, teenage rates of smoking dropped from 13 to 7 percent, according to the Education Development Center, which conducted the study.

In California, smoking has been banned in enclosed workspaces since 1995, and smoking in a vehicle with a minor has been illegal since 2008. This was done to prevent exposure to secondhand smoke, but the new proposed law would affect young smokers directly.

“The group where smokers usually start is the highest impact group,” Jacoub said. “I don’t know of anyone who would be against it.”

A handful of trade groups, such as the Cigar Association of America and the California Retailers Association, oppose the change on the grounds that Americans are considered adults under the eyes of the law, so that’s also when they should have the right to make their own decisions.

Personal choice is the crux of the argument the tobacco industry uses when opposing stricter legislation.

This new legislation has lit up an ongoing debate over when a person is considered a legal adult and what that entails.

When Are Americans Adults?

When the federal drinking age was pushed back from 18 to 21 in 1984, it was backed by health concerns, mainly the high rate at which minors were being killed in traffic accidents while under the influence.

Research shows the parts of the brain most responsible for decision-making, impulse control, sensation seeking, and susceptibility to peer pressure are still developing and changing between the ages of 18 and 21. The IOM study notes, “Adolescent brains are uniquely vulnerable to the effects of nicotine.”

Jamie Miller, a political consultant and e-cigarette lobbyist from Florida, likened the California legislation to the change in voting age in 1971 when young men were being drafted to serve in Vietnam.

The thought was that men and women old enough to serve in the armed forces should be able to vote for the people who decide to go to war.

“We’re looking at the unintended consequences of passing laws under public pressure at the moment. I personally believe we, as a society, made a mistake when we changed the Constitution to allow those who are 18 to vote just so we could draft those who are 18,” he said.

Saying he believes the fewer people who have access to addictive substances the better, Miller also says there needs to be some kind of uniformity to when young people are considered adults.

“If the age to drink and smoke is 21, we should change the draft and voting age to 21 as well,” he said. “In other words, full, legal adulthood would be 21.”

http://www.healthline.com/health-news/some-states-think-18-is-too-young-to-buy-tobacco-products-062015#5