WebMD News from HealthDay: FDA Launches Ad Campaign Against Chewing Tobacco

By Dennis Thompson

HealthDay Reporter

TUESDAY, April 19, 2016 (HealthDay News) — U.S. health officials said Tuesday that they are targeting rural teenagers with a new $36 million ad campaign that highlights the health risks associated with chewing tobacco.

The campaign’s message — “smokeless doesn’t mean harmless” — will challenge a habit that has become a tradition in the rural United States, said Mitch Zeller, director of the Center for Tobacco Products at the U.S. Food and Drug Administration.

“It is culturally ingrained in many rural communities, and can be seen as a rite of passage and an acceptable societal norm,” Zeller said during a Tuesday morning news conference. He noted that smokeless tobacco use is more than twice as common in rural areas as it is in urban settings.

Chewing tobacco, snuff and other smokeless tobacco products have been linked to multiple kinds of cancer, gum disease, tooth loss and nicotine addiction, Zeller said.

Nevertheless, smokeless tobacco use has become increasingly popular among rural male teenagers, according to FDA research.

Every day in the United States, nearly 1,000 males younger than 18 try smokeless tobacco for the first time, outpacing those who take their first puff on a cigarette, Zeller said. About one-third of rural white males aged 12 to 17 have tried or are at risk of trying smokeless tobacco, totaling approximately 629,000 male youth nationwide.

Rural teens are used to seeing role models use smokeless tobacco, including fathers, grandfathers, older brothers and community leaders, Zeller explained.

“When people who these teens most trust and admire openly use and share smokeless tobacco, the product is seen as acceptable, and even as an expected part of growing up and belonging,” Zeller said.

This is the first time the FDA has focused on smokeless tobacco in an ad campaign, said Kathy Crosby, director of the FDA’s Office of Health Communication and Education.

Crosby said the campaign will focus on 35 rural markets across the United States, including: Albany, Ga.; Billings, Mont.; Flint, Mich.; Medford, Ore.; Monroe, La.; Sioux Falls, S.D.; Little Rock, Ark.; and Tri-Cities, Tenn.

Ads linked to the campaign show young men with ugly lip sores and horrific facial scars caused by mouth cancer, and a football player being tossed around by a nicotine addiction “monster.” The ads will run on local television and in print, while others appear on local radio and through social media.

The new campaign will also collaborate with select Minor League Baseball teams to help combat the link between baseball and smokeless tobacco use among the campaign’s target audience, Crosby said.

This summer, stadiums across the country will display campaign advertising and provide opportunities for fans to meet players who support the campaign’s public health message, she said.

The FDA also is in ongoing talks with Major League Baseball about joining the campaign, and Zeller said he is “optimistic” that a partnership will be announced sometime this season.

Major cities such as Boston, Los Angeles, New York City and San Francisco have banned smokeless tobacco products at ballparks and other sports venues. Major League Baseball has warned that players caught violating the ban in these cities will be subject to discipline from the commissioner.

The smokeless tobacco campaign is an offshoot of the FDA’s award-winning “The Real Cost” campaign, which since 2014 has been warning teenagers about the health effects of smoking.

Drug Store News: CDC's latest anti-smoking campaign inspired 104,000 smokers to quit


ATLANTA – The latest outcomes measuring the impact of CDC’s national tobacco education campaign are as strong as those achieved in its first year, and suggest that three years into the campaign, the ads were still having a significant impact.

More than 1.8 million smokers attempted to quit smoking because of the nine-week-long 2014 Tips From Former Smokers ( Tips ) campaign. An estimated 104,000 Americans quit smoking for good as a result of the 2014 campaign.

The survey results are published in the March 24 release of the journal Preventing Chronic Disease.

Unlike the 2012 campaign, which aired for 12 consecutive weeks, the 2014 campaign aired in two phases, from Feb. 3 to April 6 and from July 7 to Sept. 7. Phase 1 of the 2014 campaign ran ads primarily from the 2012 and 2013 campaigns; Phase 2 contained new ads. Those new ads featured people and their struggles with smoking-related health issues, including cancer, gum disease, premature birth and stroke caused by smoking combined with HIV. About 80% of U.S. adult cigarette smokers who were surveyed reported seeing at least one television ad from Phase 2 of the 2014 campaign.

“CDC’s Tips campaign has helped at least 400,000 smokers quit smoking for good since 2012,” stated CDC Director Tom Frieden.  “Tips is also extremely cost-effective and a best buy, saving both lives and money. With a year-round campaign we could save even more lives and money.”

Tips, the first federally funded anti-smoking paid media campaign, features former smokers talking about their smoking-related illnesses. Smoking-related diseases cost the United States more than $300 billion a year, including nearly $170 billion in direct health care costs and more than $156 billion in lost productivity.

“The Tips campaign is an important counter measure to the $1 million that the tobacco industry spends each hour on cigarette advertising and promotion,” said Corinne Graffunder, director of CDC’s Office on Smoking and Health. “The money spent in one year on Tips is less than the amount the tobacco industry spends on advertising and promotion in just 3 days.”

The most recent Surgeon General’s Report, The Health Consequences of Smoking—50 Years of Progress, called for airing effective messages such as the Tips ads with high frequency and exposure for 12 months a year for a decade or more. Cigarette smoking is the leading preventable cause of disease and death in the United States, killing about 480,000 Americans each year.

For every American who dies from a smoking-related disease, about 30 more suffer at least one serious illness from smoking. And while the percentage of American adults who smoke is at the lowest level since the CDC began tracking such data, there are still an estimated 40 million adult smokers in the U.S.  Surveys show about 70% of all smokers want to quit, and research shows quitting completely at any age has significant health benefits.

Bismarck Tribune: Coalition pushes tobacco tax measure

Photo by Tom Stromme, Bismarck Tribune

Photo by Tom Stromme, Bismarck Tribune

Members of a coalition seeking an increase in the state’s tobacco tax say their proposed increase would reduce smoking rates as well as state health care costs among other benefits.
“That’s the missing leg of the three-legged stool,” Eric Johnson, a Grand Forks physician and head of the measure’s sponsoring committee, Raise It for Health North Dakota.
Two-thirds of North Dakota voters in 2012 approved a ballot measure making public places smoke-free. In 2008, nearly 54 percent of voters approved the creation of a state tobacco prevention and control program.
Other states that have raised the tax have seen decreases in smoking, according to Johnson, adding that the measure will help beef up the state’s tobacco prevention efforts.
“This is a tax nobody has to pay. It’s a product that creates death,” Johnson said.
Kristie Wolff, with the American Lung Association in North Dakota, said the measure would increase the tobacco tax for cigarettes in North Dakota from 44 cents per pack to $2.20. Taxes on liquid nicotine products would be increased from 28 percent of the wholesale purchase price to 56 percent.
The national average tax on a pack of cigarettes is $1.61.
New tax revenues created through the measure, estimated at about $100 million per biennium, would be split between health-related programs in the state’s Community Health Trust Fund as well as a newly created Veterans Tobacco Tax Trust Fund.
“We’re confident that North Dakota voters will respond positively yet again,” Wolff said.
Only Georgia, Missouri and Virginia have lower tobacco taxes than North Dakota. The tobacco tax in North Dakota hasn’t been raised since 1993.
Being a statutory initiative, 13,452 legitimate signatures will be required at least 120 days before the election. The deadline for turning in signatures for the Nov. 8 election is July 11.
Several unsuccessful attempts have been legislatively in the year since the last tax increase.
Wolff said the increase would bring North Dakota in line with the surrounding states in the tax per pack of cigarettes. The tax in Minnesota is $3 per pack, in Montana it’s $1.70 and in South Dakota it’s $1.53.
“We based it on polling we’ve done,” Wolff told reporters when asked how the group came to the $1.76 per pack increase being proposed.
According to the Campaign for Tobacco-Free Kids, the tax increase could result in a 20 percent drop in youth smoking, preventing about 5,800 youths from becoming adult smokers, Johnson said.
North Dakota Retail Association president Mike Rud said the group he leads will need to review the measure language and watch to see if it gets the necessary signatures for a vote. The group opposed both 2015 bills.
Rud said on first glance the proposed increase is substantial, adding that taxing cigarettes would negatively impact lower-income smokers.
“Taxing a group that can least afford it? It’s a bit troublesome to us,” said Rud, clarifying that tobacco products aren’t illegal and retailers sell them to meet demand among legal buyers.
“There’s got to be a limit to how involved we get with these things,” Rud said.

Valley News Live: Coalition wants to raise North Dakota tobacco tax

By: Natalie Parsons
FARGO, N.D. (Valley News Live) It has been proposed in the state of North Dakota to raise the tax on tobacco products.
If it passes, you will see it on your ballot this November.
Supporters already started collecting some of the required 13,000 plus signatures.
North Dakota has not increased its tobacco tax since 1993 and now the Raise It For Health North Dakota coalition thinks it’s time.
The proposed tobacco tax will increase the tax on cigarettes from $0.44 per pack up to $2.20 per pack.
Scott Platfers says, “Going to have to pay more if I want to continue but I’m hoping that it might deter me too because it’s something I’ve been wanting to quit for a long time.”
The ultimate goal for this tobacco tax increase is to hopefully decrease youth smoking by 20 percent and prevent 5800 youth from ever starting.
The Fargo smoker says, “It’s not going to prevent all of them but I think it’s going to get some of them and every little bit helps.”
The coalition has already started getting signatures on this initiated measure.
The petition needs exactly 13,452 signatures in order appear on the November 8th ballot.
Platfers says, “It’s a double edged sword. It’ll effect me but as long as it would help somebody? Yeah, I would sign it.”
The proposed tobacco tax is estimated to bring in over $100-million new revenue to North Dakota with plans to go towards many health care services.

Forum News Service: Proposed ND ballot measure would boost tax on cigarettes by $1.76 a pack

By Mike Nowatzki / Forum News Service
A group frustrated with the North Dakota Legislature’s repeated refusal to raise tobacco taxes will attempt to put the issue to voters in November, announcing a ballot initiative Wednesday that would hike the tax on a pack of cigarettes by $1.76.
Backers will need to gather 13,452 signatures by July 11 to place the initiated measure on the Nov. 8 ballot.
Dr. Eric Johnson, a Grand Forks physician and chairman of the measure’s 30-member sponsoring committee, estimated the higher tax would reduce youth smoking by 20 percent, preventing 5,800 youths from ever starting smoking.
He noted North Dakota voters approved a tobacco use prevention and control program in 2008 and passed a smoke-free workplace law in 2012, calling the higher tax “kind of the missing leg of the three-legged stool.”
“We do know that it reduces usage, and that saves money for everybody,” he said.
Supporters estimate the tax increase would generate more than $100 million every two years. Half of the money would be dedicated to a new trust fund to support services and programs for military veterans, while the rest would go into a community health trust fund.

Poll results as of 9:30 am on March 17, 2016

Poll results as of 9:30 am on March 17, 2016

North Dakota’s current tax of 44 cents on a pack of cigarettes ranks 47th lowest among states and hasn’t been increased since 1993, despite several attempts in the Legislature, including two bills defeated last year after strong pushback from retailers and distributors.
If approved by voters, the proposed new tax of $2.20 per pack would be lower than Minnesota’s $3-per-pack tax but higher than Montana’s $1.70 and South Dakota’s $1.53. The national average is $1.61 per pack.
The measure is being pushed by the Raise it for Health Coalition, which consists of 10 groups: the North Dakota Medical Association, American Lung Association in North Dakota, North Dakota Veterans Coordinating Council, Tobacco Free North Dakota, Campaign for Tobacco-Free Kids, North Dakota Nurses Association, North Dakota Chapter of the American Academy of Pediatrics, March of Dimes, North Dakota Association of Counties and the Dakota Boys and Girls Ranch.

InForum: Mentally ill more likely to smoke, die from tobacco-related illness

The mentally ill and those battling substance abuse are much more likely than others to smoke, and suffer higher illness and death rates as a result.
The American Lung Association in North Dakota is launching an effort to target smoking cessation programs at those who are mentally ill or dealing with addictions.
Tobacco control advocates also are working with mental health professionals to take a more aggressive approach to help those with behavioral health problems quit smoking.
“We have seen a decline in all populations except those with mental illness or substance abuse,” said Reba Mathern-Jacobson, director of tobacco control for the American Lung Association in North Dakota, referring to the drop in smoking among most groups.
As a result, those with mental illnesses and addictions can die decades earlier than the general population, and smoking is a major contributor to sickness and early death, according to statistics cited by the federal Substance Abuse and Mental Health Services Administration:
• About half of people with behavioral health disorders smoke, compared to 23 percent of the general population.
• People with mental illnesses and addictions smoke half of all cigarettes made, and are only half as likely as other smokers to quit.
• Smoking-related illnesses cause half of all deaths among people with behavioral health disorders.
“Folks are dying a lot sooner than they need to,” said Carlotta McCleary, executive director of Mental Health America in North Dakota, an advocacy group. The issue is starting to draw more attention, she said, and collaborations are forming to address the problem.
“People who are alcoholic die from tobacco-related diseases more than they do from alcohol-related diseases,” Mathern-Jacobson said.
Those with mental illness or substance abuse problems find it more difficult to quit smoking for a variety of reasons.
Nicotine’s mood-altering effects put people with mental illness at greater risk for cigarette use and nicotine addiction. Also, people with mental illness are more likely to face stressful lives, have lower incomes and lack access to health care, making quitting more difficult.
“People might be self-medicating, that kind of thing,” by using nicotine, McCleary said.
Another problem is what tobacco control advocates view as a lackadaisical attitude among some mental health professionals.
“It’s been seen as a lesser of evils,” Mathern-Jacobson said. “Now that population is bearing the brunt of it.”
Mental health professionals are significantly more likely to smoke than other health professionals, surveys show, which might suggest a culture that is more tolerant of tobacco, she said.
It’s worth noting that nicotine dependence is listed as a behavioral disorder in the diagnostic manual used by mental health clinicians, Mathern-Jacobson said. “Nicotine is a drug, let’s treat it like one.”
Melissa Markegard, a tobacco control coordinator with Fargo Cass Public Health, said she believes mental health clinicians are increasingly more likely to take nicotine addiction seriously.
“A lot of times, smoking is a trigger for other substances, especially alcohol,” she said. “It’s kind of like you can’t do one without the other.”
More integration of behavioral health and general health care would help to combat smoking among the mentally ill and those battling addictions, McCleary said.
“It’s not just OK to focus on behavioral health alone,” or on physical health in isolation, she said. There is a growing movement in health care to do more to combine the two, McCleary added, but said much more integration is needed.
The American Lung Association in North Dakota is bringing in an expert to help train behavioral health professionals including psychiatrists, counselors, nurses, social workers and other treatment providers who serve people with mental illness or substance abuse disorders.
The training sessions will be June 21-22 in Fargo and will feature Dr. Jill Williams, an addiction psychiatrist from Rutgers Robert Wood Johnson Medical School. Details still are pending. Anyone interested can contact Mathern-Jacobson or by calling 701-354-9719.