Tobacco Documents Online

FEB-22-1994 06 :38 FROM BURSON-MARSTEU.LER TO 990'15315 P. 02 CLr.ARING THX SMORBSCR88N TORACCO, PUBLIC HEALTH AND PLTBLIC POLICY MARRIOTT MARQUIS -- NEW YORK CITY FEBRUARY 22, 1994 American Medical Association Media Briefing sponsored by Robert Wood Johnson Foundation. A presentation of new research on health effects of tobacco, marketing tactics of the tobacco industry and new Also research on the history of the efforts at tobacco control. tobacco industry's efforts to recruit women to smoke, predictors of smoking cessation, effects of fetal exposure to nicotine, and.discussion of single-cigarette sales. Attendance: 70-75. Sxtensive media coverage including: C1N, ABC-News, WCBS- Radio, Reuters, Associated Press, Glamour, American Druggist, UPI, American Medical News, NBC News, New York Post, International Medical News Service. Staten Island Advance, Universal Press Syndicate, Medical News Network, Diario Medico. welcome and overview by Randolph Smoak, MD, AMA Trustee (see biographies for'full details on speakers). Dr. Smoak identified smoking as the single greatest contributor to deaths in the U.S., and tobacco as the legal products which when used as intended by the manufacturer will kill you. What distinguishes tobacco from other causes of death and morbidity, Dr. Smoak said, is that the tobacco industry fights back. He cited the Philip Morris suit against San Francisco for its tough anti-smoking ordinances. Nancy Kaufman, V.P., RWJ Foundation, noted several anti-smoking aims: Convincing kids never to light up; Removing tobacco from the children's market place; Helping farmers to convert from tobacco crops; The Smokeless States-and Smokeless Families Programs; Examining tobacco policies;

FEB-22-1994 06:38 FROM BURSON-MARSTELLtR TO 95H75315 P.b3 Examining tobacco industry marketing. GeorQe Lundbera. MD, JAMA editor, noted a continuing campaign for .TAMA to focus on the harms of tobacco (the 8th such issue is coming out presently) . He noted about 1200 tobacco deaths per day as compared to 350 from alcohol use and only 4-12 per day for narcotics. He urged maximum efforts through many societal levels toward all now addicted and for those at risk to become addicted to tobacco. He also stated the aim to provide clear environmental air to all non- smokers, and voiced the opinion that all publications currently carrying tobacco advertising should desist from doing so. David Satcb.er, M.D., CDC Director, called smoking the most preventable cause of death in the U.S. He noted the reduction in smoking since the first surgeon general's report 30 years ago from 45t of adults to 25*. He cautioned, however, that the decline has stalled in the last few years, and voiced particularly concern over teenagers, the only group not to decline from i981- 1991. Dr. Satcher stated that he wishes the anti-smoking focus to be expanded beyond health harms to an understanding of the total social, economica7l and political effects of smoking. He portrayed the battle as one between profit and health, noting the battles of some communities against tobacco ad campaigns. Questions from the press focussed on the portion of the CDC budget devoted to anti-smoking, elementary school education efforts, and differences in smoking addiction and morbidity in minority groups. Micha l Eriksen, M.D., CDC, noted upcoming events (including the Surgeon General Elder's report Thursday, focussing on kids and smoking). and outlined 6 aims: Preventing use among the young; Treating nicotine addiction; Protecting non-smokers;

FEB-22-1994 06:38 FROM BURBON-MARSTELLER TO 99075315 P.b4 Countering advertising and promotion; Pricing and other economic strategies; and regulating tobacco products (labelling, etc.) Dr. Eriksen discussed problems of minor's access to tobacco and advertising (Joe and Josephine Camel) aimed at them. He identified the issue being contested in California and Massachusetts over cigarette tax increases funnelled towards anti-smoking as a "bell.wether" issue. JeEfrev Harris, NID, PhD, MIT, a professor of economics, discussed the likely implications of tax increases -- on revenues and on preventing smoking. He outlined the likely arguments that will be mounted against cigarette taxes and countered them. He discussed growing incentives for manufacturers to focus on tobacco exports. Press questions centered on taxation in Canada and affects on teen smoking, and cigarette smuggling. Gideon Koren, NID, discussed research into effects of smoking on unborn babies through mothers who smoke or who are exposed passively to smoke. He stated that the metabolite of nicotine, cotinine, is a marker for both. Evidence shows that exposure increases chances of premature birth, low birth weight, complications, and sudden infant death. Also, retardation of brain development, shown at ages 6-9 years reflects effects of smoke in the mother's environment. Press questions focussed on the small size of the study, technical points in the study, effects on breast milk, and influence likelihood of later smoking when the child matures. Elizabeth Klonoff, ?hD, California State Universitv presented a study on the sale of single cigarettes to children and adults in convenience stores in two California counties. The study revealed that 51t of stores sold to children (more than to adults). The study examined price and effects of ethnicity --

FEB-22-1994 06:39 FROM BURSON-MPRSTELLER TO 99075315 P.b5 finding that single cigarettes were less expensive and more readily available to children in minority neighborhoods. She concluded that there is a need for further study and greater enforcement. Michael Fiore, MD, MPH, U. of Wisconsin, discussed patterns among those attempting to quit. He stated that the greatest predictor of success was total abstinence for the first two weeks, the period during which withdrawal symptoms are most intense. He discussed use of nicotine patches and counselling, and noted that while 1.3 million successfully quit each year, they are replaced by 1 million children who start annually. Questions focussed on nicotine gum, weight gain after smoking cessation, emotional dependency on smoking, and the effects of cutting down on smoking. John Pierce. PhD, University of California, San Diego, reviewed the effects of targeted advertising on smoking rates in women, pointing out the dramatic increase that coincided with the Virginia Slims ad campaign. He questioned the legality of cigarette advertising in view of other actions against other proven harmful substances. He suggested that the government should ban all tobacco advertising until the industry can prove that it is without harm. 1 In response to questions from the precs as to whether he was suggesting a voluntary cessation of advertising, he affirmed his wish for a mandatory ban. He pointed out that no one admits to being influenced by external factors, but they are there, nonetheless. Other questions focussed on magazine advertising.