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Health Preemption Behind Closed Doors: Trade Agreements and Fast-Track Authority

Eric CrosbieMAMariaelena GonzalezPhD, and Stanton A. GlantzPhD


Noncommunicable diseases result from consuming unhealthy products, including tobacco, which are promoted by transnational corporations. The tobacco industry uses preemption to block or reverse tobacco control policies. Preemption removes authority from jurisdictions where tobacco companies’ influence is weak and transfers it to jurisdictions where they have an advantage.

International trade agreements relocate decisions about tobacco control policy to venues where there is little opportunity for public scrutiny, participation, and debate. Tobacco companies are using these agreements to preempt domestic authority over tobacco policy. Other transnational corporations that profit by promoting unhealthy foods could do the same.

“Fast-track authority,” in which Congress cedes ongoing oversight authority to the President, further distances the public from the debate. With international agreements binding governments to prioritize trade over health, transparency and public oversight of the trade negotiation process is necessary to safeguard public health interests. (Am J Public Health. Published online ahead of print July 17, 2014: e1–e7. doi:10.2105/AJPH.2014.302014)

Read More: http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2014.302014

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Why Uruguay’s David and Goliath fight with big tobacco really matters

LIMA, Peru — A protracted legal battle in an obscure World Bank tribunal over the principles of market competition in a South American backwater. Even by trade dispute standards, this one sounds arcane — the perfect cure for insomnia perhaps.

But before you nod off, here’s a triple shot of espresso:

Uruguay’s fight with Philip Morris, the world’s largest cigarette manufacturer, just might mark a turning point in the global smoking pandemic that the World Health Organization (WHO) expects to cost up to 1 billion lives this century.

Four out of five of those deaths will happen in developing nations, acting like a ball and chain on those countries’ attempts to grow economically and lift hundreds of millions out of desperate poverty.

Philip Morris, whose brands include Marlboro, is objecting to a 2009 Uruguayan law that requires cigarette packs to be 80 percent covered by health warnings, including graphic photos of cancer victims.

Read More>

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New York Victory: Court Upholds Law to Prohibit Tobacco Discounts

In 2013, New York City passed a law (Local Law 1021-A-2013) that sets a minimum price for cigarettes sold in the city. The law also prohibits the use of coupons or promotional discounts to lower that price. Tobacco companies challenged the law on the grounds that it violated their First Amendment right to free speech. Recently, the U.S. District Court for the Southern District of New York returned its decision and upheld New York’s law. photo 2

Increasing the price of tobacco products is the single most effective way to prevent initiation among nonsmokers and to reduce consumption.

The International Agency for Research on Cancer has concluded that a 50% increase in price lowers consumption by 20%. Raising tobacco taxes is particularly effective in reducing youth smoking, as youth often have less disposable income and shorter smoking histories than adults. In high-income countries, a 10% increase in tobacco prices will reduce consumption by about 4%. Read more about price measures here>

In an attempt to offset the rising cost and keep tobacco products cheap and more appealing to young people, tobacco corporations often offer discounts. According to the CDC, tobacco corporations spent $7.76 billion on price discounts and promotional allowances in 2011, just in the U.S. That amounted to 92.7% of all cigarette marketing expenditures. Read more about promotions and marketing here>

New York City’s law is intended to prevent tobacco corporations from circumventing price increases by offering discounts. Tobacco corporations argued that it limits their right to free speech by restricting the dissemination of price information. The Court held that the law is aimed at regulating the price of tobacco products, which serves the city’s legitimate goal of reducing tobacco use. The law does not limit the corporation’s speech about tobacco products, and therefore does not violate the First Amendment. Read the decision here>

This is an important victory for New York and for public health. States, counties and cities can now take steps to prevent tobacco corporations from undermining price increases. Coupon and promotional bans have the potential to be important tools in the fight against tobacco.

Read more about what state and local governments can do to combat the tobacco epidemic and see examples of model legislation in our upcoming Implementation Guide and database. Check back soon!

Please leave a comment below, or continue the conversation with ASH on Facebook or Twitter.

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Action Review: 2nd Quarter Edition 2014

What Makes Tobacco Different?Certification

In recognition of the World Health Organization’s World No Tobacco Day on May 31, 2014, Action on Smoking and Health certified 193 Senators and Representatives “Free from Tobacco Money.” This certification was given to all U.S. Senators and Representatives who have not accepted campaign money from the tobacco industry over the past ten years.

Click here to read what makes tobacco money different>

Click here to read the Press Release>

Click here to see all Recipients>

Program Updates

New Report

Many Americans believe that the war on tobacco has been won, but the fact is the number of smokers is climbing globally. ASH, in partnership with Legacy, released a new report to examine US tobacco control efforts in the 50 years since the release of the 1964 Surgeon General’s Report on Smoking & Health – viewed through a global lense. Read on>



Guest Editorial by Director Laurent Huber discussing why goals to reduce tobacco use must be included in the new set of Sustainable Development Goals (SDGs) currently being negotiated at the United Nations to replace the expiring Millennium Development Goals (MDGs).Read on>


Video Campaign

Young adults make up the largest group of smokers in the US, and they are rarely affected by advertisements about death and lung cancer. So, we worked with some colleagues to reach them in a different way. View the video>

ASH Blog

Tobacco Control News

6 States to lose out on $500 million from tobacco settlement?


US Chamber of Commerce: Facing the Wrong Way

“It always seems impossible until it is done,” – Nelson Mandela

ASH has been very busy throughout this second quarter of 2014 fighting for your health and the health of your loved ones for generations to come.

It is with all of you in mind that we work tirelessly to stop the tobacco industry and to create a tobacco-free world. Our efforts to educate, advocate, and support treaty negotiations result in tobacco control measures being included in laws at the state and national levels, in international trade agreements, and in global health and economic development goals.

Please help us strengthen our fight by making a donation today.

The world is counting on us to stop the disease and death caused by tobacco.  And we are counting on you.



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Smoking Greater Health Threat Than HIV for LGBT Community

Quick—what’s the biggest health risk for gay men? No, it’s not AIDS. And no, it’s not being clubbed by a horde of knuckle-dragging, tobacco-juice-chin-dribbling, conservative troglodytes. Good guess, but the correct answer is smoking.

The latest Center for Disease Control (CDC) statistics show that 20.5 percent of heterosexuals and 30.8 percent of LGBT community use some form of tobacco product. The statistics from the American Lung Association show a similar disparity.

Read more>

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Dementia Linked to Tobacco

Today, the World Health Organization and Alzheimer’s Disease International released the statement below, in conjunction with this Fact Sheet linking tobacco as a risk factor for dementia. New evidence reveals that smokers have a 45% higher risk of developing dementia than non-smokers. Tobacco & Dementia

“This newly-identified link between smoking and dementia provides yet another good reason to quit smoking at any age,” said Laurent Huber, Executive Director of Action on Smoking and Health. “Tobacco kills half of its long term consumers, but this report suggests that even if you are lucky enough to not die prematurely from one of the many diseases caused by tobacco, you might be afflicted by dementia. If we want to increase people’s chances of living long and healthy lives, we need to do everything we can to encourage smokers to quit now.”

This Fact Sheet provides further confirmation that we must implement sound public health measures such as increasing tobacco taxes, banning smoking in public places, banning the advertising of tobacco products, and applying other life saving measures included in the first global public health treaty, the WHO Framework Convention on Tobacco Control.

For an interview with Laurent Huber or Marc Wortmann, Executive Director of Alzheimer Disease International, please contact Megan Arendt (arendtm@ash.org).



Geneva, 9 July 2014: Smokers have a 45% higher risk of developing dementia than non-smokers, according to information published today by the World Health Organization (WHO) in collaboration with Alzheimer’s Disease International (ADI).

Evidence reviewed by WHO reveals a strong link between smoking and the risk of dementia, and the more a person smokes, the higher the risk. It is estimated that 14% of Alzheimer’s disease cases worldwide are potentially attributable to smoking.

WHO warns that exposure to second-hand smoke (passive smoking) may also increase the risk of dementia.

“Since there is currently no cure for dementia, public health interventions need to focus on prevention by changing modifiable risk factors like smoking,” says Dr Shekhar Saxena, Director of the Department for Mental Health and Substance Abuse at WHO. “This research shows that a decrease in smoking now is likely to result in a substantial decrease in the burden of dementia in the years to come.”

Tobacco use is already recognized as the one risk factor common to four main groups of non-communicable diseases (NCDs): cancers, cardiovascular disease, chronic lung disease and diabetes.

“Tobacco is one of the biggest public health threats the world has ever faced, killing nearly six million people a year,” says Dr Douglas Bettcher, Director of the Department for Prevention of Noncommunicable Diseases at WHO. “WHO urges governments to actively implement and enforce the measures of the WHO Framework Convention on Tobacco Control, especially smoke-free environment laws and access to tobacco cessation services”.

Laurent Huber, Director of the Framework Convention Alliance (FCA) for Tobacco Control, comments: “It is no surprise to see these findings confirm that tobacco smoking is a major risk factor for dementia. This adds yet another item to the long list of the devastating consequences of tobacco and gives even more reason for personal and public health action to help people to quit smoking.”

“The research also shows that quitting smoking later in life might be beneficial so encouraging and supporting current tobacco users to quit should be a priority,” says Serge Gauthier, chair of the ADI’s Medical Scientific Advisory Committee.

Dementia affects more than 44 million people worldwide, with almost two thirds of them living in low- and middle-income countries.

“Every year, there are 7.7 million new cases of dementia. In 2010, the global cost was calculated at US$ 604 billion, which represents 1% of global GDP (gross domestic product),” says Marc Wortmann, ADI Executive Director. “No government can ignore the opportunity to link this new information into its planning and health system activities to reduce smoking and control NCDs.”

ADI believes that this information brief can form the basis for countries to add messages about brain health and dementia risk into public health anti-smoking programs and interventions.

For more information visit: http://www.who.int/tobacco/publications/en/

– End –

About Alzheimer’s Disease International

ADI is the international federation of 84 Alzheimer associations throughout the world.  Each of our members is a non-profit Alzheimer association supporting people with dementia and their families.  ADI was founded in 1984 and registered as a non-profit organisation in the USA.  Based in London, ADI has been in official relations with the WHO since 1996 and has had consultative status with the UN since 2012.

ADI’s vision is an improved quality of life for people with dementia and their families throughout the world. ADI believes that the key to winning the fight against dementia lies in a unique combination of global solutions and local knowledge. As such, it works locally, by empowering Alzheimer associations to promote and offer care and support for people with dementia and their family carers, while working globally to focus attention on dementia and campaign for policy change from governments.

For more information, visit www.alz.co.uk

About the World Health Organization

WHO is the directing and coordinating authority for health within the United Nations system. It is responsible for providing leadership on global health matters, shaping the health research agenda, setting norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends.

For more information, visit www.who.int 

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Tobacco regulations improve the health of pregnant women & babies

Between 2005 and 2012, Uruguay instituted a set of strong tobacco control policies. By 2012, the government had banned nearly all advertising, promotion and sponsorship of tobacco products, prohibited smoking in all indoor enclosed public places and workplaces, mandated rotating graphic warning labels covering 80 percent of the front and back of packs, allowed only one cigarette pack presentation per brand, and required healthcare providers to treat nicotine dependence.  In addition, the government moderately raised tobacco taxes.  These measures resulted in substantial declines in nationwide smoking rates.

Click here for the new study released by the U.S. National Bureau of Economic Research on Uruguay’s national tobacco control policies that led to a substantial increase in the likelihood that a pregnant smoker would quit by her third trimester and improved the health of newborns>

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New Jersey Senate passes bill to raise age to buy tobacco products to 21

TRENTON, New Jersey — New Jersey might become the first state in the nation to raise the legal age to purchase tobacco products and electronic cigarettes to 21.

The state Senate on Monday passed a bill that would raise the minimum age. The measure awaits action in the Assembly.

Full Article>

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Tobacco giant initiates EU court challenge

Tobacco giant Philip Morris International (PMI) wants to challenge new EU rules on tobacco to see if it can get the stricter labelling requirements changed.

The Marlboro manufacturer on Friday (27 June) said the EU’s new tobacco products directive “appears to ban truthful and non-misleading claims on the packaging of tobacco products”.

“PMI intends to seek review of whether this ban respects the fundamental rights of consumers to information about the products they are choosing,” it added.

Full Article>

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New Study Reveals No Drop in Use of Smokeless Tobacco for U.S. Workers

According to a recent study by the US. National Institute for Occupational Safety and Health, U.S. workers are continuing, and slightly increasing, their use of smokeless tobacco products. Smokeless tobacco (snuff and chew tobacco) are known to cause oral, esophageal and pancreatic cancer. The study did not include other smokeless tobacco products, such as e-cigarettes and candy-flavored dissolvable tobacco, therefore the usage numbers may actually be underestimated.

Full Article>

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One in Five US Adults Use Tobacco Products

Adult smoking rates have dropped from 42% in 1965 to 21.3% today, but the rate of decrease is slowing, according to the Centers for Disease Control and Prevention’s (CDC’s) latest issue of Morbidity and Mortality Weekly Report (MMWR),released online June 24. The report also found use of cigars and smokeless tobacco products remains unchanged.

Meanwhile, use of electronic cigarettes, or e-cigarettes, is rising rapidly. The number of adults who smoked traditional cigarettes and said they had tried e-cigarettes doubled from 10% in 2010 to 21% in 2011, the CDC reports. The number of high school students who reported ever using an e-cigarette also rose from 4.7% in 2011 to 10% in 2012.

Full Article>

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World Health Organisation says Pacific considering cigarette plain packaging

The World Health Organisation says a number of countries across the Pacific are considering following in Australia’s footsteps and introducing plain packaging of cigarettes.

The WHO is set to join governments across the region in a major drive to make the Pacific tobacco free within 10 years.

The WHO Pacific coordinator of non-communicable diseases, Dr Temo Waqanivalu, says the project will be launched in Honiara in two weeks and plain packaging is among the tactics being considered.

Full Article>

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The Case for Banning Cigarettes Entirely, Forever

Doctors in the U.K. will vote on Tuesday as to whether to support a “campaign to ban forever the sale of cigarettes to any individual born after the year 2000.” It’s an appealing thought exercise for public health types: Smoking rates declined steadily in the late 20th century as the health hazards became more widely understood.

So what would happen if children born in the 2000s—those just now hitting their years of tobacco experimentation—were barred from buying cigarettes—not just until they reach adulthood, but forever?

Read More>

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Tobacco companies have made cigarettes deadlier than ever

Over the last five decades, the tobacco industry has engineered cigarettes to be more addictive — and has also made them more dangerous.

Smokers suffer from higher risk of lung cancer and chronic obstructive pulmonary disease (COPD) todaycompared to 1964, when the very first Surgeon General’s report on cigarettes was issued.

Read More>

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Plain packaging pushes cigarette sales down

The Australian federal Treasury has entered the debate over cigarette sales, publishing previously secret information that shows sales falling since the introduction of graphic health warnings and plain packaging.

The Treasury collects data on sales per stick in order to levy tobacco excise, but has until now withheld it from publication to protect commercially sensitive information.

Read More>

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NYC’s cigarette price-hiking regulations ruled legal

A legal challenge to a new law aimed at keeping New York City tobacco prices sky high​ has gone up in smoke.

Manhattan federal Judge Thomas Greisa on Wednesday sided with the city in a lawsuit filed in January by tobacco companies and trade groups representing cigarette retailers.

Greisa in a 36-page ruling said pricing regulations signed into law last November by then-Mayor Bloomberg – which set the minimum price for cigarette packs at $10.50 and prohibited the use of coupons and other promotional discounts to lower that price — pass legal muster and don’t violate free speech rights protected under the First Amendment.

Read More>

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Electronic Cigarette Executives Get Schooled In Senate Hearing

“I think we have seen this movie before,” Senator Richard Blumenthal said. “It is called big nicotine comes to children near you and you are using the same kinds of tactics and promotions and ads that were used by big tobacco and proved so effective”

In a hearing Wednesday afternoon that harkened back to the famous congressional Big Tobacco hearings two decades ago, Senators on the Commerce, Science and Transportation Committee eviscerated electronic cigarette executives Jason Healy, CEO of blue eCigs (owned by tobacco company Lorillard), and Craig Weiss, CEO of NJOY, leaders of the two leading electronic cigarette brands.

Full Article>

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New Jersey Gets $92 Million After Restructuring Tobacco Bonds

New Jersey reached a deal to obtain almost $92 million for its general fund by pledging the remainder of its revenue from the national tobacco settlement to investors. The bolstered payment pledge made trading prices on bonds linked to the agreement more than triple from March 3.

Full Article>

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Real data show that plain packaging IS working in Australia

The Australian’s ‘exclusive’ story on plain packaging is just plain wrong.

Watch more here>

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Why big tobacco companies are betting on e-cigarettes

Electronic cigarettes, promoted as a healthier alternative to tobacco, are getting powerful new backers with an unhealthy reputation: big tobacco companies.

The development points to ways Big Tobacco is moving to turn the young e-cigarette market to its advantage. 

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E-Cigarettes May Get Advantage for Not Containing Tobacco

Electronic cigarettes may be closer to smoking cessation devices than regular smokes and regulators are keeping “an open mind” on their potential health benefit, said the top U.S. official overseeing their use.

In comments that may boost the developing $3 billion e-cigarette market, Mitch Zeller, head of the Food and Drug Administration’s Center for Tobacco Products, said the agency is exploring expedited reviews for tobacco products based on risk and toxicity as it prepares its e-cigarette rules.

Full Article>

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Cigarette packaging: Republic of Ireland bid to ban branded tobacco

The Republic of Ireland has become the first country in Europe to try to pass a law banning the sale of branded cigarette and tobacco packets.

The proposed legislation would force tobacco firms to use plain packaging, removing all logos and trademark colours from cigarette packets.

Read Full Article>

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Child workers in danger on US tobacco farms

HRW documents the shocking conditions on tobacco farms in the US, where child workers are exposed to nicotine, toxic pesticides and other dangers.

Human Rights Watch’s recent report, Tobacco’s Hidden Children: Hazardous Child Labor in US Tobacco Farming, documents conditions under which children – ages seven to 17 – work on tobacco farms. Research was done in the four states where 90% of US tobacco is grown: North Carolina, Kentucky, Tennessee, and Virginia.

Full Article>

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U.S. Patent Allowed For 22nd Century Group’s Technology to Regulate Nicotine Levels in Tobacco

22nd Century Group, Inc. (NYSE MKT: XXII ) today announced that on June 9, 2014 the U.S. Patent and Trademark Office (USPTO) issued a Notice of Allowance to the Company for technology that reduces nicotine in tobacco by suppressing expression of the NBB gene by itself and in combination with other nicotine biosynthesis genes.

Full Article>

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Why Read the ASH Report?

It can be hard for modern Americans to understand the amount of influence and harm US society has suffered as a result of tobacco.  It’s easy to see the disconnect, as it has been over five decades since more than ½ of the men and a 1/3 of the women in the US smoked.  50 years ago, smoking was everywhere, from hospitals to schools. ASH Report 1

There is no doubt that the US has come a long way in combating the death and disease caused by tobacco. Smoking bans have swept the country, tobacco advertisement is limited, and the overall prevalence of smoking has fallen significantly.  For all intents and purposes, it might appear as if the fight against tobacco has been won until we look at the devastating statistics.

  • If you are concerned with health, it is important to note that tobacco is still the number one preventable cause of death. Approximately 18% of adults still smoke in the US, and there are 1 billion smokers worldwide.
  • If you are concerned with saving lives, it is important to note that tobacco kills 480,000 people annually in the US; that’s more than murders, car accidents, and HIV/AIDS combined. 6 million die worldwide each year from tobacco related illnesses, and 100 million were killed in the 20th century alone.
  • If you are concerned with our economic future, it is important to note that the tobacco burden on our economy is approximately $300 billion in indirect and direct costs; and
  • If you are concerned with social responsibility, it is important to note that the tobacco industry has a vested financial interest in maintaining a high level of nicotine addiction.


The facts are staggering, but what the ASH “Avoidable Death” report demonstrates is that there are tools available to combat this ongoing epidemic.  The Framework Convention Alliance on Tobacco Control (FCTC) recognizes the uniqueness of tobacco, the only consumer product that when used as intended kills.

There is a set of scientifically validated measures contained in the FCTC that represent the collective wisdom of decades of global efforts to reduce tobacco use.  650 million unborn lives can be saved.

There are places in the world right now that have utilized measures from the FCTC guidelines to strengthen their national tobacco control policies.  Countries have recognized the importance of safeguarding their citizen’s health, and it is time for the US to intensify efforts to protect health by following suit.

Read Full ASH Report>

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