Legislation Includes Provisions to Fight Chronic Disease, Encourage Healthier Communities, Schools and Workplaces, and Improve Opportunities for Individuals with Disabilities

Legislation introduced today by Senator Tom Harkin (D-IA), Chairman of the Senate Health, Education, Labor, and Pensions (HELP) Committee, outlines critical public health and prevention initiatives to fight chronic disease, encourage healthier schools, communities and workplaces, and improve physical activity opportunities for individuals with disabilities. The Healthier Lifestyles and Prevention America (HeLP America) Act includes wellness provisions in a broad range of areas, including expanded access to fresh fruits and vegetables for all low-income elementary schools, tax incentives for businesses that offer comprehensive workplace wellness programs to their employees, improved physical activity and athletic opportunities for individuals with disabilities, and greater oversight with regard to food and tobacco marketing.

“Improving public health starts with prevention. Taking steps to improve access to healthier options, exercise opportunities, food labeling, and tobacco cessation will not only help stave off chronic disease—it will also save consumers and taxpayers money in the long run,” Harkin said. “By making health and wellness a key priority in our schools, workplaces, and communities—and by educating people to make informed choices—the HeLP America Act can open the door for more Americans to live longer and more productive lives free from chronic disease.”

Chronic diseases such as heart disease, cancer, and diabetes are among the leading causes of death and disability in the United States, and the economic impact is staggering. More than seventy-five percent of the $2.5 trillion the United States spends on health care annually is due to chronic disease.

Harkin has championed preventive healthcare initiatives throughout his career, including increased access to screenings for breast cancer and other diseases, the school fruit and vegetable pilot program, and tobacco control.  Most recently, as HELP Committee Chairman, Harkin championed the prevention and wellness measures that are included in the Affordable Care Act.  Preventive initiatives in doctors’ offices and the community help rein in costs across the full health care spectrum. The Prevention and Public Health title of the health reform law creates incentives to prevent chronic disease, and requires health insurance companies to cover recommended preventive screenings with no copays or deductibles. The bill introduced today builds upon the prevention and wellness measures contained in the health reform law and includes several new sections that further expand public health and prevention efforts, including encouraging healthier food offerings in our National Parks and increasing opportunities for physical activity in school settings.

Harkin’s legislation has been endorsed by the American Heart Association, the YMCA of the USA, the Center for Science in the Public Interest, Campaign for Tobacco-Free Kids, and Trust for America’s Health. A full summary of the HeLP America Act of 2013 is below:

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The superannuation fund for health and community services workers has become the latest fund to dump its investments in tobacco.

HESTA chief executive Anne-Marie Corboy confirmed the fund had started removing tobacco investments from its portfolios this year, following a decision by the fund’s board late last year.

Ms Corboy said she expected the fund, which has more than 750,000 members, to have sold all its tobacco investments by about April.

She said for more than a decade the fund had allowed members to put together tobacco-free portfolios, and had excluded tobacco from its ethical investment option since early 2012. She said less than $35 million of the $20 billion managed by the fund was invested in tobacco.

Anne Jones, the chief executive of Action on Smoking and Health Australia, welcomed the move.

”If a health fund invests in the tobacco industry, they are part of the tobacco industry,” she said. ”It’s clearly unethical.”

HESTA’s decision comes as the Future Fund weighs what to do with its tobacco investments, worth more than $200 million. Fund chairman David Gonski told a Senate hearing in October the fund had not set out to invest in cigarette makers, but acquired its tobacco shares through investments in fund managers, which often had a mandate to own top-performing stocks.

Ms Jones called on the Future Fund to dump its stake, arguing it was hypocritical for Australia to try to stamp out smoking domestically while profiting from it abroad.

”You can’t have Australia being a leader in tobacco control driving down smoking rates at home but saying it’s OK for us to be investing in getting poor people addicted in other countries,” she said.

In November, the New South Wales government said it would dump more than $200 million in tobacco investments and ban them in future.

First State Super, which has more than 770,000 members and more than $32 billion in funds under management, said in July it had disposed of all its tobacco investments.

The Victorian government’s investment management organisation, the Victorian Funds Management Corporation, has more than $100 million invested in tobacco and has said it has no intention of getting rid of them.

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An extra £500 million a year could be raised in tobacco tax if an independent regulatory agency to cap cigarette manufacturers’ profits was set up, academics have said.

The creation of an ‘Ofsmoke’ agency to regulate the industry – similar to those in force for utility companies – would increase tax revenue and protect public health.

The University of Bath study said the agency would have the potential to increase UK annual tobacco tax revenue by approximately £500 million a year for HM Treasury.

The money would fund, twice over, UK wide anti-tobacco smuggling measures and smoking cessation services in England. Co-authors of the study Dr Robert Branston and Professor Anna Gilmore said regulation would set a maximum price that cigarette companies could charge for their product.

They said that under their plan the retail mark-up would not be affected and neither would the price that consumers pay in shops. Instead a slice of the profits currently accrued by cigarette manufacturers would be transferred to HM Treasury through increased tax. The system would be set up at no cost to the consumer or taxpayer and would be funded instead through a levy or licence fee paid by tobacco companies.

Dr Branston said: “The market has failed to curb cigarette manufacturers in terms of pricing power and profit, and tobacco control policies have unintentionally exacerbated the problem. Clamping down on the extreme profitability of cigarettes would reduce the incentive for tobacco companies to fight public health measures and mean they have fewer funds at their disposal.

“It would also raise the small matter of £500 million for the nation. A move to regulation would make it easier to expand tobacco control policies as companies would be partially insulated against their impact on revenue and, therefore, less able to argue against them.”

Deborah Arnott, chief executive of health charity Action on Smoking and Health, added: “Tobacco multinationals are unique, they make excessive profits despite the fact their products kill half of all their customers.

“They can continue to charge premium prices and make excess profits because their products are cheap to make, highly addictive and competition in such a highly regulated market is so limited. Capping their profits is not extreme it’s essential.”

The study, which has been published in the journal Tobacco Control, is based on the UK – but the researchers are confident the system could be applied to any country where tobacco companies enjoy significant market power.

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California Department of Public Health director and state health officer Dr. Ron Chapman has unveiled new ethnic-market advertisements that will continue to educate Californians on the harmful effects of tobacco use.

An anti-tobacco ad from a previous campaign

The advertisements, which include radio and print ads for the African American market, will start airing in early January and can be viewed atTobaccoFreeCA.com. In California, Black and Hispanic men smoke at higher rates (18.9 percent and 15.5 percent, respectively) than white men (14.3 percent). Among women, Blacks continue to have the highest prevalence (15.2 percent), followed by whites (11.2 percent).

Chapman also released the state’s first “State Health Officer’s Report on Tobacco Use and Promotion,” featuring new data on illegal sales to minors, the disproportionate number of tobacco retailers and advertising in minority and low-income neighborhoods, the effect of tobacco advertising in stores, and troubling tobacco-use trends.

Highlights of the report include:

• Illegal tobacco sales to minors rose to 8.7 percent from 5.6 percent in 2011, which was the state’s lowest rate since the survey began in 1995;
• Smoking prevalence was higher at schools in neighborhoods with five or more stores that sell tobacco than at schools in neighborhoods without any stores that sell tobacco;
• In 2011, young adults 18-24 had the highest smoking prevalence among any age group in California;
• The popularity, promotion and availability of smokeless tobacco have greatly increased – examples include snus (a smokeless, spitless, moist-snuff product) and dissolvable and flavored “orbs” and “sticks” (shaped like Tic-Tacs and dissolvable breath strips, respectively), which are currently being test-marketed in other states;
• In less than a decade, sales of smokeless products have nearly tripled, from $77 million in 2001 to $211 million in 2011; and
• Nearly one-third (32.3 percent) of California stores that sell tobacco had at least one cigarette advertisement less than three feet above the floor, where it is easily seen by children.

In addition to the ads, a new Spanish website, CAsinTabaco, was launched to complement the campaign and to provide the Spanish-speaking community the tools they need to quit.

The California Tobacco Control Program was established by the Tobacco Tax and Health Protection Act of 1988. The act, approved by California voters, instituted a 25-cent tax on each pack of cigarettes and earmarked five cents of that tax to fund California’s tobacco control efforts. These efforts include supporting local health departments and community organizations, an aggressive media campaign, and tobacco-related evaluation and surveillance.

California’s comprehensive approach has changed social norms around tobacco-use and secondhand smoke, resulting in dramatic decreases in smoking in the state. It is estimated that California’s tobacco control efforts have saved more than a million lives and have resulted in $86 billion worth of savings in health care costs. Learn more at TobaccoFreeCA.com.

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The UK government could raise at least £500m a year by capping the amount of profit tobacco companies can make from cigarettes, academics have said.

They are calling for state regulation similar to that used to limit the price of water.

Writing in the journal Tobacco Control, they say reducing profits would allow for higher taxes without changing the price in shops.

However, the industry said the ideas “fly in the face of common sense”.

Dr Robert Branston, from the University of Bath, said the tobacco industry was “incredibly profitable”, with some companies making 67p in profit out of every £1 received after tobacco duties. He described that as an “incredible sum”.

Some industries in the UK are already regulated to prevent companies taking advantage of a lack of competition in the market place. The regulator Ofwat reviews the price water companies can set and Dr Branston wants a similar organisation “Ofsmoke” to limit the profits made by tobacco manufacturers.

The report calculated the effect of limiting profits to levels achieved by food and drinks manufactures in Europe – between 12% and 20%.

Tax potential

Even accounting for the cost of setting up a regulator and a fall in corporation tax paid by the tobacco companies, the researchers estimated there was a large amount of extra tax to be made.

“The results suggest that price caps could give the UK government scope to raise tobacco taxes by approximately £500m annually without affecting the price the consumer pays,” they wrote.

The report said this was the equivalent of funding anti-tobacco smuggling measures across the UK and smoking cessation services in England twice over.

Dr Branston said: “How can you say it is a bad ideas then people are dying? I think there’s a lot going for this personally.”

The Tobacco Manufacturers’s Association said the industry was already high taxed and paid more than £12bn to the Exchequer in 2011-12.

It said: “Some popular cigarette brands are already taxed at nearly 90%, yet this report chooses to ignore this fact and instead concentrate on the profit of a legitimate industry which supports over 70,000 UK jobs.

“The tobacco industry supports any regulation which is necessary, proportionate and evidence-based, but not proposals such as these, which fly in the face of common sense.”

Deborah Arnott, the chief executive of the charity Action on Smoking and Health, said, “Tobacco multinationals can continue to charge premium prices and make excess profits because their products are cheap to make, highly addictive and competition in such a highly regulated market is so limited.

“Capping their profits is not extreme, it’s essential.”

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Last week South Africa became the first country to sign a new international treaty aimed at combating tobacco smuggling.

Minister of Health, Dr Aaron Motsoaledi, signed the Protocol to Eliminate Illicit Trade in Tobacco Products at a ceremony held at the WHO headquarters in Geneva on Thursday. Eleven other countries including China, France, Panama, Turkey and Uruguay have also signed the treaty, which is now open for signature by other countries.

The aim of the treaty is to reduce tobacco smuggling worldwide. It promotes measures that governments can adopt to eliminate smuggling and encourages international co-operation between countries in identifying tobacco smuggling routes and trends, and in apprehending smugglers.

Tobacco smuggling is big business for both the tobacco manufacturers and criminal organisations. Once-secret industry documents reveal that the major tobacco companies have actively participated in smuggling worldwide. They have knowingly supplied tobacco products to criminals involved in smuggling.

Stopping smugglers from obtaining tobacco products by controlling the supply chain is an important aspect of the treaty. The treaty recommends that the supply chain be controlled through licensing of manufacturers; requiring them to verify the bona fides of their customers; tracking the movement of tobacco products across borders as well as tracing the origins of seized goods; better border controls and stronger penalties for smuggling.

The National Council Against Smoking (NCAS) commended the Minister for being the first to sign the treaty. “Reducing the illicit trade in tobacco is an important public health measure,” said Dr Yussuf Saloojee, executive director of the NCAS. “Smuggling makes cigarettes cheaper and so increases sales. It encourages adults to keep smoking instead of quitting after tax increases, and makes tobacco affordable to youth. Higher tobacco sales in turn mean more sickness and death,” he added.

“The level of cigarette smuggling in South Africa is highly over-estimated by the tobacco industry, as this creates pressure on the Treasury to keep excise taxes low. Nonetheless we do not need to combat smuggling and the way to do so is not by lowering taxes but by adopting the measures proposed by the protocol,” Saloojee said.

At the signing ceremony, WHO Director-General Dr Margaret Chan said: “The protocol gives the world a unique legal instrument for countering and eventually eliminating a sophisticated international criminal activity that costs a lot, especially for health.”

The new treaty is the first protocol to the WHO Framework Convention on Tobacco Control. The protocol will enter into force 90 days after the 40th government has ratified it.

The Protocol will help to protect people across the globe from the health risks of tobacco. In SA 44 000 are killed every year due to tobacco – that is three times as many as are killed in road accidents.

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SMOKING MAY be the world’s greatest global health threat. It kills nearly 6 million people a year around the world — more than HIV, tuberculosis, and malaria combined. The United States has done an admirable job of combating this threat within its own borders. But Washington has done embarrassingly little to address the problem overseas.

The US government spends about $8 billion on global health annually, but only about $7 million on tobacco-control efforts overseas, according to Thomas Bollyky of the Council on Foreign Relations. That’s a tiny amount, given the gravity of the problem and the cost-effectiveness of anti-smoking campaigns.

The United States has also failed to ratify the Framework Convention On Tobacco Control, an international treaty aimed at encouraging countries to implement anti-smoking initiatives that were pioneered in the United States, such as warning labels, bans on smoking in public places, and taxes.

Since the United States has already done most of what is required by this treaty, there is little to lose by ratifying it. Doing so would allow the United States to take its rightful place as a global leader on this issue. Instead, US officials had to sit on the sidelines of a recent meeting in South Korea, because the United States is not a party to the pact.

In the 1980s, US officials forced countries that wanted to trade freely with the United States to put out a welcome mat for the Marlboro Man. Thankfully, Congress ended such blatant shilling on behalf of the US tobacco industry in 1998. But US trade negotiators still fight on the side of cigarette companies, under the guise of demanding an even playing field. To join the World Trade Organization, China had to lower tariffs on imported cigarettes from 200 percent to 25 percent.

Despite the enmity between global anti-smoking activists and tobacco companies, there is one area where they might find common cause: combating cigarette smuggling and counterfeiting, which cost governments around the world billions of dollars in lost tax revenues. New efforts to require tobacco companies to put tracking numbers on packages to prevent illicit trade make a lot of sense.

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Women who smoke while pregnant can triple the chances of their child succumbing to a major cause of meningitis, according to new research.

Several studies have already suggested a link between passive smoking and meningococcal disease.

To investigate the association, scientists at the UK Centre for Tobacco Studies carried out a systematic review of 18 studies and pooled their results.

Their study, published in the online journal BMC Public Health , shows that exposure to second-hand smoke both in the home and womb significantly increases the risk of meningococcal disease.

Passive smoking in the home doubled the risk in children and raised it even further in the under-fives.

For children whose mothers smoked during pregnancy, the risk was three times higher than for children born into non-smoking households.

Study leader Dr Rachael Murray, from the UK Centre for Tobacco Studies at the University of Nottingham, said: “We estimate that an extra 630 cases of childhood invasive meningococcal disease every year are directly attributable to second-hand smoke in the UK alone.

“While we cannot be sure exactly how tobacco smoke is affecting these children, the findings from this study highlight consistent evidence of the further harms of smoking around children and during pregnancy, and thus parents and family members should be encouraged to not smoke in the home or around children.”

Scientists estimated that each year in the UK exposure to second-hand smoke led to several hundred extra children being affected by invasive meningococcal disease.

Meningococcal bacteria are responsible for the most dangerous form of meningitis and can also invade the blood, lungs or joints.

One in 20 of those struck by invasive meningococcal disease will die despite medical attention and one in six will be left severely disabled.

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Study: You’ll Likely Feel Worse After Drinking if You’ve Been Smoking, Too

For smokers, it may seem only natural to light up while imbibing at this month’s holiday parties. But a new report published in the Journal of Studies on Alcohol and Drugs suggests that those who smoke cigarettes on the same day they drink heavily suffer worse hangovers than those who stick to booze alone. Brown University researchers analyzed a group of 113 college students at a Midwestern university who tracked their drinking and smoking habits, as well as their hangover symptoms over an eight-week period, reports TIME. Students who drank about six cans of beer per hour and also smoked were most likely to feel the consequences in the morning and suffered the worst hangovers. “This is another reason for people who drink heavily to quit smoking,” Damaris Rohsenow, study author and professor of behavioral and social sciences, told TIME. “It’s not just that the smoking will increase their discomfort the next day, but it may be increasing brain problems in the long run. The fact that smoking aggravates hangover may be a warning sign that people should heed.”

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