Greg Connolly

Rendez-vous 156
October 23, 2005

Greg is now Professor of the practice of public health at Harvard University.

I last interviewed Greg on December 15, 1999. 5 years later, he is still the same combative and persistent activist.

Q1.Massachusetts used to be at the forefront of tobacco control. What is the situation now? What happened?

Currently, the Massachusetts budget for tobacco control is $3.5 million, about a tenth of what it was just three years ago.

These funds are used to provide assistance to smokers who want to quit and helping cities and towns enforce laws prohibiting smoking in work sites and sale of tobacco products to minors. The tobacco Education Media campaign has been eliminated as well as direct smoking cessation services, youth programs, research programs, and programs for minority population.

In 2003, the Governor eliminated the program and the legislature failed to restore it. Tragically, over the previous ten years, the state's revenue from cigarette excise and sales taxes and payments from the Master Settlement agreement rose from $160 million to $950 million while expenditures for tobacco control fell from $56 million in 1993 to zero in 2003. The cuts were driven by a large state budget deficit, a perception among lawmakers that the programs short term success meant the program was no longer essential and finally the influence of the tobacco industry which was threatened by the aggressive nature of the campaign including the first in the nation law requiring disclosure of ingredients and a ban on advertising near schools and the massive decline (50%) in cigarette sales also upset the industry. What Massachusetts was doing was quickly becoming the standard for other states.

Q2. You went from the Health Department to Harvard University .
Can you tell us about this transition, what you have been doing and what your next projects are (if they are not kept secret).

The transition from a public health position to an academic post is not an easy one. The missions of a public health agency and academic institution are different. The former is to improve health and that latter to conduct research and train students. As a public health administrator, one has authority, resources and the ear of media to improve health. However, this "power" often results is aggressive attacks by an industry that is effective (tobacco) and by politicians who often side with special interests and not the public. At Harvard, we are researching the manufacturing and marketing of new tobacco products including the so called "safer" products and "fire safe" products. We are studying the internal tobacco industry documents on cigarette design, sensory perception and addiction laying the foundation for future possible regulations of tobacco products. Finally, we are studying how clean in-door air laws impact worker health and the hospitality industry.

Q3. Activists in Florida are collecting signatures to change the state constitution to make sure funding for tobacco control programs is not diverted. Can you comment on this initiative?

It is my understanding that unlike Florida, the Massachusetts constitution (written by John Adams) doesn't allow a voter initiative (ballot question) to amend the constitution.

Q4. You have been traveling recently in Europe (and maybe elsewhere) to consult about tobacco control policies. Can you tell us about this experience, what you have seen, what do you think the priorities are in other countries? More specifically how do you assess the role of the EU?

I am doing work with the Open Society Institute in the Eastern European countries of Armenia, Georgia, Moldavia, and Ukraine and am also working with the Harvard Cyprus Institute on tobacco control in the Eastern Mediterranean. I have worked with Thailand and other South East Asia nations in the past as well as Ireland , the U.K. and Sweden . What's rewarding is to see how Clean Air Policies are quickly becoming a priority for many nations. Such policies are the cornerstone of tobacco control as well as price increases. The EU can play a very important role in advancing European and global tobacco policies. However, my sense is that the Commission will leave Clean Air Policies to the individual nations during the next few years and limit activities to implementing existing directives on labeling and banning advertising. One major disappointment with the EU has been the quality of its tobacco education media campaign. In the US we found such campaigns are essential to supporting state clean air policies and exposing the behavior of the tobacco industry. The EU is missing a great opportunity in this area as well as in the area of suing the tobacco industry. Finally, the EU's support of comprehensive tobacco control programs and research is a pittance compared to what is spent in the US. EU support will only grow smaller as the tobacco subsidy program is phased out.

My sense is that the tobacco industry wants the debate to go away by allowing WHO member states to ratify most provisions of the Framework Convention on Tobacco Control except price increases through taxation. I believe the industry can live with package warnings, ad bans and unenforced laws banning smoking in work sites. The challenge to the EU is to provide the resources and political leadership to implement new laws and as Ireland did aggressively educate the public about the dangers of secondhand smoke and enforce the law.

5. Are we making progress? What should be our utmost priorities?

We are making progress but only in the handful of nations that provide the resources and political leadership to implement effective laws and programs such as Ireland, Norway and Sweden. Our priorities should be raising taxes and dedicating a portion for comprehensive tobacco control, banning smoking in all workplaces including bars and restaurants and securing the political will to achieve the above. Massachusetts has provided the social strategy to do this but failed to maintain it in the face of budget deficits and tobacco industry opposition. Hopefully, other nations will learn from the Massachusetts experience and truly make smoking history.

Thank you Greg for taking the time to answer my questions.

In 2003, the Governor eliminated the program and the legislature failed to restore it. Tragically, over the previous ten years, the state's revenue from cigarette excise and sales taxes and payments from the Master Settlement agreement rose from $160 million to $950 million while expenditures for tobacco control fell from $56 million in 1993 to zero in 2003. The cuts were driven by a large state budget deficit, a perception among lawmakers that the programs short term success meant the program was no longer essential and finally the influence of the tobacco industry which was threatened by the aggressive nature of the campaign including the first in the nation law requiring disclosure of ingredients and a ban on advertising near schools and the massive decline (50%) in cigarette sales also upset the industry. What Massachusetts was doing was quickly becoming the standard for other states.

Q2. You went from the Health Department to Harvard University .
Can you tell us about this transition, what you have been doing and what your next projects are (if they are not kept secret).

The transition from a public health position to an academic post is not an easy one. The missions of a public health agency and academic institution are different. The former is to improve health and that latter to conduct research and train students. As a public health administrator, one has authority, resources and the ear of media to improve health. However, this "power" often results is aggressive attacks by an industry that is effective (tobacco) and by politicians who often side with special interests and not the public. At Harvard, we are researching the manufacturing and marketing of new tobacco products including the so called "safer" products and "fire safe" products. We are studying the internal tobacco industry documents on cigarette design, sensory perception and addiction laying the foundation for future possible regulations of tobacco products. Finally, we are studying how clean in-door air laws impact worker health and the hospitality industry.

Q3. Activists in Florida are collecting signatures to change the state constitution to make sure funding for tobacco control programs is not diverted. Can you comment on this initiative?

It is my understanding that unlike Florida, the Massachusetts constitution (written by John Adams) doesn't allow a voter initiative (ballot question) to amend the constitution.

Q4. You have been traveling recently in Europe (and maybe elsewhere) to consult about tobacco control policies. Can you tell us about this experience, what you have seen, what do you think the priorities are in other countries? More specifically how do you assess the role of the EU?

I am doing work with the Open Society Institute in the Eastern European countries of Armenia, Georgia, Moldavia, and Ukraine and am also working with the Harvard Cyprus Institute on tobacco control in the Eastern Mediterranean. I have worked with Thailand and other South East Asia nations in the past as well as Ireland , the U.K. and Sweden . What's rewarding is to see how Clean Air Policies are quickly becoming a priority for many nations. Such policies are the cornerstone of tobacco control as well as price increases. The EU can play a very important role in advancing European and global tobacco policies. However, my sense is that the Commission will leave Clean Air Policies to the individual nations during the next few years and limit activities to implementing existing directives on labeling and banning advertising. One major disappointment with the EU has been the quality of its tobacco education media campaign. In the US we found such campaigns are essential to supporting state clean air policies and exposing the behavior of the tobacco industry. The EU is missing a great opportunity in this area as well as in the area of suing the tobacco industry. Finally, the EU's support of comprehensive tobacco control programs and research is a pittance compared to what is spent in the US. EU support will only grow smaller as the tobacco subsidy program is phased out.

My sense is that the tobacco industry wants the debate to go away by allowing WHO member states to ratify most provisions of the Framework Convention on Tobacco Control except price increases through taxation. I believe the industry can live with package warnings, ad bans and unenforced laws banning smoking in work sites. The challenge to the EU is to provide the resources and political leadership to implement new laws and as Ireland did aggressively educate the public about the dangers of secondhand smoke and enforce the law.

5. Are we making progress? What should be our utmost priorities?

We are making progress but only in the handful of nations that provide the resources and political leadership to implement effective laws and programs such as Ireland, Norway and Sweden. Our priorities should be raising taxes and dedicating a portion for comprehensive tobacco control, banning smoking in all workplaces including bars and restaurants and securing the political will to achieve the above. Massachusetts has provided the social strategy to do this but failed to maintain it in the face of budget deficits and tobacco industry opposition. Hopefully, other nations will learn from the Massachusetts experience and truly make smoking history.

Thank you Greg for taking the time to answer my questions.