Friday, August 6 , 1999
Thank you Joseph for accepting our " rendez-vous ". May I ask you to introduce yourself ?
I am a family physician and a Professor of Family Medicine and Community Health at the University of Massachusetts Medical School.
I have been doing tobacco control research since 1980.
I started with publicizing the fact that tobacco contains radioactive elements. When this received so much publicity I went on to demonstrate that smokers have 50% more motor vehicle accidents.
Later I became the first person to perform tobacco compliance checks using my 11 year old daughter to purchase tobacco.
For several years I published the Tobacco Access Law News in order to stimulate and coordinate those interested in pursuing this approach to Tobacco Control.
I have had a string of articles concerning tobacco access and remain active in research on that topic.
I was the author of one of the three Joe Camel studies.
It was my complaint to the FTC that eventually led to the withdrawal of Joe Camel.
I have also published two important review articles which outlined for the first time how many children are made sick or killed by adults' use of tobacco.
1. Your study of "State and federal revenues from tobacco consumed by minors" has just been published in the July issue of the American Journal of Public Health (unfortunately it is not available on line). Could you give us a résumé of your findings?
An estimated 3.76 million daily smokers aged 12 through 17 years consume an estimated 924 million packs of cigarettes per year, generating $222 million in federal tax revenues, $293 million in state tax revenues, $480 million in tobacco company profits, and producing a retail value of $1.86 billion.
2. Those numbers indicate that the tobacco companies are making more profit from minors ($480 million) than the American Legacy Foundation will receive each year ($300). Do you have any idea how much the tobacco control budgets are at the federal and state levels compared to the taxes collected?
I don't have any figures on that but it is obvious that with the possible exception of a small handful of states like California, Massachusetts, and Arizona that the state is taking in far more than it is expending to fight the problem. The Congress approved of only $34 million for the FDA to regulate tobacco.
3. You propose that the revenue from these sales be used to fund enforcement of tobacco sales laws. Does this seem likely and do you believe all of the money should be spent on this?
Despite a federal mandate requiring states to enforce their tobacco sales laws I doubt if more than a half dozen states actually spend money on this.
My point is that the barrier to enforcing these laws is not that the states are bankrupt, the barrier is a political one in which state legislatures take the money from these sales and then refuse to allocate any of it to solving the problem.
It is my personal belief that using the money for enforcement would be the most cost effective way to spend the money on tobacco control.
Media campaigns can have an impact but they are very expensive in comparison to enforcement.
Surveys show that most kids obtain tobacco from their friends but where do their friends get it?
Jean Forster has demonstrated that the kids who are buying tobacco from stores are the ones who are supplying their friends.
It is theoretically possible that eliminating commercial sources will also reduce the availability of tobacco to kids who are downstream.
In an upcoming article I will demonstrate that effectively enforcing tobacco sales laws in every state in the US would cost less than $250 million dollars per year.
A one cent tax on a pack of cigarettes would fully pay for this.
Sates like California, Mass and Arizona that have cigarette taxes dedicated to tobacco control programs spend many times this amount on tobacco control but do not have adequate enforcement programs.
Enforcement can be done well and still leave plenty of funds left over for other tobacco control initiatives.
From our local experiences, I believe that every tobacco retailer has to be tested several times each year, three to four or more.
These inspections must include underage purchase attempts and must be associated with a penalty.
The most effective and least expensive programs include licensing of all tobacco vendors with a provision that the license may be revoked or suspended for repeated violations.
The cost of these inspections have been as little as $4 per inspection when added on as a marginal cost for a local police department (in other words, only the additional time for the police and expenses directly related to the enforcement are tallied).
When performed by private contractors costs run around $15 to $20 per inspection.
4. The main feeling I have pondering those stats is that the
corporations and the states are fundamentally partners as one Canadian
CEO recently stated.
They are partners in making money out of smokers and very reluctant
to seriously challenge the way tobacco products are marketed. Don't you
think the numbers you underline clearly show this "partnership"?
I don't. If the government were interested in making more money off of tobacco they could simply jack up the tax.
I don't think any of the politicians outside of the tobacco belt really worry about the possibility that people will stop smoking.
I think the lack of action is due to political contributions.
In the area of enforcement I think the retail arm of the tobacco industry is far more powerful in stopping legislation than the tobacco manufacturers.
5. You have been active in tobacco control for a long time. What is missing? What is the most needed? What are you wishing for?
What is missing is campaign finance reform.
The tobacco industry has no constituency in 95% of states and yet they control the political agenda in almost every state house and in Washington.
To me, that indicates that our political system is largely corrupt.
I believe that although the medical profession can supply the evidence needed, only the lawyers and politicians are capable of halting the tobacco epidemic.
The solution is more litigation to hold the companies responsible for the consequences arising from the use of their products and more regulation.
Litigation is a way to "regulate" tobacco without the participation of elected officials.
Unfortunately elected politicians are often ready to rescue the tobacco industry from receiving their just rewards from the court system.
Thank you Joseph for taking the time to be with us today.
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