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Where there’s smoke there’s money:

Where there’s smoke there’s money:. Campaign contributions and U.S. government efforts to derail the Global Tobacco Treaty Martin Donohoe. Tobacco – Weapon of Mass Destruction. 1.3 billion smokers 84% in developing countries 43 million (20% of adults) in U.S.

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Where there’s smoke there’s money:

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  1. Where there’s smoke there’s money: Campaign contributions and U.S. government efforts to derail the Global Tobacco Treaty Martin Donohoe

  2. Tobacco – Weapon of Mass Destruction • 1.3 billion smokers • 84% in developing countries • 43 million (20% of adults) in U.S. • 5.7 trillion cigarettes smoked/yr worldwide

  3. Tobacco – Weapon of Mass Destruction • 5.4 million deaths/yr worldwide (1/10 deaths) • Estimated 8-10 million by 2030 • Leading cause of death in U.S. • 450,000 deaths/yr from smoking • 50,000 from environmental tobacco smoke (ETS)

  4. Tobacco – Weapon of Mass Destruction • Numerous health consequences • Heavily pesticide-dependent crop • Tobacco industry has lobbied to weaken environmental regulations

  5. Tobacco – Weapon of Mass Destruction • Direct medical costs = $75 billion/yr • Medical care and lost productivity due to tobacco use costs each U.S. citizen $550/yr

  6. Smoking Prevention and Cessation • Over the last 10 years, only 3.2% of state revenues from tobacco taxes and settlement money spent on prevention and cessation • Average tax = $1.19 per pack (7ȼ/pack SC to 2.75/pack NY • Society saves $3 in medical costs for every $1 spent to prevent smoking; $50 per $1 in CA per 2008 study

  7. Smoke-Free Legislation 1975: Minnesota passes first clean indoor air law 1999: All 50 states and D.C. have some public smoking restrictions

  8. Smokescreen • Cigarettes most marketed products in the world • $2 billion/year in the U.S. • 3 largest companies have combined annual revenues exceeding $121 billion (2007) • U.S. leading exporter of cigarettes • U.S. tax money used to assist corporations in their marketing efforts overseas

  9. WHO Framework Convention on Tobacco Control Treaty • Finalized 2/27/05 • Ratified by 163 nations (as of 3/09) • Including Russia, Canada, Australia, Mexico, and the UK • Another 8 have signed but not yet ratified/approved

  10. WHO Framework Convention on Tobacco Control Treaty • Exempts tobacco control from free trade challenges • Limits tobacco advertising • Cracks down on tobacco smuggling • Bans tobacco sales to and by minors

  11. WHO Framework Convention on Tobacco Control Treaty • Promotes agricultural diversification and alternative livelihoods for tobacco farmers • Standardizes packaging • Bans deceptive terms such as “light” and “mild” • Improves warning labels

  12. U.S. Efforts to Undermine the Treaty • Despite overwhelming U.S. and international public support for the goals of the treaty… • U.S. government attempted to scuttle the treaty in the name of free trade and free speech • Tobacco industry documents show attempt to create alternative through Project Cerberus

  13. U.S. Efforts to Undermine the Treaty • Original U.S. negotiator Thomas Novotny resigned after the Bush administration pressured him to lobby for the deletion of 10 of 11 treaty provisions, as outlined in a Phillip Morris memo

  14. Phillip Morris and Altria • Phillip Morris = world’s largest tobacco company • Parent company = Altria (also owns 85% of Kraft Foods and 28 % of Miller Brewing) • 2008: Phillip Morris International becomes independent company, separates from Phillip Morris USA and Altria

  15. U.S. Efforts to Undermine the Treaty • U.S. Belatedly signed on 5/3/05 • Senate must ratify AND President must sign • Administration has not submitted treaty to Congress – “studying it”

  16. Bush Administration Ties to the Tobacco Industry • Karl Rove (Deputy Chief of Staff and Senior Advisor) – lobbyist/strategist for PM • Kirk Blalock (White House liaison to the business community) – PM public relations official

  17. Bush Administration Ties to the Tobacco Industry • Charles Black (informal advisor to Bush during 2000 campaign) – PM lobbyist • Daniel Troy (former FDA Chief Counsel) – represented tobacco industry when it sued the FDA over tobacco ad regulation

  18. Bush Administration Ties to the Tobacco Industry • Tommy Thompson (HHS Secretary) • received $72,000 in campaign contributions from PM executives when he was governor of Wisconsin • advisor for the primary tobacco lobbying firm in D.C. • Rejected his own advisory panel’s recommendation to increase federal tobacco tax

  19. Bush Administration Ties to the Tobacco Industry • British American Tobacco PLC’s Brown and Williamson unit and RJ Reynolds Tobacco Holdings, Inc. represented by Barbour, Griffith and Rogers • Lobbying firm stocked with Republican operatives, including: • Haley Barbour – former GOP Chairman, MS governor • Lanny Griffith – White House aide to GHW Bush

  20. Obama Administration Ties to the Tobacco Industry • US Trade Representative Ronald Kirk • Former PM lobbyist • Opposed smoking ban at Dallas airport when mayor of Dallas in early 1990s • Has opposed federal excise tax on tobacco

  21. Campaign Contributions • $3.5 million (through individual contributions and PACs) in 2004 • 74% to Republicans • $20 million to Republican candidates for federal office since 1997 • PM – leading overall campaign contributor to Republicans since 1989

  22. U.S. Non-Cooperation on International Treaties • Failure to sign or approve: • Kyoto Protocol on Climate Change • Convention on the Prohibition of Anti-Personnel Land Mines • Cluster Bomb Ban • Comprehensive Nuclear Test Ban Treaty • Convention on the Rights of the Child

  23. U.S. Non-Cooperation on International Treaties • Failure to sign or approve: • Convention on the Elimination of Discrimination Against Women • Convention on Economic, Social and Cultural Rights • Convention for the Suppression of Traffic in Persons • Failure to pay full U.N. dues • Opposition to International Criminal Court

  24. Health Care Organizations and Medical Schools • As of 2009: insurers (including some of the largest owners of HMOs) and mutual funds heavily invested in tobacco stocks • Prudential - $1.4 billion; Sun Life - $1 billion; Standard Life - $950 million • TIAA-CREF (whose mutual funds are owned by many health professionals) owns over $700 million in Phillip Morris stock.

  25. Health Care Organizations and Medical Schools • 1996-1998: PM and Cigna collaborated to censor accurate information on the harms of smoking and ETS from health newsletters • Tobacco companies sponsored “research” to refute links between tobacco and disease

  26. Health Care Organizations and Medical Schools • Tobacco industry has “white-coated” itself since the 1940s • Borrowing from medicine’s prestige and public esteem in ads featuring smoking doctors

  27. Health Care Organizations and Medical Schools • As of late 2004, despite a decade’s old plea from the AMA for medical schools to divest their tobacco holdings, some of the nation’s leading medical schools had failed to do so: • Cornell, Duke, Washington University, Yale, and possibly Penn (refused to answer requests) • Columbia is said to have divested, but could not provide details to confirm

  28. Smokefree Hospitals 1993: JCAHO mandates that all hospitals seeking accreditation adopt smokefree indoor work policies Over 45% of US hospitals have smokefree policies by the end of 2008 (>50% expected by end of 2009) 2/3 of Oregon hospitals smokefree Higher quit rates, faster quitting, less second hand smoke exposure at smokefree hospitals

  29. Conclusions • U.S. resistance to / attempts to scuttle global tobacco treaty squanders opportunity for U.S. to take lead on important international public health issue • Represents callous disregard for human health and world economy

  30. Conclusions • Some health care organizations and medical schools have failed to provide ethical and moral leadership in anti-tobacco crusade • Government / health care community’s obstructionism and failure to lead likely due to influence of campaign contributions / research funding

  31. Recommendations • President should send Treaty to U.S. Senate, which should immediately ratify, and President sign • Campaign finance reform • Strengthen smoke-free legislation

  32. Recommendations • Medical schools and health care organizations should immediately divest all tobacco holdings • Health care professionals should lobby their institutions and legislators to take the lead in the war on tobacco • Increase tobacco taxes, spend more on prevention and cessation programs

  33. Recommendations Media should more aggressively expose tobacco industry machinations Ban tobacco sales in pharmacies

  34. Family Smoking Prevention and Tobacco Control Act of 2009 • Tobacco companies must provide ingredients to govt.; govt. will regulate harmful ingredients • Govt. cannot ban cigarettes, reduce nicotine content to zero, set underage limit of more than 18 • Bans “light” and “low tar” labels; menthol flavoring still allowed

  35. Family Smoking Prevention and Tobacco Control Act of 2009 New, larger set of warning labels Limits on public advertising in publications with high numbers of young readers Bans sponsorships of sports and entertainment events Restricts vending machines to adult-only venues

  36. Family Smoking Prevention and Tobacco Control Act of 2009 • Supported by Phillip Morris • Possibly to solidify its dominant market position • May mitigate the legal liabilities of tobacco companies

  37. For references, see: Donohoe MT. Cigarettes: The other weapons of mass destruction. Medscape Ob/Gyn and Women’s Health 2005;10(1): posted 4/5/05. Available at http://www.medscape.com/viewarticle/501586

  38. Contact Information Public Health and Social Justice Website http://www.phsj.org martindonohoe@phsj.org

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