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Tobacco Foes in California Think Globally, Act Locally

California is recognized internationally as a trendsetter in discouraging the smoking of tobacco, but the state is having a hard time with its own country.

“California really is widely recognized as a leader around the world,” said Matthew Kohrman, co-director of the Stanford Global Tobacco Free Research Initiative. “Other countries have picked up where California led, but right now, the United States is missing an opportunity to move things forward.”

After more than three decades of scientific verification that smoking tobacco is bad for people’s health, 45 million Americans smoke. About four million smokers live in California, which has the distinction of the second-lowest percentage of smokers in the country. Utah’s 9.8% is lowest, followed by California’s 13.5%.

Smoking costs California an estimated $8.6 billion in direct medical costs and $7.3 billion in lost productivity a year, according to the California division of the American Cancer Society.

At a smoking cessation forum last week in San Francisco, Kohrman urged support for a global tobacco treaty. Formally known as the Framework Convention on Tobacco Control, it is one of the most widely embraced treaties in the history of the United Nations and has been approved by more than 150 countries over the past four years.

But not the United States.

Julie Gerberding, director of CDC and a panelist at the San Francisco forum, agreed with Kohrman.

“This is a global treaty that lays out a framework for controlling tobacco at an international level, and we’re one of the few countries left that hasn’t ratified the treaty,” Gerberding said.

“It’s a very frustrating situation.”

Gerberding called tobacco a global epidemic and urged policy makers, business leaders and health officials to treat it accordingly.

“We should be thinking about it as we do any toxic substance,” she said. “This is a global pandemic.”

Kohrman said there’s little chance the United States will ratify the global treaty under a Bush administration. Gerberding did not disagree.

The treaty establishes legally binding measures regulating tobacco advertising, promotion and sponsorship and limits the tobacco industry’s participation in setting public policy.

New Efforts Under Way in California

Hosted by the Commonwealth Club of California, the wide-ranging forum included announcement of new programs by two large California employers to help their workers quit smoking.

Safeway announced that all of its corporate offices in California will become tobacco-free beginning July 1 and that its regional offices in the U.S. and Canada will become smoke-free beginning Sept. 1.

CalPERS, the nation’s third largest purchaser of health benefits, announced it has asked its three health insurers to boost member participation in smoking cessation programs by 20% next year. CalPERS provides health care coverage to 1.2 million state and local government employees and their families through Blue Shield of California, Kaiser Permanente and Blue Cross of California.

Nancy Snyderman, a physician and medical editor for NBC, served as moderator for two panels featuring addiction experts, employers and government representatives.

Larree Renda, an executive vice president with Safeway, fielded the most pointed questions dealing with Safeway’s selling of cigarettes.

“Like any retailer, we don’t like to decide what our customers can and can’t buy,” Renda said, adding that choosing not to sell tobacco products would hurt Safeway’s profits and drive shoppers to competing stores.

“If the world would reward us, if people would say ‘Good for you Safeway,’ that would be one thing,” Renda said. “But that kind of a decision doesn’t make the radar screen of most shoppers,” she said.

Daniel Zingale — senior adviser to Gov. Arnold Schwarzenegger (R), an unapologetic cigar smoker — said the governor’s administration believes comprehensive health care reform is the best way to deal with smoking in California.

“This governor supports taxing tobacco but we need to change the culture as well,” Zingale said. “We still glorify and romanticize smoking. Beautiful, sexy people are smoking in the movies, on ads. We need to do something about that.”

Three years ago, Schwarzenegger vetoed a bill that would have required health insurers to pay for programs to help people quit smoking.

Another anti-smoking law made it past the governor’s desk last year. Beginning in January, it became illegal for California drivers to smoke with children in the car.

‘Semi-Legal’ Products

After several references to tobacco as a “legal product,” panelist Patrick Reynolds, founder of the Foundation for a Smokefree America, argued that tobacco was no longer entirely legal in many places.

“In 27 states it’s a semi-legal product,” Reynolds said. “Smokers can’t smoke legally everywhere. One of these days we’re going to have a tobacco-free society. It’s coming,” he said.

Congress is considering legislation that would give FDA greater authority to regulate tobacco products. The legislation (HR 1108, S 625) would ban flavored cigarettes except menthol. Flavor additives such as mint, clove and vanilla, which appeal to young people, would not be allowed.

However, menthol, preferred by more than 75% of black smokers, according to government estimates, would be allowed. Fewer than 25% of white smokers use it.

“That is a form of legislated racism,” said panelist Bill Releford, founder of the Black Barbershop Health Outreach Program. “Are we saying African-American lives aren’t as important as other lives? Is this a residue of slavery in this country?”

Phillip Morris, which makes several menthol brands and supports the bill, contends the FDA could ban menthol if it were found to be detrimental to health, but the company claims “menthol does not increase the inherent hazards of smoking.”

Quit Smoking or Lose Your Job

The most drastic incentive to quit smoking offered during the forum came from Howard Weyers, a former high school football coach who now owns a health insurance company in Michigan. He gave his workers an ultimatum: quit smoking or lose your job.

Fifteen months after the first edict, he issued the same ultimatum for spouses – quit smoking or your husband/wife will lose his or her job. Employees and spouses must submit to random testing.

“Your legislature still has you shackled here in California, but in Michigan, there’s no law that prohibits employers from making decisions about who they employ,” Weyers said.

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