The Network

for LGBT Tobacco Control

CDC Releases Historic Disparities Report: News on LGBT Health? No Data.

Scout
Director, Network for LGBT Health Equity

CDC Releases First of New Reports on Health Disparities

I have to confess, back in college when I worked at a health library, there was one publication that I would regularly mock, the Morbidity and Mortality Weekly Report. Yup, nothing seemed to quite encapsulate “scintillating” as much as that title. Sigh, which is why I guess it’s now my lot to actually list that as one of my most used resources in my adult life. Can’t even remember what was funny about it now because it’s just the highly esteemed MMWR in my mind, source of all of CDC’s breaking news and information on population health trends of every stripe. Well almost every stripe.

So, Friday CDC used the MMWR to release the first in a regular series of reports on health disparities. We had a heads up midyear this report might exclude LGBT folk altogether, so we did a little work a ways back to confirm that it would not make that big omission, and Friday we were happy to see that yes, LGBT people were in the report. But, the news is … barely.

LGBT Inclusion?

First flip was to the chapter on tobacco. Now we know that CDC included an LGBT measure on their recent National Tobacco Survey, but unsure if these data could make it into this report. And the verdict is? The chapter notes increased LGBT tobacco prevalence (great!), but “Although multiple tobacco-related disparities exist, this report highlights only racial/ethnic and socioeconomic disparities because of limited data for other demographic groups.” Sigh, ok.

What about the chapter on suicide? Sadly news just came across my desk earlier this morning about yet another gay youth who allegedly committed suicide after experiencing bullying at school. So what does CDC say about LGBT suicide rates? That they are nearing epidemic proportions? Not exactly. Eighth paragraph or so of that chapter includes this line: “Because the variables included in U.S. mortality data are limited, the results cannot be used to determine potential factors related to such disparities as mental or physical disability, sexual orientation, or income.”

In desperation, I flip to the chapter on HIV, sure enough there I can at least find some data for MSM (Men who have Sex with Men) health disparities. But even then, I scratch my head, has the flaw of categorizing transgender women as men been fixed yet? Despite shockingly high rates of infection reported by some transgender needs assessments, this information remains hidden with the current HIV reporting methods.

No LGBT Data Now But CDC Calls For Change!

Well, many of us already know one of the biggest problems with federal health systems is they don’t collect any LGBT data, therefor unwittingly hiding all our health disparities. So the gaps in this report are distressing, but aren’t really news. So, does CDC address this at all? I’m happy to say yes they do. In the introductory Rationale For Regular Reporting on Health Disparities and Inequalities chapter their longest paragraph is titled Gaps in Data Regarding Sexual Orientation. The paragraph reviews how Health People 2010 highlighted population disparities by measures including sexual orientation (Healthy People 2020 includes gender identity in this lineup) but briefly reviews how this goal wasn’t matched with supporting data collection. They review the few federal surveys that have any data at all and strongly conclude:

“To fill this notable data gap, national and state surveys should begin consistently and routinely measuring sexual identity, orientation, and behavior. Data collection should be expanded to include not only age, sex, education, income, and race/ethnicity, but also disability, geographic location, and sexual identity or sexual orientation. Only then can health disparities be measured thoroughly and accurately nationwide.”

Excellent! Hear hear! How wonderful that CDC is calling for an end to this data desert that is holding back so much work on LGBT health disparities! (And let’s hope the gender identity inclusion gets carried over from HP2020 as well.)

Change Starts At Home: CDC Funds Major Data Collection

CDC controls many of the pursestrings for major health data collection systems. Looking at Grants.gov I see that as we speak states are finalizing their proposals to CDC for $45M they are offering for state health data collection through the BRFSS (Behavioral Risk Factor Surveillance System), I know CDC puts out even more for the youth version of that survey, the Youth Risk Behavior Survey. But right now, $0 of that $45 million goes to LGBT data collection. (though some states take the initiative to add it themselves) While it’s hard to see how invisible we are in the newly released health disparity report, perhaps the call for data can shepherd in a new era. But until we see tested LGBT measures on every major health survey I hope we keep reminding policymakers at every opportunity: stop allowing LGBT health disparities to be hidden.

See Full Disparities Report here.

Also let me give a big shout out of thanks to all the LGBT community members and allies at CDC that helped shine this spotlight on LGBT data gaps and health issues.

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January 18, 2011 Posted by | Uncategorized | , , , , | 3 Comments

CDC’s National Tobacco Control Networks Support Puerto Rico LGBT Community Events & Inclusion

Sunday, June 6, 2010 was a bright sunny day and full of excitement in Puerto Rico. People from all walks of life participated in Gay Pride festivities in the capital city, San Juan. While paying respects to the families of the several transgender women murdered in the last months across the island, local LGBT groups, activists, a few government officials, and thousands from all genders and sexual orientations showed their pride and support for the LGBT community. In between vibrant shows, words of unity and calls for action, participants were thirsty for gay memorabilia, educational resources, and opportunities to support equality for all. Similar events took place in the gay-friendly setting of Boquerón on June 13 in the town of Cabo Rojo.

San Juan Pride participants complete our health-tobacco survey which is currently collecting data on the LGBT community in Puerto Rico

For these two consecutive Sundays and with much enthusiasm, a handful of volunteers led by members of the National Latino Tobacco Control Network (NLTCN) and the National LGBT Tobacco Control Network engaged over 500 people who showed interest in our “mini-gay-library” of publications on health, tobacco issues, legal rights, community surveys, a government petition, bags, pens, pins, candies, and other goodies and educational materials. Donated by Lambda Legal (www.lambdalegal.org), a national organization committed to achieving full recognition of LGBT civil rights, hundreds of “I am making the case for equality” bags were filled not only with Lambda’s materials on civil rights for HIV+ people, youth in the education system, and legal and financial planning for LGBT couples, but also with educational materials from the two Networks, the Puerto Rico Tobacco Free Coalition, the Puerto Rico Department of Health Cessation Quitline !Déjalo ya! (Leave It Now!), the Latino Commission on AIDS, and the Social Justice Sexuality Initiative from the City University of New York (CUNY). Members of these two National Tobacco Control Networks were able to pull together resources from all these organizations in order to educate the community. Some provided supplies; others purchased the tables and chairs, or paid for volunteer lunches, while allies from the University of Puerto Rico (UPR) provided staff and logistical support in preparation for the events. This collaboration was essential to provide Pride participants with health information and other educational opportunities, which seemed very limited during the festivities.

Through our participation in Pride events, we were able to collect an additional 292 NLTCN sponsored health-tobacco surveys among the LGBT community of Puerto Rico. This increases the total survey sample to 431 since distribution began in local LGBT events and activities in November 2009. We continue the search for additional venues to distribute the survey and increase the final sample. We are currently analyzing the sample with the support of our NLTCN Steering Committee Member, Dr. Elba Díaz-Toro, Associate Professor of the School of Dental Medicine, UPR.

In addition, a total of 420 signatures were collected for a Lambda sponsored petition asking the Puerto Rican Department of Justice and the local Police Department to create official links within their respective agencies with groups and individuals representing the LGBT community. Some local groups have claimed that in the last eight months seven murders of gay and transgender people have taken place around the Island, which motivated people to sign the petition. National and local groups will be taking the signatures directly to government officials and agencies. Networks’ members have been active on rallying support, sharing information, and connecting local groups and individuals with national resources in support of comprehensive approaches to address issues of health disparities, stigma, and discrimination towards the local LGBT community. Lessons learned will be shared later among other Latin@ and LGBT groups in the mainland.

Boquerón Pride participants approach our booth to fill out surveys, support a police petition, and collect educational material on tobacco control, equal rights, and other issues affecting our communities.

Just as important was the distribution of the Social Justice Sexuality Survey, a nationwide initiative that investigates the socio-political experiences of LGBT people of color, sponsored by the Sociology Department of the City University of New York (CUNY) in partnership with the Human Rights Campaign, the Gay and Lesbian Task Force, among other gay advocacy groups. During our participation at Pride events, National Network members collected a total of 115 completed surveys providing a richer set of data to create a profile of the LGBT community in Puerto Rico. The Initiative is interested in better understanding how identity enhances or inhibits the experiences of the LGBT population around accessing health, civic and social engagement, among other important issues. Folks can complete the survey online and read more about the Initiative at www.socialjusticesexuality.com

Furthermore, during the last Puerto Rico Tobacco Free Coalition meeting in June 2010, hosted by the Puerto Rico Department of Health (DOH-PR), National Networks’ members had the opportunity to bring the LGBT perspective to the agenda. We distributed valuable educational materials from NLTCN and the LGBT Tobacco Control Network and discussed the inclusion of gender and sexual orientation questions in island-wide surveillance surveys. During the exchange of ideas, Quitline staff showed interest to incorporate these questions as part of the demographic data collected during calls, but showed concern regarding LGBT cultural competency and over saturation of demographic questions. The DOH-PR is also communicating with the CDC to include these questions in the Behavioral Risk Factor Surveillance System (BRFSS) for Puerto Rico in accordance to the LGBT Surveillance and Data Collection Briefing Paper (2008) from the LGBT Tobacco Control Network and as supported in the recently released report by the American Lung Association, Smoking Out a Deadly Threat: Tobacco Use in the LGBT Community. Local tobacco Coalition members are ready to be inclusive of the LGBT community and address the need for additional research specific to the LGBT community.

Since 2009, both Networks have been overwhelmingly supportive of surveillance opportunities, outreach, and education, including the translation, edition, and adaptation of the survey instrument and by identifying (and sponsoring) national Latin@ LGBT tobacco control experts to introduce this issue at the last DOH-PR sponsored Tobacco-Obesity Summit. This was probably the first time an LGBT perspective, including preliminary local survey results, were presented to the tobacco control and public health communities of the Island.

An equally valuable opportunity took place in May 2009 at the LGBTT Health Forum: Experiences in Tobacco Control during the III Congress Against Homophobia, a week-long event sponsored by the local LGBT group, Puerto Rico Para Tod@s (Puerto Rico For All – www.prparatodos.org). The Forum was sponsored by NLTCN and the School of Dental Medicine-UPR and with support from the DOH-PR we collected more responses for the LGBT community health-tobacco survey and distributed Networks’ brochures and publications to a crowd of mostly medical students and several local Coalition members. The Forum provided a space to rally allies and educate the audience on realities of oppression and discrimination among the LGBT community and how it directly affects healthcare access and services.

Many local advocates have showed interest as we have been navigating and supporting these events in further discussing LGBT health among LGBT Puerto Ricans and their allies. Merging tobacco control efforts with other health and social justice issues (while sharing limited resources during funding cuts) will be a sensible approach to engage the LGBT community in Puerto Rico. Local advocates will seek support from the CDC National Networks and other national gay groups to move work forward in Puerto Rico.

We thank the sponsoring groups for providing unconditional support to achieving our vision and participate in these events. To all the people that have helped the work move forward, including Island volunteers (Jose Santini, Wilfredo Santana, Fernando Sosa, Thomas Bryan, Sophia Isabel Marrero, Michael Roldan, Rahul Correa, and Carmín Maldonado), NLTCN staff and members (Jeannette Noltenius, Aida McCammon, Yanira Arias, and JC Velazquez), LGBT Tobacco Control Network staff (Scout, Gustavo Torrez, and Sasha Kaufmann) and its fabulous print publications and online resources, Puerto Rico Department of Health-Tobacco Control and Prevention Division staff (Antonio Cases and Alex Cabrera), the members of the Puerto Rico Tobacco Free Coalition, the medical students and staff at the University of Puerto Rico-Medical Science Campus, and all the local Puerto Rico LGBT groups and individuals that have been supportive and excited to pursue this work.

This report was supported by CDC Cooperative Agreement Number U58/DP001515. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC. It was developed, edited, and translated into Spanish by NLTCN and LGBT Tobacco Control Network Members Juan Carlos Vega, Lissette Rodríguez, and Jean A. Leroux Guillén.

Sunday, June 6, 2010 was a bright sunny day and full of excitement in Puerto Rico. People from

all walks of life participated in Gay Pride festivities in the capital city, San Juan. While paying

respects to the families of the several transgender women murdered in the last months across

the island, local LGBT groups, activists, a few government officials, and thousands from all

genders and sexual orientations showed their pride and support for the LGBT community. In

between vibrant shows, words of unity and calls for action, participants were thirsty for gay

memorabilia, educational resources, and opportunities to support equality for all. Similar events

took place in the gay‐friendly setting of Boquerón on June 13 in the town of Cabo Rojo.

For these two consecutive Sundays and with much

enthusiasm, a handful of volunteers led by members of

the National Latino Tobacco Control Network (NLTCN)

and the National LGBT Tobacco Control Network

engaged over 500 people who showed interest in our

“mini‐gay‐library” of publications on health, tobacco

issues, legal rights, community surveys, a government

petition, bags, pens, pins, candies, and other goodies and

educational materials. Donated by Lambda Legal

(http://www.lambdalegal.org), a national organization

committed to achieving full recognition of LGBT civil

rights, hundreds of “I am making the case for equality” bags were filled not only with Lambda’s

materials on civil rights for HIV+ people, youth in the education system, and legal and financial

planning for LGBT couples, but also with educational materials from the two Networks, the

Puerto Rico Tobacco Free Coalition, the Puerto Rico Department of Health Cessation Quitline

!Déjalo ya! (Leave It Now!), the Latino Commission on AIDS, and the Social Justice Sexuality

Initiative from the City University of New York (CUNY). Members of these two National Tobacco

Control Networks were able to pull together resources from all these organizations in order to

educate the community. Some provided supplies; others

purchased the tables and chairs, or paid for volunteer

lunches, while allies from the University of Puerto Rico

(UPR) provided staff and logistical support in preparation

for the events. This collaboration was essential to

provide Pride participants with health information and

other educational opportunities, which seemed very

limited during the festivities.

Through our participation in Pride events, we were able

to collect an additional 292 NLTCN sponsored healthtobacco

surveys among the LGBT community of Puerto

Rico. This increases the total survey sample to 431 since

distribution began in local LGBT events and activities in

November 2009. We continue the search for additional

venues to distribute the survey and increase the final

sample. We are currently analyzing the sample with the

support of our NLTCN Steering Committee Member, Dr.

Elba Díaz‐Toro, Associate Professor of the School of

Dental Medicine, UPR.

In addition, a total of 420 signatures were collected for a Lambda sponsored petition asking the

Puerto Rican Department of Justice and the local Police Department to create official links within

their respective agencies with groups and individuals representing the LGBT community. Some

local groups have claimed that in the last eight months seven murders of gay and transgender

people have taken place around the Island, which motivated people to sign the petition. National

and local groups will be taking the signatures directly to government officials and agencies.

Networks’ members have been active on rallying support, sharing information, and connecting

local groups and individuals with national resources in support of comprehensive approaches to

address issues of health disparities, stigma, and discrimination towards the local LGBT

community. Lessons learned will be shared later among other Latin@ and LGBT groups in the

mainland.

Just as important was the distribution of the Social Justice Sexuality Survey, a nationwide

initiative that investigates the socio‐political experiences of LGBT people of color, sponsored by

the Sociology Department of the City University of New York (CUNY) in partnership with the

Human Rights Campaign, the Gay and Lesbian Task Force, among other gay advocacy groups.

During our participation at Pride events, National Network members collected a total of 115

completed surveys providing a richer set of data to create a profile of the LGBT community in

Puerto Rico. The Initiative is interested in better understanding how identity enhances or

inhibits the experiences of the LGBT population around accessing health, civic and social

engagement, among other important issues. Folks can complete the survey online and read more

about the Initiative at http://www.socialjusticesexuality.com

Furthermore, during the last Puerto Rico Tobacco Free Coalition meeting in June 2010, hosted by

the Puerto Rico Department of Health (DOH‐PR), National Networks’ members had the

opportunity to bring the LGBT perspective to the agenda. We distributed valuable educational

materials from NLTCN and the LGBT Tobacco Control Network and discussed the inclusion of

gender and sexual orientation questions in island‐wide surveillance surveys. During the

exchange of ideas, Quitline staff showed interest to incorporate these questions as part of the

demographic data collected during calls, but showed concern regarding LGBT cultural

competency and over saturation of demographic questions. The DOH‐PR is also communicating

with the CDC to include these questions in

the Behavioral Risk Factor Surveillance

System (BRFSS) for Puerto Rico in

accordance to the LGBT Surveillance and Data

Collection Briefing Paper (2008) from the

LGBT Tobacco Control Network and as

supported in the recently released report by

the American Lung Association, Smoking Out

a Deadly Threat: Tobacco Use in the LGBT

Community. Local tobacco Coalition

members are ready to be inclusive of the

LGBT community and address the need for

additional research specific to the LGBT

community.

Since 2009, both Networks have been overwhelmingly supportive of surveillance opportunities,

outreach, and education, including the translation, edition, and adaptation of the survey

instrument and by identifying (and sponsoring) national Latin@ LGBT tobacco control experts to

introduce this issue at the last DOH‐PR sponsored Tobacco‐Obesity Summit. This was probably

the first time an LGBT perspective, including preliminary local survey results, were presented to

the tobacco control and public health communities of the Island.

An equally valuable opportunity took place in May 2009 at the LGBTT Health Forum: Experiences

in Tobacco Control during the III Congress Against Homophobia, a week‐long event sponsored by

the local LGBT group, Puerto Rico Para Tod@s (Puerto Rico For All ‐ http://www.prparatodos.org). The

Forum was sponsored by NLTCN and the School of Dental Medicine‐UPR and with support from

the DOH‐PR we collected more responses for the LGBT community health‐tobacco survey and

distributed Networks’ brochures and publications to a crowd of mostly medical students and

several local Coalition members. The Forum provided a space to rally allies and educate the

audience on realities of oppression and discrimination among the LGBT community and how it

directly affects healthcare access and services.

Many local advocates have showed interest as we have been navigating and supporting these

events in further discussing LGBT health among LGBT Puerto Ricans and their allies. Merging

tobacco control efforts with other health and social justice issues (while sharing limited

resources during funding cuts) will be a sensible approach to engage the LGBT community in

Puerto Rico. Local advocates will seek support from the CDC National Networks and other

national gay groups to move work forward in Puerto Rico.

We thank the sponsoring groups for providing unconditional support to achieving our vision and

participate in these events. To all the people that have helped the work move forward, including

Island volunteers (Jose Santini, Wilfredo Santana, Fernando Sosa, Thomas Bryan, Sophia Isabel

Marrero, Michael Roldan, Rahul Correa, and Carmín Maldonado), NLTCN staff and members

(Jeannette Noltenius, Aida McCammon, Yanira Arias, and JC Velazquez), LGBT Tobacco Control

Network staff (Scout, Gustavo Torrez, and Sasha Kaufmann) and its fabulous print publications

and online resources, Puerto Rico Department of Health‐Tobacco Control and Prevention

Division staff (Antonio Cases and Alex Cabrera), the members of the Puerto Rico Tobacco Free

Coalition, the medical students and staff at the University of Puerto Rico‐Medical Science

Campus, and all the local Puerto Rico LGBT groups and individuals that have been supportive

and excited to pursue this work.

This report was supported by CDC Cooperative Agreement Number U58/DP001515. Its contents are solely the

responsibility of the authors and do not necessarily represent the official views of the CDC. It was developed, edited, and

translated into Spanish by NLTCN and LGBT Tobacco Control Network Members:

Juan Carlos Vega, MLS

Activist Librarian &

Information Consultant

Lissette Rodríguez, MA, BSEd

Health Educator

Jean

October 13, 2010 Posted by | Puerto Rico | , , | Leave a comment

New Fed Regulations Media Tools to Educate on “Mild” Tobacco

(From our Friends at the CDC)

CDC’s Office on Smoking and Health (OSH) and the Food and Drug Administration (FDA) are working to educate consumers, public health partners, and the general public about new tobacco regulations that took effect July 22, 2010. These regulations prohibit the tobacco industry from distributing or introducing into the U.S. market any tobacco products for which the labeling or advertising contains the descriptors “light,” “low,” “mild,” or any similar descriptor, irrespective of the date of manufacture. However, consumers may continue to see some products with these descriptors for sale in stores after July 22 because retailers are permitted to sell off their inventory.

OSH has developed several Web-based and social media materials to get the word out about these latest FDA tobacco regulations. Following are suggestions communicated to states and partners on how they can further support this communication effort.

  • Post the new “Light/Low/Mild: No such thing” graphical button on your Web site. When clicked, this button will take visitors to newconsumer-focused information entitled “No More “Light,” “Low,” or “Mild” Cigarettes.” This information provides a summary of the July 22 regulations, the public health impact, and links to key resources, including a new, expanded feature article by the same title posted on CDC’s Web site.
  • Encourage others to send Health-e-Cards emphasizing the value of being tobacco-free. See the new animated Health-e-Card that reiterates there’s no such thing as a safe cigarette.
Put Out the Myth on Light, Low, Mild. Flash Player 9 or above is required.
  • Inform others of anew widget located on FDA’s Tobacco Products Web site. A widget is an application that enables users to embed content from another Web site onto their Web site. As content gets updated on the source site, it’s automatically updated on the user’s site. This particular widget enables readers to embed regulation information from FDA’s Tobacco Products Web site, health information from OSH’s Smoking & Tobacco Web site, and quit information from NCI’s smokefree.gov Web site.
  • Follow CDCTobaccoFree on Twitter and retweeting new messages related to the July 22 FDA tobacco regulations.
  • Become a fan of CDC’s Facebook page and posting new“Light/Low/Mild: No such thing” status updates on your Facebook profiles.
  • Tell others about our new posting on CDC’s Everyday Health Widget (coming soon).
  • View OSH’s new entry on CDC’s MySpace page.
  • Follow OSH on GovLoop. GovLoop is a social networking site for the government community. It currently serves about 30,000 members, including local, state, and federal government employees and contractors. Academics and students interested in government are also welcome to join.
  • Subscribe to CDC’s Smoking and Tobacco Use main feed to receive updates of new and recently changed content from CDC’s Smoking & Tobacco Use Web site on your browser or desktop.
  • Continue to access CDC’s Smoking & Tobacco Use Web site for helpful resources and the latest information.
Tobacco Control State Highlights 2010 Widget. Flash Player 9 is required.

We hope you find this information to be helpful as you plan your communication campaigns. If you have any questions, please contact Patti Seikus (PSeikus@cdc.gov) in OSH’s Health Communications Branch.

July 27, 2010 Posted by | social media, Tobacco Policy | , , , | Leave a comment

Tobacco Trends in Next Five Years

by Scout
Director, National LGBT Tobacco Control Network

Examples of the 17% of cigs that don't have appropriate tax labels.

Hey y’all, we’re at the closing plenary of the CDC tobacco conference listening to Dr. Andrew Highland give an update of tobacco trends over the next five years. Let me try to match this guys speedtalking with some speednotetaking, ok? (and mucho gracias to him for the visuals in this post).

Tobacco Trends in Next Five Years

  1. More taxes! Currently my tiny home state, lil Rhody, leads the country in cig taxes with a lovely $3.46/pack tax. But… seems like we’re behind the world on average and sincethey’ve found this is one of themost effective tools to help motivate folk to quit, we’re gonna see more and more. Now if they’d just also use the money for cessation, or even just public health bans.
  2. More tax evasion and illegal cigarette commerce. Interesting concept, eh? The speaker gave the example that if he took the rear seats out of his minivan then loaded it with cigarettes from a tax free state then took them to NY, he’d clear about $25k in one run. And as he noted, the penalties are relatively minor. In fact, in a recent study they found that 17% of a representative sample of submitted cigarette packs didn’t have their appropriate tax stamps.
  3. More clean indoor air policies – again to reiterate the main point of the recent Institute of Medicine report, passing a good clean indoor air policy alone can disappear 1/5 of the heart attacks in the region. This is big, and how big it is is relatively new news to the health arena, so look for more work to get these strong policies passed everywhere.
  4. More comprehensive tobacco programs. We know they work, one example was in the 1st 15 yrs of CA tobacco control (ack, he changed the slide, what were those numbers??),

    Example of a store before and after retail ad ban.

    it cost oh (trying ot remember) about $11B and saved about $86B. (<- don’t quote me on that, but the proportions are close, and were those really Bs? Not Ms? I think so.)

  5. Quitting? Quitlines are cost effective, but most folk quit unaided. We should encourage quit attempts, reduce social acceptability of smoking, and focus on clean air policies. Pricing and clean indoor air policies are by far the most cost effective of all cessation activities.
  6. Youth smoking? Little evidence that school based education alone is effective. Little evidence that youth restrictions alone are effective. Policy changes affect youth too, in fact youth are more price sensitive than adults so we should really focus on this tool.
  7. FDA? Light and mild being banned this month. New labels coming in this month. They will also be ramping up enforcement all across the country. But… states can and still should be doing old-fashioned tobacco control. Limiting tobacco outlets and tobacco advertising is still a wide field of opportunity.
  8. What does this all mean for state tobacco control programs? Each state should have clean air, high prices, and a comprehensive program. But after that, there’s a lot of room to get creative. States can limit number of tobacco outlets; limit where ads are placed in a retail setting; and eliminate buy-one-get-one-free offers – these steps may really curb smoking. But, get your warchest in order because there will be legal challenges from you know who.

    Example of how the tobacco companies will convey "Light" cigs without using the newly banned word.

    (<-maybe some of the taxes should be set aside for the legal challenges.) What does the industry think of retail ad bans? Precedent from out of the U.S. shows they will counter with “research” showing ad bans promote organized crime and black market sales. (ask me for the link to the website they’ve created about this “research”, I’d prefer not to put it here.)

Some odd notes

  • On the coming ban on “Light” and “Mild” labeling. The industry is likely to replace the wording with things like “Ultra Smooth” or, in something that’s been shown to be effective, change their box colors so the lighter colors indicate the former “Light” cigarettes.
  • Check out “Urban Wave” on youtube or FB to see some examples of how the industry is creating ‘stealth’ marketing opportunities.

Conclusion

  • We’ve gotta think BIG! We still have 430k tobacco deaths/yr. We know lots of what works; high prices, clean air, and comprehensive programs all work! If you’ve got all that, explore the creative options beyond that. Look at this as an investment in your future, the payoff can be very large in terms of lives and cost-savings, and the faster you do it, the faster the payoff begins.

June 10, 2010 Posted by | CPPW | , , | 1 Comment

Nutrition, physical activity & tobacco? Bring it on!

DNPAO

Using the bike to draw the interest of the diet and nutrition folk!

by Scout

Network Director

Doctuh Scout looking ever so "cool" at the CDC conference.

CDC’s Wellness Conference + hotmath

This is it folk, the first time ever CDC has convened not just the state tobacco control staff from around the country, but our new partners in the latest greatest health mashup, the nutrition and exercise folk too! So it seems like hot new math for health folk is the following.

Tobacco + Exercise + Nutrition = Wellness!!!

And of course ya really wanna understand the new math for health folk at a national and local level, it seems like maybe I should correct it to be the following.

(Tobacco + Exercise + Nutrition)policy = Wellness policy

Yup, it’s all about policy these days. Why? Well, after some great charts this morning (which I should write more about later) it seems to boil down like this… policy changes health behaviors in a way that all the good information in the world can’t seem to affect. Ok, take it even further, money appears to change health behavior in a way good information and intentions can’t. How? Well, for example we see that smoking rates are incredibly affected by taxes on cigarettes. One of the new things you might see coming to you soon are policy campaigns to add similar taxes to SSBs. Uh… what are they? Sugar Sweetened Beverages. Seems like folk are getting a crazy amount of their calories from SSBs, and so taking lessons from the tobacco arena, public health folk are starting to push excise taxes for SSBs. While it seems like a small bit of the overall obesity epidemic, apparently SSBs are a pretty large lever to create some change.

DNPAO? Worst acronym ever!

But I gotta say one thing, the nutrition and exercise folks need some acronym help! DNPAO <- what in the world does that mean? Wait wait… people tell me it’s Diet Nutrition Physical Activity Obesity. Oh yah that rolls off the tongue. But then, being part of the LGBTQQIA block, um, I guess I can’t really be the one to register the complaint.

Working on Wellness? We want you too!

With Healthcare Reform and this recent $650M of state stimulus money on Wellness the feds put out, the emphasis on Wellness is only going to increase in the coming years. Which as public health folk, I’m sure we all will love. Face it, there’s something comforting about working on a prevention-based model, instead of our usual uh-oh-look-what-kinda-disasterous-effects-years-of bad-health-creates model. (<- I believe that’s its formal name) But – there’s no LGBT network for wellness (yet!). So… we really wanna link up these wellness folk too and help connect them with the LGBT experts like we do for tobacco. You can see the picture up there of the sign I just tacked on my bike that this conference, me shamelessly using the bike to try to get the attention of the state Wellness policymakers here. Cause come on everyone, this $650M of Wellness money alone means there’s big new projects in every single state, and we definitely want these folk to be including LGBT outreach and programs in those projects. I mean, especially if it’s all about policy these days, don’t tell me LGBTs don’t have deep policy inroads in every single state. (can you say civil rights battles?)

And hurry up already!

Ya know. I’m thinking about this new nutrition, exercise, and tobacco mix, and I’m thinking hmmmm… I’m the Director of the Network for LGBT Tobacco Control, and I’ve worked hard to get myself a kit where I can take my folding bike everywhere I go. Take it off the luggage carousel, take it outta the bag, put the bag on back and roll right away from the airport. Why? Well, main reason I usually give is that it’s near impossible to eat in hotels. As a vegetarian, you put me in a hotel and I’m stuck with white pasta and salads until I can get free and go get my own food. Of course, I also love my biking, it makes me happy. (don’t even ask me how many bikes I have). But so… let’s see, healthy eating, exercise and tobacco all rolled into one ball? Like maybe I could go to a meeting, get some vegetarian food at the hotel, find a bike lane on the street, and have it be in a tobacco-free city? Yes siree, let’s hurry up and get this work integrated everywhere! It’s a natural fit, and I’ve been waiting a long time for it.

June 8, 2010 Posted by | CPPW, NatNet, Tobacco Policy | , , , | Leave a comment

FDA Comments Requested on Tobacco Product Advertising to Youth and Racial/Ethnic Minorities

On June 22, 2009, the President signed the Tobacco Control Act into law.  The Tobacco Control Act grants FDA important new authority to regulate the manufacture, marketing, and distribution of tobacco products to protect the public health generally and to reduce tobacco use by minors.

The Food and Drug Administration (FDA) is soliciting information, research, and ideas to assist FDA in fulfilling its responsibilities regarding tobacco product advertising and promotion that is designed to appeal to specific racial and ethnic minority populations in the United States.  For the same reasons, we are also interested in receiving information about advertising and promoting menthol and other cigarettes to youth in general, and to youth in minority communities. After reviewing the submitted information, research, and ideas, FDA will be better able to fulfill its responsibilities under The Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act).

We are requesting comments that will assist the agency’s development of an action plan regarding enforcement of regulations on advertising and promotion of menthol and other cigarettes to youth generally and to youth in minority communities. FDA is also seeking information that will assist the Tobacco Products Scientific Advisory Committee in understanding and developing recommendations regarding the impact of the use of menthol in cigarettes among children, African-Americans, Hispanics, and other racial and ethnic minorities.

Those interested persons can submit electronic or written comments by July 26, 2010 at 11:59 p.m.  Submit electronic comments to http://www.regulations.gov under [Docket Number FDA–2010–N–0207] Tobacco Product Advertising and Promotion to Youth and Racial and Ethnic Minority Populations.

For more information contact Kathleen K. Quinn, Center for Tobacco Products, Food and Drug Administration, 9200 Corporate Blvd., Rockville, MD 20850–3229, 240–276–1717, e-mail: Kathleen.Quinn@fda.hhs.gov.

Sincerely,

Mary C. Hitch
Senior Policy Advisor
Office of External Relations
U.S. Food and Drug Administration

May 28, 2010 Posted by | Action Alerts, Tobacco Policy | , , , | Leave a comment

The LGBT Tobacco Policy Update You All Have Been Waiting For

Hey y’all,
A few weeks back I had the distinct pleasure of spending a few different batches of time in fluorescent lit meeting rooms in some anonymous Atlanta hotel. And you know I love that for its own sake, but also, the entertainment added some extra value. It was probably your normal cabaret show (a.k.a. CDC Office on Smoking and Health meeting and National Tobacco Disparity Networks), but in the middle, we got a few different policy updates from the good folk working on tobacco policy at a national level. So, here for your edification, is the 200% unofficial Scout-version of what might have been said, rumored, or implied. As per usual, all errors are probably someone else’s fault, and all correct information is absolutely to my credit.

They thought we were screaming mimis
So, times are a changing with tobacco. Why? Well there’s been a few bombshells recently about the potential impact of Clean Indoor Air Laws. Did you see the recent news about smoking bans cutting heart attacks by about 1/4?

iom_report_sml

IOM's Report on Secondhand Smoke Exposure and Cardiovascular Effects

Well this was a precursor to the later release of the National Institute of Health’s (NIH) Institute of Medicine (IOM) report on clean indoor air. This was rumored to be the first ever IOM report held up for release, because they couldn’t believe the strength of the findings, so they had to double check to be sure.

In that, they find smoking bans decrease heart attacks by about 1/5. Now this isn’t even considering all the associated health gains, it’s just heart attack. This is a 1-2 punch with a forthcoming Surgeon General’s report that’s staged to be released soon which continues to drive the smoking risk points home… each of these documents present conclusions that are stronger than prior claims… and as they were summarized by one guy, it’s basically such a strong negative effect between smoking and cancer that we can’t assure you that walking by a smoker once won’t be enough to give you cancer. Now in publichealthia (the land of pubic health) we rarely stumble across anything that has as big an effect as reducing 1/5 of heart attacks — so this is getting lots of notice. In the words of another, “they were dismissing our claims about clean indoor air as overestimation, now everyone realizes we were actually underestimating the risks”. This focus on policy dovetails nicely with the Obama push to move health upstream, to reclaim the dusty unfavored idea of Prevention! Remember, he also recently appointed a new bulldog to head the CDC, a guy who is rumored to work day and night and one who comes out of Bloomberg’s Tobacco-Control Land (a.k.a. New York City). So, we think tobacco control is getting more natural attention at CDC thru this move as well.

Wellness arise!
I know you all have seen the different spurts of cash coming out thru the $650M of stimulus money allocated to chronic disease prevention, the Wellness RFA, another nearly indistinguishable Wellness RFA, and some quitline $ (and yet, I’m not sure it all adds up to $650M, hmm?). So these are rumored to be Obama/CDCs shot over the prow at Wellness/prevention initiatives, with the hope they are a good testbed for smart ideas to include in bigger wellness/prevention rollouts as part of health care reform. (Or HCR for the vowel-impaired). Seems like all the states and “communities” (aka cities) are planning to submit for these awards, so it’ll be interesting to see what programs make the cut, and of course, how many of those actually include LGBT in their disparity planning. Another upshot in this wellness/prevention drift is relative lower focus on cessation, concurrent with more on policy and prevention activities. There’s an effort afoot to push cessation costs more onto employers/insurers (which only seems to be insanely logical, what mercury poisoned actuary really is advising insurance companies that it’s financially prudent not to cover nicotine replacement therapy, etc?). (Wups, will the mercury poisoning lobby dislike me for that?). Look for a large employer to take the lead in near months on showing how a smart “company” really does do comprehensive cessation benefits.

What about FDA?
It’s here! It’s vague! Get used to it! was heard being chanted outside the hotel windows, I presume they were talking about FDA. But according to the folk inside, this is a bill that is, of course you naive simpleton, not perfect, but as bills go, not dang horrid either. FDAs got some teeth, thinking is esp at a local level, where many communities have control over the laws governing advertising. Much talk of the change as we (finally) get new warning ads, but how we have a long way to progress to the ‘tombstone’ standard where tobacco companies are only able to say their cigarette name and price in a generic font at sales locations and on packages. There was some general shaming about how some lovely but not public health leading countries such as maybe Indonesia (?) are trumping our butts on having good tobacco control policies, but then, I don’t think any of us are deluded as to any US supremacy we may have on this issue, right? Anyhow, it’s power to the people here in FDA-land, where we might find lots of community action potential to keep cigarettes off our babies bodies. Of course, community level change seems a bit harder to do than one national law, but what, are we lazy? (slow yawn) No!!

Empower really always had too many vowels
So it’s the big new framework around tobacco, everything has to do with MPOWER, or as some pithy individual noted, MPOWERD. What is it? Jeez, I lost my notes… um… oh yah, it appears to be a WHO package. What? (no What’s on second) Oh, I found it, a package of 6 proven policies. M=Monitor tobacco use and prevention policies. P=Protect people from tobacco smoke. O=Offer to help people quit. W=Warn about dangers of tobacco. E=Enforce bans on tobacco ads, promotion and sponsorship. R=Raise taxes on tobacco. And of course, the silent D= eliminate Disparities!! Now isn’t that just too cute an acronym for words? Aren’t you proud of the World Health Organization (WHO) acronym generation team? I am. And mostly, if your tobacco control is working on something else, then what are you doing? Or maybe also to note, if your comprehensive tobacco control program isn’t addressing all of this, then your acronym is unspeakable. And us LGBTQIs would never ever be ok with that. Puh. (getting a feeling I should wind this up real soon)

Nu CDC combined ATS has LGBT! (vowel reduction sentence)
Oh yes, it’s true we all should be excited, the new combined Adult Tobacco Survey (ATS) coming out soon has an LGBT surveillance question!! Please contain the dancing in the streets folks, it’s just a start, but yes, we are very happy about it. Oh hey — any moment now I’m about to announce the first largescale T survey findings on tobacco, because we negotiated to get a tobacco question on the recent NGLTF national trans survey…. wanna know a preview? Yup, as expected, prevalence 50% over nat’l avg. But this is *no longer a guess*, it’s real data from 2k+ living trans folk, w00t!

In conclusion
Omigosh, I think that’s it. (and about time you’re all thinking). So from the bowels of some unremarkable hotel conference room, I remain, sincerely yours,

Dr. He’s-Just-Always-So-Professional Scout

November 16, 2009 Posted by | Uncategorized | , , , , | Leave a comment

   

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