¿Por qué nosotros no? Acción Ciudadana por la Salud y el cambio de la Ley Española de Tabaco

... Centers for Disease Control and Prevention. From lung cancer to heart

disease to diabetes, the harmful effects of smoking have been established over and over

again.

One of the great tensions between the obligation to safeguard the public good and modern

day commerce is the fact that tobacco is allowed to be sold at all. Granted, there are

historical reasons for the spread of tobacco, including its status as a key product in the

mercantilist economy imperial powers used to exploit peoples of the world.

Thus, the entrenched position of tobacco as a central part of some people's lives, and the

difficulty society encounters in rooting it out has to be placed in context that, realistically

speaking, no country has yet been able to successfully declare cigarettes legally prohibited.

Those who have done so, such as Qing China, did not see their success last.

Indeed, a major moral imperative for reducing smoking is the even more harmful effects of

second-hand smoke. Research shows that second-hand smoke is particularly unhealthy,

especially the smoke that is not filtered by the cigarette. This means that smokers are slowly

killing those they victimize by emitting harmful gas full of carcinogens into the surrounding air.

There are more than three million smokers in Taiwan, and twenty thousand people in the

country die every year from tobacco-related diseases, according to the fifth Cross-Strait

Conference On Tobacco Control in 2011. A presentation published by the conference also

points out that the poor smoke more and spend a full ten percent of their income on tobacco

products.

The structural distribution of smokers in society presents a dilemma: according to the Ministry

of Health and Welfare's statistics, only five to fifteen percent of military officers who graduated

between 2006 and 2008 smoked, whereas a far higher percentage of enlisted personnel

smoke — from 40 to 46 percent.

The dilemma in this skewed distribution of smokers points to a displayed vulnerability in a

particular class or group of people. Of the likely distinguishing factors, education stands out

as a key divider, because an officer's commission requires a university degree.

In fact, research shows groups with less education tend to smoke more, according to Wu

Deh-ming of the National Defense University's Medical School.

Given the twin association of the disadvantaged — in levels of education and income — with

higher rates of tobacco usage, society must tackle the issue by continuing to increase taxes

and institute facility limits for smokers while also singling out its efforts in particular for the

disadvantaged class.

Some of those efforts might be preventative measures creatively aimed at the vulnerable.

There may be no single cure-all policy that can hasten tobacco's demise, but we encourage

the current policy of increasing restrictions on available smoking spaces.

A long-term solution could be downgrading the cultural status of smoking to a further

unappealing, “un-cool” appearance. Our hope is for a smoke-free home and a smoke-free

world. In today's paper, we are running an AP report titled “Experts increasingly contemplate

the end of smoking,” showing a utopia for public health advocates - perhaps a smoking rate

of less than five percent - that nonetheless will not come until perhaps 2050. That is a far-off

goal, but it is one on the right track as it is dogged and realistic, combining the right

motivation with an appreciation of the complicated historical baggage of the blight of

smoking.

Copyright © 1999 – 2014 The China Post.

Back to Story

... because the octogenarian has continued to be active and never really retired. He reprised his most famous role in last year's "Star Trek Into Darkness" and appeared on Fox's "Fringe" in 2012.

Meanwhile, he's prolific on Twitter, with more than 807,000 followers. Nimoy regularly comments on his daily life, upcoming "Star Trek" events, and interacts with his fans.

Nimoy's tweet about his diagnosis was met with supportive messages from that same group.

... delays," Kessler told lawyers at the hearing. "The bottom line is the public is not getting what I would consider to be the benefit of the corrective statements."

Defendants Altria Group Inc, Lorillard Inc and Reynolds American Inc argue that the proposed wording of the ads would violate their free speech rights.

One of the proposed ads begins: "A federal court has ruled that the defendant tobacco companies deliberately deceived the American public by falsely selling and advertising low tar and light cigarettes as less harmful than regular cigarettes."

Kessler ruled for the government in August 2006. It has since taken more time to implement her ruling than it did to hold a trial and issue a judgment.

NEXT: LOGISTICS

The next step is for Kessler to approve the logistics of the proposed ad blitz. The sides agreed this month the campaign would include a year's worth of network TV advertisements in prime time, weeks of newspaper ads and more than a decade of declarations on tobacco company websites. The agreement even goes into details such as font and type size.

Once Kessler approves, a federal appeals court in Washington is expected to take up the speech question and rule perhaps in 2015, according to an estimate Kessler made in court.

"It will take some time, your honor, but I think that reflects the weightiness of the issues at stake," Noel Francisco, a partner at the law firm Jones Day who represents Reynolds American, told the judge.

A further appeal to the U.S. Supreme Court by whoever loses on the speech question "seems entirely possible," Justice Department lawyer Daniel Crane-Hirsch said.

Kessler said in 2012 that the ad campaign would not violate the companies' speech rights because the wording is factual and not controversial.

Crane-Hirsch and tobacco lawyers warned Kessler the process could take even longer if she were to modify the logistics of the ad campaign that they have hammered out. Fox Broadcasting Co and the National Association of Black Owned Broadcasters, for example, have filed court papers asking that some of the ads go on their networks.

Separately, the sides are still arguing over how tobacco companies should change their advertising at points of sale.

Howard Crystal, a lawyer who represents anti-smoking advocates as part of the lawsuit, urged Kessler to move quickly. "We'd like to get finality," he said.

Early in the long-running case, the Justice Department hoped to extract $280 billion from the companies to pay for a smoking cessation program and other remedies.

It later dropped the demand to $14 billion, and then Kessler ruled she could not force them to pay for such a program at all.

The case is USA v. Philip Morris USA, et al, U.S. District Court for the District of Columbia, No. 99-cv-02496.

(Editing by Howard Goller and Cynthia Osterman)

... Obama praised the move.

"As one of the largest retailers and pharmacies in America, CVS Caremark sets a powerful example, and today's decision will help advance my administration's efforts to reduce tobacco-related deaths, cancer, and heart disease, as well as bring down health care costs -- ultimately saving lives and protecting untold numbers of families from pain and heartbreak for years to come," Obama said in a statement Wednesday.

"This is an important, bold public health decision by a major retail pharmacy to act on the long understood reality that blending providing health care and providing cigarettes just doesn't match," said Dr. Richard Wender, chief cancer control officer at the American Cancer Society.

"We need an all-hands-on-deck effort to take tobacco products out of the hands of America's young generation, and to help those who are addicted to quit," Health and Human Services Secretary Kathleen Sebelius said in a statement. "Today's CVS Caremark announcement helps bring our country closer to achieving a tobacco-free generation. I hope others will follow their lead."

It remained unclear whether other pharmacies will follow CVS' lead.

"We have been evaluating this product category for some time to balance the choices our customers expect from us with their ongoing health needs," Walgreens spokesman Jim Graham said in a statement.

"We will continue to evaluate the choice of products our customers want, while also helping to educate them and providing smoking-cessation products and alternatives that help to reduce the demand for tobacco products."

Meanwhile, David Howard, spokesman for R.J. Reynolds Tobacco Co., said, "We value the long-term relationship with CVS and respect their commercial decision. We will work with them as they transition out of the tobacco category in the coming months."

Stopping cigarette sales comes at a price. CVS Caremark estimates it will take an annual loss of $2 billion from tobacco shoppers -- $1.5 billion in tobacco sales and the rest from other products tobacco shoppers purchase while in the store.

The company has enjoyed growing revenues in recent years, boosted by its pharmacy services business and prescription drug sales.

CVS Caremark hasn't reported its year-end results yet, but it took in nearly $94 billion in revenues in the first nine months of 2013, up slightly from the same period in 2012, according to its most recent earnings report.

In 2012, CVS Caremark reported $123.1 billion in revenues, a 15% jump from $107.1 billion the previous year.

"We commend CVS for putting public health ahead of their bottom line and recognizing the need for pharmacies to focus on supporting health and wellness instead of contributing to disease and death caused by tobacco use," the American Medical Association said.

Asked Wednesday about the reaction of tobacco executives to the decision, CVS Caremark's Merlo said they were "disappointed. At the same time, I think they understand the paradox that we face as an organization, and they understand the rationale for the decision."

On whether CVS would extend its ban to other products known to be unhealthy -- candy, potato chips or alcohol, for instance -- Merlo told reporters those items, in moderation, do not have the same adverse effects as the use of tobacco.

We know it can kill us: Why people still smoke

Helping people quit

The company also announced Wednesday it plans to launch a national smoking-cessation program in the spring. The program will include information and treatment on smoking cessation at CVS/pharmacy and Minute Clinic locations in addition to online resources.

Members of the pharmacy benefit management plan will be able to access comprehensive programs to help themselves stop smoking.

Smoking-cessation products such as nicotine patches or gum will continue to be available at CVS/pharmacy locations, Dr. Troyen Brennan, chief medical officer for CVS Caremark, said Wednesday.

The last cigarette: Nine ex-smokers who quit the habit for good

Fewer people smoke today than in the mid-20th century, but there are still a lot of Americans lighting up. In 1965, 42% of the population smoked, compared with 19% today, according to the Centers for Disease Control and Prevention. Experts said the decline in smoking has plateaued.

It's no secret that tobacco causes health problems. Cancer, stroke, heart disease and lung diseases are among the results of smoking, according to the CDC. More than 5 million deaths per year are caused by tobacco use. Smokers also tend to die 10 years before nonsmokers, according to the CDC.

Support from public health advocates

The company's announcement is "a huge step toward our country being able to have a really long-lasting culture of health," said Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, the largest U.S. philanthropy devoted to public health.

In addition to eliminating a point of sale of tobacco, CVS Caremark's removal of tobacco products also takes away an advertising opportunity, said Robin Koval, president and CEO of Legacy, an organization that conducts research on tobacco use. Young people who shop at CVS/pharmacy for other reasons will no longer see the array of tobacco products available.

"It's obviously a landmark decision and one that I hope wakes up the entire retail industry that it's the right thing to do," Koval said.

FDA launches teen anti-smoking campaign

A report from the California Department of Public Health found that while total cigarette sales decreased between 2005 and 2009 in the United States, sales in pharmacies increased. If sales of cigarettes at pharmacies continue rising at the current rate, by 2020 almost 15% of all U.S. cigarette sales will occur at pharmacies, the report said.

According to a 2011 study in Los Angeles, cited in the report, more than 32% of pharmacies sold cigarettes, and traditional chain pharmacies were far more likely to sell cigarettes than independently owned pharmacies.

Wender noted the CVS move is in line with what the American Cancer Society, American Heart Association, American Medical Association, American Lung Association and American Pharmacists Association have advocated: to stop sales of tobacco in retail outlets with pharmacies.

On the other side of the issue, there is a lot of money in tobacco. The cigarette industry spent $8.37 billion in 2011 on advertising and promotions, according to the CDC.

Most tobacco is sold in convenience stores, which would be "a tougher nut to crack" in terms of stopping tobacco sales, Wender said.

But pharmacies are a good place to start, Wender said. He is convinced the removal of tobacco products from CVS/pharmacy locations will result in some smokers quitting, particularly those who have a habit of buying their cigarettes there.

"It's going to force every one of them to pause and say, 'Why isn't my CVS selling cigarettes anymore?' " Wender said.