Smoking History and Legislation

SmokingHistory and Legislation

Caleb BolickVeronica Wallace

Hannah ThompsonMelissa GalushMichael VanceJulie Harmon

A Brief History of Tobacco

• The Pre-Columbian Americas were the first to use tobacco. The American Indians grew the plants for healing and ceremonial reasons. They smoked the tobacco in pipes.

• Christopher Columbus introduced tobacco to Europe. However, Europeans really didn’t experience tobacco until the mid-16th century. Jean Nicot from France, is how nicotine got it’s name. He was a french diplomat and scholar, he started the snuffing of tobacco in the french court.

• John Rolfe, an englishman, had the first commercial crop in 1612 in Virginia. It only took seven years to become the colony’s biggest export. Tobacco continued to expand over the next two centuries as a cash crop. This created the demand for slave labor in North America.

• Tobacco was used mainly for smoking in pipes, chewing, and snuff. The early 1800s was when the use of tobacco in cigars became popular. Cigarettes, which were used in the 1600s, became popular in the United States after the Civil War.

History Cont’d

In 1881, the cigarette-making machine was introduced by James Bonsack. This machine, in one day, could make 120,000 cigarettes.

Bonsack and James "Buck" Duke built a factory. This factory made 10 million cigarettes in their first year. Within five years, it had made around one billion cigarettes.

Duke of Durham was the name of the first brand of cigarettes. They were packaged with baseball cards. The American Tobacco Company was the first tobacco company in the US. It was owned by Buck Duke and his father, Washington Duke. It became the largest and most powerful tobacco company in the early 1900's.

The Marlboro brand was introduced in 1902, by the Philip Morris Company. R.J. Reynolds marketed the Camel brand of cigarettes in 1913.

History Cont’d

Early Anti-Smoking Movements• Early public health officials in the USA, as far back as

1931, began warning the public of the health hazards of smoking.

• Stanford researcher, Robert Proctor, explained in his book, The Nazi War on Cancer, the Nazi political elites at the top of government were health- conscious and viewed tobacco as a threat to their “master race.”

• It was the German scientist, Franz Muller, that conducted the first epidemiological study in 1939 that link tobacco to cancer. In 1943 two more German scientists confirmed cigarette smoking as a direct cause of deadly lung cancer.

History Cont’d

• During WWII, the production of cigarettes in the U.S. was up to 300 billion a year. Service men received cigarettes in their rations.

• They became loyal customers when they returned home.

• Six large cigarette companies emerged stateside after World War II: Philip Morris, R.J. Reynolds, American Brands, Lorillard, Brown & Williamson, and Liggett & Myers (now called the Brooke Group).

• They sold cigarettes in the U.S. and all over the world making millions of dollars.

Cigarettes in army rations and an advertisement for soldiers

History Cont’d

The Surgeon General of the U.S. released a report about the dangers of cigarette smoking in 1964. The report stated that cigarettes cause lung cancer. The Cigarette Labelling and Advertising Act of 1964 stated that every cigarette pack must have a warning label on its side stating "Cigarettes may be hazardous to your health."This brought about cigarettes with lower amounts of tar and nicotine and improved filters. This was called the "tar wars".

“Tar Wars”• Companies wanted to keep their smokers, so they redesigned cigarettes to seem safer. Filters came

first, then “low-tar” cigarettes. Low-tar, mild, light, or ultralight cigarettes were merchandised to seem safer.

• A smoking machine is used to determine the amount of tar in cigarettes. But this smoking machine can not tell how much tar a smoker inhales. If they inhale in long, deep, or frequent puffs, they will be getting the same amount of tar as a regular cigarette.

• In 1971, Marlboro Lights (Philip Morris)(now known as Marlboro Gold) became the best selling cigarettes.

• The reality is that there is no safe cigarette. • Light cigarettes do not reduce the health risks of smoking. • All tobacco products are harmful and can cause cancer.

Labeling Milestones of Cigarette Packaging

“Cancer by the Carton”• Reader’s Digest published “Cancer by the Carton” in 1952

The dangers of smoking started to become public knowledge:

Cigarette sales declined for the first time in more than two decades

• Tobacco Industry Research Council was formed as a response

Filtered cigarettes began being sold, promising a “healthier” smoke

Sales returned back to normal

(Cancer by the Carton, 2015)

The Beginning: Announcement

and “The Act”

• On January 11, 1964 the Surgeon General of the U.S. Public Health Service, Luther L Terry, M.D. released the findings of the first Surgeon General’s Advisory Committee on Smoking and Health tying cancer to cigarette use.

• This was the first step taken to reduce the health impact tobacco use imposed on the health and wellbeing of Americans

• Newspaper headlines and Televisions newscasts across the country broadcast the news of the findings eventually ranking this day among the top news stories of 1964.

(Luther, n.d.)

Headlines the day after the

Surgeon General’s

announcement

The Beginning in Cigarette

Warning Labels

(Category Archive:1964 Newspaper Headlines, 2011)

First Labeling Laws

Shortly after the Surgeon General’s announcement, the U.S. Congress adopted the:

•Federal Cigarette Labeling and Advertising Act of 1966 (The Cigarette Act)•Public Health Cigarette Smoking Act of 1969

Under Federal Trade Commission Jurisdiction these laws:•Required a health warning on cigarette packages (The Cigarette Act).•Banned cigarette advertising in the broadcast media. •Required warnings placed within any and all print advertising of cigarettes (1969).

•Called for an annual report on the health consequences of smoking by the FTC.

• Required the label warning: "Caution: Cigarette Smoking May Be Hazardous to Your Health"

• This only had to be in small print placed on one of the side panels of each cigarette package and prohibited additional labeling requirements at the federal, state, or local levels.

• The FTC issued its Congressional recommendations in June 1967 to change the warning label to: "Warning: Cigarette Smoking Is Dangerous to Health and May Cause Death from Cancer and Other Diseases.

(Federal Cigarette Labeling and Advertising Act of 1966, n.d)

“Original Act” First Warning Labels of 1965-67

Cigarettes “may” be hazardous?

Congress Passes the Public Health Cigarette Smoking Act of 1969

(Public Law 91–222) (FTC Jurisdiction)•Cigarette advertising is now prohibited on television and radio•Every cigarette package required to contain the label:

"Warning: The Surgeon General Has Determined That Cigarette Smoking Is Dangerous to Your Health.”

(Office of the Surgeon General, 2014)

The Next Step: Congress enacts Comprehensive Smoking Education Act of 1984 (Public Law 98-474) (CDC 1984; FTC 1986)

Seventeen years after the the Surgeon General’s announcement the FTC issued its 1981 Congressional report concluding health warning labels have had “little effect on public knowledge and attitudes about smoking.”

As a consequence four new specific health warnings requiring one warning on all cigarette packages and print advertisements are mandated:

SURGEON GENERAL’S WARNING: Smoking Causes Lung Cancer, Heart Disease, Emphysema and May Complicate Pregnancy

SURGEON GENERAL’S WARNING: Quitting SMoking Now Greatly Reduces Risks to Your Health SURGEON GENERAL’S WARNING: Smoking By Pregnant Women May Result in Fetal Injury,

Premature Birth, AND Low Birth WeightSURGEON GENERAL’S WARNING: Cigarette Smoke Contains Carbon Monoxide

(Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2009)

Tobacco Control Act

Requires all manufacturers and retailers to:

• Meet guidelines regarding labeling, branding, and advertisingProvide FDA with a list of ingredients

• Register all products and manufacturing facilities

• Obtain prior authorization for new products

Prior to the law, tobacco products were not regulated by the FDA.

The Family Smoking Prevention and Tobacco Control Act was signed in 2009 under President Barack Obama, giving the FDA the ability to regulate the manufacturing, distribution, and marketing of tobacco products, such as cigarettes, cigarette tobacco, roll-your-own tobacco, smokeless tobacco, and any other tobacco product deemed subject by law.

What the Tobacco Control Act Does

More specifically than giving the FDA authority to regulate the manufacturing, marketing, and distribution of tobacco, the Family Smoking Prevention and Tobacco Control Act:

• Restricts tobacco marketing and sales to youth• Allows the FDA the authority to require changes in product content, such as the reduction or

elimination of additives or nicotine• Regulates marketing claiming risks, prohibiting words such as “light”, “mild”, or “low” • Requires larger, more noticeable health warnings, taking up 50 percent of the front and rear

cigarette carton• Requires tobacco companies to fully fund any tobacco-related FDA costs• Prohibits the sale of all flavored cigarettes, with the exception of menthol

What’s next? The Final ‘Deeming’ RuleExpected to become effective August 8, 2016, the Final ‘Deeming’ Rule will give the FDA authority to regulate all products deemed tobacco, such as:

Electronic nicotine devices (e-cigs, vape pens, etc)

Cigars (Premium Included) Hookah Pipe tobacco Nicotine gel

These products will be held under the same regulations as tobacco products under the Family Smoking Prevention and Control Act.

International Labeling: WHO!s Tobacco Free Initiative,1998

Established the Framework Convention on Tobacco Control in 2003 becoming the first international tobacco control treaty to call for:

• Price and tax measures to reduce the demand for tobacco, and• Non-price measures to reduce demand for tobacco to include

packaging and labeling of tobacco products

First World No Tobacco Day, 31 May 2008 theme,

“Tobacco Free Youth” (Garwood, Lindmeier, 2016)

Garwood, Lindmeier, 2016)

The Future is Now: WHO!s World No Tobacco Day 2016International Labeling Timeline

Canada: 1st country to implement graphic warnings in 2001.

Australia: 1st country to introduce plain/ standardized packaging requiring graphic warnings cover 75% of front and 90% of back in 2012.

77 countries and territories require graphic warnings in 2016.

The United States tied for last among 55 other countries that do not require any graphic health warnings.

Tobacco free advocates calling for FDA to develop and implement large, graphic warnings, as required by U.S. law to replace 30 year old labeling. “Plain packaging reduces the attractiveness of tobacco products. It kills the glamour, which is appropriate for a product that kills people.” WHO Director-General Dr. Margaret Chan.

Poster based on image from the Commonwealth of Australia

(Garwood and Lindermeier, 2016)

Master Settlement of 1998Known also as the

“Big Tobacco Settlement of 1998”

The First Lawsuits Against Cigarette Manufacturers Before The MSA

After the Reader’s Digest article and other early studies in the 1950’s linked lung cancer to smoking cigarettes, some people began to sue cigarette manufacturers under several legal theories:• Negligent manufacture- the tobacco companies were irresponsible in care in making and marketing their product.

• Product liability- their product produced and marketed was unfit for use.

• Negligent advertising- cigarette manufacturers failed to warn consumers the risk of smoking.

• Fraud and violation of existing state consumer protection statutes that prohibit unfair and deceptive business practices.

Big Tobacco won each and every initial lawsuit. They used their mighty power and resources never to settle out of court and won by arguing convincingly that:

• Tobacco caused no harm to smokers.

• If smoker’s got cancer, it came from something else.

• Anyway, smoker’s assumed the risk of cancer when they decided to smoke.

Fast Forward to the 80’s • Big Tobacco’s early victories thwarted most new attempts to sue through the 1960’s and 1970’s even while

evidence of the harmful effects of tobacco continued to mount.

• Cipollone v. Liggett was a landmark case in which the plaintiff and her family claimed Liggett & Myers Tobacco Company, makers of Eve 120’s, aggressively marketed for women, knew their product was both addictive and caused lung cancer but did not warn customers.

• The plaintiff’s husband was awarded $400,0000.

• Liggett & Myers used their vast resources and the decision was reversed on appeal.

The 90’s, A Decade of Reckoning for Big Tobacco By the 1990’s Big Tobacco’s long winning streak

in court commenced changing when plaintiffs began to gain some ground with success in lawsuits.

With the ever mounting evidence that their product was both extremely harmful and addictive, internal company documents leaked that proved Big Tobacco companies were well aware of these facts yet they continued to market cigarettes aggressively.

By early 2000, a California jury awarded a smoker with inoperable lung cancer the first significant win and Philip Morris had to pay $51.5 million.

When states started suing for reimbursement of Medicaid cost to cover the ill effects of tobacco, and had the resources to mount a viable fight, it lead to the Master Settlement Agreement.

The Genesis of

The Master SettlementAgreement

• In 1994, a number of states, beginning with Mississippi, sued the largest cigarette manufacturers under a variety of legal theories, including state consumer protection and antitrust laws, arguing that cigarettes contributed to health problems that triggered significant costs to state health-care systems.

• In 1997, four states (Mississippi, Minnesota, Florida, and Texas), reached settlements to recover for medicaid and other health expenses resulting from smoking-caused illnesses.

• After these settlements, the major manufacturers, facing a growing number of suits by other states, joined with those states and petitioned Congress for a global resolution in June 1997.

• Congress failed to pass the global settlement agreement, but the manufacturers and the Settling States were still able to reach a settlement in November of the following year: the Master Settlement Agreement.

The 46 States1. Alabama 2. Alaska 3. Arizona 4. Arkansas 5. California 6. Colorado 7. Connecticut 8. Delaware 9. Georgia 10.Hawaii 11.Idaho 12.Illinois13.Indiana 14.Iowa

15.Kansas 16.Kentucky 17.Louisiana 18.Maine 19.Maryland 20.Massachusetts21.Michigan 22.Missouri 23.Montana24.Nebraska 25.Nevada 26.New

Hampshire 27.New Jersey

28.New Mexico 29.New York 30.North Carolina 31.North Dakota 32.Ohio 33.Oklahoma 34.Oregon 35.Pennsylvania36.Rhode Island 37.South Carolina 38.South Dakota 39.Tennessee 40.Utah 41.Vermont

42.Virginia 43.Washington 44.West Virginia 45.Wisconsin 46.Wyoming

The FiveU.S.

TerritoriesAmerican Samoa

GuamNorthern Mariana Islands

Puerto RicoThe Virgin Islands

AndThe District of Columbia

MSA of 1998 Cont’d

• In addition to requiring the tobacco industry to pay the settling states approximately $10 billion annually for the indefinite future.

• The MSA also set standards for, and imposed restrictions on, the sale and marketing of cigarettes by participating cigarette manufacturers.

• The Settling States gave up any future legal claims they might have based on the cigarette companies’ actions at issue in the settled lawsuits. This did not include the individual claims of their residents.

What does the MSA do:“It imposes significant prohibitions and restrictions on tobacco advertising, marketing and promotional programs or activities. For example, it prohibits or restricts ‒”

● Direct and indirect targeting of youth ● Use of cartoon characters ● Billboards, transit ads, and other outdoor advertising not in direct proximity to a

retail establishment that sells tobacco products ● Product placements in entertainment media ● Free tobacco product samples (except in adult-only facilities) ● Gifts to youth in exchange for proofs of purchase ● Branded merchandise ● Brand name sponsorships” (Tobacco Control Legal Consortium, 2015)

What Does the MSA do:

Cont’d

“It prohibits certain practices that seek to hide negative information about smoking, such as:

● Lobbying against particular kinds of tobacco control legislation and administrative rules

● Agreements to suppress health-related research● Material misrepresentations about health consequences of using tobacco”

(Tobacco Control Legal Consortium, 2015)

American Legacy Foundation and the Truth (anti-tobacco campaign)

• One of the early recipients of MSA funding was the American Legacy Foundation, the first national public health organization solely dedicated to tobacco control, founded in 1999.

• Their Truth Initiative launched in 2000, with the Mission: Educate youth and young adults about negative impact of tobacco to reach a goal that they have reject tobacco, in a way that they can relate and understand. It’s that simple: JUST SPEAK THE TRUTH!!!

• The truth research team identified effective information to reduce the harm of tobacco smoke, put interventions in place so that tobacco control can be practiced.

• Belief System: A generation free of tobacco is possible if there is education about the influence of tobacco and youth have a good support system in place. Youth can realize they have the power to say no to tobacco, preventing a life full of negative consequences.

• Impact: People need to hear the truth. The truth saves lives. Attitudes, beliefs, and behaviors can be changed.

False computer purchases totaling $3.4 million from 1999 to 2007 went undetected due to inadequate financial controls and audits

The Truth (anti-tobacco campaign)

Cont’d• The Campaign started nationwide in 2000 with The Truth tour featuring anti-smoking

information to teens at music and sports venues across the country.

• In 2005, The American Journal of Public Health credits Truth with a decline of 22 percent of the overall youth smoking rates from 2000 to 2002. That’s a decrease of 300,000 fewer smokers in 2002.

• Today……… 7% is the new number of teen cigarette use, decreased from 23% in 2000.

Where Did the Rest of the Money Go?

Big Tobacco agreed to a minimum of $206 billion payment over the first 25 years paid to 42 of the 46 states in the agreement (four states attained separate settlements). There was no written agreement how the funds were to be spent. It was just assumed the intention was for tobacco prevention. While a fraction of the money did go to tobacco deterrence, many states took the bonanza of extra funds for unrelated purposes. Some examples include:

• Alaska, - $3.5 million on shipping docks

• Niagara County, N.Y., - $700,000 for a public golf course’s sprinkler system and another $24 million for a county jail and an office building

• North Carolina, - $42 million for modernization and marketing for the tobacco farmers

Where Did the Rest of the Money Go?

Cont’d

• Many states thought it prudent to mortgage any future payments as collateral for issuing bonds and chose to spend all their cash from the settlement upfront for pennies on the dollar.

• What happened to all those anti-smoking ads that should have flooded the airwaves and print after the MSA? As reported by Tobacco-Free Kids, the states spent only 1.9 percent of their settlement payments and tobacco taxes on prevention programs in 2014.

Milestones in Surgeon General's Reports• In the 1964 report, the Advisory Committee officially stated that smoking

cigarettes:• Leads to lung and throat cancer

• Is the most significant cause of chronic bronchitis

• Even before the 1964 report was released, the previous Surgeon General had advised against smoking, stating that it created insomnia, nervousness, and other negative effects in young women.

• Many physicians at the time believed women were more susceptible to diseases and harm than men.

• But overall, most physicians at the time believed smoking tobacco did not cause any major health issues.

• Many physicians actually smoked on a regular basis.

• (Office of the Surgeon General, 2014)

Milestones in Surgeon General's Reports Cont’d

• In 1988, Surgeon General, Dr. C. Everett Koop, declared in a 618-page report tobacco went beyond just a dangerous habit but was a severe form of addiction. This was not based on any new evidence just the preponderance of the work of over 50 scientists and more than 2000 peer scientific articles.

• The 2010 Report of the Surgeon General established there was no risk-free level of tobacco smoke exposure which included both all exposure to second-hand smoke and even an occasional cigarette. All exposure, even small amounts of tobacco smokes is harmful.

Some information presented in the Surgeon General Reports:

(Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2015)

50 Years of Progress• In 2014, the Surgeon General’s Report on Smoking and Health celebrated its 50th anniversary.

• This report presented new information on the health consequences of smoking cigarettes and how tobacco control has changed over the past 50 years.

• Since the initial report in 1964, there have been a total of 29 different Surgeon General Reports documenting the harmful effects of tobacco. (Office of the Surgeon General, 2014)

(Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 2015)

50 Years of Progress• 1964 The First Surgeon General Report on Smoking

and Health was released.• 1973 Arizona became the first state in the United

States to limit tobacco smoking in some public locations.

• 1988 Nicotine present in cigarettes was declared an addictive substance.

• 1990 Congress required all airline companies to be considered smoke-free.

• 2009 The largest federal tax on tobacco was created.• 2014 After 50 years, American smoking rates

dropped significantly from 42% to 18%.

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