Why We Should Ratify: The Framework Convention on Tobacco Control and Low SES Populations

World No Tobacco Day 2011 is here, and the theme this year is “The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC).”

By Lisa Houston, Break Free Alliance Program Administrator

The FCTC was created in 2003 as the world’s first global tobacco treaty and has some significant success stories to share. But for those of us fighting to retain funding and momentum for tobacco control here in the U.S., what’s our connection to a global tobacco control treaty that seems to be taking place in countries whose struggle with tobacco appears to have no bearing on our own progress?

In particular, how is it linked to the tobacco-related burden suffered by disadvantaged populations in the U.S.?

As tobacco control regulations in the United States have eaten into profits, transnational tobacco companies (TTCs) have increasingly concentrated their efforts abroad to make up the difference. They focus on countries where it’s still possible to advertise their lies on billboards, sponsor large concerts, and keep prices low. They find ways to sue countries who are making progress in tobacco control legislation.

Like here, in these countries the most vulnerable populations – the ones with low education levels, low income, and insufficient access to health care – use tobacco the most and suffer the most.

Below are just some of the ways low socioeconomic status (SES) populations are affected by the tobacco industry both here and abroad.

In the United States:

• Loopholes in laws (often due to tobacco industry efforts) mean service workers and other blue collar or low income workers are exposed to cigarette smoke
• Socially marginalized groups such as the homeless and the mentally ill have been targeted by the tobacco industry and currently have very high smoking rates
• Poor people spend money on tobacco instead of food

In developing/transitioning countries:

• Women in developing countries are heavily targeted with ads promising luxury and beauty
• Children from poor households are vulnerable to “green tobacco sickness” when working in tobacco fields to earn income for their families
• Poor people spend money on tobacco instead of food

The more successful TCCs are in these new and/or under-regulated markets overseas, the more revenue they have to fight against our progress here. When TCCs are

“They have to find a way to feed the monsters they’ve built. Just about the only way will be to increase sales to the developing world.” Ex-tobacco company employee, R. Morelli, explaining the importance of the developing countries to the industry.

victorious in defeating legislation that could protect low income workers by spending massive amounts of money to launch attack campaigns, hiring lobbyists and buying out legislators, you can bet some of that money was made off the backs of impoverished people in developing countries.

Also, by ratifying the FCTC, the U.S. would be obligated to cover tobacco cessation in all federal health care programs, which could have a significant positive impact of the ability of low SES populations to access these programs and quit.

These are but a couple of the benefits to disadvantaged populations here if the U.S. ratifies the FCTC. If you have others, feel free to share them in the comments section below. More arguments for increased U.S. involvement in global tobacco control in general can be found here.

Back in his Senate days, President Obama indicated strong support for the FCTC, but given all of the competing issues he now faces, an extra push may be needed.

TAKE ACTION by urging President Obama to send the FCTC to the Senate for ratification.

Rolling Up Our Sleeves with Communities Putting Prevention to Work

Janet Porter and Kristi Maryman staff the Break Free Alliance table at the Tobacco Control Network reception

by Kristi Maryman, Break Free Alliance Program Coordinator

As I look back on all that took place at the Communities Putting Prevention to Work (CPPW) Annual Training that took place March 28-30, I feel fortunate to have been in the company of the numerous states, tribes, territories and communities who are doing amazing work in both obesity prevention and tobacco control. To see everyone coming together at this collaborative event to build environments that promote health was inspiring!

The National Networks for Tobacco Control and Prevention kicked off a session on Tuesday that was moderated by Break Free Alliance’s Program Director, Janet Porter. The session highlighted national network partnerships with states and included discussion time at breakout tables with representatives from each of the six funded national networks. Take home messages:

1) The national networks are important resources to the states and others working to reduce tobacco-related health disparities.
2) Policy-based initiatives in tobacco control will not succeed unless communities are engaged and a part of the process.

As a result of the session, one participant came forward to say that he will be requesting a letter be sent from his state health department to HHS officials to ensure that the national networks remain a part of the CDC Tobacco Control Program!

I presented in a workshop about making cessation more accessible in mental health or substance abuse treatment centers and prisons. Specifically, I spoke about addressing tobacco use among inmates, and many people were shocked by the statistics showing inmates having either a mental illness (40%) and/or are substance abusers (80%).

One of the take home messages from the panel was that if health care and/or public health professionals are working in one of the three populations to address tobacco use, that they also may be coming in contact with patients who have dual addictions, were previously incarcerated and/or have a mental illness…in other words, we can adopt similar models and best practices to address tobacco use across these populations.

The tobacco-free policy and cessation programming strategies that were presented by the panel shared some similarities. Here are some of those strategies:

• Integrate tobacco-free policy and cessation programming into existing systems where these populations are in order to change social norms
• Reach out to local health care clinics, community based organizations, missions, and multi-unit housing dwellings to reach these populations once they are released from prison or a substance abuse/mental illness program to continue to offer cessation resources for those wanting to quit tobacco
• Use nicotine replacement therapies (specifically nicotine patches) to  assist these populations in quitting

I will leave you with this, which was an “ah-ha” moment with session attendees: the average sentence of an inmate lasts only three years, and after that these newly released inmates return to our communities. They are in need of tobacco cessation programming and want to quit, as are others struggling with mental illness and substance abuse. We have to ensure ALL of our community members have access to cessation resources and are protected from the dangers of tobacco use and second-hand smoke.

As always, we encouraged everyone we connected with to sign up to become partners with Break Free Alliance – and we encourage you to do so as well! To find out more about us, you can visit us here.

On a final note, did you know that Break Free Alliance’s fiscal agency, the Health Education Council, has several obesity prevention programs and nutrition/physical activity resources that CPPW grantees and others working on obesity initiatives can take advantage of?  Check them out!

What topic would you like to see a blog posting about (relevant to tobacco control and low socioeconomic status populations)? Let us know!