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Updated May 2011  

What are the most recent developments in the tobacco controversy?

The popularity of tobacco use continues to steadily decline as adult use continues to decrease significantly each year.  (Click to see chart)  States and localities are continuing to enact smoke free laws and ordinances which makes the practice even less socially acceptable. There has been a very significant recent decrease in the percentage of youth who take up the habit. There is even some evidence that the U.S. tobacco industry is beginning to abandon its efforts to oppose legislative restraints on smoking and even engage in some effort to discourage smoking. In a 2004 Senate vote, most Republicans joined Democrats in approving an expanded role for the Food and Drug Administration in tobacco control in exchange for a buyout of tobacco farmers.   The effort to curtail tobacco use has increased throughout the world as more countries continue to tax tobacco heavily and restrict its use in public facilities.

How did tobacco use become so popular?

Tobacco was discovered by the European explorers to the New World and its use became popular throughout Europe and Asia in following centuries. But was not until the late 19th century that manufacturing processes for cigarettes and matches made the use of tobacco cheap and convenient. In the United States, cigarette smoking per capita grew enormously throughout the 20th century, particularly in the post-World War 2 era when smoking was constantly promoted through television advertising.  (Click to see chart)   Although concerns regarding the health hazards of cigarette smoking began in the 1950's, there was little understanding of the addictive nature of nicotine until quite recently. In retrospect, it is clearly nicotine addiction that continues the fuel the tremendous demand for tobacco products.

What is the relationship between tobacco use and public health?

The turning point in public attitudes toward tobacco began with the Surgeon General's report in 1964. That report that concluded that cigarettes were a major cause cancer and several respiratory diseases. The statistical relationship between lung cancer and smoking can be demonstrated by the high lung cancer rate in countries where smoking is prevalent and the comparatively low rate in countries where smoking is less prevalent.    Although cancer, particularly lung cancer  (Click to see chart) , is a major cause of smoking-related mortality, over half of all tobacco-related deaths are due to other medical conditions.

What has been the result of the Surgeon General's report?

The decades following the Surgeon General's report have propelled tobacco regulation into a major public policy issue. Beginning with the TV advertising ban in 1971, cigarette usage in the United States has diminished substantially, particularly among adult smokers.    Interestingly, the earlier increase in the popularity of cigarette smoking can also be linked to the beginning of radio and television advertising.    A substantial percentage of high school students still experiment with cigarette use although a low percentage are regular users.   

Overall, just over 20% of the adult population presently smokes cigarettes.   The prevalence significantly varies from state to state.  (Click to see map)    Those who have had some college education are significantly less likely to be smokers.    Almost 50% of one-time smokers have successfully quit smoking. The success rate varies significantly with the smoker's education level.    According to the CDC, among the adult smokers who remain, about 70% want to quit.

The reduction in smoking has been the result of a variety of governmental measures undertaken to discourage the public from smoking. The earliest and perhaps the most important was the ban on cigarette television advertising which began in 1971. Television advertising had been the major vehicle for cigarette promotion prior to this ban.    Manufacturers have been required to place warning labels on cigarette packaging and on print advertisements. A significant number of states tax cigarettes by over 50¢ per pack.    This increase in taxation places a considerable financial burden on low income individuals, particularly the mentally ill. Almost 90% of adult schizophrenic sufferers are heavy smokers and on an average must pay 27% of their income on tobacco products. According to one study, 44% of all cigarettes sold are to mentally ill individuals. See summary from Schizophrenia.com With varying degrees, many states have also enacted restrictions on smoking in public places.    As smoking declines in popularity, public opinion for these restrictions has grown.

Counteradvertising and public education campaigns have also become standard elements of tobacco control, although their funding levels and aggressiveness vary considerably among the states. An evaluation of the California tobacco control program concluded that it was most effective when it received a high level of funding and when advertisements emphasized deceptive practices undertaken by tobacco firms.

How have tobacco companies reacted to the attack on their product?

About half of the U.S. cigarette market has been controlled by Phillip Morris; the remainder is divided among just four other companies.    Following the Surgeon General's report, these companies have engaged in a variety of tactics. Initially in advertisements which are now being used against them in litigation, the companies initially insisted that there was no proven link between smoking and cancer and the issue was one of an "open controversy".

Although banned from television advertising, the companies substantially increased their investment in product promotion. Even when the figure is adjusted for inflation, tobacco companies now spend over five times more on promotion today than they did in 1970.    It is widely believed that the "Joe Camel" advertising campaign initiated by R. J. Reynolds in 1988 led to a significant rise in adolescent smoking. Very little promotional dollars are now spent on advertising; the bulk of promotional costs are now for price reductions in an effort to counteract increasing excise taxes.

Tobacco companies also began to spend heavily on political contributions and lobbying.    In California, a recent study has shown a significant correlation between such contributions and the legislative behavior of the donees.   The expenditures have unquestionably helped the industry. A California legislative initiative passed by the voters in 1988 was undermined by Republican Governor Pete Wilson. And despite initial optimism that Democratic Governor Gray Davis would reverse this trend, he also opposed substantial increases in funding for tobacco control.

How has litigation affected the tobacco companies?

Recently liability lawsuits have become a concern for tobacco companies. A $3 billion California award against Philip Morris in June 2001 was among the top 10 jury verdicts in the country.

Lung cancer victims began filing liability lawsuits against tobacco companies as early as 1954. In 1983 a deceased smoker was awarded $400,000, but the decision was overturned and her family could not afford to appeal. In 1992, the US Supreme Court ruled that warning labels on packs of cigarettes do not shield tobacco companies from lawsuits. In recent years litigation has gained momentum in the wake of evidence that companies purposefully withheld information about health risks of tobacco and the addictive nature of nicotine.

In 1994 and 1995, Mississippi, Minnesota, West Virginia and Florida filed lawsuits in state court against the tobacco industry to secure reimbursement from it for health care expenditures for ailments arising from tobacco use. They were shortly joined in their endeavor by 41 other states. Initially a settlement was proposed which would require Congressional legislation to provide it with the force of law. A bill authored by Senator John McCain had bipartisan support but the tobacco companies opposed language in the bill which would have required significant limits on advertising and the bill ultimately died in committee. Ultimately a comprehensive settlement was reached without Congressional legislation. The major provisions of the settlement agreement are:

  • Additional limits have been placed on cigarette promotion including a ban on billboard advertising and free product distribution in areas where minors have access.

  • Tobacco companies are required to contribute $300 million a year for five years to a newly created National Foundation for Public Education. An additional $5 million per year is to be paid to this foundation for research on tobacco use and other substance abuse.

  • The agreement dissolved the Tobacco Institute, the Council on Tobacco Research, and the Center for Indoor Air Research, which had been used by the tobacco industry for public relation purposes.

  • The agreement requires the tobacco companies to pay approximately $195.9 billion to the states between now and 2025 (in current dollars). These payments are indexed to inflation, but will be reduced if the participating tobacco companies' combined U.S. cigarette sales or their combined percentage share of the total U.S. cigarette market goes down. The agreement places no restrictions on how the states must spend the settlement funds they receive.

Critics of the tobacco settlement maintain that it does not sufficiently address many forms of cigarette promotion such as magazine and newspaper advertising and "in-store" displays. The also note that by failing to ban vending machines, it does not sufficiently prevent minors from accessing cigarettes. Nor does it require more effective and more visible health warnings on tobacco products; establish Food and Drug Administration authority over tobacco products; or restrict US tobacco company marketing to youth overseas.

In addition, tobacco opponents are dismayed that there is no restriction on the use of settlement funds and thus they are not being used for tobacco control. In the wake of current budget shortfalls, many states are applying these payments to the state general fund. Overall, states are falling fall short of CDC recommendations for tobacco control spending.    A Michigan measure which would have mandated that the bulk of the tobacco settlement funds be spent on antismoking education and health care was decisively defeated by voters while a similar measure prevailed in Montana.

Have other countries also attempted to reduce the prevalence of cigarette smoking?

Globally, the prevalence of smoking in the United States is significantly higher. In less developed countries, there is a striking difference between male and female prevalence. For example, in China the female smoking rate is minimal, but because over 60% of men smoke, there are more Chinese smokers than the entire U.S. population. There has been a signficant reduction in tobacco use in many developed countries. . Many countries now have placed limits on tobacco advertising and on smoking in public places.

Despite the decreasing demand in developed countries, there has been a marked increase in overall global cigarette production since 1970. The increased demand has primarily come from developing economies, particularly in Eastern Europe and Asia. As a result of increased global demand, the U.S. domestic production of cigarettes continued to increase until approximately 1997, long after the domestic demand for cigarettes had decreased.    The emergence of smoking prevalence in the less developed world is being addressed by the World Health Organization. Recognizing the seriousness of the problem, there was widespread approval for the adoption of a Framework Convention on Tobacco Control (FCTC) - a new legal instrument that could address issues as diverse astobacco advertising and promotion, agricultural diversification, smuggling, taxes and subsidies.

Tobacco Links

Wikipedia – Tobacco Smoking

Wikipedia – Tobacco Control Movement 

Wikipedia – Cigarette Advertising

Wikipedia - Cigarette

Wikipedia – Tobacco Industry

Wikipedia – Health Effects of Tobacco

CDC – Smoking and Tobacco Use 

Tobacco Control- World Health Organization

TobaccoPedia - The Online Tobacco Encyclopedia

American Cancer Society: Tobacco and Cancer 

American Lung Association: General Smoking Information 

Foundation for a Smokefree America 

thetruth.com

Action on Smoking and Health (ASH) 

Airspace Action on Smoking and Health

Americans for Nonsmokers' Rights (ANR) 

Californians for Smokers' Rights 

Forces International 

Nicotine - How Stuff Works

Cancer - How Stuff Works

GlobalLink – Global Tobacco Control

American Cancer Society Tobacco Site 

American Lung Association – Stop Smoking

Smoking Lobby – Smoker's Rights

 

 

Tobacco Charts
(click to enlarge)

Percentage of Adult Smokers 1965-2009
Senate Vote on Tobacco Buyout and Regulation
Cigarettes Per Capita in the U.S. 1900-2006

Statistical Relationship Between Smoking and Lung Cancer

Smoking-Related Cancer Mortality 2000-2004

Smoking-Related Mortality in the U.S. 2000-2004

High School Student Cigarette Use 1991-2007

Percentage of Adult Cigarette Users By State

Percentage of Current, Former and Never Smokers 1965-2005

Effect of Educational Status on Smoking Prevalence, 2009

Ratio of Former Smokers to Current Smokers by Education

Tobacco Advertising 1970

Excise Tax Per Cigarette Pack

Public Smoking Restrictions by State

Public Opinion on Smoking Restrictions

Market Share of U.S. Tobbaco Companies in 2000

Cigarette Promotional Expenses 1970-2006

Distribution of Tobacco Company Promotional Costs, 2006

Tobacco Company Political Contributions

Lobbying Expenses by the Tobacco Industry

California Study on Tobacco Politcal Influence

State Spending on Anti-Tobacco as Percentage of CDC Recommendations

Global Smoking Prevalence Among Men

Global Smoking Prevalence Among Women

Male Smoking Trends in Selected Countries

Global Policies on Cigarette Advertising

Status of Global Restrictions on Smoking in Public

Global Cigarette Production, 1970-2004

U.S. Cigarette Production, Consumption and Exports 1950-2005