Huffpost New York
The Blog

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors

Audrey Silk Headshot

More State Funding for Tobacco Control Programs? Don't Believe the Hype.

Posted: Updated:
Print Article

With New York State interests leading the way, the river of tears coming from anti-smoker proponents across the country over budget cuts to state-run Tobacco Control programs is about to flow from the top. The Associated Press alerts us that on March 8 the U.S. Surgeon General's office will release a tantrum damning states over their respective cuts.

Obviously the stature of the office is meant to impress but keep in mind that the report is overseen by Terry Pechacek who is the director for science in the Office on Smoking and Health at the Centers for Disease Control and Prevention (CDC) and an anti-tobacco activist since the 1970s. In other words, the report will not be coincidental in agreement but rather a partnership and calculated set-up.

Mr. Pechacek was just in N.Y. to personally oppose Albany's cut to its program. Funding in N.Y. currently stands at $41.4 million and will be reduced by $5 million in the coming fiscal year.

Declarations of how "successful" and "effective" the program is, present the defenders' case for richer funding. Where's the scrutiny?

The end figure boasted as hard fact isn't. We can't know what it is but neither can they.

Smoking prevalence statistics are obtained using telephone surveys. This self-reporting method is wholly unreliable. Belong to a vilified group and you'll lie when asked if you smoke. The CDC itself warns of this flaw. Count these annual surveys as an exercise in measuring honesty, not smoking rates.

It couldn't be more evident when, in 2005, NYC announced that smoking rates for 2004 stood at 18.4 percent. In 2009 the city released a study conducted in 2004 that went a step further by actually measuring cotinine (a byproduct of nicotine) in subjects. The rate found was 23.3 percent, "reflecting a more accurate assessment." A five percentage point difference is huge and they've never announced a public correction. How then to trust any year's figures and the ensuing year-to-year comparisons?

How can the means -- shady claims more easily debunked -- be justified if the end is so shaky?

Tobacco tax increases are cited as one of the top tools for reducing smoking. But NYS Department of Health's own 2010 report finds that in the year following the $1.50 per pack hike (to $2.75) in 2008 that smokers did indeed feel the effect but "rather than making more quit attempts or smoking less many found ways to obtain lower cost cigarettes" and that "daily cigarette consumption by New York smokers was virtually unchanged after the tax increase."

It goes on to say, "Neither tax increase [NYS June 2008 and Federal April 2009] appears to have any notable effect on the number of calls to the Quitline." The Quitline is their baby. It illustrates that the lack of interest from smokers has nothing to do with how much funding they receive and wouldn't change it if they had more. A saturation point has been reached where not even a favorite weapon -- high taxes -- is creating added incentive to call. Virtually no smoker can say they haven't heard of it after years of ad bombardment.

Aside from counseling these Quitlines rely heavily on pushing Nicotine Replacement Therapies (NRTs) such as the patch and gum. There have been two recent reports that find a failure rate so large that almost every penny invested disappears down a black hole.

While slanted toward concluding effectiveness, a closer inspection of the content of one reveals that only 1.6 percent of smokers achieved sustained abstinence. Conversely the failure rate is 98.4 percent. Dr. Michael Siegel, professor at Boston University of Public Health with over 20 years experience as a tobacco control researcher, concluded, "No one in their right mind would consider a 1.6 percent success rate with NRT to be 'effective.'"

The other -- published just this January by the Harvard School of Public Health -- followed 800 smokers long-term. Rabidly anti-smoking researcher and co-author Greg Connolly said, "One of cornerstones of [the state's Tobacco Cessation and Prevention Program] was to enhance counseling and access to nicotine replacement therapies. Yet what we found is that they have absolutely no effect." He even cautioned public health officials to think twice about how much money they spend on smoking cessation programs.

The program is also responsible for overseeing television and print ads. This tactic has not received positive reviews lately. One study concluded, "These messages are designed to scare people so that they don't smoke. It appears that this strategy may backfire." A psychological study where smokers viewed No Smoking signs "indicates that anti-smoking messages really do prompt smokers to light up." Separately, the FDA examined effectiveness of graphic images in its lead-up to implementing the Tobacco Control Act's proposal to put them on cigarette packs. They initially estimated that "the U.S. smoking rate will decrease by 0.212 percentage points" as a result of the proposed rule, a statistic the FDA admits is "in general not statistically distinguishable from zero." Ultimately that figure dropped to .088 percent in their final rule.

There was once a time where government involvement over smoking meant warning people that they were assuming a health risk and offering advice or services to those who wanted it. No one had a problem with that. Then it got ugly. Governments funding of programs whose tactics are crafted to coerce and demonize the smoker is beyond their bounds. They're no longer funding a health campaign. It's a hate campaign. With all the uproar over bullying these days the state is guilty of it and funding it.

As long as tobacco and smoking are still legal the people have more of a right to choose to smoke than the government has in this business. Even if smoking means taking a risk that's an individual's choice to make. It's private. There's nothing public about it. And no amount of the debatable "we pay smokers' health care" -- the refrain most often heard and leveled the heaviest by the non-smoking public -- can touch a most basic fundamental question: at what price freedom? No, no one has to smoke but no one has to do a lot of things except drink water and eat soy. Pleasure is subjective; life is for living, not merely a race to exist for as long as one can. Do this, don't do that; there are no guarantees.

Those running tobacco control today can be described as the radically religious crazy lady who, to save her daughter from "temptation," shackles her with a chain to the radiator. Would we say the end justifies the means and give her money when she cries she can't pay the rent so she can do more of the same?