OF TOBACCO USE · Indeed, some 450,000 people will die this year due to tobacco-related illnesses. What’s more, 50,000 people die each year from secondhand smoke-related diseases

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Tobacco use remains the leading cause of death in the United States. Indeed, some 450,000 people will die this year due to tobacco-related illnesses. What’s more, 50,000 people die each year from secondhand

smoke-related diseases. If left unchecked, by the year 2020, tobacco is projected to kill about 10 million people a year worldwide. This issue of Absolute Advantage is dedicated to addressing tobacco use at the workplace.

Give others in your company the Advantage. Please route to: q Senior Management q Human Resources q Benefits Department q Fitness Center

THE BURDENOF TOBACCO USE

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From The Executive Editor InthisissueofAbsolute Advantagewe’lladdressthetopicoftobaccouseattheworkplace.Althoughoftentimesneglected—largelyduetothenation’snewfocusonobesity—tobaccouseisacriticalissuethateveryemployerneedstoaddress.

Withhealthcarecostsapproaching1.8trillionandhealthcarebecomingapreciousresource,proactiveemployersaretakingboldandaggressivestepstostemmingthetideoftobaccouseattheworkplace.

Inthisissue,we’llexaminetheburdenoftobaccouseintheUnitedStates.Evenforthemosthardenedofskeptics,thestatisticsaresimplystaggering.

Havingprovidedanaerialviewoftheissue,we’lldelveintoaseriesofarticlesaddressingcommonlyaskedquestionsaboutcigarettes,cigars,andsmokelesstobacco.

Tohelpyouinyourquesttoaddresstobaccouseattheworkplace,we’veprovideddozensofeasy-to-implementideas.We’vealsohighlightedafascinatingwebsite—www.thetruth.com.Inaddition,we’llshareaninterviewdonewithJeffreyWigand,aformertobaccoindustryinsider.Finally,we’llexamineacasestudyofWeyco,Inc.,acompanythathassetapolicytofireitssmokers.

Ihopeyouenjoythisissue.I’dliketorecognizetheNationalCancerInstitutefordevelopingandmakingavailablemuchoftheinformationcontainedinthisissue.

Yoursingoodhealth,

Dr.DavidHunnicuttPresident,WellnessCouncilsofAmerica

David Hunnicutt, PhD

With healthcare costs

approaching 1.8 trillion

and healthcare becoming

a precious resource, proactive

employers are taking bold

and aggressive steps to

stemming the tide of tobacco

use at the workplace.

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Information in this publication is carefully reviewed for accuracy. Questions, comments, or ideas are welcome. Please direct to Dr. David Hunnicutt, Executive Editor, at the address below. Information may not be reproduced, copied, cited, or circulated in any printed or electronic form without written permission from the publisher. ©2006 Wellness Councils of America, 9802 Nicholas Street, Suite 315, Omaha, NE 68114; phone (402)827-3590; fax (402) 827-3594; visit our website at www.welcoa.org. All rights reserved. ISSN 1538-0084.

Ab•sol•ute Ad•van•tage: When a company can produce more than its competitors—even though they have the same amount of resources—it has an absolute advantage.

We believe wellness is that advantage.

WELCOMEAbsolute Advantage is the interactive workplace wellness magazine that helps large and small employers link health and well-being to business outcomes. Absolute Advantage arms business leaders and wellness practitioners with leading-edge workplace wellness information straight from the field’s most respected business and health experts. With its online component, Absolute Advantage provides the industry’s most current and accurate information. By logging on to the magazine’s interactive website, you can access a whole new world of health promotion—including in-depth interviews with national health promotion experts and insider’s information about industry products.

SUBSCRIPTION INFORMATIONFor information about subscribing to Absolute Advantage, contact the Wellness Councils of America at (402) 827-3590 or via e-mail at [email protected].

Organizational Founder, William Kizer, Sr.

EXECUTIVE EDITOR | David Hunnicutt, PhDDr. Hunnicutt is President of the Wellness Councils of America. As a leader in the field of health promotion, his vision has led to the creation of numerous publications designed to link health promotion objectives to business outcomes.

VICE PRESIDENT OF MARKETING | Galen MoesWith more than 15 years experience in a Berkshire-Hathaway company, Galen joined WELCOA as Vice President of Marketing and is responsible for developing strategic direction and taking the primary leadership role in marketing all of WELCOA’s products and services throughout the US.

SENIOR EDITOR | Mike Perko, PhDDr. Perko has significant experience in worksite wellness. Currently the Chair of Health Education at the University of Alabama, Dr. Perko also serves on WELCOA’s Medical Advisory Board and often speaks on behalf of the Wellness Councils of America.

MANAGING EDITOR | Brittanie Leffelman, MSBrittanie is the Director of Operations and manages major writing projects at WELCOA. With a Master’s Degree in Health Promotion, she regularly coordinates national health forums, major grants, and state and local wellness initiatives.

DIRECTOR OF MEMBERSHIP | David Steurer, MEdAs WELCOA’s Director of Membership, David is responsible for recruiting and servicing member organizations throughout the United States. David’s background has been grounded in worksite wellness for the past 25 years.

DIRECTOR OF COUNCIL AFFAIRS | Kelly Stobbe, MEdAs the Director for Council Affairs, Kelly is responsible for leading WELCOA’s cadre of locally-affiliated wellness Councils. In this capacity, Kelly coordinates the Well Workplace awards initiative as well as the Well City USA community health project.

DIRECTOR OF DESIGN & TECHNOLOGY | Justin EggspuehlerA 2001 graphic design graduate from Iowa State University, Justin studied design in Rome, Italy before joining the WELCOA design staff. He is responsible for the layout and design of many publications including The Well Workplace newsletter and Absolute Advantage magazine.

MULTIMEDIA DESIGNER | Adam PaigeAdam joined WELCOA in early 2005. With corporate experience in design and videography, He brings a wealth of talent to WELCOA’s publication. In the capacity of a multimedia designer, Adam contributes to the publications of The Well Workplace newsletter and Absolute Advantage magazine.

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450GreatIdeasToHelpYourEmployeesQuitSmokingIf you’re looking for easy-to-implement ideas to help you address smoking at the workplace, you’ll find this article helpful.

20Notable&QuotableThese maxims, mantras, and notable quotes about smoking and tobacco use will make you stop and think.

24Q&A:CigarSmokingCigars remain a leisure pursuit for many Americans. However, the risks of cigar smoking are very real.

28Q&A:“Light”CigarettesRecently, there’s been a lot of discussion and controversy surrounding “light” cigarettes. Get the real story.

32Q&A:SecondhandSmokeSecondhand smoke will kill 50,000 people in the US. Find out what the health effects of secondhand exposure really are.

36Q&A:SmokelessTobaccoAlthough smokeless tobacco is commonly overlooked, it remains an important issue of any tobacco cessation initiative.

40TheTruthIsFoundThe nationally recognized webiste, thetruth.com is an intriguing and enlightening place to visit. To discover the truth, read on.

44MoralTreason:AFormerTobaccoIndustryInsiderSpeaksOutJeffrey Wigand, the mythical figure that the movie The Insider was based on, speaks out about what he knows from his days as a tobacco scientist.

54HelpingYourEmployeesLiveTobaccoFreeCheck out this step-by-step approach to help your employees kick the habit.

58WhereThere’sSmoke...There’sANewKindOfFireEmployers are taking aggressive and bold measures to address smoking in the workplace. Don’t miss this article.

TheBurdenOfTobaccoUseAn estimated 45.8 million adults in the United States smoke cigarettes, even though this single behavior will result in death or disability for half of all regular smokers.

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nestimated45.8millionadultsintheUnitedStatessmokecigaretteseventhoughthissinglebehaviorwillresultin

deathordisabilityforhalfofallregularsmokers.TobaccouseistheleadingpreventablecauseofdeathintheUnitedStates,resultinginapproximately440,000deathseachyear.Morethan8.6millionpeopleintheUnitedStateshaveatleastoneseriousillnesscausedbysmoking.Ifcurrentpatternsofsmokingpersist,6.4millionpeoplecurrentlyyoungerthan18willdieprematurelyofatobacco-relateddisease.Parallelingthisenormoushealthtollistheeconomicburdenoftobaccouse:morethan$75billionperyearinmedicalexpendituresandanother$80billionperyearresultingfromlostproductivity.

Since1964,28SurgeonGeneral’sreportsonsmokingandhealthhaveconcludedthattobaccouseisthesinglemostavoidablecauseofdisease,disability,anddeathintheUnitedStates.Overthepastfourdecades,cigarettesmokinghascausedanestimated12milliondeaths,including4.1milliondeathsfromcancer,5.5milliondeathsfromcardiovasculardiseases,2.1milliondeathsfromrespiratorydiseases,and94,000infantdeathsrelatedtomotherssmokingduringpregnancy.

Smokelesstobacco,cigars,andpipesalsohavedeadlyconsequences,includinglung,larynx,esophageal,andoralcancers.Low-tarcigarettesandothertobaccoproductsarenotsafealternatives.

Theharmfuleffectsofsmokingdonotendwiththesmoker.Babiesofwomenwhosmokeduringpregnancyaremorelikelytohavelowerbirthweights,anincreasedriskofdeathfromsuddeninfantdeathsyndrome,andrespiratorydistress.Inaddition,secondhandsmokehasharmfuleffectsonnonsmokers.Eachyear,primarilybecauseofexposuretosecondhandsmoke,anestimated3,000nonsmokingAmericansdieoflungcancer,andmorethan35,000dieofheartdisease.

Anestimated150,000–300,000childrenyoungerthan18monthsofagehavelowerrespiratorytractinfectionsbecauseofexposuretosecondhandsmoke.

Althoughsmokingratesfellamonghighschoolstudentsfrom2000to2002,theydidnotdeclinesignificantlyamongmiddleschoolstudents.Thislackofprogresssuggeststheneedforgreateruseofprovenantismokingstrategiesandfornewstrategiestopromotefurtherdeclinesinyouthsmoking.

The information in this article was provided by the National Cancer Institute and is in the public domain. For more information, visit their website at

www.cancer.gov.

TOBACCO & CANCERTobacco is one of the strongest cancer-causing agents. Tobacco use is associated with a number of different cancers, including lung cancer, as well as with chronic lung diseases and cardiovascular diseases.

Tobacco use remains the leading preventable cause of death in the United States, causing more than 440,000 deaths each year and resulting in an annual cost of more than $75 billion in direct medical costs.

In 2003, 29.8 percent of the U.S. population 12 and older — 70.8 million people — used tobacco at least once in the month prior to being interviewed in a national survey. This figure includes 3.6 million people age 12 to 17.

Approximately 80% of adult smokers started smoking before the age of 18. Every day, nearly 4,000 young people under the age of 18 try their first cigarette.

Scientists estimate that environmental tobacco smoke (ETS), also called “secondhand smoke,” is responsible for approximately 3,000 lung cancer deaths per year among adult nonsmokers in the United States.

In the United States, it has been estimated that about 7.8 million people age 12 years and older currently use smokeless tobacco.

http://www.cancer.gov/cancertopics/tobacco/statisticssnapshot

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442,398 U.S. Deaths Attributable Each Year To Cigarette Smoking*

¢ Lung Cancer: 124,813

¢ Coronary Heart Disease: 81,976

¢ Chronic Lung Disease: 82,431

¢ Other Diagnoses: 104,785

¢ Stroke: 17,445

¢ Other Cancers: 30,948

*Average annual number of deaths, 1995–1999. Source: MMWR 2002;51(14):300–3.

http://www.cdc.gov/nccdphp/publications/aag/osh.htm

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Smokingcessationcouldquitepossiblybeoneofthemostdifficultprogramsyouimplementattheworkplace,butdon’tgetburnedoutjustyet—manycompanieshavehadgreatsuccess.

NorthwesternMemorialHospital,forexample,hasaddressedworksitesmokingandtakenasignificantsteptowardensuringahealthycultureattheworkplace.Theirsmokingpolicyenforcesnosmokingbothinsideandoutsidethehospital.Inaddition,theyprovetheirdedicationtothepolicybyofferingasmokingcessationclassandencouragingemployeestoquit.Theirprogramincludesindividualconsultationswithasmokingcessationspecialist,andsessionsthatareofferedonavarietyofdays,times,andlocationsonthehospitalcampuseveryquarterforemployeeconvenience.

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1Be graphic.Hanguppostersthatcontaintoughmessagesandvivid,full-colorimagesthatinformemployeesoftheharmfuleffectsofusingtobacco.

Postersshouldbedisplayedinhightrafficareas,suchaselevators,bathrooms,nearwatercoolers,etc.TheGovernmentofCanadahaspassedregulationsthatrequirecigarettemanufacturerstoplacegraphicimagesandinformationcovering50%ofeverycigarettepackage!11

>>TAKE ACTION! Logontowww.thetruth.comtodiscoveralotofexcellentinformationthatdetails—ingraphicaccount—theconsequencesandhazardsoftobaccouse.Thissiteisguaranteedtostimulatesomecreativethinking.

2Get real.InFrance,thefederalgovernmentimposedpublicsmokingrestrictionswithoutinformingthepublicofwhysuchactionswere

taken;asaresult,compliancehasbeenlessthanideal.12Toavoidnegativefeedbackorconfusionaboutsmoke-freeworkplacepolicies,holdeducationalworkshopsorseminarsthatinformemployeesaboutthehealthrisksthataccompanysmoking—thiswilllaythegroundworkforgoodadherencetoyourorganization’sregulationsandlegislations.

>>TAKE ACTION! Developacompany-widepresentationthathighlightsthecostsandconsequencesofusingtobacco.Besuretoemphasizerealissueslikenotbeingabletowalkupaflightofstairswithouthuffingandpuffing.Forgreatinformationtohelpyoupresentyourbusinesscase,visithttp://www.endsmoking.org/resources/employersguide/pdf/employersguide-2nd-edition.pdf.Thereyou’llfindagreatresourcetitledEmployers’ Smoking Cessation Guide.

3No butts about it.Implementano-smokingpolicy.AreductionofcigaretteconsumptionintheU.S.between1988and1994canbecreditedto

smoke-freeworkplaces—9.72billionlesscigarettesweresmokedasaresultofthesepolicies.13CabellCountyBoardofEducationinHuntington,WestVirginianotonlyimplementedano-smokingpolicyinsidetheirfacilities,butoutsideaswell.Plainandsimple,ifit’scompanypolicy,it’llbeeasiertoenforce.

>>TAKE ACTION!ObtainacopyofMaking Your Workplace Smokefree: A Decision Maker’s Guide,producedbytheWellnessCouncilsofAmerica(www.welcoa.org).Thisusefulbookprovidesactualexamplesofpoliciesandtheinformationthatshouldbecontainedinthem.

4Light their fire.Getseniorsupportbyshowingcosts.Aworksitesmokingcessationprogramwillgenerateeconomicbenefitsthatexceedtheprogram’s

cost.Previousstudieshaveoverestimatedtheshort-termbenefit-costratioandunderestimatedthelong-termbenefit-costratioofaworksitesmokingcessationprogram.14

>>TAKE ACTION!BeginyoursubscriptiontoThe American Journal of Health Promotionbyvisitingwww.healthpromotionjournal.com.Thisjournalisawell-respectedpublicationinhealthpromotionandprovidestonsofusefulinformationregardingbehaviorchangeandcostsandbenefits.

5Assess and progress.Healthscreeningswillallowyoutoassesstheriskfactorsofyoursmokingpopulation.Forexample,HighsmithInc.holds

anannualhealthscreeningexam,inwhichparticipantsgetresultsalongwitha20-minutecounselingsession.Iftheyneedmorehelp,ongoingsupportandfollow-upbyapersonaltrainerisavailable.

>>TAKE ACTION!Tofindoutwhathealthscreeningsaremostappropriateforyourorganization,obtaininformationaboutperiodichealthexaminations.ThisinformationisavailablefromTheAmericanAcademyofFamilyPhysiciansandcanbeaccessedonlineathttp://www.aafp.org/exam.xml.Byutilizingthisinformation,you’llknowexactlywhentoscreenyouremployees.

6Don’t be a hypocrite.Ifyousmoke,youremployeesaregoingtohaveahardtimebelievinginyourcompany’scampaignagainstsmoking—

andwithgoodreason.Beanexampletothoseinyourcompany,ifyousmoke,quitnow,ordon’tleadanysmokinginitiativesatall.

>>TAKE ACTION!Ifyoudopresentlysmoke,youcanshareyourquittingexperiencewiththerestoftheorganization.Infact,weknowofoneCEOwhowantedtobeapositiverolemodel,sohesharedhisquittingexperiencethroughdailye-mailswiththerestofthecompany.

7The more the merrier.Buildateamtopromotesmokingcessation.Thisteamshouldbemadeupofsmokers,non-smokers,andex-smokers.Withtheir

widerangeofviewsandexperiences,theywillbeabletocohesivelycreateplansandinitiativesthatwillgenerateanew,smoke-freeculture.

>>TAKE ACTION!Werecommendthatyouimmediatelyidentifyandrecruitcurrentsmokers(whoarelooking



toquit)andgetthemonyourteamASAP.Whileitisinappropriateforyoutoleadyourcompany’swellnessinitiative—andatthesametimesmoke—itismostappropriateforyoutoincludecurrentsmokersonyourwellnessteam.

8Get acquainted.Sendoutquestionnairesore-mailstofindoutwhosmokes,whowantstoquit,andwhodoesn’t.Onceyouhavethisinformationyou’ll

knowwhichinterventiontodirecttowhichpopulation.Forexample,don’texpectthosewhodon’twanttoquittostopcoldturkeyfromasingleanti-smokingbrochure.

>>TAKE ACTION!CheckoutStayWellandSummex.Bothoftheseorganizationsprovidetoolstoassessemployeehabitsandtheirwillingnesstochange.StayWell’swebaddressiswww.staywell.comandyoucanfindSummexatwww.summex.com.

9Focus on frequency.It’sgoingtobehardforsmokerstoquitifacessationprogramisonlyheldonceamonth.Ifpossible,holdmultipleweekly

meetingstocontinuetreatmentanddiscussprogress.Youmayhavetoexperimentwithavarietyofstrategiestofindoutwhatismosteffective.Forexample,LabSafetySupply,locatedinJanesville,Wisconsintookonmultipleapproachestogettheiremployeepopulationtoquitsmoking—andtheresultswereamazing.Corporatesmokingcessationprogramsareconsideredverysuccessful

iftheyachievea35to55%quitrate.AtLabSafety,80%of82peopleonthenicotinepatchquit.Eighty-fivepercentoutof78peoplequitinthehypnosisprogram,andaftersixmonths,68%werestillnotsmoking.

>>TAKE ACTION!Foraninsidelookatsmokingcessationprograms,visitwww.smokestoppers.com.Thissitewillgiveyouanoverviewofwhatittakestoquitsmokingandacurriculumtobackitup.Inaddition,you’llalsofindalotofotherhelpfulinformationlikestatisticsandpersonalassessments.

10Help wanted.Manypeoplewanttoquitsmoking,infact,arecentGallupsurveyrevealedthatone-thirdofsmokerswishthey

couldquit.15Thetruthis,manysmokerscan’tquitontheirown—theyneedthehelpofothers.Counselingcanprovidevaluablesupportforrecoveringsmokers.Tocreateyourownsupportgroup,designateaspecificspaceandtimeforgroupmeetingsandpublicizethesemeetingsinyourwellnessandcompanypublications.Besensitivetotheissueofconfidentiality.

>>TAKE ACTION!CheckoutTheHumanResourcesInstituteatwww.healthyculture.com.You’llwanttoobtainacopyoftheWellnessMentorProgramFacilitatorPackage.Thisinformationwillprovideyouwiththeinsandoutsofstartingandleadingapeersupportgroup—videosandotherhelpfulinformationisprovided.

5Health screenings will allow you to assess the risk factors of your smoking population.

11On your mark, get set.Makesmokingcessationprogramscompetitive.Employeesmightfeelmorecompelledtoquitifthere

issomethingatstake.Onestudyhasshownthatcompetitivesmokingcessationprogramsarethemosteffectiveandofferthebestreturnoninvestment.Theprogramsmaybeexpensive,costingaround$100peremployee,however,keepinmindthatasmokercostsanemployerhundredsofdollarsmoreeveryyear.13

>>TAKE ACTION!Trysplittingyourprogramintotwoteams.Havemembersoftheopposingteamskeeptabsoneachother,toensurethatnooneischeating.Theteamwhohasbeenthemostsuccessfulinkeepingtheirnon-smokingstatuswins—therewardsandincentivesareuptoyouandyourbudget.

12Sweet seductions.Plainandsimple,quittingsmokingishardandtheroadtorecoveryislong.Infact,accordingtobehaviorchange

guru,Dr.JamesProchaska,smokersarelikelytorelapsebeforepermanentlyquitting.Withthisinmind,it’sessentialthatsmokersbegintothinkaboutthepeople,places,andthingsthatmaycausethemtogobacktotheiroldbehaviors.

>>TAKE ACTION!Haveemployeesdeviseawrittenplanofhowthey’llreacttoandescapesmokingtemptations.Tolearnmoreabouttheartandscienceofquittingsmoking,visittheAmericanCancerSociety’swebsiteatwww.cancer.organdtype“smokingcessation”inthesearchbar.

13Just what the doctor ordered.Adviseemployeeswhosmoketoseetheirhealthcareprovider.Brief,personaladvicefromahealth

careprofessionalcandoubleorquadruplenormalquitrates.16Evidencealsosuggeststhatphysiciancounselingcanincreaseyourchancesofsuccessby50%.17

>>TAKE ACTION!Identifyyourorganization’shealthcareprovidersandinitiateconversationstoensurethatphysiciansareroutinelycounselingpatientsontheadvantagesofquittingsmoking.Yes,it’softentimesahardthingtotalkaboutwithhealthcareproviders—butphysicianinterventionmightbethemostcost-effectiveapproachtoquittingsmokingthatweknowof.

14Close, but no cigar.TheconsumptionofalltypesofcigarsintheU.S.increasedby46.4%between1993and1997.Compared

toacigarette,alargecigaremitsabout20timesmorecarbonmonoxide.Studiesshowthatcigarsmokershave

19Make sure that “no-smoking” signs are posted around your facility.

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anincreasedriskoforal,esophageal,laryngeal,andlungcancer—yet,only8.7%ofcigarsmokersconsiderthemselvesathigh-riskfordevelopingcancer.18

>>TAKE ACTION!Makesurethatyouincorporateinformationaboutcigarsaswellassmokelesstobaccoinallofyourpresentations.MoreinformationabouttheseotherdangerousformsoftobaccoisavailableatTheAmericanAcademyofFamilyPhysicianswebsiteatwww.aafp.org.

15Educate, educate, educate.Although90%ofAmericans“know”thatsmokingishazardous,theyonlyknowitinasuperficial

sense.3In1996,TheAmericanCouncilonScienceandHealth(ACSH)foundthatAmericansmokersandnonsmokershadonlythemostelementaryunderstandingoftheextentandmagnitudeofthehealthrisksassociatedwithcigarettesmokingascomparedwithotherallegedhealthrisksintheenvironment.

>>TAKE ACTION!Conductyourown“GreatAmericanHealthQuiz.”Incorporatequestionsaboutthehazardsofsmokingaswellasothertypesoftriviaandinterestinginformationanddistributethequizzestoyouremployees.ToobtaininformationonthestatisticsofcigarettesmokingcontactTheAmericanHeartAssociationatwww.americanheart.org.

16Cover the costs.Astudyhasshownthatthehighestratesofparticipationinsmokingcessationprogramsoccurwheninsurance

coversthecostsoftheprogram.19Don’tstickyouremployeeswiththebill—ifyourinsurancecompanywon’tpayforalltheexpensesinvolved,pickupthetabyourselfandincreaseyourparticipationrate.Learningkits,kitswithphonesupport,andcomputerizedprogramsarenotcheap,butaresometimesneededforpositiveresults.

>>TAKE ACTION!Identifyhowmuchsmokersarecostingyourorganizationandpresentthisdollarsandcentsinfotoyourseniormanagement.Onegreatresourcetoquantifythecostofsmokingis“SmokingintheWorkplaceCostsEmployersMoney”—thereportisavailableatwww.ash.org/papers/h100.htm.

17Work it.Workplacesmokingcessationclinicscanbeextremelyhelpfulandconvenient.Alongwiththeirno-smokingpolicy—inside

andoutsidetheirentirefacility—MiamiValleyHospitalalsosupportsemployeeswhoaretryingtoquitbyofferingonsitecessationclasses.They’vecomeupontherealitythatmanysmokersneedmorethanjustself-help—a

recentstudyshowedthatworkplaceclinicparticipantshadsuccessratesof21%whileself-helpgroupsonlyhad11%successrates.13

>>TAKE ACTION!Identifysmokingcessationfacilitatorsinyourcommunity.Tolearnmoreaboutsmokingcessationandhealthcoachingvisitwellcoaches.comathttp://www.wellcoaches.com/clients/index.cfm?Pageid=mainpage.Hereyoucanlearnaboutcontactingcoachesinyourarea.

18Rx.Pharmaceuticalinterventionscanplayalargepartinanemployee’sefforttoquitsmoking.Astudydeterminingthe

effectivenessofnicotinepatches(ina70-daynicotinereplacementprogram)foundthatthesmokingcessationratewasmuchmorefavorableforthosewhousedthepatch—25%comparedto6%forthosewhodidnotcompletethetreatment.13OffuttAirForceBasehasfoundthatparticipantsrespondwelltothistypeofintervention.Theirtobaccocessationprogramisoneofthemostpopularwellnessinitiatives—theyoffernicodermpatchesandprescriptionmedicationswiththeAmericanCancerSociety’sFreshStartProgram.

>>TAKE ACTION!Collectinformationonthecostandeffectivenessofavarietyofdifferentcessationtechniques(gum,inhalers,pills)andhavethisinformationreadilyavailabletoemployees.Youcanalsodisplayproductsandinformationinprominentplacesforallemployeestoview.TolearnmoreaboutsmokingcessationdrugsyoumaywanttocontactGlaxoSmithKline—www.zyban.com.

19You expect me to breathe what?Protectemployeeswhodon’tsmoke.TheCaliforniaEnvironmentalAgencyReportestimated

thateachyearintheU.S.,environmentaltobaccosmoke(ETS),alsoknownassecondhandsmoke,exposurecauses3,000deathsduetolungcancer,35,000to62,000deathsduetoischemicheartdisease,and1,900to2,700deathsduetosuddeninfantdeathsyndrome.21

>>TAKE ACTION!Makesurethat“no-smoking”signsarepostedaroundyourfacility.Alsomakesurethattheemployeehandbookisupdatedandinformnewemployeesofsmokingguidelines.Aboveall,makesuretoenforcethepolicies—smokersneedtoknowyoumeanbusiness,andnon-smokersdeservetobeprotected.

20Tell the truth.Don’tsugarcoatthedangersyouremployeesarefacing.Youmightnotbemakinganybestfriendsbytellingyour

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employeesthattheycoulddieahorrible,excruciatingdeath,butthisshowsthatyoucareabouttheirwell-being.Inadditiontolungcancerandemphysema,cigarettesmokingisknowntoadverselyaffectnearlyeverysystemandfunctionofthehumanbody.2

>>TAKE ACTION!Offergamesthatidentifythevarioussystemsandfunctionsofthebodythatareaffectedbysmoking.Forexample,ahangmanmessagereading“smokingkills”willleaveanindeliblemark.Togetmoreinformation,youmaywanttovisitwww.healthedco.comandenterthekeyword“tobacco”intothesearchengine.

21Hold demos.Visualaidscanbeveryeffective.Simplypresentingafilmorshowingapictureofahealthylungcomparedtothe

pictureofasmoker’slungcanbequitepowerful.

>>TAKE ACTION!Besuretoincludeinformationabouthowquicklythehumanbodyrecoversfromhabitualsmoking.Thiswillhelpensurethatlong-timesmokersdon’tfeeldefeatedbythegraphicimagesandkeeponpuffin’.Checkouthttp://www.cancer.org/docroot/PED/content/PED_10_13X_Quitting_Smoking.aspforatimelinethatshowstheshortandlong-termbenefitsofsmokingcessation.

22Be on your toes.It’sinevitable.Atsomepointsomeoneisboundtosay,“Billhassmokedfor40yearsandisashealthyasa

horse.”Youneedtoknowhowtorespondtothiscomment.Bepreparedtocomebackwith,“Well,400,000peoplediefromtobaccorelatedillnesseseachyear.Infact,itmostlikelywillbetheworstplaguetheworldhaseverknown.”

>>TAKE ACTION!Makeatoptenlistofthemostpopularexcusespeoplegivetojustifytheircontinuedsmoking.Listcounterpointsbelowtheseexcusesthatrefutethe“logic.”Forawholehostofcompellinginformationtohelpyoubuildyourcase,visittheWorldHealthOrganization’swebsiteatwww.who.int.

23Play the emotional card.Everyyear,702infantsdieasaresultofsecondhandsmoke.Ifyou’vebeenunsuccessfulgettingasmokerto

quitfortheirownsake,addresstheharmtheyarecausingtoothersbysmoking.Secondhandsmokeinhaledbychildrencontainsmorethan3,800chemicalcompounds.Becausechildrenhavelessdevelopedlungtissue,theyaremorevulnerabletothedamagescausedbysmoking.3

>>TAKE ACTION!Seekoutneworexpectingparentsandimpressuponthemthedangersofsecondhandsmoke.

Thebirthofachildistheultimateteachablemoment.Theymaynotbeinterestedinquittingfortheirowngood,butfewparentswillbewillingtosacrificetheirchild’shealthyfuturefortheirownpleasure.

24Have a potluck.Tryincentive-basedsmokingcessationprograms.Haveparticipantsdropmoneytheywouldhave

spentoncigarettesintoa“smokebank.”Uponcompletionoftheprogram,allowonlythosewhoarestillsmoke-freetodrawforthemoneyinthepot.

>>TAKE ACTION!Showthemthecosts.Basedonapackadayhabit,asmokerwillspendnearly$1,587oncigaretteseveryyear.Followingthislogic,asix-monthincentiveprogram,involvingonlyfiveparticipantswouldyieldawindfallofalmost$4,000.

25Start campaigning.Createyourownno-smokingadcampaignswithinthecompany—33,000ex-smokersinCaliforniacited

tobacco-controladvertisementsasasignificantfactorintheirdecisiontoquit.22Themosteffectivestrategiesforanti-smokingadvertisingfocusonindustrymanipulationandsecondhandsmoke.OneCaliforniaadendedwiththeline“TheTobaccoIndustry.Theyprofit.Youlose.”—showinghowmanipulativetheindustrycanbeintheirrelentlesspursuitofprofits.Anothereffectiveadvertisementshowedachildasavictimofsecondhandsmoke,whichmadepeoplemoreawareoftheeffectsoftheirsmokingonothers.

>>TAKE ACTION!Attheendofthecampaign,combinetheadsintoamontagethatcouldbebroadcastoverthecompanyintranet,closedcircuittelevisions,oranyvisualmediumavailableatyourorganization.CheckouttheVisualCultureandPublicHealthPosterssurroundinganti-smokingcampaigns.(http://www.nlm.nih.gov/exhibition/visualculture/antismoking.html)

26Recruit the quitters.TheAmericanCancerSocietyoffersafreetrainingprogramforex-smokerstobeleadersofsmokingcessation

classes.There’snoonemorepersuasivethanatrueex-smoker.

>>TAKE ACTION!Aftertraining,theseex-smokerscouldleadtheentiresmokingcessationprogram.Thisfreesyouuptoaddresstheorganization’sotherhealthrisks,whileaformersmoker,familiarwiththechallengesofquitting,servesasamentortothosestilltryingtoquit.CheckoutAmericanCancerSociety’swebsiteforresourcesnearyou—http://www.cancer.org.


©2006WELLNESSCOUNCILSOFAMERICA|WWW.WELCOA.ORG ABSOLUTEADVANTAGE | ��

24Based on a pack a day habit, a smoker will spend nearly $1,587 on cigarettes every year.

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27Stop in the name of love.HighlightsmokingcessationinconjunctionwithValentine’sDay.Encourageemployeestoquit

smokingforsomeonetheylove.Neverunderestimatethevalueofaccountability.

>>TAKE ACTION!EncourageemployeestomakeacommitmenttotheirlovedonestostopsmokingviaaValentine’sDaycard.Awrittencommitmentoftencarriesmoreweightandcanbeusedasareminderofthecommitment.

28Clear the air.Offersmokersthechanceto“cleartheair”bywritingtheirthoughtsandfeelingsonagraffitiboard.Sometimesyou

needtojump-startitwithanideaorquotetorespondto.Thiswillallowsmokerstoventthefrustrationsthataccompanyquitting.Theseanonymouscontributionscanbehumorousandinsightful.ThisideawassuchagoodonethatamajorhealthcareproviderinHoustoncreatedtheirown“graffitigallery”toshowcasetheircompany’scommitment.

>>TAKE ACTION!Collectthecommentsandcompilethemintoabook.Thisbookcanbeusedasaprogrambuilderdowntheroadandwillhelpothersmokersrealizethey’renotaloneintheirfrustrations.Don’tforgettoeditwherenecessary!

29Mark your calendar.GetinvolvedintheGreatAmericanSmokeout.Thiswouldbeagooddaytokickoffasmokingcessation

program.Theannualone-dayevent,sponsoredbytheAmericanCancerSociety(ACS),isheldonthethirdThursdayofeveryNovember.Thisnationwideeventtriestogetsmokerstokickthehabitforjust24hours.Theideabeing,iftheycangiveitupforoneday,theymightaswellgiveitupforgood.

>>TAKE ACTION!ContacttheACSbycalling1-800-ACS-2345orvisitingtheirwebsiteathttp://www.cancer.org/docroot/PED/ped_10_4.asp.GetstartedrightawaybyhostingyourowncorporateSmokeout.

30Protest.Findoutwhichpopulareateriesinyourcommunityhaveimplementednon-smokingpolicies.Handoutalistofthese

placestoemployees—thiswilllessenthetemptationorchancetolightupwhenoutonthetown.Alsospreadthewordthatyouencourageemployeestoonlygotosmoke-freeestablishments—thistypeof“boycott”couldmotivatetheplacesthatdoallowsmokingtoimplementnon-smokingpolicies.

>>TAKE ACTION!Haveemployeessubmitnamesoffavoritenon-smokingestablishments.Compiletheseestablishmentsintoadirectorytobedistributedcompany-wide.Sharethedirectorywithinyourcommunitytoencourageadditionalbusinessownerstogosmokefree.

31Get hooked…online.TheInternetcanbeaneasy,usefultooltohelpyouimplementsmokingcessationprograms.TheAmerican

LungAssociationoffersanonlineprogramcalled“Freedom

31The American Lung Association offers an online program called “Freedom From Smoking® Online.”


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FromSmoking®Online.”Throughprogressivestagesoftheprogram,theuserwilllearnimportantskillssuchasstressmanagement/relaxationtechniquesandlong-termstrategiesformaintainingasmoke-freelifestyle.Accessthisprogramonlineathttp://www.lungusa.org/site/apps/kb/home/login.asp?c=dvLUK9O0E&b=38973.

>>TAKE ACTION!WorkwithyourITdepartmenttocreateyourownsmokingcessationwebpage.Moderntechnologieslikestreamingvideoandinstantmessagingcanbepowerfultoolsforhelpingpeoplequit—especiallyifit’scustomizedandreflectsindividualcorporateculture.

32Say what?Doesanyonereallyknowwhat’sinacigarette?PhillipMorrisboaststheir“typical”cigarettescontainatleast90%

tobaccointhe“filler”portion.So,what’sintheremainder?Well,a“typical”Cambridge100’sfilterhardpackincludeswater,sugars,propyleneglycol,glycerol,diammoniumphosphate,cocoa,andcocoaproducts,ammoniumhydroxide,naturalandartificialflavor.23Yummy!Letemployeesknowwhattheyareusingtopollutetheirbodies—thismaycausethemtothinktwiceaboutsmoking.

>>TAKE ACTION!Astheclichégoes,“Apictureisworthathousandwords.”Providinganinsightfulvisualofwhatisbeingplacedinasmoker’sbodycanbeapowerfultoolinconvincingsmokersthattheirhabitisas“natural”asitmayseem.(http://www.thetruth.com/)

33Show them the money.Smokingisexpensive.DirectsmokerstowebsitessuchasHealthStatus.com.Smokershavethe

opportunitytoseewhatsmokingiscostingthemfinancially.Forexample,apersonsmoking19cigarettesadayforfiveyearshasspent,onaverage,$7,541.81.24Helpsmokersdiscovertheirfinancialwasteathttp://www.healthstatus.com/calculate/smc.

>>TAKE ACTION!Createyouownmonthlypublicationorwebsiteshowingoffanumberofitemssmokerswouldbeabletopurchasewiththemoneyspentoncigarettes.Ifyouwereabletochoosebetween142roundsofgolforfiveyearsworthofcigarettes,whatwouldyouchoose?

34Get technical.Createane-mailcorrespondenceorchatroomforthosewhoarequitting,sotheycanexpresshowthey’re

doing/feeling.E-mailisaquickandconvenientmethodofcommunication.Ifsmokerscantalkabouttheirtroubleswithotherswhoaregoingthroughthesamething,theymightfeelbetteraboutquitting.

>>TAKE ACTION!Getyoursmokingemployeestosubstitutetheirsmokebreaksforonlinechatswithotherstryingtoquit.Breakingahabitismucheasierwhenyoucansubstituteahealthyhabitforanunhealthyone.

35Baby talk.It’sestimatedthatsmokingduringpregnancyaccountsfor20to30%oflowbirthweightbabies,upto14%of

pre-termdeliveries,and10%ofallinfantdeaths.Womenwhosmoke,andareexpecting,needspecialandintensivetreatment—theymayknowit’snothealthytosmoke,buttheydon’tknowhowtostop.Providelong-terminterventionsandcounselingforpregnantsmokerstohelpensurethattheyaresmoke-freeduringandaftertheirpregnancy.Unfortunately,childrencanstillsufferfromnegativeconsequencesduetosmokingevenaftertheyareborn—between200,000andonemillionasthmaticchildrenhavetheirconditionworsenedbyexposuretosecondhandsmoke.25

>>TAKE ACTION!Provideprogrammingeffortsaimedatreducingandmanagingthestressofyouremployees,especiallythosewhoareexpecting.Themoresupportyoucanoffer,themoresuccessyouarelikelytosee.

36Keep your door open.Mostrelapsesoccurearlyinthequittingprocess,althoughsomerelapsesoccurmonthsoryearsafterthe

quitdate.26Providebriefrelapsepreventiontreatmentforrecentquitters.Thistreatmentcanbedeliveredbyscheduledclinicvisits,telephonecalls,supportgroups,etc.

>>TAKE ACTION!ReaduponProchaska’sstagesofchangetobetteridentifythosesusceptibletorelapseandtobrushuponkeepingquittersinthemaintenancestage.Dr.Prochaska’sbooktitledChanging For Goodisavailableatwww.amazon.com.

37The secret of my success.Findemployeeswhohavealreadyquit,andwhohavestuckwithitforatleastsixmonths.Letthese

peoplespeakatcompanymeetingsorseminarstotelltheirstories—whatmadethemquit,andwhathashelpedthemstayawayfromcigarettes.

>>TAKE ACTION!Createacampaigntitled“QuittersAlwaysWin.”Encourage“quitters”tobecometeamleadersforcompanyrecreationactivities.Besuretochoosethisrolemodelcarefully—charismacanbethedifferencebetweensomeonewhohelpsandsomeonewhoannoys.

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43A Framingham Heart Study showed that two years after light smokers quit, their risk for heart attack decreased by 20%. Heavy smokers’ risk was reduced by 60% after they quit.


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38Take it to da’ house.Letparentsknowthatit’snevertooearlytotalktotheirchildrenaboutsmoking—infact,manyadults

whosmokestartedaschildren.27Provideeducationalinformationforemployeestobringhomeandsharewiththeirkids.Also,parentsandkidsmightwanttocheckoutthewebsitehttp://www.healthfinder.gov/andtype“smoking”or“tobacco”inthesearchengineformoreinformation.

>>TAKE ACTION!Remember,kidswhosmokewillbecomeadultswhosmoke—adultswhowillonedayentertheworkforce.Sponsorparent-childactivitiesthatallowyoutodisseminateanti-smokinginformationthatisageappropriate.Also,it’simportantthatyourorganizationgetbehindtobaccocontrolpoliciesthatkeepkidsawayfromcigarettes.

39Get them puffing.Promotephysicalactivity,notdieting,withsmokingcessation.Manysmokersgainweightwhentheyquit.A

commonreactiontostopweightgainisdieting.Butrestrictionsonfoodandquittingsmokingatthesametimecouldspellrelapse.Instead,promoteexercisetoshedandmaintainahealthyweight.Thiswillhelpthosequittingtokeepbusy,aswellashelprelievestress.

>>TAKE ACTION!Onceemployeesfeelthebenefitsofkickingthehabit,theymaybecomeinspiredtofurtherimprovetheirhealthbyexercisingregularly.FormoreinformationaboutthebenefitsofphysicalactivitycheckoutwellnessguruKenCooper’saerobiccenteratwww.cooperaerobics.com.

40Get involved.Takepartinyourcommunity’sefforttostopillegaltobaccouse.Itmightseemlikeanunworthyeffort

consideringthatthoseunder18probablycan’tevenworkatyourcompany,butthinkaboutthis:youngpeoplewhodon’tstartusingtobaccobyage18willmostlikelyneverstart.28Makesurelocalconvenientandgrocerystoresareinvolvedwith“WeCard”—aprogramthattrainsretailersandemployeesfromsellingtobaccotominors.

>>TAKE ACTION!Checkoutthe“WeCard”programatwww.wecard.org.Also,lookintothepossibilitiesofcorporatesponsorshipofyouthanti-smokingeffortsthroughpartnershipwithotherbusinessesandorganizationsinthecommunity.

41Right tools, right time.Thekeytoeffectivesmokingcessationprogramsisusingappropriateinterventionsthatfit

theindividual’sstageofchange.PacificCareHealthSystemsInc.providesaStopSmokingProgramthatisself-pacedandtailoredtomeetthespecificneedsofeachparticipant—adjustingtotheirlevelofreadinesstoquit.Theprograminvolvesatoll-freenumber,behaviorchangecoachingviatelephone,writtenmaterials,video,andaudiotapes—availableinbothEnglishandSpanish.30

>>TAKE ACTION!CheckoutHealthMediaInc.’swebsiteatwww.healthmedia.com.Thisinnovativecompanyhasdevelopedonline,tailored,smokingcessationprogramsthatmeeteveryindividualwherethey’reatandencouragespositivelifestylechanges.

42Push the envelope.Offerrewardsonhealthcareplanstonon-smokingemployees.Althoughsomewhatcontroversialit’sbeen

goingonforyears.Infact,asearlyas1987,Coloradobeganofferingadiscountofsixdollarsamonthtononsmokingemployeesenrolledinitshealthplan.In1988,theKansashealthcaregoverningbodyproposedthatsmokersberequiredtocontributetendollarsamonthmorethannonsmokerstowardhealthinsurance.13ThebottomlineisthatsmokingcausesmoredeathsintheU.S.thananyotherhealthbehaviorbarnone—it’stimetopushtheenvelope.

>>TAKE ACTION!Thereareanumberofthingsyoucandoinvolvingcashprograms—whethertheyinvolvesavingmoneyorwinningit,moneycanbeagreatmotivatorforanyemployee.

43Better late than never.Althoughsmokingproducesanirreversibleincreaseinriskforsomediseases,quittingsmokingbrings

substantialhealthbenefitsatanyage.Communicatetoyouremployeesthatevenifthey’vesmokedhalfoftheirlife,stoppingnowwillhaveapositiveimpactontheirhealth.AFraminghamHeartStudyshowedthattwoyearsafterlightsmokersquit,theirriskforheartattackdecreasedby20%.Heavysmokers’riskwasreducedby60%aftertheyquit.3

>>TAKE ACTION!Researchfavoriteretirementactivitiesandproduceadocumentrepletewithvacationhomephotos.Remindsmokersthatitwon’tbelongbeforetheyarerelaxinginthesun—iftheyaren’talreadysixfeetunder.

44Out with the old…Considerofferingalternativemeanstoemployeesforquittingsmoking.Acupuncture,yoga,orhypnosis,

forexamplehavebeenusedasatreatmentforsmokingcessation.Itmightnotworkforeveryone,butforsomeitmightbeworthatry.

ABSOLUTEADVANTAGE


WELCOA®

>>TAKE ACTION!CheckoutYogaInternational’swebsiteathttp://www.yimag.org.AmorecomprehensivesourceistheNationalCenterforComplementaryandAlternativeMedicine,http://nccam.nih.gov,thissiteoffersinformationonvarioustypesofalternativehealing.

45Spread the word.Dotheparentsatyourcompanyknowthattheaverageageatwhichsmokersstartis12?Dotheyknowthatthe

averageageatwhichkidsbecomeregularsmokersis14andahalf?31Informemployeesofthedangersthatyouthfacewhenconfrontedwiththeopportunitytosmoke.Stresstheimportanceoftalkingwiththeirchildrenaboutsmoking—achoicetostartsmokingnowmaybecomeahabittheycan’tbreaklaterinlife.

>>TAKE ACTION!Encourageparentstomatchthemoneytheirchildrensavebynotpurchasingcigarettes.Ifathechildwouldhavespent$10perweek,startingatage12andtheparentsmatchthatfigure,whenthechildis16therewouldbeenoughmoneyinthepottopurchaseadecentusedcar.

46Follow up.Afterthetreatmentorprogramisover,makesuretokeepup-to-date,andfollowuponprogress.Alsobesuretoprovide

employeeswithinformationandactivitiestokeepthemfromsmoking.Youmaywanttoconsiderincorporatingotherwellnessinitiativesintothesmokingcessationprograms—stressmanagementcoursesorfitnessclassesaretwogoodexamples.Theseadditionalinterventionsmayhelpthemdealwiththepressureofwantingtosmoke.

>>TAKE ACTION!Makethecommitmenttovisittheemployeewhoisattemptingtoquitsmoking,everydayforaspecifiedamountoftime.Thesevisitswillallowyoutoencouragethemintheireffortstoquit,aswellasdirectthemtonewandrelevantinformationregardingsmokingcessation.

47A bad blend.Informsmokersoftheconsequencesinvolvedwithcombiningsmokinganddrinkingalcohol.Whenthe

twoareusedtogether,theadversehealtheffectsareintensified.Smokerswhoregularlyconsumealcoholhaveagreaterchanceofdevelopingesophagealcancerthanthosewhodojustoneortheother.3

>>TAKE ACTION!Youmaywanttoinformthemofthedangerofthiscombination

duringapresentationoutliningthedangersofdrinkinganddriving.

“Cross-selling”allowsyoutogetthemessageoutmore

thanoncetomorethanonegroup.

48Baby steps.Provide

ideasonhowtocutbackforthosewhocan’tquitcoldturkey.Forthosewhowantto

graduallyquit,provideideasandtipsinbreak

rooms,fitnesscenters,e-mails,etc.Forexample,

“keeppostponingthatfirstcigaretteofthedayforalonger

andlongertime.”Or“Cutbackbyonecigaretteeachdayuntilyou

hitzero.”

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“Problems with self-esteem” “Has menial boring job” “Emotionally insecure”

“Passive-aggressive” “Probably leads fairly dull existence”

“Grooming not a strong priority” “Lacks inner resources”

“Group conformist” “Non-thinking” “Not into ideas”

“Insecure followers”

These are all terms taken from Big Tobacco’s files that have been used to describe different groups of potential customers for their deadly, addictive products. —Source: http://www.thetruth.com

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When are people going to realize that breathing in

smoke from anything that burns is not a good idea?

Duane Alan Hahn

“”



>>TAKE ACTION!Perhapsoneofthebestwaystoquitsmokingistousethe“buddysystem.”Offertomatchonesmokerwithanotherandencouragethemtosupporteachotherthroughthetoughtimes.Thisisanothergreattimetoincorporatecompetitions.

49Risky business.Althoughsmokingputseveryoneatrisk,it’sespeciallyharmfulforcertainindividuals.Womenwhosmokeare

twotosixtimesmorelikelytosufferfromaheartattackthannonsmokers.32Andforadults60andolder,smokingisamajorriskfactorforsixofthetop14causesofdeath.33Makesureyoutargetthesegroups—informthemoftheincreasedrisksinvolvedwithsmoking.Trysendingane-mailtotheseindividualstoraisetheirawareness.

>>TAKE ACTION!Perhapsaneffectivee-mailmessagetothesemostat-riskgroupscouldincorporatehumorandlogic.Trytakingtheapproachof,“Youwouldn’tdo(insertactivity),sowhyareyousmoking?”

50Movin’ on up. Evaluatingsuchareasasparticipation,quitrates,andreturn-on-investmentwillallowyoutoseewhat

worksandwhatdoesn’t,aswellasmakeanynecessaryadjustments.Carefullyexaminingandanalyzingyourprogramwillallowyoutotakeyourprogramtothenextlevel.Itmightseemtoughortooscientific,butyoucaneasilyconductevaluationsthroughsurveys,questionnaires,orinformalmeetings.

>>TAKE ACTION!Distributesurveystoprogramparticipants(thosewhoaresuccessfulandthosewhoaren’t)tohelpyouevaluatehowsuccessfulyoureffortswere.Remember,youwon’tlearnanythingfromthesesurveysifyoudidn’thaveaprogramobjectivetobeginwith.Also,asksurveyparticipantstobebrutallyhonest.Thereisnoroomtosoft-soapanythingwhenitcomestoevaluation.

REFERENCES

Krantz, L. America by the Numbers. Facts and Figures from the Weighty to the Way-Out. Houghton Mifflin Company. 1993.

American Cancer Society. Cancer Facts and Figures 2005. http://www.cancer.org/docroot/stt/stt_0.asp.

American Council on Science and Health. Cigarettes, What the Warning Label Doesn’t Tell You. American Council of Science and Health. 1995.

Centers for Disease Control and Prevention. Targeting Tobacco Use: The Nation’s Leading Cause of Death. http://www.cdc.gov/nccdphp/publications/aag/osh.htm.

Lewis, L., C.C.N. 52 Ways to Live a Long and Healthy Life. MJF Books. 1993.

Fairclough, G. Philip Morris Notes Cigarettes’ Benefits for Nation’s Finances. The Wall Street Journal. July 16, 2001.

1.

2.

3.

4.

5.

6.

U.S. Food and Drug Administration. Statement on Nicotine-Containing Cigarettes by David A. Kessler, M.D. Commissioner of Food and Drugs, House Subcommittee on Health and the Environment, March 25, 1994. www.fda.gov/bbs/topics/SPEECH/SPE00052.htm.

The Wellness Councils of America. Healthy, Wealthy & Wise: Fundamentals of Workplace Health Promotion. P.24. 1995.

National Cancer Institute. Smoking: Facts and Tips for Quitting. http://cancerweb.ncl.ac.uk/cancernet/400111.html.

Action on Smoking and Health. WHO Report: Smoke Endangers 1/2 World’s Kids. http://www.no-smoking.org/june99/06-16-99-6.html.

Brundtland, G.H., M.D., M.P.H. Achieving Worldwide Tobacco Control. The Journal of the American Medical Association. Vol. 284, No. 6, 2000, pp. 750-751.

Davis, R., M.D. Exposure to Environmental Tobacco Smoke. The Journal of the American Medical Association. Vol.280, No.22, 1998.

University of Michigan Health Management Research Center. Cost Benefit Analysis and Report 2001.

The Robert Wood Johnson Foundation. Worksite Smoking Cessation Programs: Health, Economic, and Demographic Implications-A Computer Simulation. http://www.rwjf.org/index.jsp.

Heart Information Network. Desire to Quit on Increase Among Smokers. http://www.heartinfo.org/.

Mitka, M. Surgeon General’s Newest Report of Tobacco. The Journal of the American Medical Association. Vol 284, No. 11, 2000.

American Psychiatric Association Public Information. Treatment Works…When You Choose to Stop Smoking. http://www.psych.org/.

Baker, F., et al. Health Risks Associated with Cigar Smoking. The Journal of the American Medical Association. Vol 284, No. 6, 2000.

Curry, S.J., Ph.D., et al. Use and Cost Effectiveness of Smoking-Cessation Services under Four Insurance Plans in a Health Maintenance Organization. The New England Journal of Medicine. Vol 339, No. 10, 1998, pp. 673-679.

CDC. Tobacco Advertising and Promotion. http://www.cdc.gov/tobacco/sgr/sgr_2000/factsheets/factsheet_advertising.htm.

Davis, R., M.D. Exposure to Environmental Tobacco Smoke. The Journal of the American Medical Association. Vol. 280, No. 22, 1998.

Goldman, L., M.P.P., Glantz, S., Ph.D. Evaluation of Anitsmoking Advertising Campaigns. The Journal of the American Medication Association. Vol 279, No. 10, 1998.

What’s In A Cigarette? www.thetruth.com. http://www.thetruth.com/index.cfm?Found=Truth.

Cost of Smoking Cigarettes Calculator. http://www.healthstatus.com/calculate/smc.

American Lung Association. Asthma and Children Fact Sheet. http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=44352.

Tobacco Use and Dependence Clinical Practice Guideline Update Panel and Staff. A Clinical Practice Guideline for Treating Tobacco Use and Dependence. The Journal of the American Medical Association. Vol.283, No.24, 2000.

Centers for Disease Control and Prevention. Facts About Access to Tobacco by Minors. http://www.cdc.gov/tobacco/sgr/sgr_2000/factsheets/factsheet_minor.htm.

Centers for Disease Control and Prevention. Coaches—You Can Influence Youth. http://www.cdc.gov/tobacco/educational_materials/yuthfax1.htm.

DiFranza, J., M.D., Librett, J., M.P.H. State and Federal Revenues From Tobacco Consumed by Minors. American Journal of Public Health. http://www.apha.org/journal/abstracts/abstdifr.htm.

Krejci, R. Stop Smoking Program. American Journal of Health Promotion, Art and Science of Health Promotion Conference. Vol. 13 No. 6, 1999, pp. 376-383.

Business & Health Special Report. What Cigarettes do to American Business. August 1997.

National Heart, Lung, and Blood Institute. Facts About Heart Disease and Women: Kicking the Smoking Habit. http://www.nhlbi.nih.gov/.

National Heart, Lung, and Blood Institute. Check Your Smoking I.Q. http://www.nhlbi.nih.gov/.

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All information ©Wellness Councils of America (WELCOA) 2006. WELCOA provides worksite wellness products, services, and information to thousands of organizations nationwide. For more information visit www.welcoa.org.

Suggested Citation: 50 Great Ideas For Quitting Smoking. (2006). WELCOA’s Absolute Advantage Magazine, 5(2), 4-19.

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“IphonedmydadtotellhimIhadstoppedsmoking.Hecalledmeaquitter.”

—Steven Pearl

One California anti-smoking ad, “Nicotine Soundbites,” presents real industry executives denying that nicotine is addictive before Congress.12

—Journal of the American Medical Association

“Scientists around the world agreed that there is no safe level of exposure to second-hand smoke.”10

—Action on Smoking and Health

“The makers of Camels are naturally proud of the fact that, out of 113,597 doctors who were asked recently to name the cigarette they preferred to smoke, more doctors named Camel than any other brand.”1

—Life Magazine ad, July 8th, 1946 as reported in America By the Numbers

“A person who smokes one pack of cigarettes per day will inhale approximately one-half cup of tar annually.”5

—52 Ways to Live a Long and Healthy Life

“If you took 1,000 young adult smokers, one will be murdered, 6 will die on the roads, but 500 will die from tobacco.”—Richard Peto, Professor of Medical Statistics and Epidemiology, University of Oxford

According to Philip Morris cigarette company, cigarette consumption in the Czech Republic has “positive effects” on national finances in part because smokers’ early deaths help offset medical expenses.6

—The Wall Street Journal

Seventeen million Americans try to quit smoking each year. But more than 15 million individuals are unable to exercise that choice because they cannot break their addiction to cigarettes. The choice that they are making at a young age quickly becomes little or no choice at all and will be very difficult to undo for the rest of their lives.7

—Food and Drug Administration

Arecentreviewofthecostsoftreatingsmoking-attributablediseasesintheUSshowedthattheyrangefrom6to8percentofhealthexpenditures.2

—American Cancer Society

“Cigarettes are the only available consumer product that is hazardous to health when used as intended.”3

—The American Council on Science and Health, Cigarettes: What the Warning Label Doesn’t Tell You.

“Just what the doctor ordered.”—Ad, L&M cigarettes, 1956

Anumberoftoptobaccoindustryofficialshavestatedthattheydonotbelievethattobaccoisaddictive.Theymaytellyouthatsmokerssmokefor“pleasure,”nottosatisfyanicotinecraving.7


“Children have never been very good at listening to their elders, but they have never failed to imitate them.”

—James Baldwin

Smokingcaused

approximately$157.7

billioninannual

health-relatedeconomic

costs...2

—American Cancer Society70%ofyoungpeopleages12to18whosmokesaythattheybelievethattheyarealreadydependentoncigarettes.7


An estimated 45.8 million adults in the U.S. smoke cigarettes even though this single behavior will result in death or disability for half of all regular uses.4

—Centers for Disease Control and Prevention

ABSOLUTEADVANTAGE


Statistically, if there are 100 people in your company or department…8

1 uses cocaine

50 feel they’re under moderate stress

10 are heavy drinkers

30 smoke

60 sit all day to do their work

27 have cardiovascular disease

10 have high blood pressure

5 have diagnosed diabetes

5 have undiagnosed diabetes

25 or more have high blood cholesterol

35 are overweight by 20% or more

50 don’t wear their safety belts regularly

7 use marijuana

Whenitcomestosmoking,notablequotesabound.Thequotesbelowhavebeenresearched

bystaffatTheWellnessCouncilsofAmerica.Weencourageyoutoreplicatethesequotes

inpublicationsandinformationthatyoudevelop.Aswithallinformation,statisticschange

rapidly.Besuretocheckthecontinuedaccuracyofsomeofthisinformationasitmaychange.

REFERENCESKrantz, L. America by the Numbers. Facts and Figures from the Weighty to the Way-Out. Houghton Mifflin Company. 1993.

American Cancer Society. Great American Smokeout: Creating A Smoke-Free Workplace. http://www.cancer.org.

American Council on Science and Health. Cigarettes, What the Warning Label Doesn’t Tell You. American Council of Science and Health. 1995.

Centers for Disease Control and Prevention. Targeting Tobacco Use: The Nation’s Leading Cause of Death. http://www.cdc.gov/nccdphp/publications/aag/osh.htm.

Lewis, L., C.C.N. 52 Ways to Live a Long and Healthy Life. MJF Books. 1993.

Fairclough, G. Philip Morris Notes Cigarettes’ Benefits for Nation’s Finances. The Wall Street Journal. July 16, 2001.

U.S. Food and Drug Administration. Statement on Nicotine-Containing Cigarettes by David A. Kessler, M.D. Commissioner of Food and Drugs, House Subcommittee on Health and the Environment, March 25, 1994. www.fda.gov/bbs/topics/SPEECH/SPE00052.htm.

The Wellness Councils of America. Healthy, Wealthy & Wise: Fundamentals of Workplace Health Promotion. P.24. 1995.

National Cancer Institute. Smoking: Facts and Tips for Quitting. http://cancerweb.ncl.ac.uk/cancernet/400111.html.

Action on Smoking and Health. WHO Report: Smoke Endangers 1/2 World’s Kids. http://www.no-smoking.org/june99/06-16-99-6.html.

CDC. Tobacco Advertising and Promotion. http://www.cdc.gov/tobacco/sgr/sgr_2000/factsheets/factsheet_advertising.htm.

Goldman, L., M.P.P., Glantz, S., Ph.D. Evaluation of Anitsmoking Advertising Campaigns. The Journal of the American Medication Association. Vol 279, No. 10, 1998.

DiFranza, J., M.D., Librett, J., M.P.H. State and Federal Revenues From Tobacco Consumed by Minors. American Journal of Public Health. www.apha.org/journal/abstracts/abstdifr.htm.

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Suggested Citation: Notable & Quotable. (2006). WELCOA’s Absolute Advantage Magazine, 5(2), 20-23.

Seventeenmilliontrytoquiteachyear,butfewerthanoneoutoftensucceed.Foreverysmokerwhoquits,ninetryandfail.7


Aftersurgeryforlungcancer,almosthalfofsmokersresumesmoking.

Amongsmokerswhosufferaheartattack,38%resumesmokingwhiletheyarestillinthehospital.7


In 1998 tobacco companies spent nearly $7 billion — or more than $18 million a day — to advertise and promote cigarettes.11

—Centers for Disease Control and Prevention

Neitherthetobaccoindustrynorthewarninglabelhaseverwarnedconsumersthatsmokingisexceptionallyaddictiveorhaspointedouttheminimumamountofsmokingthatposeshealthhazards.3

—The American Council on Science and Health, Cigarettes: What the Warning Label Doesn’t Tell You

“Ithinkweoverusetheword‘addictive.’Ithinksmokingcanbeahabit.”

—Brennan Dawson, Tobacco Institute (USA), 1991

“Smoking kills, and if you’re killed, you’ve lost a very important part of

your life!”

—Anti-smoking spokesperson Brooke Shields

“The only thing that bothers me is if I’m in a restaurant and I’m eating and someone says, ‘Hey, mind if I smoke?’

I always say, ‘No. Mind if I flatulate?’ ”—Common line used by stand-up comedians

If all women quit smoking during pregnancy, about 4,000 new babies would not die every year.9

—National Cancer Institute

An estimated 3.76 million daily smokers aged 12 through 17 years consumed an estimated 924 million packs of cigarettes per year.13

—American Journal of Public Health

3,000 children under the age of 18 take up smoking every day.3

—The American Council on Science and Health, Cigarettes: What the Warning Label Doesn’t Tell You.

Morethanone-thirdofsmokersreachfortheirfirstcigarettewithin10minutesofawakening;nearlytwo-thirdssmokewiththefirsthalfhour.7


“Act as if what you do makes a difference. It does.” —William James

WELCOA®


“To quit smoking is easy—I myself have done it many times.”

—Mark Twain

ABSOLUTEADVANTAGE






What are the health risks associated with cigar smoking?

Scientificevidencehasshownthatcancersoftheoralcavity(lip,tongue,mouth,andthroat),larynx,lung,andesophagusareassociatedwithcigarsmoking.Furthermore,evidencestronglysuggestsalinkbetweencigarsmokingandcancerofthepancreas.Inaddition,dailycigarsmokers,particularlythosewhoinhale,areatincreasedriskfordevelopingheartandlungdisease.

Likecigarettesmoking,therisksfromcigarsmokingincreasewithincreasedexposure.Forexample,comparedwithsomeonewhohasneversmoked,smokingonlyonetotwocigarsperdaydoublestheriskfororalandesophagealcancers.Smokingthreetofourcigarsdailycanincreasetheriskoforalcancerstomorethaneighttimestheriskforanonsmoker,whilethechanceofesophagealcancerisincreasedtofourtimestheriskforsomeonewhohasneversmoked.Bothcigarandcigarettesmokershavesimilarlevelsofriskfororal,throat,andesophagealcancers.

Thehealthrisksassociatedwithoccasionalcigarsmoking(lessthandaily)arenotknown.Aboutthree-quartersofcigarsmokersareoccasionalsmokers.

What is the effect of inhalation on disease risk?

Oneofthemajordifferencesbetweencigarandcigarettesmokingisthedegreeofinhalation.Almostallcigarettesmokersreportinhalingwhilethemajorityofcigarsmokersdonotbecausecigarsmokeisgenerallymoreirritating.However,cigarsmokerswhohaveahistoryofcigarettesmokingaremorelikelytoinhalecigarsmoke.Cigarsmokersexperiencehigherratesoflungcancer,coronaryheartdisease,andchronicobstructivelungdiseasethannonsmokers,butnotashighastheratesforcigarettesmokers.Theselowerratesforcigarsmokersareprobablyrelatedtoreducedinhalation.

How are cigars and cigarettes different?

Cigarsandcigarettesdifferinbothsizeandthetypeoftobaccoused.Cigarettesaregenerallymoreuniform

insizeandcontainlessthan1gramoftobaccoeach.Cigars,ontheotherhand,canvaryinsizeandshapeandcanmeasuremorethan7inchesinlength.Largecigarstypicallycontainbetween5and17gramsoftobacco.Itisnotunusualforsomepremiumcigarstocontainthetobaccoequivalentofanentirepackofcigarettes.U.S.cigarettesaremadefromdifferentblendsoftobaccos,whereasmostcigarsarecomposedprimarilyofasingletypeoftobacco(air-curedordriedburleytobacco).Largecigarscantakebetween1and2hourstosmoke,whereasmostcigarettesontheU.S.markettakelessthan10minutestosmoke.

How are the health risks associated with cigar smoking different from

those associated with smoking cigarettes? Healthrisksassociatedwithbothcigarsandcigarettesarestronglylinkedtothedegreeofsmokeexposure.Sincesmokefromcigarsandcigarettesarecomposedofmanyofthesametoxicandcarcinogenic(cancercausing)compounds,thedifferencesinhealthrisksappeartoberelatedtodifferencesindailyuseandlevelofinhalation.

Mostcigarettesmokerssmokeeverydayandinhale.Incontrast,asmanyasthree-quartersofcigarsmokerssmokeonlyoccasionally,andthemajoritydonotinhale.

Allcigarandcigarettesmokers,whetherornottheyinhale,directlyexposethelips,mouth,tongue,throat,andlarynxtosmokeanditscarcinogens.Holdinganunlitcigarbetweenthelipsalsoexposestheseareastocarcinogens.Inaddition,whensalivacontainingsmokeconstituentsisswallowed,theesophagusisexposedtocarcinogens.Theseexposuresprobablyaccountforthefactthatoralandesophagealcancerrisksaresimilaramongcigarsmokersandcigarettesmokers.

Cancerofthelarynxoccursatlowerratesamongcigarsmokerswhodonotinhalethanamongcigarettesmokers.Lungcancerriskamongdailycigarsmokerswhodonotinhaleisdoublethatofnonsmokers,butsignificantlylessthantheriskforcigarettesmokers.However,thelungcancerriskfrommoderatelyinhalingsmokefromfivecigarsadayiscomparabletotheriskfromsmokinguptoonepackofcigarettesaday.

ABSOLUTEADVANTAGE


WELCOA®

What are the hazards for nonsmokers exposed to cigar smoke?

Environmentaltobaccosmoke(ETS),alsoknownassecondhandorpassivesmoke,isthesmokereleasedfromalitcigarorcigarette.TheETSfromcigarsandcigarettescontainsmanyofthesametoxinsandirritants(suchascarbonmonoxide,nicotine,hydrogencyanide,andammonia),aswellasanumberofknowncarcinogens(suchasbenzene,nitrosamines,vinylchloride,arsenic,andhydrocarbons).Becausecigarscontaingreateramountsoftobaccothancigarettes,theyproducegreateramountsofETS.

Thereare,however,somedifferencesbetweencigarandcigarettesmokeduetothedifferentwayscigarsand

cigarettesaremade.Cigarsgothroughalongagingandfermentationprocess.Duringthefermentationprocess,highconcentrationsofcarcinogeniccompoundsareproduced.Thesecompoundsarereleasedwhenacigarissmoked.Also,cigarwrappersarelessporousthancigarettewrappers.Thenonporouscigarwrappermakestheburningofcigartobaccolesscompletethancigarettetobacco.Asaresult,comparedwithcigarettesmoke,theconcentrationsoftoxinsandirritantsarehigherincigarsmoke.Inaddition,thelargersizeofmostcigars(moretobacco)andlongersmokingtimeproduceshigherexposurestononsmokersofmanytoxiccompounds(includingcarbonmonoxide,hydrocarbons,ammonia,cadmium,andothersubstances)thanacigarette.Forexample,measurementsofthecarbonmonoxide(CO)concentrationatacigarpartyandacigarbanquetinarestaurantshowedindoorCOlevelscomparabletothosemeasuredona

Blood pressure,

pulse rate,

and breathing

patterns start

returning to

normal soon

after quitting

cigar smoking.

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crowdedCaliforniafreeway.Suchexposurescouldplacenonsmokingworkersattendingsucheventsatsignificantlyincreasedriskforcanceraswellasheartandlungdiseases.

Are cigars addictive?

Nicotineistheagentintobaccothatiscapableofcausingaddictionordependence.Cigaretteshaveanaveragetotalnicotinecontentofabout8.4milligrams,whilemanypopularbrandsofcigarswillcontainbetween100and200milligrams,orasmanyas444milligramsofnicotine.

Aswithcigarettesmoking,whencigarsmokersinhale,nicotineisabsorbedrapidly.However,becauseofthecompositionofcigarsmokeandthetendencyofcigarsmokersnottoinhale,thenicotineisabsorbedpredominantlythroughtheliningofthemouthratherthaninthelung.Itisimportanttonotethatnicotineabsorbedthroughtheliningofthemouthiscapableofformingapowerfuladdiction,asdemonstratedbythelargenumberofpeopleaddictedtosmokelesstobacco.Bothinhaledandnoninhalednicotinecanbeaddictive.Theinfrequentusebytheaveragecigarsmoker,lownumberofcigarssmokedperday,andlowerratesofinhalationcomparedwithcigarettesmokershaveledsometosuggestthatcigarsmokersmaybelesslikelytobedependentthancigarettesmokers.

Addictionstudiesofcigarettesandspittobaccoshowthataddictiontonicotineoccursalmostexclusivelyduringadolescenceandyoungadulthoodwhenyoungpeoplebeginusingthesetobaccoproducts.Also,severalstudiesraisetheconcernthatuseofcigarsmaypredisposeindividualstotheuseofcigarettes.Arecentsurveyshowedthattherelapserateofformercigarettesmokerswhosmokedcigarswastwiceasgreatastherelapserateofformercigarettesmokerswhodidnotsmokecigars.Thestudyalsoobservedthatcigarsmokersweremorethantwiceaslikelytotakeupcigarettesmokingforthefirsttimethanpeoplewhoneversmokedcigars.

What are the benefits of quitting?

Therearemanyhealthbenefitstoquittingcigarsmoking.Thelikelihoodofdevelopingcancerdecreases.Also,when

someonequits,animprovementinhealthisseenalmostimmediately.Forexample,bloodpressure,pulserate,andbreathingpatternsstartreturningtonormalsoonafterquitting.Peoplewhoquitwillalsoseeanimprovementintheiroverallqualityoflife.Peoplewhodecidetoquithavemanyoptionsavailabletothem.Somepeoplechoosetoquitallatonce.Otheroptionsgainingpopularityinthiscountryarenicotinereplacementproducts,suchaspatches,gum,andnasalsprays.Ifconsideringquitting,askyourdoctortorecommendaplanthatcouldbestsuityouandyourlifestyle.

What are the current trends in cigar smoking?

Althoughcigarsmokingoccursprimarilyamongmalesbetweentheagesof35and64whohavehighereducationalbackgroundsandincomes,recentstudiessuggestnewtrends.Mostnewcigaruserstodayareteenagersandyoungadultmales(ages18to24)whosmokeoccasionally(lessthandaily).AccordingtotwolargestatewidestudiesconductedamongCaliforniaadultsin1990and1996,cigarusehasincreasednearlyfivetimesamongwomenandappearstobeincreasingamongadolescentfemalesaswell.Furthermore,anumberofstudieshavereportedhighratesofuseamongnotonlyteensbutpreteens.Cigaruseamongoldermales(age65andolder),however,hascontinuedtodeclinesince1992.

How are current trends in cigar smoking different from past

decades? Totalcigarconsumptiondeclinedbyabout66percentfrom1973until1993.Cigarusehasincreasedmorethan50percentsince1993.Theincreaseincigaruseintheearly1990scoincidedwithanincreaseinpromotionalmediaactivitiesforcigars.

The information in this article was provided by the National Cancer Institute and is in the public domain. For more information, visit their website at www.cancer.gov.

ABSOLUTEADVANTAGE






Manysmokerschoose“low-tar,”“mild,”“light,”or“ultra-light”cigarettesbecausetheythinkthatthesecigarettesmaybelessharmfultotheirhealththan“regular”or“full-flavor”

cigarettes.Althoughsmokefromlightcigarettesmayfeelsmootherandlighteronthethroatandchest,lightcigarettesarenothealthierthanregularcigarettes.Thetruthisthatlightcigarettesdonotreducethehealthrisksofsmoking.Theonlywaytoreduceasmoker’srisk,andtherisktoothers,istostopsmokingcompletely.

What about the lower tar and nicotine numbers on light and ultra-light

cigarette packs and in ads for these products?

Thesenumberscomefromsmokingmachines,which“smoke”everybrandofcigarettesexactlythesameway.

Thesenumbersdonotreallytellhowmuchtarandnicotineaparticularsmokermaygetbecausepeopledonotsmokecigarettesthesamewaythemachinesdo.Andnotwopeoplesmokethesameway.

How do light cigarettes trick the smoking machines?

Tobaccocompaniesdesignedlightcigaretteswithtinypinholesonthefilters.These“filtervents”dilutecigarettesmokewithairwhenlightcigarettesare“puffed”onbysmokingmachines,causingthemachinestomeasureartificiallylowtarandnicotinelevels.

Manysmokersdonotknowthattheircigarettefiltershaveventholes.Thefilterventsareuncoveredwhencigarettesaresmokedonsmokingmachines.However,filterventsareplacedjustmillimetersfromwheresmokersputtheirlipsorfingerswhensmoking.Asaresult,manysmokersblockthevents—whichactuallyturnsthelightcigaretteintoaregularcigarette.

Somecigarettemakersincreasedthelengthofthepaperwrapcoveringtheoutsideofthecigarettefilter,whichdecreasesthenumberofpuffsthatoccurduringthemachinetest.Althoughtobaccounderthewrapisstillavailabletothesmoker,thistobaccoisnot

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burnedduringthemachinetest.Theresultisthatthemachinemeasureslesstarandnicotinelevelsthanisavailabletothesmoker.

Becausesmokers,unlikemachines,cravenicotine,theymayinhalemoredeeply;takelarger,morerapid,ormorefrequentpuffs;orsmokeafewextracigaretteseachdaytogetenoughnicotinetosatisfytheircraving.Thisiscalled“compensating,”anditmeansthatsmokersendupinhalingmoretar,nicotine,andotherharmfulchemicalsthanthemachine-basednumberssuggest.

What is the scientific evidence about the health effects of light cigarettes?

TheFederalGovernment’sNationalCancerInstitute(NCI)hasconcludedthatlightcigarettesprovidenobenefittosmokers’health.

AccordingtotheNCImonographRisksAssociatedwithSmokingCigaretteswithLowMachine-MeasuredYieldsofTarandNicotine,peoplewhoswitchtolightcigarettesfromregularcigarettesarelikelytoinhalethesameamountofhazardouschemicals,andtheyremainathighriskfordevelopingsmoking-relatedcancersandotherdiseases.

Researchersalsofoundthatthestrategiesusedbythetobaccoindustrytoadvertiseandpromotelightcigarettesareintendedtoreassuresmokers,todiscouragethemfromquitting,andtoleadconsumerstoperceivefilteredandlightcigarettesassaferalternativestoregularcigarettes.

Thereisalsonoevidencethatswitchingtolightorultra-lightcigarettesactuallyhelpssmokersquit.

Have the tobacco companies conducted research on the amount

of tar and nicotine people actually inhale while smoking light cigarettes?

Thetobaccoindustry’sowndocumentsshowthatcompaniesareawarethatsmokersoflightcigarettescompensatebytakingbiggerpuffs.

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ABSOLUTEADVANTAGE




There is no

such thing as a

safe cigarette.

The only

proven way to

reduce the risk

of smoking-

related

disease is to

quit smoking

completely.

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Industrydocumentsalsoshowthatthecompaniesareawareofthedifferencebetweenmachine-measuredyieldsoftarandnicotineandwhatthesmokeractuallyinhales.

What is the bottom line for smokers who want to protect their health?

Thereisnosuchthingasasafecigarette.Theonlyprovenwaytoreducetheriskofsmoking-relateddiseaseistoquitsmokingcompletely.

Smokerswhoquitlivelongerthanthosewhocontinuetosmoke.Inaddition,theearliersmokersquit,thegreaterthehealthbenefit.Researchhasshownthatpeoplewhoquitbeforeage30eliminatealmostalloftheirriskofdevelopingatobacco-relateddisease.Evensmokerswhoquitatage50reducetheirriskofdyingfromatobacco-relateddisease.

Quittingalsodecreasestheriskoflungcancer,heartattacks,stroke,andchroniclungdisease.

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KEY POINTS The lower tar and nicotine numbers on light cigarette packs and in ads are misleading. Light cigarettes trick the smoking machines so that they record artificially low tar and nicotine levels. Light cigarettes provide no benefit to smokers’ health. Resources are available for people who want to quit smoking.

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ABSOLUTEADVANTAGE






What is secondhand smoke?

Secondhandsmoke,alsocalledenvironmentaltobaccosmoke(ETS),isthecombinationoftwoformsofsmokefromburningtobaccoproducts:sidestreamsmokeandmainstreamsmoke.Sidestreamsmoke,whichmakesupabouthalfofallsecondhandsmoke,comesfromtheburningendofacigarette,cigar,orpipe(1,2,3,4).Mainstreamsmokeisexhaledbythesmoker.Exposuretosecondhandsmokeisalsocalledinvoluntarysmokingorpassivesmoking(1,2,3).

What chemicals are present in secondhand smoke?

Manyfactorsaffectwhatchemicalsarepresentinsecondhandsmoke.Thesefactorsincludethetypeoftobacco,thechemicalsaddedtothetobacco,howtheproductissmoked,andthepaperinwhichthetobaccoiswrapped(1,3).Morethan4,000chemicalshavebeenidentifiedinmainstreamtobaccosmoke;however,theactualnumbermaybemorethan100,000(1).Ofthechemicalsidentifiedinsecondhandsmoke,atleast60arecarcinogens(substancesthatcausecancer),suchasformaldehyde.Sixothersaresubstancesthatinterferewithnormalcelldevelopment,suchasnicotineandcarbonmonoxide(2,4).

Someofthecompoundspresentinsecondhandsmokebecomecarcinogeniconlyaftertheyareactivatedbyspecificenzymes(proteinsthatcontrolchemicalreactions)inthebody.Afterthesecompoundsareactivated,theycanthenbecomepartofacell’sDNAandmayinterferewiththenormalgrowthofcells(5).In1993,theU.S.EnvironmentalProtectionAgency(EPA)determinedthatthereissufficientevidencethatsecondhandsmokecausescancerinhumansandclassifieditasaGroupAcarcinogen(2,6).In2000,theU.S.DepartmentofHealthandHumanServices(DHHS)formallylistedsecondhandsmokeasaknownhumancarcinogeninTheU.S.NationalToxicologyProgram’s10thReportonCarcinogens.Themostrecentreportcanbefoundathttp://ntp.niehs.nih.gov/ntp/roc/toc11.htmlontheInternet.

Scientistsdonotknowwhatamountofexposuretosecondhandsmoke,ifany,issafe.Becauseitisacomplexmixtureofchemicals,measuringsecondhandsmokeexposureisdifficultandisusuallydeterminedbytestingblood,saliva,orurineforthepresenceofnicotine,particlesinhaledfromindoorair,orcotinine(theprimaryproductresultingfromthebreakdownofnicotineinthebody)(1,3).Nicotine,carbonmonoxide,andotherevidenceofsecondhandsmokeexposurehavebeenfoundinthebodyfluidsofnonsmokersexposedtosecondhandsmoke.Nonsmokerswholivewithsmokersinhomeswheresmokingisallowedareatthegreatestriskforsufferingthenegativehealtheffectsofsecondhandsmokeexposure(5).

What are the health effects of exposure to secondhand smoke?

Secondhandsmokeexposureisaknownriskfactorforlungcancer(1,3,4,6,7).Approximately3,000lungcancerdeathsoccureachyearamongadultnonsmokersintheUnitedStatesasaresultofexposuretosecondhandsmoke(2).Secondhandsmokeisalsolinkedtonasalsinuscancer(1,4).Someresearchsuggestsanassociationbetweensecondhandsmokeandcancersofthecervix,breast,andbladder.However,moreresearchisneededinordertoconfirmalinktothesecancers(3,4,8).

Secondhandsmokeisalsoassociatedwiththefollowingnoncancerousconditions:

chronic coughing, phlegm, and wheezing (4, 6, 7)

chest discomfort (4)

lowered lung function (4, 6, 7)

severe lower respiratory tract infections, such as onchitis or pneumonia, in children (4, 6, 7)

more severe asthma and increased chance of developing asthma in children (6)

eye and nose irritation (4)

severe and chronic heart disease (4)

middle ear infections in children (4, 6)

sudden infant death syndrome (SIDS) (4)

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ABSOLUTEADVANTAGE


WELCOA®

low birth weight or small size at birth for babies of women exposed to secondhand smoke during pregnancy (4)

Certainothernoncanceroushealthconditionsmayalsobeassociatedwithsecondhandsmoke.However,moreresearchisneededinordertoconfirmalinkbetweentheseconditionsandsecondhandsmoke.Theseconditionsinclude:

spontaneous abortion (miscarriage) (4)

adverse effect on cognition and behavior in children (4)

worsening of cystic fibrosis (a disease that causes excessive mucus in the lungs) (4)

How is nonsmokers’ exposure to secondhand smoke being reduced?

InJanuary2000,theDHHSlaunchedHealthyPeople2010,acomprehensive,nationwidehealthpromotionanddiseasepreventionagendadesignedtohelpimprovethehealthofallpeopleintheUnitedStatesduringthefirst

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decadeofthe21stcentury(9).Severalobjectivesofthisprogramrelatetotobaccouseandexposuretosecondhandsmoke,includingthegoalofreducingtheproportionofnonsmokersexposedtosecondhandsmokefrom65percentto45percentby2010(9).MoreinformationaboutthisprogramisavailableontheHealthyPeople2010Websiteathttp://www.healthypeople.gov/ontheInternet(9).

Studieshaveshownthatseparatingsmokersandnonsmokerswithinthesameairspacemayreduce,butnoteliminate,nonsmokers’exposuretosecondhandsmoke(7).Individualscanreducetheirexposuretosecondhandsmokebynotallowingsmokingintheirhomeorcar.Educational,clinical,andpolicyinterventionshavealsobeenshowntoreducesecondhandsmokeexposure(9).Suchpoliciesincludeadoptionofworksiterestrictions,passageofcleanindoorairlaws,andenforcementofsmokingrestrictionsinsharedenvironments(9).

Onthenationallevel,severallawsrestrictingsmokinginpublicplaceshavebeenpassed.Forinstance,effectiveJanuary1,2005,smokingisbannedinallDHHSbuildings.InotherFederalofficebuildings,smokingislimitedtodesignatedareas.Smokingisalsobannedonalldomesticairlineflightsandnearlyallflightsbetween

Studies have shown that separating smokers and nonsmokers within the same air space may reduce, but not eliminate, nonsmokers’ exposure to secondhand smoke.

“

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theUnitedStatesandforeigndestinations.Allinterstatebustravelissmokefree.SmokingisalsoprohibitedorrestrictedtospeciallydesignatedareasontrainstravelingwithintheUnitedStates.

Manystatesandlocalgovernmentshavepassedlawsprohibitingsmokinginpublicfacilitiessuchasschools,hospitals,airports,andbusterminals.Somestatesalsorequireprivateemployerstocreatepoliciesthatprotectemployeeswhodonotsmoke,andseverallocalcommunitieshaveenactednonsmokers’rightslaws,mostofwhicharestricterthanstatelaws.Moreinformationaboutstate-leveltobaccoregulationsisavailablethroughtheCentersforDiseaseControlandPrevention’s(CDC)StateTobaccoActivitiesTrackingandEvaluating(STATE)SystemWebsite.TheSTATESystemisadatabasecontainingup-to-dateandhistoricalstate-leveldataontobaccousepreventionandcontrol.Thisresourceisavailableathttp://apps.nccd.cdc.gov/statesystem/ontheInternet.Althoughitisstillasignificantpublichealthconcern,nonsmokerexposuretosecondhandsmokedeclinedbymorethan70percentfrom1988–1991to1999–2000(2).In1999,nearly7outofevery10U.S.workersreportedhavingasmoke-freepolicyintheirworkplace(2).

KEY POINTS Secondhand smoke, also called environmental tobacco smoke (ETS), is the combination of smoke emitted from the burning end of a cigarette, cigar, or pipe, and smoke exhaled by the smoker.

Secondhand smoke contains at least 60 carcinogens (substances that cause cancer).

The known health effects of exposure to secondhand smoke include lung cancer, nasal sinus cancer, respiratory tract infections, and heart disease.

Separating smokers and nonsmokers within the same air space may reduce, but does not eliminate, nonsmokers’ exposure to secondhand smoke.

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ABSOLUTEADVANTAGE






What is smokeless tobacco?

Therearetwotypesofsmokelesstobacco--snuffand

chewingtobacco.Snuff,afinelygroundorshredded

tobacco,ispackagedasdry,moist,orinsachets(teabag-

likepouches).Typically,theuserplacesapinchordip

betweenthecheekandgum.Chewingtobaccoisavailable

inlooseleaf,plug(plug-firmandplug-moist),ortwist

forms,withtheuserputtingawadoftobaccoinsidethe

cheek.Smokelesstobaccoissometimescalled“spit”or

“spitting”tobaccobecausepeoplespitoutthetobacco

juicesandsalivathatbuildupinthemouth.

What harmful chemicals are found in smokeless tobacco?

Chewingtobaccoandsnuffcontain28carcinogens

(cancer-causingagents).Themostharmful

carcinogensinsmokelesstobaccoarethetobacco-

specificnitrosamines(TSNAs).Theyareformed

duringthegrowing,curing,fermenting,andagingof

tobacco.TSNAshavebeendetectedinsomesmokeless

tobaccoproductsatlevelsmanytimeshigherthan

levelsofothertypesofnitrosaminesthatareallowed

infoods,suchasbaconandbeer.

Othercancer-causingsubstancesinsmokelesstobacco

includeN-nitrosaminoacids,volatileN-nitrosamines,

benzo(a)pyrene,volatilealdehydes,formaldehyde,

acetaldehyde,crotonaldehyde,hydrazine,arsenic,

nickel,cadmium,benzopyrene,andpolonium-210.

Alltobacco,includingsmokelesstobacco,contains

nicotine,whichisaddictive.Theamountofnicotine

absorbedfromsmokelesstobaccois3to4timesthe

amountdeliveredbyacigarette.Nicotineisabsorbed

moreslowlyfromsmokelesstobaccothanfrom

cigarettes,butmorenicotineperdoseisabsorbed

fromsmokelesstobaccothanfromcigarettes.Also,the

nicotinestaysinthebloodstreamforalongertime.

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What cancers are caused by or associated with smokeless tobacco use?

Smokelesstobaccousersincreasetheirriskforcanceroftheoralcavity.Oralcancercanincludecancerofthelip,tongue,cheeks,gums,andthefloorandroofofthemouth.

Peoplewhouseoralsnuffforalongtimehaveamuchgreaterriskforcancerofthecheekandgumthanpeoplewhodonotusesmokelesstobacco.

Thepossibleincreasedriskforothertypesofcancerfromsmokelesstobaccoisbeingstudied.

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ABSOLUTEADVANTAGE




In 1986, the Surgeon General concluded that the

use of smokeless tobacco “is not a safe substitute for smoking cigarettes. It can

cause cancer and a number of noncancerous conditions

and can lead to nicotine addiction and dependence.

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What are other ways smokeless tobacco can harm users’ health?

Someoftheothereffectsofsmokelesstobaccouseincludeaddictiontonicotine,oralleukoplakia(whitemouthlesionsthatcanbecomecancerous),gumdisease,andgumrecession(whenthegumpullsawayfromtheteeth).Possibleincreasedrisksforheartdisease,diabetes,andreproductiveproblemsarebeingstudied.

Is smokeless tobacco a good substitute for cigarettes?

In1986,theSurgeonGeneralconcludedthattheuseofsmokelesstobacco“isnotasafesubstituteforsmokingcigarettes.Itcancausecancerandanumberofnoncancerousconditionsandcanleadtonicotineaddictionanddependence.”Since1991,NCIhasofficiallyrecommendedthatthepublicavoidanddiscontinuetheuseofalltobaccoproducts,includingsmokelesstobacco.NCIalsorecognizesthatnitrosamines,foundintobaccoproducts,arenotsafeatanylevel.Theaccumulatedscientificevidencedoesnotsupportchangingthisposition.

What about using smokeless tobacco to quit cigarettes?

Becausealltobaccousecausesdiseaseandaddiction,NCIrecommendsthattobaccousebeavoidedanddiscontinued.Severalnon-tobaccomethodshavebeenshowntobeeffectiveforquittingcigarettes.ThesemethodsincludepharmacotherapiessuchasnicotinereplacementtherapyandbupropionSR,individualandgroupcounseling,andtelephonequitlines.

Who uses smokeless tobacco?

IntheUnitedStates,the2000NationalHouseholdSurveyonDrugAbuse,whichwasconductedbytheSubstanceAbuseandMentalHealthServicesAdministration,reportedthefollowingstatistics:

Anestimated7.6millionAmericansage12andolder(3.4%)hadusedsmokelesstobaccointhepastmonth.

Smokelesstobaccousewasmostcommonamongyoungadultsages18to25.

Menwere10timesmorelikelythanwomentoreportusingsmokelesstobacco(6.5%ofmenage12andoldercomparedwith0.5%ofwomen).

Peopleinmanyothercountriesandregions,includingIndia,partsofAfrica,andsomeCentralAsiancountries,havealonghistoryofusingsmokelesstobaccoproducts.

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KEY POINTS Snuff is a finely ground or shredded tobacco that is either sniffed through the nose or placed between the cheek and gum. Chewing tobacco is used by putting a wad of tobacco inside the cheek.

Chewing tobacco and snuff contain 28 cancer-causing agents.

Smokeless tobacco users have an increased risk of developing cancer of the oral cavity.

Several national organizations offer information about the health risks of smokeless tobacco and how to quit.

w

w

w

w


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WELCOA® ABSOLUTEADVANTAGE WELCOA®


the



WELCOA®


is found!W

hen it come to leading-

edge, over-the-top, in-

your-face information

related to the hazards

and consequences of tobacco use, there’s no

better place than www.thetruth.com.

Visited by thousands and thousands of

people—many of them young—thetruth.

com is a resource that helps to put tobacco

use in America in perspective. With

creative epidemiology and a fierce focus

on an industry that produces products

that kills its customers, thetruth.com is

committed to informing everyone about

tobacco use.

With ads appearing on network television,

thetruth.com is making significant inroads

into becoming the most informative stop

on tobacco use in the United States.

Check out the statistics and fast facts

gleaned from their site.

The truth about tobacco:Every day, cows release methane gas into the air. From you know where. But methane is also found somewhere else. Yesiree, in cigarette smoke.

Every year, tobacco-related disease kills over 178,000 women.

63% of high school smokers say they want to quit.

There are 8.5 million people sick with diseases caused by smoking.

About 1/3 of youth smokers will eventually die from a tobacco-related disease.

In the U.S., about 440,000 people die a tobacco-related death every year.

About 90% of lung cancer deaths among women who continue to smoke are tobacco related.

A tobacco company once gave $125,000 worth of food to a charity, according to an estimate by The Wall Street Journal. Then they spent well over $21 million telling people about it. I guess, when you sell a deadly, addictive product, you need all the good PR you can get.

Babies born to women who smoked during pregnancy are more likely to be underweight.

By the year 2020, tobacco is projected to kill about 10 million people a year worldwide.

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Carbon monoxide is in tobacco smoke.

As late as 1999, tobacco companies placed in-store advertising signage at a child’s eye level.

Cigarette smoke contains more than 4,000 chemical compounds.

Cigarette smoking is the number one cause of preventable death in the U.S.

Cigarettes and other smoking materials are the number one cause of fire deaths in the U.S.

Cigarette companies advertised “light” cigarettes as less harmful to the smoker, although they can deliver the same levels of tar and nicotine.

According to one tobacco company VP, in 2001, a company name change could focus attention away from tobacco.

Every 8 seconds, someone in the world dies from a smoking-related disease.

Every day, cows release methane gas into the air. From you know where. But methane is also found somewhere else. Yesiree, in cigarette smoke.

Every day, about 1,500 youth become daily smokers.

Every single day, in the U.S., the tobacco industry spends about $42 million on advertising and promotions.

Every year, cigarettes leave about 12,000 kids motherless.

Every year, cigarettes leave about 31,000 kids fatherless.

Every day, about 3,900 youth ages 12 to 17 try a cigarette for the first time.

How do infants avoid secondhand smoke? “At some point they begin to crawl.” -- Tobacco Executive, 1996

Hydrogen cyanide has been used in prison executions. It’s also found in cigarettes smoke.

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There’s hydrogen cyanide in rat poison. The same stuff is in cigarette smoke.

In 1974, a tobacco company explored targeting customers as young as 14.

In 1984, a tobacco company called young adults “replacement smokers.”

In 1986, a tobacco company’s ad agency wrote to a newspaper complaining about the placement of their ad next to obituaries. They said: “We feel that this positioning was detrimental to our advertising efforts…”

In 1989, millions of cases of imported fruit were banned after a small amount of cyanide was found in just two grapes. There’s 33 times more cyanide in a single cigarette.

In 1993, the Supreme Court decided that an inmate could sue a prison claiming that exposure to his cellmate’s secondhand smoke could constitute cruel and unusual punishment.

In 1995, a major tobacco company decided to boost cigarette sales by targeting homeless people. They called their plan “Project SCUM: Sub Culture Urban Marketing.” A tobacco company once donated 7,000 blankets to homeless shelters in Brooklyn.

A Big Tobacco executive once said, under oath, that he believed Gummi Bears were addictive like cigarettes.

In 2002, U.S. consumers spent about $88.2 billion on tobacco products.

In 1985, one tobacco VP said in reference to smoking-related deaths, “People die in their beds, therefore, should we ban sleep?”

In the past, Big Tobacco has compared the addictiveness of cigarettes to M&M’s.

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In the past, Big Tobacco has compared the addictiveness of cigarettes to that of television.

In the past, Big Tobacco has compared the addictiveness of cigarettes to coffee.

In the U.S., about 50,000 people die each year from secondhand-smoke-related disease.

Tobacco kills more Americans than auto accidents, homicide, AIDS, drugs and fires combined.

Today, in the U.S., tobacco products will kill about 1,200 people.

Maternal smoking during pregnancy and exposure to secondhand smoke in infancy doubles the risk of Sudden Infant Death Syndrome (SIDS).

More than 85% of the “top 25” films from 1988-1997 contained tobacco use, and 70%25 of those included brand appearances. Brand appearances were as common in films for teen audiences as for adult audiences and were also present in 20% of those rated for children.

Nicotine has been found in the breast milk of smokers.

One tobacco company secretly developed a strain of tobacco they named “Y1” that contained 50% more nicotine.

In 1994, one tobacco company reported finding “insect infestation” in their cigarettes.

In 1989, one tobacco company brainstormed selling its product from ice cream trucks that drive through neighborhoods.

In 1989, one tobacco company’s ideas for reaching minority customers included to “be seen as a friend,” “build on black history” and “help them find jobs.” But they thought that this support shouldn’t be seen as “a big white company’s tactic to sell to blacks.”

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In 1985, a tobacco brainstorming session came up with the idea of reaching their “younger adult smokers” in candy stores.

In 1993, one tobacco company executive thought it would be a good idea to have his employees mail “grassroots” complaints to airlines about their smoking bans, pretending to be regular customers.

Pee contains urea. So do cigarettes.

“Problems with self-esteem” “Has menial boring job” “Emotionally insecure” “Passive-aggressive” “Probably leads fairly dull existence” “Grooming not a strong priority” “Lacks inner resources” “Group conformist” “Non-thinking” “Not into ideas” “Insecure followers”

These are all terms taken from Big Tobacco’s files that have been used to describe different groups of potential customers for their deadly, addictive products.

Radioactive polonium-210 is found in cigarette smoke.

Since 1964, there have been 12 million tobacco-related deaths in the U.S.

Smoking can lead to cataracts, the number one cause of vision loss in the world.

Smoking during pregnancy results in the deaths of about 900 infants every year in the U.S.

Sunburns can cause wrinkles; so can cigarettes.

Because of the tobacco industry’s products, about 339 people in the U.S. die of lung cancer every day.

The impact of nicotine is jacked up because tobacco companies add ammonia to cigarettes.

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The tobacco industry increased its spending on advertisements and promotions by $2.7 billion between 2002 and 2003.

Tobacco companies actually went to court to fight for the right to keep tobacco advertising near high schools. They won. Congrats, Big Tobacco!

Tobacco companies have been targeting women with their advertising for the last 70 years.

In 1997, one tobacco company CEO said he would probably “instantly” shut his doors if it was proven to his satisfaction that smoking causes cancer. That same company now admits on their website that smoking causes cancer, but they’re still open for business.

On its website, one tobacco company lists “cancer services” as one of the community programs they support. Yet they continue to make a product that leads to 339 deaths from lung cancer each day.

Soups, cereals and other products we consume have to list ingredients on their labels, but cigarettes, a product that kills a third of its users, are not required to list any of the 599 possible additives.

Source: http://www.thetruth.com

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All information was taken from thetruth.com. For more information be sure to visit www.thetruth.com.

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In 1988, Jeffrey Wigand, PhD, went to work for Brown & Williamson Tobacco Corporation with the intent of developing a safer cigarette for smokers around the world. Five years later, the former Brown and Williamson Vice President became the industry’s highest ranking executive to speak publicly about its darkest secrets and tactics for finding and keeping a continuous stream of customers willing to buy its dangerous products. Recently, Dr. Wigand sat down with WELCOA President David Hunnicutt to

talk about tobacco use as an ever-present public health concern, the tobacco industry’s desperate tactics for replacing the 460,000 customers who die each year from their product, and what health promotion professionals can do to prevent employees and their families from experiencing the ravages associated with tobacco use.

MORALTREASONA Former Tobacco Industry Insider Speaks Out

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In your experience, Dr. Wigand, how harmful is smoking to human health?Tobaccoistheonlylegalproductintheworldtodaythat—whenusedasintended—killsfivemillionpeopleayearworldwide.It’saproductthatcontainsanywherefrom4,000to8,000knowntoxiccomponents.Andbecauseit’sinhaleddirectlyintothebody,thosetoxicchemicalshaveaccesstovirtuallyeveryorgansysteminthebody.Nottomentionthefactthatit’sextremelyaddictive.It’sharmfulpsychologicallyintermsofbehavior,andit’sharmfulchemicallyvis-à-visnicotine,whichisfourtofivetimesmoreaddictivethancocaineorheroin.So,isitharmful?There’snoquestioninmymind—it’sdownrightdangerous.

How long do you believe it takes someone to become addicted to tobacco? Inallhonesty,itvariesfrompersontoperson.Butifyou’vereadanyofDr.JosephDiFranza’sresearchontobaccoaddiction,youunderstandthattobaccoaddictionisadiseasethatstartswithchildren,notadults.Theaverageageofayoungstertakinguptobaccoissomewhereintheneighborhoodof12to14yearsofage.Andmoreandmoreyounggirlsarelightinguptodaythaneverbefore.Infact,they’refourtimesmorelikelytolightupthanboysthesameage.Manyyounggirlsbelievethathavingacigarettewillsatisfytheirobsessionorbeliefinthinness.Andmanyalsobelievelightormildcigarettesareahealthieralternativetoregularcigarettes—whichisabsolutelyfalse.Asaresult,ifyoulookatthelong-termstatisticsassociatedwithlungcancer,therateofincreaseinlungcancerforwomenoverthepastdecadefareclipsesthatofmen.

It’simportanttounderstandthattobaccoaddictionisadiseasethatstartswithchildren.Kidsaregainingaccesstotheproductatearlierandearlierages.Infact,kidsarebeginningtosmokeatearlierages—around11and12yearsold—andapproximately66percentofthesekidspurchasethetobaccoproductsthemselves.Forthemostpart,thedayswhenchildrengettobaccoproductsfromtheirparentsorfriends,orbystealingthem,aregone.Sixty-sixpercentofthekidsinthiscountrygettobaccoproductsbypurchasingthemillegally.

Anotherfrighteningphenomenonisthenumberofchildrenaddictedtotobaccofrombirth.About20

percentofpregnantmothersstillsmokethroughallthreetrimestersoftheirpregnancy.So,manyofourunbornchildrenaresmokingwell-beforethetimetheytaketheirfirstbreathinthisworld.

Addictionstartswiththefirstcigarette,thefirstdip,orthefirstchew.Anditoftenbeginswithwhat’scalleda“gatewayproduct”—astarterproductlikehighlyflavored,moistsnuffs.Ifyou’veeversmokedacigarette,it’sphysicallytaxingintermsofcoughing,choking,vomiting,orexperiencingheadaches.Sotheindustrysellseasy-to-usegatewayproductsintheformofsnuffsandchews.Togetpeoplehooked,theyoftenflavorthemwithlicorice,honey,cocoa,spearmint,peppermint,orwintergreen.They’reinitiallypackagedlikelittleteabagsandalwayscontainammoniaorotherchemicalcompoundstofacilitatetheaddictiveprocess.

Addictionispowerful.Itdoesn’tsimplyinvolvethecontinueduseofaproductorsubstance.Withanaddiction,theuserexperiencesacontinuallyincreasingneedformoreandmoreoftheaddictivesubstancetoproducethedesiredeffectorfeeling.Nowthat’spowerful.Whereaddictionreallystartstohurt,however,isduringthewithdrawalprocess.Withdrawalinvolvesachemicalwithdrawalfromthenicotine,anditinvolvesaphysicalwithdrawalfromtheritualofsmoking—theprocessoftappingacigarette,rollingacigarette,mouthingacigarette,androllingtheashes.Soaddictionisaprocesswithmanydimensions.Itaffectstheneuralsystemofthebrain,itaffectsthesystemthatregulatesourmood,anditaffectsthesystemthatproducesourflightorfightresponse.Inessence,itcreatesanimbalanceofbrainchemistry.

There are a surprising number of people out there who refuse to believe that the tobacco companies are manipulating the nicotine levels in their products to facilitate addiction. What are your thoughts? Thetobaccoindustrynurturesastrongbeliefinthe“naturalness”ofitsproductwithits$14billionayearinadvertisingandpromotionalspending.It’sabeliefthatcouldn’tbeanyfurtherfromreality.First,acigaretteorpipetobaccoisn’tpurelytobacco.Second,bothare

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intentionallyengineeredtocontainatleast599specificchemicalsdesignedtofacilitatethesmokingprocessaswellastoenhancethecapacityforaddiction.Someoftheseadditivesincludechocolate,honey,cocoa,butterfat,lemonjuice,menthol,andsugars.Butthat’snotalltheindustryaddstotheirproduct.

Theindustryalsoaddschemicalsspecificallydesignedtoenhanceandmaintaintheaddictingprocess.Nicotine,initsnaturalstate,existsasasaltwithinthetobaccoplant.IthasalowpHlevelandthereforeisn’teasilytransportedtoorabsorbedbythelungs.Knowingthis,theindustryhasdiscoveredawaytomaketheaddictiveprocessandreleaseofnicotineeasier.Theycreatewhat’scalled“freenicotine”,andthereareveryfewdifferencesbetweentheprocessofmakingitandtheprocessoffreebasingcocaine(i.e.,makingcrackcocaine).Theindustryalsoaddschemicalssuchasammonia-basedderivativesthathaveahighcapacitytoshifttobaccoandsmokepHlevelsfromacidictobasic.Whenyoutakenicotineandmoveitfromitsnaturallyacidicenvironmenttoabasicenvironment,whereitexistsinacigarette,youscavengethenicotineinitsfreeform,whichhasahigheraddictivecapacitythannicotineinitsnaturalstate.

Additionally,manyofthechemicalsaddedtotobacco—likesugars—createotherchemicalswhenthey’reburned.Onesuchchemicalisacetaldehyde,whichresultsfrom

thebreakdownofsugarwhenburned.Thiscombinationofacetaldehydeandfreenicotinecreatesahigherbindingcapacityinthebrain,whichaidsinthebrainchemistryofaddiction.It’snotunlikegettingbettergasmileagefromyourcarusingethanolinsteadofregulargasoline.Thecigaretteisdesignedtobeahighlyeffectivedrugdeliverydevice.Thechemicalsintentionallyaddedtotobaccoareusedtoenhanceaddiction,togetnicotineinitsmostaddictiveform,freenicotine,andtokeepthedosageequaltowhattheaddictneedsforsatisfaction.Allofthisoccursaspartofcigaretteandtobaccoproductdesign.

SoifIhaveanaddictiveneedforagramofnicotineaday,I’mgoingtosmokemycigarettesdifferently,orsmokemoreofthemtogetmyfix.I’mgoingtogoaheadandinhalethemdeeperandI’mgoingtothereforefeedmyaddictionbasedonwhatwillkeepmybodyfromrevoltingagainstwithdrawal—that’sthepainofit.

Thelastpartofallthisiswhat’sunintentionallyaddedtotobacco.Tobaccoisalsooneoftheonlyconsumerproductsthatincludesmanyunintentionaladditives—additivesderivedfromtheagriculturalprocess,likepesticideorherbicideresiduesandbacteriafromthesoilwherethetobaccoplantwasharvested.Whenacigarette’smoisturecontentrisesabove15percent,there’satendencyforinactivebacteriawithinthetobaccotobegingrowingandproducingverytoxicchemicalscalledaflatoxins.

Tobacco still kills 460,000 people in this country every

year. And of the 460,000 people

who die, 55,000 of them never chose to smoke—they

died from passive or secondhand

smoke.

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WELCOA®


They court our children

in the movies with advertising that leads

them to believe

cigarette smoking is

sexy and glamorous.

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”

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Contrarytowhatiscommonlythought,acigaretteisn’tagrow-it-in-the-field,stuff-it-in-a-tubeproductthat’sshippedoutthedoor.Whyisacigarettesowhite?Well,theyusetitaniumoxideonthepapertomakeitlookaswhiteaspossible.Theyuseburnaccelerantsandburndecelerantstokeepthecigarettecomponentsburningatanequalcombustionrate.Sothere’salotofsciencetoitall.Thescienceofengineeringanddesigningacigarettestartsinthetobaccofield,wheregeneticengineeringcanbeusedtoboostthenicotinelevelsintheconsumerproduct.

Do you think smoking is still the national public health problem it was twenty years ago?Tobaccostillkills460,000peopleinthiscountryeveryyear.Andofthe460,000peoplewhodie,55,000ofthemneverchosetosmoke—theydiedfrompassiveorsecondhandsmoke.SecondhandsmokeisrecognizedbytheEPA,theRegistryofCarcinogens,theNationalInstitutesofHealth,theAmericanCancerSociety,theCentersforDiseaseControl,theWorldHealthOrganization—thereisalitanyofscientificorganizationsthatnotonlycorroborate,butalsore-amplifythefactthatpassiveorsecondhandsmoke—somebodyelse’ssmoke—isaClassAhumancarcinogenjustlikeasbestosorbenzene.

Wealsoknowthattobaccocosts,onafederallevel,about$100billionayearindirecthealthcarecosts,andabout$140billionayearinlostworkforceproductivity.Smokersaresickmoreoften;they’reoutofworkmoreoften;theyneedtohavebreaksmoreoften;andmanytimesthey’rejustnotasproductiveasnon-smokers.Nottomentionthefactthathealthcarecostsandinsurancepremiumsarehigherforsmokers.

What are your thoughts on those companies pushing the envelope by encouraging their states to pass legislation allowing them to only hire non-smokers? Ithinkthatifanadultchoosestosmoke,thentheycertainlyhavetherightto,solongasitdoesn’taffectorharmothers,andsolongasthesmokerisfullyinformedabouttherisks.Unfortunately,I’mnotsosureit’s

somethingwecanlegislate,nordoIthinkweshould—asJohnStuartMillwouldsay—“infringeuponsomebodyelse’slibertyorautonomybylegislatingsomethingthat’sanindividualdecision.”Idothink,however,thatthegovernmentshouldregulatetobaccosuchthatit’snotconsideredanormal,run-of-the-mill,everydayconsumerproductlikebreadandbutter.Tobaccohasbeenapartofourculturefor200years,anditconstitutesasizeableportionofrevenueforthefederalgovernmentaswellasstategovernments.Everytimeapackofcigarettesissold,theUSgovernmentandallstategovernmentscollecttaxes.Theproblemis,however,thateachtimetheygeneraterevenuefromapackofcigarettes,theyalsogenerateasubstantialamountofeconomicburden—intheformofmedicalcostsandlostproductivity—fromthetaxesthey’rereceiving.Tome,it’samistakeanditdoesn’tmakeeconomicsense.

Anattempttomaketheproductillegalwouldbeverydifficult.Thetobaccoindustryisa$45billionindustrywhereitcostspenniestomaketheirproduct.Fordecadesthey’vebeenhighlyinfluentialintermsofpreventingCongressandstatelegislaturesfromdoingthemorallyrightthing.They’veworkedtopreventsmoke-freeworkplaces,smoke-freehospitals,andsmoke-freeschools.It’sonlybeenrecentlythatwe’veseensomeprogressduetotheenormousamountofdocumentscharacterizingthemisbehaviorofBigTobaccooverthecourseofthepastfivedecades.

Ithinkastepintherightdirectionisregulatingthetobaccoindustry.Weneedtoregulatetheingredientsandcontentsoftheirproduct.WeneedtoregulatetheirlabelingpracticestopreventthemfromwateringdowntheSurgeonGeneral’srecommendations.Weneedtoregulatetheiradvertisingtopreventtheirpredatorymessagesfromaffectingourchildren.

Anotherstepweneedtotakeismakingbetteruseofthemastersettlementagreement(MSA)funds—the$246billion—thestatesarereceiving.Weneedtousethismoneyforcounter-advertisementsandsmokingcessationprograms.Weneedtousethismoneytoenforceourcurrenttobaccoagelaws.Remember,66percentofourchildrenarepurchasingtobaccoproductsfromstoresandotherlegaloutlets.TheMSAfundsneedtobeseenbythestatesasaninvestmentinthehealthandfutureoftheircitizens.We’vedemonstratedthatspendingtheCDCminimumrecommended20percentofthosefundsonpreventioninitiatives



candemonstratea3:1returnoninvestmentintermsofhealthcarecostsandlostproductivity.We’vealsoseenthatusingthismoneyforpreventionactuallydecreasesthenumberofchildrenusingtobacco.

Thetobaccoindustryisverypowerful,andweneedtorecognizethatit’sawhollyundesirablepower.IthinktheWorldHealthOrganizationandtheEuropeanUnionarebeginningtorealizethatthedeathtollfromtobaccois100%preventable.They’recomingtotherealizationthattheyshouldn’tbeinbedwiththetobaccocompanies—acceptingtheirpoliticalcontributionsanduntruths,andcreatingasystemwhereourchildrenandlegislatorsareblindtothetruelethalityoftobaccoproducts.

With the tobacco settlements in place, is the tobacco industry as powerful and influential as they once were? Yes.Idon’tthinkmuchhaschanged.

In1998,thestates’AttorneysGeneralbasicallycommittedtoaneconomicdeal.Theywouldget$206billioninpaymentsover25yearswithnostringsattached—very

muchdifferentthantheoriginal$368billionfromtheearliersettlementofJune1997.Themoneywasawardedfortwopurposes:tohelpstatesrecoupdamagesincurredastheresultoftreatingsicksmokers,andevenmoreimportantly,tohelppreventchildrenfrombecomingthenewstatisticsofthetobaccoindustry.Infact,exceptforfourstates—Maine,Delaware,Mississippi,andArkansas—theresthaven’tmettheminimumCDCguidelinesorBestPracticesforuseofthesettlementfundstoreversethetolltobaccotakesonourcitizens.

Byinvestingthesettlementmoneyinprevention,thesestatescouldoffsetthetensofbillionsofdollarsthetobaccoindustryspendscourtingour

children.Theycourtourchildreninthemovieswithadvertisingthatleadsthemtobelievecigarettesmokingissexyandglamorous.Theyadvertisein

highlyreadteenmagazinesframingtheissueasifhavingacigarettewillkeepyounggirlsslim.They

continuallypreyontheissueofself-esteemandthedignityofthedifferentshapes,sizes,andcolorsofourchildren.

Theyalsopreyonpeopleusingmisinformation.Theyusemonikerssuchasmildorlight,whichhavenomeaningintermsofthecigarette.They’vedesignedthecigarettesothatwhenit’stestedonamachine,itreadsalownumber.Inactuality,thelightorultralightcigarettedeliversmanytimestheamountoftarandnicotinesmokedinanormalhumanmanner.Sowe’vegotpeopleswitchingtolightsorultralightsbelievingthatthey’rebeinghealthconscious.Thisisparticularlytrueforwomen,asmoreandmorearechoosinglightsormildsbecausetheybelievethey’regettingahealthyalternative.That’swhylungcancerratesareoutstandinglyhighforwomen.Insteadofgettingonetypeoflungcancer,theygetadifferentkind.

I imagine that the tobacco companies see undeveloped, third world nations as perfect opportunities for continuity. What are your thoughts? Therearemanyforeigncountriestakingveryproactivesteps.Canadaisprobablyleadingthepack,followedbyAustraliaintermsofdenormalizingtobacco.They’reraisingtheprices,restrictingadvertisements,establishingsmoke-freeenvironments,placinggraphicrepresentationsontobaccopackaging—doingwhatittakestosavelives.TheUnitedStatesclearlyhasn’tcometothis.Infact,intheUnitedStates,weusecigarettesastradebarterwithdevelopingcountries.

Whenmakingtradebalances,weforcedevelopingcountriestotaketobaccoproductsaspartofthebalanceoftrade.TheUnitedStatesfailstorecognizetheWorldHealthOrganization’smandatetohaveaFrameworkConventionforTobaccoControl(FCTC)—smoke-freeenvironments,priceincreasesontobacco,tobaccoeducationforchildren,andabanonoutdooradvertising.

Let’sputthisproductwhereitbelongs.Ifitwereinventedheretoday,cigaretteswouldn’tbealegalproduct.In2000,theUnitedStatesSupremeCourtessentiallycriedoutforCongresstochangethelawsregardingthenatureofproductstheFDAcouldregulate.Thecourtruledina5to4decisionthatunderthe1936FoodDrugandCosmeticAct,theFDAdidn’thavethepowertoregulatetobacco.Congresshasdonenothingsince2000intermsofregulatingtobacco,mainlybecausethetobaccoindustrycontinuestoinfluenceCongress.Onceuponatimewe

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hadasmoke-freeWhiteHouse—it’snolongersmokefree.TheStateofFlorida,goingbackonanearlierdecision,nowinvestsitspensionfundswithinthetobaccoindustry.Alloftheseactionsaredueinpartbecauseofthetobaccoindustry’sinfluenceandpoliticalmotivations.

Theytoldustheycouldn’tmakeafiresafecigarette.Well,NewYorkjustpassedafiresafecigarettelawandnow,allofasudden,thetobaccoindustrycanmakeafiresafecigarette.Theycould’vemadeonein1986,buttheychosenottomakeone.

Comparedtoanyotherindustry,thetobaccoindustryengagesinthemostegregiousimmoralandunethicalbehavior,butcontinuestogounregulated.Congressandmanystatelegislatureswon’thelpcreatesmoke-freeenvironmentsbecausetheybelievedoingsowillhurtbusinesses—anabsolutefalsehood.Howwouldyouliketobearestaurantworkerforcedtobreatheasbestoseverytimeyouservedameal?Asbestosandsecondhandsmoke—there’snodifference.

In terms of solutions, what can we do to help stop the tobacco industry’s plague resulting from their products? Thetobaccoindustryclaimstobaccouseisapersonalchoice.Letmeassureyouit’snotapersonalchoicewhenyou’rean11-year-oldchildbombardedwithadvertisementsthatconveythemessagethatsmokingissexyandcool.OnceuponatimetheindustryevenusedcartooncharacterslikeJoeCameltoenticechildren.IfpeoplethinkJoeCamelwascreatedfora25-year-oldchoosingtosmokeCamelsoverMarlboros,they’vemissedtheboat.JoeCamelwasrecognizedby31percentof3-year-olds—morethantheyrecognizedRonaldMcDonaldandMickeyMouse.That’showearlyallofthisstarts.ThefirstthingwehavetodoiscreateasystemtoeducateourchildrentoseethroughinformationdisplayedonthebigscreenorTV,andteachthemtomakerational,criticaldecisionsabouttheirhealth.Itrytospendalotoftimeworkingonthis.Educationisthefirstthingweshouldbeworkingon.

Second,wehavetosetrequirementsbywhichtoregulatethetobaccoindustry.Thereshouldberegulationsthatrequirethetobaccoindustrytodisclosetobaccoadditives,disclosethetruetarandnicotinelevelsasdeterminedbyrealsmoking,notamachinethatmeasuresnumbers

consistentlybelowtheexposurelevelofanormalhumansmoker.Weneedtohaveafire-safecigarettethatwillsavethelivesofinnocentfiremen,andpreventpropertylossduetofirecausedbycarelesssmokers.Weneedtocreateregulationsthatallowforthecreationofpackagingthatremindspeopleabouttheendeffectsoftheproductthey’repurchasing.SomeofthegraphicrepresentationsdoneinCanadaaretrulydisturbing,buttheygivepeoplethatpauseforthought.Weneedtoworkoncreating100percentsmoke-freeworkplacesandpublicplaces.Ifyouwanttosmoke,smokeoutside,butdon’tsmokewhereyou’repoisoningsomebodyelse.

WealsoneedtostartdeglamorizingtobaccoproductsinthemoviesandonTV.Contrarytowhatpeoplethink,moviesdepictpeoplesmokingmorenowthantheyeverhaveinthepast.Andwhat’smore,90percentoftherevenuefromthetop10producingmoviescomesfrom11to19-year-olds.DoesJamesBondneedtosmokePhilipMorrisproductsinhismovies?DoSupermanandLoisLaneeversmokeMarlborosorhaveabattlewithMarlborosintheircomicbooks?DidFredandBarneyFlintstonesmokeWinstons?ShouldwehaveallowedtheamountofsmokingwehaveonTVandinthemovies?Shouldourchildrengetthateducation?

TheCDChasdevelopeda9-point,BestPracticesprogramtominimizethehealthtolltobaccotakesonourcitizens.Theprogramallowsforthereductionoftobaccoadvertising,increasesthecostsoftobacco,andgiveschildrenthepowertounderstandhowthetobaccoindustryisattemptingtomanipulatethem.Itgivesthemthepowertomakecriticaldecisions.Thestatesparticipatinginthisprogramhavedemonstratedthattheycanhaveasignificantimpactonthehealthofmiddleandhighschoolstudents.They’resavingliveswiththisprogramlikeMississippi,Maine,ArkansasandDelaware.

Theotherthingweshouldbedoingishelpingthosealreadyafflictedbytobaccoaddiction.Remember,90percentofsmokerswanttoquit—theyonlyneedanenvironmentlikeasmoke-freeworkplaceorbeexposedtocounter-advertisingtohelpmotivatethemtobecometobacco-free.Wealsoneedtofigureouthowbesttomedicallyintervenetohelpthesefolks.Weneedtofigureoutaninexpensivewaytobreaktheaddiction.Somethingthatcombinesanicotinereplacementtherapy(NRT),anantidepressant(Zyban),plusbehaviormodificationcoupledwithcounselinganddietaryandexerciseimprovements.Doingsowillhelpcreatetobacco-free



adults.Rightnowwe’renotdoingit;we’renotusingthemoneyfromthetobaccosettlementstohelppeoplequit.Sowhatdoweneedtogetgoing?Shouldcompaniesofferfreesmokingcessationprograms?Itmakessense.Iftheycanhelpsomeonequitsmoking,thatperson’sriskofaheartattackafteroneyearisthesameassomeonewhohasneversmoked.That’saprettygooddeal,especiallywhenyouconsiderthecostsofaheartattack—financially,medically,oremotionally.

Therearealotofquestionsthatneedtobeanswered.Shouldwerequirethetobaccoindustrytoremovepackagingmonikersthatsuggestaproductisahealthieralternativewheninfactit’smoredangerous?Shouldwerequirethetobaccoindustrytotellusthetruthwhentheyknowthetruth?Shouldtheybeallowedtoputchemicalslikeplutonium210intheirproduct?Whyshouldtheybeallowedtoputchemicalsintheirproductthatwereneverintendedtobeburned,andwhenburnedaredownrightdangerous?Shouldweallowtheindustrytoclaimthattheadditivestheyusearesafewhenthey’renotsafeandtheyknowthey’renotsafe?Shouldn’tthegovernmentrequirethetobaccocompanies—astheydowithfoodandcosmeticmanufacturers—tolistingredients?Howmuchammoniadotheyaddtomakeitmoreaddictive?Whydo

theyprovide“gateway”products?Whydotheyreimbursemerchantswhensomebodystealsproductfromastore?

Therearealotofthingsthatneedtobechanged.Unfortunately,whatwe’retryingtodoisunraveltwocenturiesoftobacconormalizationinlessthanadecade.We’vestillgotalongwaytogo.Thebiggestthingwecando,however,isbeginusingthesettlementfundsthewaytheyweresupposedtobeused.Stategovernmentshaven’tusedthemoneyappropriately,andIcallitmoraltreason.Thesegovernmentsdon’tbelievethesettlementmoneybelongstothefuture—tothechildren.Theydon’tbelievethemoneyshouldbeusedtoeducateourchildren,togivethemalifeunfetteredfromtheravagesassociatedwithtobacco.It’smoraltreason.

Why aren’t we hearing these messages, point blank, from our political and health leaders? Are the pressures that great? Ithinksomeofithastodowiththepoliticalactioncommitteesfundingofthesepoliticians.Muchofthisfundingcomesfromthetobaccoindustry,anditkeepspoliticiansfromactinginamorallyresponsiblemanner.

The people

who know and

have access to

information

about the

tobacco industry,

but choose to be

bystanders, are

wrong.

“

”

ABSOLUTEADVANTAGE


WELCOA®

Foralegislatortounderstandthatsecondhandsmokekills,andnotpassanordinancepreventingpeoplefromsmokinginpublicplaces,ismorallywrong.

JohnStuartMill,a19th-Centuryutilitarianandlibertarian,believedthattheonlytimegovernmenthadthedutytointerferewithsomebodyelse’slibertyorautonomywaswhenthatautonomyorlibertyhurtothers.Secondhandsmokehurtstheinnocent.IalsostronglybelieveinanotherprinciplethatiswrittenonamarbleplaqueattheHolocaustMuseuminWashington,DC:“Thoushaltnotbeavictim…Thoushaltnotbeaperpetrator…Butaboveall,thoushaltnotbeabystander.”Thepeoplewhoknowandhaveaccesstoinformationaboutthetobaccoindustry,butchoosetobebystanders,arewrong.

Dr. Wigand, what’s your take on the tobacco industry providing smoking cessation websites and other health interventions?It’smoreofanenticementforourchildrentosmoke.Itpassestheresponsibilityfromthetobaccocompanytowhom?Totheparentofthechildortothechildthemselves.Theresponsibilitybelongstothetobaccoindustry.Thetobaccocompaniesdon’tsurvivebygetting25-year-oldstosmoke.Ninetypercentofthosepeoplesmokingtodaydidn’tstartaftertheageof18or19;theystartedbefore.We’vegottocounterthetobaccocompaniestacticswithadsliketheTRUTHadsthathavecomeoutofFlorida.Thoseadshavebeensosuccessfulbecauseadultsdidn’tcreatethem.Theywerecreatedbychildren—thebodybags,theliedetectors,andsoon,havehelpedcreateanunderstandingofhowthetobaccocompaniesmanipulateandtargetourchildren.

Butthecyclecontinues.Igotoplaces,notonlyintheUnitedStates,butthroughouttheworld,wherekidssix,seven,oreightyearsoldarealreadysmoking,chewing,ordipping.Ifwewerespendingthemoneytohelpthesechildrenunderstandthatusingtobaccoisriskybehavior,tohelpthemunderstandwhyit’sfatalandhowthey’rebeingmanipulated,wecouldmakeadifference.Atthesametime,ifwecouldgetourlegislativebodiestorealizethatiftheyspentonly20percentofthesettlementdollarsontobaccopreventionefforts,theywouldmakeabigdifferenceinthelivesofthesechildren,nottomentionproducea3:1returnintermsofhealthcarecosts.

Idon’tunderstandwhytheycan’tdothemath.Icandoit;it’snotthatdifficult.Foreverypreventiondollaryouspend,yousavethreedollarsinhealthcarecostsandlostproductivity.

What advice do you have for worksite leaders, doctors, and health educators regarding what they can do to prevent the further spread of tobacco use? Firstandforemost,don’tbeabystander.Wehavetoomanydoctorsacrossthenationwhowon’tactivelytakepartinsolvingthisepidemic.WeneedmoremedicalpractitionerstogetinvolvedliketheAmericanAcademyofFamilyMedicinehas.Weneedmoredentistsinvolved.Weneedpolicemenouttheremakingsurethatthe66%ofthecigarettespurchasedbyunderagechildrenaren’tacquiredbecauselawsaren’tbeingenforced.

Weneedtomakethepriceexorbitantlyhigh—justlikeNewYorkStatedid—sothebarriertoentrybecomesasignificanthurdle.Forachildtoaffordeightbucksforapackofcigarettesisdifficult.Weknowthatforevery10percentincreaseinthepriceofcigarettes,there’sa7percentdecreaseintheconsumptionorpurchasingcapacityofachild,and4percentdecreaseamongadults.Weknowthat90percentofthosepeoplehookedandaddictedtotobaccowanttodoonething—breaktheiraddiction.Butthesepeopleneedhelp.Maybeit’spayingforpharmaceuticals,orprovidingaccesstoaprogramtohelpfreethemoftheiraddiction.Sometimeswhattheyneedisasmoke-freeenvironment,asmokingcessationcourse,orjustacounter-advertisement.PeoplehavewrittenandtoldmethattheynolongerwantanythingtodowithsmokingafterwatchingthemovieTheInsider.Whattheysawactuallyhelpedthemquitsmoking.

Therearemanydifferentwaysofskinningthiscat.Butweneedourlegislators;weneedpeoplefromallwalksoflifetoactivelyengageintheprocessofdenormalizingthetobaccoindustry’sproducts.


Suggested Citation: Moral Treason: A Former Tobacco Industry Insider Speaks Out. (2006). WELCOA’s Absolute Advantage Magazine, 5(2), 44-53.



Tobacco companies

don’t survive by getting

25-year-olds to smoke.

90% of those people

smoking today didn’t

start after the age of 18 or 19;

they started before.

“

”

WELCOA®


ABSOLUTEADVANTAGE






Helpingyouremployeesleadtobacco-freelivesischallenging.Giventheaddictivenatureof

cigarettes,manyemployeesstrugglewithquitting—especiallyoverthelonghaul.

Sowhatinformationcanyougivethem?

Greatquestion.Basically,tohelpthoseemployeeswhohavealreadyquitandthoseemployeeswhoarelookingtoquit,themessagesarerelativelystraightforward.

Intheparagraphsbelowandthepagesthatfollow,we’veprovidedinformationthatcanhelpyougetthejobdone.AlloftheinformationwasprovidedbytheNationalCancerInstituteandcanbereprintedwithoutpermission.Besuretousethisinformationinyourworksitesandwithyourclients.

Stick With ItHelpingyouremployeestobeatinganaddictiontonicotinetakesalotofwill-poweranddetermination.Youremployeeswhohavequitshouldfeelgreataboutthemselvesformakingitthisfar.Now’sthetimetofocusonhelpingthemstickwithit.Specifically,here’swhatyoucanconfidentlysharewiththem.

Keep Your Guard UpYourbodyhaschangedsinceyoubegantosmoke.Yourbrainhaslearnedtocravenicotine.Socertainplaces,people,oreventscantriggerastrongurgetosmoke,evenyearsafterquitting.That’swhyyoushouldnevertakeapuffagain,nomatterhowlongithasbeensinceyouquit.Atfirst,youmaynotbeabletodothingsaswellaswhenyouweresmoking.Don’tworry.Thiswon’tlastlong.Yourmindandbodyjustneedtogetusedtobeingwithoutnicotine.

Afteryou’vequit,theurgetosmokeoftenhitsatthesametimes.Formanypeople,thehardestplacetoresisttheurgeisathome.Andmanyurgeshitwhensomeoneelseissmokingnearby.LookatyourCravingJournaltoseewhenyoumightbetempted.Thenusetheskillsyou’velearnedtogetthroughyoururgeswithoutsmoking.

Fight The UrgesDrinkwater,walk,chewgum,gotosupportgroups,watchamovie.Doanythingtofighttheurgetosmoke.

Stay UpbeatAsyougothroughthefirstdaysandweekswithoutsmoking,keepapositiveoutlook.Don’tblameorpunishyourselfifyoudohaveacigarette.Don’tthinkofsmokingas“allornone.”Instead,takeitonedayatatime.Rememberthatquittingisalearningprocess.

Keep Rewarding Yourself Nowthatyouaren’tbuyingcigarettes,youprobablyhavemorespendingmoney.Forexample,ifyouusedtosmokeonepackperday:Thinkaboutstartinga“moneyjar”ifyouhaven’talready.Putyourcigarettemoneyasideforeachdayyoudon’tsmoke.Soonyou’llhaveenoughmoneytobuyarewardforyourself.

If You Do Slip UpDon’tbediscouragedifyouslipupandsmokeoneortwocigarettes.It’snotalostcause.Onecigaretteisbetterthananentirepack.Butthatdoesn’tmeanyoucansafelysmokeeverynowandthen…nomatterhowlongagoyouquit.Onecigarettemayseemharmless,butitcanquicklyleadbacktooneortwopacksaday.

Manyex-smokershadtotrystoppingmanytimesbeforetheyfinallysucceeded.Whenpeopleslipup,it’susuallywithinthefirstthreemonthsafterquitting.

Here’s what you can do if this happens:

>> Understand that you’ve had a slip.You’vehadasmallsetback.Thisdoesn’tmakeyouasmokeragain.Don’tbetoohardonyourself.Oneslipupdoesn’tmakeyouafailure.Itdoesn’tmeanyoucan’tquitforgood.

>> Don’t be too easy on yourself either.Ifyouslipup,don’tsay,“Well,I’veblownit.Imightaswellsmoketherestofthispack.”It’simportanttogetbackonthenon-smokingtrackrightaway.Remember,yourgoalisnocigarettes—notevenonepuff.

>> Feel good about all the time you went without smoking.Trytolearnhowtomakeyourcopingskillsbetter.

>> Find the trigger.Exactlywhatwasitthatmadeyousmoke?Beawareofthattrigger.Decidenowhowyouwillcopewithitwhenitcomesupagain.

>> Learn from your experience. Whathashelpedyouthemosttokeepfromsmoking?Makesuretodothatonyournexttry.

>> Are you using a medicine to help you quit?Don’tstopusingyourmedicineafteronlyoneortwocigarettes.Staywithit.Itwillhelpyougetbackontrack.

>> Know and use the tips in this booklet.Peoplewithevenonecopingskillaremorelikelytostaynon-smokersthanthosewhodon’tknowany.

>> START to stop again!

>> See your doctor or another health professional.Heorshecanhelpmotivateyoutoquitsmoking.

Thepreviousinformationcanbeusedincoachingsessionsbywellnesspractitionerstohelpquittersremainsmoke-free.Theinformationonthefollowingpagescanhelpyoucoachsmokersthroughthequittingprocess.

ABSOLUTEADVANTAGE


WELCOA®

Here’s How To Get STARTedJustthinkingaboutquittingmaymakeyouanxious.Butyourchanceswillbebetterifyougetreadyfirst.Quittingworksbestwhenyou’reprepared.Beforeyouquit,STARTbytakingthesefiveimportantsteps:

S Setaquitdate.

T Tellfamily,friends,andco-workers

A Anticipateandplanforthechallengesyou’llfacewhilequitting.

R Removecigarettesandothertobaccoproductsfromyourhome,car,andwork.

T Talktoyourdoctoraboutgettinghelptoquit.

Set A Quit Date

Pick a date within the next two weeks to quit.

Be sure to give yourself enough time to get ready.Butdon’twaitsolongthatyouloseyourdrivetoquit.

Think about choosing a special day:

Yourbirthdayorweddinganniversary

NewYear’sDay

IndependenceDay(July4)

WorldNoTobaccoDay(May31)

TheGreatAmericanSmokeout(thethirdThursdayofeachNovember)

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¸

¸

ü

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If you smoke at work, quit on the weekend or during a day off.Thatwayyou’llalreadybecigarette-freewhenyoureturn.

Tell People Of Your Plan To Quit

Quitting smoking is easier with the support of others.Tellyourfamily,friends,andco-workersthatyouplantoquit.Tellthemhowtheycanhelpyou.

Some people like to have friends ask how things are going.Othersfinditnosy.Tellthepeopleyoucareaboutexactlyhowtheycanhelp.Herearesomeideas:

¸

¸

¸

Ask everyone to understand your change in mood.Remindthemthatthiswon’tlastlong.(Theworstwillbeoverwithintwoweeks.)Tellthemthis:“ThelongerIgowithoutcigarettes,thesoonerI’llbemyoldself.”

Does someone close to you smoke?Askthemtoquitwithyou,oratleastnottosmokearoundyou.

Do you take any medicines? Tellyourdoctorandpharmacistyouarequitting.Nicotinechangeshowsomedrugswork.Youmayneedtochangeyourprescriptionsafteryouquit.

ü

ü

ü



Get support from other people. Youcantrytalkingwithothersone-on-oneorinagroup.Youcanalsogetsupportonthephone.YoucaneventryanInternetchatroom.Thiskindofsupporthelpssmokersquit.Themoresupportyouget,thebetter.Butevenalittlecanhelp.

Anticipate The Challenges Ahead

Expecting challenges is an important part of getting ready to quit.Mostpeoplewhogobacktosmokingdoitwithinthreemonths.Yourfirstthreemonthsmaybehard.Youmaybemoretemptedwhenyouarestressedorfeelingdown.It’shardtobereadyforthesetimesbeforetheyhappen.Butithelpstoknowwhenyouneedacigarettemost.

Look over your Craving Journal.Seewhenyoumaybetemptedtosmoke.Planforhowtodealwiththeurgebeforeithits.Youshouldalsoexpectfeelingsofwithdrawal.Withdrawalisthediscomfortofgivingupnicotine.Itisyourbody’swayoftellingyouit’slearningtobesmoke-free.Thesefeelingswillgoawayintime.Keepreadingfortipsonhandlingurgesandwithdrawal.

Withdrawal: How You May Feel When You Quit.Commonfeelingsofsmokingwithdrawalinclude:

Feelingdepressed

Notbeingabletosleep

Gettingcranky,frustrated,ormad

ü

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¸

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ü

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Feelinganxious,nervous,orrestless

Havingtroublethinkingclearly

Feelinghungryorgainingweight

Noteveryonehasfeelingsofwithdrawal.Youmayhaveoneormanyoftheseproblems.Andtheymaylastdifferentamountsoftime.

Remove All Tobacco Products

Getting rid of things that remind you of smoking will also help you get ready to quit. Trytheseideas:

Make things clean and fresh at work, in your car, and at home.Cleanyourdrapesandclothes.Shampooyourcar.Buyyourselfflowers.Youwillenjoytheirscentasyoursenseofsmellreturns.

Throw away all your cigarettes and matches.Giveorthrowawayyourlightersandashtrays.Remembertheashtrayandlighterinyourcar!

Have your dentist clean your teeth to get rid of smoking stains.Seehowgreattheylook.Trytokeepthemthatway.

Some smokers save one pack of cigarettes.Theydoit“justincase.”Ortheywanttoprovetheyhavethewillpowernottosmoke.Don’t!Savingonepackjustmakesiteasiertostartsmokingagain.

Don’t use other forms of tobacco instead of cigarettes.Lightorlow-tarcigarettesarejustasharmfulasregular

ü

ü

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¸

ü

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cigarettes.Smokelesstobacco,cigars,pipes,andherbalcigarettesalsoharmyourhealth.Forexample,bidicigarettesarejustasbadasregularcigarettes.Clovecigarettesareevenworse.Theyhavemoretar,nicotine,anddeadlygases.Alltobaccoproductshaveharmfulchemicalsandpoisons.

Talk To Your Doctor

Quitting “cold turkey” isn’t your only choice. Talktoyourdoctoraboutotherwaystoquit.Mostdoctorscanansweryourquestionsandgiveadvice.Theycansuggestmedicinetohelpwithwithdrawal.Youcanbuysomeofthesemedicinesonyourown.Forothers,youneedaprescription.

Yourdoctor,dentist,orpharmacistcanalsopointyoutoplacestofindsupportortoll-freequitlines.

Ifyoucannotseeyourdoctor,youcangetsomemedicineswithoutaprescriptionthatcanhelpyouquitsmoking.Gotoyourlocalpharmacyorgrocerystoreforoverthecountermedicineslikethenicotinepatch,nicotinegum,ornicotinelozenge.Readtheinstructionstoseeifthemedicineisrightforyou.

Ifyou’renotsure,askapharmacist.

¸

The information in this article was provided by the National Cancer Institute and is in the public domain. For more information, visit their website at

www.cancer.gov.

ABSOLUTEADVANTAGE


WELCOA®

Where There’s Smoke...

There’s A NewKind Of FireSome Companies Are Sending A Message To

Employees, “If You Choose To Smoke—Even On

Your Own Time—Hit The Bricks.”

| By David Hunnicutt, PhD

ABSOLUTEADVANTAGE




WEYCO, Inc. a Michigan-based Third Party Administrator

specializing in Employee Benefit Plans and Benefit Management, has implemented a new corporate policy: If you smoke, you’re fired.

AccordingtoWEYCO’swebsite(www.weyco.com),thecompanybelieves“inhavingaproactiveplanforpromotinghealthylifestylesforemployees.”TheleadersatWEYCObelievethat“healthyemployeesaremoreproductiveand,longterm,thehealthcarecostscanbelessened.”

Basedonitscompanyethos,itisclearthattheleadershipatWEYCObacksupitswordswithaction.

Inrecentmonths,WEYCOfiredfourofitsemployeeswhentheyrefusedtotakeabreathalyzertest—whichwoulddetectwhetherornotapersonwasatobaccouser—undernewrulesimposedbythecompany.

Priortoitsshowdownwiththesefour,WEYCOgaveallemployeesfifteenmonthstoquitbeforesubjectingthemtorandombreathtesting.Infact,ofthecompany’s24tobaccousers,20quit.

Bytakingthiskindof“proactive”action,WEYCObecamenationalnews.

MajormediasuchasCNN,CBS,ABC,andmanyothersrannationalstoriesscrutinizingthemeritsofWEYCO’sapproachtohealthmanagement.TheWEYCOstorybecamefodderforintensedebatebetweenpro-healthadvocatesandprivacyprotectionists.Inaddition,theACLUwascontactedonbehalfofthefiredemployeestoexplorewhetherthemovebyWEYCOwasevenlegal.

Thefindingswereclear:Itwas,indeed,perfectlylegal.Infact,there

isnolawinMichiganthatpreventsanemployerfromtakingthiskindofaction.

SincethefiringoftheWEYCOemployees,alawsuithasbeenfiledagainstCEOHowardWeyersandWEYCO,Inc.Asonewouldhavepredicted,thisissuewillnowbeplayedoutinthecourts.

WEYCO’s Not The First Or The OnlyWhilenationalmediaattentionhaspropelledWEYCO’santi-smokingstanceintothespotlight,itisfarfromtheonlycompanyattemptingtoimproveemployeehealthandcontainpotentiallymodifiablehealthcarecostsbyregulatingemployeebehaviors.

Forexample,Fortune500giant,UnionPacificRailroadrecentlyannouncedthattobaccousewouldbebannedanywhereonitsmainproperty—insideorout.Inaddition,italsoannouncedthatinOmaha,NE(itsheadquarterslocation)andsevenotherstates,UPRRwouldnotbehiringtobaccousers.

UnlikeWEYCO,UnionPacific

Railroad,accordingtoarecentWallStreetJournalarticle,isrelyingonthehonorsystemtoweedouttobaccousers—theyhaveimplementedaquestionthatpotentialemployeeswillhavetoanswerwhencompletingajobapplication.

Tosupportthosecurrentemployeeswhowerealreadytobaccousers,UPRRoffersassistancetohelpthemquitusingtobacco.

Becauseofthesekindsofefforts,UnionPacificRailroadhasseenitstobaccousingpopulationshrinkfrom40%ofitsworkforcein1990to27%in2003.

OneofthemostrecentcompaniestotakeonaWEYCO-likeapproachisScottsMiracle-GroCompany.LocatedinColumbus,OH,ScottsMiracle-Groisimplementingapolicyoffiringemployeeswholightup—evenathome.ThispolicywillgointofullforceinOctoberof2006,anditwillbeinterestingtowatchthiscompany’sstoryunfold.

Big Brother Or Big Stink?Shouldtobaccousersbefired?Doemployershavetherightnottohiretobaccousers?Dopolicymakers

“In recent months, WEYCO

fired four of its employees

when they refused to take a Breathalyzer

test... ”

ABSOLUTEADVANTAGE


havetherighttodraft,propose,andimplementlegislationthatforbidsemployersfrombeingabletotakethiskindofstanceontobacco-relatedissues?

Giventhenumberofcompanieswhoarenotonlyadoptingworksitewellnessasastandardcompanypractice,butimplementingaggressivetobacco-restrictionpoliciestopromotehealthandcontaincosts,itisclearthatcorporateleadersaredevelopingtheirownideasonhowtobestaddresstobaccousewithintheirowncorporateframeworks.Andmanyofthemarepushingthetraditionally-definedboundaries—remainingwellwithintheconfinesofstateandfederallawsaswellasabidingbynon-discriminatoryandfairhiringpractices.

What’smostinterestingaboutthisisthatthevarietyofemployer-approaches—fromnurturingandsupportingtobaccousersintheirquesttoquit,allthewaytofiringthosewhodon’tcomplywithcompanymandates—appeartobeproducingoutcomes.

Thismayverywellbeakeyunderstandingthatallowsallofustoaddressthisissuewithmoredecorumandthoughtfulness.

Differentcompanieswithqualitativelydifferentmissionstatements,waysofdoingbusiness,

employeepopulations,andgeographiclocations—getthis…operatedifferently.Thus,itwouldbereasonabletothinkthatdifferentcompanieswouldhavevastlydifferentapproachestopromotinghealthandpreventingdisease.

Forexample,wouldweassumethatthebusiness(andhealth)practicesofGEareconsistentwiththatofBen&Jerry’s?Probablynot—eachcompanyisinherentlydifferentbutbotharesuccessfulinwhattheydo.Eachhavetheirownwayofimplementingimportantchangeinitiativesconsistentwithcorporatecultureandstandardoperatingpractices.Tothinkthatone-sizefitsall,especiallywhenitcomestosomethingliketobaccocessation,isnaïve.

Inthemeantime,whiletheacceptabilityofdifferentcessationpracticescontinuestobescrutinized,tobacco-relatedillnessesremaintheleadingcauseofdeathamongAmericanskillingnearly450,000peopleeachyear.Presently,tobaccokillsmoreAmericansthanautoaccidents,homicides,AIDS,drugs,andfirescombined.What’smore,50,000peopledieeachyearfromsecondhandsmokerelateddiseases.Ifleftunchecked,bytheyear2020,tobaccoisprojectedtokillabout10millionpeopleayearworldwide.

Corporationswillbeforcedtopickupasignificantportionofthetab

onthehealth-relatedconsequencesexperiencedbytobaccousers.Thisisalsothecasefornon-tobaccouserswhowillalsohelptosubsidizetheconsequencesofthisunhealthybehavior.Withhealthcarecostsapproaching$1.8trillionandhealthcarebecomingapreciousresource,tobaccousepoliciesandrestrictionsintheUnitedStatesareonlygoingtodrawmoreattention.

The Bottom LineClearly,firingtobaccousersisaverycontroversialissue.Nothiringtobaccousersisnotascontroversial,butremainsahighlydebatedbusinesspractice.Forthoseofuscommittedtobuildinghealthierplacestowork,improvingemployeehealth,andcontainingrunawayhealthcarecosts,thesekindsofissueswillforceusasprofessionalstothinkthroughhowwefeelaboutthem—andwhereexactlywedrawtheline.

All information ©Wellness Councils of America (WELCOA) 2006. WELCOA provides worksite wellness products, services, and information to thousands

of organizations nationwide. For more information visit www.welcoa.org. Suggested Citation: Hunnicutt, D. (2006) Where There’s Smoke...There’s A New Kind Of Fire. WELCOA’s Absolute Advantage Magazine, 5(1), 58-60.

REFERENCESSnow, Mary. No Smoking. January 26, 2005. http://www.cnn.com/2005/US/01/26/no.smoking/index.html

Safer, Morely. Whose Life Is It Anyway? October 30, 2005. http://www.cbsnews.com/stories/2005/10/28/60minutes/main990617.shtml?CMP=ILC-SearchStories

Stossel, John. Where There’s Smoke, They’re Fired. April 8, 2005. http://abcnews.go.com/2020/GiveMeABreak/story?id=650390&page=1

Banzhaf, John. ASH Press Release: Firing Smokers Protects Nonsmokers – Weyco Only Latest. January 30, 2005. http://no-smoking.org/jan05/01-31-05-6.html

Gunn, Eileen. No Ifs, Ands or Butts: Smokers Need Not Apply. http://www.careerjournal.com/hrcenter/articles/20041214-gunn.html

Siegel, Michael. Anti-Smoking Interventions May Have Set the Stage for Discriminatory Employment Policies. December 12, 2005. http://tobaccoanalysis.blogspot.com/2005/12/anti-smoking-interventions-may-have.html

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ABSOLUTEADVANTAGE

ABSOLUTEADVANTAGE


InthisissueofAbsolute Advantagewe’lladdressthetopicoftobaccouseattheworkplace.Althoughoftentimesneglected—largelyduetothenation’snewfocusonobesity—tobaccouseisacriticalissuethateveryemployerneedstoaddress.

Withhealthcarecostsapproaching1.8trillionandhealthcarebecomingapreciousresource,proactiveemployersaretakingboldandaggressivestepstostemmingthetideoftobaccouseattheworkplace.

Inthisissue,we’llexaminetheburdenoftobaccouseintheUnitedStates.Evenforthemosthardenedofskeptics,thestatisticsaresimplystaggering.

Havingprovidedanaerialviewoftheissue,we’lldelveintoaseriesofarticlesaddressingcommonlyaskedquestionsaboutcigarettes,cigars,andsmokelesstobacco.

Tohelpyouinyourquesttoaddresstobaccouseattheworkplace,we’veprovideddozensofeasy-to-implementideas.We’vealsohighlightedafascinatingwebsite—www.thetruth.com.Inaddition,we’llshareaninterviewdonewithJeffreyWigand,aformertobaccoindustryinsider.Finally,we’llexamineacasestudyofWeyco,Inc.,acompanythathassetapolicytofireitssmokers.

Ihopeyouenjoythisissue.I’dliketorecognizetheNationalCancerInstitutefordevelopingandmakingavailablemuchoftheinformationcontainedinthisissue.

Yoursingoodhealth,

Dr.DavidHunnicuttPresident,WellnessCouncilsofAmerica

Tobacco Use At The Workplace

450GreatIdeasToHelpYourEmployeesQuitSmokingIf you’re looking for easy-to-implement ideas to help you address smoking at the workplace, you’ll find this article helpful.

20Notable&QuotableThese maxims, mantras, and notable quotes about smoking and tobacco use will make you stop and think.

24Q&A:CigarSmokingCigars remain a leisure pursuit for many Americans. However, the risks of cigar smoking are very real.

28Q&A:“Light”CigarettesRecently, there’s been a lot of discussion and controversy surrounding “light” cigarettes. Get the real story.

32Q&A:SecondhandSmokeSecondhand smoke will kill 50,000 people in the US. Find out what the health effects of secondhand exposure really are.

36Q&A:SmokelessTobaccoAlthough smokeless tobacco is commonly overlooked, it remains an important issue of any tobacco cessation initiative.

40TheTruthIsFoundThe nationally recognized webiste, thetruth.com is an intriguing and enlightening place to visit. To discover the truth, read on.

44MoralTreason:AFormerTobaccoIndustryInsiderSpeaksOutJeffrey Wigand, the mythical figure that the movie The Insider was based on, speaks out about what he knows from his days as a tobacco scientist.

54HelpingYourEmployeesLiveTobaccoFreeCheck out this step-by-step approach to help your employees kick the habit.

58WhereThere’sSmoke...There’sANewKindOfFireEmployers are taking aggressive and bold measures to address smoking in the workplace. Don’t miss this article.

TheBurdenOfTobaccoUseAn estimated 45.8 million adults in the United States smoke cigarettes, even though this single behavior will result in death or disability for half of all regular smokers.

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OF TOBACCO USE · Indeed, some 450,000 people will die this year due to tobacco-related illnesses. What’s more, 50,000 people die each year from secondhand smoke-related diseases