Tobacco Control

The Tobacco Settlement

Tobacco Industry Documents Available on the Web

December 1, 1999
The Department of Health and Human Services offers Internet access to tobacco industry documents that illustrate the dangers of tobacco. The Web site provides access to the Minnesota Tobacco Document Depository in an online searchable format. President Clinton says, "These important documents tell in the industry's own words the extent to which vital public health information has been systematically concealed from the public."

AARC Urges the President to Take Action on State Tobacco Settlements

September 28, 1999
The AARC has joined with the Campaign for Tobacco-Free Kids and the ENACT Coalition in a letter writing campaign to the President. In the letter, Sam Giordano and other ENACT Executive Officers asked the President to do everything in his power to urge Congress to require states to spend a substantial portion of their tobacco settlement funds on programs to reduce tobacco use. "Otherwise," the letter said, "the federal government will continue to indefinitely pay the health care costs of tobacco-induced disease through Medicaid, while the states spend this windfall on other programs or tax cuts." The letter touts this as a federal money saver and a life saving measure. The letter also aims to achieve a funding increase for the Centers for Disease Control's National Tobacco Control Program, a higher tobacco tax, and a successful federal lawsuit against the tobacco industry.

U.S. Department of Justice Sues Tobacco Industry

September 23, 1999
The U.S. Department of Justice filed a long-awaited civil lawsuit against the tobacco industry in order to recoup billions of taxpayer dollars spent treating smoking-caused illnesses. This suit, filed Wednesday, represents a serious legal threat to the tobacco industry -- a threat that far outweighs those posed by the state cases, which resulted in settlements that cost the industry $246 billion.

"In the complaint, the United States alleges that for the past 45 years, the companies that manufacture and sell tobacco have waged an intentional, coordinated Campaign of fraud and deceit,'' Reno told a news conference in unveiling the landmark civil lawsuit.

The tobacco industry has strongly questioned the government's authority to bring such a lawsuit, calling it "legally meritless.'' The suit, filed under federal racketeering laws, alleges the tobacco companies coordinated efforts since 1954 to hide their knowledge about the devastating health effects and addictive nature of smoking.

"As we allege in the complaint, it's been a campaign designed to preserve their profits, whatever the costs in human lives, in suffering, and in medical resources. The consequences have been staggering,'' Reno said. According to the Campaign for Tobacco-Free Kids, tobacco causes more than 430,000 deaths each year and costs more than $20 billion annually in federal government payments alone.

President Clinton announced plans to bring the lawsuit in his State of the Union address to Congress in January, and Justice Department lawyers since then quietly prepared the lawsuit.

"The Justice Department is taking the right course of action: It is time for America's taxpayers to have their day in court,'' Clinton said in a statement released after the suit was filed.

Justice Department sources said there have not been any talks with tobacco industry officials on a possible settlement.

U.S. to Sue Tobacco Firms

January 28, 1999
In President Clinton's State of the Union address last week, he made a surprise announcement that the Justice Department is preparing to sue tobacco companies to recover the federal costs of smoking-related illnesses.

After reviewing the legal issues for months, Attorney General Janet Reno decided last month there was legal justification for a federal suit to recover the roughly $20 billion in costs borne by Medicare and other federal programs every year, according to Justice officials. However, a decision to actually file suit hasn't been made yet. An administration official involved in the issue said that basic decisions about the suit haven't yet been made, including who would be sued, when the action would be filed and what the specific grounds for the legal action are.

To treat tobacco related diseases, the federal government spends about $10 billion from its Medicare program, $5 billion from Medicaid, and almost another $5 billion from other programs, such as the veterans benefits and the Federal Employees Health Benefits Program.

The Justice Department said its lawsuit wouldn't include "seeking funds collected by the states through settlements with the industry. The states recovered money expended under the Medicaid program. The Justice Department is developing plans to recover funds expended under other federal programs, where the government pays directly."

Surgeon General Reports on Minority Tobacco Use

May 29, 1998
Surgeon General David Satcher, MD, PhD, calls cigarette smoking the leading preventable cause of disease and death in the United States, and in the recently released Surgeon General's Report he focused on tobacco use among U.S. racial/ethnic minority groups.

The study concentrated on four groups: African Americans, American Indians and Alaska Natives, Asian Americans and Pacific Islanders, and Hispanics. Based on papers written by more than 25 scientists and reviewed by experts in the behavioral, epidemiological, medical and public health fields, the surgeon general's final report presents several major conclusions about tobacco use by minority groups in America.

Cigarette smoking is a major cause of disease and death in each of the four population groups studied. African Americans currently bear the greatest health burden. Differences in the magnitude of disease risk are directly related to differences in patterns of smoking.
Tobacco use varies within and among racial/ethnic minority groups. Among adults, American Indians and Alaska Natives have the highest prevalence of tobacco use. African American and Southeast Asian men also have a high prevalence of smoking. Asian American and Hispanic women have the lowest prevalence.
Among adolescents, cigarette smoking prevalence increased in this decade among African Americans and Hispanics after several years of substantial decline among adolescents in the four minority groups. This increase is most pronounced among African American youths who had experienced the greatest decline of the four groups during the '70s and '80s.
No single factor determines patterns of tobacco use among racial/ethnic minority groups; these patterns are the result of complex interactions of multiple factors such as socioeconomic status, cultural characteristics, acculturation, stress, biological elements, targeted advertising, price of tobacco products, and varying capacities of communities to mount effective tobacco control initiatives.
Rigorous surveillance and prevention research are needed on the changing cultural, psychosocial and environmental factors that influence tobacco use to improve our understanding of racial/ethnic smoking patterns and identify strategic tobacco control opportunities. The capacity of tobacco control efforts to keep pace with patterns of tobacco use and cessation depends on timely recognition of emerging prevalence and cessation patterns and the resulting development of appropriate community-based programs to address the factors involved.

In a letter to Vice President Al Gore, a Centers for Disease Control representative expressed that the information presented in this report will arm healthcare professionals with accurate data so that they can plan programs that will address more effectively the health needs of the groups focused on in the study.

Vice President Gore Launches Campaign to Help Stop Tobacco Sales to Children

March 10, 1998
Vice President Gore and Health and Human Services Secretary Donna Shalala announced the Food and Drug Administration's new multi-media education and advertising campaign to help reduce the illegal sale of tobacco products to children.

The campaign kick-off coincides with the one-year anniversary of the FDA rule which makes it a federal violation to sell cigarettes or spit tobacco to anyone younger than age 18 and requires retailers to ask for photo identification from anyone younger than 27 who attempts to purchase these products. The new campaign will use point-of-sale, radio, print, and billboard advertisements to drive home the message to consumers and retailers that selling tobacco products to children is against the law.

The radio advertisement and multi-media campaign began running in Arkansas on March 1. Later this spring, 10 other states (California, Colorado, Florida, Illinois, Massachusetts, Minnesota, North Carolina, Pennsylvania, Texas, and Washington) will join the campaign. The FDA plans to further expand the program to include all 50 states by the end of this year.

AAHP Receives Grant to Create National Clearinghouse on Tobacco Prevention and Cessation

February 3, 1998
The American Association of Health Plans (AAHP) will use a four-year, $1.4 million grant from The Robert Wood Johnson Foundation (RWJF) to create a national clearinghouse for information on tobacco prevention and cessation. As part of RWJF's "Addressing Tobacco in Managed Care" initiative, AAHP will direct the National Technical Assistance Office (NTAO) which is designed to be a one-stop shop for health plans to get the resources and tools necessary for implementing tobacco prevention and cessation programs in their communities. The NTAO will be co-funded by The Centers for Disease Control (CDC) and the Agency for Health Care Policy and Research (AHCPR).

Two AAHP members, Health Alliance Plan (Detroit, MI) and The Prudential Center for Health Care Research (Atlanta, GA), will work with AAHP to direct the efforts of the NTAO. Through the NTAO, health plans, consumers, and the academic and medical communities will gain access to information about health plan practices that have worked most effectively, as well as tobacco prevention information gathered from academic and professional journals, conferences, newsletters and white papers. Other important initiatives of the NTAO will include:

Creating a newsletter and a web site with on-line consultation with professionals from the NTAO;
Conducting an annual survey of health plans to determine the status of tobacco initiatives and evaluate best practices;
Establishing a benchmarking awards program for best practices by health plans in tobacco prevention and cessation;
Conducting a series of training workshops, national and regional conferences; and,
Creating a managed care tobacco prevention and cessation tool kit.

Information on the "Addressing Tobacco In Managed Care" initiative, including details on the first national conference, is available on AAHP's website at http://www.aahp.org/ under the menu item Initiatives.

The American Association of Health Plans represents over 1,000 HMOs, PPOs and other similar health plans that provide health care for more than 140 million Americans nationwide.

Tobacco Documents Posted on Internet
January 1998
House Commerce Committee Chair Representative Tom Blilely (R-VA) has posted on the Internet 800 tobacco documents suspected of containing evidence of crime and fraud. www.house.gov/commerce/welcome.html