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Biomedical subjects

Stanton A Glantz

Publications and source records attributed to Stanton A Glantz.

At least 19 recordsLinked to original sources
PubMed2006

Avoiding "truth": tobacco industry promotion of life skills training.

PURPOSE: To understand why and how two tobacco companies have been promoting the Life Skills Training program (LST), a school-based drug prevention program recommended by the Centers for Disease Control and Prevention to reduce youth smoking. METHODS: We analyzed internal tobacco industry documents available online as of October 2005. Initial searches were conducted using the keywords "life skills training," "LST," and "positive youth development." RESULTS: Tobacco industry documents reveal that since 1999, Philip Morris (PM) and Brown and Williamson (B&W) have worked to promote LST and to disseminate the LST program into schools across the country. As part of their effort, the companies hired a public relations firm to promote LST and a separate firm to evaluate the program. The evaluation conducted for the two companies did not show that LST was effective at reducing smoking after the first or second year of implementing the program. Even so, the tobacco companies continued to award grants to schools for the program. PM and B&W's role in promoting LST is part of a public relations strategy to shift the "youth smoking paradigm" away from programs that highlight the tobacco industry's behavior and toward programs in which the industry can be a partner. CONCLUSIONS: Individuals and organizations responsible for developing and implementing tobacco control and youth smoking prevention programs should be aware of PM and B&W's role and motivations to encourage the wide-spread adoption of LST in schools.

Adolescent↗
PubMed2006

Effect of increased social unacceptability of cigarette smoking on reduction in cigarette consumption.

Taxes on cigarettes have long been used to help reduce cigarette consumption. Social factors also affect cigarette consumption, but this impact has not been quantified. We computed a social unacceptability index based on individuals' responses to questions regarding locations where smoking should be allowed. A regression analysis showed that the social unacceptability index and price had similar elasticities and that their effects were independent of each other. If, through an active tobacco control campaign, the average individual's views on the social unacceptability of smoking changed to more closely resemble the views of California residents, there would be a 15% drop in cigarette consumption, equivalent to a 1.17 dollars increase in the excise tax on cigarettes.

Attitude to Health↗
PubMed2006

Televised movie trailers: undermining restrictions on advertising tobacco to youth.

OBJECTIVE: To determine the proportion of televised movie trailers that included images of tobacco use during 1 year and the extent of youth exposure to those trailers. DESIGN: Content analysis combined with Nielsen data measuring media exposure. All movie trailers (N = 216) shown on television from August 1, 2001, through July 31, 2002. MAIN OUTCOME MEASURES: Exposure among youth aged 12 to 17 years to televised movie trailers that included smoking imagery. RESULTS: Of the movie trailers televised during the study period, 14.4% (31 trailers) included images of tobacco use. Tobacco use was shown in 24.0% of the 23 trailers for R-rated (restricted) movies and 7.5% of the 8 trailers for PG-13- and PG-rated (parental guidance) movies. Ninety-five percent of all youth aged 12 to 17 years in the United States saw at least 1 movie trailer depicting tobacco use on television during this 1 year, and 88.8% saw at least 1 of these trailers 3 or more times. CONCLUSIONS: Nearly all US youth aged 12 to 17 years were exposed to images of tobacco use on television in the context of a movie trailer during the study period. Given the relationship between youth exposure to tobacco use in movies and smoking initiation, the public health community should work to enact policy to reduce or eliminate the influence of tobacco use in televised movie trailers.

Adolescent↗
PubMed2006

Tobacco and the movie industry.

Despite the tobacco industry's voluntary restrictions and its agreement with the state attorneys general prohibiting direct and indirect cigarette marketing to youth and paid product placement, tobacco use remains prevalent in movies. Extensive research provides strong and consistent evidence that smoking in the movies promotes smoking. This article summarizes the evidence on the nature and effect of smoking in the movies on adolescents (and others) and proposes several solutions to reduce adolescent exposure to movie smoking and subsequent smoking.

Adolescent↗
PubMed2006

Tobacco industry litigation strategies to oppose tobacco control media campaigns.

OBJECTIVE: To document the tobacco industry's litigation strategy to impede tobacco control media campaigns. METHODS: Data were collected from news and reports, tobacco industry documents, and interviews with health advocates and media campaign staff. RESULTS: RJ Reynolds and Lorillard attempted to halt California's Media Campaign alleging that the campaign polluted jury pools and violated First Amendment rights because they were compelled to pay for anti-industry ads. The American Legacy Foundation was accused of violating the Master Settlement Agreement's vilification clause because its ads attacked the tobacco industry. The tobacco companies lost these legal challenges. CONCLUSION: The tobacco industry has expanded its efforts to oppose tobacco control media campaigns through litigation strategies. While litigation is a part of tobacco industry business, it imposes a financial burden and impediment to media campaigns' productivity. Tobacco control professionals need to anticipate these challenges and be prepared to defend against them.

Adolescent↗
PubMed2006

Sidestream cigarette smoke toxicity increases with aging and exposure duration.

OBJECTIVES: To determine the effects of aging on the toxicity of sidestream tobacco smoke, the complex chemical mixture that enters the air from the lit end of burning cigarettes and constitutes the vast bulk of secondhand smoke. DESIGN: Statistical analysis of data from controlled experimental exposures of Sprague Dawley rats to fresh and aged (for more than 30 minutes) sidestream smoke for up to 90 days followed by histological sectioning of the respiratory epithelium. The data were obtained from a series of experiments conducted at Philip Morris' formerly secret INBIFO (Institut für Biologische Forschung) laboratory in Germany. RESULTS: Using total particulate material as the measure of smoke exposure, aging sidestream cigarette smoke for at least 30 minutes increases its toxicity fourfold for 21 day exposures and doubles the toxicity for 90 day exposures, relative to fresh sidestream smoke. CONCLUSIONS: These results help explain the relatively large biological effects of secondhand smoke compared to equivalent mass doses of mainstream smoke.

Aging↗
PubMed2006

The US Public Health Service "treating tobacco use and dependence clinical practice guidelines" as a legal standard of care.

BACKGROUND: The important factors in evaluating the role of clinical practice guidelines (CPGs) in medical malpractice litigation have been discussed for several years, but have focused on broad policy implications rather than on a concrete example of how an actual guideline might be evaluated. There are four items that need to be considered in negligence torts: legal duty, a breach of that duty, causal relationship between breach and injury, and damages. OBJECTIVE: To identify the arguments related to legal duty. RESULTS: The Treating Tobacco Use and Dependence (revised 2000) CPG, sponsored by the US Public Health Service, recommends effective and inexpensive treatments for nicotine addiction, the largest preventable cause of death in the US, and can be used as an example to focus on important considerations about the appropriateness of CPGs in the judicial system. Furthermore, the failure of many doctors and hospitals to deal with tobacco use and dependence raises the question of whether this failure could be considered malpractice, given the Public Health Service guideline's straightforward recommendations, their efficacy in preventing serious disease and cost-effectiveness. CONCLUSION: Although each case of medical malpractice depends on a multitude of factors unique to individual cases, a court could have sufficient basis to find that the failure to adequately treat the main cause of preventable disease and death in the US qualifies as a violation of the legal duty that doctors and hospitals owe to patients habituated to tobacco use and dependence.

Biomedical Research↗
PubMed2006

The tobacco industry's role in the 16 Cities Study of secondhand tobacco smoke: do the data support the stated conclusions?

BACKGROUND: Since 1996, the tobacco industry has used the 16 Cities Study conclusions that workplace secondhand tobacco smoke (SHS) exposures are lower than home exposures to argue that workplace and other smoking restrictions are unnecessary. OBJECTIVES: Our goal was to determine the origins and objectives of the 16 Cities Study through analysis of internal tobacco industry documents and regulatory agency and court records, and to evaluate the validity of the study's conclusions. RESULTS: The tobacco industry's purpose in conducting the 16 Cities Study was to develop data showing that workplace SHS exposures were negligible, using these data to stop smoking restrictions by the U.S. Occupational Safety and Health Administration. The extensive involvement of R.J. Reynolds Tobacco Company and the tobacco industry's Center for Indoor Air Research in controlling the study was not fully disclosed. The study's definition of "smoking workplace" included workplaces where smoking was restricted to designated areas or where no smoking was observed. This definition substantially reduced the study's reported average SHS concentrations in "smoking workplaces" because SHS levels in unrestricted smoking workplaces are much greater than in workplaces with designated smoking areas or where no smoking occurred. Stratifying the data by home smoking status and comparing exposures by workplace smoking status, however, indicates that smoke-free workplaces would halve the total SHS exposure of those living with smokers and virtually eliminate SHS exposure for most others. CONCLUSIONS: Data in the 16 Cities Study reveal that smoke-free workplaces would dramatically reduce total SHS exposure, providing significant worker and public health benefits.

Cities↗
PubMed2005

The tobacco industry's worldwide ETS consultants project: European and Asian components.

BACKGROUND: The tobacco industry has formed regional environmental tobacco smoke (ETS) consultants programs in order to generate controversy on the issue of secondhand smoke (SHS) in Europe, Asia and Latin America. Only those countries in which the industry foresaw SHS restrictions were included. This paper describes the European and Asian components of the tobacco industry's worldwide ETS consultants program. METHODS: A systematic search was carried out of tobacco industry documents available on the Internet between October 2002 and February 2004. RESULTS: Beginning in 1987, Philip Morris assembled an international ETS consultants program in collaboration with other tobacco companies based on their market shares in different regions of the world. The law firm Covington & Burling contacted and hired consultants with a wide range of expertise, usually affiliated with an academic institution, in order to avoid direct contact with the industry. The objective of the program was to influence policy makers, media and the public by providing, through their consultants, 'accurate' (pro-industry) information concerning smoking regulations in public places and workplaces, indoor air quality and ventilation standards, and scientific claims regarding SHS. Consultants also conducted research related to SHS and organized and attended regional and international symposiums related to SHS without acknowledging industry funding. CONCLUSIONS: Despite evidence that the issue of smoke-free environments was close to emerging within the general public throughout the world in the late 1980s, the tobacco industry used its well-organized network of consultants to avoid SHS regulations in most of the world.

Asia↗
PubMed2005

Cardiovascular effects of secondhand smoke: nearly as large as smoking.

BACKGROUND: Secondhand smoke increases the risk of coronary heart disease by approximately 30%. This effect is larger than one would expect on the basis of the risks associated with active smoking and the relative doses of tobacco smoke delivered to smokers and nonsmokers. METHODS AND RESULTS: We conducted a literature review of the research describing the mechanistic effects of secondhand smoke on the cardiovascular system, emphasizing research published since 1995, and compared the effects of secondhand smoke with the effects of active smoking. Evidence is rapidly accumulating that the cardiovascular system--platelet and endothelial function, arterial stiffness, atherosclerosis, oxidative stress, inflammation, heart rate variability, energy metabolism, and increased infarct size--is exquisitely sensitive to the toxins in secondhand smoke. The effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking. CONCLUSIONS: The effects of secondhand smoke are substantial and rapid, explaining the relatively large risks that have been reported in epidemiological studies.

Cardiovascular Diseases↗
PubMed2005

Changing conclusions on secondhand smoke in a sudden infant death syndrome review funded by the tobacco industry.

BACKGROUND: Prenatal and postnatal exposure to tobacco smoke adversely affects maternal and child health. Secondhand smoke (SHS) has been linked causally with sudden infant death syndrome (SIDS) in major health reports. In 1992, the US Environmental Protection Agency (EPA) first noted an association between SHS and SIDS, and both prenatal exposure and postnatal SHS exposure were listed as independent risk factors for SIDS in a 1997 California EPA report (republished in 1999 by the National Cancer Institute) and a 2004 US Surgeon General report. The tobacco industry has used scientific consultants to attack the evidence that SHS causes disease, most often lung cancer. Little is known about the industry's strategies to contest the evidence on maternal and child health. In 2001, a review was published on SIDS that acknowledged funding from the Philip Morris (PM) tobacco company. Tobacco industry documents related to this review were examined to identify the company's influence on the content and conclusions of this review. METHODS: Tobacco industry documents include 40 million pages of internal memos and reports made available to the public as a result of litigation settlements against the tobacco industry in the United States. Between November 2003 and January 2004, we searched tobacco industry document Internet sites from the University of California Legacy Tobacco Documents Library and the Tobacco Documents Online website. Key terms included "SIDS" and names of key persons. Two authors conducted independent searches with similar key terms, reviewed the documents, and agreed on relevancy through consensus. Thirty documents were identified as relevant. Two drafts (an early version and a final version) of an industry-funded review article on SIDS were identified, and 2 authors independently compared these drafts with the final publication. Formal comments by PM executives made in response to the first draft were also reviewed. We used Science Citation Index in July 2004 to determine citation patterns for the referenced SIDS reviews. RESULTS: PM executives feared that SHS and maternal and child health issues would create a powerful and emotional impetus for smoke-free areas in the home, public areas, and the workplace. In response to the 1992 US EPA report on SHS, the Science and Technology Department of PM's Switzerland subsidiary, Fabriques de Tabac Reunies, searched for "independent" consultants to publish articles addressing SHS. The first industry-funded article was a literature review focusing on smoking and SIDS, conducted by consultant Peter Lee and co-author Allison Thornton, which stated that the association between parental smoking and SIDS could have been attributable to the failure to control fully for confounders. That first review has only been cited once, in the subsequent industry-funded review. In 1997, PM commissioned a consultant, Frank Sullivan, to write a review, with coauthor Susan Barlow, of all possible risk factors for SIDS. The first draft concluded that prenatal and postnatal smoking exposures are both independent risk factors for SIDS. After receiving comments and meeting with PM scientific executives, Sullivan changed his original conclusions on smoking and SIDS. The final draft was changed to emphasize the effects of prenatal maternal smoking and to conclude that postnatal SHS effects were "less well established." Changes in the draft to support this new conclusion included descriptions of Peter Lee's industry-funded review, a 1999 negative but underpowered study of SIDS risk and urinary cotinine levels, and criticisms of the conclusions of the National Cancer Institute report that SHS was causally associated with SIDS. In April 2001, the Sullivan review was published in the United Kingdom journal Paediatric and Perinatal Epidemiology, with a disclosure statement that acknowledged financial support from PM but did not acknowledge contributions from PM executives in the preparation of the review. By 2004, the Sullivan SIDS review had been cited at least 19 times in the medical literature. CONCLUSIONS: PM executives responded to corporate concerns about the possible adverse effects of SHS on maternal and child health by commissioning consultants to write review articles for publication in the medical literature. PM executives successfully encouraged one author to change his original conclusion that SHS is an independent risk factor for SIDS to state that the role of SHS is "less well established." These statements are consistent with PM's corporate position that active smoking causes disease but only public health officials conclude the same for SHS. The author's disclosure of industry funding did not reveal the full extent of PM's involvement in shaping the content of the article. This analysis suggests that accepting tobacco industry funds can disrupt the integrity of the scientific process. The background of this SIDS review is relevant for institutions engaged in the debate about accepting or eschewing funding from the tobacco industry. Those who support acceptance of tobacco industry funds argue that academic authors retain the right to publish their work and maintain final approval of the written product, but this argument fails to recognize that the tobacco industry funds work to ensure that messages favorable to the industry are published and disseminated. Clinicians, parents, and public health officials are most vulnerable to the changed conclusions of the SIDS review. The national SIDS "Back to Sleep" campaign has been very successful in reducing SIDS rates. However, estimates of SIDS risk from SHS (odds ratios range from 1.4 to 5.1) have considerable overlap with estimates of risk from prone sleep positioning (odds ratios range from 1.7 to 12.9). With the Back to Sleep campaign well underway, efforts to address parental smoking behavior in both the prenatal and postnatal periods should be intensified. The tobacco industry's disinformation campaign on SHS and maternal and child health can be counteracted within clinicians' offices.

Causality↗