2. Kids and Tobacco: The Real Story Why the Tobacco Industry’s Claims of Change Are Untrue And What Really Needs to Be Done Adapted from a Presentation by Campaign for Tobacco-Free Kids

3. Tobacco’s Toll: Continues to take a huge toll in health, lives and money Tobacco Industry Has Not Changed: Despite efforts to appear reformed, cigarette companies still target kids The Real Solution: There is a real solution to the problem, but we need the political will to enact it Overview

4. Tobacco’s Toll

5. Tobacco is the leading preventable cause of death, killing more than 400,000 each year Tobacco kills more people than from AIDS, alcohol, car accidents, murders, suicides, and fires combined Tobacco results in $89 Billion in annual health care costs Nearly 90% of lung cancer cases, 1/3 of total cancer deaths, and 1/5 deaths from heart disease are tobacco related Tobacco’s Toll in U.S.

6. Everyday in America: –5,000 kids try their first cigarette –More than 2,000 kids become new daily smokers, one-third of whom will die from smoking-related diseases 28% of high school students smoke, according to CDC 41% used some tobacco product in the last month Tobacco’s Toll in U.S.

7. 9,900 tobacco-related deaths annually 41,500 new kids will try their first cigarette every year 18,200 kids will become new daily smokers every year 121,000 kids alive today will die from tobacco use $1.5 billion in annual health care costs related to tobacco use Tobacco’s Toll in Missouri

8. Potential Savings in Missouri If Missouri achieves just 1% reduction per year for 5 Years 203,000 fewer smokers in the state -- just from those averted in the first five years Saving 67,000 people from a premature death from tobacco use 21,900 Missouri kids alive today would be spared a premature death from tobacco use

9. Highly addictive product + Aggressive marketing to kids + Lack of government protections = Epidemic of smoking among kids How Did We Get Here?

10. Percent of those ever using who become addicted 0 0 5 5 10 15 20 25 30 35 Alcohol Cocaine Heroin Tobacco % % 15.4 16.7 23.1 31.9 Source: National Comorbidity Survey (1994) Highly Addictive Product

11. Aggressive Marketing to Kids Tobacco Industry knows 90% of all smokers begin at or before age 18

12. Aggressive Marketing to Kids “It is important to know as much as possible about teenage smoking patterns and attitudes. Today's teenager is tomorrow's potential regular customer…” -- March 31, 1981 Philip Morris market research report “ [T]he base of our business are high school students.” -- August 30, 1978 Lorillard Tobacco memo In Their Own Words

13. Have you seen any advertising for cigarettes or spit tobacco in the last two weeks? ("Yes" responses) Aggressive Marketing to Kids

14. Percent Smoking Three Most Heavily Advertised Cigarette Brands High School Students

15. Aggressive Marketing to Kids Percent Smoking Three Most Heavily Advertised Cigarette Brands Adults 46% High School Students

19. Tobacco products are not subject to consumer protections, like safety testing and ingredient disclosure Lack of Government Protections Guess which Philip Morris product is regulated by the FDA ?

20. Few restrictions on youth marketing Poor enforcement of laws against sales to minors Few states funding prevention programs Tobacco industry fights every effort to fill these gaps Lack of Government Protections

21. Now The Tobacco Industry Claims It Has Changed...

22. Tobacco Industry’s “Change” In 1998 industry settled lawsuits with states Claim to no longer market to kids PR -- Feel-good corporate image advertising PR -- “Youth anti-smoking efforts”

23. Tobacco Industry’s “Change” Negotiated between state attorneys general and tobacco companies The industry promised, among other items, not to market to kids Billboard advertising was banned States receive $246 billion from tobacco industry as result of settlement 1998 Tobacco Settlement

24. Philip Morris Advertisement “… [The Settlement] is an unprecedented agreement that fundamentally changed how tobacco is marketed, promoted, and advertised in the United States…”

26. ‘98 Settlement actually affects very little tobacco marketing -- e.g. magazines, store advertising not impacted In fact, advertising that impacts kids actually INCREASED after ‘98 Settlement Settlement did not require one dime of states’ money go to tobacco prevention The Truth 1998 Settlement

27. Tobacco Industry’s “Change” In 1998 industry settled lawsuits with states Claim to no longer market to kids PR -- Feel-good corporate image advertising PR -- “Youth anti-smoking efforts”

28. PUBLIC statement of R. J. Reynolds "Position on Youth Smoking": "R. J. Reynolds Tobacco Company does not want children to smoke, not only because it is illegal to sell to minors in every state, but also because of the inherent health risks of smoking and because children lack the maturity of judgment to assess those risks." The Truth Marketing to Kids

29. PRIVATE R. J. Reynolds company memo: "To ensure increased and longer-term growth for CAMEL FILTER, the brand must increase its share penetration among the 14-24 age group which have a new set of more liberal values and which represent tomorrow's cigarette business." The Truth Marketing to Kids

30. Latest Federal Trade Commission (FTC) shows cigarette advertising increased by record levels after ‘98 Settlement: –Tobacco marketing reached record-high $8.24 billion in 1999, or $22.5 million per day –Largest $ increase in history of FTC report –Increased 22% after signing ‘98 settlement –Payments for higher visibility on store shelves up 23% –Promotions, such as buy 1 get 1 free up 65% The Truth Marketing to Kids

31. July 2000 study showed increases in in-store marketing after cigarette billboards were banned by settlement 75% of kids visit a convenience store at least once a week Increased In-Store Marketing The Truth Source: University of Illinois at Chicago, July 2000

32. June 2001 study of California stores shows 48% have cigarette ads at kids’ eye level (3 feet or lower) 23% of stores place cigarettes within 6 inches of candy Average store had 17 tobacco ads Increased In-Store Marketing The Truth Source: Stanford Univ. School of Medicine; Univ. of North Carolina Dept. of Health

34. Ads in Magazines Popular with Kids Increased 33% After ‘98 Settlement Increased Magazine Advertising The Truth Source: Massachusetts Department of Public Health, May 2000

35. Increased Magazine Advertising The Truth The Wall Street Journal May 17, 2000

39. NEWS UPDATE February 2002 #1 Philip Morris pulls advertising from 80 magazines #2 R J Reynolds likely to follow suit #3 Brown & Williamson increased ad spending by 25% Overall tobacco ad spending in 2001 36% lower than in 2000

40. PM says cutback is business decision, not political or moral decision PM relies heavily on promotions, direct mail, and point-of-purchase displays rather than print advertising NEWS UPDATE February 2002

41. PM has so much market share that benefit of print advertising may be negligible Ad stoppage can allow Philip Morris attorneys to claim to juries that the company has truly mended its ways NEWS UPDATE February 2002

43. NEWS UPDATE – Part II February 2002 As Big Tobacco cuts back on media ads Apparently also want tobacco control advocates to cut back on ads Lorillard Tobacco announced plans to sue American Legacy Foundation in Wake Co NC state court for some of its “Truth” ads.

44. NEWS UPDATE – Part II February 2002 Lorillard accuses Legacy of violating the MSA by conducting prohibited “personal attack on, or vilification of” tobacco companies Since Legacy’s first broadcast a TV ad of body bags in front of a tobacco firm's headquarters, cigarette makers have complained settlement ground rules were broken

45. NEWS UPDATE – Part II February 2002 Legacy’s response? Ads merely stated the truth - - therefore did not vilify anyone Additionally, tobacco companies are powerless to sue Legacy as it is only a beneficiary of MSA and was not a party to it Legacy has sued Lorillard in New Castle Co DE state court

46. NEWS UPDATE – Part II February 2002 “Is the truth campaign actually true?... any industry that is responsible for the deaths of more than 400,000 people a year is doing some pretty ugly things. And to point those out, is that vilification?" William H. Sorrell, Vermont Attorney General Chairman of the tobacco committee of the National Association of Attorneys General

47. Tobacco Industry’s “Change” In 1998 industry settled lawsuits with states Claim to no longer market to kids PR -- Feel-good corporate image advertising PR -- “Youth anti-smoking efforts”

48. The Truth

50. PR to Avoid Change

51. The Truth The Wall Street Journal July 16, 2001

52. Philip Morris Report: "Positive effects [of smoking] include savings in public health-care costs and state pensions due to early mortality of smokers, and savings of public costs related to the support of the elderly." Response of Czech doctor Eva Kralikova: "Following that logic, the best recommendation to government would be to kill all people on the day of their retirement." The Truth What They Don’t Advertise

53. The Truth American Legacy Foundation

54. Tobacco Industry’s “Change” In 1998 industry settled lawsuits with states Claim to no longer market to kids PR -- Feel-good corporate image advertising PR -- “Youth anti-smoking efforts”

55. Industry’s “Youth Prevention” Campaign: Sends an inconsistent and ineffective message Source is not credible Offers no reasons not to smoke Positions smoking as an adult habit and, therefore, appeals to kids The Truth PR to Avoid Change

56. “The 16-20 year old begins smoking for psycho-social reasons. The act of smoking is symbolic, it signifies adulthood…” -- Philip Morris internal document The Truth PR to Avoid Change

57. The Truth

58. Tobacco Industry’s Real Targets: Policy makers who can enact real changes in laws and regulations Potential Jurors who consider liability cases costing billions of dollars The Truth PR to Avoid Change

59. “ Systematically brief all key members of Congress and state legislators on our tobacco youth initiatives... target advertising on our youth initiative to key legislative states and districts.” -- Philip Morris, “Corporate Affairs Five Year Plan 1992-1996,” January 1992 The Truth In Their Own Words

60. “…the ultimate means for determining the success of this [youth prevention] program will be: 1) a reduction in legislation introduced and passed restricting or banning our sales and marketing activities…” -- 1991 Tobacco Institute Memo The Truth In Their Own Words

61. The Truth Cigarette makers continue to market in ways that impact kids Despite the ‘98 settlement, advertising continues to increase at record levels Using PR to convince policy makers and jurors they are reformed Summary

62. The Real Solution to Reducing Youth Tobacco Use

63. 1 Food and Drug Administration (FDA) consumer protections 2 Other Policy Changes –Clean indoor air laws –Excise taxes –Health insurance coverage for cessation services 3 Comprehensive Tobacco Prevention Programs in Each State The Real Solution

64. 1 Congress must pass FDA legislation to –Stop tobacco marketing and sales to children –Force industry to disclose cigarette ingredients, like ammonia, formaldehyde and arsenic –Eliminate or reduce harmful components –Regulate dangerous and misleading health claims The Real Solution * Congress must not be fooled by Tobacco Industry’s attempt to push ineffective and inadequate FDA legislation

65. 2 Other policy changes –Clean indoor air policies to protect kids and adults from second hand smoke –Excise taxes on cigarettes to reduce youth consumption –Provide health insurance coverage for cessation services The Real Solution

66. 3 Comprehensive tobacco prevention programs in states –‘98 Settlement provided funds to states, but did not direct how money must be used –Unfortunately, most states, including MO, are failing to fund prevention programs at the minimum levels recommended by the CDC –To be successful, programs must be comprehensive The Real Solution

67. Comprehensive State Programs 1. Public Education -- Counter Marketing

68. Comprehensive State Programs 2. Community Based Programs

69. Comprehensive State Programs 3. School Based Programs

70. Comprehensive State Programs 4. Programs to Help Smokers Quit

71. Comprehensive State Programs 5. Enforcing Laws Against Sales to Minors

72. Comprehensive tobacco prevention programs in states 1.Public education (counter marketing) 2.Community-based programs 3.School-based programs 4.Helping smokers quit 5.Enforcing laws prohibiting sales to minors The Real Solution Must be well-funded, sustained and evaluated

73. In three years, Florida has reduced smoking by 47% among middle school students and 30% among high school students Since 1995, Massachusetts has reduced smoking among high school students by 15% Smoking Rates Reduced Comprehensive Programs Work

74. Lung and bronchial cancer rates reduced by 14% between 1988 and 1997, compared to less than 3% in other parts of the country (CDC, Nov. 2000) Prevented 33,300 heart disease deaths between 1988 and 1997 (University of California, San Francisco, study, December 2000) Comprehensive Programs Work Lives Saved in California

75. California - Saved $390 million in health costs by preventing 12,000 heart attacks and strokes in seven years California - Saved more than $100 million by reducing the number of pregnant women who smoke, resulting in fewer low-birthweight babies $$$ Money Saved $$$ Comprehensive Programs Work

76. Massachusetts - Saving $85 million per year by reducing smoking-caused health costs Missouri can realize significant savings in lives and money $$$ Money Saved $$$ Comprehensive Programs Work

77. The Challenge in Missouri

78. Conclusion Tobacco remains by far the #1 preventable cause of death and disease Industry claims of change are aimed at blocking real reforms The real solution must include FDA regulation and comprehensive, well-funded prevention programs

79. Supporting effective FDA authority over tobacco products Urging state legislatures to spend tobacco settlement money on tobacco prevention Working with state advocates to achieve policy changes such as tobacco excise taxes, clean indoor air laws and health coverage for cessation services What Tobacco Free Kids is Doing...

80. Tell your federal representatives to support effective FDA regulation of tobacco Tell state legislators and Governor Holden to spend tobacco settlement money on tobacco prevention and other policy changes Work for local ordinances addressing clean indoor air, youth access, etc. TO ACT NOW, go to www.tobaccofreekids.org and click on ACTION CENTER What You Can Do...

81. 2002 Missouri Legislation Current status of legislation can be obtained at www.house.state.mo.us Move cursor to 2002 Bill Info Then on Bill Tracking Search Select 2002 Advanced Then type in either –Keyword –Bill Number –Bill Sponsor

82. Additional Information Sources National Center for Tobacco-Free Kids 1400 Eye Street Suite 1200 Washington DC 20005 Tel: 202-296-5469 Fax: 202-296-5427 www.tobaccofreekids.org American Legacy Foundation 1001 G Street, NW, Suite 800 Washington, DC 20001 202-454-5555 phone 202-454-5599 fax www.americanlegacy.org

83. P.O. Box 570 Jefferson City MO 65102-0570 Tobacco related issues –Bureau of Health Promotion 573-522-2820 buchal@dhss.state.mo.us Cancer related issues –Bureau of Cancer Control 573-522-2841 cowans@dhss.state.mo.us DHSS contacts...