Tobacco-growing, tobacco-smoking Kentucky leads the nation in cancer rate

Kentucky tobacco farm

Not the least bit surprising, but something to think about when it comes to tobacco control.

This is why people in tobacco control care about the issue; ultimately it comes down to people dying from tobacco.

When most people think of Kentucky, they think of horse country, the Kentucky Derby, and idyllic bluegrass hills. But, there’s a terrible dark side to that bucolic landscape. According to this USA Today story, Kentucky has the dubious distinction of being No. 1 in the nation for having the worst cancer rate. The biggest reason why? Lung cancer. Lung cancer is the third-most common form of cancer in the U.S. (behind breast cancer for women and prostate cancer for men). However, while lung cancer represents about 13 percent of all cancers, it also represents 27 percent of all cancer deaths. That’s the most … by a LOT. Lung cancer kills more people than colon, breast, pancreatic and prostate cancer combined. It continues to be one of the most, if not the most, difficult form of cancer to treat.

According to USA Today, the rate for lung cancer deaths in Kentucky is 50 percent higher than the national average. From the article:

Lung cancer incidence per 100,000 people: 92.4, compared with 60.4 nationally. Mortality per 100,000: 68.8 — around 120 in the hardest-hit Appalachian counties — compared with 45 nationally.

Kentucky smoking rates, by county

Kentucky has a notoriously high smoking rate. It was the highest in the nation until recently, but now it is second highest in the U.S. at 26.5 percent, (only West Virginia is higher) considerably higher than the national average. Kentucky’s smoking rate was over 30 percent as recently as 10 years ago. The national average, according to this article, has dropped all the down to 15.2 percent (I haven’t seen that figure widely reported; I saw 16.8 percent a few weeks ago.). Kentucky also has a higher than normal death rate from breast, colon and cervical cancers. That might be partly attributable to smoking. Kentucky also has a ridiculously low cigarette tax at 60 cents a pack, one of the lowest in the nation.  The national average is over $1.50 a pack. There is also no statewide indoor smoking ban, though several large cities in Kentucky do ban smoking indoors. These factors help to encourage smoking. They really do. Every state that imposes a smoking ban and/or raises its cigarette tax sees its smoking rate go down. Of course, Kentucky just elected a conservative Republican as its governor, so don’t expect a cigarette tax increase any time soon.

From the article

For many years, Kentucky has had a quarter of adults smoking,” said oncologist Dr. Goetz Kloecker, a lung cancer specialist with University of Louisville Physicians. “I have patients who started puffing at 8, 9 and 10 years old…It’s part of the culture.”

Because of that culture, “cigarettes are still cheaper than in other places,” Kloecker added. “If you go to Chicago or New York, there are fewer teenagers starting to smoke. The higher the costs, the lower the smoking rate.”

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One of the reasons smoking is so ingrained in the culture is Kentucky is one of the leading tobacco-growing states. Kentucky has a lot fewer tobacco farmers than it once did (wow, there were 56,000 tobacco farms in Kentucky in 1992), but it is still second in the U.S. behind North Carolina in the level of tobacco produced. And in fact, North Carolina and Kentucky absolutely dominate the market with over 70 percent of the tobacco grown in the U.S. coming from those two states. (Interestingly, North Carolina actually has a statewide smoking ban and a relatively low smoking rate for a Southern state at 20.2 percent in 2013 — likely lower than that today.)

Other environmental factors are playing a role. Kentucky has a high level of radon in homes and especially in the Appalachian region, residents have high levels of chromium and arsenic in their systems. (Probably from mining operations and groundwater contamination.).

Other factors are mentioned by USA Today, such as poor health screenings in the state and obesity, but the high smoking rate is the biggest factor, no doubt.

Crikey! Australia kicks international Big Tobacco’s butt … again


Yet another major legal victory for Australia in its long-running battle against Big Tobacco.

Specifically, Australia defeated Philip Morris International, which has been one of the corporations fighting Australia for the past five to 10 years over that nation’s plain-packaging laws.

Initially, the government of Australia won in the Australian Supreme Court for the right to impose a plain-packaging law. In Australia, packages of cigarettes not only cannot have logos of tobacco brands, but they are required to have graphic images of the damage that tobacco does to people’s mouths, teeth, etc.

Australian plain packaging. Pleasant, huh?

Anyway, after losing before the Australian Supreme Court, Philip Morris Int’l persuaded several countries to get involved in litigation against Australia to claim that that country’s plain packaging laws were violating trade agreements and international trade law. Ukraine was one of the countries involved, but dropped out many months ago.

However, Hong Kong was still involved in this legal action, invoking something called the “1993 Investment Promotion and Protection Agreement”.  An entity known as an “arbitral tribunal” (seriously, that’s what it is called), declined to hear Hong Kong and Philip Morris Int’l’s case, ending the litigation … for now.

From the Guardian article:

The minister responsible for Australia’s tobacco policy, Fiona Nash, said: “We welcome the unanimous decision by the tribunal agreeing with Australia’s position that it has no jurisdiction to hear Philip Morris’s claim.”

The Public Health Association of Australia welcomed the decision as “the best Christmas present for public health nationally and internationally”.

“Smoking in Australia is falling in adults, in children and by tobacco volume sales,” said the association’s chief executive, Michael Moore.

“Now the tobacco companies have lost another crucial legal bid to stop this life-saving measure. The message is loud and clear – plain packaging works, and it is here to stay.”

Not surprisingly, Philip Morris was not happy with the decision. From the article:

“There is nothing in today’s outcome that addresses, let alone validates, plain packaging in Australia or anywhere else,” said Marc Firestone, Philip Morris International senior vice president and general counsel.

“It is regrettable that the outcome hinged entirely on a procedural issue that Australia chose to advocate instead of confronting head on the merits of whether plain packaging is legal or even works.”

Oh, wah! Cry me a river, Philip Morris. Shouldn’t you be busy picking on Uruguay?

Yay, go France. Cracking down on cigarette marketing.

This decision could help other countries that are proposing plain packaging laws. Ireland already does it, and France is moving ahead with plain packaging for tobacco in 2016, following Australia’s lead. Efforts to force plain packaging for cigarettes in the U.S. are stymied by a very strong First Amendment.

Philip Morris International and other tobacco companies have fought these plain packaging laws around the world; they’ve even enlisted the help of the U.S. Chamber of Commerce to aid them in their fights against Uruguay, Ireland, New Zealand, Australia, Togo and other countries. Notice most of these countries are fairly small with limited finances and resources to fight Big Tobacco. Not a coincidence.





Report: 42 percent of major video games have depictions of smoking

Elizabeth in Bioshock: Burial at Sea

Wow, here is something I’ve honestly never even given the slightest thought to — the prevalence of smoking in video games.

Here’s a good story, one that actually made me think because honestly this is something I’ve never even considered before, about smoking in video games. According to the study from UC San Francisco (No surprise there, that is the home of Stanton Glantz and the Center for Tobacco Control), smoking shows up in 42 percent of video games participants reported playing.

No surprise there is smoking in Grand Theft Auto games. These are about the most adult games you can find out there (I’m not a fan, too much sexism).  I remember smoking first showed up in Duke Nukem 3D about 20 years ago. In particular, I remember one cut scene in which Duke cuts off a monster’s head, then takes a poop down his neck while lighting a cigar (I am NOT making this up … it’s Duke Nukem, man).

Duke Nukem

Smoking also shows up in Bioshock: Burial at Sea (Elizabeth smokes cigarettes in a very sultry way in this 1930s-themed game) and in Halo games with Sargent Johnson always chomping on a cigar.

I have mixed emotions about this initially. I wouldn’t go so far as to call myself a gamer, but I will admit I play video games and find them fun, especially really violent first-person shooters. I know full well these games depict almost non-stop mayhem and gunplay (and in the case of Duke Nukem … extreme sexism) and I find myself saying, “am I supposed to be concerned about characters smoking? Jesus, Duke takes a crap down an alien’s neck.”), but to be fair, as someone who worked long and hard to try and get smoking out of PG-13 movies, I know darn well these “M” rated games are being played by 12- and 13-year-old kids. Heck, I let my 10-year-old grandnephew play Bioshock Infinite at Thanksgiving and that’s an M -rated game.

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Sgt. Johnson from Halo

Here’s some sobering statistics from this Truth Initiative story.

Grand Theft Auto, Halo and Bioshock are all wildly popular games. Counting all the games that have been sold or downloaded, that’s more than 100 million copies of games out there depicting smoking by its characters, with characters either appearing gritty (Sgt. Johnson and Duke Nukem) or suave (Elizabeth from Bioshock) due to their smoking.

So, the message here is, yeah, I get it, these games are M-rated, supposedly intended for adults, but we all know pre-teens are playing these games, and that maybe game developers might try to give this some thought to not encourage 12- and 13-year-old kids into thinking that smoking makes characters cool …. just like movies did for over half a century.

Here is Truth’s video about this important topic:

Study: Fruity flavourings in e-cigs contain chemicals behind “popcorn lung”






Yes, “popcorn lung” is actually a thing.

Another negative study about e-cigarettes. This one comes from researchers at the Harvard School of Public Health (If I had the energy, I’d check out Michael Seigel’s e-cigarette apologist blog to see him point out how the researchers at the Harvard School of Public Health have no idea what they’re doing … anyway, I digress.).

Popcorn lung doesn’t actually make lung tissue look like popcorn. It’s a name given to a disease called bronchiolitis obliterans. It got the name “popcorn lung” because scientists discovered that chemicals called diacetyl, 2,3-pentanedione and acetoin, which are used in artificial butter flavouring for popcorn, can cause lung disease, especially in people who work in packaging plants. 

Well, guess what? Those sweer and surgary e-cig flavourings also give off large amounts of diacetyl, acetoin and 2,3-pentanedione. This study found that these chemicals are found in e-cig vapour in 47 out of 51 flavours. That’s 93 percent.. Nice. OSHA has strict guidelines to how these chemicals are handled in workplaces, but they just show right up in e-cig vapour.

Bronchiolitis obliterans was first brought to light in 2000  when eight employees at a popcorn plant in Missouri developed lung illnesses. It causes dry wheezing, a cough and shortness of breath. One of the effects of this disease is that  air can actually get trapped in the lungs because of obstruction from scar tissue or inflammation. The overinflation of the lungs limits the ability to breathe in fresh oxygen molecules. There was actually a high-profile case of some guy who ate microwave popcorn every day for 10 years developing this disease. He won a multi-million lawsuit over it.


And dang, I always liked popcorn. Now, I’m paranoid of it. At least microwave popcorn.

So, this is part of a growing body of evidence showing that e-cigarettes are not completely benign and harmless. Other studies have shown that e-cig vapour contains a lot of formaldehyde. Are they still safer  than cigarettes? Do some former smokers swear by them? Sure. But, they certainly aren’t inert. And keep in mind, they are completely unregulated for the moment, in particular there are NO rulles whatsoever about sweet and surgery e-cig flavourings, which a lot of tobacco control advocates are convinced are used to entice teenagers. And it certainly seems like the more e-cigs are studied, the more nasty toxins are found contained in the vapour. It wasn’t that long ago that the industry and e-cig advocates were insisting that e-cigarette vapour was entirely, wholly innocuous.

In short, this means that e-cigs absolutely, positively must be regulated and studied further, and more must be done to keep teens from being enticed by e-cigs (ie, cracking down on e-cig marketing to teenagers.). Much is still not known about this relatively new product.


BBC investigation: British American Tobacco bribing government officials in the Third World


This is part of an ongoing series of articles about Big Tobacco’s desire to expand into emerging markets in the Third World — mostly Africa and South Asia — because of the decline of smoking rates in the West.

This awesome piece by BBC, with the help of a corporate whistleblower, shows that British American Tobacco, a seriously major player in the international tobacco business, was bribing government officials in East African nations to weaken laws on tobacco packaging and marketing.

According to email evidence obtained by the BBC from the whistleblower, British American Tobacco (BAT brands include Lucky Strike, Kent, Pall Mall,  Kool and Benson & Hedges) bribed a member of the World Health Organization Framework Convention on Tobacco Control, which is the agency trying to reduce smoking in developing nations.

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British American Tobacco also bribed officials from Burundi and the Comoros Islands $3,000 each and an official in Rwanda $20,000.

From the BBC article:

Dr Vera Da Costa e Silva, from the WHO, said BAT “is irresponsible to say the least”.

“It is using bribery to profit at the cost of people’s lives, simple as that,” she said.

“BAT should be investigated by the government and should be punished accordingly.”

The bribe to the Burundi official was to receive a copy of that country’s draft tobacco control bill and to insure that the official “accommodate” British American Tobacco in adding certain amendments to the bill.

British American Tobacco is trying to claim that these were the actions of rogue employees and that the company is conducting its own investigation (Ie, looking for ways to cover its ass).

This isn’t looking good for British American Tobacco. The whistleblower recorded conversations  with a BAT attorney, telling the attorney that the company would have to continue paying government officials to keep their mouths shut about the bribes.

According to the BBC, the lawyer responded:  “That is what we are going to be paying. Yeah, OK, fine. Anything else that you think we will need to be paying for?”

This isn’t surprising to me in the least because Big Tobacco has been extremely aggressive trying to expand its markets in these smaller countries, using trade agreements, litigation and even using the U.S. Chamber of Commerce as an ally to bully smaller nations into dropping laws regulating tobacco packaging or marketing. The industry has been utterly shameless about this and its tactics around the world have gotten the attention of the New York Times and John Oliver. And they have also shown that they’re both desperate enough and sleazy enough to resort to out-and-out bribery.

British American Tobacco is under criminal investigation for the accusations from the Serious Fraud Office in the United Kingdom. Let’s hope this results in some indictments. Good job, BBC.


Think Progress: The gun industry watched what happened to the tobacco industry and took notice


A very compelling read from Think Progress about how the gun industry watched regulators and the legal justice system cratered Big Tobacco, prompting the gun industry to take steps to make sure the same thing couldn’t happen to it.

Big Tobacco, while still vastly wealthy, is not nearly the political powerhouse that it was 25 years ago. The adult smoking rate has dropped from 42 percent to 17 percent in the U.S. over the past 50 years, smoking advertising has been seriously curtailed and few workplaces allow smoking anymore. Two things helped destroy Big Tobacco’s political influence — regulations and lawsuits. Big Tobacco fought, which minimal success (some, but not much), smoking bans, first on airplanes (a battle the industry ultimately lost) and then in restaurants and then in bars.  Now, more than 30 states have total smoking bans, another handful of states have smoking bans in restaurants and even in those states without smoking bans, most major cities have banned smoking in bars and restaurants.


In the courtrooms, Big Tobacco really got spanked. The industry won lawsuit after lawsuit for years until through the discovery process in many of these lawsuits, internal industry documents were released showing that Big Tobacco absolutely knew since the 1950s that cigarettes caused cancer and were physically addictive and showed that for decades, the industry has been trying to market to teenagers.

Because of the release of these documents, Big Tobacco actually started losing lawsuits. A bunch of state’s attorneys general filed suit because of the costs of smoking to their Medicaid programs, and rather than fight these lawsuits and potentially lose, Big Tobacco agreed to the $280 billion Master Settlement agreement in 1998. Today, the tobacco industry continues to get nailed with lawsuits, a lot of them in Florida, costing them millions in legal fees and eventual settlements (though the industry is well-known for dragging these settlements out for years through appeals, people have received multi-million jury settlements.).


The gun industry sat back and watched and took action to make sure the same thing couldn’t happen to it. The gun industry was facing similar types of class-action lawsuits which eventually crippled Big Tobacco politically.

From the Think Progress article:

Lisa Graves, executive director of the Center for Media and Democracy, told ThinkProgress that the NRA was “very afraid of the parallel between gun litigation and tobacco litigation, so it preempted that.” Through the American Legislative Exchange Council (ALEC) — the secretive free-market lobbying group that brings together conservative politicians and major corporate interests including the tobacco and gun lobbies — it pushed a “Defense of Free Market and Public Safety Resolution” to hurt Smith & Wesson’s ability to sell to law enforcement.

“ALEC helped to try to punish the one component of the industry that agreed to these measures,” Graves recalled, discouraging local police “from buying guns from Smith & Wesson — for daring to go along with safety [measures] designed to keep kids safe.”

When the NRA’s preferred candidate, George W. Bush, was inaugurated in January 2001, his new HUD secretary Mel Martinez quickly ended the department’s involvement in the lawsuits (the NRA strongly endorsed him three years later in his campaign for U.S. Senate in Florida). ALEC and the NRA worked at the same time to successfully encourage many states to prohibit local lawsuits against the gun and ammo industries.

Next, the NRA and its Congressional allies set about eliminating the threat of state or local action, once and for all. In 2005, Bush signed the Protection of Lawful Commerce in Arms Act, which effectively shielded the gun industry from legal liability when their products are used in criminal and unlawful activities.

So, the gun industry made sure to get legislation passed to make sure something like the 1998 Master Settlement Agreement or the Engle case in Florida could ever happen to it.

From the article:

A decade later, the law has been used to stop virtually all efforts to hold gun companies liable in court.

“I think that, had the really powerful litigation run its course, we would have had the same success on guns” as on tobacco, Graves said. “That tobacco litigation was historic… They were able to make some substantial progress and change the future — having information out there, showing how evilly the tobacco companies were behaving. So there was an effort to stop that for guns, which have huge number of deaths and injuries. We haven’t seen the same progress as you would have had these been allowed to go forward. ”

But the industry didn’t stop there. The gun industry also through legislation clamped down on research into gun violence. It was scientific research done by the Centers for Disease Control that helped break Big Tobacco’s power.

From the article:

Thanks to a 1996 law, pushed by the NRA and one of its life members, then-Rep. Jay Dickey (R-AR), the federal government does not do the same kind of in-depth research on gun violence and its prevention. The “Dickey Amendment” stipulated that no funds “made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control.” A 2012 appropriations law put similar restrictions on NIH funding for that year.

Though the NRA claims this was not its intent, the effect of the amendment was not simply that the CDC did not advocate for gun control, it stopped the Centers from doing almost any research on gun violence. And, according to a 2011 New York Times story, before the few remaining firearm-related studies funded by the CDC get published, the NRA gets a heads up “as a courtesy.”

Ted Alcorn, research director at Everytown for Gun Safety, told ThinkProgress in an email that his organization’s research has found that “after the gun lobby’s attacks on the Centers for Disease Control in the mid-1990s, the agency’s funding for public health research on gun violence fell more than 95 percent and publications in the field dried up.” Though groups like Everytown have worked to fill the gap, the lack of federal research has made progress on gun safety even more challenging.

The article also points out that while most doctors will talk to patients about their smoking, laws are being passed (Florida) prohibiting doctors from asking patients if they have a gun in the house. And it points out that while the majority of states and vast majority of cities have smoking bans, more and more states are passing laws allowing the open carrying of guns. Really, there’s never been a better time than now to be a gun owner in the U.S.

Thanks, unfortunately, to the lessons learned by the gun industry while watching the gutting of the tobacco industry’s political power.


Butts to Watts: Turning cigarette butts into something useful — energy


While traveling through Northern California for the holidays, I saw an interesting sign at an Interstate 5 rest stop. It was a sign for “Butts to Watts.”

I had never heard of this program. It’s some partnership between CalTrans and some outfit actually called “Cigarette Butt Services” to take used cigarette butts and incinerate them to create energy. So, smokers at rest stops all through California are being asked to drop their butts into these special bins rather than the regular trash bin. According to CalTrans, 44 million people stop at California rest stops every year, so that’s a lot of smokers stopping each year as well. (I like the little bars across the top to keep people from throwing stuff other than cigarette butts into the bin, which would make the whole program pretty useless.).


Apparently, cigarette butts create a lot of BTUs and are considered a high-yield material for incineration plants. The program also seeks to get millions of pounds of cigarette butts out of landfills.

Interestingly, while trying to do a bit of research on energy from cigarette butts, there is another way being proposed to get energy out of this source of trash. Korean scientists have found that the carbon material in cigarette butts (yeah, cigarette butts may look like they’re made out of cotton, but they’re actually mostly made out of plastic),  in cigarette butts could be cleaned and recycled as a medium for energy storage, like a battery. This material outperforms a lot of other common energy storage materials.