I disagree totally with Stan Glantz and his view that we abandon youth access efforts.

As usual in every argument there is truth on both sides. He is right in being concerned that this can be an easy way for tobacco companies to look good and that teens will attempt to substitute other social sources. But one of the main sources of such secondary supply is other minors purchasing and then selling on the 'blackmarket', and our experience has been that making the primary source more difficult has led to a doubling of the playground price - a good price deterrent.

However, he is wrong in applying his objections equally in all jurisdictions. Would he seriously suggest that I abandon a local level intervention that has been shown to work so well, reducing smoking among teenagers on the Central Coast of New South Wales by a third over six years (1)? There is no mention in the editorial of that work.

Why can't we have "smoke free workplaces and homes" (Australia has got legislation and campaigns), "taxes" (we've got far higher taxes than the U.S.), "media campaigns "(we've got those) and "secondhand smoke messages" (we've got those) PLUS youth access PLUS advertising and promotion restrictions ( the U.S. still has a long way to go there) PLUS good anti-litter laws PLUS Quit support PLUS whatever else will work?

Perhaps his conclusion should be that youth access doesn't work IF you haven't got a comprehensive approach to tobacco control and it is undermined by inaction on the enforcement aspects or by inaction on the other strategic fronts. It's certainly not sufficient by itself, but as I've shown here - it can be a very cheap way of creating non-smokers at one tenth the cost of Nicotine Replacement Therapy(2).

Douglas Tutt

1)Tutt D, Bauer L, Edwards C,Cook D. Reducing adolescent smoking rates. Maintaining high retail compliance results in substantial impovemnts. Health Promotion Journal of Australia 2000:10(1)20-24 2)Tutt D. Enforcing prohibition of tobacco sales to minors :an update. Proceedings of 13th Winter School in the Sun, Alcohol and Drug Foundation - Queensland, Brisbane, Australia 2000.

For those trying to quit smokeless tobacco, there are some helpful options. Of course, making up one's MIND is the most important thing. Many states now have Tobacco Quitlines, that give phone-based help. Washington's is 1-877-270-STOP, and can probably direct people to other states' lines. To handle the very high nicotine addiction of smokeless tobacco, it often takes combining nicotine patches and nicotine gum. The patch gives 24 hour nicotine slow absorption, while the gum (2 or 4 mg, regular, mint, or orange flavor), gives the faster nicotine replacement. These do NOT quit FOR the tobacco addict, but HELP taper the nicotine level without as much withdrawal, DOUBLING the chance of successfully quitting. Check out www.nstep.org, surgeongeneral.gov/tobacco, tobaccofreekids.org, kickbutt.org, for more. Zyban/Wellbutrin (bupropion) is a non-nicotine, non-addictive antidepressant that doubles success quitting tobacco, and can be used with nicotine meds. Secondline meds include clonidine and nortriptyline. Check with your doctor for further information. Good luck! Chris Covert-Bowlds, MD

March 14, 2002

To the Editor:

Maybe the fact that I am writing to you indicates that I still haven’t learned my lesson, but I thought I would give it a try.

In 1996, I met with a young reporter from the Baltimore Sun who wanted to do an article on the resurgence of cigar sales in the U.S. I told him, “Alec, the real story here is that the resurgence has taken place in spite of the cigar industry. Faced with an unrelenting decline in cigar sales, the Cigar Association of America embarked on a public relations campaign in 1981 in which it tried to improve the image of the cigar and the cigar smoker. In spite of our efforts – which resulted in much positive publicity – cigar sales continued to plunge and so the campaign was discontinued in 1988. Then, when cigar sales began to increase in 1994 – six years after the our public relations campaign was discontinued – it caught the industry completely by surprise. That is the real story.”

And I gave him some examples of the types of programs we funded during the 1980s because I was proud of their creativity and what we had accomplished with limited funds. Two years later no one was more stunned than I when Alec Klein’s series on our so-called stealth marketing campaign appeared in the Baltimore Sun. On one hand it made us look like marketing geniuses. But on the other hand, its distortions are now embodied as gospel by the anti-tobacco movement.

The misperceptions are evident in the article “How the tobacco industry built its relationship with Hollywood”.

But first, I want to address the FTC report cited in the article. That report indicated that total advertising and promotional expenditures for cigars increased 32% – from $30.9 million in 1996 to $41 million in 1997. This is only .6% of the more than $5 billion spent by the cigarette industry. According to the FTC, 40% ($16.3 million) of cigar company advertising and promotional expenditures in 1997 were for promotional allowances – that is, discounts and other incentives given to retailers – and 24% ($10 million) was for magazine advertising in publications such as Cigar Aficionado and Smoke magazines.

Point of sale advertising amounted to $5.2 million. But only $339,000 was reportedly spent on celebrity endorsements and appearances, and payments for product placements in movies and television.

Of course, it is much more dramatic to indicate that these latter expenditures “more than doubled”. But how unfair not to have mentioned how small the base was in the first place.

We are flattered by the description of our public relations campaign as having been well thought out. The fact is, it was a shoe string operation whose expenditures between 1981 and 1987 averaged only about $350,000 a year. It was hardly the “massive public relations campaign” which the article described it as being. And it pails in comparison to the millions spent annually by others, such as the coffee and milk industries, which also were experiencing significant sales declines during that period.

And there is no truth in the claim that the majority of role models were to be Hollywood personalities and that paid product placement would be used to help with the casting. Very few companies used product placement. In fact, it was much more common for studios to call our members for free product much like the requests we receive to contribute product for silent auctions to raise money for charitable events. And when Alec said that product was placed in the movie “Independence Day”’ he was flat out wrong.

The cigar industry does not use product placement in the entertainment industry. Although there may be isolated instances, it is wrong to tar an industry on the basis of activities by a few companies.

Furthermore, the article seems to blur the fact that the Cigar Association of America and Cigar Aficionado magazine are separate entities. And while there is no denying that the magazine helped promote the interest in cigars, its emphasis was almost exclusively on the premium, hand-made segment which makes up less than 6% of cigars sold currently.

Years of fighting the cigarette industry have predisposed many in the anti-tobacco movement to conspiracy theories. But the cigar industry is not the cigarette industry. Unfortunately articles such as yours and Mr. Klein’s continue to serve to blur the distinctions between these two very different products.

There was nothing “stealthy” about our public relations campaign in the 1980s. Our activities were those used by a number of industries. Of course we now realize that such activities are acceptable when used by other industries but not when they are used by a tobacco industry. We have learned over the years that when it comes to tobacco, different standards apply.

Alec Klein never mentioned that we discontinued our public relations campaign in 1988, nor did he mention that during the eight years of that campaign unit sales of large cigars declined 34% to 2.5 billion cigars. Sales were not to reach bottom until 1993 at 2.1 billion units. (In 1964, the peak year, nine billion were sold.)

But the fact remains that the resurgence of interest in cigars – which has since run its course – took the cigar industry by surprise and it happened in spite of the industry, not because of it.

Norman F. Sharp

President

Cigar Association of America, Inc.

Washington, D.C.

Rick Kropp PO Box 4305 Clearlake, CA 95422 (707) 994-2911 rkropp4@home.com

December 27, 2001

Dear Tobacco Control Editor:

The Landrine, Klonoff, and Reina-Patton’s article “Minors' access to tobacco before and after the California STAKE Act” in the Summer 2000 Supplemental Issue of Tobacco Control is an excellent article summarizing a carefully planned and executed study. Its findings are important to the tobacco control community in general and youth access reduction strategies specifically. It points to the strength of the California STAKE (Stop Tobacco Access to Kids Enforcement) Act, especially compared with many other state Synar-compliance laws.

Unfortunately, the Landrine article contains major errors of fact along with less serious omissions.

The Landrine article states “the California Department of Health Services TCS (Tobacco Control Section) annually collects statewide data on the effectiveness of the STAKE Act. These "youth purchase surveys" are conducted by the authors (EK) (Elizabeth Klonoff) …in 1995, …1996, …1997, and … 1998.”

This is an error. Under a contract with the California Department of Health Services (CDHS) TCS, the former North Bay Health Resources Center (NBHRC) in Petaluma, California organized and conducted the annual statewide “youth purchase surveys” to collect data on the effectiveness of the STAKE Act in 1995 and 1996. Data collected, recorded and compiled by NBHRC was furnished to CDHS/TCS.

In addition, the underage youth participating in the annual surveys, as well as youth acting as decoys in statewide tobacco sales enforcement operations in 1995 and 1996 under the STAKE Act, were also recruited and trained by NBHRC. The youth decoys and their background information were furnished by NBHRC to the Food and Drug Branch of CDHS, the state agency that organized and conducted the STAKE Act’s tobacco sales enforcement operations.

The Landrine article also stated “…many of the stores included in TCS youth purchase surveys have participated in merchant education interventions conducted by TCS, making it difficult to know if the observed decreases are caused by the law and its enforcement or are the result of educating merchants…”

Nearly all merchant education interventions in California were organized and conducted by county public health departments, nonprofit and community-based organizations, and county and regional tobacco control coalitions under funding contracts with TCS. In addition, other youth access reduction activities were organized and conducted by county public health departments, nonprofit and community-based organizations, and county and regional tobacco control coalitions under funding contracts with TCS.

At same time, secular trends, economic trends in the retail tobacco industry, merchant education and public relations activities of the tobacco and retail industries, tobacco-related news coverage in the print and electronic media, national and federal tobacco control activities, and many other intervening variables and confounding factors influenced merchant tobacco selling behavior in California. Finally, the Landrine article failed to mention the STAKE Act was developed, authored and skillfully maneuvered through the California legislature by former State Senator Tom Hayden and his staff. Hayden and his staff insured the STAKE act legislation contained the key elements of a strong tobacco sales enforcement law, even though it did not contain tobacco licensing. Hayden and his staff successfully fought off many efforts to weaken the enforcement and other components of the bill by the tobacco and retail industry lobbyists, including state preemption.

In addition, Hayden and his staff received little if any support from the California tobacco control, public health and medical communities. Also, the STAKE Act was not officially supported by the CDHS/TCS, which, in fact, officially supported another competing Synar-compliance bill. However, Hayden did receive recognition for his efforts when he was awarded the 1995 Tobacco Control Person of the Year by STAT (Stop Teenage Addiction to Tobacco), a national youth tobacco activist organization headquartered in Massachusetts.

My quite belated review and comments on the Landrine article were due to a lengthy series of serious health setbacks and major medical operations I experienced over the last two and a half years. These setbacks and operations led to my recent early disability retirement.

Sincerely,

Rick Kropp