SouthCoast cities and towns join growing roster to ban tobacco products in pharmacies

Westport has joined a tide of communities snuffing-out pharmacy tobacco sales in SouthCoast and beyond. Westport's new rule, approved in August by the town's Board of Health, went into effect in October and bans tobacco sales in all pharmacies as health care institutions, according to Judith Coykendall, program manager for the Seven Hills Behavioral Health Tobacco-Free Community Partnership. Coykendall — whose program is funded by the Massachusetts Department of Public Health's Tobacco Cessation and Prevention Program — has urged communities to pass these regulations.

Joining her are DPH-funded programs such as the Western Bristol County and Foxboro Tobacco and Alcohol Prevention Collaborative and its counterpart, the Five County Regional Tobacco and Alcohol Education Program. The latter covers several other SouthCoast communities, Cape Cod and the Islands and areas of the South Shore. "My role ... is to bring these initiatives to the boards of health and explain to them how they work and what they involve, and then it's the boards' decisions to go forward or not," said Marilyn Edge, director of the Western Bristol County and Foxboro collaborative.

She said regulation language is provided by attorneys from the Massachusetts Municipal Association and the Massachusetts Association of Health Boards. Sometimes, she said, local health boards opt against implementing the ban because they have no pharmacies selling tobacco anyway; others don't see the issue as a priority. "We've been talking about this in Westport for a very long time," said Edge, who noted that CVS and the Westport Apothecary are the only two pharmacies in town. "One of the hesitations, when we first started talking about this, was no one wanted to adversely affect the business of the independent (pharmacy)."

 But then the Westport Apothecary voluntarily stopped selling cigarettes, "which was fabulous," she said, noting that independent pharmacies in Fall River also ceased tobacco sales well before that city's ban. A list from the Massachusetts Municipal Association shows the cigarette clamp-down flaring up all over the state. Following Boston's passage of a pharmacy tobacco ban in 2008, \ more than 45 cities and towns in Massachusetts had passed similar rules as of the end of September — including New Bedford, Dartmouth, Fairhaven, Rochester, Wareham and Fall River.

The bans pertain to independent pharmacies, pharmacies in hospitals, chains like CVS and supermarkets that contain pharmacies within them, according to D.J. Wilson, the Massachusetts Municipal Association's tobacco control director. Pharmacies are "supposed to be promoting health-related type products and not selling cancer-related products, like cigarettes," said Karen Walega, health director in Rochester, which passed the pharmacy tobacco ban earlier this year. Walega serves a dual role as health director in Marion, where she said the health board is also considering tobacco regulations. Bob Collett, the director of the Five County program, said he plans to make a case for the ban in Acushnet and Mattapoisett, too.

 Pharmacy tobacco sales send the wrong message, according to Coykendall, who said smokers can still buy cigarettes at convenience stores and gas stations. "The implied message to youth is if they sell this in a health care institution, then it must be not that dangerous," she said. She also described pharmacy tobacco sales as a troubling trigger to anyone shopping at these stores for smoking cessation aides. "Why would you be selling an addictive product in a health care institution and in the same store, you're selling products to help them get over that addiction?" she asked. Many cities and towns have passed rules extending to other retailers, such as regulations on electronic cigarettes. Some communities have also prohibited individual sales of cheap, flavored cigars.

 But at what point does clamping down on tobacco and nicotine products trample on personal freedom? A man smoking in downtown New Bedford Friday afternoon said pharmacy tobacco sales should be restricted only if voters approve it. "I don't need somebody to tell me what to do at 60 years old," said the man, who declined to give his name. "I don't think that the politicians should be making rules for everybody else." Others lighting up in the city Friday didn't see the ban as an infringement on smokers' rights.

 Since pharmacies sell medicine, "it makes sense to do it, but it is a slight inconvenience, I guess," said Adam DeAraujo, 23, who works downtown and said he used to buy his cigarettes at the nearby Rite Aid. Tony Abreu, 29, lives in Fall River, where pharmacy tobacco sales have been banned since 2011. He said he's fine with restrictions as long as stores don't stop selling cigarettes altogether. "It didn't really bother me," he said. "Cigarettes were more expensive at CVS anyway."

Federal agent's fall led ATF to abandon cigarette sting

A special agent with the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) approached the Hampton Police Division in the spring of 2010 about working with him on undercover cigarette stings. Later that year, as soon as questions began to surface about the agent, Clifford D. Posey, the ATF ceased its involvement in the Hampton cigarette sting operation. Posey later admitted as part of a 2011 plea agreement that he embezzled more than $46,000 in cigarettes and guns during the operation.

Poll on black-market cigarette sting operation The Hampton Police Division ran an undercover sting into black-market cigarette sales for about 19 months, realizing thousands of dollars in revenue, yet making no arrests. The operation was shut down after allegations of misconduct. The Daily Press asked readers in an online poll: What is your assessment of the operation?

 • 33.6 percent (48 responses): It sounds like they were more interested in making money and buying cars than in making arrests.
 • 26.6 percent (38 responses): It sounds like a total boondoggle.
 • 18.2 percent (26 responses): We don't know all the facts in the case, so it's hard to make a fair assessment.
 • 10.5 percent (15 responses): The operation sounds like it had good intentions, but after it failed to yield arrests, it should have been disbanded long before 19 months.
 • 7.7 percent (11 responses): Success can't always be measured in arrests. They could have gathered valuable intel to fight crime in the city.
 • 3.5 percent (5 responses): I don't have an opinion.

Poor smokers in NY spend 25 pct of income on cigs

A new study shows low-income smokers in New York spend 25 percent of their income on cigarettes, a finding that led a smokers' rights advocate to say it proves high taxes are regressive and ineffective. The American Cancer Society said the study by RTI's Public Health Policy Research Program using state data shows a need to help more poor New Yorkers quit smoking or never start. In New York, with the nation's highest cigarette taxes, a pack of cigarettes can cost $12, though many smokers have turned to cheaper cigarettes bought online and by using roll-your-own devices.

 Wealthier smokers — those earning $60,000 or more — spend 2 percent on cigarettes, according to the study. "The poor pay $600 million in cigarette taxes and get little help in quitting," said Russ Sciandra of the American Cancer Society. He said state statistics show smokers earning less than $30,000 pay 39 percent of state and city taxes on cigarettes. More of the cigarette tax revenue has to be used to better fund smoking cessation programs, now at a fraction of the federal recommendation, and to aim more at low-income households, he said.

 Sciandra said other studies show lower income smokers have less success at quitting. He said low-income smokers trying to quit are hampered by being around many smokers and having less cash to buy smoking cessation aids. But for smokers, the study proves cigarette taxes are punitive and "undeniably regressive," said Audrey Silk of CLASH, a national smokers' rights organization. "It busts their theory that high taxes equal submission to their coercive measure at the same time," she said. She criticized government "anti-smokers" who jack up taxes, but she also found with anti-smoking groups like the Cancer Society.

 "Ulterior motives abound ... to generate bad news as reason to tighten the screws and fish for more funding to do it with," she said. "They enrich themselves at the expense of those they helped stigmatize." Peter Constantakes of the state Health Department argues that tax increases and other programs are helping people kick the habit. "Cigarette taxes are an evidence-based intervention that has proven successful in encouraging smokers to quit," he said.

"New York is promoting a number of anti-smoking initiatives, including targeted media campaigns, that are designed to reduce the smoking rate among lower-income groups and prevent young people from becoming smokers." He notes Medicaid provides extensive smoking cessation products, while some state programs are aimed at communities with low incomes and education rates and high racial and ethnic minority populations.

Smoking befogs brain post stroke

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The MoCA exam tests patients with memory and problem solving questions and gives them a score out of 30. Smokers had a median MoCA score two points lower than non-smokers -- 22 out of 30 compared to 24 out of 30. Patients who had previously quit smoking achieved the same scores as lifetime non-smokers, said Gail MacKenzie, clinical nurse specialist at Hamilton General Hospital, Canada. "This research emphasizes the importance of smoking cessation for people with stroke or TIA," said MacKenzie.

TIA, or transient ischemic attack, is a mini stroke and often serves as a warning sign that a bigger stroke is imminent, according to a Hamilton statement. "Smoking is a risk factor for cognitive impairment for people who continue to smoke and this ability to problem-solve and make decisions has implications for patients' health and self-management of care," added Mackenzie. Almost 37,000 Canadians and many more worldwide will die prematurely each year due to tobacco use, and almost a third of these deaths will be from cardiovascular disease.

 Smoking contributes to the build up of plaque in the arteries, increases the risk of blood clots, reduces the oxygen in the blood, increases blood pressure and makes the heart work harder. "There needs to be more effort to help people stop smoking to protect their brain both from stroke and from mental decline after stroke," said Mark Bayley, co-chairman of the Canadian Stroke Congress, where these findings were presented.

Smokers doubt that warning labels on cigarette packs have sense

Representatives of the Rights of Smokers public initiative think that labeling cigarette packages with warning pictures about diseases caused by smoking is peculiar to backward countries only. "Civilized states have started to give up making such packages. Recently a Washington court ruled that the U.S. government should stop demanding the labeling [of packages] with such images.

The key argumentation [of the ruling] is the absence of any proofs that such labels somehow reduce the number of smokers," the leader of the Rights of Smokers public initiative Yuriy Paliychuk said. "Today mainly backward countries, such as Kazakhstan, Kyrgyzstan, Egypt, Thailand, and Uruguay, use such 'scary' packages. Anti-smoking activists are again dictating to the society the savage rules they used to call 'European practice'.

They only put warning inscriptions on cigarette packages in the developed European countries," Paliychuk said. He added he doubts about effectiveness of such images. "The global experience shows that they [the images] have nothing in common with fight for a healthy lifestyle," he said. As reported, from September 16, 2012 practically all kinds of tobacco advertising will be banned in Ukraine. From December 16, 2012 smoking in public places, at bars and restaurants, children's play grounds, offices, and state buildings will be prohibited.

Pearl Street Mall smoking ban aired at Boulder open house

Only a few Boulder residents attended an open house Wednesday on a proposed Pearl Street Mall smoking ban, but their position was clear: Cigarettes should be snuffed out. The ban will appear on the Boulder City Council agenda Oct. 16, and then again for a public hearing Nov. 15. If passed, the ban would be enforced 24 hours a day on the pedestrian mall between 11th and 15th streets and on the Boulder County Courthouse lawn. It was drafted in response to complaints from tourists, downtown employees, restaurant owners and retail businesses about an increase in cigarette-butt litter and secondhand smoke, city officials say.

 Sharon Hillman, a 22-year Boulder resident, said she struggles with asthma and attended Wednesday's open house to show her support for the proposed ban. She said she lives near the mall and walks through it several times a day, and lately she's been bothered by how many people smoke there. "I just think this year was the tipping point where I couldn't find fresh air on the mall anymore," Hillman said. "There is a reason you live downtown, and I want to be able to hang out where I live." The ban would not be enforced in alleys or on side streets of the mall, according to the city staff. If it passes, police and city employees would spend the first month educating people seen smoking about the ban.

 After that, violators would be given one warning before being ticketed for smoking, which carries a maximum penalty of a $1,000 fine or 90 days in jail, according to information distributed Wednesday. Molly Winter, director of Boulder's Downtown and University Hill Management Division and Parking Services, said the response to the proposed ban has been almost unanimously positive. She noted a survey of downtown business owners and employees done by Downtown Boulder Inc. has so far shown that 73 percent would support the ban. Cigarette butts are the most prominent kind of litter on the mall each day, Winter said, but smoking in the public area also creates a substantial public health risk, the primary reason for the proposed ordinance.

 Jennifer Kovarik, program coordinator for Boulder County's Tobacco Education and Prevention Program, noted that about 12 percent of Boulder County adults are smokers, and there is mounting evidence that exposure to secondhand smoke in an outdoor setting can be just as damaging to one's health as indoor exposure. Robin Kolble, manager of the University of Colorado's community health department, has been working on a possible campus-wide smoking ban for years, but she came to Wednesday's open house as a concerned resident. "I think a lot of people believe that when you blow the smoke out it just goes away, but it doesn't. It lingers," she said. "I really would like to be able to take my grandchildren to the mall without breathing in smoke."

Missouri to vote on raising lowest tobacco taxes in the US

Missouri’s cigarette tax is the lowest in the nation, and that has some people doing a slow burn. At 17 cents per pack, Missouri’s tax is nearly half as much as the next lowest and well below the $1.49 national average. In Kansas, the tax is 79 cents a pack. All that could change on Nov. 6, however, when voters get another chance to decide whether to raise the tax to 90 cents per pack and make Missouri’s cigarette tax the 33rd highest in the country. If it wins approval, Proposition B is projected to generate $283 million to $423 million a year in additional tobacco tax revenue, which would be directed to a fund aimed at K-12 schools, higher education and smoking cessation programs.

“Raising the tobacco tax is one of the most effective ways to reduce smoking rates and prevent our youth from ever starting,” said Misty Snodgrass, government relations director for the American Cancer Society. “It’s also a revenue win for our underfunded public schools and universities.” But opponents argue Proposition B would hurt sales tax revenue for state and local government and drive business to neighboring states. “This would put small businesses in Kansas City at a disadvantage, which is horrific public policy,” said Ron Leone, who is running the opposition’s campaign for the Missouri Petroleum Marketers & Convenience Store Association PAC.

Voters rejected tobacco tax hikes in 2002 and 2006. Both years, the nation’s biggest tobacco companies spent millions to oppose the increase. But this time around, those same companies have said they are sitting out the campaign. “Big Tobacco is standing down this year because they support Proposition B. They support it because it reduces their competition,” Leone explained. That’s because in addition to increasing taxes on tobacco products, Proposition B also would eliminate a pricing advantage that off-brand cigarette companies currently have in Missouri.

In 1998, Missouri was one of 46 states that entered into a legal agreement with cigarette makers forcing them to pay into a state fund to help cover the cost of smoking-related diseases. Companies that didn’t sign the agreement still pay into the fund, but through a loophole in the law get their money back at the end of each year. Missouri is the only state that hasn’t closed the loophole. “This ballot initiative eliminates a loophole in the law that has created an uneven playing field for cigarette manufacturers and retailers in Missouri,” said Bryan Hatchell, a spokesman for Reynolds American Inc., a major manufacturer of tobacco products. “Primarily for this reason, Reynolds American Inc. has no plans to oppose the Missouri ballot initiative.”

Leone said the passage of Proposition B would mean off-brand cigarettes could cost customers as much as 57 cents more per pack, in addition to the new increased tax. “In one fell swoop, Big Tobacco can reduce or eliminate their competition,” Leone said. Money for schools Snodgrass said the decision to use the additional revenue generated by the proposed tax increase for public schools and higher education is a key difference from previous efforts and a big reason why supporters are so optimistic it will succeed this time. “We know that Missourians support their local public schools,” she said. If passed, the additional revenue would be put into the Health and Education Trust Fund, where 50 percent would go to K-12 schools, 30 percent to higher education and 20 percent to tobacco use prevention and quit assistance programs. Supporters estimate that the higher tax could result in millions in additional funding for area school districts, including nearly $3 million for North Kansas City, $2.7 million for Lee’s Summit and $2.3 million for Kansas City.

Leone, however, questions whether the additional revenue will actually translate into higher funding levels. Lawmakers have a history of using new revenue streams to justify cuts in other state appropriations, he said. “Even if this brought in $300 million for schools, it doesn’t guarantee the money that is currently appropriated for schools is going to stay there,” he said. “The budget is a big shell game, and what goes in the front door can just as easily go right out the back door.” Snodgrass said proponents would be vigilant to ensure the additional revenue is spent in line with how voters intended. “The coalition behind this initiative will be a constant presence in Jefferson City to remind legislators of the voters’ intent and ensure accountability for its implementation,” she said. In addition to new revenue, Snodgrass said fewer Missourians smoking will also save the state millions of dollars a year.

Medicaid costs associated with tobacco-related disease cost taxpayers $532 million annually, she said. Each pack of cigarettes sold in Missouri “costs our economy $12.68 in lost productivity and preventable health care expenses,” she added. “The low tobacco tax in Missouri costs the state dearly in state tax dollars, in lost productivity, in preventable disease and in premature deaths.” Impact on local business Leone called the increased tax “outrageous and unfair.” The real impact of the 90-cent per pack tax would be loss of business, and ultimately jobs, at stores along the state’s borders. “For some reason we’re embarrassed for being the lowest cigarette tax, even though that brings a tremendous amount of business into this state,” he said. A study commissioned by Leone’s organization and performed by Joseph Haslag, an economist at the University of Missouri, found that, if estimates are correct, Proposition B would result in 157 million fewer packs of cigarettes sold in Missouri every year. That would mean the amount collected in sales and other state and local taxes would decrease by $67 million. Haslag’s study predicts that would translate to $1.4 million in lost sales taxes for Kansas City and $824,000 for Jackson County.

 “That’s why this isn’t just about smokers,” Leone said. “That’s why everyone has skin in this game. Our state and local governments are going to lose revenue if this measure passes.” Snodgrass called that argument “fatally flawed” She said it presumes that with a decrease in smoking, none of the money currently spent on cigarettes will make its way back into the local economy and countered that tobacco use in the state costs an estimated $565 per household in public expenditures. “They are trying to convince voters that Missouri’s economy is only competitive because we sell deadly, addictive products cheaper than our neighbors,” she said. “That’s just a false argument. The harm caused by tobacco products is currently subsidized by all Missourians.” Leone said his organization is not opposed to any tax increase on tobacco. He said he spoke in favor of legislation that would have nearly doubled the tax to 33 cents per pack earlier this year, but the bill never gained traction. “For anyone to say we’re against all tax increases is ridiculous,” he said. “We’re just against any tax increase that puts us at a competitive disadvantage with our neighboring states.”