The use of cigarettes in combination with other forms of tobacco is linked with higher nicotine addiction, the inability to quit using tobacco, and increases chances of tobacco-related health problems, according to an analysis of data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS).These problems include stroke, heart disease, and tobacco-related cancers.
Data from 13 states surveyed indicate that polytobacco use -- the use of cigarettes in combination with other forms of tobacco (including cigars; pipes; bidis, a South Asian cigarette wrapped in a leaf; kreteks, a cigarette made with tobacco, cloves and other flavors; and others) -- is most common among men (4.4 percent), people who were single (4.8 percent), young adults ages 18-24 years (5.7 percent), and those with household incomes less than $35,000 (9.8 percent).
The report, "Any Tobacco Use in 13 States -- Behavioral Risk Factor Surveillance System, 2008," provides statistics about polytobacco use among adults over the age of 18. The report also finds that one in four adults in these states use at least one form of tobacco, such as cigarettes, cigars, or smokeless tobacco.
"Every day smoking kills more than 1,000 people and is the leading preventable cause of death," said CDC Director Thomas R. Frieden, M.D., M.P.H. "The more types of tobacco products people use, the greater their risk for many diseases caused by tobacco, such as cancer and heart disease."
The report also found:
• Use of any tobacco ranged from 18.4 percent in New Jersey to 35 percent in West Virginia.
• Use of any tobacco was higher among non-Hispanic whites (26.2 percent) and non-Hispanic blacks (24.4 percent) than among Hispanics (19.7 percent).
• Use of any tobacco was higher among members of an unmarried couple (36.3 percent), single (30.3 percent), or widowed/divorced (29.1 percent) than among married people (21.2 percent).
• Use of any tobacco was higher among those who had less than a high school education (33.1 percent) when compared with those with some college or more (20.5 percent).
• Polytobacco use ranged from 1.0 percent in New Jersey to 3.7 percent in West Virginia.
What's the most common piece of litter being flicked onto the ground, into lakes, parks, beaches and roads? Yep, it's the cigarette butt.
According to environmental cleanup reports, nearly 2 million cigarettes or cigarette filters and butts were picked up internationally from beaches and inland waterways as part of the annual International Coastal Cleanup (ICC) in 2010, including more than one million from the United States alone. Cigarette butts account for more than three times the number of any other item found over the past 25 years of ICC cleanups, according to Legacy, a public health organization.
Besides being unsightly and, for at least a few minutes, a fire hazard, cigarette butts have potentially toxic effects on ecosystems. In one laboratory test, one cigarette butt soaked in a liter of water was lethal to half of the fish exposed.
In observance of Earth Day on April 22, Legacy is working to raise awareness about the negative impact cigarette filters and discarded cigarette butts have on the environment. Cigarette butts contain heavy metals that can leach into waterways, posing a lethal threat to aquatic life. They are costly to local communities to clean up and dispose of as well.
Cigarette butts are made mostly of plastic, which can take years to decompose in the marine environment and down into smaller pieces. While a majority of the respondents surveyed nationally (78 percent) know that cigarette butts are not typically biodegradable and recognize their toxicity (89 percent), tobacco products are still the most prevalent type of litter collected along U.S. roadways and on beaches. These toxic pieces of trash are only biodegradable under ideal conditions and in “real world” conditions, they merely break up into small particles of plastic.
“If more than 287 billion cigarettes were sold last year, where did all those butts go?” said Cheryl G. Healton, DrPH, President and CEO of Legacy. “Cigarette manufacturers acknowledge that there is no such thing as a safe cigarette and have long known that cigarette filters don’t reduce health consequences of smoking and are a major source of coastal litter.” Cigarettes and their butts contain carcinogenic chemicals that make tobacco use the leading cause of preventable death in the United States and globally.
Cigarette litter clean-up costs can be substantial to local authorities. The Legacy poll also found that the majority (73 percent) of those surveyed believe that smokers should be responsible for cleaning up and disposing of cigarette butts after they smoke.
“Cigarette butts are commonly, unconsciously and inexcusably dumped into the global environment every year,” said Dr. Holly Bamford, Deputy Assistant Administrator for the National Ocean Service at National Oceanic and Atmospheric Association. “Once these filters make their way into our oceans, they could be mistaken for food and ingested by birds and marine life, which could cause them to choke or starve to death. We have to begin to change social norms so that just like every other form of litter, it is unacceptable to drop plastic cigarette butts anywhere other than proper receptacles,” she said.
The industry scrambles to get Congress to approve the $368 billion settlement
As negotiations were under way at the ANA Hotel outside of Washington to hammer out legislation on the historic $368 billion tobacco settlement, tobacco lawyers threw down a glove: If the White House doesn't back their requests for immunity from civil litigation, they could walk as soon as Feb. 13.
Tough talk. But who's listening? The tide has turned on the powerful tobacco lobby. This year, Big Tobacco must plead, cajole, and probably even compromise to get Congress to turn the proposed deal--and its language promising limited immunity from future litigation--into law. The promise of immunity never won widespread backing among antitobacco forces or within the Administration, anyway. And after dramatic disclosures about cigarette-marketing efforts aimed at underage smokers, even Big Tobacco's longtime Republican allies are wavering on the idea of immunity. Another complication for the industry: Because President Clinton has earmarked tobacco money for some of his domestic initiatives, Republicans have more reason to back away.
Time is running out. Unless Congress takes up the tobacco settlement soon, the issue will get pushed aside until after next fall's elections. Meanwhile, the legal assault on tobacco proceeds. Minnesota launched its case against the tobacco companies in late January and Attorney General Hubert H. Humphrey III promises to expose dozens of damaging industry documents at the trial. On Feb. 9, a major second-hand smoking trial is set to open in Indiana.
Big Tobacco is adjusting its tactics. Industry executives spent years stonewalling and challenging all scientific evidence of the health risks from smoking. But last year, when documents began to surface in state suits that showed that the companies knew of the risks and intentionally marketed to minors, they began to backpedal. By this January, when several industry CEOs testified before Congress, they were downright contrite--admitting that nicotine is addictive, that smoking plays a role in causing cancer, and that their marketing included studies of teen smokers. "It is immoral, it is unethical, as well as illegal to market to people under age," said Steven Goldstone, chairman and CEO of RJR Nabisco.
The kinder, gentler face of Big Tobacco is part of a program prescribed by Washington spin-doctor firm, Bozell Sawyer Miller Group. But Bozell also recommends maintaining tobacco's traditional hardball tactics in an ad campaign aimed at prodding voters to pressure Congress for the deal to get those billions. Meanwhile, industry lawyers are playing hardball in the negotiations.
None of this has slowed the antitobacco forces, who figure they can write laws to get the tobacco money without making the immunity deal. A bill by Sen. Edward M. Kennedy (D-Mass.), which would raise $600 billion from the industry over 3 years without granting any immunity, is the most draconian of several proposals now before Congress. The public-health community is organizing to launch, by mid-February, a new publicity campaign demanding no immunity whatsoever for Big Tobacco, and is recruiting former Surgeon General C. Everett Koop to lead the charge.
All parties are waiting for President Clinton to act. A senior White House official says that immunity is "philosophically the most difficult" issue for Clinton and that it will be "the last thing on the table." The President, the official says, will weigh a simple question: "Is what you're getting worth what you're giving up?" In his new budget, Clinton is counting on $65 billion in revenues from a tobacco deal. That motivates him to go for the deal, but negotiators are getting tired of waiting for him to decide. "If the Administration doesn't commit on immunity, you could get a walkout" by the industry, says Joe Rice, a lawyer for states suing the industry and a key player in the settlement talks.
Would Big Tobacco drop its demand for a ban on class actions? A consultant to the industry hints that it might--but only if there are no other concessions. If that's the strategy, Big Tobacco could be in trouble. Shares in the industry dropped by 15% in January amid concerns that the settlement might fall apart. And perhaps more important, the industry's difficulties with the immunity issue are exposing a previously unrecognized weakness in Big Tobacco's vaunted lobbying power. "They're very good at killing things, but they're not very good at passing things," says John Coale, a leading plaintiff's lawyer involved in the tobacco talks. It may turn out that the immunity issue is the one that ultimately makes Congress immune to the persuasions of Big Tobacco.By David Greising in Atlanta, with Susan Garland and Richard Dunham in WashingtonReturn to top