Emory Receives $14 Million Gates Foundation Grant to Reduce Tobacco Use in China

Emory University has received a $14 million, five-year grant from The Bill & Melinda Gates Foundation to help reduce the burden of tobacco use in China. The Emory Global Health Institute, in collaboration with the Tobacco Technical Assistance Consortium (TTAC) of Emory’s Rollins School of Public Health, will establish the Emory Global Health Institute – China Tobacco Partnership.

The Emory Global Health Institute will manage the partnership, which will collaborate with public health leaders in China to promote evidence-based approaches to reducing tobacco use that are tailored to the culture and circumstances of individual cities and provinces in China. The Emory Global Health Institute will also provide funding and support to establish national tobacco control resource centers in China.

"This grant will allow Emory to combine its significant public health expertise with that of health and government leaders in China to address a major international public health challenge," says Fred Sanfilippo, MD, PhD, Emory executive vice president for health affairs.

"Tobacco is the largest cause of preventable deaths globally and China has the most smokers in the world. There is a huge opportunity in this project to have a major impact on global health," says Jeffrey Koplan, MD, MPH, Emory vice president for global health and director of the Emory Global Health Institute.

Koplan will serve as principal investigator of the grant and will lead the partnership along with Pamela Redmon, MPH, executive director of TTAC, a nationally recognized tobacco control leader and technical assistance provider in the United States.

Co-principal investigators for the partnership will be Kathy Miner, PhD, MPH, associate dean of applied public health at Emory’s Rollins School of Public Health and principal investigator of TTAC and Michael Eriksen, ScD, a noted expert in national and global tobacco control efforts and director of the Institute of Public Health at Georgia State University.

Nearly two-thirds of the world's smokers live in 10 countries, with China having the highest tobacco use prevalence by far, according to the World Health Organization (WHO, 2008). Also according to WHO (2003), there are more smokers in China than there are people living in the United States. In China, two-thirds of men are smokers, and it is estimated that 100 million tobacco-related deaths will occur among people currently age 0-29 if tobacco prevention and control efforts are not implemented (Leming, et. al, Health VII Project, 2004).

Not only does China have the largest population of smokers, it also is the chief producer of tobacco products in the world. The national tobacco monopoly is the leading manufacturer and seller of cigarettes, earning billions in tobacco profits and excise tax revenues (WHO, 2003).

According to research reported recently in the New England Journal of Medicine (Gu, et. al, Jan. 8, 2009), tobacco smoking was responsible for about 673,000 premature deaths in Chinese adults age 40 or older in 2005.

The Emory Global Health Institute – China Tobacco Partnership will support the development of effective, accountable and sustainable tobacco prevention and control initiatives that address China’s unique needs and challenges. The program will be able to quickly and efficiently identify and mobilize global resources to assist China in reducing tobacco use.

The Emory Global Health Institute was established to advance Emory University’s efforts to improve health around the world through the creation of innovative global health programs. The TTAC, a trusted partner and collaborator with national tobacco control organizations, has developed and delivered training and assistance to all 50 states and the U.S. territories.

The Emory Global Health Institute – China Tobacco Partnership will coordinate and collaborate with the American Cancer Society (ACS) and the Centers for Disease Control and Prevention (CCD) Office on Smoking and Health. The program's advisory board will include representatives from Emory, Georgia State, ACS and CDC.

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National Report Ranks Georgia 50th in Protecting Kids from Tobacco

/PRNewswire-USNewswire/ -- Ten years after the November 1998 state tobacco settlement, Georgia ranks 50th in the nation in funding programs to protect kids from tobacco, according to a national report released today by a coalition of public health organizations.

Georgia currently spends $3.2 million a year on tobacco prevention programs, which is 2.7 percent of the $116.5 million recommended by the U.S. Centers for Disease Control and Prevention (CDC).

Other key findings for Georgia include:
-- The tobacco companies spend more than $444 million a year on marketing
in Georgia. This is 139 times what the state spends on tobacco
prevention.
-- Georgia this year will collect $393 million from the tobacco
settlement and tobacco taxes, but will spend less than 1 percent of it
on tobacco prevention.


The annual report on states' funding of tobacco prevention programs, titled "A Decade of Broken Promises," was released by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society Cancer Action Network, American Lung Association and the Robert Wood Johnson Foundation.

"Georgia is one of the most disappointing states when it comes to funding programs to protect kids from tobacco," said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids. "On this 10th anniversary of the tobacco settlement, we call on Georgia's leaders to raise the state cigarette tax and use some of the new revenue to increase funding for tobacco prevention. Tobacco prevention is a smart investment that reduces smoking, saves lives and saves money by reducing tobacco-related health care costs."

Georgia's current cigarette tax of 37 cents per pack is 43rd in the nation and well below the national average of $1.19 per pack. Scientific studies have found that increasing cigarette prices is one of the most effective ways to prevent kids from smoking and encourage smokers to quit.

On Nov. 23, 1998, 46 states settled their lawsuits against the nation's major tobacco companies to recover tobacco-related health care costs, joining four states (Mississippi, Texas, Florida and Minnesota) that had reached earlier settlements. These settlements require the tobacco companies to make annual payments to the states in perpetuity, with total payments estimated at $246 billion over the first 25 years. The states also collect billions of dollars each year in tobacco taxes.

The new report finds that most states have broken their promise to use a significant portion of their tobacco money to fund programs to prevent kids from smoking and help smokers quit.

According to the report, the states in the last 10 years have received $203.5 billion in revenue from the tobacco settlement and tobacco taxes. But they have spent only 3.2 percent of this tobacco money - $6.5 billion - on tobacco prevention and cessation programs.

Other findings of the report include:
-- In the current year, no state is funding tobacco prevention at
CDC-recommended levels, and only nine states fund their programs at
even half of the CDC recommendation.
-- 41 states and the District of Columbia are funding tobacco prevention
programs at less than half the CDC-recommended amount. These include
27 states that are providing less than a quarter of the recommended
funding.
-- Total funding for state tobacco prevention programs this year, $718.1
million, amounts to less than three percent of the $24.6 billion the
states will collect from the tobacco settlement and tobacco taxes. It
would take just 15 percent of this tobacco revenue to fund tobacco
prevention programs in every state at CDC-recommended levels.


The report warns that the nation faces two immediate challenges in the fight against tobacco use: complacency and looming state budget shortfalls. First, while the nation has made significant progress over the past decade in reducing smoking, progress has slowed and further progress is at risk without aggressive efforts at all levels of government. Second, the states are expected to face budget shortfalls in the coming year as a result of the weak economy. The last time the states faced significant budget shortfalls, they cut funding for tobacco prevention programs by 28 percent between 2002 and 2005. The cutbacks are a major reason why smoking declines subsequently stalled, and states should not make the same mistake again.

The report found that there is more evidence than ever that tobacco prevention programs work to reduce smoking, save lives and save money by reducing tobacco-related health care costs. Washington State, which has been a national leader in funding tobacco prevention, has reduced smoking by 60 percent among sixth graders and by 43 percent among 12th graders since the late 1990s. A recent study found that California's tobacco control program saved $86 billion in health care costs in its first 15 years, compared to $1.8 billion spent on the program, for a return on investment of nearly 50:1.

In Georgia, 18.6 percent of high school students smoke, and 11,300 more kids become regular smokers every year. Each year, tobacco claims 10,300 lives and costs the state $2.25 billion in health care bills.

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News to Use in Fayetteville, Atlanta, Savannah, Peachtree City and all of Georgia

Slightly Lower Adult Smoking Rates

Fewer U.S. adults smoke, but cigarette smoking continues to impose substantial health and financial costs on society, according to new data from CDC.

An estimated 19.8 percent of U.S. adults (43.4 million people), were current smokers in 2007, down from 20.8 percent in 2006, according to a study in CDC′s Morbidity and Mortality Weekly Report, released in advance of the Great American Smokeout. However, based on the current rate of decline, it is unlikely that the national health objective of reducing the prevalence of adult cigarette smoking to 12 percent or lower will be met by 2010.

Smoking causes at least 30 percent of all cancer deaths, including more than 80 percent of lung cancer deaths, and 80 percent of deaths from chronic obstructive pulmonary disease. Smoking is responsible for early cardiovascular disease and death. As a result, about half of all long-term smokers, particularly those who began smoking as teens, die prematurely, many in middle age.

“The good news, we continue to see fewer people smoking,” said Janet Collins, Ph.D., director of CDC′s National Center for Chronic Disease Prevention and Health Promotion. “The bad news is we need more people to quit. Quitting smoking is the most important step smokers can take to improve their health and protect the health of nonsmoking family members. Smokers should be aware that there are treatments and services available to help them quit now more than ever before. Smokers can more than double their likelihood of successfully quitting by using medications and telephone counseling.”

Another MMWR study released this week by CDC assessed the U.S. health consequences and productivity losses attributable to smoking.

National estimates of annual smoking deaths indicate that, during 2000–2004, cigarette smoking and exposure to secondhand smoke resulted in approximately 443,000 annual premature deaths, consistent with previous estimates.

In addition, during 2001–2004, average annual smoking-attributable health care expenditures were approximately $96 billion, compared to $75 billion in 1998. Accounting for direct health care expenditures and productivity losses ($97 billion), the total economic burden of smoking is approximately $193 billion per year.

November 20, 2008, marks the American Cancer Society′s 32nd Great American Smokeout. The event encourages smokers to quit for at least one day in the hope that this might help them to stop using tobacco permanently. The Smokeout also draws attention to the many proven ways to encourage people to stop smoking. These include making it more affordable for people to use medical treatments, establishing smoke-free environments in homes, workplaces and restaurants, increasing the price of cigarettes, and mass media campaigns to inform and help motivate tobacco users to quit.

“If we want to see far more people quit smoking, we need expanded access to stop smoking programs, continued progress in eliminating secondhand smoke exposure and ongoing investment in programs that work,” said Matthew McKenna, M.D., M.P.H., director, CDC′s Office on Smoking and Health. “If, starting in 2009, all states were to fully implement tobacco control programs at CDC-recommended levels of investment, an estimated five million fewer people in this country would smoke within five years, and hundreds of thousands of premature tobacco-related deaths would be prevented each year.”

Tobacco users who want help in quitting can call 1-800-QUIT-NOW (1-800-784-8669) (TTY 1-800-332-8615) for free telephone-based counseling anywhere in the United States or visit http://1800quitnow.cancer.gov for quitting assistance. Information about the Great American Smokeout is available at http://www.cancer.org/docroot/ped/ped_10_4.asp.

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New Report Estimates More than 2 million Cases of Tobacco-related Cancers Diagnosed in the United States During 1999-2004

About 2.4 million cases of tobacco-related cancers were diagnosed in the United States from 1999 to 2004, with lung and bronchial cancer accounting for almost half of these diagnoses, according to a study by the Centers for Disease Control and Prevention (CDC). In the most comprehensive assessment to date, the study marks the first time CDC has reported on all tobacco-related cancers for more than 90 percent of the population.

“The data in this report provides additional, strong evidence of the serious harm related to tobacco,” said Sherri Stewart, Ph.D., in CDC′s Division of Cancer Prevention and Control, who is lead author of the study. “We′ve long known tobacco was associated with lung and laryngeal cancer, but this study gives us even greater clarity. The rates for these two cancers were highest in areas with the highest prevalence of tobacco use.”

The Surgeon General has found tobacco use causes these cancers: lung and bronchial, laryngeal, oral cavity and pharyngeal, esophageal, stomach, pancreatic, kidney and renal pelvis, urinary bladder, cervical and acute myelogenous leukemia (AML).

Though tobacco is a major cause for all the cancers presented in this report, not all cases of cancer studied could be linked directly to tobacco use. Some of these cancers have several important risk factors such as infections or genetic factors that can operate in concert with, or independently, of tobacco. In addition, information on tobacco use was not available in these databases. Therefore, some cases of cancer included in this report may not be attributable to tobacco use.
Key Findings:

Age-adjusted rates are presented in parentheses where appropriate and are per 100,000 persons.

* The incidence of tobacco-related cancers was higher among black and non-Hispanic populations, and among men, which reflect patterns of tobacco use.
* Lung, laryngeal, and cervical cancer incidence rates were highest in the South, where the highest prevalence of smoking exists. Kentucky had the highest rates of lung cancer among men and women (133.2 and 75.5, respectively), the third highest rate of laryngeal cancers among men (9.7) and the highest rate of laryngeal cancer among women (2.6). Kentucky had the highest prevalence of current smoking (28.6 percent).
* States with the lowest smoking rates are in the West: Utah (10.4 percent), California (18.5 percent), and Montana (18.5 percent). Cancer incidence rates were consistently lowest in the West for all the cancers, with the exception of stomach cancer.
* In 2004, lung and bronchial cancer incidence rates were highest among men in the South (97.9) and lowest in the West (66.0); Among women, rates were similar in the South, Midwest, and Northeast regions (55.3–56.4) and were lowest in the West (48.1)
* In 2004, laryngeal cancer incidence rates were highest among men in the South (8.4) region of the United States and lowest in the West (4.8). Among women, rates were similar in the South, Midwest, and Northeast (1.6–1.7) and were lowest in the West (1.1).
* The high incidence rates of both lung and laryngeal cancer in the South are consistent with smoking patterns and reflect the strong association of these cancers with tobacco use.

The report also noted other cancers associated with tobacco use (pancreas, urinary bladder, esophagus, kidney, stomach, cervix, and AML) accounted for more than 1 million cases diagnosed.

“Tobacco use is the leading preventable cause of disease and premature death in the United States and the most prominent cause of cancer,” said Matthew McKenna, M.D., M.P.H., director, CDC′s Office on Smoking and Health. “The tobacco-use epidemic causes a third of the cancers in America. If proven strategies were fully implemented to decrease tobacco use, much of the suffering and death that cancer inflicts on families and communities could be prevented.”

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