When it comes to cigarettes, Stanford Law School professor Robert L. Rabin says “thank you for not smoking.”
In a talk at the Rudd Center for Food Policy and Obesity on Tuesday afternoon, Rabin — an expert on tobacco-regulation policy — discussed the relative success of governmental, legal and media-related policies in contributing to the decline over the past 40 years of the number of Americans who smoke. Rabin then suggested several methods for successful anti-smoking campaigns, based on his assessment, including instituting smoking bans in public places, raising the price of cigarettes and disseminating information to the public about the health risks connected to smoking.
Rudd Center members, including co-founder and director Kelly D. Brownell, said these initiatives could be adopted in efforts to reduce obesity.
“Food and tobacco are different in many ways, yet some of the same approaches that led to a major public health victory in the last 40 years … are worth considering in stopping the rising prevalence of obesity,” he wrote in an e-mail.
Rabin said there has been a dramatic drop-off in the number of American smokers since the 1960s — from 42 percent of the adult population in 1965 to 20 percent in 2005.
Despite these encouraging data, Rabin said, “the reduction in prevalence has tailed off” since 1992. Smoking, which is becoming increasingly concentrated among lower socioeconomic groups, is still accountable for over 430,000 premature deaths in the United States each year, he said.
Among the most successful factors in the reduction of smoking’s prevalence in the United States are informational initiatives by the government and media that warn about cigarette-related health risks, restrictions on smoking in public places and the workplace, and the excise tax on cigarettes.
But Rabin said other anti-smoking efforts — restrictions on cigarette ads, youth-access restrictions and tort litigation — have met with only limited success.
Because of restrictions on television and radio tobacco ads, he said, tobacco companies have relied on marketing ingenuity, responding with more print ads, billboards and point-of-purchase signage. Likewise, Rabin said, youth-access restrictions on cigarettes have not been highly effective because state and municipal leaders simply have more important tasks at hands.
“The enforcement vigor just isn’t there,” he said.
Rabin said tort litigation cannot be considered a strong contributor to the reduction of the smoking population because cases of individual and class-action suits in which citizens sought compensation for health risks associated with smoking have had only mixed success.
Based on his assessment of the efficacy of various anti-smoking agendas, Rabin suggested a “comprehensive approach” to the nation’s tobacco troubles. Although he said little more can be done to dissuade long-time, “hard-core” adult smokers from lighting up, he called on states to direct both anti-smoking ads and cigarette excise taxes toward youth smokers, who he said are generally more impressionable and sensitive to fluctuations in prices.
At the end of his talk, Rabin considered the parallels and divergences between obesity and tobacco use as public-health threats.
In drawing distinctions between the two, Rabin noted that, unlike smoking, obesity has no striking secondhand effects and thus public-space restrictions would not be applicable to the obesity epidemic. In addition, he said, while it is easy to attach an excise tax to cigarettes, there is no single product a tax on which would clearly help combat obesity. And, he said, a tax on fattening foods, for examplew, would have significant financial spill-over effects on the non-obese.
But Jennifer Pomeranz, the center’s director of legal initiatives, said some of Rabin’s anti-smoking strategies do translate into the realm of obesity prevention.
“Taxation, counter-advertising and the increased dissemination of information on the ill-health effects associated with tobacco use were essential to the success in reducing tobacco use in the U.S.,” she wrote in an e-mail. “We can take these ideas and apply them to the obesity/food policy field.”
Founded in 2005, the Rudd Center is a nonprofit research and public-policy organization dedicated to preventing obesity and limiting the social stigma surrounding weight.