Stubbing out a bad habit

Coming soon to an ashtray near you: a basil garden?

Using outdoor public cigarette bins as herb planters is one of many recycling ideas proposed in the wake of UC Irvine’s promise to be smoke-free as of Jan. 1, 2014.

Task forces across the University of California system worked last spring to come up with smoking restrictions that would help make campuses healthier and safer for all. The smoke-free initiative, kicked off by a request from then-UC President Mark Yudof, is part of a growing trend around the country; California State University, Fullerton went smoke-free Aug. 1.

UC Irvine’s task force chose to ban smoking but allow the use of smokeless tobacco products and e-cigarettes, which emit water vapor.

“If you’re writing a policy with the goal of protecting bystanders from secondhand smoke, it’s tough to justify regulating some of these alternative tobacco products,” says David Timberlake, an associate professor of public health and epidemiology who serves on the UC Irvine Smoke-Free Policy Task Force. He notes, however, that “the health impacts to users of so-called ‘harm-reduction products’ such as snuff, snus and electronic cigarettes are not well understood.”

One component of UC Irvine’s new policy is a menu of smoking cessation programs, and Timberlake – who studies the marketing of tobacco goods – says that Philip Morris, R.J. Reynolds and other companies have touted alternative tobacco products as a safer replacement for cigarettes. But his research shows that smokers don’t make that switch. Here, Timberlake discusses the evolution of tobacco promotion and regulation and how smokeless doesn’t necessarily mean harmless.

Q. How have tobacco companies altered their marketing strategies in recent years?

A. The biggest changes have come since the passage of the 2009 Tobacco Control Act, which gave the Food & Drug Administration control over the manufacture, distribution and marketing of tobacco products to protect the public health. So that’s when the flavored cigarettes that were attractive to teenagers were outlawed. Companies were also prohibited from handing out free cigarettes, forced to make warning labels more prominent, constrained in their use of such reduced-harm claims as “light” or “mild,” and barred from marketing at sports events. However, the real battle in the U.S. over tobacco control will continue to be fought at the state level, where excise taxes, smoking bans and marketing restrictions (not preempted by federal law) will be determined. Years before the 2009 act, the prohibition against smoking in indoor public places – which started as an occupational hazard issue and transitioned to a public health issue – had begun to denormalize smoking, which was tobacco executives’ No. 1 fear.

Q. How did tobacco companies react to smoking bans?

A. We began to see more advertising for smokeless tobacco products as an alternative – such as snus, which is a tobacco that you put in your mouth, but you don’t chew it like chewing tobacco, and you don’t have to spit. And the ads were appearing in new places – not just Field & Stream or other outdoorsy magazines, where you’d expect, but in magazines like Time, Newsweek, Vogue, even Latina. The idea was to appeal to a broader demographic of smokers. Given the ambiguity in the marketing messages, it’s difficult to test empirically whether items like Camel Snus are being promoted as true harm-reduction products or something to be used when smokers can’t smoke.

Q. And was there evidence that this marketing worked? Did people make the switch to these products?

A. In our research, we conducted a lot of focus groups with smokers who found these products unappealing. So while the tobacco companies are marketing them as an alternative to smoking, what’s likely happening is dual usage: People turn to these products when they can’t smoke and then go back to cigarettes when they can. These items aren’t inspiring smoking cessation. And let’s face it: Nicotine is very addictive, and these alternative products really pack a punch.

Q. What is the prevalence of smoking today?

A. There is good news. California has one of the lowest smoking rates in the U.S. at 11 percent of the population, second only to Utah. And in the last 10 years, there’s been significant tobacco-control legislation in Latin America, Europe and parts of Asia. You can’t smoke in Irish pubs anymore. Smoking is still very prevalent, though, in Eastern European countries – such as Russia and Ukraine –­ and in Southeast Asia. It remains to be seen how e-cigarettes will play into all this. They’re marketed as a safe nicotine delivery system, but there may be chemical toxins involved. It’s a hot research topic.