In This Issue                       August 2013

• Message from the President
• Public Health Groups and Attorneys General Ask Major Studio to Keep Smoking, Brands Out of "Rush" Movie Trailers
• CT Scans Finally Proposed for Those at Highest Risk for Lung Cancer
• New Research: CT Scans are Cost-Effective
• Little Cigars and Cigarillos Readily Advertised and Cheaply Available for Black Neighborhoods in Washington, D.C.
• Ugly truth® Extends Into Digital and Entertainment World
• New Study: Secondhand Smoke Exposure in Casinos is a Gamble with Life or Death Consequences
• Legacy Awards Scholarships to Students Working for Longer, Healthier Lives Free of Tobacco
• Support Legacy through the Combined Federal Campaign

Message from the President

At Legacy, improving public health is our passion. We have long maintained that a legacy is not something you leave behind when you die, but something you build every day you live. Whether through our annual summer tour with our truth youth smoking prevention campaign, our exciting Warner Series line-up of esteemed experts, or our efforts to continue to raise awareness of the toll tobacco use takes on our nation, we continue our commitment and resolve during these dog days of summer to save lives from the number-one cause of preventable death.

In recent weeks, we've seen important activity on research findings and policy changes around lung cancer detection. Lung cancer is the number-one cancer killer for both men and women in the United States. While there is no current treatment to cure late-stage lung cancer, screening with low-dose computed tomography ("CT scans") is the only method that has been validated as a way to reduce lung cancer deaths through early detection. This Ripple Effect newsletter details new research and policy about CT scans and how they can save lives, and save money.

Lastly, as we enter the beginning of a new fiscal year, we also invite you to read our 2012 Annual Progress Report, Charged for Life. This report details the important work we've done over the past year, chronicling our accomplishments and sharing lessons learned. Our work would not be possible without your support, collaboration and shared commitment. Thank you for helping us build this great legacy and for continuing to fight "the good fight," alongside us.

Cheryl G. Healton, DrPH
President and CEO, Legacy
 

Public Health Groups and State Attorneys General Ask Major Movie Studio to Keep Smoking, Brands Out of "Rush" Trailers

Today, public health groups have joined state Attorneys General offices to call out the depiction of tobacco brand imagery and smoking in promotions for the movie Rush -coming out in September - citing its potential impact to tobacco use among youth. In a letter to Comcast Corporation (parent company of Universal Pictures), the groups ask the company to take proactive steps minimize young people's exposure to brand imagery and actors smoking readily visible to youth in the film's promotions.

Rush hits theaters next month and is based on a historic rivalry between two race car drivers competing for the 1976 Formula One racing championship.  However, promotions for the movie are available through different mediums, including movie trailers on television, YouTube, the official website and in theaters containing images of smoking as well as the Marlboro brand name.

In the letter, the groups and Attorneys General ask Comcast to take responsible action to minimize youth exposure to smoking and brand appearances in its movie, including: 

1. Refraining from depicting smoking in the film's trailers on the Rush web site and in any other promotional materials.
2. Refraining from including Marlboro imagery in the film's trailers on the Rush web site and in any other promotional materials.
3. Including an anti-smoking PSA before the movie in all venues, formats and forms of distribution.
4. Certifying that nobody associated with the film received anything of value or entered into any agreement in connection with the depiction of tobacco products or brands.

For more details and a complete list of signatories, read the full press release here.

Annual CT Scans Finally Proposed for Those at Highest Risk of a Lung Cancer Diagnosis

New Research Further Supports Cost-Effectiveness of Lung Cancer Screenings Among High-Risk Populations

A new study published in PLOS ONE from Legacy and the Lung Cancer Alliance validates that lung cancer screening is cost-effective to commercial payers who insure adults in the U.S. workforce.  Study findings determined that CT scans for lung cancer are highly cost-effective in a commercially insured population of adults aged 50-64 at high risk for lung cancer. The research was led by Bruce Pyenson at Milliman - an actuarial consulting firm - and researchers at Legacy's Schroeder Institute for Tobacco Research and Policy Studies.

"A Cost-Utility Analysis of Lung Cancer Screening and the Additional Benefits of Incorporating Smoking Cessation Interventions" builds on the landmark findings from the National Lung Screening Trial, showing a 20 percent reduction in lung cancer mortality among high risk adults receiving CT scans rather than chest X-rays for lung cancer. Offering smoking cessation interventions with the annual screening program further improved the cost-effectiveness of lung cancer screenings by 20-45 percent. 

The study examined repeated CT scans over a period of 15 years in a high-risk, hypothetical cohort of 18 million adults between the ages of 50 and 64, each with a 30+ pack-years of smoking history. The expected cost of screening and diagnosis was $0.76 per-member-per-month.   

• When compared to the same hypothetical cohort with no screenings, the results found that the screenings were highly cost-effective, saving nearly one million quality-adjusted life years (QALYs) and costing commercial insurers $27.8 billion over 15 years for screening, diagnosis and treatment, for a cost-utility ratio of $28,240 per QALY gained.
• Adding smoking cessation to these annual screenings increased the cost of the program while also increasing the QALYs gained in this high risk population.
• These benefits resulted in more favorable cost-utility ratios ranging from $16,198 to $23,185 per QALY gained for CT scans and smoking cessation interventions combined.

The study can be found online.
 

New Study: Little Cigars and Cigarillos Readily Advertised and Cheaply Available for Black Neighborhoods in the Nation's Capitol

For years, the public health community has been monitoring the rise in consumption and use of little cigars and cigarillos, especially among minority youth. This month, Legacy researchers published new research in the American Journal of Public Health showing that little cigars and cigarillos are more available, cheaper and highly advertised in African American neighborhoods in Washington, D.C.

It is the first study to examine the relationship between marketing and price of little cigars and cigarillos in the retail environment and across specific neighborhood demographics. Between September 2011 and March 2012, trained fieldworkers visited every retail outlet designated as licensed to sell tobacco in 2011 by the Department of Health of Washington, DC. In order to discreetly collect the information in the point-of-sale environment, they used phone-based interactive voice recording, photo, and web capabilities to capture data on the retail environment.

Legacy researchers said that the high availability and lower prices of LCCs in young adult and African American communities, in conjunction with a greater amount of outdoor advertising may establish environmental triggers to smoke among groups susceptible to initiation, addiction, and the long-term negative health consequences of tobacco use.
For more details about the study and LCC's, click here. 
 

truth Gets "Uglier" with New Opportunities in the Digital and Entertainment World

New Study: Secondhand Smoke Exposure in Casinos is a Gamble with Life or Death Consequences

Today, only 19 states and Puerto Rico have laws making all state-regulated gambling establishments smoke-free. Since many casinos are still exempted from legislation mandating smoke-free environments, employees and patrons are at risk for the acute effects of secondhand smoke exposure.

A new study published this month in Circulation, a journal of the American Heart Association, takes a deeper look at the implementation of smoke-free laws in casinos and its impact on reported medical emergencies. Researchers from the University of California, San Francisco, found strong evidence suggesting that the sheer volume of secondhand smoke that people are exposed to in casinos has an immediate and harmful impact on patrons. 

Led by Dr. Stan Glantz, Professor of Medicine, researchers compared the number of medical emergencies before and after casinos implemented smoke-free regulations that were meant to protect people from the detrimental effects of secondhand smoke. They found a significant decrease in medical emergencies once those laws were implemented. 

For more details from the study and results, read more from the release here.

Legacy Awards Scholarships to Students Working for Longer, Healthier Lives Free of Tobacco

For several years, Legacy has awarded scholarships to students around the country who show a commitment and creative responses to fighting the number-one cause of preventable death: tobacco use. The Alma S. Adams Scholarship for Outreach and Health Communications to Reduce Tobacco Use Among Priority Populations is especially important because it not only nurtures the impact that young people can have on tobacco control, but also promotes life-saving work among groups that are disproportionately affected by tobacco. This year's winners earned honors for creatively championing these issues at the local level:

Bserat Ghebremicael, from Las Vegas, NV, is entering her first year at Georgetown University as a Human Science major. With a passion for public and global health, Ghebremicael informed and educated her local community about tobacco use and its consequences, in addition to working on passing bills prohibiting tobacco use in surrounding areas.

Jacob James Fitisemanu, Jr. of Salt Lake City, UT, is entering his second year of graduate school at Westminster College, working towarda Master's Degree in Public Health. Since 2006, he has served as a Steering Committee Member for the Utah Pacific Islander Tobacco Network, helping to develop and implement tobacco-related studies, resources, and programming for Pacific Islanders and youth.

Honorable Mention awards were given to Kaylea H.K. Chase, an entering freshman at Dakota State University, and Roni Jacobson, a Science, Health, and Environmental Reporting graduate student at New York University.

More details about the award and its recipients can be found online. 

Support Legacy through the Combined Federal Campaign

Legacy is proud to be a national charity in the Combined Federal Campaign (CFC). The CFC, which kicks off September 3 and runs through December 15, is the largest workplace charity campaign, raising funds for charity through the generous support of Federal civilian, postal and military donors.

If you are a Federal employee, in the military, or work for the U.S. Postal Service, please support Legacy's work as generously as you can with your donation. When the CFC comes to your workplace this fall, look for Legacy's listing among the national/international independent agencies under charity number 19203 (American Legacy Foundation). Every cent goes towards our mission to help Americans live longer, healthier lives.

TOP LINKS

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Watch the archived Warner Series on Tobacco Health Equity

Nominate a Colleague for the Legacy Community Leadership Award

CDC's Office on Smoking or Health is Recruiting Individuals for 2014 National Tobacco Education Campaign

Conference Opportunity: "Beyond the 5 A's: Improving Cessation Interventions through Strengthened Training"

Read Legacy's 2012 Annual Progress Report, Charged for Life