In This Issue                       January 2014




A Note From Robin - 50 Years Later, Tobacco Remains Our Mount Everestanotefromrobin


As we observed the 50th anniversary of the 1964 U.S. Surgeon General's Report on Smoking and Health, we had much to celebrate. In 1964, nearly 70 million people smoked. Today, about 43 million do. We know what works to drive rates down -- comprehensive programs that include prevention and cessation initiatives, such as bold anti-tobacco public education campaigns, as well as tobacco excise taxes and clean indoor air initiatives. What we need now to eliminate the tobacco epidemic once and for all is the will. 


Tobacco-related diseases remain the No. 1 preventable cause of death in our country, impacting millions of families, hurting our communities and robbing our bottom line by costing the nation billions in health care costs and lost productivity. It's the Mount Everest of public health missions. But the good news that it's not only possible but probable that we can reach the summit and solve this problem if we keep our eyes on this life-saving prize. The latest annual barometer of youth smoking prevalence - Monitoring the Future data from December 2013 - found that across 8th, 10th and 12th graders, smoking has declined to just below 10 percent. We may be at a tipping point now, and like climbing Everest, this major public health victory is well within our grasp.


Imagine with me what our world might look like once we turn that corner once and for all. Over time, 440,000 people each year could live instead of die from tobacco-related disease. That's more than half the population of San Francisco!


In this new world, we'll be on our way to reducing the nearly $97 billion loss in annual productivity costs due to smoking. We'd eventually save $193 billion in annual smoking-attributable costs. Tobacco product manufacturing facilities would no longer release the estimated 902,000 pounds of toxic chemicals that are currently released into our environment every year. And the most-littered item in the U.S. -- cigarette butts -- would slowly disappear, saving our communities from costly clean-ups and the risk of toxins leaching into the soil and water would no longer threaten our wildlife.


Our children and pets would be free of exposure to deadly secondhand smoke, and eventually, the incidence of our No. 1 cancer killer -- lung cancer -- would plummet and lung cancer would once again become the rare disease it was before the modern cigarette era.


In a tobacco-free world, our lives would be longer, our air cleaner, our bodies healthier. Our economy and collective public health would benefit dramatically. Let's resolve to make this happen. To work toward "Generation Free", the first smoke-free population in history. We don't have to wait another 50 years -- because where there's a will, there's always a way.



Robin Koval

President and CEO, Legacy 





Joining Forces: Legacy and Partners Commemorate the 50th Anniversary of the First Surgeon General's Report with Bold GoalsSI


The first Surgeon General's Report on Smoking and Health, issued on January 11, 1964, was a historic turning point in the nation's fight against tobacco use. Since its publication, the United States has cut smoking rates by more than half (from 42.4 percent in 1965 to 18 percent today) and per capita consumption of cigarettes has decreased by more than 70 percent. Reductions in smoking have saved millions of lives and are responsible for 30 percent of the increase in the life expectancy of Americans since 1964. However, the battle is far from over. Tobacco-related disease is still the number one cause of preventable death in the United States.  Smoking kills more than 440,000 Americans each year, sickens millions more and costs the nation $193 billion annually in health care expenditures and lost productivity.


On the 50th anniversary of the first Surgeon General's Report on Smoking and Health, Legacy joined six other leading public health organizations in restating a shared commitment to end the tobacco battle for good. During a news conference from the National Press Club in Washington on January 8th, the organizations collectively called for bold action by all levels of government to achieve three goals:

  • Reduce smoking rates, currently at about 18 percent, to less than 10 percent within 10 years
  • Protect all Americans from secondhand smoke within five years, and
  • Ultimately eliminate the death and disease caused by tobacco use.
Proven strategies to tackle these goals include tobacco tax increases, comprehensive smoke-free workplace laws, hard-hitting mass media campaigns, and well-funded, sustained programs to prevent kids from smoking and help smokers quit. Read the joint press statement that challenges the nation to cut smoking rates to under 10 Percent in 10 Years and protect all Americans from secondhand smoke within 5 years.


To see more Legacy resources commemorating the 50th Anniversary of the Surgeon General's landmark 1964 report, visit here.




The Surgeon General Behind the Report - Get to Know Luther Terry Through His Youngest Son, Michael TerryBKChu


As we commemorate the 50th Anniversary of the first Surgeon General's Report on Smoking and Health, it's important to look back and reflect on the report's origin, and the key role Surgeon General Luther Terry (1961 - 1965) played in handling the relationship between tobacco use and cancer. Surgeon General Luther Terry was born in 1911 in Red Level, Alabama. The son of the town doctor, his earliest memories include driving his father out to the country to visit various patients. Terry himself received his MD in 1935, and then in 1961, rose to prominence as Surgeon General of the Public Health Service, where he began his seminal work on the link between smoking and cancer. The report led to some significant tobacco control efforts, which include the Surgeon General's warning on tobacco products, banning smoking in the work place, and regulating tobacco advertising.  Even after leaving the Surgeon General post, he continued to work on the issue of tobacco awareness and control. He passed away in 1985 at the age of 73 from heart failure. The video below is an interview with Dr. Terry's youngest son, Michael Terry, who provides personal insights on his brilliant and ethical father, Surgeon General Luther Terry


The Ripple Effect - Michael D. Terry, Son of U.S. Surgeon General Luther L. Terry
The Ripple Effect - Michael D. Terry, Son of U.S. Surgeon General Luther L. Terry

Surgeon General Luther Terry's legacy is closely tied with the uniformed service he led. In addition to sparking the tobacco control movement, Surgeon General Terry's report demonstrated the continued excellence of the Public Health Service in playing a positive role in promoting a healthy America.  Fifty years after the report's release, while we have achieved much in the tobacco battle, there is still work to be done. About 19 percent of Americans smoke and about 443,000 people die each year in the United States alone from smoking-related causes. Yet there is hope, through the collective work of governments, nonprofits, public health leaders and private enterprises, in continuing to work toward bold goals, and reigniting the torch to achieve a smoke-free generation. "What would Luther Terry think?" reflected Michael Terry at the Washington news conference commemorating the 50 year anniversary.  "He'd say 'I'm disappointed, but this represents a springboard and a terrific opportunity for us to circle the wagons, gather the troops, and move forward and finally get to the American people, and let them know what a terrible matter this is for disability, disease, and death.'"




Statement from Legacy: Electronic Cigarettes Require FDA Regulation  BobGordon


As 2014 marks the 50th anniversary of the historic 1964 US Surgeon General's Report on Smoking and Health, the use of electronic cigarettes (e-cigarettes) is on the rise in the United States.  With the e-cigarette industry projected to reach more than $2 billion in 2014, more than 20 percent of adult smokers have tried these products and research from the Centers for Disease Control and Prevention shows that the percentage of U.S. middle and high school students who had ever used e-cigarettes more than doubled from 2011 to 2012.  


Against this background, this month Legacy released its policy position on e-cigarettes. In the paper, the organizations cites the need for regulation by the US Food and Drug Administration (FDA) as soon as possible - to both minimize the public health harms and maximize the public health benefits of these products. Our position also seeks to balance two emerging scenarios:

  • E-cigarettes may show promise as a significant avenue to help decrease the death and disease caused primarily from burning tobacco by helping some smokers quit cigarettes. In addition, these products may encourage smokers to migrate solely to this potentially less-harmful alternative to smoking conventional cigarettes.
  • The use of conventional cigarettes in addition to e-cigarettes, also known as dual use, may not reduce harm. E-cigarettes have the potential to attract youth to start using tobacco and serve as an alternative for current cigarette smokers to use in public places where combustible tobacco is restricted. They also provide opportunities to skirt interventions proven successful at helping people quit smoking.

In addition, Dr. David Abrams, Director of the Schroeder Institute of Tobacco Research and Policy at Legacy, outlines some additional possibilities for policies related to e-cigarettes in an opinion piece he published recently in the Journal of the American Medical Association.


Read the full statement here.




Four Young Activists Tackle Tobacco to Build Healthier Communitiestruth


Youth involvement plays a key role in the overall success of the tobacco control movement in the United States. Nearly 50 years ago, the first Surgeon General's Report on Smoking and Health set the foundation for the youth tobacco control movement which continues to evolve. Youth engagement in this issue defies a traditional label; it may be driven by unique perspectives, including the passion to fight for social justice and to account for personal losses from tobacco-related illnesses. 


The tobacco epidemic is a youth epidemic, with more than 80 percent of adult smokers trying their first cigarettes by 18. Given this fact, youth leaders can play a vital role in engaging adolescents and young adults in changing social norms surrounding this deadly addiction. 


To that end, each year, Legacy selects a group of young people to represent the organization as a part of its Youth Activism Fellowship (YAF) program. Over the course of the 18-month program, these young adults develop innovative and effective initiatives that communicate the harmful effects of tobacco use and promote systems of change in cities across the nation. Isra Ahmad, Vincent Irving, Brittany Russell and Talyah Sands hail from different backgrounds and different areas of the country, but they share a singular passion.

To learn more about the Fellows, their personal connections to the issue and the YAF program, click




New Study Reveals Advertising Tactics of Emerging Tobacco Productsrefugees


Recent research on tobacco advertising has generally focused on point-of-sale (POS) and retail displays, rather than other mediums such as magazines and direct mail. A new study reveals some of the advertising tactics being used by tobacco and e-cigarette companies to market "emerging" products, such as e-cigarettes, snus, dissolvables, and chew. The study published December 30 in the Nicotine and Tobacco Research Journal by Legacy is the first to address that scholarship gap by conducting surveillance of and examining non-point of sale advertising of noncombustible tobacco products (NCPs). 


Two advertising firms were used to systematically collect all U.S. advertisements for NCPs during a three-month period in 2012. A total of 231 unique consumer-targeted ads for NCPs were identified during this time period. Some key findings include:

  • In total, roughly $20 million was spent advertising NCPs in the U.S. between June 1 and September 1, 2012.
  • The largest portion of these advertising dollars was spent on direct mail ads -- primarily for smokeless products. This advertising channel is estimated to reach more than 25 million households. Approximately 90% of the mailings including promotional offers or price discounts.
  • The greatest spend was on snus advertising - more than $9.6 million. Camel Snus was the most heavily advertised product among this group. Direct mail, most of which included promotional coupons, was the primary advertising channel for snus-related promotions.  

Since there are no regulations specifically addressing the advertising of e-cigarettes, researchers say advertising of NCPs could potentially reach millions of consumers, many of whom may be largely unfamiliar with the products advertised. To learn more about the study as well as advertising tactics by tobacco companies, click here





Apply Now: Participate in Tobacco Policy Development Through the FDA's Tobacco Regulatory Science FellowshipAlma


The Food and Drug Administration (FDA) is currently accepting applications for its Tobacco Regulatory Science Fellowship. The 12-month, multidisciplinary, residential program is conducted in conjunction with the FDA's Center for Tobacco Products (CTP) and the Institute of Medicine (IOM).  Six fellows will be chosen this year and  placed in one of six offices within the CTP: Compliance and Enforcement; Health Communication and Education; Management; Policy; Regulations; or Science.


This Fellowship provides mid-career health care and public health professionals, with the opportunity to participate in the development of science-based public health opportunities, meet with policy leaders, gain knowledge and experience, and develop skills related to the control and regulation of tobacco products. The deadline to send in applications is March 3, 2014. Click here to learn more about the Fellowship, eligibility and to apply. 




Winning Battles in the Tobacco War - Rates of New Lung Cancer Cases Falls in the U.S. acer


A recent  Morbidity and Mortality Weekly Report published by the Centers for Disease Control and Prevention (CDC) finds that rates of new lung cancer cases overall dropped from 2005 to 2009  in the United States. A major contributor to this drop is effective tobacco control and prevention programs that are keeping people from using tobacco. Most lung cancers are attributable to cigarette smoking and the disease is the leading cause of cancer death. Other findings from the report include:

  • Lung cancer incidences decreased more rapidly among men than women
  • Lung cancer incidences decreased more rapidly among adults aged 35-44 years compared to other age groups
  • Among adults aged 35-44, men had lower rates of lung cancer than women  
The report concludes that further efforts in tobacco control conducted at local, state and national levels will help further reduce rates of tobacco use in order to reduce rates of lung cancer. As we observe the 50th Anniversary of the first
Surgeon General's Report on Smoking and Health, which provided life-saving evidence that linked smoking and lung cancer, we continue the battle to fight for increased regulation of tobacco products, effective youth education programs, greater access to cessation services and more, to create a foreseeable smoke-free generation.





January 27 - February 2: National Drug Facts WeekSmile


While this year's Monitoring the Future report showed a  decline in teen smoking rates in 2013, the rates of e-cigarette and hookah use is on the rise according to the November 14 Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention. About one-third of high school seniors report using an illicit drug in the past year. The use of tobacco among high school aged teenagers is still a cause for concern, as many teenagers in this age group are not aware of the risks they take and the dangers they pose to their bodies when using these substances.


National Drug Facts week is an event launched by the National Institute on Drug Abuse, which is part of the National Institutes of Health. It was launched in 2010 with the aim of informing teenagers of the dangers that substances like tobacco, alcohol and other drugs can have on their bodies and lives. A host of events is held at various high schools around the country to present information and counteract myths on illicit drugs. Resources include access to scientists that students and teachers may talk to and obtain facts, a National Drug Facts IQ challenge, and a host of events that include students collectively making artwork and playing community-building games. To learn more about National Drug Facts Week, visit their website.




2014 Brings Resolutions to QuitQuit


A new survey conducted for Legacy found that 56 percent of adult smokers polled were preparing to quit in the New Year to improve their health. This new data, released as the nation marks the 50th anniversary of the landmark 1964 U.S. Surgeon General's Report on Smoking and Health, also found that: 

  • 41% of adult smokers surveyed planned to quit smoking "cold turkey" for New Years - a method that is largely ineffective for the majority of smokers.
  • 12% of them planned to switch to electronic cigarettes, a product yet to be regulated by the U.S. Food and Drug Administration and whose safety risks remain unknown.
  • 37% of the adult smokers surveyed plan to quit to save money and
  • 31.7% want to quit because they don't want their clothes and hair to smell. 

Smoking is a powerful addiction that is extremely difficult to overcome. The nicotine in cigarettes changes the chemistry of a smoker's brain, creating physical dependence. Coupled with the behavioral and social aspects of smoking, it can seem next to impossible for a smoker to quit smoking. By building a quit plan, smokers can address the physical, behavioral, and emotional aspects of addiction and work toward re-learning life without cigarettes.


Quitting smoking takes preparation, tenacity and support. For those who need help quitting, the Legacy BecomeAnEX program offers free personalized quit plans, resources, information, and tools designed with input from former and current smokers. The site also hosts a thriving online community, where smokers (like Cindy) have quit by connecting with others. Watch Cindy share support and encouragement to help not only herself quit, but also help other smokers stay quit.








The First Surgeon General's Report on Smoking and Health Turns 50!


U.S. Tobacco Control Laws Have Saved 8 Million Lives in 50 Years


U.S. Smoking Warning Made History, Saved Lives


A $5,000 Scholarship to Help Students Breathe a Little Easier: Legacy's Alma S. Adams Award is Accepting Nominations


Deadline Approaching: Nominations for the Benjamin K. Chu Awards Will Be Accepted Till the 7th of February


Legacy Helps LGBTs Quit Smoking


Podcast: Clearing the Air with Cynthia Hallett


AAP Webinar - Beyond Four Walls: Smoke-Free Places with Gary Wheeler and Cynthia Hallett

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                Legacy is dedicated to building a world where young people reject tobacco and anyone can quit. 
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