Smoking kills over 480,000 Americans each year and costs the United States $300 billion a year in medical care, according to a study from the Center for Disease Control. Before 1998’s Master Settlement Agreement, these numbers were even higher.
The agreement is a deal between 46 states’ attorneys general and the five largest tobacco companies in America about the promotion and marketing of tobacco products. It made it illegal for tobacco companies to use cartoon characters or target teenagers in their advertising, and bans distribution of tobacco company branded merchandise.
Cheryl Healton, dean of New York University’s College of Global Public Health, spoke at Boston University School of Public Health on Wednesday about the lessons from the settlement and how they could be applied to other industries selling harmful products in the future.
The biggest propeller of change, Healton said, is action taken by states’ attorneys general.
“States’ attorneys general have an obligation to protect the American public from predatory marketing and harmful products,” Healton said in an interview with The Daily Free Press.
However, she said, there are reasons that attorneys general would not sue a company, including if the industry benefits their sector, or if there wasn’t enough proof to make a strong enough case against the industry.
“Without a real stick, there can be no carrot,” she said, “The industry is not in the business of just giving their money if they don’t have to.”
Part of the settlement states that if all states participate, annual recovery payments will increase from $5 billion in 2001 to $9 billion in 2018. The money from the settlement, Healton said, could be important for fueling local economies, including funding public education.
“Public education can play a far more important role in this circumstance that we find ourselves in — with respect to sugar sweetened beverages, opioids, and guns — then we probably have given it credit for,” she said.
Healton showed older tobacco commercials, which attendees collectively deemed concerning by raising their hands. Newer ads, which warn consumers about the dangers of using tobacco have significantly influenced consumers’ attitudes toward cigarettes, Healton said.
“Attitudes can move rapidly,” she said. “Unless they’re absolute core value hardened attitudes. And I think some of those do exist with respect to guns — I don’t think they exist with sugar sweetened beverages. I don’t think they exist for opioids.”
While it could prove difficult to change the sugar-sweetened beverage industry, Healton said, the opioid industry will be having its own settlement very soon. Recently, the opioid industry met for six days, and will meet again in March to further discuss regulations with a judge, Healton said.
“There are settlement talks beginning related to the 250 cases that have brought against the opioid industry,” Healton said. “We should get a letter in the right way into the hands of that judge.”
Sandro Galea, dean of BU’s School of Public Health, said he believes the opioid industry will be the next to enter a major settlement.
“I think it will be the pharmaceutical industry around opioids,” Galea said, in an interview with The Daily Free Press. “Hopefully [the companies will] offer restitution for lives lost.”
After her speech, Healton spoke with attendees directly, discussing the issue personally with a long line of guests eagerly waiting to speak with her.
Mary Crane, 61, Cambridge, was one of the few at the talk that wasn’t a health care professional but felt passionate about the cause, nonetheless.
“I’ve smoked my entire life,” she said, “I wanted the best for my children, so I stopped. It wasn’t until a decade later that I learned they were smoking. I can’t help but wonder what was worse for them — the ads or me.”
