Public Health in Oregon - Join The Conversation

The tobacco control movement in Oregon and throughout the United Sates has achieved considerable success with significant declines in its tobacco use over the past ten years. 

However, a new Center for Disease Control (CDC) report, Tobacco Control State Highlights 2010, have provided a timely reminder that it is premature to declare victory in the fight against tobacco.  “Although the nation has not experienced substantial reductions in the national smoking rate over the past five years, this report shows that states know how to end the smoking epidemic,” said CDC Director Thomas R.  Frieden, M.D., M.P.H. “Smoke-free laws, hard-hitting ads, and higher cigarette prices are among our strongest weapons in this fight against tobacco use.  We must redouble efforts to bring down smoking rates, prevent suffering and premature death, and cut health care costs by reducing smoking.” 

Tobacco use continues to be the leading cause of preventable death in Oregon and is associated with a number of diseases including multiple cancers, diseases of respiratory and cardiovascular systems, and strokes.  Tobacco use accounts for over 6,900 Oregonian lives and costs the state more than $2 billion a year and still 16 percent of high school students continue to smoke.  This is coupled with the fact that tobacco use disproportionally harms populations that are vulnerable and disenfranchised such as Native Americans, African Americans, the mentally ill, and the young. 

The fact is that we have evidence that proves when we divest in tobacco prevention and education programs smoking rates go up.  Therefore, it is unwise, if not foolish, to invest private and public dollars into successful public health interventions only to see us return back from where we came.

My position as the Executive Director for the Tobacco-Free Coalition of Oregon is to advocate for tobacco control issues.  It makes my work more difficult with decreasing resources.  The tobacco companies have not stopped manufacturing, marketing, or selling tobacco products.  The tobacco companies are still making good money.  They have done what all good businesses do; they spotted a trend and diversified their business.  The trend is that people are smoking less because of the hard work done in public health to regulate tobacco use.  This is great! But now the big push is smokeless tobacco products, some of which were tested-marketed in Portland.  And all of sudden hookah bars have started sprouting up.

The tobacco companies have not divested in tobacco so why would public health. 

But my comments are not meant to be a value statement of which public health issue is more important.  I believe that tobacco use and the obesity epidemic are both extremely important issues.  Before being a tobacco control advocate I was an oral health advocate.  So if you really want to talk about a critical public health area that is not receiving funding let us not forget about our mouths.

I do not claim to have a solution for funding public health.  But I think that is very risky business when funding appears to bounce from one issue to another without an exit strategy that preserves the work and investment that has been put into an issue.  I wrote in an email yesterday that this topic reminds of junior high.  One day your the most popular kid in school and everyone wants to be your friend.  The next day no one wants to talk to you and you eat your lunch by yourself.

Like it or not, agree or disagree.  The truth is public health is a business.  And there will be competition amongst players in that sector.  These difficult economic times make competition stiffer as many organizations existence depends upon winning grants.  I have seen this in international develop work too.  We must keep reminding ourselves that we are on the same team with the same end goal to make Oregonians healthier.  If you think about it our true goal should be that we all work ourselves out of our jobs.

My main point is what is quoted in the initial posting. As we enter the political season when both a tobacco tax and a soda tax might be in play.  I am fearful that the competition between obesity and tobacco could be used by our opponents to hurt both efforts.  Now that would be a tradegy.

Brett Hamilton