Tobacco and Obesity Prevention: Now competing for limited funding?

Tobacco and Obesity Prevention: Now competing for limited funding?

Robert Wood Johnson Funding Trends: Less tobacco, more obesity (NY Times)

In a recent New England Journal of Medicine editorial, Steven A. Schroeder, M.D., and Kenneth E. Warner, Ph.D.write that, at a time when health funding sources are focusing efforts and dollars on obesity prevention, smoking remains by far the most common cause of preventable death and disability in the U.S.

“It is tempting,” they say “to believe that the battle is largely won and that we should move on to other pressing public health issues. But the prevalence of smoking in the United States hovers at 20%, more than 8 million people are sick or disabled as a result of tobacco use, and smoking kills
450,000 Americans annually.”

However, Ken Thorpe, professor of health policy at Emory University, says obesity rates have doubled since 1985, and health problems related to obesity account for more than 30 percent of the increase in health care spending: “The smoking rate has been coming down - moving in the right direction. Obesity is moving in the wrong direction.”

Now the New York Times writes that the “steep drop-off in private funds” addressing tobacco control “illustrates the competition under way for money as public health priorities shift. In the race for preventive health care dollars, from charities and from federal and state government sources, the tobacco warriors have become a big loser.”

As Brett Hamilton, Executive Director, of the Tobacco-Free Coalition of Oregon, writes, “I continue talk about the importance of coordinating our public health messaging especially 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.”

What do you make of all this?

Is tobacco control becoming under-funded because obesity prevention is the new sexy trend?

Do you agree with Dr. Thorpe, whom the New York Times says, defends the shifting resources?

Or do you agree with Dr. Howard K. Koh, assistant secretary for health, who says that “Rather than pitting one disease against another, we want to uphold comprehensive prevention policies.”

Or is that an unrealistic supposition?



12 Comments:

Posted by Jake on May 16th, 2013 at 03:30 AM

Thank you for this interesting article.I think smoking it is quite a nasty vice and very expensive and I recommend to all of you to quit smoking if you want so have a healthy life and save some money.I’ve heard a lot of myths with electronic cigarettes but I don’t think this is also a good idea because they are not as healthy as they say because the cartridges contains anti freeze liquid.

Posted by Martin on May 11th, 2013 at 08:20 AM

Meanwhile cigarettes and alcohol make a lot of money from excise duties and taxes. The best is to use white cloud e cig and thus you cut this “vicious circle”.

Posted by Jack on April 16th, 2013 at 09:38 PM

Thank you for providing this interesting and useful article.A lot o people are caught complaining that they can’t quit smoking and they tried every possible method but my personal opinion is that with the power of will you can do it.

Posted by Deny on April 13th, 2013 at 04:30 AM

Interesting article. I was there when a teenager with obesity have some medical problems, pretty heavy. But, fortunately, the doctors had some emergency items and they did their job well.

Posted by Dudu on March 25th, 2013 at 09:32 AM

Thank you for providing us this article. I’m sorry, because are less persons who really want this kind of caring people careers. Today all want money and to be famous, but they forget about helping each other.

Posted by Iulli on March 25th, 2013 at 09:27 AM

I’ve heard that 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. Medical services manager job is used to qualify the doctors.

Posted by priyankade on January 31st, 2013 at 01:17 AM

If we will manage to prevent the obesity we could prevent a lot of diseases. I have a public health career and I know how important is prevention on healthcare. We should start teaching our children how to have a healthy lifestyle.

Posted by prabir on January 31st, 2013 at 01:16 AM

If we will manage to prevent the obesity we could prevent a lot of dieases. I have a public health career and I know how important is prevention on healthcare. We should start teaching our children how to have a healthy lifestyle.

Posted by kartick on January 30th, 2013 at 11:24 PM

Thanks.

10  Posted by nic on January 26th, 2013 at 12:49 AM

If we will manage to prevent the obesity we could prevent a lot of dieases. I have a public health career and I know how important is prevention on healthcare. We should start teaching our children how to have a healthy lifestyle.

11  Posted by George Gana on January 9th, 2013 at 10:20 AM

I enjoyed a lot reading this post and I consider it to be very interesting.I’ve recently talked with
John Studzinski who is a great financial analyst and he told me that these campaigns against drug addiction and alcohol are sometimes negative as there are people who feel encouraged to take alcohol and drugs.

12  Posted by Brett Hamilton on July 29th, 2010 at 04:22 PM

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




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