September 11, 2006
By Michael Siegel
The Attorneys General of 41 states last week sent a letter to the major Hollywood film studios requesting that they show anti-smoking commercials before any of their movies that depict smoking. Included with the letter was a DVD containing three anti-smoking ads for the studios to use. These ads are from the American Legacy Foundation's "truth" anti-smoking campaign.
In attempting to document the effectiveness of these ads in reducing youth smoking rates, and thus provide a strong rationale for why the studios should show these ads, the Attorneys General cited research which they purported shows that the "truth" campaign substantially reduced rates of youth smoking in the United States:
"Legacy, created by the states' 1998 tobacco litigation Master Settlement Agreement, is a national public health foundation devoted to prevention and cessation of tobacco use. According to peer-reviewed research, 22% of the overall decline in youth smoking during 2000 to 2002 is directly attributable to Legacy's national smoking campaign, known as truth. The study found there were approximately 300,000 fewer youth smokers in 2002 as a result of the truth campaign."
The Rest of the Story
I think the Attorneys General are presenting a premature and unsubstantiated claim that the "truth" campaign explains 22% of the decline in youth smoking between 2000 and 2002. I don't for a second believe that the one study being cited, which didn't even measure the exposure of a single youth to the "truth" campaign, can credibly be used to conclude that the campaign reduced youth smoking and to quantify the size of the effect. Especially when the research itself actually showed that the campaign was not effective.
But that's not the rest of the story.
The rest of the story is that the Attorneys General are hiding an important piece of information that I think is essential to reveal in any credible presentation of the relevant facts: the study they refer to simply as being "peer-reviewed research," was actually paid for, conducted by, and co-authored by the American Legacy Foundation. This represents a substantial and significant conflict of interest that affects the interpretation of the research findings and conclusions and which therefore must be disclosed, not hidden.
How likely do you think it is that the Legacy Foundation would author a study showing that its "truth" campaign was not effective? Knowing the way in which the Foundation has gone about its business, I find it difficult to believe that is even in the realm of possibility. So yes - there is a huge bias inherent in this research study and it most likely is substantial enough to affect the conduct, interpretation, and reporting of the research.
And in fact, I view this bias as being every bit as important as when we anti-smokers insist that tobacco industry funding of research or of authors of research papers be disclosed and argue that this conflict severely biases and discredits the research.
By failing to disclose this conflict of interest, I think the Attorneys General are misleading the studio owners and the public. They are making it sound like the research concluding that the "truth" campaign has substantially reduced youth smoking was some sort of independent, peer-reviewed research, when in fact it was not independent at all: it was conducted by, paid for, and authored by the American Legacy Foundation.
Why is it so important that this information be hidden from the public? When you start seeing continuing efforts to hide information like this, I think it's time to suspect that there is some reason why it needs to be hidden.
And I think there is good reason why it does need to be hidden. This is not research which the Attorneys General nor Legacy apparently want to be subject to any scrutiny. Perhaps they realize that a study which finds no effect of the "truth" campaign at the highest levels of exposure does not bode well for supporting a conclusion that the campaign was effective. Perhaps they realize that if the "truth" comes out about the failure to disclose this conflict of interest, the bias inherent in the study, and the weak evidence upon which their sweeping conclusions are based, the wind will be sucked out of their sails.
Read
By Michael Siegel
The Attorneys General of 41 states last week sent a letter to the major Hollywood film studios requesting that they show anti-smoking commercials before any of their movies that depict smoking. Included with the letter was a DVD containing three anti-smoking ads for the studios to use. These ads are from the American Legacy Foundation's "truth" anti-smoking campaign.
In attempting to document the effectiveness of these ads in reducing youth smoking rates, and thus provide a strong rationale for why the studios should show these ads, the Attorneys General cited research which they purported shows that the "truth" campaign substantially reduced rates of youth smoking in the United States:
"Legacy, created by the states' 1998 tobacco litigation Master Settlement Agreement, is a national public health foundation devoted to prevention and cessation of tobacco use. According to peer-reviewed research, 22% of the overall decline in youth smoking during 2000 to 2002 is directly attributable to Legacy's national smoking campaign, known as truth. The study found there were approximately 300,000 fewer youth smokers in 2002 as a result of the truth campaign."
The Rest of the Story
I think the Attorneys General are presenting a premature and unsubstantiated claim that the "truth" campaign explains 22% of the decline in youth smoking between 2000 and 2002. I don't for a second believe that the one study being cited, which didn't even measure the exposure of a single youth to the "truth" campaign, can credibly be used to conclude that the campaign reduced youth smoking and to quantify the size of the effect. Especially when the research itself actually showed that the campaign was not effective.
But that's not the rest of the story.
The rest of the story is that the Attorneys General are hiding an important piece of information that I think is essential to reveal in any credible presentation of the relevant facts: the study they refer to simply as being "peer-reviewed research," was actually paid for, conducted by, and co-authored by the American Legacy Foundation. This represents a substantial and significant conflict of interest that affects the interpretation of the research findings and conclusions and which therefore must be disclosed, not hidden.
How likely do you think it is that the Legacy Foundation would author a study showing that its "truth" campaign was not effective? Knowing the way in which the Foundation has gone about its business, I find it difficult to believe that is even in the realm of possibility. So yes - there is a huge bias inherent in this research study and it most likely is substantial enough to affect the conduct, interpretation, and reporting of the research.
And in fact, I view this bias as being every bit as important as when we anti-smokers insist that tobacco industry funding of research or of authors of research papers be disclosed and argue that this conflict severely biases and discredits the research.
By failing to disclose this conflict of interest, I think the Attorneys General are misleading the studio owners and the public. They are making it sound like the research concluding that the "truth" campaign has substantially reduced youth smoking was some sort of independent, peer-reviewed research, when in fact it was not independent at all: it was conducted by, paid for, and authored by the American Legacy Foundation.
Why is it so important that this information be hidden from the public? When you start seeing continuing efforts to hide information like this, I think it's time to suspect that there is some reason why it needs to be hidden.
And I think there is good reason why it does need to be hidden. This is not research which the Attorneys General nor Legacy apparently want to be subject to any scrutiny. Perhaps they realize that a study which finds no effect of the "truth" campaign at the highest levels of exposure does not bode well for supporting a conclusion that the campaign was effective. Perhaps they realize that if the "truth" comes out about the failure to disclose this conflict of interest, the bias inherent in the study, and the weak evidence upon which their sweeping conclusions are based, the wind will be sucked out of their sails.
Read
Meeting Marks First Gathering Since Funding to Public Education and truth(R) Has Ended
September 27, 2004
State Attorneys General, Tobacco Manufacturers and Public Health Leaders Convene to Discuss Youth Smoking
State Attorneys General, Tobacco Manufacturers and Public Health Leaders Convene to Discuss Youth Smoking
The American Legacy Foundation joins other public health leaders today at a triennial conference with state attorneys general (AGs) and tobacco industry representatives in Burlington, Vt. The foundation is sharing preliminary results from its truth(R) campaign, one of several efforts that have contributed significantly to reducing youth smoking prevalence to its lowest level in 28 years.
Participants in this conference were parties to the Master Settlement
Agreement (MSA) between 46 state attorneys general and the major tobacco
companies. This is the first joint meeting of the AGs, industry and public
health advocates since a little-known sunset clause in the MSA took effect.
This clause states that if -- after an initial five-year period -- the market
share of the tobacco companies participating in the MSA drops below
99.05 percent, funding to the MSA's public education fund would cease.
Dr. Steve Schroeder is the American Legacy Foundation's Board Chair and Distinguished Professor of Health and Health Care, Division of General Internal Medicine, Department of Medicine, University of California at San Francisco, where he also heads the Smoking Cessation Leadership Center. "The bulk of the funding for the American Legacy Foundation expired after five years, because the funds depended on the four settling tobacco companies maintaining a share of the domestic cigarette market of at least 99.05 percent. In retrospect, that percentage was probably based on erroneous projections," he said.
"In April of last year, the American Legacy Foundation received what we believe is our last major payment pursuant to the MSA," said foundation President and CEO Dr. Cheryl Healton. "We are now on a financial glide path that could lead to the end of the only effective national media campaign aimed at preventing youth from smoking, the truth(R) campaign. This is extremely unfortunate since, in a typical year, the tobacco industry earns more than a billion dollars annually on the sale of its cigarettes to 8th to 12th graders in the U.S. alone."
This loss of funding comes at a time when youth smoking rates have declined, in part because of the American Legacy Foundation's truth(R) campaign. Smoking rates among high school students declined about 18 percent between 2000 and 2002 (the most recent year for which data has been collected). However, 4,000 young people a day smoke cigarettes for the first time, 2,000 will become regular smokers and one third of them will die of a tobacco related illness.
William Sorrell, attorney general of Vermont, said the nation's attorneys general have been working to save the truth(R) campaign, given its proven successes in reaching youth who typically would be open to starting smoking.
"The industry publicly claims to support youth tobacco prevention programs," Sorrell said. "Well, here's its opportunity to step up by continuing to fund truth(R). Forget about the MSA sunset provision."
The American Legacy Foundation(R), an organization borne of the MSA, is dedicated to building a world where young people reject tobacco and anyone can quit. Located in Washington, D.C., the foundation develops programs that address health effects of tobacco use through grants, technical assistance and training, youth activism, strategic partnerships, counter-marketing and grass roots marketing campaigns, public relations and outreach to populations disproportionately affected by the toll of tobacco. Legacy's national programs include Circle of FriendsTM, Great Start, a Priority Populations Initiative, Streetheory.org and truth(R). The foundation was created as a result of the November 1998 Master Settlement Agreement (MSA) reached between attorneys general from 46 states and the tobacco industry.
Participants in this conference were parties to the Master Settlement
Agreement (MSA) between 46 state attorneys general and the major tobacco
companies. This is the first joint meeting of the AGs, industry and public
health advocates since a little-known sunset clause in the MSA took effect.
This clause states that if -- after an initial five-year period -- the market
share of the tobacco companies participating in the MSA drops below
99.05 percent, funding to the MSA's public education fund would cease.
Dr. Steve Schroeder is the American Legacy Foundation's Board Chair and Distinguished Professor of Health and Health Care, Division of General Internal Medicine, Department of Medicine, University of California at San Francisco, where he also heads the Smoking Cessation Leadership Center. "The bulk of the funding for the American Legacy Foundation expired after five years, because the funds depended on the four settling tobacco companies maintaining a share of the domestic cigarette market of at least 99.05 percent. In retrospect, that percentage was probably based on erroneous projections," he said.
"In April of last year, the American Legacy Foundation received what we believe is our last major payment pursuant to the MSA," said foundation President and CEO Dr. Cheryl Healton. "We are now on a financial glide path that could lead to the end of the only effective national media campaign aimed at preventing youth from smoking, the truth(R) campaign. This is extremely unfortunate since, in a typical year, the tobacco industry earns more than a billion dollars annually on the sale of its cigarettes to 8th to 12th graders in the U.S. alone."
This loss of funding comes at a time when youth smoking rates have declined, in part because of the American Legacy Foundation's truth(R) campaign. Smoking rates among high school students declined about 18 percent between 2000 and 2002 (the most recent year for which data has been collected). However, 4,000 young people a day smoke cigarettes for the first time, 2,000 will become regular smokers and one third of them will die of a tobacco related illness.
William Sorrell, attorney general of Vermont, said the nation's attorneys general have been working to save the truth(R) campaign, given its proven successes in reaching youth who typically would be open to starting smoking.
"The industry publicly claims to support youth tobacco prevention programs," Sorrell said. "Well, here's its opportunity to step up by continuing to fund truth(R). Forget about the MSA sunset provision."
The American Legacy Foundation(R), an organization borne of the MSA, is dedicated to building a world where young people reject tobacco and anyone can quit. Located in Washington, D.C., the foundation develops programs that address health effects of tobacco use through grants, technical assistance and training, youth activism, strategic partnerships, counter-marketing and grass roots marketing campaigns, public relations and outreach to populations disproportionately affected by the toll of tobacco. Legacy's national programs include Circle of FriendsTM, Great Start, a Priority Populations Initiative, Streetheory.org and truth(R). The foundation was created as a result of the November 1998 Master Settlement Agreement (MSA) reached between attorneys general from 46 states and the tobacco industry.
ALF's Tobacco Money Contradictions. By Michael Siegel, M.D., MPH. I had thought this problem had been taken care of, but according to a press release put out by the American Legacy Foundation today and a quote from Attorney General Sorrell (who I believe is a Legacy Foundation Board member), the Legacy Foundation is apparently still seeking tobacco industry funding to continue its "truth" campaign.
Tobacco Coalition Crumbling. By Josephine Hearn. Public-health advocates, who have for years pressed for government regulation of cigarettes, are suddenly divided on whether a pending bill in Congress deserves their support. Read more.













