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Argentina: ''Non- Smokers' Dictatorship'' USA: Make Health Insurance Include Cessation Help, Says Poll

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Argentina: ''Non- Smokers' Dictatorship'' USA: Make Health Insurance Include Cessation Help, Says Poll 6 News analysis....................................................................................... Tob Control: first published as on 25 February 2004. Downloaded from socioeconomic classes—professionals, challenges the bans on smoking in Argentina: ‘‘non- government officials, and students— closed environments. and sells approximately 10 000 copies However, the Veintitre´s article’s com- smokers’ dictatorship’’ each week. It is advertised on television. parison of the smoke-free movement On 2 October last year, just five days A well known journalist and former with the Nazis is a classic example of the after Argentina signed the Framework director of the magazine, one of the favourite tobacco industry strategy of Convention on Tobacco Control (FCTC), people whose views against tobacco con- trying to position those who work for the magazine Veintitre´s (‘‘Twenty-three’’) trol were quoted in the article, also smoke-free environments as members published a note on smoke-free envir- conducts a popular political news of an extremist movement. Tobacco onments. The main story of the maga- programme on television together with control activists around the world zine was illustrated on the front cover some of the staff of Veintitre´s. During should be aware of this strategy, and using the swastika under the title ‘‘The the show, and most unusually for be prepared to respond with the appro- non-smokers’ dictatorship’’. television, he smokes frequently—he priate arguments. Smoke-free environments are close to obtained a privileged contract to be the JAVIER SAIMOVICI becoming a reality for Argentineans, not only person allowed to smoke on the Unio´n Anti-Taba´quica Argentina, ‘‘UATA’’, only as a result of the signing of the studio set. Just as Veintitre´s is promoted FCTC but also because of strong advo- Buenos Aires, Argentina; on television, the television programme [email protected] cacy from the anti-tobacco movement itself is advertised in Veintitre´s. The and the government’s support for strong show’s large audience (about one JOAQUIN BARNOYA legislation. The story focused on the million) includes many young people. Center for Tobacco Control Research and alleged persecution that smokers endure The author of the Veintitre´s article Education, University of California, San from the ‘‘crusaders’’ for tobacco con- smokes, but no relationship has been Francisco, USA; [email protected] trol, especially the prohibition to smoke found between her or the magazine and in closed environments. In addition, it the tobacco industry, except one tobacco included the opinion of well known advertisement in each of two issues in USA: make health individuals in Argentina, some arguing the past few months. In issues following insurance include http://tobaccocontrol.bmj.com/ for and some against tobacco control. publication of the article, the editor The story also provided examples of the published some helpful letters from the cessation help, says alleged importance of tobacco in the public, sent in response to the pro- history of show business and politics. tobacco position of the original article. poll Examples included Winston Churchill Perhaps the original motivation of the Many tobacco control advocates around and Fidel Castro (nowadays, of course, author and editor was to challenge the world regard California as one of the an ex-smoker who lends his support to the present tobacco control climate world’s most successful pioneers in health campaigns). Statistics about the in Argentina, which is growing and some aspects of tobacco control. It is burden of tobacco and the commercial enjoys the support of the country’s easy to admire tobacco control pro- interests of the tobacco industry in president, just as every week the tele- grammes that may cost the equivalent Argentina were also included. vision programme mentioned above of the entire health budget of many a It was noteworthy that the author of small, less affluent country; and the US on September 25, 2021 by guest. Protected copyright. the story, Raquel Roberti, failed to west coast super-state has also had its mention the deadly effects of second- share of setbacks from recalcitrant hand smoke, or the benefits from politicians taking the easy way out to smoke-free environments that include gain popularity with taxpayers. What a decrease in heart disease mortality, really counts is the long term change in smoking prevalence, and the number of society’s attitudes to tobacco control, cigarettes smoked. Also absent from the and whether people back progressive story was the previously documented programmes to the extent that they are strategy used by the tobacco industry to willing to pay for them. Recent research avoid smoke-free environments in in California appears to have confirmed Argentina, which included banning the the state’s success in winning the battle ‘‘Neri Bill’’ in 1992. for the hearts and minds, as well as the It is worth examining the wider lungs, of its population. media context in which the magazine A state wide survey by San Jose State is published. Veintitre´s is a weekly University has shown that Californians magazine aimed at the middle and high with health insurance overwhelmingly support the inclusion of smoking cessa- tion treatment in standard health insur- ance coverage. Seventy one per cent All articles written by David Simpson believed medications and programmes unless otherwise attributed. Ideas and to help smokers quit should be part of items for News Analysis should be sent standard health benefits, and 72% to David Simpson at the address given agreed that employers should offer on the inside front cover Cover of the Argentine magazine Veintitre´s, bearing a swastika under the title ‘‘The non- employees insurance that includes cov- smokers’ dictatorship’’. erage for stop-smoking benefits. Despite www.tobaccocontrol.com News analysis 7 evidence that shows stop-smoking med- industry’’ (better than having to say it to dream that it could fend off the ications and counselling programmes was, at best, the second largest). inevitable curbs on its activities as the can double the success of smokers trying With a fine disregard for logic, and of majority seller of the country’s leading to quit, coverage for such comprehen- course no mention of tobacco related cause of preventable death and disease. Tob Control: first published as on 25 February 2004. Downloaded from sive services varies widely among health health care costs, estimated to hugely It has dared to spend a vast amount of insurance products. Yet smoking related outweigh revenue, PTC effectively took its shareholders’ money trying to por- medical costs account for almost 12% of credit for the large amounts of tax it tray itself as a benign rather than all health care expenses in California, collects from its addicted customers and malignant presence in the country, and where the direct medical costs of smok- passes on to the finance ministry. It did to try to make credulous politicians and ing are more than $8.6 billion annually. not put it that way, of course: it showed other decision makers believe in its Perhaps most interestingly, when a chart of increasing tobacco tax rev- dreamland. In reality, it is at the centre asked whether they thought the cost of enue in an ad somehow framed to of an epidemic nightmare from which smoking was so great that it was worth suggest that PTC might be making these the country urgently needs to awake. paying a little more for health insurance payments voluntarily, rather than in to cover smoking cessation benefits, response to the laws of the land and 61% agreed. In other words, a majority the decisions of the government about USA: they were putting of insured Californians, including smo- rates of tobacco duty. what, where? kers and non-smokers, are willing to But the most emetic ad of all covered In a surprisingly little noticed move, the pay slightly higher health premiums to PTC’s sponsorship of a fleet of mobile US National Association of Attorneys include stop-smoking medicines and dispensaries ‘‘that reach out to patients General (NAAG) last year successfully programmes in standard health bene- in far flung places who need medical requested that four major tobacco com- fits. As Traci Verardo, executive director attention’’. In the background of the panies cease placing advertisements in of the Next Generation California newspaper version of this one, a doctor the school editions of several news Tobacco Control Alliance put it: measures the blood pressure of an magazines. Magazines such as Time, ‘‘Californians want to take the next step elderly patient, while in the foreground Newsweek, and US News and World Report and give smokers access to resources to another doctor listens to the chest of a publish special editions for use in school quit successfully. It is a real testament younger patient, who is lying down with classrooms, and these editions can be that even in this difficult healthcare an oxygen mask over his face. It is all modified from those published for gen- marketplace, insured Californians— too easy to imagine the effect on the eral distribution. Newsweek alone distri- even non-smokers—are willing to make blood pressure of the doctors who lead butes over 300 000 copies to schools for an additional investment to reduce the Pakistan’s tobacco control movement, use in school libraries and social studies impact of smoking in our state.’’ whose clinics are packed every day with classes. http://tobaccocontrol.bmj.com/ real patients like these, suffering life The issue was brought to the atten- threatening diseases solely as a result of tion of Vermont attorney general their smoking. William Sorrell, who chairs NAAG’s Pakistan: weapons of As in all the ads, the copy under the Tobacco Committee, by a group of mass deception mobile dispensary picture ended, ‘‘PTC eighth graders (aged 13–14 years) from dared to dream, and has dared to Pakistan Tobacco Company (PTC), local Plainfield, Vermont, who found that 120 achieve’’.
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