Big Tobacco and Family Medicine

The role of Family Medicine practitioners in the prevention and treatment of tobacco use is clearly spelled out by the AAFP:

The American Academy of Family Physicians strongly encourages all of its members and staff to personally avoid tobacco use. The AAFP urges its members to:

• save lives by working toward elimination of all tobacco use;
• document use of tobacco products in patient charts;
• work cooperatively with other health professionals to provide cessation counseling and other treatments;
• discourage tobacco use in all public and workplace settings; and,
• list tobacco as a cause on death certificates when appropriate.

How can we put these things into effect on a local level?

Tar Wars is a program sponsored by the AAFP that is attempting to educate youth (12-17), which are particularly heavily targeted (and influenced) by tobacco advertisements. The program hopes to galvanize health care professionals to become proactive in the health education of their community, especially for tobacco-free education for students, by training presenters to give 1-hour-long presentations to local schools about the health risks of tobacco consumption (smoking and smoke-less).

Since youth (under 18 years old) are a primary target for much tobacco advertising (1,000+ become regular, daily smokers each day) and since much legislation, research and advocacy is focused on tobacco consumption in this age group, this seems to be a primary battleground for the "Tar Wars."

What are we doing in Family Medicine at BUSM?

We are interested in starting up a Tar Wars program here, but are looking for someone to spearhead the initiative. Send us an e-mail if you are interested in this...

What do you think? Is a "Tar Wars" program enough to battle BIG TOBACCO? What else can be done? Should BUMC receive money from Philip Morris to conduct research?

References

• AAFP: Tobacco Use, Prevention and Cessation
  
• AAFP: Tobacco Statistics
  
• Tar Wars: A tobacco-free education program for kids from the American Academy of Family Physicians (AAFP)
  

Is BUMC marketing for Philip Morris?

• Tobacco is STILL the leading cause of preventable death in the USA (~400,000 deaths/year from smoking), more than 40 years after the Surgeon General's report on the negative health effects of smoking.
• Smoking kills more people than alcohol, AIDS, car accidents, illegal drugs, murders, and suicides combined.
• Since 1998, Altria (Philip Morris) has spent more on lobbing Congress than any other business.
  
• Boston University Medical Center (BUMC) received $3.99 million from Philip Morris USA over the past decade to fund the study of tobacco-related illnesses ("Tobacco funded Mass. research", Boston Globe, March 2008).
  

On Monday (Dec. 8th), Dr. Alan Blum - the Gerald Leon Wallace Endowed Chair in Family Medicine at the University of Alabama - spoke to BU medical and public health students about the controversy surrounding university research funded by big tobacco companies. His talk, "Universities 
and 
the
 Tobacco
 Industry:
 True 
Opponents
 or
 Silent
 Partners?
", focused on the role that student advocates can play in reducing the negative health effects of smoking, especially by directly confronting the tobacco companies that produce, market, and distribute the product.

As a resident, Dr. Blum started DOC (Doctors Ought To Care), a national organization focusing on school-based and community wide health promotion, for which he received the first National Public Health Award from the American Academy of Family Physicians (AAFP).

Further coverage of the event can be found at...

• "BU forum turns spotlight on tobacco company-funded research -- including its own" (Boston Globe)
• "Tobacco funding slammed" (BU Daily Free Press)
• "Medical Research by the Marlboro Man" (BU Today)

NEJM Perspectives on Crisis in Primary Care

In a recent issue, the NEJM published a series of perspectives on the crisis in US primary care. Six experts in this area each share their brief perspectives on the current primary care situation and the value of primary care. Click here to read the perspectives.

The NEJM also brought 5 of the 6 contributors together for a roundtable discussion of the problems and potential solutions for training, practice, compensation and sytemic change. Click here to see the video and reader comments.