Reality Check, a youth group out of New York state, hosts this annual event to bring everyone together to Mobilize Against Tobacco Lies (MATL).

For the last few years, this MATL event was held virtually, but everyone was able to come back in-person this time around. These efforts in D.C. included meet-and-greets, activities, trainings, sightseeing, and culminated with a rally against Altria on May 18th.

This rally was held right in front of the Altria lobbyist office, and all the youth stood with signs and chants to make sure their voices were heard.

As Altria had its annual shareholders meeting, these youth had their own message during the rally. One of the key messages was all flavors should be removed in all tobacco products and for all people.

On May 17^th, Counter Tools conducted a training for the youth on the importance of policy and advocating for flavored tobacco product bans. We also had a presence during the rally and throughout the activities during the week.

We want to give a shout out to all the groups participating for their efforts. It was amazing to see people come together for this important cause! These youth spoke out against targeting by the tobacco industry, and made it known through their booming voices and boisterous words, that they will not be pawns in the tobacco industry’s efforts to recruit and retain tobacco users.

We will all come back together next year to continue this momentum and show the tobacco industry we cannot be fooled! To hear more about these efforts, check out our podcast. If you want to learn more about Reality Check and provide support, go to RealityCheckofNY.com and MobilizeAgainstTobaccoLies.com

The survey results will both help us improve our current offerings and guide us in developing new materials and services related to topics such as health equity and disparities in the retail environment.

If you are a current or past client-partner of Counter Tools, please share your feedback on this survey by Friday, December 9th.  We thank you in advance for your candid feedback!

See more information about this survey here.

Our team was excited to participate again this year in Reality Check’s action and advocacy to combat the tobacco industry’s targeting of youth. This year a multi-week virtual event was held with training webinars, social media advocacy, and interactive activities geared towards youth culminating with the annual Altria shareholders meeting.

Reality Check is a youth-led movement in New York State that empowers youth to become leaders in their communities and expose the manipulative and deceptive marketing tactics of the tobacco industry like Altria. The organization’s youth members produce change in their communities through grassroots mobilization and education.

Altria is one of the world’s largest owners, producers, and marketers of tobacco products. Altria owns companies including “Philip Morris USA” who makes Marlboro cigarettes, “U.S. Smokeless Tobacco Company” maker of Copenhagen and Skoal smokeless tobacco, “John Middleton” who manufactures Black & Mild cigars, “Helix Innovations” the maker of On! oral nicotine pouches, and has rights to heated tobacco product IQOS and an investment in “JUUL Labs” maker of the popular e-cigarette JUUL.

Each year Reality Check and partnering groups have met and mobilized in Richmond, Virginia at the annual Altria shareholders meeting held in May. In 2020, due to the COVID-19 pandemic, Reality Check switched to an online format for a virtual event week called “Mobilize Against Tobacco Lies” (MATL). This year Reality Check continued this virtual format under “Mobilize Against Tobacco Lies” by holding a multi-week event starting in April that included over 20 youth groups from a variety of locations. Such groups came from New York, Nebraska, Texas, Mississippi, Pennsylvania, Delaware, Arkansas, Kansas, Wisconsin, New Hampshire and Hawaii.

Along with Reality Check, No Limits Nebraska and Dover Youth to Youth have been huge contributors in the planning of activities, participation of youth and delivery of training for this event the past 2 years; and this support in planning and execution has expanded this year to include the Hawaii Youth Council, Project Prevent Arkansas, and Kick Butts Generation Delaware. Counter Tools has also been a participating group and we have partnered with Reality Check since 2015 to help plan, participate in activities and train the youth leading up to the shareholders meeting.

The multi-week event this year included interactive virtual trainings, social media efforts like posting on Facebook, and activities such as a virtual youth get-together with games. We, at Counter Tools, led specific trainings on tobacco marketing and tobacco industry targeting. Other groups including the Truth Initiative, Dover Youth To Youth, Corporate Accountability and the Center for Black Health & Equity (formerly NAATPN) also provided trainings on different topics for the youth like social media advocacy. Efforts were organized around “Take Down Tobacco National Day of Action” on April 1st, “Earth Day” on April 22nd, “No Menthol Sunday” on May 16th and ended with the Altria shareholders meeting on May 20th. The overall goal of this “Mobilize Against Tobacco Lies” theme is to foster youth engagement and mobilize against Big Tobacco by telling the truths to counter their lies.

As part of the efforts, a few select youth were given shareholder proxy tickets to be able to address corporate tobacco executives like Altria CEO Billy Gifford and shareholders with questions during the shareholders meeting while other youth spoke out against the company on social media. Youth from Reality Check, No Limits Nebraska, Dover Youth to Youth, Hawaii Youth Council, Wisconsin Fact, and Kansas Resist were designated to ask questions. Per hearing the response from Billy Gifford to their questions during the meeting, two youth from Hawaii cited:

“It was beyond disappointing that CEO Gifford would throw the FDA under the bus, in an attempt to discredit CDC guidance and the decades-long science that clearly outlines the dangers of nicotine–especially for our youth.” – Theresa Ng

“It was disheartening to hear that Altria feels it’s better to focus on adult use rather than youth prevention.”- Chanel Matsumoto

Our team was excited to participate in the event this year and share our knowledge and energy with the youth advocates along with the other groups. There is only more that can be done in the coming years to fight an industry that is killing people. The hope is to come back in-person and bring this fight back to Richmond, Virginia to look Altria in the eye and rally on the streets to show them youth don’t play and are not about their lies!

To read more about our past work with Reality Check, check out the success story we wrote last year. Learn more at RealityCheckofNY.com and MobilizeAgainstTobaccoLies.com.

Tobacco prevention and control work is a key part of public health. We know that tobacco use is the single most preventable cause of disease, disability and death in the U.S. Use of tobacco and nicotine products can be harmful to health and a persons’ well-being. Limiting the availability of products, like tobacco, that can harm and kill is of upmost importance in sustaining our communities, protecting those most vulnerable, increasing the health of all, and improving public health as a whole.

This is where a comprehensive tobacco control program can come in. A program such as this combines the efforts of many in reducing tobacco use, sustaining protections for people against tobacco-related harms, and reducing the burden of tobacco-related disease and death. In order for a program to be effective, there has to be input and involvement from different people, sectors, and actors at the state, local, organizational, and federal level. It is also important to have enough funding and long-term investment in these programs for the highest impact and sustainability.

CDC guidelines for tobacco control programs

The CDC in their 2014 “Best Practices for Comprehensive Tobacco Control Programs” talks about an integrative approach using different strategies around smoke-free policies, establishing social norms, promoting and assisting tobacco users to quit, and preventing initiation of tobacco use.

The CDC outlines the main components of a comprehensive program to include,

• State and community interventions
• Mass-reach health communication interventions
• Cessation interventions
• Surveillance and evaluation
• Infrastructure, administration, and management

The CDC defines a set of goals of a comprehensive program:

• Prevent initiation among youth and young adults
• Promote quitting among adults and youth
• Eliminate exposure to secondhand smoke
• Identify and eliminate tobacco-related disparities among population groups

In keeping the above in mind and breaking down the word “comprehensive”, we can specifically look at the four areas of point-of-sale (POS), smoke-free places/clean air, cessation, and behavioral & mental health. These areas can sometimes be siloed and treated separately. People working under these areas may not always continue to talk, join with one another, and see the direct linkage in their efforts. However, these areas all highly intersect and relate to one another. Things are most effective and synergistic when everyone is working together and there are combined efforts across these areas, which can lead to a more comprehensive tobacco control program.

The “Tobacco Control Vaccine” – an evidence-based approach

In recently published research titled, “Boosting the Tobacco Control Vaccine: recognizing the role of the retail environment in addressing tobacco use and disparities,” what works in tobacco prevention and control is explained through the visual of a “tobacco control vaccine.” Thinking of vaccines is very fitting for the time we live in today with COVID-19 vaccinations being given across the globe. What is known about vaccines? Well, they are engineered to have the highest effectiveness and reach, and they work. When putting things in a tobacco context, this “tobacco control vaccine” includes the aspects of tobacco price increases, cessation access, smoke-free policies and hard hitting media campaigns.

Even further, many times boosters are needed to a vaccine to increase its effectiveness and longevity. Now, per this research, there is a booster to this vaccine in the form of strategies focused on the retail environment, or POS. Interventions and policies, such as retailer licensing, flavored product bans, and Tobacco 21, can be implemented around tobacco product access, marketing and availability in the retail environment and are a complement and energizer to the other parts of the vaccine. All five of these vaccine elements are evidence-based and have been proven to work.

Visuals like this really show the importance of having a comprehensive and combination approach to tobacco control programming and efforts. In the same way that a real vaccine combines different components to target a pathogen, a comprehensive tobacco control program can create protections and increase immunity against the harms of tobacco and nicotine use at the societal and individual level.

For more on this research paper, check out our recent podcast where we interview one of the authors of the paper, Dr. Amanda Kong.

Context to consider in tobacco control programming

Let’s talk about a situational example to put things into perspective. So, Jim is a smoker and wants to quit, but has not been successful in quitting yet. In this example, there is a domino effect and a cycle that can continue to occur, if all aspects of Jim’s tobacco use is not addressed. What is leading to his behaviors has to be looked into. This can include understanding the neighborhood where he lives (like the availability of smoke-free housing/places), what the stores he visits are advertising and selling (the POS), the availability and effectiveness of cessation resources (like a Quitline), and sociodemographic factors (such as income). As seen, a lot can go into Jim’s smoking habits and ability to quit.

We can also think of youth, who may have never started to vape, who now do so because of factors like stress, boredom, and peer influence. We can think of those with behavioral health conditions, whom may turn to smoking for relief. There are far many other examples and situations that can be thought of. Thus, it is important to focus on all the aspects of a person’s environment, what they have access to/not, and what factors define who they are.

Program evaluation and improvement

A comprehensive tobacco control program can help create a structure in that people, like Jim, are able to make better choices and communities can grow in a healthier way. Those reading this are implored to think about starting a tobacco control program, if one does not exist where you are. If one is already established, this is the time to think about and re-evaluate how comprehensive your tobacco control program is, what parts of your program could be “boosted,” and make sure all the actors across the different areas of POS, smoke-free places/clean air, cessation, and behavioral & mental health are always working in tandem.

Creating partnerships with outside organizations working in these areas is also key. When thinking back to the “tobacco control vaccine,” these organizations could include the Campaign for Tobacco-Free Kids for taxing/pricing policymaking, Americans for Nonsmokers’ Rights for clean air/smoke-free initiatives, the North American Quitline Consortium for cessation access, the Truth Initiative for media campaigning, and us here at Counter Tools for retail environment/POS-related interventions.

With the combined efforts of our tobacco control programs across the nation, we can really curb the effect of tobacco use, dependance and harms, and aim towards a tobacco-free generation. In this new year, let’s work to re-evaluate and strengthen our programs for long-term success and for the greatest population impact!

The “What”

There has been a renewed focus nationally and internationally on “public health” in these times. When talking about the action of public health, this means promoting and ensuring the health and well-being of the “collective.” Public health involves the implementation of measures and efforts that affect everyone – it is population-centered. The key with public health is in “prevention” – it is intended to prevent problems from happening in the first place.

Being more proactive and less reactive is the key to prevention in public health, and this is now more apparent than ever. Ensuring public health has always been an important aspect of sustaining communities, but the coronavirus pandemic, cases of police brutality, high unemployment and other recent challenges have highlighted the continued importance of public health.

The “Why”

Social, environmental and personal factors influence our health and outcomes. This is why it is important to implement public health measures in order to change outcomes and improve livelihoods. In the case of coronavirus, practices like wearing masks, social distancing and proper sanitation can make a difference by reducing exposure and harm. As another example, at Counter Tools we provide education and help our partners collect data, implement policy and strengthen their tobacco control programs, which are effective measures in ensuring less addiction, disease and death from smoking.

There are many other examples of public health practices, such as…

• Food safety standards (ingredient labeling, allergen information) were established to ensure awareness and reduce sickness.
• Seatbelts were created and are utilized to keep people safer while driving.
• Vaccinations/immunizations are used to ensure greater protections from common ailments like the flu, meningitis, whooping cough, chickenpox and measles.
• Housing initiatives, like affordable housing, ensure those who need shelter and affordable living are provided it.
• Water filtration systems are employed to ensure safe drinking water and water fluoridation protects against tooth decay.
• Gloves, masks, and handwashing procedures are used in healthcare settings to prevent infections.
• Use of mosquito nets/bed nets act as a barrier to protect against insect-borne diseases like malaria, zika virus, and dengue fever.
• Creation of bike paths, sidewalks, and outdoor spaces like parks ensure people can exercise and travel safely.
• Establishment of smoke-free places reduces secondhand smoke exposure.
• Investment in education ensures people are given a chance to learn and gain more opportunities.
• Access to therapy and counseling provides for greater mental health.
• Availability of public transportation, like bus systems and railways, ensure people can access opportunity and live freely.

These examples above show the importance and reach of public health in our everyday lives. Not only can we personally ensure our health and wellness, but our “built environment” (i.e., what we have access to) ensures our health as well. Find more examples of how public health has shaped our lives from Johns Hopkins University’s “100 Objects That Shaped Public Health” and the Centers for Disease Control and Prevention’s (CDC) “Ten Great Public Health Achievements — United States, 2001-2010.”

The “How”

There are many public health issues in the world today, so what can we do about them?

…We have to ensure everyone is afforded equal protections. This means implementing public health measures across the board that help reduce disparities between populations, prevent adverse health outcomes, and lead to greater long-term health for all communities. This means “building up” our built environment and providing more resources for everyone such as affordable housing, access to healthy food, and transportation.

…We need to bring more seats to the table and allow everyone to be “seen and heard”. This means asking more questions of people that are not in our immediate circles and creating more dialogue in our communities.

…We have to continue to support one other and stand united. We should ask questions like, How can “we” figure this out? How can “we” best help each other?

…And lastly, we have to stay resilient and find strength in hard times. Keeping health at the forefront will ensure this resiliency and strength is sustained.

Change comes from a lot of small actions put together. So, if we all do a part, we can ensure a collective future, one where we are all afforded an opportunity to live positive, healthy and safe lives.