Taking a bite out of tobacco use


August 02, 2008

In his column "Up in smoke" (Commentary, July 28), Patrick Basham grossly mischaracterized the National Cancer Institute's American Stop Smoking Intervention Study for Cancer Prevention (ASSIST).

I was the senior scientific editor for the National Cancer Institute's monograph that evaluated the study, and I know that, contrary to Mr. Basham's assertions, ASSIST was found to be effective.

The 17 states that implemented ASSIST policy interventions had significantly lower smoking rates at the end of the program than states that did not implement the program had. Indeed, if all states had implemented such interventions, the National Cancer Institute estimates that there would be 1.2 million fewer smokers nationally today.

The evaluation also demonstrated that ASSIST was a cost-effective approach to improving public health.

And Mr. Basham absolutely mischaracterized ASSIST as a "traditional smoking prevention" project.

It was, in fact, a groundbreaking project that put into effect evidence-based anti-smoking strategies involving increased tobacco taxes, changes in state policies to reduce exposure to secondhand smoke and promotion of nonsmoking as a behavioral norm.

ASSIST was aggressively attacked by the tobacco industry, and some of its secret documents show that the industry viewed the program as a threat to its interests because of the program's focus on tobacco control policy change.

Despite these attacks, ASSIST was successful.

Frances A. Stillman, Baltimore

The writer is a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health.

In his column "Up in smoke," Patrick Basham makes an important point - more money should be spent on tobacco control. And indeed, tobacco use is still responsible for hundreds of thousands of preventable deaths in the United States each year.

But Mr. Basham's argument falls off the tracks when he objects to tobacco control policies that are supported by a mountain of evidence - including restrictions on marketing tobacco to kids, expanded access to smoking cessation therapies, clean indoor air laws and higher taxes on tobacco products.

It would be a grave mistake to abandon approaches that have been successful in Baltimore, in Maryland and across the country.

Dr. Joshua M. Sharfstein, Baltimore

The writer is Baltimore's Health Commissioner.

Maryland has not spent its money from the legal settlement with big tobacco on unrelated items such as broadband cable networks, as Patrick Basham says some states have. Instead, by targeting a significant portion of that money for tobacco prevention, treatment and research, we have made measurable strides in reducing the harm caused by cigarettes.

Among our accomplishments: Smoking among middle school students decreased 48 percent between 2000 and 2006, and more than 8,500 students and adults have participated in smoking cessation programs.

However, we can do better, as Mr. Basham points out.

The U.S. Centers for Disease Control and Prevention recommends that we spend $30.3 million annually to prevent and reduce tobacco use; Maryland spent $18.7 million in fiscal 2007.

Why is that the case?

Because Maryland has spent some of its tobacco settlement money to pay for the Medicaid program, which provides health care for Marylanders who would otherwise be uninsured.

Samuel I. "Sandy" Rosenberg, Baltimore

The writer is a member of the House of Delegates.

Wind can't curb carbon emissions

Mike Tidwell opined that the winds of Kitty Hawk, which helped launch the Brothers Wright, should metaphorically augur support for industrial wind initiatives ("Let's make history again," Commentary, July 23).

However, the Mid-Atlantic region, onshore and off, needs more ecologically threatening wind projects like a prom queen needs acne.

The energy flow from wind projects fluctuates erratically, which means that wind power projects must take vast amounts of power from the power grid to work reliably.

Wind technology is a highly variable, nondispatchable source of electricity. In most places in the United States, massive wind facilities will produce little or no power at times of peak demand (as has been amply documented by the record of wind projects in California, Texas and New York).

The financial and thermal costs of the integration of wind power into most grid systems have grave implications for wind power's capacity to offset carbon emissions, which is often wind power's raison d'?tre.

The use of wind power and coal power are not inversely related to one another: all other things being equal - and given continued increases in demand - the more wind projects there are, the more we will need to use reliable conventional power generators such as coal.

As a producer of sporadic electricity, wind can do nothing to dampen "our addiction to oil," since virtually no oil is used to produce electricity.

Jon Boone, Oakland

Pure harassment of political foes

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