Caution: Camel Orbs are NOT Kid Friendly

Photo from the HSPH website

Candy or tobacco? Do you think your child could tell the difference?

Harvard School of Public Health professor, Gregory Connolly, recently published an article in Pediatrics on the dangers of this Camel Orbs, a dissolvable nicotine tablet, widely available in the US.

(Click here for the news release)

Note: I looked up the Colbert Report segment that references Camel Orbs and embedded it below. I think Stephen Colbert is hilarious. Thanks, Kelsey for your comments!

 

The Colbert Report	Mon - Thurs 11:30pm / 10:30c
Cheating Death - Tobacco Mints, Breast Milk & Hallucinogens
www.colbertnation.com
Colbert Report Full Episodes Political Humor Fox News

From Cigarettes to Snus: Tobacco Advertising Returns!

I had read about the tobacco industries attempts to shift its marketing from cigarettes to a "spitless" tobacco (or what it is calling Snus), but it didn't really sink in until I was reading Entertainment Weekly.

Sitting on the T on my way up to Cambridge I saw this ad. My first thought while reading it was "That's interesting...Camel is promoting quitting smoking?" It's fascinating how quickly I recognized it as a smoking ad...

Mammography Guidelines Revisited

Reaction to the updated mammography guidelines -- see previous posts on the topic -- from the US Preventive Services Task Force (USPSTF), a panel of experts charged with determining guidelines for cancer screening, has reached partisan proportions. Republicans are trending toward outrage and Democrats sympathy.

Sugar-Sweetened Beverages the Next Tobacco?

Image from the NY City Department of Health Anti-Obesity Campaign

In class this week, we discussed strategies for reducing the consumption of sugar-sweetened beverages at home. Sugar-sweetened beverages are exactly what they sound like: any drink sweetened with sugar (sodas, fruit juices, "vitamin" or flavored waters, sports drinks, energy drinks....etc.).

The larger question at hand was: Can we utilize the same strategies that brought down the tobacco industry for reducing the consumption and availability of sugary drinks?

The idea of a "soda tax" has come under scrutiny by conservatives who don't like the idea of taxing anything, as well as groups that are strongly supported (i.e. funded) by the food and beverage industry, like the Center for Consumer "Freedom." And, yes, the quotes are my doing...

However, many in public health believe that taxation will curb consumption of sugar-sweetened beverages, particularly among those who consume the most and are most likely to suffer poor health and overweight because of it. Nonetheless, soda is just the tip of the iceberg when it comes to liquid, non-nutritive calorie consumption, especially among kids. There are many other beverages that provide just as many calories and can contribute to weight gain. What will happen when the beverage industry just switches production (and all its marketing!) to these other sugary beverages? Another tax?

Taxation of tobacco has been a primary strategy in reducing its consumption and preventing people from starting to use it. Yet, taxation of tobacco has gone extremely high! Right now the federal tax on tobacco is $1.00 per 20-cigarette pack, and states can tax tobacco even higher ($3.46). Would a soda tax ever get that high? Not likely. Harvard researchers suggest that just a $0.01 per ounce of soda would be enough to change consumption patterns of consumers; a typical 20 oz. soda would be marked with a 20 cent tax.

However, the strategy that I am most excited about is social marketing -- advertising that promotes healthy behaviors and discourages unhealthy ones. If you haven't seen the sugar-sweetened beverage ads out of New York City, check out my other post on this topic. Marketing can't just tell you that something is bad, it must suggest alternatives.

If you are looking for alternatives to sugary drinks here are a couple promoted on the Harvard Nutrition Source website:

• Plain (or Infused) Water -- I think this means throwing some lemons or cucumbers in with the plain water to add flavor without the calories.
• Tea -- Go light on the sugar and honey, of course.
• Coffee -- Choose milk over cream, go sugar-free.
• Sparkling water -- add a splash of 100% fruit juice for flavor, without packing in the calories.

The website even has a recipe for a healthy "fresh fruit cooler," which is a great alternative to store-bought smoothies. Notice, drinks that are "sugar-free" because they utilize artificial sweeteners are NOT included in this list.

Right now there is a national movement to get junk foods and soft drinks out of schools. While I believe this needs to happen soon, most kids get unhealthy foods outside of schools. A 2006 study by Harvard researchers found that 60-80% of sugar-sweetened beverages were consumed by kids at home.

This suggests that we need a national movement, not just to change school environments to provide healthier beverages, like water and low-fat milk, but also change social norms around providing sugary drinks to kids in homes.

What would sway parents to pass up purchases in the beverage aisle and stick to **free** tap water and nutrient-rich milk for kids?

That's a tough question. The strategy needs to incorporate environmental change, excellent social marketing of the health dangers of daily consumption of sugary drinks, and grassroots/community efforts. If we can get sugar-sweetened beverages out of schools (where they have no right to be!), perhaps we can raise awareness about the issues so that we can get them out of homes, too!

Could the tobacco model work? Perhaps. It may be important to look to other public health campaigns; however, to get the most insight into what public health strategies will be most effective. How about alcohol control campaigns?

"Smart Choices" Is Fool's Gold

The New York Times today ran a story today on the "Smart Choices" food labeling campaign that is being heavily endorsed by the biggest food industry players. The program claims to respond to consumers' need to be able to make quick, convenient choices on "healthier" food products. I mean, who has time to read through ingredient lists and nutrition labels? Well...I do. But, I know most people do not. Nonetheless, despite its good intentions, this food labeling system is inherently flawed.

Actually, this is a public health abomination! Walter Willett (whose name often appears on Veritas Health), is actually quoted in the article as saying "These are horrible choices." Enough said.

It is really no surprise to me that the article was titled "For Your Health, Froot Loops." As I've written before, sugary breakfast cereals seem to be constantly popping up in marketing to parents and kids as a nutritious breakfast food. It's as if food manufacturers fear people will find out that highly refined, processed cereals are not that great for them and switch to something that resembles what one might find at a farm somewhere (fruit, eggs, dairy, etc.).

So why am I so upset by this? It's just a few labels, right? Well, not exactly. This is an example of industry exploiting a true (Veritas) public health need. Consumers, parents especially, need to have a more simple, credible system on which to base their food choices. This, as Willett dually notes, is not a credible system.

It is not as though parents are choosing between donuts and Fruit Loops as Eileen Kennedy of the Friedman School of Nutrition Science and Policy is quoted as saying. Indeed, it will be more likely a consumers' choice between Froot Loops and some other "un-labeled" potentially healthier cereal product. One that possibly is unable, or unwilling to pay the annual $100,000 dues for the label.

As Kennedy notes, those products without the "Smart Choices" label will be perceived as nutritionally inferior, and, even worse, that those with the label are good for you. I believe there is a big difference between what is good for you and what is "better" for you...relative to something that is really "bad" for you. Come on, "Cocoa Puffs" do not provide any of the health benefits of cacao and there is no fruit in Froot Loops.

Other questions I have: What must companies do to get the "Smart Choices" label? And why are there such generous guidelines for what products qualify? Since when and who exactly decided that Coco Puffs and Froot Loops (in addition to many other similar products, I presume) are actually smart choices? This statement in the article is telling...

Ten companies have signed up for the Smart Choices program so far, including Kellogg’s, Kraft Foods, ConAgra Foods, Unilever, General Mills, PepsiCo and Tyson Foods. Companies that participate pay up to $100,000 a year to the program, with the fee based on total sales of its products that bear the seal.

Recently, I read that if it requires a label it probably isn't that good for you. Here's to simple criteria. In general, stick to foods that don't require a label to tell you that it is a smart choice.

NYC Ads Target Sugar-Sweetened Drinks

This is the most eye-catching public health campaign ad that I have seen in a long time that does not have to do with violence. While it specifies cutting back on sodas in the text, the liquid resembles sugar-laden iced team more than Coca-Cola and could apply to a wide range of beverages.

In fact, you can check out the entire ad campaign at the New York City Department of Health website, which shows a series of three ads: one with a bottle of Coke being poured, one using Gatorade, and one with the Snapple (of course, these bottles are not actually branded as such...). You can comment on the posters at the nycHealthy blog here.

The ad was first brought to my attention by Dr. Oz (known for his frequent guest appearances on Oprah) on Twitter who asks whether the ads are "too much?"

Too much of what? The truth?

I love this edgy ad campaign that pushes the boundaries and wakes up America to the food traps that are destroying our health and costing us millions, even billions of dollars health care bills for preventable illness. Sugar-sweetened beverages are low-hanging fruit with lots of empirical evidence to support their limited consumption. I wonder whether this campaign will be extended to other States and regions, as well.

Way to go NY City Department of Health!!

Big Food: Bad News?

Here are two articles I came across in Consumer Affairs this morning:

FDA Warns General Mills About Cheerios Claims

According the the Food and Drug Administration (FDA) Cheerios has stepped out of bounds in its recent campaign to market that "Cheerios may reduce your cholesterol!". GM also promotes other scientific claims such as the ability of Cheerios to lower LDL cholesterol (the bad kind) and to lower cholesterol 4% over 6 weeks. FDA officials feel that these statements market Cheerios as a drug, not food because of these claims.

I applaud the FDA efforts in this area. GM and other large food companies are itching to show just how "healthy" their foods really are -- when really, their foods are not all that healthy. In fact, they would love to play up the RELATIVE advantage of sugary cereal over no cereal or the benefits of diet soda over regular soda. 

Come on! Leave out the sugar, cut back the sodium and use less refined products. Then you might not have to try so hard to prove that your food is good for the public.

Nothing beats a home cooked meal. We all should try it some time.

Senate Studies Soda Tax

The Center for Science in the Public Interest, a public health advocacy group, has finally gottenthe attention of Congress in efforts to pass a national tax on soft drinks and sugar-ladenbeverages.

According to the article a study conducted by the Harvard School of Public Health in 2006 found that added sweeteners contributed to 1/3 of all carbohydrate calories that Americans consume, and that the sugar from sugar-sweetened drinks is a full 1/2 of that caloric amount.

We have been down this road before without much success. Even in Massachusetts we have a law that explicitly exempts CANDY and SODA from State sales tax. How can this be?! Our Stateneeds money and this sort of sales tax on absolutely, undeniably, unhealthy food seems likelow hanging fruit, right?

How many of our politicians are in bed with the food and beverage industry to block this votefrom passing? We will know in due time.

McDonald's Moms Marketing Madness

What alliteration! My new not-so-cuss word for how livid I am about this new marketing maneuver by McDonald's (...there I go again). I can't believe I did not see it coming. I'm sure other advocates did. 

So here is how it went down...

I was quitely watching CNN the other night, tucked under my blanket, homework in hand, when all of a sudden "moms declare McDonald's FRENCH FRIES healthy..." I think I stopped breathing. Of all things, the french fries are healthy?! And of all people, moms are now voluntary public media advocates for McDonald's?! 

This is clever, very clever. 

Honestly there is not much I can say about this. Later clips on CNN suggest that many moms won't be fooled. While I am all for a big mac (well maybe a chicken sandwich...) every once in a while, I cannot imagine anyone saying that McDonald's main offerings are healthy. Though, I will give the salads some credit. Perhaps, McDonald's is healthy if you are comparing french fries and double bacon cheeseburgers to...umm...cheez whiz and ding dongs? 

Many don't believe that big macs, chicken nuggets, and french fries harm health. I beg to differ (call me crazy or rent Super Size Me). Do you know that years ago (perhaps still today) people & their kids ate McDonald's food thinking that it was perfectly "healthy." There can be no debate that fast food corporations have done everything within their power to prevent nutrition information from effectively reaching consumers. Furthermore, even if fast food does harm health, no one can prove that disease had anything to do with diet. Maybe lack of exercise, but diet...no. For more on Big Food "wellness" tactics check out Michele Simon's Book: Appetite for Profit.

I digress. There are fervent believers on both sides of the issue. I know this post leans to the left. Feel free to comment either way. I need to know what you think -- my future public health career may depend on it!