Youth and Traditional Tobacco use rather than smoking

[Youth, Movies and Smoking]

Turtle Island Native Network is a No Smoking Zone!

Traditional tobacco has been used by many Aboriginal people in ceremonies, rituals and prayer for thousands of years. Using tobacco in non-traditional ways like smoking cigarettes or chewing tobacco or snuff is abuse of its traditional purpose.
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Smoking prevention comic book . . .
River Run is the story of a group of youth that learn the traditional use of tobacco while on a canoe trip. One of the youth, who smokes, gets her world opened up by accident. Thank you to the Vancouver Coastal Health Authority, Aboriginal Health Services for their support on this project. The first 15 pages may be previewed at www.thehealthyaboriginal.net
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"Traditional tobacco is our SACRED connection to our Creator." - Pauline Shirt Elder, Cree Nation
http://www.tobaccowise.com/


Commercial tobacco is the leading cause of preventable illness and premature death. Smoking rates among Aboriginal youth 15 - 17 years of age are more than triple those of the general Canadian population. High exposure to nicotine from first and second hand smoke has placed many Aboriginal families at high risk for serious health problems like heart disease and cancer.
http://www.tobaccowise.com/

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First Nations, Aboriginal, Native Youth Healthy Lifestyle Awareness . . .

Nahsema Boonichikewin - Youth Tobacco Control Strategy
http://nahsema.knet.ca/

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We Need Smoke-Free Movies . . .
viewtopic.php?p=10210#p10210
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Use and misuse of tobacco among Aboriginal peoples

First Nations and Inuit Health Committee, Canadian Paediatric Society (CPS)

Cultural factors
For many First Nations people, tobacco has been used traditionally in ceremonies, rituals and prayer for thousands of years. It is used for a variety of medicinal purposes and its ceremonial use has powerful spiritual meaning, establishing a direct communication link between the person giving and the spiritual world receiving. In the traditional sense, the most powerful way of communicating with the spirits is to smoke tobacco in a sacred pipe. While tobacco is sacred, the recreational use of tobacco, with its high content of nicotine, is addictive and harmful. First Nations Elders maintain that this type of use is disrespectful of the spiritual, medicinal and traditional use of tobacco. These observations echo those of the Assembly of First Nations.

While tobacco has rarely been used ceremonially in Inuit culture, over seven in 10 adults now smoke daily - a rate higher than that of First Nations and Metis people. Traditional Inuit society was smoke-free. The Inuit did not use tobacco until approximately 100 years ago. At first, it was mainly men who smoked, and it was forbidden for Inuit youth to use tobacco. In the 1940s, smoking became more prevalent among all Inuit, and today, Inuit women have one of the highest rates of lung cancer in the world.

Until recently, smoking was accepted as a fact of life in the North, so there had been few efforts to discourage it. In the mid-1990s, nicotine use in Nunavut remained widespread and showed no obvious signs of abating. However, increasing awareness of decreased life expectancy, infant mortality rates three times the national average, and high rates of lung disease and cancer spurred Nunavut to adopt fairly extensive tobacco reduction initiatives in 2003, affecting all aspects of life, school, the home and the community . Since then, a ban on smoking has been extended to all public and workplaces.

Source: http://www.cps.ca/english/statements/II/FNIH06-01.htm
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BACKGROUND:
http://www.hc-sc.gc.ca/fnih-spni/substa ... dex_e.html
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Take Charge - Youth Movement Against Tobacco . . .
http://www.takechargecrew.ca/

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Ontario's first Aboriginal-specific stop smoking strategy - special funding for youth
January 25, 2007
viewtopic.php?p=7941#p7941

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Youth Take Action - Tobacco Dont Own Toronto
http://www.t-dot.ca
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Northern Plains Tobacco Prevention Project. . .
http://aatchb.org/nptpp/
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Study says anti-tobacco programs that target teens are successful. . .
September 28, 2006. . .
viewtopic.php?p=7469#p7469

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"Now THIS is worth watching! I found it to be Funny - Serious - Humourous - Tragic - Entertaining, and a Realistic Approach to Educating Young People (of all ages) About the 'Killer' Cigarettes. An excellent animation created by Native Peoples for Native Peoples. The Creativity Keeps You Watching for More." . . .Tehaliwaskwenhas, Bob Kennedy (Oneida)

It's called, "Down to the Butt" - a Keewaytinook Okimakanak (KO) flash animation for Health Canada's Tobacco Strategy

You can view the first episode here. . . http://nahsema.knet.ca

This production was completed through the Keewaytinook Okimakanak Tobacco Control Strategy Program funded by Health Canada. The animation team included Derek Kenny (Lac Seul), Blue Mason (Keewaywin) and Jesse Fiddler (Sandy Lake). The script was prepared by Tina Kakepetum-Schultz. Tina is interested in getting everyone's feedback about this production.

Please email her at tinakakepetumschultz@knet.ca
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Aboriginal Youth for Tobacco Wise Communities. . .
viewtopic.php?p=7076#p7076

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Just one cigarette? Yikes!
viewtopic.php?p=7004#p7004

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Tobacco-related illnesses and diseases are urgent issues in First Nations and Inuit communities, where smoking rates are more than double the rate for the rest of Canada.

Traditional and Non-traditional Use of Tobacco. . .
http://www.hc-sc.gc.ca/fnih-spni/substa ... dex_e.html

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Second-hand Tobacco smoke and babies
viewtopic.php?p=6944#p6944

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Research. . .
http://www.cctc.ca/search?SearchableTex ... anguage=en

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Smoke-Free Tribal efforts / American Indian, Native Peoples Programs
http://www.legacyforhealth.org/SearchResults.aspx?searchTerm=tribal
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Maori Smoke free Coalition . . . http://www.auahikore.co.nz

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Quitting smoking is difficult.
However, the more often you try to quit, the greater likelihood you will succeed.

A note from Turtle Island Native Network
http://www.turtleisland.org
SACRED TOBACCO USE
Tobacco plays an important role in First Nations, Aboriginal, American Indian/Alaska Native cultures. Historically, tobacco is used in religious and many other Indigenous Peoples' cultural ceremonies, in healing, and in storytelling. Tobacco is considered a sacred gift of the earth to many American Indians. Traditional use of tobacco by American Indians does not resemble the common cigarette smoking which results in so much disease and deaths; inhalation of tobacco smoke was not appropriate in ceremonial contexts.

Most Indigenous nations have traditional stories of how tobacco was
introduced to their tribes and communities. It is estimated that the tobacco plant has been used in a sacred way by American Indians for over 18,000 years. Traditional tobacco stories emphasize the sacredness of the plant and its powers to both heal if used properly and to harm if used improperly. Traditional or sacred tobacco plant varieties vary from tribe to tribe and region to region. Traditional tobacco is still used by many tribes.
Some tribes grow their own tobacco gardens. Which plant varieties are grown, who tends them and who harvests them, how they are harvested, and how they are used vary from tribe to tribe and region to region.
Traditional tobacco is often gifted to elders or to people who share wisdom or prayers. Traditonal tobacco is often burned during prayer and other ceremonies. While traditional tobacco does contain nicotine, it is not processed with chemicals or used in the same way as commercial tobacco so does not pose the same health risks.

Provided by the National Tribal Tobacco Prevention Network, a project of the Northwest Portland Area Indian Health Board.
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Aboriginal Youth and Smoking - a link to heart disease
viewtopic.php?t=4014

Smoking linked to risk of diabetes . . .
viewtopic.php?t=3975

Quit 4 Life
http://www.quit4life.com/

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Youth, Movies and Smoking - Support Smoke Free Movies!
viewtopic.php?p=6309#p6309
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Thumbs Up! Thumbs Down!
http://www.scenesmoking.org
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40% of adult American Indians and Alaska Natives are smokers--this is the highest rate of commercial tobacco use among every age, ethnic, and gender category in the U.S.4

In a recent national survey, American Indian and Alaska Native youth were more likely than youths from other racial/ethnic groups to smoke cigarettes during the last month.3 Studies vary in estimating the current
AI/AN youth smoking rate to be between 30% and 50%.

Cardiovascular disease is the leading cause of death among American Indians. Lung cancer is the leading cause of cancer death among American Indians. Tobacco use is a major risk factor for both diseases.5
Targeting American Indians for future customers, some tobacco companies use American Indian images and cultural symbols in their advertising, such as warriors, feathers, regalia and words like “natural” in the brand names.1

To build its image and credibility in the community, the tobacco industry funds cultural events such as powwows and rodeos.5

While the Indian Health Service is responsible for fulfilling the U.S. trust obligation of providing healthcare, it consistently receives between 40% and 50% of the funding required to provide minimum services.2

As sovereign nations, tribes were excluded from eligibility to receive any funds from the Master Settlement Agreement, leaving them to rely on dwindling, or in some cases nonexistent, state funding for tobacco control.
Federal, state, and local funding mechanisms often assume incorrectly that most tribes have the capacity and infrastructure to launch and maintain tobacco control activities of their own, and thereby omit tribal communities from outreach and services.

Tobacco sales are important economic venture for some tribes. Cheaper cigarettes are often accessible to American Indians on tribal lands.

It is estimated that the tobacco plant has been used in a sacred way by American Indians for over 18,000 years. Traditional tobacco is still used by many tribes--often in prayer, or gifted to elders or to people who share wisdom or prayers. While it does contain nicotine, traditional tobacco is not processed with chemicals or used in the same way as commercial tobacco so does not pose the same health risks.

Provided by the National Tribal Tobacco Prevention Network, a project of the Northwest Portland Area Indian Health Board. For more information, call 503.228.4185 or visit the website: http://www.tobaccoprevention.net

Sources:
1. AMA (press release), National Coalition FOR Women AGAINST Tobacco Launches Defense Against the Tobacco Industry, 1999.
2. NPAIHB, Priority One: The FY2005 Indian Health Service Budget: Analysis and Recommendation, 2004.
3. National Household Survey on Drug Abuse. Cigarette Use Among American Indian/Alaska Native Youths, The NHSDA Report, 2002.
4. CDC MMWR Highlights—Cigarette Smoking Among Adults—United States, 2002.
5. DHHS. Tobacco Use Among U.S. Racial/Ethnic Minority Groups —African Americans, American Indians and Alaska Natives, Asian
Americans and Pacific Islanders, and Hispanics: A Report of the Surgeon General. Atlanta: U.S. DHHS. CDC, 1998.

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Anti-Tobacco Campaigns in the Native-American Community

THE ISSUE
Native Americans have used the tobacco plant for ceremonial purposes for thousands of years. But today tobacco is generally synonymous with disease and death for their community. Three out of every five deaths in Native communities can be attributed in some way to smoking or tobacco use. Although there are geographic and tribal differences, generally American Indians smoke and chew commercial tobacco twice as much as other groups. Nearly 41 percent of all American Indians and Alaska Natives-- both men and women-- use tobacco. Native women and girls have the highest rate of smoking during pregnancy: 21 percent. Even in Alaska, where tobacco is not indigenous or a sacred herb, the native population uses tobacco at twice the rate of non-natives in Alaska: 46% versus 23%. And it's not just smoking; chewing tobacco, also known as spit or smokeless tobacco, is also a major problem among Native Americans-and despite what many people think, it's not a safe alternative.

Native youth participate in many events where tobacco is promoted, such as rodeos, farmers' clubs, and pow wows. There are high rates of use both among boys and girls. Tobacco also has spiritual significance for the Native American community:

"When we "smudge", brushing the smoke from the tobacco into our bodies, the original purpose of that was to keep away the pests because tobacco has nicotine, which is a natural pesticide. But then it also evolved into this idea, it will also keep away the spirits that want to harm us as well. Using it as a way to cleanse our beings, our spirits." - Gerry Rainingbird

Native American women and men are working to put an end to recreational tobacco use in their communities. A lot of tribes are re-educating their people about the traditional uses. At the National Native Conference on Tobacco, advocates share strategies aimed at reversing this deadly tobacco trend. They say one important tool is to teach people to discriminate between traditional and commercial tobacco. Commercial tobacco products, they point out, contain nearly 4-thousand chemical additives, many of which are carcinogenic. They also say encouraging Native American youngsters to connect with the significance of tobacco can be a powerful antidote to misuse of tobacco. Prevention activities are held in conjunction with basketball tournaments, pow-wows, health fairs, and cultural dinners. The key is to get communities to develop strategies that are a fit for them and their nation.

These anti-smoking advocates also address policy issues. One third of Native Americans live on reservations. Indian and Alaskan native lands are sovereign nations and not subject to state laws prohibiting the sale and promotion of tobacco products to minors. There are few, if any restrictions on indoor smoking. With no taxes on cigarettes and an increase in internet sales of cigarettes, tribes may gain additional income but the price is high- greater access to commercial tobacco for young and old.

Advocates also fight the use of cultural symbols, designs and images to sell cigarettes - a long time practice that still continues today. Gerry Rainingbird says the Santa Fe Tobacco Company has exploited the use of Native American symbolism and their sacred use of the pipe. He also says the company has misled and misrepresented themselves as being an Indian owned tobacco company that fosters and encourages traditional use of tobacco, which he says is not the case. Iona Star agrees: "They use the "Natural American Spirit" tobacco and they put our images on these things and it makes people think the Indians are helping them do this, that we condone this, but it isn't so."

Then there's the challenge to secure additional dollars for an under funded Indian Health Service that has many priorities. Tobacco prevention and education often gets pushed aside for more pressing issues. But according Gerry Rainingbird, "If we address tobacco prevention now, we will save millions and millions of dollars in health care costs treating those diseases caused by smoking and chewing commercial tobacco products."
PBS

American Indians, Alaska Natives and Tobacco
NATIONAL SMOKING PREVALENCE AND TRENDS

Adults
Thirty-three percent (33%) of all adult American Indians and Alaska Natives smoke. Smoking rates among American Indians and Alaska Natives differ by gender; 34% of American Indian and Alaska Native men and 32% of American Indian and Alaska Native women smoke.

Smoking rates are higher among American Indian and Alaska Native adults than among adults in other racial/ethnic groups. Twenty-four percent (24%) of whites, 22% of African Americans, 17% of Hispanics and
12% of Asian Americans smoke.

Due to the diversity of American Indian and Alaska Native cultures, prevalence rates for smoking vary by geography and tribal affiliation.

Cigarette smoking is highest among American Indians and Alaska Natives in the Northern Plains (44%) and in Alaska (39%).

Cigarette smoking is lowest among American Indians and Alaska Natives in the Southwest (21%).

Teens
Based on the data available, among seniors in high school, American Indians and Alaska Natives had higher rates of tobacco use than all other youth.

In 2000, smoking rates in senior year of high school were 38% among white youth, 33% among Asian American youth, 27% among Hispanic youth and 21% among African American youth.3 From 1996 through 2000, the smoking rate among American Indians in grade 12 was estimated
to be 46%.

Trends
Smoking declined among American Indians and Alaska Native adults from 1999 to 2001.

Information is not available about whether smoking is rising or declining among American Indian and Alaska Native youth. Among other U.S. racial/ethnic groups, smoking is declining.

THE IMPACT OF SMOKING ON HEALTH
Mortality

Every year, tobacco-related disease kills over 440,000 people in the U.S., making it the single largest preventable cause of death.

Smoking is a major cause of death among American Indians.

Barriers to cessation, including cost of effective treatment and lack of access to cessation services, affect the tobacco-related disease outcome in racial/ethnic minority groups.

Cardiovascular Disease

Cardiovascular disease is the primary cause of death in the United States and among American Indians. Heart disease and stroke together accounted for about one quarter of all deaths among American Indians in 2000.

It is estimated that as many as 30% of deaths from cardiovascular disease are a result of tobacco use.

Heart Disease

In 2000, heart disease killed about 2,000 American Indians; 1,000 men and 1,000 women. Smoking is a major cause of heart disease.

Stroke

Stroke is the third leading cause of death in the United States and the fifth among American Indians. Death certificate data indicate that in 2000 nearly 600 American Indians died of stroke. It is likely that these numbers
underestimate the real number of stroke deaths among American Indians.

Heavy smokers (two packs a day) are twice as likely as those who smoke half a pack a day to have a stroke.

Heart Attack

In 2000 more than 600 American Indians died of heart attack. Smokers are at greater risk for heart attack than nonsmokers.

Cancer

Cancer is the second largest cause of death in the U.S. and among American Indians. About 17% of American Indian deaths are attributable to cancer. About 1,000 American Indian men and 900 American Indian women died of cancer in 2000.

Lung Cancer

About 500 American Indians died of lung cancer in 1998; 300 men and 200 women. Cigarette smoking is overwhelmingly the most important cause of lung cancer.

American Indian men have lower death rates for lung cancer than African American and white men, but higher death rates than Asian American or Hispanic men. Although lung cancer death rates are declining overall and among all other racial groups, among American Indian men they are rising.

American Indian women have lower death rates for lung cancer than white and African American women but higher death rates than Asian American and Hispanic women. Lung cancer death rates for American Indian women (and among women in general) are rising.

Lung cancer is the leading cause of cancer death among women, and has been for 15 years. However, 80% of American women mistakenly believe that breast cancer is the primary cause of cancer death among women.

Among American Indian women, death rates from lung cancer are about 47% higher than those for breast cancer.

QUITTING

Quitting is difficult. On average, former smokers made 8 quit attempts before succeeding.

Seventy percent (70%) of American Indian smokers reported wanting to quit smoking and 47% reported making a quit attempt in 2000. However, American Indians are among the least successful in quitting smoking for
good. In 2000, 41% of all American Indians who had ever smoked reported that they had successfully quit, compared with 51% of whites, 45% of Asian Americans, 43% of Hispanics and 37% of African Americans.

People who have a strong commitment to change and are involved in programs that make use of behavioral techniques and social support are more likely to succeed in quitting.

In 2000, a total of 44 million Americans had successfully quit smoking.

SOURCES
1. CDC. Cigarette Smoking Among Adults- United States, 2001. MMWR 2003; 52(40): 953-956.
2. CDC. Surveillance for Health Risk Behaviors of American Indians and Alaska Natives. Findings from the Behavioral Risk Factor Surveillanced System, 1997-
2000. MMWR 2003; 52(SS-7).
3. Wallace JM, Bachman JG, O’Malley OM, Johnston LD, Schulenberg JE, Cooper SM. Tobacco, alcohol, and illicit drug use: racial and ethnic differences
among U.S. high school seniors. Public Health Rep 2002;117 Suppl 1:S67-S75.
4. Farrelly MC, Vilsaint M, Lindsey D, Thomas KY, Messeri P. Legacy First Look Report 7. Cigarette Smoking Among Youth: Results from the 2000 National
Youth Tobacco Survey. Washington DC: American Legacy Foundation. August 2001.
5. U.S. Department of Health and Human Services. Tobacco Use Among U.S. Racial/Ethnic Minority Groups- African Americans, American Indians, and Alaska
Natives, American Indians and Pacific Islanders, and Hispanics: A Report of the Surgeon General. Atlanta, GA. U.S. Department of Health and Human
Services, Centers for Disease Control and Prevention, 1998.
6. Changing Adolescent Smoking Prevalence; Where it is and Why. Smoking and Tobacco Control Monograph No. 14. Besthesda, MD: U.S. Department of
Health and Human Services, National Institutes of Health, National Cancer Institute.
7. Substance Abuse and Mental Health Services Administration. (2002). Results from the 2001 National Household Survey on Drug Abuse: Volume I. Summary
of National Findings (Office of Applied Studies, NHSDA Series H-17, DHHS Publication No. SMA 02-3758). Rockville, MD.
8. Anderson RN. Deaths: Leading Causes for 2000. National Vital Statistics Reports 2002;50(16).
9. McGinnis JM, Foege WH. (1993) Actual Causes of Death in the United States. The Journal of the American Medical Association; 270: 2207-12.
10. Minino AM, Arias E, Kochanek KD et al. Deaths: Final Data for 2000. National Vital Statistics Reports 2002;50(15).
11. U.S Department of Health and Human Services. 1990. The Health Benefits of Smoking Cessation: A Report of the Surgeon General. U.S. Department of
Health and Human Services, Public Health Service, Centers for Disease Control and Prevention.
12. Wolf PA, D’Agostino RB, Kannel WB, Bonita R, Belanger AJ. Cigarette smoking as a risk factor for stroke. The Framingham Study. JAMA 1988; 259:1025.9.
13. Prescott E, Hippe M, Schnohr P et al. 1998. Smoking and Risk of Myocardial Infarction in Women and Men: Longitudinal Population Study. British Medical
Journal. 316:1043-1047.
14. CDC. Recent Trends in Mortality Rates for Four Major Cancers, by Sex and Race/Ethnicity- United States, 1990-1998. MMWR 2002;51:49-53.
15. U.S. Department of Health and Human Services. Women and Smoking. A Report of the Surgeon General. Rockville, MD. U.S. Department of Health and
Human Services, Public Health Service, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and
Health, 2001.
16. American Legacy Foundation “Women and Lung Cancer Survey.” January, 2001.

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2004 - 2005 Tobacco Wise Community Highlights

Akwesasne First Nation
Akwesasne First Nation is a community located where the borders for Quebec, Ontario, and the state of New York meet.
Project Title: “Sacredly Stoked”

Target Group: Community youth

Brief Description: Through this community-based theatre and arts production, the group called upon ancient past and explored traditional teachings regarding tobacco. This project helped the community of Akwesasne to become tobacco wise by recovering ancient protocols for tobacco use to help set the stage for improved family and community relationships by endorsing the proper etiquette regarding tobacco use.

Attawapiskat First Nation Education Authority
Attawapiskat First Nation is a remote community located in Northern Ontario slightly west of James Bay.

Project Title: Tobacco Abuse Project

Target Group: Youth and families

Brief Description: This project helped the community of Attawapiskat to become tobacco wise by undertaking a massive tobacco abuse awareness campaign, providing the community with the knowledge of the amounts of current tobacco abuse in the community, having the students create art work that expresses how tobacco abuse hurts their lives, and providing incentives for youth to become tobacco wise.

Beausoleil First Nation Health Centre
Beausoleil First Nation is located primarily on Christian Island in Georgian Bay.

Project Title: Distinction and Knowledge Project

Target Group: All Beausoleio First Nation community members

Brief Description: The community of Beausoleil First Nation worked to become tobacco wise by implementing four different objectives in their project.

an education program which provided teachings on the differences between commercial and traditional tobacco
providing clinics and support programs for those who smoke
implementing a poster contest for youth and adult long-term quit smoking contest
undertaking a smoke-free homes contest for the entire community
Ketegaunseebee Garden River First Nation
Garden River First Nation is located 5 minutes outside of Sault Ste. Marie Ontario.

Project Title: Seven Feather Prevention Program Awareness Mural

Target Group: Youth and all community members who use the communitty recreation centre.

Brief Description: The community of Garden River First Nation painted a tobacco wise mural on the walls of their newly built youth recreation center. The mural is a positive and permanent message about tobacco use and the message came from the community members themselves.Target Group: Youth and all other community members who use the recreation center.

The Métis Nation of Ontario
The head offices of the Métis Nation of Ontario’s offices are located in Ottawa. The Métis Nation of Ontario Youth Council represents 9 regions across Ontario.

Project Title: Métis Youth in the Know: Strategy Planning Meeting

Target Group: Metis Youth, Senators, and Metis community members.

Brief Description: The Métis Nation of Ontario Youth Council are working to become tobacco wise by convening a one day Youth Strategy Planning meeting. All members of the Métis Youth Council met with Senators to develop a strategy for implementing and advocating tobacco wise activities and messages in their own communities across Ontario.

Pays Plat First Nation Health Centre
Pays Plat First Nation is located 65km east of Nipigon and 25km west of Schreiber.

Project Title: Support For Those Who Want To Quit Smoking

Target Group: Youth and other community members who want to quit smoking.

Brief Description: The community of Pays Plat First Nation held a community meeting to provide education and awareness in order to create a quit smoking support group targeting both youth and other community members who want to quit smoking. The community meeting was a non-smoking event

Sheshegwaning First Nation Health Centre
Sheshegwaning First Nation is located on the northwest shore of Manitoulin Island.

Project Title: Aabnaabdaa Neegonjenji Zha-ing (looking back so we can go forward)

Target Group: All community members of Sheshegwaning First Nation

Brief Description: The community of Sheshegwaning First Nation gathered historical data (in the form of a community wide survey) on smoking trends in their community to show where they came from and to see the positive changes reducing smoking has for their future. The survey results were presented at a community feedback meeting to determine the best possible next steps for the community on their tobacco wise path.

Six Nations of the Grand River New Directions Group
Six Nations of the Grand River is located east of Brantford Ontario along the Grand River.

Project Title: Buying Influences and Selling Death

Target Group: All community members of Six Nations of the Grand River

Brief Description: The community of Six Nations worked in partnership with community schools to provided youth with hands-on and interactive learning to demonstrate healthy alternatives to smoking. They also created tobacco wise activities for elders by partnering with the local radio health promotion programming to facilitate teaching and learning about traditional and commercial tobacco. The partnerships in this project encouraged service providers and community to work together to build this tobacco wise community.

Tap Resources
TAP Resources is located at Six Nations of the Grand River

Project Title: Traditional Tobacco Provincial Scan

Target Group: Aboriginal communities and organizations in Ontario

Brief Description: This project provided information on existing traditional tobacco resources and programs available to Aboriginal people across Ontario. This information will assist in strategy planning on what resources and programs may need to be developed and/or disseminated to support Aboriginal communities across Ontario.

Wabano Aboriginal Health Centre
Wabano is an urban Aboriginal Health Centre located in Ottawa, Ontario

Project Title: Sacred Smoke Cessation Support Program

Target Group: All Aboriginal People in Ontario

Brief Description: Wabano Health Centre delivered a train the trainer cessation project. The project consisted of piloting a culturally relevant smoking cessation support program in 3 Aboriginal Health Access Centres.

Southwest Ontario Aboriginal Health Access Centre - London (SOHAC)
Shakagamik-Kwe - Sudbury
Wassay-Gezhig Nahn-Dah-We-Igamig Aboriginal Health
Wauzhushk Onigum First Nation Health Centre
Wauzhushk Onigum First Nation is located outside of Kenora Ontario.

Project Title: Wauzhushk Onigum Asemaa Awareness Campaign

The community of Wauzhushk Onigum worked to become tobacco wise by applying and promoting traditional teachings that support the respectful use of tobacco and by providing the community with information workshops in which elders shared their history and traditional stories of traditional uses of tobacco. The community also held a community-wide calendar contest to promote the new learning’s about traditional tobacco that came out of the workshops.

Target Group: All community members with a focus on children youth and young adults.

Brief Description: Wauzhushk Onigum First Nation Health Centre implemented a multiple component prevention project. Examples of the activities included 8 Community Support and Awareness Workshops profiling Elders and Health specialist speaking to traditional tobacco teachings and the harmful effects of commercial tobacco as well as a community poster contest for a tobacco wise calendar.

Webequie First Nation Health Centre
Webequie First Nation is a remote community located on the Winisk River in Northern Ontario and is accessible year round by airplane.

Project Title: Ombabatay: Smoke Rising

Target Group: All community members with a focus on youth and young adults.

Brief Description: The community of Webequie First Nation began their tobacco wise project from the belief that tobacco plays a very significant role in their ceremonies and every day life. Based on this understanding the project provided teachings and learnings to youth and young adult about the respectful way of using tobacco in ceremonies and offerings. The project was implemented though classroom presentations, hosting a community pow wow, and a community-wide quit smoking challenge.

[Youth and Tobacco]

We Support Smoke Free Movies!
Young People are Influenced by What Movies Portray.
Research says Smoking On Screen is the Number One Recruiter of New Adolescent Smokers . . .
http://www.smokefreemovies.ucsf.edu

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Increasing Evidence Points to Link Between Youth Smoking and Exposure to Smoking in Movies

November 7, 2005

Adolescents who see smoking depicted in movies are more likely to try smoking, according to a study funded by the National Cancer Institute (NCI), part of the National Institutes of Health. The study, which could have broad implications for efforts to reduce smoking among youth, appears today in the November 2005 issue of the journal Pediatrics*. James Sargent, M.D., of Dartmouth-Hitchcock Medical Center in Lebanon, N.H., and colleagues are the first to utilize a nationally representative sample of youth in the United States to examine the influence of adolescents' exposure to movie smoking on their smoking behavior.

Prior research has established that social influences, such as family and peer smoking and tobacco advertising, are important determinants of smoking in adolescents. More recently, research has focused on the impact of smoking in entertainment — including the effect of celebrities who smoke — on youth smoking.

Sargent and his team studied adolescents ages 10 to 14 and found that youth had a higher risk of smoking initiation as their exposure to movie smoking increased, with those youth most exposed to movie smoking being most at risk. Adolescents with the greatest exposure to movie smoking were 2.6 times more likely to try smoking than their peers in the least exposed group, after controlling for other factors. The increased risk of smoking initiation associated with exposure to smoking in the movies was similar to that of other well-known risk factors, such as having a parent or sibling who smokes. This increased risk was seen across youth of all racial and ethnic groups, in all geographic regions of the country.

"This study highlights the significant association between smoking in the movies and youth smoking,” said Cathy Backinger, Ph.D., acting chief of NCI’s Tobacco Control Research Branch. "The study reaffirms the need to continue to address the full range of influences on adolescent smoking.”

According to the Centers for Disease Control and Prevention, the majority of adult smokers started smoking before the age of 18, and, each day, nearly 4,000 young people try their first cigarette. “More than 6.4 million children living today will die prematurely because they started smoking as an adolescent,” said Backinger. “These statistics demonstrate how crucial it is to address the issue of adolescent smoking.”

For this research, Sargent and colleagues first analyzed the amount of smoking depicted in the 500 most popular movies released between 1998 and 2002, as well as 32 high-grossing movies released in the first four months of 2003. A “smoking occurrence” was noted when tobacco use was depicted, either by a major or minor character or in the background. By this standard, smoking occurred in 74 percent of the movies studied. Researchers then conducted a random telephone survey of 6,522 U.S. adolescents ages 10 to 14. Participants were asked whether they had seen a random selection of 50 of the 532 analyzed films. The study participants were also asked, “Have you ever tried smoking a cigarette, even just a puff?” and those who answered “yes” were classified as having tried smoking. The adolescents who participated in the study reported having seen an average of 13 movies, leading to an average exposure to 61 smoking occurrences. Exposure to smoking in movies was significantly higher among Hispanic and black adolescents than among whites.

“Our findings indicate that all U.S. adolescents, regardless of race or place of residence, have a higher risk of trying smoking as their exposure to movie smoking increases," said Sargent. Sargent and his coauthors suggest various approaches to curbing adolescent exposure to movie smoking, including persuading the movie industry to voluntarily reduce depictions of smoking and cigarette brands; incorporating smoking into the movie ratings system to make parents aware of the risks a movie with smoking poses to the adolescent viewer; and encouraging parents to more strongly enforce restrictions on youths’ viewing of R-rated movies, which contain the highest amounts of smoking.

“The findings from this national survey complement other studies that showed that exposure to smoking in the movies predicts later youth smoking," said Robert T. Croyle, Ph.D., director of NCI's Division of Cancer Control and Population Sciences. "Now we need to consider effective ways to reduce youths’ exposure to this preventable risk factor."

To learn more about tobacco control programs at NCI, please visit NCI's Tobacco Control Research Branch Web site at http://cancercontrol.cancer.gov/tcrb/.

For more information about cancer, visit the NCI Web site at http://www.cancer.gov or call NCI's Cancer Information Service at 1-800-4 CANCER (1-800-422-6237).

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U. S. Department of Health and Human Services. It is the primary Federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

--------------------------------------------------------------------------------
* Sargent JD, Beach ML, et al. “Exposure to Movie Smoking: Its Relation to Smoking Initiation among U.S. Adolescents.” Pediatrics 2005; 116: 1183-1191.

[Movies, Youth and Tobacco]

REVIEW ARTICLE
December 1, 2005

Smoking in the Movies Increases Adolescent Smoking: A Review

Objective. Despite voluntary restrictions prohibiting direct and indirect cigarette marketing to youth and paid product placement, tobacco use remains prevalent in movies.

This article presents a systematic review of the evidence on the nature and effect of smoking in the movies on adolescents (and others).

Methodology. We performed a comprehensive literature review.

Results. We identified 40 studies. Smoking in the movies decreased from 1950 to 1990 and then increased rapidly.

In 2002, smoking in movies was as common as it was in 1950. Movies rarely depict the negative health outcomes associated with smoking and contribute to increased perceptions of smoking prevalence and the benefits of smoking. Movie smoking is presented as adult behavior.

Exposure to movie smoking makes viewers' attitudes and beliefs about smoking and smokers more favorable and has a dose-response relationship with adolescent smoking behavior.

Parental restrictions on R-rated movies significantly reduces youth exposure to movie smoking and subsequent smoking uptake.

Beginning in 2002, the total amount of smoking in movies was greater in youth-rated (G/PG/PG-13) films than adult-rated (R) films, significantly increasing adolescent exposure to movie smoking.

Viewing antismoking advertisements before viewing movie smoking seems to blunt the stimulating effects of movie smoking on adolescent smoking.

Conclusions. Strong empirical evidence indicates that smoking in movies increases adolescent smoking initiation.

Amending the movie-rating system to rate movies containing smoking as "R" should reduce adolescent exposure to smoking and subsequent smoking.

--------------------------------------------------------------------------------
Annemarie Charlesworth, MA and Stanton A. Glantz, PhD

Center for Tobacco Control Research and Education, Institute for Health Policy Studies, University of California, San Francisco, California

Key Words: tobacco • prevention • film • initiation • susceptibility • media • parenting

Abbreviations: MSA, Master Settlement Agreement • MPAA, Motion Picture Association of America • CI, confidence interval • OR, odds ratio

- - - - - - -

BACKGROUND

We Support Smoke Free Movies!
Young People are Influenced by What Movies Portray.
Research says Smoking On Screen is the Number One Recruiter of New Adolescent Smokers . . .
http://www.smokefreemovies.ucsf.edu

Youth, Movies and Smoking - Support Smoke Free Movies!
http://www.turtleisland.org/discussion/ ... =6309#6309

Exposure to Movie Smoking
www.smokefreemovies.ucsf.edu

A Call for Movie Warnings
Anti-smoking public service announcements . . .
http://www.turtleisland.org/discussion/ ... =6336#6336

Study says . . .
http://www.cancer.gov/newscenter/pressr ... kingMovies

Listen to the PodCast "Smoking in the Movies" here (MP3 audio file).
http://americanlegacy.org/americanlegac ... movies.mp3

Puke Page, Gross Photos and . . .
http://www.tobaccofacts.org/o2zone/index.html

Smoking Sucks . . .
http://www.smokingsucks.ca/

Aboriginal Youth and Tobacco
http://www.fsin.com/healthandsocial/Tobacco/youth.html

Aboriginals - Tobacco Resource List . . .
http://www.tobaccofacts.org/order/aboriginal.html

Maori Smoke free Coalition . . . http://www.auahikore.co.nz

Aboriginal Youth and Smoking - a link to heart disease
http://www.turtleisland.org/discussion/ ... php?t=4014

Smoking linked to risk of diabetes . . .
http://www.turtleisland.org/discussion/ ... php?t=3975

Quit 4 Life
http://www.quit4life.com/

[Teens and Tobacco]

Aboriginal Youth for Tobacco Wise Communities. . .

Commercial Tobacco is a KILLER!

Traditional Tobacco is a HEALER!

FIND OUT MORE:

About Traditional Tobacco - What the Elders Have to Say - Sacred Tobacco Links . . .
http://www.tobaccowise.com/

In a recent study, First Nations girls, 15-17 years old, have a smoking rate of 61%. The national rate for girls in the same age range is 15%. In the same study, First Nations boys, 15-17 years old have a smoking rate of 47%. The national rate for boys in the same age range is 13%.
http://www.tobaccowise.com/downloads/30 ... inal01.mp3

A “tobacco wise” community knows the difference between Traditional Tobacco and commercial tobacco. The hope is to reduce the overall smoking rates while acknowledging the role Traditional Tobacco has in the Aboriginal community.
http://www.tobaccowise.com/downloads/30sMALE_Final3.mp3

“Traditional Tobacco is a gift that was given to Aboriginal people by the creator and it has a spiritual place within our communities,” Ernie Benedict, Elder, Iroquois Nation.

“When tobacco is burned the smoke rises, which provides a link to all the spirits beyond the sky. Tobacco in its original form had both honour and purpose. Traditional Tobacco did not contain all the chemicals that are now put into it. What is sold today has been tampered with for business and profit, taking away from its original purpose.”


Be Tobacco Wise . . .
http://www.tobaccowise.com

[Aboriginals Quit Smoking]

Province launches first ever awareness campaign to reduce smoking among Aboriginal peoples

"What You Do Matters" Is First Aboriginal-Specific Quit Smoking Campaign

TORONTO, Jan. 25, 2007

The government of Ontario is launching "What You
Do Matters," a public awareness campaign aimed at encouraging members of the Aboriginal community to quit smoking, Minister of Health Promotion Jim Watson
announced today.

"Smoking is the leading cause of preventable death and we're determined to work with Aboriginal communities to make a difference," said Watson "The
"What You Do Matters" campaign is a call to action for each individual, family and community to help improve their health environment and the quality of life for all Aboriginal peoples."

The campaign consists of 30-second radio announcements, print ads in targeted publications, posters distributed in Band offices, Friendship
Centres, Health Centres and other gathering places. Pamphlets and fact sheets are available to Aboriginal communities and the media. Additional information
is available at www.ontario.ca/SmokefreeMatters.

The rate of smoking among Aboriginal peoples can be three times the provincial average.

Tobacco-related diseases cost the Ontario health care
system at least $1.7 billion annually, result in more than $2.6 billion in productivity losses, and account for at least 500,000 hospital days each year.

Anishinabek Nation's Grand Council Chief John Beaucage supports the public awareness objective of the campaign.

"The Anishinabek Nation is committed to reducing the non-traditional use of tobacco and the health burdens from the misuse of tobacco amongst its citizens, says Chief Beaucage. "Our member communities have signalled this shared commitment by providing us with a mandate to develop an Anishinabek Nation Smoke-Free Strategy to encourage and promote the use of Anishinabek First Nation initiatives aimed at reducing non-traditional tobacco use and creating smoke free environments within Anishinabek territory."

"We will continue to work with the province where our Strategy and Anishinabek First Nation initiatives share common goals and objectives. This is an issue that affects the health of children, and healthy children are our future."

Minister Watson also announced that the Ontario government is providing $230,000 to Cancer Care
Ontario for organizing an Aboriginal Tobacco Strategy Youth Summit in March 2007. The Summit will be the first ever Aboriginal youth-specific smoke-free event sponsored by Ontario. The overall goal of the Summit is to increase awareness of the harm caused by commercial tobacco in Aboriginal communities, and engage youth in developing action plans.

This funding is part of an annual investment of $2 million under the Smoke-Free Ontario Strategy to help Aboriginal communities break the cycle of smoking addiction. The Ontario government also invests $8.8 million in programs to prevent youth from using tobacco products.

"The alarmingly high rate of commercial tobacco use by Aboriginal youth compared to national youth demonstrates a need for specific campaigns to raise
awareness about the difference between traditional tobacco and commercial tobacco use," said Dr. John McLaughlin, vice president, preventive oncology,
Cancer Care Ontario.

"The government's investment in the Aboriginal Tobacco Strategy Youth Summit is a critical step to reaching Aboriginal youth about the harms of smoking and taking action to prevent or stop Aboriginal youth
from smoking commercial tobacco."

Ontarians can learn about the dangers of tobacco and get tips on how to quit smoking from January 21-27, which is National Non-Smoking Week in Canada.

This week is a great chance for all Ontarians to quit smoking or to support friends, family members and colleagues who are making the important decision
to quit.

www.mhp.gov.on.ca

www.ontario.ca/smokefree

For further information: Adam Grachnik, Minister's Office, (416) 326-8497; Julie Rosenberg, Communications Branch, (416) 326-4833

[admin]

World Health Organization

WHO calls for enforceable policies to restrict smoking in movies
http://www.turtleisland.org/healing/tobacmovies09.pdf


1 June 2009 -- Backed by evidence that smoking in movies causes youths to want to light up, the World Health Organization is calling upon countries to enact enforceable policies that would severely restrict such depictions.


The report recommends that all future movies with scenes of smoking should be given an adult rating, with the possible exception of movies that reflect the dangers of tobacco use or that depict smoking by a historical figure who smoked.

Studies show that smoking continues to permeate movies, including those rated as suitable for youth. The policies recommended would help ensure that movies that are marketed to youth do not include tobacco imagery.

"Voluntary agreements to limit smoking in movies have not and cannot work," the report says. It continues, "Logic and science now support enforceable policies to severely restrict smoking imagery in all film media."

"The WHO recommendations are evidence-based and very much needed," said WHO Assistant Director-General Dr Ala Alwan. "Tobacco kills more than five million people per year. Each day approximately 100,000 young people take up smoking. Restricting smoking in movies will go a long way towards stemming the tobacco epidemic."

Studies show that smoking in movies misleads youths into thinking that tobacco use is normal, acceptable, socially beneficial and more common that it really is. Studies also show that such movies rarely portray the harm of tobacco, instead portraying the product as conducive of a cool and glamorous lifestyle.

From Hollywood to Bollywood and beyond, movies are a global commodity. National policies to restrict smoking in movies can produce wide-ranging global benefits.

"Smoking does not belong in youth-rated movies", said Dr Douglas Bettcher, Director of WHO's Tobacco Free Initiative. "The more smoking adolescents see on screen, the more likely they are to start smoking. These simple policies can save generations of young people from a lifetime of addiction and an early death from tobacco."

The report also recommends that movie studios should:

certify that they received no payoffs from tobacco companies to display tobacco products or their use
stop displaying tobacco brands onscreen
require strong anti-tobacco advertisements before all movies that have tobacco imagery
The report stresses that enforceable policies eliminate smoking from movies must form part of any comprehensive tobacco control programme.
- - -

Previously reported on This Subject . . .

New Report Shows Some Progress in Reducing Youth Exposure to Smoking in Films
2/25/2009

Statement by Cheryl G. Healton, President and CEO, American Legacy Foundation

WASHINGTON, D.C. — A new report released this month, Smoking Presentation Trends in U.S. Movies 1991-2008, indicates that tobacco exposure incidents per film have decreased by about half since 2005. However, smoking imagery on film still remains a problem. While the fraction of all films that are smoke free has been growing since the late 1990s, it still remains below 50%, even for youth-rated (G/PG/PG13) films, leaving a majority of movies with smoking. In fact, most youth exposure to on-screen smoking occurs in youth-rated films. In 2008, PG13-rated films delivered 65 percent of on-screen tobacco impressions.

The report was conducted by Breathe California of Sacramento-Emigrant Trails and the Center for Tobacco Control Research and Education University of California, San Francisco.

Despite the initial progress this report indicates, there is still much work to be done. What the American Legacy Foundation supports – along with a host of other organizations – are evidence-based policies that will limit or eliminate smoking on the screen, including: the elimination of smoking from G, PG and PG13 films by rating movies R if they contain smoking, with the exception of when tobacco use and its dangers and consequences are accurately portrayed or when it is necessary to portray the actual smoking habits of a real historical figure; certification of no pay-offs, by posting a certificate in movie credits declaring that no talent or members of the production team received anything in exchange for using or displaying tobacco; ending the identification of tobacco brands in any movies scenes and requiring strong anti-smoking ads to run before films with any tobacco presence regardless of its rating.

The Walt Disney Company deserves a special recognition for their role in helping reduce tobacco imagery from movies. This report indicates that smoking images have nearly disappeared from Disney’s G- and PG-rated films. Fox has also made progress, where in three of the past five years, 66 percent of the company’s youth-rated films have been smoke-free.

The American Legacy Foundation http://www.americanlegacy.org
- - -

R RATING MIGHT BE UNLIKELY TO AFFECT TEENS EXPOSURE TO SMOKING IN MOVIES
New Zealand study underscores link between exposure to on-screen smoking and adolescent smoking but questions the utility of the R rating in limiting exposure

September 25, 2007

WORCESTER, Mass.— Several recent research studies published in the United States have determined that young adolescents who see smoking scenes in movies are more likely to smoke. To combat smoking among youth, public health groups have called for Restricted (R) ratings for movies that depict smoking. A new study from New Zealand, however, calls that strategy into question, noting that the R rating may not have the intended effect of putting such movies “out of reach” of children.

“Significantly, we found that 94 percent of the 14 to 15 year olds in our sample watched R-rated movies, and 38.5 percent did so on a weekly basis. Therefore, limiting smoking to R-rated movies will likely not eliminate the influence of smoking in the movies,” said Joseph R. DiFranza, MD, professor of family medicine & community health at the University of Massachusetts Medical School, who conducted the study with colleagues from New Zealand.

The study, published in Preventive Medicine, was conducted to follow up on previous reports from the U.S. that demonstrated an increased risk of smoking among youth who watched movies that depict smoking. Almost all of the movies screened in New Zealand come from the U.S. The New Zealanders conducted surveys of 88,505 high school students of largely European, Maori, Asian or Pacific Islander ethnicity. They asked students how often they watched R-rated movies and also about their intention to smoke, past experiences with smoking and their current smoking habits.

The more often youths watched R-rated films the more likely they were to smoke, or to have intentions to smoke in the future if they hadn’t already started. Those who watched the most R-rated films were twice as likely to have tried smoking as youths who never watched them. Among the nonsmokers, those who watched the most R-rated movies were nearly three times as likely to be susceptible to starting to smoke, even when the researchers controlled for age, gender, ethnicity, peer smoking, parental smoking, socioeconomic status, pocket money and household smoking rules.

“The good example parents set by not smoking and forbidding smoking in the home can be trumped by the glamorization of smoking in the movies. The U.S. movie industry contributes to the spread of teen smoking around the globe, rivaling the influence of the tobacco industry,” said co-author Dr. Joseph DiFranza.

DiFranza conducted this study with colleagues Murray Laugensen of Health New Zealand, Robert Scragg of the University of Auckland, New Zealand, and Robert J. Wellman, MD, of both UMMS and Fitchburg State College in Massachusetts.

The article "R-Rated Film Viewing and Adolescent Smoking" was published in Preventive Medicine and is available through http://www.ScienceDirect.com
Contact: Joseph R DiFranza MD, 508 856-5658.
- - - - - - -

Smoking in youth-rated films can turn adolescents into smokers

TORONTO, Sept. 9, 2006
According to a Dartmouth University medical study, viewing smoking scenes in movies can turn adolescents into smokers. The study reports that more than one third of adolescents between 10 and 14 years of age who start smoking do so as a direct result of exposure to smoking in
movies.

A review of last year's top movie releases shows that 58% of youth-rated
films featured smoking scenes. Of the top 100 box-office hits for each year
from 1996-2004, 56% of smoking occurrences were portrayed in youth-rated films.

"Current research indicates that smoking in movies is strongly linked with youth taking up smoking during their adolescent years," says Irene Gallagher with the Ontario Tobacco-free Network.

The Ontario Tobacco-free Network sees this data as an opportunity to
raise awareness among parents and youth regarding the impact of smoking in movies and the extent to which the tobacco industry will go to ensure youth see their favourite actors smoking. Non-smoking teens whose favourite stars frequently smoke on screen are 16 times more likely to have positive attitudes about smoking in the future.

Paid tobacco product placement has been banned since 1998. So why is
tobacco still showing up in movies?

Tobacco kills 16,000 Ontarians each year and is the number one preventable cause of death in Ontario.

For more information on smoking in movies and for a copy of the Dartmouth medical study, visit http://www.theotn.org

- - -

A Call for Hollywood Studios to Insert Anti-smoking Messages
2005
viewtopic.php?p=6336#p6336

- - -

Something Stinks in Hollywood . . .
http://www.smokefreemovies.ucsf.edu

Study says . . .
http://www.cancer.gov/newscenter/pressr ... kingMovies


"Almost 1 in 8 movies geared toward adolescent audiences with a rating of PG-13 continue to feature tobacco brands."

Tobacco Brands Still Common in Pg-13 Movies, Despite ’98 Master Settlement

May 18, 2005

Seven years after tobacco companies signed an agreement prohibiting them from paying for tobacco brand appearances in movies, the number of tobacco brand appearances in PG-13 rated movies has not experienced a statistically significant decrease, according to a Dartmouth study.

Seven years after tobacco companies signed the Master Settlement Agreement prohibiting them from paying for tobacco brand appearances in movies, the number of tobacco brand appearances in PG-13 rated movies has not experienced a statistically significant decrease, according to a study by Dartmouth Medical School researchers.

The research, published in the May 18 issue of the Journal of the American Medical Association (JAMA), analyzed the number of tobacco brand appearances in 400 movies released before the Master Settlement Agreement (MSA) (1996-1999) and 400 movies released after it was signed (2000-2003) and found that overall, there was a marked decline in the number of tobacco brand appearances in R-rated movies in the wake of the agreement.

But almost 1 in 8 movies geared toward adolescent audiences with a rating of PG-13 continue to feature tobacco brands, which was not a significant change since the agreement was enacted at the end of 1998.

“The ratings piece was a big surprise,” said lead author Dr. Anna Adachi-Mejia, instructor in pediatrics at Dartmouth Medical School and a member of the Norris Cotton Cancer Center. “Although we saw an overall decline, the percentage of PG-13 movies with tobacco brands didn’t decrease post-MSA. That’s worrisome because part of the intent of the MSA was to reduce tobacco advertising directed towards youth, and our study demonstrates that tobacco brands are still appearing in films rated for adolescents.”

The number of movies with tobacco brand appearances (defined in the study as the depiction of a tobacco brand name, logo, or identifiable trademark) dropped from 20.8% to 10.5% of top box-office films after the agreement took effect. However, this decrease was not consistent across the ratings spectrum, as the percentage of R-rated movies with tobacco brand appearances decreased by 55.4% (29.8% to 13.3%) after 1999, whereas, the slight decrease in the percentage of PG-13 movies with tobacco brand appearances (15.0% to 11.8%) was not statistically significant.

Prior Dartmouth Medical School studies have shown that viewing smoking in movies is associated with smoking initiation among adolescents. If tobacco companies are not paying movie studios to feature their tobacco brands, they are not in violation of the MSA. However, Dr. Adachi-Mejia notes that, “the continued presence of tobacco brand appearances in movies, whether paid for or not, undermines the intent of the MSA and limits the favorable impact the MSA could have on preventing youth smoking.”

[admin]

NEWS RELEASE

CANCER CARE ONTARIO

Aboriginal youth take action to promote tobacco-wise sports and recreation

http://www.tobaccowise.com


“Don’t do it - you’ll get hooked!” is what Amy Waboose is telling her friends, family and her community about smoking and chewing tobacco.

Amy, a Grade 10 student from Whitefish River First Nation, is part of a “tobacco-wise” youth group, focused on raising awareness about the negative health effects of commercial tobacco use among First Nations communities.

“From March 15-19, we will be sharing our message - Scream, Shout & Butt It Out! - at the Little Native Hockey League (Little NHL) in Sudbury, Ontario,” says Amy.

Amy’s youth group - part of Cancer Care Ontario’s Aboriginal tobacco program (ATP) - brings the tobacco-wise campaign to life.

The campaign is a partnership between Cancer Care Ontario’s (CCO) Aboriginal tobacco program, the Ontario Lung Association (OLA) and Whitefish River First Nation community.

The goals of the campaign include empowering Aboriginal youth to get involved and raise awareness about the negative effects of tobacco use on health and athletic performance.

The Little Native Hockey League (NHL) tournament draws approximately 5,000 people from First Nations communities across Ontario.

Amy and other youth volunteers feel that the tournament provides an important opportunity to spread awareness.

“It is a big event and we will be surrounded by people from our communities,” says Amy. ”Together, we’ll spread a very important message, helping people understand the difference between traditional and commercial tobacco.”

“Approximately 58 percent of First Nations adults and 38 percent of First Nations youth smoke - more than double the provincial rates,” says Dr. George Pasut, vice-president, Cancer Care Ontario, prevention and screening. “Lung cancer is the leading cause of cancer death yet it is the most preventable type of cancer. The single most important thing we can do is eliminate commercial tobacco use and the Aboriginal tobacco program is committed to advancing this effort.“

The tobacco-wise youth group has met weekly since January to learn about the differences between traditional and commercial tobacco and to develop their educational resources.

The Youth Advocacy Training Institute (YATI), a program of the OLA, has led the training of the youth to prepare them to talk to the Little NHL community about these differences and being tobacco-wise.

Being tobacco-wise means understanding the difference between traditional and commercial tobacco.

Traditional tobacco has a spiritual meaning for many First Nation peoples.

It can be a sacred medicine, or a way to communicate with the spirit world, or can be given to elders when requesting guidance.

“We are thrilled to be working with First Nations youth who feel moved to make a difference in the lives of their peers. Only together will we be able to improve lung health and begin to tackle commercial tobacco use amongst Aboriginal young people”, says George Habib, president and CEO, Ontario Lung Association.

During the tournament the youth will encourage participants to visit tobacco-wise booths, located at Countryside and Walden arenas, as well as handing out “hockey cards” with tobacco-related information.

Participants will be encouraged to collect all four cards in the series and visit the booths to win prizes.

This is the second year in a row that the youth group has promoted the iobacco-wise campaign during the Little NHL.

Last year, the campaign received a positive response from the Little NHL community, First Nations Chiefs and well known hockey players, including former NHLer, Ted Nolan.

For more information about the Aboriginal tobacco program and the tobacco-wise campaign, please visit: http://www.tobaccowise.com
- - -

Also of interest on this topic . . .
http://www.turtleisland.org/discussion/viewtopic.php?p=5662#p5662

- - -

Use and misuse of tobacco among Aboriginal peoples

First Nations and Inuit Health Committee, Canadian Paediatric Society (CPS)

ABSTRACT
Changes in the use of tobacco by Aboriginal peoples have occurred over time, from the spiritual, ceremonial use of fairly mild tobacco at the time of the first contact with Europeans to the highly addictive tobacco in use today, both in ceremonies and recreationally. Although some people still have access to and are using traditional sacred tobacco, subsequent misuse of tobacco has put the health, quality of life and life expectancy of a large number of adults and children in First Nations and Inuit communities in peril (1). The present document, a revision of a 1999 Canadian Paediatric Society statement on smoking (2), looks at the consequences of tobacco use and possible reasons for its high prevalence, and explores some attempts at a solution.

Key Words: Aboriginal; Addiction; Prevention; Spiritual; Strategies; Tobacco

PREVALENCE
The prevalence of smoking in Canada has decreased gradually from a high of approximately 35% in the mid-1980s. Data published by the Canadian Tobacco Use Monitoring Survey (3) indicated that as of June 2004, an estimated 5.1 million people, representing roughly 20% of the population aged 15 years or older, were current smokers. The prevalence of smoking in youth aged 15 to 19 years also followed a downward trend, from approximately 45% in 1981 to 20% in 2004 (3).

However, the prevalence of smoking in Aboriginal Canadians, although gradually decreasing, remains high. Recent statistics (4) indicate that the rate of smoking among First Nations people in Canada (59%) is still approximately three times the rate for the general Canadian population. Among 15- to 17-year-old adolescents, the rate of smoking among boys (47%) and girls (61%) is still three times the national rate. In a 2005 study of a First Nations community in Manitoba (5), 82% of adolescents aged 15 to 19 years were current smokers. Similarly, 70% of Inuit aged 18 to 45 years are current smokers (6).

CONSEQUENCES OF TOBACCO USE
Tobacco use continues to be a leading cause of preventable death in North America, particularly due to myocardial disease, vascular disease, chronic lung disease such as emphysema, cancer of the lung and other cancers (7). Smoking is also a risk factor for the development of type 2 diabetes (8), which is very common in Aboriginal populations. There is also evidence of faster progression of complications in diabetics who smoke (8-10). Smoking is also associated with an increased risk of fires.

Smoking during pregnancy is particularly hazardous to the fetus (11,12). Complications include an increased number of perinatal deaths, placental problems, increased preterm deliveries, fetal growth retardation (13), congenital abnormalities such as gastroschisis, sudden infant death syndrome, increased risk of miscarriage and learning disabilities (11). Smoking during pregnancy has also been associated with withdrawal symptoms in the newborn period (14) and attention deficit hyperactivity disorder symptoms in childhood (15), and is a risk factor for subsequent nicotine dependence in adolescence (16). Children of mothers who smoked a pack or more of cigarettes per day during pregnancy are at elevated risk of developing nicotine dependence as adults (17).

Postnatal exposure to second-hand smoke results in increased rates of lower respiratory infections, decreased lung growth, increased otitis media, increased risk of sudden infant death syndrome and increased risk of asthma. In 2001, regular smoking occurred in 21% of homes in Canada with children younger than 12 years of age (18).

FACTORS INFLUENCING NICOTINE USE
Nicotine addiction
Nicotine, one of the most highly addictive substances in the world, acts on the same pleasure centres of the brain as other drugs such as heroin and cocaine. It was previously thought that nicotine addiction developed over months or years of exposure. However, recent evidence suggests that even occasional use over a short period of time can be addictive. Nicotine has a positive effect on mood and performance (19), resulting in more efficient processing of information. This may be the basis for addiction. Small, frequent doses increase alertness and arousal, while larger, more prolonged doses lead to sedation and reduced anxiety. In addicted individuals, increasing doses may be necessary to achieve the same beneficial effects, and symptoms of nicotine withdrawal occur when nicotine is withdrawn.

Age at onset of tobacco use may be a significant factor in the development of addiction to tobacco. When introduced to nicotine and allowed free access to the substance, 'adolescent' rats showed a significantly higher ingestion of nicotine, up to eight times more than rats first introduced to nicotine as adults (20). Reduced sensitivity to taste is associated with increased risk of addiction (21). High nicotine levels associated with first-time use may result in a less than pleasant experience and discourage further smoking.

A number of genetic factors (20), including the nicotinic acetylcholine receptor, the dopamine transporter gene (22) and cytochrome P450 2A6, appear to be associated with the development of nicotine addiction (23). Polymorphism in the genes regulating nicotine metabolism is an important factor in the development of addiction. These three enzyme systems are the subject of intense study.

Although addiction is a known consequence of tobacco use, there are no data suggesting racial or genetic differences related to nicotine metabolism.

Youth access to tobacco
Although the highest prevalence of tobacco use is among youth aged 15 to 24 years (5), smoking initiation can begin as early as 11 to 13 years of age, several years before it is legal for a youth to buy tobacco in Canada. For Aboriginal youth, smoking and the use of smokeless tobacco can begin as early as seven or eight years of age, with even younger children imitating the habits of adults around them.

Studies have shown that easy access to cigarettes is one of the best predictors of a child becoming a regular smoker at a young age; in 2004, a majority (56%) of underage smokers reported obtaining tobacco from friends and family. Furthermore, despite regulations, 33.3% of retailers have continued to sell cigarettes to underaged Canadians. This is complicated by the fact that there is no consistent minimum smoking age across Canada.

Poverty and educational level
Studies have shown a correlation among poverty, high unemployment, low income and high rates of smoking. Parents with lower incomes and educational levels are more likely than higher-paid, better-educated parents to have teenage children who smoke (24). Low income levels and high unemployment rates are problems on most reserves in Canada, and affect many off-reserve Aboriginal people as well.

Cost of tobacco
Tobacco use varies inversely with price. Among youth, a 10% increase in price is associated with a 14% decrease in the prevalence of smoking (25). Tax is a major determinant of tobacco price and varies markedly across Canada. The price of a carton of cigarettes can range from a low of approximately $20 in Quebec for discount cigarettes to a high of $42 in the Northwest Territories for duty-paid cigarettes. The availability of tax-free tobacco on reserves undermines the deterrent of high price to smoking. Furthermore, because selling tax-free tobacco off-reserve can be a good source of income, there may be little incentive to discontinue the practice (26).

Cultural factors
For many First Nations people, tobacco has been used traditionally in ceremonies, rituals and prayer for thousands of years. It is used for a variety of medicinal purposes and its ceremonial use has powerful spiritual meaning, establishing a direct communication link between the person giving and the spiritual world receiving. In the traditional sense, the most powerful way of communicating with the spirits is to smoke tobacco in a sacred pipe. While tobacco is sacred, the recreational use of tobacco, with its high content of nicotine, is addictive and harmful. First Nations Elders maintain that this type of use is disrespectful of the spiritual, medicinal and traditional use of tobacco. These observations echo those of the Assembly of First Nations (6).

While tobacco has rarely been used ceremonially in Inuit culture, over seven in 10 adults now smoke daily - a rate higher than that of First Nations and Metis people. Traditional Inuit society was smoke-free. The Inuit did not use tobacco until approximately 100 years ago. At first, it was mainly men who smoked, and it was forbidden for Inuit youth to use tobacco. In the 1940s, smoking became more prevalent among all Inuit, and today, Inuit women have one of the highest rates of lung cancer in the world (27).

Until recently, smoking was accepted as a fact of life in the North, so there had been few efforts to discourage it. In the mid-1990s, nicotine use in Nunavut remained widespread and showed no obvious signs of abating. However, increasing awareness of decreased life expectancy, infant mortality rates three times the national average, and high rates of lung disease and cancer (28) spurred Nunavut to adopt fairly extensive tobacco reduction initiatives in 2003, affecting all aspects of life, school, the home and the community (29,30). Since then, a ban on smoking has been extended to all public and workplaces (31).

ADDRESSING THE PROBLEM OF HIGH TOBACCO USE

A number of programs have been established by provincial and territorial governments to target the broad social environment. In most cases, provincial regulations do not apply to reserves. These programs include:
The establishment of smoke-free public and workplaces to protect nonsmokers from second-hand smoke (31).
Efforts to standardize legal age limits for tobacco use and penalties for selling to minors.
Keeping tobacco products out of sight - the so-called "shower curtain law".
Banning tobacco advertising and displays.
Taxing tobacco at a high level to produce cigarette prices sufficiently high to deter regular smoking among adolescents.
The use of health warnings on cigarette packages.

Success with these measures has been variable. In January 2005, during National Non-Smoking Week, the Canadian Council for Tobacco Control brought out a "Report Card", which graded the antismoking legislation accomplishments of all Canadian provinces and territories. Six categories were selected for grading. Results were variable. For example, in the area of tobacco pricing, marks ranged from an A+ for the Northwest Territories to Fs in Ontario, Quebec and the Yukon (31).
Health Canada and national Aboriginal organizations have become proactive in dealing with the issue of tobacco misuse.

National programs to increase awareness of the problems of tobacco misuse
In 2001, the federal government allocated $480 million over five years for the Federal Tobacco Control Strategy. Of this amount, the government committed $50 million to address the high rates of tobacco misuse of First Nations peoples on-reserve and of Inuit in Inuit communities. Unfortunately, this amount has been recently decreased by $10.8 million (32). The First Nations and Inuit Tobacco Control Strategy was developed to focus on building capacity and community support; influencing behaviours and attitudes; ensuring provider compliance; and coordinating and developing programs. Annually, the First Nations and Inuit Tobacco Control Strategy supports hundreds of community drive projects to reach these objectives. The First Nations and Inuit Health Branch works in partnership with national Aboriginal organizations, such as Assembly of First Nations and Inuit Tapiriit Kanatami, to raise awareness of tobacco misuse as a serious health issue to communities (33).
Among First Nations, tobacco control programs are being developed for, and delivered to, community health representatives (CHRs) and tobacco cessation counsellors. Strategies include capacity building; developing and delivering comprehensive, culturally sensitive and effective tobacco control programs; promoting the health of First Nations and Inuit peoples by decreasing the prevalence of tobacco smoking and smokeless tobacco use; and engaging leadership of First Nations and Inuit in learning to voice opinions and support tobacco control strategies (34).

Smoking cessation programs
The First Nations and Inuit Health Branch recently updated its suggestions on quitting smoking. Their Web site (35) lists toll-free smoking lines, a list of nicotine replacements and medications to assist in smoking cessation, a list of community-based cessation programs and counselling services, and detailed self-help suggestions such as the "5 steps to quitting".

These steps, which are expanded upon on their Web site, include:

Get ready.

Get support.

Learn new skills and behaviours.

Get medication and use it correctly.

Be prepared for relapse or difficult situations.

A number of links to cessation resources are also available on their Web site.

Antismoking measures
Antismoking measures include messages, spread by multiple routes and repeated over time, that aim to:

promote smoke-free spaces (public, private and work places), and are aimed mainly at adults under the age of 35 years (current prevalence for those aged 20 to 34 years is 27%, which is higher than the smoking rate of the general population [3]);
target pregnant and postpartum women;
target third-party suppliers of tobacco products to youth (eg, parents, siblings, older teens and other adults) with the goal of curtailing the supply of tobacco to youth; and
continue bans on smoking advertisements and tobacco company sponsorship.
Bans on smoking in the workplace
A number of provinces and territories have smoking bans in the workplace and in public areas to decrease exposure to second-hand smoke (31). The success of bans aimed at decreasing smoking in restaurants, bars, indoor recreational areas (including bingo halls) and public buildings has been variable (36). In Manitoba, the smoking ban legislation exempts reserves and, therefore, there is no smoking ban to follow.

Although it is true that some communities are passing bylaws that provide less protection than provincial smokefree legislation, other communities are passing bylaws that not only support provincial legislation but in some cases surpass it.

Other measures designed to address the individual misuse of tobacco

Teaching and practicing "resistance" skills.

The use of antismoking medication, either nicotine substitution (eg, the "patch") or non-nicotine drugs such as bupropion (Zyban, Biovail Pharmaceuticals,Canada) (37).

The enforcement of age limits on tobacco sales and measures to remove cigarettes from public view.

Emphasis on the role of the physician and health care professional in smoking control. This includes counselling patients to help prevent and stop smoking. This emphasis should be part of routine preventive care at each office or community health visit (38). The five "As" should be used routinely:

ASK about tobacco use

ADVISE urge to quit

ASSESS willingness to attempt quitting

ASSIST - counselling and pharmacological therapy

ARRANGE follow-up

Taking advantage of educational opportunities; for example, use the experience of a smoking-related illness of a family member to educate family and community members about the dangers of tobacco, emphasizing control measures, cessation strategies and the use of nicotine substitution therapy such as the "patch".

Advocacy: Actively promote school-based prevention programs and be actively involved in policy interventions related to smoking.

SUMMARY
The high prevalence of tobacco use and misuse among Aboriginal people compared with their non-Aboriginal counterparts, as well as the resultant health consequences, continue to be of concern not only to the individuals using tobacco but also to others, especially infants, children, youth and pregnant women exposed to second-hand smoke.

Recently proposed solutions by First Nations and Inuit groups, federal, provincial and territorial governments, and other interested organizations need to be implemented. Difficulties in implementation include acceptance of these measures by the large numbers of jurisdictions involved, often with competing priorities. These include economic factors, such as a conflict between the perceived need to raise money by selling tax-free tobacco for communities and the desirability of using a high price to discourage tobacco use. There is also no coordination of minimum smoking ages across Canada and no means to decrease exposure to tobacco products, especially to youth.

A number of recommendations have been formulated as a guide to groups interested in decreasing tobacco use. These recommendations were generated through consensus, and were prepared with the participation of a number of Aboriginal and non-Aboriginal groups.

RECOMMENDATIONS

Aboriginal communities should adopt a minimum age for the sale of cigarettes.
Aboriginal communities should encourage dialogue in the community to help change attitudes toward the acceptability of recreational tobacco use.
Aboriginal communities should continue to discourage smoking in the workplace and institute bans of nontraditional use of tobacco in public places such as restaurants, recreational facilities, bingo halls and casinos.
First Nations reserves should focus on continuing to educate retailers on-reserve about the Tobacco Act and discourage the sale of tax-free tobacco products, especially to non-Aboriginals.
Because cost influences tobacco use (25), Aboriginal communities should be encouraged to place their own surcharge on tobacco products (when purchased for nontraditional use) to increase the price to match off-reserve prices; the increased revenue should then be directed to smoking prevention programs in the community.
A well-defined system should be established within a community to enforce all tobacco laws. The consequences of breaking these laws should be well defined.
Cigarettes and other tobacco products should remain behind counters and out of sight in all stores.
Aboriginal communities should encourage community members to establish smoke-free homes to diminish exposure of children to second-hand smoke.
Nicotine replacements such as the "patch" and nicotine-free tablets such as bupropion should be encouraged as part of a smoke cessation program. While at present there is limited availability of these drugs under the Non-Insured Health Benefits Program, it is recommended that these drugs be readily available when clinically appropriate.
Physicians and health care workers should use the opportunity afforded by clinic visits to explore smoking and tobacco use habits, to educate about the dangers to individuals directly or through second-hand smoke, and to introduce smoking-cessation strategies.
All Aboriginal communities should discourage nontraditional use of tobacco products.
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FIRST NATIONS AND INUIT HEALTH COMMITTEE
Members: Drs James Irvine, La Ronge, Saskatchewan; Heather Onyett, Queen's University, Kingston, Ontario (board representative); Kent Saylor, Montreal Children's Hospital, Montreal, Quebec (chair); Sam Wong, Edmonton, Alberta; Michael Young, Stanton Territorial Hospital, Yellowknife, Northwest Territories; Sam Wong, Edmonton, Alberta
Consultants: Drs James Carson, University of Manitoba, Winnipeg, Manitoba; John C Godel, Heriot Bay, British Columbia
Liaisons: Dr George Brenneman, Baltimore, Maryland, USA (American Academy of Pediatrics, Committee on Native American Child Health); Ms Kelly Butler, Ottawa, Ontario (First Nations and Inuit Health Branch, Health Canada); Ms Debbie Dedam-Montour, Kahnawake, Quebec (National Indian and Inuit Community Health Representatives Organization); Ms Elizabeth Ford, Ottawa, Ontario (Inuit Tapiriit Kanatami); Ms Carolyn Harrison, Ottawa, Ontario (First Nations and Inuit Health Branch, Health Canada); Ms Margaret Horn, Kahnawake, Quebec (Aboriginal Nurses Association of Canada); Ms Kathy Langlois, Ottawa, Ontario (First Nations and Inuit Health Branch, Health Canada); Ms Melanie Morningstar, Ottawa, Ontario (Assembly of First Nations); Mr Mark Schindel, Ottawa, Ontario (First Nations and Inuit Health Branch, Health Canada)
Principal author: Dr John C Godel, Quadra Island, British Columbia

Disclaimer: The recommendations in this position statement do not indicate an exclusive course of treatment or procedure to be followed. Variations, taking into account individual circumstances, may be appropriate. Internet addresses are current at time of publication.

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Smoking in Top-Grossing Movies — United States, 1991–2009

Seeing smoking in motion pictures increases the probability that youth will start smoking.

Youth who are heavily exposed to onscreen smoking are approximately 2 to 3 times more likely to begin smoking than are lightly exposed youth.

An analysis of top-grossing movies from 1991-2009 found that, although depictions of tobacco use have declined in recent years, more than half of movies rated PG-13 still contained tobacco imagery in 2009.

Policies to decrease the negative impact of movie smoking could include assigning R ratings to new movies that portray tobacco imagery, requiring strong anti-tobacco ads preceding movies that depict smoking, not allowing tobacco brand displays in movies, and requiring producers of movies depicting tobacco to certify that nobody associated with the production received any consideration for that depiction.

Effective means to reduce the harms of onscreen tobacco use should be implemented.

Dr. Stanton Glantz
Professor of Medicine
Director, Center for Tobacco Control Research and Education
University of California at San Francisco
Phone: (415) 476-4683

Highlights

Overview

* Exposure to onscreen smoking in movies increases the probability that young people will start smoking.
* Young people who are heavily exposed to onscreen smoking are approximately 2–3 times more likely to begin smoking compared with young people lightly exposed to seeing people smoke in movies.
* This study counted tobacco incidents (the use or implied off-screen use of a tobacco product by an actor) and in-theater tobacco impressions (number of incidents viewed by moviegoers) for top-grossing films in the United States from 1991 to 2009.

Recent Onscreen Smoking Trends

* During 1991–2001, the total number of in-theater onscreen smoking impressions varied from 30–60 billion per year.
* The number of onscreen smoking incidents peaked in 2005 and then steadily declined over the next 4 years (in top-grossing films sampled)

o Between 1991 and 1997, onscreen smoking incidents ranged from 2,106–3,386 per year.
o The number of onscreen smoking incidents then declined, but rose again to peak at 3,967 in 2005.
o From 2005 to 2009, the number of onscreen smoking incidents dropped 52% (to 1,935 in 2009).

Onscreen Smoking in 2009

* Approximately 54% of PG-13 films contained incidents of tobacco use in 2009.
* By 2009, the total number of in-theater onscreen smoking impressions had declined to an estimated 17 billion per year.

* The percentage of smoke-free films reached a high point in 2009.
o Approximately 51% of all top-grossing films did not show tobacco use in 2009.
o Approximately 61% of all top-grossing youth-rated films (G, PG, or PG-13) did not show tobacco use in 2009.

BACKGROUND: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5932a2.htm?s_cid=mm5932a2_x