Gotham Gazette Wed, 26 Feb 2020 22:55:28 +0000 Joomla! - Open Source Content Management en-gb (Webmaster) New York Lawmakers Must Consider Consequences of Banning Both Vaping Flavors and Menthol Cigarettes laws reduce smokers num 160

(photo: Michael Appleton/Mayoral Photography Office)

The New York City Council recently voted to ban flavored e-cigarettes. Mayor Bill de Blasio will reportedly either sign the bill or let it pass into law. The City Council also considered a bill banning menthol-flavored traditional cigarettes but did not vote on the measure.

Still, energized by their legislative victory, anti-smoking activists continue to push for the menthol ban. Yet by banning all of these products, policymakers would both remove a legal alternative to menthol cigarettes and increase the likelihood of significant black market activity.

To be sure, smoking is terrible for you and has claimed an astounding number of lives. The motivation behind the ban proposals is thus both noble and understandable. But ban advocates have committed a fundamental error in reasoning: They assume that a ban will magically end all sales of menthols and flavored e-cigarettes. However, both economic reasoning and history suggest that bans often shift sales to an illicit market.

The reality is that people with strong consumer preferences tend to seek out certain products regardless of their legal status. And plenty of research shows that menthol smokers don’t find other cigarettes to be substitutable alternatives. Worse still, areas attempting to ban menthols — usually larger urban hubs — tend to have strong pre-existing infrastructure for illicit cigarette markets. In fact, New York is the “smuggled cigarettes capital” of the country. This suggests that if a menthol ban were imposed, a black market in menthols would spring up quickly and be difficult to eradicate.

Ban proponents respond by pointing to a survey in which 40 percent of menthol smokers indicated they would try to quit if a ban were instituted. But a study from a menthol ban in Ontario showed that while just under 30 percent attempted to quit in response to the ban, only 7 percent were successful.

The good news is that smoking rates have been trending downward for decades. And with the rising popularity of e-cigarettes, this trend could continue. Vaping products like e-cigarettes often serve as an alternative for menthol smokers looking to quit combustibles (traditional cigarettes that are burnt and smoked, not vaped). This is good for public health: Evidence suggests that these products are safer than combustible cigarettes.

Unfortunately, menthol ban advocates like those in New York often push just as strongly for bans on flavored vape products as they do for menthol bans. But in prohibiting the sale of both menthol cigarettes and flavored vaping or e-cigarette products, policymakers remove a healthier, legal alternative for menthol smokers looking to quit and thereby increase in the likelihood they will turn to the black market to obtain menthols.

Of course, there are no close substitutes for e-cigarettes either, so those consumers will likely choose illicit products as well. In a twist of tragic irony, the vaping black market is actually what has led to the recent outbreak of lung illnesses — not flavored products or even vaping itself. Former Food and Drug Administration head Scott Gottlieb acknowledged this fact when he said, “It appears that many of these acute lung injuries are being driven by illegal products that have oils in them.”

Illicit markets do more than just endanger consumers; their revenues often end up in the accounts of criminal syndicates and gangs. And to the extent any ban is effective, it will require police to stamp out illegal transactions. This puts both law enforcement and the communities they protect in tense situations, which tends to increase levels of mistrust. And neither group nor the larger society is served by a thriving black market.

Bans on vaping products and menthol cigarettes will not make communities safer. Rather than saving people from themselves, budding black markets could instead expose them to other harmful substances. Even as Governor Cuomo lists instituting and enforcing these bans as part of his 2020 agenda and as the New York City Council considers further  prohibition, both the governor and the city’s leaders should acknowledge the possibility that waving a legislative wand does not make smoking disappear. Instead, by banning both products, they would be inviting a black market that endangers smokers, vapers, the police and the communities they protect.

Jonathan Haggerty is a Resident Fellow of Criminal Justice and Civil Liberties Policy at the R Street Institute. Jesse Kelley is R Street’s Criminal Justice and Civil Liberties Government Affairs Manager. On Twitter @Jhaggrid & @JessDKelley.

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New York Lawmakers Must Consider Consequences of Banning Both Vaping Flavors and Menthol Cigarettes Mon, 06 Jan 2020 05:00:00 +0000
NAACP, Anti-Smoking Groups Press City Council Speaker on Bills Banning Flavored Cigarettes press conf flavored

Council Members Levine, center, & Cabrera, behind him (photo: John McCarten/City Council)

The New York chapter of the NAACP and four of the nation’s largest anti-smoking groups are urging City Council Speaker Corey Johnson to support two bills that would effectively ban the sale of flavored tobacco products in New York City. The groups recently sent a letter urging Speaker Johnson to bring the two proposals up for a vote in the City Council.

The first bill, Intro. 1345, sponsored by Bronx Council Member Fernando Cabrera, would end an exemption in a previous city law that banned the sale of flavored cigarettes to allow for the continued sale of menthol, mint, and wintergreen flavors.

The second bill, Intro. 1362, sponsored by Manhattan Council Member Mark Levine, who chairs the Council’s Health Committee, would ban the sale of flavored e-cigarettes.

The American Heart Association, Campaign for Tobacco-Free Kids, American Lung Association, and American Cancer Society joined the NAACP’s New York State Conference in calling for flavored tobacco products to be banned in New York City. They say the tobacco industry uses flavored products to specifically target young people and communities of color.

“We strongly urge you to enact two proposals pending before the Council – both cracking down on flavored tobacco products that lure and addict our children,” reads the letter.

The letter states that 85% of African-American smokers use flavored productions (compared to 29% of white smokers). These organizations believe this is a leading reason why “African Americans suffer the greatest burden of tobacco-related mortality of any racial or ethnic group in the United States.”

Last year, youth e-cigarette use, which increased 80% in 2018, was declared an “epidemic” by the U.S. Surgeon General. The advocacy groups’ letter points to a survey that found that “81.5% of youth e-cigarette users and 73.8 percent of youth cigar users saying they used the product ‘because they come in flavors I like.’”

The letter calls these trends “simply unacceptable” and implores Speaker Johnson to act on the issue. Both bills were first introduced in January and hearings were held in that same month, but there has been no change in the legislation’s status for five months, save additional sponsors signing on.

In May, all five borough presidents signed on to a letter drafted by Brooklyn Borough President Eric Adams supporting the two bills. Both Adams, who has made public health a signature issue, and Bronx Borough President Ruben Diaz Jr. are considering runs for mayor, as is Johnson, who has also had a focus on health and chaired the Council’s health committee last term.

Johnson has been waging a public battle to quit smoking cigarettes, recently tweeting that he had hit 40 days without one (he told Gothamist he bought a juul, but did not indicate if it is flavored).

“The Council is always working to improve the public health outcomes of all New Yorkers, and we are continuing to review these proposals as they go through the legislative process,” according to a spokesperson for Johnson, who did not indicate where the speaker himself falls on the bills.

Neither bill has a majority of sponsors in the Council.

Eighteen of 51 Council members have sponsored Cabrera’s bill. “Flavored tobacco leads to the preventable deaths of thousands of New Yorkers each year and it is people of color and our children who are most at risk of getting hooked,” Cabrera said in a statement to Gotham Gazette. “We must move quickly to significantly restrict menthol cigarettes and flavored cigarettes in our city.”

Fourteen Council members have sponsored Levine’s bill. Twelve of the 14 also sponsor Cabrera’s bill. “To protect kids and our communities, we have to end the sale of flavored tobacco products in New York,” Levine said in a statement, adding that he is “working hard in the City Council to pass legislation to ban these products and ensure they can no longer be used to addict the most vulnerable New Yorkers.”

Some anti-tobacco advocates have posited that the bills haven’t moved because the National Action Network, a civil rights organization led by Rev. Al Sharpton, has come out against Cabrera’s proposal.

During the Council health committee hearing on the bills in January, Kyra Stephenson-Valley, NAN’s cessation coordinator, said “it is proven that increased regulation does not necessarily stop users, but rather criminalizes addicts without resource,” pointing out that there have been “disparate impacts.”

She went further, declaring that “bans and prohibitions can lead to an increase in negative interactions between law enforcement and African-Americans.” She also alluded to Eric Garner’s death, saying “history has shown us here in New York City that can take your life over a loose cigarette.”

In addition to City Council testimony, according to Politico, NAN “has held town halls at prominent black churches throughout the United States to talk about how menthol bans criminalize the black community.” According to a spokesperson for Council Speaker Johnson, Sharpton has mentioned the issue to him in passing, but has not directly lobbied Johnson or the Council.

City Council Member Keith Powers, a Manhattan Democrat who supports Levine’s bill but not Cabrera’s, said in a statement, “I have been an ardent supporter of stricter laws on smoking but want to ensure that no community feels targeted.” He did not respond when asked whether any individual or group personally lobbied him against Intro. 1345.

According to FairWarning, NAN receives funding from R.J. Reynolds, the second-largest tobacco company in America. The company produces Newports, which are the nation’s best-selling menthol cigarette brand. According to FairWarning, R.J. Reynolds’ donations to NAN are part of a broader corporate strategy of “seizing on the hot button issue of police harassment of blacks to counter efforts by public health advocates to restrict menthol sales,” with the help of prominent African-Americna leaders and advocacy groups.

The tobacco industry has a long history of employing similar tactics. According to the CDC, tobacco companies have historically attempted “to maintain a positive image among African Americans have included such efforts as supporting cultural events and making contributions to minority higher education institutions, elected officials, civic and community organizations, and scholarship programs.”

by Andrew Millman, Gotham Gazette

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NAACP, Anti-Smoking Groups Press City Council Speaker on Bills Banning Flavored Cigarettes Tue, 18 Jun 2019 04:00:00 +0000
The City’s New Pharmacy Ban and Next Steps in Fighting Cigarette Smoking de Blasio New York City anti-smoking

(photo: Michael Appleton/Mayor's Office)

Shoppers at pharmacies are there to buy products that will make them healthier, whether that’s tissue boxes to help with colds or prescription medication for a chronic issue. Pharmacies shouldn’t be home to items that make people sick.

CVS recognized this in 2014 when it took the unprecedented step of stopping the sale of tobacco products in its stores. Many public health professionals thought this would be the beginning of a wave of pharmacies following CVS’ lead. That didn’t happen.

Until January 1 of this year New Yorkers could still buy tobacco products at 500 pharmacies throughout the city. That’s when a new law went into effect that banned New York City pharmacies from selling tobacco products. This rule was part of a package of legislation signed into law by Mayor de Blasio in August 2017 aimed at reducing the number of smokers in the city by 160,000 by 2020. More than 5 decades after the U.S. Surgeon General first warned against the dangers of smoking, more than 880,000 adults in New York City still smoke.

The ban on tobacco sales in pharmacies is another important step in the long fight against tobacco use in New York City. Despite many years of progress, that fight is far from over, and we’re now facing unprecedented challenges. Policymakers need to continue pushing for a healthier, smoke-free city by taking an even more restrictive approach to purchasing tobacco products and turning their attention more closely to the dangers of products that can act as a gateway to traditional cigarettes.

There are many ways to continue building on the anti-smoking momentum that has been accelerating since the passage of the Smoke Free Air Act in 2002.

Now that pharmacies no longer sell cigarettes, policymakers should turn their attention to where else New Yorkers are buying tobacco products. After it pulled tobacco products from its shelves, CVS found that 38 percent of people who exclusively bought cigarettes at their stores were more likely to stop buying them at all. Imagine the impact that can be made if access were further restricted at other stores that traditionally sell cigarettes, along with restricting access near places that young people frequent, including schools, houses of worship, playgrounds, and libraries. An aggressive campaign to reduce access – whether through halting sales altogether or continuing to increase prices – will pay dividends in public health and lower the number of smokers in New York City.

Looking beyond traditional cigarettes, one of the most pressing new challenges in public health is the rise of addictive e-cigarettes, which have exploded in popularity among youth. More than 20 percent of U.S. 12th-graders reported that they vaped nicotine in 2018. Alarmingly, a study found that teens that used e-cigarettes had three times the level of cancer-causing chemicals in a urine test than their non-using peers.

The New York CIty pharmacy ban includes e-cigarettes, but there are still too many avenues through which young people can buy these dangerous products. There is also a persistent, misleading narrative that e-cigarettes help people quit smoking, despite the blatant lack of evidence to support this assertion. Policymakers need to take comprehensive action to prevent the further spread of e-cigarettes by continuing to limit sales and launching comprehensive education programs, or we risk reversing decades of progress in curbing smoking.

While we celebrate the critical milestone achieved by this ban and its companion legislation, we must turn our attention to the next frontier in reducing the number of smokers and improving the health of all New Yorkers. There are still too many places to buy tobacco products, and the looming threat of e-cigarettes grows bigger every day. We’ve recognized the dangers of smoking for long enough, and it has only become clearer that increasingly firm action is critical to combatting this problem.

Lisa David is president and CEO at Public Health Solutions (PHS). PHS’ NYC Smoke-Free program has contributed to changes in tobacco control measures in New York City. On Twitter @wearephsny.

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The City’s New Pharmacy Ban and Next Steps in Fighting Cigarette Smoking Sun, 06 Jan 2019 05:00:00 +0000
NYCHA Prepares to Implement Smoking Ban de blasio anti smoking presser 2020

(photo via the Mayor's Office)

Following the announcement of a nationwide smoking ban in public housing residences last year, the New York City Housing Authority (NYCHA) has been preparing to implement the controversial federal policy across its more than 320 developments that house approximately half-a-million residents.

“Smoke-Free NYCHA” involves updating resident leases with language that prohibits smoking, running an awareness campaign to inform residents about the new ban as well as the harms of secondhand smoke, and crafting an enforcement plan for repeat offenders. According to the city's health department, NYCHA residents "smoke at higher rates than other New Yorkers, and suffer from higher rates of chronic disease including heart disease, diabetes, and asthma."

Required by the federal government to have a smoke-free policy in place by July 2018, NYCHA has encountered skepticism and criticism from its residents. Moreover, while anti-smoking advocates applaud the new federal policy and NYCHA’s efforts to implement it, they worry that Mayor Bill de Blasio’s administration will fail to provide the necessary financial resources to support meaningful tobacco cessation efforts across NYCHA campuses.

De Blasio has expressed support for the ban and has backed other anti-smoking measures, including a recent legislative package he signed into law, aimed at reducing smoking in New York City writ large. The mayor has also invested heavily in NYCHA overall, though City Hall has not yet made competely clear what it will do to support implementation of the NYCHA smoking ban, while the Department of Health and Mental Hygiene is working with NYCHA stakeholders to prepare for implementation of the smoking ban.

In late November of 2016, shortly before the end of President Barack Obama’s second term, the Department of Housing and Urban Development (HUD) declared that all public housing authorities were required to prohibit smoking within their campuses. "Every child deserves to grow up in a safe, healthy home free from harmful second-hand cigarette smoke," said then HUD Secretary Julian Castro in a press release. "HUD's smoke-free rule is a reflection of our commitment to using housing as a platform to create healthy communities.”     

Upon learning of the new policy, NYCHA, the largest public housing authority in the United States, began to ready its residents and staff. Given that City Council Member Donovan Richards had previously proposed banning smoking in city-funded housing, and earlier experience regulating smoking in its developments, the agency was not unprepared. “We certainly ramped up our planning and collaboration as soon as we heard the rule was being made final, but we already had a foundation of work before that time,” said Andrea Mata, Director of Health Initiatives at NYCHA, in an interview with Gotham Gazette.

She explained that, in 2012, NYCHA began working with the New York City Department of Health (DOH) on a pilot project at 830 Amsterdam, a single building development on the Upper West Side, to create a “resident-led and initiated strategy” to reduce secondhand smoke exposure. After three years, the project culminated with representatives of 85 percent of all units voluntarily signing a pledge to not smoke within the building.

Upon announcement of the federal ban, NYCHA sought to build on the 830 Amsterdam pilot as well as pull from earlier examples of public housing authorities implementing smoking bans within their developments, including those of Philadelphia and Albany.

NYCHA began by reaching out to residents and experts to develop a comprehensive policy. Representatives engaged the Resident Advisory Board, a collection of public housing leaders, conducted community meetings across the city, and are now beginning to brief all local Resident Associations in the five boroughs. They also consulted organizations like the New York University School of Medicine as well as the American Cancer Society for feedback.

In addition to ongoing community engagement, the housing authority is also preparing to update resident leases with language that stipulates adherence to the smoking ban. According to NYCHA’s plan for 2018 released mid-October, the agency will begin informing residents of changes to their lease in early 2018, who will then have the opportunity to comment on the new clause. After revisions, they will mail residents an updated lease.

Finally, NYCHA is in the midst of developing an enforcement process to ensure residents comply. “At this point we don’t have a final policy that we can share, but we’d imagine that it would have a few points of escalation,” explained Sideya Sherman, Executive Vice President for Community Engagement and Partnerships at NYCHA, in an interview with Gotham Gazette.

A policy of “graduated enforcement,” it will begin with warnings, then interventions, continuing to escalate until NYCHA staff announces a “commencement of termination of tenancy proceedings,” said NYCHA spokesperson Jasmine Blake to Gotham Gazette of the outline of the enforcement plan.

The possibility of eviction for offenders has been a point of contention, as has an alleged lack of information about the smoke-free rule being provided by NYCHA to residents. “I think it’s a horrible policy,” said Charlene Nimmons, resident of Wyckoff Gardens and president of the Wyckoff Gardens Resident Association from 2003 to 2015, in a phone call. “There’s this privileged rule and law being forced down upon public housing residents.”

A resident of Fort Greene’s Ingersoll Houses also expressed frustration in comments to DNAinfo earlier this year. “How can they kick you out for something that’s just like a disease, basically?” said Curtis Flemister. “It’s not like you can say, 'I’m just not going to do it if I’m going to get kicked out.'”

“I have not received and have not had any information about it,” said Geraldine Lamb, president of the Bronx’s Castle Hill Resident Association, in an interview with Gotham Gazette.

When the public housing smoking ban was first proposed, in 2015, de Blasio said that “the goal is a good one,” but that there would be “a lot to work through” in terms of implementation. NYCHA Chair and CEO Shola Olatoye has also expressed concern about enforcement, wanting it to be “resident-led” as opposed to involving the NYPD.

On Monday, City Hall spokesperson Melissa Grace said in a statement, “This administration is dedicated to creating healthy living environments for all New Yorkers, and NYCHA and the City Department of Health are working closely with our public housing residents, advocates and the federal government as this ban takes effect.”

According to the Department of Health (DOHMH), there is a position within its Center for Health Equity that is dedicated to supporting NYCHA's Health Initiatives Unit. Since the start of this year, NYCHA and DOHMH have spoken with more than 1,200 NYCHA residents at community meetings and other activities, and will continue to engage residents to craft the smoke-free NYCHA policy. The process is being led by an advisory group of NYCHA residents, academics, healthcare practitioners, and representatives of community organizations. The group is drafting a set of priorities to help guide implementation of the ban, according to DOHMH, including principles related to education, cessation support, communication, and enforcement.

In December, DOHMH will be launching new efforts to help NYCHA residents connect to smoking cessation resources and to "help them address the longstanding injustices brought by tobacco companies who target low-income communities and communities of color." According to DOHMH, "NYCHA residents have made their priorities clear: they want to live in smoke-free environments, but the implementation of Smoke-free Public Housing must be resident-led, include resources and support from NYCHA and DOHMH, and focused on celebrating success."

City Council Member Ritchie Torres, who chairs the Council’s Committee on Public Housing and grew up in NYCHA, expressed reservations in a Monday interview with Gotham Gazette. “I agree with the sentiment,” Torres said of the smoking ban. “I agree with investing in more programs to curb smoking. But, I disagree with a coercive approach.”

Torres said that while he may not chair the committee next year when a new class of the City Council is seated and new positions assigned (Torres is running to be the speaker of the Council), “We should have a hearing ahead of implementation.”

Despite criticism from residents and skepticism from high-ranking city officials, anti-smoking advocates are impressed with NYCHA’s efforts so far. “They are doing a lot,” affirmed Michael Davoli, Director of New York Metro Government Relations at the American Cancer Society Cancer Action Network. “They have a concrete plan.”

However, Davoli questioned the mayor’s and governor’s financial commitment to financing the distribution of effective tobacco cessation services to NYCHA residents, like written materials and nicotine replacement therapy (NRTs). “The question is, is the money going to be put into it to really provide NYCHA the resources to provide smoking cessation,” said Davoli. “This is an opportunity for the mayor and the governor to really help these people quit once and for all.”

When pressed for more information on how much funding the mayor will provide the authority, NYCHA did not provide specifics. “We are working with the Office of the Mayor throughout this process to further support his tobacco and smoking control policies,” said Blake.

Although the amount of money City Hall is willing to commit is unclear, the city’s current efforts against smoking support NYCHA’s. In April of this year, the Health Department launched a media campaign to educate New Yorkers “on the dangers of secondhand smoke at home and encouraging them to make their home smoke-free.” The press release announcing the effort says it “is aligned with the recent smoke-free rule passed by the U.S. Department of Housing and Urban Development” that will require NYCHA to go smoke-free.

“We certainly don’t have lots of financial resources and so we’re leveraging our partners to make sure we’re that connecting residents to appropriate services,” explained NYCHA’s Sherman, possibly in reference to NYCHA’s budget woes. “But we certainly are putting our best foot forward to taking a multi-faceted approach to implementing this policy.”

by Ben Weiss, Gotham Gazette

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NYCHA Prepares to Implement Smoking Ban Mon, 13 Nov 2017 05:00:00 +0000
Bills Fight Smoking by Keeping Pace with Tobacco Companies de Blasio anti-smoking

Mayor de Blasio & co. (photo: Michael Appleton/Mayor's Office)

Thanks to aggressive policies and programs over the past decade, the adult smoking rate declined significantly in New York City, from 21.5% in 2002 to 14.0% in 2010. However, to maintain these gains we need to continue to update our tobacco control policies to respond to an ever-changing market where tobacco company strategy attempts to circumvent current regulations.

As a physician whose primary practice involves helping New Yorkers quit smoking, I strongly support the four bills proposed by New York City Mayor Bill de Blasio and City Council members to strengthen the city’s tobacco control policies.

I have seen firsthand the many challenges smokers face when trying to quit. On top of the addictive properties of tobacco products, New Yorkers who smoke are faced with a retail environment that creates cues to smoke on every corner. The widespread availability of tobacco products in retail outlets, along with extensive marketing at the retail point-of-sale, is designed to attract new tobacco users, discourage quitting and create a normative environment that makes tobacco use acceptable and even makes it desirable. To reduce smoking, we cannot simply focus on the individual smoker: we must also change an environment that encourages young people to initiate tobacco use and blocks efforts by smokers to quit. This package of bills moves New York City closer to that goal.

Individually, each of these bills represents an effective method for addressing gaps in current policies. Implemented together, they represent a powerful, comprehensive and synergistic approach to addressing multiple aspects of the retail environment that undermine tobacco tax policy and create environmental triggers to smoke.

One bill would limit new licenses to sell tobacco products, setting caps for retail outlets to sell tobacco products in community districts. It responds to strong evidence that a high-density retail environment in residential neighborhoods is associated with recent initiation of tobacco use among young adults and greater difficulty quitting among smokers.

Another bill in the package prohibits pharmacies or retail stores that contain pharmacies from selling cigarettes and electronic cigarettes, which will act synergistically with the previous bill to further reduce retail density. In 2014, CVS led the way in ending the sale of cigarettes and tobacco products saying that it was “inconsistent with our purpose – helping people on their path to better health.” Although an important step, other national chains have not adopted this policy, creating the need for government action.

There is precedent and evidence supporting the pharmacy ban. Other cities have already passed similar bills—backed by high levels of public support—and subsequent studies demonstrated the link between these bans and reduced retail density in communities.

Finally, the proposal to establish price floors for cigarette packages, other tobacco products and non-tobacco shisha, and to establish taxes on previously untaxed tobacco products, will reduce the likelihood that smokers switch from cigarettes to cheaper products. This will create a tax and price environment that will reduce youth initiation of tobacco use and encourage people to quit.

Unfortunately, the tobacco epidemic is not static. New products are introduced at an alarming rate, the tobacco industry continues to look for loopholes to circumvent tobacco policies, and sometimes policies have unintended consequences that need to be remedied. To continue to achieve our prevention and cessation goals, we must be proactive and keep pace with this changing environment by introducing new laws to fill gaps in current policies, particularly when the evidence points us in the right direction.

The evidence-based policy package put forth by Mayor de Blasio and City Council members represents a tremendous step forward for New York City’s efforts to meet the National Healthy People 2020 goal of 12% smoking prevalence and, most importantly, will prevent individuals—especially young people—from picking up a habit that is much easier to start than to stop.

Donna Shelley, MD, MPH is an associate professor of Medicine and Population Health at NYU School of Medicine and leads the smoking cessation service at NYU Langone Medical Center’s Laura & Isaac Perlmutter Cancer Center and directs NYC Treats Tobacco, which helps healthcare organizations help their patients quit. Dr. Shelley has conducted research on health disparities related to tobacco use for over 15 years.

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Bills Fight Smoking by Keeping Pace with Tobacco Companies Sun, 11 Jun 2017 04:00:00 +0000