ANTI SMOKING LOBBY

Legalization of cannabis threatens clean indoor air and public health

Most localities that allow onsite cannabis smoking lounges do not protect nonsmokers from the ill effects of secondhand cannabis smoke, researchers report in the American Journal of Preventive Medicine

Peer-Reviewed Publication

ELSEVIER

Ann Arbor, September 7, 2021 – After years of progress on protections against secondhand tobacco smoke, multiple states and local governments now allow indoor smoking of cannabis at licensed cannabis businesses. A new study in the American Journal of Preventive Medicine, published by Elsevier, found that over 50 localities in the United States allow indoor smoking at these businesses, exposing customers and employees to secondhand cannabis smoke (SHCS).

“While many states maintain strong tobacco smoking and vaping bans to protect public health, our research reveals that some state and local laws exempt cannabis smoke from clean air laws and open the door to smoke-filled businesses, defeating decades of public health advances,” said first author Thomas L. Rotering, MPH, of the Center for Tobacco Control Research and Education, and the Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA.

The researchers systematically searched legal databases, public reporting, government websites, and local laws that address cannabis smoking lounges. They found wide variation in how state and local governments address SHCS exposure in these businesses. All of the 11 states that have legalized adult-use cannabis as of June 2020 prohibit consumption in public places, but six states (Alaska, California, Colorado, Illinois, Massachusetts, and Michigan) allow onsite consumption in licensed cannabis businesses subject to local government approval. No state prohibits local governments from implementing more rigorous requirements. Massachusetts only allows onsite consumption through vaporization or other nonsmoking forms of consumption involving heat.

Although the only effective means of preventing the health problems associated with SHCS is to require a smoke-free environment, most local laws either do not address SHCS or use ineffective ventilation or engineering requirements. Of the 56 localities that permit onsite cannabis consumption businesses, only 9% require that indoors be smoke-free. Twenty-three percent of local governments provide for smoking in isolated rooms but only require that the smoke not drift to nonsmoking areas or that there be a smoke-free employee viewing area. Other common local legal requirements address onsite odor control, ventilation/filtration, and building location. Such requirements are often vague, and the investigators observe that they resemble the tobacco industry’s “accommodation” framework by allowing smoking inside and positioning ventilation or engineering controls as solving secondhand smoke.

“After decades of progress in clearing the indoor air of tobacco smoke, we are seeing it replaced with cannabis smoke using the same discredited arguments the tobacco industry used in its unsuccessful fight against tobacco smoke restrictions. We need to learn from the past and keep the air clean for all,” commented senior investigator Stanton A. Glantz, PhD, retired from the Center for Tobacco Control Research and Education, and the Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA.

Some cannabis advocates argue that designating indoor spaces for renters, tourists, and people experiencing homelessness to smoke or vape is the only reasonable alternative to illegally consuming in public or exposing nonsmokers to SHCS. The investigators suggest that reasonable alternatives may include permitting outside, out-of-view cannabis use at retailers, or allowing only the use of non-inhalable modes of administration that do not pollute the air. Local officials could consider allowing multiunit housing or other places serving these groups to create outdoor, designated consumption smoking areas out of public view.

Policymakers should be made aware that ventilation and other engineering interventions cannot fully protect workers and patrons. “Health authorities and local leaders should educate policymakers on the science of secondhand smoke remediation and advocate for the same standards for secondhand cannabis smoking and vaping that apply to tobacco, particularly because other cannabis administration modes do not pollute the air,” said the authors in their paper. “Where onsite smoking or vaping is permitted, even measures such as truly separate indoor and outdoor smoking areas may reduce but not eliminate SHCS exposure to patrons, staff, and residents.”

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JOURNAL

American Journal of Preventive Medicine

DOI

10.1016/j.amepre.2021.05.012 

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Emerging Indoor Air Laws for Onsite Cannabis Consumption Businesses in the U.S.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases

Research Letter 

Substance Use and Addiction

September 7, 2021

Association of Marijuana Legalization With Marijuana Use Among US High School Students, 1993-2019

D. Mark Anderson, PhD¹; Daniel I. Rees, PhD²; Joseph J. Sabia, PhD³; et alSamuel Safford, MA³

Author Affiliations Article Information

JAMA Netw Open. 2021;4(9):e2124638. doi:10.1001/jamanetworkopen.2021.24638

Introduction

Thirty-six states have legalized medical marijuana and 18 states have passed recreational marijuana laws (RMLs). Organizations such as the American Academy of Pediatrics are concerned that legalization will encourage youth marijuana use.¹ Marijuana use during adolescence may adversely affect areas of the prefrontal cortex, which control important cognitive processes.¹

Using data from the Youth Risk Behavior Survey (YRBS) for the period 1993-2017, Anderson et al² found that RML adoption was associated with an 8% decrease in the odds of marijuana use among high school students. These authors, however, had prelegalization and postlegalization data from only 7 states and pre– and post–recreational sales data from only 3 states, calling into question the generalizability of their results.³

Using data from the YRBS for the period 1993-2019, this study provides updated estimates of the association between legalization and adolescent marijuana use. During this extended period, pre- and post-RML data from the YRBS are available from 10 states; 7 states contributed more than one wave of post-RML data, and these same 7 states contributed data to the YRBS before and after the first dispensary sales began. Anderson et al³ had multiple waves of post-RML data from 3 states.

Methods

Following Anderson et al,² national and state YRBS data were pooled in this repeated cross-sectional study. Ethical review was not required because analyses of secondary, deidentified data are considered exempt from requiring institutional review board approval by the San Diego State University Institutional Review Board. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guidelines.

Multivariable logistic regression was used to estimate the association between legalization and marijuana use. Effective legalization dates come from Anderson and Rees.⁴ To control for time-invariant factors at the state level and common trends, all models were adjusted for 50 state and 13 survey wave indicators. Alternative models were further adjusted for individual- and state-level characteristics; event-study estimates were produced by replacing the RML indicator with a series of leads and lags. Two-sided hypothesis tests were used, and estimates were considered significant if P < .05. Analyses were conducted with STATA 16.1 (StataCorp).

Results

The mean (SD) age of YRBS respondents was 15.9 (1.23) years, 51.4% of respondents reported as female, and 57.6% reported as non-Hispanic white. The first two columns of the Table show estimated odds ratios (ORs) of current and frequent marijuana use, adjusted for state and survey-wave indicators. In the third and fourth columns, ORs were further adjusted for individual- and state-level covariates.

Based on the pooled YRBS data, and in the fully adjusted models, RML adoption was not associated with current marijuana use (OR, 1.00; 95% CI, 0.92-1.10) or frequent marijuana use (OR, 0.98; 95% CI, 0.90-1.07). In the fully adjusted models, medical marijuana law (MML) adoption was associated with a 6% decrease (OR, 0.94; 95% CI, 0.89-0.98) in the odds of current marijuana use and a 7% decrease (OR, 0.93; 95% CI, 0.87-0.99) in the odds of frequent marijuana use. Estimates from separate analyses of the national and state YRBS and estimates of the association between the opening of the first recreational dispensary and marijuana use were qualitatively similar to those above (Table).⁵

Finally, the Figure shows RML event-study estimates (Panel A). Prior to legalization, there was no association with marijuana use, suggesting the parallel-trends assumption held. After 2 or more years, RML adoption was associated with a decrease in marijuana use (OR, 0.85; 95% CI, 0.76, 0.95). Panel B of the Figure shows an event study for MML adoption.

Discussion

Consistent with estimates from prior studies, there was little evidence that RMLs or MMLs encourage youth marijuana use.^2,6 Contrary to results of the study by Anderson et al² the overall association between RML adoption and marijuana use among adolescents was statistically indistinguishable from zero. One limitation of this study is that RMLs are a relatively new phenomenon. As more postlegalization data become available, researchers will be able to draw firmer conclusions about the relationship between RMLs and adolescent marijuana use.

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Article Information

Accepted for Publication: July 8, 2021.

Published: September 7, 2021. doi:10.1001/jamanetworkopen.2021.24638

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Anderson DM et al. JAMA Network Open.

Corresponding Author: D. Mark Anderson, PhD, Department of Agricultural Economics and Economics, Montana State University, PO Box 172920, Bozeman, MT 59717-2920 (dwight.anderson@montana.edu).

Author Contributions: Dr Sabia had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Anderson, Sabia, Safford.

Drafting of the manuscript: Anderson, Rees, Sabia.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Rees, Sabia, Safford.

Obtained funding: Anderson, Sabia.

Supervision: Anderson, Sabia.

Conflict of Interest Disclosures: Dr Sabia reported grants from Troesh Family Foundation and grants from Charles Koch Foundation during the conduct of the study. No other disclosures were reported.

Funding/Support: Dr Anderson acknowledges partial support from a Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health (NIH) research infrastructure grant, R24 HD042828, to the Center for Studies in Demography and Ecology at the University of Washington. Dr Sabia and Mr Safford acknowledge partial support from the Center for Health Economics & Policy Studies (CHEPS) at San Diego State University, including grant funding received from the Charles Koch Foundation.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

References

1.

Committee on Substance Abuse, Committee on Adolescence; Committee on Substance Abuse Committee on Adolescence.  The impact of marijuana policies on youth: clinical, research, and legal update.   Pediatrics. 2015;135(3):584-587. doi:10.1542/peds.2014-4146PubMedGoogle ScholarCrossref

2.

Anderson  DM, Hansen  B, Rees  DI, Sabia  JJ.  Association of marijuana laws with teen marijuana use: new estimates from the Youth Risk Behavior Surveys.   JAMA Pediatr. 2019;173(9):879-881. doi:10.1001/jamapediatrics.2019.1720
ArticlePubMedGoogle ScholarCrossref

3.

Anderson  DM, Rees  DI, Sabia  JJ.  Challenging the association of marijuana laws with teen marijuana use-reply.   JAMA Pediatr. 2020;174(1):99-100. doi:10.1001/jamapediatrics.2019.4238
ArticlePubMedGoogle ScholarCrossref

4.

Anderson  DM, Rees  DI. The public health effects of legalizing marijuana. NBER Working Paper No. 28647. Accessed August 13, 2021. https://www.nber.org/papers/w28647

5.

Jones  CM, Underwood  JM, Volkow  ND.  Challenging the association of marijuana laws with teen marijuana use.   JAMA Pediatr. 2020;174(1):99. doi:10.1001/jamapediatrics.2019.4235
ArticlePubMedGoogle ScholarCrossref

6.

Coley  RL, Kruzik  C, Ghiani  M, Carey  N, Hawkins  SS, Baum  CF.  Recreational marijuana legalization and adolescent use of marijuana, tobacco, and alcohol.   J Adolesc Health. 2021;69(1):41-49. doi:10.1016/j.jadohealth.2020.10.019PubMedGoogle ScholarCrossref

 

Quitting smoking after lung cancer diagnosis may extend life without cancer recurrence

Peer-Reviewed Publication

AMERICAN COLLEGE OF PHYSICIANS

Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing to the terms of the embargo not only on their own behalf, but also on behalf of the organization they represent.

Quitting smoking after lung cancer diagnosis may extend life without cancer recurrence

Abstract: https://www.acpjournals.org/doi/10.7326/M21-0252

Editorial: https://www.acpjournals.org/doi/10.7326/M21-2997

URL goes live when the embargo lifts

A prospective cohort study found that quitting smoking after being diagnosed with early-stage non-small cell lung cancer may slow disease progression and decrease mortality. Given that about half of all smokers continue to smoke after a lung cancer diagnosis, these findings present an opportunity to improve overall and progression-free survival in this type of cancer. The study is published in Annals of Internal Medicine.

More than 80% of patients with non-small cell lung cancer have a history of smoking, and about half are current smokers at the time of diagnosis. There is limited evidence that smoking cessation may improve survival, so many patients may feel it is too late to quit once they've been diagnosed with lung cancer.

Researchers from the International Agency for Research on Cancer, the specialized cancer agency of the World Health Organization, in collaboration with the N.N. Blokhin National Medical Research Centre of Oncology in Russia, recruited 517 adults who currently smoked when diagnosed with early-stage non-small cell lung cancer from 2 sites in Moscow, Russia to determine whether quitting smoking after diagnosis affects the risk for disease progression and mortality. The participants were interviewed at the start of the study to ascertain medical and lifestyle history, including tumor characteristics, and the amount of lifetime smoking, and then followed each year for an average of 7 years to record any changes in their smoking behavior, treatments, and disease status. Of 517 patients who were smoking when diagnosed with lung cancer, less than half quit (44.5%), and very few relapsed. The patients who quit smoking were more likely to live longer overall (6.6 years vs. 4.8. years), live longer without lung cancer (5.7 vs. 3.9 years) and have a longer time to death from lung cancer (7.9 vs. 6 years).

According to the authors, these results show that even after being diagnosed with lung cancer, there is still significant benefit to quitting smoking. Physicians should make their lung cancer patients aware that quitting smoking can extend life overall and extend life without cancer recurrence.

Media contacts: For an embargoed PDF, please contact Angela Collom at acollom@acponline.org. To speak with the lead author, Mahdi Sheikh, MD, please contact Véronique Terrasse, at terrassev@iarc.fr.

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JOURNAL

Annals of Internal Medicine

Disclaimer: AAAS and EurekAlert! are 

Auto union boss urges New Jersey lawmakers to pass casino smoking ban

Shawn Fain, the international president of the United Auto Workers union, recently won large raises for his workers

ByWAYNE PARRY 

Associated Press
December 12, 2023

A gambler smokes while playing a slot machine at the Ocean Casino Resort in Atlantic City N.J. on Nov. 29, 2023. On Tuesday, Dec. 12, casino workers pushing for a smoking ban at the city's nine casinos publicized a letter
The Associated Press

ATLANTIC CITY, N.J. -- Shawn Fain, the international president of the United Auto Workers union who recently won large raises for his workers, is taking aim at a new target: New Jersey lawmakers who are delaying votes on a bill to ban smoking in Atlantic City’s casinos.

The head of the powerful union, which represents workers at three casinos here, is urging legislators to move the bill forward in a scheduled hearing Thursday, warning that the union will “monitor and track” their votes.

Many casino workers have been pushing for three years to close a loophole in the state's public smoking law that specifically exempts casinos from a ban. Despite overwhelming bipartisan support from lawmakers, and a promise from the state's Democratic governor to sign the measure, it has been bottled up in state government committees without a vote to move it forward.

The same state Senate committee that failed to vote on the bill last month is due to try again on Thursday. Fain's letter to the state Senate and Assembly was timed to the upcoming hearing.

The casino industry opposes a ban, saying it will cost jobs and revenue. It has suggested creating enclosed smoking rooms, but has refused to divulge details of that plan.

“Thousands of UAW members work as table game dealers at the Caesars, Bally’s, and Tropicana casinos in Atlantic City, and are exposed on a daily basis to the toxic harms of secondhand smoking,” Fain wrote in a letter sent last week to lawmakers. “Patrons blow cigarette/tobacco smoke directly into their faces for eight hours, and due to the nature of their work, table dealers are unable to take their eyes away from the table, so they bear through the thick smoke that surrounds their workplace.”

Fain rejected smoking rooms as a solution, calling the suggestion “preposterous," and said it will oppose any amendment allowing anything less than a total ban on smoking in the casinos.

Currently, smoking is allowed on 25% of the casino floor. But those spaces are not contiguous, and are scattered widely throughout the premises.

At a Nov. 30 hearing in the state Senate, several lawmakers said they are willing to consider smoking rooms as a compromise.

The Casino Association of New Jersey did not immediately respond to a request for comment Tuesday. Nor did state Sen. Joseph Vitale, chairman of the committee that will conduct this week's hearing.

Chris Moyer, a spokesperson for the Atlantic City casino workers who want a smoking ban, said similar movements are under way in Pennsylvania, Rhode Island, Virginia, Kansas, Michigan and Nevada, and noted Connecticut’s casinos are already smoke-free. Shreveport, Louisiana ended a smoking ban in its casinos in June.

“Workers should leave work in the same condition they arrived,” Fain wrote. “Union. Non-union. Factory, office, casino, or any workplace in between, worker safety must be the #1 goal of every employer and worker throughout the state.”

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Follow Wayne Parry on X, formerly Twitter, at www.twitter.com/WayneParryAC

New Zealand plans to phase out tobacco sales

THE GOAL OF THE ANTISMOKING LOBBY

The measures mean that today's young teens will never be able to buy cigarettes legally (AFP/Khalil MAZRAAWI)

Wed, December 8, 2021

New Zealand announced plans Thursday to effectively ban smoking by progressively lifting the age at which tobacco products can be bought, in a "world-first" bid that means today's young teens will never be able to buy cigarettes legally.

New Zealand currently outlaws tobacco sales to under-18s and Associate Health Minister Ayesha Verrall said that from 2027, the age ban would increase by one year annually to keep the cohort smoke free.

"We want to make sure people never start smoking... as they age, they and future generations will never be able to legally purchase tobacco, because the truth is there is no safe age to start smoking," she said.

She added that the government would also legislate to restrict where tobacco is sold and only allow products with low nicotine levels into the market, to reduce the prospects of people becoming addicted.

Verrall said the measures maintained New Zealand's role as a global trailblazer in restricting tobacco, with actions such as banning cigarette sponsorship of sports in 1990 and banning smoking from bars in 2004.

"This is a historic day for the health of our people," she said.

"Smoking is still the leading cause of preventable death in New Zealand and causes one in four cancers."

She said the health toll was particularly heavy on Maori and Pacific communities, where smoking rates are around double the 13.5 percent recorded in the rest of the population.

The government aims to reduce that to five percent by 2025 and estimates achieving the goal would save the health system NZ$5.5 (US$3.6 billion) in future expenditure.

Lobby group Action on Smoking and Health said the planned changes meant that was now a realistic prospect, hailing the government for challenging "Big Tobacco".

"This collection of complementary measures will be the envy of countries struggling to combat the death and misery caused by smoked tobacco," ASH chairman Robert Beaglehole said.

"We will lead the world in tobacco control."

British American Tobacco New Zealand said the measures were "untested, unproven and without any scientific evidence of effectiveness".

"The combined impacts are effectively a gradual prohibition, which simply pushes supply underground to the black market," it said in a statement.

ns/arb/jah

New Zealand plans lifetime ban on cigarette sales for future generations: How will it work?

Plan is to make it illegal to sell cigarettes to anyone aged 14 and under from 2027. The ban will remain in place for the rest of the person’s life

09 December 2021 - 11:12BY BYRON KAYE

Currently, 11.6% of all New Zealanders aged over 15 smoke, according to government figures, with four in five smokers having started before the age of 18. Stock image.
Image: 123RF/GIN SANDERS

New Zealand on Thursday said it wants to ban young people from buying cigarettes for life, one of the toughest approaches in the world to curbing smoking deaths.

New Zealand is already one of 17 countries where plain cigarette packaging is compulsory. It also bans sales to anyone under 18, but it says those measures are not enough to reach its goal of a national adult smoking rate of less than 5% by 2025.

“We want to make sure young people never start smoking, so we will make it an offence to sell or supply smoked tobacco products to new cohorts of youth,” New Zealand associate minister of health Ayesha Verrall said in a statement.

Currently, 11.6% of all New Zealanders aged over 15 smoke, according to government figures, with four in five smokers having started before the age of 18.

A LIFETIME BAN

New Zealand plans to make it illegal to sell cigarettes to anyone aged 14 and under from 2027. The ban will remain in place for the rest of the person’s life. That means a person aged 60 in 2073 will be banned from buying cigarettes, while a person aged 61 would be allowed to do so.

WHY 14 AND UNDER?

New Zealand health authorities say smokers typically take up the habit during youth, with four in five New Zealanders who smoke beginning by age 18 and 96% by age 25. By stopping a generation from taking up smoking, they hope to avoid about 5,000 preventable deaths a year.

SA 'taking baby steps' in reducing smoking — WHO report

SA is one of the countries that is steadily reducing its smoking rates thanks to its anti-tobacco policies, a new report from the WHO said.

NEWS

2 weeks ago

WHAT OTHER CHANGES ARE PLANNED?

Under the proposed legislation, which the government plans to bring into law by the end of next year, it will first limit the number of stores that can sell cigarettes from 2024. It will then lower the level of nicotine — the most addictive ingredient — in cigarettes from 2025, to make them easier to quit. Finally, it will bring in the “smoke-free” generation from 2027.

HOW WILL THE RULES BE ENFORCED?

The New Zealand authorities have not said how they plan to police the ban, nor which retailers would be barred from selling tobacco products. More detail is expected to be provided when legislation is brought before parliament next year.

WILL NEW ZEALAND BE THE WORLD’S TOUGHEST ANTI-TOBACCO JURISDICTION?

Not quite. The Himalayan kingdom of Bhutan banned cigarette sales outright in 2010 (though it lifted the ban temporarily in 2020 to stop black market imports from India during a Covid-19 border closure, Al-Jazeera reported).

WHAT HAPPENS NEXT?

The New Zealand government says it wants to introduce the changes in phases to lessen the economic shock on retailers and give people with mental health issues — a group with far higher smoking rates — time to manage the change.

The restrictions are expected to be rolled out from 2024, beginning with a sharp reduction in the number of authorised sellers, followed by reduced nicotine requirements in 2025 and the creation of the “smoke-free” generation from 2027.

Reuters

 

Book Review: ‘Cigarettes and Soviets’ Examines Social and Political Impact of Cigarettes in Former USSR

January 23, 2023 Nick Flores Admin, Archives, Reviews

Cigarettes and Soviets: Smoking in the USSR, by Tricia Starks (Cornell University Press: Ithaca, New York, 2022)

Tricia Starks’ Cigarettes and Soviets: Smoking in the USSR (2022) is an exploration into the evolution of a unique industry throughout the course of the former Soviet Union.

Juxtaposed against the development of the cigarette industry in the West, the evolution of tobacco within the USSR provides a looking glass into both the distinctions between the two systems and how they both similarly confronted social pressures. In the author’s words, “[the book] presents the relationship among state, production, profit, health, culture, gender, biology, use, image, and users” (p. 10).

The Cigarette Industry’s Utility in a Nascent Socialist State

Starks begins prior to the Bolshevik Revolution, in 1917, during Lenin and his comrades’ famous train ride back to the then-Russian Empire. She proceeds to move the reader through time by commissioning a theme for the periods that she covers in each chapter, including posters and photographs for reference throughout. The book concludes with the fall of the Soviet Union in 1991 and a brief preview of the transformation of tobacco in the immediate aftermath.

The choice to focus on the tobacco industry through the paradigm of the Soviet system is an interesting case study in what distinguished their socialist system and the particular challenges they faced throughout the 20th century. In the capitalist West, and particularly in the United States, the traditional narrative on the rise of the tobacco industry is one of capitalist marketing and the explosion of consumerism as industrial modes of production expanded throughout the century. However, despite the lack of consumption-driven marketing within the newly formed Soviet republics, the demand for tobacco was tremendous. Soviets initially smoked it in the form of a coarse Russian tobacco known as makhorka or as filterless Russian cigarettes known as papirosy, only later increasing consumption of cigarettes.

Soviet Approach to Health and Cigarettes

Lenin despised the use of tobacco, going as far as to enforce designated smoking areas and issue smoking vouchers during the revolutionaries’ train ride back to Petrograd (p. 1). Following the triumph of the October Revolution, the Soviets would go on to found the first national prophylactic [preventative] healthcare system in 1918 (p. 2). Under the leadership of Nikolai Aleksandrovich Semashko, the new People’s Commissariat for Public Health (known as the Narkomzdrav) quickly acknowledged the dangers of smoking and launched the world’s first mass anti-smoking campaign, calling for both wide-reaching public education and curtailment of production and distribution. However, the conditions that the USSR’s planned economy faced presented them with a difficult choice. That was because demand for tobacco far exceeded supply coming out of the destruction of World War I and the Bolshevik Revolution, the industry’s unions were strong, and the revenue from its sale and export was badly needed. Thus, they decided to continue production while committing to a robust propaganda campaign to inform the public about the dangers of smoking.

The perspective that the public awareness campaigns took serves as a great example of what distinguished the Soviet approach from the West. Representative of the collectivism that guided the state, posters and resources throughout the period highlighted individuals’ responsibility to their community and the social impacts of smoking. While the extent of tobacco’s danger to physical health was far from fully understood, the socialist perspective of Soviet medical professionals led them to include the social implications of smoking in their understanding of its dangers. At a delicate time for the revolutionary project, Narkomzdrav rightfully warned smoking could not only limit one’s ability to be a productive member of society, but could also drain badly needed resources from the state. Posters highlighted how smokers caused fires in factories and in homes, polluted public and personal spaces, and influenced the next generation to take up the habit.

An Unusual Analysis of Former USSR

The focus of Cigarettes and Soviets is enticing. Starks’ avoidance of Cold War-era pseudo-history and histrionic oversimplifications, which seek to disparage the Soviet project, is particularly refreshing. Starks notes:

“The depiction of tobacco as the true opiate of the masses assumes a passive smoking population and a state in total control. The potency and popularity of papirosy prepared the Soviets to have a massive market for any tobacco they produced, and for the state to interfere in the biopsychosocial bond between smoker and tobacco held danger (p. 8).”

The first anti-smoking campaign demonstrated the question of tobacco was complex and the way Soviets chose to respond illustrates their principles. Pamphlets and other materials produced during this early period criticized alcohol and tobacco for “[endangering] order, health, and political progress” as well as “[softening] consciousness (p. 95).” Narkomzdrav looked to align their message with the Bolshevik Revolution and tap into the revolutionary energy among the people to dissuade them from smoking. However, Starks also points out the Soviets were restricted in their ability to take action by both the social conditions and the concrete benefits tobacco production provided. In 1931, Anastas Mikoian, head of the People’s Commissariat of Food Industry, “praised tobacco workers for fueling the Stalinist industrialization drive (p. 111).” Mikoian was commenting on the reality the USSR faced; industry and the economy were still developing and tobacco was in high demand, able to provide welcome satisfaction in the face of shortages of other products while the revenue it produced funded development.

In later chapters of Cigarettes and Soviets, the thoughtfulness that guides the author’s exploration of the pre-Stalin era at times fades. Starks mentions the Soviets declined aid offered through the Marshall Plan, but fails to explain that this was due to the purposefully small amount offered to a country that suffered a great deal of damage throughout World War II and that the USSR recognized the strings attached to the aid in the plan (p. 157). The analysis of later decades doesn’t provide the depth to fully understand the profound changes happening within the tobacco industry and within the USSR. For example, one of the first Western industries to break into the Soviet market was tobacco, following the lead of Marlboro owner Philip Morris’ joint venture with a Soviet tobacco factory on the topically named Soiuz-Apollon cigarettes in 1975 (p. 175). However, unlike her analysis of how the post-1921 New Economic Policy era’s policies influenced tobacco imagery and propaganda, Starks does not elaborate on the post-WWII sociopolitical developments influencing the changes.

Nonetheless, Tricia Starks’ new book, Cigarettes and Soviets: Smoking in the USSR, is enlightening and thought-provoking. The case study on the peculiar USSR tobacco industry provides an interesting window into the Soviet project, highlighting challenges the Soviet people faced and successes the Bolshevik Revolution was able to produce.

Nick Flores is a co-founder of and organizer with Bushwick, Brooklyn-based G-REBLS, a grassroots organization as well as a member organization of the Black Alliance for Peace’s Solidarity Network. Nick holds a double-major bachelor’s degree in history and Latin American studies.