Dr Walton-Shirley performs invasive cardiology, nuclear cardiology, and stress echocardiography in a private practice in Glasgow, KY.
Her chief medical interests are CHF/hypertrophic obstructive cardiomyopathy and the promotion of primary PCI for acute MI. Recently she played a significant role in helping to launch an ambitious pilot study of primary PCI in Kentucky, the Kentucky Primary Angioplasty Pilot Project. She has also participated in the TIMI 19, Duke-HF, NRMI, and CRUSADE trials and is proud to have been an advocate of the first smoke-free initiative in Kentucky (2011). She champions a smoke-free America.
Dr Walton-Shirley received her undergraduate degree at the University of Kentucky and went to medical school and did her residency and fellowship at the University of Louisville. She is married with two daughters. Her interests include singing, writing poetry and songs, fitness, and, of course, theheart.org.
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View all posts »Gross pics of tobacco carnage: Reverse marketing or empty drama?
Nov 11, 2010 09:21 EST-
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By mid 2011, attractive high-sheen packages sitting neatly on small shelves behind counters in pharmacies, groceries, and tobacco huts around the US will change. They will become banners of the reality of the greatest preventable scourge on society in the history of its existence.
The tobacco industry is gearing up for a legal battle, the greatest hint at the potential efficacy of this reverse marketing campaign. If it weren't going to make any difference, they'd just change the packaging and continue to rake in billions in blood money. Instead, they are preparing to litigate, always a sure sign that the tobacco industry has blinked. Sure, their argument will be couched in the perfect counter of "freedom of speech" and debated in the name of "the need to shrink government" served up with a cup of hot "tea-party" banter, but the fact they are arguing is the best reason to proceed. It's going to shrink the US tobacco market another 5% to 6%. When you apply the math to 50 million US smokers, that means a lot of grandchildren can look into an audience and see their papas and nanas looking on with pride at weddings, soccer games, and graduations instead of having to lay flowers on graves of folks they don't quite remember but are told they would have loved.
It's interesting how the US prides itself on "being first in flight," "first in democracy," first or best in whatever we can find to brag about, but we are running behind in reverse marketing. It's because we are "winded" from smoking so much, which belies the fact that we have become the perfect lair for the tobacco industry. Our progress on the topic has been mired by the growing "Branch Davidian-like" paranoia regarding "big government" and all of the "horrible effects" of overlegislation in the safety arena. It's why other folks such as Canada beat us to the punch and Australia is a little bit further ahead as well.
Australia, also dabbling in reverse marketing, has chosen a minimalist approach. Dr Fiona Godlee, editor of BMJ, wrote this year, "From 2011, all tobacco products in Australia will be sold in standardized plain packets, giving only the name of the manufacturer in a standard font [1]. The Australian government predicts it will cut the number of smokers by 2% to 3%. A 25% hike in tobacco excise will also help to cut consumption, as well as saving healthcare costs and increasing tax revenues." She then added, "The move has two wonderful ironies nested within it. First, the rationale for the change has come from the industry's own trade publications, which extol the importance of packaging, especially in 'dark' markets where tobacco advertising is banned. Second, it will use reverse marketing to make the packaging as unattractive as possible, especially to young people." Taking the slick packaging and turning it into a dull, lackluster harbinger of death appeals to me, in part because it is a great example of taking tobacco-industry tactics and turning the table on them. It reminds me of how the Pfizer folks took the nicotine-molecule research sponsored by Big Burley and created the most efficacious smoking-cessation tool, Chantix, in the history of addiction.
Gross pictures on tobacco packages will work here in the US because we are an intensely visual society. Those of us who do not read much do take notice of pictures in ads and watch TV. Historically, smoking has been predominant in those sections of society whose legacy of addiction has not been able to afford a postgraduate education for their children, although the march of death and healthcare expenditures have spread to other areas of society as well. Second, Canada already saw a 6% reduction in smoking during the period in which gross pictures were added. Although not all of that 6% comes from that move. Other changes like education campaigns are also contributors, but nonetheless, 6% of its five million current or potential smokers were saved, and that's a lot of human life-years. In the US, we can use every bit of the help that we can get. Even 0.1% of 50 million smokers is a big number.
I think I have a better idea, though. Along with gross pictures of tracheotomy Joe, the "Marlboro man" on the autopsy table, Joe on chemo, or Joe Camel who has lost his hump to cancer, freshly excised and laid bare on the front of a tobacco package, we'd better launch a negative campaign on Facebook, where the greatest majority of potential addicts spend their time. It's because Facebook is the place where most US kids spend their time communicating these days.
Historically, whether admirable or not, the US has always prided itself on war strategy, and when it comes to fighting the tobacco industry for the longevity of our young, we need a General Patton–like approach that considers every single avenue, angle, and opportunity to beat the tobacco industry at their own game. Gross images on tobacco packages are just the beginning. Let's hope we continue the march across America to make life in the US more picture perfect and applaud our plans for the latest "gross picture" reverse tobacco marketing campaign.
1. Sweet M. Australia to mandate plain packs for cigarettes as part of new tobacco control offensive. BMJ 2010; DOI:10.1136/bmj.c2401. Available here.
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