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Volume 5, No. 6, June/July 2007
From Your Colleagues
Gordon Belcourt, Montana Wyoming Tribal Leaders
FTC Releases Reports on Cigarettes and Smokeless Tobacco
Here is what we are up against or Sales Volume and Marketing Expenditure Data
The number of cigarettes sold or given away, as well as the amount spent on advertising and promotion by the five largest cigarette companies in the United States, decreased in 2004 and 2005, according to a report released today by the Federal Trade Commission. In a separate report on smokeless tobacco, the FTC said the number of pounds sold by the five largest manufacturers rose for each year from 2002 to 2004, then decreased in 2005, while advertising and promotional expenditures fluctuated during that period, with the most spent in 2005. The FTC has issued cigarette reports since 1967 and smokeless tobacco reports since 1987. This year’s reports contain statistics on sales volumes and marketing expenditures – for cigarettes for the years 2004 and 2005 and for smokeless tobacco for the years 2002-2005. The cigarette report also updates other information contained in previous reports, such as the market share of filtered versus non-filtered cigarettes. This year’s smokeless tobacco report has new categories of information than past years, such as sales data broken down by package size.
According to information from the companies and their subsidiaries,
- no company solicited the appearance of any cigarette product in any motion picture or television show, or granted permission for the appearance of any cigarette product in any motion picture or television show.
- In 2004, the number of cigarettes sold and given away decreased 1.1 percent from 2003 levels.
- In 2005, the number fell another 2.4 percent. Advertising and promotional expenditures fell from $15.15 billion in 2003 to $14.15 billion in 2004, and then to $13.11 billion in 2005.
- For both years, the single largest subcategory of promotional allowances was price discounts paid to cigarette retailers or wholesalers in order to reduce the price of cigarettes to consumers.
The smokeless tobacco report has sales and advertising and promotional expenditures by tobacco type:
- dry snuff,
- moist snuff,
- plug/twist, and
- Loose-leaf chewing tobacco.
- The five largest domestic manufacturers had $2.13 billion in sales in 2001.
- The amount of sales rose each year from 2002 through 2004, to $2.62 billion in 2004, but dropped to $2.61 billion in 2005. Advertising and promotional expenditures fluctuated in this time period, with the lowest point of $231.08 million in 2004 and the highest point of $250.79 million in 2005.
Copies of the reports are available from the FTC’s Web site at http://www.ftc.gov
http://www.ftc.gov/opa/2007/04/cigaretterpt.shtm
http://www.vectorgroupltd.com/abtus.asp
Ben Garnett, Anchorage
Control over schedule: Most important predictor of provider work-life balance and burnout
RESULTS: Both women and men report being highly satisfied with their careers (79% compared with 76%, P<.01), having moderate levels of satisfaction with work-life balance (48% compared with 49%, P=.24), and having moderate levels of emotional resilience (51% compared with 53%, P=.09). Measures of burnout strongly predicted career satisfaction (standardized beta 0.36-0.60, P<.001). The strongest predictor of work-life balance and burnout was having some control over schedule and hours worked (standardized beta 0.28, P<.001, and 0.20-0.32, P<.001, respectively). Physician gender, age, and specialty were not strong independent predictors of career satisfaction, work-life balance, or burnout. CONCLUSION: This national physician survey suggests that physicians can struggle with work-life balance yet remain highly satisfied with their career. Burnout is an important predictor of career satisfaction, and control over schedule and work hours are the most important predictors of work-life balance and burnout. LEVEL OF EVIDENCE: II.
Keeton K, et al Predictors of physician career satisfaction, work-life balance, and burnout. Obstet Gynecol. 2007 Apr;109(4):949-55.
Scott Giberson, HQE
Names-Based Reporting for All U.S. States by End of 2007
Names-based HIV reporting will be implemented throughout the United States by the end of 2007. This transition began when the Ryan White CARE Act tied funding for HIV services to the institution of names-based reporting. The last three states to use code-based reporting -- Hawaii, Vermont and Maryland -- are now slated to switch to the new system by the end of the year. Although all U.S. states will soon officially use names-based reporting, most states still permit individuals to test anonymously. (see ID Society link below)
Survey suggests Medicare Part D still has to make improvements for HIV patients and providers
According to preliminary results from an informal survey of U.S. HIV health care providers conducted by the American Academy of HIV Medicine and the HIV Medicine Association. Bureaucratic hurdles, high co-pays and plans that won't cover necessary medications prevent many HIV-infected patients from getting their antiretrovirals and other drugs, the survey found. Of the 561 HIV health care providers who answered the survey, 83% said their HIV-infected patients had trouble getting their prescriptions filled since joining a Medicare drug plan. Seventy-nine percent also said they were spending more time now than before making sure Medicare patients obtained their medications. (see ID Society link below)
U.S. AIDS Drug Assistance Program Waiting Lists growing
As we already know, all AI/AN are eligible for ADAP services if they qualify in their respective states – the same for all races/ethnicities. However, nearly 600of HIV-infected patients (all races/ethnicities) in Alaska, Montana, Puerto Rico and South Carolina are waiting to receive antiretrovirals through their state's or territory's AIDS Drug Assistance Program (ADAP), the National Alliance of State and Territorial AIDS Directors (NASTAD) reports. According to NASTAD's latest "ADAP Watch" report, the number of patients on waiting lists is likely to keep growing. (It is already up by 269 patients since last September.) The current level of federal funding, NASTAD says, falls short of what is needed to provide treatment to poor, uninsured and underinsured HIV-infected patients in the United States. (see ID Society link below)
HRSA’s Special Projects of National Significance
For the last 5 years (2001-2006), HRSA’s Special Projects of National Significance (SPNS) has funded a specific "AI/AN HIV Initiative". 2006 marked it’s final year and subsequently the timeline for reporting outcomes in 2007. The meeting, held in Rockville, (info from HRSA HIV/AIDS Bureau) capped off this Initiative and provided a link to the HRSA TARGET Center library where some of the final products may be posted (unsure of timeline). The focus of this meeting was on presenting findings and lessons learned throughout the five years of engaging AI/AN in HIV primary care, substance abuse, and mental health services in Alaska, Washington State, California, New Mexico, and North Carolina. 'Dissemination products developed from this initiative will be made available in the future through the TARGET Center and the HRSA clearinghouse. See the TARGET Center TA Library for products focusing on AI/AN populations. The HRSA/SPNS team, project leads and IHS HIV Program will be reviewing the projects and outcomes. For the purpose of sharing successful projects and increasing interagecy transparency, we will attempt to obtain permission to post any outcome information / tools / resources / model practices/etc on the IHS HIV/AIDS webpage (in addition to HRSA's Target Center) and continue to work together to further disseminate the information.
http://www.careacttarget.org/librarysearch.asp
Behavioral Health HIV/AIDS Collaborative Training
The most recent IHS Behavioral Health HIV/AIDS Collaborative Training was executed in Anchorage, Alaska May 2-3. Participants included professionals from many facilities /program across the Alaska Area and beyond including Anchorage, Bethel and Kotzebue. Topics discussed included stigma and discrimination, motivational interviewing, data collection and HIV testing and resources to name a few. The training had representation from the Alaska Native Tribal Health Consortium and from Alaska Area Office senior officials. We are grateful to all their support and dedicated work, which made for a successful event. The final HIV Behavioral Health training with FY06 funds will take place in the Portland Area in early August. More detailed information on the FY06 trainings can be found at http://kauffmaninc.com/IHSAIDStrainings/ and our IHS HIV website at http://www.ihs.gov/MedicalPrograms/hivaids/
Sexual Health Web Site Offers Resources for Providers Treating MSM
STDCheckup.org, a Web site funded by the STD Control Branch of the California Department of Health Services, offers clinicians information on diagnosing and managing sexually transmitted diseases (STDs) in men who have sex with men (MSM). The "Resources for Clinicians" section of the site includes information on routine and periodic sexual history taking, laboratory screening for STDs, risk-reduction counseling, guidance for creating a safe clinical environment for MSM patients, and a downloadable toolkit in PDF format. The Body PRO offers information on STDs other than HIV.
Roberta Ward, Anchorage
FDA Proposes New Warning Labeling About Suicidal Thinking / Behavior In Young Adults
FDA notified healthcare professionals that the Agency proposed that makers of all antidepressant medications update the existing black box warning on the prescribing information for their products to include warnings about the increased risks of suicidal thinking and behavior in young adults ages 18 to 24 years old during the first one to two months of treatment. The proposed labeling changes also state that scientific data did not show this increased risk in adults older than 24 years of age and that adults 65 years of age and older taking antidepressants have a decreased risk of suicidality. The proposed updates apply to the entire category of antidepressants. Individuals currently taking prescribed antidepressant medications should not stop taking them and should notify their healthcare professional if they have concerns.
Manufacturers of antidepressant medications will have 30 days to submit their revised product labeling and revised Medication Guides to FDA for review. See the FDA press release for the list of products affected by the proposed antidepressant product labeling changes.
http://www.fda.gov/medwatch/safety/2007/safety07.htm#Antidepressant
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OB/GYN
Dr. Neil Murphy is the Obstetrics and Gynecology Chief Clinical Consultant (OB/GYN C.C.C.). Dr. Murphy is very interested in establishing a dialogue and/or networking with anyone involved in women's health or maternal child health, especially as it applies to Native or indigenous peoples around the world. Please don't hesitate to contact him by e-mail or phone at 907-729-3154.
