New Surgeon General's Report Released Today

Posted by Gustavo

Today the 30th tobacco related Surgeon General’s report since 1964 was released. This very scientific based report, How Tobacco Smoke Causes Disease – The Biology and Behavioral Basis for Smoking-Attributable Disease, focused on how smoking causes damage to almost every organ on the body. As we know there has been a lot of studies on the effects of smoking, but this over 700 page report details in depth the true effects of cigarette smoking and the ways tobacco smoke damages the human body. More importantly as a result we have a New Comprehensive Strategic Plan to address this issue.

To ensure comprehension of the findings an Executive Summary was created to outline the original 700+ page report in a more user friendly format which consists of a 9 page report.  A Consumer report was also created as a result of the new Report.

In addition to the release of the reports, a factsheet was created which outlines 6 scientific evidence based conclusions to help support us in our work:

  • There is no safe level of exposure to tobacco smoke. Any exposure to tobacco smoke – even an occasional cigarette or exposure to secondhand smoke – is harmful.
  • Damage from tobacco smoke is immediate.
  • Smoking longer means more damage.
  • Cigarettes are designed for addiction.
  • There is no safe cigarette.
  • The only proven strategy for reducing the risk of tobacco-related disease and death is to never smoke, and if you do smoke to quit.

While these conclusions may look very basic, and may have been identified in the past, there is even more scientific evidence to support the conclusions than ever before.

With the new regulation of tobacco, this report adds more support for stricter regulations of tobacco products. The report was designed to be very scientific based bringing together over 70 researchers to ensure comprehensive findings that can be used in the regulation of tobacco by the FDA.

Regulation of nicotine levels in a cigarette, for example, is one of the areas the FDA is looking at. This report outlines that the design and contents of tobacco products make them more attractive and addictive than ever before, and that cigarettes today deliver nicotine more quickly from the lungs to the heart and brain. With the scientific documentation to support the findings this could mean huge gains with the new FDA regulation of tobacco. Additionally, we know there is no safe cigarette. With new evidence from this report we know that changing cigarette designs over the last five decades, including filtered, low-tar, and “light” variations, have NOT reduced overall disease risk among smokers and may have hindered prevention and cessation efforts. So although we have speculated and have known some of these findings we yet again have more research to support the regulation of tobacco. Also, the report identified that the overall health of the public could be harmed if the introduction of novel tobacco products encourages tobacco use among people who would otherwise be unlikely to use a tobacco product or delays cessation among persons who would otherwise quit using tobacco altogether. So although there was not a lot that went into other smokeless tobacco products through this report they initially scratched the surface and maybe a next step would be looking into more tobacco products other than just cigarettes in the near future.

The most important section for me is the last point identified in the factsheet. The only proven strategy for reducing the risk of tobacco-related disease and death is to never smoke, and if you do smoke to quit. Although it sounds easer that it actually is we know that there are major strides to offer comprehensive cessation services to everyone. We know that it is never too late to quit, and that it takes an individual several attempts to quit before they are actually successful. Dr. Regina Benjamin noted today that patents who physicians talked to them about quitting have a 66% higher success rate of quitting. As a result a new Factsheet for physician was created. More importantly, in the quest to make sure everyone has equal access to cessation resources the federal government has amended their healthcare plans to offer comprehensive cessation services, and as Health and Human Services Secretary Kathleen Sebelius mentioned “we need to lead by example”. We know It’s important for all companies to have comprehensive cessation offered in their health care plans. In addition, we know that Medicare offers cessation services, and there will be an announcement soon regarding Medicaid offering cessation coverage, which will come from the new Affordable Care Act.

Finally, the factsheet released today informs individuals to call 1-800-QUIT-NOW to get started on a quit plan today. We have created an LGBT friendly poster version to promote the national quitline. In addition, we have a list of excellent cessation resources for LGBT communities from the field. If you know of any resources we don’t have on the site please send them to us so we can share them on our site.

Visit for the full 722 page report and all of the attachments, including a new PSA featuring the Surgeon General, Dr. Regina Benjamin. You can also request printed copies of all of the supporting documents as well.

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Posted by on December 9, 2010 in Uncategorized


It’s about the facts… Black and White really tells the story!

By Gustavo Torrez

Reporting from 2010 National Coalition for LGBT Health Meeting

OK OK I know what you are thinking, Really !?! what are you talking about Gustavo…

Well, I attended a panel discussion today titled Prevention and Public Health with the following individuals:

» Jeff Levi, Executive Director, Trust for America’s Health

» Nevena Minor, Legislative Affairs Manager, American Congress of Obstetricians and Gynecologists

» Dr. Garth Graham, M.D., M.P.H. Deputy Assistant Secretary for Minority Health

The session focused on the passage of the Affordable Care Act (ACA). As we know prevention and public health initiatives are moving into center stage in the efforts to overhaul the US healthcare system and to improve the health and well being of communities throughout the country. So this session focused on some of the major prevention and public health provisions of the ACA, and a major gain was how the act established a $15 billion prevention and public health fund. More importantly this act provides the ability to collect better data, this is a direct benefit of the law and will definitely include disparity groups with the hopes of inclusion of LGBT communities. Although it’s not clear in the law, there is work in being done ensure inclusion. If you followed this bill you know that the House bill that was passed was inclusive of LGBTs, but the Senate bill, which ended up being the final approved bill was not inclusive of LGBT communities. Negative right, well maybe not, although LGBT communities were excluded, there is the support for inclusion across the board. Although it was not explicitly stated in the bill there are a lot of insiders searching to be inclusive of all communities.

This is, yet again a classic example of why we need to mobilize our communities for action on the federal level.  SIDE NOTE: As you know the Network has and will continue to reach out to our community for input on federal initiatives to ensure LGBT inclusivity. BUT we can’t do it alone, we need your support on action items promoted by the network. There are two opportunities which can be found on the website right now.

Sorry I digress… back to the topic!

I am sure by now you are thinking, where does the Black and White situation come into play… Well one of the panel members, in response to a question addressed, stated that it is all about the black and white. DATA that is, until there is equality across the board with inclusive LGBT data, we will still be fighting for overall inclusion of our communities. We all know there is not enough data to support our work, we have to continue barking at the doors for inclusion. Together we will succeed, and there is hope for the future.

In closing, I wanted to thank all of the LGBT focused researchers who have spend so much time addressing the needs of our community. Your data is what is helping to prove the case on the federal level. This was echoed in the presentation and, I know I just wanted to take an opportunity to say thank you to all, and please please keep us informed of your new projects. We want to showcase the work that is being done in our communities, and showcasing your data, and to support the work we are all doing.

Until next time,


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Posted by on October 26, 2010 in Uncategorized


Good Morning from National Coalition for LGBT Health Meeting

by Gustavo Torrez

Reporting from 2010 National Coalition for LGBT Health Meeting

Currently Scout and I are in Washington DC for The 2010 National Coalition for LGBT Health Annual Meeting. The Coalition’s annual meeting provides opportunity for participants to network with LGBT health advocates from across the country, attend workshops and trainings applicable to state and federal advocacy work, and learn about the Coalition’s policy initiatives. Here is a brief overview of the agenda for day 1, minus the actual breakouts for the day.
This morning Cornelius Baker, National Policy Advisor, National Black Gay Men’s Advocacy Coalition;
member, President’s Advisory Council on HIV & AIDS will be delivering the opening keynote address.
Leading into the afternoon, the Luncheon Plenary: LGBT Health on the Political Landscape speaker lineup looks amazing. We will hear from the following:
» Rebecca Fox, Consultant, Federal Agencies Project
» Mara Keisling, Executive Director, National Center for Transgender Equality
» Jeff Krehely, Director of LGBT Communications and Research, Center for American Progress
» Sharon Lettman, Executive Director, National Black Justice Coalition
The closing plenary will be provided by David Hansell,
Acting Assistant Secretary, Administration for Children and Families, Department of Health and Human Services.

Stay tuned, for more detailed blog posts from throughout the day from myself and Juan Carlos Vega, the ActivistLibrarianPR from Puerto Rico…


Institute 2010: The Business Case and Sustainability Workshop

Guest Blogger, Lisa Houston Break Free Alliance


The Business Case and Sustainability

Linking the Business Case for Chronic Disease Program and Policy Sustainability kicked off with an overview of sustainability. Definitions of sustainability differ between organizations and programs, but     generally instructors Denise Cyzman (National Association of Chronic Disease Directors) and Jay Desai (Minnesota Department of Health) emphasized that you don’t want to see all of your hard work and the resulting community health benefits dependent upon political whimsy. In putting together a sustainability plan, here are some of the key questions they posed:

1. Who would be important organizations and/or people to consider when planning for your program or policy?

2. What would be their initial motivation for involvement in the program or policy? What about their sustainable (i.e. long-term) motivation?

3. What could they contribute? What specific role would they have?

4. How could you get them interested in your specific program or policy?

5. Who are your two or three key strategic partners and why?

One of the factors important to establishing sustainability is making the business case for any given program or policy. Your program/policy likely saves money somewhere, and may even generate money. And of course, money isn’t the only component – there are things beyond value that your audience for the business case may value, such as being seen as progressive on matters of health. The trick is in framing your case. In a nutshell, you need to identify your target audience, explain the need, determine and demonstrate the value, evaluate progress and re-assess your business case.  Of course, you may have several different audiences, so here are some examples from different perspectives:

  • • Internal business perspective: Translate customer needs into products or services; meet organizational mission and goals; demonstrate commitment to prevention, self-management and    quality care
  • • Regulatory perspective: Meet local, state or federal regulatory requirements; conditions for reimbursement from 3rd party payers
  • • Community perspective: Shape organizational image in community; create image of quality provider; meet accreditation standards; enhance community welfare as a whole
  • • Innovation and learning perspective: Improvements in processes of care and health outcomes; improve strategic positioning; effects on employee satisfaction, absenteeism, presenteeism
  • • Customer perspective: Identify the customer and understand their perspective; determine program benefits that match their perspective.

Then comes the evaluation – figuring out if your policy or program continues to meet community need and if it’s sustainable in the long run.

Take-away: A sustainability plan with a business case probably cannot be whipped up overnight, but the two definitely provide at least one path to sustainability at a time when that word has saturated calls for proposals.




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Posted by on October 6, 2010 in Uncategorized


Institute Keynote – Author of "Switch: How to Change Things"

Gustavo Torrez

I am currently at The Institute 2010 – Shifting to a Higher Gear tobacco skills conference hosted by CDC and TTAC.

The opening Keynote Speaker was Dan Heath, Author of the Book Switch – How to change things when change is hard.

Dan’s charismatic nature sweep the room, and all of a sudden 8:30am did not feel so early!

He begins talking about how Psychologists have discovered that our minds are ruled by two different systems – the rational mind and the emotional mind, both compete for control.

The Rational conscious deliberative mind wants a great beach body the Emotional unconscious automatic mind wants that the ice cream… Sound familiar? I see it as the good gender-neutral individual in white on one shoulder and the bad gender neutral individual in red on the other shoulder. How may times do we have these types of discussions with ourselves?

What happens if they agree… CHANGE can be made with very little resistance!

It is not always that easy, and sometimes you need to address how to really create change.

Dan shows us the picture below, a man on an elephant. The man thinks he is in control but in reality who is in control? Of course the elephant!

Dan’s 3-part framework for behavior change he addresses in the follow ways

Direct the rider (man on the elephant), direction for the rider

Motivate the Elephant, we have to have the desire to change

Shape the path, make it simply easier to make the change, clear your path

When we talks about “Directing the rider”, he says the rider focuses on problems. The elephant is doing what it wants…

So what can you do to create change?

Find bright spots, identify what’s working today and do more of it…

People remember the negative longer than they remember the positive, he referenced a study which showed that individuals pay more attention to the negative things, an not enough of the positive.

This is so true though right? When we watch the evening news the top story is something negative, throughout the evening they focus on the negative things happening in our communities more that the positives.

Dan believes “we need to identify the bright spots” When you look at your kids report card don’t highlight the F in math, but highlight the A in English and the B in History, then identify ways it take to assist them in bringing the F grade up.

How often do we look for the bright spots, and build on them? Got you thinking… I know it has me thinking….

Part two if his framework is to “Motivate the Elephant”

The elephant speaks feeling, speak to the feeling to insight action. Knowledge is not enough, have to speak to the emotions. Change comes from emotion and if you motivate the elephant, you will create change.

Shrink the change, our elephants are easily spooked, he addressed phrasing the issue without making it look more daunting than it actually is! Take it one step at the time, and you will see it is easier than you think.

Ambiguity is the enemy of change.

Our role is to get people moving in the right direction, and if we shrink the change and take it one step at a time we will take the path of less resistance. Which transitions into part three of his framework.

“Shaping the path”

We have to make it easier, give people the map, be more direct he says…

Don’t just tell someone that there is a food drive on Friday at the town center, give them a map to the town center, tell them what you need, and the times to come by.

What can you do to make it easier for people, I believe we are a society of convenience… bottled water, sliced bread, it’s all convenient! So if we shape the path we will create the road of less resistance!

All in all, think about Dan’s 3-part framework, and spend a little extra time focusing on the bright spots, from talking with your child about grades, to embarking on your next social cause see how these strategies can assist you!

And if his great presentation wasn’t enough to get me reading the book, right after it Bronson Frick from Americans for Nonsmokers’ Rights stood up and said it’s one of the best books he’s ever read on behavior change. OK, this book now becomes a must read!

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Posted by on October 5, 2010 in Uncategorized


North Dakota will ALWAYS hold a special place in my heart!

First, as some of you may or may not know the Network is available to conduct LGBT Cultural Competency Trainings. A major goal of the Network is to assist states in closing disparity gaps in LGBT tobacco control.

We have crafted an amazing LGBT Cultural Competency Training that will leave participants with a stronger understanding of the LGBT community, and how to best address LGBT health Disparities.

Training your frontline staff is a great way to ensure your programs, organizations, and services are accessible & welcoming to LGBTs. Having the training offered at conferences and summits is another way you can help train individuals to be more welcoming to the LGBT communities.

The Objectives of the training are to:

  1. Help participants learn how to reach LGBT people through community access points and structures
  2. Gain a better understanding on ways to ensure their agency is accessible to the LGBT community
  3. Establish individualized goals to reach and serve more LGBT people, with Network resources to assist them

Enough about Network plugs, let’s talk about NORTH DAKOTA!

The North Dakota Department of Health brought me out to the Beautiful town of Bismarck for their Annual Statewide Alcohol and Substance Abuse Summit and their quarterly sites meeting of CDC grantees. We conducted a 4 hour LGBT Cultural Competency Training during one of the breakouts at the summit, and their quarterly sites meeting of CDC grantees. During Both presentation the Network linked with Sharri Paxon, a local North Dakotan for both presentation to explain the local climate and to link participants with a local advocate willing to assist them in their work.

A little more about Sharri, she is an advocate for health equity, she supports the practice of looking beyond race and ethnicity to fully define affected populations. Through QPax Unlimited, Sherri provides consultation and training on a variety of public health topics, including health equity, cultural competency, the social determinants of health, program planning and integration and survey development. She specializes in lesbian, gay, bisexual and transgender health and equity issues.

Sharri was a great asset and provided so much great information which led into a group discussion and project where participants identified ways they could make themselves and their programs more accessible to LGBTs. Some of those ideas included:

  • Posting LGBT friendly materials in the lobby of their building
  • Posting a comprehensive non-discrimination statement and informing staff of the new statement
  • Set up LGBT Cultural Competency Trainings for entire staff
  • Partner with local LGBT organizations on projects
  • Ensure intake surveys/questionnaires asks sexual orientation and gender identity
  • Encourage all 28 Local North Dakota Public Health Programs to adopt a non-discrimination policy

North Dakota has been doing some great work and we will continue to see significant progress from North Dakota in the future. We look forward to going back and building on some of the major accomplishments we achieved earlier this month.

Many thanks to all of the ND Health Department staff for opening your doors and your program to us! I am so impressed on all of the great work you are doing and can’t wait to see what comes next…


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Posted by on September 29, 2010 in Uncategorized


TCN Strategies for Smoke-Free Air Policy Implementation

The Tobacco Technical Assistance Consortium (TTAC) held their second webinar in the 2010 Tobacco Control Network (TCN) series this week, “TCN Strategies for Smoke-Free Air Policy Implementation,” titled “The Devils in the Details: Achieving the New Gold Standard in Smoke-free Policies.”

The call focused on helping participants Identify the updated or new provisions in model smoke-free air legislation, Understand the rationale for current model, Determine what provisions are essential (deal breakers) for effective, enforceable smoke-free air legislation, and Apply lessons learned from case studies to recognize challenges that need to be addressed in your state or community

The list of speakers included:

  • Bronson Frick
    Associate Director, Americans for Non-Smokers Rights Foundation
  • Maggie Mahoney, JD
    Deputy Director, Tobacco Control Legal Consortium
  • Sally Herndon, MPH
    Head, Tobacco Prevention and Control Branch, North Carolina Division of Public Health
  • Jim D. Martin, MA
    Director of Policy and Programs, Tobacco Prevention and Control Branch, North Carolina Division of Public Health
  • Sharon R. Biggers, MPH, CHES
    Director, Division of Tobacco Prevention and Control, South Carolina

The call focused a lot around the ANR Model Ordinance and the evolution of the document throughout the years… from smoking sections in the 80’s to 100% smoke-free policies now.

One main take away message from the call was to “Plan before you act… don’t put the cart before the horse”. I think this is so true no matter what type of project you’re working on. Many times we get so excited, we have people ready to act and work on a new project or campaign and we just dive in with excitement. Having a great group ready to act is a great thing but, it is always better to plan your attack. Especially in today’s climate with the tobacco industry using new tactics to derail our efforts. Check out this page to view ANR’s What to Expect from the Tobacco Industry

When we are talking about smoke-free air legislation, Bronson noted that ANR’s Guiding Principles, Fundamentals of Smoke-Free Workplace Laws document great place to start!

When developing your language they also suggest to start with ANR model language and then amend to include more state specific language with partners at the table.

In his presentation he addressed the following:

  • Agree on “dealbreakers”
  • Be realistic about resources
  • State with a strong grass roots base
  • Start with Model Policy language
  • Include expert advisors
  • Importance of broad-based community support

He said it is important Agree on deal breakers & Key Principals early in process

Put decisions in writing…

Once you get your main players at the table work out a plan. Sometimes you might have additional partners join later, or staff changes throughout the process so it is good to have everything in writing so that everyone can be on the same page always. In addition, determine your deal breakers; ANR has created Determining Your Dealbreakers page to assist in this process.

View ANR’s Model Ordinance, this document is updated almost yearly to continue to offer the most up to date resources for your work.

Some key updates in the current version included definitions of

  • E-Cigs
  • Restaurants/Bar Patios
  • Penalties/Enforcement

In addition there are other issues to watch for such as:

  • 100% smokefree hotels
  • Medical Marijuana SHS
  • Other Emerging Issues

One main thing of interest was the new hot topic of Electronic Cigarettes.

While there is some scientific evidence showing that E-Cigarettes are not a healthy product, there is still very little scientific evidence to support any secondhand smoke or vapor can be harmful. The new ordinance showcases some of the findings and the reason why they are being included in enforcement activities etc.

The definition of smoking has been amended to include e-cigarettes.

“E-cigarette” any electronic oral device, such as one composed of a heating element, battery, and/or electronic circuit, which provides a vapor of nicotine or any other substances, and the use or inhalation of which simulates smoking. The term shall include any such device, whether manufactured, distributed, marketed, or sold as an e-cigarette, e-cigar, e-pipe, or under any other product name or descriptor.

Also, if you are working on Hookah they noted focusing on the language stating “heated tobacco or plant products intended for inhalation” can encompass hookahs.

TTAC has uploaded all of the materials from the call to their site. To view the supporting materials, speaker’s bios, and presentations you can visit:

Or click the links below:

In addition to the great presentation resources, I wanted to let you all know that The Campaign for Tobacco Free Kids released an updated Special Report on Smoke-Free Laws Protecting Our Right to Breath Clean Air this month. This is another great resource I think you all might find useful!

ALSO, don’t forget to view the Networks LGBT People and Smoke-Free Air factsheet.