FDA, Center for Tobacco Products Stakeholder Discussion Series Session focusing on Minority Communities and Groups Affected by Tobacco-Related Health Disparities

Last week I was in Oakland CA for the FDA, Center for Tobacco Products Stakeholder Discussion Series Session focusing on Minority Communities and Groups Affected by Tobacco-Related Health Disparities.

For those of you who don’t know, The U.S. Food and Drug Administration (FDA) Center for Tobacco Products (CTP) is charged with implementing the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act). The overall goal is to find effective ways to reduce the tremendous toll of disease and death caused by tobacco use. After conducting in-depth conversations with representatives from various audiences affected by tobacco product regulation, including tobacco control advocates and regulated industry, CTP decided to host a variety of meetings to understand the true implications the regulations have on the audiences affected. So far 3 of the 7 meeting have taken place.

Below is a list of the Meeting that has and will take place.

• State and Local Tobacco Control Officials – October 3, 2010 Atlanta, GA

• Tobacco Manufacturers and Growers – December 8, 2010 Raleigh, NC

• Minority Communities and Groups Affected by Tobacco-Related Health Disparities – February 8, 2011 Oakland, CA

• Public Health Advocates – April 13, 2011 Chicago, IL

• American Indians/Alaska Natives – June 28, 2011 Gila River Indian Community (Phoenix, AZ)

• Distributors, Importers, Retailers, and Wholesalers – August 24, 2011 Dallas, TX

• Youth – September 13, 2011 Boston, MA

To see the agenda and a recap of the meetings click here.

CTP limits the amount of individuals invited to actively participate in the discussion and each of the National Tobacco Networks were asked to submit names of individuals to sit at the table. This process was very difficult for most of us as there were no travel resources attached to the invitation. Most networks reached out to their California based contacts for representation at the meeting. The Network was pleased to have great representation from our communities, and would like to thanks the following individuals for taking time out of their schedules to attend and or provide input for the meeting:

Bob Gordon

Naphtali Offen

Gloria Soliz

Francisco Buchting

Gary Humfleet

Kurt Fowler

The meeting opened with Dr. Lawrence Deyton, Director for the FDA Center for Tobacco Products. For those of you who may not be as familiar with Dr. Deyton he has a long standing history within LGBT health and Tobacco Control. In 1978 Dr. Deyton founded the Whitman Walker Clinic which is one of his many accomplishments. As the director of the FDA Center for Tobacco Products Dr. Deyton opened with his commitment to tobacco control and moving forward with a unified messages and actions to protect our communities from the dangers to Tobacco.

After the opening by Dr. Deyton each of the Disparity Networks (minus the National Native Commercial Tobacco Abuse Prevention Network as there will be another discussion specifically geared towards American Indians/Alaska Natives) presented on their network and the role they play in helping to reduce disparities within their communities in regard to tobacco control. Each of the presentations closed with initial recommendations  for the FDA Center for Tobacco Products to consider as they implement the Tobacco Control Act. There was some definite consensus across all of the networks from banning menthol, to the need for more data for all of our communities, as well as the need to regulate new tobacco products such as SNUS and existing products like mini cigars, and cigarillos.

One major take away message as we began discussing each of these common themes was the need for data, and testimony to  support  the proposed regulations implemented by the FDA Center for Tobacco Products. The Center has built into their infrastructure time for public comments on proposed or new regulations, in most cases the comment windows will be around 60 days. This is our opportunity to ignite our communities to take action, to ensure our voices are heard. I know what you are thinking, if you do not know that there is a comment period open how do you make comments? Additionally if they are soliciting “evidence based comments” and all you have is the practical knowledge of working with your community which may not be scientific based will your comments be heard? Everyone’s comments are welcome, and yes they need as much scientific based materials to support comments as possible (they are fighting an uphill battle against the tobacco industry) but your comments will be heard and they are needed. Let’s say we are all noticing a common theme in our communities, how will they know where to focus some more of their efforts let’s say gathering data on the issue if they are unaware that a specific issues exists in our communities. In addition,  I urge everyone to sign up to the FDA news list. Keep up to date on current news that can affect our communities, and/or opportunities we can support the Center moving forward such as public comment when needed. Click here to sign up, I signed up and I love knowing what’s going on right from the source. This weekly update is so valuable if you are interested in the Act.

Back to the meeting, Throughout the day, there was a lot of rich dialogue from the partners at the table. Dr. Deyton ended the day with 15 points gathered from the meeting, and he noted that the dialogue today is just the beginning as we move forward with the regulations. Below are the points as I interpreted them:

1. Trust, we need to have trust! Open and honest communication and a sense of Transparency and understanding that at times we are not all going to be on the same page but Trust that the goals are aligned just have to work out the best way accomplish them.

2. Knowledge about the FDA and how it interacts with our communities is important to them, and they will get the information to our communities for feedback. Understanding the Tobacco Control Act and the authority the FDA has and what they are unable to do in the same regard is important. We can support in these efforts by helping to generate comments for the FDA, and address areas where more work is needed to gather data where there is none. At times we may not feel that there is enough being done so we need to explain that and unite our communities in these efforts.

3. The FDA will look into maybe an office on disparities, or a disparity advisory board to assist with the implementation of the act. There is a strong commitment to disparities and this is one piece we hope to see address in the near future.

4. We opened their eyes to the whole arena around education, and the complexities of working with diverse communities. As each of our communities are different we need to take a tailored approach to ensure all of our communities are represented in educational efforts and that no one community is left behind. So they will look into a more tailored approach moving forward.

5. The Center will needs to look at the trickledown effect more and how much of what the FDA does will affect the local operational level.

6. The need for more data and research is apparent. They will look into ways to utilize existing data and ways to fund community specific data collection.

7. Menthol, they defiantly heard the concerns around the ban of menthol and we will soon see what will take place moving forward with the menthol debate

8. FDA’s Assertion of jurisdiction on other tobacco products. The FDA has the ability to assert jurisdiction over other tobacco products and they are addressing opportunities as they arise and are moving forward. This is an area we all need to keep an eye out for, in hopes that little cigars, hookah tobacco, cigarillos etc. are all addressed by the FDA.

9. Graphic Health Warnings, they are aware that there is support to add the Quitline and/or other cessation messages to the warning labels. This is another hot topic to keep an eye on and we will see what happens moving forward.

10. Enforcement, the FDA is aware that the need for enforcement is great and that they need to find ways that they can foster the community into these efforts

11. Optimal collaboration with other federal agencies with the thought of leveraging resources/discussions to ensure tobacco is always on each other’s agendas.

12. Throughout the discussion the Center realized that there were populations left out of the discussion today such as incarcerated individuals, those with mental health issues etc. and they feel these communities are very important and will be discussed more moving forward.

13. Funding (the elephant in the room), Dr. Deyton acknowledged that there is a need for resources for implementation and is trying to look at ways to address this growing issue. Although there are not any answers now, this is another area of interest that they will look into.

14. Dr. Deyton also explained the need for understanding that the tobacco control act makes FDA the “primary regulatory authority with respect to the manufacturing, marketing and distribution of tobacco products” and with that adds new slivers in tobacco control, but the FDA cannot correct the issues in the rest of the Tobacco Control arena. They have a specific task that they have been granted authority over through the Act.

15. Trust and Commitment again, Dr. Deyton explained that we have to trust that we all have a common goal and the road getting there may not seem like the most logical but that we have to trust in each other moving forward.

As you can gather there was a lot of discussion during the meeting. I found was quite difficult to break it all down in a way that makes sense but I hope the information provided was useful at this stage. I will be monitoring the progress moving forward, and will continue to update you all as new opportunities, or outcomes arise. Again, I do urge you all to sign up to the FDA’s Email list to ensure you receive your weekly update!