Please send items of interest for the E-News -- and any other feedback -- to E-News editor Dave Cundiff, MD, MPH. Thanks!
CONTENTS:
1) AAPHP Members discuss business, nuclear terrorism
2) PSTK Workshop and ACPM Annual Meeting this week
3) What authority to regulate tobacco will FDA get?
4) Board Certification in Public Health for non-physicians
5) Masks may work pretty well to prevent disease
6) AAPHP Annual Meeting 2007-06-23 in Chicago
7) 2007 Dues announcement
8) Member News - Kwalick retirement
1) AAPHP Members discuss business, nuclear terrorism:
AAPHP members and guests gathered in Boston on November 5, 2006 for a General Membership Meeting. AAPHP dues will remain the same for 2007. A financial set-aside will cover the future costs of servicing AAPHP Life memberships. We discussed the representation of Public Health Physicians at the American Medical Association.
Our educational session featured IRA HELFAND, MD, a past president of Physicians for Social Responsibility (PSR), discussing "The U.S. and Nuclear Terrorism: Still Dangerously Unprepared". Dr. Helfand summarized PSR's recent report on the subject, answered questions from public health physicians, and led discussion. Dr. Helfand noted several technical and policy disagreements between PSR and the Bush Administration. On at least one of these points, the Nuclear Regulatory Commission recently admitted that PSR was right!
Minutes of the 2006-11-05 meeting, including a summary of the educational program, are available at http://www.aaphp.org/Meetings/Minutes/nov06.html.
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2) PSTK Workshop and ACPM Annual Meeting this week:
AAPHP past president JOEL L. NITZKIN, MD, MPH, DPA and other AAPHP leaders will present a half-day workshop from the "Preventive Services ToolKit" (PSTK) on FRIDAY, FEBRUARY 23, 2007, from 1:30 to 5:30 pm, at the Intercontinental Hotel in Miami, Florida.
The workshop is co-sponsored by the American College of Preventive Medicine (ACPM), in connection with ACPM's Annual Meeting. AAPHP is a Supporting Organization for the ACPM Annual Meeting.
Registration for the full ACPM meeting is not required. ACPM's fee for the PSTK workshop is $95.00. Advance registration for the workshop may still be available at http://www.preventivemedicine2007.org. On-site registration will definitely be available.
Post-workshop consultation will be available to PSTK workshop attenders.
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3) What authority to regulate tobacco will FDA get?
Amid fanfare from many large national organizations, Senator Ted Kennedy presented the 2006 version of the "Family Smoking Prevention and Tobacco Control Act" last week. Bill numbers are reportedly S.625 and H.R.1108.
As of today, official copies of the bills are not available on the Congressional Web site. AAPHP has obtained what we believe to be a reliable copy, now posted at http://www.aaphp.org/resources/IntroducedBilLanguageFDATobacco.pdf (cut and paste onto one line in your URL, or use http://www.aaphp.org/WebLinks/weblink.htm, select the "Topical" tab, and click on "Kennedy-Cornyn Bill".
The bill has been touted as giving FDA the authority to regulate cigarettes as it regulates other consumer products. Does that mean a modern-day David Kessler or Everett Koop could write large-scale reforms into law? Not really. The bill's 155-page framework appears to contain detailed descriptions of what rules the FDA must, and may not, adopt.
Passage of this bill, without amendments, is a major strategic objective of Philip Morris, which dominates the current cigarette market. Analysts believe this bill will help Philip Morris by discouraging the development and marketing of new cigarette brands, and of tobacco products that may be quantitatively less harmful than cigarettes.
Many analysts also believe that the bill's regulatory framework will provide legal protection for any marketing activities later judged to have been deceptive. If the law permits deceit, these analysts reason, there will be no legal recourse for those who have been deceived.
Most large national health organizations believe this bill's advertising restrictions will slow youth smoking. Grassroots activists appear to be sharply divided on whether these advertising restrictions will survive legal challenges, and on whether they would have much public health impact anyway.
An emerging debate (which may be cut off before it starts) involves the regulation of nicotine-containing products (including most "smokeless" tobacco products) that kill a much smaller proportion of their users than cigarettes. Public health campaigns against these products have been very successful -- so successful that the public seems to believe they are "just as bad as smoking".
More affordable than pharmacologic nicotine replacement, a potential "gateway" into nicotine use for some, a potential "harm reduction" agent for those already addicted -- how should "spit tobacco" and other smokeless products be regulated? Epidemiologic data from the USA are sparse. Data from Scandinavia may not translate well into the American market and culture.
We're already seeing a push for fast passage of the Kennedy-Cornyn bill -- presumably without amendments -- from most Democrats, from a few Republicans, and from many large health groups. A sample "grassroots alert" from the "Campaign for Tobacco-Free Kids": "Every day Congress fails to act, another 1,200 Americans die from tobacco use and more than 1,000 kids become regular smokers." Will these numbers decrease if Congress acts? CTFK doesn't say. [Your editor is unaware, at least so far, of any epidemiologically based -- let along peer-reviewed -- analysis of this bill's effect.]
Opposition to the bill currently appears much smaller, less well-organized, and less well-funded. This bill is strongly opposed by tobacco interests other than Philip Morris, and by a relatively small network of grassroots anti-tobacco groups. (The "elephant in the room" may be the trial lawyers' lobby -- strong benefactors of Democrats, and adept at analyzing the details of any measure they deem relevant.) Expect opponents -- especially those who think the regulations won't help the public's health -- to demand hearings in which the details of the bill are explored and fully debated.
AAPHP will analyze the bill. We will keep the Public Health Physician community informed of our analysis and policy positions.
[Editor's Note: This bill is a 155-page PDF document, originally formatted for 8.5"x14", and takes about 300K of disk space. Because the bill is long and awkwardly formatted, consider saving it to your own computer before printing.]
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4) Board Certification in Public Health for non-physicians:
A while ago, the Robert Wood Johnson Foundation, concerned that just anybody with an MPH degree could claim competency in public health, quietly funded a new organization called the "National Board of Public Health Examiners".
That organization recently announced plans by which anyone with an MPH from an accredited School of Public Health, after they pass an additional examination, can claim to be "Board Certified in Public Health".
This isn't the first time we've heard of plans to use "Board Certified" to describe professionals other than physicians. Board members, some of whom are Board-certified public health physicians themselves, have explained to your editor that they won't be confused by the use of "Board certified" and they believe the public won't be confused either.
AAPHP Board members have reacted to the proposal with some alarm, believing it to be a major dilution of the credentials of the Board-certified Public Health Physician. We don't know whether the American Board of Preventive Medicine (ABPM) or the AMA will share that reaction.
Further information about the National Board of Public Health Examiners is available at their Web site, http://www.nbphe.org.
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5) Masks may work pretty well to prevent disease:
A recent review by public health physician ERIC TONER, MD, at the University of Pittsburgh Center for Biosecurity, suggests that surgical masks may provide almost as good a protection against aerosolized infection as N95 masks. In one study, the N95 masks filtered 97% of an experimental aerosol, while standard surgical masks filtered about 95%. The difference between the two masks matters -- but, in a community-wide emergency, there won't be enough N95 masks to go around. Consider using N95 masks for highest-risk workers, and surgical masks for the rest of the community.
The Institute of Medicine is hosting a meeting entitled "Workshop on Personal Protective Equipment for Healthcare Workers in the Event of Pandemic Influenza: Next Steps and Research Agenda" on 2007-02-22 in Washington, DC, to explore these issues. Information on this event is at http://www.iom.edu/CMS/3740/39644/39679.aspx. Registration is closed, but comments are being taken.
Dr. Toner's report is available at:
http://www.upmc-cbn.org/report_archive/2007/02_February_2007/cbnreport_02152007.html
(If the link doesn't work, cut and paste it onto a single line of your browser.)
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6) AAPHP Annual Meeting 2007-06-23 in Chicago:
AAPHP's President ALFIO RAUSA, MD, MPH has scheduled our Annual General Meeting for SATURDAY, JUNE 23, 2007 in Chicago, in conjunction with the Annual Meeting of the American Medical Association.
AAPHP member RONALD M. DAVIS, MD, MS will be inaugurated as AMA's President during this year's AMA Annual Meeting. We hope to have Dr. Davis as a speaker for our Meeting if his schedule allows. There are many other attractions and opportunities at the AMA meeting, which is generally free to AMA members.
The AAPHP Annual Meeting is free to all AAPHP members. Please make plans to join us!
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7) 2007 Dues Announcement:
AAPHP's 2007 dues are unchanged from 2006. Medical students and residents pay no dues. Retirees pay $40.00. Associate members (other than physicians) pay $60.00. Active members (physicians not eligible for other categories) pay $95.00. Life membership remains a bargain at $950.00.
To help us hold expenses down, please download the form at
http://www.aaphp.org/Membership/2007MembForm.pdf and fax it to the office in Rolling Meadows, Illinois, at (847) 255-0559.
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8) Member News - Kwalick retirement:
AAPHP Life Member DONALD S. KWALICK, MD, MPH will retire as Chief Health Officer of the Southern Nevada Health District (formerly Clark County Health District) on March 23, 2007. Residency-trained in Public Health at the New Jersey State Department of Health, Dr. Kwalick has worked in state and local Public Health leadership positions nationwide.
Public Health Physician LAWRENCE SANDS, DO, MPH has been named Assistant Health Officer, with a Board of Health recommendation that he be named Chief Health Officer upon Dr. KWALICK's retirement: http://www.southernnevadahealthdistrict.org/press_releases/2007/012507.html (cut and paste to a single line if needed).
The Southern Nevada Health District will host a dinner in Dr. Kwalick's honor on Saturday, March 10, 2007, in Las Vegas. Tickets are still available as of this writing. For more information, please contact Shelli Clark at (702) 759-1201.
In addition to those mentioned, thanks to BILL GODSHALL, MPH, Executive Director of Smokefree Pennsylvania, and to K. MICHAEL CUMMINGS, PhD, MPH, Chair of the Department of Health Behavior at Roswell Park Cancer Institute, for background information about the proposed tobacco regulation legislation. [Opinions in the E-News are those of your Editor, though, unless stated otherwise.] Thanks also to AAPHP members for your support of AAPHP's work!
Dave Cundiff, MD, MPH (cundiff@reachone.com)
AAPHP Secretary and E-News Editor
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