Lee County’s Basin Management Action Plans – The 1 st Five Years
Five years of action
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Transcript of Five years of action
IActivities of the Youth Smoking Prevention Foundation
F I V E Y E A R S
OF ACTIONFOR A SMOKE-FREE COUNTRY
CONTENTS
Preface
Aims
To rid society of tobacco
Facts
200 new smokers every day
Tools
Two lung specialists against the tobacco industry
Self-help book for a smoke-free existence
A successful policlinic for stopping smoking
Prize-winners
Youth Smoking Prevention Foundation
Manifesto on Tobacco Prevention
Media appearances
TabakNee unmasks the lobby
Reactions to TabakNee
Smoke Alarm mobilizes children and parents
Five popular short films
Laying the blame where it belongs
Next
The battle against the killer industry continues
Campaign aimed at politics
The State on trial
Board of Youth Smoking Prevention Foundation
Committee of Recommendation
1
3
6
9
11
13
17
22
24
27
30
30
1
PREFACE
As doctors, we want to treat our patients as best we can. We do
all in our power to offer them every chance of surviving, but for
most of our patients there is unfortunately no cure. What we can
do, however, is make the quality of their remaining life as good as
possible.
And that involves trying to convince patients, with increasing
urgency, to quit smoking. Already diseased because of tobacco,
our patients find quitting so difficult that it underlines the
importance of preventing others from starting to smoke. We must
encourage smokers to stop and, more importantly, ensure that
children don’t start smoking.
That is why we try to make as many people as possible aware —
through the Youth Smoking Prevention Foundation, the TabakNee
website and the Smoke Alarm campaign — of the damage caused
by tobacco and of the vile methods that the industry employs to
get people hooked and keep them hooked.
We do not do this alone, but with a team of scientists,
journalists, researchers and lawyers, and with our
secretary Frits van Dam as the driving force. This
book offers an overview of the work accomplished
over the past five years and our plans for the near
future. We hope that you will support us financially
so that we can continue our work. Help us to make
tobacco a thing of the past.
Pauline Dekker
Lung specialist, Red Cross Hospital, Beverwijk
Wanda de Kanter
Lung specialist, Antoni van Leeuwenhoek Hospital,
Amsterdam
2
one main aim
RID SOCIETY
OF TOBACCO
3
Given all that we now know, would tobacco be allowed on
the market today if it weren’t already there? Of course it
wouldn’t. A highly addictive and poisonous substance that,
if used as intended, is ultimately lethal, wouldn’t stand a
chance of being allowed onto the shop shelves.
But tobacco is already on sale in shops, and its legal status
is the most important argument made by manufacturers and
some politicians to keep tobacco on sale. For the government
too, 19,000 deaths a year from smoking are apparently no
reason to ban tobacco, or at the very least impose greater
restrictions on it than are currently in place.
The Youth Smoking Prevention Foundation has one clear
aim: to rid society of tobacco and make smoking a thing of
the past. The only way to achieve this aim is to ensure that
nobody starts smoking. The foundation is therefore urging
the government to adopt a number of measures to create an
effective prevention policy:
• substantial increase in sales tax to put tobacco out of
the reach of children
A packet of cigarettes should cost at least 10 euros so that most
children cannot afford to buy them.
• tobacco-free school playgrounds
Smoking in and around schools should no longer be allowed.
AIM
4
• effective enforcement of the age restriction for buying
tobacco
It should effectively be impossible for persons under 18 to buy tobacco.
• reduction in the number of points of sale
With some 60,000 points of sale, tobacco is far too easily available, and
enforcing compliance with the age restriction is impractical. Tobacco
should be removed from supermarkets, chemist’s shops and bookshops,
and should only be sold from special licensed tobacco outlets.
• tobacco products should not be visible to customers
at points of sale
A wall filled with packets of cigarettes is a tobacco advertisement.
Tobacco advertising is illegal, and tobacco products should therefore no
longer be visible in shops.
OTHER COUNTRIES HAVE SHOWN THE WAY
More and more countries are proving that these measures
are not uncommon. Countries such as Australia, New
Zealand, Norway, Finland and Ireland have implemented
strict anti-smoking policies.
Cigarette vending machines are illegal in England, and since
April 2012 cigarettes are no longer allowed to be displayed in
ordinary shops. The same is true in Finland.
Anybody found to have sold cigarettes to a person under the
age of 18 in Finland can receive a half-year prison sentence.
Australia, New Zealand and Iceland are considering the
introduction of a total ban on cigarette sales.
Ireland aims to be smoke-free by 2025.
In the interests of our children’s future, the Netherlands
should join this list as soon as possible.
5
200 NEW SMOKERS A DAY
Some 200 children under 18 start smoking in the
Netherlands every day. 126 of them will start
smoking daily, 70 will remain smokers for the rest
of their lives, and 35 of them will die from its
effects.
200
70
35
6
Some 19,000 people die each year of diseases caused
by smoking. Half of those people are younger than 65.
Half of all people who smoke throughout their life die from
the effects of tobacco, on average 10 to 15 years before
the age at which they would otherwise have died.
87% of all new cases of lung cancer are caused by
smoking. The figure for COPD (chronic obstructive pulmonary
disease) is 85%, for acute heart attacks 31%, and for strokes
20%.
In 2013 the percentage of smokers among Dutch people
aged 15 and older was 25%
(26% men, 25% women, rounded).
In 2013, 30% of Dutch youths aged from 15 to 19 had
smoked within the past four weeks.
Some 200 children under 18 start smoking in the
Netherlands every day. 126 of them will start smoking daily,
70 will remain smokers for the rest of their lives, and 35 of
them will die from its effects.
FACTS
7
In 2013, 65% of smokers aged 15 and older in the
Netherlands admitted they had made a serious attempt to
stop smoking. If they could live life all over again, almost
90% of smokers would not start smoking.
4 to 10% of smokers aged 15 and older in the Netherlands
who tried to stop smoking in 2011 had not smoked a single
factory-made or hand-rolled cigarette one year (in 2012)
after stopping.
Each year the Dutch state collects 2,4 billion euros
in tax on tobacco sales.
In 2012 Dutch people bought a total of 12.2 billion cigarettes,
which cost them 3,3 billion euros.
Sources:
National Public Health Compass; Continu Onderzoek Rookgewoonten;
Roken Jeugd Monitor; International Tobacco Control Netherlands Survey;
AC Nielsen; Ministry of Finance.
8
Two lung specialists
against the tobacco
industry
9
In 2007 Pauline Dekker and Wanda de Kanter have had
enough. The two lung specialists at the Red Cross Hospital in
Beverwijk see that almost everybody in their waiting rooms
sit there as a result of smoking. And the diseases in question,
mainly lung cancer and COPD, are incurable.
When Dekker and De Kanter realize that there’s no substance
more addictive than nicotine, they no longer want to stand by
and watch. Instead, they decide to take action. So together
the two doctors write the book Nederland Stopt! Met roken
(‘The Netherlands Stops Smoking!’), which they present in
May 2008. The presentation coincides with the centenary
of NVALT, the Dutch society of lung specialists, and the
introduction on June 1 of the smoking ban in cafes and
restaurants in the Netherlands.
The timing can’t be better, and thanks in part to the
unflinching efforts of both doctors, the book receives plenty
of media attention. Ever since, Dekker and De Kanter succeed
in reaching the media whenever tobacco is in the news.
SELF-HELP BOOK FOR LIFE WITHOUT TOBACCO
Nederland stopt! Met roken is a practical and
effective manual for stopping smoking. The
book reveals and explains many issues related
to smoking and what makes quitting so difficult.
It discusses the myth of addiction, the tactics
employed by the tobacco industry, the health
advantages for those who stop, and the dangers
for those who don’t.
Featuring a ‘step-by-step guide to stopping’,
the book helps readers to prepare properly for
TOOLS
10
stopping, which is essential for maximising the
chances of success. In addition, the book discusses
the various methods for stopping smoking: cold
turkey, with and without supervision, with and
without nicotine substitutes or medicine.
Moreover, medical specialists tell of the effects
of smoking in their area of expertise. The book
also translates the latest scientific insights into
everyday life.
That makes Nederland stopt! Met roken a
comprehensive manual for a smoke-free existence.
Scores of readers express how helpful the book
was to them. Here are some of their comments:
‘The step-by-step guide to stopping shows you
just how bad your situation is. The book is not the
slightest bit aggressive in tone, but written so you
can see the facts for yourself.’
‘For me as a social worker the book has become a
real bible!’
‘The good thing about this book was that I was
prepared for difficult moments, especially those
moments when I didn’t want to stop.’
‘I am now a non-smoker thanks to your book.
I really have been rescued. MY DEEPEST
GRATITUDE TO YOU!’
‘The book includes a letter from a woman who
was diagnosed with lung cancer within one week.
Her lung specialist asked her to write a letter to
11
her children. While reading the letter I stood up,
cut my remaining cigarettes in two, and I haven’t
touched a cigarette ever since.’
But the lung specialists also continue to highlight the
disastrous effects of smoking in the news. In Beverwijk they
open a Stop Smoking Policlinic, which proves extremely
successful within a few years. According to a survey it
conducts, half of the participants hadn’t smoked one year
after treatment. That high percentage is in part the result
of a method adopted from England called ‘motivational
interviewing’ (MI) and, allied to that, a strict selection of
motivated participants. Asking the right questions makes
patients feel they are taken seriously, but they also have
to face up to the peculiar reasoning they follow to justify
their unhealthy habit. In 2010 Dekker and De Kanter write
a second book devoted to this method entitled Motiveren
kun je leren (‘Motivation can be learned’), specially intended
for people working in health care. The book helps medical
professionals to discuss healthier behaviour with patients in
a more effective manner.
Both books are successful, with print-runs of 40,000 and
10,000 copies respectively. A tear-off calendar and an
audio-book based on Nederland stopt! also prove popular.
On top of all that, Dekker and De Kanter set off on a lecture
tour in which they explain to 10,000 doctors, dentists and
pharmacists in the Netherlands why it is so important to
advise patients to stop smoking and how they should do that.
A SUCCESSFUL POLICLINIC FOR STOPPING SMOKING
12
PRIZE-WINNERS
Thanks to all their activities and success, in 2012
the Dutch Foundation on Smoking and Health
(Stivoro) proclaims Dekker and De Kanter as the
best practitioners treating tobacco addiction in the
Netherlands, and the news makes the front page
of De Telegraaf newspaper. In the same year they
receive the 38th Professor Muntendam Prize from
the Dutch Cancer Society ‘for their innovative
approach to the treatment of tobacco addiction
and their tireless battle for a no-smoking country’.
On May 31, 2013, the lung specialists earn another
accolade when, within the framework of World
No Smoking Day, they receive the Gerbera Award
2013 from Stivoro on behalf of the Dutch Cancer
Society, the Dutch Heart Foundation and the Lung
Foundation.
According to the jury report: ‘The lung specialists
Wanda de Kanter and Pauline Dekker deserve all
support and admiration for their tireless efforts
to put the problem of smoking on the political and
social agenda. They are motivated in those efforts
by their concern for the health damage caused by
tobacco that they see in their daily work.
And like few other people they have the courage to
take on the tobacco lobby in their crusade. Pauline
and Wanda are part of a long tradition of doctors
with the courage to highlight social issues with the
aim of creating a healthier society. A doctor on the
barricades fighting for a cause: that’s something
the sector should be extremely proud of!’
In late October 2013, both lung specialists receive
distinctions abroad, this time the Roy Castle
13
Lung Cancer Foundation Prize for their TEDx
performance entitled ‘Replacement smokers’. The
prize of 500 pounds is awarded during the 15th
World Conference on Lung Cancer in Sydney.
In their contribution to TEDxNijmegen in
April 2013, Dekker and De Kanter gave their
presentation the form of a biting role play in which
they denounce the involuntary nature of tobacco
addiction, the shame felt by patients for their
‘self-inflicted’ disease, and the shameless greed for
profit in the tobacco industry.
As Dekker and De Kanter immerse themselves more deeply
into the subject, they realize that all efforts to help people
stop smoking are ultimately futile as long as new smokers
continue to join the ranks of those already smoking. All the
information that reaches them from the literature and from
their international network teaches them to see through the
devious methods employed by the tobacco industry to recruit
new smokers among young people. So to offer resistance,
they set up the Youth Smoking Prevention Foundation
in 2009. The aim of the foundation can be summarized
succinctly: to make smoking a thing of the past.
That aim can be achieved through a number of related
measures:
• heavy increase in sales tax to put tobacco out of the
reach of children
• creation of tobacco-free school playgrounds
• increase in the minimum age for buying tobacco in
combination with an effective age control
• drastic reduction in the number of sales points
• concealment of cigarettes from view at points of sale
YOUTH SMOKING PREVENTION FOUNDATION
14
The foundation’s advisory council is made up of leading
figures from the medical and academic worlds and other
prominent figures. Foreign members of the council are:
Robert N. Proctor, professor of the History of Science
at Stanford University and author of Golden Holocaust;
Professor Robert West, University College London, Smoking
Cessation Institute; and Dr Jeffrey Wigand PhD, whistle-
blower from the tobacco industry and founder of Smoke-Free
Kids,
Dekker and De Kanter express their views at every possible
opportunity, and the Dutch Clean Air Foundation (CAN)
proclaims them to be the 2009 Non-Smokers of the Year.
Soon afterwards, the foundation’s ranks are strengthened
with radiation therapist Lukas Stalpers, secretary of the
Dutch Oncology Society, and Frits van Dam, Emeritus
Professor of Psychology and former researcher at the Dutch
Cancer Institute. Van Dam is appointed foundation secretary
and Stalpers becomes a member of the Committee of
Recommendation. Around the same time, the Dutch Cancer
Society decides to support the foundation financially.
That support is vital, because the political climate takes
a turn for the worse in the autumn of 2010 when Edith
Schippers is appointed as the new Minister for Health,
Welfare and Sport. Very quickly she reverses a number of
measures in the area of tobacco policy. She lifts the ban on
smoking in small cafés, halts information campaigns, and
takes remuneration for stopping smoking out of basic health
insurance policy.
Dekker and De Kanter decide to respond and draw up a
Manifesto on Smoke Prevention in which they call on the
minister ‘to do all in her power to make tobacco addiction
a thing of the past for future generations and to limit its
damage to current generations’. Some 1000 physicians,
15
MANIFESTO
Based on their knowledge of and responsibility
for sustainable public health, the undersigned
call on the new Minister for Health to do what is
necessary to make tobacco addition a thing of the
past for future generations and to limit its damage
on present-day smokers. Specifically:
1 To greatly increase the cost of tobacco
products (a doubling of the price)
2 To remove tobacco products from view at
points of sale (‘wall of fame’ in supermarkets)
and reduce the number of points of sale
3 To ban smoking in or near schools (smoking is
contagious)
4 To raise the age at which people can buy
tobacco to 18
5 To enforce the ban on smoking in cafes and
pubs and to balance the legislation from the
viewpoint of prevention for youths
16
academics and prominent figures sign the manifesto. After
much perseverance Dekker and De Kanter are allowed to
present their manifesto to the minister on 19 January 2011.
In her reply, Schippers asserts that she too wants to prevent
children from taking up smoking, but has decided to use
other means to achieve that aim.
Even so, the media devote plenty of coverage to the
appeal by the doctors to the minister. The current affairs
TV programme EenVandaag reports on the presentation
made to the minister and gives Dekker and De Kanter amply
opportunity to explain what should be done.
Later that year, in October 2011, the investigative TV
programme Zembla, with help from the Youth Smoking
Prevention Foundation, convincingly shows how short
the lines are between Minister Schippers and the tobacco
industry. No wonder that she is rightly known as the ‘Minister
for Tobacco’. The programme does not go unnoticed. The
authoritative medical periodical The Lancet devotes an
editorial to the subject entitled Can the Dutch Government
really be abandoning smokers to their fate? (Volume
379, issue 9811, p. 121) and the programme is screened at
international congresses with English subtitles.
Questions raised in parliament after the programme prompt
the decision to relieve Schippers of responsibility for tobacco
policy and put it in the hands of state secretary Martin
van Rijn.
Door een onzer redacteuren
Amsterdam. Twee longartsen
van het Rode Kruis Ziekenhuis in
Beverwijk hebben een website
opgezet waarop zij mensen ver-
oordelen voor banden met de ta-
baksindustrie. Zij noemen onder
meer oud-senator en oud-minis-
ter van Defensie Hans Hillen
(CDA), die betaald advies gaf aan
sigarettenfabrikant British Ame-
rican Tobacco en emeritus hoog-
leraar Irene Asscher, moeder van
de vicepremier en commissaris
bij sigarettenfabrikant Philip
Morris. Minister Schippers
(Volksgezondheid, VVD) wordt
wegens veronderstelde contac-
ten met de tabaksindustrie neer-
gezet als ‘minister van Tabak’.
De longartsen, Wanda de Kan-
ter en Pauline Dekker, voeren al
jaren actie tegen roken. Vo l g e n s
hen overlijden jaarlijks 23.000
mensen aan de gevolgen. Hun
voornaamste doel is te voorko-
men dat jongeren ermee begin-
nen. Voor het naming and shamingop hun website ‘Tabak Nee’ base-
ren ze zich deels op het werk van
onderzoeksjournalisten.
Volgens een woordvoerder van
Schippers zijn de aantijgingen op
de website „nergens op geba-
seerd”. Als minister in het kabi-
net-Rutte I verhoogde zij juist
het budget voor antirookvoor-
lichting aan jongeren, stelt hij.
Wel beëindigde Schippers de du-
re televisiecampagnes via Post-
bus 51, omdat voorlichting via de
sociale media effectiever zou zijn.
Inmiddels valt het ontmoedi-
gingsbeleid voor roken onder
staatssecretaris Martin van Rijn.
Longartsen hekelen ‘minister van tabak’
17
MEDIA APPEARANCE
Pauline Dekker and Wanda de Kanter appear
frequently in the media after the release of
their book Nederland stopt! They give scores
of interviews and contribute to all national and
regional newspapers, consumer magazines from
J/M to Opzij, and professional journals such as the
Nederlands Tijdschrift voor Geneeskunde, Medisch
Contact and Arts en Auto. In addition, they appear
regularly on popular radio and TV programmes
such as De Wereld Draait Door and Nieuwsuur.
The Youth Smoking Prevention Foundation also
actively campaigns through social media. Since
2008 the www.nederlandstopt.nu weblog is
updated weekly with all activities from the past
week. More than 10,000 contacts receive daily
news and updates via Facebook, Twitter (@
Wdekanter) and LinkedIn about matters relating to
tobacco and the fight against tobacco.
De Zembla documentary shows just how far the tentacles
of the tobacco industry extend into society and politics
and teaches us the effect of exposing that. The foundation
therefore decides to continue its investigative journalism and
to unmask the tactics and tools employed by the tobacco
industry on a separate website. The TabakNee site publishes
profiles of current and former politicians and other public
figures who, directly or indirectly, work for the tobacco
industry.
TABAKNEE UNMASKS THE LOBBY
18
When the TabakNee website goes online on March 11, 2013, it
provokes an unprecedented media explosion. All newspapers,
radio stations and TV programmes highlight this unusual
form of ‘naming and shaming’ by a website. Politicians and
others linked to the tobacco industry by the website are
furious and the press rubs its hands with glee.
In its first year TabakNee makes numerous revelations about
the lobby of ‘the tobacco industry & its cronies’. In addition
to its own publications, the team behind the website works in
various ways with established media channels. For example,
two of those who work for TabakNee, Stella Braam and Ivo
van Woerden, make a series of four stories for the weekly
Vrij Nederland magazine about the lobby and the network
of the tobacco industry. The first story, about the powerful
support from the Confederation of Netherlands Industry and
Employers (VNO/NCW) for the tobacco industry, appears
in July 2013 and comes as a bombshell. Many other media
report on the subject and the revelations lead directly to
questions in parliament.
Articles on the website itself highlight a PR advisor who
works for both the tobacco industry and the health care
sector, so-called independent research that turns out to be
funded by the tobacco industry, the powerful lobbying by
the VNO/NCW on behalf of the tobacco industry, the work of
small tobacconists and café owners on behalf of the tobacco
lobby, academics who dance to the tune of the tobacco
industry, the heavy lobby in the European Parliament, and
the interweaving of the tobacco lobby in the political arena.
Many articles result in questions in parliament. On at least
five occasions, members of parliament put questions to
responsible ministers as a result of information from the
TabakNee website, which operates with its own editorial
charter and independent editorial office, and posts more than
250 articles in less than a year. Visitor numbers grow steadily
19
20
and increase even more rapidly after the launch of a two-
weekly newsletter.
In late 2013 TabakNee receives internal documents from
Philip Morris concerning the tobacco manufacturer’s
lobbying in Brussels. The documents disclose in detail how
Philip Morris tries to influence members of the European
Parliament who have to decide about revisions to the
European Tobacco Product Directive. These internal
documents form the basis for a series of stories on TabakNee
published after December 2, 2013. In late February 2014,
current affairs programme EenVandaag airs a TV report
based on the same documents and on additional research.
That collaboration illustrates once again the added value of
TabakNee. The investigative journalism of TabakNee forms a
welcome addition for editors of current affairs programmes
such as EenVandaag. In this way, TabakNee works beyond
its own website to disseminate information about the tactics
employed by the tobacco industry and to make people
understand that implementing measures against smoking is
essential.
REACTIONS TO TABAKNEE
Immediately after the launch of TabakNee,
politicians and other figures in positions of
authority are asked to respond. They have two
choices: they are either for or against the website.
The Dutch Labour Party (PvdA) and Socialist
Party (SP) issue statements in which they express
support for TabakNee. Myrthe Hilkens (PvdA) tells
NOS news: “The tobacco industry sells outdated
nonsense and this is about public health. We
should be concerned about the health of young
people, and smoking is always bad. If people work
with the tobacco industry, it is good we are aware
of that.”
21
NRC Handelsblad newspaper observes that this
comment increases tensions between the parties
in the coalition cabinet, the PvdA and the Liberal
Party (VVD).
Former minister for health Els Borst (D66) is also
pleased with the site. “It is the only thing that
the tobacco industry listens to. People who sit on
the board of directors of a tobacco manufacturer
should ask themselves if they would be better
off spending their time doing something more
useful,” she tells the AD newspaper.
There is less enthusiasm from the VVD and CDA
parties. VVD member of parliament Arno Rutte
is angry about his own profile on the site. “We
should conduct the discussion on the basis of
serious arguments. For me that means showing
the arguments for and against. And if I take
tobacco manufacturers seriously, surely that
doesn’t immediately mean I’m a lobbyist? The
VVD is also concerned about the increase
in the number of smokers,” he says in de
Volkskrant newspaper.
In an editorial article NRC Handelsblad
newspaper writes: “Luxury goods
industries should be able to handle some
rough treatment. After all, they know
exactly what they’re doing when it comes
to making tobacco and alcohol appeal
to children and inventing an effective ‘lifestyle’
to go with it. [...]The doctors who have to clean
up the mess are the whistle-blowers. Take them
seriously.”
Trouw newspaper describes the efforts of
Dekker and De Kanter outside their surgeries
Een aantal artsen heeft het wel
gehad: zij radicaliseren. Kin-
derarts Nico van der Lely, al jaren
in touw tegen alcoholmisbruik on-
der minderjarigen, zei zondag in
Brandpunt dat het „nu klaar is”. Op
zijn polikliniek worden twaalfjari-
ge kinderen met een Jägermeister-
vergiftiging binnengedragen. De
gemiddelde alcoholcomalengte bij
kinderen is nu drie uur. Dat was
negentig minuten. Als hij denkt
aan de mannen „met stropdassen
in hoge gebouwen die hieraan ver-
dienen, word ik een pitbull”.
Twee Beverwijkse longartsen
openden maandag met de website
Tabak Nee frontaal de aanval op
politici, bestuurders en andere me-
deplichtigen aan de nicotineversla-
vingsindustrie. Deze artsen willen
de schuld- en schaamtegevoelens
van hun kankerpatiënten op hun
spreekuur niet meer incasseren.
Hun lieve stichting Rookpreventie
Jeugd (‘Zoek je een spreekbeurt?’)
is nu met www.TabakNee.nl grof
in de aanval. Dat gaat met stevige
retoriek en ad hominem. Wier zoon
minister is maar zelf toch voor de
tabaksindustrie blijft werken of
wie privé ervaring met kanker
heeft maar weigert tabaktegen-
stander te worden, krijgt onderuit
de zak. Dat is niet steeds gepast of
Tabak en alcohol: 18 plusCOM M ENTAAR
even smaakvol, maar begrip kan er
wel voor worden opgebracht. De
rauwe realiteit uit de kliniek van
de longarts of alcoholdokter mag
in het debat gevoeld worden. De
genotmiddelenindustrie moet te-
gen een stootje kunnen. Zij weet
immers precies wat ze doet: hoe ze
tabak en alcohol op smaak voor
kinderen brengt en er een effectie-
ve ‘lifestyle’ bij verzint. Heineken
is cool, althans denkt dat te zijn.
Verslaving doet de rest. Het indivi-
du leeft er korter door.
Ernst en omvang van alcoholin-
cidenten bij kinderen nemen in-
tussen toe. Het aantal jonge rokers
groeit eveneens. Ieder kabinet ont-
werpt opnieuw grootschalige pre-
ventieplannen waarin ouders, be-
drijfsleven en overheid er ‘samen’
uit moeten komen. Dat artsen daar
verveeld mee raken, valt te begrij-
pen. Zij helpen immers jaarlijks
tienduizend burgers met longkan-
ker hun levenseinde zo lang moge-
lijk uitstellen. Dat gaat tegenstaan.
De rokers hebben het uiteinde-
lijk zichzelf aangedaan – het was
hún individuele keuze. Aangemoe-
digd, uitgelokt door uitgekiende
marketing, dat zeker. En niemand
is nog ongeïnformeerd over de risi-
co’s of onwetend over de gevolgen.
Tegelijk behoort dat individu
ook beschermd te worden, zeker
de minderjarigen. Een rookverbod
op scholen, een rookleeftijdsgrens
van 18, een verder terugdringen
van rookgelegenheid – het ligt al-
lemaal in de rede. Net als een ver-
dere verscherping van alcoholma-
tiging voor de jeugd. De artsen die
de rommel opruimen, zijn de klok-
kenluiders. Neem ze serieus.
De een z’n brood is
de ander z’n dood,
jaagt artsen op stang
22
as exemplary. “Against their better judgement,
manufacturers have for years denied that smoking
causes cancer. Now they finally acknowledge the
risk, but they still do everything they can to get
young people everywhere on earth smoking. That
is not only in bad taste and offensive but also life
threatening.”
Columnists from everywhere join in the discussion.
“Everybody support TabakNee!” writes Max
Pam in de Volkskrant. Frits Abrahams in NRC
Handelsblad writes: “I wish the campaigners
lots of success. Their mission deserves it.” His
colleague Bas Heine comments: “The website
by the two lung specialists is therefore justified,
because it rationally exposes an accepted form of
hypocrisy.” And Youp van ’t Hek puts it succinctly
the following Saturday: “Keep it up, ladies! Full
speed ahead.”
In the meantime, the foundation works to reach parents
through their children in the battle against tobacco. In
collaboration with ad agency Pool, it launches the Smoke
Alarm campaign to fan the flames of indignation among
parents concerning the tactics of enticement employed by
the tobacco industry and the lazy attitude adopted by the
government in response.
At the core of the Smoke Alarm campaign are a number
of short films in which primary school children gradually
expose the power field around tobacco. The films are shared
on social media platforms like Hyves – later continued on
SMOKE ALARM MOBILIZES CHILDREN AND PARENTS
23
Facebook – and Smoke Alarm attracts 40,000 followers.
The films then form the raw material for a new documentary
aimed at adults entitled ‘The Replacers’, which appears in
2014. The aim of the film is to motivate parents to make their
opinions known to people in politics.
FIVE POPULAR FILMS
The riddle of group 8
from 3 April 2013 – 66,796 views
One thing that all children in group 8 know for
certain: they are never going to smoke. But
five years later a third of them do, because in
puberty they forget everything they now consider
important. This video shows how that happens.
The proposal from group 8
from 30 May 2013 – 40,714 views
All cigarette manufacturers say they don’t want
children to start smoking. Even so, they design
pretty packaging and add flavours to cigarettes
that children find appealing. Because of this,
Group 8 tries to help manufacturers to find an
alternative.
Get it at AH
from 5 September 2013 – 31,876 views
Why do supermarkets sell cigarettes? They
should not do that because many children enter
supermarkets. That is why over half the children
in the final year of primary school know about
cigarettes largely from supermarkets. In this
film the children ask Albert Heijn to stop selling
tobacco.
24
AH has it all
from 11 September 2013 – 291,108 views
Albert Heijn supermarket puts cigarettes on
display so that many children know exactly what’s
for sale. A serious pastiche on the AH commercials
on TV.
Group 8 in The Hague
from 30 May 2014 - 26,052 views
Laws are made in The Hague. Pupils in their final
year of primary school visit politicians and ask
them to take action. If not, the pupils plan to go to
court.
2837 petitions signed
Figures per 3 June 2014
In early 2014 a DVD is released containing nine interviews
with lung cancer patients and/or surviving relatives. Made
by film and television maker Frans Bromet and entitled
‘You have to die of something’, the films are produced with
money that Dekker and De Kanter receive for the Muntendam
Prize. The films are also circulated through the Dutch Cancer
Society website and on YouTube.
‘With these films we want to let patients have their say,’
says Wanda de Kanter, who now works as a lung specialist
at the Antoni van Leeuwenhoek Hospital. ‘Mostly we don’t
hear them in the discussion, because their disease usually
develops rapidly and they die quickly. Even so, we want to
make these patients more visible and give them a voice.
LAYING THE BLAME WHERE IT BELONGS
25
These portraits are about empowering patients. At the same
time, they are intended to lift the sense of guilt that patients
feel about their smoking behaviour. After all, that guilt lies
squarely with the tobacco industry, which makes people
addicted to a product that kills if used as intended.’
The series of portraits prompts the Nieuwsuur TV
programme to air a report on 31 January 2014 entitled ‘The
invisible cancer’. It asserts, among other things, that the
relative invisibility of lung cancer is the reason why so little
money is allocated to research into this disease.
An article in De Correspondent also covers this subject under
a headline that reads: ‘The deadliest form of cancer has a
major marketing problem’. The article quotes Paul Baas, lung
specialist at the Antoni van Leeuwenhoek Hospital:
‘There is a form of cancer, says lung specialist Paul
Baas, that claims so many victims and that could
be tackled easily through focused government
intervention. After all, the tax on tobacco could be
channelled directly into research. “A new incentive
fund, an extra euro charged on each packet of
cigarettes, intended solely for research,” says
Baas. ‘But maybe the government itself is just as
addicted to the tax collected from cigarette sales
as the smokers are to smoking. This year it is
allocating 5 million euros to tobacco prevention,
while some 2.5 billion euros are collected annually
through tax on tobacco sales. “That’s why I had
such mixed feelings when I saw the Minister for
Health Edith Schippers appear on the Stand Up
Against Cancer programme,” says Baas.’
The films are screened by the Dutch Cancer Society on
February 4, 2014, World Cancer Day, in the presence of those
featured and who, it must unfortunately be stated, are still
alive.
26
The battle against the
killing industry continues
27
The Youth Smoking Prevention Foundation has achieved
much in five years, especially in terms of raising awareness.
With the support of the Dutch Cancer Society, the foundation
succeeded in distributing a lot of information through its
own publications, and certainly through the press, about the
harmful effects of smoking, the powerful influence of the
tobacco industry, and the measures that will actively help to
protect the youngest in society from becoming addicted to
smoking.
One of the aims of the foundation has even been achieved
already: tobacco may not be sold to anybody under the
age of 18. That has prompted many schools to ban smoking
around their buildings. Nonetheless, progress has been
limited here, since enforcing the age restriction is a farce at
the moment, and a law to turn school playgrounds into no-
smoking zones is a very long way away.
In general, it should be stated that the battle is far from over.
There is hardly any movement in the halls of power in The
Hague. Politicians are not prepared to implement real change
in the area of tobacco prevention. The tobacco industry is
leading the VVD by the nose, and the PvdA is keeping quiet
on the matter so as not to disturb the peace. Parties that feel
a responsibility to do something about the almost 20,000
tobacco-related deaths each year can make no headway.
NEXT
28
CAMPAIGN AIMED AT POLITICS
That is why the Youth Smoking Prevention Foundation
is going to concentrate even greater efforts on exerting
influence in the political arena. Politicians and public
officials must dispense with the notion that smoking is a
free choice for people who don’t need overprotection. The
truth is, however, that free will is eliminated when it comes
to addiction to nicotine, the most addictive substance on
earth. Almost nobody thinks of the compulsory safety belt
and motorbike helmet as forms of overprotection. So why is
that the case for protective measures against tobacco? The
absence of measures amounts to neglect of citizens.
The only person with a choice is the child who can
decide to start smoking or not. But it is precisely
the brain of adolescents that does not bother with
bans or sensible decisions. And the tobacco industry,
which owing to the harm inflicted by its own
product has no choice but to constantly find new
customers, skilfully exploits that brain weakness. It
deliberately makes its product lethally addictive, or
‘deadly by design’ as the historian Robert Proctor puts
it. That is what politicians must realize and what they should
protect the population from. That is not overprotecting but
simply protecting people.
Once upon a time politicians took a stand against the legal
practice of slavery. They decided that the practice was no
longer acceptable and decided to end it. Now is the time
to decide that the cigarette, a stealthy but skilled killer, no
longer belongs in our world.
The Youth Smoking Prevention Foundation will battle
tirelessly to achieve that goal.
29
THE STATE ON TRIAL
One of the means to that end is the legal action that
the foundation is preparing against the Kingdom of
the Netherlands. These legal proceedings will test the
interpretation of the Framework Convention on Tobacco
Control (FCTC) from the World Health Organization.
More specifically, it will examine the provisions of Article 5.3,
which states that in determining its policies for preventing
and reducing tobacco consumption, the government shall
act to protect these policies from all vested interests of the
tobacco industry. It has been demonstrated, thanks in part
to the editorial staff of TabakNee, that Dutch officials at the
Ministry of Health, Welfare and Sport, and at the Ministry of
Finance, have totally ignored precisely this provision. Since
the responsible cabinet ministers claim again and again that
their ministries cannot be blamed for anything, it is time to
hear the verdict of the judge.
30
Committee of ReCommendation
BoaRd of Youth Smoking PRevention foundation
Wanda de kanter, lung specialist, Antoni van Leeuwenhoek Hospital, author of Nederland stopt! Met roken (chairwoman)
emeritus Professor frits van dam, psychologist, University of Amsterdam, former staff member of Antoni van Leeuwenhoek Hospital (secretary)
Rob giebels, econometrician, former advisor financial affairs and risk management for the City of Amsterdam (treasurer)
Professor René Bernards, molecular biologist, Utrecht University, Antoni van Leeuwenhoek Hospital, member of Royal Netherlands Academy of Arts and Sciences (KNAW)
Barbara van den Broeke, child and youth psychologist/psychotherapist
geertje Creijghton LL m, administrative lawyer, Baarn
Pauline dekker, lung specialist, Red Cross Hospital, author of Nederland stopt! Met roken
Professor Jacques Wallage, former state secretary for Education and Social Services, former mayor of Groningen
Rob Barnasconi mSc, dentist, chairman Netherlands Association of Dentists and Dental Specialists
dr Renee Bittoun, adjunct associate professor of Medicine, head of Smoking Cessation Institute, University of Sydney
emeritus Professor Piet Borst, former Scientific Director of Netherlands Cancer Institute
Professor Paul Brand, child lung specialist Isala Clinics Zwolle
31
COMMITTEE OF RECOMMENDATION
Ireen van Ditshuyzen, documentary maker
Gert van Dijk, medical ethicist KNMG
Marjolein Drent, Professor of Interstitial Lung Diseases, Maastricht University
Benedicte Ficq LL M, criminal lawyer
Bas van Goor, former volleyball player, Director Bas van Goor Foundation
Pauline Haasbroek, stop smoking coach
Dr. Miriam de Kleijn, general practitioner-epidemiologist
Emeritus Professor Caro Koning, radio therapist
Emeritus Professor Bob Pinedo, oncologist, VU University Amsterdam
Professor Dirkje Postma, Professor in Pulmonology, University of Groningen
Robert N. Proctor, Professor of the History of Science, University of Stanford
Dr. Lukas Stalpers, radio therapist Academic Medical Center
Dr Jeffrey Wigand, tobacco industry whistle-blower, founder of Smoke-Free Kids Inc.
Professor Robert West, health psychologist, Director of Tobacco Studies, University College London
Dr Nout Wellink, former president De Nederlandsche Bank
Professor Michiel Westenberg, developmental psychologist, Leiden University
Professor Rudi Westendorp, geriatrician, Leiden University
Professor Reinout Wiers, developmental psychopathologist, University of Amsterdam
32
The members of the board of the Youth Smoking Prevention
Foundation receive no remuneration for their work for
the foundation. A number of professionals do receive
remuneration for various activities of the foundation.
The funding for that remuneration comes from a limited
number of financial supporters, among them the Dutch
Cancer Society. We ask for your support to give the Youth
Smoking Prevention Foundation a more solid basis and to
ensure that it can continue its work.
Make a donation to us, big or small, so that we can continue
to expose the tobacco industry and make smoking a thing of
the past.
You can support us by sending your donation to the Youth
Smoking Prevention Foundation in Amsterdam, bank account
number NL11 TRIO 0390 186 511.
The Dutch Tax and Customs Administration recognizes the
Youth Smoking Prevention Foundation as an Institution
for Public Benefit. This means that private donations to
the foundation are tax deductible at a rate of 125% of the
donated sum.
For more information, please contact Frits van Dam,
+31 6 20 61 67 43
SUPPORT THE YOUTH SMOKING PREVENTION FOUNDATION
CREDITS
TabakNee
Final editing: Frits van Dam
Journalists: Stella Braam, Bas van Lier, Broer Scholtens
Design: Wiebe de Wolf
Logo design: Nathalie Soetens
www.tabaknee.nl
Smoke Alarm
Campaign: Pool ad agency, Amsterdam
www.rookalarm.nl
'You have to die of something'
Bromet & dochters
www.bromet.nl
COLOFON
© 2014 Youth Smoking Prevention Foundation, Amsterdam
Text: Bas van Lier, Amsterdam
Translation: Billy Nolan, Amsterdam
Design: Philip de Josselin de Jong, Haarlem
Printing: Kapsenberg van Waesberge, Rotterdam
www.stichtingrookpreventiejeugd.nl