Contact Audrey Silk, NYC C.L.A.S.H., (917) 888-9317

As part of its anti-smoker crusade, the New York City Department of Health, under the direction of Health Commissioner Thomas Frieden, embarked on another round of giving away the nicotine patch and gum beginning on April 22nd.  It ended last Thursday, May 7th.  And what will the city really have to show for it?  A failure rate so large that sends almost every penny of millions of dollars down the black hole of the financially strapped city.  This waste is hitched to falsely reported smoking prevalence rates to begin with -- a propaganda tool employed to drive the perception that they have been successful which buys approval for government interference in private lives and to influence others to follow in their bootsteps (sic).


In 2005 Commissioner Frieden justified his and Mayor Michael Bloomberg's anti-smoker policies by boasting a decline in the number of smokers as per survey results for the year 2004. (1)  In that year, and others in which this same claim has been made, NYC Citizens Lobbying Against Smoker Harassment, a grassroots organization dedicated to advancing, promoting and protecting the interests of adults who choose to smoke cigarettes, refuted the validity of these figures.

The methodology employed (telephone survey) to obtain these statistics is wholly unreliable.  When the targets of a crusade reeking of intolerance have been so vilified and persecuted it's crystal clear they will lie to authorities when asked, "Do you Smoke?" (2,3)  The respondent's fear of being truthful is undoubtedly cemented by the introduction to the survey with, "I am calling for the New York City Department of Health and Mental Hygiene. We're conducting an important study to improve the health and health care of New Yorkers." (4)

The evidence that it's unreliable is now in. By its own unpublicized admission, information the DOH announced to the public was subsequently neither accurate nor unquestionable. In a study conducted by the DOH and released last month on another smoking-related issue the following is found:

"A notable finding is that smoking prevalence [by measuring the biomarker cotinine]... was 23.3% in NYC [in 2004].  The NYC... prevalences reported here are higher...  than results obtained from a random-digit–dialed telephone survey conducted in the same year — 18.4%...  — presumably reflecting a more accurate assessment than is possible with self-reported smoking status captured via telephone survey." (5)

Their original claim was off by 27%.  It's highly probable it's even higher than that by a factor of two miscalculations (6), one of which -- in a study conducted by Dr. Frieden -- is another deception that smells of scientific malpractice in order to arrive at a preconceived conclusion that will support the furtherance of anti-smoker policies. (7)

Today the assertion is that the smoking rate is now down to "15.8%." (8) Using the web-based NYC Interactive Health Data System (Epiquery) we queried the most recently completed Community Health Survey (2007) for "Smoking Status" that was the basis for this assertion.  We found that for "Current Smoker" the 15.9% (not ".8") figure represented the lowest bound of a statistical range that ended at 17.9%.  Based on their graph the actual figure is 16.9%. (9)  The DOH intentionally misrepresented even that data for ideological gain -- data that suffers anyway from the same flaw in every year's report.  Not one of the yearly results for total number of current smokers, and thus the subsequent comparative differentials, is a reliable conclusion. The entire historical account is a house of cards.


This deception comes with a cost not only to a person's right to be left alone but to the taxpayer.  Touted as "free," the yearly giveaway of nicotine patches and gums is no such thing.  Since this program's inception in 2003 it has reportedly cost the city anywhere between $2.3 million and $4 million a year. (10,11,12)  Only in 2004 and 2005 did the pharmaceutical company Pfizer foot the bill by donating the patches. (13,14)  Uncalculated is the additional untold cost of advertising the giveaway in print, radio, and television. However, the return on this investment is close to zero.

Last month a study on the effectiveness of the use of nicotine replacement therapies (NRT) was published in the British Medical Journal. (15)  While slanted toward concluding effectiveness, a closer inspection of the content reveals that only 1.6% of smokers achieved sustained abstinence.  In other words, the failure rate is 98.4%.

Dr. Michael Siegel, professor at Boston University of Public Health with over 20 years experience as a tobacco control researcher, concluded, "As you can [tell] from the actual study results, the conclusions of this paper are highly slanted. With a long-term smoking cessation percentage of only 1.6%, one can hardly call NRT treatment an 'effective' intervention. Even though the 1.6% abstinence rate is better than the 0.4% achieved with placebo, no one in their right mind would consider a 1.6% success rate with NRT to be 'effective.' In fact, the logical conclusion from this paper is that NRT was a dismal intervention. The overwhelming majority of smokers - 98.4% - failed to achieve long-term sustained abstinence with NRT treatment." (16)

To help put this in context we believe even Dr. Frieden would have a hard time explaining (considering his other well known passion), someone's support for a condom manufacturer whose product failed to work 98% of the time yet called it an effective method of preventing sexually transmitted diseases and birth control.

"Let me be quite clear about our organization's objections," says Audrey Silk, founder of C.L.A.S.H.  "Protesting against the distribution of the patch does not mean we're advocating for people to smoke or celebrating that there are more smokers than reported. If people choose to quit of their own free will then more power to 'em in fulfilling a personal goal via their own means.  What we're advocating against is propaganda manufactured to drive the zealots' agenda.  Government misleading the public for the sake of imposing its will on them is offensive. The ends don't justify the means, whether the means are costly patches or the price of freedom."

We're sure that, especially during these difficult financial times, the public would agree that the city giving away free nicotine replacement therapies is poor use of taxpayer money.  MTA or NRT anyone?

And with Dr. Frieden on his way to head the CDC, now how much of the nation's money is going to be wasted on this finagled moral crusade?


(1) David B. Caruso, "Number of New York City Smokers Drops After Ban, Tax Increase," Associated Press, June 9, 2005.

(2)  Monica A. Fisher et al.  "Age and Race/Ethnicity-Gender Predictors of Denying Smoking, United States." Journal of Health Care for the Poor and Underserved ,19.1 (Jan 2008) 75-89

"Table 2 presents the overall denial of smoking by true smokers 18 years of age and older (8%), and the increase in denial of smoking among older participants. The age-specific denial of smoking increased from 6% of 18–34 year olds, to 8% of 35–54 year olds, to 13% of 55–74 year olds, to 25% of elderly (75 years or older) participants." (Pg. 79)

"Social desirability related to the social unacceptability of cigarette smoking25 is a possible explanation for the higher denial of smoking among elderly. That is, elderly smokers may be more prone to being influenced by social pressure not to smoke and thus provide the socially desirable non-smoking response. In a similar manner, a finding that smoking is not socially acceptable among college students,26 would be strengthened if smoking status was validated." (Pg. 86)

(3) New York City Independent Budget Office, "Higher Cigarette Tax Has Led to More Tax Revenue, More Tax Evasion," Inside the Budget, Number 152, October 19, 2007.

(4) 2005 Community Health Survey Questionnaire

(5) Jennifer A. Ellis et al.  "Secondhand smoke exposure among nonsmokers nationally and in New York City." Oxford Journals, Nicotine &Tobacco Research, Volume 11, Number 4. doi:10.1093/ntr/ntp021, April 7, 2009.

(6)  Monica A. Fisher et al.  "Age and Race/Ethnicity-Gender Predictors of Denying Smoking, United States." Journal of Health Care for the Poor and Underserved ,19.1 (Jan 2008) 75-89

"[T]he use of such biomarkers to identify smokers may not identify the occasional smoker who denies smoking. Thus, even estimates using biomarkers should be considered under-estimates of the true proportion of smokers who deny smoking." (Pg. 76)

"We used the gold standard for smoking status, which defines current smokers as having serum cotinine levels of 15ng/mL or greater.5,15 Henceforth, we will refer to cotinine-determined smokers as true smokers. This definition was based on the report that analyses using a cutpoint of 15ng/mL and 10ng/mL were similar.5 We used the more conservative cutpoint of 15ng/mL of serum cotinine to identify true smokers denying smoking because they self-reported currently not smoking. More specifically, this definition of true smokers was developed as a result of the finding that serum cotinine level has a bimodal distribution, with a separation between the two peaks at serum cotinine level of 10–15ng/mL. This distinguishes tobacco use and environmental exposure to tobacco or second-hand smoke.5" (Pg. 77)

(7) Jennifer A. Ellis et al.  "Secondhand smoke exposure among nonsmokers nationally and in New York City." Oxford Journals, Nicotine &Tobacco Research, Volume 11, Number 4. doi:10.1093/ntr/ntp021, April 7, 2009.
[In contradiction to footnote 6]: "We defined smokers as those having a serum cotinine level higher than 10 ng/ml; nonsmokers had a serum cotinine level of 10 ng/ml or lower."
(8) New York City Department of Health and Mental Hygiene. "New York City Smoking Rates Fall to Lowest Rate on Record."   Press Release #023-09, May 5, 2009.


(10) Chuck Bennett, "Cig-nificant Drop in N.Y. Smokers' Quit Kits," NY Post, May 14, 2007: "The program, which began in 2003, costs $4 million a year."

(11) Lisa L. Colangelo, "Time to Patch Out the Cigs," NY Daily News, May 4, 2006: "The latest patch giveaway, which will cost the city about $2.3 million..."

(12) Stephanie Gaskell, "Up In Smoke: Free Nicotine Patches Gone," NY Post, May 16, 2003: "The city Health Department spent $2.5 million on the freebies... The campaign, which was paid for by city and state funds, was a one-time deal, Frieden said."

(13) Lisa L. Colangelo, "Stick it to Cigs With Free Patch," NY Daily News, July 8, 2004:  "Pfizer is donating $3.7 million worth of nicotine patches to the city's Department of Health."

(14) Thomas R. Frieden. Sarah B. Perl. "Controlling the State of Tobacco in the City of New York."  Cancer Prevention. NewYork-Presbyterian Hospital Newsletter, Issue 6, Fall 2005:  "This effort - which distributed 45,000 free 6-week courses of nicotine patches that were donated by Pfizer Inc...."

(15) David Moore, Paul Aveyard, et al.  "Effectiveness and safety of nicotine replacement therapy assisted reduction to stop smoking: systematic review and meta-analysis."  BMJ 2009;338:b1024.  April 2, 2009.

(16) Michael Siegel.  "New Study Demonstrates How Conflicts of Interest with Big Pharma Influence Reporting of the Effectiveness of Smoking Cessation Drug Treatment."  The Rest of the Story: Tobacco News Analysis and Commentary.  April 3, 2009.


NY Post Editorial - April 4, 2003

New Yorkers listening to Mayor Bloomberg lament the city's fiscal woes can be forgiven a bit of confusion, given the weird ways Hizzoner sometimes spends the tax dollars he does have.

The latest example:

Wednesday, city Health Commissioner Thomas Frieden announced a scheme meant to save smokers from themselves - at city expense, of course.

Under the plan, some 35,000 smokers can get six-month supplies of nicotine patches for free to help them quit.

"Make no mistake," Frieden says. "Tobacco is Public Enemy No. 1."

We would have put impending municipal bankruptcy at the top of the list. But silly us, right?

Tobacco, after all, is a perfectly legal product, irrespective of the mayor's anti-smoking jihad.

That campaign, involving a draconian smoking ban and outrageous taxes on tobacco, is so extensive that cops now use the term "street value" to quantify unregulated cigarettes - just like cocaine.

As for the patches, Frieden says "quitting is . . . the most important thing any smoker can do to improve his . . . health."

His logic: "Healthy" New Yorkers will save taxpayers money in the long run.

Maybe some smokers will quit smoking, as Frieden says.

Maybe the program will save lives, as he also insists.

Maybe the program will stave off more costly health-care expenses to treat emphysema, heart disease or lung cancer, as Frieden and Mayor Mike suggest.


In 30 or 40 years.

But Bloomberg must close a $4 billion municipal budget gap.

In 11 days!

Sure, the program's $2.5 million cost is chump change in a city budget of $44 billion.

Then again, one of the principal reasons the budget got that big is because it's chock full of chump-change programs.

Like this one.

Meanwhile, Hizzoner is looking to pare down the police force to save dough.

And $2.5 million will pay the salaries of 50 cops for a year.

Priorities, anyone?

By Lisa L. Colangelo
NY Daily News - May 6, 2003

Health Commissioner Thomas Frieden has been aggressive in his battle to get New Yorkers to stop smoking - even offering them free nicotine patches to help them kick the habit.

But two Republican City Council members said the money used on his nicotine patch program would be better spent on other public health needs, such as nurses for the city's private and public schools.

Funding for the nursing program has been slashed due to budget cuts.

"Your agency found and spent $2.5 million on nicotine patches," Council Majority Leader James Oddo and Council member Andrew Lanza and U.S. Rep. Vito Fossella (R), all from Staten Island, wrote in a letter to Frieden. "It is confounding that your agency found $2.5 million for nicotine when you had testified that you could not afford less than that amount for school nurses."

The Health Department did not immediately respond to a request for comment.

Frieden, who worked with Mayor Bloomberg on the new tough smoking ban, unveiled the nicotine patch campaign when that law went into effect last month.