City gets big money to trim waistlines, smoking

Philadelphia snagged $25 million in federal stimulus grants announced nationwide Friday and immediately launched an ambitious public-health campaign to cut obesity and smoking.

Philadelphia's rates of both are the highest among the 10 largest cities in the United States, Mayor Nutter said, calling the statistics "red flags for serious illnesses."

The grants - comprising nearly 7 percent of the $373 million handed out - will pay for initiatives that include completion of bicycle and walking paths, vouchers to the poor to buy fresh fruits and vegetables at half-price, and free nicotine-replacement therapy for 10,000 smokers.

The Department of Public Health, which had been planning and interviewing for months in anticipation of the awards, began making job offers to the first of an estimated 20 to 25 hires - more will be in local organizations that are taking part - minutes after the news conference at City Hall.

The U.S. Centers for Disease Control and Prevention, which made the awards in a competitive process, required that they be scientifically based and "transformative," Health Commissioner Donald F. Schwarz said.

"We all must change the way we think, the way we eat, and the way we behave," Schwarz said.

The city has set tough five-year goals, including a 25 percent increase in the number of bikers and walkers on major transit corridors and the elimination of all junk foods from schools, including fund-raisers and classrooms.

Perhaps the most ambitious is for tobacco, which is responsible for an estimated 3,000 resident deaths a year. The city wants to cut the number of adult smokers by 80,000, or 26 percent, which it estimated would prevent 40,000 tobacco-related deaths.

New York City achieved a similar reduction through a public-health campaign that began in 2003, and Philadelphia plans to use many of the same strategies.

For example, it will publicize and make expanded use of the Pennsylvania Free Quitline (1-877-724-1090, www.determinedtoquit.com). The service typically gives five sessions, in English or Spanish, seven days a week from 8 a.m. to 3 a.m.; a person makes the first call, and the counselors follow up.

Free nicotine-replacement therapy, such as patches or gum, will be available to Philadelphians by mail beginning in the fall.

"About half of smokers in Philadelphia have tried to quit in the last year," said Giridhar Mallya, director of policy and planning for the city health department, "and about two-thirds of them try to do it cold turkey."

Research shows that only about 10 percent will succeed on their own, he said, "but we know clearly that if people use any type of help, whether counseling, medication or both, they are two to three times more likely to succeed."

A media campaign funded by the grant will try to change beliefs that the current smoking rate - 27 percent of adults - is the norm, when in other cities it is not.

The city will try to use local zoning and planning regulations to limit the number of tobacco retailers, particularly near schools.

A key part of New York's strategy was to raise taxes on cigarettes, which Philadelphia has limited authority to do. "I think we would explore local- and state-based ways to change the price," said Mallya, mindful of the current fight over a proposed tax on beverages with added sugar.

One of the new staff positions is for a public-policy lawyer, said Mallya, who is overseeing all the new projects.

At the news conference, Mayor Nutter described the initiatives as the latest in a series of major public-health moves by the city, including the ban on smoking and what will be the strictest menu-labeling law in the nation when it is fully phased in on April 1.

The grant's $15 million for obesity prevention over two years - the rest is for tobacco control - will provide a foundation, Nutter said, for what must be long-term funding to attack long-term health problems. He said he hoped that future funding will be the $20 million a year from the 2-cents-an-ounce soda tax that would be targeted for obesity prevention.

Grants in the past often have gone to groups that were then expected to start a new project, said Marla Gold, dean of the Drexel University School of Public Health.

This time, Gold said, the organizations already have track records using - and often developing - these strategies.

These awards, she said, were "truly based on scientific rigor."