During his tenure as New York City mayor, Michael Bloomberg (I) has had no qualms about cracking down on products that pose a public health risk, tackling everything from sugary sodas, to salt in snack foods, to illegal guns. Now, the three-term executive has his sights set on the tobacco industry, pushing legislation that would raise cigarette pack prices in the city to at least $10.50 and end tobacco companies’ ability to offer coupons or special discounts on their products.

The recently-announced initiative comes at the heels of another Bloomberg-endorsed plan to limit cigarette makers’ ability to publicly advertise their products in city store fronts. Combined, the two proposals would constitute something of a public health coup for Bloomberg, targeting smokers’ bad habit where it hurts the most: their wallets. And as the New York Times reports, the effort is targeted at teens and low-income Americans:

“This is kind of a landmark set of proposals here,” said Kurt Ribisl, a professor of public health at the University of North Carolina, Chapel Hill, whose research on tobacco control influenced Mr. Bloomberg’s proposal. “For someone like me, who’s spent 18 years studying point-of-sale issues, this is kind of big.”

Dr. Ribisl studies what happens at the retail counter, where a customer at a typical convenience store sees a colorful array of signs, packaging and “shelf talkers” — the small tags that flutter from shelves — promoting two-for-one, dollar-off and other types of deals. According to a Federal Trade Commission report issued last year, the tobacco industry spent $6.5 billion on discounts in 2010, and Dr. Ribisl said they are one of the major ways cigarette makers encourage price-conscious customers like teenagers and low-income smokers to buy.

New York’s price-regulation bill would, in effect, close off the remaining means of access to cheap cigarettes and little cigars, which make it easier for teenagers to experiment with smoking, and progress to smoking regularly, said Brett Loomis, a researcher at RTI International, a nonprofit institute that offers research and technical services to governments and businesses.

Poor Americans are more likely to smoke, but less likely to be able to afford the habit and its associated health care costs. In fact, one study showed that low-income New York City smokers spend as much as a quarter of their income purchasing cigarettes — Bloomberg’s initiatives have the potential to price them out of the deadly habit altogether. While encouraging poor people to stop smoking is undoubtedly good from a public health standpoint, doing so through a commodity-based financial regulation has the potential to further drain their disposable incomes.

And Bloomberg’s legislative push won’t address all aspects of the problem. As cigarette prices rise nationwide and smoking rates plummet in the aggregate, studies have shown that low-income Americans — particularly, low-income women — are still smoking at higher rates than average, and turning to less costly alternatives such as loose leaf tobacco to get their fix on the cheap. Raising cigarette prices even further could propagate even more of that kind of behavior.

On the heels of his failed effort to combat rising rates of obesity by banning the sale of large sugary drinks, New York Mayor Michael Bloomberg is tackling a new public health initiative: dissuading Americans, and especially youth, from purchasing tobacco products.

Bloomberg is pushing a proposal that would ban stores from displaying cigarettes, which would make New York the first city in the nation to attempt to curb smoking by keeping tobacco products out of sight. The initiative wouldn’t prevent stores from advertising cigarettes or displaying the prices of their products — but it could significantly change the atmosphere in the city’s small corner stores. As the New York Times puts it, “In many of these stores, cigarettes are like wallpaper, the backdrop that every customer sees when going to the register to pay.”

But, considering the fact that tobacco kills an estimated 7,000 New Yorkers each year, Bloomberg doesn’t want customers to be exposed to that backdrop any longer. “Young people are targets of marketing, and the availability of cigarettes and this legislation will help prevent another generation from the ill health and shorter life expectancy that comes with smoking,” the mayor explained at a press briefing to unveil his new proposal.

Bloomberg has been a big proponent of anti-smoking initiatives, including public awareness campaigns and increased cigarette taxes, during his time in office. Those efforts have paid off. Smoking rates in the city have plummeted from 21.5 percent in 2002 to 14.8 percent in 2011. Despite the model that New York City provides for the rest of the nation, however, other states haven’t followed suit — austerity policies have led states across the country to slash funding for their smoking cessation programs over the past decade, even when those programs have proved to be effective.

As part of President Obama’s Affordable Care Act, Congress passed a national menu labeling law in 2010 that would require restaurant chains with more than 20 locations post calorie counts for each standard menu item. Three years later, the Food and Drug Administration is still deliberating on the “extremely thorny” issue of how to accommodate various special interests in executing the law. The latest delay concerns clashing interests in the restaurant and grocery lobbies, which believe they should be exempt from the labeling rules:

While the restaurant industry has signed on to the idea and helped to write the new regulations, supermarkets, convenience stores and other retailers that sell prepared food say they want to no part of it.

“There are very, very strong opinions and powerful voices both on the consumer and public health side and on the industry side, and we have worked very hard to sort of figure out what really makes sense and also what is implementable,” FDA Commissioner Margaret Hamburg said in a recent interview with The Associated Press.

Hamburg said menu labeling has turned out to be one of the FDA’s most challenging issues, and while requiring calorie counts in some establishments might make sense on paper, “in practice it really would be very hard.” She did not say what specific types of establishments she was referring to.

If the FDA could set aside these competing business interests, a national labeling rule should be fairly straightforward — in fact, many chains already post calorie counts on their menus in compliance with local laws. But the FDA is not accustomed to writing mandatory rules for the food industry. The agency typically offers optional guidelines and allows businesses to self-regulate, even though voluntary industry standards tend to be far more lenient than actual regulation. One such set of voluntary guidelines, concerning antibiotic overuse in livestock, was rejected by a federal judge unimpressed by the FDA’s insistence that simply asking companies to reduce antibiotics would be more effective and less costly than enforcing a ban. Only after the judge ordered the agency to come up with a new rule did they restart a stalled review process initiated in 1977. Later, internal memos showed the FDA doubted the effectiveness of its own voluntary strategy.

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Mississippi — where about one in three adults is at least 30 pounds heavier than a healthy weight — isn’t on board with New York City Mayor Michael Bloomberg’s attempt to combat obesity rates by regulating large sugary drinks. In fact, lawmakers in Mississippi want to be absolutely certain their own local officials won’t implement the same kind of public health initiatives. A bill awaiting Gov. Phil Bryant’s (R) signature would prevent any Mississippi county from taking steps to address the obesity epidemic by regulating the food and beverage industries:

A bill now on the governor’s desk would bar counties and towns from enacting rules that require calorie counts to be posted, that cap portion sizes, or that keep toys out of kids’ meals. “The Anti-Bloomberg Bill” garnered wide bipartisan support in both chambers of the legislature in a state where one in three adults is obese, the highest rate in the nation.

The bill is expected to be signed by Gov. Phil Bryant, a Republican. It was the subject of intense lobbying by groups including the restaurant association, the small business and beverage group, and the chicken farmers’ lobby.

Mike Cashion, executive director the Mississippi Hospitality and Restaurant Association, says the bill is a direct reaction to Bloomberg-style government intervention in public health.

Despite the fact that a judge recently struck down Bloomberg’s soda initiative, preventing it from taking effect this week, public health experts still agree it was a good policy. Unlike other foods that can have some benefits if they’re consumed in moderation, sugary drinks have absolutely no nutritional value — and portion sizes have continued to spiral out of control anyway.

“There is really very clear evidence now that soft drinks are related to weight gain and obesity and, most certainly, diabetes,” Dr. Walter Willett, a nutrition expert at the Harvard School of Public Health, told NBC News. “We are in the midst of an epidemic of diabetes and obesity. The evidence is very clear that soda consumption has a role in the epidemic.”

Some proponents of Mississippi’s measure claim it’s simply an attempt to standardize nutrition policy across the state. Still, passing reactionary legislation to New York City’s attempt to address the obesity epidemic — which already accounts for 21 percent of national health care spending, a figure that’s likely to continue to rise since roughly 42 percent of Americans are projected to be obese by 2030 — is a step in the wrong direction.

Mayor Michael Bloomberg’s (I) public health initiative to ban the sale of sugary drinks larger than 16 ounces was set to begin on Tuesday — but after a state judge struck down the initiative on Monday, New Yorkers won’t have to relinquish their supersize sodas anytime soon.

The news will likely come as a relief to the New Yorkers who were already preparing to circumvent the city’s ban. Even if the new regulation had gone into effect, there would still have been several ways for soda lovers to get their super size fix — by going to any local convenience store (which wouldn’t have been subjected to the rule because they’re regulated by the state), by crossing state lines into New Jersey, or simply buying several smaller-sized sodas at once.

The judge’s opinion cites those loopholes as one his primary reasons for striking down the law, since he believed the “uneven enforcement” throughout the city rendered the regulation ineffective. But even though Bloomberg’s proposal wasn’t perfect, it was on the right track.

As an increasing body of research has tied the consumption of sugary drinks to obesity, public efforts like Bloomberg’s represent one small step toward reorienting a culture where portion sizes have continued to spiral out of control. Restaurants’ portion sizes are more than four times larger now than they were in the 1950s — and that culture of excess is making its way into Americans’ homes, too, where meals are also getting bigger. Soft drinks sizes specifically have seen one of the largest increases, ballooning by over 50 percent since the mid-1970s. And research suggests that larger portion sizes do lead people to consume more than they would have otherwise, since we tend to estimate calories with our eyes rather than our stomachs.
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As part of a voluntary public health initiative led by New York Mayor Michael Bloomberg (I) to lower the amount of sodium in popular foods, 21 companies — including Butterball, Heinz, Subway, Starbucks, and Kraft Foods — have cut salt content in certain products by as much as 30 percent.

As CBS News reports, the affected products include a variety of foods including hot dogs, cold cuts, cheese singles, sandwiches, and crackers. Bloomberg lauded Kraft in particular for “reducing sodium in its Kraft Singles American Slices by 18 percent” and Subway for eliminating sodium entirely from two of their popular sandwiches.

Bloomberg and public health advocates welcomed the companies’ decisions, noting that Americans consume an excessive amount of sodium, and that the source of the excess is in pre-packaged foods rather than salt manually added to products by consumers:

“These companies have demonstrated their commitment to removing excess sodium from their products and to working with public health authorities toward a shared goal — helping their customers lead longer, healthier lives,” said Bloomberg.

Noting that Americans eat about twice as much salt as they should and citing its link to high blood pressure and resulting diseases, the city set voluntary guidelines in 2010 through the National Salt Reduction Initiative for various restaurant and store-bought foods. Bloomberg said that 80 percent of salt came from prepackaged foods, not people adding salt.

“Consumers can always add salt to food, but they can’t take it out,” NYC Health Commissioner Dr. Thomas Farley said at the time.

Bloomberg has established himself as a leader in battling America’s obesity, diabetes, and smoking-related public health epidemics, enforcing strong public smoking bans and limits on soda sizes in his city.

While some critics have labeled his methods as overbearing, some of the evidence vindicates Bloomberg’s tactics, as cities with stronger nutritional regulatory regimes tend to be healthier and less obese — particularly children in such cities. And the companies’ decisions to voluntarily lower salt content is a welcome change from the tendency of Big Food to market heavily processed products, thereby undermining public health.

Curbing obesity rates in the United States would go a long way toward reducing health care costs and improving general wellness among Americans. Other recent efforts aimed at addressing obesity and public health include initiatives to promote healthy school lunches and Obamacare provisions requiring chain restaurants to conspicuously post caloric information on their menus.