That’s the conclusion of a study issued Thursday by the Centers for Disease Control — one third of high school students smoke, and 4 million American children will end up dying a painful and early death as a result.

It’s a grim statistic — every day, 2,000 teen-agers start smoking. The trick is to stop smokers when they’re young, before they get hooked.

“When we think of smoking, we tend to think of adults and older adults dying of lung cancer or emphysema. What we miss is the fact that they’re dying as adults because of decisions they made as a child,” said Michael Ericksen, of the CDC’s Office on Smoking & Health.

That casts considerable doubt on the effectiveness of health care messages delivered in schools.

“Children are really unaffected by long-term health outcomes,” said Ericksen. “All they care about is the present. They care about how they look, how attractive they are to others, and they also don’t like to be exploited.”

Some good news, though

The state of Massachusetts has caught on to this. Officials there have devised an ad campaign that taps into teen image consciousness and wariness of manipulation.

And that’s not all. In the early 1990s, Massachusetts voters approved a 25-cent cigarette tax hike. California did the same thing.

“What both of those states have done is they’ve increased the tax on cigarettes and used a portion of those funds to pay for very aggressive media campaigns to educate the public, particularly children,” Ericksen said.

It seems to be working. In Massachusetts and California, smokers are quitting at a rate double that of the other 48 states.

But health officials said that’s still not enough to keep teens from smoking. They say what’s needed is what President Clinton has proposed: limiting access to cigarettes and limiting the appeal of advertising.

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As smoking goes passe in U.S., Third World lights up (CNN, 970416)

(CNN) — While American cigarette companies look to cut their losses at home — where the environment is increasingly hostile to smoking — elsewhere in the world tobacco is a growth industry.

The World Health Organization estimates there are one billion smokers worldwide, and they smoke six trillion cigarettes a year.

The WHO also estimates that tobacco kills more than 3 million people each year, or one every 10 seconds.

What concerns it even more is that, at the current growth rate for both the population and smoking, the death rate from smoking will exceed 10 million a year in 30 years.

Smoking is booming in developing countries.

In Malaysia and the Philippines, for example, television ads trumpet the joys of smoking American-made cigarettes. And in China, where billboards featuring cigarettes are everywhere, consumption is double what it was a few years ago.

Even the French find it hard to quit

Even in France, a country where lack of information can hardly be the problem, anti-smoking crusaders are having a hard time converting their countrymen.

To many French, the opportunity to light up one of the country’s notoriously pungent cigarettes is considered as much a part of the national heritage as drinking wine or eating a baguette.

And in Japan, one could be forgiven for thinking that drinking and smoking after work is the national sport of the salaryman.

Although more men smoke than women, the number of female smokers is increasing, raising concerns about the children of smokers. Smoking during pregnancy has been shown to have harmful affects on the human fetus, and the danger of “passive” smoking — inhaling smoke from nearby smokers — is well-established as a health threat.

Hence the concern among health authorities.

“Tobacco is fast becoming a greater cause of death and disability than any single disease,” says the WHO.

John Seffrin, CEO of the American Cancer Society, has an even bleaker outlook. “We’re about to witness the largest manmade, tobacco-industry-induced pandemic that the world has ever seen,” he says.

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To smoke or not to smoke: What is the cost? (CNN, 970406)

NEW YORK (CNN) — About a third of the estimated 48 million adult smokers in the United States try to quit each year. But only about 10% actually succeed in kicking the habit for a year or more.

If news about health risks isn’t sufficiently motivating the other 90%, perhaps a careful look inside their wallets might help.

The average American smoker puffs more than a pack of cigarettes a day, spending $750 to $1,000 a year just on smokes. Also, smoking-related illnesses cost the U.S. economy $97 billion annually in health care and lost worker productivity.

Quitting, on the other hand, is much less expensive.

Cold turkey cheapest but hardest

Giving up tobacco cold turkey is the cheapest way to go and the most common. But it is also the hardest, with only an 8% success rate.

“By 2 o’clock in the afternoon, I was just getting really anxious and irritable,” says former smoker Wendy Schechter of her cold turkey experience. “I started fighting with my husband and my friends. It was really painful.”

Schechter found help with a nicotine patch, which replaces the agent in cigarettes that quitting smokers so crave. Over-the-counter nicotine substitutes, designed to wean smokers away from their habit within 12 weeks, cost between $180 and $300.

But some experts warn that using a nicotine substitute alone won’t do the trick.

Behavior modification increases success

“The patch or the gum, by themselves, aren’t all that effective,” says John Garrison, managing director of the American Lung Association. “You’ve got maybe a 15% chance of success that way.”

“You must also deal with behavior modification, so when you combine the patch with freedom-from-smoking programs, such as the American Lung Association’s, you then have a better than 30% chance of quitting smoking,” Garrison says.

The association’s group program costs between $65 and $150. Other behavior therapy programs, such as Smoke Enders, can run from $150 to $320.

“I would definitely recommend Smoke Enders,” says former smoker James Sears. “It was something that was able to lessen my nicotine intake, so by the cutoff time, it was rather easy to quit.”

First-day abstinence key to success

In calculating the cost of quitting, keep in mind that for many people, it may take more than one try to give up cigarettes.

A recent study at Duke University showed that the success or failure of an attempt to quit may be determined on the first day. Smokers who abstain completely on day one are 10 times more likely to remain smoke-free for six months than those who light up even just one or two cigarettes.

If the method of quitting first selected doesn’t seem to be working, experts say give it up and try another approach, rather than continue through an entire course of treatment.

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Cigarette tar directly linked to cancer (CNN, 961017)

WASHINGTON (CNN) — Add this to the evidence that smoking is bad for you: Scientists say they have found the component of cigarette smoke that causes lung cancer. The study, published in Thursday’s issue of the journal Science, says the factor is found in the tar of cigarette smoke.

“We have found a specific component of cigarette smoke, benzo pyrene, to be very strongly implicated in lung cancer development,” said Gerd Pfeifer, a researcher at City of Hope Medical Center, a cancer center near Los Angeles.

Pfeifer says scientists knew tobacco tar contained numerous possible cancer-causing agents, but now he says his team has pinpointed the exact one. When the scientists put the benzo (a) pyrene chemical compound on human lung cells, a gene called p53 that normally keeps tumors from forming was damaged.

The cells then started dividing abnormally, eventually leading to tumors. “We found that the DNA in these cells gets specifically damaged at the same sites where people find mutations in lung cancer tissue,” Pfeifer said.

Researcher say the finding refutes the tobacco industry’s long-standing claim that there is no scientific proof that cigarette smoking causes cancer, despite stacks of studies showing people who smoke are more likely to develop the disease.

A spokesman for Brown & Williamson Tobacco Company played down the research’s significance, while Philip Morris declined comment.

The U.S. Food and Drug Administration, which is attempting to regulate tobacco, also declined comment on the study.

But anti-smoking activists say the discovery could help efforts to compensate smokers through hundreds of lawsuits being brought against the tobacco industry.

“This finding will definitely be the death sentence for the tobacco industry, because it is the final, last step, the conclusive proof, the smoking gun if you will, that tobacco smoke causes lung cancer,” said John Banzhaf of the group Action on Smoking and Health.

Other scientists are skeptical of Banzhaf’s view. They say while the study provides one more important piece of evidence, they doubt it will change the legal landscape much, since thousands of other studies documenting a strong link between smoking and lung cancer have failed to do so.

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The Lawyer Who Breached Tobacco’s Defense (970424)

NEW YORK — Michael T. Lewis’s anger turned to rage as he watched the life of Jackie Thompson, his bookkeeper and a heavy smoker, slowly slip away from heart disease in 1993. The tobacco companies are responsible for this, the Clarksdale, Mississippi-based lawyer remembers thinking, and he vowed not to let them get away with it.

Lewis’s wrath, though, soon turned to frustration as his legal research revealed the sorry history of previous efforts to hold tobacco companies culpable for smoking-related illnesses.

Thumbing through case books, Lewis, now 50, learned that juries had repeatedly refused to rule against the industry —again and again, the tobacco companies had successfully argued that it was not themselves, but the plaintiffs, who were responsible for the smoking that was killing or had already killed them.

“I found out what everybody knows,” Lewis said, “that for 40 years the tobacco companies had basically beaten every plaintiff who ever tried to sue them, based upon chiefly the ‘personal choice’ defense.”

Even if juries accepted that smoking was addictive and caused illness, they tended to view a smoker’s habit as a personal choice — even when the habit had been formed before government mandated health warnings on cigarette packs; even when smokers had developed the habit as minors.

“The industry’s argument was basically victim-blaming — anyone who’s stupid enough to use our product deserves to die from it, even though we deny it’s dangerous,” said Professor Richard Daynard, chairman of the Northeastern University School of Law’s Tobacco Liability Project in Boston, Massachusetts. “It was simply their big theme, and one that resonated with juries.”

So Lewis, a small-town lawyer in a two-person practice who had never fought a tobacco case before, found another way: He developed a novel legal theory that sidestepped the “personal choice” defense.

“The idea was that if we could not recover individually, perhaps we could recover as a society for the harm that the tobacco industry has done to the American public,” said Lewis, his soft, lilting Southern drawl damping the obvious intensity of his feelings. “The method was a suit on behalf of government to recover funds it spent for Medicaid benefits paid out for the care of people with smoking-related illnesses.”

Finding Tobacco’s Legal Achilles Heel

Lewis’s idea didn’t come utterly out the blue. For years, plaintiffs’ attorneys had been looking for ways around the “personal choice” argument that had so stymied their efforts to hold the tobacco industry liable for the damages its products caused.

One lawyer, for example, had filed a suit on behalf of a paranoid schizophrenic who had started to smoke while he was in a mental institution — the idea being that such an individual could not be construed to have exercised his own will in his smoking. The judge in the case, though, refused to allow into evidence information about the plaintiff’s mental state.

But, legal experts say, there was more to be recommended about Lewis’s theory than just the way it sidestepped the “personal choice” argument. It also created the potential for suits involving enormous sums of money, which created a variety advantages for the legal opponents of the tobacco industry.

In Mississippi, for instance, where there are about a half-million people on Medicaid, 200,000 of whom have smoking-related illnesses, a successful suit could easily result in multi-billion dollar damage awards. These amounts, of course, far outstrip those that could be sought in piecemeal actions by individuals. They therefore pose a far greater potential danger to the tobacco industry, particularly when so many states, a lot of them with far larger Medicaid rolls than Mississippi, have filed such suits to date. Minnesota, for example, estimates that it pays out a billion dollars a year in smoking-related Medicaid costs.

In addition, actions based on Lewis’s theory neutralized another key tobacco company legal strategy against suits by individuals — drawing out litigation for so long that in the very occasional instance when a jury did find for a plaintiff, the award usually didn’t even cover the cost of mounting the suit. This, of course, made filing an action bad business for injured plaintiffs paying their legal fees out-of-pocket and an unattractive proposition for attorneys working on a contingency basis, in which the fee is based on a percentage — typically one-third —of any successful judgment less expenses.

The potential for lucrative awards created by Lewis’s theory, however, drew into the fray the cream of the plaintiffs’ bar, litigators with the talent and financial staying power to go up against big tobacco’s high-priced legal army. The very presence of such practitioners — who, in Mississippi, for example, are financing and aiding Moore’s legal effort — put new pressures on the tobacco industry and immeasurably improved the likelihood of either a settlement or a victory at trial.

Tobacco Timeline

Important events in the history of liability lawsuits against tobacco companies and the increased regulation of the industry:

1954	Industry faces its first liability lawsuit by lung cancer victim alleging negligence and breach of warranty. The suit is dropped 13 years later.
1964	Surgeon General Luther L. Terry releases reports on smoking and health that conclude smoking causes lung cancer.
1965	Passage of the Federal Cigarette Labeling and Advertising Act, which requires the Surgeon General’s Warnings on cigarette packs.
1971	All broadcast advertising for cigarettes is banned.
1981	Insurance companies begin offering discounts on life insurance premiums to nonsmokers.
1983	Start of what became a landmark lawsuit filed by Rose Cipollone, a smoker dying from lung cancer, which would last nine years and typified the tobacco industry’s success in defending against smoker lawsuits. It included a $400,000 verdict for the plaintiff that was later overturned, two arguments before the Supreme Court and an eventual voluntary dismissal of the case by Cipollone’s son, who could no longer afford the cost of litigation. The case focused attention on the defense’s deep pockets and strategy of blaming the plaintiff for failing to quit smoking.
1990	Smoking banned on interstate buses and all domestic airline flights lasting six hours or less.
1993	Vermont becomes first state to ban indoor smoking. U.S. Postal Service bans smoking in its facilities.
April 1994	Executives of the seven largest U.S. tobacco companies swear in congressional testimony that nicotine isn’t addictive and they deny allegations that they manipulate nicotine levels in cigarettes.
May 1994	Mississippi files the first of 22 state lawsuits seeking to recoup millions of dollars from tobacco companies for smokers’ Medicaid bills.
August 1995	President Clinton announces FDA plans to regulate tobacco which include picture identifications for purchasers under 27 years of age, a ban on outdoor advertising near schools and playgrounds and tobacco giveaways.
November 1995	ABC settles suit with Philip Morris with an extraordinary on-air apology over broadcast report that suggests tobacco makers manipulate nicotine levels in cigarettes.
March 20, 1997	Liggett Group settles with all 22 state attorneys general, which insulates the company from tobacco litigation in return for admitting cigarettes are addictive and providing evidence that implicates other tobacco companies.
April 16, 1997	Attorneys general confirm they are in talks with Philip Morris and RJR Nabisco about a settlement that reportedly would cost up to $300 billion.

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Study Finds Secondhand Smoke Doubles Heart Disease Risk for Women (970520)

DALLAS (AP) — Secondhand cigarette smoke is more harmful than previous studies have indicated, according to a report published today by Harvard researchers.

A 10-year study that tracked 32,000 healthy nurses who never smoked found that regular exposure to secondhand smoke appeared to almost double the risk of heart disease.

For women like college student Carrie Carter, a nonsmoker who spends 25 hours a week waiting tables in a Dallas restaurant smoky enough to make her throat swell, the findings were not surprising.

“My doctor’s like, ‘You don’t smoke, right? You work in a sports bar, that’s almost as bad,”‘ Ms. Carter said.

Past studies have linked secondhand smoke to an increased risk of heart disease, asthma and bronchitis.

In a study published last August, nonsmoking spouses of smokers had about a 20% higher rate of heart disease deaths than nonsmokers whose spouses did not smoke.

This latest study — published today in the American Heart Association journal Circulation — found that nurses who said they had regular exposure to smoke at work or home had a 91% grater chance of heart disease.

Nurses who reported occasional exposure had a 58% greater risk of heart disease.

“They’re startling in terms of the strength of the association,” said Ichiro Kawachi, assistant professor of medicine at Harvard Medical School and the study’s lead author.

However, researchers did not differentiate between smoke exposure at work and home, and left it up to participants to decide what constitutes “regular” or “occasional” exposure.

Kawachi said that is one possible weakness of the study, along with the fact that the women were asked about exposure only once, at the beginning of the 10-year study period, then tracked for heart problems.

Michael Eriksen, director of the Office on Smoking and Health at the Centers for Disease Control and Prevention, said the study is one of the strongest to date on the dangers of secondhand smoke.

The researchers at Harvard Medical School and Brigham and Women’s Hospital studied 32,046 female participants in the Nurses’ Health Study ages 36 to 61 who had never smoked and free of diagnosed heart disease, stroke and cancer in 1982.

During 10 years of follow-up, they recorded 152 cases of heart disease, including 127 nonfatal heart attacks.

Kawachi said his study took into account other factors that might explain an association between secondhand smoke and heart attack, including diet, exercise, obesity, high cholesterol and use of the pill.

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Study: Passive smoke an even greater risk (CNN, 970519)

DALLAS (CNN) — New research provides some of the strongest evidence yet that constant exposure to passive smoke nearly doubles the risk of heart attack and death in non-smokers.

The study, published in this week’s American Heart Association’s journal Circulation, finds that non-smoking women who were regularly exposed to passive smoke either in their workplaces or in their homes had a 91% higher risk of heart attack or death than those who were not subjected to smoke.

For those who had only occasional exposure to smoke, the increase was 58%, the study concludes.

The 10-year investigation of more than 32,000 women found a higher level of risk from passive smoking than has been seen before.

A study published last August found non-smoking spouses of smokers had about a 20% higher death rate from heart disease than non-smokers living with spouses who did not smoke.

“The 4,000 chemicals in tobacco smoke just about do everything that we know that is harmful to the heart,” Dr. Ichiro Kawachi of the Harvard School of Public Health said. “It will damage the lining of the arteries, increase the stickiness of your blood, therefore increasing the chances that you will develop clotting and develop a heart attack.”

The AHA estimates that from 37,000 to 40,000 people die from heart and blood vessel disease caused by other people’s smoke each year.

The new research was conducted between 1982 and 1992. Since then laws have been passed in many places forcing people to smoke outside some public buildings.

But many bars and restaurants still allow smoking, and millions of Americans smoke.

“Thirty percent of adults still smoke — men and women are equal,” said Dr. Virgil Brown of Emory University. “That 30% should quit; they’re exposing their loved ones or fellow workers to second-hand smoke. They are certainly not being good family members or members of the community.”

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Addicted (Foxnews, 9705)

Why is it so difficult for us to stop smoking? So hard for drug addicts to kick the habit? Or alcoholics to crawl out of the bottle? New answers to those questions — which affect more than 80 million Americans — are emerging from studies of powerful chemicals inside the brain. TIME Magazine’s Joëlle Attinger takes us to Winston-Salem, North Carolina, a city once built on the fortunes of tobacco and now on the front lines of a new war on drugs.

Addiction not caused by loose morals

The newest findings support the view that drug addiction is not the result of loose morals and low culture. Rather, it is biologically rooted in our natural craving for pleasure. The same brain cells that make us feel good in our normal lives are hijacked by drugs that literally hold the mind hostage.

Brain cells communicate with each other through chemicals called “neuro-transmitters.”

One of these chemicals is “dopamine.” It is released naturally when we eat, drink or have sex, all crucial for our species to survive.

Part of the brain translates the dopamine signal into a feeling: Pleasure! Cocaine feels good because it artificially triggers a flash flood of dopamine.

Says Adaline Toney, “You know how they have this saying, ‘Beam me up, Scotty’?”

“The brain is responding in a way that evolution has taught it to respond over millions and millions of years,” says Dr. David Friedman, a neurobiologist at Wake Forest University. “But the control of the brain has now been handed over to some substance that the brain was never prepared to have to deal with.”

Dopamine linked to numerous vices

Some evidence links the dopamine system not only with drug and alcohol abuse, but also with cigarettes, compulsive eating, compulsive gambling and compulsive sex.

“The more modern neuroscience probes into the brain, we’re discovering that psychological things have a biological basis.” says Madeleine Nash, TIME’s science reporter.

Using a powerful imaging machine to examine the brains of anesthetized monkeys, researchers at Wake Forest found ways they were physically changed by cocaine, possibly forever.

Within the monkey’s brain, they measured the number of “dopamine receptors,” the sites where dopamine molecules create euphoria in the brain.

They found that with repeated cocaine use the number of dopamine receptors dropped nearly in half.

Scientists think that’s why an addict needs more and more cocaine to feel pleasure, or just to feel normal.

Says Dr. Friedman, “The change in dopamine receptors may be, we don’t know, but it may be one of the reasons that people crave cocaine when they can’t get it.”

‘No more morals...no more values’

The impulsiveness and the craving for drugs become involuntary.

“There are no more morals,” Toney says. “There are no more values. You become actually animal-like.”

Animal experiments help explain why.

At Wake Forest, researchers use tiny probes to measure the electrical activity of a single brain cell, a millionth of a volt. They found specific cells that become programmed to respond to cocaine.

The brain cells get conditioned to fire just from the sights and sounds they associate with cocaine.

The same thing happens in humans. For Shane Welch, seeing ordinary razor blades in a drug store was enough to trigger his craving for cocaine. It reminded him of the ritual he loved, preparing the cocaine with a razor blade.

“I loved to just chop it up,” he says. “I’d sit there in front of the mirror for an hour just chopping it into dust, and once it was already powdered I’d still just be playing with it.”

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Tobacco to Widen Male-Female Life Span Gap (970523)

LONDON — The gap in life expectancy between men and women is set to continue to widen in the coming decades, partly because of men’s growing addiction to tobacco, American scientists said Friday.

In an article published in the British medical magazine the Lancet, Christopher Murray of the Harvard School of Public Health and Alan Lopez of the World Health Organization said that by 2020 smoking-related diseases would be the leading cause of death in the world.

They predicted that there would be 8.4 million smoking-related deaths a year in 2020 compared with 3.0 million in 1990.

This would be a key factor in extending the survival rates of women over men “far beyond biological differences in potential,” the authors said.

Women in every region of the world will be living longer in the next century, with the biggest gains seen in sub-Saharan Africa, India, Asia and the Pacific Islands. Men will also live longer, with the exception of those born in former socialist countries in eastern Europe, who may not see their life expectancy improve at all.

In 2020 a baby girl born in developed economies would have an average life expectancy of almost 90 compared with 81 at present. A male child born at the same time could be expected to live to about 78 compared with 74 at present.

The report predicted that as economies and health services improved around the world, the traditional scourges of impoverished developing nations such as infectious diseases, malnutrition and disorders related to pregnancy and infancy would become less important causes of death.

However heart disease, stroke and cancer will become more common, even in the developing world, with tobacco seen as the major culprit.

“The largest increases in the epidemic of tobacco mortality will be in India, China and other Asian nations and the Pacific Islands, where attributable deaths will increase from 1.1 million to 4.2 million,” the article said.

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Serious Back Problems Linked to Smoking (970709)

NEW YORK — In addition to lung disease, cancer and heart disease, cigarette smoking may also increase the risk of serious back problems.

A review of the data available on smokers found that they are more likely than nonsmokers to have back problems such as pain, sciatica and degenerative disease of the spine.

In a study published in the July issue of the journal Neurosurgery, two researchers reported that smokers were four times more likely than nonsmokers to require spinal fusion surgery, particularly for low-back problems. Compared with nonsmokers, the time to heal from the surgery was much slower for smokers and more likely to be fraught with complications.

Dr. Mark N. Hadley of the University of Alabama at Birmingham, and Dr. Sadda V. Reddy of Valley Medical Center in Fresno , Calif., concluded that chronic tobacco use leads to a weakening of the bones and a slowing down of the production of new, healthy bone cells.

These bone changes put people at risk for a number of back problems by causing an overall weakening of the vertebra (spinal column). Smoking may weaken bones by reducing the blood supply to the bone, by making the chemical environment around the bone more acidic, or by interfering with the activity of bone-forming cells called osteoblasts, the researchers wrote.

Although nicotine is a likely culprit, Hadley and Reddy said the thousands of breakdown products found in tobacco smoke may also play an important role in contributing to weak bones.

Studies have shown that smoking reduces the bone mineral content of individual vertebrae, which causes them to become brittle and weak. Women are at particularly high risk of thinning bones after menopause because of reduced levels of bone-strengthening estrogen in their bodies.

Postmenopausal women who smoke would appear to be at highest risk if they do not take estrogen-replacement therapy or stop smoking. Weak and brittle bones break easier than healthy bones and do not heal as fast. But the good news, according to the researchers, is that the rate of bone-loss slows down when people stop smoking.

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Price cut produces more young smokers (970710)

Tobacco firm’s documents reveal 4-per-cent climb in Canada since taxes fell

A cigarette-company poll indicates that 97,000 more young Canadians were smoking at the end of 1996 than before the federal government cut cigarette taxes in 1994.

Internal documents of RJR Macdonald obtained by The Globe and Mail support what tobacco companies claimed throughout their fight over this year’s bill to restrict company advertising —that price is the key determinant in selling cigarettes, regardless of what goes on billboards or race-car logos.

The percentage of young adults aged 19-24 who smoke rose to 32.3 per cent in December, 1996, up from 28.3 per cent in 1994, suggest polls conducted for RJR Macdonald by Thompson Lightstone and Co. The 4-per-cent increase translates to 97,000.

The survey of 2,000 adults is said to have a margin of error of plus or minus .63 per cent.

“Incidence of 19-24s appears at highest levels since 1988,” said the June 10, 1997, memo from Richard Kauffeld, chairman and chief executive officer of RJR, Canada’s third-largest tobacco manufacturer.

The data are in line with that of Statistics Canada surveys, said RJR vice-president Mary Trudelle in Toronto.

The memo estimates under-age smokers, who are not tracked officially, account for another 3 per cent of the industry’s sales.

That means Ottawa is profiting from more than $90-million in taxes raised through the illegal sale of cigarettes to minors, said Cynthia Callard, a spokeswoman for Physicians for a Smoke-Free Canada.

The price of a package of cigarettes has dropped to about $2.75 in Ontario and Quebec, down from as high as $6.50 a pack before Prime Minister Jean Chrétien cut the taxes in February, 1994, to try to combat a smuggling habit that had grown to $5-billion a year.

At the time, the Prime Minister announced a package designed to fight under-age and teen-age smoking, stop the smuggling and help replace about $600-million in federal revenue lost because of the tax decrease.

But several of those promises, including the $8-a-carton export tax, have not been translated into action.

Last year, Canadian companies exported $221-million worth of tobacco products, mainly to the United Kingdom, the U nited States, Turkey and Russia.

But asked how much the government had so far collected from its tax, Revenue Canada spokesman Chris Kealey replied that “there really isn’t a number that we’ve been able to find.”

In other words, the government has not collected any export taxes.

The tax, which the Prime Minister said would work “to reduce the profitability of tobacco smuggling,” was designed to prevent tobacco companies from vastly increasing exports to have other parties import the cigarettes back into Canada, Mr. Kealey said.

But written into the legislation that imposed the tax —Bill C-32 —is a loophole that makes it unlikely the government will ever collect much. Manufacturers are exempt from payment as long as they do not export more than 3 per cent of the total amount they produce.

The tax has been very successful in helping to prevent large-scale contraband from being reimported, said Ms. Trudelle. It was not intended to replace the $600-million in lost federal revenue, she said.

“I think it was probably billed that way, and it probably shouldn’t have been,” she said from Toronto.

Mr. Chrétien also promised a three-year, $60-million annual health-promotion surtax levied on tobacco profits. That program has now ended, and the government has allocated just $10-million a year to antismoking education and promotion for the next five years.

Ms. Callard compares the $10-million unfavourably with the $90-million the government collects from taxes on illegal cigarette sales to minors.

“They’re benefitting from this crime far in excess of what they’re spending to try to stop it,” Ms. Callard said in an interview yesterday.

She doesn’t believe any of the money for health promotion, announced in November, 1996, has so far been paid out. A spokeswoman for Health Canada was unable to confirm whether any money had been spent.

The Liberals did make an election commitment to double the money spent on health promotion and education. And the government increased its tax on corporate profits, designed to give federal coffers an extra $200-million a year over three years, and increased taxes on cigarettes slightly in a later budget.

But there have been no changes so far to strengthen health warnings on tobacco packages or to implement a recommendation in the report of the Commons health committee for no-name cigarette packaging.

And even as Health Canada announced it was spending money to convince Canadian kids that smoking is deadly, Agriculture Canada was supporting efforts of tobacco growers and cigarette manufacturers to increase their sales overseas.

In 1995 and 1996, officials with the Agriculture Department helped arrange annual meetings between Canadian tobacco growers and manufacturers and the Tobacco Manufacturers Association in London, according to documents obtained through an Access-to-Information request by Ottawa researcher Ken Rubin. Those meetings were to help Canadian companies find markets abroad.

“That’s an important but not a unique example of where the government is actually supporting both the sale and manufacture of tobacco and its export, but also its promotion in Canada,” Ms. Callard said.

The government also kept quiet, at the industry’s request, about a 1995 outbreak of a fungal disease affecting the Ontario tobacco crop. The industry was worried that news of 15 cases of blue mould would lend credence to China’s ban on importing tobacco from Canada and the United States on the ground their crops could catch the disease.

“As of Aug. 10 this year (1995), 15 cases of blue mould of tobacco have been confirmed in Ontario by AAFC scientists,” Agriculture Canada documents say.

“The Ontario tobacco producers are very concerned over media or public reports about this disease occurrence in Ontario tobacco since it could affect export sales of cured tobacco leaf. Specifically, the industry has been trying to convince the People’s Republic of China to eliminate blue mould-related barriers to importation of cured tobacco leaf from Canada on the basis that the disease rarely occurs in Canada and does not survive in cured leaf tissue.”

The department “will continue activities to identify and monitor blue mould disease in tobacco and will report these findings only to the OFCTGMB [Ontario Flue-Cured Tobacco Growers’ Marketing Board] as requested by the industry,” the documents say.

Frank Marks, director of Agriculture Canada’s Pest Management Research Centre, confirmed the 1995 outbreak and the government’s compliance with the industry request “not to make a public statement about it.”

On the export front, Agriculture Canada officials acknowledged their department is walking “a fine line.”

The department gives the minimum possible assistance to tobacco manufacturers, responding only to specific requests for help with exports, said Lucie Larose, director, special crops. For example, if U.S. tobacco companies gain access to potential clients in the United Kingdom, the Canadian government helps to ensure that Canadian companies get the same access by facilitating meetings.

They did so in 1995 and 1996 in meetings with the Tobacco Manufacturers Association of Britain that were attended by the Canadian embassy’s commercial councillor, tobacco company executives and representatives of the Ontario Flue-Cured Tobacco Growers Marketing Board.

“We would be very ill-advised to negate those services because they are also Canadian taxpayers,” Ms. Larose said.

“So we are finding ourselves in a tight spot. I think the Department of Agriculture is walking a very fine line and walking it well, in that we provide them on a responsive basis only the same level of service that we would provide to other sectors asking to facilitate meetings.”

Agriculture Canada left that to the marketing board, which is the normal contact point with growers, Mr. Marks said from Delhi, Ont.

The government was also worried that growers might use unnecessary pesticides on their tobacco crops if they were spooked by a blue-mould scare, Mr. Marks said.

Frank Menich, chairman of the Ontario Flue-Cured Tobacco Growers’ Marketing Board, said yesterday he did not know whether the board asked the government to keep quiet about blue mould. But he said it was reasonable, in his view, for Ottawa to help the industry with export markets.

“I don’t see anything wrong with it. We have a product and it’s moving to other countries. If the government provides assistance for other products, there shouldn’t be an exception as long as it’s a legal product,” Mr. Menich said.

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Study: 6,200 children die yearly from parents’ smoking (970715)

CHICAGO (AP) — At least 6,200 children die each year in the United States because of their parents’ smoking, killed by such things as lung infections and burns, a study says.

“More young children are killed by parental smoking than by all unintentional injuries combined,” the researchers said in the July issue of the Archives of Pediatrics and Adolescent Medicine.

In addition, some 5.4 million other youngsters each year survive ailments such as ear infections and asthma that are triggered by their parents’ smoking, and these problems cost $4.6 billion annually to treat, the researchers from the University of Wisconsin Medical School in Madison estimated.

The study looked at reports from 1980 to 1996 involving children up to 18, existing research about the risks associated with parental smoking and the costs of treating smoking-related illnesses.

The researchers estimated that the childhood loss of life from parental smoking costs $8.2 billion a year, based partly on how much a child would be expected to earn over a lifetime.

The cost analyses are conservative, because they don’t include the cost of work time lost by parents caring for sick youngsters, said Dr. Thomas E. Novotny, an epidemiologist with the Centers for Disease Control and Prevention.

“All of these illnesses and economic costs are foisted upon children who have had absolutely no choice in the matter,” said Novotny, who was not involved with the study.

The researchers said 2,800 of the deaths are due to low birthweight caused by mothers who smoke while pregnant. Low birthweight babies are frail and vulnerable to many ills, including respiratory distress syndrome, bleeding in the brain and blood infections.

About 2,000 of the deaths are attributed to sudden infant death syndrome caused by secondhand tobacco smoke. An additional 1,100 are due to respiratory infection.

About 250 children die of burns from fires caused by cigarettes, matches or lighters. And 14 children die of asthma.

A related study in the July issue of the Archives of General Psychiatry found that women who smoke while pregnant are more likely to give birth to boys who are diagnosed with what psychiatrists call “conduct disorder.”

The disorder is marked by frequent and persistent lying, fire-setting, vandalism, physical cruelty, sexual aggression or stealing that begins much earlier than typical juvenile delinquency and is much more severe.

A team led by Benjamin B. Lahey, a psychiatry professor at the University of Chicago, studied 177 boys ages 7 to 12 who had been referred to outpatient clinics in Pennsylvania and Georgia for possible conduct disorder. The team said 105 were diagnosed with the disorder.

Among the 42 mothers who reported smoking more than half a pack of cigarettes or more a day during pregnancy, 80% of their sons had conduct disorder. Among the 23 mothers who smoked to up a half a pack a day, 70% of their sons had conduct disorder. And among the 112 moms who didn’t smoke while pregnant, about 50% of their sons had conduct disorder.

The researchers figured in other traits that might cause children to develop conduct disorder, such as socioeconomic status, whether a parent had antisocial personality, and poor parenting. But the women who smoked were four times as likely as non-smoking women to give birth to children with the disorder.

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Mothers who smoke may give birth to tearaways (London Times, 970715)

WOMEN who smoke ten cigarettes or more a day during pregnancy and have boys are far more likely to see them grow up into troublemakers, scientists claim.

The risk of so-called “conduct disorder” is more than four times higher in boys whose mothers smoked at least half a packet of cigarettes a day in pregnancy compared with women who smoked fewer than ten cigarettes a day or none at all. The findings, published in the Archives of General Psychiatry, come from a study of 177 boys aged 7 to 12. They were monitored for six years.

The researchers, from the University of Chicago and led by Lauren Wakschlag, defined conduct disorder as “frequently and persistently engaging in a variety of serious anti-social behaviour”, including lying, stealing, physical cruelty, arson and vandalism. Boys who carried out at least three of these activites for at least six months were diagnosed as having the disorder.

Dr Wakschlag said the women and children involved in the study were attending clinics because the boys were suffering from mild to severe deliquency. She said: “We found those mothers who had not smoked had a 50-50 chance of having a boy with conduct disorder. The group that smoked up to half a pack a day had a 70 per cent chance. In the group that smoked more than ten cigarettes a day there was an 80 per cent chance of an offspring with conduct disorder.”

She said the team had tried to screen out socio-economic background and factors such as the quality of family life and violence in the family.

The researchers are about to launch another study into the effects of smoking in pregnancy on boys and girls.

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The addiction that gives babies a smaller chance in life (London Times, 970715)

TEENAGE girls are now just as likely to smoke as boys. In some communities, they are more likely.

This may store up problems. Less than a quarter of women smokers give up when they become pregnant. Smoking remains a frequent cause of babies being smaller than would otherwise be expected. The babies born to smoking mothers are an average of half a pound lighter, and appreciably shorter, than those born to non-smokers. This could be of immediate importance to a baby who is already small as the result of a pre-term birth. In the long term, smaller babies are more likely to develop high blood pressure and heart disease.

It is unusual for babies to be abnormally small only as the result of the mother’s diet. Although near starvation will affect birth weight, even the low birth weight of children born to mothers in extreme poverty is more likely to be related to the mother’s strenuous lifestyle, lack of rest and the consequent failure of the uter-placental blood supply delivering essential nutrients, than to a lack of nourishment in the mother’s fare.

Cigarette smoking is one of the factors which can limit the efficiency of the uter-placental circulation, and hence damage the nutritional lifeline essential to proper growth. Not only are the babies from smoking mothers shorter and lighter, but the mothers are also more likely to have a miscarriage, to go into labour early, or to suffer placental detachment and haemorrhage during the pregnancy. The babies of smoking mothers also have a higher incidence of foetal neurological abnormalities such as spina bifida, cleft palates and hare lips, and congenital heart disease. As these groups of congenital abnormalities are known to be associated with low folic acid, and as smoking causes a reduction in blood folate levels, it will be interesting to see if the situation is eased when more women are persuaded to take additional folic acid when planning to become pregnant.

The brain develops at a greater rate in the uterus and in the first year or two of life, than at any other time. If a baby is deprived of adequate nutrition in the uterus, whether from smoking or any other cause, it could well have long-term effects on mental development. Smaller babies born to smoking mothers do not always catch up in later life, and it has been claimed that there may be some comparative intellectual loss which persists into school years.

Recent evidence has emerged that the biochemistry of people who have a schizotypal personality, or actual schizophrenia, may be particularly liable to become addicted to cigarettes as nicotine has a strong, but short-lived, calming effect when they feel agitated.

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Some Smokers at Greater Risk for Heart Disease (970807)

NEW YORK — Smokers whose can’t achieve a target heart rate during exercise are at greater risk of heart disease and death than other smokers, a new study suggests.

Overall, male smokers had five times the risk of heart disease and more than twice the risk of dying than nonsmokers if they were unable to achieve an adequate heart rate while exercising, according to the report in the American Heart Association’s journal Circulation. Compared with other smokers they had twice the risk of heart disease and a slightly greater risk of dying during an eight-year period.

The study was unable to determine if the same is true for female smokers with the same problem, called chronotropic incompetence. About 25% of male smokers and 32% of female smokers were unable to achieve a target heart rate during exercise compared with 15% and 18% of nonsmokers, according to the study that included 1,468 men and 1,642 women. The study participants were part of the ongoing Framingham Heart Study, a study of heart disease risk factors in residents of Framingham, Massachusetts.

“While, of course, everybody who smokes should quit, people who smoke and have an impaired heart-rate response to exercise are really at high risk,” stated lead study author Dr. Michael Lauer in release from the American Heart Association. “We should strongly counsel these people to stop smoking,” said Lauer, of the cardiology department at the Cleveland Clinic Foundation in Ohio.

Smokers are twice as likely as nonsmokers to stop exercise tests because of fatigue, shortness of breath, or leg pain. However, the chronotropic index is not just a measure of impaired ability to exercise, rather it takes into account age, physical fitness, resting heart rate, and helps predict health outcome. Those with a low chronotropic index are considered to have chronotropic incompetence.

“The mechanisms by which cigarette smoking is associated with chronotropic impairment are unclear,” Lauer and colleagues wrote. Smoking does constrict coronary arteries and reduce blood flow to the heart. However, the researchers believe that the defect lies in the autonomic nervous system, or the system that tells the heart to speed up to meet the demand for oxygen.

Nicotine from cigarettes stimulates the autonomic nervous system in the same way that the hormone epinephrine does naturally. Therefore, the constant supply of the stimulant may prompt some smokers to lose their sensitivity to the natural stimulation, and thus interfere with the heart’s ability to increase output.

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Smokers May Have Mental Health Problems (970812)

NEW YORK — Hard core smokers may be using nicotine to help manage psychiatric problems such as depression, anxiety, attention deficit-hyperactivity disorder (ADHD), and bulimia or binge-eating, says a researcher at the University of Michigan.

Her conclusion, based on a review of studies involving smokers, may help explain why it is so hard for some smokers to quit. The proposed solution: treat the psychiatric disorders first or along with smoking-cessation efforts.

“Many of those who have given up smoking in the past appear to have been the ‘easy quits’ or casual adult smokers,” says Dr. Cynthia S. Pomerleau, a senior researcher with the Nicotine Research Laboratory at the University of Michigan’s department of psychiatry, and Substance Abuse Research Center in Ann Arbor, Michigan.

Pomerleau says health professionals concerned with helping smokers with psychiatric “co-factors” quit nicotine “need to develop new kinds of smoking interventions tailored to the special needs of these difficult-to-treat, at-risk populations.”

The researcher notes that smoking has declined among adults in the United States from about 40% in 1965 to less than 29% in 1990. Despite the decline, Pomerleau sees smoking rates leveling off at about 15% to 20% of the adult population.

“Nicotine produces temporary, small but reliable adjustments in a wide variety of cognitive and behavioral functions,” she says. “Administered via smoking, nicotine quickly enters the brain where it affects neural regulators (neurotransmitters) such as norepinephrine, dopamine and serotonin, and can either sedate or stimulate depending on the timing, dosage, and other factors,” the researcher explains.

Pomerleau points out that when smokers with co-factors such as depression or binge-eating try to quit, their psychiatric symptoms are worsened or “unmasked” by the absence of nicotine and can persist well beyond the usual two-to three-day nicotine withdrawal period. Consequently, they are more likely to relapse back to smoking than smokers with no psychiatric co-factors, she says.

The researcher points to a substantial accumulation of research to support her conclusions, including:

— a 1986 comparison study of psychiatric patients and non-psychiatric outpatients in which 47% of patients with anxiety disorder and 49% of those with a major depressive disorder smoked, compared with 30% of non-psychiatric outpatients.

— a 1994 study conducted by Pomerleau and her colleagues found that 42% of men and 38% of women diagnosed with ADHD were current smokers — nearly twice the rate in the general population. Also the “quit ratio” was 29% for ADHD patients who had ever smoked compared with 48% in the general population.

— a 1991 study of young adults in which the rate of nicotine dependence was twice as high in adults with any anxiety disorder, three times as high in individuals with major depression, and more than four times as high among those with the two disorders combined.

— a 1992 study of women entering college in which less than 10% of non-dieters and casual dieters smoked, compared with almost 20% who reported eating behaviors typical of bulimia. Similarly, a 1986 study of 10th grade females found 28% of bulimics and 32% of food “purgers” smoked regularly, compared with 18% of girls without eating disorders.

Pomerleau concludes that health professionals helping smokers with co-factors quit smoking may have to treat the depression, anxiety, ADHD, or binge-eating behaviors first or simultaneously.

“A 1995 study found that Prozac helped smokers with depression to quit, but it had no effect on smokers who were not depressed,” she says.

“It is possible that some of these patients (with co-factors) wouldn’t need nicotine replacement treatment once they received appropriate medications or psychotherapy for their underlying conditions,” she adds.

Nicotine replacement products — such as nicotine patches, inhalers, nasal sprays, or gum — may in fact be useful in the treatment of ADHD and other diseases such as Parkinson’s and Alzheimer’s disease, says Pomerleau, but more research is needed. “We need more data on the possible toxic effects of nicotine to weigh against its possible therapeutic effects.”

And recent studies in twins suggest that there may be a genetic component to smoking, perhaps influencing the age at which people start smoking, the amount smoked, and the likelihood of quitting.

“It may be that some families are predisposed to both smoking and depression,” says Pomerleau. “There also is good evidence of assortative mating in smokers — the tendency to find each other, marry and have children, with the nature and severity of problems experienced by smokers with co-factors being magnified in succeeding generations. Prevention efforts and early identification and treatment of the co-factor itself may be needed in these children.”

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Study: Smoking during pregnancy linked to childhood delinquency (CNN, 970714)

(CNN) —Women who smoke while pregnant are much more likely to give birth to boys who are diagnosed with what psychiatrists call “conduct disorder” or a severe form of delinquency, a study shows.

The findings, published in the July issue of the Archives of General Psychiatry, reveal that the women in the study who smoked while pregnant were four times as likely as nonsmoking women to give birth to children with the disorder.

A team led by Benjamin Lahey, a psychiatry professor at the University of Chicago, studied 177 boys ages 7 to 12 who had been referred to outpatient clinics in Pennsylvania and Georgia for possible conduct disorder. The team said 105 were diagnosed with it.

“What we found is mothers who smoke during pregnancy and, in particular, mothers who smoke more than half a pack a day, were significantly more likely to have a son who develops “conduct disorder,” said University of Chicago researcher Lauren Wakschlag

This may be due to the way nicotine affects the growing fetus, researchers said.

According to the university’s Dr. Bennett Leventhal, “the exposure to nicotine changes the way ... nerve cells in the brain organize, so that the kind of connections that are necessary to support behaviors are disrupted.”

Nicotine can interrupt genetic messages to the developing brain, he said.

Among the 42 mothers in the study who reported smoking more than half a pack of cigarettes or more a day during pregnancy, 80% of their sons had conduct disorder. Among the 23 mothers who smoked up to a half pack a day, 70% of their sons had the problem.

And among the 112 moms who didn’t smoke while pregnant, about 50% of their sons had conduct disorder.

The researchers took into consideration other traits that might cause children to develop conduct disorder, such as socioeconomic status, whether a parent had antisocial personality and poor parenting.

What can be done with boys with conduct disorder? Not much, researchers say. It’s difficult to treat, and there is a high rate of relapse. Many spend their lives in the criminal justice system.

The researchers say one-third of boys with conduct disorder develop the adult equivalent known as antisocial personality. These people account for 10% of all criminals, but commit 50% of all crimes.

Smoking during pregnancy already had been linked to other problems —miscarriages, stillbirths, premature deliveries and low birth-weight babies. The latest University of Chicago findings offer one more argument against the habit.

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RJR Nabisco Chairman Links Smoking and Cancer (970822)

WEST PALM BEACH, Fla. — The chairman and chief executive of RJR Nabisco, the maker of Winston and Camel cigarettes, said Friday he believes smoking contributes to lung cancer, according to a court transcript.

“I have always believed, rightly or wrongly, I have always believed that smoking plays a part in causing lung cancer. What that role is, I don’t know, but I do believe it,” Steven Goldstone said in a deposition.

The remark by Goldstone, a former cigarette smoker who switched to cigars, was one of the strongest-ever statements by a high-level executive of a major tobacco company linking smoking and disease. Other industry executives have acknowledged previously that cigarettes may play a role in causing cancer.

The R.J. Reynolds Tobacco Co., a unit of RJR Nabisco, is among the cigarette makers and industry groups named as defendants in Florida’s $12.3 billion lawsuit, which seeks punitive and compensatory damages to cover the public costs of smoking-related illness.

Goldstone hedged his remarks on the smoking-cancer link, saying “I’m not a scientist” and that “There are gaps in scientific knowledge.”

Ron Motley, the lawyer for the state of Florida, questioned Goldstone as Florida prepares for its $12.3 billion lawsuit against the tobacco industry. Jury selection is under way in the case.

“He admitted cigarettes caused cancer, outright and without equivocation. He admitted that in the past mistakes have been made,” Motley said.

Goldstone would not comment on his deposition, except to say, “I was asked questions by Mr. Motley and I gave very forthright answers.”

Goldstone’s sworn statement follows a deposition Thursday by Geoffrey Bible, chairman and CEO of Philip Morris Cos., who was the first executive of the nation’s biggest cigarette maker to acknowledge a possible link between smoking and death.

Bible said smoking “might have” killed 100,000 Americans.

Motley, the attorney who drew out Bible’s admission Thursday, brought nine plastic bins and six cardboard boxes of papers with him for Goldstone’s questioning at a hotel. Three hours were set aside for the deposition, but it lasted 36 minutes.

In response to a question about future intentions, Goldstone said he would include warnings on cigarettes sold in Third World countries where warnings are not required. Reynolds now has a policy of using warnings only if they are required by the country.

Goldstone said that if scientists discover a direct link between cigarette smoke and cancer, “these tobacco companies better work like lunatics to find out how to improve their products.”

He took part in talks resulting in a $368 billion settlement now being considered by Congress that would wipe out most lawsuits against the industry.

Florida Attorney General Bob Butterworth said Golstone’s remarks bolstered the state’s claim that cigarette smoking causes illness.

“It’s what we’ve been saying. It’s the reason why we brought the lawsuit in the first place. He’s telling the American people his company no longer is going to be part of the lie,” Butterworth said.

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Study: Children of Smokers More Likely to Smoke (970902)

WASHINGTON — Children who have parents or friends who smoke are much more likely to smoke themselves, researchers reported Thursday, saying intervention aimed at pre-adolescents could steer them away from cigarettes.

The children knew smoking was bad for them but tried it anyway, said a report in the American Journal of Public Health.

Kurt Greenlund and colleagues at the Tulane University School of Public Health and Tropical Medicine surveyed more than 900 children aged nine through 12 in southeastern Louisiana and found nearly 15% had smoked.

“Smoking prevention programs should begin as early as possible, and those aimed at pre-adolescents should target family and peer influence as well as attitudes that reinforce smoking behavior.”

“Curiosity was the main reason for having tried cigarettes,” Greenlund’s team wrote.

“Students generally agreed that smoking had adverse health, psychological, and social consequences,” they added.

Eighty percent of children who smoked had parents who did.

Forty percent said they smoked with a family member, while 46% got their first cigarette from a family member or at home.

“Overall, 14.8% of students reported ever trying cigarettes,” they wrote.

“Only 11 children regularly smoked at least once a week. More white than black children tried smoking — 20% versus eight percent,” they added.

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Chinese Less Sensitive to Smoke Hazard (970902)

NEW YORK — Young Chinese smokers may be less susceptible to some of the damages of cigarette smoke compared with their white counterparts in Britain and Australia, a new study suggests. The finding may help explain why the risk for heart disease in China is one-fifth that of other nations, despite the fact that 70% of Chinese men are smokers and Chinese women are frequently exposed to second-hand smoke.

In the study, young adult smokers from Britain and Australia showed a reduced ability to dilate blood vessels in response to body signals to supply more blood — a problem that can lead to clogging of the arteries. This reduced ability is called endothelial dysfunction, because it affects the endothelium — the inner lining — of arteries.

In comparison, young Chinese adults had no such impairment, according to the report in the Annals of Internal Medicine.

“It remains to be determined, however, whether protection from smoking-induced vascular dysfunction is caused by environmental or genetic influence, or both, and whether populations other than those in China are protected,” according to an editorial by Dr. Mark Shriver of the Allegheny University of the Health Sciences in Pittsburgh.

The study included 144 healthy subjects, aged 16 to 45. The researchers used ultrasound to measure endothelial function in smokers and those exposed to second-hand smoke, as well as in nonsmokers. The blood vessel dilation in nonsmokers from any country was essentially identical with 7.9% dilation in Chinese individuals and 8.4% in whites. However, in white smokers, the blood vessels dilated only 3.9% while Chinese smokers had 7.3% dilation.

“There are several possible explanations for this finding,” according to lead author Dr. Kam Woo, of the Chinese University of Hong Kong. “The chemical composition of the cigarettes smoked in China may be different from that of cigarettes smoked elsewhere; however, most Chinese smokers use imported cigarettes or smoke locally made non-filtered cigarettes that contain high levels of tar (23 to 34 mg per cigarette) and nicotine (0.7 to 1.2 mg per cigarette).”

Or the effect could be because Chinese smokers tend to pick up the habit later than in other countries — in their late teens or early 20s. However, Woo and colleagues tried to match the smokers as closely as possible based on exposure to cigarettes. There may also have been differences in diet between the two groups — most of the Chinese consumed the traditional diet based on vegetables, rice, fish and green tea, whereas the Western diet contains more fat.

And finally, the difference could have been due to genetic factors, according to Shriver. However, more study is needed to determine if this is true.

“If the protection seen in Chinese persons living in China is also seen in westernized Chinese persons, the case for involvement of genetic elements would be strengthened,” Shriver wrote. “The role of genetic elements would not be proven, however, because immigrants may have brought protective factors, such as diet, with them.”

The findings does not mean that Chinese individuals are immune to the negative health effects of cigarettes.

“Cigarette smoking is clearly also a health hazard in China, where it is associated with many thousands of deaths annually, primarily because of pulmonary disease,” Woo wrote. “However, Chinese persons appear to be less susceptible than white persons to cigarette smoke-related endothelial dysfunction.”

SOURCE: Annals of Internal Medicine (1997;127:372-375)

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Passive Smoking-Cancer Link Found (970910)

WASHINGTON — U.S. researchers said Wednesday they had found a cancer-causing chemical in the bodies of people exposed to second-hand smoke — the first hard evidence of how passive smoking can cause cancer.

The compound, NNK, is found in the urine of people exposed to tobacco smoke but not in those who have not breathed someone else’s smoke, Stephen Hecht and colleagues at the University of Minnesota Cancer Center in Minneapolis found.

They told a meeting of the American Chemical Society in Las Vegas that NNK is found only in tobacco smoke.

“This is the first time that a metabolite of a tobacco-specific lung carcinogen has been found in the urine of nonsmokers exposed to environmental tobacco smoke under field conditions,” Hecht said in a statement released by organizers of the meeting.

His team collected urine samples from nine hospital workers who were caring for smoking patients in a Canadian veterans hospital. They compared their samples to the urine of people who did not work around smokers.

All the workers had signs of NNK in their urine, although at levels 70 times lower those found in smokers.

NNK has been found to cause adenocarcinoma, one type of cancer, in animal studies. “Adenocarcinoma is the type of lung cancer that’s most commonly found in nonsmokers who are exposed to environmental tobacco smoke,” Hecht said.

Doctors know that smoking causes cancer and heart disease and have strong evidence that second-hand smoke does, too. But tobacco companies argue that studies have not positively linked specific components of tobacco smoke with cancer-causing effects.

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Study finds genetic changes in lungs of smokers (970917)

WASHINGTON — Researchers said Tuesday they had found more evidence that smoking causes genetic changes in the lungs that can lead to cancer.

They said the damage lasts for many years and affects both current and former smokers, even those who had quit for many years.

Samples from the lungs of healthy volunteers showed damage to the genes that look just like changes seen in cancer, they wrote in a report in the Journal of the National Cancer Institute.

Ignacio Wistuba of the University of Texas Southwestern Medical Center in Dallas and colleagues across the United States and in Chile and Canada, took biopsies, or tissue samples, from 63 volunteers.

“Among individuals with a history of smoking, 86% demonstrated (genetic changes) in one or more biopsy specimens, and 24% showed (changes) in all biopsy specimens,” the researchers wrote.

“No genetic alterations were seen in nonsmokers,” they added.

The genetic changes they saw were a loss of heterozygosity — which means one copy of a pair of genes was missing. Genes are usually found in identical pairs.

They said this damage was seen in genes known to be involved in cancer, including the P53 gene, and said their tests could be used as a way to detect cancer early so that could be more effectively treated.

Adi Gazdar, who led the research, said there have been various reports of such genetic changes, and that his team decided to look at people who had been heavy smokers — smoking the equivalent of a pack a day for 20 years.

“The most surprising thing in the study is that in ex-smokers, the changes persisted for many, many years — for 48 years,” he said, referring to one volunteer who had quit smoking 48 years before participating in the study.

“We also found some change in a woman who smoked for only one year,” he added. “But that doesn’t mean you shouldn’t stop smoking.”

Gazdar said the damage was very slight in that woman and stressed that people definitely reduce their risks by quitting.

“We hope we can prevent some of the changes,” he added. The volunteers were now taking several drugs, including the retinoids, derivatives of vitamin A, which have been shown to reduce genetic damage.

Lung cancer is the most common cause of cancer deaths in the United States.

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Passive smoking reports find risk of cancer, heart disease (971017)

LONDON (AP) — Living with a smoker increases a nonsmoker’s risk of lung cancer and heart disease by about 25%, according to two studies published in the British Medical Journal.

The findings made clear the dangers of secondhand smoke, researchers said in the journal, out Saturday.

“The effect of environmental tobacco smoke is not trivial, as is often thought. It is a serious environmental hazard and one that is easily avoided,” said the team behind one of the studies, conducted by researchers at St. Bartholomew’s Hospital and the Royal London School of Medicine.

In that study, scientists analyzed published studies of heart disease in lifelong nonsmokers, comparing those who lived with smokers to those who didn’t.

It concluded secondhand smoke increased risk by 25%.

The second paper, which analyzed epidemiological studies of lung cancer in nonsmokers, concluded “all the available evidence confirms that exposure to environmental tobacco smoke causes lung cancer.”

It said a woman who has never smoked has an estimated 24% greater risk of lung cancer if she lives with a smoker.

They also reported that tobacco‑specific carcinogens are found in the blood and urine of nonsmokers exposed to environmental tobacco smoke.

“The studies reinforce the already compelling case for reducing smoking rates,” British Minister for Public Health Tessa Jowell said Friday. “We are determined to tackle these rates, especially for the two‑thirds of smokers who want to give it up and for the most vulnerable group — young teen‑agers — who are smoking in increasing numbers.”

She said the government would release a plan later this year aimed at reducing smoking levels “for the health benefit of all.” Plans include a tobacco advertising ban and promoting more smoke‑free public places, she said.

Marjorie Nicholson, director of the Freedom Association for the Right to Enjoy Tobacco, accused the government of actively promoting discrimination.

“The government seems to be clutching at anything that justifies going down the anti‑smoking path,” she said.

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Smoking Around the World (971017)

In the United States:

In 1965, more than 42% of American adults 18 years of age and older smoked cigarettes. In 1993, about 25% of adults — about 46 million people — smoked cigarettes. Approximately 28% of men and 23% of women are smokers. Blacks smoke about the same as whites; 26% and 25%, respectively. Education level seems to affect smoking rates as shown by a consistent decrease in the smoking rate in groups with a higher level of education. In 1995, 38.3% of white and 34% of Hispanic high school students smoked cigarettes during the 30 days preceding a recent CDC survey compared with 19.2% of African-American high school students. Although smoking rates among African-American female students continued to be low (12.2% in 1995), smoking rates among African-American male students nearly doubled from 14.1% to 27.8% between 1991 and 1995.

Internationally:

According to the World Health Organization, tobacco consumption in Asia increased 15% between 1988 and 1992. The tobacco industry has predicted that sales in Asia will increase 33% between 1991 and 2000. In Singapore especially, the incidence of smoking seems certain to rise. The Singapore health ministry recently reported that the number of people between the ages of 18 and 19 who smoke tripled from 1987 to 1991. Amount tobacco companies spend annually on advertising in the United States: $6 billion.

Source: American Cancer Society, U.S. News and World Report, Centers for Disease Control and Prevention

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Tobacco and Health (971017)

General Health Facts:

1. Tobacco smoke contains at least 43 carcinogenic (cancer‑causing) substances.

2. Smoking can cause many kinds of cancer, not just lung cancer.

3. Tobacco use accounts for 30%, or one in three, of all cancer deaths in the United States.

4. Approximately 90% of lung cancer cases in men, and 79% in women are attributable to cigarette smoking.

5. Smoking prevalence is higher for men (28%) than women (23%)

6. It’s estimated that 37,000 to 40,000 people die from heart and blood vessel disease caused by other people’s smoke every year

7. Cigarettes inflict their worst damage on the lungs of black women, according to a study that compared the lung capacity of different groups of two pack a day smokers and non‑smokers

8. The World Health Organization estimates that the number of women who die each year from smoking‑related diseases will double to more than 1 million over the next 3 decades

Quitting:

1. According to Journal of the National Cancer Institute, about 17 million smokers try to quit each year, with only 1.3 million succeeding.

2. Since the Great American Smokeout began in 1997, the rate of Americans who smoke has dropped from 36% to 25%.

3. Almost half of all cigarette smokers have been told by a doctor that they need to quit. 85% of current smokers and 84% of former smokers have tried to quit this way.

4. According to a 1979 Surgeon General’s report, at any given time approximately 80% of U.S. smokers wish to quit smoking.

Sources: American Cancer Society, Chicago Tribune, The Houston Chronicle, National Cancer Institute, Cancer Facts and Figures

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Passive Smoke May Put Children at Risk (971107)

ATLANTA — Federal health officials said Thursday approximately 15 million children risk health problems because they are exposed to passive cigarette smoke at home.

The Centers for Disease Control and Prevention (CDC) said one-third to one-half of adult cigarette smokers have children living in their home. Of those, more than 70% allow smoking in some or all areas of their home.

Children exposed to passive cigarette smoke at home are more likely to miss school because of illness, the agency said. They also face an increased risk of asthma, sudden infant death syndrome, ear infections and lower respiratory tract infections such as pneumonia and bronchitis.

“Parents need to be particularly concerned to avoid exposing their kids to environmental tobacco smoke,” Michael Eriksen, director of the CDC’s Office on Smoking and Health, said.

“They need to really think twice about when their smoking will adversely affect the health and well-being of their children,” he said.

The percentage of adult smokers with children where smoking was allowed in some or all areas of the home ranged from 70.6% in Washington to 95.6% in the District of Columbia, the CDC said.

Overall, about 23.5% of adults smoke, the CDC said. State-by-state figures for adult smoking prevalence ranged from 15.9% in Utah to 31.5% in Kentucky.

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Cigarette Ads Influence Teen Smoking (980217)

NEW YORK — Cigarette advertising and promotional items do appear to play a role in an adolescent’s or teenager’s decision to begin smoking, two new reports suggest. A survey of adolescents, aged 12 to 17, who said they had no intention of trying a cigarette found that those who had a favorite cigarette advertisement at the time were nearly twice as likely as their peers to begin smoking over the next two years.

What’s more, those youngsters who possessed or were willing to use a promotional item (such as a hat, T-shirt, or other item with a cigarette logo) were 2.89 times as likely to start smoking, according to a report in the February 18th issue of The Journal of the American Medical Association.

“From these data, we estimate that 34% of all experimentation in California between 1993 and 1996 can be attributed to tobacco promotional activities,” concluded Dr. John Pierce and colleagues from the Cancer Prevention and Control Program at the University of California, San Diego. “Nationally, this would be over 700,000 adolescents each year.”

The study included 1,752 adolescents who had never smoked. More than half had a favorite cigarette advertisement and though only 5% had a promotional item for cigarettes, another 10% were willing to use such an item.

The second report found that certain brands of cigarettes more likely to be used by young smokers — Marlboro, Newport, Camel, Kool, and Winston — were more likely to be advertised in youth-oriented magazines, according to the analysis of 12 cigarette brand advertising in 39 magazines.

“Youth brands” were considered those used by more than 2.5% of adolescents aged 10 to 15, and when that age group made up only 4% of a magazine’s reading audience, such brand advertising was half as likely to be found as “adult brand” advertising.

When youth readership was 14%, the magazine had equal mixes of “adult” and “youth” advertising. But when the young readers increased to 34%, “young” brand advertising was five times more likely than “adult” brand advertising.

“Cigarette brands popular among young adolescents are more likely than adult brands to advertise in magazines with high youth readerships,” reported the researchers from Harvard University, Boston University School of Public Health, and the Massachusetts Department of Public Health.

However, the study could not demonstrate intent on the part of cigarette manufacturers to lure youngsters into smoking, and the advertising pattern may have been partly complicated by the reading habits of 18 to 24 year olds, a group that is clearly targeted by tobacco companies.

SOURCE: The Journal of the American Medical Association (1998;279:516-520, 511-515)

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Tobacco Company Targeted Teen Smokers (980205)

WASHINGTON — Internal documents from the Brown & Williamson Tobacco Co., a unit of B.A.T. Industries Plc, appear to detail a long-running marketing strategy aimed at underage smokers, The Washington Post reported Thursday.

The documents, to be released at a congressional hearing Thursday, are the fourth batch from a major American tobacco company that describes underage smokers as the future of the cigarette market.

Documents have been released detailing the effort to target teenage smokers from R.J. Reynolds Tobacco Co, Phillip Morris and Lorillard.

The latest documents came from state lawsuits against the tobacco companies and were provided to the Post by attorney working for legislation based on a settlement with tobacco companies.

The newspaper said the latest documents spanned nearly two decades, starting in 1972 and discussed tracking the smoking habits of 15-, 16-and 17-year-olds.

One internal memo recommended flavoring cigarettes, saying, “Coca-Cola, apple or some other ‘sweet flavor’ cigarette ... It’s a well-known fact that teenagers like sweet products.”

A 1975 report from outside marketing consultants suggested that efforts to attract beginning smokers should “start out with the basic assumption that cigarette smoking is dangerous to your health — try to go around it in an elegant manner but don’t try to fix it — it’s a losing war,” according to the Post report.

Brown & Williamson has repeatedly denied that it markets to underage smokers. The Post said a company official declined comment on the new documents because he had not seen them.

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Smoking Linked Strongly to Crib Death, Study Shows (980422)

ROUEN, France — Scientists warned parents Monday that smoking and high room temperatures increased the likelihood of crib death, the mysterious syndrome that kills tens of thousands of infants a year.

But routine childhood vaccinations do not appear to have a causal link to the syndrome, according to recent studies described at a medical conference that brought together some 450 experts on the condition in Rouen, northern France.

Researchers addressing the conference expressed satisfaction that infant mortality due to crib death had plummeted in recent years as parents learned the correct way to lay their children down to sleep.

Scientists said the remaining deaths could be caused by a variety of factors ranging from smoking to genetic factors or viral or bacterial infections.

“Despite the fantastic decline in the death rate, crib death remains the main cause of infant mortality in the developed world and particularly in France,” said Dr Eric Mallet, a French expert.

Crib death is the sudden and unexplained death of an infant, most common among babies aged between 4 and 6 months.

Until the early 1990s, doctors had recommended that babies be laid down to sleep on their stomachs for fear they might choke if they vomited in their sleep.

However, this view was subsequently discredited and doctors now advise parents to lie their infants on their backs.

Due to this change alone, researchers said that the number of crib deaths in the industrialized nations had declined to fewer than one per thousand from 1.5 to 2 deaths per thousand in 1991.

In France, this change has reduced the number of crib deaths from 1,900 in 1991 to fewer than 500 last year, the researchers said.

Among the factors now being studied as potential explanations for the remaining deaths are smoking and high bedroom temperatures, Mallet told reporters.

“One must pay a lot of attention to the temperature of the room, which should not exceed 18 degrees (64 degrees Fahrenheit). One must also avoid smoking in an apartment where there is a baby. This would enable us to dramatically reduce the number of deaths,” Mallet said.

U.S. researcher Dr Stanley Plotkin of the Pennsylvania Medical College said a series of recent studies had found no cause-and-effect relationship between childhood vaccinations and crib deaths.

Plotkin urged parents to continue to assure that their children are vaccinated against major childhood diseases.

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Study: Smoking May Worsen Mental Decline in Elderly (980430)

MINNEAPOLIS (AP) — Elderly smokers may lose the ability to think, perceive and remember more quickly than people who never smoked or who quit smoking, according to a new study.

The study suggests that the mental decline of may be tied to silent strokes — very small strokes that go unnoticed by their victims, said study coordinator Laura Launer of Erasmus University Medical School in Rotterdam, Netherlands.

She said smoking already is known to be a risk factor for stroke, which is a loss of blood flow that damages the brain.

Launer released her abstract Wednesday during the American Academy of Neurology’s annual meeting.

The researchers pooled data from four European studies that looked at 9,223 non-demented people age 65 and older. Twenty-two percent were smokers, 36% were former smokers and 42% never had smoked.

Participants were tested once and then two years later on such things as short-term memory, time and place orientation, attention and calculation.

“The degree of the decline can’t really be translated into impairment in daily activities,” such as taking telephone calls or remembering names, said study coordinator Laura Launer of Erasmus University Medical School in Rotterdam, Netherlands. “But it tests all functions necessary to do those activities.”

All three groups experienced a decline in cognitive abilities, but the study found that older smokers had a significantly larger decline. Former smokers had a slightly more rapid decline than non-smokers, but the difference was not statistically significant.

The Tobacco Institute, which performs public relations for member tobacco companies, said it does not comment on studies until its scientists review them.

Dr. Robert Friedland, a neurologist from Case Western Reserve University School of Medicine in Cleveland, called the study intriguing but said it needs to be verified by others.

He also said it is difficult to say whether the study would shed light on the causes of more serious mental problems, such as Alzheimer’s or dementia. Up to 15% of people who experience cognitive decline become demented each year, he said.

The study adjusted for other factors that might affect cognitive function, such as age, education and history of stroke. But it did not take into account whether elderly smokers drank alcohol, how heavily they smoked and how long former smokers smoked and when they quit.

Friedland said factors such as alcohol use and diet are important.

“There’s a very strong relationship between smoking and alcohol use,” he said.

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Cigarette Smokers May Suffer Hearing Loss (980604)

CHICAGO — Researchers Tuesday added another potential peril to the hazards facing cigarette smokers: Hearing loss.

A study of 4,753 adults age 48 to 97 found that smokers had a 70% higher risk of hearing loss than nonsmokers. The problem also affects nonsmoking family members who live with smokers, though at a decreased level, it said.

Though the exact cause-effect relationship remains undetermined, some earlier studies have speculated that cigarette smoke has a toxic effect on cells in the inner ear which are important to hearing, the report from the University of Wisconsin said.

Other investigators suspect that smoking constricts blood flow to the inner ear, in the same way that it cuts off blood supply to the heart and can cause heart disease.

The report, published in this week’s Journal of the American Medical Association, was based on a five-year study among the residents of Beaver Dam, Wisconsin, a town of 20,000 which has been used for other research, including an earlier study on vision and vision loss.

“Cigarette smoking is well recognized to be associated with other lifestyle and socioeconomic factors that may adversely affect health,” the report said.

“For example people who smoke may be more likely to be exposed to noisy workplaces and leisure activities, they may be more likely to consume alcoholic beverages and they may have chronic conditions, such as heart disease, that may be associated with hearing loss,” it added.

But even after adjusting for those factors, it said, “smoking history remained significantly associated with hearing loss, suggesting that smoking is not merely serving as a marker for other lifestyle factors.”

For purposes of the study hearing loss was defined as an average decline of 25 decibels compared to normal hearing — a loss that would make it difficult to understand conversation when there is background noise. The study said that the more people smoked, the greater were their odds for at least a mild hearing loss.

Smokers who went through an average of one pack a day for 40 years were 30% more likely to have a hearing loss than smokers who consumed a pack each day for 10 years.

The earlier Beaver Dam study on vision found that cigarette smokers run two to three times the risk of developing age-related macular degeneration, an eye condition that is a leading cause of blindness.

“All of this information is useful in providing another important reason to quit smoking or, better yet, not start,” said Ronald Klein, a University of Wisconsin researcher involved in the vision study.

“Age-related macular degeneration and hearing loss become more frequent as people get older,” he added. “For this reason, identifying possible causes of these age-related conditions may improve quality of life.”

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Smoking byproducts tied to eye, heart risks (981022)

NEW YORK, Oct 22 — Chemical byproducts of smoking known as “advanced glycation endproducts” (AGEs) may raise the smoker’s risk for cataracts and cardiovascular disease, researchers report.

The smoking-related buildup of AGEs in the lens may “contribute to the higher incidence of cataract noted in smokers,” conclude a group of American and UK researchers led by Dr. Iain Nicholl of The Picower Institute for Medical Research in Manhasset, New York. Their findings are published in the September issue of Molecular Medicine.

The authors explain that AGEs can come from many sources and “accumulate in tissue as a consequence of diabetes and aging.” Previous studies have linked the compounds to cataract formation, atherosclerosis, and kidney disease.

In their study, the authors sought to discover if these chemicals might be present in tobacco smoke.

They used high-tech fluorescent imaging to compare levels of AGEs in the lenses and coronary arteries of nondiabetic smokers versus nonsmokers.

Based on their research, the investigators report that “AGEs were present at significantly higher levels in the lenses... of nondiabetic smokers” compared with nonsmokers. They believe this finding could help explain the generally higher incidence of cataracts among smoking populations.

Nicholl’s team also found “significantly elevated” levels of AGEs in the coronary arteries of smokers versus nonsmokers. They believe AGEs should be added to the list of chemicals found in tobacco smoke, which are thought to increase the smoker’s risk of heart disease, heart attack, and stroke.

AGEs seem to be generated during the tobacco-curing process, the authors write, “and have been proposed to confer aroma and flavoring to tobacco products.”

SOURCE: Molecular Medicine 1998;4:594-601.

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Study: Smoking, Adult Crime Linked (990315)

CHICAGO (AP) C Researchers examining the relationship between mothers who smoke and their child=s adult behavior say babies of smokers could be at a higher risk of turning into criminals.

Although such links have been studied in children and teen‑agers, researchers say a study published in this month=s Archives of General Psychiatry is the first to examine the relationship between mothers who smoke and the actions of their mature offspring.

While stopping short of saying that babies whose mothers smoked while pregnant will become criminals, researchers say their findings are significant.

“Our results support our hypothesis that maternal smoking during pregnancy is related to increased rates of crime in adult offspring,=> the authors wrote, adding that the results “suggest an additional critical reason to support public health efforts aimed at improving maternal health behaviors during pregnancy.=>

However an expert not involved in the study said there is not enough research to say that prenatal smoking can be risk factor for adult crimes.

The researchers from Emory University in Atlanta, the University of Southern California and the Institute of Preventive Medicine in Denmark based their findings on data for 4,169 males born in Copenhagen between September 1959 and December 1961 and studied the men=s arrest histories at age 34.

The number of cigarettes their mothers had smoked during the third trimester of pregnancy affected the men=s arrests for nonviolent and violent crimes as adults, even after factoring out other possible causes such as alcohol use, divorce, income and home environment, researchers said in the study, which was released Sunday.

Only one other risk factor C delivery complications C was found to be significant.

Researchers found that more than a quarter of the men whose mothers had the highest levels of smoking and delivery complications were arrested for a violent crime as an adult.

Further study should be aimed at determining the effects of smoking on the brain of developing fetuses and to see if specific agents in tobacco smoke can be more directly linked to antisocial behavior, they said.

A spokeswoman for Patricia Brennan, the study=s lead author and a researcher at Emory=s Department of Psychology, could not be reached for comment Sunday.

But David Fergusson, a psychiatric epidemiologist at the Christchurch School of Medicine in New Zealand, said there is not enough research to add prenatal smoking to the list of established risk factor for adult crimes.

Fergusson, who wrote an editorial accompanying the article, said the study did not rule out the possibility that genetics C not smoking C caused behavior problems.

“Mothers who smoke during pregnancy are often young women who have previous misconduct problems and there is quite an inheritability of misconduct problems,=> Fergusson said in a telephone interview Sunday.

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British Group: Many Men Unaware Smoking Can Cause Impotence (990601)

LONDON — Smoking can cause impotence but few men are aware of the dangers, British doctors said on Wednesday.

A new report by the British Medical Association (BMA) and the anti-tobacco group Action Against Smoking (ASH) presents a stark contrast to the slick advertising images of rugged, sexy male smokers.

The report estimates 120,000 men in Britain are impotent as a direct result of their habit and says a recent MORI poll showed 88% of smokers do not know the sexual risks they are taking.

Both groups are urging the British government and the European Union to add new warnings on cigarette packets saying smoking causes impotence and can damage sperm.

“It is staggering that so few smokers realize there is a link,” Dr Bill O’Neill, the tobacco adviser to the BMA, said in a telephone interview.

“We need to highlight the issue. It is an educational issue but secondly it should be added to the list of warnings that are put on cigarette packets.”

The damage smoking causes is cumulative. Years of smoking make it difficult for men to achieve or sustain an erection. Teenage smokers who can’t kick the habit could be impotent by the time they reach their 30s or 40s.

“It is amazing how difficult it is to get across significant health messages in relation to smoking. One of the reasons for that, clearly, is the enormous investment that is put into advertising and marketing (cigarettes),” O’Neill said.

Smoking causes a buildup of fatty deposits in delicate blood vessels. But instead of blocking blood flow to the heart, as in the case of heart disease, it stops the supply to the penis.

Nicotine can also cause rapid contractions in penile tissue or damage a valve mechanism that traps blood in the penis.

“Impotence may not be as serious as cancer or heart disease, but it might be more important and immediate for men in their 20s to quit smoking,” said Clive Bates, the director of ASH.

Research studies have shown that smoking can increase the chances of becoming impotent by 50% and can also compound other risk factors for erectile dysfunction.

Hormone abnormalities, high cholesterol levels, diabetes, strokes and kidney and liver problems can cause impotence.

Cigarettes sold in Thailand already carry an impotence warning, according to ASH, and Hong Kong is considering a similar move.

A new European Union directive is due to replace the current warnings on cigarettes.

“Most smokers are unaware of the risk and that’s why we think new warnings are needed,” Bates said.

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Second-hand smoke raises stroke risk: study (990817)

AUCKLAND - Exposure to second-hand smoke can raise a non-smoker’s chance of having a stroke by as much as 82 per cent, a New Zealand study said Tuesday.

The University of Auckland Stroke Study, published in the magazine Tobacco Control, studied all stroke cases in Auckland in people older than 15 1991. It compared 521 stroke patients with 1,851 healthy people.

Researchers have previously suggested that smoking damages brain functioning by a series of small, silent strokes that are not detectable. But the New Zealand research is one of the first to link second-hand smoke with an increased risk of strokes.

The study also found that smokers are four times as likely as non-smokers to get strokes, which kill up to 4.2 million people around the world each year. Woman are more vulnerable than men to be affected by tobacco smoke, the study added.

Second-hand smoke has also been shown to cause an increased risk in lung cancer and heart disease.

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Women At Higher Risk Of Lung Cancer (Foxnews, 991102)

WASHINGTON — Women who smoke may have a much higher risk of lung cancer than male smokers, simply because of their sex, researchers said on Tuesday.

They warned that their study was small and that results need to be repeated in larger studies, but said it sent an important message to women smokers.

“Women may very well be more susceptible to lung cancer than men,” Dr. David Yankelevitz, a radiologist at New York Presbyterian Hospital who worked on the study, said in a telephone interview.

Yankelevitz and colleagues did CT scans — computed tomography scans — on 459 women and 541 men who were over the age of 60 and who had smoked for years.

None had any symptoms of lung cancer, but the scans showed tumors in the lungs of 29 of the volunteers, 19 women and 10 men. “Almost twice as many women had lung cancer as men,” Yankelevitz said.

The people in the study were known to have a high risk of lung cancer. Each had at least 10 “pack-years” of smoking.

“To calculate pack-years, you take the number of packs (a person smokes) per day and multiply it by number of years the person has been smoking,” Yankelevitz said.

“Two packs a day for 5 years is a 10 pack-year history.”

Many of the smokers had as many as 40 pack-years. “These are people that started smoking in their 20s, and so 40 pack-years is not all that much,” Yankelevitz said.

They analyzed everyone for known risk factors such as age, income and other factors. “In each group, it was across the board. Women just seemed to be at higher risk,” Yankelevitz said.

The women also were more likely to have malignant cancer. The size of a tumor is the biggest predictor of whether it is malignant, but sex also plays a role.

“Gender is predictive of malignancy, second only to nodule size,” Yankelevitz said.

“It’s not good news, especially when you think the smoking incidence in young women is continuing to rise,” he added.

“If you live in Manhattan, just take a walk down any avenue and see the young women smoking. It’s pretty shocking.”

An estimated 172,000 new cases of lung cancer are diagnosed each year in the United States.

The American Cancer Society says only 14% of all lung cancer patients are still alive five years after being diagnosed. If lung cancer is caught early, half of all patients live, but only 15% of lung cancer cases are caught early enough.

Regular CT scans of high-risk smokers could help catch the cancer earlier, when it is more curable, Yankelevitz said.

In July a team at his center reported that CT scans detected three times more precancerous swellings than chest X-rays did.

They also spotted four times more cancerous nodules and six times more early-stage tumors. Any malignant tumors were much smaller than those detected using chest X-rays.

“We think there is compelling evidence that lung cancer should be looked for and treated aggressively,” Yankelevitz said.

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Smoking ban linked to fewer heart attacks (UPI, 030401)

By Ed Susman

UPI Science News

CHICAGO, April 1 (UPI) — A six-month ban on smoking in public places in Helena, Mont., resulted in a 60% reduction in heart attack admissions to the local hospital, researchers said Tuesday.

“This striking finding suggests that protecting people from the toxins in secondhand smoke not only makes life more pleasant — it immediately starts saving lives,” said Stanton Glantz, professor of medicine at the University of California, San Francisco cardiovascular research institute and a statistics authority. “This work substantially raises the stakes in debates over enacting and protecting smoke-free ordinances,” he added.

“What surprised us was how quickly there was an impact from this ordinance,” said Dr. Richard Sargent, who presented the study Tuesday at the annual meeting of the American College of Cardiology.

From June 2002 until December 2002, an ordinance in the city of Helena, Montana’s state capital, banned smoking in bars, restaurants, casinos and workplaces in the city. Within a couple of months, Sargent said, heart attacks became rare.

“Helena represents a unique situation,” said Glantz. The city of 65,000 people is relatively isolated and is served by one general hospital.

“Also interesting, we found that people from the surrounding area around Helena where smoking was permitted still had similar heart attack levels,” Sargent said. “I liken it to a doughnut. In the hole is smoke-free Helena. In the dough is the high-smoke, high-heart attack surrounding area.”

Researchers at St. Peter’s Community Hospital reviewed records for the past four years and determined that about 6.8 admission for heart attacks occurred each month. During the time of the smoking ban there were three admissions a month, Glantz told United Press International.

“That represents a 60% decline in admissions and is highly statistically significant,” he said. “The possibility that the finding occurring by chance would be two in a thousand.”

Sargent said he and a colleague were chatting about lack of heart attacks in the hospital since the passing of the ordinance. They decided to see if their observations were correct. “You aren’t going to believe these numbers,” his colleague told Sargent after checking the heart attack admission records.

Sargent said the records were meticulously scrutinized to make sure the findings were real. “We believe this is the first time we have been able to show that a smoking ban has resulted in such a reduction in heart attacks,” he said.

“This is a small study so we have to be cautious in how we interpret these results,” Richard Pasternak, associate professor of medicine at the Harvard Medical School in Boston, told UPI. “However, the direction of the impact is correct. We know that the smoke from one cigarette can rupture a plaque in blood vessels.”

The rupture of blockages in coronary arteries creates a cascade of events in which clots can form, choking of blood to arteries of the heart, and causing chest pain or a heart attack. Pasternak said second-hand smoke also is known to have similar impact on people with heart disease.

“So when we have less people exposed to smoke as was the case in Helena it makes sense that the hospital admission rate will be decreased,” Pasternak said.

Dr. Robert Shepard of St. Peter’s Community Hospital, a co-author, said a court challenge to the smoking ordinance has resulted in the law being suspended. “We are seeing an increase in heart attacks again since December,” he said.

In December 2002, there were six heart attacks. Eight occurred in January 2003, five in February and nine in March. Shepard said in a couple of more months he will be able to confirm that the suspension of the ban can be blamed on causing 14 to 16 extra heart attacks in the city.

Sargent said the results of the Montana study could help other communities fighting to implement smoking bans, such as Chicago and the states of Delaware and Florida.

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Smoking ‘killed 5 million’ in 2000 (Reuters, 030912)

LONDON, England (Reuters) — Smoking killed nearly five million people in 2000, accounting for almost equal numbers in the developed and developing nations and painting a bleak picture for the future, scientists have said.

Men accounted for three-quarters of all the deaths, a figure rising to 84% in the developing nations where 930 million of the world’s 1.1 billion smokers are to be found.

The figures are based on work done by researchers from Harvard School of Public Health in Boston, Massachusetts and Australia’s Queensland University, and published in the Lancet medical journal Friday.

The main causes of the tobacco-related deaths were heart and lung diseases, they noted.

The news comes as the major tobacco companies, increasingly under siege in the industrialized world, switch their sales efforts to emerging nations with their expanding populations and rising spending power.

“Our findings mark the beginning of an era when the majority of smoking-caused deaths occur in developing countries,” lead author Majid Ezzati of Harvard said.

“Smoking-related deaths will rise substantially, especially in developing countries, unless effective intervention and policies to curb and reduce smoking among men and prevent rises among women are implemented,” he added.

Ezzati said that although anti-smoking policies were being widely implemented in the developed world, they were lagging far behind in the poorer nations, which consequently faced a rising hazard.

The World Health Organization (WHO) estimates that tobacco-related deaths will at least double by 2030 as smoking takes its toll of men in the developing world and more women start to take up the habit.

“This should provide a motivation to strengthen the case to implement tobacco control programs and policies, which have generally lagged in developing countries, worldwide,” Ezzati said.

Earlier this year the WHO adopted a sweeping anti-tobacco treaty in a bid to curb the product that it said is a death warrant for half its habitual users.

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Smoking Rate Among U.S. Adults Continues to Drop (Foxnews, 041111)

ATLANTA — Heavily Mormon Utah has become the first and only state to meet the government’s goal of reducing the smoking rate to about one in eight adults, federal health officials said Wednesday.

The overall smoking rate among U.S. adults continues to drop, falling to 22.1% in 2003, the according to the Centers for Disease Control and Prevention. That was a decline of just one percentage point from the year before.

“It’s a slow decline, but at least it is still is going down,” said Dr. Corinne Husten, acting director of the CDC’s Office on Smoking and Health.

But the rate is falling too slowly to meet the government’s goal of having a smoking rate of 12% or less by 2010, officials said.

Utah met that goal in 2003 with a smoking rate of 12%, Husten said.

Utah’s “strong social prohibitions” against smoking among its predominantly Mormon residents have helped, Husten said. She also cited the state’s restaurant smoking bans and moderately high cigarette tax of 69.5 cents a pack.

California had the second-lowest smoking state at nearly 17%.

But other states, including tobacco-producing Kentucky, with the nation’s highest adult smoking rate, at nearly 31%, “have a long way to go,” Husten said.

The U.S. smoking rate has dropped every year since 1998, when more than 24% of American adults lit up.

The CDC attributed the drop to such factors as smoking bans, media campaigns against smoking, higher cigarette taxes and insurance coverage for kick-the-habit programs.

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Smoking Pill Shows Promise (Foxnews, 050308)

GROTON, Conn. — Researchers are racing to develop a drug that would make smoking as treatable — and lucrative — as erectile disfunction, high cholesterol and acid reflux disease.

Major pharmaceutical companies and small startups see the potential for billions of dollars in sales for a vaccine or a nicotine-free pill that could end addiction at the chemical level for America’s 50 million smokers.

“It’s the biggest addiction market there is,” said Dr. Herbert D. Kleber, a psychiatry professor and addiction researcher at Columbia University. “Is it realistic to be able to help addicts stop smoking and remain off with a pill? I think the answer is yes and we’re working on a number of them.”

While nicotine patches, gums, lozenges and sprays help wean smokers off cigarettes by slowly reducing their dependence on nicotine, researchers are tailoring drugs to mimic or block nicotine’s chemical reactions with the body.

In Connecticut, researchers at Pfizer Inc. identified a brain receptor that nicotine binds to and designed a drug, varenicline, that latches to the same site. Varenicline is in Phase III testing, normally the last step before a company applies for approval from the Food and Drug Administration.

Researchers hope that the drug will attach to nicotine receptors in the brain, preventing overpowering cravings from setting in when someone stops smoking.

If varenicline’s claims hold up, the drug could generate more than $500 million a year in sales, said David Moskowitz, an analyst with Friedman, Billings, Ramsey & Co.

“It’s an unmet medical need,” said Dr. Karen Reeves, executive director of clinical development for Pfizer. “The morbidity and mortality rate is so high, and doctors and smokers really have not had enough in their armamentarium to help smokers stop smoking.”

The French pharmaceutical company Sanofi-Synthelabo said it will ask for FDA approval this year for the drug rimonabant, which it would market under the name Acomplia as a way to help stop smoking and overeating.

Acomplia targets circuitry in the brain that encourages smokers to keep lighting up. If the body’s chemical reward system is blocked, smoking might not be as pleasurable or as addictive.

Researchers have high hopes for the drug, saying it might also treat alcohol and drug abuse.

That combination could translate into billions in yearly sales, Moskowitz said.

Then there’s NicVax, a drug that Florida-based Nabi Pharmaceuticals claims could be used as a nicotine vaccine. NicVax triggers the production of antibodies that bind to nicotine molecules, preventing them from reacting with receptors in the brain.

NicVax, which was developed primarily with grants from the National Institute on Drug Abuse, has shown promise in early trials and could begin Phase III testing late this year, the company said.

A similar drug, called Ta-Nic, is in early testing by the Xenova Group in England.

“Everyone has been looking for the magic bullet,” said Thomas Glynn, director of cancer science and trends for the American Cancer Society.

Whether one will be found remains uncertain, he said. It’s more likely, doctors agree, that scientists will develop a number of successful drugs that will prove effective, but no single pill will “cure” smoking.

Doctors with high hopes have been let down before. In 1997, the FDA approved bupropion, commonly sold under the name Zyban, as an anti-smoking drug.

The drug, which was originally marketed as an antidepressant, has proven successful for some smokers but was never the industry blockbuster some expected.

Dr. Cheryl Oncken, associate professor of medicine at the University of Connecticut Health Center, said the new drugs being developed represent the next generation of medicine. Oncken will present a research study this weekend on varenicline, which in an earlier Pfizer study was shown to help nearly half of smokers quit within seven weeks — compared to about 33% with bupropion.

Investors are proceeding cautiously. Scott Henry, a Pfizer analyst at Oppenheimer & Co., said it’s too early to tell whether there is a smoking wonder drug in development. He said varenicline has shown promise, but like all drugs being tested, there are many unanswered questions.

“Is it truly a revolutionary new treatment, or is just another bell and whistle?” he said.

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Teen Smoking No Longer Declining (Foxnews, 050401)

Tobacco use is no longer decreasing among middle and high school students, underscoring the need to fully implement smoking-prevention measures targeting youths, the federal government reported Thursday.

After years of declining tobacco use among children starting in the late 1990s, new data indicates use of cigarettes, cigars and other tobacco products among students in grades 6 to 12 has not changed in recent years, the Centers for Disease Control and Prevention said.

More than one out of five high school students (22.3%) and one out of 12 middle school students (8.1%) said they were cigarette smokers in a national survey of 31,774 students conducted last year by the CDC.

When including the use of any form of tobacco, the rates climbed to 28% among high schoolers and 11.7% among middle schoolers.

The rates were about the same as those in a similar 2002 survey, the CDC said.

The report disappointed tobacco opponents and health advocates.

“It says the significant progress that we’ve made as a nation in reducing youth smoking has stalled,” said Bill Corr, executive director of Campaign For Tobacco-Free Kids.

The CDC said the data underscores the need to implement “evidence-based strategies,” such as increasing the retail price of tobacco products, running more smoking-prevention media campaigns and decreasing children’s access to tobacco.

Even though most states have increased their taxes on tobacco in recent years, Corr said the tobacco industry has responded by lowering the wholesale prices for their products, offsetting the tax hikes. At the same time, many budget-strapped states also have cut funding to tobacco prevention and cessation programs.

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Cigarette smokers’ revenge (townhall.com, 050505)

Larry Elder

No more smokers. Is the next step no more Democrats?

So the CEO of a Michigan company announced a no-more-smokers policy. Employees of Weyco Inc. could not smoke at the office, in the parking lot, in an ally or even at home. Weyco founder Howard Weyers gave his employees who smoked 15 months warning and offered them smoking cessation courses. Weyco eventually fired or forced out workers who refused to take nicotine tests to show that they did not smoke.

“We’re not telling you, you can’t smoke,” said Weyco CFO Gary Climes. “We’re telling you, you can’t smoke and work here.” Weyco says it expects to reduce its health-care costs. Action on Smoking and Health, an anti-smoking advocacy group, says that the cost of smokers’ medical care is $3,000 a year more than non-smokers, and that lost productivity caused by illness and smoking breaks during the workday costs the employer another $2,000 a year per smoker.

Across the country, nearly 5,000 municipalities require 100% smoke-free workplaces and/or restaurants and/or bars. Some localities go even farther. In Montgomery County, Md., councilmen approved one of the most restrictive anti-smoking measures in the nation, setting stiff fines for people who smoke in their own homes if it offends their neighbors.

“You can smoke in your house, but if you smoke on your property or in your home, that smoke cannot interfere unreasonably with your neighbor,” said Isiah Leggett, a Montgomery council member.”

In San Francisco, the Board of Supervisors passed an ordinance banning smoking in all city parks. The simple act of lighting up a cigarette while outdoors in a San Francisco park will cost you several hundred dollars in fines. The ordinance extends to city parks, recreation centers and open spaces.

Taking this to the next logical step, Investors Property Management, a Seattle-based company, simply refuses to hire cigarette smokers. But not because of health-care costs. Vice president Dieter Benz says he stopped hiring smokers three years ago because he did not want his company associated with the negative image of cigarette smokers.

“The image of smokers is they aren’t well educated, they don’t care about themselves or others, they are less mentally stable,” said Benz. “We don’t want that image associated with our company, so we won’t hire them.” Wow.

So smokers look bad, and — as a class — lead less happy lives. There is some support for Benz’s claim. Recent studies find smokers 4.7 times more likely to suffer from major depression than the general population. Dozens of other surveys show cigarette users more likely to have anxiety disorders, schizophrenia, attention-deficit hyperactivity disorder, alcoholism and drug addiction. Smokers also demonstrate higher levels of neuroticism and high-risk behaviors, and demonstrate poorer impulse control than nonsmokers.

Researchers at Michigan State University and Detroit’s Henry Ford Health System found that daily smokers were 174% more likely than nonsmokers to seriously consider or attempt suicide. And a study of almost 7,000 Navy recruits entering active duty in 2001 found that smokers were five times more likely to have skipped classes in high school and more likely to have committed crimes than nonsmokers.

Weyco Inc. and Investors Property Management may be onto something. If employers seek to control costs, improve morale, boost the company image and reduce workplace drama, why not refuse to hire ... Democrats?

Democrats — compared to Republicans — on average are less affluent, more unhappy, more prone to anti-social behavior, more prone to self-destructive behavior, and more likely to have been shot at, robbed or burglarized. More of them see X-rated movies, more of them smoke, and they’re less likely to be married and more likely to have separated or divorced.

George Washington University professor Lee Sigelman looked at 22 years of survey data collected by University of Chicago’s National Opinion Research Center. Overall, he found Democrats less affluent, more distrustful, more sickly and more suicidal, and thus doomed to an earlier death. In short, Democrats as a class — like smokers — have, uh, issues. So let’s just extend this hiring ban to cover unhappy, anti-social, self-destructive, unhealthy Democrats.

And what about last year’s “Primetime Live” sex survey? It found Republicans, more than Democrats, to be satisfied with their sex lives, more likely to wear something sexy to entice their partner and more likely to be in a committed relationship, in which they claim to be very satisfied. The survey also found that Republicans are less likely to cheat on their partner or to fake orgasms. No wonder Democrats are unhappy, unhealthy and anti-social.

Poor smokers. Can’t smoke in the office, can’t smoke on the factory floor, can’t smoke in a company car. You can’t smoke in a restaurant. You can’t go outside, down the street, down the ally or down the manhole. You gotta go three-and-a-half miles, you’ll see a Denny’s, make a right, if you come to an International House of Pancakes, you’ve gone too far.

But take comfort. Things could be worse. You could be a smoker — and a Democrat.

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Smoking, Drinking: Young Kids Learn From Adults (Foxnews, 050906)

New study results show that children at a very early age begin to model harmful behaviors from observation of adult behaviors.

When pretending to shop for a “social evening,” researchers found preschoolers were nearly four times more likely to choose cigarettes if their parents smoked and five times more likely to choose beer or wine if they watched PG-13 or R-rated movies.

Researchers say that tobacco and alcohol prevention programs may need to be targeted at younger age groups rather than adolescents and teenagers.

Kids Model Bad Behaviors Early

In the study, which appears in the September issue of the Archives of Pediatrics & Adolescent Medicine, researchers used a role-playing scenario to assess the attitudes of 120 preschool children toward cigarettes and alcohol. Until, now, researchers say it’s been difficult to study young children’s attitudes toward cigarettes and alcohol due to their limited communication skills.

In the role-playing scenario, researchers gave the children, aged 2 to 6, two dolls. The children were asked to pretend to be one of the dolls; a researcher pretended to be the other doll, who was a friend invited over to watch a movie and have something to eat.

When the “friend” commented that there was nothing to eat, the child was invited to shop at a doll grocery store. For the youngest children, this scenario was simplified to asking the children to take a doll shopping.

The results showed that the children purchased an average of 17 of the 73 items available at the doll grocery store. About 28% bought cigarettes and 62% bought alcohol.

Kids’ Awareness of Cigarettes and Alcohol

Researchers found the likelihood of the child including cigarettes or alcohol in this social evening was closely related to behaviors they saw at home or at the movies. For example:

—Children were nearly four times as likely to buy cigarettes if their parents smoked.

—Children were three times as likely to choose beer or wine if their parents drank alcohol at least once a month.

—Children were five times as likely to choose beer or wine if they watched PG-13- or R-rated movies.

“Children’s play behavior suggests that they are highly attentive to the use and enjoyment of alcohol and tobacco and have well-established expectations about how cigarettes and alcohol fit into social settings,” write researcher Madeline A. Dalton, PhD, of Dartmouth College, and colleagues.

“Several children were also highly aware of cigarette brands, as illustrated by the six-year-old boy who was able to identify the brand of cigarettes he was buying as Marlboros but could not identify the brand of his favorite cereal as Lucky Charms.”

Researchers say the results suggest that observation of adult behavior, particularly parental behavior, may influence preschool children to view smoking and drinking as appropriate behavior in social situations.

“Although it is not clear whether these expectations predict future use, the data provide compelling evidence that the process of ‘initiation,’ which typically involves shifts in attitudes and expectations about the behavior, begins as young as three years of age. The results from this study suggest that alcohol and tobacco prevention efforts may need to be targeted toward younger children and their parents,” write the researchers.

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Many Parents Don’t Set Secondhand Smoke Rules (Foxnews, 050404)

Without Rules, Children Exposed to Secondhand Smoke at Home and in Cars

Many parents don’t enforce rules about exposing their children to secondhand smoke at home or outside the home, a new study suggests.

Despite health warnings about the dangers of secondhand smoke exposure for children, researchers found that a large portion of parents don’t restrict smoking at home, in the car, or at a restaurant.

The study showed that 40% of parents and guardians surveyed in New York and New Jersey don’t have rules to limit their children’s secondhand smoke exposure at home, and more than 50% of family cars may expose children to secondhand smoke.

Secondhand Smoke Harms Children

Researchers say secondhand smoke is classified as a Class A environmental carcinogen (cancer-causing substance) and is especially harmful to children, according to the World Health Organization. Exposure to secondhand smoke increases children’s risk of lower respiratory tract infections, such as bronchitis and pneumonia, as well as ear infections and worsening of asthma.

In the study, which appears in the spring issue of Families, Systems & Health, researchers surveyed 1,770 parents and guardians who were waiting for their child’s appointment with a pediatrician in the New York-New Jersey metropolitan area.

The participants were asked about whether they enforced rules such as “Only adults can smoke,” “Adults can smoke, but not around children,” and “No smoking is allowed in my home.”

In regard to smoking at home, the study showed:

* About 60% of all families reported having a smoke-free home.

* Slightly over 20% of parents allow adults to smoke in the home.

* Over 50% ask people to smoke outside the home rather than inside.

* About 35% allow smoking in the home but not around young children.

In general, researchers found Asian parents were least likely to establish home smoking rules. Families with higher incomes were less likely to endorse rules that restricted smoking but were more likely to have a totally smoke-free home.

People who had never smoked were also more than five times less likely to allow smoking in their home. Having smokers in the home increased the likelihood of rules that allowed restricted smoking.

Secondhand Smoke Outside the Home

Outside the home, the study showed that less than half of the participants forbid smoking in the car or usually sit in the nonsmoking section of restaurants.

Nearly 40% of parents say they ask others not to smoke around their children.

Researchers found families with low incomes and ethnic minorities were less likely to have rules that limit their children’s exposure to secondhand smoke outside the home. Families with incomes over $41,000 were more likely to limit secondhand smoke exposure outside the home and report having a completely smoke-free home.

SOURCES: Pyle, S. Families, Systems & Health, spring 2005; vol 23: pp 3-16.

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Youth Smoking Rates Hit Standstill (Foxnews, 050331)

Nearly 30% of American high school students are still using tobacco, worrying health officials and advocates that previous gains against youth smoking have slowed.

CDC figures released Thursday show that 28% of high school students were current smokers in 2004, a number essentially unchanged since 2002. Cigarette smoking rates for middle school students dropped slightly from 9.8% to 8.1% during the same period, though the change was not significant.

Overall, 28.2% of high school students and 11.7% of middle school students now use cigarettes, cigars, smokeless tobacco, or other products, the agency reported. Approximately 4.5 million American teens currently smoke, according to 2003 federal surveys.

Antismoking Efforts Slowing

Officials warn that Thursday’s figures represent a significant slowdown in efforts to curb smoking by young people that previously helped produce deep cuts in minors’ tobacco use. Cigarette smoking peaked at 36% of high school students in 1997. It dropped to 22.5% by 2002, after the 1998 Master Settlement agreement between states and cigarette makers greatly curbed industry advertising and forced companies to pay for campaigns to end smoking by young people.

“No changes were observed in the use of tobacco or in access to tobacco products,” the CDC stated in its report. More than two-thirds of middle school youth surveyed said they were able to buy tobacco products without showing proof of age. Also, 87% of high school students reported seeing actors smoking on screen in 2004, the CDC said.

Officials blame several other factors, including lower state spending on tobacco prevention and a slowdown in price increases that previously made it more difficult for youth to buy cigarettes. Increasing excise taxes caused an 80% rise in the cost of the average cigarette pack between 1997 and 2002, but that increase slowed to just 4% by 2004, they said.

William V. Corr, executive director of the Campaign for Tobacco-Free Kids, who says that youth smoking rates have “clearly stalled,” blames the tobacco industry and “short-sighted state legislatures” for the slowdown.

Jennifer Golisch, a spokeswoman for Philip Morris USA, the nation’s largest tobacco company, says that her company actively works to curtail minors’ access to cigarettes and that the company greatly cut its newspaper and magazine advertising in recent years.

“In 2004, we didn’t advertise in magazines at all,” she says.

States, Industry Blamed for Slowdown

But Corr notes that Philip Morris and other companies have made up for advertising cuts by greatly increased spending on price promotions and subsidies that help retailers lower the cost of cigarettes at retail counters. Nearly $8 billion of the industry’s $12.5 billion in total tobacco promotions in 2002 went to such subsidies, he says.

“They have used their marketing and promotion allowances to encourage retailers to cut pricing, and that makes cigarettes more attractive to youth,” Corr says.

Golisch said that the overall rise in the retail price of cigarettes has increased the cost of offering price promotions, accounting for the billions in spending.

CDC officials also point to a steep drop in state spending on tobacco prevention and control efforts, brought about in large part by near-ubiquitous budget crises. Spending for the programs dropped from $750 billion in fiscal 2002 to $543 billion in fiscal 2004, a figure which now represents just 3% of all funds available to states for tobacco prevention from the Master Settlement and from cigarette taxes.

“You would never see state legislatures cutting back on child immunization, yet they cut back on smoking immunization that we know works,” Corr says.

Meanwhile, supporters of giving the Food and Drug Administration the authority to regulate tobacco products and all aspects of their advertising pegged Thursday’s report as evidence of the need for stricter cigarette regulations.

“The CDC report shows how critical it is to pass laws that will crack down on youth smoking,” Sen. Edward M. Kennedy (D-Mass.) said through a spokesperson. “We cannot in good conscience allow the Food and Drug Administration, the federal agency most responsible for protecting the public health, to remain powerless to deal with the enormous risks of tobacco — the most deadly of all consumer products,” he said.

SOURCES: Morbidity and Mortality Weekly Report, CDC, March 31, 2005.

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The Next Big-Screen Battle: Smoking (Foxnews, 040602)

It’s a classic movie scenario — two sexy stars rip each other’s clothes off, get busy and then later light up a couple of cigarettes in bed.

Such a charged cinematic scene could earn a film an R-rating — because of the smoking.

Films in which actors light up may soon receive the same branding as nipple flashes and cursing: Lawmakers are looking to extinguish, or at least regulate, smoking on the big screen.

Anti-smoking activists want films with smoking in them to be given an R-rating. Most lawmakers have said they’d be satisfied if movie ratings included advisory information about smoking in films like they do for foul language, sexual content and violence. Meanwhile, movie lobbyist Jack Valenti is defending Hollywood’s right to have characters light up without interference.

The issue has heated up in the wake of the recent flap over indecency in the media, and because several studies have shown that teens are influenced to start smoking by watching screen idols do the same.

“What we’re simply asking for is that smoking be treated by Hollywood as seriously as it treats offensive language,” said Stanton Glantz, a professor of medicine at the University of California, San Francisco, who co-authored one of the studies.

According to Glantz’s research, nearly 80% of movies rated PG-13 feature some form of tobacco use, while some 50% of G- and PG- rated films depict smoking.

But legislating big screen smoke scenes would be “very difficult to actualize,” said Michael D. Friedman, an entertainment attorney in New York. “There will be a lot of push-back from the film and artistic community.”

Valenti has staunchly fought smoking regulations, citing first amendment rights and artistic license.

“I don’t believe that whatever the director does ought to incite the intervention of the government in any form,” Valenti told the Senate Commerce Committee at a hearing last month.

Smoking is a major device that filmmakers use to help define characters, said Robert Thompson, professor of media and pop culture at Syracuse University, who pointed out that even Santa Claus lights up in films such as “Bad Santa.”

“Good art is filled with people behaving badly,” he said. “Smoking is still legal but unarguably so bad for you. That’s one of the things that gives it such a charge — when you have a character smoking in a film it tells you a lot about them. They’re flaunting the norms of what’s considered safe and conservative behavior.”

But Glantz wants to appeal to Hollywood’s bottom line rather than argue over artistic choices.

If smoking were added to the list of criteria that would make a film R-rated, Glantz hopes filmmakers would be discouraged from depicting unnecessary smoking, such as the nicotine-addicted worm aliens in “Men in Black.” Because R-ratings limit the number of teens who can attend a film, these flicks earn less money and are therefore not as desirable in Hollywood.

“When you get into rating the film, which can have significant economic impact on the film, you’ll find a lot of resistance,” said Friedman. “Producers, actors and directors are going to want to depict characters the way they choose.”

Another suggestion before the movie studios is to include a warning that there is smoking in a film, an idea that is “not all that controversial,” said Friedman.

However, Tinseltown is apt to try to avoid any regulation for fear that it will only open the floodgates to more demands.

“Where does this type of restriction and regulation end?” asked Friedman. “One interest group will say they don’t want to see smoking on the screen, another will say they don’t want to see something else ... I don’t believe you can start selecting on a piecemeal basis.”

Still, some officials have vowed not to let the smoking issue turn to ash.

“I guarantee you if something isn’t done by the industry, there’s certainly going to be efforts” by lawmakers, Sen. Ron Wyden, D-Ore., said at the hearing with Valenti.

Though the battle over smoking promises to be fierce, Thompson pointed out that the issue is ironic given the history of cinema.

“For many years Hollywood wasn’t allowed to show sex through voluntary standards. The prevalence of smoking in classic movies was a replacement, like scenes with Humphrey Bogart and his leading ladies where they light each other’s cigarettes, it’s very sexually charged,” he said.

“Now it turns out the stand-in activity is as dangerous, or more dangerous, than the activity it was standing in for.”

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Evil and Penniless Light Up at the Movies (Foxnews, 050901)

It was a tale of the devil and the pauper — and both were chain smokers.

A study out last month in the journal Chest found that movie characters who light up are more often antagonists rather than protagonists and poor rather than rich.

“The message is clear: Only someone who isn’t from the right side of the tracks would put their health at risk and smoke,” said Anderson Jones, film critic for AMC’s Movie Club.

Thirty-six percent of smoking characters in box-office hits from the 1990s were villains versus 21% who were heroes, and 48% were lower-class versus 23% who were middle-class and 11% who were upper-class.

“It’s a form of screenwriting shorthand. If you want to indicate a character is bad or shady, you give him a cigarette,” Jones said.

Those flicking ashes onscreen are also more likely to be white rather than nonwhite (38% vs. 26%) and male rather than female (26% vs. 21%), according to the study in Chest, a journal published by the American College of Chest Physicians.

Because evil and down-and-out characters are the ones most often puffing away in pictures, “Smoking in Contemporary American Cinema” concluded Hollywood isn’t portraying smoking cigarettes as “all that” — in spite of what previous research has suggested.

“There are many studies that say Hollywood is trying to glamorize smoking,” said lead researcher Karan Omidvari, a doctor of pulmonary medicine at St. Michael’s Medical Center in Newark, N.J.

“[Our] conclusion was that they were not trying to show it as an upper-class, glamorous thing. It may be cool to be bad, but we were trying to be objective, and these were our conclusions.”

While there are still plenty of so-bad-they’re-cool characters who smoke in today’s movies, it would be a tall order to make the habit look wildly appealing these days, in light of the massive public awareness campaign about the hazards of smoking and several high-profile cases of lung cancer.

The disease recently claimed the life of longtime smoker Peter Jennings and afflicted Christopher Reeve’s widow Dana Reeve.

“Steadily, smoking has gotten to be known to be such a killer,” said David Irving, associate professor of film and television at New York University. “It makes it difficult to put your lead character with a cigarette in his mouth.”

Among the characters and films looked at in the latest study: The wicked manipulator Sebastian Valmont (Ryan Phillippe), who lights up in the “Dangerous Liaisons”-based “Cruel Intentions” (1999); evil terrorist Castor Troy (played by both Nicolas Cage and John Travolta), who chain smokes in “Face/Off” (1997); nasty vampire Deacon Frost (Stephen Dorff), a nicotine fiend in “Blade” (1998); and antagonist Jim Phelps (Jon Voight), a smoking spy in “Mission: Impossible” (1996).

And none other than villain-of-all-villains Satan himself — played by Al Pacino — puffs away in “The Devil’s Advocate” (1997).

“Smoking is just a prop or wardrobe that helps identify a character as a bad guy,” Irving said. “They have to do whatever they can to make the audience feel that this is a despicable person who is fighting or challenging the hero.”

But unlike prior research on the topic — which Omidvari characterizes as subjective and slanted — the Chest study found that people don’t light up more in movies than they do in real life and the habit isn’t on the rise onscreen.

Twenty-three percent of movie characters smoked in the 447 Top 10 box-office hits from the 1990s that were studied. That’s compared to the 25% of the U.S. general population who are smokers. There is more smoking in R-rated films, particularly independent ones, than in those with G, PG and PG-13 ratings.

But overall, movies look mighty different today than they did in bygone eras — when every Tom, Dick and Harry (not to mention Harriets) were lighting up on the silver screen.

“The rates of smoking in Hollywood movies are on the decline,” Omidvari said. “If you look at the movies from the ‘40s, everybody smoked.”

Though it’s good news that movies seem to have snuffed out at least some cigarette smoking, parents are still concerned about the impact lighting up onscreen has on their kids — no matter what kinds of characters are shown doing it.

“I really don’t think that makes a difference,” said Chuck Saylors, the secretary-treasurer of the National Parent Teacher Association (PTA) and a father of four. “Whether they’re good or bad, poor or rich, black or white, if a student finds favor with a character and that guy smokes, it has an effect.”

Saylors, of Greenville, S.C., said his own son — now 21 — began smoking when he was 16 or 17, much to his parents’ surprise and chagrin. Saylors believes Hollywood played a role.

“When we confronted him about the dirty deed, he said [he smokes] because it’s cool,” Saylors said. “[Hollywood] did have some factor in it. It’s big in the movies. I would be hard-pressed not to believe that movies have an influence on these decisions.”

That may be so, and according to Omidvari, the study doesn’t deny that onscreen cigarette use can affect real-life behavior. Jones, the Movie Club critic, said Hollywood’s power of persuasion shouldn’t be underestimated — even though he characterized films as “dangerously misleading.”

“Movies are the most influential medium in the entire world,” said Jones. “They shape our dreams and our hopes, they define our heroes, they often show us how to live. They can be especially influential to the young.”

But Omidvari and others say his findings contradict accusations that Hollywood is engaged in a calculated plot to encourage teens and other people, especially those from certain demographic groups, to take up cigarettes.

“I don’t think the heads of Hollywood studios are sitting there conspiring to get people to smoke,” Omidvari said. “If there is a conspiracy, they’re a lot more subtle about it and a lot more smart about it.”

But the study doesn’t necessarily reveal a deliberate effort by the movie industry to show smoking as undesirable and dissuade people from adopting the habit, either.

“It has nothing to do with pushing an agenda,” Jones said. “Hollywood is going with the times. It’s not cool to smoke — that’s why the bad guys are smoking, the antiheroes. If smoking were cool in the real world, it would be out of control in the movies like it used to be.”

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Smoking Linked to Lower IQ, Diminished Thinking (Foxnews, 051012)

Years of smoking may cloud the brain as well as the air, according to a new study.

Researchers found long-term cigarette smoking was associated with diminished thinking skills as well as lower IQ among a group of alcoholic and nonalcoholic men.

Previous studies have shown that long-term alcoholism dims thinking skills and eventually lowers IQ, and researchers say 50%-80% of alcoholics are also smokers.

If the findings of this study are confirmed by others, researchers say they suggest that smoking may account for a portion of the mind-numbing effects normally associated with alcoholism.

“We can’t say that we’ve found a cause-and-effect relationship between smoking and decreased thinking ability,” says researcher Jennifer Glass, PhD, a research assistant professor of psychiatry at the University of Michigan, in a news release. “But we hope our findings of an association will lead to further examination of this important issue. Perhaps it will help give smokers one more reason to quit, and encourage quitting smoking among those who are also trying to control their drinking.”

Smoking May Dim Thinking Skills

The study was designed to look at alcoholism’s long-term effect on the brain and thinking skills in a group of 172 alcoholic and nonalcoholic men over a period of about 15 years.

The results, published in the Alcohol and Drug Dependence, concurred with previous findings that alcoholism caused thinking problems and lowered IQ, but they also showed that smoking had a similarly negative effect on the brain.

Researchers found the effect of smoking on memory, problem-solving, and IQ was most pronounced among those men who had smoked for many years. The negative effect of smoking on the brain remained significant in alcoholic men after alcohol and drug use were taken into account.

“The exact mechanism for smoking’s impact on the brain’s higher functions is still unclear, but may involve both neurochemical effects and damage to the blood vessels that supply the brain,” says researcher Robert Zucker, PhD, professor of psychology at the University of Michigan, in the release. “This is consistent with other findings that people with cardiovascular disease and lung disease tend to have reduced neurocognitive function.”

Researchers say the findings should prompt alcoholism researchers to re-examine their data for any impact from smoking because smoking is not usually taken into account in studies of alcoholism’s effects on the brain, despite the fact that many alcoholics smoke.

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Light Smoking May Have Heavy Health Risks: Researchers Say Even a Few Cigarettes a Day Can Up Heart Disease and Lung Cancer Risk (Foxnews, 050921)

Smoking just a few daily cigarettes raises the risk of dying of heart disease, lung cancer, and from any cause, according to a Norwegian study.

The study appears in Tobacco Control. The researchers included Kjell Bjartveit of the National Health Screening Service in Norway’s capital, Oslo.

Heart Deaths Tripled

Heart disease deaths were nearly three times as common among light smokers as among nonsmokers. The risk was a bit higher for women than men, the study shows.

The study included more than 42,000 adults in Oslo and three mainly rural Norwegian counties.

In the U.S., heart disease is a leading cause of death among men and women. Smoking is widely viewed as a risk factor for a host of health problems, including heart disease and several cancers.

Higher Cancer, Death Risk

Lung cancer deaths were also more common among the study’s light smokers. Light smokers puffed one to four cigarettes daily.

Men who were light smokers were nearly three times as likely to die of lung cancer, compared with nonsmokers.

The lung cancer risk was even bigger for women who were light smokers. They were five times as likely as nonsmokers to get lung cancer, the researchers report.

More light smokers than nonsmokers also died of any cause during the study, which stretched from the mid-1970s to 2002.

Changing Habits?

When the study started, participants were screened for heart disease and noted whether they smoked. Their health was followed for nearly 30 years.

Thirty years is a long time — long enough for some people to quit smoking and others to start.

Ten years after the study started, some nonsmokers reported that they had become smokers. A large proportion of “light” smokers had also changed their habits. Roughly equal numbers of light smokers had increased or cut down on daily cigarettes.

It’s hard to know exactly how those changes affected the results, write the researchers. However, they note “no strong reason” to believe that light smokers’ results were substantially biased.

The health risks of light smoking should be emphasized more strongly, write Bjartveit and colleagues.

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Secondhand Smoke Hurts Heart Like Smoking: Even Minutes and Hours of Exposure Count, Say Researchers (Foxnews, 050523)

May 23, 2005 — The heart just doesn’t like smoking, no matter who’s doing it.

That’s the take-home message of a review of research about secondhand smoke’s cardiac toll. The report — published in Circulation — documents a long list of heart hazards from secondhand smoke.

Wisp for wisp, secondhand smoke’s heart damage often rivals that of active smoking, and even a little exposure may have an impact, says the review by Joaquin Barnoya, MD, MPH, and colleagues.

Secondhand smoke’s heart effects are “rapid and large,” like those of air pollution, say Barnoya and colleagues. How large? On average, the heart effects of even brief secondhand smoke exposure are about 80% to 90% as large as that from chronic active smoking, they say.

An ‘Exquisitely Sensitive’ Heart

Smokers’ hearts bear the biggest burden. They are exposed to more toxins from smoking than people who only get secondhand smoke. But that doesn’t appear to make much difference to the heart, says the review.

Passive smoke has a much larger effect on the heart than would be expected from a comparison of the dose of toxins, they write.

Despite the fact that the dose of smoke delivered to active smokers is 100 times or more than that delivered to a passive smoker, the risk of heart disease for smokers is more than two-thirds higher compared with a third higher for passive smokers, says the review.

The cardiovascular system may be “exquisitely sensitive to the toxins in secondhand smoke,” write the researchers.

Growing Evidence of the Dangers of Secondhand Smoke

The researchers say that the effects of passive smoke are numerous and interact with each other, increasing the risk of heart disease. Here are some of the heart hazards that the review linked to secondhand smoke.

Evidence about secondhand smoke’s heart dangers has been growing since the mid-1980s, say the researchers.

“Secondhand smoke increases the risk of heart disease by [about] 30%, accounting for at least 35,000 deaths annually in the United States,” they write.

Brief Exposure Can Have an Impact

Secondhand smoke may register on the heart in a short time, the review shows.

“The effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking,” says the review.

For instance, one study exposed 12 men to six hours of secondhand smoke — about what someone might get from an evening in a smoky bar. For the next 24 hours, the men’s levels of HDL “good” cholesterol were significantly lower than before the experiment.

In another study, healthy men breathed secondhand smoke from 15 cigarettes for an hour in an unventilated room. During that hour, the men had a significant increase in aortic arterial stiffness — an early marker of blood vessel wall abnormalities that increases heart disease risk.

The stiffness started after just 15 minutes, then hit and maintained its peak at 30 minutes.

Antioxidant Defense?

Antioxidant supplements might help replenish antioxidant levels lowered by secondhand smoke, says the review.

However, that “probably will not prevent the [heart] damage associated with secondhand smoke because such supplements do not seem to reduce the risk of heart disease in general,” say the researchers.

Quitting smoking and limiting exposure to secondhand smoke may help your health. Smoking has been tied to many other health problems besides heart disease, including cancer, erectile dysfunction, sudden infant death syndrome (SIDS), asthma, infertility, and problems in pregnancies.

Mechanisms May Work Together

The mechanisms behind secondhand smoke’s heart damage may gang up, egging each other on to raise heart disease risk, write Barnoya and colleagues.

Barnoya worked on the review while on staff at the University of California, San Francisco. Now, he works at the Unidad de Cirugía Cardiovascular de Guatemala.

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Anywhere except inside and outside (townhall.com, 051116)

by Jacob Sullum

If you’ve gotten used to smoke-free bars, here’s a new concept to wrap your mind around: smoke-free cigar lounges. This innovation comes to us courtesy of Washington state’s voters, who recently approved an initiative that bans smoking in nearly every indoor location except for private residences.

The ban makes no exception for businesses whose raison d’etre is tobacco consumption, even if they have ventilation systems that whisk smoke away as soon as it’s produced. By forbidding smoking within 25 feet of entrances and windows, it even threatens to eliminate sidewalk smoking sections and quick outdoor cigarette breaks.

As these provisions suggest, the real motivation behind government-imposed smoking bans is not to shield customers and employees from secondhand smoke, although that rationale is popular with the general public. For the activists and government officials who push the bans, the main point is to discourage smoking by making it inconvenient and socially unacceptable, transforming it into a shameful vice practiced only in privacy and isolation.

That doesn’t mean everyone who voted for the Washington ban, which will be the most restrictive state law of its kind in the country when it takes effect on Dec. 8, is eager to save smokers from themselves. By and large, I’m sure, the ban’s supporters simply wanted to avoid tobacco smoke without having to make any sacrifices.

For example, they did not want to have to choose between tolerating smoke and passing over otherwise appealing bars and restaurants that allow smoking. Instead they decided to force the owners of those establishments to change their policies by threatening to fine them and take away the licenses on which their livelihoods depend.

Contrary to the propaganda put out by the initiative campaign (which raised about $1.4 million, more than 100 times as much as the opposition), support for the ban probably had little to do with the possible long-term health effects of secondhand smoke. It’s hard to believe there are many people who sit in smoky bars and worry that, if they stay there for 30 years, their tiny risk of

lung cancer might increase slightly.

People who object to secondhand smoke are much more likely to be worried about the immediate smell and discomfort. But they feel that if they pretend to believe the smoke is not only bothering them but might be killing them, their complaint becomes a legally enforceable right.

There is nothing noble about this impulse to impose one’s own tastes and preferences on everyone. “People ... stood up and said we believe this is the right thing to do,” an American Cancer Society spokesman told the Seattle Post-Intelligencer after the vote. “We’re proud to stand along [with] others who are trying to protect their community.”

How much courage does it take, in a state where nonsmokers outnumber smokers by four to one, to declare that the minority’s desires should count for nothing, even when business owners want to accommodate them? How admirable is it, in a state where 80% of restaurants already are smoke-free, to insist that the rest follow suit?

The employee protection excuse does not make this demand any more reasonable. As a nonsmoking Seattle bartender told The Seattle Times, “You know what you’re getting into when you work in a bar. If I had a problem with smoke, I’d get another job.”

Secondhand smoke is, in any case, not the main concern of those who promote smoking bans in the name of “public health.” Laws like Washington’s are “one of the most effective ways to provide the strong incentive often needed to get smokers to quit,” according to John Banzhaf, executive director of Action on Smoking and Health.

“We know tough indoor laws are a motivator to quit,” a spokesman for the Washington Department of Health told the Everett Herald. “We want to help people do that.” How could smokers be anything but grateful?

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Smoking is back on the big screen: as the lights go down, the stars light up (Times Online, 051207)

WARNING: movies can seriously make you want a cigarette. After years of decline, smoking scenes in Hollywood films, especially those rated for young, impressionable audiences, are back in style.

Those who thought that the Hollywood glamorisation of tobacco was over when James Bond gave up his 60-a-day habit should think again. According to researchers at the University of California at San Francisco, 80 per cent of films rated PG-13 contain smoking scene. Recent offenders include Anchorman, set in a 1970s television studio, and Ocean’s Twelve, a comedy about a group of glamorous thieves.

Jude Law, the British actor, was singled out over his nicotine addiction in films including Closer, Alfie and The Aviator. Uma Thurman played a seductive smoker in Pulp Fiction. Even Julia Roberts, a sweet-natured romantic lead, was criticised for lighting up, as was Brad Pitt.

Another remarkable fact uncovered by the researchers was that the number of yellow- fingered scenes in all American films is back to levels not seen since the 1950s. As with almost all things Hollywood, the number of people who smoke on the silver screen bears no relation to real life.

The number of American smokers has halved since the 1950s. In the movies, the amount of tobacco use has gone up from 10.7 “smoking events per hour” in 1950 to 10.9 in 2002. Everything from a character lighting up to a shot of a tobacco advert counts as a smoking event. According to the study, conducted by Stanton Glantz and Annemarie Charlesworth, and published in the December issue of Pediatrics, on-screen smoking causes 390,000 teenagers a year to try their first cigarette. That is half of all new teenage smokers.

“We now have multiple studies making the same point: adolescents who see a lot of smoking in the movies are more likely to start smoking themselves,” said Mr Glantz, who reviewed more than a decade’s worth of data for his report. Health researchers have long urged an R-rating for films that depict smoking.

A website and blog, which can be found at www.scenesmoking.org, keeps track of smoking scenes in all new films. Those with no smoking, such as Harry Potter and the Goblet of Fire (PG-13), are marked with a symbol of healthy pink lungs. Those such as Rent (PG-13) earn a pair of cancerous black lungs. The remark posted next to Rent says: “I’m not sure how some of the characters will do, health-wise, if they keep smoking.”

The website urges smoking scenes to be deleted even when they are factual. Walk the Line (PG-13), the biopic of Johnny Cash’s boozy, drug-addled life, merits the following comment: “This movie receives the automatic black lung for tobacco use around a child and pregnant woman.”

Mr Glantz and Ms Charlesworth are a little easier on films such as Good Night, and Good Luck, about the smoky 1950s television newsroom of Edward R. Murrow. “The cigarette was a defining part of the persona of Edward Murrow, who ended up dying of lung cancer.”

The Motion Picture Association of America disputes the findings, quoting industry statistics that show that only about half of PG-13 rated films over the past two years include smoking scenes. “Everybody agrees that smoking is a serious health problem and that our industry shouldn’t be encouraging or glamorising smoking,” a spokeswoman said.

Yet the research also found that, whereas real-life smokers are often poor, tobacco users in the movies are wealthy. Sometimes, in the case of the extraterrestrial comedies Men in Black and Men in Black II, they are not even human.

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Cigarette Smoking Down, Prescription Drug Use Up Among Teens (Foxnews, 051219)

WASHINGTON — Cigarette smoking is at its lowest level in a survey of teenagers and use of illicit drugs has been declining, but continuing high rates of abuse for prescription painkillers remain a worry, the government reported Monday.

The decline in drug use is “quite remarkable news,” Dr. Nora D. Volkow, director of the National Institute on Drug Abuse, said in issuing the agency’s annual survey of drug use by children in grades eight, 10 and 12.

But she added that “prescription drugs are very powerful medicines that are effective when used properly and with a doctor’s supervision. Using these drugs without a prescription is dangerous. It’s imperative that teens get this message.”

She also raised concerns about increased use of inhalants and Lloyd Johnston, director of the study, noted that declines in smoking seem to have stopped among eighth-graders, a finding that could raise concerns in the future, he said.

Karen Tandy of the Drug Enforcement Administration warned of the increased availability of drugs.

“The drug dealers that used to be in the back alley are now in the bedrooms of our children because they come to them through the Internet,” she said.

In the study, 9.5% of 12th-graders reported using the painkiller Vicodin and 5.5% reported using OxyContin in the past year. Long-term trends show a significant increase in the abuse of OxyContin from 2002 to 2005 among 12th-graders.

Also of concern is the significant increase in the use of sedatives and barbiturates among 12th-graders since 2001.

Overall, however, the report had good news, particularly about cigarette smoking.

It cited a 19% decline over the past four years in the use of any illegal drug in the month before the survey was done.

“Teens are getting the message. Drugs are harmful and will not only hurt their brains and bodies, but also damage their futures,” said John P. Walters, director of the White House’s Office of National Drug Control Policy.

In the survey, teens were asked about use of drugs, tobacco and alcohol in their lifetime, in the month before the survey and in the year before the survey.

Lifetime use of cigarettes declined 2% among eighth-graders, decreased 1.7% among 10th-graders and declined 2.8% among 12th-graders, according to the Monitoring the Future survey done by the University of Michigan. The study surveyed 49,347 students in 402 public and private schools.

Smoking is a concern because cigarette use is often seen prior to use of other drugs.

Other findings included:

—Use of alcohol during the year before the survey was down 2.7% among eighth-graders; down 1.5% among 10th-graders; and down 2.1% among 12th-graders.

—Use of methamphetamine during their lives fell 1.2% among 10th-graders and fell 1.7% among 12th-graders.

—Between 2001 and 2005, lifetime and last-year use of steroids declined for all grades.

—Lifetime use of marijuana fell from 2001 to 2005 for all grades and past-month use declined for 8th- and 10th-graders.

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Most Canadian homes now smoke-free, poll finds (National Post, 060116)

Most Canadian homes are now smoke free, according to a recent survey by the Canadian Cancer Society.

TORONTO — Walk along a downtown street in any Canadian city and you’ll likely see one or more smokers on the sidewalk or huddled in doorways indulging their habit. But it’s not just smoking bans in public places like offices and restaurants that have driven tobacco users outdoors.

A majority of Canadians, it seems, have declared their homes smoke-free zones, too. At least that’s the finding of a survey released Thursday by the Canadian Cancer Society, in which 78 per cent of respondents reported that no one had smoked inside their homes in the previous week. And that included 48 per cent of households with one or more smokers.

For homes with no smokers, 94 per cent were tobacco-free, the December 10-21 telephone survey of 2,044 Canadians adults concluded. (The Environics poll is considered accurate within plus or minus 2.2%age points, 19 times out of 20.)

The 2005 figures represent a huge shift in behaviour and attitude compared to those in a similar poll conducted by the society in 1992, when just over one in 10 Canadian households with smokers were taking their cigarettes, pipes and cigars outside.

“It’s huge. It’s wonderful,” Cheryl Moyer, the society’s director of cancer control programs, said of the jump in no-smoking homes.

Most Canadians also require smokers to butt out before getting in their vehicles, the survey shows. Seventy per cent of respondents in households with only one set of wheels say they never allow smoking in their vehicle - including 37 per cent among homes with one or more smokers and 90 per cent with no smokers.

A number of factors are driving the trend towards more smoke-free homes, from government legislation banning smoking in public buildings to increased education about tobacco’s health risks to a growing assertion by non-smokers for a clean environment, Moyer said.

“Certainly non-smokers are very aware of the seriousness of the health risk, so they would put a fair amount of pressure on people who would like to smoke in their homes, and say no.”

Many of those who continue to smoke are also more conscious of tobacco’s effects on others, she said. “I think people really want to look after their friends and loved ones and protect them.”

The survey found that about two-thirds (64 per cent) of respondents consider second-hand smoke to be a “very serious” health risk, while another 27 per cent consider it “somewhat serious.”

Despite the improving numbers, Moyer said there are still too many Canadians who don’t realize the long-term dangers of second-hand smoke, which contain about 4,000 chemicals - 50 of them known cancer-causing agents.

“People don’t realize the amount of poisons that come off the end of a cigarette,” said Moyer, adding that the non-filtered smoke emits twice as much tar and five times more carbon monoxide than that present in inhaled smoke.

Roberta Ferrence, a senior scientist at the Centre for Addiction and Mental Health in Toronto, said children are especially at risk because their lungs are smaller and their rate of respiration higher - meaning they inhale more passive smoke then adults, especially inside closed vehicles.

“If you don’t have the windows open and you have small children, it’s a little gas chamber,” Ferrence stated bluntly. And she cautioned that opening vehicle windows does little to mitigate the effects of second-hand smoke.

Exposure to passive smoking has been linked to a wide variety of health conditions, from sudden infant death syndrome and asthma in children to many cancers and heart disease in adults.

Tobacco use is the No. 1 cause of preventable disease, disability and death in Canada. It is responsible for more than 47,500 deaths a year, says the Canadian Cancer Society.

Cigarette smoking causes about 30 per cent of cancers in Canada and more than 85 per cent of lung cancers. In 2005, an estimated 22,000 Canadians were diagnosed with lung cancer and about 19,000 died of the disease, the leading cause of cancer death for both men and women.

Smoke from tobacco doesn’t just magically disappear into thin air, said Ferrence, who is also director of the Ontario Tobacco Research Unit at the University of Toronto. Indoors, tar and chemicals stick to walls, furniture and clothes - and can outgas dangerous molecules from weeks to months afterwards.

Those who smoke outside can carry the residue inside on their clothing, transferring it to children, other adults and pets, said Ferrence, who advises smokers to wash their hands and change outer clothing before picking up a baby, for instance.

Furthermore, puffing away in doorways can allow tobacco smoke inside when the door is opened, she said. “People don’t understand that.

“And if you’re huddling with other smokers, you might as well be smoking indoors with them, because if you’re within one or two feet (less than a metre), you’re getting almost identical exposure (as smoking) indoors.”

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Black smokers more at risk for lung cancer, study finds (Washington Times, 060126)

LOS ANGELES (AP) — Even when they smoke the same amount, blacks are more likely than whites and others to develop lung cancer, suggesting that genes may help explain the racial differences long seen in the disease, researchers say.

The largest study done on the subject found that whites who smoke up to a pack a day have half the risk of lung cancer compared with blacks and native Hawaiians who smoke the same amount. Hispanic and Asian smokers also were found to be less likely than blacks to develop the disease. However, the racial differences disappeared among heavy smokers.

Researchers from the University of Southern California and University of Hawaii analyzed lung cancer cases from an eight-year period. After adjusting for diet, education and other factors, the researchers found that whites who smoked up to a pack a day had a 43% to 55% lower risk of lung cancer than blacks who smoked the same amount. Hispanics and Japanese-Americans were 60% to 80% less likely than blacks to develop the disease.

Doctors have long known that blacks are substantially more likely than whites to develop lung cancer and more likely to die from it, but the reasons for the disparity are not clear.

Some say the difference is a matter of genetics, while others contend smoking habits may play a role. For example, researchers say blacks tend to puff more deeply than whites, which may expose them to more carcinogens.

In the latest study — published in today’s New England Journal of Medicine — researchers compared the lung cancer risk among ethnic groups who smoked the same amount.

Although the study did not address the potential reasons for the racial disparity, lead researcher Christopher Haiman, an assistant professor of preventive medicine at USC, said the findings suggest that genes may be one of the factors.

The study involved more than 180,000 people, more than half of them minorities. Patients filled out questionnaires about their smoking habits, diet and other personal information.

The study found no difference in lung cancer risk among the ethnic groups for those who smoked more than three packs a day.

Black, Hispanic and Japanese-American men who never smoked had higher risks of lung cancer than white men who never smoked, but hardly any difference was seen in women in those ethnic groups.

According to the American Lung Association, black men are 50% more likely to develop lung cancer and 36% more likely to die from the disease than white men.

Previous studies have suggested that black smokers tend to absorb more nicotine and tobacco carcinogens than whites, geneticist Neil Risch noted in an accompanying editorial.

The effect of race on the risk of disease is disputed, in part because race was used to discriminate in human experiments. Now it is increasingly being exploited in the emerging field of medicine that tailors drugs to a person’s genetics. Last year, the Food and Drug Administration approved a heart-failure drug specifically for blacks.

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U.S. Cigarette Sales Drop to Lowest Level Since 1951 (Foxnews, 060309)

WASHINGTON — The number of cigarettes sold in the United States in 2005 fell to the lowest level in 55 years largely due to enforcement of marketing restrictions imposed on the tobacco industry, the National Association of Attorneys General (NAAG) said on Wednesday.

According to federal tobacco tax figures, cigarettes sales slid 4.2% from 2004 levels in the largest one-year percentage decrease since 1999, the group said in a statement.

The attorneys general said 378 billion cigarettes were sold in the United States in 2005, the lowest number since 1951.

The drop continues an eight-year decline in cigarette smoking since the 1998 Master Settlement Agreement (MSA) between U.S. states and the tobacco industry that settled state lawsuits over the costs of treating smoking-related illnesses, the NAAG said.

Overall, cigarette sales have plunged more than 21% since the agreement, which raised cigarette prices and severely restricted industry marketing practices, the organization said.

“It is not a coincidence that cigarette sales are down and fewer people are smoking. The Master Settlement Agreement was designed to protect the public and reduce cigarette consumption — and it does just that,” said Vermont Attorney General Bill Sorrell.

The major companies that signed the MSA are Philip Morris, a unit of Altria Group Inc. (MO); R.J. Reynolds Tobacco Holdings Inc. (RAI); British American Tobacco Plc’s Brown & Williamson unit; and Lorillard, which trades as Carolina Group (CG) and is part of Loews Corp.

The U.S. Centers for Disease Control and Prevention considers cigarette smoking to be the leading preventable cause of death in the United States. About 440,000 people die each year from lung cancer and other diseases related to tobacco use.

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Tobacco On Track to Kill 1 Billion This Century (Foxnews, 060710)

If current trends hold, tobacco will kill a billion people this century, 10 times the toll it took in the 20th century, public health officials said Monday.

Tobacco accounts for one in five cancer deaths, or 1.4 million deaths worldwide each year, according to two new reference guides that chart global tobacco use and cancer. Lung cancer remains the major cancer among the 10.9 million new cases of cancer diagnosed each year, according to the Cancer Atlas.

Reducing tobacco use would have the greatest affect on global cancer rates, health officials said. Improving nutrition and reducing infection by cancer-causing viruses and bacteria could also cut rates dramatically, they said.

“We know with cancer, if we take action now, we can save 2 million lives a year by 2020 and 6.5 million by 2040,” said Dr. Judith Mackay, a World Health Organization senior policy adviser.

The new Cancer Atlas and updated Tobacco Atlas were released Monday at a International Union Against Cancer conference. The American Cancer Society published the two atlases with help from the Union, WHO and Centers for Disease Control and Prevention.

“Even if smoking rates decline worldwide, there will be a constant or even slightly increasing number of smokers due to population increases,” said Michael Eriksen, director of the Institute of Public Health at Georgia State University.

An estimated 1.25 billion men and women smoke cigarettes now, according to the Tobacco Atlas.

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U.S. Report: More Nicotine in Cigarettes (Christian Post, 060830)

BOSTON (AP) - The level of nicotine found in U.S. cigarettes has risen about 10% in the past six years, making it harder to quit and easier to get hooked, according to a new report released Tuesday by the Massachusetts Department of Health.

The study shows a steady climb in the amount of nicotine delivered to the lungs of smokers regardless of brand, with overall nicotine yields increasing by about 10%.

Massachusetts is one of three U.S. states to require tobacco companies to submit information about nicotine and the only state with data going back to 1998.

Public Health Commissioner Paul Cote Jr. called the findings “significant” and said the report was the first new release on nicotine yield in more than six years nationally.

The study found the three most popular cigarette brands with young smokers — Marlboro, Newport and Camel — delivered significantly more nicotine than they did years ago. Nicotine in Kool, a popular menthol brand, rose 20%. More than two-thirds of black smokers use menthol brands.

Calls to Philip Morris USA, the United States’ largest cigarette maker and manufacturer of Marlboro cigarettes, and R.J. Reynolds Tobacco Co., manufacturer of Kool and Camel cigarettes, were not immediately returned Tuesday.

The study tried to measure nicotine levels based on the way smokers actually use cigarettes, health officials said, in part by partially covering ventilation holes as they smoke and taking longer puffs. Traditional testing methods which do not take real-life smoking habits into account, typically report lower nicotine contents, officials said.

Of the 179 cigarette brands tested in 2004 for the report, 93% fell into the highest range for nicotine. In 1998, 84% of 116 brands tested fell into the highest range.

Smokers who choose “light” brands hoping to reduce their nicotine intake are out of luck, according to the report that found for all brands tested in 1998 and 2004, there was no significant difference in the total nicotine content between “full flavor,” “medium,” “light,” or “ultra-light” cigarettes.

The finding means that health care providers trying to help smokers quit may have to adjust the strength of nicotine replacement therapies like nicotine patches and gums, according to Department of Public Health Associate Commissioner Sally Fogerty.

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Cigarettes are Lethal Weapons (Christian Post, 070531)

John W. Whitehead

“Choking smoker, don’t you know the joker laughs at you?”

- John Lennon, “I am the Walrus”

One of the most emotionally trying times of my life came when my father had a heart attack. I’ll never forget standing by his bedside, looking at a man who had once been full of vigor and life but now had tubes and machines hooked to his body. Although he was only 45 years old at the time, he had smoked unfiltered cigarettes since he was a teenager. And, of course, the medical prognosis indicated that smoking nearly cost him his life.

The fact is that tobacco is deadly. Indeed, over 438,000 people die from smoking-related diseases every year. And incredibly, as recently reported by the Massachusetts Department of Public Health, all tobacco brands have increased the nicotine dosage in each cigarette steadily during the last six years. The overall increase has been about 10% during 1998-2004. The higher the nicotine dose, the more hooked a person gets, making it much more difficult to quit. Thus, the tobacco industry has taken steps to secure sales by making people more addicted.

Moreover, public health officials recently issued an annual report calculating that one billion people worldwide will die from smoking in the next century if current trends continue. Indeed, smoking causes numerous kinds of cancer and heart and bone diseases.

But it’s not just the smokers who are harmed. In fact, the Surgeon General has now issued a statement concerning the effects of secondhand smoke, declaring, “The science is clear: Secondhand smoke is not a mere annoyance but a serious health hazard. Even a few minutes of inhaling someone’s smoke in a well-ventilated area can cause significant harm.”

Thus, exposure to smoke is no longer questioned as a possible cause of illness in the medical world. And pregnant mothers who smoke put their unborn children at much higher risk for childhood cancers and genetic malformations. All these consequences are due to not only the addictive properties of nicotine but also to its high level of availability, few legal and social sanctions and expert marketing strategies. Thus, the evidence is clear: cigarettes should be regarded as lethal weapons.

Physicians consistently show that smoking cigarettes during pregnancy is not only dangerous for the mother but could also cause genetic damage to the fetus in utero. Studies have been conducted on amniotic fluid taken from women who smoked while pregnant and compared with the fluid of non-smoking women. Results show that there were 3.5 times more genetic abnormalities in the fetal cells of the smoking women. This provides evidence of tobacco-associated mutations and has important implications for the long-term health of children of mothers who smoke.

Maternal smoking affects between 10,000 and 100,000 babies per year. Many are lost in utero, with miscarriages being two to three times more common in smokers. Others, already weakened in the womb, do not survive the birth process due to low birth weight or pre-term delivery. Tens of thousands are admitted to intensive care units after birth for underdeveloped lungs or brain damage. Two-thirds of all cases of Sudden Infant Death Syndrome have also been attributed to maternal nicotine use.

The mothers are the problem: about 50% of pregnant smokers claim to have quit, but blood and urine tests revealed the actual percentage to be only 30%. Clearly, these women are aware of the dangers and stigmas associated with smoking during pregnancy but are either too afraid to seek help or have been unsuccessful in quitting. Plain and simple, these moms are addicted to a dangerous drug.

Tobacco marketing strategies are dastardly. Take, for example, the candy-flavored cigarettes targeted to children. With nearly 5,000 kids trying cigarettes for the first time each day and 2,000 in the 12-17 age group becoming daily smokers, deterrence instead of encouragement is needed. About 90% of smokers started before the age of 21. “It’s appalling that the tobacco industry is not held responsible for the deadly products it continues to market and sell to young people,” said John Kirkwood, president of the American Lung Association. “Clearly, the industry is trying to get young people hooked on smoking and nothing is being done to limit this targeted marketing.” No wonder young adults (ages 18-25) have the highest reported usage of cigarettes. Teens, however, are not the only group deceived by tobacco companies. In 2003, 29.8% of the U.S. population (70.8 million people) used tobacco.

But aren’t tobacco companies reducing the dangers of smoking by giving us less lethal weapons to inhale, such as so-called “light” cigarettes? Despite the hype, studies show that “light tar” cigarettes pose just as much of a health threat as the regular brand, an incredibly deceptive fact kept hidden from consumers. “Light” smokers (those smoking between one and four cigarettes per day) also face health risks similar to heavy smokers. These smokers were at a significantly increased risk of coronary heart disease and cancer when compared to non-smokers. Quite simply, there is no safe level of smoking.

As a consequence of a nation toking on cigarettes, health care costs are soaring, with nearly $92 billion in direct medical costs attributable to smoking. However, this figure excludes indirect costs such as secondhand smoke inhalation, burn care from smoking-related fires and care for low birth-weight infants. Indirect and direct costs combined total nearly $167 billion yearly.

Government restriction of nicotine products is controversial and riddled with problems. And if any effective restrictions are challenged, the nation’s highest court is liable to side with the tobacco industry. However, the inherent dangers of tobacco products cannot be ignored. Now that lack of information is no longer an issue, governmental agencies must take steps to limit both the hazards of and access to cigarettes. After all, the lives of our children are at stake.

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Smoking is a turn-on for some genes: study (National Post, 070930)

WASHINGTON (Reuters) - Smoking may turn on some genes in the body in a permanent and harmful way, scientists said on Thursday in a study that may help explain why the risk of cancer remains high even after smokers quit.

They found many genetic changes that stop when a smoker quits, but found several genes that stay turned on for years, including several not previously linked with tobacco use.

“These irreversible changes may account for the persistent lung cancer risk despite smoking cessation,” the researchers wrote in their report, published in BioMed Central journal BMC Genomics.

In any cell, only about one-fifth of the genes are switched on at any given time.

Raj Chari of the British Columbia Cancer Research Centre in Vancouver and colleagues took tissue samples from 20 smokers and former smokers and compared their gene activity to one another and to the genes of four people who had never smoked.

They found some DNA repair genes were turned off in smokers and stayed off in the former smokers. Damage to the DNA is one of the main causes of cancer.

One gene that was switched on in smokers and former smokers was CABYR, a gene involved in helping sperm to swim.

It may also help other types of cells move. For instance, cells in the airways may be helped to move their tail-like cilia to push mucus along. And it has been associated with brain tumors, the researchers said.

Another gene that was switched on in smokers but not in people who had never smoked was called ENTPD8. It appears to play a role in damaging DNA.

Other genetic changes seen in smokers appeared to reverse themselves a year or more later in the former smokers. Some were involved in helping cells in the airways repair and regenerate.

“Fifty percent of newly diagnosed lung cancer patients are former smokers. It is therefore important to understand the effects of tobacco smoking on the (airways) in both active and former smokers,” the researchers wrote.

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Last bastions of smoking fall in France (Paris, International Herald, 080102)

PARIS: Overnight, conviviality has taken on an entirely new meaning in France.

Under a sweeping decree that took effect Wednesday, smoking has been banned in every commercial corner of “entertainment and conviviality” - from the toniest Parisian nightclub to the humblest village café.

No matter that cigarette is a French word. Or that the great icons of French creativity - from Colette to Cocteau, Camus to Coco Chanel - all smoked. Or that Paris boasts a Museum of Smoking.

Or that Paris has named a street after Jean Nicot, the 16th-century French diplomat who took tobacco leaves imported from America to Catherine de Medici as a cure for her migraines. (Nicotine was named after him).

The ban is the final step under a 2006 law prohibiting smoking in public places, which had granted reprieves to restaurants, bars, discothèques, casinos and other commercial pleasure enterprises so that they could better brace themselves for smokelessness.

To celebrate, Health Minister Roselyne Bachelot on Wednesday visited the high-ceilinged, 100-year-old Wepler brasserie in Paris and announced that there was “perfect” compliance with the new rule.

“This is a new art de vivre,” she said, as she warned of consequences for “repeat offenders and rebels.”

Smokers who break the rules will face fines from €68, or $100, to €450. Owners can be fined from €135 to €750.

But Michèle Alliot-Marie, the minister of the interior, has ordered the police not to go looking for trouble, telling them that they do not have to meet quotas in issuing fines, and urging them to leave policing to “competent” agents like public health inspectors.

The French government eased the country gently into the ban. It was supposed to take effect Jan. 1, but to preserve the New Year’s Eve party spirit - and avoid the risk of violence - French smokers were given a day of grace.

The decree coincides with a broad Europe-wide nonsmoking movement that started four years ago when Ireland banned smoking in public places.

In 8 of Germany’s 16 states, including the city of Berlin, on Jan. 1, for example, smoking was banned in public buildings, including bars, restaurants and nightclubs. Three German states have already put the ban into effect, while the rest of the country will come comply by the end of 2008. In Portugal, a ban on smoking in most public places went into effect Jan. 1.

But something about smoking seems so French. And here, there are fierce pockets of resistance. Opponents claim the ban signals the erosion of French liberté.

They say it is undemocratic because it was not passed as a law through the Parliament but announced by government decree.

Some smaller bar and café owners call the ban unfair, since it favors large, wealthy establishments that can take advantage of loopholes. (Smoking is allowed in outdoor cafés and special indoor “hermetically sealed areas, furnished with air-extraction systems and subject to extremely rigorous health norms.”

In crafting the ban, little thought seemed to have been given to the country’s 800 water pipe teahouses, most of them extremely modest enterprises owned by ethnic Arabs.

“We have sacrificed everything to open these little places, borrowing money from our family members, using our cars and apartments as collateral, and what’s going to happen to us?” said Tariq El Hamri, the 33-year-old owner of Dar Daffia House of Hospitality, a water pipe bar in Paris. “If the government wants to have healthy people, it should stop selling cigarettes - and alcohol.”

El Hamri belongs to the Union of Hookah-Pipe Professionals, an organization that is lobbying for the same exception for water pipe smokers that is in effect in parts of the United States and Canada and plans to challenge the ban in French courts.

“We are second-class citizens,” said Badri Helou, president of the union, which was created last February and now has 270 members. “The reason you come to a water pipe club is to smoke a water pipe. The mint tea and the pastries come afterward. We cannot survive on them. It would be as if you go to the movies and there’s no film - just popcorn.”

The Confederation of Tobacco Dealers, which represents 28,000 tobacconists in France, has accused President Nicolas Sarkozy of duplicity.

During the presidential campaign last year, Sarkozy called for flexibility to protect small businesses.

“To ban smoking in places where tobacco is sold, is somehow strange,” he said at the time, adding that there also should be leniency for the small café-tabac in a village of 750 people where “if it closes, there is nothing else.”

The confederation’s monthly newsletter reprinted the opening two-page spread in a recent issue of Paris-Match magazine that shows Sarkozy, seated at his desk lighting up a very large cigar. “Is the Elysée Palace a private space where one can smoke or a place of work?” asked René Le Pape, president of the confederation. “The president is setting a bad example. This is a provocation.”

For Le Pape, the ban signals the demise of a part of French culture.

“It means the destruction of village life,” he said. “What will happen to the ritual of arriving at the café in the morning to read the morning paper over a coffee and a cigarette?”

At Le Muséee de Fumeur, or Museum of Smoking, there is concern that the absence of nicotine may make the French think less well.

“All our great writers seem to have been smokers,” said Michka Seeliger-Chatelein, one of the curators. “There has always been an obligatory connection between artistic inspiration and smoke.”

Still, there are efforts to keep a sense of humor. The café-restaurant Le Fumoir, or the Smoking Room, has made gifts of its signature ashtrays. The cover of the current Le Figaro Magazine retouched black and white photos of Che Guevara, Jacques Brel, Brigitte Bardot and other iconic smokers; they grip giant yellow buttercups instead of cigarettes between their lips.

Most establishments seemed resigned to complying with the ban. About 12 million of the French - approximately 20% of the population - are smokers, according to official figures, and more than 70,000 people die in France every year from smoking-related illnesses and second-hand smoke.

“We are not taking sides,” said Colin Peter Field, head bartender at the Hemingway Bar at the Ritz. The bar will continue to sell from 40 to 50 different types of vintage cigars, and is studying plans to renovate its outdoor spaces to accommodate smokers when spring comes.

==============================

Not following through on the global tobacco threat (Paris, International Herald, 080219)

Three years ago, an international treaty took effect that was designed to help developing countries resist aggressive marketing by big tobacco companies. The idea was that if a large number of countries committed themselves to the same tobacco control policies - including bans on all advertising and promotion - they would be better able to resist pressure from multinational tobacco companies and their own tobacco sellers.

Unfortunately, the governments of low- and middle-income countries have not followed through. With tobacco use declining in wealthier countries, tobacco companies are spending tens of billions of dollars a year on advertising, marketing and sponsorship, much of it to increase sales in these developing countries.

A new report issued by the World Health Organization offers the first comprehensive analysis of tobacco use and control efforts in 179 countries. It notes that tobacco will kill more people this year than tuberculosis, AIDS and malaria combined. It warns that unless governments do more to slow the epidemic, tobacco could kill a billion people by the end of the century, the vast majority in poor and middle-income countries.

There is no great mystery about what needs to be done. The WHO recommends several proven strategies: very high taxes on tobacco products; a total ban on all advertising and promotion; a ban on smoking in all public places and workplaces; large, scary warning pictures on packs; and strong programs to help people quit.

Yet few countries are doing any of these things with vigor. Not a single country fully implements all of the measures, and not one of the recommended steps covers more than about 5% of the global population. The tobacco companies’ vigor to sell is unflagging.

As part of a strategy to ramp up its sales in the developing world, Philip Morris International is being spun off from the Altria Group so that it can escape the threat of litigation and government regulation in the United States. The international company is also planning a slew of new products aimed at particular countries, including sweet-smelling cigarettes that have more tar and nicotine.

It is impossible to believe claims by many companies that they are not trying to addict new smokers but are only trying to convert adults who are using inferior local brands. The WHO survey contends that the industry is targeting teenagers and women in developing countries.

One problem is that many low- and middle-income countries have become addicted to revenues from tobacco taxes, which may lessen their zeal to curb tobacco sales. Such governments need to realize that unless they move now to curb the epidemic, tobacco will cause horrendous health and economic damage.

The Bush administration, which reluctantly signed the international treaty, has not submitted it to the Senate for ratification. That means that the U.S. officials will not have a seat at negotiations, begun last week, over a supplementary treaty to combat smuggling, counterfeiting and other illicit trade in tobacco products - a source of funds for criminal gangs and terrorist groups that could threaten this country’s security. The White House needs to stop dithering and present the treaty for ratification.

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Beijing tries to kick smoking habit before Olympics (Paris, International Herald, 080331)

BEIJING: Cui Dalin, China’s deputy sports minister, told legislators that the Beijing Olympics would inspire the Chinese to live healthier lives.

Then he stepped into a hallway where smoking was prohibited and lit a cigarette.

The incident illustrates the uphill battle China faces as it prepares to take what health advocates hope will be a big step against smoking in what is the world’s biggest tobacco market. A ban on smoking in most Beijing public places is expected to take effect in May, in hopes of meeting China’s pledge of a smoke-free Olympics.

China is home to 350 million smokers, a third of the global total. More than 150 Chinese cities already have limited restrictions, but Beijing would be the first to ban smoking in all restaurants, offices and schools, said Cui Xiaobo, a health expert who helped draft the regulations.

“There’s no way it will work!” said Jin Xianchun, a co-owner of Little Jin’s Seafood Restaurant, where diners were smoking as they chose live fish and shrimp from tanks. “Of course it will affect my business,” she said.

Cigarettes are woven into Chinese daily life. They’re an icebreaker, a way of greeting a friend and a means of bribery.

Almost two trillion cigarettes are sold every year, at prices as low as 1.50 yuan, or 20 cents, for a pack of 20. The government estimates that one million Chinese die smoking-related deaths annually; that is projected to double by 2020.

Beijing has had some smoking restrictions since 1995, when the municipal government prohibited lighting up in large public venues such as schools, sports arenas and movie theaters.

The new rules, which were announced in state media Saturday, expand the scope to include restaurants, bars, hotels, offices, vacation resorts and indoor areas of medical facilities, according to a draft released earlier this year.

“The whole world will be watching Beijing, because its success means a big step toward the success of the whole world, given the large smoking population of China,” said Cui, an associate professor at the Capital University of Medical Sciences in Beijing.

Organizers of the Aug. 8-24 Olympics have said they want smoking bans in all hotels serving athletes and all competition venues and restaurants in the Olympic Village by June.

After a branch of the Meizhou Dongpo restaurant chain went smoke-free, revenues dropped by 5 to 8%, but picked up as word got out to nonsmokers, said deputy manager Guo Xiaodong.

“Some customers didn’t understand why there was a ban in a restaurant, a public place,” Guo said “They think cigarettes and liquor can’t be separated.”

In 2005, China ratified World Health Organization rules that urged it, within three years, to restrict tobacco advertising and sponsorship, put tougher health warnings on cigarettes, raise tobacco prices and taxes, curb secondhand smoke, prohibit cigarette sales to minors and clamp down on smuggling.

“The problem is that there are commercial interests that make it hard,” said Sarah England, who heads the tobacco control department of the WHO’s Beijing office. She means the state-run tobacco industry, which made 388 billion yuan last year, up 25% from a year earlier.

Meng Qiliang, a vice governor in the tobacco-rich southern province of Guizhou, is willing to try kicking his pack-a-day habit.

“I’ve been smoking since I was 26,” said Meng, 50. “It’s hard to give up.”

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Scientists Find Genetic Link That Makes People More Likely to Get Addicted to Tobacco (Foxnews, 080402)

Scientists say they have pinpointed a genetic link that makes people more likely to get hooked on tobacco, causing them to smoke more cigarettes, making it harder to quit, and leading more often to deadly lung cancer.

The discovery by three separate teams of scientists makes the strongest case so far for the biological underpinnings of the addiction of smoking and sheds light on how genetics and cigarettes join forces to cause cancer, experts said. The findings also lay the groundwork for more tailored quit-smoking treatments.

“This is kind of a double whammy gene,” said Christopher Amos, a professor of epidemiology at the M.D. Anderson Cancer Center in Houston and author of one of the studies. “It also makes you more likely to be dependent on smoking and less likely to quit smoking.”

A smoker who inherits this genetic variation from both parents has an 80% greater chance of lung cancer than a smoker without the variants, the researchers reported. And that same smoker on average lights up two extra cigarettes a day and has a much harder time quitting than smokers who don’t have these genetic differences.

The three studies, funded by governments in the U.S. and Europe, is being published Thursday in the journals Nature and Nature Genetics.

The scientists surveyed genetic markers in more than 35,000 people in Europe, Canada and the United States, zeroing in on the same set of genetic differences. They aren’t quite sure if what they found is a set of variations in one gene or in three closely connected genes. But they said the result is the same: These genetic quirks increase the risk of addiction and lung cancer.

The studies’ authors disagreed on whether the set of variants directly increased the risk of lung cancer or did so indirectly by causing more smoking that led to the cancer.

The genetic variations, which encode nicotine receptors on cells, could eventually help explain some of the mysteries of chain smoking, nicotine addiction and lung cancer that can’t be chalked up to environmental factors, brain biology and statistics, experts said. These oddities include why there are 100-year-old smokers who don’t get cancer and people who light up an occasional cigarette and don’t get hooked.

In the last 40 years, the rate of adult Americans smoking has been cut from 42% in 1965 to less than 21% now.

The new studies point to surprising areas of the genes not associated with pleasure and addiction rewards. That may help explain why people have trouble quitting, said Dr. Nora Volkow, director of the National Institute of Drug Abuse in Bethesda, Md., which funded one of the studies. Eventual testing for the genetic variants could lead to custom treatments for quitting smoking.

“This is really telling us that the vulnerability to smoking and how much you smoke is clearly biologically based,” said psychiatry professor Dr. Laura Bierut, of Washington University in St. Louis, and a genetics and smoking expert who did not take part in the studies. She praised the research as “very intriguing.”

The studies mostly looked at smokers and ex-smokers — although two of the studies also looked at several hundred nonsmokers. The research only involved white people of European descent. People of Asian and African descent will be studied soon and may yield quite different results, scientists said. Smoking-related diseases worldwide kill about one in 10 adults, according to the World Health Organization.

The studies show on average the consequences of the set of variations in the alphabet of genetic code that people inherit from each parent:

— Smokers who get the set of variants from only one parent see a risk of lung cancer that is about one-third higher than people without any variants. They also smoke about one more cigarette a day on average than other smokers. This group makes up about 45% of the population studied.

— Smokers who inherit the variants from both parents have almost a one in four chance of developing lung cancer. Their risk is between 70 and 80% higher than the cancer risk of other smokers without the genetic variants. They smoke on average of two extra cigarettes a day, and have a 45% higher risk of peripheral artery disease. This group accounts for about one in nine people of European descent.

— Smokers who don’t have the variants are still more than 10 times more likely to get lung cancer than nonsmokers. Smokers without the variant overall have about a 14% risk of getting lung cancer. By comparison the risk of lung cancer for people who have never smoked is less than 1%, said another study author, Paul Brennan of the International Agency for Research on Cancer in Lyon, France.

Brennan and Amos, working on different teams, linked the genetic variation itself — when triggered by smoking — directly to lung cancer. Brennan said the nicotine receptors that the variants act on also can stimulate tumor growth.

Brennan’s study also found that lung cancer risk for nonsmokers with the variants was higher than for those without the variants. However, his small sample size of nonsmokers requires further study. Amos’ study didn’t find increased lung cancer risk for people with the set of variants who have never smoked.

But Kari Stefansson, lead author of the largest of the three studies and chief executive of deCode Genetics of Iceland, said the increased lung cancer risk was indirect, and that the variant caused more addiction and more smoking. It was the extra cigarettes from increased daily smoking and the inability to quit that contributed to the higher cancer risk, Stefansson said.

“It’s very likely that in the end there’s going to be a test and this is going to be folded into a panel of tests for the risk of cancers,” said Stefansson, whose company already does prostate cancer genetic tests. The tests will lead to better treatments, but probably not prevention of smoking, he said.

Stefansson and others emphasize that people without the variants should not take that genetic finding as a green light to smoke. There are other smoking-related diseases and they would still be at high risk of lung cancer.

For Stefansson, the research hits home. His father, a smoker, died of lung cancer. And Stefansson, who doesn’t smoke, frequently lectures his 23-year-old daughter “who smokes like a chimney.” She acts like she is immortal and smoking can’t kill her, Stefansson said. But his own research shows that her genes are probably stacked against her.

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Whirlpool Factory Suspends 39 Workers, Saying They Lied About Tobacco Use (Foxnews, 080423)

INDIANAPOLIS — Smoking can be hazardous to your health, and it’s turning into a bad career move, too.

A Whirlpool Corp. factory in Evansville, Ind., has suspended 39 workers who signed insurance paperwork claiming they don’t use tobacco and then were seen smoking or chewing tobacco on company property. Now, some could be fired for lying, company spokeswoman Debby Castrale said.

As annual health care premiums rise more than 10% a year, many companies are trying to rein in costs by encouraging healthy living.

“I can’t think of a client of ours who has not shifted their focus to controlling the cost of their health care plan,” said Indianapolis benefits lawyer Mike Paton.

Some employers have developed wellness programs to motivate employees, while others ask employees to state on benefits forms whether they use tobacco.

Whirlpool, based in Benton Harbor, Mich., uses financial incentives to encourage U.S. workers and their dependents to abstain from tobacco use, spokeswoman Jill Saletta said. The specifics vary according to location.

In Evansville, the 1,500-employee factory charges tobacco users an extra $500 in annual health insurance premiums. The refrigerator factory has levied the extra premium since 1996, and it depends on employees to honestly fill out forms. It doesn’t mandate blood tests to detect nicotine or trail employees outside work, Castrale said.

Management suspended the 39 employees Friday after they were spotted using either chewing tobacco on company property or taking a drag in one of the factory’s dozen shelters for outdoor smoking, Castrale said.

“It’s definitely not something we wanted to do,” she said. “It’s unpleasant.”

The employees were suspended without pay, and they’ll present their case at “fact-finding” meetings before management determines their fate. Whirlpool had to recall some laid-off workers to keep production running due to the suspensions.

A 2007 national survey showed that 16% of all large employers — those with 20,000 or more employees — adjust health care premium contributions according to the worker’s smoking status, according to the human resources consulting firm Mercer.

The federal Employee Retirement Income Security Act limits the changes an employer can make to a health premium because of a worker’s unhealthy habits. But it doesn’t set parameters on punishment if an employee lies about his or her habit, Paton said.

Lewis Maltby, president of the National Workrights Institute, which advocates for employee privacy, sees no problem with employers trying to curb smoking. But he worries that the trend of cracking down on employees’ unhealthy behavior is extending beyond tobacco use.

“We shouldn’t have to give employers complete control over our private life so they can save a few dollars on medical care,” he said.

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‘Shaming’ smokers makes it harder to quit: study (National Post, 100107)

Years of anti-smoking laws and campaigns have amounted to a public shaming of smokers that could make it harder for them to quit, a group of UBC researchers argue in a new report.

There is an “urgent” need for governments to revisit their anti-smoking policies, the academics say, suggesting that the stigma around smoking could lead to patients hiding their tobacco use from doctors, and feeling desperate about ever kicking the habit. The policies run counter to how other addictions are treated by the public-health field, they argue.

“People are made to feel really, really bad about their smoking and are treated quite badly, but feel quite helpless in quitting,” said Kirsten Bell, a medical anthropologist at the university and lead author of a paper just published on the issue.

“They feel really negatively about themselves, but quitting seems like an impossibility ... They’re not really given much support.”

Her views raise questions about decades of conventional wisdom on how to combat the threat of tobacco use, blamed for 45,000 preventable deaths in Canada yearly. Anti-smoking advocates reacted vigorously to the article in the journal Social Science and Medicine, saying policy-makers have strived not to victimize smokers themselves, while the falling rate of tobacco use is clear evidence the programs have succeeded.

The researchers’ “shoddy” work just parrots the tobacco industry’s attempt to portray anti-smoking efforts as an attack on individuals, said Garfield Mahood of the Non-Smokers Rights Association.

“What they’ve done with this paper is mischievous and careless and ill-informed,” he said. “These people ... have simply bought into the tobacco industry’s mischief.”

The paper and further research yet to be published by Ms. Bell and colleagues was supported by a grant from the ethics branch of the Canadian Institute for Health Research.

Their work looks at a range of anti-smoking measures they contend have “de-normalized” smoking and smokers themselves. Those include restrictions on where people can light up, bans on convenience-store “power walls” and other limits on tobacco sales, publicity campaigns to deter smoking, and graphic warnings on cigarette packages.

Such programs have generally been hailed as a public-health triumph, with smoking rates plummeting to about 20% in Canada from 50% in the 1960s, according to the most recent federal statistics.

Intentionally or not, though, such policies have also stigmatized the remaining smokers, with various potentially negative impacts, the paper argues. It cites anecdotal reports of surgeons and other doctors refusing to treat cancer patients who smoke heavily. As many as one in four doctors who responded to a 2005 Canadian Lung Association survey admitted to providing lesser care to smokers. A University of Washington survey published last year found just under one in 10 smokers hid their tobacco use from doctors, often because of stigma.

In a survey of 25 smokers and ex-smokers soon to be published by the UBC group, respondents talked of being refused access to city buses after they were spotted smoking at a bus stop, harassed by strangers in public and otherwise treated as pariahs. “You really are labelled as a bad person if you smoke,” said one person.

Ms. Bell, whose work focuses on tobacco and cancer, said her interest was piqued by what she sees as the contrast between how smokers are treated, and the non-judgmental, “harm-reduction” approach now widely applied by public health to people with other addictions. Illicit injection-drug users, for instance, often have access to needle exchanges and, in Vancouver, a safe-injection site, all designed to curb the spread of HIV and other infectious diseases, and to keep them in touch with public-health officials.

Tobacco policies also now disproportionately affect the poor, the paper argues, as smoking rates are almost twice as high among low-income Canadians as among the highest-income group.

Katherine Frohlich, a public-health expert at the University of Montreal, said studies by her research group found that poorer smokers feel the policies have discriminated against them by, for instance, restricting their social interaction and isolating them at home.

“We shouldn’t dismiss the fact these interventions have been incredibly successful,” she said. “[But] we have to take into consideration the fact that there are some pretty serious unintended consequences.”

Cynthia Callard of the group Physicians for a Smoke-free Canada rejected the notion, however, that smoking is now a predominately low-income phenomenon. The rates may be higher among the poor, but the sheer numbers are still much larger in middle- and upper-income groups, she said.

“Soccer moms smoke significantly more than single Moms,” said Ms. Callard.

Mr. Mahood said the tobacco-control movement has not tried to stigmatize individual smokers, but argued it is positive that society now views smoking as unhealthy, rather than sexy and glamourous, as was the case just a few decades ago.

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The E-Cigarette - A Cheaper Alternative To Cigarettes That You Can Smoke Almost Anywhere... (Advertisement, 100111)

No SmokingHere’s a riddle for you: what looks like a cigarette, smells like a cigarette, tastes like a cigarette, and feels like a cigarette? No, the answer is not: a cigarette. Instead, the answer is the key to what may be a revolution for smokers: the e-cigarette. Finally, smokers can say goodbye to yellow teeth, bad breath, and expensive cigarettes - while enjoying their e-cigarette almost anywhere.

It is not hard to hear about all the ways that smoking is injurious to personal health. The messages are delivered everywhere - from our doctors, schools, media and even on cigarette packages themselves. Still, nearly one out of five Americans still smokes.

Enter the e-cigarette, a battery powered device that is controlled by an advanced microprocessor that provides smokers with the same nicotine they get from regular cigarettes. Smokers may be a bit shocked when they first see an e-cigarette. It looks like a cigarette, and e-smokers puff on it like a cigarette, yet it emits mostly water vapor instead of dangerous secondhand smoke. At the same time, this vapor delivers the same nicotine that smokers get from cigarettes, along with a very similar experience.

E-cigarettes at a glance:

* No tar, tobacco, carbon monoxide, or ash

* Get the same amount of nicotine as a regular cigarette

* No odors or worries about harmful secondhand smoke

* Smoke indoors - no more running out in the rain, snow or cold weather!

* Considerably less expensive than traditional cigarettes

* Choose from a variety of flavors including tobacco and menthol

So what’s missing from these e-cigarettes that are in regular cigarettes? For starters, the dozens of carcinogens and hundreds of chemicals found in traditional cigarettes. There is also no tobacco, no tar, and no ash. This means not only is the smoker dodging these harmful substances, but so are all others exposed to harmful secondhand smoke from the “old kind” of cigarette. Since there is nothing to light, you don’t need to carry around matches or lighters, and because there is no flame there is no ash to deal with.

Another big difference is cost

One of the major benefits of e-cigarettes over conventional cigarettes is the cost savings you can have by switching. The chart below compares the cost of smoking regular cigarettes to e-cigarettes over a time period of one year, assuming you smoke a pack a day, and a pack costs $5:

As you can see above, switching to e-cigarettes can save you over $1400 per year, or $116 per month. Of course your savings will vary depending on how much you smoke and what state you live in - however, most US residents will see substantial savings by switching. E-cigarettes can save you money because the reusable cartridges, which are equivalent to about one pack of cigarettes, cost less than $2.

How does the e-cigarette work?

The e-cigarette has 3 main components. The first is a rechargeable battery, similar to they type you may find in a cell phone or laptop. The second piece is an atomizer which vaporizes the contents of the cartridge. The third part is the cartridge that holds the solution. A cartridge usually holds to an equivalent of between 1 - 1.5 packs of cigarettes, and can easily be changed.

When you inhale, the atomizer automatically turns on, and the nicotine you would absorb by smoking a normal cigarette is still absorbed - however without the other harmful substances contained in regular cigarettes. You exhale mostly water vapor, which looks very similar to smoke, but has almost no odor.

E-cigarette user experiences

Many users have reported that the device has helped them get the same nicotine as from cigarettes, without many of the negative aspects of traditional cigarette smoking.

A recent media story described the experience of one Illinois man, Scott Riddle, who had recently switched to e-cigarettes:

“Riddle, a public safety dispatcher who lives in Schaumburg, was a pack-a-day smoker for 12 years before he tried an e-cigarette this June. Riddle had tried a nicotine patch, and nicotine gum, which he called “disgusting,” but nothing simulated the habit of smoking like an e-cigarette. The day he started using e-cigarettes was the last day he smoked an “analog” cigarette, as old-fashioned smokes are called. “It replaces my need for a cigarette,” he said. Now he can use it around friends, in their homes, and in bars or restaurants, because there’s not that smoky smell. “

The article went on to say:

“People in public, including bar and restaurant workers, ask him what it is, and when he explains it, he says they have no problem with it and often want to try it or see if it could help someone they know...

Riddle says he feels much healthier. “My lung capacity has increased tremendously,” he said. “I’m able to taste foods better now, and can smell better now.” (Daily Herald, 10/12/2009) “

Another recent story in the media reported on a foreign study of 349 smokers, who were given e-cigarettes as a test group:

45% of folks in the study quit smoking (cigarettes) entirely within 8 weeks. Furthermore, 52% reported both increased levels of energy and visible improvement in their physical appearance. According to Dr Kishore Deva, “around 10 to 15 puffs are equivalent to the same amount of nicotine delivered by a tobacco cigarette.”

He added that the nicotine present in e-cigarettes is not responsible for the health risks that tobacco cigarettes hold. Every doctor participating in the study agreed that e-cigarettes are significantly more healthy alternative to conventional smoking. (Published by News 24, 8/27/09).

How you can try an e-cigarette

The e-cigarette produces a “very cigarette like” experience, which is why the device is growing rapidly in popularity. Even some famous celebrities have been photographed smoking e-cigarettes. The big attraction to this device is that you get the same nicotine you would get from regular cigarettes, without the 4000+ chemicals, high costs, yellow teeth, and bad smells.

Imagine smoking anywhere you want, not smelling like tobacco and saving money - all at the same time.

==============================

Tennessee Hospital Is Hiring; Smokers Need Not Apply (Foxnews, 100122)

Wanted: health care workers. Smokers need not apply.

Beginning next month, Memorial Hospital in Chattanooga, Tenn., will do its darnedest to snuff out nicotine. The hospital will not hire smokers, and it will test all job applicants for nicotine as part of its pre-employment drug screening.

Now chew on this: Any evidence of nicotine use — including cessation products like nicotine gum or a patch — will make job applicants ineligible, hospital spokesman Brian Lazenby told FoxNews.com.

Current employees at the hospital will not be affected, but applicants who test positive for tobacco use will not be offered jobs and may be disqualified from reapplying for six months.

The decision to reject job-seekers who smoke is intended to set an example in the community and is not based on potential health care savings, Memorial Hospital Vice President Brad Pope told the Chattanooga Times Free Press.

“I understand the concerns people have, but we are here for the health of our community,” Pope told the newspaper. “Like it or not, what’s proven is that tobacco is the most preventable cause of death and disability in the United States. I think Chattanooga and surrounding communities should expect this from Memorial.” Pope did not return several messages seeking comment from FoxNews.com.

But Dr. Michael Siegel, a professor at Boston University School of Public Health, said the policy is “too invasive” and creates a “slippery slope,” even though it’s legal.

“My position is I oppose these types of policies, although I am a very strong anti-smoking advocate,” Siegel said. “I believe this is going too far. It really is employment discrimination.”

He said he considered the policy discriminatory, since smoking during non-work hours has no direct relevance to a worker’s job performance.

“It really sets a dangerous precedent,” he said. “What about people who eat really poor diets?”

He said he also was concerned that other employers might take note and delve into the personal lives of their employees.

“Obviously, if it’s illegal activity, that’s relevant,” Siegel said. “But if it’s legal, I think it’s inappropriate and an invasion of privacy.”

Another cessation expert agreed.

“My personal take on that is it’s a little heavy,” said Barbara Forbes, director of the Institute for Smoking Prevention and Cessation at Tennessee’s Vanderbilt University Medical Center. “What we do in our personal lives shouldn’t mandate whether or not [candidates] are hired.”

Forbes said employees at Vanderbilt University Medical Center are prohibited from smoking within 50 feet of hospital grounds, but hospital policy regarding smoking does not extend beyond those limits. She said she was unaware of another hospital with a smoking policy as tough as Memorial’s.

Memorial Hospital is owned and operated by Catholic Health Initiatives, a national nonprofit organization based in Denver.

Jeff Hentschel, a spokesman for the Tennessee Department of Labor and Workforce Development, said the hospital’s policy is legal since it pertains only to new hires. State law prohibits termination of an employee for engaging in legal activities during non-work hours.

According to the U.S. Centers for Disease Control and Prevention, cigarette smoking accounts for roughly 443,000 deaths annually, or nearly one in five deaths — more than are caused by HIV, drug and alcohol use, suicides, murders and motor vehicle injuries combined.

Smoking also is responsible for an estimated $96 billion in direct medical costs and $97 billion in lost productivity annually, the CDC estimates.

Forbes said roughly 7% of doctors smoke, far lower than the national average of 20.3%.

“They know, and smokers know,” she said of the benefits of quitting. “It’s not that they don’t want to quit, it’s that they haven’t had the right methodology.

“Four out of five smokers will tell you they want to quit, but there are life circumstances sometimes that get in the way. It’s difficult to do even if you want to do it.”

==============================

French Ad Shocks, but Will It Stop Young Smokers? (Paris International Herald, 100223)

PARIS — A new French anti-smoking ad aimed at the young that plays off a pornographic stereotype has gotten more attention than even its creators intended, with critics suggesting that it offends common decency and creates a false analogy between oral sex and smoking.

France has banned smoking in cafes, bars and restaurants. But smoking is still increasing among the young in France, according to the French Office for the Prevention of Smoking, prompting an anti-tobacco organization called “Droits des non-fumeurs,” or “Non-smokers’s rights” to create the ad.

The slogan is bland enough: “To smoke is to be a slave to tobacco.” But it accompanies photos of an older man, his torso seen from the side, pushing down on the head of a teenaged girl with a cigarette in her mouth. Her eyes are at belt level, glancing upwards fearfully. The cigarette appears to emerge from the dress trousers of the adult.

Marco de la Fuente, vice president of BDDP & Fils, the advertising firm that created the campaign, said the ads were not designed either “to please or to shock people, but to change, to put back into the news a topic we don’t talk about enough, which threatens young people.”

According to the French Office for the Prevention of Smoking, between the years 2004 to 2007 and 2008 to 2009, the percentage of daily smokers among French 14-year-olds rose to 8% from 5%; among those aged 16, it went up to 18% from 14%. Fully a quarter of 18-year-olds are daily smokers.

“The younger you begin to smoke, the stronger the addiction,” Mr. de la Fuente said in an interview. “But young people think they’re invincible. They like to flirt with danger.” He added that young people see smoking as a symbol of emancipation, as a passage to adulthood and a “transgressive act.”

The campaign, he said, is to convince young people that smoking is instead “an act of naïveté and submission.” He continued: “We can’t be tepid on this subject, we have to hit hard. We are working against years of myth on the basis of films and stars, and we fight against this with zero euros.”

But the reaction on the Web site of Droits des non-fumeurs has been mixed. One comment read: “The campaign trivializes sexual abuse — worse, it implies guilt on the part of the abused.”

Florence Montreynaud is president of an organization — La Meute des chiennes de garde, or the “Pack of female watch dogs” — that opposes symbols of sexual violence in images, films and advertising. She called the ads “unbearable” and said that “what is most shocking is the banalization of sexual violence.”

She is a feminist, she said, and a long-time member of the Droits des non-fumeurs. “But it is terrible to represent in the public space this kind of image restricted to pornography,” Ms. Montreynaud added. “I’m appalled. It’s a poverty of imagination. When people have no ideas they use female bodies.”Nadine Morano, the Secretary of State for the Family, said she wanted the campaign to stop, saying she found the symbolism intolerable. “One can shock on the issue of tobacco, that doesn’t bother me, but there are other campaigns to do instead of this one,” she told Radio Monte Carlo.

The president of the Droits des non-fumeurs, Gérard Audureau, said that the campaign was launched after being viewed favorably by high-school students. For 18 years, he said, “we did it gently, on the health aspect, with deteriorated lungs, but young people feel invincible, immortal.”

He told the newspaper Le Parisien: “Young people are no longer afraid of the cigarette. Using sex is a way to get their attention. And if it’s necessary to shock, let’s shock.”

Bertrand Dautzenberg, president of the French Office for the Prevention of Smoking, doubted whether the ads would work. He told the newspaper Le Parisien: “This will shock adults while not scaring kids.”

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The War on Cigarettes (townhall.com,k 100420)

by William Wilson

Add another chapter to the long and voluminous history of government’s failed “Vice Wars.” Just like Prohibition and the so-called “War on Drugs,” the ongoing cigarette crackdown in both the United States and Canada has not only failed to achieve its objective, but it is creating bureaucracies that threaten liberty and prosperity as well as spawning a violent subculture that puts lives at risk on both sides of the border.

And the more this “sin” tax is raised, the more lucrative profits from contraband cigarettes become – adding fuel to an already-volatile conflagration.

Did we really expect government to do anything differently, though? After all, we’re dealing with a government culture that continues to operate under the fatally-flawed assumption that anything can be solved simply by borrowing and spending more tax dollars. In fact, in today’s world unsustainable borrowing and spending itself can be solved by – you guessed it – additional borrowing and spending, all in the name of “economic development.” Is it at all surprising, then, to discover that our politicians are resorting to the same failed “solutions” of the past in prosecuting their war on cigarette smoking?

Just keep raising taxes and pouring more money into government, right? What could possibly go wrong?

For starters, the same vicious cycle that brought us Al Capone and his band of murderous thugs in the 1920s – and which made Pablo Escobar one of the richest men in the world in the 1990s – will be back for another bite at the taxpayer-funded apple. Just last month in Virginia, for example, a contraband cigarette smuggler pleaded guilty in court of hiring a hit man to murder two people that he suspected of stealing his bootleg cigarettes. According to media reports, the man’s gang was hoping to make a cool $1 million by selling nearly 400,000 cartons of cigarettes in New York City – where taxes alone on a pack of smokes are $4.25. Amazingly, New York lawmakers are seeking to add another $1 to this already obscene amount, an increase which will only fuel additional bootlegging – and additional violence.

“New York has a long, bloody history of cigarette tax evasion,” writes Patrick Fleenor of the Tax Foundation. “Serious problems began in the early 1960s, when tax hikes caused organized crime to ruthlessly push aside competitors and dominate the racket. By 1967, a quarter of the cigarettes consumed statewide were bootleg, and the problem was much worse in New York City.”

Meanwhile in Canada – where exorbitant taxes have pushed the price of brand-name cigarettes over $10 per pack – the purchase of contraband cigarettes doubled from 2007 to 2008.

As a result, Canadian authorities are also facing an increase in organized crime as well as fewer people giving up the habit thanks to the availability of cheaper cigarettes. Suggestions to lower taxes have fallen on deaf ears, however, and beginning on July 1, cigarette taxes in British Columbia will actually increase - to $60 on a $96 carton.

Once again, government is doing the same thing and expecting a different result – which of course is Einstein’s famous definition of insanity.

“Government policies should suppress crime, not encourage it,” Fleenor says. “Bootlegging could be eliminated overnight by relying on broad-based, low-rate taxes—such as those on income, property and sales - rather than on high taxes on easily transportable goods.”

Faced with clear and compelling evidence which proves conclusively that decades of tax hikes have only compounded the problems associated with contraband cigarettes, governments in Canada and the United States are continuing to pursue the same failed solutions. Rather than cutting taxes and let the marketplace do its job, they’re betting our money – and our safety – on an approach that they know doesn’t work.

The only question isn’t ‘when’ these tax hikes will fail, it’s how spectacularly and expensively they will fail – and how many lives will be lost in the process.

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Ex-smokers less stressed out, study finds (National Post, 100617)

Smokers often say they need a cigarette to calm their nerves but a British study has found that chronic stress levels may go down after a person kicks the habit.

A study of 469 smokers who tried to quit after being hospitalized for heart disease found that those who stayed away from cigarettes for a year reported a reduction in their perceived stress levels.

Stress levels were essentially unchanged among heart patients who went back to smoking, according to researchers from Barts and The London School of Medicine and Dentistry.

The study, reported in the journal Addiction (http://www3.interscience.wiley.com/journal/123497661/abstract),

supported the theory that, at least for some people, smoking actually contributes to chronic stress.

“Smokers often see cigarettes as a tool to manage stress, and ex-smokers sometimes return to smoking in the belief that this will help them cope with a stressful life event,” researcher Peter Hajek told Reuters Health in an email.

Yet studies have shown that non-smokers tend to report lower stress levels than smokers do.

The reason for that difference has been unclear, but it could mean that people vulnerable to stress are more likely to take up smoking.

On the other hand, smoking itself may generate long-term stress, even if people feel it offers them temporary relief from trying situations.

Hajek’s study found that most of the 469 smokers — 85% — believed at the start of the study that smoking helped them deal with stress to some extent. Half said that the habit “very much” helped them cope.

But one year later, the study participants were surveyed again at which point 41% had not returned to smoking.

On average, Hajek and his colleagues found the abstainers showed a 20% reduction in their reported stress levels, while patients who had gone back to smoking showed little change in their perceived stress. The relationship between abstinence and reduced stress held up when the researchers accounted for factors such as patients’ age and education, how heavily they had smoked before quitting, and how high their stress scores were at the start of the study.

The researchers said the findings support the idea that dependency on cigarettes is itself a chronic source of stress.

“When dependent smokers cannot smoke, as the period without cigarettes lengthens they tend to feel more and more edgy, irritable and uncomfortable,” Hajek said. “A cigarette relieves this stressful state, and this is probably the main reason smokers think that smoking relieves stress.”

Someone who smokes 20 cigarettes per day, for example, essentially goes through 20 bouts of stress each day, as the levels of nicotine in the body decline. Once that person quits — and gets over the initial period of withdrawal — he will have 20 fewer periods of stress each day, Hajek said.

Hajek said these findings suggested that quitting may not only benefit smokers’ physical health, but possibly their mental well-being as well.

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