WHO urges stiff regulatory curbs on e-cigarettes

BY STEPHANIE NEBEHAY, Geneva
(Reuters) – The World Health Organization (WHO) stepped up its war on “Big Tobacco” on Tuesday, calling for stiff regulation of electronic cigarettes as well as bans on indoor use, advertising and sales to minors.

In a long-awaited report that will be debated by member states at a meeting in October in Moscow, the United Nations health agency also voiced concern at the concentration of the $3 billion market in the hands of transnational tobacco companies.

The WHO launched a public health campaign against tobacco a decade ago, clinching the WHO Framework Convention on Tobacco Control. Since entering into force in 2005, it has been ratified by 179 states but the United States has not joined it.

The treaty recommends price and tax measures to curb demand as well as bans on tobacco advertising and illicit trade in tobacco products. Prior to Tuesday’s report the WHO had indicated it would favor applying similar restrictions to all nicotine-containing products including smokeless ones.

In the report, the WHO said there are 466 brands of e-cigarettes and the industry represents “an evolving frontier filled with promise and threat for tobacco control”.

It urged a range of regulatory options, including banning e-cigarette makers from making health claims such as that they help people quit smoking, until they provide convincing supporting scientific evidence.

Smokers should use a combination of already-approved treatments for kicking the habit, it said.

While evidence indicates that they are likely to be less toxic than conventional cigarettes, the use of e-cigarettes poses a threat to adolescents and the fetuses of pregnant women using them, it said.

“NOT MERELY WATER VAPOR”

E-cigarettes also increase the exposure of bystanders and non-smokers to nicotine and other toxicants, it said regarding Electronic Nicotine Delivery Systems that it calls ENDS.

“In summary, existing evidence shows that ENDS aerosol is not merely ‘water vapor’ as is often claimed in the marketing for these products,” the WHO said in the 13-page report.

E-cigarettes should be regulated to “minimize content and emissions of toxicants”, and those solutions with fruit, candy-like and alcohol-drinks flavors should be banned until proven they are not attractive to children and adolescents, it said.

Adolescents are increasingly experimenting with e-cigarettes, with their use in this age group doubling between 2008 and 2012, it said.

Vending machines should be removed in almost all locations, it added.

Scientists are divided on the risks and potential benefits of e-cigarettes, which are widely considered to be a lot less harmful than conventional cigarettes.

One group of researchers warned the WHO in May not to classify them as tobacco products, arguing that doing so would jeopardize an opportunity to slash disease and deaths caused by smoking.

Opposing experts argued a month later that the WHO should hold firm to its plan for strict regulations.

Major tobacco companies including Imperial Tobacco (IMT.L), Altria Group (MO.N), Philip Morris International (PM.N) and British American Tobacco (BATS.L) are increasingly launching their own e-cigarette brands as sales of conventional products stall in Western markets.

A Wells Fargo analyst report in July projected that U.S. sales of e-cigarettes would outpace conventional ones by 2020.

Uptake of electronic cigarettes, which use battery-powered cartridges to produce a nicotine-laced inhalable vapor, has rocketed in the last two years and analysts estimate the industry had worldwide sales of some $3 billion in 2013.

But the devices are controversial. Because they are so new there is a lack of long-term scientific evidence to support their safety and some fear they could be “gateway” products to nicotine addiction and tobacco smoking.

The American Heart Association said in a report on Monday that it considered e-cigarettes that contain nicotine to be tobacco products and therefore supports their regulation under existing laws on the use and marketing of tobacco products.

“Although the levels of toxic constituents in e-cigarette aerosol are much lower than those in cigarette smoke, there is still some level of passive exposure,” the AHA said.

(Reporting by Stephanie Nebehay in Geneva; additional reporting by Ben Hirschler and Martinne Geller in London, Editing by Angus MacSwan)

http://www.reuters.com/article/2014/08/26/us-health-who-ecigarettes-idUSKBN0GQ0PF20140826

CDC: E-cigs may be tempting non-smoking youths to smoke

By Reuters Media

CHICAGO – Electronic cigarettes may be more tempting to non-smoking youths than conventional cigarettes, and once young people have tried e-cigarettes they are more inclined to give regular cigarettes a try, U.S. researchers said on Monday. A report, released by a team at the U.S. Centers for Disease Control and Prevention, lends evidence to the argument that electronic cigarettes encourage youth smoking.

The study, based on nationally representative youth surveys, found that more than a quarter-million adolescents and teens who had never smoked used an electronic cigarette in 2013, a threefold increase from 2011.

Youths who had tried e-cigarettes were nearly twice as likely to say they would try a conventional cigarette in the next year compared with those who had never tried an e-cigarette, according to the study in the journal Nicotine and Tobacco Research.

E-cigarettes are slim, reusable, metal-tube devices containing nicotine-laced liquids that come in exotic flavors. When users puff, the nicotine is heated and released as a vapor containing no tar, unlike conventional cigarette smoke.

Health experts have raised concerns that the burgeoning $2 billion e-cigarette industry, which has been virtually unregulated, would reverse gains in the decades-long effort to curb youth smoking in the United States. Just 15.7 percent of U.S. teenagers reported smoking in 2013, the lowest rate on record.

In April, the U.S. Food and Drug Administration proposed rules that would ban the sale of e-cigarettes to anyone under 18 but would not restrict flavored products, online sales or advertising, which public health advocates say attract children.

Earlier this month, attorneys general from 29 states urged the FDA to strengthen those rules to better protect young people from nicotine addiction.

“We are very concerned about nicotine use among our youth, regardless of whether it comes from conventional cigarettes, e-cigarettes or other tobacco products,” Dr. Tim McAfee, director of CDC’s Office on Smoking and Health, said in a statement.

“Not only is nicotine highly addictive, it can harm adolescent brain development.”

In the CDC study, researchers analyzed data from the 2011, 2012, and 2013 National Youth Tobacco Surveys of students in grades 6-12. They found that more than 263,000 who had never smoked a conventional cigarette used e-cigarettes in 2013, up from 79,000 in 2011.

Among non-smoking youth who had tried electronic cigarettes, 43.9 percent said they intended to smoke conventional cigarettes within the next year, compared with 21.5 percent of those who had never used e-cigarettes.

Lorillard Inc leads the U.S. e-cigarette market, while Reynolds American Inc and Altria Group Inc are rolling out their own brands nationwide this summer. A Wells Fargo analyst report in July projected that U.S. sales of e-cigarettes would outpace conventional ones by 2020.

http://www.inforum.com/content/cdc-e-cigs-may-be-tempting-non-smoking-youths-smoke

Schilling: Tobacco gave me cancer

Former Boston Red Sox pitcher Curt Schilling revealed Wednesday for the first time the type of cancer he was battling — squamous cell carcinoma, a type of mouth cancer — and detailed the painful treatment and recovery process that caused him to lose 75 pounds.

Telling his story for the WEEI/NESN Jimmy Fund Radio-Telethon on Wednesday morning, Schilling said he believes that a 30-year habit of chewing tobacco is what caused the cancer.

“I do believe, without a doubt, unquestionably that chewing was what gave me cancer,” he said. “I’m not going to sit up here from the pedestal and preach about chewing.”
The 47-year-old Schilling said he spent six months in the hospital with a feeding tube, undergoing chemotherapy and painful radiation treatment. During that time, he said, he developed a staph infection and there was a week of his life he doesn’t remember.
“I got chemo and radiation for [seven] weeks, and I came back to my room and my family was sitting there and I thought, ‘You know what, this could be so much worse. This could be one of my kids,'” Schilling said. “I’m the one guy in this family that can handle this. From that perspective, I’ve never said ‘Why me?’ and I never will.”
The most painful part of the treatment, he said, was the radiation, which he received five days per week for seven weeks. Schilling said doctors created a pliable mask to put on his face, an implement the former pitcher said was “the straitjacket for when they are giving you radiation.”
“The first day I went in, they clamped [the mask] down, they do the radiation into the tumors,” Schilling said. “The second day they did it. And about the third day I started developing almost a phobia and I literally had to be medicated for the seven weeks to go and do that. I couldn’t control myself under the mask.”
He added: “If this happened again, I’m not sure if I would go through the treatment again, it was that painful.”
Schilling said he’s lost so much weight because it is still painful to swallow — “I can’t put enough calories in my body” — and he is still shaky and weak at times.
He paused several times during the interview to take sips of water (he says he still does not have any saliva), and his voice sounded different than we’re used to hearing from Schilling. He is currently on leave from his job as an analyst on ESPN’s Sunday Night Baseball telecast.

“Recovery is a challenge,” Schilling said. “There are so many things that are damaged during the process. I don’t have any salivary glands, I can’t taste anything and I can’t smell anything right now. And there’s no guarantee they’ll come back.”

Schilling reiterated that the cancer was in remission, a statement he tweeted to the world for the first time in June, and that his follow-up care includes doctor visits every 1-2 months and scans every few months to determine if the cancer has returned.

He described how he first discovered the cancer over the winter.

“This all came about from a dog bite,” Schilling explained.

He said the dog bite damaged his finger enough to send him to the doctor. On his way to see the physician, he felt a lump on the left side of his neck and decided to get it checked out with a nearby ear, nose and throat specialist.

“He did a biopsy and two days later he diagnosed me with squamous cell carcinoma,” Schilling said.

It is the same type of cancer former Buffalo Bills quarterback Jim Kelly is suffering from.

“Commonly this is known as mouth cancer … cancer of the lining of the mouth,” said Schilling’s physician, Dr. Robert Haddad of the Dana Farber Cancer Institute. “The lump in the neck is why most patients go to the doctor first because they feel the lump in the neck, that’s the lymph node that’s enlarged.”

This was Schilling’s second public appearance since the cancer diagnosis. In May, he appeared at Fenway Park as the Red Sox celebrated the 2004 World Series-winning team.

“It was weird,” Schilling explained of the appearance. “I was in the hospital at the time. They wouldn’t let me come over [to Fenway] and go back [to the hospital]. So I had to determine if I was OK and ready to be discharged. I said ‘Yeah, yeah, OK.’ And two days later I was back in the hospital. That’s why [my son] Gehrig walked out with me, because I was afraid I was going to fall on the way in because I was so discombobulated.”

He was asked Wednesday why he has stayed out of the spotlight in recent months, choosing only now to talk about it for the first time.

“I didn’t want people feeling sorry for me,” he said. “I didn’t want the pity, I didn’t want any of that stuff.”

Schilling pitched in the majors for 20 seasons with the Baltimore Orioles, Houston Astros,Philadelphia Phillies, Arizona Diamondbacks and Red Sox. The six-time All-Star finished with a career record of 216-146 and a 3.46 ERA. His 3,116 strikeouts rank 15th all time. He won two World Series titles with the Red Sox and one with the Diamondbacks.

Red Sox manager John Farrell noted how the use of smokeless tobacco is not prohibited on the big-league level, protected by the players’ collective bargaining agreement with Major League Baseball.

“MLB has taken steps to dissuade players from using it through educational programs that are administered to every team,” Farrell said. “It’s even got to the point [in the minor leagues] now where players can be fined if smokeless tobacco is in view of the general public. There have been some of those warnings and penalties levied on some of our players.

“I think we all recognize that it’s addictive and causes cancer. That’s proven. [But] at this time, it’s upon the player to make the conscious decision for himself to use it or not. All we can do is continue educate guys what the ramifications are. … On the heels of the unfortunate passing of Tony Gwynn and what Curt is going through, you would think this would be a current beacon for guys to take note that there’s a price to be paid, if you’re one of the unfortunate ones stricken by cancer.”

http://espn.go.com/boston/mlb/story/_/id/11380584/curt-schilling-former-boston-red-sox-pitcher-says-chewing-tobacco-led-mouth-cancer

Why Can’t the Pentagon Stop Smoking?

By The Editors

Even the most oblivious member of Congress knows that smoking is bad for you. As it turns out, it’s even worse for you if you happen to be a soldier. So why would Congress insist that the Pentagon sell cigarettes — at a discount, no less?

The rationale has long been that members of the military have to smoke because their jobs are so stressful. There’s no denying the stress of military service, or that troops who smoke experience more of it than their comrades who don’t (though it may come more from their nicotine addiction than from their work).

Yet soldiers who smoke are not immune to lung cancer and the other lethal pulmonary illnesses that smoking causes. And like all smokers, they face an increased risk of cardiovascular disease. In fact, as an article in the current New England Journal of Medicine points out, smoking is especially harmful to soldiers because it lowers their fitness for service: It makes them more susceptible to injuries and infections, slows the time it takes for their wounds to heal, and leads them to take more frequent breaks than nonsmoking soldiers take.

The Pentagon, to its credit, has been trying for decades to restrict smoking. Most recently, Navy Secretary Ray Mabus said he’s considering banning tobacco sales on Navy ships and Navy and Marine Corps bases. Defense Secretary Chuck Hagel has asked for a Defense Department-wide review of tobacco policies.

Sadly and predictably, political forces are fighting back. In response to the Navy’s possible sales ban, Representative Duncan Hunter, Republican of California, has inserted language in the defense authorization bill that would require military commissaries to keep selling tobacco products. Congress responded the same way in the early 1990s after the captain of the USS Roosevelt said he planned to make that aircraft carrier smoke-free.

So it’s little wonder the military has continued to have a smoking problem. The Defense Department spends more than $1.6 billion a year on medical care and lost days of work due to smoking, and the Veterans Administration spends billions more treating ex-soldiers with lung disease.

About 1 in 4 members of all branches of the U.S. military smoke, compared with about 1 in 5 of the general population. But the percentages differ across the military: While about 30 percent of Marines smoke, members of the Air Force and Coast Guard smoke less than the national average, as do officers in all branches.

Millions of troops, in other words, have found more healthy ways to deal with the stress that inevitably accompanies military service. Nor are smoking bans especially difficult to impose or enforce: There is no smoking allowed during basic training, for example, and a 2010 ban on smoking on submarines — instituted after a warning period, to allow sailors time to quit — went off with no trouble.

The policy review Hagel has requested is expected to be finished within a couple of months, and it can be expected to take account of the Institute of Medicine’s 2009 recommendation to work toward a tobacco-free military. That need not result in an immediate ban on all smoking. But gradual limitations on where and when troops are allowed to smoke are necessary, as are greater efforts to help them quit.

In the meantime, the military is right to want to get out of the cigarette-sales business — and Congress should let it.

To contact the senior editor responsible for Bloomberg View’s editorials: David Shipley at davidshipley@bloomberg.net.

Letter: Tobacco taxes should be raised

By Jay Taylor from Durbin, N.D.

Hey! I have a great idea! Let’s raise a tax on something,” said no North Dakota legislator ever.

Wow! Raising a tax on anything, with North Dakota being so flush from oil money, just doesn’t make any sense at all.

And yet, taxes (or fees if you want a more politically correct term) do continue to inch up here and there.

During the 2013 legislative session, North Dakota lawmakers passed a bill that increased fees for many hunting and fishing licenses.

A tax is generally imposed to gain funds to pay for specific services or products: “It is a compulsory contribution to state revenue, levied by the government on workers’ income and business profits or added to the cost of some goods, services, and transactions.”

As said, to raise a tax in North Dakota today just doesn’t seem to make any sense, unless it’s a tax to protect the health of our residents, prevent disease and thwart kids from starting a path of extremely unhealthy behavior.

OK, I’ve beat around the bush long enough. I have read a lot about the idea of increasing the tobacco tax in North Dakota, and I am totally in favor of such an action. Here’s why:

The tobacco tax in North Dakota is one of the lowest in the nation (we are 46th at 44 cents per pack of 20 cigarettes), the lower-than-us states include: Missouri at 17 cents; Louisiana at 36 cents; Georgia at 37 cents and Alabama at 42 cents.

Our tobacco tax hasn’t increased since 1993.

The effects of North Dakotans’ tobacco use also affects the wallets of those who don’t use tobacco. North Dakota’s annual health care costs directly caused by smoking are $326 million. The portion covered by state Medicaid is $47 million.

But the most important reason is that a higher tobacco tax encourages people to quit and discourages younger folks from starting. According to the Tobacco Free Kids organization, “tobacco tax increases are one of the most effective ways to reduce smoking and other tobacco use, especially among kids. Every 10 percent increase in cigarette prices reduces youth smoking by about seven percent and total cigarette consumption by about four percent.”

For all the work being done by public health and health advocacy organizations, raising the tobacco tax is win-win.

I think it’s about time the North Dakota legislators started having a serious talk about this rather serious idea.

http://www.westfargopioneer.com/content/letter-tobacco-taxes-should-be-raised

Letter: Tobacco taxes should be raised

“Hey! I have a great idea! Let’s raise a tax on something,” said no North Dakota legislator ever.

Wow! Raising a tax on anything, with North Dakota being so flush from oil money, just doesn’t make any sense at all.

And yet, taxes (or fees if you want a more politically correct term) do continue to inch up here and there.

During the 2013 legislative session, North Dakota lawmakers passed a bill that increased fees for many hunting and fishing licenses.

A tax is generally imposed to gain funds to pay for specific services or products: “It is a compulsory contribution to state revenue, levied by the government on workers’ income and business profits or added to the cost of some goods, services, and transactions.”

As said, to raise a tax in North Dakota today just doesn’t seem to make any sense, unless it’s a tax to protect the health of our residents, prevent disease and thwart kids from starting a path of extremely unhealthy behavior.

OK, I’ve beat around the bush long enough. I have read a lot about the idea of increasing the tobacco tax in North Dakota, and I am totally in favor of such an action. Here’s why:

The tobacco tax in North Dakota is one of the lowest in the nation (we are 46th at 44 cents per pack of 20 cigarettes), the lower-than-us states include: Missouri at 17 cents; Louisiana at 36 cents; Georgia at 37 cents and Alabama at 42 cents.

Our tobacco tax hasn’t increased since 1993.

The effects of North Dakotans’ tobacco use also affects the wallets of those who don’t use tobacco. North Dakota’s annual health care costs directly caused by smoking are $326 million. The portion covered by state Medicaid is $47 million.

But the most important reason is that a higher tobacco tax encourages people to quit and discourages younger folks from starting. According to the Tobacco Free Kids organization, “tobacco tax increases are one of the most effective ways to reduce smoking and other tobacco use, especially among kids. Every 10 percent increase in cigarette prices reduces youth smoking by about seven percent and total cigarette consumption by about four percent.”

For all the work being done by public health and health advocacy organizations, raising the tobacco tax is win-win.

I think it’s about time the North Dakota legislators started having a serious talk about this rather serious idea.

http://www.westfargopioneer.com/content/letter-tobacco-taxes-should-be-raised

Ebola-fighting compound created using tobacco

Laura Ungar, USA TODAY

LOUISVILLE, Ky. — A Kentucky company used local tobacco to help produce an experimental serum to fight Ebola, which may help save two American aid workers stricken with the deadly disease.

David Howard, a spokesman for Reynolds American Services, said Owensboro-based Kentucky BioProcessing complied with a request from Emory University Hospital in Atlanta and Samaritan’s Purse this week “to provide a limited amount” of the compound, called ZMapp.

Kentucky BioProcessing, which was acquired by North Carolina-based Reynolds American Inc. in January, does contract work for many clients, including ZMapp maker Mapp Biopharmaceutical of San Diego.

Howard couldn’t confirm that the compound was used on the aid workers, and Emory officials didn’t respond by deadline to a call or email seeking confirmation. But The Associated Press, CNN and other media outlets reported that the aid workers have gotten the serum and have improved.

The fact that a Kentucky company focused on plant-based science played a part “is fantastic,” said Kenneth Palmer, a University of Louisville professor who is involved in tobacco-based research in Owensboro but not in this project. “The more that (medicines) made in plants are used, the better the acceptance. … It gives tangible evidence of how what we do can be applied to help people.”

Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, pointed out that ZMapp is not a proven treatment for Ebola but said it’s a good example of the intriguing science of growing medicines in tobacco plants.

“We’d love to see tobacco used for health,” said Frieden, who was in Hazard, Ky., on Tuesday for a series of talks on health problems in Appalachia. But he added, “We don’t have proven treatments or vaccines against Ebola. … This Ebola outbreak is the biggest, worst, most complicated one that the world has ever seen.”

Howard said tobacco helps in the production of ZMapp, acting like a “photocopier” to mass-produce proteins used to make the serum. Palmer said three, single-gene antibodies are put into trays of plants at Kentucky BioProcessing and replicate the antibodies after about 10 days.

Palmer likened it to antibodies being produced in the bodies of people or animals after an infection.

“What the plants are doing is pumping out the antibodies,” Palmer said. “The plants are used to make the antibodies, and then they purify the antibodies.”

“It’s faster than more traditional methods,” Howard added. “It allows for rapid growth of proteins … on a reasonably large scale.”

At the direction of Mapp, the Kentucky company developed a precursor to ZMapp, called MB-003, which was tested in non-human primates and showed good results, published last August in the journal Science Translational Medicine.

Researchers said the treatment previously had been shown to protect all the primates when it was given an hour after exposure to Ebola, and two-thirds of them when given 48 hours after exposure.

ZMapp was never tested in humans, but even before the latest Ebola outbreak, the companies had planned later this year to begin the federal process to get the drug approved, Howard said.

Meanwhile, tobacco plants also will be used to develop a gel to prevent the transmission of HIV, the virus that causes AIDS. University of Louisville researchers announced this week they will lead the international effort, which is being funded by a five-year, $14.7 million grant from the National Institutes of Health.

The gel — designed to be used during sexual intercourse by people at risk for HIV — is developed using a synthetic copy of a protein found in red algae shown to act against HIV in the lab.

Research is also underway at Louisville using tobacco plants to produce a cheaper version of the vaccine against human papillomavirus, which causes most cervical cancer.

University of Louisville President James Ramsey said all of the tobacco-based research is exciting, particularly in a state where smoking kills at the highest rate in the nation.

“It is ironic,” Ramsey said in an interview Tuesday. “We’ve been a tobacco state, and it’s been such a part of our economy, and it’s pretty amazing that they can take tobacco and potentially solve some of the biggest health problems around the world.”

Laura Ungar also reports for The (Louisville, Ky.) Courier-Journal

http://www.usatoday.com/story/news/nation/2014/08/05/ebola-fighting-compound-created-using-tobacco/13642819/

The Post's View: Raising all federal tobacco taxes can stop tax avoidance

By Editorial Board, Washington Post

ENACT A LAW, and companies will find loopholes to exploit. That was the fear which drove lawmakers in 2009 to raise cigarette taxes together with taxes for roll-your-own tobacco and small cigars, both easy substitutes for cigarettes. To prevent manufacturers from shifting toward lesser-taxed alternatives, Congress equalized taxes between all three products — hiking the existing roll-your-own tobacco tax by over 24 times and small cigars by over 27 times.

These products have plunged in sales since 2009. But tobacco manufacturers, unfazed in their quest to fatten their purses, found a new loophole. Unlike these three highly taxed tobacco products, post-2009 taxes on pipe tobacco and large cigars are relatively low. All it took to shift consumers to those products was relabeling roll-your-own tobacco as pipe tobacco, and slightly adding weight to qualify small cigars as large cigars. As evidence from a recent Senate finance committee hearing shows, the popularity of pipe tobacco and large cigars have exploded.

That market shift has cost the federal government up to $3.7 billion in forgone revenue. Even worse, it’s hampered the effect of high tobacco prices on preventing teen smoking.

The first instinct might be to blame the Alcohol and Tobacco Tax and Trade Bureau, which has yet to sharpen definitions of many of these products. While action by the bureau could help close the loopholes, it faces a daunting task. For example, where should it draw the line between roll-your-own and pipe tobacco? In many cases, “it is difficult to establish objective physical standards for differentiating between the two products,” the bureau’s chief said in his testimony. Sometimes the difference is virtually nothing at all.

So forget rewriting definitions. The foolproof solution is for Congress to pass a law equalizing all tobacco taxes. That would raise taxes for pipe tobacco and large cigars to the same level as cigarette taxes, preventing any market shift. A bill introduced by Sen. Richard Durbin (D-Ill.) in 2013, still stuck in committee, would accomplish this task.

Better yet, Congress should hike all tobacco taxes — not just the lower ones — up to higher and equal levels. State taxes vary widely, from $4.35 per cigarette pack in New York to $0.17 per pack in Missouri, making smuggling a big problem for law enforcement. The current cigarette and small cigar federal tax is a meager $1.01 per pack of 20; a higher federal tax would diminish the effect of inconsistency between states and allow for a more uniform response.

These are two common-sense solutions to close tobacco tax loopholes. But the problem of tobacco manufacturers exploiting definitions has another dimension. The Food and Drug Administration, the other arm of the U.S. public health response, has proposed a long-awaited rule to expand its regulatory authority over “all” tobacco products. But premium cigars may be exempted from these regulations, potentially allowing manufacturers to “sweep other cigar products under its umbrella,” as the FDA has admitted before. This proposed exemption, as demonstrated by the tax avoidance case, is a disaster waiting to happen.

http://www.washingtonpost.com/opinions/raising-all-federal-tobacco-taxes-can-stop-tax-avoidance/2014/08/02/4b542a76-180d-11e4-9349-84d4a85be981_story.html

Smoking Kills (Your Organs): 6 Major Organs Damaged By Cigarette Smoke

By , Medical Daily

Coughing up heaping globs of mucous isn’t even the half of it. Neither is losing all sense of stamina, or coming home to a stale-smelling house with yellowed walls and furniture. No, the biggest consequences of smoking are, by and large, ones you will never see. These, however, tend to be the deadliest.

As you inhale cigarette smoke, the 7,000 or so carcinogens begin to swirl through the caverns of your body, beginning in your esophagus and winding up in distant locations you wouldn’t give second thought to. The truth is, for all its declining popularity, smoking still emerges as the single greatest preventable cause of death in the United States. Each year, some 480,000 people die from smoking-related causes. Here are six organs that feel the effects in the meantime.

1. Your Lungs

Best to get this one out of the way early. Lung cancer, emphysema, and bronchitis are three of the most common diseases directly associated with smoking. Eighty percent of lung cancer cases are due to smoking.

Columns of harmful smoke pour into the organs, paralyzing the delicate cilia lining the inner walls and irritating them to the point where they overproduce mucous. When these cilia die, and mucous builds, respiration suffers. Once the soft healthy tissue turns hard and black, asthma and cancer tend to follow. While many of the body’s processes stabilize after someone quits smoking, damaged lung tissue can never heal.

2. Your Skin

It’s easy to forget the largest organ in your body is even an organ at all. Smoking damages the skin in more ways than one. On the one hand, you’ll notice some profound cosmetic changes, such as bags under the eyes, a toughening of the skin, wrinkles, and stretch marks — all stemming from the skin’s dying elasticity. But you should also expect major health risks to rise. Among the heavy-hitters:skin cancer, warts, psoriasis, and poorer wound healing.

We don’t think of skin as playing much more than a cosmetic role, but the largest organ in the body is the first line of defense for keeping out invading forces, like bacteria and viruses. Psoriasis, for instance, was found in 2007 to double in risk for people who smoked a pack a day for 20 years. To put it bluntly, when there’s a tear in the sheath of shrink-wrapped flesh draped over the other organs, getting sick becomes a lot easier.

3. Your Uterus

Among smoking’s long cons is its effect on reproductive health. Cigarettes significantly raise a woman’s risk for ectopic pregnancy — the maturation of an embryo outside the walls of the uterus, typically in the fallopian tubes. One 2010study suggested this was due to an overproduction of the protein PROKR1, making it harder for the fallopian tubes to contract and send the egg all the way to the womb.

In addition to ectopic pregnancies, research has found cigarette smoking to lead to more failures involving in vitro fertilization, adverse reproductive outcomes, and a lower fecundity rates overall. Women have also been having kids later in life, upping their risk even further, as it means they’ll have been smoking longer before pregnancy.

4. Your Penis

The ability to achieve and maintain an erection could suffer drastically if a man smokes. That finding has been repeated over and over throughout the decades, most compellingly in a 2011 study that found men who kicked the habit had quicker, firmer, and most durable erections than men who smoked — achieving that erection up to five times faster than smokers who relapsed.

Important to keep in mind: Nicotine, not smoking, determined men’s physical arousal. They didn’t see full return to health until after they quit nicotine patches or gum. Also, study co-author Christopher Harte, of the VA Boston Healthcare System, pointed out, a man’s success depends on his relationship with his sexual partner.

5. Your Eyes

As previously stated, expect some under-eye droopage after having smoked for a while. More than that, cigarette smoking has been found to lead to a raft of conditions related to vision loss, such as age-related macular degeneration, cataracts, glaucoma, diabetic retinopathy, and dry eye syndrome.

Smoking attacks the eye from two fronts. The first is the smoke itself, which collects in front of your face as you smoke and again after you exhale. The constant exposure to the smoke can dry your eyes out and irritate them. Combine this with smoking’s effects on blood flow, which stops the optic nerve from getting enough antioxidants. As a result, scientists believe, the chemicals in cigarette smoke pollute the blood and starve the ocular organs.

6. Your Liver

The liver isn’t confined to damage from alcohol consumption. Smoking ups people’s risk for liver cancer dramatically, according to a 2011 study that found nearly half of all liver cancer cases were the result of smoking. By contrast, 21 percent were associated with hepatitis C, 16 percent from obesity, 13 percent from hepatitis B, and, all the way at the bottom, 10 percent for alcohol consumption.

The majority of liver cancer deaths are the result of hepatocellular carcinoma, a leading cause of cancer deaths worldwide, among sub-Saharan African and Southeast Asian countries. Cirrhosis — when liver cells turn to scar tissue — is one of the greatest non-cancerous forms of liver damage; in the U.S. cirrhosis is often alcohol-related, which is why the conventional wisdom keeps the two so closely linked.

http://www.medicaldaily.com/smoking-kills-your-organs-6-major-organs-damaged-cigarette-smoke-295436

Tobacco tax law reportedly cost U.S. billions in revenue

By Reuters Media
WASHINGTON – A 2009 law that raised federal taxes to discourage smoking cost the U.S. government billions of dollars in lost revenue as manufacturers relabeled products and consumers shifted to cheaper pipe tobacco and large cigars, the U.S. Government Accountability Office said in a report released on Tuesday.

The GAO estimated $2.6 billion to $3.7 billion in lost revenue from April 2009 to February 2014 as manufacturers exploited loopholes in the Children’s Health Insurance Program Reauthorization Act which raised taxes for smoking-tobacco products.

“Each of the three tobacco manufacturers that agreed to speak with us explained that their companies switched from selling higher-taxed roll-your-own tobacco to lower-taxed pipe tobacco to stay competitive,” the congressional watchdog agency said in the report, which was the focus of a Senate hearing on Tuesday.

At the hearing, Liggett Vector Brands LLC Chief Executive Ronald Bernstein urged lawmakers to take action against abuses by manufacturers.

He held up two seemingly identical, but differently labeled non-Liggett bags of tobacco. Showing a third sample, he pointed out that a label saying “all-natural pipe tobacco” covered up a statement that the bag “makes approximately 500 cigarettes.”

“Everyone knows this is cigarette tobacco,” Bernstein said. “The manufacturer knows. The consumer knows. And I know. I know because I tried smoking it in a pipe and it was not a pleasant experience.”

Some manufacturers also add a few ounces of tobacco to small cigars so they qualify as the larger product. Others even mix in clay or kitty litter to increase the weight, Michael Tynan, policy officer at the Oregon Public Health Division, told the hearing.

The GAO said the tobacco market shifted accordingly. Yearly sales of pipe tobacco rose more than eight-fold from fiscal 2008 to 2013, while sales of roll-your-own tobacco declined almost six-fold.

Over the same period, large cigar sales doubled, while small cigar sales dropped to just 700 million from 5.7 billion.

Senate Finance Committee Chairman Ron Wyden, who convened the hearing, criticized the Treasury Department’s Alcohol and Tobacco Tax and Trade Bureau (TTB), which is responsible for collecting tobacco taxes and cracking down on evasion, for “footdragging.”

In recent years, the agency has pushed to apply “advanced investigative techniques to uncover illicit trade and fraudulent activity,” including deploying about 125 auditors and investigators, the TTB wrote in its Senatetestimony.

Responding to a push to better differentiate between roll-your-own and pipe tobacco, the agency published an “advanced notice of proposed rule making” in 2010 and 2011. But no rule had yet been issued, the GAO wrote.

In 2015, the TTB will issue a proposed regulation cracking down on the illegal activities, TTB Administrator John Manfreda said on Tuesday.

But Wyden, an Oregon Democrat, said it was not enough. He said the problem reminded him of “the old marquee at the movie house that says: ‘Coming soon,’ and it never gets there.”

http://www.inforum.com/content/tobacco-tax-law-reportedly-cost-us-billions-revenue