Affordable Care Act: Smoking sends health premiums higher

BY FRANCINE KNOWLES Staff Reporter

If you light up, prepare to get burned with higher premiums when buying insurance in the new health insurance marketplaces.
Under rules of the Affordable Care Act, in Illinois and most other states, insurers can charge smokers and other tobacco users as much as 50 percent more on their premiums due to the higher health risks they face compared to non-tobacco users.
In some cases, the surcharge wipes out the subsidy for which some smoking health plan enrollees would qualify in the marketplaces, said Karen Pollitz. She is senior fellow at Kaiser Family Foundation, a nonprofit focused on health-care issues.
“So you’d be back up to the sticker price,” Pollitz said. “The tobacco add-on is not covered by the tax-credit subsidies.”
Some insurers have imposed surcharges below 50 percent. Meanwhile Washington D.C. and states, including California, Massachusetts, Rhode Island, and Vermont have prohibited insurers from applying a tobacco surcharge. Other states lowered the maximum surcharge allowed.
There were 1.8 million smokers in Illinois in 2012, or 18.6 percent of adults 18 and older, and nearly 240,000 residents used smokeless tobacco, according to the Illinois Department of Public Health.
Blue Cross and Blue Shield of Illinois, among six insurers in the Illinois Health Insurance Marketplace, imposes a surcharge on tobacco users ranging from 10 percent at age 27 to 32 percent at age 54, according to BCBS spokeswoman Mary Ann Schultz.
“Generally, the effects of tobacco use are cumulative, so the costs increase with the length of time one has used tobacco,” she said in an email explaining the insurer’s rationale for the variance. “Since the length of time someone has used tobacco is reasonably well-correlated with age, the effect is for costs to increase with the member’s age. We don’t see many people in their later years who choose to start using tobacco.”
Coventry Health Care Inc. imposes a 20 percent surcharge on premiums for all smokers above age 21 who purchase insurance in the Illinois marketplace, Coventry spokesman Walter Cherniak Jr. said.
For a 55-year-old smoker choosing a Coventry silver PPO, the monthly cost would be $699.78 compared with $583.15 for a nonsmoker, he said. That’s $1,400 more a year for smokers.
Health Alliance Medical Plans, the insurance arm of Carle Foundation, imposes an 18 percent surcharge, said spokeswoman Kelli Anderson. Tobacco use is defined as using an average of four or more times per week in the past six months, excluding religious or ceremonial use, she said.
Humana Inc., Aetna Inc. and Land of Lincoln Health Inc. Co-op, all impose a 10 percent surcharge on smokers’ premiums, representatives said.
Consumers applying for insurance self-report whether they use tobacco. “They need to check off a box on the form,” said Schultz.
When making a policy purchase, insurance shoppers don’t have to prove whether they use tobacco. But smokers who might consider lying about tobacco use to cut their premium rates should think again.
“If a tobacco user does not check the box, and we later found out through a review of medical records or other reasons that he or she is a tobacco user, that is considered fraud,” Schultz said. “An insurance policy may be terminated if one commits fraud and does not share accurate medical information.”
Humana policyholders would be required to pay the difference in premium, according to spokesman Jeff Blunt.
Tobacco users who buy insurance have access to help in kicking the habit as part of their benefits. All health plans must cover 100 percent of the tab for smoking cessation programs with no co-pay, Pollitz said.
At Humana, members who participate in its smoking cessation programs who become tobacco-free are eligible for plan savings upon renewal, Blunt said.
http://www.suntimes.com/news/metro/23188991-418/affordable-care-act-smoking-sends-health-premiums-higher.html

Cotton Candy and Atomic Fireball flavored electronic cigarettes are forging a new pathway to addiction, death and disease

By:  Ross P. Lanzafame, American Lung Association National Board Chair
Harold Wimmer, American Lung Association National President and CEO
E-cigarette use among middle school children has doubled in just one year.  Last month, the Centers for Disease Control and Prevention (CDC) announced that e-cigarette use also doubled among high school students in one year, and that 1 in 10 high school students have used an e-cigarette.  Altogether, 1.78 million middle and high school students nationwide use e-cigarettes.  Yet, the Food and Drug Administration (FDA) still is not regulating e-cigarettes.  The absence of regulatory oversight means the tobacco industry is free to promote Atomic Fireball or cotton candy-flavored e-cigarettes to our children.  Clearly, the aggressive marketing and promotion of e-cigarettes is reaching our children with alarming success.
It is well known that nicotine is a highly addictive substance, whether delivered in a conventional cigarette or an e-cigarette.  The use of sweet flavors is an old tobacco industry trick to entice and addict young children to tobacco products, and the entrance of the nation’s largest tobacco companies into this market clearly is having an impact.   Why does Big Tobacco care about e-cigarettes?  Tobacco use kills more than 400,000 people each year and thousands more successfully quit.  To maintain its consumer ranks and enormous profits, the tobacco industry needs to attract and addict thousands of children each day, as well as keep adults dependent.   Big Tobacco is happy to hook children with a gummy bear-flavored e-cigarette, a grape flavored cigar or a Marlboro, so long as they become addicted.  We share the CDC’s concern that children who begin by using e-cigarettes may be condemned to a lifelong addiction to nicotine and cigarettes.
In addition, the American Lung Association is very concerned about the potential safety and health consequences of electronic cigarettes, as well as claims that they can be used to help smokers quit.  With no government oversight of these products, there is no way for the public health and medical community or consumers to know what chemicals are contained in an e-cigarette or what the short and long term health implications might be.   That’s why the American Lung Association is calling on the FDA to propose meaningful regulation of these products to protect to the public health.
The FDA has not approved e-cigarettes as a safe or effective method to help smokers quit. When smokers are ready to quit, they should call 1-800-QUIT NOW or talk with their doctors about using one of the seven FDA-approved medications proven to be safe and effective in helping smokers quit.
According to recent estimates, there are 250 different e-cigarette brands for sale in the U.S. today. With that many brands, there is likely to be wide variation in the chemicals that each contain.  In initial lab tests conducted by the FDA in 2009, detectable levels of toxic cancer-causing chemicals were found — including an ingredient used in anti-freeze — in two leading brands of e-cigarettes and 18 various e-cigarette cartridges. That is why it is so urgent for FDA to begin its regulatory oversight of e-cigarettes, which must include ingredient disclosure by e-cigarette manufacturers to the FDA.
Also unknown is what the potential harm may be to people exposed to secondhand emissions from e-cigarettes. Two initial studies have found formaldehyde, benzene and tobacco-specific nitrosamines (a well-known carcinogen) coming from those secondhand emissions. While there is a great deal more to learn about these products, it is clear that there is much to be concerned about, especially in the absence of FDA oversight.
http://www.gilmermirror.com/view/full_story/23870545/article—Cotton-Candy-and-Atomic-Fireball-flavored-electronic-cigarettes-are-forging-a-new-pathway-to-addiction–death-and-disease?instance=home_news_bullets

Poll: Most Nebraska voters support increasing cigarette tax

By KEVIN O’HANLON / Lincoln Journal Star

A majority of Nebraska voters favor increasing the state’s cigarette tax and using the money to provide property tax relief and smoking-cessation programs, according to a poll released Friday.
“Nebraskans have made it clear they are ready for a tobacco tax increase,” said David Holmquist of the American Cancer Society Cancer Action Network, which paid for the poll.
The poll of 500 likely voters in Nebraska showed strong bipartisan support, with 68 percent supporting and only 29 percent opposing a proposal to increase the state tobacco tax in order to reduce property taxes and fund smoking cessation programs.
“A tobacco tax increase would have many immediate positive impacts, from the reduced health costs from smokers who choose to quit and youth who are priced out of the market to the ways that increased revenues could be used to fund smoking cessation efforts or offset property taxes,” Holmquist said.
Support for the tax increase was consistent across all subgroups, including smokers. Support remained high when voters were told that the state tobacco tax could be increased by $1 per pack, which if adopted would make Nebraska, currently a low tobacco tax state, slightly higher than Iowa’s current tax.
Nebraska’s cigarette tax is 64 cents a pack, which ranks 38th nationally. Iowa’s is $1.36, which ranks 26th.
The highest cigarette tax is New York’s $4.35 a pack. The lowest is Missouri’s 17 cents.
According to the poll, 78 percent of Nebraska voters said it was important to fund programs that will prevent kids from smoking and help smokers quit, with 36 percent saying that this is very important.
The poll was done as the 14 members of the Legislature’s Tax Modernization Committee are looking to create a tax system that is fair, simple, stable and competitive with other states. The tax committee has asked business leaders and the public to come forward with ideas to help the process.
Gov. Dave Heineman said the priority should be lowering income and property taxes.
The framework for the present tax system was built in the 1960s. Three major tax sources fund state and local governments in Nebraska: 44 percent comes from property taxes, 29 percent from income taxes and 27 percent from sales taxes.
According to the poll, most voters said property taxes are the most problematic tax by far. When asked which tax concerns them the most, 57 percent of Nebraskans said property taxes, only 26 percent said income taxes and 11 percent said sales taxes.
“Now is the time for our state’s political leaders to listen to their constituents and step up and lead on the issue of tobacco taxes,” Holmquist said. “We have an opportunity here, within the tax reform discussions that are taking place, for a winning plan — we can improve Nebraska’s health, and we can provide much needed property tax relief.”
The poll was done by Public Opinion Strategies from Oct. 6-8. It included 500 likely voters and was done via cellphones and landlines. The survey had a margin of error of plus or minus 4.38 percent.
http://journalstar.com/news/state-and-regional/govt-and-politics/poll-most-nebraska-voters-support-increasing-cigarette-tax/article_ba7d9805-7b29-50f1-a97a-ea05665afcd4.html

Big Tobacco Invests in E-Cigarettes. Should You?

By 
U.S. sales of electronic cigarettes are expected to jump past $1 billion this year, and where there’s growth like that you can bet someone is making money – whether it’ll be new companies or Big Tobacco remains to be seen.
While still a tiny fraction of total tobacco sales, the market is already a lucrative one for some fledgling e-cigarette firms, though companies that promote and advertise the products are receiving much of the benefits, not manufacturers themselves. Longer term, the burning question is: Who is best positioned when government regulators take control of a market that’s so unfettered it can legally target adolescents with candy-flavored smokes.
Nationwide, e-cigarettes are sold with little restrictions except for one big one – they cannot claim to be a cure for habitual smoking or they risk U.S. Food and Drug Administration sanctions (several states also restrict sales to minors). Instead, sales have grown slowly in a curious niche – a hybrid of traditional smokers and those trying to quit. The battery-operated smokes heat nicotine-infused vapors that can be inhaled like a regular cigarette, making them safer than carcinogenic tobacco, but not necessarily risk-free, according to the FDA. Studies about their safety or effectiveness in quitting tobacco are not conclusive, and health officials say more research is needed.
In economic terms, e-cigarettes hit a classic inflection point last year when, after years of gradual sales growth, they became too big for the $100 billion tobacco business to ignore. Suddenly, celebrities like Leonardo DiCaprio are puffing on black-tube, blue-tipped e-cigarettes and touting them on commercials on MTV. E-cigarettes are becoming cool, and marketers have taken notice.
E-cigarette maker NJOY, with about 40 percent of the market, isn’t selling itself based on its hipness factor. It’s positioning itself as the choice of Main Street smokers who just want to quit tobacco, says S&P Capital IQ equity analyst Esther Kwon, who covers the tobacco industry. Targeting “smoke-quitters” makes business sense, she says. The Centers for Disease Control and Prevention says about 70 percent of smokers want to quit. To reach that group, Kwon says NJOY tries to duplicate the look and feel of a real cigarette.
Still, if its mainstream focus lacks downtown hipness, NJOY has generated buzz with its high-profile investors and anti-smoking “cred.” NJOY’s roster of supporters include billionaire Sean Parker, of Facebook and Napster fame, and former U.S. Surgeon General Richard Carmona, who will head a NJOY research committee that will study the e-cigarettes. The company is positioned for a possible takeover by one of the major tobacco players or a possible initial public offering, analysts say, though that could be some time into the future.
“Some smaller players will be taken over by Big Tobacco, and NJOY could eventually go public,” says Adriana de Lozada, an analyst for private company research firm PrivCo. “NJOY has done a great job of positioning itself, but it’s not ready to do an IPO, not yet. Growth is important, but so is size to be able to go public and to compete in this market.”
Lorillard, the scrappy No. 3 cigarette maker behind giants Altria and Reynolds American, has moved aggressively with its blu brand, says Kwon, adding that the company has “always been an innovator.” It’s trying to bring a touch of Mad Men-style glamour to cigarettes, and bringing smokes back to the tube for the first time in four decades with ads featuring television celebrity Jenny McCarthy puffing up the benefits of e-cigarettes by saying “it’s not sexy” to smell like an ashtray and pointing out she doesn’t have to freeze outside to smoke a cigarette.
Lorillard trades at about the same relative price-to-earnings as the other tobacco makers. Its market cap of $17 billion is far less than Altria’s $70 billion. A successful IPO or acquisition of its startup competitor, NJOY, could boost its valuation further, according to Kwon. “They could get rewarded by the publicity of NJOY’s IPO,” she says. “It might get their value noticed more.”
Lastly, Vapor is the pure play, the lone publicly traded e-cigarette company. Its performances suggest that the economics of e-cigarettes are difficult, as it trades at 85 cents a share and has lost money on flat earnings the past year. But others, like Swisher, have succeeded in building market share with savvy marketing, de Lozada says.
“There is a window with a bit of an opening now, but if they have to compete with big brands that are already established, their profit margins will be squeezed,” Kwon says. “And Big Tobacco has the advantage of huge distribution no one can match.”
More broadly, media firms could be a big winner regardless of which e-cigarettes prevail, because they’re being advertised on television – a venue where traditional cigarettes have been banned for years. It’s a new front for the tobacco industry, which still spends billions of dollars on other media, including magazine ads, promotions and sponsorships. That trend will probably accelerate in an all-out marketing e-cigarette war as Altria and Reynolds enter the market this year. And e-cigarettes already have outspent traditional cigarette makers advertising in major media this year, according to data by Kantar Media.
New frontiers in advertising and social media may win some of that spending. The Internet advertising industry could benefit from e-cigarettes supported by people online via the likes of Google’s recently launched “shared endorsement” service, which sells information about users’ endorsements. (It’s not a coincidence that digital entrepreneurs like Parker have entered the space.)
And what about Big Tobacco’s role? Altria and Reynolds need to compete, but the cost of a massive new marketing push in a sector where regulatory issues are still being sorted out might not make perfect sense, at least for now, analysts say, especially if such new costs mean any trade-off for tobacco company shareholders who purchase the stocks in part for their high dividend yields. “They are in a business that is highly profitable that does not require a whole lot of investment,” says Kwon, while noting a changing market could upend such reluctance. “This could be much different in the future, and this is something they will have to invest in. It’s in its very early stages, but it has potential to become something big, and it could have an impact.”
Analyst Bonnie Herzog of Wells Fargo Securities sparked media attention with a report earlier this year that e-cigarette growth will continue for the next decade and overtake traditional smoking sales for U.S. tobacco companies. A number of analysts declined to comment, citing a pending earnings period for tobacco companies, and Herzog was not available for comment. However, big brokers have generally been recommending the stocks for their dividends and steady earnings, and analysts have expressed skepticism that e-cigarettes, with less than 1 percent of the total market, will make much impact anytime soon.
Meanwhile, the regulatory and legal issues surrounding their marketing has been slowed by Washington’s budget stalemate that led to government shutdown. A number of decisions are due soon that could bring clarity and more regulation.
“All of these big gains [for e-cigarettes] are coming at a time of zero regulation, no taxes and a lot of hype,” says one analyst who requested U.S. News to not use his name. “The bottom line is that only a limited number of people will switch once the playing field is leveled. Our research shows that it won’t happen because e-cigarettes are just not as satisfying.”
http://money.usnews.com/money/personal-finance/mutual-funds/articles/2013/10/17/big-tobacco-invests-in-e-cigarettes-should-you?page=2

Costly cigarettes and smoke-free homes: Both effectively reduce tobacco consumption

Researchers at the University of California, San Diego School of Medicine say high-priced cigarettes and smoke-free homes effectively reduce smoking behaviors among low-income individuals – a demographic in which tobacco use has remained comparatively high.

Writing in the October 17, 2013 issue of theAmerican Journal of Public Health, principal investigator John P. Pierce, PhD, professor and director of population sciences at UC San Diego School of Medicine, and colleagues found that expensive cigarettes – $4.50 or more per pack – were associated with lower consumption across all levels.

Writing in the October 17, 2013 issue of theAmerican Journal of Public Health, principal investigator John P. Pierce, PhD, professor and director of population sciences at UC San Diego School of Medicine, and colleagues found that expensive cigarettes – $4.50 or more per pack – were associated with lower consumption across all levels.
“Living in a state where the average price paid for cigarettes is low ($3.20 or less per pack) means that all , regardless of income, will smoke a lot more than those who live in a state with higher prices,” said Pierce. “This is the case for those living below the  as well as for the wealthy.”
When smokers agreed to a smoke-free home, not only were they more likely to reduce their smoking but, in addition, if they quit, they were less likely to relapse.
“Price is a deterrent to smoking,” said Pierce, “but successful quitting (90 or more days) was associated in this study only with a smoke-free home.”
The challenge to anti-smoking groups is that low-income smokers are less likely to adopt a smoke-free home environment. Pierce offered several possible explanations: “First, there’s a higher prevalence of smoking in people with lower incomes, which means that there will be more spouses who smoke as well. When both adults smoke, there is much lower motivation to introduce a smoke-free home. Also, social norms against smoking have historically been lower in those with lower incomes.
“No one is mandating a smoke-free home,” Pierce continued. “We are telling people that if they really want to quit, then introducing a smoke-free home will help them be successful. This study supports the current policy of increasing (cigarette) prices and building social norms that protect against secondhand smoke. These policies will reduce consumption among all smokers – reducing potential harm – and the ensuing smoke-free homes will help smokers quit successfully.”
The findings are derived from the 2006-2007 Tobacco Use Supplement to the Current Population Survey, a monthly nationally representative cross-sectional survey conducted by the U.S. Census Bureau. The researchers analyzed three sets of supplement data containing responses from more than 150,000 participants aged 18 and older who self-reported both income and smoking habits.
Maya Vijayaraghavan, MD, assistant clinical professor in the Department of Family and Preventive medicine and the study’s first author, said one potential avenue for intervention was to increase regulation of  in public housing.
“This may change norms around smoking among low-income populations living in public housing,” Vijayaraghavan said. “What is important is that clinicians need to emphasize  concerning tobacco use and should encourage and discuss strategies for adopting smoke-free homes among all smokers. Additionally, there is a lot of interest in raising cigarette price to reduce smoking. While we have evidence that moderate increases reduce  behavior in all income groups, it is important to match such a policy with support to help lower income smokers to quit successfully.”
http://medicalxpress.com/news/2013-10-costly-cigarettes-smoke-free-homes-effectively.html

15 Years Later, Where Did All The Cigarette Money Go?

by NPR STAFF
Fifteen years after tobacco companies agreed to pay billions of dollars in fines in what is still the largest civil litigation settlement in U.S. history, it’s unclear how state governments are using much of that money.
So far tobacco companies have paid more than $100 billion to state governments as part of the 25-year, $246 billion settlement.
Among many state governments receiving money, Orange County, Calif., is an outlier. Voters mandated that 80 percent of money from tobacco companies be spent on smoking-related programs, like a cessation class taught in the basement of Anaheim Regional Medical Center.
“So go ahead and take a minute or two to write down reasons why you want to quit and we’ll talk about them in just a bit,” Luisa Santa says at the start of a recent session.
Every year since 1998, this program has been funded by money from the tobacco settlement. The five-part class is free for anyone living or working in Orange County. When they sign up, participants get a “quit kit” full of things like toothpicks and gum. And, if they come for at least three of the five sessions, they get a free two-week supply of nicotine patches.
Making Big Tobacco Pay
In the mid-1990s, Mississippi was the undisputed leader on the tobacco issue. In 1994, Mike Moore, the state attorney general, filed the first state lawsuit against big tobacco.
Individual lawsuits by smokers failed because courts held people responsible for their decision to smoke, but Moore argued that Mississippi shouldn’t be forced to pay the costs of treating smoking-related diseases.
“Things such as lung cancer, heart disease, emphysema, low-birth-weight babies and others, we have to pay,” Moore told NPR in a 1994 interview. “The state is obligated to pay for those for our citizens that are not covered in other ways, and we feel like they’re caused by the tobacco products.”
Moore argued that tobacco companies should pay for medical bills, and eventually the courts agreed. That agreement said no ads and no targeting youth. Popular advertising characters like Joe Camel and the Marlboro Man were killed off as a result.
The settlement left the tobacco industry immune from future state and federal suits, but the agreement said nothing about how states had to spend the money. Looking back on it, Moore remembers it was a long slog.
“It was not an easy task,” Moore tells NPR’s Arun Rath. “When we filed our case here in 1994, my governor actually sued me to try to stop the tobacco case.”
The tobacco companies sued Moore as well, he says, and it went all the way to the Supreme Court. “It took me two years before I even had five states who would agree to join the efforts.”
Moore now serves on the board of directors of the American Legacy Foundation, a group created by the tobacco settlement. The organization’s mission is to create national anti-smoking campaigns, like the famous Truth ads.
The tobacco settlement included money specifically to fund public service announcements, but Moore says most of the settlement money came with no strings attached, and that has made it impossible to hold states accountable.
In Mississippi, where the settlement money was put into a trust fund, a lot of it was spent on things other than smoking prevention and health care, Moore says.
“What happened as the years went by, legislators come and go, and governors come and go … so we got a new governor and he had a new opinion about the tobacco trust fund,” he says. “So a trust fund that should have $2.5 billion in it now doesn’t have much at all, and unfortunately that’s one of my biggest disappointments.
And it’s not just Mississippi; Moore says that all across the country hundreds of millions of dollars have gone to states, and the states have made choices not to spend the money on public health and tobacco prevention.
It’s not all bad news in Mississippi, however; Moore says money that was spent on tobacco prevention has helped reduce teen smoking by more than 50 percent in just five years. Adult smoking has been reduced by about 25 percent, and he says it is that way around much of the U.S. as well.
“We need to continue the vigilance,” he says. “We have new products coming out — e-cigarettes and the like — we just need to talk the states into spending the money to do something about it.”
The Settlement Aftermath
Myron Levin covered the tobacco industry for the Los Angeles Times for many years and is also the founder of the health and safety news site Fair Warning. He says talking states into spending settlement money on tobacco prevention is a tough sell.
To show the settlement was not just a big money grab, Levin says, there was definitely a feeling that states had a moral obligation to spend at least a sizeable chunk of money on programs to help people quit smoking and to prevent kids from starting.
“So it was understood without being codified into the agreement that states would make a big investment in this,” he says. “They haven’t.”
To help guide state governments, in 2007 the Centers for Disease Control and Prevention recommended that states reinvest 14 percent of the money from the settlement and tobacco taxes in anti-smoking programs. But most state governments have decided to prioritize other things: Colorado has spent tens of millions of its share to support a literacy program, while Kentucky has invested half of its money in agricultural programs.
“What states have actually done has fluctuated year by year … but it’s never come close to 14 percent,” Levin says. “There are some fairly notorious cases of money being used for fixing potholes, for tax relief [and] for financial assistance for tobacco farmers.”
Levin says some states don’t have any money coming in anymore because they securitized their future payments with an investor in order to receive a lump sum. That lump sum often went into their state’s general fund.

For its part, the tobacco industry has managed to weather the settlement fairly well. New products like smokeless tobacco and electronic cigarettes have put many companies on the road to big sales, Levin says.
“When you are supplying the most widely used addictive product in the world, you have certain advantages,” he says. “Their cash flows remain enormous.”
One indirect effect of the settlement, Levin says, is legislation that gave the Federal Drug Administration control over tobacco products. President Obama signed the law in 2009.
“Something that could happen, although I wouldn’t put a lot of money on it, is they could ratchet down the allowable levels of nicotine in cigarettes to a level that is essentially nonaddictive,” he says. “That would be a total game changer.”
Nonaddictive cigarettes would indeed be a game changer for people like Susan Hallock, an attendee at the class in Orange County, who says she desperately wants to quit.
“I feel ashamed,” she says. “I feel like I have to hide my hand with the cigarette in it.”
But the nicotine keeps her coming back, over and over. “I’ll smoke like six to eight months and quit. Or a month and quit. It’s just different every time.”
She’s hoping that this time, with the help of the free class, she’ll be successful. And she has a real chance: The program has a 50 percent success rate for adults like her.
http://www.npr.org/2013/10/13/233449505/15-years-later-where-did-all-the-cigarette-money-go

Study: Light Smokers Face High Risk Of Early Death

(CBS ATLANTA) – Light smokers are not safe from the large life expectancy cuts that come from mild cigarette use.
A new tracking study of health and smoking levels from 200,000 people finds that not only does smoking cut 10 years from a smoker’s life expectancy, but that even mild smokers will double their risk of an early death by continuing cigarette use.
“The international rule of thumb is that half of all smoker deaths are directly caused by tobacco,” Professor Emily Banks of the Australian National University study told ABC News.
“We found that [over the four years] people who are current smokers were three times more likely to die than people who had never smoked, and their life expectancy within that four-year period was diminished by 10 years compared to the never-smokers.”
According to the Centers for Disease Control and Prevention, “Tobacco use is the single most preventable cause of disease, disability, and death in the United States. Each year, an estimated 443,000 people die prematurely from smoking or exposure to secondhand smoke, and another 8.6 million live with a serious illness caused by smoking.”
Despite these risks, approximately 46.6 million U.S. adults smoke cigarettes. Smokeless tobacco, cigars, and pipes also have deadly consequences, including lung, larynx, esophageal, and oral cancers, reports the CDC.
The study echoes previous research that quitting smoking at any age still reduces the risk of smoking-related death.
The CDC reports: “Each year, primarily because of exposure to secondhand smoke, an estimated 3,000 nonsmoking Americans die of lung cancer, more than 46,000 die of heart disease, and about 150,000–300,000 children younger than 18 months have lower respiratory tract infections.”
http://atlanta.cbslocal.com/2013/10/12/study-light-smokers-face-high-risk-of-early-death/

Letter: E-cigarettes will burn users in the long run

DR. THECKEDATH MATHEW BRIGHTON, Senior interventional cardiologist, Rochester Heart Institute
E-cigarettes are real nicotine products, camouflaged in heat and vapor, carrying all the ill effects that nicotine could do on the cardiovascular system.
Nicotine is a vasoconstrictor agent that produces spasm on the blood vessels, including the coronary arteries and the vessels in the brain, leading to heart attack and stroke. Nicotine can lead to blood clots that eventually leads to heart attack and stroke.
Nicotine is an atherogenic agent. It promotes plaque formation in the blood vessels that contribute to plaque rupture in the heart and brain, again leading to heart attack and stroke. Nicotine has a deleterious effect on the arteries to the legs compromising the blood supply leading to amputation of the legs in many cases.
E-cigarettes are real nicotine products carrying all the adverse effects of nicotine and there is nothing to be glamorized about it.
http://www.democratandchronicle.com/story/opinion/letters/2013/10/12/letter-e-cigarettes-will-burn-users-in-the-long-run/2969185/

POV: Seven reasons the FDA should regulate e-cigarettes

By Kevin Keenan
In a recent online blog post by Campaign for Tobacco Free Kids, it was clearly explained why e-cigarettes should soon be regulated by the Food and Drug Administration (FDA). The CDC recently reported that rates of electronic cigarette use among U.S. youths more than doubled from 2011 to 2012, when 10 percent of high school students reported ever having used e-cigarettes.
These numbers are troubling but not surprising. There has been an explosion in e-cigarette marketing in recent years, and e-cigarette manufacturers are using the same slick tactics long used to market regular cigarettes to kids. The following are seven ways in which makers of the e-cigarette are using the same marketing strategies as the tobacco industry used back in the 1950s through the early ’70s:
1. They have celebrity spokespeople.
Like cigarette ads of old, television, online and print ads for e-cigarettes feature catchy slogans and celebrity endorsers, including actor Stephen Dorff and rock musician Courtney Love for NJOY. Their message: Using these products is trendy and cool.
2. Their magazine ads feature rugged men … and glamorous women.
These ads feature today’s equivalents of the Marlboro Man and the Virginia Slims woman, depicting e-cigarette use as masculine, sexy or rebellious. E-cigarette ads have appeared in magazines that reach millions of teens, including Rolling Stone, Sports Illustrated, InStyle and Us Weekly.
3. They know sex sells.
Like cigarette companies have long done, e-cigarette makers portray use of their products as sexually attractive. The allure for young people to start using is just as real; particularly in the Internet age we live in.
4. They sponsor sports … and music festivals.
For decades tobacco companies used sponsorships of sports and entertainment events, especially auto racing and music festivals, to promote cigarettes to huge audiences, including kids. Cigarette sponsorships are now banned, however today e-cigarette brands have auto racing sponsorships of their own. The Blu Cig company is one of them.
5. Their products come in sweet flavors.
A 2009 federal law banned fruit- and candy-flavored cigarettes, but many e-cigarette companies gleefully pitch similar flavors. Apollo Vapors, for example, offers Almond Joyee (“the candy bar taste without the calories!”), French Vanilla (“like biting into a deliciously sweet vanilla cupcake”) and Banana Cream (“yummy ambrosia of bananas and whipped cream”).
6. They use cartoons.
The website for blu eCigs has featured a cartoon pitchman named “Mr. Cool.” It was reminiscent of the Joe Camel cartoon character that so effectively marketed cigarettes to kids in the 1990s.
7. Their ads say, “Switch, Don’t Quit.”
Tobacco companies have long tried to discourage smokers from quitting by marketing cigarette changes as reducing health risk. Some e-cigarette ads carry a similar message. No wonder youth e-cigarette use is on the rise. These developments underscore the need for the FDA to quickly regulate e-cigarettes and take steps to prevent their marketing and sale to kids.
Kevin Keenan is project director for Smoke-Free NOW, a program of Genesee/Orleans Council on Alcoholism and Substance Abuse.
http://thedailynewsonline.com/opinion/article_84e8a47a-32f7-11e3-a8fc-001a4bcf887a.html

Smokers Are Using E-Cigarettes to Get High

By  @elizalgray
Marijuana smokers are using electronic-cigarettes to get high, say local reports from across the country.
Electronic cigarettes are a growing industry in the United States, having ballooned from $300 million in retail sales in the U.S. last year to $1.8 billion by the end of 2013, according to Bonnie Herzog, a senior tobacco industry analyst at Wells Fargo Securities.
Marijuana users are seeing some of the same benefits in the devices, which produce a vapor of nicotine liquid or, in the case of marijuana, cannabis oil, liquid, or wax, that can be inhaled without the inconvenience of smelly, carcinogenic smoke.
Marijuana users, who explain their methods of using e-cigarettes to vaporize cannabis liquid in videos online, can make their own hash liquid and put it inside an e-cigarette, a lithium battery-powered device that heats liquid into vapor.
Local reports from Florida, New York, and Philadelphia, have reported on the trend of using electronic cigarettes to vaporize marijuana, citing concerns of parents, law makers, and law enforcement agents who worry that electronic cigarettes allow users to get high without detection. Both products are legal in some states and not in others, making enforcement even more challenging.
While states and cities across the country have begun to limit the use of electronic cigarettes–banning their sale to minors or indoors–the federal government has yet to regulate them, raising concerns about their safety. TIME explored the pros and cons of vaping in a feature on electronic cigarettes in September. While electronic cigarettes are believed by many in the public health field to be safer than regular cigarettes, without regulation by the FDA, there is no way for consumers to be sure about the safety of the products they are buying, whether they contain nicotine or marijuana
http://nation.time.com/2013/10/11/smokers-are-using-e-cigarettes-to-get-high/#ixzz2i1ElVhkY