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Latest Research on Tobacco Use and Health Care Cost Has Global Implications

By Derek Yach, Executive Director, The Vitality Institute, and a former executive director of the World Health Organization (WHO), and Katie Tryon, M.D., Clinical Director, The Vitality Institute.
This month’s articles on health care costs and tobacco control in the South African Medical Journal (SAMJ) have far reaching implications beyond the shores of South Africa. The latest Global Burden of Disease data (Lancet, 2012) show that two of the top three risk factors that contribute to the highest burden of disease in Western Europe and the U.S. are tobacco and high Body Mass Index (BMI). This not only has serious health consequences, it has significant financial implications for governments, businesses and individuals — both in terms of direct health care costs and indirect costs such as work productivity.
One of the papers, published by RAND Corporation and Vitality, looks at the direct health care cost impact of these two risk factors. They show that severely obese individuals have a 23 percent higher health expenditure than those at a healthy weight, and moderately obese individuals have an 11 percent higher health cost. Furthermore, current or past smokers have an 11 percent higher health expenditure. The research was carried out on an insured South African population with similar demographic and health care profiles to counterparts in Western Europe and the US. It supports recent research carried out by Pandya et al. in the U.S. (Health Affairs, 2013) which predicted a significant increase in healthcare costs in the U.S. from cardiovascular disease due to the aging population, declining mortality and ever increasing obesity rates.
While Pandya et al. research highlighted declining smoking rates in the U.S. as positively influencing cardiovascular disease cost projections, they were not outweighed by the other pressures increasing the costs. An additional paper published by Reddy et al. also adds caution to the enthusiasm over declining smoking rates. It shows that while there has been a significant decline in smoking in school age children in South Africa between 1999 and 2008, there has been a marginal increase between 2008 and 2011 (to 16.9 percent in 2011). This has been mirrored in the U.S. by the CDC Youth Risks Behavior Surveillance that showed a significant decline in youth smoking rates between 1997 and 2009, but no significant decline between 2009 and 2011 (remaining at 18.1 percent in 2011). As today’s young smokers are our tomorrow’s smoking adults, a leveling of the decline, or even a potential increase could have significant impact on future health care costs.
Continued cigarette consumption worldwide, despite all interventions that have been tried, argues for a look at new breakthrough interventions to prevent the inevitable future costs.The editorial co-authored by David Sweanor of the University of Ottawa highlights the need to provide smokers with alternative viable options, rather than continuing along the same lines of controlling combustion cigarette supply and demand. Taxes have played a key role in getting smoking rates down across the world but an improved approach, complimentary to accepted policies in place, is needed to better tackle addiction. E-cigarettes have been a consumer breakthrough that should be embraced by public health personnel and governments rather than vilified. As they state, “We can still strive for complete nicotine cessation… but we are currently presented with the very real prospect of massively reducing the individual and population risks of smoking by something in the range of two orders of magnitude.”
High BMI and smoking remain among the top three risk factors that contribute to the highest burden of disease in Western Europe and the U.S., and the research mentioned above highlights this issue and discusses potential solutions, with implications far beyond South Africa.
The Vitality Institute is a global health think tank with the mission to advance knowledge about the evolving science and art of prevention and health promotion in order to build healthier societies. To join the conversation, follow us on Twitter at The Vitality Institute @VitalityInst.
http://www.huffingtonpost.com/dr-derek-yach/tobacco-use-research_b_4164593.html

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

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

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

Forum editorial: Minn. tax on tobacco is a health tax

Opponents of Minnesota’s new tobacco tax seem to believe the $2.83 per pack of cigarettes tax is about only revenue and business. It’s not. It’s first and foremost about public health.
While the tax has had expected impacts on revenue and business since it went into effect July 1, its primary purpose is to discourage smoking. The tax is having the predicted results: Sales of cigarettes are down. Early evidence suggests the steep rise in the tax will generate a corresponding decline in smoking. That has been the experience of every other state that raised its cigarette tax substantially. Young smokers or potential smokers are especially sensitive to price.
Even as sales of cigarettes slipped as the tax took hold, revenue increased, as forecast. The tax is up 30 percent, after all. Some of that additional revenue will be used to fund the new Vikings stadium.
However, as fewer Minnesotans take up the habit and others quit or reduce cigarette purchases, revenue will decline. The ideal situation, of course, would be that tobacco use falls so far as to make revenue from the tax unimportant to the state’s overall financial picture.
Reacting to the decline in sales, one person at a retail store said: “It’s very bad.” No, it’s not. In the long term, fewer people smoking cigarettes is a good thing. It’s good for their health, their medical bills and the nation’s health care system.
Often characterized as “sin taxes,” taxes on cigarettes and other tobacco products are in effect health taxes. There is no sin in public policy that aims to improve and protect health. The real sin is peddling a product that sickens and kills people.

Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.
http://www.inforum.com/event/article/id/414349/

E-Cigarette trend catching on, but what are the effects?

by Stephanie Zepelin
BOISE — It might be a trend you have noticed: electronic cigarettes. The devices use battery power to heat a liquid (usually containing nicotine) the user inhales. Some folks are choosing this option over traditional cigarettes.
Electronicstix, a company that started in Utah, just opened their first store in Boise.
“We have three stores that have been pretty seasoned down in Utah,” said Devin Norager, who works at ElectronicStix.
Norager smoked traditional cigarettes before switching to vaping, and says a lot of people are in that same situation.
“Ninety-nine percent of it is people that do smoke and want a healthier alternative,” Norager said.
Kody Girard smoked for more than a decade, and is using vaping to cut costs from purchasing traditional cigarettes. Girard said he doesn’t know much about the health effects of vaping.
“It’s just like smoking,” said Girard. “You don’t know much about it you try to ignore it the best you can because it’s bad. So this might not be, but it’s gotta be better than cigarettes.”
Doctor Jim Souza, Vice President of Medical Affairs at St. Luke’s Medical Center in Boise, talked with KTVB about the health effects of e-cigarettes.
“I think the state of the science right now is there’s not enough information to draw a conclusion,” said Souza.
Dr. Souza said the main concern in health care is e-cigarette marketing targeting to kids.
“It’s estimated now that 10 percent of high school seniors have used e-cigarettes, of that 10 percent, 75 percent of them also use tobacco,” Souza said. “So because nicotine is so powerfully addictive, the concern from a public health perspective is that this could be a gateway into traditional tobacco for young people, and that would be a public health disaster.”
However, the reserve effect could be good for public health.
“I think most folks in health care think that if all smokers could convert to e-cigarettes, that would probably be a public health boon, although we don’t know that for sure,” said Souza.
He said it does help people kick the habit.
Audra Johnson started smoking years ago, and has been vaping for about three months.
“I figured it would help because I’ve tried patch, the pill, everything else, Chantix, nothing has really worked,” said Johnson.
Johnson said she is saving money by switching over to e-cigarettes, and feels better.
E-cigarettes range anywhere in price from a few bucks for a disposable one to several hundred dollars for the high-end products.
http://www.ktvb.com/news/E-Cigarette-trend-catching-but-what-are-the-effects-226619581.html

DoD starts new effort to get troops, employees thinking healthy

By Patricia Kime
Staff Writer
Summertime refused to cede to fall Thursday in Falls Church, Va., as temperatures soared to 90 degrees and the Pentagon’s top doctor led a shorts-clad group on a fast-paced 1-mile run at the future Defense Health Agency headquarters.
The sweaty PT session marked the kickoff of the facility’s participation in the Defense Department’s “Healthy Base Initiative,” a nutrition and wellness program being field-tested at 14 military bases and offices nationwide.
The $6 million demonstration project is designed to assess the health of each facility’s population and improve it through healthy nutrition, physical activity and tobacco reduction.
Assistant Secretary of Defense for Health Affairs Dr. Jonathan Woodson said the Healthy Base Initiative will determine what health and fitness programs actually work and should be implemented DoD-wide.
“Society at large is dealing with the issue of health, nutrition and weight gain, and we need to take this on full force, having a good strategy to do better,” Woodson said.
The Defense Department spends $3.2 billion on obesity-related disease treatment and tobacco-related illnesses and treatment each year, said Charles Milam, principal director for military community and family policy.
A 2011 survey of active-duty members indicated that a quarter of troops smoked, while roughly 13 percent were classified as obese and 51 percent were considered overweight.
The numbers are even worse for military retirees: More than 40 percent of the youngest retirees, ages 40 to 49, are obese, according to DoD data.
Under the Healthy Base Initiative, participating facilities were given a baseline assessment of certain health metrics, including aggregate weight, tobacco use and fitness program participation.
Individual bases are left to determine how they will improve their numbers and the facilities will be reassessed after a year, said Capt. Kim Elenberg, director for medical readiness and training for the U.S. Public Health Service.
At Defense Health Headquarters, changes have included hosting a farmer’s market on Thursdays, banning smoking from the 44-acre campus, mapping out indoor walking trails in the building and an outdoor running path.
Officials acknowledge they face an uphill battle in changing habits, even on a day set aside to gin up enthusiasm for the program.
At the kickoff, fewer than 10 percent of the 3,000 employees at the Defense Health Headquarters showed up for the festivities. The most popular kiosks at the farmer’s market include the bread tent and the home-baked goods. Some employees dropped out of the run/walk.
To be fair, it was hot.
“It’s going to to take a while, but I do think it’s going to work,” said Navy Capt. Tonya Hall, vice chief of staff for the Bureau of Medicine, who participated in the festivities despite being in full uniform.
“Initiatives like this really go a long way to bringing this to people’s minds, because that’s half the battle, making people think about healthy habits,” she said.
Personnel at participating bases could see new programs, such as weight loss groups and fitness classes, revamped chow hall menus and new vending machine choices. Additional plans include an online assessment tool for personnel, family members and retirees to measure their overall health and map out plans for improvement.
What participating bases won’t see is the removal of base fast-food restaurants or snack foods from commissary shelves, Elenberg said.
“That’s not our goal. What we want to do is increase health literacy and offer healthy choices. If we can do that, if we can have farmer’s markets, teach parents how to pack a healthy lunch, encourage people to kick their tobacco habits, we can succeed,” she said.
The participating bases and facilities are: Fort Bragg, N.C.; Fort Sill, Okla.; Joint Base Pearl Harbor-Hickam, Hawaii; Submarine Base New London Conn.; Mountain Home Air Force Base, Idaho; Yokota Air Base, Japan; Marine Corps Air Ground Combat Center, Twentynine Palms, Calif.; Marine Corps Base Quantico, Va.; Coast Guard Air Station Cape Cod, Mass.; March Air Reserve Base, Calif.; Fort Meade, Md.; Camp Dodge, Iowa; and the Defense Logistics Agency, Fort Belvoir, Va.
http://www.navytimes.com/article/20130913/NEWS/309130026/DoD-starts-new-effort-get-troops-employees-thinking-healthy

Graphic anti-smoking ads helped 100,000 kick the habit for good, CDC says

Maggie Fox,  NBC News
A graphic, deliberately shocking, anti-tobacco campaign starring former smokers — including a woman who lost her voice box to throat cancer — helped 100,00 Americans kick the habit permanently, government researchers say.
And an estimated 1.6 million people at least tried to quit smoking after seeing the first national mass ­media anti-smoking initiative to be funded by the U.S. government, according to researchers from the Centers for Disease Control and Prevention.
The series of ads, called “Tips,” featured images of an 18-year-old wearing an oxygen mask in the hospital after suffering an asthma attack caused by secondhand smoke; a 57-year-old Army veteran with chronic obstructive pulmonary disease who tearfully declares “I’m running out of time,”; and a heart attack victim showing a gruesome scar from his surgery.
One of the most striking ads featured Terrie Hall, a 52-year-old North Carolina woman who suffered throat cancer caused by smoking. “The only voice my grandson has ever heard is this one,” the well-groomed blonde woman croaks in one video.
“People would come up to her in the grocery store or drug store in other towns and ask ‘if you are the woman on the ad — you inspired me to quit smoking – thank you so much’,” said Dr. Tim McAfee, director of the CDC’s Office on Smoking and Health, who directed the study.
The 2012 three-month campaign reached nearly 80 percent of US smokers, the CDC team says in a report published Monday in the Lancet medical journal.
“The Tips campaign seems to have resulted in millions of non-­smokers talking to smokers about quitting and getting help,” the CDC researchers wrote.
To figure this out, the CDC team sent questionnaires to 3,051 smokers and 2,220 non-smokers completed baseline and follow-up assessments. They found that 78 percent of the smokers and 74 percent of the non-smokers recalled having seen at least one Tips advertisement on television during the three-month campaign.
Before the campaign started, 31 percent of smokers said they had tried to quit for at least one day in the previous three months. This went up to nearly 35 percent after the campaign. And 13 percent said they succeeded.
The differences may look small percentage wise, but when multiplied over the whole U.S. population, they added up. Twenty percent of U.S. adults smoke.
“We found over a million and half smokers made quit attempts because of the campaign,” McAfee told NBC News. “This study shows that we save a year of life for less than $200. That makes it one of the most cost-effective prevention efforts,” McAfee added.
The CDC says half of all smokers try to quit every year, but only 5 percent succeed. Drugs, acupuncture, counseling and nicotine replacement therapies are all available to help, but nothing works perfectly. Over the weekend, researchers reported that e-cigarettes work about as well as nicotine patches to help people quit.
“This is exciting news. Quitting can be hard and I congratulate and celebrate with former smokers – this is the most important step you can take to a longer, healthier life,” said Director Dr. Tom Frieden. “I encourage anyone who tried to quit to keep trying – it may take several attempts to succeed.’’
The CDC says its $54 million campaign, paid for out of the 2010 health reform law, counters the $8 billion the tobacco industry spends on advertising and promotions.
“Tobacco use remains the leading cause of preventable death worldwide, causing nearly 5 million deaths annually,” the CDC team wrote. “For individuals, smoking shortens life expectancy by more than 10 years, whereas adults who quit before age 45 years regain almost a decade in life expectancy.”
CDC says cigarettes kill 440,000 Americans a year, and tobacco use costs $96 billion in direct medical costs and $97 billion in lost productivity.
http://www.nbcnews.com/health/graphic-anti-smoking-ads-helped-100-000-kick-habit-good-8C11111432

E-cigarettes health: Carcinogens found in e-cigarettes a danger, study finds

E-cigarettes health reports recently reveal that this seemingly “healthy” cigarette alternative may not be as good for users as many would like to believe, and that they might even include a similar number of dangerous carcinogens as regular cigarettes when smoking, Yahoo! reports this Tuesday, Aug. 27. The study highlights in its finding that researchers found that up to 3 out of 10 e-cigarettes had levels of acrolein and formaldehyde that were almost the same as those in standard cigarettes, a shocking discovery for some.
The e-cigarettes health study comes at a time when these electronic cigarettes have become an increasingly well-known substitute for smokers (many of whom may be trying to quit). Although the device also uses heat which vaporizes the nicotine into the body when inhaled, it does not contain the unhealthy tobacco.
Smokers that want to try to avoid some of the dangers and health risks associated with smoking, or in the process of kicking the bad habit, often use e-cigarettes as another option to still get their nicotine fix, while avoiding many of the serious health risks linked to regular cigarette smoking, most notably cancer.
Yet France’s National Consumer Institute magazine released some shocking new findings this Monday, reporting that a majority of e-cigarettes on the market today still hold “a significant quantity of carcinogenic molecules” that could pose a similar danger to these electronic smokers.
The study discovered via its researchers that 3 out of every 10 e-cigarettes still contained high levels of some carcinogenic substances, including that of formaldehyde and acrolein.
Though a banning may not be in order, raising public health awareness or putting limits to the e-cigarettes might be a sensible option, notes the magazine’s editor-in-chief
“This is not a reason to ban them, but to place them under better control.”
Added another statement on the rising popularity of e-cigarettes and the highly believed health benefits of the substituent device in terms of this new study:
“E-cigarettes are more than just a fad,” reads a piece from the report. “E-Cigarettes’ appeal stems from a variety of perceived advantages over traditional cigarettes, most commonly the perceptions that e-cigarettes are healthier, cheaper, and can be used almost anywhere … Yet they may have some hidden dangers, including those of carcinogens and other dangers.”
Do you have any insight into the e-cigarette health news? Do you agree with the study’s finding that dangerous carcinogens may lurk in these seemingly more healthy e-cigarettes?
http://www.examiner.com/article/e-cigarettes-health-carcinogens-found-e-cigarettes-a-danger-study-finds

Smokers and the Affordable Care Act: Q&A

WebMD Health News
By Kathleen Doheny
Reviewed by Lisa Zamosky
The Affordable Care Act has ended some age-old health insurance practices such as denying people with pre-existing conditions. But it does allow insurance companies to charge people who use tobacco 50% more for their premiums.
Supporters say the higher premiums make sense because smokers and other tobacco users have higher health care costs. Critics say the higher rate is more likely to make people lie about their tobacco use or go without coverage than it is to encourage them to quit their habit. Smokers without insurance also put their partners and children at risk.
Here’s what smokers and others need to know.

What does the Affordable Care Act allow insurers to charge tobacco users?

Companies can charge tobacco users up to 50% more. States, though, can mandate a lower percentage or no surcharge.

What is ”tobacco use,” and how is a smoker or tobacco user defined?

Tobacco use is the use of any tobacco product, including cigarettes, cigars, chewing tobacco, snuff, and pipe tobacco, four or more times a week within the past 6 months. (Religious or ceremonial use of tobacco is allowed, such as by Alaska natives or Native Americans). It’s an honor system.

Will every state charge the maximum?

Seven states and Washington, D.C., will not charge smokers higher insurance premiums. The states are: California, Connecticut, Massachusetts, New Jersey, New York, Rhode Island, and Vermont.
Connecticut voted against the higher premiums only for the small group Marketplace, not the individual Marketplace. The other states outlawed higher premiums for both individuals and small business policies.
Three states — Arkansas, Colorado, and Kentucky — will allow companies to charge tobacco users less than 50%.
The remaining states are expected to allow the full 50% additional charge.
The highest possible premiums, though, won’t be effective for the first year because of a limitation in the software systems. That is being fixed.
Tobacco users in a small business plan don’t have to pay the higher premium if they enroll in a quit-smoking program; tobacco users in an individual plan may get a break on the premium if they enroll in a program. The law, however, does not require companies to offer the break in the individual Marketplace.

Will the Affordable Care Act require coverage of quit-smoking programs?

Yes.
The law requires all new private health insurance plans and Marketplace plans to cover services recommended by the U.S. Preventive Services Task Force, with no cost-sharing fees. That includes tobacco cessation treatments.

What will quit-smoking treatments or programs include?

That is unclear.
Insurance companies don’t have a consistent approach to quit-smoking programs, says Erika Sward, a spokeswoman for the American Lung Association. “What we have seen is a patchwork quilt.”
While the Affordable Care Act requires that new plans cover services recommended by the task force, the task force does not give specifics. It recommends that doctors ask adults about tobacco use, provide cessation programs, and provide counseling for women who smoke during pregnancy.
But there are no ”typical” tobacco cessation programs, according to a survey conducted by Georgetown University researchers.
What’s needed, Sward says, is a comprehensive approach. According to the American Lung Association, tobacco cessation benefits should include the choices recommended by the Public Health Service. These include:
   -Nicotine — from a patch, gum, lozenge, nasal spray, or inhaler
   -Medications — bupropion (Zyban) and varenicline (Chantix)
-Counseling — individual, group, and phone
In one area, the law is specific: It requires that pregnant women on Medicaid be offered the treatments recommended by the U.S. Public Health Service. Those include asking about tobacco use and offering counseling, with no recommendation aboutmedication use in pregnancy.

Who supports higher premiums for tobacco users?

The insurance industry supports higher rates because smokers have much higher health care costs than nonsmokers, according to Susan Pisano, a spokeswoman for America’s Health Insurance Plans, a trade industry group.
“There is clear documentation of so much greater health care costs [for tobacco users], and we think that should be reflected in the rates,” she says.
In 2004, smoking cost the U.S. $97 billion in lost productivity and $96 billion in direct health care costs, or $4,260 per adult smoker, according to the CDC.
More than half of Americans favor charging smokers more for insurance, according to a Gallup poll released in mid-August.

Who is against higher premiums for tobacco users?

Many health organizations, including the American Lung Association and the American Cancer Society, are against higher rates for smokers and other tobacco users.
The higher premium, besides being discriminatory, may backfire, Sward says.
“We really urge the carrot over the stick approach,” she says. “We know smokers want to quit and they need help to do so. It’s in everyone’s best interest that smokers have access to a good cessation program.”
SOURCES: Erika Sward, spokeswoman, American Lung Association.Susan Pisano, spokeswoman, America’s Health Insurance Plans.Alicia Hartinger, Health and Human Services.U.S. Public Health Services.U.S. Preventive Services Task ForceGallup.