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Drug Store News: CDC's latest anti-smoking campaign inspired 104,000 smokers to quit

BY MICHAEL JOHNSEN

ATLANTA – The latest outcomes measuring the impact of CDC’s national tobacco education campaign are as strong as those achieved in its first year, and suggest that three years into the campaign, the ads were still having a significant impact.

More than 1.8 million smokers attempted to quit smoking because of the nine-week-long 2014 Tips From Former Smokers ( Tips ) campaign. An estimated 104,000 Americans quit smoking for good as a result of the 2014 campaign.

The survey results are published in the March 24 release of the journal Preventing Chronic Disease.

Unlike the 2012 campaign, which aired for 12 consecutive weeks, the 2014 campaign aired in two phases, from Feb. 3 to April 6 and from July 7 to Sept. 7. Phase 1 of the 2014 campaign ran ads primarily from the 2012 and 2013 campaigns; Phase 2 contained new ads. Those new ads featured people and their struggles with smoking-related health issues, including cancer, gum disease, premature birth and stroke caused by smoking combined with HIV. About 80% of U.S. adult cigarette smokers who were surveyed reported seeing at least one television ad from Phase 2 of the 2014 campaign.

“CDC’s Tips campaign has helped at least 400,000 smokers quit smoking for good since 2012,” stated CDC Director Tom Frieden.  “Tips is also extremely cost-effective and a best buy, saving both lives and money. With a year-round campaign we could save even more lives and money.”

Tips, the first federally funded anti-smoking paid media campaign, features former smokers talking about their smoking-related illnesses. Smoking-related diseases cost the United States more than $300 billion a year, including nearly $170 billion in direct health care costs and more than $156 billion in lost productivity.

“The Tips campaign is an important counter measure to the $1 million that the tobacco industry spends each hour on cigarette advertising and promotion,” said Corinne Graffunder, director of CDC’s Office on Smoking and Health. “The money spent in one year on Tips is less than the amount the tobacco industry spends on advertising and promotion in just 3 days.”

The most recent Surgeon General’s Report, The Health Consequences of Smoking—50 Years of Progress, called for airing effective messages such as the Tips ads with high frequency and exposure for 12 months a year for a decade or more. Cigarette smoking is the leading preventable cause of disease and death in the United States, killing about 480,000 Americans each year.

For every American who dies from a smoking-related disease, about 30 more suffer at least one serious illness from smoking. And while the percentage of American adults who smoke is at the lowest level since the CDC began tracking such data, there are still an estimated 40 million adult smokers in the U.S.  Surveys show about 70% of all smokers want to quit, and research shows quitting completely at any age has significant health benefits.

http://www.drugstorenews.com/article/cdcs-latest-anti-smoking-campaign-inspired-10000-smokers-quit

Drug Store News: CDC's latest anti-smoking campaign inspired 104,000 smokers to quit

BY MICHAEL JOHNSEN

ATLANTA – The latest outcomes measuring the impact of CDC’s national tobacco education campaign are as strong as those achieved in its first year, and suggest that three years into the campaign, the ads were still having a significant impact.

More than 1.8 million smokers attempted to quit smoking because of the nine-week-long 2014 Tips From Former Smokers ( Tips ) campaign. An estimated 104,000 Americans quit smoking for good as a result of the 2014 campaign.

The survey results are published in the March 24 release of the journal Preventing Chronic Disease.

Unlike the 2012 campaign, which aired for 12 consecutive weeks, the 2014 campaign aired in two phases, from Feb. 3 to April 6 and from July 7 to Sept. 7. Phase 1 of the 2014 campaign ran ads primarily from the 2012 and 2013 campaigns; Phase 2 contained new ads. Those new ads featured people and their struggles with smoking-related health issues, including cancer, gum disease, premature birth and stroke caused by smoking combined with HIV. About 80% of U.S. adult cigarette smokers who were surveyed reported seeing at least one television ad from Phase 2 of the 2014 campaign.

“CDC’s Tips campaign has helped at least 400,000 smokers quit smoking for good since 2012,” stated CDC Director Tom Frieden.  “Tips is also extremely cost-effective and a best buy, saving both lives and money. With a year-round campaign we could save even more lives and money.”

Tips, the first federally funded anti-smoking paid media campaign, features former smokers talking about their smoking-related illnesses. Smoking-related diseases cost the United States more than $300 billion a year, including nearly $170 billion in direct health care costs and more than $156 billion in lost productivity.

“The Tips campaign is an important counter measure to the $1 million that the tobacco industry spends each hour on cigarette advertising and promotion,” said Corinne Graffunder, director of CDC’s Office on Smoking and Health. “The money spent in one year on Tips is less than the amount the tobacco industry spends on advertising and promotion in just 3 days.”

The most recent Surgeon General’s Report, The Health Consequences of Smoking—50 Years of Progress, called for airing effective messages such as the Tips ads with high frequency and exposure for 12 months a year for a decade or more. Cigarette smoking is the leading preventable cause of disease and death in the United States, killing about 480,000 Americans each year.

For every American who dies from a smoking-related disease, about 30 more suffer at least one serious illness from smoking. And while the percentage of American adults who smoke is at the lowest level since the CDC began tracking such data, there are still an estimated 40 million adult smokers in the U.S.  Surveys show about 70% of all smokers want to quit, and research shows quitting completely at any age has significant health benefits.

http://www.drugstorenews.com/article/cdcs-latest-anti-smoking-campaign-inspired-10000-smokers-quit

U.S. News/HealthDay: Graphic Cigarette Warnings May Target Brain's 'Quit Centers'

By Robert Preidt, HealthDay Reporter

FRIDAY, Feb. 26, 2016 (HealthDay News) — Disturbing images on cigarette pack warning labels activate brain regions crucial in quitting smoking, a new study suggests.

“Regulators can and should use this research to craft more effective warning labels and messages to smokers that both deliver facts about the negative effects of smoking and trigger thoughts and actions that move smokers toward quitting,” said study senior author Raymond Niaura. He is director of science at the Schroeder Institute for Tobacco Research and Policy Studies at the Truth Initiative in Washington, D.C.

“Tobacco is still the leading preventable cause of death in the U.S., and the growing body of research showing the effectiveness of warning labels should energize policymaking,” Niaura said in a news release from Georgetown University Medical Center, in Washington, D.C.

For the study, the researchers conducted brain scans on 19 young adult smokers. During the scans, the smokers were shown non-graphic and graphic pictures used on cigarette pack warning labels. For example, one image included an open mouth with rotten teeth and a tumor on the lower lip. The images were accompanied by the text: “WARNING: Cigarettes cause cancer.”

Seeing the graphic pictures triggered activity in areas of the brain called the amygdala and medial prefrontal region, the study showed. These areas are involved in emotion, decision-making and memory, the researchers said.

“The amygdala responds to emotionally powerful stimuli, especially fear and disgust. And experiences that have a strong emotional impact tend to impact our decision-making,” said study co-lead author Adama Green, a cognitive neuroscientist at the Georgetown University Medical Center and the Truth Initiative.

The study was published online recently in the journal Addictive Behaviors Reports.

“What we found in this study reinforces findings from previous research where scientists have asked participants to report how they think and feel in response to graphic warnings on cigarettes,” said co-lead author Darren Mays, an assistant professor of oncology at Georgetown’s Lombardi Comprehensive Cancer Center.

This study should help researchers understand the biological factors underlying responses to such warnings. And it may help them learn how these warnings can work to motivate a change in behavior, Mays said.

http://health.usnews.com/health-news/articles/2016-02-26/graphic-cigarette-warnings-may-target-brains-quit-centers

Inquisitr: 7 Reasons E-Cigarettes Are Bad

By Dieter Holger
E-cigarettes, also known as electronic cigarettes, have become a popular alternative to smoking the real deal, but the pros and cons of turning to this futuristic alternative are still under debate. Are e-cigarettes really any better than smoking a cigarette? Here are seven reasons e-cigarettes pose dangers to our health.
The effects of e-cigarettes are nowhere near as well-documented as cigarettes.
The e-cigarette industry is already worth billions of dollars, but there is nowhere near as much information on e-cigarettes as tobacco products. This should raise alarms, as the tobacco industry lived under a veil of scientific obscurity for decades until the detrimental health effects of cigarettes became well-known. Many people think e-cigarettes are a safer alternative, but that belief remains scientifically unproven, and evidence continues to come out saying e-cigarettes have toxic effects.
E-cigarettes contain plenty of cancerous chemicals.

By smoking e-cigarette vapor, people hope to avoid the cancerous chemicals inhaled from burning tobacco. Yet, e-cigarettes carry their fair share of toxic chemicals, too. Here’s a summary from the American Lung Association.

“In 2009, the FDA conducted lab tests and found detectable levels of toxic cancer-causing chemicals, including an ingredient used in antifreeze, in two leading brands of e-cigarettes and 18 various cartridges. A 2014 study found that e-cigarettes with a higher voltage level have higher amounts of formaldehyde, a carcinogen. It is urgent for FDA to begin its regulatory oversight of e-cigarettes, which would require ingredient disclosure to FDA, warning labels and youth access restrictions.”

Also, a 2013 study from the German Cancer Institute detected 8 different toxic chemicals in various e-cigarette liquids. And because the e-cigarette industry remains largely unregulated, the chemicals found in e-cigarettes aren’t uniform across the market. Some products may be less toxic than others, but without enough research or regulation it’s hard to know.
E-cigarettes are just as addictive as smoking tobacco.
E-cigarettes and tobacco products have the same highly addictive drug: nicotine. E-cigarettes derive nicotine from traditional cigarettes, delivering the same drug in a smokeless (vapor) form. In July, Daily Mail reported on a study by the American University of Beirut and the Center for the Study of Tobacco Products which demonstrated e-cigarettes contained highly addictive forms of nicotine. E-cigarettes might not have the same carcinogenic materials as cigarettes (like tar), but its nicotine still fosters addiction.
E-cigarettes have negative effects on lungs.
A supposed benefit of e-cigarettes is inhaling vapor instead of smoke. However, e-cigarette vapor is turning out to have a destructive effect on lungs. A recent July analysis by the University of Athens claimed that “using an e-cigarette caused an instant increase in airway resistance that lasted for 10 minutes.” Put simply, smoking e-cigarettes unhealthily constrains your airways.
Additionally, a study published in May by Indiana University showed that even nicotine-free e-cigarette vapor had damaging effects on the endothelial cells of the lungs. Endothelial cells protect the lungs from infections, so damaging them can’t be good for your immune system.
E-cigarettes won’t help you quit.
A lot of people vape e-cigarettes because they think it will help them kick their addiction. But recent research, including a comprehensive study by UC San Francisco, show that e-cigarettes don’t provide any extra help in quitting smoking. After surveying 849 smokers, the researchers found that users of e-cigarettes weren’t more likely to quit smoking.
“We found that there was no difference in the rate of quitting between smokers who used an e-cigarette and those who did not,” said head researcher Dr. Pamela Ling, a professor at the Center for Tobacco Control Research and Education at UC San Francisco.
E-cigarettes might create the equivalent of secondhand smoke.
Even if you don’t smoke, avoiding smokers is good for your health. But the American Lung Association point out e-cigarettes can also create the equivalent of toxic secondhand smoke, secondhand vapor.

“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 (all carcinogens) coming from those secondhand emissions. Other studies have shown that chemicals exhaled by users also contain formaldehyde, acetaldehyde and other potential irritants. 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.”

E-cigarettes could be a gateway into tobacco products for youth.
The tobacco industry spends millions of dollars advertising to youth, and it turns out e-cigarettes might be helping convince young people to smoke nicotine. Here’s a summary of studies from the American Lung Association.

“The American Lung Association is concerned about e-cigarettes becoming a gateway to regular cigarettes, especially in light of the aggressive industry marketing tactics targeted at youth—including the use of candy flavors and the glamorization of e-cigarette use. Studies are showing a dramatic increase in usage of e-cigarettes, especially among youth. For the first time ever, a national study released in December 2014 found e-cigarette use among teens exceeds traditional cigarette smoking. The study also found that e-cigarette use among 8th and 10th graders was double that of traditional cigarette smoking. CDC studies have also shown e-cigarette use among high school students increased by 61 percent from 2012 to 2013.”

Another study, conducted this August by the University of Southern California, found that teenagers who try e-cigarettes are more likely to smoke tobacco. The researchers sampled 2,500 9th graders who had never had smoked a cigarette, finding those who tried vaping e-cigarettes were 23 percent more likely to smoke a tobacco cigarette over those who had never tried an e-cig. On top of that, one-fourth of the surveyed youth who tried e-cigarettes admitted to smoking tobacco cigarettes within the last 6 months.
http://www.inquisitr.com/2378144/7-reasons-e-cigarettes-are-bad/

Today's Smokers Are Having a Harder Time Quitting — What Changed?

Dr. Daniel Seidman,  Smoking cessation expert | From HuffPost Healthy Living Blog

Over the last 25 years, cigarette consumption by smokers in the United States decreased by almost one-third. Over that same period, however, many tobacco companies reengineered cigarettes to more efficiently deliver the nicotine that keeps their customers coming back (1,2). This is called the “yield.” Increased yield means smokers, even if they smoke fewer cigarettes per day, still get plenty of nicotine. In other words, most of today’s cigarettes are not the same ones your mother or father smoked.

Not only are today’s cigarettes different — so are smokers. They are more likely to experience stress, worry, and depression regardless of their income (3). Recent research shows that it is quitting that brings stress relief rather than the other way around; cigarette addiction itself is a source of stress, anxiety, and depression (4,5) As the number of smoke-free environments increased, and because smokers smoke fewer cigarettes on average, today’s smokers generally wait longer between cigarettes. This delay increases the psychological and emotional reward value of each cigarette. At the same time, because they can’t smoke whenever they want, the timing is often uncertain, and the payoff — being able to light up — is irregular. Paradoxically, this sort of “intermittent” sporadic or random reinforcement is actually the strongest form of psychological reinforcement, thus making current patterns of smoking behavior harder to extinguish. Waiting to smoke is not quitting smoking!

Another factor making it harder to quit smoking today is that funding for tobacco prevention has been cut significantly. This illustrates the diminished importance society places on efforts to help smokers. Meanwhile, tobacco companies spend $18 to market their products for every dollar spent to support smokers and reduce smoking (6). Ostracized from private homes, work, cars, and public spaces, many smokers report high levels of shame when they leave social gatherings to get a nicotine fix. Our cultural norm of self-help places the burden of quitting, and blame of failure, squarely on smokers’ shoulders. Self-help, however, is clearly not working for many struggling to quit.

The United States has made remarkable progress against smoking, but most of that progress occurred in the 40 years before 2004, when the adult smoking rate was cut about in half to 20.9 percent. The most recent data, released by the Centers for Disease Control (CDC) on May 22, 2015 (7), is that the median prevalence of cigarette smoking in 2011 was 21.2 percent. Even adjusting for changes in the way smoking rates are being measured, this is higher, not lower, than the 20.9 percent reported 7 years earlier! For 2012, the smoking rate was 19.6, and for 2013 it was 19.0, barely budging from a decade earlier!

As we observed World No Tobacco Day 2015 this past Sunday, May 31, many smokers continued to find themselves in a trap set for them by cigarettes. Cigarettes are designed for addiction and not for recreational “take it or leave it” use. Many of today’s smokers therefore find themselves caught between a lack of constructive social and psychological support, and the destructive effects of highly nicotine-efficient cigarettes, creating a tobacco control stalemate.

What can be done?

We can start by requiring manufacturers to limit or taper permitted nicotine levels in cigarettes. All tobacco and nicotine products should be standardized and openly disclose their nicotine levels, and how much is absorbed into smokers’ bodies the same way people track calories or carbohydrates.

Here are five quick tips for smokers trying to quit:

  • Try to challenge beliefs that justify smoking. Beliefs such as “I smoke because I’m stressed,” “I’ll quit tomorrow,” “I’ll only smoke one,” and “I’m not strong enough to quit” are common and tend to cement smoking as a behavior.
  • Consider these three “triggers” to smoking, and be prepared with strategies to cope with them: 1) Other smokers: Avoid other smokers or ask them not to smoke around you, 2) Alcohol: Avoid alcohol or limit drinks as necessary, and 3) Emotional stress: Learn to adjust to situations without smoking.
  • With cigarettes delivering a stronger dose of nicotine, consider using two forms of NRT. The combined NRT approach not only delivers nicotine more aggressively to replace that from cigarettes, the U.S public Health Service 2008 update (8) found this to be the best of the medical options available for helping smokers quit.
  • Beware of cutting down as a strategy to quit unless you schedule your reduction of smoking in advance for a limited and specific amount of time prior to a target quit date. Stalling, delaying, or reducing smoking are tactics to avoid smoking, but are also ways to avoid quitting. Randomly reducing to quit is a common cessation strategy which recent research suggests is associated with lower cessation success rates. A 2013 Gallup poll (9) found smokers who succeed are more likely to quit abruptly (48 percent) vs. gradually (2 percent). A short-term technique for building confidence to prepare a successful quit day is smoking by the clock, otherwise known as “scheduled smoking” (10).
  • Download an app on your smartphone so you always have access to scientifically supported psychological and behavioral techniques. Such an app should help you prepare for and plan a successful quit day, as well as offer relapse prevention tools. It is critical that the app address not only the physical ties to your smoking addiction, but also the emotional side. Of course, I would like to highlight my own Up in Smoke app for iPhone, iPad Android, and the web!

Dr. Daniel Seidman, a clinical psychologist, is director of smoking cessation services at Columbia University Medical Center. He is author of the book Smoke-Free in 30 Days and of the “Up in Smoke” app from Mental Workout for iPhone, iPad, Android, Mac, and PC.

References:

  • Variation in nicotine intake in U.S. Cigarette smokers Over the Past 25 Years: evidence From nHanes surveys. Martin J. Jarvis, Gary A.Giovino, Richard J. O’Connor, Lynn T. Kozlowski, John T. Bernert.
  • SRNT Journal Research Advance Access published July 25, 2014
  • Recent increases in efficiency in cigarette nicotine delivery:implications for tobacco Control. Thomas Land, Lois Keithly, Kevin Kane, Lili Chen, Mark Paskowsky , Doris Cullen, Rashelle B. Hayes, Wenjun Li. SRNT Journal Advance Access published January 13, 2014
  • 2013 Gallup-Healthways Well-Being Index.
  • Tanya R. Schlam, Megan E. Piper, Jessica W. Cook, Michael C. Fiore and Timothy B. Baker. “Life 1 Year After a Quit Attempt: Real-Time Reports of Quitters and Continuing Smokers.” Annals of Behavioral Medicine, Vol. 44, Issue 3, 309-319. December, 2012.
  • West R, Brown J (2015) How much improvement in mental health can be expected when people stop smoking? Findings from a national survey, Smoking in Britain, 3,6. http://www.smokinginbritain.co.uk/read
  • Campaign for Tobacco Free Kids. Broken Promises to Our Children: The 1998 State Tobacco Settlement Fourteen Years Later (Updated in 2014).
  • State-Specific Prevalence of Current Cigarette Smoking and Smokeless Tobacco Use Among Adults Aged ≥18 years -United States, 2011-2013. CDC, Morbidity and Mortality Weekly Report (MMWR) May 22, 2015 / Vol. 64 / 19. See Table 1. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6419a6.htm?s_cid=mm6419a6
  • The 2008 update to Treating Tobacco Use and Dependence, U.S. Department of Health and Human Services Public Health Service May 2008. See page 109 http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/clinicians/update/treating_tobacco_use08.pdf
  • http://www.gallup.com/poll/163763/smokers-quit-tried-multiple-times.aspxhttp://www.gallup.com/poll/163763/smokers-quit-tried-multiple-times.aspxThe effects of smoking schedules on cessation outcome: Can we improve on common methods of gradual and abrupt nicotine withdrawal? Cinciripini, Paul M.; Lapitsky, Lynn; Seay, Sheila; Wallfisch, Annette; Kitchens, Karen; Van Vunakis, Helen. Journal of Consulting and Clinical Psychology, Vol 63(3), Jun 1995, 388-399.

http://www.huffingtonpost.com/daniel-seidman/todays-smokers-are-having_b_7471194.html

Opinion: Cigarette smoking’s growing income gap

By: Peter Orszag

The income gap between smokers and nonsmokers has grown. And it’s something companies may need to address directly in their efforts to help employees kick the habit.

Over the past several decades, smoking rates have fallen sharply among high-income, highly educated Americans and not as much for less educated, low-income people. The result is that, in 2013, the smoking rate exceeded 20 percent for people with a high school degree or less while among those with a graduate degree it was just 5.6 percent. Among people living in poverty, smoking was almost twice as common (29 percent) as among those at or above the poverty line (16 percent).

The good news is that the financial incentives many companies are considering, and some are now using, to help people quit smoking can work, as a new study in the New England Journal of Medicine shows. The researchers randomly assigned employees of CVS Caremark and their relatives and friends to different groups, which were given various financial incentives to stop smoking. This study did two fabulous things that are unfortunately quite unusual in the corporate wellness field: It used a randomized controlled trial (to boost confidence in the causality of its results), and it paid careful attention to the teachings of behavioral economics – testing, for example, whether carrots or sticks were more effective.

The results were encouraging. People who were told they would receive an individual bonus of $800 for quitting stopped at almost three times the rate of those not offered any direct financial inventive. Behavioral theory generally suggests, though, that loss aversion would work even better. In other words, if subjects made an initial deposit that they would stand to lose if they failed to quit, that would provide an even stronger incentive. And that was indeed the case, the researchers found, but people had to be willing to make the deposit in the first place. And because many were not willing to do that, the bonus approach was more effective overall. So unless a company finds a way to force its employees to follow the stick approach, the bonus works better.

These findings were widely reported in the news, but one thing went largely if not entirely unnoticed: A table in the appendix to the study showed that, for each of the four kinds of interventions studied, the share of high-income smokers who quit – those earning $60,000 or more – was larger than that of lower-income smokers. The reason, according to the study’s lead author, is that lower-income smokers were less willing to participate under any of the incentive programs offered. That was true despite the bonus or deposit being the same dollar amount for everyone, and therefore a higher share of income for lower-paid workers.

Reducing smoking among any group of employees is a good thing, and companies should act on this new research. At the same time, it is reasonable to be concerned about the gap in smoking rates by socioeconomic status, which is one of the forces widening the gaps in life expectancy by education and income. To reverse this trend, disproportionately larger dollar bonuses may be needed to get lower earners to quit.

Contact Peter Orszag at porszag3@bloomberg.net

http://www.delawareonline.com/story/opinion/contributors/2015/05/26/cigarette-smokings-growing-income-gap/27977649/

NPR: Smokers More Likely To Quit If Their Own Cash Is On The Line

Richard Harris

Screen Shot 2015-06-03 at 2.19.15 PM

A new study finds that employer-based programs to help people stop smoking would work better if they tapped into highly motivating feelings — such as the fear of losing money.

This conclusion flows from a study involving the employees of CVS/Caremark. Some workers got postcards asking them if they wanted a cash reward to quit smoking. One card ended up in the hands of Camelia Escarcega in Rialto, Calif., whose sister works for CVS.

Escarcega says she had smoked for many years and wanted to quit, and figured money would be a good incentive. Her sister told her she was welcome to enroll in the study, so she did.

Screen Shot 2015-06-03 at 2.15.01 PMEscarcega didn’t know it at the time, but the study was comparing different financial incentives to help people quit smoking. Hers was straightforward: Over a span of six months, she’d get up to $800 if she quit and didn’t start again.

She did pretty well, she says. “I’ve been smoke-free for a year and a half now.” The program offered her free nicotine patches, but Escarcega says she didn’t even need that added help.

Dr. Scott Halpern, a professor of medicine, epidemiology, medical ethics and health policy at the University of Pennsylvania, worked with colleagues to design the study, as a way of exploring the best way to entice people to quit tobacco, using financial incentives.

“A dollar is not a dollar,” Halpern says, “and how you design smoking cessation programs of the same approximate value goes a long way toward determining how effective these programs will be.”

The researchers compared a few approaches. Some people simply got cash for quitting. Others were offered a carrot-and-stick approach. They’d get a similar financial reward if they quit, but they’d also lose $150 of their own money if they started smoking again.

“People are much more afraid of losing $5 than they are motivated to earn $5,” Halpern says. “And so people’s actions go with their psychology.”

It came as no surprise that the researchers found it a lot harder to convince people to put down a deposit of their own money. But when they did, the results were remarkable.

“The deposit programs were twice as effective as rewards, and five times more effective than providing free smoking cessation aids like nicotine replacement therapy,” Halpern says.

More than half of the people who had money on the line stopped smoking for at least six months. These results are reported Wednesday in the latest New England Journal of Medicine. And Halpern argues the approach is much more effective than what most companies do now.

“Many programs are structured such that employees who stop smoking are rewarded by having less money taken out of their paychecks for insurance premiums the following year,” Halpern notes. “But by bundling the rewards into paychecks they’re relatively invisible to people — and the fact that they occur in the future — makes it less influential than if people were handed the same amount of money more quickly.”

Mercer, a benefits consulting company, reports that 21 percent of large employers currently offer financial incentives to workers who quit smoking or don’t start — primarily by reducing their health-insurance premiums. (An additional 5 percent of those companies offer other incentives). And more than half of the nation’s biggest employers use incentives.

Halpern says insurance premium rebates aren’t the best way to go.

“Employers and insurers could do a whole lot more to curb smoking than they currently are,” he says. “And doing so, they would reduce costs to themselves and improve public health.” Each employee who smokes costs a company more than $5,000 extra a year, due to health care costs and other expenses.

This is potentially tricky ground to navigate, though.

“Companies may have a concern that if they sign people into this kind of a wellness program and [the employees] lose that deposit, they’re going to feel really badly,” says Oleg Urminsky, at the University of Chicago’s Booth School of Business.

The worry is that those bad feelings “may spill into other things,” Urminsky says. “Are they going to resent the employer? Are they going to be complaining? It’s a powerful tool but it’s one that has to be used carefully.”

http://www.npr.org/sections/health-shots/2015/05/13/406459255/smokers-more-likely-to-quit-if-their-own-cash-is-on-the-line?utm_source=facebook.com&utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_content=20150513

Cigarette tax and e cigarettes debated in ND legislature

By KX News

Bismarck, ND -A bill that would have substantially raised taxes on cigarettes in North Dakota failed Friday afternoon.
But two others limiting access to electronic cigarettes passed.
The proposed cigarette tax would have raised taxes more than 200 percent on a package of cigarettes.
Currently the cigarette tax in North Dakota is 44 cents.
By contrast, the tax in Minnesota is 2.90 and in South Dakota it’s a 1.53.
Supporters of the bill say the increase would reduce the number of smokers and lower health care costs.
“Whenever a tobacco tax is increased, smoking, especially youth smoking goes down and it goes down dramatically. That I believe is undeniable,” says Rep. Jon Nelson, R – Rugby.
Bill opponents argued that a tax won’t stop smoking, and burdens business.
“If it truly is our duty to coerce people into a healthy lifestyle through taxation, why don’t we tax fast food with high fat content and high cholesterol, all things supersized and salt,” says Rep. Rick Becker, R – Bismarck.
The cigarette tax bill failed by a 56-34 vote.
The house passed two bills designed to keep e-cigarettes away from kids.
The two bills differ in these ways —
One labels e-cigarettes as tobacco products, tying them to the laws and enforcement already in place for cigarettes.
Those laws include things like compliance checks from local police and how cigarettes are displayed in stores.
The other bill separates e-cigarettes into their own category with their own set of enforcement laws.
“I don’t know how we can separate the idea of discussing e-cigarettes and then we’re going to talk about the taxing of tobacco when it’s clearly a tobacco product,” says Rep. Kenton Onstad, D – Parshall.
“We do not want kids under the age of 18 to buy cigarettes, whether it be on the internet, whether it be in the store. E-cigarettes, anywhere. We don’t want them to by regular cigarettes, we don’t want them to buy e-cigarettes,” says Rep. Al Carlson, R – Fargo.
Both bills now move to the Senate where only one, if any, is likely to pass.
http://www.wdaz.com/news/north-dakota/3679119-cigarette-tax-and-e-cigarettes-debated-nd-legislature