By Alan Mozes / HealthDay

Tobacco treaty unratified in U.S.

Pact signed in 2004, but never sent to Senate

More than 13 months ago, the United States signed an international tobacco treaty designed to tighten control of cigarette advertising and consumption worldwide, and President Bush said he wanted the Senate to ratify it.

But the treaty -- already in effect in 70 nations from Britain to India to Mexico -- today remains unratified and little discussed in the United States.

It was May 2004 when then-Health and Human Services Secretary Tommy G. Thompson signed the treaty for the United States and said, "I'm hopeful we can get this treaty to pass on a bipartisan basis -- this year." It then disappeared into the State Department and so far has not reappeared.

"The treaty is still under interagency review," State Department spokesman Edgar Vasquez said, adding that it is unclear when the review will be completed. "No decision has been made."

The treaty, negotiated in Geneva over three years, calls for reducing tobacco consumption through various measures, including substantially increasing the size of safety warnings on packaging, strictly limiting cigarette advertising, and moving toward smoke-free workplaces and public areas. It also works to reduce cigarette smuggling -- a priority for tobacco companies.

The Bush administration has been slow to act on six other treaties that it has signed but not sent to the Senate for ratification, but inaction on the tobacco treaty poses unique problems.

Only a spectator?
Long the world leader in tobacco control, the United States now runs the risk of being a spectator when ratified treaty members meet early next year to establish a permanent operating structure and to set priorities for action. If the United States is not a voting treaty member, public health officials say, American views on issues including cigarette advertising, smuggling and secondhand smoke will inevitably be less persuasive.

The organizational meeting will be convened by the World Health Organization and will begin to implement the principles and directives of the Framework Convention on Tobacco Control. All 168 signatories will be able to attend, but only nations that have ratified the treaty will be able to vote. To qualify as a voting member, the United States would have to ratify the treaty by late October or early November, WHO officials said.

"Those who have not ratified can participate as observers, but they'll have no vote and it's unclear how much of a voice," said Heather Selin, tobacco control adviser for WHO's Americas office in Washington. "This will be an important meeting and will get the treaty machinery to start rolling."

Public health advocates report that even without the United States, the invigorated tobacco-control movement has been surprisingly effective in motivating governments to implement potentially lifesaving initiatives.

The use of tobacco by smoking or chewing is the second-leading cause of preventable death worldwide -- after high blood pressure -- and kills almost 5 million people a year, WHO estimates.

The Bush administration has not publicly voiced concerns about the treaty, but neither has it shown any enthusiasm since it was signed.

Objections by tobacco companies
Some congressional officials say the administration doubts the treaty can win the two-thirds Senate majority needed for ratification, in large part because the two largest U.S. tobacco companies have objected to some of its provisions. Others say the administration is unwilling to displease the tobacco industry, which has long been a generous source of campaign funding.

Seth Moskowitz, a spokesman for R.J. Reynolds Tobacco Co., said his company has not taken a formal position on ratification, but it objects to treaty provisions that, it says, would restrict cigarette advertising and centralize and expand government authority over other aspects of the industry. "Some of the restrictions are things that could prevent us from competing effectively for the business of adult smokers," Moskowitz said.

Dawn Schneider, a spokeswoman for Altria Group, the parent of Philip Morris USA, said her company also has some concerns about the treaty -- especially possible restrictions on the sale of cigarettes in duty-free stores and an advertising ban in nations with constitutions that allow it.

But Schneider said Altria, unlike R.J. Reynolds, favors having the Food and Drug Administration regulate tobacco products and is using its influence in Congress to get a bill passed. "We believe the best and most effective way to implement [the goals of the treaty] is through FDA legislation," Schneider said.

It remains unclear how much support the treaty has in the Senate. Some senators, such as Richard Burr (R-N.C.), have been outspoken opponents. "Tobacco is an important agricultural product in our state, and anything that threatens the viability of tobacco farmers, he's opposed to it," said spokesman Douglas Heye.

But others have begun lobbying the administration to move the treaty forward.

‘Long delay’
"This long delay has been very discouraging to many senators," said Allison Dobson, spokeswoman for Sen. Tom Harkin (D-Iowa), who is drafting a letter to Bush calling for a prompt ratification vote. "Harkin believes the votes are there to ratify, but we're very concerned that the administration will end up siding with big tobacco again and not with public health," Dobson said.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, said the administration is forfeiting the United States' long-standing leadership on tobacco-control issues and faces the prospect of having other nations make decisions that will have a significant impact on U.S. consumers and companies.

"Unlike some of the environmental treaties, nobody can point to any provision of this treaty that would infringe on American autonomy or otherwise adversely affect other American rights. The question then is 'Why haven't we even sent the treaty up for ratification?' " he asked. "The only answer I can come up with is this: that the administration is listening to our least progressive tobacco companies who oppose the treaty. At one point, the administration considered the treaty worth signing. What happened?"

Govt goes back on tobacco ban

TIMES NEWS NETWORK[ WEDNESDAY, JULY 06, 2005 12:34:43 AM ]

NEW DELHI: After so much song and dance over the need to ban smoking on screen, the government has backtracked on imposing such a fiat and insisted that self-regulation by the industry is the best way to fight tobacco.
 

Study: Tobacco Firms Wooed Female Smokers

May 31, 2005 — Tobacco companies did elaborate research on women to figure out how to hook them on smoking even toying with the idea of chocolate-flavored cigarettes that would curb appetite, according to a new analysis.

Researchers at Harvard University's School of Public Health said they examined more than 7 million documents some dating back to 1969, others as recent as 2000 for new details about the industry's efforts to lure more women smokers.

Carrie Carpenter, the study's lead author, said companies' research went far beyond a marketing or advertising campaign.

"They did so much research in such a sophisticated way," she said. "Women should know how far the tobacco industry went to exploit them."

The report, published in the June issue of the journal Addiction, says tobacco companies looked for ways to modify their cigarettes to give women the illusion they could puff their way into a better life.

One of the documents, a 1987 internal report from Philip Morris, extolled the virtues of making a longer, slimmer cigarette that offered the false promise of a "healthier" product.

"Most smokers have little notion of their brand's tar and nicotine levels," the report states. "Perception is more important than reality, and in this case the perception is of reduced tobacco consumption."

A Philip Morris spokesman declined to comment on the report, saying the company hasn't had a chance to fully review it.

The Harvard researchers spent more than a year sifting through an online database of internal documents made public following the 1998 settlement between tobacco companies and 46 states.

Carpenter said they found at least 320 documents that focused on women's smoking patterns, including a 1982 report from British-American Tobacco Co. that said women buy cigarettes to help them "cope with neuroticism."

"We can safely conclude that the strength of cigarettes that are purchased by women is related to their degree of neuroticism," the report stated.

Other internal studies showed that companies explored adding appetite suppressants to cigarettes.

In 1980, for instance, R.J. Reynolds Co. proposed creating a cigarette with a "unique flavor that decreases a smoker's appetite, including brandy, chocolate, chocolate mint, cinnamon, spearmint and honey."

However, researchers didn't find any evidence they followed through with that idea. Officials at R.J. Reynolds didn't respond to requests for comment.

Paul Bloom, a marketing professor in the business school at the University of North Carolina at Chapel Hill, noted that cigarettes aren't the only "sin product" marketed specifically to women.

"For a long time, they just marketed beer to men. Then they discovered women would drink it, too," Bloom said. "Now binge drinking on campus is just as big a problem with women as it is with men."

Worldwide smoking rates among women are expected to increase 20 percent by 2025, "driven by the growth of female markets in developing countries," while men's smoking rates are steadily declining, the Harvard report says.

Jack Henningfield, a professor of behavioral biology at the Johns Hopkins University School of Medicine, said he hopes the report serves as a "call to action" for government officials to focus their anti-smoking efforts on women, particularly in developing countries.

"It's a time bomb," said Henningfield, director of the Innovators Combating Substance Abuse Program at Johns Hopkins. "They've got to act now to prevent the time bomb from exploding."

Carpenter said there is no evidence in the trove of documents that suggests tobacco companies have stopped targeting women.

"Without regulation from government agencies, we don't know what they're doing today," she added.

The Harvard research project was funded in part by the National Cancer Institute.

Saturday January 29, 05:20 PM

Anti-Tobacco Advertising Associated With Reduced Smoking

Newswise — Reduced cigarette smoking and more favorable anti-smoking attitudes were found among youth exposed to state-sponsored anti-tobacco advertising, according to a study in the July issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

The U.S. population has been exposed to an increasing number and variety of televised anti-tobacco advertisements since the early 1990s, according to background information in the article. However, given recent state budget crises and other political influences, many states have severely cut their anti-tobacco campaigns. Despite early evidence suggesting that state-sponsored anti-tobacco media campaigns may reduce adult smoking, few studies have explored their effect on youth.

Sherry Emery, Ph.D., from the University of Illinois at Chicago, and colleagues examined the association between exposure to state anti-tobacco advertising and youth smoking-related beliefs and behaviors. The researchers used targeted ratings point (TRPs) to assess the ratings of an advertisement among U.S. teen audiences. An ad with 80 TRPs per month is estimated to have been seen an average of one time by 80 percent of this age group. This information was combined with survey data from school-based samples of 51,085 students in the contiguous 48 states.

The researchers found that among survey respondents, 14 percent had an average of zero exposures to state-sponsored advertisements in the last four months, 65 percent of the students had an average exposure greater than zero, but less than one, and 21 percent had an average exposure of one or more state-sponsored anti-tobacco advertisements. Students in states with a TRP measure of one or higher were significantly less likely to report having smoked in the past 30 days (18.6 percent) compared with those in markets with no exposure to anti-tobacco advertisements (26.7 percent). Those with one or more state TRPs were more likely to perceive great harm from smoking one or more packs of cigarettes per day (72.1 percent vs. 65.1 percent). Also, students living in areas with an average exposure of at least one state-sponsored anti-tobacco advertisement were more likely to say that they believed they would definitely not be smoking in five years (64 percent vs. 55.3 percent).

“Our analyses suggest that state-sponsored anti-tobacco media campaigns were associated with more favorable antismoking attitudes and beliefs among youth and reduced youth smoking,” the authors write. “The strong associations between antismoking attitudes and beliefs, as well as reduced smoking, among students with a state TRP measure of at least one suggest that it is important to maintain a minimal mean exposure level of at least one cumulative state-sponsored anti-tobacco ad per four-month period for the general teen viewing audience.”

(Arch Pediatr Adolesc Med. 2005; 159: 639-645. Available pre-embargo to the media at http://www.jama.com.)

Editor’s Note: This study was funded by grants from the State and Community Tobacco Control Initiative of the National Cancer Institute, Bethesda, Md., the National Institute on Drug Abuse, Bethesda, Md., and from the Robert Wood Johnson Foundation, Princeton, N.J.

State Tobacco Counteradvertising and Adolescents

In an accompanying editorial, David E. Nelson, M.D., M.P.H., from the Centers for Disease Control and Prevention, Atlanta, writes about state-sponsored anti-tobacco advertising, “Despite tremendous strides in reducing youth tobacco use, and substantial research demonstrating that counteradvertising and other components of comprehensive programs are effective in reducing prevalence, as well as being cost-effective, it is obvious that tobacco prevention activities are not institutionalized and that state program expenditures in this area are viewed by many as discretionary.”

“Given the magnitude of the tobacco problem, and the fact that most regular smokers begin by age 18 years, preventing tobacco use among children and adolescents is one of the most important pediatric successes imaginable,” he writes. “Pediatricians and other health care providers, either individually or collectively through professional or other organizations, need to actively support sustaining state comprehensive tobacco control and prevention activities that include counteradvertising. Failing to do so could mean losing the hard-won gains achieved in tobacco prevention over the past several years, and unfortunately, that would be deadly for many people.”

(Arch Pediatr Adolesc Med. 2005; 159: 685-687. Available pre-embargo to the media at http://www.jama.com.)

A study on passive smoking has found children who are exposed to tobacco smoke every day are three-and-a-half times more likely to develop lung cancer than children who are not exposed.

The study involved more than 300,000 people throughout Europe, and is one of the largest ever undertaken on passive smoking.

Professor Paolo Vineis, from the Imperial College of London, says the study confirms previous research.

"There is a large amount of evidence about the association between environmental tobacco smoke and lung cancer," he said.

"In fact in 2002 there was a working group from the International Agency for Research on Cancer, which established that there is sufficient evidence concerning this association.

"There are more than 50 case control studies and a few prospective studies, so the association is well established."

Professor Vineis says the duration for which children are exposed to smoke is the biggest factor in their risk of developing lung cancer.

"The information we collected about childhood exposure tells us that these people were exposed for a very long time, and that's the main issue," he said.

"They started being exposed in childhood and that's what really counts in terms of cumulative risk of lung cancer."

Professor Vineis says it is not clear if children are more vulnerable to the effects of smoke or if the risk of developing cancer is related just to the length of time children are exposed to smoke.

"However, I must say that there is experimental evidence in animals showing that animals at a young age are in fact more susceptible to carcinogens," he said.

Professor Vineis hopes that the study will make some difference.

"People might be more worried about the presence of environmental tobacco smoke in the environment where they work and live," he said.

"In fact, the knowledge of that long-term exposure is important, probably more than the concentration of smoke is quite important."

The study, which has been published in the British Medical Journal has also found that reformed smokers are more susceptible to the effects of passive smoking.

Smokeless Tobacco Presents Heart Risk
6/27/2005

Some people chew tobacco thinking it is less unhealthy than smoking, but new research shows that snuff and chewing tobacco appear to increase the risk of heart disease, HealthDay News reported June 24.

Male smokeless-tobacco users were 20 percent more likely to die of heart disease than nonusers, according to researchers from the American Cancer Society who examined health surveys of more than 1 million American men, including about 10,000 smokeless-tobacco users.

Previous research had shown that smokeless-tobacco users were less likely than smokers to have cardiovascular problems. Lead researcher Jane Henley said that while more research may be needed, it is possible that smokeless tobacco increases the heart rate and stimulates clotting, which can block blood flow.

Henley said that the study should discourage people from using smokeless tobacco as a bridge between smoking and quitting. "We should be encouraging smokers who want to quit to use nicotine-replacement and other safe therapies," she said.

The study was published in the June 2005 issue of the journal Cancer Causes and Control.

India to require pictures of smoking-related diseases on cigarette packs

NEW DELHI (AFP) - India's health ministry will introduce a law forcing tobacco companies to carry pictures of smoking-related diseases on cigarette packs as a health warning, according to a news report

The law is likely to be introduced in parliament within three months, Health Minister Anbumani Ramadoss was quoted as saying by the Hindu newspaper.

"We are going through the models, pictures and images that the tobacco companies will have to put on their packs. I have no hesitation in adding that we are going to chose some of the most horrific, gory images," he said.

Singapore and Thailand currently carry pictures showing oral cancer and other smoking-related diseases on cigarette packs.

Earlier this month Ramadoss called for a ban on smoking scenes in movies and television.

The ban provoked widespread criticism from India's movie industry, Bollywood, which said it would have to edit thousands of films to comply with the ban. But the minister has refused to back down.

India, which accounts for one-sixth of tobacco illnesses worldwide, signed a a global anti-smoking treaty which took effect in March.

At least 2,200 people die daily from tobacco-related diseases in the country of more than one billion people.

Therapies to help tobacco addicts kick the habit

Therapies to help tobacco addicts kick the habit

Tobacco addiction is the leading preventable cause of death in India, accounting for over 800,000 deaths each year. A tobacco addict can improve his health and lengthen his life more, by quitting tobacco addiction along with other lifestyle changes like diet, exercise or stress management. Given the disastrous health hazards caused due to tobacco, anyone who's ever tried quitting knows it's easier said than done. This is because quitting can produce unpleasant withdrawal symptoms like depression, insomnia, irritability, difficulty concentrating, restlessness, anxiety, decreased heart rate, increased appetite, weight gain, and craving for nicotine.

Studies have shown that taking help of various therapies can help a tobacco addict avoid relapse of the addiction, and results in some of the highest long-term abstinence rates from tobacco. Quitting smoking or chewing of tobacco can be achieved successfully, provided the determination to quit is strong along with the involvement of different therapies.

Let us look at the various therapies for quitting tobacco addiction available today:

1. Nicotine Replacement Therapy (NRT)

Nicotine replacement therapy is a successful and an approved form of medication that can help quit smoking or chewing of tobacco. Nicotine gum is a popular form of NRT available as an FDA approved tobacco cessation aid. NRT gum (NuLife) —now in India, is available on doctor’s prescription. NRT gum delivers small but sustained levels of nicotine in the blood. Nicotine per se is not harmful. Sustained levels of nicotine are useful in quitting as nicotine levels are maintained in the blood and the craving for tobacco is reduced. Here, nicotine is provided but the uptake of nicotine by the body is not as quick as nicotine uptake observed in cigarettes or other forms of tobacco. Hence it’s easier to give up a NRT gum than it is to give up cigarettes and gutka. It is documented that tobacco cessation rates are increased three to four folds if NRT is used along with counseling and behavioral therapy and a strong determination to stop tobacco usage. NRT is also endorsed by leading medical organizations in the world, like the American Cancer Society.

2. Counseling and Behavioural Therapy

Counseling therapy involves the use of continued motivational techniques and support. Here, the doctor helps the tobacco addict move to the preparation stage to quit tobacco addiction, where plans are made for the initiation of therapies like NRT. The doctor or the counselor also helps him change his routine or behavior to avoid situations that increase the chances of failure. For example, if the morning ritual of a tobacco addict is drinking a cup of tea and smoking a cigarette, then that cup of tea can be had later or avoided during those first few weeks. Other means are finding alternative ways to reduce stress caused by quitting tobacco such as exercise, dancing or hot baths. Combined use of counseling, behavioural and drug therapies can dramatically improve the patient's chance of quitting smoking.

3. Yoga and meditation

Yoga is a form of relaxation and exercise that incorporates stretching, meditation, and knowledge of the body's full potential. Yoga helps relieve tension and stress and helps increase the strength and vitality of

physical and mental health. This helps a tobacco addict deal with the difficulty experienced during quitting tobacco.

Meditation calms nerves and allows one to think more clearly. Using the healing power of yoga along with involvement of other therapies helps quit tobacco addiction through an assertive behavior.

4. Support Therapy

Studies have shown that there is a better chance of being successful in quitting tobacco addiction if help is taken in the form of social support along with drug therapies like NRT. One can get support from family, friends, and co-workers. One way is to ask them not to smoke around a tobacco addict or leave cigarettes out and to stop him from smoking or chewing gutka, incase of a relapse.

5. Hypnosis/ other alternative therapies

Hypnosis is a psychological technique that helps reframe thoughts and reshape the world of a person. Though hypnosis is not known to be of considerable benefit, psychiatrists consider this technique helpful as long as one is ready to take multiple tries and many sessions to succeed and finally quit smoking. One must of course, find a reputable skilled practitioner. Other therapies which work well with hypnosis include drug therapy like NRT, Reiki and acupuncture.

Health Benefits of quitting tobacco

•  
• Within 8 hours, carbon monoxide levels drop in the body and oxygen levels in blood return to normal
• Within 48 hours, the risk of heart attack decreases and sense of smell and taste improve
• Within 72 hours, lung capacity increases and breathing becomes easier
• Within 2 weeks to 3 months, blood circulation improves and lung function improves up to 30 percent
• Within 6 months, coughing, sinus congestion, fatigue and shortness of breath improve
• Within 1 year, the risk of a smoking-related heart attack is cut in half
• Within 10 years, the risk of lung cancer is cut in half
• Within 15 years, the risk of dying from a heart attack is equal to a person who never smoked
• Reduction in complications of pregnancy and improvement in chances of conceiving

Source: British Columbia Cancer Agency Care and Research.

A Holistic approach

A holistic method doesn't rely on one or two techniques; rather, it combines as many as possible and addresses the life of the entire person -body, mind, and spirit. Along with the involvement of different therapies, getting plenty of exercise, eating a vegetarian diet, trying a therapeutic fast and taking vitamins during the period when one is trying to quit tobacco also helps. While choosing potentially effective therapies helps achieve the goal of quitting tobacco addiction, the key is to find the right combination of treatments that will help boost the chance of success.

Dr Mohan Jagde

MS (ENT), MCh, FAIS, MBA, DHA, Fe WHO
Head of Department ENT, JJ Hospital, Head and neck cancer surgeon, JJ Hospital
Professor of ENT at JJ Hospital and Grant Medical College

Salman Khan supports ''No Tobacco'' campaign
May 20, 2005
 

Supporting the "No Tobacco" campaign, actor Salman Khan, has urged the Government to curb sale of tobocco and alcohol. "If these are so bad why does not the Government put an end to it. They have done it with drugs they can do it with these as well", he said while announcing a friendly cricket match between actors and doctors to be played on May 21, observed as "The World No Tobacco Day". "Though it appears stylish and cool to smoke on the screen and glossy magazine it is uncool to do so", the actor said while reiterating that he makes special efforts not to project himself as an actor who smokes on the screen. "I have just smoked in one film "Tere Naam", he said. Speaking on the occasion, Justice Y K Sapru of the Cancer Patients Aid Association, revealed that Salman had always supported the cause of cancer patients. The actor has also offered his bone marrow to treat an ailing patient, he said. On other occasions, the actor has participated in Rose Day programmes in aid of cancer patients. He has also organised donation worth lakhs of rupees from various celebrities in the film world. Among those present at the function were actors Ritesh Deshmukh, Sohail Khan, cricketer Vinod Kambli, and TV star Yash Tonk. Salman, later, distributed voice boxes to cancer patients.

New Cancer Drugs Fight Tumors Many Ways

May 13, 2005 — A new generation of experimental cancer drugs is poised to upstage current hotshots by attacking the multiple methods tumors use to grow and spread, instead of just one.

These drugs are like a repairman who brings an entire toolbox to a job instead of just a wrench or hammer. They go beyond current favored medicines like Herceptin, Avastin and Iressa, which have impressed scientists for their ability to precisely target cancer cells while leaving healthy cells alone.

At a cancer meeting Friday, doctors reported that one of Pfizer's new multitasking drugs shrank tumors in 40 percent of people with advanced kidney cancer. Current treatments do that in only about 1 out of 10 cases.

Some patients have been on the experimental drug for more than a year far longer than they'd been expected to live.

Kurt Bonham is one. The California accountant was only 49 when he was diagnosed with kidney cancer that had already spread to his lungs.

"I'd been given my death sentence," he said.

Now, 13 large masses in his lungs have been reduced to specks.

"If I can have five more years, I think that they can come up with something fandangled that will either cure the cancer or manage it," he said.

Doctors hope the new generation of cancer drugs will do just that by blocking cancer's multiple pathways, such as cutting off the blood supply to a tumor or jamming the "switchboard" it uses to send messages to grow and spread.

The Pfizer drug, so new that it's just called AG-013736 for now, attacks blood supply and one of the switchboard's main lines. Another Pfizer drug, Sutent, also takes this approach. Eleven studies testing it against various cancers will be presented at the meeting, held by the American Society of Clinical Oncology.

Amgen, AstraZeneca and Eli Lilly have multitasking drugs in early stages of development. So does Novartis Pharmaceuticals, but its drug, called PTK/ZK, disappointed in a study involving people with advanced colon cancer, doctors reported Friday.

Short-term Effects Of Spit Tobacco Suggest Long-term Health Risks

The study of 16 young men who were habitual spit tobacco users measured their responses 30 minutes after dipping snuff. These readings were compared with measurements from another session involving the same participants after they had used a placebo product that was similar in taste, color and texture but did not contain tobacco or nicotine. The study was randomized and double-blinded; neither the researchers nor the subjects were told when they were taking the placebo and when they were using the tobacco product.

After snuff use, heart rate increased by about 15 beats per minute (25 percent), systolic blood pressure went up by 12 mmHg (10 percent), and measurements of adrenalin in the bloodstream increased by more than 50 percent.

"These results suggest a very significant excitatory effect of substances contained in spit tobacco on the part of the nervous system regulating the heart and blood vessels," says Virend Somers, M.D., Ph.D., the Mayo Clinic cardiologist who led the study. "Although we did anticipate some increase in blood pressure, we were surprised at the magnitude of the increase, as well as the very striking increases in heart rate and plasma epinephrine, or adrenalin. We anticipated that since these individuals were young and healthy and were accustomed to using spit tobacco, that any responses that we measured would be blunted. This makes the degree of increases even more noteworthy."

Robert Wolk, M.D., Ph.D., lead author on this study, noted that these results have implications both for long-term users and for individuals with established heart disease.

"The degree of speeding up of heart rate and increase in blood pressure, as well the increase in adrenalin (epinephrine) levels, suggest that if similar changes occur in people with established heart disease, who use spit tobacco, there may be reason to expect adverse consequences," Dr. Wolk says.

"Dipping" is Rising

More than five million adults – and more than 750,000 adolescents – use smokeless tobacco in the United States. Snuff use is increasing, especially in young males who participate in athletics. Its cardiovascular effects are not as clear or well understood as those of cigarettes, partly because fewer studies have been done, and partly because many spit tobacco users are relatively young and the bad effects may not be apparent unless use continues for prolonged periods.

Blunting a Protective Mechanism

By placing electrodes into the sympathetic nerves of the participants, the researchers also obtained a window on the message from the brain to the blood vessels on a moment-by-moment basis.

Normally, when blood pressure is increased by an external substance, the body seeks to protect the cardiovascular system by decreasing heart rate and dilating the blood vessels. It does this by "shutting down" the sympathetic nervous system, so that heart rate is slower, and the widening of blood vessels starts to bring blood pressure down.

The researchers demonstrated this by giving another group of subjects an intravenous medication, phenylephrine, to raise blood pressure about as much as they saw when spit tobacco was used. In response, those subjects' heart rates decreased by more than 10 beats a minute and the activity of the sympathetic nervous system went down to very low levels.

"This is an example of how the body tries to protect itself from the higher blood pressures," Dr. Somers explains. "However, when the blood pressure is raised by spit tobacco, the heart rate actually speeds up dramatically and there is no decrease in the sympathetic nervous system activity. This tells us that the normal protective mechanisms which help dampen down spikes in blood pressure are blunted when using spit tobacco.

"Spit tobacco is a very potent cause of acute increases in blood pressure, heart rate, and adrenalin levels," Dr. Somers concludes. "Since many athletes, who are already under a fair amount of stress in competitive situations, also use spit tobacco, the blood pressure and heart rate increases need to be recognized and understood. And since spit tobacco not only raises blood pressure but also blunts the body's normal defense response to blood pressure increases, long-term dipping would seem likely to increase the risk of cardiovascular disease."

Smoking bad for pets: insurer-(Yahoo News-13/09/2004)

Dogs living with smokers have a higher incidence of serious conditions such as asthma, nasal and sinus cancer and lung cancer than those who have non-smoking owners, a pet insurer in Britain says. Research carried out in the United States also showed that cats living in smoking households were twice as likely to develop certain forms of cancer, including lymphoma, Asda Pet Insurance said. 

"Many people don't realise that passive smoking can have a very harmful impact on pets in the home, with knock-on implications for vet bills," a spokesman said. The effects of passive smoking were greater on young animals because their lungs were smaller, their immune systems were less well-developed and they breathed faster, the insurer quoted veterinarians as saying.

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Ventilation in bars doesn't control health risk for hospitality workers-(Yahoo News-09/09/2004)

The level of cancer-causing particles is much higher in the air of smoke-filled bars and casinos than on truck-choked highways and city streets, according to the first published comparison of indoor air quality before and after smoke-free workplace legislation. The study, conducted in a casino, six bars and a pool hall in Wilmington, Delaware, is published in the September 2004 Journal of Occupational & Environmental Medicine.

"This research clearly shows that it is far worse for your health to be a bartender or casino dealer in a smoking-permitted establishment than it is to be a turnpike toll collector," says James L. Repace, MSc., the study's author. "These workers breathe an average of 90% cleaner air after a smoke-free workplace law." Repace, a health physicist, is visiting assistant clinical professor at Boston's Tufts University School of Medicine and a secondhand smoke consultant based in Bowie, Md. In 2002, Repace received a Robert Wood Johnson Foundation Innovators Combating Substance Abuse award for his ground-breaking work on the effects of secondhand smoke. Funds from the award helped make this study possible.

Repace assessed air quality in the eight hospitality venues on Friday evenings in November 2002 – before Delaware's smoking ban -- and again in January 2003, two months after the ban took effect. Using state-of-the art monitoring equipment, he measured respirable particulate air pollution (RSP) and particulate polycyclic aromatic hydrocarbons (PPAH), pollutants proven to increase risk of respiratory disease, cancer, heart disease and stroke. Repace's findings demonstrate the dramatic effect of Delaware's smoking ban: Except for residual chalk dust in the pool hall – at 17% of pre-ban levels -- air quality levels post-ban in all venues were indistinguishable from those measured out-of-doors.

Prior to the smoking ban, however, Repace found all eight venues to be heavily polluted. Indoor RSP levels averaged 20 times those in the outdoors and were 4.6 times higher than the level permissible under the U.S. Environmental Protection Agency's National Ambient Air Quality Standard (NAAQS). The hospitality workers were exposed to RSP levels 2.6 times higher than those Repace measured on diesel-exhaust polluted streets in Boston and on Interstate-95 in Delaware. Carcinogenic PPAH levels pre-ban were five times higher than outdoor levels in Wilmington, and exceeded those measured at an I-95 tollbooth at the heavily trafficked Baltimore Harbor Tunnel.

"Before the ban, secondhand smoke contributed 90% to 95% of the RSP air pollution in the studied venues, and 85% to 95% of the carcinogenic PPAH," says Repace. "This demonstrates conclusively that ventilation does not control the life-threatening pollutants inherent to a smoking environment. Only a smoke-free workplace law can protect the health of these workers." Few states have taken action to protect hospitality workers; only 14% of states have laws banning smoking in restaurants, bars, casinos and all other workplaces. According to the federal Agency for Toxic Substances and Disease Registry, people exposed to polycyclic aromatic hydrocarbons (PAHs) for prolonged periods can develop cancer. Ten carcinogenic particulate phase PAHs have been identified in tobacco smoke, representing one-sixth of all known tobacco smoke carcinogens.

Repace has conducted research on indoor air pollution from secondhand smoke for 28 years, and has published more than 60 scientific papers on the topic. Among his major accomplishments, in 1979 he initiated the Environmental Protection Agency's policy interest in indoor air pollution. In 1980 he identified secondhand smoke as a major source of indoor air pollution in a groundbreaking paper that received international scientific attention. Five years later, he estimated that 5,000 lung cancer deaths per year in the U.S. were caused by passive smoking, in a seminal study.

Innovators Combating Substance Abuse is a national program of The Robert Wood Johnson Foundation that recognizes and rewards those who have made substantial, innovative contributions of national significance in the field of substance abuse. Each award includes a grant of $300,000, which is used to conduct a project over a period of up to three years that advances the field. The program addresses problems related to alcohol, tobacco and illicit drugs, through education, advocacy, treatment and policy research and reform at the national, state and local levels. The Innovators program is run by a national program office at The Johns Hopkins University School of Medicine. 

The Robert Wood Johnson Foundation, based in Princeton, N.J., is the nation's largest philanthropy devoted exclusively to health and health care. It concentrates its grantmaking in four goal areas: to assure that all Americans have access to quality health care at reasonable cost; to improve the quality of care and support for people with chronic health conditions; to promote healthy communities and lifestyles; and to reduce the personal, social and economic harm caused by substance abuse - tobacco, alcohol and illicit drugs. To this end, the Foundation supports scientifically valid, peer-reviewed research on the prevention and treatment of illegal and underage substance use, and the effects of substance abuse on the public's health and well-being. 

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Scientific research supports smoking bans-(Yahoo News-18/08/2004)

With the St. Paul City Council’s approval of a smoking ban in bars and restaurants, the council has acknowledged what the U.S. government concluded 18 years ago: Exposure to secondhand tobacco smoke — “involuntary smoking” — is a serious threat to nonsmokers’ health. In 1986, Surgeon General C. Everett Koop issued a report, “The Health Consequences of Involuntary Smoking,” outlining the risks of inhaling secondhand smoke. The report concluded that “involuntary smoking is a cause of disease, including lung cancer, in healthy nonsmokers.”

It also concluded that smokers’ children have a greater risk of developing respiratory disorders than nonsmokers’ children, and that separation of smokers and nonsmokers in the same air space does not eliminate nonsmokers’ exposure to environmental tobacco smoke. The report also called on smokers and nonsmokers to take responsibility for their health, as well as that of their children and employees: “As employers and employees we must ensure that the act of smoking does not jeopardize the health of others.”

Eighteen years later, a study in the British Medical Journal published in June concluded secondhand smoke is even more dangerous than previously thought. The study, which followed more than 2,000 nonsmokers for 20 years, measured cotinine (a nicotine byproduct of tobacco smoke) levels in subjects’ blood, and found that nonsmokers with cotinine were at an increased risk for heart attacks by up to 60 percent — which might account for up to 80,000 heart attacks in the United States annually. Stanton Glantz, a University of California-San Francisco researcher, said being close to someone smoking several cigarettes a day is about as bad as being a light smoker yourself.

Whatever people think about other issues related to smoking bans, secondhand smoke poses serious health risks to nonsmokers, period. Nonsmoking employees of bars and restaurants should not be forced to put their health in jeopardy in their workplaces, and nonsmoking bar patrons should not be expected to deal with other patrons’ poor health choices. The St. Paul City Council made the right choice. Mayor Randy Kelly should follow suit, and the rest of Minnesota should wake up and smell the smoke-free air, too.

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Nicotine patch helps teens cut cigarette use, Stanford and Packard researchers learn-(Yahoo News-15/08/2004)

Nicotine patches may work as well for teens trying to kick the smoking habit as they do for adults, say researchers from the Stanford University School of Medicine and Lucile Packard Children's Hospital. The findings suggest that physicians should consider the popular therapy for teenaged patients who routinely light up but want to quit. The researchers also found that the patches were equally effective in adolescents regardless of whether they were combined with an antidepressant often used to help adults stop smoking. All teens in the study also received behavioral skills training to help them identify and manage trigger situations that usually had them reaching for a cigarette.

"We're encouraged because in our study the initial quit rates for kids treated with nicotine patches and skills training were similar to those seen in adults," said Joel Killen, PhD, professor (research) of medicine at the Stanford Prevention Research Center and lead author of the study. "Just as importantly, most of the kids in the study were able to substantially reduce their tobacco usage, which has not been seen in previous studies."

The study, published in the August issue of the Journal of Consulting and Clinical Psychology, is the first randomly controlled trial of medication to help young smokers quit and is the first to compare success rates of the patch with and without antidepressant medication in this age group. Despite a national effort to shield kids from the lure of tobacco, one in five U.S. high school seniors smokes daily. Reasons for lighting up for the first time can run the gamut from mimicking family members to deliberate risk taking to weight control. The desire to stop can be equally complex.

"Kids tend to think they can quit whenever they want, that they're bulletproof," said Killen. But a rising awareness of the unpleasant aspects of smoking, coupled with tight pocketbooks and rising cigarette costs, is spurring more teens to reduce or stop smoking. A lot of teens realize that it's a nasty habit," said study co-author and adolescent medicine specialist Seth Ammerman, MD. "Some have noticed that they have poor stamina or have seen relatives die from smoking-related causes. Others have friends who are encouraging them to stop." Ammerman is the medical director of Lucile Packard Children's Hospital's Teen Health Van, which provides care for homeless youth. Quitting can be much more difficult than a teen had expected, however. And those who turn to their doctors for help may not always be getting the support they need. "Most pediatricians who work with kids are not used to treating a drug addiction," said Ammerman. "We're used to giving a kid medicine and then they do well and move on, but treating tobacco addiction takes repeated time and effort."

In the study, the authors tested the effect of the nicotine patch on 211 teens between the ages of 15 and 18 who smoked at least 10 cigarettes a day and had been smoking for the previous six months. The volunteers had all made at least one failed attempt to stop smoking and scored highly on a questionnaire that rates nicotine dependence. Teens were recruited from nine continuation high schools in the San Francisco area. Participants were divided into two groups, one treated with the nicotine patch plus the antidepressant bupropion, and one with the nicotine patch plus placebo. Bupropion, which is also approved as a smoking-cessation aid in adults, is thought to help reduce the depressive symptoms and cravings that can accompany nicotine withdrawal. All of the teens attended weekly group counseling sessions to cope with smoking urges.

Every participant was required to stop smoking two weeks after the first counseling session. All patients received the nicotine patch in tapering strengths for eight weeks. Starting levels were tailored to the daily number of cigarettes a teen had been smoking. Those randomized to receive bupropion began one week before quitting, and continued treatment for nine weeks. Medication and smoking status was confirmed through blood, urine and breath tests. After 10 weeks of treatment, 23 percent of the teens using both the patch and the antidepressant had stopped smoking completely and 28 percent of teens using the patch plus placebo had kicked the habit - a statistically insignificant difference. Maintaining abstinence was even more difficult for teens than it is for adults, however: only 8 percent of teens on both medications and 7 percent of teens on the patch plus placebo were still abstinent after 26 weeks.

Although it was tough to turn down cigarettes for good, most of the kids in both treatment groups were able to reduce and maintain their cigarette intake to just a few cigarettes per day, indicating that the treatment had at least some benefit for nearly all the participants. "Physicians used to believe that they didn't have the appropriate skills to help teens stop smoking," said Killen. "Nicotine-replacement therapies may be a valuable tool for these doctors. This finding gives us a platform to build on, whereas before doctors threw up their hands when faced with teen smokers."

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Does Zarda plus supari equal gutkha? If so, anti-tobacco crusader wants state to ban products-(Times of India-20/05/2004)

In August 2002 the Bombay high court had banned the sale of gutkha. But if anti tobacco crusader and WHO award winner Vincent Nazareth, convener of Crusade Against Tobacco, is to be believed, the lethal product is still available in the market. All the buyer has to do is to purchase two products, zarda and supari, mix them together and presto, he gets gutkha. 

Nazareth wrote to the FDA and state government asking them to test mixes of zarda and supari and ban products if the results revealed anything hazardous. He has now sent a legal notice to Uttam Khobragade, FDA Commisioner, contending that these products could contain magnesium carbonate which can lead to life threatening diseases like cancer and tumours.

FDA Minister Anil Deshmukh has rejected the demand to ban these products. "The basic issue is the presence of magnesium carbonate. We found very few samples of zarda and supari separately and together with this chemical.". the government has initiated action against manufacturers whose samples do not measure up to the standards.

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Death Risk for Smokers’ families-(Mid Day-06/04/04)

People who have never smoked but live with smokers have a 15% greater risk of premature death than those in smoke free households, a study has revealed. It shows exposure to smoke in the home can dramatically increase the chances of developing a fatal illness. The findings published in the British Medical Journal led to new demands for a ban on smoking in public.”the results from this study add to the weight of evidence of harm caused by passive smoking and support steps to reduce exposure to other people’s smoke-in the home and in other settings,” said the report’s author, Dr. Tony Blakely.

The study, conducted at the Wellington School of Medicine and Health Sciences in New Zealand, studied data involving householders aged between 45 and 74 at the time of the 1981 and 1996 censuses. They compared the number of deaths in the three years after each census amongst those who never smoked but lived with at least a smoker and those who had never smoked and had a smoke free home.

The figures showed that those who had been exposed to passive cigarette fumes in their own homes were 15% more likely to die during those three years than those who were not.

Dr. Vivienne Nathanson, of the British Medication Association, said the center should some courage and ban smoking in public places. She added, “Evidence is clear-it’s time for action. If Ireland can do it, why not us?” Deborah Arnott, director of the anti-smoking group, ASH said, “The case for a law to end smoking in the workplace and in enclosed public places is now overwhelming.” The chief medical officer Sir Liam Donaldson has already called for an outright ban. A spokesman for the Department of Health said the issue would be addressed in a white paper on public health. He added, “We recognize the danger of second hand smoke and are trying to encourage smoke-free areas in public places.”

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Children are using tobacco laced dental products-study-(Times of India-20/05/2004)

A recent survey has found out that a substantial percentage of school-going children use dental-care products containing tobacco. The first phase of the Global Youth Tobacco Survey 2004, sponsored by the WHO and Centre for Disease Control, USA, has come up with disturbing facts like these for India. Fourteen states, including Maharashtra, have been covered in the survey so far

Says Prakash Gupta of the Epidemiology Research Unit, Tata Institute of Fundamental Research: "We did a survey of 13- to 15-yearold school-going children and found that a disturbing percentage of these children are using dental-care products which contain tobacco. These (products) include Lal Dantamanjan as well as what is colloquially known as the `tobacco toothpaste' which comes in various brands like IPCO, Ganesh,Dentobac or Tona. Other dental-care products like gudaku (a paste of tobacco and molasses), misri (containing powdered, roasted tobacco) and gul are also used by children today"

According to the study the percentage of children using tobacco-laced dental-care products ranges from 6 per cent in Goa to 60 per cent in Bihar The effect of these products is as habit-forming as any other tobacco product. "There is already a law effective from 1992, which says tobacco cannot be added to any dental-care product;" Gupta says. `All that the concerned ministry has to do now is to enforce this law strictly. These dental-care items should be treated as tobacco products. Their ads should be banned, their packaging should carry statutory warnings."

The next part of the study includes an intervention programme and periodical surveys for monitoring the situation.

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Ban on Gutka but what about ads?-(Times of India-14/05/2004)
Study reveals high recall of gutka ads among kids

The two-year gutka ban in the state has not diminished the demand for the tobacco product. The reason-the ban does not cover its advertising, which has retained the gutka on the minds of youngsters. And now, a study conducted by city-based NGO Salaam Bombay Foundation exposes the stronghold of tobacco advertising on the minds of Mumbai teenagers.

Titled “Cancer of the Mind” the study questioned 3,260 children between the age group 12-17 from 15 municipal schools to assess the recall of tobacco advertising amongst them. The findings were revealing-77% recalled a gutka/pan masala advertisement, 17% remembered a raw tobacco ad and only 4% recalled a cigarette ad.

Again over 70% actually recalled the slogan of the ad like Manikchand gutka. Incidentally boys recalled more brands (33%) than girls (23%). Television had the highest impact on the children in remembering the ads. 81% of the respondents watched them on TV, 9% on radio abd only 6% in newspaper ads.

“Ad industry is only focusing on the cigarette ads but it is gutka which is affecting kids. TV has a huge impact since these ads are shown on cable TV. Other products of a tobacco manufacturing company should not be allowed to carry the same brand and slogan as it reiterates the tobacco imagery,” explains Padmini Somani, director, Salaam Bombay.

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Parents smoking outdoors still subject kids to passive smoking-(Times of India-12/05/2004)

Parents who choose not to smoke inside the home may still be subjecting their children to the effects of passive smoking, with harmful particles riding home, clinging to hair and clothes, a new study suggests.

Nicotine, a major ingredient of secondhand smoke, can be detected in the dust and air inside the homes of smokers who deliberately go outside for a puff, `Nature' magazine reports quoting the study. Children in such homes have up to eight times more nicotine in their bodies than the offspring of non-smokers, researchers found.

The levels of nicotine are still quite low says George Matt from San Diego State University, California, who led the study. But they could build over time, potentially making the children more prone to smoking-related problems, such as asthma and sudden infant death syndrome. Cigarette fumes probably get lodged on the hair and clothes of parents, `Nature' quoted Matt as saying.

Particles could then be brought back inside the house, where they would hang in the air or settle in dust. Family members may then inhale them directly or unwittingly transfer them from hand to mouth. Infants are particularly at risk as they spend most of their time indoors and often put objects into their mouths; says Matt. Contaminated dust can settle on toys, carpets and bedding and may remain there for months, he adds.

"The study shows that parents can reduce the amount of passive smoke inhaled by their children by always smoking outdoors," says Matt. "But they would be mistaken to think that this completely protects their children from exposure."

Matt's team, `Nature' reports, looked at 49 family homes with children less than one year old. Fifteen homes were occupied by non-smokers. The remainder were split between indoor and outdoor smokers. The researchers assessed nicotine levels in urine samples from the children, and in dust and air samples taken from the children's bedrooms and living rooms.

The children of indoor smokers had the highest nicotine levels of all- up to eight times more than outdoor smokers' children, and up to 14 times more than those of nonsmokers. Levels of nicotine in dust and air followed a similar pattern. If nicotine is present, then other more harmful chemicals from cigarette smoke are also likely to be there, tobacco researcher Martin Jarvis from University College London was quoted as saying. Cigarette smoke is a complex mix of some 4,000 chemicals. Many of these, such as formaldehyde, ammonia and hydrogen cyanide, are harmful to human health.

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Tobacco advertising will go up in smoke: State ban on ad May 1 onwards-(Indian Express-06/04/2004)

-No ads on railway stations; auditoriums after April 30
-No retail outlets within l00 mt of govt offices, schools
-Outlets must display statutory warning.
-Smoking only in restaurants with separate enclosure

Come May and cigarette and tobacco advertisements will no longer be seen at railway stations or auditoriums. In line with the legislation enacted by Parliament in the last session, the state government has banned advertisements of cigarettes and other tobacco products from all public places and also decided to put restrictions on its retail sale from May 1 onwards. This will include all public places including railway stations, auditoria and play grounds. Manufacturers have been asked to withdraw advertisements from such places by April 30.

“The decision is in line with the act passed by the central government," said additional chief secretary (public health) Navin Kumar after holding a meeting to discuss the implementation of the ban.

Government agencies have been informed to put up notices informing the public that smoking is banned at these places. Smoking will be permitted at restaurants only if they provide separate smoking sections for customers wanting to enjoy a smoke. Several restrictions are also in the offing for retailers selling tobacco products. Outlets will not be allowed within 100 metres of educational institutions and government buildings. They will not be allowed to sell to minors. Further, it will be mandatory to display statutory warnings against smoking and chewing tobaccos prominently at the shop.

There is more to come. "What we are implementing are initial steps. Several restrictions on distribution and sale of tobacco are in the offing," said Kumar. Also, the government is seeking information from the Centre regarding the ban on tobacco products ads on television and print media.

To effect the ban, the health department is coordinating with the police, the Food and Drugs Administration and district collectors. It is also planning to rope in NGos and National Service Scheme volunteers to create awareness about government campaigns against tobacco consumption.

Though India's biggest tobacco firm, ITC did not comment officially on the issue, company insiders said any ban on tobacco product ads will not make much difference in their sales. “There were bans earlier also but tobacco products sales worldwide are growing. Even in India, tobacco products sales will shoot up whether the government bans the ads or not” said an ITC official.

Tobacco is one of the biggest contributors to the state exchequer. Industry officials say governments impose the ban with an eye to please the electorate.

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Should This Logo Sit On Your Favourite Pack?-(Global Link-03/07/2004)

Three years. That’s the time cigarette companies want before they can put together any mandatory skull-and-bones logo on their product packs. The World Health Organisation framework convention on tobacco control (FCTC)—India ratified it in February—doesn’t compulsorily require a pictorial warning on tobacco product packs.

But the health ministry is about to do so. There will be new statutory text as well, reading either ‘Tobacco Kills’ or ‘Tobacco Causes Cancer’. The FCTC recommends a period of three years for implementation. Cigarette companies have said they need the three years to get over ‘logistical changes’ required to incorporate the new packaging requirements. This primarily includes changing printing parameters and incorporating a new picture. It also includes re-registration of certain brands which may be under license from abroad (like Four Square) and getting through with all the legal paperwork.

ITC Ltd, the country’s largest producer of cigarettes, said it is a question of practicability. “It would be difficult to go through with the whole process. It is currently not possible for this requirement to cover all tobacco products, so our stand is that guidelines be issued once all products can be covered,” ITC senior vice president K Vaidyanathan said.

Tobacco Institute of India director Sundeep Kumar—he’s also senior vice president (corporate affairs) at India’s second largest cigarette company Godfrey Phillips—felt the switch over to new graphics for cigarette packs require new outlays and investments. These would take time to line up. “For example, our Four Square brand is licensed by Philip Morris. If we have to make changes to the Four Square pack, it will need to be vetted by them, which will follow legal work and re-registration,” Kumar said.

The health ministry is understood to be in consultation with the printing industry to draw up guidelines so that pictorial sy mbol guidelines may be issued to cover all tobacco products. Singapore recently handed out pictures of a smoker’s lungs and a cancer patient, among others, telling cigarette makers that they will need to put these on their packs.

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India : Ban on smoking in Parliament from tomorrow-(Global Link - 04/07/2004)

More than two years after the Supreme Court had asked the Centre and state governments to ban smoking at public places, the Central Hall of Parliament and the lobbies have been declared as no smoking zones from tomorrow, when the Budget session begins.The decision was taken at an all party meet convened by Lok Sabha Speaker Somnath Chatterjee today.''We have declared that from tomorrow, the Central Hall and lobbies will be smoke free. No smoking will be allowed,'' the Speaker told reporters.

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Pakistan : Government accused of doing nothing for tobacco growers-(Global Link-04/07/2004)

Tobacco growers demanded that tobacco, which generates 25 percent of Pakistan’s total excise duty, should be included in the Pakistan Trade Corporation as a crop like cotton, rice, wheat and sugar cane.

Speaking to reporters on Thursday, the President of the Central Organising Committee of Ittehad-e-Kashtkaran, Arif Ali Khan and member Professor Munawar Khan said that the government had done nothing for tobacco growers even though tobacco contributed around Rs 35 billion annually to the national exchequer in taxes. They accused the Pakistan Tobacco Board (PTB) of working for the interest of cigarette companies instead of the growers.

“The objective of PTB’s establishment was to protect the interests of the growers,” said Arif Ali Khan. “However, it is working solely for the interest of cigarette companies.” The speakers at the press conference said that the two major cigarette companies purchased half of their supplies through established purchasing centres and the rest through local agents at low prices.
“In this way these companies not only evade taxes but also fleece the growers by purchasing tobacco at lower prices,” they said. “PTB doesn’t do anything to regulate this but actually assists these companies in the exploitation of the growers.”

Besides two major companies, 14 small cigarette companies also purchased tobacco through their agents at low prices and made very late payments. The speakers said that the central and the provincial governments were not imposing checks and balances on these tobacco companies to prevent them from exploiting growers.

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Cancer experts back return of tobacco ‘teabags'-(Yahoo News -28/06/2004)

TWELVE years after it was banned in Europe, the so-called tobacco teabag is ready to make a comeback with the blessing of anti-smoking campaigners and cancer experts.

The European Court of Justice has been asked by two manufacturers of snus – a tobacco powder popular in Sweden – to have the EU ban rescinded.It is regarded as healthier than products such as Skoal Bandits – run out of town in 1990, after its US manufacturer had set up a factory in East Kilbride with controversial funding aid.

With only a fraction of the carcinogens present in many brands originating in North America, and few of the problems associated with cigarettes, snus – which is placed under the upper lip – is being seen as a credible harm-reduction measure that could save 200,000 lives in Europe every year. It is cured, manufactured and stored in a way which leaves lower concentrations of many of the harmful chemicals associated with other oral tobacco, although it may cause a slight increase in cardiovascular risk and is likely to be harmful to the unborn foetus.

The EU is obliged to review the ban by the end of this year, and an international group of anti-smoking experts including Clive Bates, director of anti-smoking group Ash, and Professor Martin Jarvis, of Cancer Research UK's behavioural psychology unit, supports replacing the ban with a regulation of the toxicity levels of all smokeless tobacco products.

About 20% of Swedish men use snus and 19% smoke, the total equating to the proportion who smoke throughout the EU. The claim about the potential of snus to reduce the 500,000 deaths in the (then) 15 states of the EU by 40% is contained in a report in the European Journal of Epidemiology produced by researchers from Alabama University. Among these would be 10,694 lives saved in the UK.

The authors acknowledge sponsorship by the US Smokeless Tobacco Company, which is trying to introduce its own snus products into the European market, but their report reinforces a view already held by health experts.
A spokesman for Ash said yesterday: "The ban on the Swedish type of smokeless tobacco product is the one we are keen to see lifted.
"Snus isn't completely risk-free, but it takes us into the area of nicotine replacement."

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'Safer' Tobacco Products Not as Safe as They Seem-(Reuters-01/06/04)

A new type of cigarette that contains less cancer-causing substances than conventional brands may not be doing much to protect smokers, according to new research released Tuesday.

Although testing of the new OMNI cigarettes showed that they contain 50 percent less of a particular carcinogen, or substance that causes cancer, smokers who switched to the OMNI cigarette had only 20 percent less of the carcinogen in their bodies than they did while smoking conventional cigarettes.

This relatively small drop in carcinogen levels may not be enough to reduce a smoker's chance of developing cancer, study author Dr. Dorothy K. Hatsukami told Reuters Health. "Does that (20 percent difference) really translate to reduced cancer risk? We're not sure," she said.

She warned that smokers should not believe that by switching to a less carcinogenic brand, they are sidestepping the dangers of smoking.

If smokers think the new so-called "reduced-exposure" tobacco products are safe, "they'll maintain their smoking rather than make a concerted effort to quit," Hatsukami pointed out. "The best way to reduce your risk of disease is still quitting smoking," she added.

Tobacco naturally contains carcinogens, which are enhanced during the processing of tobacco leaves. In order to design safer tobacco products, companies are beginning to release cigarettes and snuff products that contain fewer carcinogens, created by adding protective chemicals, processing the tobacco differently, or using genetically engineering tobacco.

In the current study, Hatsukami and her colleagues at the University of Minnesota in Minneapolis tested the benefits of reduced exposure products by asking 54 smokeless tobacco users and 51 smokers to switch to either the newer brands or a nicotine patch for four weeks. Snuff users tried Swedish snus, while smokers switched to OMNI cigarettes.

Reporting in the Journal of the National Cancer Institute (news - web sites), the researchers found that smokers who switched to reduced-exposure products experienced a smaller decrease in the carcinogen NNK than was predicted by machine testing. Snuff users showed lower levels of carcinogens after switching to snus, but both snuff users and smokers experienced a smaller decrease in carcinogens than nicotine patch users.

In an interview, Hatsukami explained that people smoke in a different way than machines, and some smokers may have absorbed more carcinogens by taking more puffs per cigarette or inhaling more smoke than the machine predicted.

"Consumers really need to be wary when they see advertisements for reduced exposure products," she said.

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Smoking converts saliva into deadly cancer cocktail!(ANI-02/06/2004)

Latest research has revealed that smoking converts healthy saliva into a deadly chemical cocktail that increases the risk of mouth cancer. There are nearly 8,000 new cases of mouth cancer and 3,000 deaths each year in Britain and the causes of the disease are mostly smoking or drinking alcohol. Saliva is the body's first line of defence against cancer as it provides a protective buffer between toxins and the lining of the mouth.

"Most people will find it very shocking that the mixture of saliva and smoke is actually more lethal to cells in the mouth than cigarette smoke alone," the Telegraph quoted Dr Rafi Nagler, of the Technion-Israel Institute of Technology and lead author of the study, as saying.

"Our study shows that once exposed to cigarette smoke, our normally healthy saliva not only loses its beneficial qualities, but it turns traitor and actually aids in destroying cells of the mouth and oral cavity. Cigarette smoke is not only damaging on its own, it can turn the body against itself," added Nagler.

The researchers found that that tobacco smoke destroys protective anti-oxidant compounds in saliva, leaving a corrosive mix that damages cells and increases the risk of mouth cancer. In fact, the longer that mouth cells are exposed to saliva contaminated with tobacco smoke, the more damage is done to cells. 

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Survey: Smokers twice as likely to suffer cancer recurrence-(The Hochi Shimbun-18/05/2004)

The rate of recurrence of liver cancer among those who smoke more than 10 cigarettes a day is almost double that of nonsmokers, according to research conducted by Kitasato University. Akitaka Shibuya, a lecturer at Kitasato University School of Medicine, carried out follow-up studies on 131 patients whose liver cancer was believed to have gone into remission after receiving treatments at the university hospital between 1991 and 2002. Of the patients, Shibuya conducted research on 73 who were found to have suffered a recurrence of cancer, recording their sex, age, methods of treatment and lifestyle to find the cause of their relapse. Shibuya found that those who smoked more than 10 cigarettes a day had a 1.8 times higher likelihood of suffering a recurrence of the cancer than nonsmokers.

The survey also found that patients who had contracted hepatitis C were about three times more likely to suffer a relapse than those without the virus--the highest recurrence rate among the categories studied.

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Workplace smoking ban passes committee-(Yahoo News-15/04/2004)

The House Labor Committee voted 7-0 in favor of the workplace safety bill sponsored by House Majority Leader Gordon D. Fox to ban smoking in restaurants, bars and other workplaces. The bill will now be sent to the full House for a vote. "The time has come for this legislation. Exposure to second-hand smoke is very dangerous, and there is no reason that any worker should be forced to be exposed to it and risk his or her health each day," said Fox, a Democrat whose district includes the Mount Hope, Summit and Blackstone neighborhoods. The bill (2004 - H8392) would ban smoking in nearly all places that are open to the public, including private businesses, restaurants, most bars, public restrooms, athletic fields, health care facilities, shopping malls, bingo facilities, common areas of apartment buildings with more than four units and many other places. The ban would take effect on March 1, 2005, although small bars with fewer than 10 employees and gaming facilities would not have to comply until October 1, 2006.

The legislation is the result of months of research and negotiation between legislators, business owners and advocacy groups. It has the support of the governor, the American Cancer Society, the Heart and Lung Associations, the Campaign for a Healthy Rhode Island, Ocean State Action and the AFL-CIO. "Our goal was to craft a bill that would do as much as possible to protect public health, and I think this legislation does that," Fox said. "We can level the playing the field for businesses across the state, and provide safer working conditions for all Rhode Islanders at once." The bill drew strong support from restaurant workers, owners and health advocates during committee hearings.

Department of Health Director Patricia Nolan testified in favor of the bill, saying that prolonged exposure to secondhand smoke at work leads to higher cancer rates for workers in certain professions. The average secondhand smoke inhaled by a bar employee during an eight-hour shift is the equivalent of smoking 16 cigarettes-almost a pack, she said. Connecticut, Maine, Vermont, New York, Florida, California, Delaware, Idaho and Utah each have some kind of smoking ban. Many Massachusetts towns have banned smoking in workplaces, and its legislature is considering a statewide ban that would take effect July 5. Leader Fox said he is optimistic about his bill's passage in the General Assembly and Governor Carcieri has supported the measure publicly.

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Smoking Ban Linked to Drop in Heart Attacks-(Reuters-04/04/2004)

Ireland's ban on smoking in pubs and restaurants could have added health benefits if research in the United States is anything to go by. Nearly two years before the emerald isle became the first country to outlaw smoking in public places, the city of Helena in Montana passed similar legislation and saw a sharp drop in heart attacks. Opponents subsequently had the U.S. law overturned but in the six months it was enforced, hospital admissions for heart attack fell by 40 percent in the city. "The observations...suggests that smoke-free laws not only protect people from the long-term dangers of second-hand smoke but also that they may be associated with a rapid decrease in heart attacks," said Professor Stanton Glantz of the University of California, San Francisco.

Smoking is a risk factor for heart disease and stroke but Glantz's research, which is published online by the British Medical Journal Monday, is the first to report a link between a ban and heart attacks. Only 24 people were admitted to the city's heart hospital with a heart attack during the six-month smoking ban, compared to an average of 40 during the same periods in the year before the law was imposed and after it was overturned. Thirty-eight percent of the heart attack patients in the study were smokers, 29 percent had quit and 33 percent had never smoked. Further studies are needed to confirm the findings but Glantz said the impact is consistent with the known effects of second-hand smoke on cardiac disease. "The dramatic decrease in heart attacks in the Montana study makes sense because exposure to passive smoking can increase the risk of heart attack," a spokesman for the anti-smoking group ASH (Action on Smoking and Health) said. "It all basically points to the need for a ban on smoking in public places and how crucial it is to public health," he added.

In Ireland, which introduced the nationwide ban last week, around a quarter of deaths from heart disease are caused by smoking. Smokers have twice the risk of heart attack of non-smokers. In further research into the dangers of passive smoking also published online, pubic health experts in New Zealand discovered that people who have never smoked but who live with a smoker have a 15 percent higher risk of death than someone who resides in a smoke-free environment. "The results from this study add to the weight of evidence of harm caused by passive smoking and support steps to reduce exposure to other people's smoke -- in the home and in other settings," Tony Blakely of Wellington School of Medicine and Health Sciences in New Zealand, said in the study.

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Anti-Smoking Ads Draw Cautious Praise-(ET-10/02/2004)

He's billed as America's most pathetic superhero: Buttman, an overweight chain-smoker who hacks, spits and gets too winded to respond to emergencies. Buttman is part of a series of anti-smoking ads increasingly popular with youths in Virginia, a steadfast tobacco state that's home to industry giant Philip Morris USA. A recent survey suggests that most children in the state are aware of the television and radio initiative, perhaps due to its in-your-face humor and high gross-out factor. "You should be almost able to stop any kid on the street, and only one in four couldn't tell you about the campaign," said Danny Saggese, marketing coordinator for the Virginia Tobacco Settlement Foundation, which funds the advertisements.

Last year, the advertising industry publication Adweek gave its approval to the Buttman ads. And a leading anti-smoking group, the Campaign for Tobacco-Free Kids, cautiously praised the foundation and its Richmond ad firm, Work Inc. It called the campaign a step forward in spite of the state's poor record of funding tobacco prevention. "I think the foundation is on the right track," said Danny McGoldrick, research director for the Washington, D.C., organization. The edgy campaign has reached about three-quarters of its target audience - kids ages 10 to 17 - since it began in 2002, according to a recent Harris Interactive survey commissioned by the foundation. The research also revealed that more Virginia teens and preteens now believe tobacco use hurts their self-esteem and social acceptance.

Among the kids' favorites is an ad in which a girl tastes a trash-can lid and car tire, with the message that these disgusting habits are comparable to smoking. The same theme emerges when a group of kids visits the school's cool nose-picking spot, a takeoff on the informal smoking areas outside many schools. Wearing thick, black-framed glasses, the disheveled Buttman appears in several spots: lighting up at a gas station, flicking ashes into the cup of a prospective employer and making kids cry. Under development is an ad that mimics a reality TV program; kids eat bowls of nasty critters to show that smoking can diminish the ability to taste. In addition to the broadcast ads, the marketing campaign includes a Web site and billboards. Anti-smoking advocates say such aggressive initiatives are needed to help lower youth tobacco use rates.

The 2002 National Youth Tobacco Survey found that 13.3 percent of middle school students and 28.4 percent of high school students used some form of tobacco. Virginia has no recent figures on youth tobacco use, and its earlier reporting was not comparable to national numbers, a state health official said. But in 2002, about a quarter of Virginia adults smoked, compared with the national rate of 23 percent, according to the Centers for Disease Control and Prevention. The younger the adult, the higher the rate. Funding for the ads come from the state's share of a historic settlement with tobacco manufacturers. The Virginia Tobacco Settlement Foundation gets about $14 million a year to cover a number of community, education and enforcement programs to prevent youth tobacco use. Virginia officials have reduced some of the foundation's funding due to budget problems. While Buttman and similar ads have proven to be popular, they compete with the tobacco industry's multibillion-dollar marketing machine. Cigarette companies can no longer target U.S. youths, but they still depict adult smokers as "cool," an image that conflicts with and perhaps overpowers the message of Virginia's upstart campaign, said McGoldrick of the Campaign for Tobacco-Free Kids.

Virginia isn't the only state that has created edgy ads attacking smoking. California, for instance, plastered billboards with pictures of a cowboy resembling the Marlboro Man. "I miss my lung, Bob," he says to a friend. But Virginia's ads make a point of not chasing after tobacco companies. Foundation and ad-firm officials say politics aren't involved. Rather, the advertisements are successful because they don't preach - the "kiss of death" for ads targeting teens and preteens, said Rob Austin, executive vice president of the Work ad firm, which has a three-year, $27 million contract for its part in the campaign. But sometimes grown-ups can't seem to help themselves. Rebecca Darby, a 17-year-old member of the foundation's board of trustees and a Goochland High School senior, says she sometimes has to remind the adults in the group that finger-wagging isn't the best approach for her generation. Kids "just like to know the information so they can decide for themselves," said Rebecca.

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Philip Morris to Fight Illinois Ruling Seeks Reversal of Verdict on Light Cigarettes Claim due to Legal Errors-(The Economic Times-12/12/2003)

PHILIP MORRIS USA said it sees numerous grounds for appeal in the Illinois case in which it was found to have tricked smokers into thinking "light" cigarettes were safer than regular ones. The company, which was ordered to pay $10.1 bn in the Price vs. Philip Morris case in March, said reversal of the verdict and decertification of the class in the case are needed due to legal errors committed by the Madison County Circuit Court, which heard the case. Philip Morris USA, which filed an appeal brief with the Illinois Supreme Court, said it is seeking reversal of the judgement mainly on four grounds, including that the $10.1 bn award lacked any legal or factual basis: It also claims that the class of smokers should not have been certified. The appeal process could take several months. Plaintiffs' attorneys will now have at least 35 days to file a response brief. Philip Morris USA, a unit of New York based Altria Group, may then file a response before oral arguments are scheduled.

Stephen Tillery, a lawyer representing plaintiffs in the case, said lie had not been served with a copy of Philip Morris' brief and therefore could not comment on it. The Illinois Supreme Court in September agreed to hear Philip Morris' appeal of the verdict against it without the need for intermediate appellate court review, raising hopes that the verdict could be reduced or overturned. The state's high court also slashed the size of the bond that that Philip Morris USA, the top US cigarette company; was required to post pending an appeal in the case. In March, Madison County Judge Nicholas Byron ordered Philip Morris to pay $ 10.1 Un over its marketing of Marlboro Lights and Cambridge Lights cigarettes. Plaintiffs in the Price class were not seeking damages to pay for any smoking-related illnesses, but instead wanted compensation for the amount they spent on "'lights" cigarettes. "Judge Byron awarded an enormous amount of money to a group of smokers who claimed no personal injuries, smoked cigarettes that always were labeled with government health warnings and, for the most part, continued to purchase the company's 'lights' cigarettes despite their claims of deception," William Ohlemeyer, Philip Morris USA associate general counsel, said. "Simply put, the Price judgement is contrary to Illinois consumer fraud law and conflicts with federal laws and policies governing cigarette advertising, labelling and tar and nicotine disclosures." Judge Byron ordered Philip Morris to post a $ l2bn bond to protect its assets while it appealed the verdict, an amount the company suggested could force it to file for bankruptcy protection.

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Double Filter : Tobacco Cos Win Florida Smoker Suit-(The Economic Times-12/12/2003)

RJ Reynolds and Brown & Williamson said a jury in Florida returned a verdict in their favour, finding the cigarette makers were not responsible for a smoker's illness. The jury in the case found there was "ample evidence" that Emmett Hall, who suffers from lung cancer and pulmonary disease, was aware of the potential health risks of smoking and yet he chose to smoke, RJ Reynolds Tobacco said. "The jury recognised and agreed with our claims that Mr. Hall knew and understood the risks of smoking," said Jeff Raborn, an attorney for Louisville, Kentucky-based Brown & Williamson.

RJ Reynolds in October announced plans to buy Brown & Williamson from London based British American Tobacco, bringing cigarettes such as Camel and KOOL together under a holding company to be named Reynold American.

Philip Morris USA does not expect the ongoing appeal process of the $10:1 bn "lights" verdict against it in Illinois to affect its next payment to the states under the Master Settlement Agreement, the company said on Wednesday. The company's next payment is due April l5, '04, William Ohlemeyer, Philip Morris USA associate general counsel, said. Earlier this year, attorneys general from most US states joined legal efforts to have the original $I2bn appeal bond in the case reduced, after Philip Morris USA said the full amount could force it to seek bankruptcy protection and so be unable to make $2.6bn in payments agreed under the 1998 Master Settlement Agreement. The company made those payments after the amount of the bond was reduced. The amount Philip Morris USA, is expected to pay under the agreement on April 15, '04 was not immediately available.

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Low-tar cigarettes fail to cut cancer risk-(Yahoo News-08/01/2004)

Millions of people around the world who smoke low-tar cigarettes face just the same risk of lung cancer as smokers who puff on medium-tar brands, according to the first major study to compare the health risks of tar ratings. Death rates from lung cancer among smokers of medium-tar brands -- classified as between 15 to 21 milligrams of tar per cigarette -- were indistinguishable from those who smoked low (eight to 14 mg) or very low brands (seven mg or less), the study says. Those most at risk were smokers who smoked non-filtered high-tar cigarettes, which are rated as having 22 mg or more tar. The peril of dying prematurely from lung cancer for people in the high-tar category was 44 percent higher than in the other groups. The study, published in the British Medical Journal (BMJ), compared the smoking habits and mortality from lung cancer among 364,000 men and 576,000 women aged 30 years or more over six years, from 1982-88.

The authors suggest that smokers who switch to low-tar cigarettes in the hope of skirting the cancer risk may be dangerously deluding themselves. "Addicted smokers who switch from a higher to lower tar cigarette can maintain their nicotine intake by blocking ventilation holes, increasing the puff volume or the time during which the smoke is retained in the lungs, and smoking more cigarettes. "As a result, the actual dose of toxicants to the smoker may be much higher than is predicted by machine-measured yields," they say. "Changes in inhalation patterns induced by lower tar cigarettes may increase the surface area of the lung exposed to carcinogens in smoke and thus result in greater deposition of submicron-sized particles deep into the airways." The 1980s research project was initiated by the American Cancer Society, yielding a mountain of data that is still being sifted.

Lead authors are Jeffrey Harris of Massachusetts General Hospital in Boston and Michael Thun, an epidemiologist at the American Cancer Society in Atlanta. Low-tar cigarettes were introduced in the late 1960s with the advent of ventilation holes in filter tips; in the 1970s, "expanded tobacco" reduced the tar yield further. Those innovations held out the promise -- or so it appeared at the time -- that a safe or at least safer cigarette had been invented. The nicotine-rich tarry byproduct of smoking is implicated, along with a bouquet of toxic gases, in triggering lung cancer, cardiac disease, circulation problems and many other health ailments. Smoking kills around five million people a year and the toll will rise inexorably unless the habit is tackled in developing countries, according to a study published in September by epidemiologists Majid Ezzati of the Harvard School of Public Health and Alan Lopez of the University of Queensland, Australia.

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UK Heart Charity Launches Anti-Smoking Campaign-(Reuters Health-03/01/2004)

Smoking just three-to-six cigarettes a day doubles the risk of a fatal heart attack, the British Heart Foundation warned as it launched a government-backed 4 million anti-smoking campaign. The charity said smoking kills more people worldwide from cardiovascular disease than cancer does. More than a third of the five million annual death-toll was due to cardiovascular disease. In Britain, around 114,000 people die every year as a result of smoking, including 30,600 from cardiovascular disease. In young British women, smoking is the leading cause of heart attacks before the menopause, claiming about 1,000 lives a year.

The television and newspaper advertising campaign shows large quantities of saturated fat oozing out of a cigarette-shaped artery to remind smokers to quit before their arteries clog up. "Smokers are twice as likely as non-smokers to have a heart attack," the charity's medical director, Professor Sir Charles George said in a statement. "They have a much higher risk than non-smokers of developing atherosclerosis...This can lead to angina or a sudden heart attack." Most of the campaign money comes from the Department of Health, which in 2003 gave 15 million to the British Heart Foundation and Cancer Research UK in 2003 specifically for anti-smoking programs over the next three years. Public Health Minister Melanie Johnson said in a statement: "The effect of smoking on the heart and arteries is hugely damaging...Currently one-in-seven deaths from coronary heart disease is directly linked to smoking."

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Smoking named as main cause of avoidable death in France-(Yahoo News-03/01/2004)

Smoking is the main cause of avoidable death in France, killing around 66,000 people each year, the health ministry says. "On average, one regular smoker in every two dies prematurely from his or her smoking habits... Half of those who die are between 35 and 69 years old," the ministry continued in a statement issued jointly with the National Institute of Health Education and Prevention (INPES). Smoking causes a third of all cancers in France, according to the statement, which was posted on an internet site -- www.jarreteetvous.org -- set up by the ministry and the INPES as part of a national stop-smoking campaign launched in March 2003.

Lung cancer is a particular danger among smokers and those forced to inhale their noxious fumes, including children. In France 90 percent of all lung cancers are caused by actually smoking and a further five percent by passive smoking, the statement stressed. There is already a law in France against smoking in workplaces, airports, metro and rail stations and in some parts of restaurants. But it is widely ignored. The government is reinforcing its anti-smoking campaign by increasing the price of tobacco by eight to 10 percent as of January 5, the third rise in the space of a year. The main aim of the campaign is to reduce the number of smokers by 30 percent among young people and 20 percent among adults. The increase in smoking among young people is of particular concern, especially given scientific information that the dangers are more widespread than originally thought.

In 2002 the International Agency for Research on Cancer, a unit of the World Health Organisation (WHO) based in the French city of Lyon, added the following to the long list of cancers to which smokers are vulnerable -- leukaemia and cancer of the stomach, liver, uterus and kidney. Cigarettes also cause chronic bronchitis and heart attacks, the scientists say. The WHO itself says smoking kills 4.9 million people around the world every single year and warns that number could double by 2020. Smoking is "the only weapon of mass destruction used against people all over the world," commented John Seffrin, president of the American Cancer Society, during the world cancer congress in Chigaco in May 2003. Eight people die every minute as a result of smoking, cancer specialist Richard Hunt told the congress.

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Costs of Smoking Linger Long After You Quit-(HealthDayNews-23/12/2003)

Even after you quit smoking, you and the health-care system could still be paying the price of that bad habit for years to come. Research published in the November/December issue of the American Journal of Health Promotion says quitting smoking does eventually lead to reduced health-care costs. But increased care costs start before smokers quit and remain high for five to 10 years after a person kicks the habit. One study of Minnesota patients in a managed-care health system found smokers with higher health-care bills tried to quit smoking as a result of the added health expenses. That was the case whether the smokers were semmingly healthy or had been diagnosed with high blood pressure, heart disease, diabetes or high cholesterol.

Another study of more than 20,000 General Motors workers and their spouses found former smokers who had quit in the previous four years had higher costs for treatment of cancers, circulatory problems and musculoskeletal complaints than current smokers. The study found three common chronic health problems -- arthritis, allergies and back pain -- not usually associated with smoking are found more often in smokers and result in increased health-care costs even after they quit. Smoking triples the risk of frequent back pain, increases the risk of chronic allergies by as much as five times, and doubles the risk of rheumatoid arthritis. It took about five years for former smokers without chronic health problems and nearly 10 years for former smokers with chronic conditions to see their medical charges decline to levels similar to those of people who never smoked.

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Popular Snuff Brands Have Lots of Nicotine: Study-(Reuters Health-22/12/2003)

The most popular brands of smokeless tobacco have the highest levels of the most easily absorbed form of nicotine, according to a new study. The three brands of moist snuff that have the largest market share also contain the highest levels of so-called unprotonated, or "free-base," nicotine, researchers from the Centers for Disease Control and Prevention in Atlanta, report. This form of nicotine is rapidly absorbed through the mouth. The speed of nicotine absorption has a major impact on the odds of becoming addicted, according to the study's authors, Drs. Patricia Richter and Francis W. Spierto. "Consumers need to know that smokeless tobacco products, including loose-leaf and moist snuff, are not safe alternatives to smoking," the authors state in the December issue of the journal Nicotine and Tobacco Research.

The researchers point out that in 2000 the U.S. surgeon general concluded that tobacco products should be not be any more harmful than necessary. "Regarding the health of consumers, and in light of the surgeon general's response, smokeless tobacco manufacturers should take steps to reduce the addictiveness of their products," Richter and Spierto conclude. Under a 1986 law, tobacco manufacturers must report to the U.S. Department of Health and Human Services the amount of nicotine in their smokeless tobacco products. Because such information is considered a trade secret, however, it is not released to the public. But through a little bit of detective work, Richter and Spierto were able to determine how much nicotine -- particularly the most easily absorbed kind -- is found in smokeless tobacco.

Based on testing performed by a private, independent lab in Canada, the three brands of moist snuff that have the largest market share -- Kodiak, Skoal and Copenhagen -- also had the highest level of "free-base" nicotine. The number-one brand of loose-leaf smokeless tobacco, Levi Garrett, contained the most free-base nicotine in its category, but the levels of unprotonated nicotine did not correspond to market share in other brands of loose-leaf tobacco. Using smokeless tobacco, including moist snuff and chewing tobacco, increases the risk of oral cancer and precancerous lesions in the mouth. Per dose, smokeless tobacco delivers more absorbable nicotine than a cigarette.

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Swedes Increasing Their Use of Snuff-(AP-28/12/2003)

Inside a waterfront factory soaked with the acrid smell of tobacco, about half the blue-clad workers show an odd facial deformity: Their upper lips look swollen. It's a telltale sign they are sampling some of the 20 tons of smokeless tobacco being produced here daily. Snus (pronounced snoos) - a Scandinavian form of moist snuff - has been banned elsewhere in the European Union for more than a decade, but its popularity has rebounded strongly in its country of origin, where one of every nine Swedes uses it. And the top snus maker, Swedish Match, now is targeting world markets with claims that its blend of tobacco, water, salt and flavoring is a safer alternative to smoking. "We don't claim that snus is a completely problem-free product," Stefan Gelkner, a Swedish Match executive, says while squeezing a pouch of prepackaged snuff under his upper lip. "But we refer to the scientific studies conducted that haven't found any link between snus and cancer."

After falling out of style in the 1970s, the traditionally male, working-class habit has spread into all sectors of Swedish society, male and female. Grimy, used snus packets litter the otherwise clean streets and subway stations of Stockholm. Meanwhile, the smoking rate has fallen below 20 percent in the Scandinavian country of 9 million people - lowest in the world. Unlike American snuff, which is placed in the lower part of the mouth, causing users to salivate and spit, a Swedish snus portion, or "prilla," is savored on the gum above the front teeth. Many users opt for snus in thumbnail-sized paper pouchs, to prevent the tobacco from spreading around the mouth.

As protruding upper lips replace smoke rings in Swedish bars and offices, scientists are debating the ethics of replacing cigarettes with another tobacco product - less harmful, perhaps, but just as addictive because of the nicotine it contains. "I don't think there's any question that Sweden is a model for safer use of tobacco products," said Dr. Brad Rodu, a smokeless tobacco advocate at the University of Alabama-Birmingham. "The only consequential risk of smokeless tobacco is mouth cancer, and historically, that risk is extremely small." Rodu spent six months researching snus in northern Sweden and claims it's a much safer alternative for smokers who can't kick the nicotine habit. He noted several studies have failed to link snus to cancer, which Swedish Match attributes to its efforts to remove carcinogens during manufacturing. But critics say there are other concerns.

Apart from causing stained teeth and bad breath, snus raises the pulse and blood pressure. Some studies have linked it to increased risk of heart disease, diabetes and premature births in pregnant women. "I'm not interested in whether it causes cancer," said Dr. Gunilla Bolinder, chief physician at Karolinska Hospital in Stockholm. "I think it's about quality of life. Snus is extremely addictive." First-time snus users often feel dizzy and nauseous. Some throw up. But those who get past that find quitting is difficult. "I've tried to stop several times, but it is awfully hard," says Rikard Palm, a television news anchor at public service network SVT, whose smile reveals a lump of the black mash. "I use snus almost all the time." Other well-known users are national soccer team coach Lars Lagerback, Social Affairs Minister Lars Engqvist and Ingvar Kamprad, founder of the furnishings giant Ikea.

According to the World Health Organization, Swedish men have the lowest rate of lung cancer in Europe, partly because of the low smoking rate. Nevertheless, WHO argues against substituting snus for smoking, saying the health effects of snus remain unclear. The EU banned the sale of snus in 1992, citing a 1985 WHO study that said "oral use of snuffs of the types used in North America and western Europe is carcinogenic to humans." A WHO committee on tobacco has acknowledged evidence is inconclusive regarding Swedish snus. Only Sweden is exempt from the EU ban - a concession considered key to Swedish voters when they approved membership in the bloc. Bumper stickers reading "EU - not without my 'prilla'" were a common sight leading up to the 1994 referendum. Swedish Match is lobbying for an end to the EU ban and has two legal challenges before the European Court of Justice. "It's illogical and discriminating," says Gelkner, head of the company's northern Europe division. "All other tobacco products are allowed, while snus, which is considered the least damaging to health, is prohibited."

Swedish Match is exploring other markets with traditions of smokeless tobacco, including North America, South Africa and India. Export products are modified to local tastes: American snus is flavored with wintergreen oil, Indian products have traces of eucalyptus, licorice and cardamom. The company's factory in Owensboro, Ky., accounts for about 9 percent of the moist snuff sold in the United States. At home, Swedish Match has a virtual monopoly. Its factory in Goteborg makes 212 million cans of snus yearly for Sweden and neighboring Norway, which is not an EU member. A new plant just north of the city is expected to boost production by 120 million cans. A can comes with 1.8 ounces of loose snus, or about 20 prepackaged pouches of 0.01-0.04 ounce. Palm, 42, who started using snus regularly at age 12, says he empties nine cans a week, for an annual cost of $1,200. By comparison, a Swedish smoker who buys a $4.90 pack of cigarettes daily spends $1,782 a year. Pondering the impact of snus on his life, Palm says, "The best thing is probably a body free from poison."

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Passive Smoking Can Kill Nonsmokers-(HealthDayNews-11/12/2003)

Experts have long agreed secondhand smoke causes cancer, but how much so has been a question that has remained hazy for equally as long. A new study, however, begins to bring into detailed focus some of the cancer risks that nonsmokers face when exposed to passive smoking. Working with data from two large studies in Europe and the United States, researchers have found nonsmokers exposed to secondhand smoke had a lung cancer risk 18 percent to 32 percent higher than those not exposed, with risks increasing proportionate to the length of exposure. "We pooled them together to try to look at two things: to try to look at long-term exposure, and to try to get out some of the other factors out, such as dietary and occupational factors," says lead researcher Paul Brennan, of the International Agency for Research on Cancer. "What this study has been able to show clearly is the more exposed one is to passive smoke, the greater the lung cancer risk."

In the study, Brennan and his researcher team measured lung cancer risk from 1,263 nonsmoking lung cancer patients, as well as 2,740 control subjects, about their exposure to secondhand smoke -- from a spouse, at work and in social settings. Nonsmokers whose spouses had ever smoked had an increased lung cancer risk of 18 percent. For those who lived with smoking spouses for more than 30 years, the increased risk was 23 percent. Those exposed to smoke in the workplace had an increased lung cancer risk of 13 percent. For those exposed for more than 21 years, the risk jumped to 25 percent, the study found. In social settings, those exposed to secondhand smoke saw their lung cancer risk rise by 17 percent. For those exposed for 20 or more years in social settings, the risk was 26 percent above that of never-exposed nonsmokers. Nonsmokers exposed to the most secondhand smoke from all sources combined had the highest levels of increased risk for lung cancer, or 32 percent when exposure was long term.

The study found no evidence that other measured risks, including diet and occupation, had an effect on lung cancer risk. "What the pooled analysis does is confirm the earlier ones, and it gives a more precise estimation of the risks. This is useful and important in reducing the level of uncertainty, i.e. the range of estimates, in the calculated risk," says David Phillips, a professor at England's Institute of Cancer Research. "Given that many millions of nonsmokers are exposed to passive smoking at work, the impact on public health is very significant." The United States has led the way on the issue of exposure to cigarette smoke, with laws, and lawsuits, led by California in the 1990s.

That trend has begun to reach Europe's smoky cafe culture, where secondhand smoke is being increasingly seen as a costly public health problem. But governments efforts to reduce nonsmokers' exposure in Europe face fierce resistance from the tobacco industry. In the Netherlands, for example, the restaurant and hospitality industry, a sector with perhaps the highest exposure to secondhand smoke, was recently granted an exemption from new workplace antismoking laws set to go into effect in 2004, according to a spokesman for the Ministry of Health. "Reducing the opportunities for smokers to do so in public is likely to lead to a reduction in smoking overall," says Phillips. "The tobacco industry is bound to resist such moves, which will further undermine the already diminishing social acceptability of smoking." "The point is that now there is good health evidence to support such moves, not just the 'smoking is unpleasant for nonsmokers' argument," he adds. The study appears in the Dec. 10 issue of the International Journal of Cancer.

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Women smokers face twice the risk of lung cancer as men, US study finds-(AFP-01/12/2003)

Women smokers face twice the risk of developing lung cancer as men, but it is not yet clear why the cancer risk for women is higher, according to the findings of a study. The study, presented here to the annual meeting of the Radiological Society of North America, also found women smokers faced a much higher risk than men of developing lung cancer no matter how often they smoked or how old they were. "We found that women had twice the risk of developing lung cancer as men, independent of how much they smoked, their age, or the size and textures of nodules found in their lungs," explained Claudia Henschke, a professor of radiology and division chief of chest imaging at the Cornell Medical Center in New York. "There is as of yet no clear consensus why women are at increased risk," Henschke said. "We also found that the more you smoke and as you age the greater the chances of developing lung cancer," the professor added.

Lung cancer is the leading cause of cancer-related deaths among women and men across the United States, according to the American Cancer Society. The society estimates there were 171,900 new cases of lung cancer this year, and 157,200 lung-cancer related deaths. The study's findings are the result of 10 years research using X-ray images taken by computer tomography. The study involved 2,968 women and men aged 40 and older, and it identified 77 cases of lung cancer.

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Cigar, Pipe Smoking Boost Cancer, Heart Risks-(Reuters Health-21/11/2003)

The health risks of cigar or pipe smoking, from cancer to heart disease, are as great as those of relatively light cigarette smoking, according to a UK study. Researchers found that among more than 7,100 middle-aged men, those who smoked cigars or pipes faced higher risks of heart disease, stroke, lung cancer and other ills, compared with non-smokers. They were also 49 percent more likely to die over the two-decade study period. These risks were on par with those of men who smoked up to 19 cigarettes a day, according to findings published in the International Journal of Epidemiology.

Tobacco use in its various forms has long been known to carry serious health risks. Yet there's been a popular perception that cigars, which enjoyed a surge in popularity starting in the 1990s, offer a "safer" way to smoke. Even medical research has been divided on the extent of the risk that cigars and pipes pose, according to the authors of the new study. They note that some studies have suggested the habit is less hazardous than cigarette smoking, while others indicate that cigars, in particular, may cause as much smoking-related disease as cigarettes do. To investigate, A.G. Shaper and colleagues at Royal Free and University College Medical School in London looked at data from a long-running health study of British men.

All participants were in their 40s and 50s when the study began in the 1970s. The study included both primary cigar or pipe smokers---those who had never smoked cigarettes--and secondary cigar or pipe smokers--former cigarette smokers who had switched to cigars or pipes. Shaper's team found that together, these two groups were 69 percent more likely than non-smokers to suffer a fatal or non-fatal heart attack or die of cardiac arrest. They were 62 percent more likely to have a fatal or non-fatal stroke. Both groups also had heightened risks of smoking-related cancers, mainly lung cancer. Other smoking-related cancers included cancers of the mouth, throat, pancreas, kidney and bladder. "Overall," the researchers write, "the pipe/cigar smokers, whether primary or secondary, experienced much the same outcomes as regular light cigarette smokers." These findings, they conclude, add to evidence that "all tobacco smoking, not just cigarette smoking, should be regarded as hazardous to health."

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Study: 8.6 Million Americans Sick With Tobacco-related Illnesses-(ET-04/11/2003)

Although fewer US adults are smoking these days, millions are still lighting up and suffering the consequences, according to two recent reports from the Centers for Disease Control and Prevention. Both reports appear in the CDC's Morbidity and Mortality Weekly Report ( Vol. 52, No. 35: 842-844 and Vol. 52, No. 40: 953-956). The CDC reports that more than 46 million American adults -- about 23% of the population -- were current smokers in 2001. That figure is about 2% lower than the number of people who reported smoking in 1993. While any decline in the smoking rate is good news to public health officials, the report isn't all rosy: The decline is not fast enough to meet the national health goal of cutting adult smoking to 12% by 2010. "For smoking, it's incredibly important to meet the 2010 goals because smoking is the leading cause of (preventable) death in this country, and if we can reduce smoking prevalence we can save a lot of lives," said Corinne Husten, MD, a medical officer with the CDC's Office on Smoking and Health.

Reducing the smoking rate would also cut the staggering number of Americans living with debilitating diseases caused by tobacco. Researchers from the CDC, the Roswell Park Cancer Institute in Buffalo, New York, and the Research Triangle Institute in North Carolina have come up with the first such estimate, detailed in another CDC report. Using data from national health surveys, the researchers calculated that 8.6 million people in the United States have a serious illness caused by smoking. "That's a little bit more than the entire population of New York City," said co-author Andrew Hyland, PhD, of Roswell Park's Division of Cancer Prevention and Population Science. Most of those people -- about 59% -- have either chronic bronchitis or emphysema, lung conditions that make breathing difficult and can be deadly.

Smoking-related cancers accounted for 13% of the serious diseases; more than 1.5 million people are affected. Among cancer cases, lung cancer accounted for only 1% of cases (184,000 people). Yet lung cancer strikes nearly 172,000 Americans each year, and kills more people than any other cancer. Why weren't the numbers in the survey higher? Hyland has one explanation. "The reality is, if you have lung cancer, the survival is just a few months." Lung cancer is frequently not found until it is advanced, when it kills quickly. Many patients simply don't survive long enough to be found by surveys like the ones used to collect this data. This is the first time researchers have tried to quantify the chronic health effects of smoking, as opposed to looking at the number of deaths it causes. But as shocking as the figure is -- 8.6 million Americans with serious illnesses -- Hyland says it probably understates the problem. "Our estimates, I think, are very conservative," he said.

The surveys only looked at a handful of serious smoking-related illnesses, he explained, and did not include less debilitating conditions, like sinusitis, impotence or impaired wound healing. Also, only diseases related to smoking were included; if the researchers had also included diseases related to other tobacco products, like chewing tobacco or snuff, the numbers would have been higher, Hyland said. Husten pointed out that smokers with serious, chronic illnesses can benefit from quitting. "The good news for people living with these diseases is, if they quit they can slow the progression of the disease and perhaps prevent some of the complications," she said. "Quitting is very important to maximize length and quality of life."

According to reports from the US Surgeon General's office, some health benefits of quitting, like lower blood pressure, start to kick in within hours of the last drag on a cigarette. Within a few months, lung function improves. Even for long-time smokers the risk of heart attack drops markedly after about a year, and by 15 years they have the same risk as non-smokers. Ten years after quitting the risk of lung cancer is half that of a current smoker. The risk of other cancers (mouth, bladder, and others) also is lower. If the benefits of quitting are so great, why do so many Americans still smoke? "There's no easy answer," said Hyland. "Nicotine dependence is a terrible addiction."

There are tools to help smokers fight this deadly addiction, and smokers who are serious about quitting should take advantage of them, Husten said. "Part of the reason the success rates (for quitting) are so low is that most people try to do it on their own." In fact, only 15% of current smokers and 6.8% of former smokers report using any of the recommended therapies in their last quit attempt. First and foremost, smokers should enlist the help of their doctor, Husten said. Physicians can help smokers find appropriate medications for controlling nicotine cravings -- and steer them away from remedies that haven't been proven to work. Doctors can also give practical advice about what to expect when trying to quit, and help smokers develop a plan for weathering rough patches. Another valuable resource is telephone quitlines, which are available in many states. These services offer free advice and counseling to smokers trying to quit, and can provide important support that a busy doctor may not be able to give. "The best strategy is to be on the medication and be getting some form of intensive counseling," said Husten.

Of course, medication may not be appropriate for some smokers (pregnant women, adolescents, people with contraindications) so it's important to consult a doctor before taking any drugs, she added. Enlisting the help of family and friends is also important, Husten said. Smokers can ask their friends and relatives not to smoke around them, or offer them cigarettes, and to have a little extra patience if grumpiness sets in. "The really key point is for people to get help to quit smoking," Husten said. "People don't hesitate to get help for other medical problems, and they shouldn't hesitate to get help for this one." Persistence also pays off, she said. "If they've tried to quit in the past and weren't successful, that doesn't mean they won't be successful this time. They need to keep trying."

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Eye On Health: Smoking Cessation, Part II-(ET-06/11/2003)

A couple of months ago, Carleen Wild introduced you to Tammy Noble. She's one of the smokers News 3 is following, as she tries again to quit Trying to catch up with her is never an easy thing, but two months ago News 3 finally found her on the back porch -- one of the few places she stops long enough to talk. She was having a cigarette. "I usually don't smoke in front of the kids because I don't want them seeing me -- thinking it's OK to smoke," she said. "Because it's not." At 33 years old, she is a wife and a mother, who works full time and goes to school full time with the goal of soon being a nurse -- and a non-smoker. She started when she was 18. "Being a health care professional, it just doesn't look right," she said. "You're supposed to be trying to make people healthy, and smoking, that's not healthy. I've tried patches, I've tried Zyban, Inahler, I've tried the gum." This time, she is trying the state quit line.

"The quit line is probably the single most helpful thing the state spent tobacco money on," said Dr. Jorenby. "It's a toll-free number, that's available to anyone in the state." "It was kind of hard setting a quit date because it's a routine for me," she said. "It's always hard to get out of the routine." One day after she quit, she was having trouble. "It's been one day since I quit, and I'm irritable, tired, always thinking about it, so sure hope it gets better," she said. Same thing on day two. "It's 1 p.m. and the hardest time for me was this morning, so scrubbed the floor, cleaned the carpeting, cleaned the bathroom … pretty quick here I'm going to make a couple of pies," she said. As long as she's busy, she said she's fine. On day seven, she was still having trouble, but said it was getting better. "I'm still edgy, a lot more irritated, but my house is really clean," she said. "I slept better last night, seems like it's getting easier. Still think about it, but not as bad." The Zyban is also easier to handle. She said the lightheadedness and almost drunk feeling has gone away. It's also taken away her appetite. She's glad about that because she used the weight gain excuse not to quit in the past. There's on more benefit that Nobel's family is very happy about. "I don't stink anymore," she said. "My daughter hasn't told me I smell bad anymore so that's kind of nice." Now, on a beautiful afternoon, you might find Nobel on her back deck, but not to smoke.

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Turning Off Smokers with Rotting Lung Pictures-(Reuters-08/09/2003)

The European Commission has started the hunt for images of rotting lungs and dying cancer patients to be printed on cigarette packets across the European Union, a spokesman said. Next month cigarettes sold in the EU must show even larger health warnings than now, and from mid-2004 member states will have the option of adding pictures to the packs showing the hazards of smoking, the EU's executive body said. The European Commission announced a tender for organizations to come up with images and test their impact on different European audiences. "Research and experience in countries which have introduced health warnings illustrated with color pictures have proven that they speak more than a thousand words," Health and Consumer Protection Commissioner David Byrne said in a statement.

Brazil and Canada compel tobacco companies to print pictures of premature babies and brain hemorrhages on their products. Commission health spokesman Thorsten Muench said Europe would follow their lead but there would also be a lighter touch. "We will have rotten lungs and we will also have more humorous images. It's not just dead bodies lying around," he said at a news conference. For each of the current 14 health warnings, there will be a choice of five or six pictures so that member states can choose the ones that best fit local tastes. "There will be research into how every image works in every country," Muench said. He accepted the images might not put off hard-core smokers but said he hoped they would stop people starting smoking.

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New Cigarette Less Toxic-(HealthDayNews-09/09/2003)

Reduced levels of cancer-causing chemicals called nitrosamines were found in a new cigarette tested by Virginia Commonwealth University researchers. The independent three-week study of the Advance cigarette included 12 smokers between the ages of 18 and 50. By the fifth day of smoking Advance cigarettes, the levels of nitrosamine metabolites in the smokers' urine was 51 percent lower than when they smoked their own brands of light or ultra-light cigarettes. The nitrosamine levels were 70 percent lower when the smokers didn't have any cigarettes. Nitrosamines are considered one of the most potent cancer-causing toxins in cigarette smoke. "Not smoking is the only proven method to decrease exposure to tobacco-related carcinogens and the likelihood of tobacco-related disease and death. However, most smokers find it difficult to quit because they are dependent upon cigarette-delivered nicotine," researcher Thomas Eissenberg, an associate professor of psychology and head of the Clinical Behavioral Pharmacology Laboratory, says in a news release. The study appears in the September issue of Tobacco Control. The research was supported by grants from the National Institute on Drug Abuse and the university's Massey Cancer Center.

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Anti-Smoking Efforts Cut Lung Cancer Deaths-(ET-20/08/2003)

Lung cancer death rates among adults age 30-39 are lower and are falling in most states that have strong anti-tobacco programs, according to a study published in Cancer Causes and Control. Lung cancer rates in this age group reflect smoking behavior over the preceding 5-25 years, when communities first began to control and discourage tobacco use. The findings suggest that efforts to prevent smoking are having a positive effect, said lead researcher Ahmedin Jemal, DVM, PhD, program director for cancer occurrence at the American Cancer Society. "Where you have high tobacco control efforts you have low lung cancer death rates," he said, "but what's most interesting is that the death rates decreased in most states with strong tobacco control programs, but increased in states with low tobacco control efforts."

But many anti-smoking programs are in jeopardy, said study coauthor Michael Thun, MD, who directs epidemiological research for ACS. "Unfortunately, because of tight budgets, many states are currently cutting their expenditures on tobacco control," he said. "Now is the time to point out that these programs are working and must be sustained if the progress seen in this study is to continue."

Lung cancer is the No. 1 cancer killer in the United States among both men and women. Roughly 171,900 people will get lung cancer in 2003, and 157,200 will die from it, according to American Cancer Society estimates. Cigarette smoking causes about 82% of these deaths, as well as deaths from several other types of cancer, other lung diseases, and heart disease. Smoking is responsible for more than 400,000 deaths each year in the United States, according to the Centers for Disease Control and Prevention. Worldwide, tobacco use is responsible for nearly 5 million deaths each year, according to the World Health Organization. Because of the immense health problems caused by smoking and other forms of tobacco use, US and global health advocates have spearheaded a campaign to encourage current smokers to quit, and discourage young people from beginning to smoke.

The World Health Organization's 190 member nations recently approved the Framework Convention on Tobacco Control. Countries that ratify the treaty would be required to take steps to reduce tobacco use, such as restricting tobacco advertising, raising tobacco taxes and putting more explicit health warnings on tobacco packages.

Similar anti-smoking measures are already in place in many US cities and states. Throughout the late 1980s and 1990s, many states enacted laws banning smoking in workplaces, restaurants, and public buildings, raising taxes on cigarettes, or limiting advertising, especially to teenagers. But how effective have these programs been? Researchers generally look at smoking rates among adults and high school students to make that determination. Jemal and his colleagues took a different approach. They examined lung cancer trends in adults age 30-39. They reasoned that people who got lung cancer at younger ages - generally smokers who are genetically more susceptible - would provide an early indication of the benefit of tobacco-control policies. "Monitoring trends in young adults is really important for measuring the effectiveness of tobacco control activities," Jemal said.

Most lung cancers take decades to develop; the average age for people who develop lung cancer is close to 70, though most smokers start the habit in their teenage years. However, a decrease in lung cancer among younger people now predicts a future decrease in lung cancer among older people.

Jemal and the other ACS researchers looked at smoking patterns and lung cancer deaths between 1990 and 1994, and between 1995 and 1999. Then they compared these rates with an index of anti-tobacco programs in each state. Only 33 states were included in the analysis because the others had too few deaths from lung cancer in the 30-39 age group. The lung cancer death rate in both time periods was lowest in states like Arizona and California, which had strong anti-tobacco programs. It was highest in states such as Mississippi, Arkansas and Kentucky, which had weak anti-smoking programs. The death rate also dropped the most between the two time periods in states with strong anti-smoking programs. California's rate fell almost 19%, while Oregon's fell 28%. But 11 states with weak anti-tobacco programs saw the lung cancer death rate among 30-39 year-olds increase in the same interval. The rate in Kentucky, the state with the weakest anti-tobacco measures, rose the most -- more than 34%. Missouri's rate rose more than 29%, and West Virginia's rose 25%.States that had strong anti-tobacco programs also had fewer current smokers and more people who had quit in the 30-39 age group. These findings are in line with previous studies that found more rapidly declining rates of heart disease deaths and lung cancer incidence in California after that state adopted anti-tobacco programs in 1989.

Overall, Jemal said, his findings indicate that anti-smoking measures are working. "There is no question about that," he said. "Where you have stronger tobacco control activities you're going to have lower lung cancer death rates." He said future evaluations of the effectiveness of state anti-tobacco programs should look at lung cancer in young people, as well as other indicators of tobacco usage.

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Smoking Major Cause of TB Death, India Study Shows-(Reuters-15/08/2003)

Smoking is to blame for half the tuberculosis deaths among Indian men, according to new research, highlighting a neglected link between tobacco and the killer lung disease. Most big studies into smoking and health until now have been conducted in developed countries where tuberculosis (TB) has been uncommon for more than half a century. As a result, the connection with TB -- which is still endemic across much of Asia and Africa -- has been greatly underestimated, according to the authors of the first major study on how smoking causes death in India. "This is something that causes at least a few hundred thousand deaths a year worldwide...but the relationship had been forgotten and ignored," Richard Peto of the University of Oxford, co-author of the study, told Reuters.

The study also predicted the number of men dying from smoking related illnesses in India could double to more than a million a year by 2025. Three quarters of male Indian smokers who become ill with TB would not have done so if they had not smoked, Peto and colleagues said in a paper published in medical journal The Lancet. Their findings suggest that in some parts of the world the main way smoking kills is not via cancer and heart disease, but by damaging the lung's defenses against chronic TB infection. About a billion people worldwide are carrying live TB infection in their lungs, but if they do not smoke then most will never become seriously ill. Smoking increases the danger that any infection will get out of control and cause clinical TB, which can kill and spreads easily to other people.TB causes about 1.6 million deaths worldwide each year, including more than a million in Asia and 400,000 in Africa. India has more TB deaths than any other country.

The study by the Epidemiological Research Center in Madras, India -- with funding from the UK Medical Research Council and Cancer Research UK -- compared the smoking habits of 43,000 men who had died of various diseases in the late 1990s with the habits of 35,000 living men. It found that smokers were about four times as likely to become ill with TB as non-smokers, and consequently four times as likely to die from the disease. Vendhan Gajalakshmi of the Epidemiological Research Center, who led the research, estimates almost 200,000 Indians die each year from TB because of smoking -- half of them are still only in their 30s, 40s or early 50s.Smokers of both Western-style cigarettes and "bidis" -- thin Indian cigarettes containing small amounts of tobacco wrapped in a greenish-brown leaf -- are similarly at risk. Overall, smoking currently causes some 700,000 deaths a year in India, 550,000 among men aged 25-69. The number of deaths could double by 2025 if current smoking patterns persist, the authors conclude.

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Betel chewing found to be cancer hazard-(AFP-07/08/2003)

Betel chewing products, used from time immemorial in India and elsewhere in Asia as a mild stimulant and consumed even by children, are a major cancer hazard, according to a new study. Countries where betel chewing is prevalent have higher rates of cancer of the mouth, pharynx and oesophagus, and Asian immigrant communities also suffer more from these diseases than the surrounding population, according to the report by the International Agency for Research on Cancer (IARC). "There are hundreds of millions of users worldwide, and there is great concern that the habit will spread to populations in North America and Europe not previously exposed to the habit," the agency said.Britain is the world's leading importer of betel products outside Asia, it added.

A common product known as betel quid is a kind of candy made from areca tropical palm nuts, slaked lime and spices, and wrapped in a leaf from the betel vine. Tobacco is often added to the mix. The quid is held between the teeth and the cheek, where it slowly releases a stimulant called arecoline. People who use betel frequently over a long period of time usually have red teeth. They are also likely, the new study finds, to suffer from a hardening of tissue called oral submucous fibrosis, which can turn into cancer.

A previous IARC study in 1985 showed that chewing betel mixed with tobacco was a cause of cancer and the original assumption was that cancer was caused by the tobacco. But recent investigations have shown that chewing betel on its own was dangerous as well. The latest study reveals just how dangerous. Of the 390,000 cases of cancers of the mouth and related systems estimated to occur in the world each year, 228,000 or 58 percent occur in the Indian sub-continent and southeast Asia, the IARC study said. In some parts of India, oral cancer is the most common. A steep increase in chewing of betel products without tobacco in Taiwan in the 1970s led to an equally steep rise in the incidence of oral cancer a few years later.

The IARC, which is part of the World Health Organization, said it was concerned about the easy availability of mass-produced, pre-packaged betel products in many countries around the world. "Aggressive advertising, targeted at the middle class and at children, has enhanced the sales and use of these products," the study said. "In some parts of India, almost one out of three children and teenagers regularly or occasionally chew these products."

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Judge Dismisses Tobacco Suit vs. Calif.-(Reuters-22/07/2003)

A federal judge dismissed a lawsuit by big tobacco companies against the state of California in which they had challenged the state's anti-tobacco ads. The suit, by R.J. Reynolds Tobacco and Lorillard Tobacco Co, a unit of Loews Corp, had claimed the ads violated the companies' right to free speech, since they had been funded through a special tax on tobacco sales. However, in dismissing the lawsuit, Federal Judge Lawrence Karlton ruled that the tobacco companies had failed to show that the anti-tobacco ads were misleading or false. "If the plaintiffs truly believe that the challenged advertisements are both provably false and disparaging to their business reputations, they are free to seek relief against the state of California or its officials in a defamation action," Karlton, of the federal court in the eastern district of California, wrote in his decision.

Under California's voter-approved Proposition 99, the state imposes a 25-cent-per-pack tax on cigarettes and uses the funds generated for smoking prevention and education efforts. R.J. Reynolds had maintained the anti-smoking ads funded by the program were "highly prejudicial, outrageous, and wrong." California, however, has defended the campaign and says it has helped to reduce the state's smoking rate.

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Teens Misusing Nicotine-Replacement Products-(HealthDay-13/06/03)

New survey results suggest a small number of teenagers, including non-smokers, are misusing nicotine patches and gum. The authors of the study warn the teens could be setting themselves up for health trouble if they smoke and use the patch or gum at the same time or if they use the products to maintain their nicotine levels. But an expert on the psychology of smoking says the students may have lied on the survey. And even if they weren't, that doesn't mean the products are putting them at risk, says Dr. John R. Hughes, a professor of psychiatry at the University of Vermont.

At issue are two over-the-counter drugs that provide nicotine boosts: gum and patches. Smokers use both "nicotine-replacement" products to combat such symptoms of nicotine withdrawal as anxiety, depression and insomnia. "You don't need much nicotine to relieve that," Hughes says. "People can get 10 percent of the nicotine they normally get and still relieve their withdrawal symptoms." A third over-the-counter product, the nicotine lozenge, became available too late to be included in the survey. Study co-author Dr. Karen Johnson, vice chairwoman of the department of preventive medicine at University of Tennessee Health Science Center, became interested in the products during a visit to a store in Memphis. Although federal officials wanted to keep the products out of reach of minors, "it was out on the counter just like aspirin," she says. "My then-7-year-old son could have bought it." Johnson and her colleagues launched two studies of young people and nicotine replacement products.

Results of the first study, which analyzed use of the products among teenagers, appear in The Archives of Pediatrics & Adolescent Medicine. The second study, examining buying habits, will be published later. For the first study, researchers surveyed 4,078 teenagers from the Memphis area during the 1998-99 school year. Five percent of the teens reported using the nicotine patch or nicotine gum. Nearly 40 percent of former smokers said they used the products to help them quit. But surprisingly, 18 of those who reported having used the products -- less than 1 percent of all the students -- said they had never smoked. "It doesn't seem like it would be too appealing," Johnson says. "You don't get that rapid uptake of nicotine and the jolt that a cigarette gives you. That's a little surprising to me." Some students said they smoked and used the products at the same time, potentially putting them at risk of nicotine poisoning, Johnson adds. A few "were smokers who used the patch (during school) when they couldn't smoke, maybe to maintain their nicotine level. That's not its intended use," she says.Johnson says more research needs to be done to figure out why teens are misusing the products and how teens could use them to quit smoking.

On the other hand, University of Vermont professor Hughes says he's skeptical of the findings and of the idea that misuse of the products may be worrisome. The results are questionable because surveys of teenagers can be unreliable, he says. In some studies, teens have admitted using drugs that don't actually exist. Hughes adds he knows of no medical complications from misuse of nicotine-replacement products. "If a (nicotine) patch made you drive drunk and run into cars, it would be a different story. Even if you misuse it, it doesn't cause you to have medical problems or mental illness," he says. The real question, he adds, is whether the products even work in teenagers, who may not be addicted enough to smoking to need them. "We don't know if they're helpful to adolescents," he says.

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Study Links Smoking to Poor Adult Memory-(ET-29/05/03)

Another study suggests smoking is bad for your brain: Researchers tracking the health of almost 2,000 British adults found heavy smokers had poorer memories in middle age. People in the British study are in their 50s, far too young to know if the memory decline will translate into dementia when they're elderly. But testing so far suggests that heavy smokers who survive smoking's bigger threats - lung cancer and heart disease - into old age may be at risk of serious cognitive decline, the researchers report in the American Journal of Public Health.

Other research already has labeled smoking a risk factor for dementia. One cause of dementia is restricted blood flow in the brain, and smoking is linked to narrowed arteries and silent mini-strokes that choke that blood supply. The latest study is part of a broader tracking of the health of thousands of people born in Britain in 1946. A sample of the study participants underwent tests of memory, concentration and visual speed at age 43 and again at age 53. Heavy smoking - more than 20 cigarettes a day - was associated with faster declines in verbal memory and visual speed, although the declines were small, concluded researchers from University College London. They will continue tracking the study participants to see how their brains fare as they age.

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Smoking, Drinking Alter Beta Carotene's Effects-(ET-28/05/03)

Beta carotene, a nutrient that is converted in the body to vitamin A, has been touted as a possible cancer preventive for years, largely because of its antioxidant properties. But new research is showing that its effects on cancer risk may be much more complicated than once thought. In a study led by researchers at Dartmouth Medical School, beta carotene supplements were found to reduce the risk of colon polyps (a precursor to colon cancer) by more than 40% among people who did not smoke or drink. But these benefits appeared to be wiped out by tobacco or alcohol use. In fact, among people who reported both smoking and drinking, the supplements actually doubled the risk of developing polyps. "These findings illustrate the complexity we face in designing safe and effective chemopreventive strategies for any cancer," said John Baron, MD, the lead author of the study, which was published in the Journal of the National Cancer Institute (Vol. 95, No. 10: 717-722).

Baron and colleagues studied more than 700 people taking part in the Antioxidant Polyp Prevention Study. All of the participants had polyps (noncancerous growths on the inside of the colon) removed by colonoscopy before the study started. They were then assigned to take either a 25 milligram beta carotene supplement or a placebo (sugar pill) each day, and completed a questionnaire about their smoking and drinking habits. All participants had colonoscopies one and four years later. At the end of the study, those who reported they neither smoked nor drank alcohol were 44% less likely to have developed any new polyps if they were taking beta carotene instead of a placebo. But among those who smoked or drank (even as little as less than one drink a day), the supplements had essentially no effect on polyp risk. More surprisingly, those taking beta carotene who smoked and had, on average, more than one drink a day were more than twice as likely to develop polyps as the group taking the sugar pill.

The study authors concluded that alcohol and tobacco may somehow block any protection offered by beta carotene supplements. They couldn't explain why people who both smoked and drank developed more colon polyps. Did the extra beta carotene in pill form fuel the growth of new polyps? It's also not known whether the smaller amounts of beta carotene that people typically get from eating fruits and vegetables have any effect on colon polyps. The authors advise that more careful research is needed when looking at supplements as possible preventives. "These results suggest that caution must be applied in choosing interventions for large-scale use in well people, particularly when the mechanisms of action and possible interactions with lifestyle factors are not well understood," they conclude.

This is not the first time a study has suggested that beta carotene supplements might actually do more harm than good among certain groups. Several previous studies have looked at whether beta carotene could reduce the risk of lung cancer. Two large studies, both of which looked mainly at smokers, found that beta carotene actually increased the risk of lung cancer, particularly among those who also drank alcohol. A third study, which looked chiefly at non-smokers, found that beta carotene had no effect.

While some people probably do benefit from taking vitamin supplements, as of yet there is not enough scientific evidence to recommend taking them to reduce the risk of cancer. Several large clinical trials are now underway to help clarify this issue. In the meantime, whenever possible, people should try to fulfill their nutritional needs by eating a healthy diet. This should include at least five servings of vegetables and fruits each day, eating whole grain foods as opposed to refined carbohydrates like white flour and white rice, and limiting intake of red meats, especially those that are high in fat or processed.

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Levels of Carcinogen Higher in Marlboro Cigarettes-(Reuters-22/05/03)

Marlboro, the world's No. 1 selling brand of cigarettes, contains significantly higher levels of a cancer-causing agent than its rivals when purchased in many of the largest markets overseas, U.S. scientists say. Tests by the U.S. Centers for Disease Control and Prevention found that the U.S. brand contained higher amounts of tobacco-specific nitrosamines (TSNAs) than other locally available cigarettes in 11 of 13 countries. In 10 countries, including Japan and Germany, Marlboro cigarettes purchased locally had at least twice the amount of TSNAs, one of the major classes of carcinogens found in tobacco products, than competitor brands. The findings, published in the latest edition of Nicotine & Tobacco Research, come at a time when worldwide demand for American-style, blended cigarettes is outpacing demand for other types of cigarettes.

David Ashley, a CDC tobacco expert and the lead author of the article, said it was not known whether higher levels of TSNAs would lead to a greater prevalence of cancer and other smoking-related diseases. Ashley did, however, note that reducing TSNAs in tobacco products would not make cigarette smoking any safer. The World Health Organization has estimated that there are more than 1.2 billion smokers on the planet and that 4 million people die each year from cancer and other smoking-related diseases. Philip Morris USA, which markets Marlboro cigarettes, said the CDC findings were not surprising since the levels of TSNAs found in American cigarettes were traditionally higher because of differences in curing and processing. Philip Morris USA is a unit of Altria Group Inc. . "We're aware of these higher TSNAs and have worked to reduce them," Philip Morris USA spokesman Brendan McCormick said.He added that the company had spent $35 million to lower the levels of this type of carcinogen in its products. But anti-tobacco activists said the tobacco giants had done precious little to strip harmful contaminants from cigarettes.

"Today's study is just the most recent example of the tobacco industry's reckless disregard for the health of smokers and yet another compelling reason why cigarettes need to be regulated by the federal government," said Matthew Myers, president of the Campaign for Tobacco-Free Kids. About 440,000 people in the United States die each year from lung cancer and other diseases caused by smoking, making it the leading preventable cause of death in the nation. There are about 46.5 million smokers in the United States.

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Parents: Quit Smoking Before Your Child Turns 8-(Reuters Health-09/05/2003)

New research suggests that, for parents, quitting smoking before children turn eight or nine appears to steer them away from becoming teenagers who smoke. U.S. researchers discovered that children of parents who quit smoking before the youngsters entered third grade were 39 percent less likely to be smokers themselves at age 17 or 18 than children whose parents never butted out for good. Children start to experiment with cigarettes soon after they reach eight or nine, and these findings suggest that parents who smoke while children are faced with the option of smoking themselves are "providing a model of smoking behavior in the household," study author Jonathan B. Bricker told Reuters Health. In other words, smoking in front of your children can have both physical and psychological effects, he added. "By parents quitting smoking, they are not only protecting their children from the health hazards of secondhand smoke, but they are also preventing the children from becoming smokers themselves," said Bricker, who is at the Fred Hutchinson Cancer Research Center in Seattle, Washington. He added that he hopes these findings provide "a new motivation for smoking parents to quit."

During the study, published in the journal Addiction, Bricker and his colleagues interviewed both parents of 3,012 third graders, then re-contacted the families when the children reached 17 or 18. Although having both parents quit in childhood lowered teen smoking rates by almost 40 percent, even one parent's choice to quit during the child's youth reduced the risk of teen smoking by 25 percent compared to families where both parents continued to smoke. However, the best protection against teen smoking appeared to come from families in which both parents never smoked, in whom children were 71 percent less likely to become smokers themselves, than families in which both parents were still smoking into their child's teen years.

"The best situation of these groups is to be the child of a never smoker," Bricker said. He added that parents who quit smoking might discourage the habit in their children by becoming somewhat of an "activist." Kicking an addiction for good requires a strong resolution, he said, and parents who don't want to restart smoking may adopt certain habits -- such as speaking negatively about smoking, sitting the family in non-smoking sections of restaurants, or forbidding smoking in the house -- which discourage smoking in kids. These findings clearly suggest that anti-smoking messages need to target parents early, Bricker said. Distributing pamphlets and hotline numbers, or holding meetings at school may help teach parents of young children the damage their habit can cause, and the "double benefit" that comes from kicking it for good, he noted. "If they quit, they not only help themselves, they can keep their children from smoking," Bricker said. He added that he and his colleagues are currently investigating whether parents who quit smoking after their children enter third grade also protect them from teen smoking.

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Smoking May Hasten Spread of Cancer: Study-(Reuters Health-18/04/2003)

At diagnosis, cancer patients who are smokers are more likely than nonsmokers to have cancer that has spread beyond the original tumor, research suggests. This seems to be true for a broad range of cancers, including prostate cancer. The findings do not prove that smoking causes cancer to spread but they do provide another incentive to kick the habit, according to a team led by Dr. Nathan L. Kobrinsky at the MeritCare Children's Hospital in Fargo, North Dakota. Kobrinsky and his colleagues note that there are stacks of scientific evidence that "unequivocally" show that smoking is the major cause of a number of cancers, including cancers of the head and neck, lung and bladder. It is also a major contributing factor to cancers of the esophagus, pancreas and kidneys, according to the researchers. However, even though smokers who are newly diagnosed with any type of cancer are advised to quit, this recommendation is "often given and received with ambivalence" since it is uncertain whether cigarette smoking promotes cancer growth once cancer has already formed, the authors write in the Journal of Clinical Oncology.

In the present study, the team of researchers aimed to better understand smoking's relationship with cancer that has spread beyond the primary organ to another area of the body, referred to as metastatic cancer. Using a tumor registry for eastern North Dakota, northwestern Minnesota and northern South Dakota, Kobrinsky's team evaluated 11,716 cases of cancer. The team not only assessed the stage of cancer at the time of diagnosis but also evaluated information about the cancer patient's current and past smoking habits. The investigators found that current smoking doubled a person's risk of having metastatic disease at diagnosis of a broad range of cancers. This risk was increased by 56 percent in previous smokers. Current smokers, but not previous smokers, also had a 39 percent increased risk in their chance of being diagnosed with regional disease -- cancer that has spread just outside of the primary area of disease.

Prostate cancer carried the most increased risk for metastatic disease, while head and neck, prostate and breast cancer were all more likely to be associated with regional disease among smokers, the study indicates. "In summary, smoking is associated with cancer spread at diagnosis," the authors write. "This finding has major implications for future research and offers support for the notion that, with regard to cigarette smoking, 'it 's never too late to quit,"' they conclude. Nonetheless, the authors point out that their study does not prove that quitting smoking upon diagnosis of cancer will reduce a person's risk of metastatic disease. More research will be needed to directly answer that question, they said.

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Secondhand Smoke Speeds Tumor's Blood Vessel Growth-(Reuters Health-02/04/2003)

It is known that repeated exposure to secondhand smoke can increase a person's risk for cancer, and now a new study in mice helps explain why. Secondhand smoke seems to stimulate tumor growth and angiogenesis, the formation of new blood vessels in tumors, according to Dr. Stanton A. Glantz of the University of California at San Francisco and his colleagues. This is a concern because the abnormal formation of new blood vessels is believed to encourage cancer growth by giving small tumors the blood supply they need to thrive and spread. "One of the really important things that has to happen for a tumor to grow is you have to have blood vessels grow in to supply blood to the tumor," Glantz told Reuters Health.

In his team's study of mice with a lung cancer-like condition, secondhand smoke seemed to stimulate angiogenesis and tumor growth. In other words, Glantz said, "the cancer-causing chemicals in the smoke not only initiate the (tumor formation) process, but other things in the smoke facilitate the growth of the tumor." The findings were presented this week at the 52nd annual meeting of the American College of Cardiology, held in Chicago.Previous research indicates that people exposed to secondhand smoke face an increased risk of lung cancer and death from cardiovascular disease. Secondhand smoke has also been linked to a number of respiratory health problems, including pneumonia and impaired lung function in children, and asthma in both children and adults.

In the current study, three groups of mice had lung cancer cells implanted in their lungs and were exposed to smoke from four cigarettes every 15 minutes for six hours each day. After six days, the researchers say, mice exposed only to secondhand smoke showed "excessive tumor growth." However, tumor growth and tumor angiogenesis were lower in a comparison group of mice that were exposed to secondhand smoke and then given mecamylamine, a so-called nicotine-blocker. This suggests that although nicotine plays a role in speeding up angiogenesis, it does not act alone, according to Glantz. "Even when you blocked it, you still got an effect," he said. "I just never realized that secondhand smoke had such a strong effect on angiogenesis," Glantz added, noting that scientists are currently investigating how to prevent this vessel-forming process in cancer. "If you block angiogenesis in tumors, you could kill the tumor," he said, "so the secondhand smoke is having effects which are just the opposite of the therapeutic interventions people are trying to develop."

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Nicotine May Speed Lung Cancer Growth-(Reuters-27/03/2003)

Smoking not only causes cancer, it may also speed up the growth of existing tumors. Research by scientists at the Oregon National Primate Research Center in Beaverton suggests that nicotine in cigarette smoke could stimulate the production of a molecule which can make lung cancer cells more aggressive and encourages them to divide and grow. "Smoking may boost the growth of existing tumors as well as triggering cancer," New Scientist magazine said.

The molecule, called acetylcholine, is a neurotransmitter, or message-carrying chemical, in the brain and nerves. Eliot Spindel and his colleagues found that some cancerous cells have receptors, or molecular doorways into cells, for the molecule. They also discovered that fast-growing cells make large amounts of the molecule and have a feedback loop so that the acetylcholine they make encourages them to divide and grow. But when the scientists cut the loop by blocking the receptors with the nerve gas antidote atropine the cells stopped growing. "Our discovery reveals the little extra push by nicotine," said Spindel, who reported his research in the journal Life Sciences. He believes it may be possible, though not easy, to adapt drugs such as atropine to treat lung cancer but added that the correct dose and making sure it doesn't affect the nervous system would be crucial. "This loop can be revved up by smoking," Spindel said, "so there's no question that not smoking is the best thing you can do."

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France Seeks to Stub Out Smoking in Cancer Fight-(Reuters-24/03/2003)

President Jacques Chirac, himself a former chain-smoker, launched a high-profile anti-smoking campaign that will mean French smokers end up paying more for their pungent Gauloises. Turning to his domestic agenda after months of diplomatic wrangling trying to prevent war in Iraq, Chirac declared a "war on smoking" as the main thrust of a fight against cancer, to which he pledged to devote half a billion euros over five years. "The fight against smoking is a must, an absolute priority," Chirac said in a speech to health professionals and politicians. "This isn't about undermining individual liberties, but about doing everything to change attitudes and save lives."

Allowed in many offices until recently, smoking is a part of everyday life in France. Lighting up after dinner or over a drink is common, and smokers can sometimes be seen sneaking a quick, illegal puff while waiting for the Paris Metro. Chirac, who has made fighting cancer a major theme of his five-year term, said one in three Frenchmen smoke and one in four women. Among young people, he put the rate at 50 percent. France would continue to raise cigarette prices after a tax rise added about 15 percent to the cost in January, Chirac said. In the broader fight against cancer, research would be boosted, access to treatment improved and more preventative measures taken. Screening for breast cancer would be made available to all women in France by the end of the year. With 150,000 deaths a year, cancer is France's biggest killer of people under 65 years of age. Some 30,000 people die each year from cancers caused by smoking, Chirac said. "Over the last 10 years, (cancer) has claimed as many victims as the most devastating conflict of our history, as many victims as the First World War, or one and a half million people," he said.

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Smoking Ups Chances of High-Risk Prostate Cancer-(Reuters Health-11/03/2003)

Smoking may increase younger men's odds of developing a more advanced form of prostate cancer, new research suggests. Among men younger than 55 who'd had their prostates removed due to cancer, researchers found that current smokers were more than three times as likely as non-smokers to be diagnosed with an advanced form of the disease. The risk of advanced disease was also increased for men who had smoked during the 10 years before surgery, the authors note--suggesting the risks of smoking may persist for many years. What's more, the longer the men had smoked before surgery, the more likely they were to have higher-risk prostate cancer, Dr. William W. Roberts and colleagues at Johns Hopkins University in Baltimore, Maryland, report in the Journal of Urology. "It's another reason why people shouldn't smoke," Roberts told Reuters Health.

Roberts and his team surveyed 498 men who had undergone surgery to remove their prostates between 1992 and 1999. Respondents gave information about their health habits, including whether they smoked before or during the year of their surgery. The information was compared with analyzes of their prostates, completed after the tissue was removed, to determine whether patients had a form of the disease that was at risk of recurring. High-risk cases were those that were graded highly on a scale of disease severity, or those that were deemed "extraprostatic," meaning they had spread outside the prostate, but not to distant sites in the body. According to Roberts, extraprostatic prostate cancer is considered an advanced form of the disease because the cancer is more likely to recur once the prostate has been removed.

Despite the new findings, though, Roberts cautioned that the study is based on the men's ability to recall how much they had smoked in the past, a method that is often unreliable. As such, he said the findings are only "suggestive" that smoking ups the odds of higher-risk prostate cancer, and further research is needed. Still, there is reason to believe smoking could directly promote more-advanced disease, according to the researchers. For example, a protein called GSTP1 appears critical in eliminating certain tobacco-smoke toxins from the body, and one of the hallmarks of prostate cancer involves the inactivation of this protein. So in theory, Roberts said, men who have prostate cancer and also smoke might experience an increase in toxic compounds in their bodies, which could, in turn, render their cancer more advanced.

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Half of UK Workers Fear Passive Smoking-(ReutersHealth-13/01/03)

Charities have launched a new clean air campaign after a survey showed that half the country's workforce is concerned about developing lung cancer from passive smoking. The campaign, by Cancer Research UK, Marie Curie Cancer Care and the anti-smoking groups ASH (Action on Smoking and Health (news - web sites)), QUIT and No Smoking Day, is aimed at reducing workers' exposure to second-hand smoke. "Passive smoking is deadly and it is about time the government acted on this," Marsha Williams of ASH told a news conference to kick off the campaign. "Twelve million people are concerned about the impact of passive smoking," she added.

According to the MORI poll of 2,000 Britons, 51%, or 12 million working people, are worried that they will become ill because of their exposure to cigarette smoke in the workplace. The survey also revealed that 68% of people overestimate the chances of surviving lung cancer--which are less than 5%. Williams said that a recent poll by ASH showed that 85% of people believe the right to a smoke-free workplace outweighs the right to smoke at work. The campaign will include an online survey aimed at workers (www.cancerresearchuk.org/smokingsurvey) to identify industries where smoking is a problem. The results will be passed on to the government to encourage it to introduce an Approved Code of Practice (ACoP), which would lead to smoking being banned in most workplaces.

Williams said that more than 2 years after the code was suggested, the government has still failed to introduce it, mainly because of opposition from the hospitality industry. Dr. Teresa Tate, medical adviser of Marie Curie Cancer Care, emphasized the dangers of passive smoking, which the British Medical Association estimates kills 1,000 people each year in Britain. "Passive smokers have a 20-30 percent increased risk of developing lung cancer," she said.

In addition to cutting the health risk for non-smokers, a no-smoking policy could also help smokers to give up the habit. Doreen McIntyre, the chief executive of No Smoking Day, which organizes the national day devoted to quitting, said smoking in the workplace makes it difficult for those who want to quit. Lung cancer is the most commonly diagnosed cancer in Britain and causes nearly a quarter of all cancer deaths. About 40,000 new cases of the illness are diagnosed each year in Britain.

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Nicotine Replacement Backed Despite Cancer Study-(HealthScoutNews-10/01/03)

Nicotine replacement products are much safer than smoking despite a new study suggesting that nicotine could play a role in lung cancer. That assurance comes from a leading maker of these products as well as researchers who reported last week that nicotine appears to give a helping hand to cancer cells in the lungs. "Our study is probably the first to show that nicotine can act similarly to a carcinogen," says Kip A. West, a researcher with the National Cancer Institute. However, the study is based on findings in the laboratory, and researchers haven't tested their theories on animals or humans. And the scientists aren't suggesting that smokers give up trying to quit with the aid of nicotine replacement products, which now include lozenges in addition to the ubiquitous patches and gum.

To make the point even clearer, GlaxoSmithKline issued a statement saying the risks of using nicotine-based smoking cessation products "are extremely small compared to the known deadly risks of smoking." The pharmaceutical company makes NicoDerm CQ nicotine patches, Nicorette gum and Commit lozenges, which let smokers slowly wean themselves off their addiction by getting doses of nicotine without having to light up. According to the American Cancer Society, the nicotine replacement products deliver lower doses of the chemical than tobacco. They also let smokers focus more on the psychological difficulties of quitting than the physical addiction.

While nicotine is considered to be largely responsible for turning smokers into addicts, scientists have not considered it to be a cause of cancer. Instead, researchers blame hundreds of other poisonous chemicals in cigarettes, pipes and cigars. Federal researchers, however, wondered whether nicotine could play a role in the development of cancer. They set up experiments involving lung cells in a laboratory and report their findings in a recent issue of the Journal of Clinical Investigation. In a healthy body, cancer-infected cells will automatically activate a kind of suicide program: The cells will kill themselves before they can wreak havoc on the body. However, when researchers hit human lung cells with cancer-causing chemicals, the levels of nicotine normally experienced by smokers appeared to prevent the cells from switching on the suicide protocol. "It has a protective effect," West says.

The survival of the cells, in turn, "allows them to accumulate mutations that would enable them to become tumor cells." The researchers found that nicotine and a related chemical in tobacco known as NNK appear to affect the cells by influencing pathways where command signals travel. What does this mean for nicotine products that are geared to help people stop smoking? West says the research does raise concerns if people use the products for a long time. "Prolonged use could be a bad thing," he says.

GlaxoSmithKline says its products are designed to be used over 10 to 12 weeks as a "step-down therapy" that more than doubles the chances of successfully quitting over the "cold turkey" approach. However, the company suggested that long-term use might not be a problem. It cited a 1997 federally funded study that found people could safely take nicotine gum for five years.

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Study Looks at Nicotine's Role in Cancer-(Associated Press-03/01/2003)

Nicotine makes smoking addictive and is bad for the heart, but 60 other cigarette chemicals are blamed for causing cancer. Now some biochemists say nicotine might help set the stage for those chemicals to do their dirty work. Certain tobacco chemicals trigger cellular genetic damage. Damaged cells are supposed to commit suicide; if they do not, the damage eventually accumulates enough to turn cancerous. Nicotine activates an enzyme reaction that inhibits cellular suicide, says new research by scientists at the National Cancer Institute.

Nicotine starts activating that enzyme, called Akt, within minutes, while cancer-causing genetic damage takes hours to begin, NCI researchers report in Thursday's Journal of Clinical Investigation. That suggests nicotine - along with other chemicals that also block cell suicide - may make cells more vulnerable to the cancer-causers. "Nicotine is not a carcinogen and we're not trying to make that argument," said the study leader, Dr. Phillip Dennis. But "it may have a permissive effect" for cancer formation.

Scientists first discovered nicotine may block cell suicide 10 years ago, said nicotine expert Dr. Neal Benowitz of the University of California, San Francisco. But the new research uncovers the actual enzyme involved. That enzyme pathway could prove important in developing cancer-preventing drugs, Dennis said. The immediate question is whether the effect matters for people using nicotine in gum or patches in an effort to kick the habit. "It's clearly better for people to stop smoking and use a patch than to continue smoking," Dennis said. But the study reinforces that anti-smoking medicines are for short-term use because "there may be biologic consequences" of using patches for months or years, he added. But Benowitz said the NCI study used cells in laboratory dishes, while previous studies of snuff users - who do not absorb nearly as many carcinogens as smokers - suggest there is little cancer risk from nicotine.

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Tobacco Helps Cancer Cells Evade Destruction-(Reuters Health-01/01/2003)

New research suggests that tobacco not only promotes cancer development, but also helps early cancer cells evade detection by the immune system, which might otherwise mop up harmful cells before they reproduce and spread. Dr. Jane A. McCutcheon and her colleagues at New York University in New York City discovered that cells exposed to tobacco have fewer substances on their surfaces used to signal whether or not the cell is dangerous and should be destroyed by the immune system. As such, McCutcheon suggested in an interview with Reuters Health, cells with fewer of these warning devices, if they become cancerous, would be more likely to evade detection by the immune system, grow and spread throughout the body.

The cellular warning devices are known as HLA class 1 molecules, which are usually unique to each person. These molecules sit on the surface of cells and present a protein to the outside environment. If this protein is derived from harmless substances inside the cell, immune system components known as killer T cells will bypass the cell, considering it to pose no threat to the body. However, if the protein inside a class I molecule was made as a result of a cancer inside the cell, or comes from a virus, the T cells hone in on the cell and destroy it.

In a recent issue of the Journal of Immunology, McCutcheon and her colleagues presented the results of experiments in which they found that cells exposed to tobacco showed fewer HLA class 1 molecules. Further experiments revealed that cells exposed to tobacco show lower levels of a particular protein that forms a link in the chain that assembles HLA class 1 molecules inside the cell. Reductions in this protein, known as TAP1, likely lead to lower amounts of HLA class 1 on the cell surface, the authors suggest. In an interview with Reuters Health, McCutcheon cautioned that these changes do not cause cancer, but simply allow the cancer to thrive in the body once it appears. "The class 1 is gone before the cell becomes cancerous," she said. "If those cells become cancerous, there isn't enough class 1 for T cells to kill them."

McCutcheon noted that tobacco has a lot of ingredients, and she and her colleagues remain unsure about which particular ingredients might interfere with the cells' production of HLA class 1. In the meantime, she noted that all tobacco-containing substances--not just those that people smoke--would likely have the same effect. "If you just sucked on a cigarette it could do this to you," she said. In the future, McCutcheon predicted, it may be possible to design a product that smokers could suck or somehow ingest that could help restore healthy HLA class 1 levels. Tobacco still triggers cancer, she said, but boosting the body's ability to destroy early cancers might help smokers fight off more cases of the disease than they would otherwise. However, the bottom line remains the same, McCutcheon noted: "Cigarettes are bad."

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