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State Stimulus Funding for Tobacco Cessation - Communities Putting Prevention to Work In response to the American Recovery and Reinvestment Act, the Department of Health and Human Services has developed a funding opportunity – Communities Putting Prevention to Work – to reduce risk factors and prevent/delay chronic disease and promote wellness in both children and adults. On a recent NTCC monthly call, members discussed these stimulus funds and opportunities for NTCC around the funding. NTCC can have a role in promoting this information and other related information (including NTCC publications) to states and communities and encourage them to take advantage of this opportunity and apply for funding to prevent tobacco use and increase cessation among youth and adults. More information on the funding program is provided below. Communities Putting Prevention to Work will change systems and environments and put into place policies at both the state and local levels to promote the health of populations. This program will:
The program is being led by the Centers for Disease Control and Prevention and will have 4 initiatives, two of which have been launched: a Community Initiative and a States and Territories Policy and Environmental Change Initiative. Community Initiative Nearly $373 million will support evidence-based prevention and control strategies for youth and adults. These grants will be awarded to urban, rural, and tribal communities through a competitive selection process. With these grants, communities will implement a set of evidence-based interventions to achieve high-impact, broad-reaching, and sustainable change. In the area of tobacco control, these interventions would include:
These grants will also promote partnerships across communities and sectors, including local and state health departments, schools, businesses, community and faith-based organizations, academic institutions, health care, and other community partners working together to promote health and prevent chronic diseases. An additional $76 million is allotted for support, including program support, community mentoring, and evaluation, to ensure funded communities are successful in implementing the interventions. A letter of intent for the Community Initiative is due October 30, 2009. The application deadline is December 1, 2009. Questions can be emailed to CPPW@cdc.gov. For more information about the Community Initiative, visit http://www.cdc.gov/nccdphp/recovery/community.htm. States and Territories Policy and Environmental Change Initiative An additional $120 million will support states and territories in promoting wellness and preventing chronic disease through state-wide policy and environmental change for chronic disease prevention and to increase tobacco cessation through expanded quit lines and tobacco cessation media. There are three major components to this initiative, one of which focuses solely on tobacco cessation. 1. Tobacco Cessation through Quitlines and Media This component will provide funds to expand tobacco quit lines, together with expanded cessation media campaigns. States and territories will receive funding based on the number of smokers in their jurisdiction. Additional funds will be used to support national efforts including support for surge capacity, additional quit line monitoring, and quality improvement measures. The other components include: 2. Statewide Policy and Environmental Change States and territories submitting quality applications will receive funding to promote state-wide policy and environmental changes. These activities will support healthy behaviors related to tobacco control and prevention, obesity control, nutrition, and physical activity. All states and territories will be eligible for a base funding amount determined by population. 3. Competitive Special Policy and Environmental Change Initiative States and territories can compete for funds to be used to implement at least one or more high-impact additional policy, environmental, or system change strategies to eliminate health disparities in the areas of tobacco, physical activity, or nutrition, or a combination of these. The application deadline for the state projects is November 24, 2009. Questions can be emailed to ARRA@cdc.gov. For more information about the State and Territories Initiative, visit http://www.cdc.gov/nccdphp/recovery/state.htm. For more information about the Communities Putting Prevention to Work Program, visit http://www.cdc.gov/nccdphp/recovery/index.htm. If you are interested in participating in a workgroup to focus on the stimulus funding and identify opportunities for NTCC to promote this information or other related information to states, please contact Jessica Rowden at jrowden@aed.org. New Survey Finds One in Three Sports Fans Smoke, Five Out of Six Smoke While Watching Sports A new survey conducted by the American Legacy Foundation® (Legacy) finds that the majority (63 percent) of sports fans surveyed are current or former smokers and 76 percent of them have smoked while watching or attending sporting events. The study examines whether sports fans were exposed to secondhand smoke while watching sports; smoked while watching sports at certain venues; or whether those who quit smoking relapsed while watching a game. The survey also examined whether watching sports was a trigger for fans who smoke. The survey also indicated that 60 percent of sports fans have been exposed to secondhand smoke in the past year while watching or attending sporting events and that 36 percent of sports fans who smoke or used to smoke are extremely or very tempted to smoke while viewing sporting events in their own homes. When the score of the game is close, nearly one third are extremely or very tempted to light up. Through the winter, many smokers will be exposed to new quit smoking messages through the EX® national smoking cessation campaign. Legacy, along with the National Alliance for Tobacco Cessation (NATC), announced that the next round of new ads in its two-year old EX campaign are now being featured during FOX Sports’ broadcast of Major League Baseball’s American League Championship Series (ALCS) and World Series. The campaign’s new ad debut includes traditional 30-second in-game commercials, as well as new virtual home plate signage that will be seen during live action. The placement of the ads during the ALCS and World Series is the first of several that will appear in different sports venues through the winter, including “Bassmasters” programming on ESPN2 and national radio programming on Sporting News Radio. The ads are now prominently featured during ALCS games on FOX and will run in various formats through January to encourage smokers to visit www.BecomeAnEX.org for a free comprehensive plan to “re-learn life without cigarettes. “For years, tobacco industry advertisements were prominently displayed during sporting events, circumventing the federal ban on tobacco advertising on television,” said Cheryl G. Healton, DrPH, Legacy’s president and CEO. “Through EX, we hope to help fans who smoke to beat this addiction with a free, easy-to-follow three-step plan to quit smoking.” These new ads may also help to counter the images of players who use smokeless tobacco – both snuff and chew – whom fans of professional baseball are accustomed to seeing. Eight million Americans 12 and older use smokeless tobacco products and annually one million more begin using them. Adolescents who use smokeless are more likely to become cigarette smokers. Released just prior to Lung Cancer Awareness Month and the Great American Smoke Out in November, a critical time to help the 43 million Americans who smoke to finally quit, these findings indicate a high proportion of smokers among sports fans surveyed (34 percent). Eighty-four percent of sports fans who are current smokers reported that they smoke cigarettes while watching or attending sporting events. The NATC encourages fans who smoke to use the EX quit plan, a two-year old collaborative of state and national public health groups spearheaded by Legacy. This is the second phase of EX advertising and promotions which are designed to help smokers “re-learn” life without cigarettes. For more information, see web link:
Report Confirms Smoking Bans Prevent Heart Attacks A new report from by the Institute of Medicine, Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence, confirms scientific evidence that smoke-free laws prevent heart attacks and save lives. The new report was written at the request of the Centers for Disease Control and Prevention in the wake of a growing number of studies from smoke-free states and countries that found that smoke-free laws reduced heart attack rates. The committee that prepared the report reviewed 11 studies done in the U.S., Canada, Italy and Scotland. The report found that:
A 2006 U.S. Surgeon General’s report found that exposure to secondhand smoke can cause heart disease and indicated that smoke-free policies are the most economical and effective way to reduce exposure. The IOM adds significantly to the Surgeon General’s report with its conclusions that smoke-free laws prevent heart attacks and even short-term exposure to secondhand smoke can precipitate a heart attack. “This report is a powerful reminder of why we need comprehensive smoke-free laws that apply to all workplaces and public places, including restaurants and bars,” said Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO of the Robert Wood Johnson Foundation. “While 27 states have now enacted smoke-free laws that include restaurants and bars,” says Lavizzo-Mourey, “we can't be satisfied until all Americans are protected from the deadly diseases caused by secondhand smoke.” Matthew L. Myers, president, Campaign for Tobacco-Free Kids, says the report should spur every state to enact a comprehensive smoke-free law that includes all workplaces, restaurants and bars. “No one should have to put themselves at risk of a heart attack, lung cancer or the other serious diseases caused by secondhand smoke in order to earn a paycheck or enjoy a night out.” But experts say it will take a multiple efforts to reduce tobacco use among youth and adults. “The multi-pronged approach we need,” says Danny McGoldrick, vice president, research, at Campaign for Tobacco-Free Kids, “includes an increase in tobacco taxes, funding for tobacco-cessation programs and comprehensive smoke-free laws that that protect everyone’s right to breathe clean air.” For more information, see web link:
Indianapolis Anti-smoking Advocates Release Study Results An anti-smoking group is calling on the Indianapolis City-County Council to ban smoking in all workplaces including bars, restaurants and bowling alleys. The group says the danger of second hand smoke is not a cloudy issue. Employees who breathe in someone else's smoke in the workplace have their own health jeopardized every day. That's according to new air quality studies comparing a smoke-free environment to places where smoking is allowed. The study measured air quality at ten workplaces in the city. The group Smoke-Free Indy found the indoor air pollution was 11 times higher in these venues compared to smoke-free establishments. "It is time to enact a comprehensive public health ordinance that seeks to protect workers in Indianapolis - our patients - from the adverse health effects of secondhand smoke. It is unconscionable especially in this current economy to place our citizens in a position of having to decide between their own health and whether or not to keep their current job," said Dr. Christopher Doehring, St. Francis Hospital. The results were announced at Crackers Comedy Club, a smoke- free venue. This comes as the City-County Council considers expanding the smoking ban to all work places in Indianapolis. Proponents point to reduced heart attack rates in communities that implement smoking bans, as well as overall healthier work environments. But some restaurants and bars say that an expanded ban would cut into their business, and that they should be free to allow smoking if they choose to do so. There are also smokers who bristle at the idea of an expanded ban when smoking is already restricted in many venues. Dr. Doehring said there is no safe level of secondhand smoke. "Eliminating exposure to secondhand smoke in the workplace is the most significant public health measure the city county could will address this year," said Doehring. The US Environmental Protection Agency has set limits of 15 micrograms per cubic meter as the average annual level of PM2.5 exposure and 35 micrograms per cubic meter for 24-hour exposure. PM2.5 is the concentration of particulate matter in the air smaller than 2.5 microns in diameter. Particles of this size are released in significant amounts from burning cigarettes and are easily inhaled deep into the lungs, according to Smoke-Free Indy. The study found that the smoking venues had rates of 164 micrograms per cubic meter of PM2.5 exposure, much higher than the EPA's limit of 15. Advocates for an expanded ban say about 360 communities across the United States have enacted smoke-free workplace laws that cover all workplaces including bars and restaurants. They say such an effort is necessary because secondhand smoke is a known human carcinogen and is responsible for an estimated 50,000 deaths and other illnesses every year. For more information, see web link:
NBCH Releases Findings on Tobacco Cessation Efforts of Health Plans Tobacco cessation is one of the most cost-effective activities an employer can implement to improve the health and productivity of their employees while reducing health care costs. To help employers in this effort, the non-profit National Business Coalition on Health released its report on health plan performance related to tobacco cessation. The report finds that health plans are playing an important role in administering smoking cessation benefits and encouraging physicians and other providers to focus on smoking cessation through education, tools, and incentives. Using data from the eValue8(TM) Request for Information (RFI) tool which examines current health plan performance for a variety of areas including tobacco cessation, the report illustrates how employers can leverage health plan services to help their employees to quit smoking. NBCH's eValue8 is the nation's leading standardized RFI tool used by employers and coalitions to measure and compare health plan performance from more than 100 health plans and health insurers. Over 100 million Americans, or two in every three Americans insured through an employer, are members of health plans that respond to eValue8. Publicly available, the report can be accessed on NBCH's website, http://www.nbch.org/. eValue8 establishes benchmarks, along with specific performance scores of health plans which are then used by employers and local business coalitions to identify opportunities for improvement in their tobacco cessation programs. Specifically related to tobacco cessation programming, no health plan achieves 100 percent of the points allocated by eValue8 and about half of the plans achieve 50 percent or better, with 17 percent of plans scoring 75 percent or above. "Tobacco cessation is a complex issue for employers and health plans," said Dennis White, Senior Vice President for Value-Based Purchasing, NBCH. "There is a significant process from identification of individuals needing support to successful treatment. eValue8 findings show that 80 percent of health plans are adopting evidence-based benefit design and are incorporating counseling and the use of FDA-approved medication with positive results." The report illustrates the importance of active employer engagement in their own workplace programs. Employer activities including the development of programs and policies and the design of health benefits augment those of the health delivery system. With the evidence of both the cost impact of tobacco use and the successful design for support programs for cessation, employers can work in collaboration with health plans to promote this benefit and the related policies and communications. For more information, see web link:
Motivational Techniques, Personalized Skills Make It Easier for Teen Smokers to Kick the Habit Proactive telephone counseling and individually tailored motivational interviews help teen smokers kick the habit, new research indicates. Two studies, published in the Oct. 12 online issue of the Journal of the National Cancer Institute, indicate smoking-cessation programs that involve motivational techniques and personalized behavioral skills training by phone can make it easier for teens to give up the habit early. Arthur V. Peterson, PhD, and colleagues at the Fred Hutchinson Cancer Research Center in Seattle designed a smoking- cessation program to evaluate the effectiveness of individualized telephone counseling. They identified more than 2,000 smokers through classroom surveys of juniors in 50 high schools in Washington state. In half of those schools, teen smokers received smoking-cessation counseling that combined motivational interviewing and cognitive behavioral skills training. The techniques used the smoker’s own words and values to increase the importance of quitting, anticipating and coping with stress and other smoking triggers, and making plans to stop, the researchers say. More than a year after the intervention started, nearly 22 percent of counseled teen smokers reported six months of abstinence, compared to almost 18 percent among students in a non-interventional group. For teens who were daily smokers, the difference in six-month smoking abstinence was statistically significant (10 percent vs. 6 percent). Researchers say they found evidence that intervention made a difference, even as early as after seven days. Kathleen Kealey, also of the Hutchinson Center’s Cancer Prevention Program, contends in a second article that the design of the study was conducive to success. Students were telephoned by trained counselors who delivered personalized smoking-cessation tips and motivational interviewing. Scott Leischow, PhD, and Eva Matthews, MPH, both of University of Arizona cancer and community medicine centers, describe the success of the program as remarkable in an accompanying editorial. They credit the researchers’ success to good relationships with the school system and a rigorous implementation strategy tailored to individual students. “When a game-changing study provides new hope for how tobacco-using youth can be treated, the collective ears of the public health community should perk to attention,” Leischow and Matthews write. The research by Peterson and colleagues, they say, is such a study. For more information, see web link:
Smoking Costs NHS in Wales £1m a Day, Research Reveals Smoking is costing the NHS in Wales a staggering £1m a day, research reveals. And the shocking figures show that more than one in five hospital admissions in Wales is smoking related. But writing for Health Wales in Western Mail, Wales’ chief medical officer Dr. Tony Jewell insisted the nation was now reaping the benefits of schemes to help people stop smoking. “There are encouraging signs that attitudes towards smoking in Wales are changing,” he said. “Research commissioned by the Welsh Assembly Government shows that the smoking ban has had a significant impact on smoking habits, with people reporting that they’re smoking less and thinking more about quitting.” Anti-smoking campaigners will call for more action and a 10-year government strategy to address teenage and adult smoking rates. Tanya Buchanan, chief executive of Ash Wales, said: “These figures demonstrate the huge costs of smoking to the NHS in Wales. “However, what this report doesn’t include is the huge cost to the economy – more than £23m from lost productivity through smoking-related sickness absences and £6m from smoking- related fires. “Not to mention the emotional cost of family members seeing their loved ones suffer daily from smoking-related illnesses. “We need to move our focus towards a more proactive health service, promoting and protecting people’s health throughout their lives. “Smoking places a substantial economic and social burden on the NHS in Wales. It is evident that the existing pattern of services cannot last.” Professor Ceri J Phillips, of Swansea University, who will present the research at an international tobacco control conference in Cardiff, found that smoking-related diseases cost NHS Wales an estimated £386m in 2007-08. The 22 percent of adult hospital admissions, which are smoking related, cost more than £235m a year and a further £43m is spent on GP consultations. The annual NHS smoking bill currently would pay for six new children’s hospitals or cover the total cost of the millions of doses of swine flu vaccinations ordered for the whole of the UK, with money to spare. Dr. Richard Lewis, Welsh secretary of the British Medical Association said: “Despite the fact that we’ve had the ban on smoking in enclosed public places for almost two years now, thousands of people in Wales are still dying each year from smoking-related illnesses. “Today’s report shows the immense cost of that to the NHS, to families, and to the Welsh economy. “The younger someone starts smoking, the less likely they are to give up. Children who start smoking early face years of tobacco addiction that leads to life-threatening diseases and premature death. “Smoking cessation services play a vital role in supporting people to kick the deadly habit, but they need increased long-term investment especially in targeting their services and smoking prevention messages at a younger audience.” For more information, see web link:
Study Counters Warnings on Quit-Smoking Drug The smoking cessation drug varenicline (Chantix) does not increase the risk for self-harm or depression, according to a new British study. In July, the U.S. Food and Drug Administration mandated that the drug carry a "black-box warning" on its packaging, indicating that people who use it face increased risk for "serious neuropsychiatric symptoms," including changes in behavior, hostility, agitation, depressed mood, suicidal thoughts and behavior and attempted suicide. In the new study, British researchers analyzed database information on 80,660 men and women, ages 18 to 95, who were prescribed a smoking cessation product between September 2006 and May 2008. Prescriptions were for varenicline, the antidepressant bupropion (Zyban) or nicotine replacement products, such as a patch, inhaler, gum, tablet or lozenge. People were followed through the period of the prescription and for three months after the date of their last prescription. No clear evidence emerged that varenicline or bupropion increased the risk for self-harm, suicidal thoughts or depression, the study reported. However, the researchers added that "the limited power of the study means we cannot rule out either a halving or a twofold increased risk." They recommended further study of varenicline's effect on suicide risk. They also said that any risks associated with varenicline must be balanced against the long-term health benefits of stopping smoking and the drug's effectiveness as a smoking cessation product. The study, which had no drug company funding, was published online Oct. 1 in BMJ. For more information, see web link:
Program Evaluation and Implementation Fidelity Discussed in New HYSQ Publications Two new studies were published using data collected from a national sample of programs identified in Phase I of the Helping Young Smokers Quit initiative. First, with a limited evidence base for what works in youth tobacco cessation, HYSQ researchers examine the extent to which administrators of community-based youth smoking cessation programs engage in program evaluation. Using survey data from Phase I of HYSQ, program characteristics and associated evaluation components are summarized. Use of Program Evaluation in Community Youth Tobacco Cessation Programs appears in the American Journal of Health Behavior. For more information, visit http://helpingyoungsmokersquit.org/home/publications_presentations/phase1#PhaseI_art1. Second, as "packaged" youth smoking cessation programs become more widely available, the issue of fidelity in implementation of these programs becomes important. Researchers describe the frequency and types of modifications made to packaged teen smoking cessation programs offered in the community. Program administrators' reasons for program modifications are discussed. Implementation Fidelity of Packaged Teen Smoking Cessation Treatments Delivered in Community-based Settings appears in Health Education Research. For more information, visit http://helpingyoungsmokersquit.org/home/publications_presentations/phase1#Implementation%20fidelity. These and other findings are available on the HYSQ Web site, http://helpingyoungsmokersquit.org/home. For more information, see web link:
University of Kentucky Wants Smoke-free to Include Sidewalks When the University of Kentucky campus goes smoke-free on Nov. 19, there's about a 4-foot wide loophole where people could still smoke. It's the city sidewalks. The university's jurisdiction to ban smoking on campus stops at the edge of the sidewalk. Anthany Beatty, assistant vice president for campus services, asked the Urban County Council to allow UK to enforce its tobacco-free policy "to the curb." This would apply to sidewalks immediately adjacent to the main campus. The university's medical center went smoke-free in November 2008, but people stand on the sidewalk to smoke, Beatty said. The ban would cover students, faculty, staff, visitors, people making deliveries, "everyone who comes to our campus," Beatty said. He and Ellen J. Hahn, professor and director of the Tobacco Policy Research Program, are co-chairs of the campus ban. One-fourth of Kentuckians smoke; the national average is 18 percent. "We understand this is going to be a cultural change," Beatty said of the ban. Other universities that have campus-wide smoking bans include the University of Arkansas, the University of South Carolina and Indiana University, Beatty said. The University of Louisville and the University of Florida go smoke-free in 2010. UK will provide nicotine cessation programs and products "at a much reduced price on campus for students," Beatty said. Councilwoman Linda Gorton asked whether the ban will apply to fraternity and sorority houses. "We own the land, and they will be covered" by the prohibition, Beatty said. Basically, "any property owned and operated by the university" will not allow smoking.
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AAP Calls For Tobacco-Free Environments For All Children Children deserve to live tobacco-free lives. A new policy statement by the American Academy of Pediatrics (AAP) advises pediatricians and families to work together to make this happen. A life free of tobacco means smoke-free homes and apartment buildings, cars, schools, restaurants, parks, beaches, sidewalks and sporting events - everywhere children live, study and play. It means freedom from the harmful effects of tobacco use on family health, income and safety. The policy statement, "Tobacco Use: A Pediatric Disease," and two accompanying technical reports released Oct. 19, at the National Conference and Exhibition of the AAP, lay out the AAP's recommendations for tobacco- and smoke-free environments for children, guidelines for treatment of tobacco use and dependence, implementation and enforcement of tobacco-control measures, and support for training and research in pediatric tobacco control. There is no safe way to use tobacco and no safe level or duration of exposure to secondhand smoke, said David T. Tayloe, Jr., MD, immediate past president of the American Academy of Pediatrics. "Children's environments should be tobacco- and smoke-free, even when children are not present," Tayloe said. "The AAP supports and advocates for laws that protect children from tobacco smoke everywhere they learn, live and play." "Tobacco use is deadly, and the affects of secondhand smoke exposure of children are severe," said Dana Best, MD, MPH, FAAP, a former member of the AAP Committee on Environmental Health and co-author of the tobacco policy statement. "Children exposed to secondhand smoke are more likely to develop asthma, permanent harm to their lungs, and other significant health effects. Infants born to mothers who smoked or exposed to secondhand smoke during the prenatal period have a higher risk of sudden infant death syndrome and many other harms. It's important that families make their homes and cars completely smoke- and tobacco-free." Parents should ask about the tobacco use policies at their children's schools and child care centers. There should be no tobacco use on the premises, whether or not children are present. If parents use tobacco, they can talk to their child's pediatrician about how to quit - and even get help with quitting and accessing cessation therapies, services and resources. "Parents and children should know that it is not safe to 'experiment' with tobacco," said Tammy Sims, MD, MS, FAAP, a member of the AAP Committee on Substance Abuse and co-author of the tobacco policy statement. "Nicotine is so highly addictive that dependence can begin immediately, even occasional use of tobacco is harmful." For more information, see web link:
The American Cancer Society and Free & Clear Announce Joint Collaboration to Reduce Tobacco Use to Prevent Cancer and other Chronic Diseases The American Cancer Society and Free & Clear announced a strategic business collaboration that will combine the legendary brand reach of the world's leading voluntary health organization with the technical strength of the industry leader in tobacco cessation coaching. The collaboration will more efficiently and effectively help tobacco users nationwide access evidence-based tobacco cessation services. The combination of the former American Cancer Society Quitline with Free & Clear's commercially offered Quit For Life Program will provide one single best-in-class telephone-based coaching and Web-based learning support service to tobacco users who want to quit. The two organizations will co-brand and jointly promote tobacco cessation services by offering the Quit For Life Program to tobacco users through employers, health plans and state public health agencies. Under the terms of the collaboration, Free & Clear will apply 25 years of industry leading operational expertise and clinical experience to handle all cessation service delivery, promotional support, account management and reporting. The American Cancer Society will continue to build broad public awareness of the scientific relationship between tobacco use and chronic disease, while also actively promoting the cessation coaching service. During and following the transition, existing American Cancer Society Quitline clients can expect business as usual with no interruptions in service. Together, the two organizations currently serve more than 400 states, employers and health plans, allowing them to help an estimated 500,000 or more tobacco users per year. "For decades, the American Cancer Society has been leading the fight to reduce tobacco use and limit secondhand smoke exposure," said John R. Seffrin, Ph.D., chief executive officer, American Cancer Society. "And we're so proud that for the past nine years our own Quitline service has allowed us to directly help more than 500,000 smokers try and quit. After an extensive evaluation of our business model and the costs associated with maintaining a leadership position in a competitive marketplace, we recognized that collaborating with the industry leader Free & Clear would enable us to provide even more leadership and maximize resources." "Together, our two organizations are a formidable force against tobacco use, one of the most prevalent unhealthy behaviors leading to cancer, debilitating chronic disease and early death," said Tim Kilgallon, president and chief executive officer, Free & Clear. "This collaboration enables each organization to focus on what it does exceedingly well: the American Cancer Society fighting tobacco domestically and globally through prevention and awareness, and Free & Clear helping individuals gain the knowledge and skills they need to overcome dependence on tobacco." In addition to collaborating on cessation services, the two organizations will also work together on new product innovations, international market expansion opportunities, scientific research opportunities and the ongoing development of protocols based on the most current scientific evidence. For more information, see web link:
Cigarette Firm Destroyed Studies, Review Finds Imperial Tobacco Canada destroyed up to 60 early studies that linked cigarettes to addiction and carcinogens, according to a review published in the online Canadian Medical Association Journal. The internal studies, done from 1967 to 1984, were destroyed in 1992 on orders from head office at British American Tobacco in the United Kingdom to avoid "exposing the company to liability or embarrassment," the authors of the review say. The studies were later uncovered in British American Tobacco files, which began to be made available through disclosure during a U.S. trial in 1998, Dr. David Hammond of the University of Waterloo said in an interview. Hammond said he and his team undertook the review because they knew the studies existed and involved high-quality research into cigarette design and the health effects of smoking. Hammond's team concluded that the destruction of the research documents has implications for industry liability and litigation now underway in Canada. Last month, Ontario launched a $50-billion lawsuit against Imperial Tobacco. British Columbia and New Brunswick have also filed lawsuits against the company. Hammond said the uncovered studies were particularly interesting because they were funded by the cigarette company itself and showed Imperial was trying to improve the safety of its product. A lot of the studies the tobacco company ordered destroyed looked at the effects of filtered versus unfiltered cigarettes and the effects of second-hand smoke. In many cases, the studies contradicted conventional beliefs at the time that filtered cigarettes were safer than non-filtered and that second-hand smoke was not dangerous, the review found. In one of the older studies, a senior research scientist found that people smoking filtered cigarettes inhaled more smoke to get about the same amount of nicotine they'd get from unfiltered. Eleven of the destroyed documents focused on original research about the effects of second-hand smoke. These studies, most of which were experiments performed on rats, indicated cellular changes from second-hand smoke. For more information, see web link:
Canadian Provinces Sue Tobacco Companies Canada's two largest provinces — have announced that they are suing tobacco companies for a total of $80 billion. The lawsuits are the latest in an effort by the Canadian government to reduce smoking and recover some of the health care costs associated with smoking. Ontario Attorney General Chris Bentley announced that the government is suing tobacco makers for $50 billion. He pointed to several issues that are in question, including, "What did the tobacco companies know? When did they know it? And what did they tell the people of Ontario about the addictiveness and related effects of tobacco use?" The Ontario lawsuit draws heavily on secret tobacco company documents released in 1998, when the U.S. government won a $200 billion settlement to recover health care costs. Ontario officials claim that tobacco companies have known since at least 1950 that smoking is addictive and causes disease, and that those facts were deliberately kept secret. Bentley says the province needs the money to pay for smoking-related health costs, which he estimates at $1.6 billion a year. Anti-tobacco campaigners hope the lawsuit will yield even bigger results. "It will show the industry not to be in the bounds of normal business behavior," says Michael Perley, director of the Ontario Campaign for Action on Tobacco. "There's no other industry that produces products that have no safe level of use at all, that kill half their long-term users, all with the manufacturer's full knowledge. So the revelation of that information then creates a huge climate for further regulation of the industry." Canadian tobacco manufacturers have not answered the allegations in the lawsuit, but say the government is being hypocritical. Eric Gagnon, a spokesperson for Imperial Tobacco, said Ontario already collects around a billion dollars every year by taxing cigarettes. "This is sheer hypocrisy by the government," Gagnon says. "They're the ones who are licensing the industry, legislating the industry and collecting billions of dollars of taxes. So for them to turn around and with one hand legislate the industry and collect all the taxes, and on the other hand just to turn around and sue the industry is sheer hypocrisy." British Columbia and New Brunswick are also planning to sue, and all but one of Canada's 10 provinces has passed legislation that would allow them to join in the lawsuit. With the tobacco companies gearing up to fight, it will likely be years before the cases are resolved. For more information, see web link:
Healthways Inc. announced it has signed a three-year contract with the Wyoming Department of Health to offer its tobacco cessation program, QuitNet, to Wyoming residents. The program uses phone and online professional counseling, an online support network and discounted or free medication to help smokers kick the habit. It was acquired by Healthways as part of its $450 million purchase of Axia Health Management in 2006. Since 1995, the program has helped more than a million people quit smoking. The company didn't disclose a value for the contract, but a study of managed-care organizations from earlier this decade put the annual cost per plan member at about $7.50.
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N.C. to Penalize Obese Workers, Those Who Smoke North Carolina is poised to become only the second state to penalize state employees by placing them in a more expensive health insurance plan if they're obese. Smokers will feel the drag of higher costs, too, as North Carolina and South Carolina state employees who use tobacco are slated to pay more for health insurance next year. N.C. officials, coping with a steady uptick in health care costs for state employees each year, are aiming to improve state workers' health, which saves money in medical expenses. "Tobacco use and poor nutrition and inactivity are the leading causes of preventable deaths in our state," said Anne Rogers, director of integrated health management with the N.C. State Employees Health Plan. "We need a healthy workforce in this state. We're trying to encourage individuals to adopt healthy lifestyles." State workers who don't cut out the Marlboros and Big Macs will end up paying more for health insurance. Tobacco users get placed in a more expensive insurance plan starting in July and, for those who qualify as obese, in July 2011. Some state employees, though, are criticizing the planned changes. The State Employees Association of North Carolina opposes the tobacco and obesity differentials as invasive steps that could have been avoided if the legislature had fixed the plan. "It's my understanding they're talking about testing (for tobacco use) in the workplace which, to me, would create a hostile environment," said Kim Martin, a sergeant at Piedmont Correctional Institution in Salisbury. "And it's an invasion of privacy. This is America, the land of the free. I don't think (body mass index is) a very good measure. I know some folks who would have a high body mass index because they're muscular." The health plan covers more than 600,000 state employees, retirees and teachers at a total cost last year of $2.6 billion. Last spring, the legislature bailed out the plan with an infusion of $250 million to pay the bills after rising costs and inaccurate projections left little money for claims. Over the next two years, the state general fund will pump about $408 million into the health plan. While officials have not yet estimated any potential savings from the obesity requirement, the higher costs for smokers could save $13 million in the 2010-2011 budget year, Rogers said, emphasizing that the plan's priority is to improve health and save money in the process. The idea of penalizing unhealthy lifestyles and rewarding healthy conduct is hardly new among insurance plans. Public health insurance plans in other states already penalize smokers or reward nonsmokers in insurance costs. South Carolina's state employees health plan is scheduled to add a $25-per-month surcharge on smokers in January. Elsewhere in the southeast, Kentucky and Georgia impose surcharges, and Alabama gives nonsmokers a discount. Alabama was out front on weight testing. Starting in January, state workers will have their blood pressure, cholesterol, glucose and body mass index checked by a nurse. If they're in a risk category, such as a body mass index of 35 or greater or a blood pressure of 160/100 or greater, they are charged an extra $25 per month on their insurance premium. If they go to a health screening, either offered by the state or by their personal physician, then the $25 is subtracted, according to Gary Matthews, chief operating officer for the Alabama State Employees Insurance Board. North Carolina will allow state workers with a BMI of up to 40 to keep the discount, although a BMI of 30 is considered obese by some experts. Only a fraction of employers, though, offer financial incentives for healthy behavior or wellness programs, such as gym memberships or smoking cessation, according to a Kaiser Family Foundation study last year. Differences in employees' education, health literacy and access to basic health care could affect the usefulness of financial incentives in reducing health-care costs over time, the study said.
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