Clean-Air Backer Wants Blitz on Public Smoke
By gail johnson
Publish Date: 23-Dec-2004
Clean-Air Backer Wants Blitz on Public Smoke. Mark Atomos Pilon illustration
British Columbia has taken some positive steps to reduce people's exposure to secondhand smoke. But according to the provincial health officer, B.C. needs to do more. Dr. Perry Kendall also says the government should step up public-education programs about the benefits of quitting smoking.
Kendall's call to eliminate secondhand smoke falls on the heels of newly proposed legislation in Ontario that, if enacted, would bring about aggressive smoke-free laws. He made the recommendations in his annual report, released in mid-December, which this year focused on air quality.
Ontario's bill to make all workplaces and public spaces 100-percent smoke-free by May 2006 was introduced on December 15, the same day Kendall issued his report. Besides prohibiting smoking in all restaurants, bars, banquet halls, health-care facilities, schools, casinos, bingo halls, and offices and government buildings, as well as in private clubs (including Royal Canadian Legions), common areas in residential buildings (including hotels and apartment and condominium buildings), and work vehicles, the proposed legislation would also eliminate all designated smoking areas and enclosed ventilated rooms in such public places. The new law would restrict the display of tobacco products in stores, banning the walls of cigarette packs and cartons behind convenience-store counters.
Kendall's office would welcome similar rules here.
"A number of provinces are moving toward major bans on smoking," said deputy provincial health officer Dr. Eric Young in a phone interview with the Straight. "We're hoping that there will be some impetus for such changes based on this report now that Ontario has introduced its proposal.
"We approach things from a public-health perspective," Young added. "In B.C., there are over 5,500 deaths per year related to smoking. We've known for a long time that smoking leads to lung cancer, heart disease, breast cancer, leukemia, asthma, premature birth, low birth weight, SIDS... It's an extremely important issue, one individuals and society have a lot of control over."
According to the Ottawa-based Physicians for a Smoke-Free Canada, 1,107 nonsmoking adults died in 1998 as a result of tobacco-related causes, as did 96 infants under the age of one year. The organization's Web site (www .smoke-free.ca/) lists illnesses known to be caused by secondhand smoke, including nasal-sinus cancer and nonmalignant respiratory disease in adults, and bronchitis, asthma, pneumonia, and middle-ear disease in children. It describes other conditions thought to be caused by secondhand smoke, like stroke, cervical cancer, and miscarriages in adults and decreased lung function and the exacerbation of cystic fibrosis in children.
Kids are especially vulnerable when it comes to secondhand smoke, because they have weaker immune systems and breathe more air relative to body weight than adults. According to the PSFC, exposure to cigarette smoke causes up to about 220,000 ear infections in Canadian children annually, 2,100 tonsillectomies and adenoidectomies, and 270 sudden-infant-death-syndrome fatalities. Maternal smoking can negatively affect the fetus, since it deprives the baby of oxygen and other nutrients.
Also known as environmental tobacco smoke, secondhand smoke contains at least 40 carcinogens, the PSFC says, and some of them are in stronger concentrations in secondhand smoke than they are in the smoke that goes directly into smokers' lungs. Among the toxic substances are arsenic, cadmium, formaldehyde, benzene, vinyl chloride, and lead.
"Even if smoking is restricted to a single room, the harmful constituents of cigarette smoke can be dispersed throughout the house," the PSFC Web site states. "Many of these highly dangerous chemicals are in invisible gas form."
Sixty-eight percent of British Columbians have no real protection from secondhand smoke, the group alleges.
Antitobacco organizations support any efforts to enforce stricter smoke-free laws. Take Airspace, a Burnaby-based group that maintains on its Web site that nonsmokers have a right to breathe air that is not polluted with carcinogenic secondhand tobacco smoke; that smokers and passive smokers have the right to hold the tobacco industry accountable for smoking-related illnesses and death; and that smokers have a right to publicly funded smoking-cessation services.
That last is a critical point, because no one denies how hard it is for some people to quit smoking. Young said that smokers trying to stop need a lot of support.
"It's difficult to change habits, especially highly addictive habits," he said. "People need to get from the thinking-about-it stage to actually taking steps to making it a reality. And they need to recognize there will be setbacks but not beat themselves up. If they have a setback, they need to say, 'All right, I'll just try again.'
"We encourage those who are smoking to make every attempt to quit; it's a very, very addictive substance and it's difficult to quit. But keep trying to quit. Use every available means. They might want their doctor's advice. They might need medication in the form of patches or gum. There are other aids; there are a variety of methods.
"If people are committed to smoking, they have a personal responsibility not to expose other people to secondhand smoke," he added. "They shouldn't smoke at home if there are children in the home. They shouldn't smoke in the car if other people use that car."
Not surprisingly, the smoke-free movement has its opponents. Last September, the Canadian Tobacco Manufacturers' Council funded an on-line smoker's association called mychoice.ca. The group says it is committed to "restoring common sense, balance and civility" to the way Canadian adult smokers are treated by their federal, provincial, and municipal governments.
"Research shows Canada's adult smokers are tired of feeling powerless and voiceless as they are hit time and again with increasing taxes, more severe restrictions, and social stigmatization," the Web site states.
Smokers and nonsmokers will obviously never see eye to eye, but tougher secondhand-smoke laws would at least help clear the air.
Live T.O. club highlights of 2004
By MARY DICKIE -- Toronto Sun
Quotes of '04: Artists with some rhyme and reason
The best thing to happen to the club scene this year -- if not this decade -- was the blessed freedom from cigarette smoke from June 1 onward.
Despite warnings of dire consequences, people adapted, smokers moved outside and clubs still managed to sell out, leaving us with the novel experience of being able to see the musicians and breathe as well. Hallelujah! Here are the live club highlights of my year:
The semi-reunion of the legendary proto-punk band MC5 could have been sad or disastrous, with two members dead, the rest getting on and the fill-ins including the annoying wingnut Evan Dando. But damn it if survivors Wayne Kramer, Michael Davis and Dennis Thompson, plus Mudhoney's Mark Arm on vocals, didn't pull it off, kicking out the jams with passion and energy to shame kids half their age.
Another guy with supernatural rock 'n' roll energy is Ian Blurton, who kept powerhouse drummer Randy Curnew from Blurtonia and added former Nashville Pussy bassist Katie Lynn Campbell's Southern grooves to make a dynamite new band -- perhaps (gasp!) his best ever.
Hips shook, hearts raced and sweat flew. Must be that mystical Toronto-New Orleans-Newfoundland axis.
A breathtaking show that was mostly solo, except for lovely keyboards from Geraint Watkins on a few
songs, and proved that the Basher's voice is still in fine honeyed-whisky form and that his songwriting has few equals. A highlight was the acoustic What's So Funny 'Bout Peace, Love and Understanding.
The Whitby native adds soul, rock, reggae and R&B to
hip-hop, broadening its reach, expanding its barriers and saving it from staleness and mediocrity. This sold-out, confident, ground-breaking extravaganza proved that the kids are listening, and that in fact no one can resist K-OS, or at least his Krabuckit.
A beautiful songwriter and singer -- whose album inexplicably went nowhere despite the devastating single Somewhere Else -- parted ways with his label and treated a few lucky fans to a gorgeous solo acoustic set with sporadic guest vocals from protege Kathleen Edwards. Make an album!
The toast of Paris returned home triumphantly for a packed show, during which she showcased the versatility of her lovely voice and delicate songs, rocking some up and making the Bee Gees
sound like Bacharach. Can do no wrong.
Television's guitar god teamed up with Jimmy Ripp to perform Music For Film, live soundtracks to avant-garde films by Man Ray, Fernand Leger and others. Lyrical, flowing, dazzling and highly atmospheric -- an ode to the powers of the sensitively played guitar.
Ah, the rewards of constant touring -- from loose and raggedy (but still endearing) small shows to transfixing a huge outdoor crowd with a seemingly effortless mix of a dozen players and a multitude of beautiful sounds in a year. Man, they're bloody arena-ready!
The amount of pure concentrated rock energy that can emanate from one supercharged singer/drummer and an equally manic bassist is still astounding. It's impossible not to move head, hips and feet in time to the relentless beat, and hum along as well.
This birthday show marked 20 years of solid, sometimes brilliant alt-country-rock with smiley vibes, old friends like Jack de Keyzer and fans that sang every word to Hasn't Hit Me Yet. A love-in for a band that despite its popularity, can get taken for granted.
Unscheduled landing
Smoker busted for puffing on flight
By CARY CASTAGNA, POLICE REPORTER Fri, December 24, 2004
A 33-year-old Ontario man is accused of flying into a rage Wednesday after he was allegedly caught smoking in a bathroom aboard a Jetsgo flight
The mid-air antics forced the aircraft's pilots to make an unscheduled pit stop in Winnipeg, where the man was taken into police custody.
The flight was to be non-stop from Toronto to Vancouver.
"He had been caught smoking in one of the washrooms and when confronted about it became combative with the staff on board and it was decided at that point to divert to Winnipeg," said Winnipeg police spokesman Const. Bob Johnson.
Officers with the Winnipeg police airport unit arrested James Miller shortly after 5:30 p.m. at Winnipeg International Airport.
Miller, 33, of Orillia, Ont., was charged with two counts of breaching the Aeronautics Act and failing to comply with the instructions of the flight crew, Johnson said.
Miller was detained in custody at the Winnipeg Remand Centre. He declined an interview request yesterday from The Winnipeg Sun.
Miller is slated to appear in Winnipeg court on Feb. 7.
A Jetsgo spokesperson was unavailable yesterday. But Brad Cicero, a rep with the low-cost carrier, recently told The Sun that it's "very infrequent" that flights have to be diverted due to disruptive passengers.
"It's up to the captain to decide what's best for the flight, both in terms of the crew and the passengers," he said.
Since June 2002, Winnipeg police have had to contend with five other major incidents of air rage that forced aircraft to land in the city.
And just last Friday, a Winnipeg-bound commercial plane had to be diverted to Bismarck, N.D., after a babbling passenger locked himself in a bathroom and took all his clothes off.
UNSTABLE PASSENGER
Police and FBI agents were called to the Bismarck Municipal Airport to help the flight crew remove an apparently unstable passenger.
After a failed attempt at negotiating with the 23-year-old California resident who had barricaded himself in the biffy, authorities broke the lock on the door and forced their way inside.
The man, who was discovered in an inappropriate state of undress, was arrested without incident. He was slated to undergo a physical and mental evaluation.
No one backing down on smoking ban
Last Updated Dec 24 2004 08:56 AM CST
REGINA – With a provincewide smoking ban a week away, no one is blinking in the dispute over how the ban will apply on Indian property.
On Thursday, Health Minister John Nilson said he intends to apply the Jan. 1 smoking ban everywhere in Saskatchewan – including Indian reserves and Indian-controlled casinos off-reserve.
But Saskatchewan chiefs say they'll only ask people to butt out in just over half of the indoor areas on reserves.
Federation of Saskatchewan Indian Nations chief Alphonse Bird says each reserve will create its own law.
"The issue is not whether smoking is good or bad. The issue is creating laws over territories and First Nations that have the ability to create their own laws," Bird said.
Bird said he's not concerned about bar owners who complain they'll be hurt by on-reserve smoking – there are already different rules for First Nations when it comes to cigarettes and gas taxes.
Nilson wasn't saying Thursday what he plans to do if smokers are still puffing away in casinos and bars on reserves.
Nilson added Saskatchewan people tend to obey the rules in this province and he doubts many tickets will be written in the first two months of the ban.
"We're law abiding people in Saskatchewan and people respect the law and it's actually been quite reasonable in how people have responded," he said.
A coalition of health groups is also telling the provincial government not to compromise on what they call an important public health policy.
The Tobacco Control Amendment Act prohibits smoking in all enclosed public places such as restaurants, bars, bingo halls, casinos, bowling alleys, taxis, and private clubs, effective Jan. 1.
Essays on the Anti-Smoking Movement
http://www.smokingsection.com/issues2.html
Obesity and Alcohol Abuse - Is there a "sneaky" link between these serious health risks and stopping cigarette smoking?
http://www.wellnessnet.com/obesity-smoking-press-release.html
Smokers: An Endangered Species
http://reliableanswers.com/patriot/?20040209
Where there’s no smoking, there’s fire -MS
JOHN LARRABEE, Staff Writer12/23/2004
A lobbyist who led the charge to snuff out cigarette smoking in Massachusetts’ bars and restaurants is predicting any effort to change the law will likely fizzle.
"I find it unlikely, if not impossible," says Diane Pickles, executive director of Tobacco Free Massachusetts, a coalition of groups that support anti-smoking efforts. "This is a law that is working very well. The Department of Public Health has certainly not been flooded with calls or complaints."
Those could be the first words in a knock-down tobacco row in the Statehouse, where a new legislative session begins in early January.
Bar owners and restaurateurs throughout the Blackstone Valley -- and in other small towns across the state -- have been organizing for months for a push to loosen the smoking ban during the next session. Several bills to amend the law have already been filed, including one that would exempt smaller establishments.
And the effort has picked up guarded support from state Rep. Jennifer Callahan, a former nurse and health administrator who originally supported the ban. The Sutton Democrat (whose district includes Uxbridge, Millville, Blackstone and Bellingham) has called the smoking bill "a good law that needs some tweaking."
The smoking ban, which took effect July 5, prohibits lighting up in any workplace, ostensibly to protect the health of employees exposed to cigarette smoking. Supporters cite a recent health study that reported the air in smoky bars and casinos contains 50 times more cancer-causing particles than are found on city streets at rush hour.
Taverns and eateries that once had smoking areas have been hit hardest by the law. Some establishments in the Blackstone Valley claim they’ve lost 30 to 40 percent of their business to members-only clubs, which are exempt from the law, or to bars in Rhode Island. While the neighboring state has adopted a similar smoking ban, it won’t take effect until March, and bars with fewer than 10 employees are exempt.
Not all Massachusetts bar owners have jumped aboard the
See BAN -- Page A-4
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campaign, however. Boston and more than 60 other cities and towns in the state have municipal restaurant smoking bans, and most business owners in those communities support the state law. The Massachusetts Restaurant Association has taken no stand on the issue.
Pickles insists that Blackstone Valley establishment could soon see a boost in business, once customers learn to appreciate the cleaner atmosphere. "There is always a period of transition," she says. "It may take awhile for the general public and employers to get used to the changes."
And she doubts the amendment effort has much strength in the Statehouse. "There was broad support for this in both branches of the legislature, and the governor had no problem signing the bill into law," she says.
Callahan has said the economic impact on business owners is just one of her concerns. She has also heard from municipal officials, who charge the law has created enforcement problems in small towns. And neighbors living near bars have complained about noise problems caused by sidewalk smoking.
State Sen. Richard Moore, the area’s other legislator, has avoided questions about the law in recent weeks. The Uxbridge Democrat was one of the bill’s strongest supports; Recently, however, an aide refused to say if Moore will support or oppose amendments.
"He won’t have any comment until the legislation is taken up," aide Debra Montville says. "That’s when the senator will look at it."
During the last legislative session, Moore accepted sizable campaign contributions from lobbyists working for large tobacco companies.
http://www.zwire.com/site/news.cfm?newsid=13613474&BRD=1712&PAG=461&dept_id=478996&rfi=6
Exercise 'can't end obesity risk'
Dec. 24/04
Exercise is not enough to offset the increased death risk associated with being obese, research suggests.
A study of more than 116,000 women nurses found physical activity did not totally compensate for the higher death risk associated with being obese.
The Harvard School of Public Health researchers said the key was both to exercise and lose weight.
Nurses who were lean but inactive also had an increased death risk, they told the New England Journal of Medicine.
Excess weight and physical inactivity together could account for about a third of all premature deaths, two-thirds of deaths from cardiovascular disease, and a fifth of deaths from cancer among non-smoking women, they estimate.
They defined excess weight as a body-mass index (weight in kg divided by the square of the height in meters) of 25 or more.
For example, a 5ft 2ins woman was considered obese if she weighed more than 160 pounds and lean if she weighed less than 135 pounds.
Women who did more than 3.5 hours per week of exercise were considered "active".
Compared with the lean, active women, varying degrees of obesity and inactivity increased the risk of an early death.
Double whammy
Lean women who exercised less than 3.5 hours per week increased their risk of early death by 55%.
Obese women who worked out for at least 3.5 hours a week increased their risk by 91% and those who were obese and inactive increased their risk of a premature death by 142%.
The researchers said the key to a long life, for both men and women, is to keep weight down and take regular exercise.
"Public health campaigns should emphasise both the maintenance of a healthy weight and regular physical activity," they said.
Lead author Dr Frank Hu said: "If you are overweight or obese, exercise is good for you even if you don't lose weight.
"For people who are lean and sedentary, it's really important for them to get out of the couch and exercise, even if they don't have to lose weight."
Professor Neil Armstrong, from the Children's Health and Exercise Research Centre in Exeter, said: "If you really want to do something about obesity, it really needs to be a two-fold process, which includes aerobic exercise and a reduction in energy intake.
"Obesity is related to many diseases, such as heart disease, high blood pressure and diabetes, so it's a very important issue.
"And of course the advantage of exercise is not just related to obesity.
"It reduces the risk of heart disease and in postmenopausal women the risk of osteoporosis.
"Plus it generally raises your quality of life."
Dr David Haslam of the National Obesity Forum said: "An obese person who is exercising and maybe getting a bit despondent because the weight is not falling off should take great comfort from the fact that they are at much less risk of heart disease and stroke than if they hadn't been exercising.
"Inactivity, like smoking, is a massive risk factor for heart disease in it's own right."
http://news.bbc.co.uk/1/hi/health/4120259.stm
Systems for grading the quality of evidence and the strength of recommendations I: Critical appraisal of existing approaches
The GRADE Working Group
David Atkins , Martin Eccles , Signe Flottorp , Gordon H Guyatt , David Henry , Suzanne Hill , Alessandro Liberati , Dianne O'Connell , Andrew D Oxman , Bob Phillips , Holger Schunemann , Tessa Tan-Torres Edejer , Gunn E Vist , John W Williams and . The GRADE Working Group
BMC Health Services Research 2004, 4:38 doi:10.1186/1472-6963-4-38
2 December 2004
Abstract (provisional)
Background
A number of approaches have been used to grade levels of evidence and the strength of recommendations. The use of many different approaches detracts from one of the main reasons for having explicit approaches: to concisely characterise and communicate this information so that it can easily be understood and thereby help people make well-informed decisions. Our objective was to critically appraise six prominent systems for grading levels of evidence and the strength of recommendations as a basis for agreeing on characteristics of a common, sensible approach to grading levels of evidence and the strength of recommendations.
Methods
Six prominent systems for grading levels of evidence and strength of recommendations were selected and someone familiar with each system prepared a description of each of these. Twelve assessors independently evaluated each system based on twelve criteria to assess the sensibility of the different approaches. Systems used by 51 organisations were compared with these six approaches.
Results
There was poor agreement about the sensibility of the six systems. Only one of the systems was suitable for all four types of questions we considered (effectiveness, harm, diagnosis and prognosis). None of the systems was considered usable for all of the target groups we considered (professionals, patients and policy makers). The raters found low reproducibility of judgements made using all six systems. Systems used by 51 organisations that sponsor clinical practice guidelines included a number of minor variations of the six systems that we critically appraised.
Conclusions
All of the currently used approaches to grading levels of evidence and the strength of recommendations have important shortcomings.
http://www.biomedcentral.com/1472-6963/4/38/abstract
Doctors' fears over cigarette ads blitz -UK
LEADING doctors claim tough new measures to restrict the advertising of cigarettes in shops, pubs, and clubs, will make little or no difference.
From today, the total space taken up in advertising for all tobacco companies at kiosks and other places selling cigarettes will be limited to an A5-sized area - around the size of a paperback book.
This space will also have to include a health warning taking up 30 per cent of the area.
The regulations also mean that vending machines will only be able to carry a picture of the products on sale.
The restrictions will be enforced by Trading Standards officers and violations will lead to fines of up to £5000 or five months in prison.
But the Royal College of GPs said that while the move was positive, it would do little to tackle the real problem.
Vice-chairman Graham Archard said: "We welcome this move but question whether it will make any real difference.
"People buy cigarettes because they are addicted, not because the machine or kiosk has a picture on it."
The Department of Health said the new regulations - part of the Tobacco Advertising and Promotion Act - were among the strictest in the world.
Health Secretary John Reid was expected to launch the new-look tobacco counter at an Asda supermarket in London today.
He said the new regulations would mean people were no longer "bombarded" by the large, colourful tobacco advertising at their local supermarket or corner shop.
http://news.scotsman.com/uk.cfm?id=1454592004
State-Specific Prevalence of Current Cigarette Smoking Among Adults—United States, 2003
JAMA. 2004;292:2966-2967.
MMWR. 2004;53:1035-1037
1 table omitted
Cigarette smoking causes approximately 440,000 deaths annually in the United States.1 To assess the prevalence of current cigarette smoking among adults, CDC analyzed data from the 2003 Behavioral Risk Factor Surveillance System (BRFSS) survey. This report summarizes the results of that analysis, which indicated substantial variation in cigarette smoking prevalence in the 50 states, the District of Columbia (DC), Guam, Puerto Rico, and the U.S. Virgin Islands (USVI) (range: 10.0%-34.0%). To further reduce the prevalence of smoking, states/areas should implement comprehensive tobacco-control programs.
BRFSS is a state-based, random-digit–dialed, telephone survey of the U.S. civilian, noninstitutionalized population aged 
18 years. In 2003, the median state/area response rate was 53.2% (range: 34.4%-80.5%). Estimates were weighted by age and sex distributions for each state’s population, and 95% confidence intervals were calculated. BRFSS respondents were asked, "Have you smoked at least 100 cigarettes in your entire life?" and "Do you now smoke cigarettes every day, some days, or not at all?" Current smokers were defined as those who reported having smoked 100 cigarettes during their lifetimes and who currently smoke every day or some days.
In 2003, the median prevalence of current cigarette smoking among adults was 22.1% in the 50 states and DC (range: 12.0% [Utah]–30.8% [Kentucky]) (Table). Smoking prevalence was higher among men (median: 24.8%; range: 14.0%-33.8%) than women (median: 20.3%; range: 9.9%-28.1%) in the 50 states and DC. Smoking prevalence for both men and women was highest in Kentucky (men: 33.8%; women: 28.1%) and lowest in Utah (men: 14.0%; women: 9.9%). In areas other than the 50 states and DC, the median prevalence of current cigarette smoking among adults was 13.6% (range: 10.0% [USVI]–34.0% [Guam]).
Reported by: J Bombard, MSPH, A Malarcher, PhD, M Schooley, MPH, A MacNeil, MPH, Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, CDC.
CDC Editorial Note:
Although the prevalence of current cigarette smoking among U.S. adults has declined, the rate of decline has not been rapid enough for the nation to achieve the 2010 national health objective of 
12% of adults smoking cigarettes (objective 27-1).2-3 The median prevalence of adult smoking decreased 1 percentage point from 2002 to 2003, and the national objective for 2010 was achieved in Utah and the USVI. The high prevalence of current cigarette smoking in most of the remaining states/areas underscores the need for increased efforts to reduce tobacco use.
The findings in this report are subject to at least three limitations. First, the BRFSS survey does not sample persons in households without telephones, a population that might be more likely to smoke.4 Second, data for cigarette smoking are based on self-reports and are not validated with biochemical tests. However, self-reported data on current smoking status have high validity.4 Third, the median response rate was 53.2% (range: 34.4%-80.5%); lower response rates indicate a potential for response bias. However, BRFSS estimates for cigarette smoking are comparable with current smoking estimates from other surveys with higher response rates.5
Comprehensive tobacco control is effective in preventing and reducing tobacco use.6 CDC recommends the following evidence-based interventions as strategies within comprehensive tobacco-control programs: clean indoor air laws, telephone support quitlines, media campaigns, increased excise taxes on tobacco products, insurance coverage for cessation counseling and pharmaceuticals, and health-care system changes that support cessation.7 Substantial variation exists across states in their use of these strategies. For example, in 2002, two states offered Medicaid coverage for all recommended medication and counseling treatments for tobacco dependence, whereas 11 states covered no tobacco-dependence treatments.8 In addition, the average cost of a single pack of cigarettes (which includes state-based excise taxes) ranged from $3.10 in Kentucky to $5.54 in New York in 2003.9 The majority of states offer telephone support quitlines, and residents of all states soon will have access to a nationwide network of quitlines. Finally, only six states (California, Connecticut, Delaware, Maine, Massachusetts, and New York) have comprehensive statewide bans in effect on smoking in indoor workplaces and public places.
The more funds that states spend on comprehensive tobacco-control programs, the greater the reduction in smoking.6 However, the amount of money that states spend for tobacco control decreased 28% during the preceding 2 years to $541.1 million, which is less than 3% of the estimated $19 billion states expected to receive from tobacco excise taxes and tobacco settlement money in 2003.10 For fiscal year 2004 (i.e., July 1, 2003–June 31, 2004), only four states (Arkansas, Delaware, Maine, and Mississippi) were investing at least the minimum per capita amount that CDC recommends for tobacco-control programs.10 Efforts and resources must be expanded if more states are to reduce smoking prevalence to 12% by 2010.
REFERENCES
1. CDC. Annual smoking-attributable mortality, years of potential life lost, and economic costs—United States 1995-1999. MMWR. 2002;51:300-303. MEDLINE
2. CDC. Cigarette smoking among adults—United States, 2002. MMWR. 2004;53:427-431. MEDLINE
3. US Department of Health and Human Services. Healthy people 2010 (conference ed, in 2 vols). Washington, DC: US Department of Health and Human Services; 2000. Available at http://www.health.gov/healthypeople
4. Nelson DE, Holtzman D, Bolen J, Stanwyck CA, Mack KA. Reliability and validity of measures from the Behavioral Risk Factor Surveillance System (BRFSS). Soz Praventivmed. 2001;46(suppl 1):S3-S42. ISI | MEDLINE
5. US Department of Health and Human Services. Women and smoking: a report of the Surgeon General. Rockville, MD: US Department of Health and Human Services, Public Health Service, Office of the Surgeon General; 2001:24-25.
6. Farrelly MC, Pechacek TF, Chaloupka FJ. The impact of tobacco control program expenditures on aggregate cigarette sales: 1981-2000. Health Econ. 2003;22:843-859.CrossRef
7. Task Force on Community Preventive Services. Guide to community preventive services: tobacco use prevention and control. Am J Prev Med. 2001;20(Suppl 1):1-87.
8. CDC. State Medicaid coverage for tobacco-dependence treatments—United States, 1994-2002. MMWR. 2004;53:54-57. MEDLINE
9. Orzechowski W, Walker RC. The tax burden on tobacco, volume 38. Arlington, VA: Orzechowski and Walker; 2003.
10. Campaign for Tobacco-Free Kids; American Heart Association, American Cancer Society, American Lung Association. A broken promise to our children: the 1998 state tobacco settlement five years later. Washington, DC: Campaign for Tobacco-Free Kids; 2003. Available at http://www.tobaccofreekids.org/reports/settlements/2004/fullreport.pdf.
http://jama.ama-assn.org/cgi/content/full/292/24/2966
Ingested Arsenic, Cigarette Smoking, and Lung Cancer Risk
A Follow-up Study in Arseniasis-Endemic Areas in Taiwan
Chi-Ling Chen, PhD;Lin-I Hsu, PhD; Hung-Yi Chiou, PhD; Yu-Mei Hsueh, PhD; Shu-Yuan Chen, PhD; Meei-Maan Wu, PhD; Chien-Jen Chen, ScD; for the Blackfoot Disease Study Group
JAMA. 2004;292:2984-2990.
ABSTRACT
Context Arsenic has been documented as a lung carcinogen in humans in only a few follow-up studies, which were limited by a small number of cases or the lack of information on cigarette smoking.
Objectives To elucidate the dose-response relationship between ingested arsenic and lung cancer and to assess the effect of cigarette smoking on the arsenic–lung cancer association.
Design, Setting, and Participants A total of 2503 residents in southwestern and 8088 in northeastern arseniasis-endemic areas in Taiwan were followed up for an average period of 8 years. Information on arsenic exposure, cigarette smoking, and other risk factors was collected at enrollment through standardized questionnaire interview.
Main Outcome Measures The incidence of lung cancer was ascertained through linkage with national cancer registry profiles in Taiwan (January 1985-December 2000). The joint effect of arsenic and cigarette smoking was estimated by both etiologic fraction and synergy index.
Results There were 139 newly diagnosed lung cancer cases during a follow-up period of 83 783 person-years. After adjustment for cigarette smoking and other risk factors, there was a monotonic trend of lung cancer risk by arsenic level in drinking water of less than 10 to 700 µg/L or more (P<.001). The relative risk was 3.29 (95% confidence interval, 1.60-6.78) for the highest arsenic level compared with the lowest. The etiologic fraction of lung cancer attributable to the joint exposure of ingested arsenic and cigarette smoking ranged from 32% to 55%. The synergy indices ranged from 1.62 to 2.52, indicating a synergistic effect of ingested arsenic and cigarette smoking on lung cancer.
Conclusions There was a significant dose-response trend of ingested arsenic on lung cancer risk, which was more prominent among cigarette smokers. The risk assessment of lung cancer induced by ingested arsenic should take cigarette smoking into consideration.
http://jama.ama-assn.org/cgi/content/full/292/24/2984
Judge rules Big Tobacco doesn't have to pay farmers
Court: Companies also due a refund
By Michael Felberbaum Associated Press
RALEIGH, N.C. — The tobacco-quota buyout approved by Congress this year releases cigarette companies from making payments to Kentucky farmers and others that had been required by a landmark 1998 settlement, a North Carolina judge ruled yesterday.
The millions of dollars in Phase II payments have compensated tobacco growers for losses they were expected to suffer under higher cigarette prices resulting from the agreement between Big Tobacco and the states.
Cigarette companies contend they weren't obligated to make a final $189 million payment this month to farmers in 14 states because Congress approved a $10.1billion tobacco buyout this fall.
North Carolina Business Court Judge Ben Tennille agreed and also ruled that the companies should get a refund on payments made earlier this year.
Though the suit was being heard in a special state court in North Carolina, the ruling will apply to tobacco companies and farmers in other tobacco states.
An appeal of the ruling is likely, which would delay a final decision for months.
In 1999, the four major tobacco companies agreed to make $5.15 billion in Phase II payments over 12 years to compensate growers and quota holders for losses stemming from the $206billion tobacco settlement approved the previous year.
Tobacco growers were counting on the final payment at the end of 2004, before the buyout takes effect.
Some expected to use the money to pay off operating loans, said Ed Bissette, a director of the North Carolina Phase II board and a fourth-generation tobacco farmer in Nash County.
Attorneys for the boards in the 14 states, as well as the trustees at JPMorgan Chase, argue that the companies aren't relieved of the Phase II payments until they actually make payments for the buyout to the U.S. Department of Agriculture. That won't happen until early 2005.
Tennille's decision was posted late yesterday on the court's Web site and dated Dec. 23.
http://www.courier-journal.com/localnews/2004/12/23ky/A1-tob1223-7157.html
Tobacco farmers' group files notice to appeal judge's decision
A group overseeing payments to tobacco farmers and quota holders from a 1999 settlement said Thursday that it will appeal a judge's decision that cigarette companies don't have to make the last of those payments.By ESTES THOMPSON, Associated Press Writer, The Associated Press
December 23, 2004
The board overseeing distribution of the payments, called Phase II funds, filed the notice of appeal in North Carolina Business Court.
Judge Ben Tennille angered farmers Wednesday when he ruled that cigarette companies didn't have to make final annual payments to growers because the 1999 settlement was superseded by Congress' approval of a $10.1 billion tobacco buyout this fall.
In 1999, the four major tobacco companies agreed to make $5.15 billion in Phase II payments over 12 years to compensate growers and quota holders for losses stemming from the $206 billion tobacco settlement.
The final payments under the settlement would have totaled $430 million in 14 tobacco-producing states.
Farm advocates said the ruling, if it holds up under appeal, means farmers who were counting on a check this month won't have money to buy supplies for the 2005 crop or to pay debts.
"I hope Judge Tennille has a merry Christmas," said Larry Wooten, president of the N.C. Farm Bureau. "Yesterday's ruling makes it hard for North Carolina farmers to truly have a merry Christmas. His ruling will cause many farmers and communities in rural North Carolina to suffer."
John Davis, executive director of the state's Phase II Tobacco Certification Entity, said the appeals would delay any payments for a few months.
In addition to rejecting the demand that the last payment be made into the fund, Tennille told the states to work out a plan to refund previous payments being held until the Dec. 31 payout date.
The appeal puts that refund plan on hold, Davis said.
Cigarette maker Philip Morris USA said in a statement Thursday that when the trust was created it was "with an understanding by all parties that the companies' payments would cease if a tobacco quota buyout funded by the companies was passed."
Philip Morris expects the buyout payments to start next year.
The ruling is a blow to farmers, said Johnston County farmer Jimmy Lee.
"It's going to be a hard lick because most farmers went in anticipating to get a payment," said Lee, president of the Contract Tobacco Growers Association. "I know that we've got this buyout coming, but that's in 12 months. It might be the law, but it's not the right thing to do."
Farmers affected are in North Carolina, Kentucky, Tennessee, South Carolina, Virginia, Georgia, Ohio, Indiana, Florida, Missouri, West Virginia, Alabama, Maryland and Pennsylvania.
http://www.zwire.com/site/news.cfm?newsid=13618000&BRD=2212&PAG=461&dept_id=465812&rfi=6
Award Upheld to Flight Attendant in Secondhand Smoke Case
Catherine Wilson The Associated Press
12-27-2004
A state appeals court upheld a $500,000 award to a flight attendant who blamed secondhand smoke on airliners for her bronchitis and sinus trouble -- a decision Wednesday that could clear the way for damage trials on up to 3,000 similar claims.
The ruling for former TWA attendant Lynn French was a test case interpreting a $349 million settlement reached in 1997 between the tobacco industry and nonsmoking attendants.
The flight attendants blamed their illnesses on smoke in the cabin before smoking was banned on domestic flights in 1990.
"The court agreed with us, and we're happy with it," said Marvin Weinstein, French's attorney. "Based on this, I think there are a lot more they're going to be paying."
After the tobacco industry agreed to settle, a system of mini-trials was set up for each flight attendant to decide whether he or she deserved compensatory damages.
Under the ground rules, each jury was to presume that secondhand smoke causes several diseases; the attendants had to prove only that they suffered from one of those diseases and that their exposure to smoke occurred on the job.
The c
