Tag Archives: cigarettes

Should Philip Morris pay for lung cancer screenings? Case goes to trial

A decade after a group of smokers from Massachusetts sued Philip Morris USA to try to force the cigarette maker to pay for lung cancer screenings, the case goes to a jury trial.

Smokers in the class-action lawsuit allege Philip Morris manufactured a defective cigarette knowing it could have made a safer product with fewer carcinogens.

They are not seeking money, but instead want to compel Philip Morris to pay for highly detailed, three-dimensional chest scans that can detect signs of early-stage lung cancer that may be too small to show up on traditional X-rays.

The closely watched case going to trial this week in federal court in Boston.

The jury will be asked to decide whether Philip Morris made Marlboro cigarettes that are unreasonably dangerous. If the jury finds in favor of the smokers, a second phase will be held to determine how a medical monitoring program will be administered.

No smokers are expected to testify during the first phase. Instead, it will be a trial of dueling experts.

The plaintiffs plan to call a former Philip Morris employee to testify that feasible alternative designs of Marlboros have existed for decades. They also plan to call a psychologist who will testify that given a choice between Marlboros or a safer cigarette, a non-addicted, informed person would choose the safer alternative.

Philip Morris is expected to call experts in cigarette design and marketing who are likely to testify that the company’s lower-tar and lower-nicotine cigarettes — on the market since the late 1970s — have failed to gain a significant market share among any group of smoker.

Richard Daynard, a law professor at Northeastern University and anti-smoking activist, said past lawsuits seeking to force tobacco companies to provide medical monitoring have failed. But Daynard said he believes the Massachusetts case has a stronger chance of succeeding because recent studies have found that the sophisticated screening can save lives.

“What’s happened is you have better technology which captures the tumors at a much earlier stage where there’s a very good chance that if you get them that the person … is probably not going to die from it,” Daynard said.

A Philip Morris spokesman declined to comment, and lawyers for the company did not respond to messages.

In court documents, the company denied that its cigarettes are defectively designed and argued that three-dimensional chest scans would not be effective or necessary for every person covered by the lawsuit.

The case covers Massachusetts smokers who, as of February 2013, were at least 50, had at least a 20 pack-year history of smoking Marlboros and have not been diagnosed with lung cancer. Pack-years are calculated by multiplying the average number of packs per day by the number of years a person has smoked.

The two sides agree that the chest scans are “reasonably and periodically necessary” for smokers 55 to 74 with at least a 30 pack-year history. They disagree on the rest of the smokers in the lawsuit.

Since the case was filed in 2006, insurers have begun to cover the screenings for certain smokers. Last year, Medicare announced it would pay for annual screenings for beneficiaries 55 to 77 with at least a 30 pack-year history.

U.S. District Judge Denise Casper rejected a request to exclude evidence about insurers agreeing to pay for three-dimensional chest scans, but said she’ll instruct jurors that they are not allowed to consider whether any of the smokers have insurance coverage for screening.

“The fact that insurance now covers it and it’s recognized for certain groups as being efficacious may have some evidentiary value in the case, but it does not change the fact that Philip Morris could be liable for the cost of the scans,” said Christopher Weld, an attorney for the smokers.

Lawsuit: Amusement park gives isolated chimp cigarettes, soft drinks

An animal rights group is suing to get a chimpanzee named Candy out of an amusement park where, it says, she smokes cigarettes and is given soft drinks instead of water.

Candy is isolated in an inadequate cage at the Baton Rouge park, and should be moved to a sanctuary, according to the federal suit filed in Baton Rouge by the Animal Legal Defense Fund.

“Defendants have for decades allowed members of the general public to throw items into Candy’s cage, including lit cigarettes that Candy smokes. Just as with humans, cigarette smoking is very harmful for chimpanzees,” and letting her smoke violates the Endangered Species Act, the suit states.

The lawsuit is the first filed under a new federal rule that requires captive chimps get the same protection as wild chimps, said Carter Dillard, the group’s attorney. That rule, which was made public in June and took effect Sept. 14, changes captive chimps’ classification from threatened to endangered, the same classification as wild chimpanzees.

Jennifer Treadway-Morris, attorney for park owner Sam Haynes, said she had not had time to read the lawsuit. However, she said, government agencies such as the U.S. Fish and Wildlife Service cannot make rules retroactive.

She also cited a letter from a veterinarian stating that an attempt to retire Candy to the Baton Rouge Zoo failed.

“She was returned because she couldn’t adjust and couldn’t assimilate,” Treadway-Morris said. “It seems that if they want her to have company, she doesn’t want it.”

The animal rights group said it went to court for Cathy Breaux, 62, and Holly Reynolds, 96, who have campaigned for decades to get Candy moved from the Dixie Landin’ park and its predecessor.

“Cathy and Holly remain upset, distressed and concerned that Candy is isolated throughout the day, deprived of companionship with other chimpanzees, and insufficiently stimulated in her empty cage,” the lawsuit states.

It said the women have seen visitors throw lit cigarettes into Candy’s cage for the chimp to smoke.

City animal control officials cited the park in 2012 for not providing water for Candy, according to the suit.

“Defendants provide Candy exclusively with Coca-Cola instead, claiming that Candy does not like water. However, Candy has readily accepted and drunk water offered to her by visiting experts. Water, not Coca-Cola, is an essential requirement for chimpanzees,” according to the suit.

Should the smoking age be 21? Some legislators say yes

While a growing number of states have turned their attention to marijuana legalization, another proposal has been quietly catching fire among some legislators — raising the legal age to buy cigarettes.

Nearly a dozen states this year have considered bills to boost the legal age for buying tobacco products.

This summer, Hawaii became the first state to approve increasing the smoking age from 18 to 21 starting Jan 1. A similar measure passed the California Senate, but stalled in the Assembly. And nearly a dozen other states have considered bills this year to boost the legal age for buying tobacco.

“It really is about good public health,” said Democratic Hawaii state Sen. Rosalyn Baker, who sponsored the legislation. “If you can keep individuals from beginning to smoke until they’re at least 21, then you have a much greater chance of them never becoming lifelong smokers.”

Supporters say hiking the legal age to 21 not only will save lives but also will cut medical costs for states. But opponents say it would hurt small businesses, reduce tax revenue and violate the personal freedom of young adults legally able to vote and join the military — an argument also made when the drinking age was raised to 21.

Measures to raise the smoking age to 21 also were introduced this year in Massachusetts, New York, Oregon, Rhode Island, Utah, Vermont, Washington and the District of Columbia, according to the Preventing Tobacco Addiction Foundation, an advocacy group aimed at keeping young people from starting to smoke. Iowa and Texas considered measures to increase the legal age to 19. None of those bills passed. And just last week, a Pennsylvania legislator introduced a bill to up the age there to 21.

Cities Act First

In almost every state, including Wisconsin, the legal age to buy tobacco products is 18. Four states — Alabama, Alaska, New Jersey and Utah — have set the minimum at 19.

Anti-tobacco advocates say that hiking the smoking age to 21 is a fairly new approach in their effort to reduce young people’s tobacco use. Only recently has there been substantive research on the topic.

That hasn’t stopped a growing number of local governments from taking action. As of late September, at least 94 cities and counties, including New York City, Evanston, Illinois and Columbia, Missouri, had passed measures raising the smoking age to 21, according to the Campaign for Tobacco-Free Kids.

One of those communities is Hawaii County, the so-called “Big Island” of Hawaii, where the law changed last year after a grassroots effort by health care advocates, anti-smoking groups and local high school students. That coalition, joined by teens from across Hawaii, continued its fight at the state level, and legislators heard the message, said Baker, whose bill also included e-cigarettes.

Supporters of raising the smoking age say that a turning point was a March report by the Institute of Medicine, the health arm of the National Academies of Sciences, Engineering and Medicine, which predicted that raising the age to 21 would cut smoking by 12 percent by the time today’s teenagers are adults. It also would result in about 223,000 fewer premature deaths.

The institute’s report also supported health care advocates’ argument that preventing or delaying teens and young adults from experimenting with smoking would stop many of them from ever taking up the habit. About 90 percent of adults who become daily smokers say they started before they were 19, according to the report.

“Raising the age to 21 will keep tobacco out of high schools, where younger kids often get it from older students,” said John Schachter, state communications director for the Campaign for Tobacco-Free Kids.

Supporters also point out that 21 became the national legal drinking age after President Ronald Reagan signed legislation in 1984 that forced states to comply or risk losing millions of dollars in federal highway funds. That has resulted in reduced alcohol consumption among young people and fewer alcohol-related crashes, national  studies have found.

“Smoking kills more than six times as many people as drinking.” said Rob Crane, president of the Preventing Tobacco Addiction Foundation. 

On Sept. 30, Democrats in the U.S. Senate announced they were co-sponsoring a federal bill that would ban the sale of tobacco products to anyone under 21.

U.S. Sen. Elizabeth Warren said restricting tobacco sales to adults 21 or older would save lives and promote healthier communities.

Supporters of the bill said that in the last 50 years, nearly 21 million people in the United States have died from tobacco-related illnesses, making it the leading cause of preventable death in the country.

Personal Choice

Opponents say that raising the smoking age to 21 would have negative consequences for businesses, taxpayers and 18-year-olds who should be free to make a personal choice about whether they want to smoke.

Smokers’ rights groups, retailers and veterans’ organizations are among those who’ve opposed such legislation.

“If you’re old enough to fight and die for your country at age 18, you ought to be able to make the choice of whether you want to purchase a legal product or not,” said Pete Conaty, a lobbyist for veterans groups who testified against the California bill. “You could enlist in the military, go to six months of training, be sent over to Iraq or Afghanistan and come back at age 19 and a half to California and not be able to buy a cigarette. It just doesn’t seem fair.”

Opponents say it’s wrong to compare cigarettes with alcohol. “If you smoke one or two cigarettes and get behind the wheel of a car, you’re not driving impaired,” Conaty said.

Opponents also say taxpayers would take a financial hit if the smoking age is raised. In New Jersey, where a bill to hike the smoking age to 21 passed the Senate and remains in an Assembly committee, a legislative agency estimated a $19 million a year loss in tax revenue.

In California, an analysis by the Senate appropriations committee estimated raising the age to 21 would cut tobacco and sales tax revenue by $68 million a year. That would be offset by what the analysis said could be “significant” health care cost savings to taxpayers — reaching as much as $2 billion a year.

Stores that sell tobacco products and e-cigarettes also fear the effect. Bill Dombrowski, president of the California Retailers Association, suggested that raising the smoking age would simply drive young people to the black market.

“If you raise the age, people under 21 will find the cigarettes somewhere else,” he said.

Doctors, industry locked in vape debate over youth use

Cool Vapes on Pittsburgh’s McKnight Road is in an average-looking storefront at the foot of Ross Park Mall, sandwiched between a bridal shop and a cellphone outlet.

Inside, the place bustles with customers peering into glass cases full of flavored liquid nicotine with names like Strawberry Cheesecake, Fruity Fun and Crunchberry. Buyers heat the liquids with battery-operated devices and inhale the vapor in a process known as vaping.

The store contains several prominently placed signs warning: “You must be 18 years old to make a purchase.”

Legally, Cool Vapes does not need the signs. Pennsylvania is one of four states without age restrictions for purchasing electronic vaporizers, e-cigarettes and liquid nicotine, according to the American Vaping Association, an industry trade group.

Still, most vape shop owners in Western Pennsylvania maintain a casual agreement not to sell to minors.

“Selling to kids under 18 doesn’t send a good message,” said Cool Vapes owner R.J. Marino. “It’s a personal decision, and I think most vape shop owners agree. But do I have that legal right? Absolutely, at least for now.”

Anthony Fricchione, owner of Villain Vape Shop, which has stores in Lawrenceville, Cheswick and Butler, agreed.

“You would be hard-pressed to go into a vape shop and find an owner selling to teens,” he said. “Our goal is to help people quit smoking. Selling to minors is the last thing we want to deal with _ we’re already battling so much.”

One of those battles is Gov. Tom Wolf’s proposed 40 percent tax on e-cigarettes and vaporizers. On a national level, the Food and Drug Administration might soon classify liquid nicotine as a tobacco product, which members of the vaping industry say will lead to overregulation, hidden costs and red tape that could put them out of business.

“This industry is under consistent attack,” said Greg Conley, president of the AVA. “It’s new technology and confusing to some, so they’d just like to altogether eliminate it. We’re dealing with the toxic legacy of the tobacco industry.”

A recent study by JAMA Pediatrics said teenagers who try vaping or e-cigarettes are more likely to turn to traditional cigarettes for their nicotine fix and become addicted smokers. Researchers from the University of Pittsburgh, Dartmouth University and the University of Oregon surveyed young people from across the country.

A U.S. Centers for Disease Control and Prevention study produced similar results and indicated e-cigarette use among middle and high schoolers tripled from 2013 to 2014.

“In many ways, it’s the perfect starter cigarette for teens. It comes in flavors like chocolate or mango,” said Dr. Brian Primack, director of Pitt’s Center for Research on Media, Technology and Health and lead author of the JAMA Pediatrics study. “It’s electronic, it’s cool-looking, and it’s new. The problem is nicotine is one of the most addictive chemicals known to humans. Once you get addicted, you run the risk of needing more in the form of a traditional cigarette.”

Critics believe the e-cigarette industry markets to younger users with sleekly designed vaporizers and flavored juices.

“As a parent of an 8-year-old son, this stuff really scares me,” said Dr. Anil Singh, director of the breathing disorders center at Allegheny General Hospital. “If used in the right way and regulated, I can see some potential benefit for adults trying to quit smoking. But with the flavors and tools, it’s a great way for hooking young people in. I’d say it’s pretty dangerous.”

Bill Godshall, executive director of Smokefree Pennsylvania, scoffed at the JAMA Pediatrics study. He pointed to a recent CDC study that indicates teen smoking is at an all-time low.

“Cigarette smoking among youths is plummeting every year, but they say vaping is a gateway?” he said. “C’mon. I can’t believe JAMA is pushing this theory.”

As school let out at Taylor Allderdice High School in Squirrel Hill on a recent afternoon, a few students lit cigarettes as they walked down Forward Avenue. Oskar Porter, 15, a sophomore who was not smoking, said it’s not uncommon to see students vaping.

“I think some of the kids do it to be edgy,” he said. “And they can get away with it easier in the bathroom or the back of a classroom.”

Porter said he’s unsure whether vaping is a gateway to cigarettes, as studies suggest.

“I’ve seen plenty of kids who both vape and smoke cigarettes,” he said. “I’m not sure one leads to the other. They’re both pretty common.”

Published via the AP member exchange.

Research: 48.5 percent of deaths from 12 cancers attributable to smoking

Researchers estimate that 48.5 percent of the nearly 346,000 deaths from 12 cancers among adults 35 and older in 2011 were attributable to cigarette smoking, according to an article published online by the JAMA Internal Medicine.

Researcher Rebecca L. Siegel of the American Cancer Society and coauthors provided an updated estimate because they note smoking patterns and the magnitude of the association between smoking and cancer death have changed in the past decade.

While smoking prevalence decreased from 23.2 percent in 2000 to 18.1 percent in 2012, some data suggest the risk of cancer death among smokers can increase over time, according to background in the study.

The authors used data from the 2011 National Health Interview Survey, the Cancer Prevention Study III and the pooled contemporary cohort. The National Health Interview Survey provides smoking prevalence estimates based on in-person interviews of a representative sample of U.S. adults and the other data sources ascertained smoking from self-administered questionnaires.

The study estimates that of 345,962 deaths there were 167,805 attributable to smoking cigarettes.

The largest proportions of smoking-attributable deaths were for cancers of the lung, bronchus and trachea (125,799, 80.2 percent) and larynx (2,856, 76.6 percent).

About half of the deaths from cancers of the oral cavity, esophagus and urinary bladder were attributable to smoking, according to the results, which were reported in a research letter.

“Cigarette smoking continues to cause numerous deaths from multiple cancers despite half a century of decreasing prevalence. … Continued progress in reducing cancer mortality, as well as deaths from many other serious diseases, will require more comprehensive tobacco control, including targeted cessation support,” the study concludes.

Key dates in tobacco fight since smoking report

Some key events in the fight over tobacco during the last 50 years: 

1964: U.S. surgeon general report concludes smoking causes lung cancer.

1965: Warning labels required on cigarette packs.

1971: TV and radio commercials for cigarettes banned.

1972: Airlines told to provide no-smoking sections.

1987: Aspen, Colo., becomes first U.S. city to ban smoking in restaurants.

1988: Smoking banned on short domestic airline flights.

1998: Forty-six states reach $206 billion settlement with cigarette makers.

2000: Smoking prohibited on international flights.

2009: Food and Drug Administration authorized to regulate tobacco products.

Groups seek to free LGBT smokers from tobacco trap

Anti-tobacco groups have released a new report exploring efforts to crush tobacco use in the LGBT community and highlighting the reasons LGBT people fall into the tobacco trap.

The analysis emphasizes Big Tobacco’s efforts to promote cigarette smoking among LGBT people, such as R.J. Reynold’s Project SCUM campaign that launched in 1995 and marketed smokes to gays.

On Dec. 11, the Legacy Foundation, an anti-tobacco group, released a report, “Tobacco Control in LGBT Communities,” which explores the reasons behind continued disparities in tobacco use among LGBT people versus the general population, explains Legacy’s role in addressing tobacco use in the community and provides case studies in reducing smoking in the community.

“It’s very likely that smoking is the single greatest health issue stealing years off the lives of LGBT people,” said Dr. Scout, director of the Network for LGBT Health Equity, one of six CDC-funded tobacco disparity networks and a project of The Fenway Institute in Boston. “Why do LGBT people smoke so much? We’ve been targeted by the tobacco industry, we’re extremely vulnerable for social acceptance as we come out and the pressures of stigma can nudge anyone towards unhealthy behaviors.”

Scout added, “More LGBT civil rights leaders’ voices have been silenced by tobacco disparities than any other single thing. For me, tobacco is one of the biggest social justice issues.”

A recent article in the American Journal of Public Health found that LGBT people smoke cigarettes at rates that are nearly 70 percent higher than the general population. It is estimated that LGBT adults are 1.5 to 2.5 times more likely to smoke than heterosexual adults.

Twelve years ago, Legacy, at a forum in Atlanta, announced a program aimed at understanding and controlling tobacco use in the community. A focus was on the:

• Lack of LGBT community representation in mainstream tobacco control efforts.

• Targeted marketing of LGBT communities by tobacco companies.

• Reliance on tobacco company funding by LGBT organizations.

• Lack of knowledge among community members in recognizing the public health threat that tobacco poses.

“For more than a decade, Legacy has worked hard with grassroots groups across the country to help combat the direct targeting that the industry has had on this community in an effort to reduce tobacco use and encourage cessation,” said Legacy CEO Cheryl Heaton. “Through funding and research, it has been our charge to help the LGBT community fight back and educate others on the dangers of tobacco use and nicotine addiction.”

Heaton and Scout agreed there have been advances, but more needs to be done.

“People in the community want and need help, but it is difficult to provide them with knowledge and training when there is a lack of support for the LGBT population,” said Scout. “With the help of others, people from within and even outside of the community can continue to improve tobacco education among a population that needs and deserves help.”

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