Archive for January, 2011|Monthly archive page

U.S. Military Takes Tough Line Against Tobacco

In National News on January 31, 2011 at 9:53 am

Check out this article written that was published by The Sacramento Bee. 

Three improvised bombs exploded last Easter outside a Baghdad government building, and Sgt. 1st Class Malcolm Russell, an Elk Grove Army reservist deployed in Iraq, was on high alert, his adrenaline pumping.

When calm finally arrived, Russell reached for a pack of smokes, lit up and inhaled. “I’ll never forget that drag, with the hair-raising moments we had. It brought down the stress,” he said.

Russell, 34, has lived the horrors of war, but it is his addiction to cigarettes, he said, that has been the toughest battle of all.

When it comes to quitting, “I’m trying to win the war. Sometimes it feels like I’m losing the battle,” said Russell, who is back home and, two weeks ago, began a smoking cessation class at Mercy General Hospital, where he oversees security.

The U.S. military vowed to join the national fight against smoking, saying it is stepping up its efforts to help military personnel kick their tobacco habits.

Earlier this month, the Navy banned smoking inside submarines. It was the latest sign of a cultural sea change within the U.S. armed services after years of condoning the cigarette addictions of generations of enlisted men and women.

Until the Vietnam War, cigarettes were part of military meal rations: a few smokes served with green tins containing breakfast, lunch or dinner.

These days, the anti-smoking message is plastered across bases and websites that urge the country’s 2.2 million warriors to battle their cravings for tobacco, even offering online poker and video games to help soldiers ward off cravings for cigarettes.

Last June, the government’s health plan for military families, TRICARE, launched a telephone help line to dispense anti-smoking advice and counseling.

Under pressure from public health officials and anti-tobacco forces, who say smoking drains military budgets and undermines combat readiness, the Department of Defense has vowed it will eventually go tobacco-free. But the Pentagon has yet to say when.

“There’s been a long history of the tobacco industry integrating itself in the culture of the military,” said Dr. Darryl Hunter, a radiation oncologist who treated military personnel, many of them smokers, for nine years at Travis Air Force Base before going to work for Kaiser Permanente in Roseville.

“Tobacco is the single largest cause of loss of life and health-related expenditures,” said Hunter, who is also an Air Force reservist.

In 2006, military hospitals provided $564 million in services for tobacco-related conditions. The Department of Veterans Affairs spent more than $5 billion in 2008 to treat pulmonary disease, much of it traced to smoking.

While the smoking rate among military personnel has plunged over the years, from 51 percent in 1980 to 30 percent today, it remains at least 10 percent higher than that of civilians.

The proportion of smokers is even higher among military personnel deployed overseas, particularly to such volatile regions as Iraq and Afghanistan, where cigarettes help relieve the stresses of combat and the tedium of duty.

In 2007, the departments of Defense and Veterans Affairs asked the national Institute of Medicine to suggest ways to reduce tobacco use among the enlisted and veterans.

The result was a 2009 report that urged the U.S. military to take the war on tobacco more seriously and produce a comprehensive strategy to curb the use of cigarettes, chew and other tobacco products.

The Navy responded in April by announcing a ban on smoking in submarines.

“Despite our atmosphere purification technology, there are unacceptable levels of secondhand smoke in the atmosphere of a submerged submarine,” Vice Admiral John Donnelly said last year.

Dr. Michael Fiore, a former major in the U.S. Army and director of the Center for Tobacco Research and Intervention at the University of Wisconsin, acknowledged the military’s progress but said it needs to do more.

“Veterans who smoke survive the battlefield,” he said, “only to come back home and die from disease, such as lung cancer, heart attacks, strokes, emphysema – the list goes on.”


Exemptions Make Proposed Smoking Ban Useless

In Local News, State News on January 28, 2011 at 8:47 am

The Washington Times-Herald published an article Jan. 25 titled “House exempts bars from proposed smoking ban.” Our state legislators have so watered down the proposed law with exemptions that it’s practically useless at this point.

Indiana needs a smoke-free workplace law that covers all workers, including those in the hospitality industry, because all workers deserve a safe and healthy work place, no matter where they work.

Many employees in the restaurant, bar, and casino industry have limited employment options, especially in this economic environment. They should not have to choose between their health and earning a living for their families. Secondhand smoke kills thousands of nonsmokers every year, especially people working in restaurants, bars, and casinos.

Numerous polls show a majority of Hoosiers support a smoke-free law that covers all workplaces. Bars and casinos in other states with smoking bans have not been financially harmed because of the law. Instead, those states are seeing drops in heart attacks and other diseases related to secondhand smoke exposure.

It all boils down to this – secondhand smoke is a worker safety issue, the same as any other workplace safety hazard. I like how Dave Crooks put it in his recent blog: “It’s time to ban smoking in ALL public places in Indiana. We have nothing to fear but cleaner air and a more attractive state for all.”

I urge you to contact your legislators today and ask them to support a smoke-free law for everyone.

Indiana’s Faith Leaders Call For Legislature To Approve Tobacco Prevention & Cessation Funding, Statewide Comprehensive Smoke-Free Workplace Law

In State News on January 25, 2011 at 12:29 pm
Yesterday in Indianapolis, leaders of Indiana’s major faiths and denominations called upon the members of the Indiana General Assembly to commit to reducing the serious burden tobacco smoke takes on both the primary user and also those who are exposed to secondhand tobacco smoke. Leaders from a diverse array of faith denominations issued this call to action at Christ Church Cathedral on Monument Circle in Indianapolis at an event hosted by the Hoosier Faith and Health Coalition.
Reverend Dan Gangler of the United Methodist Church said, “The clear and present danger caused to Hoosiers by tobacco products, plus the costs to the state incurred because of disease and death caused by tobacco products and secondhand smoke demand that our state’s policymakers show true commitment to addressing the toll of tobacco by providing meaningful funding to Indiana Tobacco Prevention & Cessation Agency and by adopting a comprehensive smokefree workplace law.
“Hoosier Faith & Health Coalition members are proud to partner with ITPC in its community- based campaign to reduce tobacco use. Our faith leaders and health leaders in communities across Indiana have a great resource in ITPC’s state office staff and the community partners across the state. Hoosiers need the experienced, dedicated staff of ITPC and the independent, expert guidance provided by ITPC’s Executive Board in order to continue the decade of progress Indiana has witnessed in reducing youth and adult smoking rates and consumption,” Gangler said.
Research shows that reducing tobacco use is one of the most effective ways to protect our state’s health and prevent deadly and costly diseases such as cancer and heart attacks by preventing kids from starting and helping adults quit.
The Hoosier Faith and Health Coalition event celebrated 10 years of service to Hoosiers by the Indiana Tobacco Prevention and Cessation Agency. During this last decade of service, ITPC has led Hoosiers to major successes in tobacco prevention, such as:
  • Successfully reducing adult smoking to an historic low of 23.1%. Consequently today there are 208,000 fewer smokers in Indiana than there were just 10 years ago;
  • Reducing annual per capita cigarette consumption of Hoosiers by 40%; and 
  • Reducing the high school smoking rate by 42%, resulting in 49,000 fewer youth smokers.
In spite of this success, there still is a tremendous amount yet to do to help Hoosiers quit smoking, prevent young people from starting to smoke, eliminating exposure to secondhand smoke and reducing disparities caused by tobacco. At the same time while ITPC has been efficiently and effectively doing its work to combat the significant health and financial toll caused by tobacco and providing Hoosiers with a positive return on their investment by reducing tobacco-related costs for the state, businesses and individuals, the tobacco industry continues to spend hundreds of millions of dollars more than Indiana dedicates to tobacco control efforts. For example, tobacco companies spent $426 million to market their products in Indiana in 2006 alone, according to the most recent Federal Trade Commission report that tracks these expenditures, outspending tobacco prevention funding by a scale of 46 to one.
Kevin O’Flaherty of the Campaign for Tobacco-Free Kids said, “We ask the Indiana General Assembly stand up for healthy Hoosiers and against disease, death and $2 billion per year in costs due to smoking and $390 million per year in costs due to secondhand smoke. Investing in ITPC is a smart investment, especially in such hard economic times, because it’s an expenditure that is shown to provide a positive return on investment. We ask Indiana’s leaders to not turn back the clock on our decade of progress but to commit to continue these important programs and the valuable work of ITPC.”

How Long Will We Hold Out?

In State News on January 19, 2011 at 12:36 pm

Opinion piece by Richard Feldman that was published recently in the Indianapolis Star.

The Indiana General Assembly again is considering a comprehensive smoke-free statute that would prohibit smoking in enclosed public places including worksites, restaurants and bars. The legislature has previously lacked the courage to overcome the powerful political influence of the tobacco industry. Hoosiers also fervently value personal liberties and resent intrusive governmental control of business. These attitudes, although understandable, are applied excessively regarding this issue.

Individual freedoms are not absolute; they are balanced by the greater public good, and they end when one’s actions injure another. Smokers do hurt those around them. Nonsmokers cannot always deliberately avoid environmental tobacco smoke. It is ubiquitous. Although the enactment of smoke-free laws has reduced the risk, studies demonstrate that Americans greatly underestimate their exposure to secondhand smoke. Commonly, people who believe that they are not exposed to smoking have significant blood levels of tobacco-smoke metabolites.

Also, workers may be trapped in smoke-filled environments. Jobs are not easily found and many workers have no alternatives. For example, I had a patient with severe asthma. She was a cocktail waitress in a smoky work environment that triggered her asthma. I advised her that she should find another job. Surprised, she looked at me and said, “Dr. Feldman, working in bars is what I do. It’s all I know. If I found another job, it would be in another smoky bar.”

Consider these additional facts as ample rationale for a smoke-free statute:

No legitimate study has ever found a negative economic effect of a smoke-free law on restaurants, bars, convention business or the hospitality industry. These include studies conducted in Bloomington and Fort Wayne. My goodness, the pubs in Ireland went smoke-free and they’re doing fine.

Environmental tobacco smoke annually kills 1,300 people in Indiana, 53,000 in the United States (including 6,200 children), and 600,000 worldwide. It is America’s third leading cause of premature death.

Secondhand smoke causes lung cancer and at least 15 other cancers in nonsmokers chronically exposed. Tobacco smoke is America’s number one airborne carcinogen.

Secondhand smoke significantly increases the risk of chronic obstructive lung disease and asthma in nonsmokers and various respiratory infections, including pneumonia, in children.

Environmental tobacco smoke increases the risk of heart disease in nonsmokers by up to 60 percent and stroke by 50 to 80 percent.

Before the era of smoke-free laws, restaurant and bar workers had up to four times the risk of lung cancer and more than twice the risk of heart disease as compared to other workers.

Numerous studies have demonstrated hospital admissions for acute heart attack have been reduced between 14 and 42 percent in the months after smoke-free laws take effect; in one study, hospital admissions for childhood asthma were reduced by 16 percent.

Pregnant women exposed to secondhand smoke have twice the risk of having a low-birth weight baby, which is associated with 40 percent of neonatal deaths. These women also have higher rates of miscarriage, premature birth and other obstetrical complications.

Secondhand smoke considerably increases direct and indirect costs to businesses and is responsible for $390 million in health-related costs yearly in Indiana.

Nearly two-thirds of likely Hoosier voters support comprehensive smoke-free laws that include restaurants and bars. That would be a landslide victory in any election.

As the Indiana legislature debated this issue last year, South Dakota became the 29th state to enact a comprehensive smoke-free statute. Minnesota, Wisconsin, Michigan, Ohio and Illinois all have good smoke-free laws.

Although there may be more momentum this year, its enactment remains an uphill battle. Will Indiana or Kentucky be the last state in the country to enact a comprehensive smoke-free statute? Tough call.

Feldman, M.D., is director of medical education and family medicine residency at St. Francis Hospitals and Health Centers and is a former state health commissioner. Contact him at

Indiana Needs A Comprehensive Smoke-Free Workplace Law

In State News on January 17, 2011 at 10:29 am

On Wednesday, the House Public Health Committee held a hearing on HB 1018, the Indiana Comrehensive Indoor Clean Air Act, which would require all Indiana workplaces, including restaurants and bars, to go smoke-free.

The bill, however, contains exemptions for casinos. Radio show host Dave Crooks wrote a great blog about the issue here:

We feel all workers deserve to breathe clean air. No one should have to choose between their health and a paycheck. You can support smoke-free workplace by contacting your representative and patronizing only smoke-free businesses.

FDA To Require Substantial Equivalence Reviews For New Tobacco Products

In National News on January 7, 2011 at 12:24 pm

The U.S. Food and Drug Administration announced this week that certain tobacco products introduced or changed after Feb. 15, 2007 must be reviewed by the agency. In FDA guidance, the agency outlines a pathway for marketing a product whereby the company marketing the product must prove that it is “substantially equivalent” to products commercially available on Feb. 15, 2007.  

“Substantially equivalent” means the products must be the same in terms of ingredients, design, composition, heating source and other characteristics to an existing, single predicate product or have different characteristics, but not raise different questions of public health. This specific part of the law is meant to ensure that new tobacco products are evaluated by the FDA before they are cleared to enter the marketplace. The law requires FDA to carefully examine the impact those products may have on the public health,” said Lawrence R. Deyton, M.S.P.H., M.D., director of the agency’s Center for Tobacco Products. “Products that are equivalent to those which were on the market on February 15, 2007, may be cleared to go to market; those that are not may be prohibited from the market, or withdrawn if they are already available, if the changes raise different questions of public health.”

“This piece of the Tobacco Control Act protects the health of all Americans,” said Health and Human Services Secretary Kathleen Sebelius. “It does this by setting a clear deadline for tobacco companies to provide important product information to the FDA so the agency can then begin evaluating tobacco products for any potential new risks to public health.”

The Family Smoking Prevention and Tobacco Control Act, which became law June 22, 2009, granted the FDA regulatory authority over tobacco products. Generally, the law allows the FDA to deny applications for new products if marketing the product poses a harm to public health.

FDA may deny applications for substantial equivalence if the marketing of that modified product would raise different questions of public health. An example would be a product that poses an increased health risk to users of the product or to nonusers by causing more of them to start smoking.

In general, in order to continue to market these products, manufacturers of tobacco products that were introduced or changed after Feb. 15, 2007, which include cigarettes, roll-your-own tobacco and all smokeless products must apply for equivalency by Mar. 22, 2011. Manufacturers intending to introduce new products into the market after that date must submit an application for the new product and obtain a marketing order from the FDA before introducing the product to market.

“No known existing tobacco product is safe, and a market order issued by the FDA for these products should never be interpreted as such” said Deyton. “One of the FDA’s missions required by this new law is to ensure new products do not pose an increased threat to the American public. These products will not be safer, but we are required by this law to not allow even more dangerous products to cause further harm to those Americans who use tobacco products.”

FDA also intends to issue guidance on materials the agency believes would show that a tobacco product was on the market on Feb. 15, 2007, as well as hold a Webinar Series in order to provide more assistance to manufacturers.
Information on the Webinar Series (available soon) and application process details and answers to questions can be found here.

The FDA welcomes public comment on this issue. Go to and insert docket number FDA-2010-N-0646 into the “search” box and follow the prompts.

2010 In Review

In Local News on January 3, 2011 at 9:57 am

The stats helper monkeys at mulled over how this blog did in 2010, and here’s a high level summary of its overall blog health:

Healthy blog!

The Blog-Health-o-Meter™ reads Fresher than ever.

Crunchy numbers

Featured image

The average container ship can carry about 4,500 containers. This blog was viewed about 17,000 times in 2010. If each view were a shipping container, your blog would have filled about 4 fully loaded ships.

In 2010, there were 59 new posts, growing the total archive of this blog to 214 posts. There were 15 pictures uploaded, taking up a total of 19mb. That’s about a picture per month.

The busiest day of the year was April 19th with 186 views. The most popular post that day was CDC Finds Poisons In Dissolvable Tobacco Products.

Where did they come from?

The top referring sites in 2010 were,,,, and

Some visitors came searching, mostly for mouth cancer, mouth cancer pictures, smokeless tobacco, chewing tobacco, and mouth cancer from chewing tobacco.

Attractions in 2010

These are the posts and pages that got the most views in 2010.


CDC Finds Poisons In Dissolvable Tobacco Products October 2009


Through With Chew Week January 2009


New Tobacco Product Display March 2009


Are You Through With Chew? January 2009


Dissolvable Tobacco Products, Tobacco Candy New Threat May 2009