TIME Addiction

Hawaii Set to Become First State to Raise Smoking Age to 21

TIME.com stock photos E-Cig Electronic Cigarette Smoke
Elizabeth Renstrom for TIME

The bill covers both cigarette and e-cigarette use

Hawaii is set to become the first state to pass a law banning the sale, use and possession of cigarettes and e-cigarettes to people under the age of 21.

If a bill approved by Hawaii lawmakers on Friday is signed into law by Gov. David Ige, adolescents will be prohibited from smoking, buying and possessing both conventional cigarettes and e-cigarettes. First-time offenders will be fined $10, and after that they can be charged a $50 fine or be required to complete community service, the Associated Press reports.

Some local governments have raised the smoking age to 21 in certain counties and cities — New York City among them — but if the bill becomes law, Hawaii will be the first state to do so.

Though the rates of high school age smokers have dropped in recent years, some 2.3 million children and young adults started smoking in 2012. In addition, a recent report from the U.S. Centers for Disease Control and Prevention (CDC) revealed that e-cigarette use among middle school and high school students tripled in one year.

If the Hawaii bill passes, it will go into effect Jan. 1, 2016.

[AP]

TIME Addiction

FDA Panel Votes Against Smokeless Tobacco Safety Claims

Swedish Match Targets Wall Street Smokers With Snus Tobacco
Getty Images

The panel's vote was split on some important points

An FDA advisory panel voted on Friday that it does not agree with the evidence and claims put forward by smokeless tobacco manufacturer Swedish Match regarding its application to change warning labels on its tobacco product, called snus.

Snus, pronounced snoose, is a cloth baggie with moist tobacco powder which users stick under their upper lip for a nicotine buzz. As TIME reported on Thursday, Swedish Match wants to remove the required warnings that say snus causes mouth cancer, gum disease and tooth loss, arguing that there isn’t sufficient scientific evidence to support them. The company also wants to change the warning to read: “No tobacco product is safe, but this product presents substantially lower risks to health than cigarettes.”

On Thursday and Friday an advisory committee to the FDA met about the company’s application and voted on a series of questions related to the application. The FDA will use the committee vote as a recommendation that it may or may not adopt. On Friday, the committee largely voted against many of Swedish Match’s claims, with some exceptions.

On certain claims, the panel’s vote was clear cut. The committee unanimously voted that there was not evidence to suggest that snus products do not pose risks to gum disease or tooth loss. The committee was, however, split on the question of whether snus products do not pose risks for oral cancer. Three members voted yes, three members voted no, and two abstained from the vote.

The committee was split on the question of whether there’s evidence to support the statement that the health risks for people who exclusively use snus products are “substantially lower” than the health risks from smoking cigarettes. Four members voted yes and four voted no.

The vote suggests the committee is still unconvinced that solely using the smokeless tobacco product is indeed safer than using cigarettes. A large part of Swedish Match’s argument is that snus has contributed to what’s called the “Swedish experience.” Sweden has similar tobacco consumption rates as other European countries but has the lowest smoking-related mortality rate. Many say that’s because Swedish men tend to choose snus over cigarettes (the product is less popular among women). Members of the public health community watching the vote have been largely divided on whether harm reduction has a place in tobacco control and whether pushing people toward products with lower levels of nicotine is good for public health.

The committee also voted that the proposed warning statement from Swedish Match does not adequately communicate the potential health risks from using snus.

“I am very happy with the vote,” says Shyam Biswal, a professor in the department of Environmental Health Sciences at the Johns Hopkins Bloomberg School of Public Health. “My main concern is [snus attracting] new users who would otherwise not smoke. Saying snus is significantly less harmful [than cigarettes] is a very broad claim.” Biswal adds that he thought the evidence presented by Swedish Match was weak, including studies with small sample sizes. Biswal was not involved in the vote, but has studied modified risk tobacco products.

Swedish Match did not respond to requests for comment by time of publication.

TIME Addiction

A New Government Anti-Smoking Campaign Includes E-Cigs

Past campaigns have increased calls to quitlines by 80%

A new federal ad campaign against smoking features e-cigarettes for the first time.

The U.S. Centers for Disease Control and Prevention (CDC) released its latest ad in its ongoing “Tips From Former Smokers” campaign. The campaign features real Americans who have experienced serious health or social consequences from smoking. Often the ads are explicit. On March 30, the first ad about e-cigarettes, as opposed to traditional tobacco, will air.

The ad features a 35-year-old woman named Kristy who picked up e-cigarettes as a way to quit smoking. She ended up using both products. Eventually she had a collapsed lung and was diagnosed with lung disease. She’s a married mother of three who works as a truck driver.

Kristy's Tip Print Full Page Ad
CDC

“Nationally, about 3 in 4 adult e-cigarette users also smoke cigarettes,” the CDC says in a statement. “If you only cut down the number of cigarettes you smoke by adding another tobacco product, like e-cigarettes, you still face serious health risks.”

Other ads focus on side effects like vision loss and colorectal cancer.

In 2014, the CDC says the national quit line received 80% more calls when the ads were on the air, and since 2012 the ads have generated more than 500,000 additional calls. The ads will run for 20 weeks on TV, radio, online, billboards, in theaters and in magazines and newspapers. Kristy’s ads will be on the radio and in print.

The ads encourage smokers to call 1-800-QUIT-NOW or visit www.cdc.gov/tips.

Read next: These 4D Ultrasound Photos Show How Fetuses Respond to Their Mothers’ Smoking

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TIME Addiction

This Is Not a Good Reason to Smoke Cigarettes

Cigarettes
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But smoking causes weight loss, a new study says

Anyone who’s considered lighting up knows smoking’s skinny-making reputation, and a new study of 80,000 people shows there’s truth to the claim. Researchers found that smokers weighed about 5 pounds less than people who had never smoked, according to new research in the International Journal of Epidemiology. The cause of that lighter weight, the researchers say, is tobacco.

Those findings are a direct contradiction to several observational studies that have linked smoking to just the opposite: higher body weight and BMI. But researchers at Copenhagen University Hospital wanted to look at the link genetically, in a way that wouldn’t be plagued by confounding lifestyle factors that often go along with smoking. They took weight and BMI measurements of 80,342 people, along with blood samples that they analyzed for DNA.

They looked at a genetic variant associated with higher tobacco consumption, close to a gene called CHRNA3—”the smoking craving gene,” says study author Børge G. Nordestgaard, MD, professor at the University of Copenhagen in the department of clinical biochemistry. Smokers with this genotype weighed almost three pounds less than smokers who didn’t inherit this genetic variant. But in people who had never smoked or formerly smoked, there was no link between CHRNA3 and a lower body weight.

“That’s really the proof that smoking causes it,” Nordestgaard says.

That doesn’t mean that smoking will give you a better figure. In the study, smoking only affected total body weight, not body shape or fat distribution.

The weight loss effect may be due to a laundry list of chemicals in cigarettes, the authors say—some studies have found nicotine to suppress appetite and increase resting metabolic rate. “There’s a possibility that many of these chemicals may influence weight in some pathway we don’t know about yet,” Nordestgaard says.

That’s obviously no reason to start—or continue—smoking, the researchers caution. “From what we know so far, the hazards of smoking much overweigh the slight benefit of having a lower body weight,” Nordestgaard says. “But when smokers tell you they won’t stop smoking because they’re afraid of gaining weight, I think it’s important to know that this is real—so we can try at the same time to help them quit smoking and keep a lower body weight.”

Read next: What Diet Soda Does to Belly Fat

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TIME Addiction

Watching E-Cig Ads May Increase the Urge to Smoke, Study Says

TIME.com stock photos E-Cig Electronic Cigarette Smoke
Elizabeth Renstrom for TIME

A new study shows possible consequences of vaping in commercials

Seeing commercials for electronic cigarettes can increase the urge to smoke traditional cigarettes, a new study suggests.

Researchers at the Annenberg School for Communication at the University of Pennsylvania discovered that watching advertisements that showing vaping can increase the desire of current and former smokers to pick up a conventional cigarette.

In the new study, published in the journal Health Communication, the researchers assessed the urge to smoke among 301 daily smokers, 272 intermittent smokers and 311 former smokers. They then had the participants watch three e-cigarette commercials. Some of the commercials showed vaping, and others did not.

After they viewed the advertisements, the men and women were once again asked about their urge to smoke. Their responses showed that the daily smokers who saw vaping ads had a greater desire to smoke a regular cigarette, and a higher likelihood of actually doing so during the experiment.

The former smokers who watched the advertisements with vaping were more likely to report decreased intention to abstain from smoking. Intermittent smokers showed no significant changes.

The researchers say the data suggests that watching the commercials with vaping could lead to actual smoking behaviors or interfere the ability of former smokers to refrain from picking up the habit again.

“The jury is still out on the efficacy of e-cigarettes to reduce tobacco use and tobacco smoking,” says study author and communication professor Joseph N. Cappella in a video about his study. “If it turns out to be the case that e-cigarettes are a good vehicle for reducing tobacco addiction, then we not want to stand in the way of advertising…but it doesn’t mean we couldn’t carry out that advertising without the vaping cues in order to not have these deleterious consequences.”

MORE: The Future of Smoking

TIME Cancer

Taking Medication May Make It Easier to Quit Smoking

74076298
Getty Images

A Pfizer-funded study suggests the anti-smoking drug Chantix could be used to slowly help smokers quit

According to the results of a new trial published in JAMA, an anti-smoking medication may make it easier for smokers who aren’t yet ready to quit to do so later on.

Nearly seven out of every 10 current U.S. adult cigarette smokers want to quit completely, according to data from the Centers for Disease Control and Prevention. But some smokers who aren’t yet ready to quit for good want to lower their consumption and increase their chances for success at kicking the habit down the line. That’s possible with the help of a drug called varenicline, which is sold under the trade name Chantix and is manufactured by Pfizer, finds the new study, which was also funded by Pfizer.

The researchers conducted a two-year trial with 1,510 cigarette smokers who weren’t willing to quit within the next month, but who were willing to try to quit within the following three months. The men and women were split into two groups: some received Chantix, and others received a placebo for 24 weeks. The goal for all the volunteers was to reduce smoking by at least 50% by week four, and then continue to ease up on the habit until a quit attempt at week 12.

The volunteers who were taking Chantix were significantly more successful at quitting by the end of the study compared to the people on the placebo, and the effect stuck at one year.

Developing smoking cessation strategies that allow smokers to quit gradually could attract many more smokers to the method, a Pfizer spokesperson said in an e-mail.

Chantix is not without side effects and controversy. Some data has suggested the drug is linked to serious psychiatric side effects and heart problems.

The authors disclose several conflicts of interest, including the fact that Chantix manufacturer Pfizer was involved in the design, data collection and analysis of the study, and many of the study authors received fees or grants from Pfizer. However, the findings highlight a new potential strategy for curbing smoking and possibly allowing more people to be successful. According to the American Cancer Society, only around 4% to 7% of people are able to quit smoking without medication or other means, and about 25% are able to quit smoking for over six months with the help of medicine.

TIME public health

Paying People Could Help Them Quit Smoking

Peter Dazeley—Getty Images

Researchers offered women more than $1,000 to get them to stop smoking

Paying people to quit their bad health habits may be a powerful way to address public health issues like smoking, according to a new study in the BMJ. In the study, pregnant women were more than twice as likely to quit smoking when offered financial incentives than when they were given regular counseling.

“If financial incentives are effective and cost effective they may well have the future potential to sit with vaccines as an important preventive healthcare intervention strategy,” the study says.

The research, which looked at more than 600 pregnant women in the United Kingdom, offered women up to $1,200 dollars in shopping vouchers for following steps to quit smoking. Nearly a quarter of women who were offered the money successfully quit smoking. In the control group, a separate group of women received free nicotine therapy and were counseled on how to quit. Less than 9% of those women were able to kick the habit.

Read More: What I Learned From My $190,000 Surgery

That success gap remained when researchers followed up a year with the women in both groups who had quit. Fifteen percent of the women who had been paid to quit had stayed away from cigarettes, while only 4% of the counseling group quitters had done the same.

Using financial incentives to encourage better health behavior has been explored in depth in recent years by public health experts, but many remain skeptical due to underlying ethical concerns. Some have argued that such incentives are coercive and diminish a person’s sense of personal responsibility. But the researchers in this study argue that it can help in more ways than one; getting additional funds before a child’s birth helps the people who need financial assistance the most at the time they need help.

“In the developed world there is now a clear socioeconomic gradient in smoking, with tobacco use concentrated among the poorest in society,” the study says. “Receipt of financial incentives can contribute to needed household income in advance of the arrival of a baby in low income households.”

TIME Addiction

Typical American Smokers Burn Up at Least $1 Million During Their Lifetimes

Alaska smokers will spend over $2 million

American smokers spend at least $1 million dollars on cigarette-related expenditures over their lifetimes, according to a state-by-state analysis done by the financial consultancy company WalletHub.

The most expensive state for smokers is Alaska, where the habit costs over $2 million dollars on average. For a bargain, move to South Carolina, but that still comes in at nearly $1.1 million.

“I and most people really just think of the cost of cigarettes and taxes on the packs, but if you think about the healthcare costs, which can totally be avoided, healthcare insurance premiums, and in the workplace, bias against smokers, that can … add up,” said WalletHub spokeswoman Jill Gonzalez.

The study’s “average smoker” is someone who smokes one pack a day starting from the age of 18 (legal age to buy) and ending at 69 (the average age of death for a smoker).

So, if you’re looking for another excuse to quit, perhaps take a quick peak down millionaire’s row.

MONEY health

Smoking Can Cost You $1 Million to $2 Million in a Lifetime

smoking cigarette wrapped in money on ashtray
John Knil—Getty Images

Your pack-a-day habit isn't just destroying your lungs, but your bank account as well—more than you ever imagined.

According to the American Lung Association, tobacco kills nearly half a million Americans annually and costs the nation $333 billion per year in health-care expenses and lost productivity to boot. But it’s hard for the average person—specifically, the average smoker—to wrap one’s brain around such an enormous figure.

Coming to the rescue, timed to coincide with the CDC’s Tobacco Awareness Week, is a new state-by-state analysis from WalletHub detailing the lifelong financial costs of smoking for an individual. Because the average price of a pack of cigarettes varies widely around the country—$5.25 in Virginia, $8 in Michigan, $12.85 in New York—the lifetime outlay varies greatly from state to state as well. In all cases, though, the data gathered by WalletHub show that smoking is incredibly costly in addition to being potentially deadly.

The total cost per smoker is estimated at $1,097,690 in South Carolina—and it’s the least expensive state in the nation. A Kansas City Star headline noted that the “cost of smoking is cheap in Missouri … relatively,” as the state ranks as the eighth least expensive on WalletHub’s list, with the total cost for a lifetime of smoking running “only” $1,177,230. At the high end of the spectrum, there’s Rhode Island, Massachusetts, New York, and Connecticut, where the habit costs more than $1.9 million per person in a lifetime. Priciest of all is Alaska, which crosses the $2 million mark.

For a little perspective, federal data estimates that the cost of raising a child to age 18 is about $250,000—a big chunk of change, but only a small fraction of expenses reportedly incurred by smokers.

Right about now, the average smoker (or just the average reader with a healthy degree of skepticism) is probably thinking: hogwash. The process of coming up with such wild figures must involve a fair amount of smoke and mirrors, so to speak, right?

Let’s have a look at what WalletHub did, exactly. By far, the largest expense incorporated into the per-person total is the “tobacco cost per smoker,” measured at $786,346 in South Carolina, up to roughly $1.5 million in Alaska. WalletHub came up with that figure by multiplying the average price of a pack of cigarettes in each state by the number of days in 51 years. Fair enough. There are cheaper ways to go about buying cigarettes, like buying smokes by the case, but many people purchase by the pack.

What’s trickier is the way that WalletHub pumped up its tobacco cost estimates by calculating “the amount of return a person would have earned by instead investing that money in the stock market over the same period. We used the historical average market return rate for the S&P 500 minus the inflation rate during the same time period to reflect the return in present-value terms.” In other words, the assumption is that money not spent on cigarettes would have been dutifully and wisely invested over those same 51 years.

Similar assumptions have also been used in the now (mostly) discredited “latte factor,” which is the theory that holds that people can wind up with millions in the bank by cutting back on everyday expenses like a daily latte. Among other reasons, this line of thinking is questionable because people don’t necessarily invest money that they don’t spend on some product or service—they’re more likely to simply spend that money on something else.

WalletHub also includes other costs that many smokers never think about, factoring in added health care expenses (with state-by-state data from the CDC) and an 8% hit on income due to smoking, as determined in a study by the Federal Reserve Bank of Atlanta.

Add up all of these and a few other estimated expenses, and over the course of a half-century, the cost to the pack-a-day smoker runs $1 million to $2 million, according to WalletHub. Are the figures overblown? Well, perhaps a bit. There’s a good argument to be made that the data were construed to come up with totals that are as big and headline-worthy as possible. (After all, they got our attention.)

Nonetheless, even if the figures are on the inflated side, it’s an undeniable reality that the smoking habit costs big bucks over a lifetime. And oh yeah, it can make your lifetime a lot shorter. Let’s not forget that.

TIME Brands

One of the Last Marlboro Men Has Died

Darrell Hugh Winfield was discovered while working on a ranch in Wyoming

One of the last Marlboro Men died earlier this week.

85-year-old Darrell Hugh Winfield passed away Monday at his home in Riverton, Wyoming, the Associated Press reported.

Winfield, discovered by ad agency Leo Burnett in 1968 while working on a ranch, was the quintessential macho cowboy — a quality that made him one of the rugged faces of the cigarette company between the late 1960s and the late 1980s.

The Marlboro Man was first introduced in the 1950s in an attempt to sell filtered cigarettes to men. They had previously been targeted at women.

[AP]

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