TIME Cancer

Taking Medication May Make It Easier to Quit Smoking

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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 Addiction

Plain Cigarette Packs May Deter Smokers, Studies Show

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Largely based on findings in Australia, which removed branding from tobacco packaging two years ago

Tobacco packaging without labels or branding may keep new smokers away and prevent habitual smokers from lighting up regularly, a new series of studies finds.

According to the studies, published in the journal Addiction, there is growing evidence that plain packages of cigarettes and other tobacco products reduce smoking rates and reduce outdoor smoking. The findings are largely based on evidence noted in Australia, where the government removed labels from cigarette packages and added graphic health warnings to packs two years ago.

The studies also show that by removing the branding, young experimental smokers focus more on the health warnings on the package — though it found the impact on daily young smokers is minimal.

“Even if standardized packaging had no effect at all on current smokers and only stopped 1 in 20 young people from being lured into smoking it would save about 2,000 lives each year,” Addiction editor-in-chief Professor Robert West said in a statement.

Addiction published the series just months before the U.K. Parliament votes on standardizing tobacco product packaging, following in the footsteps of Australia. The government is already facing fierce backlash from tobacco companies in response to the law, Reuters reports.

John Oliver brought up Australia’s law in his segment on tobacco marketing on this week’s Last Week Tonight:

Read next: This Is The Easiest Way to Get Better Sleep

Listen to the most important stories of the day.

TIME States

Kentucky Mulls Statewide Smoking Ban

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Shui Ta Shan—Flickr RF/Getty Images

But measure unlikely to become law

Kentucky lawmakers voted Friday to ban smoking in all public buildings and workplaces, but the measure faces a steep uphill battle to become law.

The vote was seen as a landmark move in Kentucky, which ranks among the states with highest tobacco yield. The sponsor of the bill, state Rep. Susan Westrom, said secondhand smoke kills about 950 Kentuckians each year.

The bill passed 51-46 in the Democratic-controlled state House of Representatives, WLWT reports, but will face harsher odds in the Republican-controlled state Senate.

[WLWT]

TIME Smoking

Smoking May Be More Dangerous Than Previously Thought, Study Says

A man smokes outside of a building on June 11, 2009 in New York.
Spencer Platt—Getty Images A man smokes outside of a building on June 11, 2009 in New York.

Kidney disease and fatal infections now linked to the nasty habit

Smoking may contribute to the deaths of an additional 60,00-120,000 Americans per year says a new study published by The New England Journal of Medicine.

From the years 2000 to 2011 researchers followed nearly a million people, including 89,000 current smokers, and concluded that smoking increased the risk of deaths from diseases not previously associated with the habit, according to the New York Times.

“The smoking epidemic is still ongoing, and there is a need to evaluate how smoking is hurting us as a society, to support clinicians and policy making in public health,” Brian D. Carter, head author of the study told the Times.

The study found that smokers were twice as likely to die from kidney failure, fatal infections and possibly even breast and prostate cancers in addition to the 21 diseases already linked to smoking.

Because it is unethical to direct people to start smoking for a study, the findings are observational and only prove a correlation, not causation. However, Carter has faith in the study because smoking is already known to create risk factors, such as a weakened immune system and artery disease, which contribute to the newly linked ailments.

Finally, the facts that heavier smokers were at a higher risk and that ex-smokers saw the dangers decrease over time added to Carter’s confidence in the study.

[New York Times]

TIME Smoking

Secondhand Smoke Exposure Gets Cut in Half

Secondhand Smoking
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But 1 in 4 nonsmokers is still being exposed

Secondhand smoke exposure in the U.S. fell by half between 1999 and 2012, according to a new study, but 1 in 4 nonsmokers, or 58 million Americans, is still being exposed.

Secondhand smoking is more heavily affecting children, with 2 in 5 children exposed, including 7 in 10 black children, the Centers for Disease Control and Prevention’s monthly Vital Signs report said Tuesday. More than 1 in 3 nonsmokers living in rental housing are being exposed to secondhand smoke.

While the CDC said in November that U.S. smoking rates are at a historic low — about 18% for 2013 — the agency also warned that any amount of secondhand smoke is unsafe. More than 400 infants and 41,000 adult nonsmokers are killed by secondhand smoking each year, according to CDC data.

TIME public health

Paying People Could Help Them Quit Smoking

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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 Research

What to Know About the Science of E-Cigarettes

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

A guide to understanding conflicting and ongoing research

Two Columbia University professors warned in a new study Thursday that the health fears over electronic cigarettes are hindering research. The very same day, another new study showed that smoking e-cigs, or “vaping,” can produce cancer-causing formaldehyde.

Clearly there’s some disagreement among scientists about the risks and benefits of a product that’s growing in popularity. Here’s what you need to know about the latest science.

What’s with the latest disagreement?

Columbia public health professors Amy Fairchild and Ronald Bayer argue in Science magazine that the staunchest opponents of electronic cigarettes are so concerned about the potential downsides that they advocate for an anti-e-cigarette regulatory and research approach that may be bad for public health. This approach of “deep precaution,” they argue, “has served as a kind of trump argument, hostile to the notion of trade-offs, seeing in them perilous compromise. Such a posture does not serve either science or policy well.”

MORE The Future of Smoking

It “may be years before the disagreements over the evidence” about the effects of electronic cigarettes can be resolved, Fairchild and Bayer wrote. On the one hand, electronic cigarettes may serve as gateway drugs for young people to start smoking cigarettes, and “dual” use of electronic cigarettes with tobacco cigarettes may stop some smokers from quitting. Electronic cigarettes may also carry unknown health consequences of their own. On the other hand, they may provide harm reduction for people who have been unable to quit any other way.

Given these two competing possibilities, the authors argued that the best formula for public health is to acknowledge the possibility for costs and benefits and to push for a regulatory scheme that is flexible enough to account for both outcomes. It is better to make public policy and execute scientific research under the assumption that e-cigarettes could bring good as well as bad.

But also on Thursday, the New England Journal of Medicine published a new study reporting that chemicals inside e-cigarettes—like propylene glycol and glycerol—can produce a type of the cancer-causing chemical called formaldehyde when heated during the vaping process. The researchers report that when testing samples of the aerosol from vaped e-cigs, they found that the e-cigs can contain formaldehyde-releasing agents slightly different from regular formaldehyde, and that the levels are especially high when a user vapes at high voltages. Scientists don’t yet know if formaldehyde-releasing agents carry the same risk as pure formaldehyde, but the researchers said in their report that if they assume the substances do carry the same risks, then long-term vaping could be associated with a significantly higher risk for cancer compared to long-term smoking. The researchers said formaldehyde-releasing agents may actually burrow into the respiratory tract more efficiently than regular formaldehyde, though the observation wasn’t confirmed.

Are there other reasons experts are concerned?

There’s also debate over the safety of the liquid nicotine inside e-cigarettes. In April 2014, the Centers for Disease Control and Prevention (CDC) released a report showing what they called a “dramatic” rise in e-cigarette-related calls to U.S. poison centers. Calls went from one a month in September 2010 to 215 calls a month in February 2014, and more than half of the calls involved children age five and under. Forty-two percent involved people age 20 and older. Symptoms of liquid nicotine ingestion are known to be vomiting, nausea and eye irritation.

Researchers are also wary of the long term effects of inhaling propylene glycol, one of the main ingredients in e-cigarettes. The jury is still out, but some physicians are concerned. “As for long-term effects, we don’t know what happens when you breathe the vapor into the lungs regularly,” Thomas Glynn, the director of science and trends at the American Cancer Society, told ABC News. “No one knows the answer to that.”

Are they really attracting young people?

Several recent—but fairly small—studies say yes. A December 2o14 study in the journal Pediatrics surveyed 1,941 Hawaii high school students and found that about 17% of the high schoolers smoked e-cigarettes only, 12% smoked both e-cigarettes and conventional cigarettes, and only 3% smoked conventional cigarettes. The findings suggested that kids who smoked e-cigarettes scored lower on outside risk factors to pick up a conventional smoking habit. “The fact that e-cigarette only users were intermediate in risk status between nonusers and dual users raises the possibility that e-cigarettes are recruiting medium-risk adolescents, who otherwise would be less susceptible to tobacco product use,” the authors wrote. Numbers released in 2013 from the National Youth Tobacco Survey showed that the percentage of middle school and high school students who have tried e-cigarettes doubled from 3.3% in 2011 to 6.8% in 2012.

What’s the argument in favor of e-cigarettes?

Some smokers use e-cigarettes to help them curb their traditional cigarette habit, or even quit. An August 2014 study that surveyed over 20,000 Americans showed that among adults who used a product to help them quit smoking, 57% chose e-cigarettes. That’s compared to the 39% who used prescription drugs like Chantix and the 39% who used other over-the-counter methods like patches or nicotine gum. Another study from July 2014, which reviewed 80 studies on e-cigarettes’ safety and their effects on users, revealed that not only can e-cigarettes help smokers quit, but they are less harmful to smokers and bystanders’ health compared to regular cigarettes.

What’s the FDA doing about it?

The U.S. Food and Drug Administration (FDA) only regulates e-cigarettes that are marketed for therapeutic purposes, though the agency has proposed a rule that would give it more regulatory power over e-cigarettes but that has not yet been implemented. The FDA has suggested a ban on sale of e-cigarettes to minors, and admits that there is a lot consumers don’t know about the product like whether they attract kids and teens or just how much nicotine is inhaled when a person vapes.

TIME Smoking

E-Cigarettes May Be More Toxic Than Tobacco, Researchers Say

A patron demonstrates an e-cigarette at Vape store in Chicago, April 23, 2014.
Nam Y. Huh—AP

Study finds five to 15 times more formaldehyde in vapour than tobacco smoke

Formaldehyde, a known human carcinogen found in cigarette smoke, also dwells in the vaporized liquid of popular electronic or e-cigarettes, researchers said Wednesday.

E-cigarette sales are booming in the United States and many hoped so- called “vaping” would replace tobacco smoking and be a panacea for the nearly 160,000 lung cancer deaths associated with conventional cigarettes.

But according to an analysis published Wednesday in the New England Journal of Medicine, the exposure to formaldehyde from e-cigarettes, based on similar chronic use as tobacco, could be five to 15 times higher than from smoking cigarettes…

Read the rest of the story from our partners at NBC News

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.

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