TIME Companies

CVS Health Leaves U.S. Chamber of Commerce Over Smoking Spat

CVS
Ben Torres—Bloomberg/Getty Images A CVS store in Dallas in 2014.

The pharmacy says the Chamber's efforts to target anti-smoking laws abroad runs counter to CVS's efforts to promote better health

CVS Health is quitting the U.S. Chamber of Commerce because of the trade group’s purported efforts to lobby against anti-smoking laws in countries around the globe.

The drugstore and pharmacy benefits manager, which last year stopped selling cigarettes and other tobacco products at its stores in a quest to become more of a healthcare destination, said the chamber’s lobbying efforts were not compatible with CVS’s mission to promote and facilitate better health.

“We were surprised to read recent press reports concerning the U.S. Chamber of Commerce’s position on tobacco products outside the United States,” David Palombi, a senior vice president at CVS, said in a statement on Tuesday to several media outlets. “CVS Health’s purpose is to help people on their path to better health, and we fundamentally believe tobacco use is in direct conflict with this purpose.”

CVS has 7,800 drugstores across the United States, with more retail spots to come shortly when it takes over Target’s pharmacy business. Last year, the company decided to stop selling tobacco products, which generated $2 billion a year in sales and a lot of shopper traffic, betting it could more than make up for the lost business by selling healthier foods, expanding its walk-in clinics business, and winning more pharmacy business. Last month, CVS Health gave Fortune a close-up look at its new post-tobacco retail strategy.

“Given the leadership position we took last year in removing tobacco products from our stores … we have decided to withdraw our membership in the chamber,” Palombi said.

Last week, the New York Times reported that the chamber and its foreign affiliates have been taking aim at restrictions abroad on smoking in public spaces, bans on menthol, advertising restrictions, and graphic warning labels. Cigarette sales have been in free fall in many developed countries, including the United States, for years, but have been strong in many developing countries.

The U.S. Chamber of Commerce responded to the New York Times story by saying it had made it clear to foreign governments that it supported their anti-smoking efforts.

“It’s disappointing that the New York Times gathered a number of letters the Chamber sent to governments around the world for its recent articles but then doesn’t seem to have bothered to read them. Our communications to governments concerning tobacco have explicitly made clear that we support their efforts to address public health concerns,” the Chamber said in a statement last week.

The Chamber on Tuesday said it nonetheless supports “protecting the intellectual property and trademarks of all legal products in all industries and oppose[s] singling out certain industries for discriminatory treatment.”

Its efforts earned it brickbats from the World Health Organization.

“By lobbying against well-established, widely accepted and evidence-based tobacco control public health policies, the U.S. Chamber of Commerce undermines its own credibility on other issues,” Margaret Chan, director general of the WHO, said in a statement on Tuesday to the Times. “So long as tobacco companies continue to be influential members of the chamber, legitimate businesses will be tarred with the same brush.”

This article originally appeared on Fortune.com

TIME Cuba

The Hazy Future for Cuban Cigars

TIME-Cuba-Cover
TIME

When long-forbidden Cuban cigars become more available to Americans, will they maintain their aroma of glamour?

From the new TIME special edition Inside the New Cuba. Pick up your copy in stores today. Digital edition available at TimeSpecials.com

If the opening to Cuba proceeds to its logical conclusion, it’ll be cigars all around. The island’s iconic product, forbidden as imports to the U.S. since 1962 by the economic embargo, long ago moved from sorely missed to the realm of nearly fetishistic obsession. After half a century, the hand-rolled House of Habano puros now appear to contain all that was just out of reach to Americans, as well as the flavor distinct to the soil of Pinar del Río, the southwestern province where the world’s most famous tobacco leaves are grown. The 100 million Cuban cigars sold worldwide count as one of the nation’s leading exports, up there with nickel and cane sugar, a crucial source of hard currency for a government that never figured out the economy.

It’s not just the distinctive taste. A great deal of both history and mystique gets wrapped up in the leaves assembled on the wooden tables where the tabaqueros famously sit in rows, facing the elevated platform where a lector reads a newspaper aloud, to occupy the mind while the fingers fly. A tour of the Partagás factory remains one of the tourist mainstays of Havana—state property since its building, farms and brands were appropriated, along with every other private concern, by a revolutionary government that over time actually managed to enhance the brand. Fidel Castro’s cigar was as much a part of his image as his fatigues, and far less egalitarian. The cigar was a Cohiba, a brand created specially for the upper echelons of the Communist elite (Che Guevara loved them too) before being marketed as a global label in 1982, three years before Fidel quit smoking.

The contradiction—elite taste vs. leveling ideology—never seemed to bother anyone; such was the power of a tradition that goes to the heart of Cuba’s appeal as a culture. The modern hotel where U.S. diplomats first openly met Cuban officials to discuss renewing relations was pleasant enough, but you only knew you were in Cuba within the dark wooden walls of its tobacco shop. Beside the door sits an elegantly groomed older man in a guayabera, Arnaldo Alfonso Ibáñez, rolling them fresh in Cohiba wrappers. He may have to pick up the pace. Under the new regulations published by the Obama administration, U.S. citizens can bring back up to $100 of tobacco (or alcohol) products. Should Congress vote to lift the embargo outright, Habanos, a 50-50 partnership of the Cuban state and a British firm, estimates that its sales would jump 70%.

And what would be lost? A certain cachet. Some memories. I learned to smoke on Cubans, two boxes I carried back to Washington from a visit to Havana in the late 1990s. It was good to start small—the Romeo y Julieta “Cedros”—and in the open air, to build up tolerance before moving on to the second box, Cohiba “Lanceros” so obviously counterfeit that the customs agent at the Dallas airport (“we just had a class on cigars”) handed them back to me, shaking his head. By the time I moved abroad, Havanas were about all you could buy in the duty-free humidors of the airports a foreign correspondent knows better than his own bed. I once expensed a box of Bolivar Gigantes after handing them out to help battle the stench on a Ugandan hilltop that produced not one but two mass graves; the accounting department put it through.

They also made great gifts, though it was a mistake not to tell a friend about the handful I’d tucked into his knapsack before driving him to the airport for his flight back to Los Angeles. A customs agent found them first and “cut them up there in front of me,” he reported later, not happy. He was a freelancer who wrote profiles for Cigar Aficionado, usually celebrities, some of whom would stay in touch after publication, calling him up when they got their hands on some Cubans. “The people who want ’em are getting them,” says Bill Sherman, grandson of the New York tobacconist who took in the owner of Partagás after he was driven out of Cuba. The Nat Sherman Townhouse sells its own brand, but a cabinet of 400 pre-embargo Partagás has pride of place in the members’ vault on 42nd Street in Manhattan, perhaps the largest stock in the U.S. of pre-Revolutionary cigars, a level of exclusivity that approaches either the effervescent or the ridiculous, depending. But there’s a reason for its following.

“What makes a Bordeaux from Bordeaux special?” Sherman asks. “You can’t take a Bordeaux seed and plant it in Napa Valley and get the same wine. It’s the soil, the sun, the climate.” Still, over the years, California has managed some superior varietals of its own, as drinkers grew more sophisticated and learned to trust their own tastes. Something like that may happen if Cubans hit the States.

“I gotta tell you, as a retailer, I’m ecstatic. We’ll be selling them,” Sherman says. But without the mystique of the forbidden, Cubans will have to earn their place in the pantheon. “You go to Spain,” he notes, “and Cuban cigars are less expensive than Domincans.”

From the new TIME special edition Inside the New Cuba. Pick up your copy in stores today. Digital edition available at TimeSpecials.com

TIME White House

Why It Matters if Obama Smokes (and Why It Doesn’t)

President Barack Obama speaks during a news conference after meeting with Gulf Cooperation Council leaders and delegations at Camp David in Maryland.
Pablo Martinez Monsivais—AP President Barack Obama speaks during a news conference after meeting with Gulf Cooperation Council leaders and delegations at Camp David in Maryland.

Since taking office in 2009, President Obama has aced three physicals. He regularly exercises, especially playing basketball, and has a personal chef — not to mention wife — who ensure he eats healthy.

But he has one (potential) vice that keeps coming back up: smoking.

A photo posted on Instagram by a spokesman for Italian Prime Minister Matteo Renzi buzzed around the Internet this week because it appeared to show President Obama on an outdoor balcony at the G-7 summit holding what might be a pack of cigarettes. (Or might not.)

Talking #elmau #g7 #cosedilavoro #germania

A photo posted by Nomfup (@nomfup) on

The general public doesn’t care much. A 2009 poll by CNN found that most Americans’ views of the President aren’t affected by his struggle to quit smoking and only a third wanted to see him give up cigarettes completely.

The White House has typically responded by implying the President is free from his addiction.

Former White House spokesman Robert Gibbs said in December 2010 the President hadn’t smoked in “about nine months.” In 2011, First Lady Michelle Obama said the President hadn’t smoked in “almost a year,” saying his daughters had inspired him to kick the habit for good. After his 2014 physical, Obama’s personal physician said he “remains tobacco free.”

In a press briefing Wednesday, White House spokesman Josh Earnest said the object in Obama’s hands was not a pack of cigarettes. “It’s not,” he said, simply.

Obama clearly still struggles with his former habit, acknowledging that he chews Nicorette gum to quell his desire to smoke. But his previous statements that he’s given up cigarettes entirely raise questions when a photo like this surfaces. And when the White House avoids questions posed by TIME and other outlets about the President’s smoking habits, it allows rumors like this to fester.

In the end, it doesn’t matter that much. As a Washington Post writer noted, Obama has “the best health care and the lousiest gig in the world,” so if he chooses to light up from time to time, he’ll probably be just fine.

TIME China

China Launches Bid to Stub Out Smoking in Beijing

Offenders can be fined or even shamed

China launched an ambitious campaign to curb smoking in its capital city on Monday, with signs urging the masses against the habit and penalties ranging from fines to public shaming.

The rules prohibit smoking in public places like restaurants, hospitals, schools and hotels, Reuters reports, as well as in specific outdoor areas. Individuals who are caught violating the new restrictions will have to pay the equivalent of a $32.25 fine, and multiple offenders could have their names shamed on a government website. Businesses that don’t comply could face a fine of up to $1,600.

Stubbing out public smoking in China, the world’s largest tobacco consumer and home to more than 300 million smokers, has been on the agenda of health advocates for years.

[Reuters]

TIME tobacco

Big Tobacco Sues British Government Over Effort to Strip Logos From Cigarette Packaging

New laws would strip logos from cigarette packages

Tobacco companies are fighting a recently passed law that would strip logos and branding from cigarette packages to in order to make them less enticing to consumers in the United Kingdom.

Philip Morris International, which owns the Marlboro band, filed suit Friday in a British court seeking to stop regulators from imposing standardized packaging on cigarettes. Philip Morris argues that such regulations would unlawfully deprive the company of use its own trademarks.

“Countries around the world have shown that effective tobacco control can co-exist with respect for consumer freedoms and private property,” Philip Morris said in a statement.

Under the new law, traditional cigarette logos would be replaced with large, graphic health warnings. Australia enacted a similar law in 2012.

According to Philip Morris, Marlboro was the ninth most valuable brand in the world in 2014 with an estimated value of $67 billion.

TIME Research

The New Science of How to Quit Smoking

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Getty Images

Two studies shed light on promising new ways to make kicking the habit easier, using both biology and behavior

Studies show that most smokers want to quit. So why are some people more successful at cutting out nicotine than others? The latest studies looking at the brains and behavior of smokers may provide some explanations.

Some people may be hardwired to have an easier time giving up their cigarettes, suggests one new trial described in the journal Neuropsychopharmacology. It turns out that some smokers start out with a particularly rich network of brain neurons in an area called the insula, which regulates cravings and urges and communicates cues: like seeing a cigarette or smelling tobacco smoke, then wanting to light up. Joseph McClernon, an associate professor of psychiatry and behavioral sciences at Duke University School of Medicine, ran MRI scans of 85 smokers who puffed more than 10 cigarettes a day. The smokers were then randomly assigned to continue smoking their brand or to smoke low-nicotine cigarettes, along with nicotine replacement therapy, for 30 days. All of the people in the study were then told to stop smoking and given nicotine replacement for 10 weeks.

MORE The Best Way to Quit Smoking Isn’t E-Cigs

Those who relapsed during that time tended to have lower activity in the insula, particularly in the connections between the insula and other motor areas that translate cravings into action, while those who successfully kicked the habit showed more robust activity in this brain region. The pattern remained strong despite how many cigarettes the smokers smoked.

“We’ve known for a while that some people seem to be able to quit and other people can’t,” says McClernon. “This gives us a better sense of what neural mechanisms might underlie those differences.”

The results suggest that it might be possible to identify people who may have a harder time quitting—a quick MRI scan of their brains would reveal how much activity they have in their insula—and provide them with more support in their attempts to quit. “Some smokers might benefit from more intensive, longer duration or even different types of interventions to stop smoking,” says McClernon. “They might need a higher, different level of care to help them make it through.”

But how much this system can be manipulated to help smokers quit isn’t clear yet. Previous studies show how potentially complicated the insula’s connections may be—smoking patients who have strokes and damage to the insula suddenly lose their desire to smoke and quit almost cold turkey. McClernon believes that the richer connections may not only promote interactions between cravings and behavior, but also enhance the connections that can inhibit or suppress those urges as well. Having a more intense communication in the insula may help strengthen the ability to quiet urges and inhibit the desire to smoke, despite cues and the urge to light up.

MORE Taking Medication May Make It Easier to Quit Smoking

But even if you’re not blessed with a brain that’s wired to make quitting easy, you still have options. In another study, published in the New England Journal of Medicine, scientists studied one of the oldest and most reliable ways to motivate people: money. In that trial, Dr. Scott Halpern from the University of Pennsylvania and his colleagues assigned 2,538 employees of CVS Caremark to one of five different smoking cessation programs. All received free access to nicotine replacement and behavioral therapy, and some were also assigned to an individual reward program in which they could earn up to $800 if they remained abstinent at six months. Another group was assigned another individual deposit program which was similar, except they had to pay $150 to participate, which they got back if they remained abstinent. Others were assigned to group versions of the reward and deposit programs so that what they received depended on how many in their group quit successfully.

Not shockingly, more people who were assigned to the reward program (90%) agreed to participate than people who were assigned to the deposit strategy (14%), likely because most people weren’t wiling to put their own money on the line. But when Halpern looked more closely at those who did enroll, the smokers in the deposit programs were twice as likely to be abstinent at six months than those in the reward group and five times as likely to be smoke-free than those who received only free counseling and nicotine replacement.

MORE Paying People Could Help Them Quit Smoking

That’s not entirely surprising, says Halpern, since having some of their own money at risk provided more motivation for the smokers to quit. When it comes to incentivizing smoking cessation, “adding a bit of stick is better than having just a pure carrot,” he says.

Finding the perfect balance of stick and carrot, however, may be more challenging. Halpern believes that from the perspective of an employer, insurer or government, offering even higher rewards than the $800 in the study and lowering the deposit slightly might still provide benefits to all parties. Smokers cost an average of $4,000 to $6,000 more each year in health services than non-smokers, he says, so offering even as much as $5,000 can still result in cost savings for employers, many of whom are now dangling financial incentives in front of their smoking employees to motivate them to quit.

How the financial carrot is proffered is also important, says Halpern. Now, most employers or insurers reward quitting in more hidden ways, with bonuses in direct deposit accounts or with lower premiums. While helpful, these aren’t as tangible to people, and humans respond better to instant gratification. “They’re rewarding people in ways that are essentially blind to the way human psychology works,” he says. “The fact that the benefits occur in the future make them a whole lot less influential than if people were handed money more quickly. Our work suggests that in addition to thinking about the size of the incentive, it’s fundamentally important to think about how to deliver that money.”

Another factor that can make financial incentives more powerful is to make the experience more enjoyable, either by introducing some competition in a group setting or encouraging smokers along the way. In the study, smokers in the group programs were not any more successful than those in the individual regimes, but that may be because the employees didn’t know each other. Grouping colleagues in the same office might have more of an effect, says Halpern. Either way, he says, incorporating such incentives to help more people quit smoking is “really a win-win.”

Read next: The Best Way to Quit Smoking Isn’t E-Cigs

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TIME medicine

The Best Way to Quit Smoking Isn’t E-Cigs

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Peter Dazeley—Getty Images

In the latest in-depth review of studies investigating which smoking cessation methods work best, experts say there isn’t enough evidence to support using e-cigarettes to kick the habit

The U.S. Preventive Services Task Force, a government-convened group of experts, says that if you want to quit smoking, you’re better off with drug-based methods, behavior modification programs or a combination of both—not puffing on e-cigarettes. There isn’t enough evidence to support claims that e-cigs, which have been touted as the latest way to wean people off tobacco, can actually help people quit.

The task force focused on studies that investigated how effective various smoking cessation methods are, for both adults and pregnant women. Drugs that address nicotine’s effects on the body, as well as nicotine replacement options, are better ways to quit, and the data suggest that they are even more effective if used together. In addition, behavioral interventions, including support groups and counseling sessions, can boost quit rates from 7-13% compared to rates of 5-11% among those who don’t use them.

MORE: E-Cigs Are Smokers’ Favorite Quitting Tool

“We have an embarrassment of riches in terms of a menu of things to offer patients who want to quit smoking,” says Dr. Francisco Garcia, director and chief medical officer of the Pima County Health Department in Arizona and member of the task force. “But every individual is different; some might respond better to behavioral therapy, some might respond better to varenicline, some might feel nicotine replacement is important to bridge them away from tobacco use.” For most people, it’s a matter of discussing with the smoker which method has the most appeal, and which one they are more likely to stick with long enough to go smoke-free.

But for certain populations, there isn’t enough data to support one strategy over another. Among pregnant women, for example, there haven’t been many studies to show how drug-based methods might affect the developing fetus, so it’s hard to determine if the benefits of quitting outweigh he risks represented by the medications. So for now, the task force advises that pregnant women rely on behavioral, non-drug strategies to help them stop smoking.

MORE: This Is The New Best Way to Quit Smoking, Study Finds

And for e-cigarettes, the data is sparse. The panel concluded that there was “insufficient” evidence to determine whether e-cigarettes improve or hinder quit rates.

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 Governor 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 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 Baseball

The San Francisco Giants Could Become the First MLB Team to Ban Chewing Tobacco

Minnesota Twins v San Francisco Giants
Brace Hemmelgarn—Getty Images A general view of the exterior of AT&T Park following the game between the San Francisco Giants and the Minnesota Twins on May 23, 2014 in San Francisco, California.

Players have been dipping for as long as anyone can remember, but that could soon change

A San Francisco city ordinance could make the Giants the first team in Major League Baseball to ban chewing tobacco on the field.

City supervisors voted unanimously on Tuesday to ban smokeless tobacco in playing fields throughout the city and specifically targeted baseball—a sport infamous for the player’s use of tobacco, according to a statement from the Campaign for Tobacco-Free Kids, which pushed for the law.

The ordinance must pass one more vote and, if San Francisco Mayor Ed Lee signs, the rule will be implemented on Jan. 1 2016—in time for the MLB baseball season.

Jess Montejano, a legislative aide for the ban’s chief sponsor, Supervisor Mark Farrell, told TIME that legislators began working on the ordinance in the beginning part of 2015 because “it’s a serious health issue” in which “kids are seeing their athletic heroes chewing tobacco on the baseball diamond.”

Montejano also added the San Francisco Giants “are fully aware of the intention” and that proponents of the ban believed the team would support MLB’s stance on the issue of chewing tobacco.

After the law was initially proposed in late Feb., MLB issued a statement saying that it “has long supported a ban of smokeless tobacco at the Major League level” and that it had been seeking “a ban of its use on-field in discussions with the Major League Baseball Players Association.”

A study published April 10 from the University of California San Francisco suggested that seeing players chewing tobacco was akin to product endorsement. It found that “modeling of smokeless tobacco use by…elite athletes is strongly associated with smokeless tobacco initiation among adolescent males.” The study also cited an NCAA statistic that found that 52.3% of collegiate baseball players tried smokeless tobacco at least once in 2012 to 2013.

When asked if the ban would essentially force players to quit, Montejano cited former MLB pitcher Curt Schilling, who blames tobacco for his mouth cancer. “Schilling said it was the worst thing about his life and if he could change one thing from his younger years it would be to quit.”

TIME medicine

Smokers Don’t Think a Few Cigarettes Will Harm Their Health

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Nearly everyone knows that smoking is harmful for your health. But some refuse to admit that their habits may be killing them

Heart disease, lung cancer, throat cancer, diabetes—the list of bad things that smoking does to your health is long and growing longer. Thanks to public health warnings and education campaigns, most of us have heard that cigarettes can be dangerous to your wellbeing and can shorten your life.

But one group who should be getting that message loud and clear may be in a bit of denial. In a study of more than 1,600 French smokers and non-smokers, 34% said that lighting up 10 cigarettes a day would not put them at higher risk of lung cancer. And fewer than 40% knew that their risk of lung cancer wouldn’t disappear if even if they quit smoking. The results were presented at the European Lung Cancer Conference in Geneva, Switzerland.

“The fact that one third of subjects wrongly considered that a daily consumption of up to 10 cigarettes was not associated with any risk of lung cancer is particularly impressive and threatening,” writes study author Dr. Laurent Greillier from Aix Marseille University in response to questions about the findings.

The results were especially worrisome since the participants in the study were 40 years old to 75 years old and therefore spent most of their adult lives hearing strong public health warnings about the dangers of smoking. That means that while anti-smoking campaigns have been effective, they may not have educated people deeply enough about the dangers of tobacco. That’s especially true for people who engage in what they consider to be “safe” or “light” smoking, the study finds. “Our results suggest that public health policies must continue to focus on the tobacco pandemic, and notably initiate campaigns concerning the risk of any cigarette,” says Greillier.

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