Tobacco.org

• Seventy per cent of Bulgarian smokers wanted to quit, survey says  

More than 70 per cent of smokers in Bulgaria wanted to give up smoking, Yulia Medichkova of the Greenwild Foundation was quoted by Bulgarian news agency BTA as saying on November 19 2009.

Medichkova presented the results of a one-year campaign entitled The Culture of Breathing. Over 50 per cent of Bulgarians approved of increased restrictions on smoking that will be introduced by mid-2010. Bulgaria ranks third in the world in terms of number of smokers, after Japan and Greece, Medichkova said.

What was more worrying, according to another survey released by the Health Ministry on November 17 2009, was that every second pregnant woman in Bulgaria smoked during pregnancy.

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• Massachusetts' 'Model' Tobacco Cessation Benefit Spurs Unprecedented Drop in Smoking Rates, Heart Attacks, Asthma, and Birth Complications 

A "model" tobacco cessation benefit offered to Massachusetts' Medicaid participants has produced an astounding 26% drop in smoking rates in only two and a half years, and has already been linked to decreases in heart attacks, hospitalizations for asthma and COPD, and a significant decrease in birth complications.

Researchers from the Massachusetts Tobacco Cessation and Prevention Program (MTCP) found that up to 38% fewer MassHealth cessation benefit users were hospitalized for heart attacks in the first year after using the benefit, and that 18% fewer benefit users visited the emergency room for asthma symptoms in the first year after using the benefit. Researchers also found that there were 12% fewer claims for adverse maternal birth complications since the benefit was implemented.

The Massachusetts Executive Office of Health and Human Services said more than 75,000 people -- a full 40% of MassHealth members who smoke -- have used the benefit to try to quit smoking. Cost savings are being studied, and all indications suggest they will be significant.

"It is clear from these latest findings that the Commonwealth's efforts to help people quit smoking is a sound investment," Executive Office of Health and Human Services Secretary JudyAnn Bigby said. . . .

"As the nation debates the future of its health care system, the national significance of this research cannot be understated," said Robert J. Gould, PhD, President and CEO of Partnership for Prevention, a national organization that advances policies and practices to prevent disease and improve the health of all Americans. "These findings demonstrate that prudent investments in preventive health today will have a dramatic and positive effect on our health care system tomorrow."

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• With aid, Mass. poor cut smoking  

Lower income Massachusetts smokers have dramatically abandoned their habit amid a major state campaign that vigorously promotes and pays for tobacco addiction treatment, according to a report scheduled to be released this morning.

Smoking rates among the poor plummeted 26 percent in the first two years of the ongoing state program, a striking result that is already drawing national attention to the effort. Officials targeted a population that historically had the highest smoking rates in Massachusetts.

The study, issued by the Department of Public Health, found early indications that the tobacco cessation efforts - aimed at patients enrolled in the state’s medical insurance for the poor, MassHealth - are reaping immediate health benefits.

Once patients began receiving counseling and medications to help snuff out their habits, they made fewer trips to emergency rooms because of wheezing bouts of asthma, and there was a trend toward fewer life-threatening heart attacks.

The stop-smoking initiative, which covers virtually all the costs of cessation counseling and drugs, was ordered by the Legislature as part of the landmark health care overhaul in 2006 with a dual purpose: saving lives and money. National health leaders plan to point to the Massachusetts experiment to bolster efforts to expand tobacco cessation services as part of federal health care legislation.

“These findings are extraordinary - they have major public health implications as Congress is debating health care reform,’’ said Matthew Myers . . .

The expectation, based on the experience of other states and health plans, was that 5 to 10 percent of MassHealth patients who smoked might seek help in the first couple of years, Keithly said.

Instead, from July 2006 to May of this year, about 75,000 patients had used the services - two of every five MassHealth smokers.

“We wondered if this population would be interested in cessation,’’ said Dr. Nancy Rigotti, director of the Tobacco Research and Treatment Center at Massachusetts General Hospital. “It turns out they were interested - they just couldn’t afford it.’’

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• Dose-dependent Effects of Second-hand Smoke on Vascular Function  

Purpose

The purpose of this study is to determine the vascular effects of brief second-hand smoke exposure on normal healthy individuals. . . .

Despite evidence to suggest that secondhand smoke contributes to adverse cardiovascular outcomes, little is known about the dose-dependent vascular effects of brief secondhand smoke exposure at low doses commonly encountered in the community. This study will investigate the acute vascular effects and dose-dependent biological mechanisms of secondhand smoke on endothelial function and oxidative stress.

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• P.M. UPDATE: Cherokee Nation sponsoring tobacco cessation events  

TAHLEQUAH -- In an effort to keep area residents healthy, Thursday, has been designated as Great American Smoke-out Day in the Cherokee Nation. In honor of the event, the tribe is offering classes and incentives to help smokers and tobacco users stop for at least one day.

Cherokee Nation Healthy Nation will be celebrating the day by offering free cessation kits and prizes to all who commit to stop smoking and using tobacco for at least one day. Resources

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• 'Light' cigarette case going back to court 

The application for certification was filed by Ches Crosbie on behalf of Victor Todd Sparkes - the class action's representative plaintiff - against Imperial Tobacco Canada Ltd., Imperial Tobacco Company Ltd. and the Attorney General of Canada.

Sparkes' lawyers claimed the tobacco companies descriptions of "light" and "mild" as well as other descriptive terms were part of a deliberate misinformation campaign by the tobacco manufacturer to mislead and deceive the public into thinking the use of such products would have less harmful effects than smoking "regular" cigarettes.

But Supreme Court of Newfoundland and Labrador Justice James Adams said in 2008 the plaintiff failed to establish a cause of action under the federal Trade Practices Act. Adams denied the certification on the basis consumer Victor Sparkes did not buy the cigarettes directly from Imperial Tobacco. But the matter is being heard again by the Court of Appeal Wednesday and Thursday.

Crosbie argues people can't buy cigarettes directly from the supplier.

Lewis originally joined the class action because it sounded like his life story.

"We were blindsided. We were misled and taken advantage of. ... At the end of the day, I wanted to quit. I thought the switch to light cigarettes was going to help me take that edge off from smoking regular cigarettes," Lewis said.

"So they had me. I couldn't win."

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• Anti-smoking ads rekindle desire 

ADVERTISING encouraging people to quit smoking may be making it harder for quitters to stay on the wagon.

In the world's first long-term international study of people who have given up smoking, researchers found that respondents showed widespread resilience to cravings in the first 30 days.

But after that, cravings occurred more often in those reminded of smoking, by being exposed to stimuli such as friends who smoke or by viewing advertisements.

Ron Borland of Cancer Council Victoria, who co-wrote the study published in the international journal Addiction, said people who experienced long-term cravings were much less likely to kick the smoking habit.

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• Nabi makes deal for smoking vaccine 

The Rockville maker of an experimental nicotine vaccine has signed a licensing deal with pharmaceutical giant GlaxoSmithKline that could produce a huge payday if the anti-smoking drug can be successfully brought to market.

Nabi Bioparmaceuticals outlined the terms of the deal Monday. It said a unit of GlaxoSmithKline has agreed to pay $40 million initially for the exclusive worldwide licensing rights to the drug, called NicVax.

Nabi would receive additional money if it meets certain developmental and regulatory milestones, including the development of follow-up nicotine vaccines. Nabi would also earn double-digit royalties from sales if the product reaches the market.

All told, Nabi could collect more than $500 million from the development and sale of the vaccine and its successors, the company said.

"It's the biggest deal we've ever had," said Raafat Fahim, Nabi's president and chief executive. He added that NicVax would become the company's flagship product if it successfully passes final rounds of testing.

Nabi says its vaccine causes a body's immune system to produce antibodies that bind to nicotine molecules, making them too large to reach the brain's receptors.

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• UPDATE 2-Nabi, Glaxo sign nicotine-addiction vaccine deal  

* Nabi to get $40 mln upfront, total potential of $500 mln

* Deal expected to complete in Q1, 2010

* Nabi shares jump 26 pct (Adds details, share movement)

Nov 16 (Reuters) - Nabi Biopharmaceuticals (NABI.O) and a unit of GlaxoSmithKline Plc (GSK.L) signed a licensing agreement for Nabi's experimental vaccine to treat nicotine addiction and the prevention of smoking relapse, the companies said, sending Nabi shares up 26 percent.

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• Reynolds' pursuit of a company that promotes smoking cessation raises marketing question 

Trying to buy a company that specializes in products that help people quit smoking may seem like a radical change for Reynolds American Inc.

But analysts said yesterday that it all depends on how Reynolds would potentially use and market cigarette-replacement products in gum, pouch and spray form made by that company, Niconovum AB.

Media reports have said that Reynolds is close to buying Niconovum, of Helsingborg, Sweden, for $44.5 million. The reports are based on comments by David Sweanor, a law professor at the University of Ottawa and a tobacco analyst. Sweanor could not be reached for comment.

Reynolds said it is against its policy to comment on speculation. Niconovum officials could not be reached for comment. . . .

Niconovum was formed in 2000 by Karl Olov Fagerström, who is considered a leading expert on smoking cessation and nicotine dependence. It is managed by many of the individuals who were pivotal in the development of Nicorette, a nicotine-replacement gum.

Although some analysts view Niconovum's products as primarily smoking cessation, the company says on its Web site that it "believes that there is a market for a range of nicotine-replacement therapy products that will deliver nicotine more quickly and effectively than those currently available, thereby giving the consumer a perceived better control of cravings."

The evolution of some health-advocacy groups from anti-smoking to anti-tobacco is ratcheting up the moralistic aspect of buying and consuming a legal product.

Bill Godshall, the executive director of SmokeFree Pennsylvania, said he believes that smokers and public health could benefit if Reynolds buys Niconovum or its patents.

"Its smoke-free nicotine products are 99.9 percent less hazardous alternatives to cigarettes, pose no risks to nonusers, and appear to be more smoker friendly than similar products marketed as smoking cessation aids,'' Godshall said.

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• Will Cigarette Maker Reynolds Try Kicking the Habit?  

It would be either one of the most cynical diversifications ever--or a brilliant stroke of synergy.

If a report in The Wall Street Journal is correct, America's second-largest seller of cigarettes may soon be peddling products that help people quit smoking. The Journal reported on Nov. 9 that Reynolds American (RAI), the distributor of Pall Mall, Camel, and Natural American Spirit cigarette brands as well as smokeless tobacco, is in "advanced talks" with Niconovum, a Swedish manufacturer of nicotine replacement products such as gum and mouth spray. University of Ottawa law professor David Sweanor told the Journal he was briefed by people close to the deal.

The move would mark the first time that a big tobacco company also sold smoking-cessation products, according to industry analysts. But it would be in line with the industry's efforts to diversify as cigarette purchases shrink in the U.S. One analyst referred to a purchase of Niconovum as a "cheap hedge" against the smoking decline. . . .

But as Morningstar's Gorham points out, Reynolds can make far more money convincing people to smoke than helping them quit. The cost per unit to produce cigarettes is extremely low—operating margins average 25%-30% industrywide, he says, which is high for consumer goods. (Pepsi (PEP), by comparison, which enjoys enormous scale and volume operating margins, reaches into the high teens, according to Gorham.)

It's unlikely that returns from smoking-cessation products can compete with that anytime soon. "I think we're talking 20 years-plus at this point before tobacco sales are offset by other sources," says Gorham.

Indeed, some view any talks between Reynolds and Niconovum as more of a publicity stunt, designed to place Reynolds in a better light.

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• Down to the last cigarette - and beyond  

Like a fast-food chain selling diet supplements or a gasoline company building electric cars, a major tobacco company is eyeing a surprising business: Helping the smokers who buy their products kick the habit.

Reynolds American Inc. , which sells the Camel and Pall Mall brands of cigarettes, is in talks to buy a Swedish company that makes nicotine gum and mouth spray designed to help people quit smoking by reducing their cigarette cravings, according to a report in The Wall Street Journal.

Reynolds could buy Niconovum AB for roughly $44.5-million (U.S.), according to University of Ottawa law professor and tobacco expert David Sweanor, who said he had spoken with someone close to the deal. A spokesperson for Reynolds declined to comment.

The deal would also mark a shift for cigarette companies, many of which embraced diversification decades ago but have changed course in recent years. . . .

The acquisition of Niconovum would give Reynolds another cigarette alternative.

In addition to the gum and mouth spray, the Swedish company also makes a Snus-like product called the Zonnic pouch, which has nicotine but no tobacco. Many countries in the European Union as well as Australia and New Zealand, ban oral tobacco, Prof. Sweanor said. The pouch could give Reynolds a way around those regulations.

"I think this may be a very profitable business. They're catering to the same crowd, essentially," said Indiana University's Prof. Beneish, who was a smoker for 30 years. "They have a captive audience. Trust me."

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• Trial drug may help smokers kick butts 

STORY HIGHLIGHTS

* Drug maker given $10 million grant to take anti-nicotine vaccine to Phase III clinical trial

* "Smoker's high" comes from release of dopamine in brain, triggered by nicotine

* NicVAX stimulates immune system to prevent nicotine from entering brain

* In theory, it would help smokers quit for good by reducing pleasure

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• Reynolds in Talks to Buy Sweden's Niconovum  

Tobacco giant Reynolds American Inc. is in advanced talks to buy a Swedish maker of products that help people stop smoking, a move that could signal a profound shift in direction in the global tobacco industry.

Reynolds, the second-largest U.S. cigarette maker by sales, is near a deal to buy closely held Niconovum AB, according to David Sweanor, a Canadian law professor and tobacco expert who says he was briefed by people close to the deal.

Niconovum, based in Helsingborg, makes nicotine-replacement therapies such as Zonnic pouch and Zonnic gum. The company, whose products aren't currently sold in the U.S., was formed in 2000 by Karl Olov Fagerstrom, a leading expert in nicotine dependence who has been involved in such products as Nicorette gum.

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• State Medicaid Coverage for Tobacco-Dependence Treatments --- United States, 2007 

The prevalence of tobacco use among adults in the United States has been reduced by half since the 1960s (1,2). Despite this progress, low-income populations, such as Medicaid enrollees, continue to smoke at substantially higher rates than the general population (33% versus 20%) (1). The Public Health Service's Clinical Practice Guideline (2) and the Partnership for Prevention's Call for ACTTION (3) recommend comprehensive insurance coverage of tobacco-dependence treatments without barriers such as copayments, limitations in duration of treatment, prior authorization, and stepped-care therapy. Healthy People 2010 aims to expand coverage of evidence-based treatments for nicotine dependency to all 51 Medicaid programs (objective 27-8b) (4). To monitor progress toward that objective, in 2007, the Center for Health and Public Policy Studies at the University of California, Berkeley, surveyed all 51 Medicaid programs. This report summarizes the results of that survey, which found that 43 (84%) programs offered coverage for some form of tobacco-dependence treatment to Medicaid enrollees in traditional fee-for-service (FFS) Medicaid, with four Medicaid programs adding coverage since 2006 and 20 programs adding coverage in the past decade. Only two states (New Mexico and New Jersey) reported access to tobacco-dependence treatments without any limitations or restrictions. Of the 25 states covering pharmacotherapy for Medicaid enrollees in both FFS and managed-care organizations (MCOs), only 13 covered the same tobacco-dependence treatments for enrollees in both populations. Research demonstrates that providing access to comprehensive tobacco-dependence treatments increases quit rates. Providing Medicaid coverage for these treatments would ensure that all enrollees can access and benefit from these treatments.

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