Tobacco.org

• Anti-Smoking Lawsuit Takes New Turn 

After a 2007 landmark court decision that recognized the cause-and-effect relationship between smoking and cancer, anti-smoking crusaders have been rearranging their focus to address the additives contained in cigarettes. This time, a court is showing renewed interest in the issue amid a growing public awareness over the harmful effects of smoking.

The legal battle dates back to 1999 when a group of lung cancer patients and distraught families filed a damages suit against KT&G, Korea's largest tobacco company by sales volume.

It took the court eight years to reach the conclusion that smoking can cause lung cancer but denied a request for compensation, stating that it couldn't be ruled out that other factors besides smoking had caused their affliction.

Now, the families and victims, supported by a group of lawyers, are changing their tack, claiming that KT&G uses additives to make cigarettes more addictive, and therefore more difficult quit.

For the first time, the presiding judge in the appeal case visited the KT&G factory to conduct an on-site inspection.

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• Swedish Match under fire in secret snus substance investigation  

Tobacco company Swedish Match has been accused of adding a substance to moist snuff or 'snus' to purposely increase user dependency and, in turn, boosts sales of their products.

Since 2005, the company has introduced eight new snus products with higher than average nicotine levels.

The usual level for snus is eight milligrams per gram. In one product, levels have almost doubled that figure.

”Certain consumer groups have shown demand for a high nicotine content,” the company’s production director Torbjörn Åkeson explains.

Allegations that the company adds a substance, known as E500, to purposely increase the amount of so-called ‘free’ nicotine – which increases dependency – are presented in a new report by investigative news programme Kalla Fakta. . . .

Yet, Professor Greg Connolly at the Harvard School of Public Health believes that Swedish Match is consciously using the substance to increase addiction and their profits.

”In a study in 2008 he concluded that we are manipulating the pH value, something that we consider hugely speculative,” Brehmer adds.

”It never led to demands from any authority that we need to change something.”

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• Nicotine Tob Res -- Table of Contents (October 2009, 11 [10]) 

• AUDIO: The link between smoking and darker skin  

new research says just how addictive smoking is for you depends on the color of your skin. "Living on Earth's" Ike Sriskandarajah filed this report.

Dr. Gary King from Pennsylvania State University studied nicotine -- the highly addictive stimulant that makes people crave cigarettes -- and melanin, a compound your body makes that determines how dark you are. And he found a connection.

According to Dr. King, the melanin is strongly attracted to nicotine, and the way it works is when you light up a cigarette, the tobacco and all the chemicals created when it burns into your mouth, into your lungs and the rest of your organs, including your biggest organ ... skin.

"Skin does react like every other organ in the body unto nicotine and the other 4,000 chemicals that are consumed when one actually smokes," said Dr. King. "And that binding process in and of itself may lead to greater dependence."

Inhaling thousands of chemicals is not a good idea. But it is especially bad for people with dark, melanin-rich skin. That's because melanin grabs and hangs onto the nicotine.

Greater dependence means it's much harder for darker skinned people to kick the habit. In fact white smokers on average are 15 percent better at quitting than blacks. . . .

Which is why Dr. King's next step is to survey dark and light skinned people all over the world. His findings are based on a pretty small sample -- 150 subjects, all of whom are African American.

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• Smoking Cessation During Substance Abuse Treatment 

Conclusions

Many individuals in substance abuse treatment are quite willing and able to quit smoking with the assistance of pharmacological and behavioral support. Although absolute quit rates tend to be lower for smokers who are in treatment than for those in recovery from alcohol and other substance use disorders, smoking cessation interventions are effective for both groups and do not appear to increase the risk of relapse to alcohol and other drug use.

Some individual and organizational barriers need to be overcome to improve smoking cessation outcomes among those in substance abuse treatment. However, the available research as well as our own experience suggest that quitting smoking during substance abuse treatment is indeed achievable--in other words, a mission possible.

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• Women and Smoking: An Interdisciplinary Examination of Socioeconomic Influences  

• Research shows temptation more powerful than individuals realize 

Whether it's highlighted in major news headlines about Argentinean affairs and Ponzi schemes, or in personal battles with obesity and drug addiction, individuals regularly succumb to greed, lust and self-destructive behaviors. New research from the Kellogg School of Management examines why this is the case, and demonstrates that individuals believe they have more restraint than they actually possess--ultimately leading to poor decision-making.

The study, led by Loran Nordgren, senior lecturer of management and organizations at the Kellogg School, examined how an individual's belief in his/her ability to control impulses such as greed, drug craving and sexual arousal influenced responses to temptation. . . .

In developing their case, the study's authors cited previous research demonstrating that people often have difficulty appreciating the power of impulsive states. People in a "cold state" (not experiencing hunger, anger, sexual arousal, etc.) tend to underestimate how a "hot," impulsive state will influence their behavior. To expand upon these findings, the study authors set out to test whether:

* People in a cold, non-impulsive state will overestimate their ability to control impulses

* People in a hot, impulsive state will have a more realistic view of their capacity for impulse control

* People who perceive they have a high capacity for impulse control will expose themselves to more temptation and will ultimately exhibit more impulsive behavior

To test their hypotheses, the researchers conducted four experiments focusing on hunger, addiction and mental fatigue. Each experiment resulted in significant "restraint bias."

For example, one experiment focused on cigarette addiction found those who overestimated their capacity for self-control were much more likely to smoke a cigarette after simply watching a movie about smoking. Another experiment centered on hunger. Results found a satiated group was significantly less likely to return snacks than a hungry group who limited their temptation by choosing less appealing snacks.

"A system which assumes people will control themselves is going to fall prey to this restraint bias; we expose ourselves to more temptation than is wise, and subsequently we have millions of people suffering with obesity, addictions and other unhealthy lifestyles," said Nordgren. "And, while our study focused on personal behaviors like smoking and eating, it is easy to apply our findings to a broader context. Understanding the power of temptation, you might also ask about the extent to which we need oversight or regulatory guidelines for business and political leaders."

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• Defeating nicotine's double role in lung cancer 

A lung cancer treatment that inhibits nicotine receptors was shown to double survival time in mice, according to Italian researchers.

The results of the early phase animal model study were reported in the June 15 issue of the American Journal of Respiratory and Critical Care Medicine.

Changes in genes encoding nicotine receptors are strongly associated not only with the tendency to smoke, but with susceptibility to lung cancer. Nicotine exposure also heightens the expression of the nicotine receptors, which leads to increased cell proliferation and inhibition of apoptosis, further setting the stage for cancer. . . .

John Heffner, M.D., past president of the ATS stated that "this research clearly has profound clinical implications regarding the role of nicotine in stimulating lung cancer and nicotine receptor antagonists in treating the disease. The highly addictive nature of nicotine, however, complicates patients' ability to quit smoking and avoid ongoing nicotine exposure."

"This [addictive nature of nicotine] underscores the importance of potential FDA regulation of nicotine in tobacco products to limit exposure to this drug that promotes tumor growth," wrote Dr. Spindel.

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• Table of Contents (August 2009, 11 [8]) 

• HUGHES: You can escape the ciggy siren's song, not its silence 

I have a confession to make. Ten years after giving up smoking I have started the wretched habit again. And it's not just the occasional puff. Rather, it's the full-on 15-a-day craving-led nicotine addiction that I swore blind to rid myself of forever a decade ago.

I kept my promise faithfully for more than 3,600 days so why did I relapse? Why have I gone back to almost kippering myself on a daily basis when just a few weeks ago I found the smell chokingly repugnant?

Quite simply, Beijing seduced me like a sexy siren.

Within one week of stepping off the plane, I tentatively, guiltily accepted the offer of a splendidly-branded Craven A from a colleague after watching him inhale with an almost beatific look of pleasure following a fine meal washed down with plenty of thirst-quenching beer. I must admit when I lit up it felt good. It was as if I had breathed new life into the ghost of my old addiction. . . .

discovering how incredibly cheap they are here. My chosen brand cost 5 yuan. Back home in the UK they are more than 10 times that. Only a serious addict would fork out so much at that price.

Then there is the near ubiquitous tolerance of smoking here. . . .

In London, I didn't smoke at home because I had young children. A smoking ban in bars and restaurants was rigidly enforced. At work you had to leave the office . . .

However, the government, despite receiving mountains of excise revenue from the habit, has been trying to discourage it.

Smoking is banned inside all public buildings in Beijing. Just this week, it was announced the government had raised consumption tax on cigarettes by between 6 and 11 percent both to curb smoking and add revenue to state coffers.

But there has not yet been a seismic shift in society's laissez-faire attitude to smokers and smoking and, until there is, it is a habit that will not be stubbed out.

Now, excuse me, sucker that I am, while I nip out to satisfy my craving.

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• Nicotine Receptors Could Be Lung Cancer Treatment Target 

In a study of mice with lung cancer, a treatment that targeted nicotine receptors more than doubled the animals' survival time, Italian researchers say.

Nicotine plays a dual role in lung cancer. Changes in genes encoding nicotine receptors not only drive the urge the smoke, but also increase susceptibility to lung cancer. Exposure to nicotine boosts the expression of nicotine receptors, which leads to increased cell proliferation and inhibits the programmed cell death known as apoptosis.

In the new study, published in the June 15 issue of the American Journal of Respiratory and Critical Care Medicine, the compound α-CbT dampened the expression of nicotine receptors and increased apoptosis, prolonging the lives of the mice.

"This research clearly has profound clinical implications regarding the role of nicotine in stimulating lung cancer and nicotine receptor antagonists in treating the disease," said Dr. John Heffner, past president of the American Thoracic Society, in a news release from the society. Heffner, who was not involved in the research, added, "The highly addictive nature of nicotine, however, complicates patients' ability to quit smoking and avoid ongoing nicotine exposure."

Previous research has shown that it's possible to dampen the response of nicotine acetylcholine receptors (nAChRs) using an antagonist called d-tubocurarine/α-Cobratoxin (α-CbT), which specifically targeted the area most linked to increased cell growth.

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• Christopher Caldwell - Addicts have made a choice 

We have a justice system that treats drug use as a malevolent act of will (to be punished) and a medical profession that treats it as an unfortunate disease (to be cured). Who is right? In a magnificent new book, Addiction: A Disorder of Choice , Gene M. Heyman, a lecturer in psychology at Harvard Medical School, argues that it is not his fellow medical professionals.

Addiction is voluntary. The idea that addiction is a “chronic, relapsing brain disease” may be well-meaning but it is false. “Everyone,” Mr Heyman writes, “including those who are called addicts, stops using drugs when the costs of continuing become too great.” We need to make clear, though, what Mr Heyman means by “voluntary”. He does not deny that addiction is an enormous problem that can wreck a life, or several. If you drive drunk or embezzle money to pay for your coke habit when you ought to be studying, the consequences can be permanent and devastating.

But addiction is not the kind of problem that most people think it is. It is not so very far from setting interest rates, devising depreciation schedules and other economic problems of “intertemporal choice”. It involves weighing the value of a current good (intoxication) against the value of various future ones that are shrouded in uncertainty. . . .

The centrepiece of the disease theory of addiction is philosophical, not scientific. It is that nothing that produces sub-optimal outcomes as consistently as addiction does can be freely chosen. “No one chooses to be an addict,” as the saying goes. Mr Heyman shows that this is wrong – or at least that this is the wrong way of getting at the problem.

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• People with Intellectual or Developmental Disabilities Particularly Vulnerable to Effects of Tobacco Use and Dependence 

While tobacco use is an ongoing health hazard for the entire population, its consequences for people with developmental or intellectual disabilities can be especially severe. And the medical community often tends to overlook the tobacco-related burdens these people face. An extensive review of published research on this topic appears in the June edition of the journal Intellectual and Developmental Disabilities.

“This is too important an issue to ignore,” said Dr. Marc L. Steinberg, an assistant professor of psychiatry at the UMDNJ-Robert Wood Johnson Medical School and the article’s lead author. “Health care professionals often do not ask these individuals about tobacco use or exposure.”

Steinberg and his co-authors report that they were able to identify several negative implications of tobacco use that are unique to this population group: . . .

• People with developmental or intellectual disabilities are three times more likely to live in poverty, making them more susceptible to financial distress from tobacco use.

• Tobacco use may decrease the effectiveness of some medications commonly prescribed to this population group.

• Ironically, many of these individuals became addicted to tobacco at the hands of the very institutions that are meant to help them. In the past, hospitals and facilities treating vulnerable populations have even given cigarettes as good behavior ‘rewards’ to mentally ill patients and to those with developmental or intellectual disabilities.

• On the rare occasions when individuals in this population gain access to tobacco treatment programs, they still may “fall through the cracks” because they have difficulty understanding the health information presented to them.

“Like any other patients, this population should be offered resources for quitting if they smoke and offered protection from environmental tobacco smoke if they do not,” said Steinberg.

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• Shoveling Up II: The Impact of Substance Abuse on Federal, State and Local Budgets 

NEW CASA REPORT FINDS FEDERAL, STATE AND LOCAL GOVERNMENTS SPEND ALMOST HALF A TRILLION DOLLARS A YEAR ON SUBSTANCE ABUSE AND ADDICTION OF EVERY FEDERAL AND STATE DOLLAR SPENT, 96 CENTS GOES TO SHOVEL UP WRECKAGE OF ILLNESS, CRIME, SOCIAL ILLS; ONLY 2 CENTS GOES TO PREVENTION AND TREATMENT . . .

Substance abuse and addiction cost federal, state and local governments at least $467.7 billion in 2005, according to Shoveling Up II: The Impact of Substance Abuse on Federal, State and Local Budgets, a new 287-page report released today by The National Center on Addiction and Substance Abuse (CASA) at Columbia University.

The CASA report found that of $373.9 billion in federal and state spending, 95.6 percent ($357.4 billion) went to shovel up the consequences and human wreckage of substance abuse and addiction; only 1.9 percent went to prevention and treatment, 0.4 percent to research, 1.4 percent to taxation and regulation, and 0.7 percent to interdiction.

The report, based on three years of research and analysis, is the first ever to assess the costs of tobacco, alcohol and illegal and prescription drug abuse to all levels of government. Using the most conservative assumptions, the study concluded that the federal government spent $238.2 billion; states, $135.8 billion; and local governments, $93.8 billion, in 2005

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• Drug Abuse-Related Government Spending Hit $468 Billion, Report Says 

Government spending related to smoking and the abuse of alcohol and illegal drugs reached $468 billion in 2005, accounting for more than one-tenth of combined federal, state and local expenditures for all purposes, according to a new study.

Most abuse-related spending went toward direct health care costs for lung disease, cirrhosis and overdoses, for example, or for law enforcement expenses including incarceration, according to the report released Thursday by the National Center on Addiction and Substance Abuse . . .

The study is the first to calculate abuse-related spending by all three levels of government.

"This is such a stunning misallocation of resources," said Joseph A. Califano Jr., chairman of the center, referring to the lack of preventive measures. "It's a commentary on the stigma attached to addictions and the failure of governments to make investments in the short run that would pay enormous dividends to taxpayers over time."

Beyond resulting in poor health and crime, addictions and substance abuse -- especially alcohol -- are major underlying factors in other costly social problems like homelessness, domestic violence and child abuse. . . .

The new report cites the antismoking campaigns of the last several decades as a promising model: education, higher taxes and restrictions on smoking zones have cut the incidence of smoking by close to half, saving billions in costs. It called for similar efforts to curb under-age drinking and excess alcohol consumption by adults, using higher taxes on beer, for example.

Even with tobacco, far more could be done, according to the report, which noted that only a small fraction of the more than $200 billion the states have received since 1998 under the Multi-State Tobacco Settlement had gone to prevention of smoking.

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