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Massachusetts' Success in Helping Medicaid Recipients Quit Smoking Shows Why Congress Should Require Cessation Coverage in Health Reform 

Massachusetts today announced extraordinary results from its aggressive efforts to help Medicaid beneficiaries quit smoking by providing easy access to coverage for smoking cessation medication and counseling.

Massachusetts reported that smoking rates among beneficiaries in its MassHealth program plunged by 26 percent in the first two and a half years after the state began providing coverage of smoking cessation in July 2006. Costly medical procedures among those who utilized the cessation benefit also fell dramatically. Among benefit users, there were 38 percent fewer hospitalizations for heart attacks and 17 percent fewer emergency-room visits for asthma symptoms in the first year after using the benefit. There were 17 percent fewer claims for maternal birth complications since the benefit was implemented, state health officials reported.

Massachusetts is leading the way in demonstrating that health insurance coverage for smoking cessation quickly improves health and saves lives, and no doubt reduces health care costs as well.

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• Cigarettes harbor many pathogenic bacteria 

Cigarettes are "widely contaminated" with bacteria, including some known to cause disease in people, concludes a new international study conducted by a University of Maryland environmental health researcher and microbial ecologists at the Ecole Centrale de Lyon in France.

The research team describes the study as the first to show that "cigarettes themselves could be the direct source of exposure to a wide array of potentially pathogenic microbes among smokers and other people exposed to secondhand smoke." Still, the researchers caution that the public health implications are unclear and urge further research.

"We were quite surprised to identify such a wide variety of human bacterial pathogens in these products," says lead researcher Amy R. Sapkota, an assistant professor in the University of Maryland's School of Public Health.

"The commercially-available cigarettes that we tested were chock full of bacteria, as we had hypothesized, but we didn't think we'd find so many that are infectious in humans," explains Sapkota, who holds a joint appointment with the University's Maryland Institute for Applied Environmental Health and the department of epidemiology and biostatistics.

"If these organisms can survive the smoking process -- and we believe they can -- then they could possibly go on to contribute to both infectious and chronic illnesses in both smokers and individuals who are exposed to environmental tobacco smoke," . . .

The study will appear in an upcoming edition of the journal Environmental Health Perspectives. . . .

Sapkota's team took a more holistic approach using DNA microarray analysis to estimate the so-called bacterial metagenome, the totality of bacterial genetic material present in the tested cigarettes.

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The commercially-available cigarettes that we tested were chock full of bacteria, as we had hypothesized, but we didn't think we'd find so many that are infectious in humans. If these organisms can survive the smoking process -- and we believe they can -- then they could possibly go on to contribute to both infectious and chronic illnesses in both smokers and individuals who are exposed to environmental tobacco smoke.
Lead researcher Amy R. Sapkota, an assistant professor in the University of Maryland's School of Public Health, on the study that will appear in an upcoming edition of the journal Environmental Health Perspectives.

Cigarette stamps proposal not a done deal - Teves  

The proposal of Swiss firm SICPA Product Security SA to provide security stamps on cigarettes is not a done deal, Finance Secretary Margarito Teves said yesterday, assuring lawmakers that there was nothing final yet.

"It must be clarified that the SICPA (proposal) is merely an unsolicited proposal under the BOT (Build-Operate-Transfer) Law. It's not a done deal yet," Teves said.

He said that even if the Bureau of Internal Revenue (BIR) is already in negotiations with SICPA for its stamp-tax technology project, it would still be sent back to the National Economic and Development Authority (NEDA) for its board approval and subsequently, be subjected to a "Swiss Challenge."

"Processes must be observed before a decision on SICPA is made," he told reporters yesterday.

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EDITORIAL: Remember ‘blue seal’ cigarettes  

A SWISS company is proposing to put in place a system where tax stamps will be affixed on every pack of cigarette and every bottle of liquor to raise more revenues for the government.

The company, SICPA, wants to make it appear affixing stamps on highly taxable goods is a fool-proof way of curbing smuggling and tax evasion by manufacturers. The reality is that it is selling a fraudulent bill of goods.

It’s only about 20 years now that cigarettes and liquor have been free of the green BIR stamp on every pack . . .

SICPA claims its stamps cannot be counterfeited. In this land of fake peso bills, diplomas, passports and even visas, does SICPA really want us to believe its stamps could not be faked? Even a reasonable facsimile would do as in the previous experience with BIR stamps. The BIR stamps, it will be recalled, were also printed in security paper with watermark. A close look at the genuine BIR stamps and the fakes would show which was which. But to repeat, this did not discourage the smugglers.

But the biggest objection to the SICPA proposal is that it will raise prices by an estimated P1.50 a pack, a cost that will be passed on to consumers. Out of that P1.50, about P1 will go to the government and P0.50 to SICPA.

Given that kind of sharing, why does not the government simply increase the specific tax on cigarettes across-the-board by P1 a pack? The government collects the same revenues. The consumer gets a P0.50 break.

The only loser would be SICPA and, presumably, its sponsors who are ramming the proposal down the throat of the BIR.

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SICPA not a done deal, Teves tells solons  

Finance secretary Margarito Teves yesterday assured lawmakers that there is nothing final in the ongoing negotiations of the Bureau of Internal Revenue (BIR) with Swiss firm SICPA Product Security SA, stressing that a "process" has to be observed.

"It must be clarified that the SICPA (proposal) is merely an unsolicited proposal under the BOT (Build-Operate-Transfer) law. It’s not a done deal yet," Teves said.

He said even if the BIR wraps up its negotiations with SICPA for the latter’s stamp-tax technology project, the proposal would still be sent back to the National Economic Development Authority (NEDA) for board approval and subsequently be subjected to a Swiss Challenge.

"Processes must be observed before a decision on SICPA is made," he said. "It must be first accepted, approved and go through some more processes like getting NEDA board approval."

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Cigarette Tax Debate  

A proposed state initiative would increase cigarette taxes by 1 dollar a pack to provide more than 500 million dollars a year to prevent and cure cancer. Cigarette tax proposals in California tried before and failed, but the question, will this proposal help or hurt the bottom line...smokers?

Guests: For the Pro-Tax side, Paul Knepprath, an executive with the American Lung Association of California, which underwrote the survey... AND Grant D. Gillham, a Government Affairs Consultant in California for the nation's oldest tobacco company, Lorillard Tobacco Company.

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Butt out: Health agency kicking smokers out in Tumwater  

Smokers for a long time have been unwelcome in or near the doors of public areas, including state agencies.

But the new decree announced today (Wednesday) means that beginning in mid-May, visitors and state employees cannot use smokeless tobacco, cigarettes and other tobacco products at the state Department of Health's headquarters and campus in Tumwater.

A similar rule is in effect at the state's Public Health Lab in Shoreline, and next year it will apply to DOH's four buildings, parking lot, parking garage and grounds in Tumwater.

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EDITORIAL: Tobacco shakedown: It's not 'for the children'  

When the state attorney general fabricates an allegation to justify charging a person with criminal activity, everyone in the state ought to take note.

Attorney General Michael Delaney is pursuing a case against Tobacco Haven, a roll-your-own tobacco shop in Brookline. According to the Attorney General's Office, Tobacco Haven owes the state a whole bunch of back taxes on cigarette tobacco. Tobacco Haven says it doesn't because the tobacco in question is for pipes, not cigarettes. Cigarette tobacco is taxed; pipe tobacco is not. . . .

The "for the children" line is deployed every time government goes after tobacco users. From the industry settlements in the 1990s to the massive increases in cigarette taxes in the last few years, states (New Hampshire included) have tried to justify soaking tobacco dealers and users by claiming that their revenue grabs were "for the children."

But it's never for the children. It's always for the revenue. Delaney's attempt to demonize these tobacco shop owners is an abuse of authority. His boss, Gov. John Lynch, should make clear that he won't stand for such abuses in the future.

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• UPDATE 2-Lorillard starts CEO succession review  

Lorillard Inc (LO.N) had begun reviewing options for succession to CEO Martin Orlowsky, whose contract expires on Dec. 31, 2010, the third-largest U.S. cigarette maker said on Thursday .

The board will weigh "all relevant options," the company said in a filing with the U.S. Securities and Exchange Commission.

A spokeswoman for Lorillard declined to comment further on the succession options.

Orlowsky, 67, has been president and chief executive since 1999 and became chairman in 2001. Lorillard was spun off from Loews Corp (L.N) in June 2008.

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• The science behind moving smoking bans outside  

Reflecting on the existing scientific research on second hand smoke exposure outdoors, William Saletan of Slate.com sifts through the most relevant points from two major studies on the subject (the 2006 California Air Resources Board study, and a 2007 study from Stanford). Among the findings: outdoors, second hand smoke levels vary widely and quickly, depend on the individual's distance from a smoker (farther than 6.5 feet or 2 meters, generally reduces exposure to "background" levels), are influenced by how confined the outdoor space is (if there are walls or fences), and the concentration of smokers in a given area. The data, Saletan concludes, point to the need for a measured approach for crafting policy to reduce second hand smoke exposure outdoors. He writes:

"If you want to argue for parkwide smoking bans based on asthma or on an analogy to noise pollution, go ahead and make that case. But let's not cloud that debate by invoking the general harm of secondhand smoke. Studies of secondhand smoke have indeed moved outdoors. Their findings support restrictions on lighting up within a few feet of other people. But they don't warrant more than that."

A new study published in the November issue of the Journal of Occupational and Environmental Hygiene may contribute to the debate. Researchers from the University of Georgia measured second hand smoke exposure among people sitting in the outdoor areas of bars and restaurants where indoor smoking was banned in the city of Athens, Georgia. . . .

generally speaking, hanging out in an outdoor smoking area exposes you to less second hand smoke than being in an indoor, confined space with smokers, and the more space you have between yourself and smokers, the lower levels of exposure you will have. So, this particular study doesn't ring the death knell for outdoor smoking. But, the researchers point out, wielding the official trump card of the public health argument:

Although the increment in cotinine concentrations and, thus, the [second hand smoke] exposure levels were relatively low at the sites of interest, the current view is that there is no level of personal exposure to [second hand smoke] that can be regarded as safe. This study demonstrates the ongoing exposure of nonsmokers to [second hand smoke] outside restaurants and bars, and the limitations of indoor smoking bans alone in protecting the public from exposure to [second hand smoke] outside these establishments.

In other words, the movement to ban smoking in outdoor spaces is here to stay.

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Lights out at hospitals  

Hospitals across southwest Florida are banning smoking completely. It's impacting more than just employees, like Adrienne Jones. She used to smoke a pack a day.

"Our lunch hour, smoke as many as you can instead of eating," admits Jones.

That attitude stopped a year ago when her 42-year old husband, also a smoker, suffered a heart attack.

"It was sudden," said Jones. "We didn't expect it, we didn't know he had a bad heart."

Health concerns are the main reason her employer, Lee Memorial Health System, is installing a tobacco ban on all their properties starting November 19.

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SMOKE FREE  

In conjunction with The Great American Smoke Out, an annual event aimed at helping people quit smoking, Westfield Memorial Hospital will become a tobacco-free campus today. According to a press release from the hospital, the new policy will prohibit the use of any type of tobacco product such as cigarettes, cigars, pipes and chewing tobacco anywhere on the hospital's grounds, and the policy will affect all employees, physicians, visitors, patients, volunteers, vendors and other medical staff.

"As a healthcare provider, we were going to do it for a year, but we had so many changes with the Berger Commission that we didn't want to do it until now," said Tina Newell, a community educator at Westfield Memorial Hospital.

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• Gristedes chief still on warpath on cheap Indian cigarettes 

The freshly remodeled Gristedes supermarket on 25 University Place has expanded its space, adding new sections for beer, hot food, a salad bar, bakery and organic products, all looking like crowd-pleasers beneath Thanksgiving decorations strung above the aisles.

But cigarettes are no longer on sale here -- seemingly a sign of the times in this upscale Greenwich Village neighborhood near New York University.

"We haven't had them for some time now," said an assistant manager who identified himself only as Thomas. He noted that cigarettes are available at other Gristedes stores in New York (about 20 still carry them), even though he believes the demand is down. The main reason for the decline in tobacco sales, another Gristedes manager said, is that "people know where they can get them elsewhere" for half the price that conventional retailers in New York charge -- upward of $95 per carton, with $4.25 in state and city taxes tacked on.

He was alluding to untaxed tobacco sold on Indian reservations, a subject that has bedeviled convenience-store operators and New York governors from Cuomo to Paterson.

Led by its Greek-born owner and C.E.O., John Catsimatidis, a longtime New York City mayoral wannabe who smokes an occasional cigar, Gristedes Foods Inc. has claimed in protracted litigation that Indian merchants on two Eastern Long Island reservations are luring away New York customers, and even helping to fund organized crime gangs and terrorist groups like Hezbollah with bulk sales, a charge some politicians dismiss as absurd but others solemnly repeat. . . .

Since he cares so much about health, why does he sell any cigarettes at his grocery stores?

"There is such a thing as freedom of choice," the mogul replied. "I lecture my wife, who smokes, and tell her, Why don't you just have one or two instead of more? It's like what the Greek philosophers say: Everything in moderation."

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Newark grocers, others named in Philip Morris USA litigation 

Reyes Grocery Store and Sunny’s Supermarket , in Newark, were among the defendants named in litigation brought by tobacco company Philip Morris USA.

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International Trade Commission Blocks Illegal Internet Cigarette Sales  

The International Trade Commission (ITC) took action this week to stop illegally imported Marlboro®, Virginia Slims® and Parliament® cigarettes from entering the United States. The ITC issued a General Exclusion Order requiring U.S. Customs and Border Protection (CBP) to deny entry of these illegal goods, which infringe on Philip Morris USA's (PM USA) trademarks.

"We're pleased that the ITC has granted the General Exclusion Order, which should be a helpful tool for law enforcement in addressing illicit Internet cigarette sales and reinforces that preventing these imports is a priority," said Joe Murillo, vice president and associate general counsel, Altria Client Services, speaking on behalf of Philip Morris USA.

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