Obesity adds more health-care costs than smoking, study finds

Obesity costs the health care system more than smoking does, a new study has found. The annual health costs for someone who is obese average $1,850 more than for a person a normal weight. The excess costs were up to $5,500 per year for people who are morbidly obese. Smokers' health costs averaged $1,275 more than those of nonsmokers.

Researchers studied the additional costs "of smoking and obesity among more than 30,000 Mayo Clinic employees and retirees. All had continuous health insurance coverage between 2001 and 2007," reports research-reporting service Newswise. The findings were published in the Journal of Occupational and Environmental Medicine.

The additional costs associated with obesity appeared to be lower after they were adjusted for other related health problems. "This may lead to underestimation of the true incremental costs, since obesity is a risk factor for developing chronic conditions," said James P. Moriary and his fellow researchers. (Read more)

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Number of teens and young adults who smoke, use smokeless tobacco is on the rise

A "shocking" number of American teenagers smoke cigarettes and/or use smokeless tobacco, the first U.S. surgeon general's report on youth tobacco since 1994 has found. (Photo by Karen Bleier, AFP/Getty Images)

"The numbers are really shocking," Surgeon General Regina Benjamin said, noting the data show 1 in 4 high school seniors and 1 in 3 young adults under age 26 smoke. "It's a problem we have to solve."

Though there was dramatic progress in reducing youth smoking rates from 1997 to 2003, the 899-page report shows the decline has flattened. "Smokeless tobacco is up among white high school-age boys, and cigar smoking appears to be rising among black high school girls," reports David Brown for The Washington Post.

Data from the 2010 Kentucky Youth Tobacco Survey show that almost 25 percent of the state's high-school students are smokers. Although the prevalence of smoking among youth has declined in the past few years, the smoking prevalence among teenagers and young adults is higher than among other adult populations.

"Two people start smoking for every one who dies from the habit each year," Benjamin said. "Almost 90 percent of those 'replacement smokers' first try tobacco before they are 18."

The findings showed smoking can damage lung function at a very young age. One study of "nearly 700 children from East Boston found that those who started to smoke at age 15 exhaled 8 percent less air in one second — a key measure of lung function — than non-smoking teenagers. The growth of lung capacity stopped a year earlier in smokers — at 17 in girls and 19 in boys — than in non-smokers," Brown reports.

Another study showed how smoking affects the cardiovascular system. Researchers looked at autopsy results of white men ages 25 to 34 who were killed either by trauma or homicide. Smokers were two times as likely to have advanced damage of the abdominal aorta as non-smokers. "They also had somewhat greater damage to the blood vessel most often implicated in acute heart attacks," Brown reports.

Danny McGoldrick of the Campaign for Tobacco-Free Kids told USA Today's Wendy Koch tobacco marketing "is a big cause of the problem." He pointed to his organization's report revealing the tobacco industry's relationship with convenience stores to blatantly advertise and display tobacco products.

The industry's success in fighting increases in tobacco-related taxes is considered to be another factor. But industry officials like Ken Garcia of Altria Group, parent company of Philip Morris USA, said "there's already quite a (tax) burden on adult smokers." (Read more)

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Replacing cigarettes with smokeless tobacco reduces disease risk, says U of L prof who's received tobacco-industry funding

Smokers can greatly reduce their risk of disease if they replace their cigarettes with spit-free smokeless tobacco or electronic cigarettes, University of Louisville professor Brad Rodu, right, said in a presentation at the annual meeting of the American Association for the Advancement of Science last week. It's the same message residents of Owensboro heard in an advertising campaign with which Rodu was involved late last year, one partly funded with grants from the tobacco industry.

"Quit or die: That's been the brutal message delivered to 45 million American smokers, and it has helped contribute to 443,000 deaths per year," Rodu said in a U of L press release. "The truth, however, is that total nicotine and tobacco abstinence is unattainable and unnecessary for many smokers."

Rodu's 20 years of research has reportedly shown that e-cigs and smokeless tobacco are relatively safe alternatives for smokers who can't or are unwilling to quit nicotine. "Nicotine is addictive, but it is not the cause of any smoking-related disease," he said. "Like caffeine, nicotine can be used safely by consumers."

Research has shown smokeless products are 98 percent safer than cigarettes, the press release states. A 2002 study in the United Kingdom found smokeless tobacco to be up to 1,000 times less hazardous than smoking.

As for whether smokeless tobacco can contribute to mouth cancer, Rodu said the risk "is extremely low." "The annual mortality rate among long-term dry snuff users is 12 deaths per 100,000 and the rate among users of more popular snus, moist snuff and chewing tobacco is much lower. For perspective, the death rate among automobile users is 11 per 100,000 according to the 2009 report from the National Highway Traffic Safety Administration. Compare those to the rate among smokers: more than 600 deaths per 100,000 per year." (Read more)

The Oral Cancer Foundation's website says about 37,000 Americans will be diagnosed with oral or pharyngeal cancer this year and cause about 8,000 deaths. The foundation does not support the contention that smokeless tobacco is "safe." "Promoted by some as a safer alternative to smoking, it has in actuality not proven to be any safer to those who use it when referring to oral cancers," the website reads. "Campaigns to promote the safety of smokeless are being initiated, but it is clear that while it may reduce lung cancers, it has a negative effect on the rates of oral cancers."

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Judge continues to block graphic images on cigarette packs

Getting graphic labels on cigarette packages continues to be an uphill battle for the Obama administration, as a skeptical judge sided with cigarette makers who say "they can't be forced to spread the government's anti-smoking advocacy with 'massive shocking, gruesome warnings' on products they legally sell," reports The Associated Press.

U.S. District Judge Richard Leon of Washington, D.C., has already decided that the cigarette makers will probably succeed in their lawsuit, because he has ordered the government to not enforce the requirement that the labels appear on cigarette packages next year.

The labels, approved by the Food and Drug Administration, "included color images of a man exhaling cigarette smoke through a tracheotomy hole in his throat; a plume of cigarette smoke enveloping an infant receiving a mother's kiss; a pair of diseased lungs next to a pair of healthy lungs; a diseased mouth afflicted with what appears to be cancerous lesions; a man breathing into an oxygen mask," among others, AP reports.

Leon has indicated he thinks the labels go overboard in their efforts to convey the dangers of cigarettes. He has ruled they are too large; they were intended to cover the top half of packs. "It sounds like they are headed to a place," he said Wednesday, "where you have to watch a 10-minute video before you can even buy a pack of cigarettes." (Read more)

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Should companies refuse to hire employees who smoke? Opposing views outlined

The growing controversy surrounding companies who refuse to hire employees who smoke is featured in two opposing opinion pieces in USA Today.

Paul Terpeluk, medical director of employee health services at Cleveland Clinic, explains why the policy makes sense for his company. "Consider that cigarette smoke contains hundreds of chemicals and compounds that are toxic and at least 69 that cause cancer," he writes. "To ignore this would be to undermine our commitment to health and wellness, which includes providing a healthy environment for our employees, visitors and patients. Plus, the policy has not proved to be an overwhelming obstacle for job applicants. Since it was instituted, less than 2 percent of job offers — about 300 out of 20,000 — have been rescinded due to positive nicotine tests." (Read more)

But a USA Today editorial expresses a different view, in response to Baylor Health Care System's move to stop hiring workers who smoke. "Intruding this deeply into people's privates lives raises questions that bear scrutiny," it reads. "Companies can charge smokers more for health coverage or ban smoking on the job. But punishing people for using a legal product on their own time crosses a troubling line."

The editorial makes an exception for health-care companies who want to practice what they preach. "But such practices are not confined to the health care industry, and they raise a broader issue: If employers routinely reject people who engage in risky, but legal, behavior on their own time, what about such things are overeating or drinking too much alcohol?" (Read more)

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In 11-1 vote, Somerset passes comprehensive smoking ban

Lighting up in Somerset, once a big tobacco town, will no longer be allowed in all enclosed public places. The city council voted 11-1 Monday evening to pass a smoking-ban ordinance, reports Heather Tomlinson of the Commonwealth Journal. (C-J photo)

The ordinance includes restaurants, bingo halls, gaming facilities, nursing homes and any place of employment. "It's a public health safety issue," said councilor Jerry Girdler, who lost his well-known brother Eddie two weeks ago to throat and lung cancer. "The facts back up that smoking is harmful to the people around them."

The meeting attracted a crowd of more than 50, many of whom voiced their opinions. Business owner Teresa Singleton said, "I am really shocked at the fact that the City of Somerset is considering taking away the rights of businesses to make those decisions on whether we want our place of business to be smoking or non-smoking. For you to take that on your own, I think that's a major step in the wrong direction."

Local podiatrist Pamela Jensen-Stanley disagreed. "I believe the ban is necessary," she said. "I think it's time that Somerset moves up and gets with the program." (Read more)

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Spend $1 on smoking cessation, save $3 in health costs, Massachusetts study finds

Every $1 spent on smoking cessation in Massachusetts, saved $3 in health costs, a study of low-income Bay State residents found. That could bode well for the impact of a new smoking-cessation benefit in Kentucky's Medicaid program.

Massachusetts added a smoking-cessation benefit to its Medicaid program in 2006 and "let members choose from any FDA-approved options," reports Martha Bebinger for National Public Radio.

Researchers at George Washington University "found that members who quit saved three times the cost of the program in fewer heart-related hospitalizations after just over one year," Bebinger reports. "The study does not take into account the benefits of avoiding cancer or other long term smoking related illnesses."

Kentucky ranked 36th in the nation for tobacco prevention spending. Though it received $389 million in tobacco-settlment funds in fiscal year 2012, and ranks first or second in tobacco use, Kentucky spent just $2.2 million of that on prevention of tobacco use. It recently added a smoking-cessation benefit to Medicaid, a program that is funded mainly by the federal government but administered by individual states.

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Smoking hookahs can cause carbon monoxide poisoning

Though they're often viewed as just cool and unusual, hookahs, exotic-looking water pipes that can be smoked at several restaurants and bars in Lexington and Louisville, can cause carbon-monoxide poisoning.

That was the case with a young man who was brought to Jewish Hospital in Louisville last fall after passing out, reports Joseph Lord of The Courier-Journal. His symptoms indicated carbon monoxide poisoning, but doctors were confused by its source. After more research, they determined it was from a hookah. His monoxide level was tested at about 29 percent. A cigarette smoker can have a level of about 5 percent. (Photo of Amanda Steinhauer and Don Moore by Aaron Borton) "They're the levels we're used to seeing when you have furnace issues, house fires, car in the garage — the really significant carbon-monoxide poisonings," said Henry Spiller, director of the Kentucky Regional Poison Center.

The increased level is not entirely surprising, given that research shows the average cigarette smoker takes about 10 puffs per cigarette, while a hookah session might involve 100 puffs. Data from the Centers for Disease Control and Prevention show a one-hour hookah session involves the user inhaling 100 to 200 times the volume of smoke than would be inhaled from one cigarette.

Symptoms of carbon-monoxide poisoning include nausea and fatigue. Long-term health problems can include neurological damage. (Read more)

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State health department starts new ad campaign against secondhand smoke, including three 15-second TV commercials

The Kentucky Department for Public Health is launching a new campaign to educate Kentuckians about the dangers of secondhand tobacco smoke and its potential effect. The campaign is funded by $281,000 from the economic stimulus package of 2009 and about $90,000 from the federal Centers for Disease Control and Prevention. This week the department will start running television, billboard and radio advertisements to show the dangers of smoke that comes from the burning end of cigarette, cigar or pipe or the exhaled smoke from a smoker. The ads, which will run statewide, highlight the link between secondhand smoke and dangerous illnesses in both adults and children.



The ads, produced by Louisville-based Doe-Anderson, feature people being unwillingly exposed to secondhand smoke in places such as residences and cars. Each ad carries the tag line, “Secondhand smoke is 100 percent unsafe, 100 percent of the time.”

Kentucky’s smoking rate remains the second highest in the country, with 24.8 percent of the adult population identified as current smokers, and secondhand smoke exposure is equally high. The health department says 39.5 percent of Kentucky children live with someone who smokes – the highest percentage in the country. Secondhand smoke has become a major public health concern because it contains approximately 4,000 chemicals, many of which are known carcinogens, and is responsible for approximately 3,000 cases of lung cancer deaths among nonsmokers each year.



The campaign is another project of the Kentucky Tobacco Prevention and Cessation program. Community interventions for tobacco cessation are available through local health departments staffed with tobacco control specialists, and the program operates a toll-free telephone line, 1-800-QUIT NOW. It also provides technical assistance, with the Kentucky Center for Smoke Free Policy at the University of Kentucky, to assist communities in seeking smoke-free ordinances.

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Most Kentuckians now favor statewide smoking ban, poll finds

Graph shows results by smoking history, party

Just over half of Kentuckians support a statewide law that would ban smoking in most public places, including restaurants and bars, the Kentucky Health Issues Poll has found.

Just under 53 percent said they were in favor of such a law, and another 1 percent said they lean toward favoring it. Only 40.5 percent opposed the idea, with 2 percent leaning against it. Four percent had no opinion.

Including leaners, the law was favored by 53.7 percent to 42.5 percent, a double-digit margin. Last year, Kentuckians were split down the middle, 48 percent to 48 percent. The poll's error margin is plus or minus 2.44 percentage points, meaning that each figure could vary that much from actual public opinion in 19 of 20 cases. It could vary more in one out of 20.

The poll was released yesterday by the Foundation for a Healthy Kentucky. It asked 1,614 Kentuckians, "Would you favor or oppose a state law in Kentucky that would prohibit smoking in most public places, including workplaces, public buildings, offices, restaurants and bars?" The detailed results were: 40.9 percent favored strongly, 11.8 percent favored somewhat, 11.5 percent opposed somewhat and 29 percent opposed strongly.

Despite those strong views, there was again no split along party lines; 55 percent of Democrats and 55 percent of Republicans were supportive of a ban and independents were slightly less so. As was the case last year, respondents who are registered to vote were more likely to support a smoke-free law, with six in 10 in favor.

Respondents in the Lexington area showed the strongest level of support, with nearly 57 percent of people living there either strongly or somewhat in favor of passing a statewide ban.

Interestingly, respondents living in Appalachian Kentucky — which historically has very high smoking rates — also expressed strong support, with 53.4 percent in favor, plus or minus 4.96 percentage points. (The poll groups counties by area development districts; Appalachian Kentucky was defined as counties in ADDs that are mainly Appalachian, in green on the map.)

Despite Campbell County overturning its smoking ban earlier this year and controversy surrounding the ban in Kenton County, which is the only county in the region with a ban, respondents in Northern Kentucky showed the third highest level of support for a statewide law, with 52.9 percent in favor. The error margin for that small sample of 152 was plus or minus 7.95 percentage points.

In Louisville, 52.4 percent favored the law, plus or minus 5.26 percentage points. Western Kentucky had the lowest level of support, with 49.5 percent in favor and 47.1 percent opposed, plus or minus 4.63 percentage points. The poll included the Lincoln Trail Area Development District, generally recognized as part of the Louisville region, as part of Western Kentucky.

The issue is most strongly supported by non-smokers. Of respondents who have never smoked, 3 in 4 are in favor of a smoke-free law. Fifty-seven percent of respondents who are former smokers were in favor. When it came to smokers, just 3 in 10 support a law. For tables showing the detailed poll results, click here.

The poll, which was funded by the Foundation for a Healthy Kentucky and The Health Foundation of Greater Cincinnati, was conducted Sept. 27 to Oct. 27 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,614 adults across Kentucky were interviewed, including 1,313 landline interviews and 308 cell-phone interviews. For more from the Foundation for a Healthy Kentucky, click here.

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Teens turning to flavored cigars

A study shows teens are dispensing with cigarettes and turning to flavored mini-cigars with fun flavors — strawberry, chocolate, vanilla — enticing to young palates. (National Cigar Museum picture) "Young smokers say these cigarette-size little cigars and cigarillos — slimmer versions of big cigars — look better and can be bought one at a time instead of spending more than $5 for a pack of cigarettes," writes Lena H. Sun of The Washington Post. "Many teens also think that they are less addictive."

After cigarettes, cigar smoking is the second most common tobacco product used by youth nationwide, according to the Centers for Disease Control and Prevention. About 14 percent of high school students smoke them (18.6 percent among boys and 8.8 percent among girls). Though the Food and Drug Administration banned flavored cigarettes in 2009, it did not apply to cigars. They are only available to adults 18 and older, but many stores in Kentucky do not ask for ID.

In many states, mini cigars are taxed less than cigarettes. Federal excise tax is about 39 cents on a pack of 20 cigarettes. The tax on cigars that are the size of cigarettes is 4 cents for a pack of 20. In Kentucky, the tax rate on a pack of 20 cigarettes is 60 cents. Other tobacco products, including cigars, are taxed 15 percent.

While more enticing and less expensive, they are just as dangerous as cigarettes. "You have the same cancer-causing chemicals but wrapped in flavors that don't let you experience the harsh sensation of cigar or tobacco use," said Donald Shell, interim director for Maryland's Center for Health Promotion, Education, Tobacco Use Prevention and Cessation. (Read more For a fact sheet on mini-cigars, on the Kentucky Cabinet for Health and Family Services' website, click here.

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Kentucky is 43rd among the states in health rankings report

Kentucky is near the bottom of the list in a ranking that determines which states are the healthiest. It came in 43rd, up from 44th last year.

Kentucky's low ranking is attributed to its unusually high numbers of people who smoke, are obese, die of cancer and are hospitalized for preventable reasons, according to America's Health Rankings, funded by the United Health Foundation.

"As it has for the last decade, Mississippi was ranked 50th on this year's list, which was topped by Vermont at No. 1," Louisville's Business First reports.

"Kentucky's rank of 43rd is a reminder that, while are making progress, as Kentuckians we still have much to do to keep ill health from holding us down," said Susan Zepeda, president/CEO of the Foundation for a Healthy Kentucky. "The good news is there are many concerned civic leaders working to reduce rates of smoking and obesity in the state and keep young people from starting to smoke."

Highlights of the report show:

• While smoking has decreased from 30.5 percent to 24.8 percent of Kentucky adults in the past 10 years, 822,000 still smoke. Recently, Kentucky ranked 36th in the nation for its smoking cessation efforts.

• Almost 1.1 million Kentuckians are obese, 353,000 more than 10 years ago.

• Diabetes decreased from 11.5 percent to 10 percent of the populations in the past year, but there are still 322,000 adults in Kentucky with diabetes.

• In the past five years, the percentage of people without health insurance increased from 13 percent to 15.4 percent.

• In the past 10 years, the percentage of children living in poverty increased from 15.2 percent to 24.7 percent.

As for the entire country, overall health has not improved this year over 2010. "Between 1990 and 2000, the overall health of the nation ... improved by an average of 1.6 percent each year. After 2000, however, the upward trend slowed to 0.5 percent annually," until this year, Health.com reports.

"Physical activity, nutrition, and tobacco: If we could get people focused on those three, we could take a huge bite out of the chronic-disease epidemic," said Georges Benjamin, the executive director of American Public Health Association. "This is not an infinite list of things that people have to address."

America's Health Rankings has been assessing health data for the past 22 years, making it the longest-running health assessment report in the country. For its methodology, researchers look at four groups of health determinants: behaviors, such as smoking and obesity rates; community and environment, such as children living in poverty, violent crime and infectious disease; public and health policies, such as lack of health insurance and public health funding; and clinic care, such as prenatal care, the number of primary care physician and preventable hospitalization rates.

Each of these four determinants are intimately connected with one other, researchers contend. "For example, an initiative that addresses tobacco cessation requires not only efforts on the part of the individual but also support from the community in the form of public and health policies that promote non-smoking and the availability of effective counseling and care at clinics," the report reads.

Data sources include the Centers for Disease Control and Prevention; American Medical Association; Federal Bureau of Investigation; U.S. Census Bureau; and National Center for Health Statistics.

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Kentucky ranks 36th for tobacco prevention spending; many states have made cuts

Though it received $389 million in tobacco-settlement funds in fiscal year 2012, and ranks first or second in tobacco use, Kentucky spent just $2.2 million of that on prevention of tobacco use. The figures rank Kentucky 36th in the nation for helping its residents stop smoking or using smokeless tobacco.

The findings come from a report called "A Broken Promise to Our Children: The 1998 State Tobacco Settlement 13 Years Later," which was released by the Campaign for Tobacco-Free Kids, American Heart Association, American Cancer Society and other non-profit groups. The "promise" in the settlement among cigarette makers and state attorneys general was not specific, but strongly implied.

The report found that the Centers for Disease Control and Prevention recommend Kentucky spend $57.2 million each year to establish a comprehensive tobacco prevention program. But while Kentucky does not come close to that figure, most states don't either and have cut tobacco prevention spending even more in 2012 in the face of budget deficits, The Associated Press reports.

"There are no easy cuts anymore. There's the old expression, tried and true, it's not fat anymore, we're talking about bone," said Debra Miller, director of health policy for the Council of State Governments. "All revenue is looked at as revenue for the highest priority programs ... They aren't ignoring the whole idea of tobacco cessation and the public health issues, the budgets are just such a problem right now."

States have cut their funding 12 percent this year, putting it at its lowest level since 1999, AP reports.

Kentucky is one of 33 states that is spending less than a quarter of the amount recommended by the CDC. Only Alaska is meeting or exceeding the recommendation. Connecticut, Nevada, New Hampshire, Ohio and the District of Columbia did not put any funds into tobacco prevention in 2012. Kentucky cut its tobacco prevention spending by $400,000 from fiscal year 2011. In the past four years, states have cut funding by 36 percent.

About 46 million Americans smoke, while more than 3 percent of American adults use smokeless tobacco, according to the CDC. A recent poll found Kentucky has the highest smoking rate in the country, with 29 percent of people surveyed in a Gallup-Healthways Well-Being Index poll answering "yes" to the question. To find county-specific smoking rates, click here. (Read more)

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Corbin City Commission enacts smoking ban

The Corbin City Commission passed an ordinance this week to ban smoking in all enclosed public areas and enclosed public buildings. The ordinance will also require smokers to remain at least 25 feet from building entrances. Areas subject to the ban include bingo parlors, restaurants except for outdoor seating, and motels and hotels, "which may not offer more than 20 percent of rooms as smoking," Dean Manning of The News Journal reported. "Once the ordinance is advertised, it will become law," Becky Kilian of The Times-Tribune reports.

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Poll finds Kentucky has the highest smoking rate in the country; a statewide ban would reduce it, advocates say

Kentucky has the highest smoking rate in the country, with 29 percent of people surveyed by the Gallup-Healthways Well-Being Index answering "yes" to the question, "Do you smoke?" (United Press International photo by Alexis G. Glenn)

Kentucky's number is 8 percentage points higher than the national average, which remains unchanged from 2008. Utah had the lowest rate, 11 percent. The survey included answers collected from 1,000 Americans from January to June.

Smoking rates remain highest in the South and Midwest. "The findings suggested government smoking bans were effective," United Press International reports. "There were no bans on smoking in bars in all but one of the states where rates are 25 percent or higher and no bans on smoking in restaurants in all but two." (Read more)

In an op-ed piece in Monday's Lexington Herald-Leader, public health advocate Joan Buchar of the Foundation for a Healthy Kentucky asks the upcoming General Assembly to pass a statewide ban, and lists the benefits: Teens and preteens are less likely to begin smoking because they see fewer adults smoking. There are fewer visits to the emergency room for heart attacks in communities with comprehensive bans. And businesses are attracted to areas where bans are in effect, Buchar writes.

"Kentucky is known for its hospitality and beautiful places," she writes. "We can be known, too, as a beautiful and healthful place to live. Twenty years from now, our children will thank us for taking this bold step today." (Read more)

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FDA finds more than 1,000 retailers selling tobacco products to minors, several in Kentucky

More than 1,200 retailers, including CVS, Walgreens and Rite Aid, were issued warning letters by the Food and Drug Administration this year for illegally selling cigarettes to minors. FDA inspectors conducted 27,500 undercover checks by sending children under 18 into stores to buy cigarettes. These checks resulted in hundreds of letters being sent to retailers. Many of the warnings were sent to stores in rural areas where a recent U.S. Department of Health and Human Services report found youth are more likely to use tobacco products.

Alina Selyukh reports for Reuters that under the Tobacco Control Act of 2009, the FDA was given broad authority over tobacco manufacture and sales. One of the provisions of the act "allows the agency to contract with states to inspect spots where youths could buy cigarettes or chewable tobacco." Under the law, store workers are required to check identification of anyone looking younger than 27. Selyukh writes: "FDA officials said they are on a mission to begin battling the stubbornly high U.S. smoking rates by keeping tobacco out of underage hands in the first place."

The agency posted the warning letters on its website last week along with a searchable database of all checks it conducted. The letters allow retailers to correct their infractions without fines, but repeat offenders could face fines or loss of ability to sell tobacco products of any kind. To see if retailers in your state, community or city were issued a warning letter, search the FDA database of compliance checks.

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Race for city commission seat puts an end to debate over city's smoking ban, advocate and opponent agree

The Bowling Green City Commission candidate who said he wanted to rewrite the city's smoking ban ran last in the five-way race for an unexpired term on the commission Tuesday, and he and a commissioner in the 3-2 majority that enacted the ban said the result is an indicator of public opinion on the issue.

Candidate Bill Goodwin got only 682 votes, or 8.6 percent of the total. "Commissioner Brian 'Slim' Nash said he believes voters sent a message in Tuesday’s election: Citizens are satisfied with the city’s smoking ban," Andrew Robinson of the Daily News reports. "Goodwin said he spoke to a few citizens who told him the result is a clear sign there’s little support for revisiting the ordinance."

“The people spoke or the people didn’t show up,” Goodwin told the  newspaper. “It’s got to be an issue that’s dead right now. That’s all there is to it.” (Read more)

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Federal judge rules proposed warning labels on cigarettes are too biased, blocks them from appearing on packs

The graphic warning labels that were going to start appearing on cigarette packages in the fall of 2012 have gotten hung up in court, with a federal judge ruling Monday they "impinge on the tobacco companies' right to free speech," reports James R. Carroll of The Courier-Journal.

District Judge Richard Leon's ruling will prevent the labels from being used until tobacco companies resolve a lawsuit against the federal government regarding the issue, something that could end up in the Supreme Court and take years. Leon said the five tobacco companies involved in the lawsuit "have demonstrated a substantial likelihood that they will prevail on the merits of their position."

Leon said the labels do not objectively warn about the risks of smoking and that tobacco companies "will suffer irreparable harm" if a ruling is not made on the label's constitutionality.

The labels, which were released by the Food and Drug Administration this summer, show graphic images of rotting teeth, a man with a zipper-like scar down the length of his chest and a man with smoke coming out of a tracheotomy tube. It is the first time in 25 years warning labels on cigarette packages have been altered, a move that was made possible when the FDA was given the authority to regulate tobacco products as part of a 2009 law.

FDA's aim is to "reduce the number of smokers by 213,000 by 2013 and save between $221 million and $630 million every year over the next 20 years," Rob Stein of the Washington Post reported in June.

Leon wrote that the images cause an emotional response that provokes "the viewer to quit, or never to start smoking: an objective wholly apart from disseminating purely factual and uncontroversial information. Thus, while the line between the constitutionally permissible dissemination of factual information and the impermissible expropriation of a company's advertising space for government advocacy can be frustratingly blurry here — where these emotion-provoking images are coupled with text extolling consumers to call the phone number '1-800-QUIT' — the line seems quite clear."

Matthew Myers, president of the Campaign for Tobacco-Free Kids, called Leon's ruling wrong. "If allowed to stand, this ruling would make it impossible to implement any effective warning labels," he said. An FDA spokesman said the agency is reviewing the ruling and had no immediate comment. More than 40 countries have pictorial health warnings on their cigarettes packages, including Canada. (Read more)

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Light up at school? Face a $150 fine in Jessamine County

If students at the two Jessamine County high schools are found with cigarettes or any kind of tobacco product while on campus, they can face a fine up to $150.

East Jessamine High started issuing tickets a few years ago, and West Jessamine joined the effort last month, reports Jim Warren of the Lexington Herald-Leader. Since it was implemented, the number of students caught with the contraband items has gone down at East, with 120 incidents in 2009-09 and 149 in 2009-10. "Last year, we only had 39," Principal Janet Granada said. "Once the word spreads that there's a fine involved, it seems to lessen smoking greatly."

The idea came from Billy King, a school resource officer at East Jessamine High. "We recognized we had a problem with minors using tobacco," he said. "I felt that it would prevent them from bringing tobacco to school if they knew they could get a fine. But I also knew that they probably didn't think it would happen. Police generally don't cite juveniles for tobacco possession, even though the law has been on the books forever."

King posted signs around the school warning students of the possibility of a fine. A few weeks later, he started handing out tickets. "The word got around pretty quickly," he said. School resource officers write up the citations, which are referred to juvenile court. Fines are paid to the court, so the schools have no financial incentive to issue the citations.

Though many school districts in Kentucky have adopted tobacco-free policies on their campuses, Lisa Gross, spokeswoman for the Kentucky Department of Education said this is the first she's heard of students being given a fine. (Read more)

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Smokeless tobacco can help you quit cigarettes, Owensboro-area residents are told (partly with tobacco money)

"Switch and quit" is the theme of an advertising campaign being promoted by a prominent cancer center in Kentucky, in which smokers are advised to lay off the cigarettes in favor of smokeless tobacco such as chew or snuff. "Supporters say smokers who switch are more likely to give up cigarettes than those who use other methods such as nicotine patches, and that smokeless tobacco carries less risk of disease than cigarettes do," The Associated Press reports.

AP reports the program is partly funded with grants from the tobacco industry, though program director Brad Rodu, a University of Louisville professor of medicine, said the industry has "absolutely no influence whatsoever." Smokeless tobacco has been linked to oral cancer.

"We need something that works better than what we have," said Dr. Donald Miller, an oncologist and director of the James Graham Brown Cancer Center, which is co-sponsoring the campaign with the university. "This is as reasonable a scientific hypothesis as anybody has come up with and it needs to be tried."

The campaign is being pushed in Owensboro using print, radio, billboard and other advertising. Residents of Owensboro and the surrounding area reportedly consume about 3 million cigarettes a week. "That amounts to well over a pack for every man, woman and child in the community of about 115,000 people," AP reports.

"The worst that you can say about smokeless tobacco is that it's the lesser of two evils," said Dr. Randall Thomas, an oncologist at the Owensboro Medical Health System. "I don't think we have any problem in telling a person that drinks a six-pack a day that if they could cut it back to two beers a day or two drinks a day that their health risks are greatly reduced ... Finding a way to let people have their nicotine that carries less risk, it's the realistic solution."

But there are opponents to the program, including Matthew Myers, president of the Campaign for Tobacco-Free Kids, who called it "a giant experiment with the people of Owensboro without rules or guidance designed to protect individuals from experimental medicine." The theme of the program does seem to run counter to warnings by the Centers for Disease Control and the National Cancer Institute at the National Institutes of Health, whose websites say the use of all varieties of tobacco products "should be strongly discouraged" and that there is "no scientific evidence that using smokeless tobacco can help a person quit."

Owensboro is an old tobacco town, and in the face of falling cigarette sales, tobacco companies are marketing more smokeless tobacco and other cigarette alternatives. (Read more)

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