Les anglonautes

About | Search | Vocapedia | Learning | Podcasts | Videos | History | Culture | Science | Translate

 Previous Home Up Next


Vocapedia > Health > Lifestyle > Smoking


Tobacco, cigarettes






















































 “It’s just what we do here,”

said Ed Smith Jr.,

in Manchester, Ky., the seat of Clay County,

which had a smoking rate of 36.7 percent in 2012,

little changed from 1996.


Photograph: Tim Harris

for The New York Times


Smoking Proves Hard to Shake Among the Poor


MARCH 24, 2014



















Chris Britt

The State Journal-Register

Springfield, IL


24 June 2011

















Vic Harville

Little Rock, Arkansas

Stephens Media Group


15 November 2010


















by Garry Trudeau


March 09, 2014















Health Harms Veins 20 sec

NHS Smokefree    28 December 2017





Health Harms Veins 20 sec

Video    NHS Smokefree    28 December 2017

















TOP 40:



20 February 2015






Video    HelloImAPizza    20 February 2015


















Break Free

Fresh Empire    8 May 2015





Break Free

Video    Fresh Empire    8 May 2015


You don’t let life hold you back

and you keep pushing things forward.

See what the deal is with staying positive.

Fresh Empire’s got your back.

Find out more about being fresh

and in control at https://www.FreshEmpire.gov





Related > FDA
















A commercial I put together

for an Elements of copy writing class

at The Art Institute of Tampa

20 March 2013





A commercial I put together for an Elements of copy writing class

at The Art Institute of Tampa

Video        Domonic Smith        20 March 2013


Tell someone not to do something and they will.

Don't read the next sentence.

See what we mean?

We're not here to tell people not to smoke,

because, well, it doesn't work.


© Shooter Productions 2013



















smoke        UK










smoke        USA












smoke        USA
















smoke        UK












smoker        UK

























smoker        USA




















heavy smoker








diehard smoker        UK










chain smoker        USA










black smokers        USA












France > smoking / tabagisme        FR












smoking        UK




















smoking        USA































































smoking age / minimum age for people buying tobacco products        USA












pancreatic cancer risks > smoking        USA










Genetic map of cancer

reveals trails of mutation

that lead to disease        UK        2013


Map shows

how 20 patterns of mutation

drive 30 cancer types,

pointing the way to prevention

and treatment strategies




Most cancers

are thought to be caused

by mutations in DNA,

perhaps triggered

by chemicals or radiation,

which go unrepaired and build up

over a person's lifetime.


The mutations eventually lead

to uncontrolled cell proliferation.


The causes of some cancers

are well understood.


Too much ultraviolet (UV) light

from the sun's rays

causes mutations in skin cells,

and if those mutations fall

in certain genes in one cell,

the cell becomes a cancer.



the chemicals in tobacco smoke

cause mutations

in mouth, throat and lung cells,

and lead directly to tumours

in those areas.










smoking-related illnesses        USA












Jesse Leonard Steinfeld    USA    1927-2014


as surgeon general

in the Nixon administration

(Steinfeld) spoke out

against cigarette smoking,

bringing new attention

to the risks it posed to women

and to people exposed

to secondhand smoke










lung cancer












On January 11, 1964,

Luther L. Terry, M.D.,

Surgeon General

of the U.S. Public Health Service,

released the first report

of the Surgeon General's

Advisory Committee

on Smoking and Health.


On the basis

of more than 7,000 articles

relating to smoking and disease

already available at that time

in the biomedical literature,

the Advisory Committee concluded

that cigarette smoking is—


A cause of lung cancer

and laryngeal cancer in men


A probable cause

of lung cancer in women


The most important cause

of chronic bronchitis






















give up smoking        USA



























the craving for a cigarette        USA
















Wanna Smoke?

It Could Cost You A Tooth,

The FDA Warns Teens


February 04, 2014





Wanna Smoke?

It Could Cost You A Tooth, The FDA Warns Teens


February 04, 2014    3:46 AM
















antismoking movement        USA






antismoking advocates        USA








anti-smoking campaign        USA










anti-smoking ad        USA






Warren Henry Braren        USA        1932-2015


reformed smoker

who helped trigger

a congressional ban

on tobacco advertising

on television and radio in 1970

by blowing the whistle

on broadcasters’

lax self-regulation






In November 1998,

the tobacco industry and 46 states

reached what is known

as the Tobacco Master Settlement Agreement

(four states reached separate settlements).


This group deal exempted

the industry from legal liability

for the harm caused by tobacco use.


In return,

the tobacco companies agreed

to make annual payments,

in perpetuity, to the states

to fund anti-smoking campaigns

and public health programs.


The industry guaranteed

a minimum of $206 billion

over the first 25 years.












the Smokefree Generation,

a proposal by A. J. Berrick,

a mathematics professor

in Singapore.


The idea is simple:

no one born in or after 2000

can ever be sold cigarettes.                USA






Family Smoking Prevention and Tobacco Control Act,

signed by President Obama in June 2009        USA








Current Cigarette Smoking Among Adults — United States, 2011 and 2007










Dying habits:

UK cuts down on heavy drinking and smoking        UK


Office for National Statistics issues snapshot

of demographic, social and economic change

over 40 years






The smoking map of England:

get the data by local authority        2013        UK


Nationally, the death rate

caused by smoking is decreasing,

according to the latest release

from the London Health Observatory (LHO),

but rates still differ hugely

across England.


Manchester recorded the highest rate

for smoking attributable mortality

in 2008-10

at 372 deaths per 100,000 population

and the local authority figures

show how prevalence of smoking,

the cost of smoking-related

hospital admissions

and the percentage of women

smoking during pregnancy

vary by area.


The LHO state

that smoking related hospital admissions

cost the NHS over £1bn in 2010/11

or £37 per capita.






What are the health risks of smoking?        UK        2012


If you smoke,

you increase your risk

of more than 50 serious health conditions.


Some may be fatal

and others can cause

irreversible long-term

damage to your health.



is one of the biggest causes

of death and illness in the UK.


You can become ill:


if you smoke yourself

through other people’s smoke

(passive smoking

or secondhand smoke)


In the UK,

around 114,000 people

die every year

from smoking-related illnesses.






smoking deaths        UK






no smoking










pro-smoking activists        UK






smoke-free        UK






smoke-free        USA
















tobacco        UK














tobacco > advertising, ads        UK












tobacco        USA
















nicotine - cigarettes' notoriously addictive ingredient        USA












flavoured nicotine pouch        UK










tobacco prevention        USA










Food and Drug Administration    F.D.A.        USA








stop smoking service        NHS        UK






anti-smoking campaign        UK












antismoking campaign        USA










Department of Health's anti-smoking ad        UK






graphic ad campaign showing tumour growing on cigarette        UK







































quit        USA / UK

















quit        USA





















Ireland’s smoking ban        UK












USA > ban smoking        UK










NZ > implement

an annually rising legal smoking age        UK










ban on smoking        USA










U.S. Imposes Nationwide Ban On Smoking

In All Public Housing    November 30, 2016










smoking ban        UK












In July 2007,

it became illegal to smoke

in enclosed public spaces

and shared workplaces in the UK.



















light up        UK










light up        USA










reek of stale tobacco








cigarettes        UK / USA













































cigarette sales        USA


























menthol cigarettes        USA
















ban menthol cigarettes / menthol-flavored cigarettes        USA






















legal age for cigarette sales        USA










cigarette price-fixing        UK










ads > cigarettes        USA










cigarette displays > "power walls" – behind-the-counter displays of cigarettes        UK

















pack of cigarettes / cigarette packs        USA








label        USA






warning        USA






F.D.A. > cigarette packs > graphic warning labels        USA






The Australian cigarette packet

that puts you off smoking        UK


Purposefully hideous and utterly unappealing,

this future design classic is now up for an award






cigarette branding        UK






plain, brand-free packaging for cigarettes

plain packs / standardised cigarette packaging        UK


stopping manufacturers

showing logos, branding, colours

and promotional text

on tobacco packaging















































plain packet / plain, unbranded packaging

drab packets with graphic health warnings        UK
















F.D.A.’s plan

to augment the textual warnings

on cigarette packages

with graphic color images,

including diseased lungs,

a cadaver on an autopsy table

and a man blowing smoke

from a hole in his throat        USA










graphic labels on cigarette packs        USA

















cigarette butt





fag break        UK






smuggling / contraband        UK






UK > William Richard Shaboe Doll, epidemiologist    1912-2005        UK


Doctor and scientist

who proved the link

between lung cancer and smoking

with pioneering long-term research

started in the 1950s






kick the habit / the smoking habit        UK






quit / stop smoking        UK



article/PIIS0140-6736(12)61720-6/fulltext - October 27, 2012







passive smoking        UK








Close up: Smoking on film becomes a burning issue        UK


A report published this week suggests

films showing smoking

should automatically be classified 18










Corpus of news articles


Health > Lifestyle


Smoking > Tobacco, cigarettes




Jury Awards $23.6 Billion

in Florida Smoking Case


JULY 19, 2014

The New York Times



MIAMI — A jury in northwestern Florida awarded a staggering $23 billion judgment late Friday against the country’s second-largest tobacco company for causing the death of a chain smoker who died of lung cancer at the age of 36.

The company, the R. J. Reynolds Tobacco Company, promised a prompt appeal.

Michael Johnson Sr. died in 1996 after smoking for more than 20 years. In 2006, his widow, Cynthia Robinson, of Pensacola, sued R. J. Reynolds the maker of the Kool brand cigarettes her husband had smoked, arguing that the company had deliberately concealed the health hazards its product caused.

The four-week trial ended Wednesday. The jury deliberated for 18 hours over two days, first awarding $17 million in compensatory damages and then emerging at 10 p.m. Friday with a $23.6 billion punitive judgment.

“When they first read the verdict, I know I heard ‘million,’ and I got so excited,” Ms. Robinson said in a phone interview Saturday. “Then the attorney informed me that was a ‘B’ — billion. It was just unbelievable.”

She said Mr. Johnson, a longshoreman and hotel shuttle bus driver to whom she was married from 1990 until his death six years later, began smoking around age 13. He often lit a fresh cigarette with the butt end of another.

“He really did smoke a lot,” she said.

He had two children, who are now 23 and 29.

“The damages awarded in this case are grossly excessive and impermissible under state and constitutional law,” J. Jeffery Raborn, vice president and assistant general counsel for R. J. Reynolds, said Saturday in a statement. “This verdict goes far beyond the realm of reasonableness and fairness and is completely inconsistent with the evidence presented. We plan to file post-trial motions with the trial court promptly and are confident that the court will follow the law and not allow this runaway verdict to stand.”

Such efforts by the industry are often successful. In October 2002, a Los Angeles jury awarded $28 billion in punitive damages against Philip Morris USA. In August 2011, an appeals court reduced the punitive damages to $28 million.

The Florida case was among the thousands of the so-called “Engle progeny” cases that stemmed from a 2006 court decision ruling that smokers could not file class-action suits but were free to do so individually.

That decision reversed a $145 billion verdict in a class action awarded in 2000 on behalf of a Miami Beach pediatrician, Howard A. Engle. An appeals court voided the award, saying it was excessive and the cases of individual smokers were too disparate to be considered as a class.

The plaintiffs petitioned the Florida Supreme Court, which upheld the decertification of the class but permitted individuals to sue, which set the stage for Ms. Robinson’s lawsuit.

Friday’s verdict was the highest granted to an Engle progeny case.

Ms. Robinson was represented by Christopher M. Chestnut, based in Georgia, and Willie E. Gary and Howard M. Acosta, both based in Florida.

“The jury just got it,” Mr. Chestnut said. “The jury was outraged with the concealment and the conspiracy to conceal that smoking was not only addictive but that there were deadly chemicals in cigarettes.”

He said the jury seemed most persuaded by 1994 C-Span footage of tobacco industry executives claiming smoking did not cause cancer and was not addictive, and by 60-year-old internal documents showing the company knew otherwise.

Scott P. Schlesinger, a Fort Lauderdale, Fla., lawyer who has sued big tobacco but was not involved in the Robinson case, said a verdict this large is not typical.

“There have not been multibillion-dollar punishments in the Engle cases for one reason: We are afraid to ask for them. We are afraid of what will happen in the appellate process,” he said. “This verdict is important because it goes back to an ongoing saga that goes back to 1990. People have been filing suit one by one, and we have been winning about 70 percent of them.”


Correction: July 19, 2014

An earlier version of this article misstated

the location of Willie E. Gary,

a lawyer for Cynthia Robinson.

He is based in Florida, not Georgia.


A version of this article appears in print

on July 20, 2014,

on page A17 of the New York edition

with the headline:

Jury Awards $23.6 Billion in Florida Smoking Case.

Jury Awards $23.6 Billion in Florida Smoking Case,






List of Smoking-Related Illnesses

Grows Significantly in U.S. Report


JAN. 17, 2014

The New York Times



WASHINGTON — In a broad review of scientific literature, the nation’s top doctor has concluded that cigarette smoking — long known to cause lung cancer and heart disease — also causes diabetes, colorectal and liver cancers, erectile dysfunction and ectopic pregnancy.

In a report to the nation to be released on Friday, the acting surgeon general, Dr. Boris D. Lushniak, significantly expanded the list of illnesses that cigarette smoking has been scientifically proved to cause.

The other health problems the report names are vision loss, tuberculosis, rheumatoid arthritis, impaired immune function and cleft palates in children of women who smoke.

Smoking has been known to be associated with these illnesses, but the report was the first time the federal government concluded that smoking causes them.

The finding does not mean that smoking causes all cases of the health problems and diseases listed in the report, but that some of the cases would not have happened without smoking. The surgeon general has added to the list of smoking-related diseases before. Bladder cancer was added in 1990 and cervical cancer in 2004.

The report is not legally binding, but is broadly held as a standard for scientific evidence among researchers and policy makers.

Experts not involved in writing the report said the findings were a comprehensive summary of the most current scientific evidence, and while they might not be surprising to researchers, they were intended to inform the public as well as doctors and other medical professionals about the newest proven risks of smoking.

“I thought the science was very well done and up to date,” said Dr. Robert Wallace, a professor of epidemiology and internal medicine at the University of Iowa, who helped review the report.

The report comes 50 years after the pivotal 1964 surgeon general’s report in which the government concluded for the first time that smoking caused lung cancer. That report was credited with starting to change public attitudes toward smoking, which has declined sharply. In 1965, about 43 percent of adults were smokers; in 2012, about 18 percent were.

But that decline has slowed in recent years, and the new report calls for stronger action in combating smoking. Smoking is the largest cause of premature death in the country, killing more than 400,000 people a year. The report notes that far more Americans have died prematurely from cigarette smoking than in all the wars ever fought by the United States.

The report concluded that the evidence was insufficient to say that smoking caused prostate cancer. The evidence was suggestive, but not definite, that smoking causes breast cancer.

The document also celebrates the public health success of smoking’s decline since Dr. Luther Terry, the surgeon general in 1964, released his landmark finding. Smoking was deeply embedded in American culture at the time. Half of adult men were smokers, and a third of women. Even doctors smoked.

That report was so controversial that it was released on a Saturday when Congress was on recess to minimize the political repercussions, said Dr. Richard D. Hurt, a professor of medicine at the Mayo Clinic.

Dr. Judith Fradkin, a diabetes scientist at the National Institutes of Health, who was not involved in the report, said the evidence that smoking increases the risk of Type 2 diabetes had been gathering for about 20 years.

While smoking causes most cases of lung cancer, it causes only a small fraction of liver and colorectal cancers. A current smoker is 25 times as likely to develop lung cancer as someone who has never smoked, but only about 1.5 times as likely to develop liver cancer.

“It’s a fairly modest association, but because so many people smoke, it’s still an important cause of these cancers,” said Neal Freedman, an epidemiologist at the National Cancer Institute.

He pointed out that the surgeon general last looked at the effect of smoking on liver cancer in 2004, and found the evidence only suggestive. Since then, 90 new studies have been published allowing the surgeon general to conclude smoking is a cause.

The report also finds that the risks of lung cancer are far higher today than in past decades, even though smokers today consume fewer cigarettes. In 1959, women who smoked were 2.7 times as likely as women who never smoked to develop lung cancer, and by 2010, the additional risk had jumped nearly tenfold. For men, the risk doubled over the same period. The report said changes in cigarettes’ design, namely to the filter, contributed to the increased deadliness.

“It is stunning that the risk of a premature death from smoking is greater than it was 50 years ago,” said Matthew Myers, head of the Campaign for Tobacco-Free Kids, an advocacy group.


A version of this article appears in print on January 17, 2014,

on page A15 of the New York edition with the headline:

List of Smoking-Related Illnesses Grows Significantly

in U.S. Report.

List of Smoking-Related Illnesses Grows Significantly in U.S. Report,






States Cut Antismoking Outlays

Despite Record Tobacco Revenue


December 6, 2012
The New York Times


Faced with tight budgets, states have spent less on tobacco prevention over the past two years than in any period since the national tobacco settlement in 1998, despite record high revenues from the settlement and tobacco taxes, according to a report to be released on Thursday.

States are on track to collect a record $25.7 billion in tobacco taxes and settlement money in the current fiscal year, but they are set to spend less than 2 percent of that on prevention, according to the report, by the Campaign for Tobacco-Free Kids, which compiles the revenue data annually. The figures come from state appropriations for the fiscal year ending in June.

The settlement awarded states an estimated $246 billion over its first 25 years. It gave states complete discretion over the money, and many use it for programs unrelated to tobacco or to plug budget holes. Public health experts say it lacks a mechanism for ensuring that some portion of the money is set aside for tobacco prevention and cessation programs.

“There weren’t even gums, let alone teeth,” Timothy McAfee, the director of the Office on Smoking and Health at the Centers for Disease Control and Prevention, said, referring to the allocation of funds for tobacco prevention and cessation in the terms of the settlement.

Spending on tobacco prevention peaked in 2002 at $749 million, 63 percent above the level this year. After six years of declines, spending ticked up again in 2008, only to fall by 36 percent during the recession, the report said.

Tobacco use is the No. 1 cause of preventable death in the United States, killing more than 400,000 Americans every year, according to the C.D.C.

The report did not count federal money for smoking prevention, which Vince Willmore, the vice president for communications at the Campaign for Tobacco-Free Kids, estimated to be about $522 million for the past four fiscal years. The sum — about $130 million a year — was not enough to bring spending back to earlier levels.

The $500 million a year that states spend on tobacco prevention is a tiny fraction of the $8 billion a year that tobacco companies spend to market their products, according to a Federal Trade Commission report in September.

Nationally, 19 percent of adults smoke, down from over 40 percent in 1965. But rates remain high for less-educated Americans. Twenty-seven percent of Americans with only a high school diploma smoke, compared with just 8 percent of those with a college degree or higher, according to C.D.C. data from 2010. The highest rate — 34 percent — was among black men who did not graduate from high school.

“Smoking used to be the rich man’s habit,” said Danny McGoldrick, the vice president for research at the Campaign for Tobacco-Free Kids, “and now it’s decidedly a poor person’s behavior.”

Aggressive antismoking programs are the main tools that cities and states have to reach the demographic groups in which smoking rates are the highest, making money to finance them even more critical, Mr. McGoldrick said.

The decline in spending comes amid growing certainty among public health officials that antismoking programs, like help lines and counseling, actually work. California went from having a smoking rate above the national average 20 years ago to having the second-lowest rate in the country after modest but consistent spending on programs that help people quit and prevent children from starting, Dr. McAfee said.

An analysis by Washington State, cited in the report, found that it saved $5 in tobacco-related hospitalization costs for every $1 spent during the first 10 years of its program.

Budget cuts have eviscerated some of the most effective tobacco prevention programs, the report said. This year, state financing for North Carolina’s program has been eliminated. Washington State’s program has been cut by about 90 percent in recent years, and for the third year in a row, Ohio has not allocated any state money for what was once a successful program, the report said.

    States Cut Antismoking Outlays Despite Record Tobacco Revenue,
    NYT, 5.12.2012,






U.S. Backs

Antismoking Ad Campaign


March 15, 2012
The New York Times


For the first time, the federal government will directly attack the nation’s tobacco addiction with a series of advertisements highlighting the grisly toll of smoking, a campaign that federal health officials hope will renew the stalled decline in the share of Americans who smoke.

The government’s investment in the campaign is relatively modest: $54 million this year. The tobacco industry spends that much and more, on average, in just two days of promotional efforts. California has spent about $20 million annually since 2000 on anti-tobacco advertising, while New York spent about $10 million annually between 2003 and 2009. Other states also finance such ads.

But the effort by the Centers for Disease Control and Prevention is the first in which such advertisements will be played throughout the country. Dr. Thomas R. Frieden, the C.D.C.’s director, said the campaign would save lives and money.

“We estimate that this campaign will help about 50,000 smokers to quit smoking,” Dr. Frieden said Wednesday in an interview. “And that will translate not only into thousands who will not die from smoking but it will pay for itself in a few years in reduced health costs.”

The advertisements, which will appear on television and in newspapers starting Monday, show former smokers discussing the terrible health consequences of their habits.

In one TV ad, Terrie, 51, of North Carolina, who has a hole in her neck and barely any hair on her head after suffering head and neck cancer, tells the camera, “I want to give you some tips about getting ready in the morning.” She then pops in a set of false teeth, dons a blond wig and inserts a small speaker into the tracheotomy in her neck. She ties on a scarf to hide the device and says, “And now you’re ready for the day.” An announcer says: “You can quit. For free help, call 1-800-QUIT-NOW.”

Studies have shown that such graphic advertisements are effective in persuading smokers to quit, but they have also often led to opposition from smokers, who call them alarming and demeaning, and to efforts by the industry to end financing for the ads.

David Howard, a spokesman for the R. J. Reynolds Tobacco Company, which makes Camel and Pall Mall cigarettes, declined to comment directly on the advertising campaign because he had not seen it.

“We believe that adult tobacco consumers should be provided with accurate information about the risks associated with tobacco use,” he said. R. J. Reynolds is part of a group of tobacco makers that have sued the Food and Drug Administration to overturn rules that would require cigarette companies to cover much of their packaging with graphic warning labels. Two weeks ago, a federal judge in Washington declared the rules an unconstitutional violation of the companies’ free speech rights. The government is appealing.

Mr. Howard said that he doubted that tobacco companies would raise similar objections to the C.D.C. advertising campaign since it would not involve “taking our packaging to deliver anti-tobacco information.”

Dr. John Seffrin, chief executive of the American Cancer Society, said that cancer mortality rates are dropping faster than ever in the United States, and that the reduction in the proportion of Americans who smoke is one of the main reasons. He noted that a third of all cancers are directly attributable to smoking, and that many smoking-related cancers are unusually deadly and expensive to treat.

“If this ad campaign helps people quit and prevents some from starting, it’s the right thing to do,” he said.

Along with vaccinations, few public health efforts have the capacity to save as many lives as those that combat smoking.

Smoking remains the leading cause of preventable death and disease in the United States, killing more than 443,000 Americans each year, according to federal estimates. More than eight million Americans live with a smoking-related disease.

The C.D.C. ads will emphasize that smoking causes immediate damage to the body, and feature three former smokers providing tips about how they successfully quit.

“I’ve been waiting for the government to do this for 40 years,” said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids. “Even in the tightest budget times, this is absolutely the right thing to do.”

    U.S. Backs Antismoking Ad Campaign, NYT, 15.3.2012,






The Smokers’ Surcharge


November 16, 2011
The New York Times


More and more employers are demanding that workers who smoke, are overweight or have high cholesterol shoulder a greater share of their health care costs, a shift toward penalizing employees with unhealthy lifestyles rather than rewarding good habits.

Policies that impose financial penalties on employees have doubled in the last two years to 19 percent of 248 major American employers recently surveyed. Next year, Towers Watson, the benefits consultant that conducted the survey, said the practice — among employers with at least 1,000 workers — was expected to double again.

In addition, another survey released on Wednesday by Mercer, which advises companies, showed that about a third of employers with 500 or more workers were trying to coax them into wellness programs by offering financial incentives, like discounts on their insurance. So far, companies including Home Depot, PepsiCo, Safeway, Lowe’s and General Mills have defended decisions to seek higher premiums from some workers, like Wal-Mart’s recent addition of a $2,000-a-year surcharge for some smokers. Many point to the higher health care costs associated with smoking or obesity. Some even describe the charges and discounts as a “more stick, less carrot” approach to get workers to take more responsibility for their well-being. No matter the characterizations, it means that smokers and others pay more than co-workers who meet a company’s health goals.

But some benefits specialists and health experts say programs billed as incentives for wellness, by offering discounted health insurance, can become punitive for people who suffer from health problems that are not completely under their control. Nicotine addiction, for example, may impede smokers from quitting, and severe obesity may not be easily overcome.

Earlier this year, the American Cancer Society and the American Heart Association were among groups that warned federal officials about giving companies too much latitude. They argued in a letter sent in March that the leeway afforded employers could provide “a back door” to policies that discriminate against unhealthy workers.

Kristin M. Madison, a professor of law and health sciences at Northeastern University in Boston, said, “People are definitely worried that programs will be used to drive away employees or potential employees who are unhealthy.”

Current regulations allow companies to require workers who fail to meet specific standards to pay up to 20 percent of their insurance costs. The federal health care law raises that amount to 30 percent in 2014 and, potentially, to as much as half the cost of a policy.

When Wal-Mart Stores, the nation’s largest employer, recently sought the higher payments from some smokers, its decision was considered unusual, according to benefits experts. The amount, reaching $2,000 more than for nonsmokers, was much higher than surcharges of a few hundred dollars a year imposed by other employers on their smoking workers.

And the only way for Wal-Mart employees to avoid the surcharges was to attest that their doctor said it would be medically inadvisable or impossible to quit smoking. Other employers accept enrollment in tobacco cessation programs as an automatic waiver for surcharges.

“This is another example of where it’s not trying to create healthier options for people,” said Dan Schlademan, director of Making Change at Walmart, a union-backed campaign that is sharply critical of the company’s benefits. “It looks a lot more like cost-shifting.”

Wal-Mart declined to make an official available for an interview and provided limited answers to questions through an e-mail response. “The increase in premiums in tobacco users is directly related to the fact that tobacco users generally consume about 25 percent more health care services than nontobacco users,” said Greg Rossiter, a company spokesman.

Wal-Mart requires an employee to have stopped smoking to qualify for lower premiums. The company, which has more than one million employees, started offering an antismoking program this year, and says more than 13,000 workers have enrolled.

Some labor experts contend that employers can charge workers higher fees only if they are tied to a broader wellness program, although federal rules do not define wellness programs.

Employers cannot discriminate against smokers by asking them to pay more for their insurance unless the surcharge is part of a broader effort to help them quit, said Karen L. Handorf, a lawyer who specializes in employee benefits for Cohen Milstein Sellers & Toll in Washington.

Many programs that ask employees to meet certain health targets offer rewards in the form of lower premiums. At Indiana University Health, a large health system, employees who do not smoke and achieve a certain body mass index, or B.M.I., can receive up to $720 a year off the cost of their insurance. “It’s all about the results,” said Sheriee Ladd, a senior vice president in human resources at the system.

Initially the system also rewarded employees who met cholesterol and blood glucose goals, but after workers complained that those hurdles seemed punitive, Indiana shifted its emphasis a bit.

Workers who do not meet the weight targets can be eligible for lower premiums if a doctor indicates they have a medical condition that makes the goal unreasonable, Ms. Ladd said. “There are not many of those who come forward, but it’s available,” she said, adding that workers must be nonsmoking to get the other discount. About 65 percent of roughly 16,000 workers receive a discount.

Some benefits consultants say companies may be increasingly willing to test the boundaries of the law because there has been little enforcement, even though there is a provision requiring employers to accommodate workers with medical conditions limiting their ability to meet certain standards. “They are thumbing their nose at the accommodation provision,” said Michael Wood, a consultant at Towers Watson.

Still, “The employer is going to win not by cost-shifting but by getting people to stop smoking,” said Barry Hall, an executive at Buck Consultants, which advises employers.

Some versions of tougher standards have already been abandoned. The UnitedHealth Group, for example, had introduced a health plan called Vital Measures, which allowed workers to reduce the size of their deductible by meeting various health targets, but discontinued the offering three years ago because of insufficient demand, according to a spokesman. The insurer now offers plans that allow employees to earn rewards by either achieving health targets or participating in a coaching program to improve their health.

Wal-Mart’s decision to start charging smokers more for insurance came abruptly, according to some employees who say they had no chance to quit or consult a doctor. Jerome Allen, who works for Wal-Mart in Texas, says he realized he was paying $40 a month more as a smoking surcharge only when he saw a printout of his insurance coverage.

“Forty dollars is a lot of money,” said Mr. Allen, 63, who works part time. He says he has now quit smoking.

Wal-Mart says it mailed information about benefits changes weeks in advance of the enrollment deadline.

Under Wal-Mart’s programs, employees who want to enroll in some of the company’s more generous plans, which offer lower deductibles and out-of-pocket maximums, can pay as much as $178 a month, or more than $2,000, a year more if they smoke.

Many other companies charge smokers a smaller, flat amount, and have kept any financial penalties under the 20 percent threshold set by the federal rules, according to benefits experts. Target, a Wal-Mart competitor, does not charge smokers more for insurance, while Home Depot charges a smoker $20 a month. PepsiCo requires smokers to pay $600 a year more than nonsmokers unless they complete an antismoking program.

Some critics say Wal-Mart’s surcharge may have the effect of forcing people to opt for less expensive plans or persuade them to drop coverage altogether. Dr. Kevin Volpp, the director of the Center for Health Incentives and Behavioral Economics at the Leonard Davis Institute at the University of Pennsylvania, pointed out that surcharges and stringent health targets might wind up endangering those whose health was already at high risk. “There is this potentially very significant set of unintended consequences,” he said.

    The Smokers’ Surcharge, NYT, 16.11.2011,






The Tobacco Horror Show


November 14, 2011
9:00 pm
The New York Times


I’m sure you’ve noticed those TV ads for pharmaceutical products that include an incredibly long list of side effects and possible hazards recited by a cheerful voice as men and women are shown living the happy lives made possible by a drug that can inflict on them everything from bloating and joint pain to death. This combination of positive and negative communications is mandated by the government requirement that drug manufacturers must disclose all the risk factors attending the product they are hawking.

The result is what one might call the “battle of information.” The drug companies are providing information about the benefits of their product, and under duress (it would not be their choice to do this) they are also providing information about the dangers of that same product. It is their hope that the positive message will have more impact than the negative one, and that hope is supported by the fact that they get to tell their happy story in images (look what this drug can do for you), while the other, distressing story (hear what this drug can do to you) is conveyed by words. The companies are counting on the fact that not all information-delivery systems are equal and, as the old proverb goes, a picture is worth a thousand words.

The same dynamics are on display in a case decided on Nov. 7 in the United States District Court for the District of Columbia, but the positions are reversed: it is the government that is deploying images and the drug companies — in this case tobacco companies — that are standing up for words.
FDA, via/European Pressphoto AgencyAn example of an ad campaign warning people about smoking.

The case — R. J. Reynolds et al v. United States Food and Drug Administration — concerns the F.D.A.’s plan to augment the textual warnings on cigarette packages with graphic color images, including diseased lungs, a cadaver on an autopsy table and a man blowing smoke from a hole in his throat. The tobacco companies requested an injunction on the implementation of the plan until certain constitutional matters could be resolved in the courts. They argued that the “mandatory graphic images unconstitutionally compel speech”; for were they in place every cigarette package would be a “mobile billboard” for a message the companies did not choose to proclaim, but one they were required to display and, in effect, pay for. (This of course would not be materially different from the list of risk factors drug manufacturers are required to insert in ads they pay for.)

The companies also claim that “the purpose and effect of the warnings is to drown out Plaintiff’s own constitutionally protected speech and replace it with the Government’s emotionally-charged anti-smoking message.” “Emotionally-charged” is the key phrase here. The companies do not object to particular images, but to the use of images at all because they speak to the emotions and, in this instance, are “designed to shock, disgust and frighten” rather than “provide purely factual and uncontroversial information.”

But is the producing of an effect, even of an effect that is visceral, unrelated to the communication of information? Maybe yes if we’re talking about a horror movie where the eliciting of shock, disgust and fear is the entire point. That’s what people go to horror movies for — to experience an emotional rollercoaster that is unattached to any cognitive message.

In the case of the tobacco warnings, however, the emotions intentionally produced by the graphic images bring a cognitive message home. It is in fact a horror-message — if you smoke, all kinds of horrible things are likely to happen to you — and it is the government’s judgment, expressed in its brief, that the print warnings we are now accustomed to have become “stale” and no longer “convey [the] relevant information in an effective way,” no longer, that is, convey the message.

Of course, the tobacco industry has lived with print warnings for a long time and is fully aware of how humdrum they have become. What alarms them is the specter (another kind of horror show) of warnings that might really convey the relevant information effectively. What alarms them is not that the proposed images distort the truth, but that they tell it. “Ultimately,” the government’s brief concludes, “plaintiff’s objection to the pictorial health warnings is not that they are false, but that they are true.”

Given that the conveying of true information about the risks of a legal product has been held constitutional even when the government burdens a manufacturer’s delivery of its message, one would have expected the government to prevail. But is does not. Judge Richard J. Leon issued the injunction sought by the tobacco companies and gave as a reason the illegitimacy of images as conveyers of information: “[T]he government’s emphasis on the images’ ability to provoke emotion strongly suggests that the government’s actual purpose is not to inform, but rather to advocate a change in consumer behavior.” And again, “the graphic warnings cross the line from information to advocacy.”

This is wrong in both directions. Images can inform and the bare recital of information can advocate by appealing to the emotions. The line Leon wants to draw is, at best, a blurry one, as is his contrast (borrowed from the plaintiff’s brief) between images “calculated to provoke the viewer to quit” and “disseminating purely factual and uncontroversial information.” It takes only a second’s thought to undermine the contrast. Is the factual and uncontroversial assertion that “ smoking can kill you” (one of the new print warnings) without persuasive intent or effect? “Oh, I just thought I’d tell you that smoking kills and can harm your children. Nothing hortatory on my mind, just sayin’.” And just as the information that smoking kills is offered with the intention to “provoke” the informee to quit, so is the image of a cadaver on a slab offered with the intention of conveying a piece of factual and uncontroversial information — smoking kills.

Leon regards that image as non-factual and therefore controversial because, he says, the government does not offer “a single shred of evidence to support the proposition that smoking causes autopsies.” But the proposition is not that smoking causes autopsies, it’s that smoking causes death, and there’s plenty of evidence of that. In order to draw from the image the conclusion he wants to reach, Leon must read it in an obtusely literal way as claiming that every time a cadaver lies on an autopsy table it has been brought there by smoking.

The claim, however, is at once narrower in scope and less controversial, in fact not controversial at all: if you continue smoking, one of the things likely to happen is that you’ll end up on a slab. The image of the cadaver stands in for death, for the proposition that smoking kills. It is an example of metonymy, a figure of speech in which a thing or concept — in this case death — is not presented directly but by reference to something — the condition of being in a morgue — with which it is closely associated. As a figure of speech, metonymy operates at a remove from the object it points us to; it requires an inference. But the inference, once made (and it is no trick at all to make it), puts us in direct and forceful contact with an uncontroversial fact.

If Leon’s objection to the image were taken seriously, if assertions of fact could be made only in the absence of figures of speech — no metonymies, allusions, metaphors, comparisons, similes, patterned repetitions and a thousand other deviations from an impossible literalism — the account of even a single fact would fill 300 pages. As John McEnroe is fond of saying, “you cannot be serious.”

But apparently Judge Leon is serious and one can only wonder why. The answer given on some left-wing blogs is that he is in the pocket of the tobacco industry. But a more generous and analytic answer might point to a very old philosophical/theological tradition in which he enrolls himself, perhaps unwittingly. That tradition is marked by two related oppositions. The first opposes the verbal to the visual and stigmatizes the latter as the medium of deception and false appearances. Aristotle’s distrust of spectacle (opsis) founds an anti-theatrical prejudice that finds a high (or low) watermark in Stephen Gosson’s “School of Abuse” (1579) and Ben Jonson’s invectives against the set designer Inigo Jones. The theological counterpart to this prejudice is derived from the second commandment (“thou shalt not make unto thee any graven image”) and 1 John 2:16: “For all that is in the world, the lust of the flesh, and the lust of the eyes, and the pride of life is not from the Father, but is from the world.” The fruits of these texts can be seen in the periodic eruption of iconoclastic frenzy.

The second opposition in the tradition is located within the realm of the verbal itself. The literal, identified with pure observation and description, is opposed to the rhetorical, identified (again) with deception and with a surrender to the lure of surfaces and to base emotional appeals.

Either singly or in combination, the two binaries — words vs. images and literal, information-bearing words vs. words aiming to persuade — have led to a search for what Thomas Kuhn has called a “neutral observation language,” a super-literal language uninflected and uninfected by the distortions of any human, or as Leon terms it, “subjective” perspective. Although there have been innumerable attempts to come up with such a language — from the efforts to recover the language of Eden, to the linguistic reforms (no figures of speech) proposed by England’s Royal Society in the 17th century, to the 20th century logical positivists, to the construction of artificial languages with universalist ambitions like Esperanto — it has never been found and never will be found. One could say, then, that Judge Leon’s reasoning and the decision it leads to are based on a linguistic mirage, a will o’ the wisp, although the damage the decision might allow to be done, if it is upheld, is no mirage at all.

    The Tobacco Horror Show, NYT, 14.11.2011,






Court Blocks Graphic Labels

on Cigarette Packs


November 7, 2011
The New York Times


A federal judge on Monday blocked a Food and Drug Administration requirement that tobacco companies put big new graphic warning labels on cigarette packages by next September.

In a preliminary injunction, Judge Richard J. Leon of United States District Court in Washington ruled that cigarette makers were likely to win a free speech challenge against the proposed labels, which include staged photos of a corpse and of a man breathing smoke out of a tracheotomy hole in his neck.

The judge ruled that the labels were not factual and required the companies to use cigarette packages as billboards for what he described as the government’s “obvious anti-smoking agenda!”

The 29-page ruling was a setback for Congressional and F.D.A. efforts to bolster the warnings on tobacco packages. The agency has said they are the most significant change to health warnings in 25 years.

The Justice Department is reviewing the ruling, a spokesman, Charles S. Miller, said. The F.D.A. declined to comment, a spokeswoman said.

If the ruling is appealed — as both sides expect — it would join a different federal judge’s ruling on similar issues on appeal and raise the possibility that the issue will be decided by the United States Supreme Court.

Floyd Abrams, a New York lawyer and First Amendment specialist who argued the case for Lorillard Tobacco of Greensboro, N.C., praised the ruling. He said the companies had just objected to “grotesque” images, but not to new words of warning.

“It’s basically rooted in the notion that compelled speech by the government is presumptively unconstitutional,” Mr. Abrams said. “The only exception that could fit here is the one which says that the government can require warnings to be placed on products including tobacco products, but that the warnings must be factual and uncontroversial in nature.”

Five tobacco companies had challenged the selection of nine specific graphic warnings as an unconstitutional intrusion on commercial free speech. The judge agreed with them on almost every point, saying the companies would suffer irreparable harm if the provision were enforced before it was fully decided in courts, a process that is likely to take years.

“It is abundantly clear from viewing these images that the emotional response they were crafted to induce is calculated to provoke the viewer to quit, or never to start, smoking: an objective wholly apart from disseminating purely factual and uncontroversial information,” Judge Leon wrote.

“At first blush, they appear to be more about shocking and repelling than warning,” Judge Leon added in a footnote.

Antismoking activists called on the Justice Department to appeal immediately.

“This ruling presents a direct and immediate threat to public health,” Charles D. Connor, president and chief executive of the American Lung Association, said in a statement. “The tobacco industry’s efforts to halt the replacement of cigarette warning labels that are 25 years old, ineffective and hidden on the side of packages, will result in more lives lost to tobacco.”

Matthew L. Myers, a lawyer and president of the Campaign for Tobacco-Free Kids, a Washington advocacy group, said Judge Leon had sympathized with tobacco companies during oral arguments.

“The government has been expecting this decision and will appeal,” Mr. Myers said. “In addition, many of the same issues are now pending before a panel of the United States Court of Appeals for the Sixth Circuit because a federal judge in Kentucky reached a decision different than Judge Leon’s decision today.”

In that case, Judge Joseph H. McKinley Jr. ruled the cigarette makers could be forced to put graphic images and warnings on the top half of their packages, as Congress required. But Judge Leon noted that Judge McKinley had not seen the actual proposed images.

Judge Leon was appointed to the bench in 2002 by President George W. Bush. Last year, Judge Leon also ruled against the F.D.A. over e-cigarettes, an electronic device that looks like a cigarette and delivers nicotine, saying they should be regulated as tobacco products rather than under the stricter regimen as drug delivery devices. The government has not appealed that case.

The Family Smoking Prevention and Tobacco Control Act of 2009 gave the F.D.A. authority for the first time to regulate tobacco products. It included a provision directing the F.D.A. to require larger, graphic warning labels covering the top half of the front and back of cigarette packs by Sept. 22, 2012, as well as 20 percent of print advertising.

The F.D.A. had studied 36 images and narrowed them down to nine after surveys of effectiveness. The photos are similar to some included with cigarettes in Canada. But the tobacco companies argued, and the judge agreed, that the F.D.A. could not prove the images would make a statistically significant difference in smoking rates in the United States.

“We are pleased with the judge’s ruling and look forward to the court’s final resolution of this case,” Bryan D. Hatchell, a spokesman for R.J. Reynolds Tobacco of Winston-Salem, N.C., makers of Camel cigarettes, said after the ruling.

Other plaintiffs in the suit are Commonwealth Brands, the Liggett Group, and Santa Fe Natural Tobacco. The Altria Group, parent company of Philip Morris, makers of the dominant brand of Marlboro cigarettes, did not join the lawsuit. Altria was also the only major cigarette maker to support the new legislation.

    Court Blocks Graphic Labels on Cigarette Packs, NYT, 7.11.2011,






Study Links Smoking Drug

to Cardiovascular Problems


July 4, 2011

The New York Times



Chantix, the best-selling prescription drug for smoking cessation, was linked to an increased risk of a heart attack, stroke or other serious cardiovascular event for smokers without a history of heart disease compared with smokers who did not use the drug, according to a Canadian medical journal report released on Monday.

The finding added to previous warnings about the pill’s connection to psychiatric problems and cardiovascular risks for people with a history of heart disease.

It posed a new challenge to a product that has been prescribed to 13 million people and had $755 million in sales last year.

Officials of Pfizer, the manufacturer of Chantix, and the Food and Drug Administration responded that they had been planning to conduct a joint analysis of clinical trials on whether Chantix posed heart risks, due next year.

“This would have raised a red flag for us if the flag hadn’t already been flying,” Dr. Celia Winchell, a team leader with the agency’s Center for Drug Evaluation and Research, said in an interview.

Pfizer, in a statement, said the analysis in the Canadian Medical Association Journal was based on too few heart or cardiovascular events to draw conclusions about the risks. The company said Chantix brought “immediate and substantial” health benefits to smokers who quit.

The senior author of the new report, Dr. Curt D. Furberg, a Wake Forest medical professor, said there were better ways to quit and called for removal of the drug from the market.

“It piles up,” he said. “I don’t see how the F.D.A. can leave Chantix on the market.”

The lead author, Dr. Sonal Singh, assistant professor of medicine at Johns Hopkins University, said the agency and Pfizer had failed to pursue signs of cardiovascular risk since Chantix was approved in 2006.

“The F.D.A. should have already put it on their warning label,” Dr. Singh said. “The risk is substantial, the risk is present in smokers without heart disease, and Pfizer knew about this for five years.”

Last month, the agency issued a safety notice about cardiovascular risk from Chantix use by people with a history of cardiovascular disease, based on a study of 700 people.

The new report is broader, analyzing 14 randomized clinical trials involving 8,200 patients, excluding those with cardiovascular disease so that it gives a better picture of which heart problems the drug could cause in otherwise healthy people trying to quit smoking.

The new study, known as a meta-analysis, compiled data from 14 random, blinded, placebo-controlled clinical trials that tracked cardiovascular outcomes. It found 52 out of 4,908 people taking Chantix had serious cardiovascular events, a rate of 1.06 percent, compared with 27 out of 3,308 people taking a placebo, a rate of 0.82 percent. While the absolute difference is only 0.24 percent, the weighted, relative difference is 72 percent.

“We have known for many years that Chantix is one of the most harmful prescription drugs on the U.S. market, based on the number of serious adverse effects reported to the F.D.A.,” Dr. Furberg said in a statement. “It causes loss of consciousness, visual disturbances, suicides, violence, depression and worsening of diabetes. To this list we now can add serious cardiovascular events.”

Dr. Furberg, who once directed clinical trials for the government and writes widely about drug safety, has been paid as an expert witness in cases against Pfizer. Dr. Singh and two other researchers said they had no conflicts of interest.

When combining studies of smokers with and without pre-existing disease, the study found that doctors could expect to get one extra cardiac event associated with Chantix for every 28 smokers they treated with the drug. The researchers also estimated one additional person would quit for every 10 treated with Chantix.

The benefit of Chantix was emphasized in a separate commentary in the journal by Dr. J. Taylor Hays of the Mayo Clinic in Rochester, Minn. He described the meta-analysis as “timely and important” but said it lacked overall size and standardization. Dr. Hays, who has been paid by Pfizer to study Chantix, said the benefits of quitting smoking outweighed the risks of the drug.

Chantix is selling well overseas. In Japan, for instance, some pharmacies ran out for a while recently, even as the drug failed to meet expectations in the United States because of health warnings and bad publicity.

Study Links Smoking Drug to Cardiovascular Problems,
NYT, 4.7.2011,






A Social Networking Device for Smokers


May 10, 2011

The New York Times



Companies have started adding the ability to communicate wirelessly to an increasing range of devices, like tablet computers, cars and refrigerators.

Now they are doing it with cigarettes.

Blu, the maker of electronic cigarettes that release a nicotine-laden vapor instead of smoke, has developed packs of e-cigarettes with sensors that will let users know when other e-smokers are nearby.

Think of it as social smoking for the social networking era.

“You’ll meet more people than ever, just because of the wow factor,” said Jason Healy, the founder of Blu, who did not appear to be making friends as he exhaled the odorless vapor of an e-cigarette at a coffee shop in Midtown Manhattan recently. “It’s like with any new technology.”

E-cigarettes have several obvious advantages to their traditional counterparts. They allow users to avoid bans on smoking in public places because they release only water vapor. Mr. Healy and other e-cigarette manufacturers also claim that they have practically no negative health effects — an assertion that draws skepticism in many quarters. But the devices are also, in their own way, gadgets.

The new “smart packs,” which will go on sale next month for $80 for five e-cigarettes, are equipped with devices that emit and search for the radio signals of other packs. When they get within 50 feet of one another, the packs vibrate and flash a blue light.

The reusable packs, which serve as a charger for the cigarettes, can be set to exchange information about their owners, like contact information on social networking sites, that can be downloaded onto personal computers.

The packs also conveniently vibrate when a smoker nears a retail outlet that sells Blu cigarettes.

Later versions will be tethered to a smartphone through an app, allowing more options for real-time communication, Mr. Healy said. The company also plans to develop a system through which the packs will monitor how much people are smoking and report back to them — or to their doctors.

Marketers think people want more devices to link to each other. More than 105 million adult Americans have at least two types of connected devices, and 37 million have five or more, according to Forrester Research.

Nintendo’s new hand-held gaming systems, the 3DS, communicate with one another when brought into close proximity. A smartphone app called Color allows users to take photographs that are then automatically shared with anyone nearby who has also downloaded the app. It recently raised $41 million from venture capitalists.

But Charles S. Golvin, an analyst at Forrester Research who has studied connected devices, said that ideas like Blu’s connected cigarettes or Color show that digital connections can get ahead of the reasons for doing so.

“The way that groups of affinity are conferred just by physical proximity makes a bit of sense,” he said. “If someone walks by with a Nintendo, great, I share a common interest. The fact that I walk by a smoker? Seems like a weak link.”

Mr. Healy says he thinks the connected packs would be most useful in nightclubs, where people are interested in striking up conversations and want to smoke without being forced outside.

Adam Alfandary, 24, a Brooklyn resident who works for a technology start-up, was skeptical. He said that the social aspects of smoking were a part of the reason he continued to light up, but he scoffed at the idea of a cigarette that would do the social part for him. “I think that’s the dumbest thing I’ve ever heard in my life,” he said.

“And I’m saying that in full acknowledgment that smoking is one of the dumbest things I can do.”

A Social Networking Device for Smokers,
NYT, 10.5.2011,






Too Much of a Good Thing


February 4, 2011

The New York Times


When Mayor Michael Bloomberg began his campaign against cigarette smoking eight years ago, most New Yorkers breathed a sigh of relief. The great indoors — bars, restaurants, hotels, office buildings — all are now smoke-free by law, making New York City a healthier place. And, for those already addicted or tempted, the city offered kits to help people stop smoking and gruesome television ads to try to keep them from starting.

That antismoking campaign has been a great public service, but now the mayor and City Council have overreached. The council voted — 36 to 12 — to ban smoking outdoors in city parks, beaches and even plazas, including in Times Square.

No smoking at the crossroads of the world? The vortex of tourism that brings smokers and nonsmokers in great numbers? The site of the world’s most famous New Year’s Eve party, where who knows what goes on? All of this takes the mayor’s nannying too far, even for those of us who want to avoid the hazards of secondhand smoke.

Already smokers are forced to huddle outside, these days perched on the city’s gray, leftover snowdrifts. Starting in early summer, after the mayor signs the bill into law, they will not be able to stray onto the 14 miles of city beaches or into the city’s 1,700 parks, not even Central Park or windswept Battery Park. Instead of smoking on Brighton Beach, what does a smoker do — take a boat out 12 nautical miles into international waters?

Some City Council members wanted to find a less-drastic solution — like having the ban but establishing smoking areas on the beach or patches of the park. It’s not great, but it’s better than an all-out ban. Also, the city would have to provide a lot more receptacles for cigarette butts and enforce antilittering laws in those areas.

Meanwhile, there is talk that the mayor and the City Council want even more, like banning smoking near doors of office buildings and apartments. They need to take a deep breath and remember that we tried prohibition 90 years ago. They called it a noble experiment. It turned into a civic disaster.

Too Much of a Good Thing,






February 20 1954


Cancer and smoking:

the American story


From The Guardian Archive


February 20 1954

The Guardian


For thirty years or more the scandal sheets have printed articles on "The Tobacco Habit" as a mild variation on their standard treatment of such shockers as prostitution, political graft, and the traffic in dope. The tobacco companies paid only sidelong heed, with bold hints that, on the contrary, a cigarette was a relaxant, a soothing syrup and a social grace.

Their long golden age — twenty years of soaring sales — exploded in a bombshell prepared by Dr. Ernest Wynder of New York and Dr. Evarts Graham of St Louis. They reported they had produced skin cancer in 44 per cent of the mice painted with tobacco tar condensed from cigarette smoke.

This study was hardly as comprehensive as the British study of fifteen hundred human lung-cancer patients, but it was piquant. The newspapers sat up when the Institute of Industrial Medicine examined all the tumours reported in the Wynder-Graham study and declared them to be malignant.

Papers [reported] speeches made by Dr. Wynder and Dr. Ochner, Chief of Surgery at Tulane University. Dr. Wynder quoted thirteen American and foreign studies to conclude that "the prolonged and heavy use of cigarettes increases up to twenty times the risk of developing cancer of the lung."

Dr. Ochner foresaw that the male population of the United States might be decimated within fifty years by this type of cancer if cigarette-smoking increases at its present rate. Within an hour of the opening of the Stock Exchange that day big blocks of tobacco stocks were up for sale.

By the first of this year the horrid truth was out that the sale of cigarettes in the first ten months of 1953 was off 2.1 per cent. It seems a negligible fraction. But nothing gets to feel so normal as unrelieved luxury, and a desperate tobacco executive reflected that if every American smoker used "one cigarette less a day, our sales would drop by 5 per cent," which is to say three million packs a day, or an annual loss of $255.5 millions.

The makers of filter-tip cigarettes came out celebrating the providential insight that had led them to manufacture a cigarette that "filtered out" all those by implication cancerous tars and fumes. Filtered cigarettes sold as many in 1953 as they had sold in the preceding seven years.

The Institute of Industrial Medicine means to break down tobacco tars in an attempt to discover which fraction caused the skin cancer in mice. This ambition is evidently so beset with chemical and biological problems that it has taken almost a year to build and set up the necessary equipment.

Alistair Cooke

From The Guardian Archive > February 20 1954 >
Cancer and smoking:
the American story,
Republished 20.2.2007,
p. 32,






February 19 1903


A health indictment of tobacco


From The Guardian Archive


February 19 1903

The Guardian


There is probably a great deal more smoking among the undistinguished mass of women than careless observers think, [Mr. E. Oliver Duerr told the Manchester Physical Health Culture Society last night].

In Montrose, smoking among the women is only less general than among the men. There you see them, in the evening and after their day's labours, sitting on the upturned boats which they have helped to beach or on their own doorsteps pulling at their short clay pipes with contentment written upon their brows.

Mr. Duerr would tell them that there is enough nicotine in their tobacco to poison the whole of them if they would take the trouble to extract it and swallow it as nicotine. The same thing has been said of carrots except that it is arsenic in that vegetable; and yet everybody eats carrots.

Napoleon did not smoke, says Mr. Duerr, and neither does Lord Roberts. There are 50 diseases which spring from or are aggravated by smoking. The tobacco habit damages the eyes, it reduces the temperature, it affects nutrition on both sides of the skull, for while it impairs the brain it also causes the hair to fall out, it makes otherwise honourable and human men selfish in the society of non-smoking ladies and children, and it keeps the working classes from attending public worship.

In short, it was set down that all tobacco should be reduced to a solution which would be found useless for killing snakes — once you have caught them — and for washing sheep. If smokers will not give it to the snakes or wash sheep with it, but will obstinately smoke it, they are requested by Mr. Duerr and one of his quoted authorities to inhale the smoke into their lungs and there retain it to be absorbed.

If they will deprive the snakes of a most effectual poison and the sheep of a superior wash, let them at least consume their own smoke and not pollute the atmosphere in defiance of the rights of non-smoking man. If they would give the snakes and the sheep their due but feel unable to make the sacrifice let them, Mr. Duerr advised, give up breakfast and supper, let them give up tea and coffee, and soon they will give up all their bad habits naturally and without conscious effort.

To frighten these young smokers Mr. Duerr exhibited a book called "The Cigarette Smoker," which has on its cover the picture of a skull and crossbones constructed of cigarettes, and he gave a number of awful examples which only an American doctor with a book in his mind could discover.

From The Guardian Archive,
February 19 1903,
A health indictment of tobacco,
Republished 19.2.2007, p. 32,






June 22 1899


A doctor's theory on smoking


From The Guardian archive


June 22 1899

The Guardian


The sixty-third annual meeting of the Lancashire and Cheshire Branch of the British Medical Association was held at the Bolton Town Hall yesterday.

In a paper on cigarette smoking and carbonic oxide poisoning, Dr. J. Hilton Thompson advanced a new theory. By some, the paper on cigarettes had been condemned as injurious, while others looked with suspicion upon the metals used in the lettering, and suggested copper poisoning. None of the explanations advanced appeared to him to be satisfactory. In considering this question it was necessary to remember there were two kinds of smoking — by simply drawing the smoke into the mouth and then expelling it, and smoking in which the smoke was inhaled into the lungs and then expelled as a thin diffused cloud.

The first mode was the usual one adopted by pipe and cigar smokers, and when they considered the enormous number of people in all ranks of life who indulged in these luxuries without apparent detriment, they felt that a moderate indulgence in this kind of smoking was not to be looked upon as being injurious to health. The inhalation of smoke was entirely con fined to cigarette smoking, and it was amongst this class that one found the deleterious consequences.

Dr. Thompson gave the results of extensive experiments in burning tobacco by pipe, cigar, and cigarette, and showed the presence of carbonic oxide in tobacco smoke. As the blood had an affinity for carbonic oxide 300 times greater than it had for oxygen there was sufficient in cigarette smoke to do an immense amount of injury if inhaled in sufficient quantities.

The Doctor, continuing, turned his attention to cigarette smokers, and spoke of the habitual inhalers as being slaves to the habit, as having a peculiar anaemic, earthy complexion, in some cases laryngitis being produced. They had a disinclination to work, and appeared not to have much mental or physical vigour.

After referring to the consequences of inhaling carbonic oxide poison, the speaker showed how an indulgence in cigarette smoking during a student's college career might alter the whole course from a success to a failure.

Those of mature age indulging in cigarette smoking, probably beyond making themselves less fit and less inclined for work, would not be affected to any great extent. The strong opinion held by the public concerning the injurious effects of this habit was justified, and the American people who enacted laws to remedy the evils to the young smokers had a good deal more wisdom than many gave them credit for at the time.

From The Guardian archive >
June 22 1899 >
A doctor's theory on smoking,
republished 22.6.2007,
p. 38,










Explore more on these topics

Anglonautes > Vocapedia


smoking > vaping > e-cigarettes



smoking > tobacco industry



smoking, allergy, respiratory diseases



respiratory diseases > asthma



respiratory diseases

chronic obstructive pulmonary disease




lifestyle / health > exercise,

smoking / tobacco, vaping,

drinking / alcohol,

diet, obesity




health, medicine, drugs,

viruses, bacteria,

diseases / illnesses,

hygiene, sanitation,

health care / insurance



health > cells, DNA,

genes, genetics, gene editing



health > cells > cancer, tumors




contraception, abortion,

pregnancy, birth, life,

life expectancy,

getting older / aging,




UK, USA > drugs > pot / marijuana






Related > Anglonautes > Arts > TV series


USA > Mad Men




home Up