Appeals court upholds FDA's right to use menthol cigarettes report

A federal appeals court upheld the right of the U.S. Food and Drug Administration to use a report written by an advisory committee that concluded menthol cigarettes pose a greater public health risk than non-menthol cigarettes.

The court's ruling overturned an order by District Court Judge Richard Leon's that the report be barred from use.

In 2014, Leon had ruled in favor of the tobacco companies Lorillard Inc and Reynolds American Inc who had argued that three members of the FDA's Tobacco Products Scientific Advisory Committee were conflicted because they had acted as expert witnesses in lawsuits against tobacco manufacturers or consulted for drug companies making smoking-cessation drugs.

The tobacco companies had argued that the FDA's appointment of those panel members increased the risk that the FDA would regulate menthol tobacco products in a way that would hurt their interests.
They also argued that the committee members would have access to confidential company information that they could use against them; and that they could shape the menthol report to generate more expert witness business.

Judge Leon ordered the FDA to reconstitute the committee to exclude the allegedly conflicted members and barred the agency from using the report for regulatory purposes.

The report found that while menthol cigarettes, which account for about a quarter of all cigarettes sold in the United States, are no more or less toxic than regular cigarettes, menthol's cooling and anesthetic properties reduce the harshness of cigarette smoke, increasing their appeal to new smokers.

Judge Stephen Williams, writing on behalf of the United States Court of Appeals for the District of Columbia Circuit, said the plaintiffs lack standing because they must show an injury that is "actual or imminent, not conjectural or hypothetical" and that all three of their cited injuries did not meet that test.

"We conclude that all three are too remote and uncertain, or, to put the same thing another way, insufficiently imminent," he wrote.

FDA officials were not immediately available to comment.

Aberdeen University hosts talk on e-cigarettes

Dr Steve Turner

Researchers at Aberdeen University will host a discussion on the pros and cons of e-cigarettes next week.

At the first Cafe Med event of 2016, research fellow Heather Morgan and senior clinical lecturer Dr Steve

Turner will present findings on the rise in e-cigarette use alongside its social and medical effects.

Although it has been claimed that using e-cigarettes is far less harmful than traditional smoking methods, it will be another 10 or 20 years until thorough investigations are complete.

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Dr Turner said: “Because e-cigarettes have only just hit the market in the last three or four years, it’s hard to determine the long term effects of e-cigarettes.

“There are many questions we won’t know for 10 or 20 years.”

Dr Turner, who is interested in creating a smoke-free bubble around children, however, has identified that e-cigarettes can play a big part in harm reduction.

He said: “For smoking parents who live in tenements and high storeys, they can’t always go outside to smoke so with e-cigarettes the children aren’t exposed to the smoke from cigarettes.

“This wouldn’t make difference to an unborn child though as they still contain nicotine and if you look at the blood supply to the baby in real time while the mum is smoking, the blood vessels narrow.”

Monday’s free talk, No Smoke Without E-cigarettes, will be held at the Suttie Centre Lecture Theatre, Forsterhill from 6pm.

Kids overexposed to ‘cool’ cigarettes in their video games, study finds

Hundreds of video games come out every year. Avid gamers have at least 326 new ones to look forward to in 2016.

If previous years are any indication, many of these games will contain images of cigarettes and tobacco use. Experts worry they could lead young people, who clock hours a day playing video games, to start smoking.

Some 42% of video games featured characters smoking cigarettes, cigars, e-cigarettes and other products or made references to these products and smoking equipment, according to a study published in September.

Researchers at the University of California San Francisco limited their search to the 118 games released between 1994 and 2015 that were rated by the Entertainment Software Ratings Board, an independent regulatory body that makes age recommendations for games.

Although there is ample research showing that images of smoking in movies influences young people, much less is known about the effect of tobacco references in video games. Adolescents from 12 and 17 who see the greatest amount of smoking in movies are about twice as likely to start smoking as those with the least exposure, according to a U.S. surgeon general’s report.

Video games could be even more influential than movies, said Robin Koval, chief executive officer and president of Truth Initiative, a tobacco-control advocacy organization in Washington.

“We know video games are much more immersive (than movies) and frequently played by young people … those who play games spend even more time playing them than (time spent) on social media,” Koval said.

“The influence (of video games) might even be stronger (than movies), both because of large exposures from repeated play and because of the highly personal, active nature of video game play,” said Dr. Brian A. Primack, associate professor of medicine and pediatrics at University of Pittsburgh who has done research on the effect of smoking in movies on adolescents.

The representation of tobacco use in video games also seems to be largely positive. Researchers at the Truth Initiative interviewed 44 young people ages 15 to 21 about their impressions of smoking in games.

In a YouTube video the organization posted in December, interview participants reported that the characters who smoke are seen as “bad ass” and “look more in charge.” “These are the cool characters, the more powerful characters,” Koval said.

However, using smoking to signify cool or powerful is antiquated on the part of game makers.

“A lot of young people don’t like smoking. … I don’t think there’s a strong majority of kids saying ‘Put more tobacco in these games, we really like that,’ ” Koval said. “I’m kind of surprised. Why aren’t people designing games to reflect thoughts of young people?”

A 2014 report by the Centers for Disease Control and Prevention found that 13% of high school students and 3% of middle school students smoke cigarettes.

Whether or not smoking is out of touch with what young people want, it has only become more common in video games over the past decade. A 2012 study found that, among the games that the ESRB rating system deems appropriate for people 10 and older, the number that contain characters that use tobacco or references to tobacco has increased from less than 1% in 2005 to more than 12% in 2011.

The tobacco content in video games really started to shoot up around 2005, which is also when smoking in U.S. films started to wane, said James Thrasher, associate professor in the Arnold School of Public Health at University of South Carolina who led the research for the 2012 study.

Part of the reason for the decline in smoking images on the big screen was a 1998 settlement between the tobacco industry and the state attorneys general prohibiting the tobacco industry from paying for product placement in movies.

It is not publicly known whether tobacco companies pay video game makers to feature cigarettes and other products in games, Thrasher said.

“(But) there would be lots of ways for the tobacco industry or representatives to muck around or pay off for product placement in video games just because the [gaming] industry is more flexible and dynamic than the film industry” and video games come out much more frequently than movies, Thrasher said.

To make matters worse, it may often be hard to find out which video games contain smoking characters and other tobacco references. The study in September by the University of California San Francisco found that only 8% of the games they reviewed were described by the ESRB as containing tobacco, whereas 42% of them actually did.

“[This study] would suggest that the ESRB system is not adequately capturing tobacco content,” Primack.

The ESRB system allows game makers to submit information about their products, which independent reviewers use to determine the appropriate rating, similar to movie ratings. Although the system is independent, it is sponsored by the gaming industry.
The system could be strengthened to make it more reliable, Thrasher said. More money would allow ESRB reviewers to conduct more independent evaluations of games, rather than just rely on what game makers tell them. Another tactic would be to have game makers sign an agreement they didn’t receive money from tobacco companies if their games have tobacco content, Thrasher added.

However, the ESRB ratings really only serve to let parents know more about the games their children are playing, Thrasher said. It is not against the law to sell games rated as “M” for mature to people younger than 17.

Parents can get a better handle on what their kids are playing by watching them play and talking with them about the content, Koval said.

“One of the things that’s always true is that if you raise awareness with young people as to the fact that you’re being influenced by others, that’s just the first step (because) young people do not like being manipulated,” she added.

“There’s an opportunity for parents and the gaming community itself to make it known that these games are tons of fun to play without having to include smoking in them,” Koval said.

Turkmenistan forces shops to stop selling cigarettes in 'mass eradication'

The Caspian nation has banned the sale of tobacco productstai chang hsien/Flickr

Turkmenistan authorities have banned the sale of tobacco products, according to reports. State anti-narcotics officials have been scouring the capital city Ashgabat in recent days forcing shop owners to remove cigarettes from shelves.

A recent anti-smoking campaign featured President Gurbanguly Berdymukhamedov taking part in outdoor activities such as cycling and running. The nation's anti-smoking efforts were slammed by Berdymukhamedov, who called for "mass measures to eradicate smoking" on 5 January leading to further measures.

According to the World Health Organization only eight per cent of the nation's citizens smoke and since the crackdown., packets of cigarettes can change hands for over £9 on the black market. Although the national ban has not been announced, independent websiteChrono-TM, operating from Vienna said that stores and kiosks had been targeted.

Berdymukhamedov, a former dentist, has ruled the Caspian nation since 2006, and has increasingly clamped down on smokers. His predecessor Saparmurat Niyazov was a chain smoker who signed an anti-smoking decree in 2000 after heart surgery.
Since then stricter measures have been introduced, including a hike in excise taxes for tobacco in 2011 then compounded by a ban on smoking in public areas in 2013. The measures made cigarettes in the country more expensive than in any in the region.

The AFP quoted Bairam Saryev, 34, a store owner as saying that anti-narcotics officials "came to our shop recently and forced us to remove cigarettes from the shelves, threatening us with huge fines."

Chrono-TM says that vendors of tobacco face fines of up to 6,900 manats (£1,171; $1,680). Another trader, 24-year-old Vepa, said that the fine for violating the ban amounted to "10 (average) monthly salaries. Because of the high price, the sales of single cigarettes are growing, for about 2 manat apiece."

The state had broadcast a new media campaign which featured the mass incineration of thousands of cigarettes. In 2004, the remote landlocked Himalayan kingdom of Bhutan became the first nation in the world to ban all tobacco sales.

Study: E-cigarettes don't help smokers quit



A customer puffs on an e-cigarette at the Henley Vaporium in New York City in this file photo taken  
Electronic cigarettes are widely marketed as a way to help smokers quit traditional cigarettes, but a large new analysis finds they may actually have the opposite effect.

In fact, the report, published online today in The Lancet Respiratory Medicine, found that adult smokers who use e-cigarettes are actually 28 percent less likely to stop smoking cigarettes.

The question has been studied numerous times in the past, yielding sometimes conflicting results. But the new study -- systematic review and meta-analysis of published data -- is the largest to date.

"As currently being used, e-cigarettes are associated with significantly less quitting among smokers," wrote first author Dr. Sara Kalkhoran, who was a clinical fellow at the UCSF School of Medicine when the research was conducted. "E-cigarettes should not be recommended as effective smoking cessation aids until there is evidence that, as promoted and used, they assist smoking cessation." Kalkhoran is now at Massachusetts General Hospital and Harvard Medical School.

E-cigarettes, also called e-cigs, are powered by batteries that heat up liquid nicotine and flavorings to deliver inhaled vapor to the user. The process is meant to simulate the feeling of smoking, but without tobacco.

E-cigarettes are often promoted as a healthier alternative to regular cigarettes -- since users aren't inhaling carcinogenic smoke -- that can be used to wean smokers off tobacco.

But in 2015, the U.S. Preventive Services Task Force concluded that there was insufficient evidence to recommend the devices to help adults quit smoking.

None of the companies that manufacture e-cigarettes has submitted an application to the U.S. Food and Drug Administration to approve the devices for smoking cession, and the FDA has not taken any action against companies that claim e-cigarettes are effective for quitting smoking.

The FDA has also expressed concern that as the products are currently unregulated, they may contain unknown chemicals and toxic substances.

For the current study, Kalkhoran and her team reviewed 38 studies assessing the association between e-cigarette use and cigarette cessation among adult smokers. They selected 20 studies that had control groups of smokers not using e-cigarettes, and combined their results in a meta-analysis.

They found that the odds of quitting smoking were 28 percent lower among smokers who used electronic cigarettes when compared to those who did not.

"The irony is that quitting smoking is one of the main reasons both adults and kids use e-cigarettes, but the overall effect is less, not more, quitting," co-author Stanton A. Glantz, PhD, UCSF professor of medicine and director of the UCSF Center for Tobacco Control Research and Education, said in a statement. "While there is no question that a puff on an e-cigarette is less dangerous than a puff on a conventional cigarette, the most dangerous thing about e-cigarettes is that they keep people smoking conventional cigarettes."

Some experts say e-cigarettes can actually interfere with efforts to quit smoking by keeping users hooked on nicotine.

"It tells us simply switching from one nicotine delivery system to another nicotine delivery system doesn't lead to quitting the first nicotine delivery system," Dr. Norman Edelman, senior scientific advisor to the American Lung Association, told Health Day. "People will not naturally give up cigarettes, even though in most venues e-cigarettes are cheaper and people consider e-cigarettes to be safer."

The studies in the review included both real-world observational analyses as well as clinical studies, and took into account other factors that could influence the outcomes, including demographics, past attempts to quit, and level of nicotine dependence.

But some researchers are speaking out and criticizing the methods used in the review.

Peter Hajek, Director of the Tobacco Dependence Research Unit at Queen Mary University of London, called the study "grossly misleading."

"The studies that are presented as showing that vaping does not help people quit only recruited people who were currently smoking and asked them if they used e-cigarettes in the past. This means that people who used e-cigarettes and stopped smoking were excluded. The same approach would show that proven stop-smoking medications do not help or even undermine quitting," he said in a statement posted on the Science Media Centre's website.

Ann McNeill, Deputy Director of the UK Centre for Tobacco & Alcohol Studies and a professor at King's College London, co-authored one of the studies in the analysis and called the review "not scientific." "The information included about two studies that I co-authored is either inaccurate or misleading," she said. "I am concerned at the huge damage this publication may have - many more smokers may continue smoking and die if they take from this piece of work that all evidence suggests e-cigarettes do not help you quit smoking; that is not the case."
Still, some experts point to other evidence of potential harms of e-cigarettes. Dr. Daniel Neides at Cleveland Clinic's Wellness Institute pointed out that e-cigarettes are often a gateway to using cigarettes themselves.

"Patients using e-cigarettes may end up using higher amounts of nicotine with the e-cigarettes because they are using the devices more frequently throughout the day and when they feel like they need a stronger nicotine content, they transition to cigarettes," he told CBS News.

The Glantz and Kalkhoran concluded that regulation of e-cigarettes has the potential to make a difference.

"The inclusion of e-cigarettes in smoke-free laws and voluntary smoke-free policies could help decrease use of e-cigarettes as a cigarette substitute, and, perhaps, increase their effectiveness for smoking cessation," they wrote. "The way e-cigarettes are available on the market -- for use by anyone and for any purpose -- creates a disconnect between the provision of e-cigarettes for cessation as part of a monitored clinical trial and the availability of e-cigarettes for use by the general population."

Getting help to quit smoking

Getting help to quit smoking increases chances of keeping New Year resolutions

Source: Homecare Medical

[Statements from Quitline - comments can be attributed to Quitline Team Manager Willie Unuka]

Made the resolution to quit smoking in 2016? Prompted by the tax increase? Get in touch with Quitline. People who use Quitline’s services and support are five times more likely to successfully quit than those who try to quit alone.

An increase in tobacco tax on January 1 will push the price of a pack of cigarettes up. This, coupled with New Year resolutions to lead healthier lives, will definitely mean an increase in people calling Quitline for support. Every year Quitline helps 12,000 Kiwis beat their smoking addiction.

Whatever the prompt to quit smoking, the Quitline team encourage people who are thinking of giving up smoking, to get in touch.

Quitting on your own is so much harder, so we shout out at this time of year … get support, get in touch. People who use Quitline’s services and support are five times more likely to successfully quit than those who try to quit alone.

We also know that the more Quitline services a person uses, the higher their rate of success. Smokers can choose the support services that work best for them, including phone, email, blogs, text and online support to help people beat their addiction. Smoking is highly addictive and is a notoriously difficult habit to kick, so it makes sense that people should get as much help as they can to quit.

A price increase always prompts smokers to try to quit the addiction. Smoking is an expensive habit. A pack a day costs more than $7,400 a year (based on $20.50 for a packet of 20). Other reasons people are telling us that they want to quit are for their families and their health. A lot of people will make a New Year’s resolutions to get fit and healthy. Other things that prompt people are things like lower insurance premiums or just being sick of it.

The next step is to get yourself some support - this gives the best chance of success.

And we encourage anyone who has tried before to Quit and hasn’t made it, to give us a call and we’ll help them to try again. It is really normal to take several attempts to quit smoking and it is important that people don’t feel like they have failed.

It’s hard to reach out when you’re feeling vulnerable, but a Quitline Advisor can suggest things to do in the tough times. Many Advisors are ex smokers and know what quitting is like We also encourage people to join Quitline’s blog community - 24 hour support from people who are going through just the same trials.

Quitline details:

-Call Quitline on 0800 778 778 for free. Quit Advisors work with people make a plan to help beat cravings and send our free quit packs.

-At Quitline’s website at www.quit.org.nz people can see how much money they are saving but quitting - there’s a ‘Quit Stats’ tool.

-As well as the blog on www.quit.org.nz Quitline has a Facebook page at www.facebook.com/quitlinenz

-Register by phone or online for our Txt2Quit service and get sent texts to motivate you as you quit.

-Nicotine patches, gum and lozenges can double someone’s chances of successfully quitting. They are $5 each when you order them from Quitline by phone or online. The team can also give advice on other stop smoking medication options.

-If you’d like to talk to someone in person, Quitline can connect you with someone in your area. You could also talk to your healthcare provider or Aukati Kai Paipa (www.aukatikaipaipa.co.nz).

B.C. gov’t makes quit-smoking help more accessible


The program is adding more nicotine replacement choices for people trying to quit. Available products include gum, patches, lozenges, or a combination tailored to meet individual needs. “I have seen friends and family struggle to break their awful addiction to cigarettes”. The program helped to decline the smoking from 42% of adults in 1965 to 18% in 2012.

Community pharmacies in every region of British Columbia are ready to help people sign up, starting New Year’s Day.

This came after the province issued a request for proposals from suppliers. The successful bid was from Johnson and Johnson Inc., for Nicorette- and Nicoderm-brand products.

UC Quits, a program started by a UC Davis doctor is making efforts to help smokers in California to quit smoking.

Scott McDonald, CEO of the B.C. Lung Association, praised the decision to expand the program. It features people who are suffering negative health consequences from using tobacco who share their tips to prevent young people from ever using tobacco and to help motivate others to quit tobacco use.

With the latest price hike, the expensive habit will jump to more than $7,000 a year if you buy a pack a day. “We very much support nicotine replacement therapy and I’m very pleased that the government has made it easier now for them to get this”. More than a quarter of the people surveyed had quit smoking. Those who complete Freedom from Smoking are six times more likely to be smoke free one year later than those who quit on their own.

Sarbit specifically focuses on helping men quit smoking.

“Best of luck to everyone trying to quit, and congratulations on taking this important step toward improving your health”.

If you’re thinking about quitting consider the benefits.

Each year, more than 6,000 British Columbians die from the effects of tobacco use.

“It’s still a concern that there’s 13% using addictive products that we know causes death and disease”, says Amanda Mortenson.

The main barriers to attending a stop smoking service was lack of knowledge of the support available and motivation, the survey found.

RESOLVED TO QUIT SMOKING? AN ASSOCIATION SHARES SOME TIPS



A resolution that many people are committed to in 2016: Quitting smoking. The American Lung Association has some tips to help them achieve success.

With the countdown to the new year comes the inevitable list of easily broken New Year’s resolutions from losing weight to spending more time with family to quitting smoking. For the latter resolution, the American Lung Association (ALA) has five tips for those smokers trying to kick the deadly habit.
TIPS TO QUIT1. Make a plan
2. Consult a doctor
3. Join a support group
4. Involve friends and family
5. Try again

Only 4 to 7 percent of individuals who try to quit cold turkey are successful in avoiding cigarettes for up to one year, according to the association. So make a plan unique to your own lifestyle to help break the addiction.

The association’s Freedom From Smoking program helps participants progressively quit by taking them through modules with lessons and accompanying assignments building up to a Quit Day. It helps set that quit date, identify triggers and urges, and motivate the person throughout the quitting process.

ALA suggests individuals who are trying to quit smoking talk to a doctor about the process they are beginning. Doctors can help set up quitting plans and provide information on smoking medications. After all, smokers are twice as likely to quit with the advice and support of doctors and healthcare professionals. An app from the American Lung Association and Pfizer,Quitters Circle, helps connect users with those healthcare providers.

Quitters should look to join a support group either online or in-person. Tackling this resolution with fellow quitters can help the participant fight the urges and stay on track, especially during the most difficult part of the whole journey—the first seven to 10 days. The mobile app’s social community or the Freedom From Smoking program’s in-person meet-ups offer a place where quitters can encourage each other during the process.
The association said 80 percent of quitters agree that support from friends, family, or coworkers is a significant aspect of successfully quitting smoking. Don’t be afraid to involve friends and family as they can be the best cheerleaders when things are tough and can even follow along with your progress on the app.

Sometimes the urge is too strong to fight, and you have a cigarette. But try again and don’t give up. “Slip-ups—having a puff, or smoking one or two cigarettes—are common but don’t mean that a quitter has failed,” the association said. “Each person needs to find the right combination of techniques for them. The important thing is to keep trying to quit, until you quit for good.”

Your resolution maker: How to quit smoking


Curbing the cigarettes boils down to managing addiction, breaking a habit and controlling emotional triggers.

We talked to: Quitline Team Manager Willie Unuka and Robyn Bern from Homecare Medical.

Where to begin?

It starts with mindset: the mental determination, the will to quit, and the realistic expectations - if your body is used to nicotine, reducing it in your system will be a difficult process.

Smoking is an addictive habit, which the experts break down into three parts: addiction, habit and emotional triggers. 

Knowing your personal reasons for smoking will help you understand how you can make positive steps towards reducing the habit. This is a great place to begin your new, healthier lifestyle of being a non-smoker. 

An increase in tobacco tax that has just taken effect in New Zealand will push up the price of a pack of cigarettes. This, coupled with New Year's resolutions to lead healthier lives, means it's a great time (as is anytime) to pull the pin on your smoking habit. 

It's also a good idea to consider whether you want to begin the process using your own tools or advice you've heard, or by seeking help in the form of Quitline's online and verbal communication and tools. 

Proclaiming your decision to change your smoking habit may not be for everyone, however by sharing goals with others you are more likely to feel not only accountable to yourself but to others as well, which could make your chances of success even higher. 

What tools are available to me? 

The great news is there is a multitude of free tools and tips to get you started.

Quitline is New Zealand's most prominent smoking support site and it is bursting with information that you'll find helpful. Their team are also ready on the other end of the phone whenever you are, and can support you physically and mentally, and work with you through a 12-month programme should you wish. 

"Quitting on your own is so much harder, so we shout out at this time of year … get support, get in touch.," says Quitline Team Manager Willie Unaka. "People who use our services and support are five times more likely to successfully quit than those who try to quit alone.

"Smokers can choose the support services that work best for them, including phone, email, blogs, text and online support to help people beat their addiction."

How do I stay accountable? 

Knowing your triggers and then forward-planning to avoid them can make your transition from smoker to non-smoker a lot easier. Quitline has a practical and helpful printable document which can help focus your mind on something other than the desire for nicotine at trigger times. 

For example, if you must start your day with a quick smoke, try getting in the shower immediately after wake-up, or going for a brisk walk instead. Often, smokers need to activate their mind (and hands) in some way to avoid naturally thinking about nicotine. 

Another way to keep yourself motivated is to use some of the money you would spend on cigarettes (see more on that below) on a small reward, or even better, put your 'cigarette money' into a savings account for an annual holiday, the next birthday bash, or the kids' school fund. 

Will it cost me anything to quit smoking?

Calling for support is free, but there is access to subsidised patches, gum and lozenges online should you wish to purchase additional helping hands.

Remember it's smoking that's expensive - a pack a day costs more than $7400 a year (based on $20.50 for a pack of 20). So quit smoking and give yourself a pay rise.


Whether it's weight gain, cravings and stress, or simply the desire to return to your old ways, Unaka reminds us that quitting is a journey.

"Most people try more than once to quit smoking, it's the same as learning any new skill, you learn from your mistakes and keep trying," says Unaka.

"Think about why you wanted to quit in the first place. Those reasons are still good ones. You've stopped before and you can stop again. Yes, it may be hard work, but you've done other hard things before. Believe in yourself."

This time of year can be exceptionally hard, due to the holiday vibe and the endless social scenarios, but Quitline's have tips to stay smokefree while still being social:

* Avoid alcohol until you feel stronger, as it can lower your inhibition
* Stay inside or in non smoking areas
* Let people know you have quit – and ask them not to offer you cigarettes
* Choose non-smoking thoughts or affirmations to use e.g. 'I am in control of my life – cigarettes don't control me'
* Keep your hands and mouth busy with a straw, toothpick or lollipop 
* Have an escape plan if things get too much

How To Quit Smoking

NEW ORLEANS – Each new year, one resolution that consistently appears at the top of many lists is “quitting smoking.” Louisiana currently ranks 46 (44 in 2014) out of 50 states for tobacco use according to the recently released 2015 America’s Health Rankings® Report from the United Health Foundation. Presently, 24.0 percent (23.5 percent in 2014) of the state’s adult population lights up, well above the national average of 18.1 percent (19.0 percent in 2014).

“While smoking nationally continues to decrease, smoking in Louisiana, unfortunately, increased slightly this year,” said Mike Rogers, CEO, Smoking Cessation Trust Management Services. “These latest numbers for Louisiana only strengthens our resolve to help people kick this addiction. To that end, the Trust has enrolled more than 44,000 members, to date, who are now on the road to becoming cigarette-free.

In addition to helping restore smokers’ health, the Smoking Cessation Trust can help smokers save hundreds of dollars annually, as smoking becomes a progressively more expensive habit to support. Also, applying for benefits only takes a few minutes. Louisiana residents who began smoking cigarettes before Sept. 1, 1988 and who are approved for inclusion in the Trust program receive completely free services that include: cessation medications (such as Zyban® and Chantix®) nicotine replacement therapy (gum, patch, lozenge, inhaler, nasal spray), individual/ group cessation counseling, telephone quit-line support, and/or intensive cessation support services. By using these services, evidence suggests that participants will increase the success rate of attempts to stop smoking cigarettes (on average, it takes 9-11 quit attempts), and may successfully quit—for good.

Here are five quit steps from the CDC, which the Smoking Cessation Trust believes could help Louisiana smokers become cigarette-free:

Step 1: Set a quit date

Pick a date to quit smoking. This will give you enough time to prepare. Really think about your quit date. Avoid choosing a day where you know you will be busy, stressed, or tempted to smoke (for example, a night out with friends, days where you may smoke at work).

Step 2: Tell family and friends

Telling family, friends and coworkers about a quit attempt can increase a smoker’s chances of success. By sharing what kind of support a smoker is looking for–either encouragement or accountability–the loved one can be involved in the process. The more people a smoker has in his corner, the more likely he is to succeed. Have a spouse or friend who wants to quit too? Do it together!

Step 3: Plan for challenges

Stopping smoking is not just about dealing with nicotine cravings. Many smokers need to work through the habitual tendencies surrounding cigarette use. By going to a group workshop run by a certified tobacco treatment specialist (“CTTS”) smokers can learn how to work through cravings and triggers like stress, boredom and nervousness without reaching for a cigarette. Many major hospitals in the area offer cessation counseling, contact the Trust for a full list.

Step 4: Remove cigarettes and other tobacco

You will be tempted to smoke during your quit. Stay strong; you can do it! Removing things that remind you of smoking will get you ready to quit. A few good ideas are:

• Throw away all your cigarettes and matches. Give or throw away your lighters and ashtrays. Remember the ashtray and lighter in your car!

• Don't save one pack of cigarettes “just in case.” Keeping even one pack just makes it easier to start smoking again.

• Remove the smell of cigarettes from your life. Make things clean and fresh at work‚ in your car‚ and at home. Clean your drapes and clothes. Shampoo your car interior. You will be less tempted to light up if you don't smell smoke.

• Have your dentist clean your teeth to get rid of smoking stains. Your teeth will look amazing. When you quit smoking, they will always look that way.

Step 5: Talk with your doctor

Smokers should discuss cessation treatments with their doctor. The Smoking Cessation Trust provides access to all recommended cessation methods; knowing an individual’s medical history, the doctor can suggest and prescribe pharmaceuticals or a nicotine replacement therapy that will work best for each smoker. Doctors can also talk about the benefits of quitting and what to expect.

The next smoking ban?

A chara, – The anti-smoking legislation being introduced in Tasmania that Robert Carty mentions sounds very interesting (December 21st). A rolling ban prohibiting “the sale of tobacco products to anyone born after the year 2000” in an effort to create a “tobacco-free generation” seems quite sensible. After all, tobacco is one of the few products on the market that if used as intended is guaranteed seriously to damage the health of the user and cause the death of a very significant percentage of them.
Addictive, dangerous and potentially lethal, tobacco is, as is so often said, something that if it were being brought to the market today simply would not be considered as suitable for public sale. So introducing a firewall to try and protect a generation that has yet to be exposed to its all-too-fatal charms, while not without its difficulties, is nonetheless an experiment worth trying.

Vested interests will, of course, complain. Perhaps they will whine about the nanny state and people being given a choice. We don’t listen to such nonsense when it comes to heroin and other dangerous substances and we shouldn’t listen to it when it comes to smoking. It is an idea that if introduced here will save lives. So well done to Mr Carty for letting us know about it. – Is mise,

Rev PATRICK G BURKE,
Castlecomer,
Co Kilkenny.