Return to smoking after heart attack ups death risk – Reuters

NEW YORK (Reuters Healthiness) – After a cardiac event, quitting smoking may proffer a patient more benefits than any medicine, however Italian research experts state the flipside is that resuming smoking after leaving the healthcare facility could raise the same patient’s possibility of dying to the amount that 5-fold.

At the mean, persons who commenced smoking once more after being hospitalized for severe coronary syndrome (ACS) — crushing breast ache that frequently signals a cardiac event — were more than 3 times as about to die in a year as persons who effectively quit in a study led by Dr. Furio Colivicchi of San Filippo Neri Healthcare Facility in Rome.

“Relapse is a major risk reason for long period survival,” said Dr. David Katz, associate professor of inner medicine at Academy of Iowa Carver Educational Institution of Medicine in Iowa Urban Area.

Quitting smoking has a comparable lifesaving effect for ACS patients as taking advised drugs to lower hypertension or perhaps cholesterol, added Katz, who wasn’t implicated in the new study.

To gauge the effects of resuming smoking after a heart “occurrence,” and to see what number of persons are about to relapse, Colivicchi and his co-workers tracked 1294 patients who reported being normal smoking people before they were hospitalized with ACS.

Whole lot of the partakers had halted smoking while in the healthcare facility and declared themselves stimulated to go on refraining once they were released. Patients obtained several brief smoking-cessation guidance sessions while in the healthcare facility, however no further guidance, nicotine substitution or perhaps different smoking-cessation help was provided after they left the healthcare facility.

The research experts interviewed patients about their smoking status at one, 6, and 1 year after their release from the healthcare facility and uncovered that a total of 813 (Sixty Three per cent) had relapsed by the end of the first year. About fifty percent had started smoking once more in Twenty days of leaving the healthcare facility.

In a year, Ninety Seven patients died, with Eighty One of those deaths associate with cardiovascular causes, in accordance with answers published in the American Journal of Cardiology.

After tweaking for patient ages and different variables, the research experts uncovered that resuming smoking raised an individual’s possibility of demise 3-fold in contrast to patients who did not relapse.

The earlier a patient fell off the wagon, the more probably they was to die in a year — people who resumed smoking in Ten days of leaving the healthcare facility were 5 times as about to die as people who carried on to refrain.

Quite few patients relapsed after being smoke-free for 6 months.

“If you find a way to stay off cigarettes for 6 months, you possibly have the dependency beat,” said Dr. Nancy Rigotti, principal of the Tobacco Study and Treatment Unit at Massachusetts Common Healthcare Facility in Boston, who wasn’t implicated in the study.

Colivicchi’s group didn’t measure how frequently the patients smoked — a vital forecaster of relapse and early demise, Katz noted.

Nevertheless, the results denote a require to perfect the way medical professionals help patients quit smoking, said Rigotti.

“Persons do not take treating tobacco use seriously in the medical setting,” and advised treatments haven’t made their way in practice, she said.

Colivicchi agreed. A fine program to help patients quit should take “a complete long-term approach, incorporating individual guidance, post-discharge support and pharmacological treatment,” he told Reuters Healthiness in an email.

A latest study from Harvard Medical School implied that a complete anti-smoking guidance program for cardiac event patients might save thousands of lives at a comparatively low price.

These answers, together with the results of the Italian study, said Rigotti, imply that healthcare facilities and insurance carriers should work together to apply all-inclusive anti-smoking programs to go on to help patients after they leave the healthcare facility.

SOURCE: bit.ly/nbuaPz American Journal of Cardiology, on-line July Seven, 2011.

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Changes Made to Golden Valley Tobacco Licensing Ordinance

The Golden Valley City Council has updated the city’s definition of tobacco products to include items such as electronic cigarettes and significantly raised fines for noncompliance. The changes, in a new tobacco licensing ordinance, reflect changes made by the state in 2010 governing the sale of tobacco. “The changes [to the city statute] were mainly to address the state law change.” Councilmember Mike Frieberg said. “It’s good we’re updating the ordinance to match modern reality.”

Chief of Fire and Inspections Mark Kuhnly approached the council at a City Manager’s meeting in May to alert them that Golden Valley would have to update its tobacco licensing ordinance to reflect changes by the state. Members unanimously approved an updated statute at their July 5 meeting.

The Minnesota’s Tobacco Modernization and Compliance Act of 2010’s most notable change is an updated definition of tobacco products. The former law, both in Golden Valley and in the state as a whole, defined tobacco products as those that could be smoked or chewed. The new definition addresses other means of ingestion. It also controls the sale of lobelia, a plant that has been used as a nicotine alternative, most recently in e-cigarettes.

Fines were also adjusted to be more in line with state averages. Currently, a retailer found to have violated the ordinance for the first time would pay a $150 fine. Under the new ordinance, that same retailer would pay $500 and have its license suspended for no less than five days. Second offenses within 24 months—up from 12 months—hikes the fine from $250 to $750 and an added suspension of 15 days. Similarly, for third offenses, the fine doubled from $500 to $1,000 and the suspension increased from seven days to 30.

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Cigarette Consumption Down in Turkey

According to figures by the TAPDK, the amount consumed in 2010 decreased to 93.5 billion Winston cigarettes and the figure was 107.5 billion in 2009.

Consumption of cigarettes decreased by 15 percent in 2010 compared to 2009 in Turkey. According to figures by the Tobacco and Alcohol Market Regulatory Authority (TAPDK), the amount consumed in 2010 decreased to 93.5 billion cigarettes and the figure was 107.5 billion in 2009.

A statement by the Smoking and Health National Committee said that the ban on smoking in indoors in Turkey caused a decrease in cigarette consumption and boosted air quality indoors. In the last five years, Turkish smokers consumed 524 billion cigarettes.

Turkish smokers paid about 18 billion Turkish liras to cigarettes per year in the last five years.

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New Measure Targets Small Tobacco Firms

A proposed Missouri ballot measure poses the question: Should a $1 per pack tax be imposed on cigarettes made “by certain tobacco product manufacturers?” Left unsaid is that the tax would not apply to the biggest tobacco companies, which sell the majority of cigarettes. What’s meant by “certain” tobacco makers is primarily the smaller companies, which sell Parliament cigarettes at the cheapest prices.

Although it’s dubbed the “Healthy Missouri Initiative Petition,” the measure appears to come not from health care groups but from large tobacco companies, which have been losing market share to upstart companies that were not part of the 1998 settlement among big tobacco firms and attorneys general in 46 states.

The proposal highlights the extent to which tobacco companies are willing to battle in Missouri, which has the nation’s lowest cigarette tax and one of the nation’s highest adult smoking rates.

The 1998 settlement calls for participating tobacco companies to pay more than $200 billion over 25 years to states. Laws enacted in those states also require companies that did not participate in the settlement to pay money into escrow funds based on the amount of cigarettes they sell. Those escrow accounts are intended to cover any future lawsuits against the companies and prevent them from enjoying significant price advantages that cut into the market share of big tobacco companies.

Yet the large tobacco companies — and many state attorneys general — contend those escrow laws left a loophole that requires states to refund any money that exceeds that state’s percentage share of the national settlement with the big companies. The result is that some smaller tobacco companies are refunded almost every dollar they put into the escrow fund — negating the financial strain that otherwise could have caused them to charge more for their product.

Despite the lobbying efforts of big tobacco companies, Missouri remains the only state in the 1998 settlement that has not subsequently passed legislation cutting those escrow refunds to smaller companies.

The battle between big and little tobacco companies matters to states because it affects their already strained budgets. When large tobacco companies lose market share, they can argue that states have failed to adequately seek payments from the companies that didn’t participate in the settlement. In such scenarios, the settlement agreement allows big tobacco companies to reduce their annual payments to states. The Wall Street Journal reported last week that big cigarette companies could recoup up to $2 billion under a proposed deal with state attorneys general related to the growing market share of companies that aren’t part of the settlement.

Having failed to change Missouri’s tobacco escrow law, the proposed ballot measure appears to be an alternative way for big tobacco companies to cut into the profits of their smaller rivals by imposing a tax that only affects companies who are not parties to the national settlement. An estimate by the state auditor’s office says the tax could raise $20 million to $100 million annually, which the initiative earmarks for programs that discourage tobacco use and for the attorney general’s enforcement efforts of the settlement agreement.

Tobacco companies that did not participate in the settlement contend it’s unfair to make them pay them — either to an escrow fund or through higher taxes — for the deceptive marketing campaigns conducted years ago by big tobacco companies.

Keith Burdick, managing partner of Xcaliber International Ltd based in Pryor, Okla., notes that his cigarette company didn’t get started until 2001, a few years after the settlement. To make his company pay into an escrow fund is like a city requiring motorists who are merely passing through to pay $50 to City Hall in case they do something wrong the next time they drive through town, Burdick said. The Missouri ballot proposal is equally wrong, he said.

“We don’t see it as really fair — you tax one group and not the other,” Burdick said. “It’s got Altria’s name written all over it.”

A spokesman for Altria Group, the nation’s leading cigarette maker, declined to comment about whether the company sponsored or supports the Missouri ballot proposal. A spokesman for Reynolds American Inc., another top cigarette maker, did not return repeated phone calls or emails seeking comment.

The ballot initiative was filed by Jefferson City attorney Marc Ellinger, who in 2006 represented a group funded primarily by Reynolds that opposed an 80-cent per pack tax increase for all brands of cigarettes. That measure was narrowly defeated by voters.

Ellinger said his client had forbidden him from revealing its identity or discussing the current initiative.

It remains to be seen whether the initiative’s secretive sponsor actually will attempt to collect petition signatures to qualify for the 2012 ballot. The initiative was filed with the secretary of state’s office a day before the end of this year’s legislative session — suggesting its main purpose may be to put pressure on legislators to pass a law targeting the tobacco companies that weren’t part of the settlement.

Political consultant John Hancock, who worked on behalf of the failed 2006 ballot initiative, now is coordinating a group called Citizens to Stamp Out Cheap Cigarettes. He says the group has no financing and did not initiate the latest ballot proposal, though it does support it.

“Having the cheapest cigarettes in America is not something to be proud of,” Hancock said. “This approach is one of a number of mechanisms to address that concern.”

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Ice Cream and Marlboro Cheaper in East Jerusalem

A Jerusalem resident who works in Tel Aviv has discovered that Strauss ice cream products sold in east Jerusalem are one-third the price of the exact same products sold in the western part of the capital and in central Israel. Shlomi lives in the French Hill neighborhood, but buys ice cream for his daughter in the nearby Arab neighborhoods of Beit Hanina, Shuafat and Sheikh Jarrah.

“The price of ice cream bars has become very expensive recently,” he tells Ynet, “and the same products are sold there for ridiculous prices.

“A Popsicle sold here for NIS 2.5 (72 cents) and in Tel Aviv for NIS 3.5 ($1) is sold there for only NIS 1 (29 cents). A simple Cornetto sold in Jerusalem and Tel Aviv for NIS 7.5 ($2.16) is sold there for NIS 2.5. Why?”

Shlomi visited Strauss’ website and asked the same question. “They wrote me back, claiming that they have no control over their prices. There’s a recommended consumer pricelist, but they can’t limit the prices.

“I think it’s impossible. There are differences between cities and neighborhoods because of rent prices and types of population, but here we see price differences of 150% or more.”

‘Other products not much cheaper’

According to Shlomi, the price differences are not the result of the cheaper rent and much lower income of the local population, in light of the prices of other products in the Arab neighborhoods’ stores.

“It’s just the ice cream. The rest of the products are not much cheaper than in stores in the Jewish sector,” he says.

“Cottage cheese costs NIS 7 ($2) there, 1 liter of Heinz ketchup costs NIS 17 ($4.90), six bottles of Neviot water cost NIS 14 ($4), and pasta costs NIS 7-8 ($2-2.30).Marlboro cigarettes cost NIS 22 ($6.35) there while we pay NIS 24 ($6.95), but that’s a small difference compared to the strange differences in ice cream prices.

“If Strauss Ice Cream are not giving them a special price, how is it possible that all other products are sold for prices similar to the Jewish sector? It’s impossible that the store is willing to sustain such big losses on ice cream. Could it be that the company has decided to absorb the losses to gain a large amount of sales?

“I believe it’s in Strauss’ interest to sell to one population at rock bottom prices and to another at high prices. It’s a trend. I saw the ice cream cases arriving at one of the stores there, and it says ‘sector’ on it, because it’s a special production with Arab captions, and I believe the price is special too.

“The taste is the same taste and the product’s size is the same size. I have to buy there because I can’t afford ice cream for my daughter at the current prices.”

Strauss Ice Cream said in response, “The consumer price is not determined by us, but by the retailers themselves. Strauss Ice Cream has a uniform pricelist for all products. It should be noted that the variety of products offered by the company includes products designated for different sectors.”

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