Smoking bans dramatically reduce the number of people hospitalised for heart attacks, stroke and respiratory diseases such as asthma and emphysema, new research has shown.

In the largest analysis of smoke-free legislation to date, American researchers found the more stringent the laws, including those for workplaces, restaurants and bars, resulted in the highest health benefits. 

The research, published in the American Heart Association journal Circulation, analysed 45 studies covering the US and other countries such as New Zealand and Germany.

It found heart attack hospitalisations declined by an average of 15 per cent after communities passed laws banning smoking in areas such as restaurants, bars and workplaces.

Admissions for strokes declined by 16 per cent, while hospitalisations for respiratory diseases such as asthma and chronic obstructive pulmonary disease, were rapidly followed by a 24 per cent decrease in hospitalisation.

Exposure to cigarette smoke induces rapid changes in blood chemistry, making it much more prone to clotting. 

In someone who has narrowed or damaged coronary arteries, smoke exposure can tip the balance and cause a heart attack.

The findings are consistent with other studies that have found smoking bans are linked with a decline in cardiac problems.

Department of Health figures found the number of heart attacks in England plummeted by 10 per cent in the year after the ban was imposed in July 2007.

A similar drop was also recorded in Scotland where another study discovered a 14 per cent decrease in the year after the ban was introduced there.

Around 114,000 people die every year from smoking-related diseases.

But while many link smoking to lung cancer, the connection between it and heart attacks is less well known. About 275,000 people suffer heart attacks in Britain each year, with 146,000 of those dying.

Commenting on the research, Maureen Talbot, senior cardiac nurse at the British Heart Foundation (BHF), said: ‘The risks of passive smoking on our health are well known and this is the reason smoking legislation was introduced throughout the UK in 2007. 

‘Restrictions on smoking in public can help smokers to cut down or quit as well as reducing our exposure to second hand smoke. 

‘This study provides encouraging data about the benefits of a smoke-free environment on our heart health and shows that the right decision was made five years ago. 

‘If we want this downward trend to continue, policy makers should introduce further measures to reduce the appeal of smoking, such as plain, standardised packaging for tobacco.’

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Lawyers for major tobacco companies said Monday they do not want the full U.S. Court of Appeals for the D.C. Circuit to touch a panel’s ruling that went against the government’s controversial graphic warning labels requirement.

A divided three-judge panel of the D.C. Circuit in August ruled against the U.S. Food and Drug Administration’s requirement that cigarette packs carry graphic images that depict the dangers of smoking. Judge Janice Rogers Brown called the images “inflammatory” and said they were “unabashed attempts to evoke emotion.” The court said the proposed warning images violate the First Amendment.

The U.S. Justice Department wants the full D.C. Circuit to overturn the panel decision. Yesterday, responding to DOJ, lawyers for tobacco companies that include R.J. Reynolds and Lorillard urged the D.C. Circuit not to tangle with the panel decision. Ultimately, the U.S. Supreme Court could be asked for its assessment.

“The proposed warnings will not create more informed consumers and were never intended to,” Jones Day litigation partner Noel Francisco, lead counsel for R.J. Reynolds Tobacco Co., said in a court filing Monday. Francisco also said the images “had no measurable effect on consumer knowledge of the smoking risks the warnings address.”

John Seffrin, chief executive of the American Cancer Society, issued this warning while speaking at a high-level forum of the world’s 100 leading cancer experts gathered in the Swiss resort of Lugano.

They said governments must do far more than they have done to control the global tobacco industry, either by raising cigarette prices dramatically, outlawing tobacco marketing or by taxing the multinational profits of the big cigarette firms.

According to scientists, smoking kills more than half of all smokers, mostly from cancer, and yet despite it being the single biggest avoidable risk of premature death, there are about 30 million new smokers a year.

They said that if the current trends continue – with cigarette companies targeting the non-smoking populations of the developing world – then hundreds of millions of people will be dying of cancer in the second half of this century.

Some of the experts attending the World Oncology Forum went further by calling for an outright ban on cigarettes and for the tobacco industry to be treated as a terrorist movement for the way it targets new markets with a product that it knows to be deadly when used as intended.

“We have a major global industry producing a product that is lethal to at least half the people who use it. It will kill, if current trends continue, a billion people this century,” the Independentquoted Dr Seffrin as saying.

“It killed 100 million in the last century and we thought that was outrageous, but this will be the biggest public health disaster in the history of the world, bar none. It all could be avoided if we could prevent the terroristic tactics of the tobacco industry in marketing its products to children.

“There is a purposeful intent to market a product that they know full well will harm their customers and over time will kill more than half of them. The industry needs to be reined in and regulated,” he said.

Worldwide, tobacco causes about 22 percent of cancer deaths each year, killing some 1.7 million people, with almost 1 million of them dying from lung cancer. Yet the numbers of new smokers among the young is rising faster than the numbers giving up.

The latest study into the health effects of smoking, which was published in The Lancet and involved 1.3 million women, showed that tobacco is even more dangerous than previously supposed but the benefits of giving up smoking are greater than expected.

Sir Richard Peto of Oxford University, a co-author of the Million Women study who worked closely with Sir Richard Doll, is also the scientist who first calculated how many people this century will die from tobacco-induced cancers.

“We have about 30 million new smokers a year in the world. On present patterns, most of them are not going to stop, and if they don’t stop, and if half of them die from it, then that means more than 10 million a year will die – that’s 100 million a decade in the second half of the century,” Professor Peto said.

“So this century we’re going to see something like a billion deaths from smoking if we carry on as we are. In Europe we have about 1.3 million premature deaths per year now, of which about 0.3 million are deaths by tobacco. There’s nothing else as big as that.

“If you put all causes together, you wouldn’t get a total that’s half of that caused by tobacco, and tobacco kills more people by cancer than other diseases. Smoking is still the most important cause of cancer… If you smoke a few cigarettes a day, it will be the most dangerous thing you do,” he added

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A 1999 settlement banned tobacco companies from advertising outdoors or at stadiums but there’s another grey zone where the definition of an ad remains fuzzy — smartphone apps. According to the latest research from Australia, apps are loosely regulated, sold worldwide, and increasingly popular—all appealing features for cigarette makers. They’re even open to kids.

In their report, published in the journal Tobacco Control, researchers at the University of Sydney searched the Apple and Android app stores with keywords like “smoke,” “cigarette,” and “tobacco,” to see how many promotional apps they could find. They tallied up anything that looked to be pro-smoking — apps showing branded images or info about where to buy tobacco products — even if the product claimed to be an aid for quitting. The final count? More than 100 different mobile-phone applications that appear to promote smoking.

It’s doubtful all the promos come straight from tobacco companies. The researchers, however, believe that some may. Speaking to Bloomberg earlier this week, author Nasser BinDhim said he finds it “suspicious” that smoking apps are typically released by developers who work under nicknames rather than business names, unlike in other industries. TIME selected five of the most creative pro-smoking apps described in the study, so you can judge for yourself:

1) myAshtray

Most apps identified by the Sydney researchers were tools to simulate or mimic the act of smoking. In this one, users click on the screen to drop ash into the virtual ashtray.

Although the app’s download page claims it can be used to help to quit smoking, BinDhim and colleagues felt the messages that users receive when they drop ash into the ashtray might actually encourage smoking behavior. One such message: “Would be even better with a beer in your hand!” The scientists also say there is no evidence that simulated smoking can prevent cigarette cravings.

2) Cigarettes

This app for Android gives tar and nicotine specs, photos of packaging, and a list of global availability for major cigarette brands from all over the world. Helpful, perhaps, if you’re visiting Estonia and trying to figure out which smokes to buy.

Don’t underestimate how global the market for smartphone apps has become. Today there are more than 6 billion mobile phones worldwide and while most of those are not smartphones, the number of smartphone users continues to rise. In rich countries, like the U.S., the U.K, and Australia, more than one third of mobile phones are already app-ready, according to the new study.

3) Puff Puff Pass

In this cartoon game, players click on a character to make the virtual person smoke. You win points for passing the cigarette (or the pipe, or the cigar — you choose) quickly between characters in a designated order.

There’s strong evidence that smoking in movies can encourage kids to smoke more. A cartoon game with lots of smoking may have the same effect.

4) Cigarette Battery Widget

This app uses a cigarette icon to show you how much battery power remains on your smartphone. It’s simple and requires very little engagement from users. But it can still be a constant reminder of cigarettes, and smoking. So far, this app has been downloaded more than 50,000 times.

5) CRA — Cigar Rights of America

Cigar Rights of America is an advocacy group that will petition various local, state, and federal governments to “protect the freedoms of cigar enthusiasts,” according to the group’s website. This app lets users stream audio and video related to cigar regulation, and gives updates on news, events, and ways to get involved with the group.

Given this latest research on the number of smoking promotions now available in app stores, it may not be long before CRA finds itself with a new legal battle to address: the rights of the virtual cigar smoker.

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Proposed new restrictions in Russia — modeled after laws in Western countries that coincided with a drop in smoking rates — would limit cigarette advertising and public smoking in Russia, and more than double excise taxes on cigarretes. A Wall Street Journal article on the Kremlin’s campaign details Russia’s cigarette problem, which costs 400,000 lives and $48.1 billion every year.

The international smoking data is mapped out above. It’s a fascinating bit of comparative data, with some potentially surprising pieces of information:

• The highest rates are all in Eastern Europe. The one Eastern European exception is Romania, which had similarly bleak numbers until it enacted tough anti-smoking laws in 1997.

• The biggest smokers outside of Eastern Europe are South Koreans, Kazakhs, and Japanese, in that order. China’s smoking rate still lags behind Korea’s and Japan’s (1,711 cigarettes per person in China versus 1,958 in Korea and 1,841 in Japan), but China is the world’s largest overall consumer of cigarettes. As the country urbanizes and develops, don’t be shocked if they rise in the rankings.

• A 1998 study of Russian smoking habits found a direct correlation between cigarette and alcohol consumption rates and a direct correlation between smoking and exposure to “Western influences,” such as Western tobacco companies marketing cigarettes as symbols of a “glamorous Western lifestyle.”

• Americans rank right in the middle. The U.S. is ranked 34th in the available data, with about a thousand cigarettes consumed per person per year. We’re about tied with the Israelis, the Australians and the Irish.

• In this data set, poorer countries tend to be healthier. Sub-Saharan Africa and South Asia have some of the lowest smoking rates in the world. Indians smoke only 96 cigarettes per year per person. Ethiopians only 46. If Americans smoked like that, cigarette companies would collapse overnight, but health-care costs would drop dramatically as well; direct health-care costs related to smoking in the United States are estimated at $96 billion per year.

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The companies are required by court order to widely disseminate the so-called “corrective statements,” which address topics that include the marketing of cigarettes, addiction and health damage. The language of the statements, which must issue through ads in newspapers, on television networks and in retail displays, remains in dispute. U.S. District Judge Gladys Kessler will have the final say on the text of the statements.

The statements are the most publicly visible component of the high-profile injunction issued against tobacco companies following a judge’s conclusion in 2006 that industry leaders participated in a decades-long campaign to dupe consumers about the health risks of smoking. The Justice Department sued the major companies in 1999 under federal racketeering laws.

A lawyer for R.J. Reynolds Tobacco Holdings Inc., Noel Francisco of Jones Day, said during a hearing on October 15 that the statements must be “purely factual and uncontroversial.” Francisco argued that the government wants to appeal to consumers’ emotions, moving beyond factual statements to try to embarrass tobacco companies through what he described as “forced public confessions.” One of the proposed statements says that tobacco companies intentionally manipulated cigarettes to make them more addictive.

Francisco took the lead in advocating for the tobacco companies during the hearing. Beth Wilkinson of Paul, Weiss, Rifkind, Wharton & Garrison and Gibson, Dunn & Crutcher‘s Miguel Estrada were in court for Philip Morris USA.

“[W]hile the government may claim that at least some of its proposed statements do not literally compel defendants to utter the words, ‘We lied,’ there can be no question that the proposed statements are subject to that interpretation,” Estrada said in court papers filed in September.

Justice Department lawyer Daniel Crane-Hirsch, who practices in consumer litigation, argued that the corrective statements must prevent and restrain any future fraudulent statements by the tobacco companies. Generic statements about the dangers of smoking that don’t go to corporate liability, he said, are insufficient. “These companies don’t want people to know what they have done,” Crane-Hirsch told Kessler. He later said the tobacco companies “want to erase history.”

In court papers, Crane-Hirsch disputed that one of the proposed statements—”Smoking kills 1,200 Americans. Every day.”—is an improper appeal to emotion. He said the statement is rooted in an unchallenged finding of fact by Kessler, who presided over a nine-month bench trial in the racketeering case.

The lawyers on both sides are also trying to assess the effect a recent decision by the U.S. Court of Appeals for the D.C. Circuit will have on the scope and substance of the corrective statements. A divided D.C. Circuit in August struck down a U.S. Food & Drug Administration rule requiring cigarette packages to carry graphic images depicting the hazards of smoking. Francisco said the decision provides a guideline for Kessler to restrict the corrective statements.

The majority on the three-judge panel in the graphic images litigation determined that the images violated the First Amendment. Judge Janice Rogers Brown, writing for the majority, said the “inflammatory images” cannot be deemed an attempt to convey information to consumers. The court said the FDA failed to show that graphic warning images have directly caused a decrease in smoking.

DOJ lawyers last week asked the full D.C. Circuit to rehear that case. “The government’s interest in effectively communicating the health risks of smoking cannot be overstated,” the government said in its petition.

The government said there’s sufficient evidence showing that “cigarette health warnings with graphics are far more effective in communicating health-risk information than are health warnings with text alone.” The tobacco companies are expected to respond to the DOJ petition later this month.

Kessler didn’t say when she would rule in the corrective statements dispute. The judge said she is not bound to accept the proposed language from the Justice Department. She indicated she was inclined to modify the language.

By Mike ScarcellaContactAll Articles

The National Law Journal

The website, www.tobacco.money.com, also encourages lawmakers and legislative candidates in Oklahoma to sign a pledge to not accept campaign contributions, meals or other gifts from any tobacco company political action committee or from any registered lobbyist for a tobacco company or tobacco trade association.

Dr. Robert McCaffree, co-director of the Oklahoma Tobacco Research Center, said a clear correlation exists between tobacco industry contributions and the suppression or opposition of legislation intended to reduce tobacco use in the state.

Since 2006, state legislators now in office have accepted $242,719 in campaign contributions, meals and other gifts from tobacco lobbyists and tobacco company political action committees, according to the website. Nine representatives and 11 senators have accepted at least $3,000.

The website’s author, Doug Matheny, is the former director of tobacco prevention at the state Health Department; he retired in February 2011 after 28 years of service. “For decades, we’ve watched tobacco lobbyists manage to kill bills they oppose and pass bills they support,” he said.

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“The tobacco industry is seeing a major return on its investment in Oklahoma’s political system,” said Robert McCaffree, MD, Co-Director of the Oklahoma Tobacco Research Center. “There’s a clear correlation between tobacco industry contributions and the suppression or opposition of legislation intended to reduce tobacco use in our state, particularly among legislators accepting campaign contributions from tobacco company PAC’s.”

Since 2006, Oklahoma state legislators now in office have accepted $242,719 in campaign contributions, meals and other gifts from current tobacco lobbyists and tobacco company PAC’s. Separately, over $50,000 has been accepted by various statewide House or Senate election committees. The highest total amount taken since 2006 by any individual representative is $6,298 and by any individual senator is $11,239. Nine representatives and 11 senators have accepted a total of $3,000 or more.

“The more light we can shine on industry efforts to stop meaningful tobacco prevention measures, the less effective those efforts will be,” says Laurent Huber, executive director of Action on Smoking & Health (ASH). A national leader in the fight on tobacco, ASH is focused this election year on political contributions. “Oklahoma’s website is a model we hope to help replicate in all states, said Huber.”

According to the Oklahoma Ethics Commission, there are 11 individuals currently registered to lobby the Oklahoma legislature on behalf of tobacco companies or tobacco industry trade associations. The tobacco lobbyists and listings of their clients are shown on the website.

“For decades, we’ve watched tobacco lobbyists manage to kill bills they oppose and pass bills they support,” said Doug Matheny, the website’s author. “Even if it never influenced legislation, money distributed by tobacco lobbyists should be refused as a matter of principle. Accepting money or gifts from representatives of an industry that addicts young people to deadly products is inconsistent with Oklahoma values. Most tobacco lobbyists in Oklahoma take direct orders from companies that federal courts recently found guilty of racketeering.” Matheny is the former director of tobacco prevention at the Oklahoma State Department of Health. He retired in February 2011 after 28 years of service.

“Speaking on behalf of physicians now starting practices in Oklahoma, our legislators need to take a stand for health,” said Chris Sudduth, MD, MPH of Tulsa. Dr. Sudduth is Chair of the Oklahoma State Medical Association Resident and Fellow Section. “These powerful tobacco lobbyists and their money should be rejected. Business as usual must change.”

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Cigarette costs add up to about $7400 a year for a New Yorker with a two pack-a-day habit. Here are some suggested alternatives for spending that kind of money:

• Lease a 5 series BMW, and have enough left over for gas.
• A sailing vacation in the Galapagos for you and your spouse, every year (or you could go somewhere different each year).
• Start a college fund for your 4 year old. Private university tuition would be completely covered when they turn 18.
• VIP seats for you and a friend at every Super Bowl.

Next time> the retail cost is only the tip of the iceberg for what cigarettes cost us

If you’re feeling relieved that you live in one of America’s 49 other states, don’t rest so easy. The national average is about 14% of smokers’ incomes spent on cigarettes — that’s about one-seventh of total income, and still a whopping percentage.

Even if you don’t smoke, keep reading — because these shocking statistics can help all of us rethink and improve our spending habits.

How Much We Shell Out for Smokes

Let’s get a little more precise now. In New York State, the average cost of a pack of cigarettes recently was $10.14, the highest in the nation. The lowest average price per pack was $4.02, in Missouri. Nineteen states — plus the District of Columbia — sported average prices above $6.

New York is certainly not alone in taxing cigarettes heavily. The total taxes per pack in New York average about $4.74, and 17 states (including D.C.) levy taxes of $2 or more. (Remember that these are average numbers. In some spots in New York, cigarettes can cost more than $12 a pack!)

A little simple math shows us that a one-pack-a-day habit in New York can cost $3,701 a year. Those who smoke two packs a day are coughing up more than $7,000 annually. Even if you only pay $6 per pack, that amounts to more than $2,000 per year for a daily pack.

Here’s the biggest problem with these numbers: Taxes and the price of tobacco have clearly been rising in recent years — yet the typical household’s income has not. In fact, according to a recent report from the U.S. Census Bureau, the median household income slipped 1.5% between 2010 and 2011, and remained lower than (inflation-adjusted) 1989 levels. Thus, the cost of cigarettes has been taking up a bigger and bigger slice of the typical household’s budgetary pie in recent years. Ouch.

How Much Should Smokers Spend?

It can be helpful to look at the big picture, to see how much average Americans spend on major budgetary categories — and how much they’re advised to spend on them.

The Bureau of Labor Statistics can help with that. Here are some interesting stats, revealing the percentage of after-tax income the average household in America spends on various categories, as of 2010:

27% Housing (including mortgage, rent, utilities, furnishings, and upkeep)
13% Transportation
10% Food
5% Health care
4% Entertainment
3% Clothing
1% Alcohol
1% Tobacco

(The tobacco percentage is low because it’s averaged across smokers and nonsmokers alike.)

It’s very valuable for us to keep tabs on our own spending, to see how much of our hard-earned assets we’re devoting to various items. It’s also good to compare that data to an ideal — to how we should be spending our money.

Spending Guidelines From the Experts

The 50-30-20 Rule: This has been advocated by, among others, Elizabeth Warren, Harvard professor, creator of the new and vital Consumer Financial Protection Bureau, and Senate candidate in Massachusetts. It suggests that you take your after-tax income and devote no more than 50% of it to your “needs” — such as food, housing, transportation, medications, insurance, and so on. Then spend no more than 30% on your “wants” — which would include items such as most clothing, cable television, entertainment, eating at restaurants, travel, etc. Finally, devote at least 20% of your after-tax income to your financial security, by paying off debts, maintaining an emergency fund, and contributing aggressively to retirement savings.

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