Posts Tagged ‘effects of smoking’

In visit here, U.S. health chief touts anti-smoking campaign

Thursday, June 17th, 2010

anti-smoking campaignKathleen Sebelius, U.S. health and human services secretary, met with St. Louis County health officials Wednesday to discuss their plans for spending $7.6 million in federal grant money on an anti-smoking campaign. County officials said the grant would pay for nine new jobs in the health department, including an accountant, administrators, health educators and a media consultant. The three goals of the grant are to keep young people from starting to smoke, lower residents’ exposure to secondhand smoke and help people who want to quit smoking.

Anti-tobacco marketing efforts will be aimed at schoolchildren and businesses will be offered resources to create smoking cessation programs, said Barry Freedman, manager of the campaign coined “Changing Tobacco Norms in St. Louis County.”
The health department announced in March that it won the two-year grant from the U.S. Centers for Disease Control and Prevention.

Sebelius’ visit to St. Louis County was part of a tour of the 44 communities nationwide that received stimulus grants totalling $373 million for preventive health efforts. The grants were awarded for programs to combat smoking or obesity, two of the main causes of preventable chronic diseases.

“Seventy-five cents of every health dollar is spent now on chronic diseases,” Sebelius said Wednesday at the North Central Community Health Center in Pine Lawn. “It’s going to be healthier for America to figure out a way to get at these two (causes).”

A smoking ban in most public places goes into effect in St. Louis County Jan. 2. Sebelius, former Kansas governor, challenged Missourians to pass a statewide smoking ban like the one in her home state.

Missouri has one of the highest smoking rates in the country, with one in four adults identifying as a smoker.

None of the funds will go toward changing Missouri’s cigarette tax rates, which at 17 cents a pack will be the lowest in the country as of July 1. The nation’s highest cigarette tax belongs to Rhode Island, at $3.46 per pack, according to the Campaign for Tobacco-Free Kids.

stltoday.com, By Blythe Bernhard, June 17, 2010

Pregnant smokers ‘unaware of health risks’

Wednesday, June 16th, 2010

pregnant women smokerDoctors have warned that Scottish pregnant smokers do not know enough about the health risks for themselves and their babies. Currently, 19% of pregnant women are smokers, compared to 29% in 1995. The BMA Scotland said the fact one in five mothers-to-be still smoked showed the Scottish government had a lot to do to educate people on the effects. On the UN’s World No Tobacco Day, the organisation called for more support for adults to quit the habit. Smoking in pregnancy can lead to an increased risk of premature birth and cot death.

It also increases by one-third the risk of stillbirth or death within the first week of a baby’s life.

Children born to parents who smoke are also twice as likely to suffer from serious respiratory infections.
Dr Sally Winning, deputy chairman of BMAS, said: “Around one in five women smoke during pregnancy and, although this is an improvement on previous years, it reflects the lack of knowledge among Scots about the health risks of smoking, not only to themselves, but to the health of their children.”

She said partners and families could help pregnant smokers by quitting at the same time.

Dr Winning said it was “essential” that the Scottish government tackles the issue of parental smoking.

She added: “Parents should be educated about the effects of smoking, not just on their own health, but to their children.

“We need to offer more smoking cessation support to adults and parents to help those who wish to stop smoking stay stopped.”

‘Plain packaging’
Ash Scotland, the anti-smoking charity, said tobacco companies should be prevented from aggressively marketing their products to women.

The charity’s chief executive Sheila Duffy said: “Smoking is still the biggest killer of Scots, with a quarter of all deaths due to tobacco, and we are seeing an increase in smoking-related diseases like lung cancer among women as a result of a rise in women smokers in Scotland 30 to 40 years ago.

“Although teenage smoking is on a downward trend, there are still more girls than boys taking up smoking younger.”

A ban on displays in shops and sales from vending machines comes into force across Scotland next year.

Ms Duffy welcomed the ban, but called for further measures “such as plain packaging and holding tobacco companies more accountable”.

news.bbc.co.uk, June 16, 2010

The Good and the Bad of the Tobacco Suit

Tuesday, June 15th, 2010

big tobacco industryTo psychiatrists the term DENIAL, DENIAL, DENIAL is noted everyday. Big tobacco also practices this faulty mechanism. Think of the Marlboro man astride his mount or from decades past, white coated physicians with a lighted Camel in hand. Tobacco’s effective advertising leading to hundreds of thousands of deaths yearly is okay for them. But the fatal effects of smoking on a poster, they deem offensive. I trust the courts will apply rational thinking to refute the insane mockery by the tobacco industry.

As much as I wish the city’s messages will be more than marginally effective, people don’t quit smoking simply by looking at a poster. Rational thought doesn’t do it no matter how graphic the photos.

One of my colleagues, a professor of pathology and someone who holds dead tissue daily, was a smoker. Putting up posters and giving out the patch for free are not nearly as effective as treating smoking addiction like the medical condition that it is. No physician would use a single program to treat an ulcer, asthma, cancer or any other disease.

While the city’s efforts have been valiant and any initiatives to get individuals to quit smoking should be applauded not challenged, they don’t often work and can be dangerous. For example, giving the patch to someone with high blood pressure can be detrimental. Additionally, the dosage of the nicotine should be different for every smoker. Nicotine dependency is a specific illness requiring one on one, selective treatment for each patient. One treatment does not fit all.

Doctors and behavioral therapists have the tools and they are effective. However, most medical insurance programs do not pay for smoking cessation therapy. Some patients are covered because unfortunately, they already have a diagnosis such as chronic bronchitis or emphysema caused by smoking. These insurers will put out $200,000 for lung replacement but not a penny to prevent smoking-related diseases such as, lung and other cancers, heart disease, skin conditions and a new ailment from smoking comes to light virtually every year.

Medicine has the ultimate solutions to the fatal smoking scourge destroying hundreds of thousands of lives yearly. Perhaps the city should use their smoking cessation funds on individuals and not posters.

From huffingtonpost.com, June 15, 2010

Tobacco Taxes Finance Terrorism

Thursday, June 10th, 2010

tobacco and moneyThe next terror attack on America could be a self-inflicted wound — specifically, a cigarette burn.
Politicians expand tobacco taxes to discourage smoking and to feed their own nicotine-like addiction to public spending. Like so many others, this government action smolders with unintended consequences. Tobacco taxes create a perfect arbitrage opportunity that radical Muslims exploit to collect money for terrorist groups that murder Americans and our allies. Tobacco taxes should be cut, or at least frozen, before they fuel further Islamic-extremist violence.

Consider the first attack on the Twin Towers, which killed six and injured 1,040. As Patrick Fleenor recalled in a Cato Institute study, “counterfeit cigarette tax stamps were found in an apartment used by members of the Egyptian Islamic Jihad cell that carried out the 1993 bombing of the World Trade Center.”

By article.nationalreview.com, June 10, 2010

Puff, puff, puff, nicotine rises gradually

Tuesday, March 9th, 2010

Nicotine builds up gradually in smokers’ brains rather than spiking after each puff, according to a study that might help point to new ways to help people quit smoking.

Dr. Jed E. Rose of Duke University reports in Monday’s online edition of Proceedings of the National Academy of Sciences that nicotine buildup in the brain was gradual over several minutes.

Scientists have theorized that there is a spike of nicotine in the brain about seven seconds after each puff, but almost no measurements had been taken until now, Rose said in a telephone interview.

“We were surprised to find that the rate of uptake was much different from what one commonly hears,” said Rose, who directs the Duke Center for Nicotine and Smoking Cessation Research, a part of the university’s School of Medicine.

Rose used brain scans to measure the nicotine levels in 13 regular smokers and 10 people who smoke only occasionally, an indication they were not addicted to nicotine.

Maximum brain levels of nicotine were reached in 3 to 5 minutes, and built up slower in addicted smokers than in casual ones, the researchers found.

“This slower rate resulted from nicotine staying longer in the lungs of dependent smokers, which may be a result of the chronic effects of smoke on the lungs,” Rose suggested.

“Now that we know there are not these spikes” that had been expected, Rose said, researchers may be better able to develop new approaches to help smokers get what they need from cigarettes, but in a way that’s not addictive.

His laboratory, for example, is working on a mist inhaler to deliver nicotine without any combustion.

Still in question: Why do some people become addicted to cigarettes and others don’t? The difference in the rate of nicotine buildup in the brain doesn’t explain this, the researchers said.

The research was funded by the giant tobacco companies Philip Morris USA and Philip Morris International. The researchers said the companies had no role in designing or carrying out the research or analyzing the results.

Rose’s findings confirm his earlier work on blood levels of nicotine, and “the brain is what really matters,” commented Dr. Kenneth A. Perkins, a professor at the University of Pittsburgh who also studies smoking addiction.

The assumption was that a critical effect of smoking was a shot of nicotine with each puff, then another shot with the next puff, and so on, Perkins said.

“He is showing that, at least when you look at the blood and brain concentration levels, that’s not really what’s going on, it’s much more gradual,” Perkins, who was not part of Rose’s research team, said in a telephone interview.

“Clinically, what you do with that, I’m not quite sure,” he added.

By RANDOLPH E. SCHMID

Electronic Cigarette Inhalants Do Not Contain Carcinogenic TSNAs

Thursday, January 14th, 2010

SCOTTSDALE, Ariz. – NJOY, the world’s leading electronic cigarette brand, has completed a scientific analysis that has determined that “there is no evidence that carcinogenic TSNAs are present in the aerosol” of its brand of electronic cigarette products.

These results address concerns raised by the FDA and others about product ingredients, safety and health risks, and specifically, found that there is no carcinogenic risk from TSNAs – tobacco specific nitrosamines – in the vapor inhaled by NJOY product users or nonusers who may be exposed to the constituents passively.

“In July the FDA released study information about the constituents of our electronic cigarettes that may have inadvertently misled the media and consumers about their health risks,” said Jack Leadbeater, CEO of NJOY. “The FDA analysis evaluated only the contents of the cartridges used with our products, and not the constituents of the aerosol or vapor to which users are actually exposed or the potential health risk, if any, that may be posed by that exposure.”

The FDA study reported the presence of four TSNAs – N-nitrosonornicotine (NNN), N-nitrosoanabasine (NAB), N-nitrosoanatabine (NAT) and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butaone (NNK) – in NJOY cartridges at levels so minute they were not quantifiable, not dissimilar from science that has found low quantities of TSNAs in other FDA-approved products.

Of the four TSNAs noted by the FDA study, only NAT has been shown through published scientific studies to be nontoxic and noncarcinogenic, and only NAT was found in the NJOY vapor and only at trace levels. None of the other three TSNAs were present in the vapor.

“Based on my review of scientific literature, NAT is not toxic and not carcinogenic, and based on the vapor analysis, it is my conclusion that TSNAs do not pose a health risk to the users of the electronic cigarettes distributed by NJOY,” said Ben Thomas, Ph.D., a well-respected consultant with 35 years’ experience in toxicology, pathology and risk mitigation who conducted the analysis in conjunction with premier independent consulting laboratory ANALYZE.

This study and others conducted by NJOY also reveal that FDA-approved products offering nicotine, such as inhalers, gum and patches, contain TSNAs, but likewise at trace levels. To date FDA has not required manufacturers of these other nicotine-containing products to reference the presence of TSNAs in their product labeling.

“We realize smoking is a target, and so the notion of electronic cigarettes can rub some agendas the wrong way. But, we also realize that smokers desire options,” said Leadbeater. “Our product provides smokers a way to partake in an activity they enjoy, but without acrid odors, fire hazards and excessive cost, and now with some scientific clarity.”

Thomas noted that ANALYZE conducted the study “using a method based on that used by the FDA” and that the studies “were technically appropriate and appear to have been well done.”

Thomas has a bachelor’s of science degree in biology from Tulane University, and master’s of science and Ph.D. degrees in pathology from the University of Texas Health Science Center, where he is currently an adjunct professor of toxicology/risk assessment in addition to being president of the Ben Thomas Group. He has been published or presented nearly 60 times, has chaired six toxicology task forces, has provided expert testimony for numerous cases, and was a senior managing scientist at Exponent among other positions.

Since the introduction of NJOY, acceptance among smokers has been excellent and more than 300,000 committed smokers in 50 countries have begun using its products. NJOY is a smoking alternative that offers committed smokers who are of legal age the chance to smoke with many of the satisfactions of traditional smoking and without many of the inconveniences.

NJOY Resources

Going smoke-free may raise diabetes risk

Tuesday, January 5th, 2010

No one doubts that quitting smoking is one of the best ways to improve your health. But a new study by Johns Hopkins researchers suggests that, in the short term, tossing the cigarettes might actually increase the risk of developing diabetes.

People who quit smoking tend to gain weight, and those extra pounds can put a person at increased diabetes risk. In fact, the diabetes risk was higher for people who gave up cigarettes than for those who continued to smoke – but only within the first couple of years of quitting, according to the research appearing in today’s Annals of Internal Medicine.

After that, the diabetes risk decreased and almost disappeared after 10 years, researchers found.

The study shouldn’t deter people from quitting smoking, researchers urged. Rather, quitters should be conscientious about their weight, and doctors who counsel them should offer lifestyle coaching, intensive weight management and glucose level checks, said Hsin-Chieh Yeh, an assistant professor of internal medicine and epidemiology at the Johns Hopkins University School of Medicine and the report’s lead author. In addition, some studies suggest nicotine-replacement therapy such as the patch could help patients keep off the pounds, she said.

Most importantly, “don’t even start smoking,” said Yeh. “Quitting is good, but you need to watch your weight.”

In the study of nearly 10,900 middle-age adults who were followed for 17 years, those who quit smoking had a 70 percent increased risk of developing diabetes in their first six years smoke-free. But smoking is also a risk factor for developing diabetes, researchers said. Over the same period, smokers had a 30 percent increased risk. The more a person smoked and the more pounds they gained, the higher the risk, researchers found.

Dr. Kevin Ferentz, a smoking cessation expert and associate professor in the department of family and community medicine at the University of Maryland School of Medicine, said the study confirms what he sees in his practice – about a third of all smokers who quit gain an average of 5 to 8 pounds. It’s not because of a slowed metabolism, he said. Quitters often substitute eating for smoking.

To stop successfully, smokers need nutritional advice and a plan to tackle the triggers that keep them vulnerable to relapse, he said. Ferentz reminds quitters to munch on low-calorie snacks like carrot sticks, celery and sugar-free gum when the cravings hit.

“The key to stopping smoking is preparation, it’s not will power,” he said. “The analogy that I use is stopping smoking is a test. You either study for the test and there’s a good chance you will pass, or you don’t study and there’s a good chance you will fail.”

Dr. Mansur Shomali, a diabetes specialist at Union Memorial Hospital, questioned the study’s scope. Researchers don’t know for sure if weight gain was the sole cause for a higher diabetes risk. Quitters might have been at higher risk for developing diabetes long before they tried to kick the habit, for example.

Shomali said patients who smoke and have diabetes are at greater risk for severe cardiovascular problems.

“We sometimes think of these patients like a time bomb waiting for a heart attack or stroke,” he said. “Diabetes is bad, smoking is bad, doing both together is worse. If you stop smoking it will be better for you in the long run. There is some short-term weight gain, but you can control that.”

Virginia spends 1.5 percent less on tobacco prevention

Thursday, December 10th, 2009

Virginia is spending about 1.5 percent less on tobacco-prevention programs in the current fiscal year, according to a report by a coalition of public-health groups.

And other states are cutting funding for the programs overall by more than 15 percent this year, pushing it farther than ever below federally recommended levels, the report said.

Virginia’s spending on the programs, including federal funding, is about $13.4 million, down from $13.6 million in 2009.

That spending represents more than 4 percent of the estimated $307 million in tobacco-generated revenue Virginia collects each year from tobacco-settlement payments and tobacco taxes, according to the report.

Virginia ranks No. 32 on tobacco-prevention spending, committing about 13 percent of the minimum amount recommended by the U.S. Centers for Disease Control and Prevention.

“I am concerned that Virginia ranks so low,” said David DeBiasi, director of public advocacy for the American Lung Association of Virginia. “The impact of teen smoking on future health-care expenses, after they have developed cancer or emphysema, makes an investment in prevention not only a logical step but a necessary, fiscally sound decision.”

Under legislation passed by the Virginia General Assembly in 1999, the state puts 10 percent of its payments from the national tobacco settlement into youth-smoking prevention, but lawmakers have shifted some of that money in subsequent years to help balance the state budget.

Also, state legislators this year added childhood-obesity prevention to the mission of the foundation that oversees the smoking-prevention program, raising concerns among tobacco-control advocates that smoking-prevention programs will lose funding.

All states, including Virginia, should spend $567.5 million of their own money and $62 million in federal grants on programs to prevent tobacco use — about 17 percent of the $3.7 billion, the Centers for Disease Control recommends, the report says.

Thirty-four states and the District of Columbia trimmed funding for such programs this year. New York cut the most at $25.2 million, or 31 percent, the report said.

States will collect more than $25 billion in a combination of tobacco taxes and legal settlements from the tobacco industry this fiscal year. They will spend about 2.3 percent of that on programs to prevent or stop tobacco use, the report says.

Released by the Campaign for Tobacco-Free Kids and several other groups, the report says smoking-related health care costs $95.9 billion annually nationwide.

Tobacco companies agreed in 1998 to settle lawsuits several states brought over smoking-related health-care costs by paying them about $206 billion during a two-decade-plus period.

The largest U.S. tobacco company, Henrico County-based Altria Group Inc., parent company of Philip Morris USA, pays a majority of that amount. Altria spokesman David Sutton said states should use more of the settlement money for youth-smoking prevention and health-related initiatives.
December 10, 2009

Moms-to-Be Smoke Less After Workplace Smoking Ban

Thursday, November 26th, 2009

NEW YORK – Ireland’s implementation of a workplace smoking ban in 2004 appears tied to a decline in maternal smoking rates as well as lower risk for preterm births, study findings hint.

Compared with the year prior to the smoking ban, 12 percent fewer women reported smoking during pregnancy in the year after the ban, Dr. Zubair Kabir, of the Tobacco Free Research Institute in Dublin, Ireland, and colleagues report.

Their study, in BJOG: An International Journal of Obstetrics and Gynecology, also revealed “a welcome sign,” Kabir’s team notes. They observed 25 percent lower risk for preterm births in the year after the smoking ban compared with the year prior to the ban.

Kabir and colleagues analyzed records at Coombe Women and Infants University Hospital to assess whether Ireland’s workplace smoking ban altered smoking during pregnancy, a known risk factor for preterm birth and having a low birth weight infant.

Their comparison included 7,593 births in 2003 and 7,648 births in 2005, and allowed for other maternal factors tied to birth risks such as the mother’s age, number of previous births, alcohol intake, blood pressure, and complications during pregnancy.

Overall, babies with the highest birth weights on average were born to former smokers. By contrast, babies with the lowest birth weights had mothers who smoked during pregnancy.

However, in addition to the noted declines in maternal smoking and preterm birth risk, the investigators also identified 43 percent greater risk for low birth weight in the year after the smoking ban compared with the year prior to the ban.

This finding “is intriguing and needs further exploration,” Kabir and colleagues say, particularly in light of evidence that exposures to secondhand smoke during pregnancy may play a role in having babies with low birth weight.

They also call for further exploration of their observed increase in Caesarean delivery rates – from 15.4 in 2003 to 19.5 percent in 2005.

BJOG, An International Journal of Obstetrics and Gynaecology, December 2009

Questioned About Seal In Smoking Ban Trial

Friday, November 13th, 2009

South Dakota’s smoking ban faces one burning question. Did the notaries who verified the petitions do enough to make them official?

A two-day trial started Thursday in Pierre. The opponents of the ban are only 18 signatures short of getting the issue on the ballot.

Several notaries took the witness stand Thursday and were questioned about how they signed and dated the petitions and if they did it legally.

Linda Wegman was one of the notaries questioned and always thought she had her ‘I’s’ dotted and ‘T’s’ crossed when it came to notarizing documents.

“It’s hard to remember the date so I had my date printed right on it, thought I had all my bases covered,” Wegman said.

Wegman had a customized stamp made to make sure all of her information could be seen clearly. But when she took the witness stand and was questioned about the stamp, she said she never had it registered with the state, and the six petition sheets she stamped were never officially notarized.

“I’ve notarized hundreds and hundreds of documents using that stamp and if anyone wanted to contest it, I guess they [the notarized documents] are all wrong,” Wegman said.

The Secretary of State and the American Cancer Society did contest Wegman’s notarized documents along with several others Thursday. Supporters of the smoking ban are pointing to those miscues as the reason to throw out thousands of signatures.

“The rules are there. Are they tough? That’s not really what we’re here today to argue. The rules are there, the laws are there, the time has past for that,” Darrin Smith with the American Heart Association said.

Notaries were also questioned about only putting the month and year of their expiration date on the petition. The state argues the month, day and year all should have been included.

Opponents say questions about those technicalities are why this issue is in court.

“What’s a complete date, what’s not a complete date? I don’t know. I thought when somebody signed and dated something, 11-09, as far as the year and the month, I thought that was a complete date. But evidently it needs a number too,” smoking ban opponent and Sioux Falls bar owner Don Rose said.

Judge Kathleen Trandahl will hear from more notaries and witnesses Friday. It will ultimately be her decision if the notaries did enough to authenticate the petitions.


By Ben Dunsmoor
© 2009 KELOLAND TV

National tobacco case to be heard in Bangor

Thursday, October 22nd, 2009

BANGOR, Maine— Attorneys from around the country descended Wednesday on the federal courthouse in Bangor for a conference on a class-action lawsuit against the makers of light cigarettes.

It is the first multidistrict litigation case ever assigned to U.S. District Court in Bangor.

Multidistrict litigation, or MDL, is the label the federal judiciary gives cases filed against the same party or parties in federal courts around the nation. Once cases have been combined, a three-judge panel assigns them to one federal judge.

At least 20 lawsuits from around the country have been combined in Bangor. The MDL has been assigned to U.S. District Judge John Woodcock, who has not handled one since his appointment to the federal bench in 2003. Moreover, the original Maine case that led to the 20-case MDL is once again in the hands of Woodcock, whom the U.S. Supreme Court reversed last year.

In a 5-4 a split won by the court’s liberals, the justices ruled in December that smokers may use state consumer protection laws to sue cigarette makers for the way they promote “light” and “low tar” brands. The Altria Group Inc. argued on behalf of its Philip Morris USA subsidiary that the lawsuits are barred by the federal ciga-rette labeling law, which forbids states from regulating any aspect of cigarette advertising that involves smoking and health.

Tobacco litigation in federal court is not unusual. Cigarette cases regularly are filed in state and federal courts around the country. It is unusual for the first case in the nation against a particular tobacco company to be filed in Maine.

Bangor lawyer Samuel W. Lanham Jr. filed the lawsuit in August 2005 on behalf of Lori A. Spellman of Levant and Stephanie Good and Allain L. Thibodeau, both of Bangor. Each smoked Marlboro Lights for 15 years or more. The plaintiffs are not seeking damages for personal injuries or health problems caused from cigarette smoking.

Instead, the lawsuit alleges that they were hoodwinked into thinking that “light” cigarettes contained less tar and nicotine than full-flavor cigarettes. The plaintiffs are seeking unspecified compensatory, punitive and other damages.

Woodcock granted summary judgment in the cigarette makers’ favor in 2006. The 1st U.S. Circuit Court of Appeals reversed that ruling the next year and attorneys for the tobacco firm appealed to the nation’s highest court. It was the first case argued during the U.S. Supreme Court’s term last year.

The meeting Wednesday was purely about scheduling — which motions the judge will hear first, when briefs must be filed, how often Woodcock will hold conferences with attorneys, and which attorneys on both sides will act as liaisons from the court to the more than 25 attorneys scattered throughout the country.

The case is not expected to be decided anytime soon.

No hearings in the case will be held until January or February. Once Woodcock rules on whether the facts in a landmark case upheld earlier this year by the U.S. Court of Appeals for the Washington, D.C., Circuit can be applied to the MDL case, his decision is expected to be appealed to the U.S. 1st Circuit Court of Appeals in Boston. That decision also could go to the U.S. Supreme Court.

Attorneys appeared visibly relieved when Woodcock, a Bangor native, said he would conduct monthly conferences via telephone and they would not have to fly to Bangor.

“I’m sure it would be helpful to the Bangor economy to have you all come her once a month, but I don’t think that’s the most efficient use of your clients’ money,” he said.



By Judy Harrison Bangordailynews

Canadian Provinces Sue Tobacco Companies

Monday, October 12th, 2009

Ontario and Quebec — Canada’s two largest provinces — have announced that they are suing tobacco companies for a total of $80 billion.

The lawsuits are the latest in an effort by the Canadian government to reduce smoking and recover some of the health care costs associated with smoking.

Hide-And-Seek Cigarettes

Customers can buy cigarettes at Wally’s Smoke Shop in Toronto’s West End, but you wouldn’t know it when you walk through the door, because the cigarettes are behind the counter. A law passed last spring means store manager Susan Pak has to keep them hidden behind a bank of white metal doors.

“We don’t have to show the customer,” Pak says. “See, we’re hiding. Over here.”

The government’s idea is that if people don’t see cigarettes, they won’t be tempted to buy them. According to Pak, that policy has helped her sales drop by as much as 10 percent.

The out-of-sight, out-of-mind policy is just one of the things that make Ontario a tough place to buy and sell cigarettes. Over the past few years, the province has put strict limits on advertising, legislated graphic warning labels on cigarette packages and outlawed smoking everywhere except on the street or at home.

Last week, Ontario Attorney General Chris Bentley announced that the government is suing tobacco makers for $50 billion. He pointed to several issues that are in question, including, “What did the tobacco companies know? When did they know it? And what did they tell the people of Ontario about the addictiveness and related effects of tobacco use?”

The Ontario lawsuit draws heavily on secret tobacco company documents released in 1998, when the U.S. government won a $200 billion settlement to recover health care costs. Ontario officials claim that tobacco companies have known since at least 1950 that smoking is addictive and causes disease, and that those facts were deliberately kept secret.

Hypocritical?

Bentley says the province needs the money to pay for smoking-related health costs, which he estimates at $1.6 billion a year. Anti-tobacco campaigners hope the lawsuit will yield even bigger results.

“It will show the industry not to be in the bounds of normal business behavior,” says Michael Perley, director of the Ontario Campaign for Action on Tobacco. “There’s no other industry that produces products that have no safe level of use at all, that kill half their long-term users, all with the manufacturer’s full knowledge. So the revelation of that information then creates a huge climate for further regulation of the industry.”

Canadian tobacco manufacturers have not answered the allegations in the lawsuit, but say the government is being hypocritical. Eric Gagnon, a spokesperson for Imperial Tobacco, said Ontario already collects around a billion dollars every year by taxing cigarettes.

“This is sheer hypocrisy by the government,” Gagnon says. “They’re the ones who are licensing the industry, legislating the industry and collecting billions of dollars of taxes. So for them to turn around and with one hand legislate the industry and collect all the taxes, and on the other hand just to turn around and sue the industry is sheer hypocrisy.”

Some smokers say they think Gagnon has a point.

Carol Bragagnolo huddles in the rain outside her office in downtown Toronto, taking a furtive mid-day smoke break.

“I just ran the treadmill this morning,” she says. “If my trainer knew I was doing this.”

Bragagnolo says she started smoking at 19 and doesn’t think the tobacco companies are to blame.

“I think that smoking starts with the individual,” she explains. “My father smoked inside the house, and so I’ve been growing up with secondhand smoke every day of my life, and I know I’m doing it to myself.”

British Columbia and New Brunswick are also planning to sue, and all but one of Canada’s 10 provinces has passed legislation that would allow them to join in the lawsuit. With the tobacco companies gearing up to fight, it will likely be years before the cases are resolved.

© by Anita Elash Npr