While the proven negative health consequences of smoking and tanning are undeniable, tobacco and indoor tanning advertisers would like consumers to think otherwise. In fact, a new study comparing the tactics used in advertising tobacco and indoor tanning products found several similarities in how these two industries market unhealthy products.

In the report entitled, “Comparison of advertising strategies between the indoor tanning and tobacco industries,” published online in the Journal of the American Academy of Dermatology, dermatologist David A. Jones, MD, PhD, FAAD, in private practice in Newton, Mass., presented results of an observational study which concluded that both industries employ advertising strategies to counteract health concerns of their products in order to positively influence the consumer’s perception of smoking and indoor tanning and drive industry demand.

“The indoor tanning industry reported domestic sales in excess of $2.7 billion in 2007 , and it relies heavily on advertising to sell the misleading idea of a ‘safe’ or ‘healthy’ tan to the public,” said Dr. Jones. “Even though it is well documented that UV radiation from natural sunlight and indoor tanning devices is a known cause of skin cancer, the public is not always aware of the serious health risks associated with indoor tanning – and the tanning industry’s advertising practices capitalize on this fact.”

In reviewing 2,000 advertisements from four large tobacco advertising image databases, Dr. Jones and his colleague, Jennifer Herrmann, MD, identified four key strategy profiles that were used to sell their products. These strategies included: mitigating health concerns, appealing to a sense of social acceptance, emphasizing psychotrophic effects, and targeting specific population segments. Dr. Jones added that tobacco advertising was selected as a reference framework because it is well documented and designed to promote a product with known health hazards.

Subsequently, a collection of approximately 350 contemporary tanning advertisements was compiled from a variety of sources – such as industry magazines, salon and industry Web sites, and in-store promotional materials – and evaluated based on the four key strategies identified in the tobacco advertisements.

As the increased incidence of lung cancer, respiratory and cardiovascular diseases and other health risks linked to smoking continued to mount over the years, the tobacco industry adjusted its advertising strategy to mitigate these known health risks. Specifically, the tobacco industry recruited physicians as crucial allies in marketing their products, reassured the public that their brands had competitive health advantages, and commended the intelligence of smokers for choosing cigarettes marketed as “safer” cigarettes.

Using Physicians as Allies
Dating back to the 1930s and 1940s, Dr. Jones and his colleague found that physicians wearing white lab coats frequently appeared in cigarette advertisements – using the doctor’s image to reassure consumers that cigarettes were safe. Similarly, indoor tanning advertisements have resorted to using physicians and citing medical research studies to try to persuade the public that indoor tanning is somehow “safe” or “safer” than tanning outdoors.

“The thinking behind these ads is that if physicians do something, then somehow it must be okay,” said Dr. Jones. “However, these ads omit the results of a recent survey indicating that 100 percent of dermatologists and 84 percent of non-dermatologist physicians would discourage UV tanning for non-medical purposes, even in healthy patients.”

Promoting Misleading Health Advantages
When awareness of the health risks of cigarettes began to grow in the 1950s and 1960s, the tobacco industry responded with what it coined as “safer,” “filtered” cigarettes. Dr. Jones noted that the goal of these ads was to convince consumers that filtered cigarettes provided protection from harmful effects of smoking, but without admitting that smoking was detrimental to one’s health.

To dispel growing concerns about the dangers of UV exposure, the indoor tanning industry countered with “harm reduction” campaigns that were similar to those used by the tobacco industry. For example, some advertisers began promoting their tanning beds as “UVB-free” or “99% pure UVA” during the 1980s when research confirmed that UVB rays are carcinogenic. These ads, of course, failed to mention that UVA rays also are harmful and can cause skin cancer.

Another popular harm reduction tactic used in tanning advertisements is to promote the health benefits of vitamin D production from UV exposure. In these types of ads, consumers are led to believe that UV exposure from both natural sunlight and tanning beds is beneficial in producing vitamin D, which research suggests may provide protection against heart disease and other cancers.

“What these ads omit is that UV exposure increases your risk of skin cancer, and there are safer ways to get this important vitamin,” said Dr. Jones. “An adequate amount of vitamin D can be obtained from vitamin D supplements – without the health risks of obtaining vitamin D from intentional UV exposure.”

Nothing Smart about Ads that Appeal to the Consumer’s Intelligence
Another tactic used by tobacco manufacturers in advertising is to try to somehow make consumers believe they are “smart” by smoking a certain brand of cigarettes over another brand. Dr. Jones and his colleague found that the indoor tanning industry makes similar appeals to the intelligence of consumers by promoting sunburn prevention at tanning bed facilities through trained professionals who teach consumers how to “tan safely” without getting sunburned.

“This tactic fails to mention that tanning to prevent sunburn provides only an SPF protection of 3, while simultaneously causing damage to the skin that can lead to future skin cancers,” said Dr. Jones. “In addition, studies also show that staff members of indoor tanning facilities do not always enforce the tanning intensity of tanning beds and time regulations of their patrons.”

While Dr. Jones and his colleague concluded that further consumer education about the dangers of tanning is needed, they also point out that the lack of government regulation has allowed the tanning industry to thrive on the public’s misconceptions about tanning through deceptive advertising practices.

FTC Bans Misleading Indoor Tanning Ads
Recognizing the seriousness of this issue, in January 2010 the Federal Trade Commission (FTC) issued a consent order that prohibits the Indoor Tanning Association (ITA) from making false health and safety claims about indoor tanning. The American Academy of Dermatology (Academy) raised its concerns about the false statements being made by the ITA with the FTC in 2008 after the ITA launched an advertising campaign designed to portray indoor tanning as safe and beneficial.

“The American Academy of Dermatology commends the FTC for its investigation into the false and deceptive health and safety claims about indoor tanning being perpetuated by the indoor tanning industry,” said dermatologist David M. Pariser, MD, FAAD, president of the American Academy of Dermatology. “The scientific facts are clear: Exposure to UV radiation – either from the sun or from artificial light sources such as indoor tanning – increases the risk of developing skin cancer, including melanoma, the deadliest form of skin cancer.”

SOURCE American Academy of Dermatology

The more that teens see cigarette ads, the greater their risk of taking a puff. A new study shows that the particular content of tobacco marketing resonates with youth and that the vivid imagery in tobacco advertising captures their interest, although teens typically are more resistant to the promotional seduction of other products.

“Cigarettes have created a brand for every personality trait,” said study lead author Reiner Hanewinkel, Ph.D., director of the Institute for Therapy and Health Research in Kiel, Germany.

“If you are looking to project independence and masculinity, think of the lonely cowboy in the Marlboro ads,” added Hanewinkel, who collaborated with Dartmouth Medical School. “On the other hand, if you’re looking to project a desire for romantic relationships, and friendships are playing a role, then you will choose Lucky Strike if you are a man and Virginia Slims if you are a woman.”

Kids with high exposure to tobacco advertising were twice as likely to have tried smoking and three times as likely to have smoked in the past month, compared to those with low exposure. Exposure to tobacco advertising also was associated with higher intent to smoke in the future among the never-smokers, suggesting that it affects how adolescents perceive smoking even before they start.

The study, which appears online and in the April issue of the American Journal of Preventive Medicine, has relevance for the United States and other nations with partial advertising bans similar to Germany’s restrictions.

The 2008 survey involved 3,415 German schoolchildren, ages 10 to 17, in rural and urban areas. Students saw images (with all the writing and brand logos removed) of six cigarette ads and eight commercial products such as clothing, cars, candy and detergent.

With the brand information missing, researchers measured adolescents’ ad recognition by applying psychological assumptions about attention and memory. They inquired about how frequently students had viewed each ad image and asked about smoking habits and intentions.

“We were amazed at how often they had seen the images and could correctly recall the cigarette brand,” said study collaborator James Sargent, M.D., a professor of pediatrics at Dartmouth. “For example, 55 percent had seen the Lucky Strike image and almost one quarter correctly decoded the brand.”

After analyzing the data, the researchers assessed how likely nonsmokers were to try smoking. Researchers classified survey participants as current smokers if they reported smoking at least once a month.

“This is a well-done study. They controlled for all the things they needed to control for,” said Stanton Glantz, Ph.D., director of the Center for Tobacco Control Research & Education at the University of California, San Francisco. Among the outside variables was whether a parent or peers smoke.

“It’s a nice contribution to the literature showing that cigarette advertising is very powerful,” Glantz said, noting the strong link between the amount of ad exposure and the level of youth response.

By Susan Kreimer, Cfah

As early as 2006 Michelle Obama secured a promise from her husband that he would give up smoking if he ran for President. Four years on he has the job, but he has still not quit.
The proof consists of four opaque words in the written summary of his first routine medical as President: “Continue smoking cessation efforts”. In a list of medications occasionally used by Mr Obama the summary also notes “nicotine replacement therapy, self use” — a reference to the nicotine gum that he sometimes chews.

That was enough to trigger a flurry of inquiries about the presidential smoking habit, including several to his press secretary, Robert Gibbs, who repeated what his boss admitted once last year: Mr Obama “occasionally falls off the wagon.”

On that occasion the First Smoker called himself a “former smoker”. He was clearly more candid with Captain Jeffrey Kuhlman of the US Navy, his personal physician, whose choice of words left no doubt that he is in fact a current smoker.

No known photographs exist of him smoking as President, although plenty have been faked, including one of him dressed as the Marlboro Man. He cannot light up inside the White House since it is designated a no-smoking building, and he dislikes being asked about his habit by reporters.

His preferred brand is thought to be Marlboro, and he is believed to minister to his nicotine cravings on the West Colonnade, which leads from the Oval Office to the Rose Garden.

Mrs Obama has never smoked or had much sympathy for her husband’s apparent inability to quit. “I hate it,” she told the CBS news programme 60 Minutes in 2007. In that interview she appeared to believe that he had stopped smoking and said proudly: “I outed him — I’m the one who outed him on the smoking. That was one of my prerequisites for, you know, entering this race.”

The book The Race of a Lifetime, an account of the 2008 campaign, stated that months before the CBS interview Mrs Obama had not only demanded that her husband promise to quit as a condition of supporting his presidential run, but that she made the promise a “deal-breaker”.

In 2008 Mr Obama admitted in an interview with Men’s Health magazine that he was still occasionally “bumming” cigarettes. “But I figure, seeing as I’m running for President, I need to cut myself a little slack.” As President he continues to do so. What Mrs Obama makes of that remains to be seen.

House rules

According to Monica Lewinsky, Bill Clinton found pleasure from his cigars, even without lighting up

George W. Bush did not smoke while in office, but his wife Laura was known to escape onto the White House balcony for the occasional cigarette

Ronald Reagan, who in his film star days featured in an advert for Chesterfield cigarettes, quit before becoming President after his brother developed throat cancer

Dwight Eisenhower, like Mr Obama, was ordered by his doctor to cut back — but from four packs to one pack a day. After following orders for a few days, he then went ahead and quit cold turkey

Theodore Roosevelt barred his daughter Alice from smoking while in the White House, so she took to lighting up on the roof instead.

By Giles Whittell, Timesonline

The online open-access journal PLoS Medicine said this week that it would no longer accept for publication reports of research sponsored by tobacco companies. The journal joins two of its sister publications, PLoS Biology and PLoS One, in formally adopting this position, but the announcement might be viewed as self-serving in that the journal has never published such a paper. In fact, PLoS One has published only two.

The decision highlights a dispute among journal editors. The leading tobacco-control journal, Tobacco Control, does not ban industry-sponsored research, in part because it does not wish to appear biased.

The BMJ, formerly the British Medical Journal, argues that such a decision is an unacceptable form of censorship.

The editors of PLoS Medicine cited two reasons for their decision. “First, tobacco is indisputably bad for health. Half of all smokers will die of tobacco use. . . . Tobacco interests in research cannot have a health aim — if they did, tobacco companies would be better off shutting down business — and therefore health research sponsored by tobacco companies is essentially advertising.”

Because publication in journals like PLoS Medicine is funded by research sponsors, “we believe it would be irresponsible to act as part of the machinery that enhances the reputation of an industry producing health-harming products.”

Second, “we remain concerned about the industry’s long-standing attempts to distort the science of and deflect attention away from the harmful effects of smoking. . . . We do not wish to provide a forum for companies’ attempts to manipulate the science of tobacco’s harms.”

Not everyone agrees with the editors. Jeff Stier of the American Council on Science and Health said, “By deciding to no longer allow for research funded in any part by the tobacco industry, they’re acknowledging that they’re no longer able to evaluate science.”

By Thomas H. Maugh, Latimes

The 2008 WI Youth Tobacco Survey found that 7 percent of high school students and 3 percent of middle school students use chewing tobacco. Its use is more common among boys than girls.
With the numbers doubling in the years from middle school to high school, it is very important that our youths are educated about chewing tobacco, its effects on their bodies, and the products and advertising aimed at them by the tobacco companies.

Many people have the incorrect assumption that because chewing tobacco is smokeless, it is also harmless, since the poisons and chemicals are not released into the air. However, that is not the case. Chewing tobacco contains 28 cancer-causing agents, all of which are absorbed into the bloodstream during its use. In fact, chewing tobacco is more addictive and harder to quit than cigarettes. Using spit tobacco eight to 10 times a day can put as much nicotine into the body as smoking 30 to 40 cigarettes, since the nicotine content of spit tobacco is two to three times greater than a single cigarette. Nicotine is more addictive than cocaine or heroin (“About Spit Tobacco,” ETR Associates, 2007).

With the smoking bans that are being implemented around the nation, tobacco companies are changing the focus of their advertising — turning more to promotion of smokeless products as discreet alternatives to cigarettes in places where smoking is not allowed (www.cancer.org). This is creating a new tobacco user — one who smokes in their home, and uses smokeless products in public, posing even more serious health threats to their bodies.

Additionally, the smokeless products that the tobacco companies are advertising have an increasing appeal to teenagers, due to the variety of candy flavors that are available. A recent study by Portland State University Chemistry Professor James Pankow found that smokeless tobacco products have up to 700 percent more flavor additives than candy! The high levels of flavorings are used to cover the taste of the tobacco, luring kids into using it because of the good taste, and not forcing them to think about the health risks associated with its use.
Anti-tobacco advocates state that parents who don’t smoke are not aware about the new threat coming from smokeless flavored tobacco, as they simply have no idea that such products exist. The landmark Tobacco Control act adopted last June, and put into effect in November, prohibits the sales of cigarettes with any flavoring besides menthol; however, the ban doesn’t cover other flavored tobacco products.

Chewing tobacco users face a multitude of health risks, including cancers of the lip, tongue, cheeks, gums and floor and roof of the mouth, nicotine addiction, oral leukoplakia, gum disease and gum recession, heart attack and stroke . According to the Centers for Disease Control and Prevention, oral cancer is the sixth-leading cancer in men, and almost 75 percent of people diagnosed with oral and pharyngeal cancer use tobacco. Additionally, only 56 percent of people diagnosed with mouth or throat cancers live longer than five years.

Feb. 14 to 20 was Through With Chew Week. Established in 1989 by the American Academy of Otolaryngology — Head and Neck Surgery Inc., the week serves as an educational campaign to decrease spit tobacco use and increase awareness of the negative health effects of using these products . Locally, our Youth Initiatives group organized a number of events to increase awareness of the dangers associated with chewing tobacco. These kids have taken a stand to not use tobacco products, to educate their peers about the risks associated with the use of tobacco and to fight against the tobacco companies and their deceptive marketing practices. Join the kids in their efforts: Educate yourself about the dangers of chewing tobacco, and consider developing an action plan to quit if you are a current user.

Wendy Young is a Marshfield Clinic AmeriCorps Member serving the Inner Wisconsin Coalition for Youth (IWCFY), working on prevention activities with students in the local schools, including Wisconsin Rapids public and parochial, Immanuel Lutheran, Nekoosa, Pittsville and Auburndale. IWCFY is a network of community members promoting and facilitating healthy lifestyles.

The U.S. Department of Defense, caught off guard by the swift spread of the H1N1 flu virus last year and delays in producing a vaccine, is backing an unusual plan to use tobacco plants to make the vaccine.

Flu vaccines are typically grown in chicken eggs. Although the technique is slow and expensive, vaccine makers have done little to improve on this reliable method for more than 60 years. The urgent need for a better way became apparent last year.

“The response to H1N1 was a disaster,” said Brett Giroir, vice chancellor for research at Texas A&M University System, part of a consortium testing plant-based vaccines for H1N1, or swine flu.

The Defense Advanced Research Projects Agency—which conducts research to protect soldiers from infectious diseases, and also is concerned about the U.S. capability to react swiftly to a bioterrorist attack, among other things—has awarded the consortium $40 million to make an initial 10 million doses of H1N1 vaccine.

Texas A&M and closely held firm G-Con will together invest a further $21 million. Details of the project, known as GreenVax, will be announced Wednesday.

For several years, vaccine companies have worked on harvesting vaccines in everything from caterpillar cells to cocker-spaniel kidney cells. Plants have certain advantages over animal parts, which may contain pathogens harmful to humans. The tobacco plant is particularly promising: It has been extensively researched, is cheap to grow and can yield large amounts of vaccine quickly—potentially reducing production time to weeks instead of several months.

Earlier this month, Arizona State University researchers showed a plant-based drug could prevent and treat West Nile virus infection in mice. In January, Germany’s Bayer AG said it was testing a plant-based vaccine for non-Hodgkins lymphoma.

In December, Medicago Inc. of Quebec City reported positive results for a tobacco-based vaccine for avian flu, or H5N1, which has killed more than 250 people world-wide. Biotechnology firm VAXX Inc. of Tucson, Ariz., says it soon plans to start a human trial of a tobacco-based vaccine for Norwalk norovirus—or “cruise ship virus”—which causes gastroenteritis in as many as 74 million Americans annually.

GreenVax is one of the more ambitious of the plant-based vaccine projects. It is partly based on research done at Fraunhofer USA Center for Molecular Biotechnology, in a partnership with the biotech firm iBio Inc., both based in Newark, Del.

As a first step, researchers at Fraunhofer isolated a protein from the H1N1 virus known to trigger a protective immune response in a patient without causing an infection. A gene for this protein was then introduced into a bacterium. Tobacco plants were placed in a special chamber and dipped into a soup of the bacteria, which caused the plants to get infected with the gene-carrying bacteria.

The infected plants then began to produce the protein from H1N1 in large quantities. The plants grew for about a week. Their leaves were then chopped up and crushed, and the protein from H1N1—the essence of the vaccine—was extracted from the slurry and purified.

Initial tests on ferrets, which can catch human flu, showed the vaccine was safe and effective. “The good news is that this vast amount of human protein isn’t toxic to the plant,” so it can keep producing large amounts of the vaccine’s raw material, said Barry Holtz, president of G-Con. And the plants don’t become “transgenic”—their seeds, for example, aren’t changed, so they can’t spread genetic alterations to normal plants.

The GreenVax project still has a long way to go. It needs to show that it can produce sufficient quantities of purified vaccine-ready protein quickly and safely. And such a vaccine would have to be tested in humans and get the approval of the Food and Drug Administration before it can be provided more widely.

The consortium plans to build a 145,000-square-foot vaccine production facility in Bryan, Texas, managed by G-Con. One innovation being developed: Mobile manufacturing “pods” that can be deployed swiftly in areas where the vaccine is urgently needed.

GreenVax hopes to produce the initial 10 million doses of H1N1 vaccine within 12 months. Large-scale human clinical trials are expected to begin in 2011, and could take up to 18 months to complete. The setup could be used to produce other vaccines as well.

“The science hasn’t yet been unleashed to get past chicken eggs for making vaccines,” says Dr. Giroir. “But now that the system is stressed, there’s a reason to get past it.”

By GAUTAM NAIK, Online.wsj

My proudest moment as state health commissioner was sitting beside Gov. Frank O’Bannon as he signed Indiana’s historic 1999 tobacco settlement legislation and handed me the pen.

This legislation, Indiana’s greatest public health achievement, created the Indiana Tobacco Prevention and Cessation Agency to administer a comprehensive tobacco-prevention program with funding adequate to meet CDC-recommended guidelines.

During the settlement legislation deliberations, I was asked if I wanted the program placed at the Indiana State Department of Health. Although tobacco control was my top priority, I supported locating it in an independent agency with a governing board to preserve its focus, to maintain some measure of separation from gubernatorial control, and to insulate it from the capriciousness of politics and tobacco-industry influence.

SB298 contains a provision that would abolish ITPC, move this independent program and its funding to the ISDH, terminate its 14 staff positions, and dissolve its 22-member volunteer executive board that includes tobacco control experts and public health professionals.

Passed by the Senate and now under consideration in the House, it is most likely headed for conference committee.

This legislation would save about $1 million yearly in administrative costs mostly by eliminating all of the staff positions. Moving it to the ISDH may sound like a good governmental-consolidation plan, but as their former head, I can assure you that it isn’t.

ISDH staffing is already marginal and there is no one there to administrate a meaningful program. It will be given to a few individuals with other full-time responsibilities and little or no expertise in tobacco prevention. It will become a backwater ineffectual program with its funding eventually raided for other uses. Although ISDH officials publicly say they can efficiently administer the program, privately they admit they lack the necessary personnel and the capacity to work with local communities. It is going there to die. The same scenario occurred in Mississippi and Ohio. Their programs have since withered.

Over the past 10 years the agency has received $137 million, nearly half of that appropriated in the first three years. Unfortunately, funding was brutally cut in 2004. The current annual appropriation is now only $10.8 million (Indiana’s CDC-recommended annual amount is $78.8 million) despite Indiana receiving an average of $150 million from the settlement yearly. Meanwhile, the tobacco industry spends $426 million annually in Indiana to promote their products.

Despite insufficient funding, ITPC has produced impressive results. Although the smoking rate has dropped only modestly for adults 25 and older, the smoking declines in Hoosier children have been astonishing and far greater than the national downward trend. Between 2000 and 2008, smoking declined 42 percent among high school students and 58 percent among middle school students.

These decreases cannot be adequately explained by the relatively modest increase in the state cigarette tax or the enactment of smoke-free laws.

States with functional tobacco-control programs have the greatest declines in smoking. Beyond the numbers, the agency has benefited the state’s tobacco-control efforts in many ways, including serving as the catalyst for local community organization necessary for enactment of smoke-free ordinances. And tobacco prevention is a wise investment. Tobacco costs Indiana $3.5 billion annually in health-care costs and business-related expenses. Each tobacco-prevention dollar spent reduces that bill by up to $7.

Indiana now ranks second-highest in adult smoking. Indiana should not only increase tobacco-control funding but also retain ITPC, a wisely-designed nationally-acclaimed independent agency with the expertise to deliver CDC evidenced-based tobacco-prevention and cessation programs.

In one of the unhealthiest states in the nation, it is shameful, unconscionable and short-sighted to do otherwise. If this agency is dismantled, a future of more death and disease from increased smoking awaits Hoosier children.

Georgia lawmakers, health-care advocates and business leaders are united in opposing a proposed “bed tax” on hospitals to shore up a financially struggling Medicaid program.

What they don’t agree on is where to find $247.8 million to replace the revenue the tax would raise, money Gov. Sonny Perdue is counting on to help balance a recession-ravaged fiscal 2011 budget.

“There’s no consensus on what to do to fill the hole, it’s so big and bad,” said Rep. Ben Harbin, R-Evans, chairman of the House Appropriations Committee. “Medicaid is in such bad shape, we’ve got to come up with revenue for that.”

The governor is recommending a 1.6 percent tax on hospitals’ net revenue to help plug a projected $506 million Medicaid shortfall driven by growing demand for services and the impending loss of federal stimulus funds.

Rhonda Medows, commissioner of the Georgia Department of Community Health, gave lawmakers an either-or choice last month: approve the bed tax and accompanying fees on managed-care organizations or slash Medicaid reimbursements to all health-care providers by 16.5 percent.

But opponents see that as a false choice. Rather than offsetting the bed tax revenue with spending cuts, they would prefer to replace it with other taxes, more aggressive tax collecting or with savings from other areas of the Medicaid budget.

One possibility is raising Georgia’s tax on cigarettes and other tobacco products.

Perdue pushed a 25-cents-per-pack increase in the tax through the General Assembly in 2003 during a milder recession than the current downturn. That brought the tax per pack to 37 cents. Now, health-care advocates are calling for an additional $1-per-pack tax.

Kevin Bloye, spokesman for the Georgia Hospital Association, said there’s logic in scrapping a tax on hospitals and replacing it with a higher tobacco tax because smoking contributes to health-care costs.

“Why are we taxing organizations that make us well and not products that make us sick?” he asked.

Bert Brantley, a spokesman for Perdue, said the governor considered raising the tobacco tax when he developed his budget recommendations late last year.

But Brantley said a higher tobacco tax would have diminishing returns for the state because it would reduce smoking and, thus, tobacco tax revenue. “You end up collecting less than anticipated because demand goes down,” he said. “That’s good public policy, but you end up with a hole.”

Harbin said the only way to sell a tobacco tax hike to a tax-averse legislature would be through tieing it to health care. But he said he’s not convinced that argument would sway enough lawmakers.

While the tobacco tax doesn’t appear to be gaining traction, legislative leaders are giving a better reception to bringing in more tax revenue by giving the state more tax-collecting tools.

The House version of the amended fiscal 2010 budget includes $342,000 to hire more investigators and auditors for the Department of Revenue.

Also, House Republican and Democratic leaders have introduced bills to let cities and counties share information with the state agency, making it easier to identify and go after businesses that aren’t remitting sales taxes to the state.

“(Consumers) are paying the taxes, but they’re not being collected. We’re talking about cheating,” said House Minority Leader DuBose Porter, D-Dublin, chief sponsor of the Democrats’ bill. “It (also) would ease the pressure in this budget.”

But Brantley warned that relying on a sales tax crackdown would be risky because it’s uncertain how much additional revenue could be collected.

He said there’s also no guarantee that additional sales taxes brought in through more aggressive collecting would go toward Medicaid and not other cash-strapped state agencies.

Proposals put forth by the Georgia Chamber of Commerce would directly affect Medicaid because they would generate savings inside the program.
Chamber President George Israel, a former managed-care industry executive, said more serious efforts to prevent Medicaid fraud and abuse could save the state $100 million.

Israel also suggested big savings could be had if the Department of Community Health got more aggressive with its disease management programs.

“Seventy to 80 percent of the cost (of Medicaid) comes right out of chronic disease,” he said. “They haven’t exhausted the options.”

In response, the Department of Community Health issued statistics showing that the agency’s Medicaid fraud-and-abuse program has generated millions in savings in recent years.

Brantley said a key advantage to the hospital tax is that the revenue would be plowed back into the Medicaid program.

He also noted that the state revenue would be matched by larger drawdowns from the federal government.

Because of that federal match, hospitals serving large numbers of Medicaid patients – including Atlanta’s Grady Memorial – would be net gainers.

The hospitals that would lose money typically have more paying patients.

by Dave Williams, Atlanta.bizjournals

Scientists recently explored the effects of pipe and cigar smoking on the lungs. They conclude that smoking a pipe or cigar should be considered as unhealthy to the lungs as cigarette smoking, and just as socially unacceptable.

The researchers say pipes and cigars are also a risk factor for lung damage that leads to COPD (chronic obstructive pulmonary disease). Smoking a pipe or a cigar may not be a less risky alternative to cigarettes like some people may think.

Cotinine, a byproduct of nicotine that can be measured in urine samples, can signal risk of lung disease from smoking. Researchers studied 3,528 individuals who never smoke cigarettes but did smoke pipes or cigars, discovering findings consistent with decreased lung function, that can lead to obstructive lung disease – a finding the scientists say should be considered by clinicians who should counsel patients to stop smoking.

The study raises concerns for public health because of the increased incidence of tobacco use in the United States say the researchers who also advocate counseling for patients by their physicians to quit smoking pipes and cigars.

R. Graham Barr, MD, Dr.PH, Assistant Professor of Medicine and Assistant Professor of Epidemiology at Columbia Presbyterian and lead author of the study says, These findings, together with increased cotinine levels in current pipe and cigar smokers, suggest that long-term pipe and cigar smoking may damage the lungs and contribute to the development of COPD. Physicians should consider pipe and cigar smoking a risk factor for COPD and counsel their patients to quit.”

Michael B. Steinberg, MD, MPH, of the University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School comments that the tobacco industry perpetrates the social acceptability of pipe and cigar smoking, linking the practice to “sophistication, affluence, education, and celebration”. Smoking pipes and cigars can lead to lung damage and COPD and should be treated as unacceptable as cigarette smoking.

by Kathleen Blanchard, Emaxhealth