Closing the door of another semester... and smoking?

Approaching soon is the closing of Fall semester. The holidays are coming, a time to rejoice with family and friends. This past weekend I was eating dinner with my parents, and my dad mentioned that one of his clients has been diagnosed with terminal lung cancer and that hopefully she will make it to enjoy one last Christmas. Although this woman is in her late eighties and has lived a long and fulfilling life, perhaps it could have been longer had she not smoked cigarettes. My father also mentioned this weekend that quality of life is on the rise, so much that in the future people might be living up to 150 years old! Mind you, the current life expectancy is 78 years old, so we have a long wait before we reach that high mark (and mind you my dad is a smart man, but he is by no means a credible source to quote as fact).

My Uncle Ed lives in South Dakota. Unmarried and with no children, he lived with my Aunt Ann, his sister - not wife - in a small farmhouse in Watertown, S.D. Although my Aunt Ann has recently passed, Ed is still alive and kicking and over 100 years in age. This weekend when I was with my family, we were talking about how Uncle Ed has managed to live well past the average American life expectancy. My mother, a on and off lifetime smoker (currently on), replied: "Well its because he didn't have any children." Which makes sense, since children do cause increased stress both emotionally and economically in one's life (BUT also bring lots of joy :) ). My dad, who has never smoked in his life and HATES HATES HATES the fact that my mother smokes her "cancer sticks," had a different explanation: "Its because he never smoked cigarettes."

Getting at my point - other than the fact a weekend holiday vacation with the family has turned me into a rambling fool - life is a precious thing. Although I may be a fool at this moment, due to lack of sleep, sixteen hours in a car and a sore throat that has been looming for the past two weeks - some good ol' R & R will cure that. A real fool is someone who fails to realize how precious life is, because there is no easy cure for lung cancer, just an end: death.

So I will be ending this blog by examining the numerous ways to end smoking. I found a list of quit-smoking products at the Mayo Clinic web site, which includes:

Nicotine replacement therapy, which includes a small amount of nicotine:

Nicotine Patch

Nicotine Gum

Nicotine Lozenge

Nicotine Inhaler

There are also several prescription medications:

Bupropion SR (Zyban)

Varenicline (Chantix)

Under each kind of quit smoking product is: an overview, pros, cons, cautions and a timeline of how long each product should be used. The anti-smoking prescription medication Zyban also function as an anti-depressant, and both Zyban and Chantix are required by the FDA to carry a black box warning:

In July 2009, the Food and Drug Administration (FDA) required bupropion (Zyban) SR to carry a black box warning — the strongest safety warning that the FDA can issue about a prescription medication. The warning is required because bupropion SR may be associated with serious mental health problems either while taking it or after stopping it, including an increased risk of suicidal thoughts or behavior, hostility and depression.

In July 2009, the FDA required varenicline (Chantix) to carry a black box warning — the strongest safety warning that the FDA can issue about a prescription medication. The warning is required because varenicline may be associated with serious mental health problems either while taking it or after stopping it, including an increased risk of suicidal thoughts or behavior, hostility and depression.

Click here to read more about these products and depression.

On top of these cautionary side effects, these prescription drugs can be pricey. Reading the comments from a blog written about Chantix, it seems to range from thirty to low one hundred dollars in price. Maybe you are a smoker, maybe you are not - but most likely someone close to you or at least someone you know is a smoker. Perhaps these products are the trick to quitting smoking for some people, but surely anyone who is quitting smoking needs the support and encouragement of fellow friends and family members. Help someone close the door on smoking and open a new door to a longer and healthier life, a guaranteed cheap - yet also priceless - gift to give this holiday season.

Forget food and water, I want my candy and cigarettes

After looking at state excise tax rates for cigarettes, I have become intrigued with the relationship between smoking and recession. I will continue to delve into how smoking rates and cigarette sales are affected by recession. Common sense would say that cigarette sales would decline in recession. Smoking cigarettes is not necessary for survival, so when Americans have to make budget cuts, shouldn't cigarettes be the first to go? Not necessarily.

I found an article from USA Today that actually reports that despite financial difficulties, consumers are not prepared to forgo their "guilty pleasures" - alcohol, cigarette and candy makers are all reporting healthy sales amid the economic gloom. I will note that this article was written from London a little over a year ago, but I believe its message is not outdated as the world economy continues to struggle and is applicable to the United States.

Some interesting pieces of information I found in the article:

"Sin stocks, ranging from gambling to liquor, are usually a safe bet in hard times. While shares in some of those companies have fallen along with stock exchanges this year, lots are still seeing strong revenues and sales."

"It's inelastic demand as far as many of these stocks are concerned," said Hargreaves Lansdown analyst Keith Bowman, using the economists' term for consumption that is not deterred by higher prices. "So far there's signs that they are holding up, although there's still concern that these industries will see some impact.

Inelastic demand is usually a term prescribed to goods that are necessities (think bread or milk). Are cigarettes a necessity for one who is a regular smoker?

Philip Morris International (PM) said its earnings rose 23% in the second quarter and it raised its earnings forecast for this year, saying it had not been affected by inflationary pressures like other consumer products companies.

"Cigarettes in general can withstand such an environment better than many consumer products," Chief Financial Officer Hermann Waldemer said at the time.

Although these statistics are from August 2008, a more recent stock update from October 2009 reports that although volumes disappoint for Philip Morris and RJ Reynolds in the past 3rd quarter, their profits are beating expectations of analysts. CNNMoney.com also reports Philip Morris International as #14 in the Fortune 500's Biggest Winners.

I also found a more recent article from BBCNews.com that says that many smokers have been unable to quit because of increased stress caused from financial worries. Its findings are reported from a study of 877 smokers and ex-smokers commissioned by McNeil Products Ltd, which makes nicotine replacement therapy products. Although this study has interesting findings, knowing McNeil Products manufactures nicotine replacement therapy products may expose a potential conflict of interest. The company may hope to exploit people's increased stress levels by telling them they can quit smoking but still relieve their stress with their nicotine therapy products. However, the poll in the article did find that people are willing to cut in other areas in order to continue smoking, a fact I found interesting:

"Some 42% of respondents admitted they were more likely to cut spending on clothes, and 21% said they were more likely to try to cut down their weekly supermarket shop."

An article from Reuters written in March this year offers support for the other end of this argument, proposing that a big hike in the federal tax on cigarettes will lead to decreased smoking rates:

Danny McGoldrick, the Campaign for Tobacco-Free Kids advocacy group's vice president for research, said the formula is simple: as prices rise, fewer people buy cigarettes.

McGoldrick forecast the tax hike will persuade just over 1 million current smokers to quit and prevent 2 million children from starting. These changes will avert about 905,000 smoking-related deaths and save $44.5 billion in healthcare expenses over time, McGoldrick predicted.

The article also notes that U.S. smoking rates have been slowly declining for decades and that rates are often higher where state tobacco rates are lower.

Are smoking rates completely determined by economics, or do other factors play a role in the big picture of why choose or choose not to smoke? What is more important to consumers, losing their hard earned cash or losing their sanity?

A Smoke Free Initiative

This past Thursday (November 12) I attended the "Smoke Free University Session" which was at 4:30 P.M. in Palmer Commons. The session's goal was to create an open discussion in which diverse opinions can be heard. This session is the first of many sessions to discuss the Smoking Ban on all UM Campuses (Ann Arbor, Dearborn and Flint). These sessions are the first step taken by the Smoke Free University Steering Committee, which was formed by President Coleman after her announcement of the smoking ban, which will be effective July 1, 2011. The decision for the ban was made by President Coleman to fulfill her goal of a healthy campus community. The Steering Committee, who conducted this session, was not involved in the decision of a smoke free campus, but has been elected by President Coleman to decide the best way to carry out this goal.

The Steering Committee has two co-chairs: Kenneth Warner, Dean of the School of Public Health, and Robert Winfield, U-M Chief Health Officer and Director of the University Health Service. Mr. Warner was present at the session, but his co-chair Mr. Winfield was unable to attend. Mr. Warner sat at the front of the room in the middle of a panel, with various people on either side of him who are the chairs of the various sub-committees, which include:

(1) Faculty, Staff and Affairs

(2) Guests, Events and Athletics

(3) Facilities and Grounds

(4) Student Life

(5) Communications

(Note: when I looked at the Smoke Free Initiative web site, the committee names were slightly different from what the chairs said at this session)

These sub-committees each have about twenty people, with members consisting of: faculty, staff, union representatives, students, smokers, non-smokers and those who have quit smoking. The Student Life Sub-Committee in particular has student representatives from various University Student Organizations, such as: MSA (Michigan Student Assembly), Greek Life and various other undergraduate and graduate students.

This move of the University to go completely smoke free is not seen as a drastic decision, but rather the next step in regulation:

*1987: U-M first adopted a University-wide ban on smoking in buildings (except several designated residence halls) and University vehicles

*1998: Health System prohibited smoking on the grounds and in public places

*2003: RHA (Residence Hall Association) eliminated smoking from all residence halls

*2010: All U-M Campuses will be smoke free

There is also a timeline that the committee will be following in their implementation process:

- Open discussion sessions, such as the one I recently attended

- Focus groups

- Committee's recommendation will be presented to President Coleman in Fall 2010

- Full blown implementation will be July 1, 2011

After the Committee presented this information a Q & A session followed.

A good question that was asked was how does the University plan to implement this policy, and how does it plan on dealing with multiple offenders of the policy?

The committee says that they will be seeking compliance through good will, and that no tickets will be given out to offenders. They are hoping this most recent decision will be a situation similar to previous smoking restrictions, in which enforcement was a non-issue. They say this is an issue that is currently being examined, but that their goal is not to be punitive but to leverage educational opportunities. The committee says they are respectful of those who continue to smoke, but that free behavioral counseling will be offered to students and faculty along with discounts of smoking smoking cessation products. Upon looking on the web site for such services, I found a free support group, but Tobacco Treatment Programs cost $100 for anyone who is not a U-M Employee or a patient with a UMHS Physician Referral. I did not see any offering of discounted smoking cessation products, but perhaps such products and more services will be available as we approach the date of the actual smoking ban.

When asked why this decision was made, one of the women sitting on the panel offered a different answer than President Coleman's goal of a healthy campus community: "Those who choose to smoke cost the University Money." That made me wonder, what truly is the University's goal? Could the true goal be about economics, and the added health benefits of a smoke free campus is simply a perk that goes along with it? Consider this except from the news release found on the Smoke Free Initiative's web site:

"There’s a strong business case for encouraging employees to quit smoking. Male smokers miss 3.9 more days of work per year than non-smoking males, and female smokers miss an additional 2.1 days of work per year. A 1996 study by Warner and colleagues also found that workplace smoking cessation programs reduce health care costs, absenteeism costs, on-the-job productivity losses and life insurance costs."

One woman, who named herself as the President of the Nurses Union and a smoker, voiced her concern that there be a places for nurses to smoke. As a smoker of course, her comments to the committee seemed a tad bitter, but she made an excellent point that received many nods of agreement from those attending the session:

"I don't want anybody telling me how to live my life. A lot of people don't."

Although this may be true, a smoke free University is no longer an idea, but a goal that will be reached by July 2011. If you would like to attend a session such as the one I attended, there will be another session this Thursday, November 19. Click here to find more information and to sign up if you are interested.

Thank you for (not) smoking

I found this video particularly interesting because just yesterday I was Skyping with my friend Mara, who is currently studying abroad in France. I mentioned my blog about smoking, and she said that "true Europeans" (aka the French) view smoking as a way of life - everyone smokes everywhere. She even mentioned that she sees preteen girls standing outside of their middle school smoking cigarettes, which in France is not only seen as socially acceptable, but legal. The video is from December 24, 2007.

Nous vous remercions de (non) fumeurs

Put your money in your mouth, and smoke it

In these hard economic times, it seems like we are all trying to watch what we spend. As college students, perhaps we are feeling the trickle down of the economic burden that faces our parents, but as for right now, most of us do not face this burden ourselves (not until graduation at least!). I mean, it doesn't seem like many college kids can't go out on the weekends because they don't wanna spend money - not by the look of the line at Skeeps on Thursday nights - so obviously our alcohol budgets have not suffered too greatly. Another costly, yet also dirty habit, that many U of M students partake is cigarette smoking. I have not recently bought a pack myself, but cigarettes in Ann Arbor, especially on campus (Campus Corner loves to overcharge on cigarettes - from my personal experience) seem to run around $7 a pack. I come from Grosse Ile, MI, which is only 45 minutes away, and the cigarettes there are much cheaper, running around high $5 to $6 a pack.

So this gets me thinking: if you smoke a pack a day in the city of Ann Arbor @ $7 x 7 days in a week, that is roughly $49 a week spent on a dirty little habit. That is $196 a month and $2548 a year. I don't know about you, but I could think of a lot of things that I could buy for that much money.

Back when I used to smoke cigarettes, we will call it B.Q.C. (Before Quitting Cigarettes), I went to Florida with my friend Mara. I was amazed when I bought a pack of cigarettes and it was under $4 - cheap cigarettes and lots of sun, what isn't there to love about Florida? I also found this extremely strange because every time I got into the car I would hear an anti-smoking PSA. Now why would Florida launch this huge campaign to try to curtail smoking, but keep the prices of cigarettes so low? I was tempted to buy an entire carton and smuggle it back to Michigan in my suitcase. However, I did not - I could never get myself to buy a carton and admit that I smoked that many cigarettes, although I can assure you I probably did in the year or two that I smoked.

This got me thinking about cigarette tax rates. I personally believe that anti-smoking PSA's, especially the ones put out by the Truth campaign, are ineffective and sometimes laughable because they are just that ridiculous. What I do think is more effective, especially during these tough economic times - is hitting smokers where it really hurts - their pockets. According to TobaccoFreeKids.org, the state of Michigan is ranked the 11th highest state in terms of its state cigarette excise tax rate with $2.00 a pack. Florida is ranked 24th, with a tax rate of $1.339 per pack (perhaps cigarettes there are more expensive now, it was probably about two years ago when I bought cigarettes there). South Carolina is 51st with a tax rate of $0.07 a pack, and the highest state-local cigarette tax rate, at which I was not at all surprised, is in New York City:

"The highest combined state-local tax rate is $4.25 in New York City, with Chicago, IL second at $3.66 per pack."

This map shows the state cigarette tax rates in dollars as of May 2009.

Putting the tax rates into perspective, I decided to see if state smoking rates were reflective of their tax rates, which means that many of the southern states (Georgia, Alabama, the Carolinas) would have the highest amount of smokers. But looking at this map that shows the rate of smoking in each state, that seems to not be the case. The accompanying article from CNN.com is a good read, covering many of the topics I have looked at in this blog, such as celebrity smoking and smoking bans in public places. Here is a quote from the article I found particularly interesting:

"According to the CDC, about 43.4 million Americans (19.8 percent of the population) smoke."

also:

"According to the American Cancer Society, each day more than 3,500 people younger than 18 try their first cigarette, and 1,100 others become regular daily smokers."

So even though we are in recession and cigarette taxes are increasingly on the rise, it seems like many Americans are still not willing to give up their dirty little vice. Perhaps those who see it as a stress reliever see that $7 they pay for a pack as a tradeoff for the stress that smoking seems to keep at bay. Okay so maybe it doesn't seem too bad when you look at it that way, but is it worth $2548 each year to keep your stress down? Personally, I'd rather just go for a run to relieve my stress, which has the added benefit of being non-taxable AND non-cancerous.

It looks like a cigarette, it tastes like a cigarette, it feels like a cigarette, but it ISN'T a cigarette... Is it?

It seems like lawmakers have enough problems trying to regulate the tobacco industry, but now they have to manage a "fake" tobacco industry as well. E-cigarettes, or electronic cigarettes, are battery-operated devices that generally contain cartridges filled with nicotine, flavor and other chemicals. The e-cigarette turns nicotine, which is highly addictive, and other chemicals into a vapor that is inhaled by the user. Many controversies surround e-cigarettes. As a new product introduced in the past five years, not much information is known about its health effects.

Furthermore, e-cigarettes are marketed and sold to young people, available online and at shopping malls. Smoking Everywhere, an electronic cigarette company based in Florida, has an agreement before you enter their website that makes the user agree he/she is at least 18 or 21 (depending on the tobacco laws in their state), but what is stopping youth under the age of 18 from clicking "agree"? The web site also sells e-cigarettes (shown in the picture above) and what is stopping the young adults who illegally enter the web site from buying e-cigarettes? E-cigarettes are not cigarettes, but if they are available to young adults who cannot legally smoke, will constant use of something that looks like a cigarette, is used like a cigarette and contains the addictive substance nicotine lead young adults to switch to the real thing once they hit 18? The Food and Drug Administration was concerned about the safety of e-cigarettes, and in July 0f this year they released a news release that warned against potential dangers of e-cigarettes. Here are some highlights to their findings:

The FDA’s Division of Pharmaceutical Analysis analyzed the ingredients in a small sample of cartridges from two leading brands of electronic cigarettes. In one sample, the FDA’s analyses detected diethylene glycol, a chemical used in antifreeze that is toxic to humans, and in several other samples, the FDA analyses detected carcinogens, including nitrosamines. These tests indicate that these products contained detectable levels of known carcinogens and toxic chemicals to which users could potentially be exposed.

The FDA has been examining and detaining shipments of e-cigarettes at the border and the products it has examined thus far meet the definition of a combination drug-device product under the Federal Food, Drug, and Cosmetic Act. The FDA has been challenged regarding its jurisdiction over certain e-cigarettes in a case currently pending in federal district court. The agency is also planning additional activities to address its concerns about these products.

Another concern that arises from e-cigarettes is that users can circumvent smoking bans because they are "vaping" rather than "smoking." Users can use e-cigarettes in restaurants, workplaces and airports - places where cigarettes are usually banned - because e-cigarettes do not emit smoke (they emit a vapor). I found the following diagram in a NY Times article, and I found it and the article very informative in regards to e-cigarettes.

The Times article says you can buy an e-cigarette starter kit for about $100 to $150. The pink e-cigarette at the beginning of this entry was listed as costing $99. An LA Times article about e-cigarettes says "a kit costing $70 to $100 will last a pack-a-day smoker perhaps 10 days." For smokers who smoke less than a pack a day, e-cigarettes may actually cost more than the real thing. However, heavy smokers who spend over $10 a day on cigarettes (2+ packs a day), e-cigarettes may actually be cheaper, especially with rising taxes on cigarettes.

Another primary concern about e-cigarettes is that they are offered in various candy and fruit flavors and come in a variety of colors (like the pink) that they may attract young people. This seems very similar to the ban recently passed by the FDA on REAL candy and fruit flavored cigarettes in an attempt to curtail youth smoking.

The Electronic Cigarette Association, or ECA, is an association of private sector companies engaged in electronic cigarette technologies. The ECA says on its website that it needs your help to ensure the survival of the e-cigarette as an alternative to a known killer. Although this seems extremely noble, I cannot help but think back to the LA Times article I read that says this year (2009) e-cigarette sales are expected to reach $100 million. Are they really concerned about our health, or is it just a ploy to put money into their own pockets?

I'm not going to make any assumptions, but go to their website and you can be the judge.

Hollywood's not America

Celebrity obsession seems harmless when we duplicate silly things such as fashion trends and hairstyles, but what happens when the obsession goes too far? Celebrities may be beautiful, glamourous, and loaded with cash, but are they good role models for America's youth? Take these questions into consideration:

(1) What constitutes a role model? Qualities such as beauty and fame, OR qualities such as brains, ambition, drive, honesty, and kindness? Sadly, it seems many young girls look to celebrity role models because of the former and not the latter.

(2) Hollywood is not "America." This is a song by Ferras, and I think it makes a good point. Celebrities often indulge in a variety of dirty habits, such as excessive drug use and reckless partying - not your typical American lifestyle. Female celebrities in particular seem to be getting thinner and thinner. "Thin may be in" in Hollywood, but it becomes dangerous when young girls take the idea of a thin body image too far and it adversely affects their health.

So celebrities may not be the best role models, but regardless of their shortcomings, we continue to duplicate their behavior. Is it possible we can admire a certain celebrity to such a great extent that our own personal values get thrown on the back burner behind blinded idolization? Smoking is pervasive in celebrity culture. Although celebrities try their hardest not to get caught lighting up in front of the paparazzi, it looks like someone, or rather MANY someones, have been caught red handed.

Similar to the body image issue, female celebrities receive the brunt of criticism for smoking cigarettes. Gawker points it out in this article and from my research online and personal celebrity gossip experience it seems to hold true. I may be unconsciously searching for female smokers since I am a female, but I think it may be due to the fact that young girls seem to be more impressionable to celebrity culture than their male counterparts. This article from the New York Daily News seems to focus on female celebrity smokers as well.

I looked to see if two of my favorite Hollywood icons, Marilyn Monroe and Audrey Hepburn, were smokers, and I could not find evidence that they were regular smokers, but it is evident from their movies and pictures that they smoked cigarettes at least on occasion.

Yes that is a cigarette in Audrey's mouth! Granted that during these starlets' time the ill-fated effects associated with smoking were still unknown and smoking was seen as elegant and trendy.

Does that trend still hold today? Will the glamour and beauty that female celebrities possess make everything they do beautiful and glamourous as well? I must admit I was extremely surprised when I read in another New York Daily News article that MTV reality star Lauren Conrad is a smoker. Although I would not say I look to Lauren as a role model, I do think she is a smart girl and a hard worker and I will admit I am envious of her glamorous career in the fashion industry and trendy L.A. lifestyle. For a second I caught myself thinking: "Hmm if Lauren does it [smokes cigarettes], maybe its not so bad," and then I realized that I was getting caught in the awe of celebrity I am currently condemning. But then I thought again, and I realized that it is not the glamour of Lauren's lifestyle that I envy, it is the fact that a small town girl (much like myself) moved to the big city with big dreams and made them come true. Seeing Lauren makes me realize that a regular girl who is smart, hard-working and determined can be successful. I'm not going to start smoking just because Lauren does it, who even knows if it is true? Hopefully other young women who follow celebrity trends will stick to fashion tips and realize that even though smoking can be a "celebrity" dirty habit, the celebrity label does not make smoking any less harmful to your health.