From New York Times

The House Commerce Committee approved a bill Wednesday that would give the Food and Drug Administration sweeping regulatory authority over the tobacco industry, clearing the way for a floor vote on the legislation, which has long been sought by antitobacco activists.

The bill is meant to severely curtail tobacco marketing, to emphasize health warnings on tobacco products, to ban many flavored cigarettes, and to prohibit labeling of cigarettes as light or low tar. Dozens of health groups have supported the bill as potentially life-saving.

But despite broad support in both the House and the Senate, where a similar proposal cleared a committee in July, the legislation faces formidable obstacles.

The Bush administration and the Senate Republican leader, Mitch McConnell of Kentucky, have indicated their opposition.

In a statement shortly after the vote, a White House spokeswoman, Emily A. Lawrimore, said the administration thought that the legislation would do more harm than good, creating a false impression that regulated tobacco products were safe.

The administration believes that tobacco is not a drug or device to be regulated by the F.D.A., Ms. Lawrimore said.

A spokesman for Senator McConnell noted that he had said he would review the bill.

Senator Richard Burr, Republican of North Carolina, has reportedly threatened to filibuster the legislation if it reaches a vote on the Senate floor. In a statement Wednesday, shortly after the House committee vote, Mr. Burr said he remained opposed to the legislation, in part, he said, because it would strain an already burdened agency. The bill is also running up against an abbreviated election-year legislative schedule.

The House committee approved the bill 38 to 12, with much of the opposition from Republicans who argued that the F.D.A. was already overwhelmed and could not handle regulating another industry.

That position has recently been articulated in an advertising campaign by Reynolds American, the tobacco company that sells Camel cigarettes and other brands. But Representative Henry A. Waxman, Democrat of California, who sponsored the bill, said such arguments were clearly red herrings from those who are fundamentally opposed to regulating tobacco at all.

And Representative John D. Dingell, Democrat of Michigan and the Commerce Committee chairman, said he was separately working on legislation to clean up this mess at Food and Drug, and we plan to do it with all vigor and enthusiasm.

The tobacco bill has been endorsed by the cigarette maker Philip Morris, and some people have criticized it as a compromise that does not go far enough. For example, it prohibits the F.D.A. from raising the legal age for buying cigarettes beyond the current level of 18.

And while the bill prohibits the sale of candy-flavored cigarettes

which account for less than 1 percent of the market

it allows the continued sale of popular menthol cigarettes. One menthol brand, Newport, marketed by Lorillard Tobacco, is the nations second-leading cigarette, after the Philip Morris brand Marlboro. Lorillard has not yet taken a position on the legislation, a spokesman said.

Representative Mike Ferguson, Republican of New Jersey, offered an amendment that would have prohibited menthol flavoring. I think its inconsistent to say we want to protect kids from flavored cigarettes,

Mr. Ferguson said, but then we have a provision in the bill that allows menthol cigarettes.

Mr. Dingell acknowledged that the legislation was not ideal. In a perfect world, wed ban all cigarettes, he said. But the hard fact of the matter is that there are a lot of jobs depending on this. And more importantly, there are a lot of people out there who are addicted to this, and theyve got to have their fix.

Antismoking groups have sought regulation of the tobacco industry for years. In 1995, a former F.D.A. commissioner, David A. Kessler, drafted regulations declaring nicotine a drug and cigarettes a drug delivery device subject to F.D.A. authority, but these were struck down by federal courts.

The Senate approved a proposal in 2004, but the House has never voted on one.

Within minutes of Wednesdays action, statements supporting the committees vote were issued by supporters including Senator Edward M. Kennedy, Democrat of Massachusetts, who sponsored the Senate version of the bill; the American Academy of Pediatrics; and the American Cancer Society.

Although the White House had expressed its opposition, it has not yet threatened to veto the legislation. In testimony last fall, Dr. Andrew C. von Eschenbach, the current F.D.A. commissioner, indicated the Bush administrations reluctance to embrace a new regulatory role, citing wide efforts already begun by both state and federal agencies to reduce tobacco use.

The bill would create a center within the F.D.A specifically for tobacco regulation financed by industry fees projected to exceed $5 billion over the next 10 years.

It would also require disclosure of the contents of tobacco-based products and set standards that would require removal or reduction of harmful ingredients; require that the findings of industry research be made public; prohibit companies from making health claims about tobacco products, and require larger and more effective warning labels.

Up to half of cancer deaths could be avoided with lifestyle changes, experts say

From HealthDay

Imagine therapies that could cut cancer deaths in half.

Well, these “breakthrough” treatments are here, according to a recent American Cancer Society report that said as many as 50 percent of cancer deaths could be prevented with lifestyle changes, such as quitting smoking, maintaining a healthy weight, and getting screened for certain malignancies.

“Nearly half of all cancer is related to two things — tobacco and obesity,” said Dr. Jay Brooks, chief of hematology/oncology at Ochsner Health System in Baton Rouge, La. “That’s something I don’t think people truly grasp.”

Dr. Neil Hayes, a medical oncologist specializing in lung and head and neck cancers at the University of North Carolina School of Medicine, concurred. “Most of my patients are smokers, so it’s rare I see someone truly surprised by the diagnosis. But I don’t think they fully think through the risk associated with smoking,” he said.

Evaluating your risk of cancer, and taking steps to modify those risk factors within your control, could save your life.

Smoking is far and away the leading cause of preventable cancer deaths. In the United States, nearly one-third of all cancer deaths — more than 170,000 Americans — each year are related to tobacco use, according to the American Cancer Society (ACS). Yet, almost one in four American adults still uses tobacco. And, about 22 percent of teens are still lighting up.

“Not smoking is the single most important thing you can do to lower your risk of cancer,” Brooks said.

Another important risk factor cited by the cancer society is the increasing girth of the average American. Poor nutrition, lack of exercise, and excess weight are likely at the root of as many as 188,277 cancer deaths annually, according to the ACS.

A recent New England Journal of Medicine study that included more than 900,000 U.S. adults found that the heaviest people had the highest risk of death — 52 percent higher for men and 62 percent for women — compared to people of normal weight.

However, what isn’t yet known, Hayes said, is if proper nutrition can prevent that increased risk. “We have an incomplete understanding of diet’s impact on cancer. But a healthy lifestyle is associated with all kinds of good things,” he said.

The ACS recommends eating at least five servings of fruits and vegetables a day, and getting at least 30 to 60 minutes of moderate to vigorous activity at least five days a week. Walking, biking and skating are examples of moderate activity, while jogging, fast bicycling, weight training, aerobics and swimming are considered vigorous activity.

Hayes said too much alcohol is also associated with some cancers, particularly tumors of the esophagus, pharynx, and mouth. The ACS recommends that women drink no more than one alcoholic beverage a day and men no more than two alcoholic drinks a day.

Then there’s the lifesaving issue of screenings. Some cancer screenings, such as those for skin, breast, cervical and colon cancers, can actually detect precancerous changes that may eventually lead to malignancies.

For instance, with a colonoscopy a doctor can find and remove polyps before they turn into cancer. The ACS report estimated that as many as half of the 55,000 colon cancer deaths that occur each year could be prevented with proper screening.

“Aside from avoiding tobacco and maintaining a healthy body weight, cancer screening is the most important thing people can do to reduce their chances of dying from cancer,” the ACS report stated.

From New York Times

Tobacco could kill up to a billion people during the 21st century, as cigarette sales soar in poor and middle-income countries even as they drop in wealthier ones, says a report issued Thursday by the World Health Organization.

The report, financed by Mayor Michael R. Bloombergs foundation, suggests a six-point program for fighting the tobacco industrys influence.

The W.H.O. is described by the tobacco industry as its biggest enemy, Dr. Margaret Chan, the organizations director general, said at a news conference introducing the report. Today we intend to enhance that reputation.

Nicknamed Mpower and based on a partly successful program for fighting drug-resistant tuberculosis, the report suggests raising cigarette taxes, banning smoking in public places, enforcing laws against giving or advertising tobacco to children, monitoring tobacco use, warning people about the dangers and offering free or inexpensive help to smokers trying to quit.

The report, to which Bloomberg Philanthropies contributed $2 million, is the first to compile global data on how many smokers or tobacco chewers each country has, how much they pay in tobacco taxes, and how antismoking efforts are faring.

Among its conclusions: poor and middle-income countries collect 5,000 times as much in tax revenue from tobacco as they spend in fighting its use. Only 5 percent of the world has no-smoking laws like those in New York City. Uruguay does more than any other country to reduce smoking.

Mayor Bloomberg, who is well known for his antipathy to smoking, said in presenting the report that it would be re-issued annually and would grade countries. The United States would get a C or D, he said, New York, an A or a B.

His statement puts him at odds with W.H.O. The agency has traditionally been cautious about offending members, and in interviews, officials from its Tobacco Free Initiative specifically said countries would not be graded.

Perhaps the oddest aspect was that the report itself was presented as if it were a campaign for menthol cigarettes, full of pictures of happy children and mottos like fresh and alive. It even came with what appeared to be a pack of Mpower-brand cigarettes, with a cheerful blue bubbles logo and a mock warning on the box

which actually contained a pad and pens.

That also seemed to fly in the face of the sort of harsh ads that Mayor Bloomberg endorsed, like those showing dying smokers croaking through tracheotomy tubes.

After the presentation, officials hastened to explain that the cigarette pack was not meant for the public, but to catch the eyes of health and finance ministers in poor countries.

Were co-opting the tobacco industrys branding strategies to capture the attention of government officials, said Sandra Mullin, a spokeswoman for the World Lung Foundation, which contributed to the report. We want to show that they dont own those mottos

freshness and fun and health.

From - WSJ.com

The public health advisory highlighted warnings issued by Pfizer last month stating that Chantix users should be monitored for suicidal behavior, depressed mood and other changes in behavior.

On Jan. 18, Pfizer said it would update the product label for Chantix to more prominently display post-marketing reports of adverse events that were first added to the product label last November after the FDA conducted a preliminary assessment of reported side effects.

Such reports included depression, changes in behavior and suicidal thinking in some patients within days or weeks after starting Chantix treatment. At the time, the FDA said the role of Chantix wasn’t clear.

Now, the FDA said, “it appears increasingly likely that there may be an association between Chantix and serious neuropsychiatric symptoms.”

The FDA said it was working with Pfizer to develop a so-called medication guide highlighting the warnings for patients. A drug’s label is typically directed at doctors.

“Chantix has proven to be effective in smokers motivated to quit, but patients and health-care professionals need the latest safety information to make an informed decision regarding whether or not to use this product,” said Bob Rappaport, director of the FDA’s division of anesthesia, analgesia and rheumatology products.

Chantix, an oral tablet taken up to twice daily for 12 weeks to help adults stop smoking, was approved in the U.S. in May 2006. Sales of the drug totaled $280 million during the fourth quarter, up from $68 million during the same time period in 2006.

The more rays people caught, the less prone they were to get the disease, study found

From HealthDay

Something as common and available as sunlight may help prevent some lung cancers, researchers say.

A new study finds that lower levels of the sun’s ultraviolet B (UVB) rays are associated with a higher incidence of lung cancer across 111 countries.

Still, that doesn’t mean that spending more time in the sun will ever offset the risks that come with smoking, according to the study, which is published in the January issue of the Journal of Epidemiology and Community Health.

It’s also not an excuse to trade skin cancer for lung cancer.

“The problem is that people might over-interpret this and stay in the sun for hours,” said Cedric Garland, study senior author, professor of family and preventive medicine at the University of California, San Diego (UCSD), and participating member at the Moores UCSD Cancer Center in La Jolla.

Too little sun isn’t great either, however, since sunlight helps the skin manufacture healthy vitamin D. “It would be false prudence to stay out of the sun to prevent skin cancer and not get enough vitamin D,” Garland said.

Other experts, however, feel the focus should stay on cigarette smoking as the number one cause of lung cancer.

“When you have such a strong factor as tobacco, it really weighs out all these other small influences,” said Dr. Jay Brooks, chairman of hematology/oncology at the Ochsner Health System in Baton Rouge, La. “It’s a very interesting observation, but the main message is tobacco is such a strong influence in the development of lung cancer that we should concentrate on that.”

More than one million people die of lung cancer worldwide each year. Cigarette smoking causes about 85 percent of lung cancers. The remaining cases are caused by exposure to secondhand smoke and a variety of other (some unknown) factors.

Sunshine is a significant source of vitamin D, as the sun’s UV rays trigger synthesis of vitamin D in the skin.

Previous research, much of it by the same group, has found a strong association between breast cancer, colon cancer and other internal-organ cancers and living in latitudes with less sunlight. For example, one paper observed double the death rate from colon cancer above the U.S. Mason-Dixon line as below, leading the researchers to focus on lack of sunlight as the culprit.

It wasn’t a new idea. “There were people in epidemiology dating back to Hippocrates who thought it was a good idea to live on the south side of a hill,” Garland said.

Another study linked lower levels of a vitamin D metabolite in the blood with a higher level of colon cancer.

For this study, Garland and his colleagues looked at the association between latitude and exposure to UVB light and rates of lung cancer in 111 countries. Data came from an extensive United Nations database.

Although smoking showed the strongest association with lung cancer, exposure to UVB light also had an impact.

UVB light is greatest closer to the equator. This study showed that lung cancer rates were highest in regions farthest away from the equator and lowest in those regions nearest to it.

Higher cloud cover and aerosol use (both of which absorb UVB rays) were linked with higher rates of lung cancer.

For men, smoking was associated with higher rates of lung cancer, while greater exposure to sunlight was associated with lower rates.

For women, cigarette smoking, along with total cloud cover and aerosol levels, were associated with higher rates of lung cancer, while sunlight was again associated with lower rates.

Previous research has indicated that vitamin D may be able to stop the growth of malignant tumors.

“Everyone should be taking vitamin D, and, at all latitudes, there’s plenty of potential to make vitamin D,” Garland said. “Even in Helsinki, people can take advantage of the sun in summer months.”

And vitamin D produced in the summer will carry over into the winter. Even so, unless you know what your vitamin D levels are, it might be wise to take a supplement, Garland advised.