Wednesday, January 8, 2014
CONTACT ME HERE: manessmorrison2@yahoo.com

News For The Day



Unexpected diagnosis: Some medical tests may be harmful to your health – NBC
Maggie Fox NBC News


Everyone’s heard a story: Someone got an MRI for a sports injury or dizziness and the radiologist found a tumor, just in the nick of time. Or maybe it was an aneurysm, just about to burst. Lives were saved. It was great luck.

Some of the stories are dramatic. Joan Rachlin of Boston got what seemed to be a routine Pap smear 27 years ago. Like most Pap smears, it was deemed normal. “I got a call something like seven months later from a gynecological pathologist at Brigham and Women’s Hospital in Boston,” Rachlin told NBC News.

“He was doing research on Pap smear tissue and he had come across mine. He discovered that my Pap smear had been misread and that, in fact, I had a cancerous lesion.”
It’s what’s called an incidental finding — the researcher, who Rachlin says does not wish to be named, was studying something else and in fact had to go to some trouble to match the sample to a real person. “He thought my Pap smear had really been so poorly interpreted that my life was in danger,” said Rachlin, who is executive director of Public Responsibility in Medicine and Research. “I am alive today because a very, very conscientious researcher had read my Pap and decided to break the code and find me.”

Joan Rachlin found out she had cancer 27 years ago, purely by accident. There were no guidelines at the time for telling her.

There were no guidelines — the researcher just went rogue. More checks showed Rachlin did indeed have cancer, but it was early stage and surgery took care of it.
Today whole industries are building up around the possibility that a test will find a medical problem that was just about to kill you. The latest entry — whole genome tests that promise to detail your medical future in a drop of spit.

But it’s starting to become clear that not all these findings are lifesaving, and some can be downright harmful. Take the case of the elderly woman whose chest lung X-ray showed what looked like lung tumors. She had a biopsy done — a tricky procedure that involves poking a long needle through the chest wall, or sending a bronchoscope down into the delicate lungs. Her lung collapsed and she died. The tumor, it turned out, was harmless. Were it not for the scan, she would have still been alive.
Her case is outlined in a report issued last month by the Presidential Commission for the Study of Bioethical Issues.

Or what about Dr. Danielle Ofri, who teaches at New York University School of Medicine, who had to deal with the fallout from another case? “I had a patient who had suffered abdominal pain forever,” Ofri told NBC News.

The patient, whose English is poor, has gastritis, high blood pressure, acid reflux, diabetes and a variety of other chronic pains. “I don’t think she has anything significant,” Ofri said.

One weekend, the patient panicked and went to the emergency room. “Of course they scanned her belly,” Ofri said. The scan showed something called an adrenal mass. “Adrenal glands often have benign tumors,” Ofri said. “They are never noted unless you do a CT scan for other reasons.”

Only about 15 percent are doing something harmful, like causing the adrenal gland to underproduce hormones.

But now, in addition to managing the patient’s chronic conditions, Ofri had to address this mass, which she was certain was harmless but which was unnerving the patient. “Everything else was fine. Her stomach was fine, her intestines were fine,” Ofri said. “But now her other problems got short shrift.”

“Most people may think on the face of it, why wouldn’t you want to know something more about your body and your health?” said Amy Gutmann, a political science and philosophy professor who heads the bioethics commission. “But there’s a wide variety of reactions of people to incidental findings. Some people want to know them. Other people don’t.”

The tests that Ofri needed to order to check out the mass were expensive, and required the patient to take some complicated steps. “She got so befuddled by the instructions that it fell apart,” Ofri said. “I decided to let it lie. I decided the risks outweighed the benefits. The cost, the time, the distraction from other medical issues wasn’t worth it. We don’t have four hours to spend with each patient.”
As more and more tests become available and standard, from MRIs to CT scans, to genetic tests and ultrasounds, these issues will come up more often. There’s even a name for these often harmless tumors that get discovered — they’re called incidentalomas. 

For instance, 10 percent of brain scans and more than 30 percent of abdominal CT scans turn up something that doctors weren’t looking for and that may need more tests, says Dr. Stephen Hauser, who heads the neurology department at the University of California, San Francisco and who helped lead the Bioethics Commission panel in its report on the issue.

“Managing incidental and secondary findings is an issue that has the potential to touch many of us as we seek medical care, participate in research, and even send a cheek swab to a company for a peek at our own genetic make-up,” the commission says in its report.

“The reality is that you or a loved one just might find out more than you bargained for. Yet practitioners are getting conflicting advice about how to manage such findings across contexts and modalities such as genetics, imaging, and biological specimen testing.”

And there is little guidance for doctors who may be the first to make these discoveries. “There are no consistent guidelines for how we best manage these issues,” Gutmann told reporters.

Clearly, a Pap smear that shows an aggressive cancer or an MRI that shows a malignant brain tumor are easy calls. But what if someone has a gene that makes them likely to develop an untreatable disease?

Some groups are coming out with guidelines. The American College of Medical Genetics and Genomics lists specific conditions that might pop up on a genetic test that require more testing and a report to the doctor who ordered the test. Some examples -- mutations in the BRCA genes that raise the risk of breast and ovarian cancers.
More such guidance is needed, the bioethics commission says. Professional groups need to write up specific recommendations for accidental findings that are likely, and what, if anything, should be done when they are made. Doctors need guidelines for talking to patients about what might come up on a test before it’s done, and doctor and patient should agree on what the patient wants to be told.

“We know the difference between night and day,” Gutmann said. “That doesn’t mean there aren’t difficult issues of dusk and dawn.”


I thought this would be an article about invasive tests, and in one case it was. It is also, however, about the fear that if patients are told about test results that show something unexpected they will become unnerved and order lots of expensive and time consuming tests. Dr. Ofri is quoted as saying “We don’t have four hours to spend with each patient.”

This is what I want from my doctor. I want him to know that while I respect him as an expert, I don't consider him to be a god and he is doing me a service, for which my insurance company is paying him well. I want him to tell me everything he finds on any tests, but put it into a context of likely risks and explain the tests necessary for verification of the condition.

I don't need for him to give me four hours on each visit – heaven forbid! I do need for him to give me an extra ten minutes when it is needed, and not charge extra for that ten minutes of communication. If I am convinced that the “shadow” on the x-ray is likely an anomaly and not a real problem, I will either go to a specialist for another test or ask for a different kind of test to see the problem from another angle. I would prefer that he not stick a long needle into my lung unless it's absolutely necessary, and put me to sleep for the procedure if he does do that. But whatever he does, I would like to be informed about everything he finds or is about to do. I would probably never want to have a breast removed on the chance that I might contract breast cancer. I accept the possibility of death. I have lived a long life, already. I would not want any radical solutions to potential problems. He and I would very likely agree on what we choose to do. I just want to be included in the decision.




India bars non-diplomats from US embassy club amid escalating spat – NBC
By Frank Jack Daniel, Reuters


NEW DELHI - India has told the United States it cannot allow non-diplomats to visit a club at its Delhi embassy, escalating a spat over the arrest of an Indian diplomat in New York. 

Hundreds of expatriate Americans use the American Community Support Association club, which has a bar, swimming pool, restaurant and a beauty parlor within the embassy premises. The club has been in existence for decades. 

The embassy must cease all commercial activities benefiting non-diplomatic staff on its premises by January 16, a government source with direct knowledge of the dispute told Reuters. 

India is furious at the December 12 arrest, handcuffing and strip search of its deputy consul in New York, Devyani Khobragade, who prosecutors accuse of underpaying her nanny and lying on a visa application. 

Still festering nearly a month on, the row has started to affect the wider relationship between the world's two largest democracies, with one high-level visit already postponed and a visit scheduled for next week by U.S. Energy Secretary Ernest Moniz now looking doubtful. 

India has already taken a number of retaliatory measures and is now stepping up the pressure on Washington ahead of a court appearance by the diplomat due on January 13. 
The latest move is aimed at closing the embassy's social club to non-diplomats. India says the facilities are tax free because they are located in the embassy grounds. 
"Basically the thing is that the provision of such facilities to non-diplomats and not paying taxes is clearly not in accordance with the Vienna convention," the government source with knowledge of the dispute told Reuters. 

"You can't have these facilities inside and not pay taxes and allow non-diplomats," the source said. 

A U.S. embassy spokesman was not immediately available for comment. 
India had already curtailed privileges offered to U.S. diplomats to bring them in line with the treatment of Indian envoys to the United States. Since December, the U.S. ambassador in Delhi can be subjected to airport frisking and most consular staff have reduced levels of immunity. 

Concrete barriers were removed from a road near the embassy last month, apparently in retaliation for the loss of a parking spot for the Indian ambassador in Washington. 
Known as the American Embassy club, the social center is located on embassy grounds and along with the American Embassy School is the heart of Delhi life for the families of many expatriate employees of U.S. corporations in India. 

India is also preparing to take steps against the embassy school, which it suspects may be employing some staff in violation of visa requirements, the government source said. 


This is a story with at least two sides. First, I think all this skirmishing back and forth between the US and India damages our relationship as democracies of the world and allies. That's really not good. I must say, though, that I have never agreed with the freedom from prosecution for crimes that has long been the privilege of diplomats. This is not the first case of diplomats committing crimes, and keeping an employee under conditions like slavery is not a small crime, or shouldn't be. On the other hand, strip searching is one of those things that I think is against basic human rights unless a dire threat to public safety or the suspicion of carrying drugs or a dangerous weapon is involved. The police use it to shame people sometimes, just as they sometimes beat suspects to get a confession for crimes. I would suspect that that was the reason this diplomat was strip searched – to shame her.






Marriage may not be silver bullet for poverty, study says – NBC
Allison Linn CNBC

Getting married may not be the panacea for poverty that many say it is, a new study argues.
Getting hitched can also hitch you to a better financial future – or so a slew of data shows.

But after years of the government throwing money at trying to promote marriage as a way to help single moms and their children out of poverty, some experts are arguing it’s time to try something different.

“We are continuing to spend money on … these healthy marriage initiatives and I think the evidence is now clear that these are not effective policies,” said Kristi Williams, an associate professor of sociology at The Ohio State University. “So, it’s time to start thinking about spending that money in a way that’s more likely to help single mothers and their children.”

A new briefing paper, written by Williams and released Monday by the Council on Contemporary Families, argues that even when single mothers do later marry, those marriages are not necessarily beneficial to the women and their children.
Williams points to a study finding that more than half of single moms who married were divorced by the time they reached ages 35 to 44. In many cases, she notes, women who marry and later divorce are worse off financially.

Children also don’t always benefit, she said. Her research found that the children of single mothers who later married did not often have extra physical or psychological advantages once they were adolescents.

Williams said she did see advantages for children whose biological parents later got and stayed married, but she notes that’s uncommon. A long-running project called the Fragile Families study found that only 16 percent of the low-income unwed mothers they studied were married to their child’s biological father five years after the child’s birth.

The government has long funded initiatives to encourage healthy marriages and responsible fatherhood, stemming from the welfare reform efforts that began in 1996.
Williams argues that policymakers might get more bang for their buck if they used that money for other efforts to improve the financial futures of young, low-income women. Those include programs to help reduce unintended pregnancies and ones that subsidized child care for children three years old and younger, she said.
The report comes as about four in 10 children in the United States are born outside of marriage, a sharp increase from decades past, according to the latest government data. Single mothers also face much higher rates of poverty than married parents, according to the Census Bureau.

Williams and others say their research has found that low-income women, like most Americans, do want to get and stay married. But, Williams said, they hesitate because they are realistic about how challenging it will be to have a successful marriage amid severe economic strain.

“In many ways it’s a rational decision, and that’s why we (think) that this sort of idea of promoting marriage is sort of misguided,” Williams said. “Women, in many ways, are probably more aware than the government of the challenges of having a beneficial marriage.”

Bradford Wilcox, director of the National Marriage Project at the University of Virginia, said it’s not surprising to find that single mothers who later marry are less likely to have a successful marriage than those who get married before having kids.

“They are more likely to have all the attendant problems that ensue when you put the baby carriage before the marriage,” he said.
Still, Wilcox said he doesn’t think that means Americans should just make peace with very high rates of single motherhood. Instead, he said that promoting stable marriages before having children should be one tactic in helping poor, working-class Americans improve their financial and personal lives.

“Regardless of your ideological status, we have a crisis in this country when it comes to quality and stability of relationships for poor, working class (people),” Wilcox said. “Marriage is not a panacea for that crisis, but I would say it’s one part of the policy mix.”



In the old days – before the Women's Liberation Movement of the 1970s, that is – marriages tended to stay together despite their flaws. As a result young men were raised who had seen their mothers beaten by their father and followed in his footsteps to beat their girl friends. And there was always the father who was allowed to stay in the home while refusing (or simply failing) to keep a job, or lift a hand to help with the housework, thus contributing to the poverty in the home. Divorce was a scandal as well as a sin, and the couple stuck it out against all odds. They fussed and fought mightily, but they stayed together.

The fathers were taken by surprise by the Women's Movement in that there was no corresponding “Men's Movement.” They were shocked and enraged when their young wives actually left the marriage on grounds of cruelty or non-support, due to having had their “consciousness raised” about the fact that you only have one life to live, and if it is miserably unhappy you've lost your only chance. Women rebelled. Marriage will never again be what it was before the revolution of the '70's.

Personally, I am not sorry for that, because I think that the change needed to be made from a situation of unconditional loyalty to a rational and flexible relationship between the sexes. Fathers need to know that their rights do not include freedom from changing a baby diaper or washing the dishes, and that they do not own their wife. She has a right to disagree, and even to leave the relationship.

This attempt at preventing poverty by keeping all marriages together is not only doomed to fail, it is against my personal principles, in that I think those abusive marriages foster mentally disturbed children and mental health issues among the mothers and the fathers – a man who hits his wife and gets away with it is not a mentally healthy man. He is also a criminal, but that is secondary. He could use some good therapy or anger management, and may be a depressed individual in general. Poor mental health is at an epidemic state in our society, if a gentle and happy person is deemed the best example of being mentally healthy.

To me, we can do without this particular tax write off and put more money into subsidized therapy for the husband or wife who abuses their spouse or children, or who simply would like to try to mend their marriage to make it a good one. You could also subsidize classes in financial management for the family. That would help poverty.





IRS: Identity theft prosecutions doubled in 2013-- NBC
Stephen Ohlemacher The Associated Press


The Internal Revenue Service is seeing a big jump in thieves stealing Social Security numbers to fraudulently claim tax refunds, the agency said Tuesday. 

The IRS says prosecutions for identity theft doubled in 2013.
The IRS launched 1,492 criminal investigations into identity theft last year, a 66 percent increase from the year before. Prosecutions and indictments more than doubled. The numbers dwarf those from just two years ago. 

In all, the IRS said it has flagged 14.6 million suspicious tax returns since 2011, blocking more than $50 billion in fraudulent refunds. 
New IRS Commissioner John Koskinen told reporters this week that stopping identity theft was a top priority for the agency. 

"The people working on that are confident that while it's a growth industry for the last two or three years that it's getting under control," Koskinen said at his introductory news conference Monday. "I would stress that it's an area that has everybody's attention." 

In a common scam, thieves use stolen Social Security numbers to file tax returns early in the filing season so they can claim refunds before legitimate taxpayers file their returns. The IRS, which prides itself on issuing quick refunds, often sends out refunds before it receives documents verifying wages and other income from employers and financial institutions. 

Koskinen said waiting for such documents could delay refunds for months. This year, the IRS boasts on its website that it expects to issue "more than nine out of 10 refunds in less than 21 days." 

A recent inspector general's report said the IRS is stepping up efforts to fight identity theft but thieves are getting more aggressive. 
The IRS issued $4 billion in fraudulent tax refunds in 2012 to people using stolen identities, according to the inspector general's report released in November. The IRS sent a total of 655 tax refunds to a single address in Lithuania, and 343 refunds went to a lone address in Shanghai, the report said.
 
The agency said it has since improved its computer filters to flag suspicious refunds, including cases in which many refunds go to the same address. On Tuesday, the IRS said more than 3,000 agents were working to fight identity theft. 
The agency said a coast-to-coast sweep in January 2013 led to 109 arrests and 189 indictments. 

The issue has exploded in just a few years. In the 2011 budget year, the IRS recommended 218 cases of suspected identity theft for prosecution, a number that grew to 1,257 last year. The number of indictments grew from 165 to 1,050 in the same period. 

Last year, 438 people were sentenced in identity theft cases, the IRS said. Sentences ranged from two months in prison to more than 26 years. 


This is a nightmare. I'm glad the IRS has tightened up its procedures about identity theft. I was job hunting last year this time, and I did give my social security number to a few web sites in application to advertised jobs. I had no proof that they were genuine, unfortunately, but I wanted to be sure to get an application in assuming there was a job. It was sorry later, but it was already done. This article shows what a criminal can do with a social security number to quickly cash in on his information. At least the IRS is checking for duplicate addresses now. I would like to see them mete out penalties of much greater than two months in prison, though. That is like giving a child rapist a two year sentence. It is much too lenient.



­
Emails Tie Gov. Christie's Aides To Lane Closings Controversy – NPR
by Mark Memmott
­
"A series of newly obtained emails shows that Gov. Chris Christie's office was closely involved with lane closures on the New Jersey side of the George Washington Bridge in September, and that officials closed the lanes in what appeared to be retribution against the mayor whose town was gridlocked as a result," The New York Times reported Wednesday morning.

Our colleagues at WNYC, who have posted copies of the emails, write that:
"An email message to the central figure in the fray surrounding the closure of traffic lanes to the George Washington Bridge links a top aide to Governor Chris Christie to the growing scandal. 'Time for some traffic problems in Fort Lee,' the aide to Christie, Bridget Ann Kelly wrote to David Wildstein. A minute later, Wildstein replied 'got it.' "

New Jersey's largest newspaper is on the story as well and writes that:
"Gov. Chris Christie's deputy chief of staff had advance knowledge of a plan to shut down local access lanes to the George Washington in September, and was aware that the closures would snarl traffic on Fort Lee streets, according to documents obtained by The Star-Ledger.

" 'Time for some traffic problems in Fort Lee,' read an email message from the deputy, Bridget Anne Kelly, dated Aug. 13, nearly a month before the Sept. 9-13 closures, which snarled traffic and sparked a scandal that has drawn national attention."

Another New Jersey newspaper, The Record, starts its report this way:
"Private messages between Governor's Christie's deputy chief of staff and two of his top executives at the Port Authority reveal a vindictive effort to create 'traffic problems in Fort Lee' by shutting lanes to the George Washington Bridge and apparent pleasure at the resulting gridlock.

"The messages are replete with references and insults to Fort Lee's mayor, who had failed to endorse Christie for re-election and they chronicle how local officials tried to reach the Port Authority in a vain effort to eliminate the paralyzing gridlock that overwhelmed his town of 35,000, which sits in the shadow of the bridge, the world's busiest."

It's All Politics reported in December that "what began as a local story involving The Port Authority of New York and New Jersey, the agency that oversees the Hudson River crossings between the two states," was already snowballing "into an alleged case of political revenge and abuse of power."

And the story was of interest nationally, of course, because Christie is among those considered to be leading contenders for the 2016 Republican presidential nomination.
Christie has said he that neither he nor his staff had anything to do with the lane closings. The Times writes that "after the emails were released on Wednesday, Mr. Christie canceled his one public event for the day, which had been billed as an announcement of progress in the recovery from Hurricane Sandy."

The mayor of Fort Lee, N.J., is a Democrat. Before November's election, Christie had been pressing the state's Democrats to cross party lines and endorse his re-election. "Democrats suspect the unusual [lane] closings were retaliation for the mayor's failure to support Christie's re-election," the Star-Ledger says.
The official reason for the lane closings, Christie and his aides have said, was that they were part of a study to determine if bridge traffic would be smoother if access from Fort Lee was restricted.

There's more about "GWBridgegate" on WNYC's The Brian Lehrer Show.
State lawmakers have launched an investigation into all this.



This is very disappointing. Christie has seemed to me to be a middle of the road Republican, but apparently his efforts to woo Democrats have been very calculated, and backed by this “dirty tricks” retaliation. Richard Nixon became known for his “dirty tricks” campaign, and here it is again in the Republican Party.

Christie is a very clever man, and this particular trick would have gone undiscovered if newspaper reporters in the New York Times hadn't been informed. Careless inter-party communications look like proof positive of the plan to cause trouble for the Democratic mayor, and I don't feel at all sorry for Christie. He looks guilty. I expect he will fire the deputy, Bridget Anne Kelly soon, but I will not be fooled. Their explanation of an experiment to test the traffic situation on the bridge comes too late and looks too convenient. I'll bet he won't be so popular as a presidential candidate now.




­ 50 Years After Landmark Warning, 8 Million Fewer Smoking Deaths – NPR
by Richard Knox
­
Saturday marks an important milestone in public health – the 50th anniversary of the first Surgeon General's Report on Smoking and Health.
Few if any documents have had the impact of this one — both on the amount of disease and death prevented, and on the very scope of public health.

An analysis in the JAMA, the American Medical Association journal, estimates that 8 million Americans avoided premature death as a result of tobacco control efforts launched by the 1964 report. Those efforts range from cigarette warning labels to escalating taxes on cigarettes to proliferating restrictions on where people can smoke. They were augmented by a series of high-profile surgeon general reports detailing the dangers to smokers, unborn children and bystanders.

But the impact of the 1964 report is even broader than that, according to Harvard historian Allan Brandt. "If we look at the history of public health – from the safety of cars and roads, other dangerous products, the environment, clean air, the workplace – all of these issues really have their origins in a moment 50 years ago around the first surgeon general's report," Brandt tells Shots. He's the author of a 2007 history, The Cigarette Century.

But all that impact unfolded over decades, and for many years it didn't appear the report would launch such a revolution.

In the 1970s, when Joanne Iuliucci of Staten Island, N.Y., started smoking at age 12, she says she had no idea that smoking was dangerous, even though surgeon general's bombshell report had come out six years earlier.

Surgeon General Luther Terry holds a copy of the 387-page report that connected smoking to lung cancer and heart disease on Jan. 11, 1964.

"Absolutely not! Why would I?" says Iuliucci. "Because everybody was smoking. Mother and Father were smoking. Doctors were smoking. You were able to smoke in the movie theater, food shopping with Mom. Really, back then nobody knew what we know today."
In large part that's because the tobacco industry maintained for years that experts still disagreed about the evidence, Brandt says.

"Their campaign – their invented controversy – was actually enormously successful," Brandt says. "If you asked people on the street, 'Do we know whether smoking causes lung cancer or not?' many would say, 'Well, you know, there's a very significant controversy about that.' "

But in fact, by 1964 there was very little controversy among scientists outside the tobacco industry. In the 1950s, highly regarded studies had already made the link between smoking and lung cancer. By the early 1960s, there was mounting concern among public health officials and cancer and heart disease specialists.

President John F. Kennedy was not eager to take on the tobacco industry, Brandt says, because Kennedy needed the support of tobacco-state Democrats to further his civil rights agenda.

"So Kennedy was not happy about the idea," Brandt says. "But when asked about it publicly in a press conference, it became harder and harder for him to back away. And he punted, really. He said: 'This is what my surgeon general will do.' "

That was Luther Terry – the first surgeon general to get such an assignment. Back then, public health rarely concerned itself with any hazards beyond infectious disease epidemics. And the American Medical Association wasn't keen to have government officials preach on the dangers of smoking.

"There were some people in the profession who would say, 'You know, this is really between a patient and his or her doctor,' " Brandt says.

Terry also had to worry about tobacco industry opposition. So when he put together the expert panel that wrote the report, he allowed the industry to veto any member without cause. And he carefully balanced the committee – there were five smokers and five nonsmokers among the scientists and physicians, and none had a publicly declared position on the question of smoking and health.

Tobacco companies incorporated doctors in their ads, such as this 1930 Lucky Strike campaign, to convince the public that smoking wasn't harmful.

One Harvard statistician on the panel was a four-pack-a-day smoker. During the meetings there were ashtrays on the conference table, and smoke filled the room.
But the group didn't flinch when it came to declaring that smoking is deadly.
"The strongest relationship between cigarette smoking and health is in the field of lung cancer," Surgeon General Terry told the 200 reporters gathered for the release of the report on January 11, 1964. It was held on a Saturday morning to minimize impact on tobacco stock trading, and also to guarantee good play in the Sunday newspapers.

"There is a very strong relationship, and probably a causal relationship, between heart disease and cigarette smoking," Terry said.

The effect of that declaration has been enormous, according to Theodore Holford of Yale, a principal author of the JAMA analysis published Tuesday.
"We estimate that 17.7 million Americans have died since 1964 from smoking-related causes," Holford says. "While that's a large number, an additional 8 million deaths would have occurred had there not been any tobacco control. This amounts to about 157 million years of life – about two decades for each of those lives that were saved as a result of tobacco control efforts."

And many of those years of life – 42 million years of human experience – were among Americans who would have died before the age of 65.
Holford says tobacco control has increased U.S. life expectancy by 30 percent since 1964, more than any other public health or medical measure. And the benefits in reducing smoking deaths continue into the future.

Still, about 1 in 5 American adults is a smoker – more than 43 million people. And each year more than 440,000 people die prematurely in this country from tobacco-related disease.

Joanne Iuliucci eventually stopped smoking – after her mother died of lung cancer.
"I quit on November 1, 2010," she says, "and a year later, they told me I needed a lung transplant." The transplant, which she got 18 months ago, was necessary because she had end-stage emphysema.

And that Harvard statistician on the surgeon general's panel who smoked four packs a day was diagnosed with lung cancer within a year of the 1964 report, and died of the disease.



I can remember being impressed by the fierceness of the struggle that the cigarette companies put up when faced with the requirement to put a warning on their cigarette packs of the danger of smoking. That's what big business is capable of doing, and why so many politicians don't want to go up against them over anything. The oil companies are the same way. BP and its half-done cleanup of the Gulf of Mexico is another case, and when it came to taking blame, they simply passed the buck to someone else.

I was a twenty year smoker at two packs a day when I quit in 1995. I first tried nicotine gum, but found that as soon as I wasn't using the gum my urge to smoke came back. When I got an urge to smoke I just reached in my purse for a piece of the gum – still addicted. Luckily I then tried the “step down” patches. The patches prevent the user from getting an urge to smoke by supplying a steady dose of nicotine. There are two patches available, but the one that does not reduce the dose that the body craves is no more help than going “cold turkey.” The reduced dosage patches wean the body gradually to the point that you don't really miss nicotine that much, while also stopping the physical habit of reaching for a cigarette and lighting it, which is a large part of the battle, and why the gum doesn't really work. With the gum you are still reaching for the chemical and putting it in your mouth. But I did stop eventually, and two things improved very soon. I had fewer colds and bronchitis and my acid reflux condition improved tremendously. I hadn't known that my stomach problems were caused partly by smoking.

This news article cheers me up. It shows one public service battle that was bitterly opposed that has produced a very successful result. Now if we could only keep people from picking up the first cigarette, we would be doing fine. Knowing the danger to health isn't enough, unfortunately, to stop people who want to distract themselves from problems in their life by consuming a chemical. Alcohol is another such case, and now I notice that several states have legalized marijuana as well. That will end up being another problem for our society, but there is too much public support for legalizing it right now to stop it. It's one more product for businesses to get rich by selling. Individual battles can be won, but the war never stops.