CMS expands Medicaid coverage for smoking cessation services

The Centers for Medicare and Medicaid Services has informed state Medicaid directors of new smoking cessation services and reminded them that Medicaid programs are now required to fully cover those services for pregnant women.

The Centers for Disease Control estimates that smoking results in more than $96 billion in healthcare services annually and costs another $97 billion in lost productivity. While 45 of 51 Medicaid programs already offer some form of smoking cessation services or coverage, most beneficiaries and doctors aren't aware of them. A 2004 study found that 36 percent of Medicaid-enrolled smokers and 60 percent of Medicaid physicians knew that their state Medicaid program offered any coverage for tobacco-dependence treatment.

CMS also wants to increase awareness among doctors and pregnant women that these benefits are now required by law under health reform.

“In pregnant women, smoking can cause serious complications,” said CMS Administrator Donald M. Berwick, MD, in a blog post touting the new regulations. “Babies born to mothers who smoke are more likely to be lower birth weight, have lung problems and other health problems. They’re more likely to die from sudden infant death syndrome.”

To help get the word out to all Medicaid-covered smokers, CMS is making federal Medicaid matching funds available to states for the costs associated with telephone services.

“We urge all states to offer comprehensive cessation benefits, including telephone quitlines, to all Medicaid recipients and to aggressively promote the availability of the services in order to achieve the maximum public health benefit,” said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids, in a statement. “There is strong evidence that Medicaid coverage to help smokers quit is highly cost-effective and saves money.”

Myers cited a Massachusetts program, which has provided Medicaid coverage of smoking cessation services since 2006, that saw a 26 percent decline in the smoking rate among beneficiaries in the first two-and-a-half years. Those who used the benefit also showed a 46 percent decrease in hospitalizations for heart attacks and a 49 percent decrease in hospitalizations for cardiovascular disease.

To help guide the states in covering smoking cessation programs and treatments, CMS is recommending guidelines proposed in a May 2008 Public Health Service report, “Treating Tobacco Use and Dependence: 2008 Update: A Clinical Practice Guideline.”

Anti-smoking groups praise Aussie PM

The Smokefree Coalition and New Zealand Public Health Association (PHA) have applauded Australian Prime Minister Julia Gillard for refusing to back down against tobacco industry threats to sue over cigarette packaging legislation.
Tobacco giant Phillip Morris is planning to sue the Australian government over legislation requiring increased health warnings on cigarette packets, saying the packaging will stop it standing out from competitors. The PHA, Smokefree Coalition and the Cancer Society are calling for the New Zealand Government to follow in Australia’s footsteps and introduce plain, unbranded cigarette packaging.

Dr Stone says the tobacco industry will be hit “really hard” by the plain packaging and will use “whatever tactics they can” to stop the legislation.
PHA National Executive Director Dr Gay Keating says it is “beyond immoral” that Phillip Morris is threatening court action in what she says is a “mercenary attempt” to continue to attract Australians to smoking.
“The PHA applauds Canberra for its courage and leadership in standing up to the bully tactics of big tobacco,” she says.

Smokefree Coalition executive director Dr Prudence Stone says Julia Gillard has the moral high ground and her actions are a good example for our Government.
“She’s saying, ‘We don’t care who or how big you think you are; a business that causes death is not as big as a country that prevents it.’”
Philip Morris is a US company, and is using a bilateral investment treaty that Australia signed with Hong Kong in 1991 to bring the case in an offshore international tribunal.

New Zealand has a similar bilateral investment treaty with Hong Kong that was signed in 1995, and the Green Party is warning that corporations could take the New Zealand Government to court over legislation that isn’t in their favour.

UT to implement stricter smoking policy

Smokers may lose their favorite place to light up on the University of Toledo campus, starting on August 15. That's when a new tobacco policy will go into effect.

The Health Science campus has been tobacco-free since 2006 but the foundation is now in place, literally, for a stricter policy on the main campus and its satellite branches.

You will notice digging going on between the Nash, White, and Dowd residence life buildings. Under construction is an outside shelter that will keep smokers confined.

It is one of only seven areas on the main campus where smoking will be allowed.

UT senior Jeff Schlekie responded to the stricter policy, saying, "You know, too many people do smoke cigarettes at the front door entrances all the time, so this should help."

The policy was created to reduce the effects of secondhand smoke and help students and employees cut back or quit smoking.

Junior Matthew Ellis is ready for the change, saying, "A lot of times they don't stay 30 feet away from the building, especially if it is raining or something. They will be right by the doors, and I personally can't stand the smell of smoke."

The university says the new policy will be "consistently" enforced among all students, faculty, staff, and visitors. But there will be those who do not support it, including sophomore Spencer Wotring, who says it's not time to take away some of the freedom to puff away.

"No, I don't think it's a good idea because smoking is not illegal and it's an addiction for most people so they really can't help it. I mean, it's something they've got to do so there's no reason why they should do it," Wotring said.

The policy also includes chewing tobacco, SNUS, cigars, and pipes but tobacco use will be permitted in personal vehicles.

Montgomery County considers partial smoking ban

Smokers would be banned from lighting up in common areas of at least 1,200 properties under a proposal being considered by the Montgomery County Council.

The regulation, which received a mixed reaction from a council committee Thursday, would prohibit smoking in hallways, laundry rooms, lobbies or other indoor common areas of multi-family homes, such as apartment complexes or townhouse developments. The ban would not apply to outdoor common areas, except playgrounds.

Councilman George L. Leventhal (D-At large) of Takoma Park, who authored the regulation, also seeks to expand the ban to smoking on all private playgrounds not just those that belong to multi-family homes. This would include playgrounds that are overseen by homeowners associations, but not a playground in the backyard of a single-family home.

“If you are exposed to secondhand smoke under these circumstances, it is not fair,” he said during the Rockville meeting.

Bruce Bereano, a lobbyist for the state’s tobacco wholesalers, said Leventhal’s regulation is another step toward an outright smoking ban.

“This is really a de facto ban on smoking in Montgomery County,” Bereano said.

Leventhal said he considered a complete ban on smoking in multi-family housing, but determined a majority of the nine-member council did not support such a policy.

The full council is expected to vote July 12 on the partial ban.
The council’s Health and Human Services Committee, which Leventhal chairs, voted Thursday to support the ban on smoking in indoor common areas. Leventhal supported expanding the ban to include all private playgrounds, but Councilman Craig L. Rice (D-Dist. 2) of Germantown did not. Councilwoman Nancy M. Navarro (D-Dist. 4) of Silver Spring was not at the meeting to break the tie.

Enforcement of the partial ban is expected to cost the county about $11,000 annually.

Rice said he takes his children to a playground near his Germantown home that would be subject to the proposed ban. And while he does not want them exposed to second-hand smoke, he questions whether his rights trump those of smokers who take their children to the playground.

Montgomery County already outlaws smoking in workplaces and restaurants. The county does not have the authority to ban smoking in parks overseen by the Maryland-National Capital Park and Planning Commission.

Leventhal said his proposal closes a loophole that allows people to come into contact with dangerous secondhand smoke where they live and play.

Bereano questioned the lawmaker’s motives in proposing the ban.

“The anti-smoking, anti-tobacco people have long used children as the Trojan horse for their real agenda,” he said.

Cigarette makers sue over ad ban

The nation’s three biggest tobacco companies are taking aim at part of a new Worcester antismoking ordinance that would dramatically limit advertising of tobacco products.
The citywide ban would prohibit any signs visible from the street that entice buyers to purchase specific cigarettes brands like Marlboro or Camel, or tobacco products. Retailers would be allowed to advertise only that they sell cigarettes in general.

Philip Morris USA Inc., R.J. Reynolds Tobacco Co., and Lorillard Tobacco Co., along with the trade group National Association of Tobacco Outlets Inc., last week filed suit against the city in federal court, arguing the ban violates freedom of speech rights by severely limiting how they advertise a legal product.

Historically, tobacco companies have prevailed in such cases. But a 2009 change in federal law strengthened communities’ regulatory muscle and could bolster Worcester’s case and provide a model for other communities, said Richard A. Daynard, a law professor at Northeastern University. He said congressional findings in that law about how tobacco ads lead youths to smoke, and the ineffectiveness of current advertising restrictions, could influence the court.

“As Worcester goes, so goes the nation — maybe,’’ said Daynard, who is also president of the law school’s Public Health Advocacy Institute. “I think they could do it — in theory, I think they could.’’

The Worcester City Council approved the tobacco advertising ban last month, over concerns that such ads were contributing to a high incidence of smoking in the city, the second largest in Massachusetts. Nearly one-fourth, or 24 percent, of Worcester adults smoke, compared with a state average of 16 percent, according to city health statistics.

“The smoking rate in Worcester today is about where the state smoking rate was 20 years ago,’’ said Dale Magee, the city’s public health commissioner.

City officials said they expected a legal challenge, given issues involving the Constitution’s First Amendment, which guarantees freedom of speech. Tobacco interests have succeeded in overturning similar bans. In 2001, for example, the US Supreme Court affirmed a lower court decision that struck down as too broad a Massachusetts regulation prohibiting outdoor advertising of tobacco products within 1,000 feet of a school or playground.

But David M. Moore, Worcester’s city solicitor, said officials believe the Family Smoking Prevention and Tobacco Control Act, approved by Congress in 2009, “rewrote the whole landscape’’ by giving local governments greater authority to regulate tobacco marketing based on “smoking and health ’’ concerns for the entire population, not just to protect children.

Courts have given communities greater latitude to regulate tobacco advertising aimed at children. “Congress in 2009 said you can worry about everybody,’’ Moore said.

But some First Amendment specialists question whether Worcester’s ban will survive, especially given previous court rulings.

“I think it’s dead on arrival [because] it’s not a regulation that’s aimed at false or deceptive advertising, it’s not a regulation that’s aimed at unlawful activities,’’ said Jonathan M. Albano, a partner at Bingham McCutchen LLP in Boston, who has also represented the Globe on First Amendment issues. “Unless and until we make tobacco products illegal, allowing bans on advertisements like this would mean you could apply it to other activities that are disfavored by some, but are not illegal.’’

Dan Jaffe, a spokesman for the Association of National Advertisers Inc., a trade group, agreed that Worcester’s ban, if found constitutional, would curtail companies’ freedom to advertise. “You cannot make a product legal and then say no one can hear about it,’’ Jaffe said.

If Worcester succeeds in implementing its law, it could have national implications on how companies and retailers market tobacco products, according to the National Association of Tobacco Outlets.

“If we allow one city to get away with interpreting the Constitution of the United States in the way they want to, it will potentially have a domino effect,’’ said Andrew Kerstein, the trade group president.

The ban was supposed to take effect tomorrow, but has been delayed while the court considers a request by tobacco companies and the National Association of Tobacco Outlets to halt the ban.

“What it boils down to for us is that this ordinance is not about youth tobacco prevention, rather it’s about prohibiting communication about a legal product to adults who choose to use tobacco,’’ said David Howard, a spokesman for R.J. Reynolds. “It’s not just a matter specific to Worcester.’’

NY State Gets Go-Ahead to Collect Taxes on Tribe Cigarette Sales

New York State can move forward with collecting taxes on cigarettes sold by Indian tribes to non-tribal members now that the Appellate Division of the State Supreme Court has lifted a preliminary injunction.

In a decision handed down yesterday afternoon, the court denied a motion by the Seneca Nation of Indians to extend a ban on the collection of the taxes until a legal challenge against the state is decided.

In making its ruling, the legal panel upheld a lower-court ruling that said New York State followed state procedural requirements in adopting regulations spelling out how the taxes would be collected and how the undisputed tax exemption on Indian sales to tribal members would be preserved.

"This extends a long string of federal and state-level court rulings that New York is entitled to collect taxes when non-Indian customers buy cigarettes from tribal enterprises," said James Calvin, president of the New York Association of Convenience Stores, which filed a friend-of-the-court brief opposing the Seneca Nation’s legal challenge. "The law is the law, and it needs to be enforced fairly in the interest of small businesses, taxpayers, and public health. Let's get on with it."

With the state cigarette excise tax at $4.35 -- the highest in the country -- some estimates put New York's lost revenue from its failure to collect taxes from Indian reservations at $110 million a year.

However, the Seneca Nation of Indians is not giving up its fight and will ask for a review of the most recent court decision. In part, President Robert Odawi Porter said that "New York will never collect a cent of revenue from tobacco sales occurring in our territories, and revenue projections so indicating are foolishness."

"Instead, today marks the beginning of a new era in the Nation's tobacco trade and exercise of our sovereignty," he added. "Seneca people are now manufacturing cigarettes in our territories and our Nation's government will work with them to ensure that our tobacco economy is sustained and regulated."

He vowed to continue to block the state's efforts. "While the state may be able to embargo through taxation premium brands from entering our territory, it cannot tax the brands made in our territory or any of the Six Nations," Porter explained.

In 2010, the New York State Legislature passed a law requiring the collection of cigarette taxes on cigarette sales to non-tribal members. The law provided Indian tribes with several options for collecting those taxes, while ensuring that cigarette sales to qualified tribal members would remain tax free. The law was slated to go into effect Sept. 1, 2010. However, in August 2010, several Indian tribes sued the state in federal district court to bar enforcement of the new law. The tribes argued that the law violated their tribal sovereignty and caused them irreparable harm.

Men held over cigarette haul released

Three men arrested over the seizure of 7 million contraband cigarettes in west Dublin yesterday have been released.

The haul was uncovered at Baldonnell Business Park as it was being offloaded from a 12-metre container.

Three Irish men, one in his 40s and two in their 20s were arrested at the premises, were questioned last night before being released in the early hours of this morning. A Garda spokesman said today a file on the case was being prepared for the DPP.

The 'BusinessMan' brand cigarettes had a potential a retail value of €2.9m and could have caused a loss of €2.3 million to the Exchequer if sold on the black market.

They arrived into Belfast Port on Monday from Malaysia and were declared to customs as “wooden flooring” before being transported to Dublin.

The Revenue Customs Service, HMRC Customs Northern Ireland, the PSNI and Garda were among the bodies involved in the joint operation. Some 62 million cigarettes with a retail value of €26m have been seized by Customs officers so far this year.