Tobacco an Occupational Hazard: The Case Against Cigarette Sales by Pharmacies

Smoking continues to be a two edged sword in workers' compensation claims. Smokers in the workplace cause serious and sometimes fatal consequences to both themselves (synergistically with other toxic substances in the workplace) and their co-workers (environmental tobacco smoke exposures). On the flip side is the employer's defense that the smoking habit is not work-related and a pre-existing or co-existing disease caused by habit and not compensable. Nevertheless, public opinion continues to trend against permissible smoking and for the sale of cigarettes. Today's post is shared from cdc.com :

Florida jury awards $23 billion punitive damages against RJ Reynolds

R. J. Reynolds Tobacco Company (Photo credit: Wikipedia)

This post is shared from reuters.com A Florida jury has awarded the widow of a chain smoker who died of lung cancer punitive damages of more than $23 billion in her lawsuit against the R.J. Reynolds Tobacco Company, the nation's second-biggest cigarette maker. The judgment, returned on Friday night, was the largest in Florida history in a wrongful death lawsuit filed by a single plaintiff, according to Ryan Julison, a spokesman for the woman's lawyer, Chris Chestnut. Cynthia Robinson of Florida Panhandle city of Pensacola sued the cigarette maker in 2008 over the death of her husband, Michael Johnson. Johnson, a hotel shuttle bus driver who died of lung cancer in 1996 at age 36, smoked one to three packs a day for more 20 years, starting at age 13, Chestnut said. "He couldn't quit. He was smoking the day he died," the lawyer told Reuters on Saturday. After a four-week trial and 11 hours of jury deliberations, the jury returned a verdict granting the widow $7.3 million and the couple's son $9.6 million in compensatory damages. The same jury deliberated for another seven hours before deciding to award Robinson the additional sum of $23.6 billion in punitive damages, according to the verdict forms. Lawyers for the tobacco company, a unit of Reynolds American Inc [RAI.N] whose brands include Camel cigarettes, could not immediately be reached for comment. But J. Jeffery Raborn, vice president and assistant general counsel for R.J. Reynolds, said in a statement quoted by the New York...

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The 50-year war on smoking

The 1964 U.S. Surgeon General's report on smoking — the first official acknowledgment by the federal government that smoking kills — was an extraordinarily progressive document for its time. It swiftly led to a federal law that restricted tobacco advertising and required the now-familiar warning label on each pack of cigarettes. Yet there was nothing truly surprising about the conclusion of the report. Throughout the 1950s, scientists had been discovering various ways in which smoking took a toll on people's health. Britain issued its own report, with the same findings, two years before ours. Intense lobbying by the tobacco industry slowed the U.S. attack on smoking. And even when then-Surgeon General Luther Terry convened a panel before the report was issued to make sure its findings were unimpeachable, he felt compelled to allow tobacco companies to rule out any members of whom they disapproved. Saturday marks the report's 50th anniversary. The intervening decades have seen remarkable progress against smoking in the United States, despite the stubborn efforts of the tobacco industry, which lobbied, obfuscated and sometimes lied outright to the public about the dangers of its products. During those years, though, independent research tied smoking and secondhand smoke to an ever-wider range of ailments. According to the U.S. Centers for Disease Control and Prevention, smoking causes cancer of the lungs, larynx, bladder, bone marrow, blood, esophagus, kidneys and several...

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Why Are Children Working in American Tobacco Fields?

Child Labor prohibitions are enforced through workers' compensation acts. Unfortunately that is an inefficient enforcement mechanism. Today's post was shared by Steven Greenhouse and comes from www.thenation.com

Young farm workers are falling ill from “green tobacco sickness” while the industry denies it and government lets it happen.   This article was reported in partnership with the Investigative Fund of the Nation Institute.   The air was heavy and humid on the morning the three Cuello sisters joined their mother in the tobacco fields. The girls were dressed in jeans and long-sleeve shirts, carried burritos wrapped in aluminum foil, and had no idea what they were getting themselves into. “It was our first real job,” says Neftali, the youngest. She was 12 at the time. The middle sister, Kimberly, was 13. Yesenia was 14. Their mother wasn’t happy for the company. After growing up in Mexico, she hadn’t crossed the border so that her kids could become farmworkers. But the girls knew their mom was struggling. She had left her husband and was supporting the family on the minimum wage. If her girls worked in the tobacco fields, it would quadruple the family’s summer earnings. “My mom tends to everybody,” Neftali says. This was a chance to repay that debt. The sisters trudged into dense rows of bright green tobacco plants. Their task was to tear off flowers and remove small shoots from the stalks, a process called “topping and suckering.” They walked the rows, reaching deep into the wet leaves, and before long their clothes were soaked in the early morning dew. None of them knew that the dew represented a...

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N.Y. AG announces order against major tobacco companies

Today's post was shared by Legal Newsline and comes from legalnewsline.com

New York Attorney General Eric Schneiderman announced Thursday that a panel of arbitrators threw out an $800 million claim brought by major tobacco companies against New York state. The arbitrators ordered the tobacco companies, known collectively as Big Tobacco, to pay New York state more than $92 million in money the companies allegedly withheld from their 2003 annual payment due under the 1998 tobacco Master Settlement Agreement. The arbitration panel rejected Big Tobacco’s demand for a significant reduction in its annual payment to New York. The claim alleged that New York state was not in full compliance with agreement obligations related to the taxation of cigarettes to or on Indian reservations. Consequently, Big Tobacco alleged the state was not entitled to its complete payment. The arbitrators denied the claim, which could protect the state from billions of dollars in future claims. “This ruling is a huge victory for all New Yorkers, and I applaud the panel for denying Big Tobacco’s efforts to avoid responsibility for illnesses caused by cigarettes-and paid for by taxpayers,” Schneiderman said. “Big Tobacco companies contribute to the deaths of thousands of people every year, in large part by luring more and more young people onto cigarettes. Finally, these companies will be required to reimburse the state for money spent treating New Yorkers made ill by their deadly product.” In...

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Is Big Sugar the Next Liability Target?

Today's post was shared by The Health Care Blog and comes from thehealthcareblog.com

By Vik Khanna Growing paranoia is the hallmark of the aging process for me.  Although I am a generally affable sort (I know, it doesn’t always seem that way from my writing), I am also a fairly suspicious person.  I am starting to think that all the food industry’s sweet talk about the innocence of sugar is really just icing on a toxic cake and that we’ve all been sold a bill of goods.  In particular, I wonder — and part of me hopes — that Big Sugar might soon replace Big Tobacco as the favorite target of our most underappreciated and misunderstood national resource…the plaintiff’s bar.  There is no question we eat way too much sugar and that the increase in consumption has coincided nicely with both our rise in obesity and decline in health status even though we are living longer. Not that I think the Tobacco Settlement (TS) was great social policy.  You can read my full view here; but, to summarize, as an immigrant and a person of color, a part of me resents the TS because all it did is push the burden of fulfillment of the financial terms into the hearts and lungs of people in Africa, Asia, and Latin America.  The smug satisfaction of tobacco opponents in the US and their glib dismissal of the impact on predominantly poor people of color around the world is first order racism. Any analogous move against Big Sugar (BS) could be quite interesting.  There is, of course, the delectable duality of...

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Why Is Obama Caving on Tobacco?

Tobacco in the workplace has been greatly reduced. It is,, and was a major contributing factor to occupational disease claims. Today's post was shared by WCBlog and comes from www.nytimes.com

LAST year I endorsed President Obama for re-election largely because of his commitment to putting science and public health before politics. But now the Obama administration appears to be on the verge of bowing to pressure from a powerful special-interest group, the tobacco industry, in a move that would be a colossal public health mistake and potentially contribute to the deaths of tens of millions of people around the world.

Although the president’s signature domestic issue has been health-care reform, his legacy on public health will be severely tarnished — at a terrible cost to the poor in the developing world — unless his administration reverses course on this issue.

Today in Bandar Seri Begawan, Brunei, representatives from the United States and 11 other nations begin the latest round of negotiations over the Trans-Pacific Partnership, a multinational trade agreement. The pact is intended to lower tariffs and other barriers to commerce, a vitally important economic goal. But if it is achieved at the expense of people’s health, the United States and countries around the world will be worse off for it.

Anti-Smoking Battle Moves Outdoors

Today's post was shared by RWJF PublicHealth and comes from abcnews.go.com

First it was bars, restaurants and office buildings. Now the front lines of the "No Smoking" battle have moved outdoors.

City parks, public beaches, college campuses and other outdoor venues across the country are putting up signs telling smokers they can't light up. Outdoor smoking bans have nearly doubled in the last five years, with the tally now at nearly 2,600 and more are in the works.

But some experts question the main rationale for the bans, saying there's not good medical evidence that cigarette smoke outdoors can harm the health of children and other passers-by.

Whether it is a long-term health issue for a lot of people "is still up in the air," said Neil Klepeis, a Stanford University researcher whose work is cited by advocates of outdoor bans.
Ronald Bayer, a Columbia University professor, put it in even starker terms.

"The evidence of a risk to people in open-air settings is flimsy," he said.

There are hundreds of studies linking indoor secondhand smoke to health problems like heart disease. That research has bolstered city laws and workplace rules that now impose smoking bans in nearly half of the nation's bars, restaurants and workplaces.

Largest Study to Date Finds State Smoke-Free Laws Would Not Hurt Restaurant and Bar Business

Smoking is a major cause of disease and workers' compensation claims. Tobacco usage in restaurants and bars is a danger to both the employees and the guests. Banned in some jurisdictions, this study confirms that prohibiting smoking in restaurants and bars is not an economic detriment to businesses. Today's post was shared by RWJF PublicHealth and comes from www.cdcfoundation.org

A study conducted by RTI International in nine states concludes that statewide smoke-free laws would not be expected to have an adverse economic impact on restaurants and bars in these states. The study, which was supported by the CDC Foundation, was released today in the journal Preventing Chronic Disease.

The findings of the new analysis are consistent with the results of previous peer-reviewed studies. However, this study (www.cdc.gov/pcd/issues/2013/12_0327.htm) is unique in that it is the largest of its kind, aggregating all the available data from local jurisdictions in the studied states.

The Global Adult Tobacco Survey: Saving Lives From Tobacco Related Diseases

Antismoking mass media campaigns can help reduce the prevalence of smoking by discouraging young persons from initiating smoking and by encouraging current smokers to quit (1,2). Smoking cessation is a multistage process; intention to quit smoking precedes quit attempts (3). 

To assess whether awareness of anti-cigarette smoking information in four mass media channels (television, radio, billboards, and newspapers or magazines) was significantly associated with a current cigarette smoker's intention to quit, CDC analyzed data from 17 countries that participated in the Global Adult Tobacco Survey (GATS). Logistic regression was used to analyze the relationship between awareness of antismoking messages and intent to quit smoking; odds ratios were adjusted to control for demographic factors, awareness of warning labels on cigarette packages, and awareness of tobacco advertisements. 

In nine of 17 countries, intent to quit was significantly associated with awareness of antismoking messages in a single media channel versus no awareness, with adjusted odds ratios ranging from 1.3 to 1.9. In 14 countries, intent to quit was significantly associated with awareness of messages in multiple channels versus no awareness, with adjusted odds ratios ranging from 1.5 to 3.2. Antismoking information in mass media channels can help reduce tobacco consumption by encouraging smokers to contemplate quitting and might be more effective when presented in multiple channels.

Should Employers Hire Smokers?

Workers' Compensation claims seem to increase with both complexity and severity when a worker is a smoker and suffers an occupational exposure. The class case is the synergistic effect that smoking has with some carcinogenic substance such as asbestos.

The ethical implications are reviewed this week in the New England Journal of Medicine

 where the authors seem to take the position that smokers should not be punished, but rather reformed.

"Finding employment is becoming increasingly difficult for smokers. Twenty-nine U.S. states have passed legislation prohibiting employers from refusing to hire job candidates because they smoke, but 21 states have no such restrictions. Many health care organizations, such as the Cleveland Clinic and Baylor Health Care System, and some large non–health care employers, including Scotts Miracle-Gro, Union Pacific Railroad, and Alaska Airlines, now have a policy of not hiring smokers — a practice opposed by 65% of Americans, according to a 2012 poll by Harris International. We agree with those polled, believing that categorically refusing to hire smokers is unethical: it results in a failure to care for people, places an additional burden on already-disadvantaged populations, and preempts interventions that more effectively promote smoking cessation."

The Obama Agenda: The Road to Workplace Wellness

As workers compensation programs are being diluted by soaring medical costs, The Obama Administration's policy makers are taking a bold new step to focus on promoting wellness and disease-prevention efforts in the workplace. 

Immediately following the presidential elction last November, the Department of Labor, Internatl Revenue Service and the Department of Health and Human Services proposed regulations to enforce workplace wellness programs under thre Affordable Care Act. The proposed regulations will stimulated employer programs to invite healthier workers and may go as far as penalizing those who maintian poor diets and inadequate exercise regiems. 

"... regulations would increase the maximum permissible reward under a
health-contingent wellness program offered in connection with a group
health plan (and any related health insurance coverage) from 20 percent
to 30 percent of the cost of coverage. The proposed regulations would
further increase the maximum permissible reward to 50 percent for
wellness programs designed to prevent or reduce tobacco use. These
regulations also include other proposed clarifications regarding the
reasonable design of health-contingent wellness programs and the
reasonable alternatives they must offer in order to avoid prohibited
discrimination."

One analysis of the proposal concludes......
"We are cautiously optimistic about the potential of workplace-wellness programs to help contain healthcare costs and to improve the health and well-being of millions of California’s workers. Preventing illness and injury through workplace-based strategies potentially benefits employees and their families, employers, and public and private insurance providers. There is emerging evidence about the effectiveness of WWPs in improving chronic disease outcomes, and a long history of occupational health and safety practices reducing workplace injury and death. Incentives in the ACA have the potential to serve as a catalyst for expanding WWP’s broadly in California. However, policy solutions need to respond to potential unintended consequences and account for the state’s incredibly diverse communities and businesses in order to make wellness programs work for all Californians."

Read The Greenlining Institute's report "Helth, Equity and the Bottom line: Workplace Wellness and California Business

Comments are due on or before January 25, 2013.

Read more about health care and workplace injuries and illnesses.

Workers' Compensation: Curing the Profit Motive in Health Care

Jan 10, 2013

Curing the Profit Motive in Health Care. Soaring medical costs have afflicted the workers' compensation industry with economic distress and have severely impacted the efficient and effective delivery of medical care to injured ...

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Workers' Compensation: 8 Hazardous Jobs In The Healthcare Industry

Nov 20, 2012

The National Institute For Occupational Safety And Health (NIOSH) has revised and republished informational material concerning the health hazards to healthcare workers were exposed to hazardous drugs. The publication ...

http://workers-compensation.blogspot.com/

Workers' Compensation: Loss of Health Insurance Access: The ...

Nov 05, 2012

Access to health insurance is under attack. President's Obama's comprehensive health care reform law, intended to increase health care coverage for millions of Americans, faced extreme scrutiny by the U.S. Supreme Court ...

http://workers-compensation.blogspot.com/

Workers' Compensation: Health Care Continues to Eat Away at ...

Sep 12, 2012

Throughout the nation Workers' Compensation systems have been impacted by health care costs that now take a large piece of the premium dollar. Traditional health care offered by employers mirrors the same problem of ...

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Tobacco Industry Argues Against New Cigarette Warnings

Big Tobacco continues to argue against the Federal requirement of new dramatic warnings of cigarette packs. Tobacco is the a leading contributing cause for death in the workplace.

Click here to read more from Jurist blog....

"A panel of judges for the US Court of Appeals for the District of Columbia Circuit [official website] heard oral arguments on Tuesday over the constitutionality of newFood and Drug Administration (FDA) [official website] regulations [text] requiring cigarette packaging and advertisements to display more prominent graphic health warning labels [materials]. A federal judge issued a permanent injunction [JURIST report] last month prohibiting the warnings as unconstitutional. The new requirements of graphic image and textual warning labels were imposed by the Family Smoking Prevention and Tobacco Control Act (FSPTCA) [HR 1256 text].

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The Lingering Consequences of Smoke in the Workplace

Countless studies have confirmed the health risks associated with smoking and secondhand smoke exposure. Now, new research is bringing attention to potential health risks associated with so-called thirdhand smoke, the mixture of tobacco smoke toxicants that lingers in the air and on surfaces after the smoke itself dissipates. 


An article in the current issue of Environmental Health Perspectives takes a look at the state of the science on thirdhand smoke and discusses why some researchers believe it is a cause for concern.

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Warning: Surgeon General Finds Workplace Tobacco is Even More Dangerous to Your Health

Workers who are exposed to tobacco smoke, even in small quantities, are subjecting themselves to an increased risk of illness and disease. The newly published Surgeon General Report, How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease, takes a detailed, scientific look at the toxicology and biology behind nicotine addiction and tobacco smoking, including carcinogenic effects and the adverse effects on cardiopulmonary and reproductive health.

Exposure to tobacco smoke – even occasional smoking or secondhand smoke – causes immediate damage to your body that can lead to serious illness or death, according to a report released today by U.S. Surgeon General Regina M. Benjamin.  The comprehensive scientific report - Benjamin’s first Surgeon General’s report and the 30^th tobacco-related Surgeon General’s report issued since 1964 - describes specific pathways by which tobacco smoke damages the human body and leads to disease and death.

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Casino Employee in NJ Wins Cancer Suit for Second-Hand Smoke Forecasting a New Wave in Litigation

An Atlantic City NJ casino card dealer employed at the Claridge Hotel who was exposed to second hand tobacco smoke was awarded workers' compensation benefits. NJ Judge Cosmo Giovinazzi awarded $150,00 for lost wages and medical benefits to a card dealer holding that second-hand tobacco smoke materially contributed to the employee's lung cancer.

Environmental tobacco smoke has long been associated with lung cancer. A survey of London casino workers indicated that most wanted their environments should be smoke-free. A recently published study by researchers at the University of Nevada revealed that casino floor workers are exposed to four times more tobacco smoke tham amy other workers increasing their risk of cradiovascular disease and lung cancer. Ventilation does not eliminate the poisonous toxins and chimcal components of secondhand smoking.

In The History of the War on Cancer , authored by Devra Davis, in a recent speech broadcast on Book-TV, expresses the urgent need for the removal of carcinogens, inluding tobacco, from the workplace and indicates the need to eliminate the causes.

The Surgeon General of the United States has stated two major observations:

"For the majority of American workers who smoke, cigarette smoking represents a greater cause of death and disability than their work environment." U.S. Department of Health and Human Service. The Health Consequences of Smoking. A Report of the Surgeon General, U.S. Department of Health and Human Services, Public Health Service, 1985 at p. 11.

"In those worksites where well-established disease outcomes occur, smoking control and reduction in exposure to hazardous agents are effective, compatible, and occasionally synergistic approaches to the reduction of disease for the individual worker ..." However, "asbestos exposure can increase the risk of developing lung cancer in both cigarette smokers and non-smokers." Id. at p. 13.

"Cigarette smoking is a major cause of cancer of the lung, larynx, oral cavity, and esophagus and is a contributory factor for cancer of the kidney, urinary bladder, and pancreas. These cancers will cause 278,700 of the estimated 910,000 new cancer cases in the United States during 1985 (ACS 1985), or 30.6 percent of the cancers occurring in the United States other than skin cancer. Exposures to agents in the workplace other than cigarette smoke will also cause some of these new cancers, and a number of cancers will result from the combined effects of cigarette smoking and carcinogenic exposures in the workplace." Id. at p. 101.

Approximately 30 percent of indoor workers in the United States are not covered by smoke-free workplace policies. Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke. Exposure of adults to secondhand smoke has immediate adverse effects on the cardiovascular system and causes coronary heart disease and lung cancer.

Secondhand smoke contains hundreds of chemicals known to be toxic or carcinogenic (cancer-causing), including formaldehyde, benzene, vinyl chloride, arsenic, ammonia, and hydrogen cyanide. Secondhand smoke has been designated as a known human carcinogen (cancer-causing agent) by the U.S. Environmental Protection Agency, National Toxicology Program and the International Agency for Research on Cancer (IARC). The National Institute for Occupational Safety and Health has concluded the secondhand smoke is an occupational carcinogen.

Eliminating smoking in indoor spaces fully protects nonsmokers from exposure to secondhand smoke. Separating smokers from nonsmokers, cleaning the air, and ventilating buildings cannot eliminate exposures of nonsmokers to secondhand smoke.

Conventional air cleaning systems can remove large particles, but not the smaller particles or gases found in secondhand smoke. Routine operation of a heating, ventilating, and air conditioning system can distribute secondhand smoke throughout a building. The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), the preeminent U.S. body on ventilation issues, has concluded that ventilation technology cannot be relied on to control health risks from secondhand smoke exposure. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006.

Already an area of new litigation is that of Suing the Smoker Next Door. Ironically, in a lawsuit against their neighbors, tenants allege that the common hallways of their NY apartment building smell like "a Las Vegas casino," jeopardizing the health of those who live and work in building.

Workers' Compensation has been the genius of many lawsuits and one could easily predict that a new wave of litigation will be third-party civl actions generated against building property owners and those who are responsible to maintain the premises including: management companies, co-op and condominium associations.