Health
Tobacco smoke exposure reduction strategies – do they work?
https://www.sciencedirect.com/science/article/abs/pii/S1876285920300796
Abstract
Objective
Many children experience tobacco smoke exposure (TSE) and parents may take preventive measures to reduce TSE. The study goal is to assess if these strategies are associated with lower cotinine values, an objective biological measure of TSE.
Methods
Families admitted to Children’s Hospital Colorado from 2014-2018 who screened positive for TSE were invited to participate in a tobacco smoking cessation/reduction program. Caregivers were consented and asked about demographics, beliefs around smoking, and strategies to reduce TSE. Child urine samples were collected, tested for cotinine levels, and analyzed using geometric means. Bi-variable comparisons and multivariable linear regression were completed using SAS v9.4.
Results
213 children (81.4%) are included in this analysis. The median ages of children and parents were 4 and 32 years. 57% of children were male, 36% were Hispanic, and 55% were white. 56% of parents had at least some college education and 69% had an annual income less than $50K. The median daily cigarettes smoked per day was 10. 88% reported using at least one type of protective measure to prevent TSE and 90% believed they protect other household members from TSE. None of the strategies had a significant relationship with lower cotinine levels on bi-variable or multivariable analyses.
Conclusions
Parental strategies to decrease TSE did not result in lower cotinine levels. Many measures are not evidence-based and do not protect children. Parent’s clothing and homes may create a reservoir for nicotine. Education should focus on exposure elimination and cessation rather than protective measures.
$26.75M Award in Retrial Over Smoker’s Death More Than Doubles Original Trial Verdict
https://blog.cvn.com/26.75m-verdict-in-tobacco-case-retrial-over-smokers-fatal-cancer-more-than-doubles-original-award
St. Petersburg, FL— A Florida state court jury awarded $26.75 million to the family of a Florida smoker after finding the nation’s two largest tobacco companies responsible for his cancer death. Duignan v. R.J. Reynolds and Philip Morris, 13-010978-CI.
The award includes $2.75 million in compensatory damages handed down last week and $24 million in punitives imposed equally against R.J. Reynolds and Philip Morris Tuesday for the 1992 cancer death of Douglas Duignan.
Duignan, 42 when he died, smoked up to two packs of cigarettes a day for more than 25 years. His family contends Reynolds and Philip Morris’s role in a conspiracy to hide the dangers of cigarettes hooked Duignan to nicotine and caused his fatal cancer.
The award more than doubles the $12 million handed down in a 2015 trial in the case. That verdict was thrown out two years later, however, after the Florida Court of Appeals for the Second District found the trial judge in the case improperly discouraged a jury readback request.
The case is among thousands that stem from Engle v. Liggett Group Inc., a 1994 Florida state court class-action lawsuit against tobacco companies. The state’s supreme court later decertified the class, but ruled Engle progeny cases may be tried individually. Plaintiffs are entitled to the benefit of the jury’s findings in the original verdict, including the determination that tobacco companies placed a dangerous, addictive product on the market and hid the dangers of smoking.
To be entitled to those findings, however, each plaintiff must prove the smoker at the heart of their case suffered from nicotine addiction that was the legal cause of a smoking-related disease.
After Friday’s verdict finding class membership and awarding compensatories, the two-day punitive phase of trial turned on whether harsh financial punishment should be imposed in light of broad changes by the companies, and the industry at-large, over the last two decades.
During Tuesday’s closing statements, Shook Hardy & Bacon’s Kenneth Reilly reminded jurors that the tobacco industry now faced strict oversight by the U.S. Food and Drug Administration, or FDA, while Philip Morris had paid billions of dollars under a settlement with states’ attorneys-general. Meanwhile, he said, the company had gone farther than required in restricting their marketing.
“What message are you guys going to send to the people who are operating the business today and have been for a quarter of a century?” Reilly asked jurors. “They’ve never failed to comply with the FDA requirements. They’ve never failed to comply with the attorneys-general requirements. They’ve never been criticized, and look at all the voluntary things they did.”
Jones Day’s Jack Williams, representing Reynolds, agreed, and argued Reynolds now sent clear messages about smoking’s dangers while spending decades and billions of dollars trying to make a safer cigarette. “Punishing Reynolds now would… be saying that if a company changes and becomes more responsible and tries to do more of the right thing, it’s still… going to get punished,” Williams said.
But Searcy Denney’s James Gustafson argued that none of the changes the companies detailed affected Duignan’s ultimate end.
“Nothing that the defendants brought you… mitigated, or made less severe, what they did to Douglas Duignan,” Gustafson said. “If they don’t get punished for what they did, what does that do to deter others from doing the same thing?”