No one under 21 would be able to buy cigarettes in New York City, under a new proposal announced Monday that marks the latest in a decade of moves to crack down on smoking in the nation's largest city.

New York City Council Speaker Christine Quinn discussed details of a proposed law that would raise the minimum age for tobacco purchases from 18 to 21. City Health Commissioner Dr. Thomas Farley, some of Quinn's fellow City Council members and health advocates were to join her.

Under federal law, no one under 18 can buy tobacco anywhere in the country, but some states and localities have raised it to 19. Texas lawmakers recently tried to increase the minimum age to 21, but the plan stalled.

Public health advocates say a higher minimum age discourages, or at least delays, young people from starting smoking and thereby limits their health risks. But opponents of such measures have said 18-year-olds, legally considered adults, should be able to make their own decisions about whether or not to smoke.

Some communities, including Needham, Mass., have raised the minimum age to 21, but New York would be the biggest city to do so.

"With this legislation, we'll be targeting the age group at which the overwhelming majority of smokers start," Quinn said.

Officials say 80 percent of NYC smokers started before age 21, and an estimated 20,000 New York City public high school students now smoke. While it's already illegal for many of them to buy cigarettes, officials say this measure would play a key role by making it illegal for them to turn to slightly older friends to buy smokes for them. The vast majority of people who get asked to do that favor are between 18 and 21 themselves, city officials say.

"We know that enforcement is never going to be perfect," but this measure should make it "much harder" for teens to get cigarettes, Farley said.

The Richmond, Va.-based Altria Group Inc., parent company of Philip Morris USA, which makes the top-selling Marlboro brand, had no immediate comment, said spokesman David Sutton. He previously noted that the company supported federal legislation that in 2009 gave the Food and Drug Administration the power to regulate tobacco products, which includes various retail restrictions.

Under Mayor Michael Bloomberg and the health commissioners he has appointed, including Farley, New York has rolled out a slate of anti-smoking initiatives.

Bloomberg, a billionaire who has given $600 million of his own money to anti-smoking efforts around the world, began taking on tobacco use in the city shortly after he became mayor in 2002.

Over his years in office, the city — at times with the council's involvement — helped impose the highest cigarette taxes in the country, barred smoking at parks and on beaches and conducted sometimes graphic advertising campaigns about the hazards of smoking.

Last month, the Bloomberg administration unveiled a proposal to keep cigarettes out of sight in stores until an adult customer asks for a pack, as well as stopping shops from taking cigarette coupons and honoring discounts.

Bloomberg's administration and public health advocates praise the initiatives as bold moves to help people live better. Adult smoking rates in the city have fallen from 21.5 percent in 2002 to 14.8 percent in 2011, Farley has said.

But the measures also have drawn complaints, at least initially, that they are nannyish and bad for business.

Several of New York City's smoking regulations have survived court challenges. But a federal appeals court said last year that the city couldn't force tobacco retailers to display gruesome images of diseased lungs and decaying teeth.

Quinn, a leading Democratic candidate to succeed Bloomberg next year, has often been perceived as an ally of his.

Bloomberg also has pushed a number of other pioneering public-health measures, such as compelling chain restaurants to post calorie counts on their menus, banning artificial trans fats in restaurants, and attempting to limit the size of sugary drinks. A court struck down the big-beverage rule last month, but the city is appealing and Bloomberg has urged voluntary compliance in the meantime.

While Bloomberg has led the way on many anti-smoking initiatives, this one arose from the City Council, Farley said. City Councilman James Gennaro, who lost his mother to lung cancer after she smoked for decades, has been a particularly strong advocate.

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Mark Lennihan / AP

Harry Patel, an employee of Blondie's Deli and Grocery, talks on the phone while waiting for customers in New York on Monday. A new anti-smoking proposal would make New York the first city in the nation to keep tobacco products out of sight in retail stores. Mayor Michael Bloomberg says the goal is to reduce the youth smoking rate.

New York City Mayor Michael Bloomberg raised eyebrows Monday, proposing a new law – the first of its kind in the nation – that would require cigarettes and other tobacco products be hidden from view of shoppers.

“We know that out of sight doesn’t always mean out of mind,” Bloomberg said during a news conference at Queens Hospital Center. “But in many cases it can and we think this measure will help reduce impulse purchases and if it does, it will literally save lives.”

Experts say there is evidence that the mere sight of a pack of cigarettes really can make smokers want to buy them.

“Nicotine is the most addictive drug there is and cigarettes are both biologically and psychologically addictive,” says Dr. Gail Saltz, a NYC psychiatrist, author and regular TODAY contributor. “Seeing cigarettes is a trigger. ‘There it is.’ It very well may make you want it more.”

Numerous studies back this up. A 2008 study published in the journal Addiction surveyed nearly 3,000 adults (including smokers, ex-smokers and those currently trying to quit) and found more than 25 percent of smokers bought cigarettes after seeing a cash register display -- even though they weren’t shopping for smokes. And one in five smokers trying to quit said they avoided the stores where they usually bought cigarettes because they knew if they went in, they’d buy them.

The allure is so strong even 31 percent of smokers readily admitted that removing cigarettes from store displays would make it much easier to quit.

“Point of purchase cigarette displays act as cues to smoke, even among those not explicitly intending to buy cigarettes and those trying to avoid smoking,” wrote psychologist and lead author Melanie Wakefield, director of the Centre for Behavioural Research in Cancer in Victoria, Australia. “Effective POP marketing restrictions should encompass cigarette displays.”

Other studies have shown store cigarette promotions are strongly correlated with rates of youths taking up smoking as well as increased tobacco sales in the stores. A 2009 study in the journal Tobacco Control found that one of five shoppers who bought smokes at retail outlets with cigarettes on display at the check-out counter made an impulse buy.

“Visual triggers are a huge part of addiction,” says Joe Guppy, Seattle psychotherapist and addiction specialist. “That’s why when people are in recovery, they try to avoid visual triggers. I once had a client mention a magazine ad he saw once when he was trying to quit smoking. It showed a man taking that first drag off a cigarette, looking right into the camera. It probably took thousands of shots to capture that exact moment. But when it hit his brain, it made him go, ‘Oh, I want that so bad.’”

Adds Danny McGoldrick, vice president of research for Campaign for Tobacco-Free Kids, “Impulse buying can occur when you’re exposed to a number of different product displays but particularly if you have nicotine addiction.”

Guppy hails Bloomberg’s proposal, adding that “out of sight, out of mind” can be helpful with all kinds of addictions – from internet porn to sweets.

“I have a thing with chocolate,” he says. “If I want to moderate my intake of brownies, I’ll put them on top of the refrigerator instead of on the counter. That way, I’m not constantly triggered.”

Saltz warns that when it comes to something as addictive as nicotine, though, out of sight, out of mind may not always work.

“It’s not that simple because nicotine is addictive you’re going to seek it anyway if you’re already addicted,” she says. “But for people who may be trying to stay away and may not particularly be shopping for them, it would be better if it’s not in their face.”

Related:

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By Catherine Winters
MyHealthNewsDaily

Plenty of smokers swear they’ll quit. But nagging concerns about post-smoking weight gain, and perhaps the effect it'll have on their risk for cardiovascular disease, may prompt some to put their plans to quit on the back burner. Now, a new study suggests that post-smoking weight gain won't raise people's risk for cardiovascular disease or death even if they have diabetes. 

Researchers found that people without diabetes who stopped smoking reduced their risk for heart attack, stroke or cardiovascular death by about 50 percent. Gaining weight didn’t change that reduction in risk. People with diabetes — a group that has to be especially careful about weight gain — had the same reduction in risk regardless of how much weight they gained.

During the study, researchers analyzed data on 3,251 people enrolled in the Offspring Cohort of the landmark Framingham Heart Study. That study was desgined to identify the causes of heart disease. People in the Offspring Cohort, which began in 1971, underwent regular physical examinations. During these visits, study participants were weighed; their body mass index, or BMI, was calculated; their cholesterol and blood glucose levels were measured; and their smoking habits were recorded.

The researchers found that on average, smokers, nonsmokers and long-term quitters —those who had been smoke-free for four or more years — gained an average of one to two pounds between study visits, which occurred every four years. Recent quitters — those who had quit within the previous four years — gained much more weight, about five to 10 pounds. At their first examination, 31 percent of people in the study smoked. By the fourth examination, about 20 years later, just 13 percent did.

Among people without diabetes, recent quitters gained much more weight —nearly six pounds — than long-term quitters and smokers, who each gained about a pound, and nonsmokers who gained about three pounds. Among people with diabetes, recent quitters gained nearly eight pounds on average; smokers, nearly two pounds; long-term quitters, zero; and nonsmokers one pound.

Typically, people who quit smoking gain between about seven and 13 pounds within the first six months, a gain that lingers over time. Death from cardiovascular disease increases by 40 percent for each five-unit increase in body mass index, or BMI. In a person who is 5 feet 7 inches tall and weighs 180 pounds, that's the equivalent of a 30-pound gain, according to the researchers.

During about 25 years of follow-up, the researchers found that 631 cardiovascular events had occurred. Of these, 337 (53.4 percent) were heart attacks and 147 (23.3 percent) were strokes.

Among people without diabetes, recent quitters were 37 percent less likely to have a heart attack; long-term quitters were 68 percent less likely; and nonsmokers were 81 percent less likely. Among people with diabetes, recent and long-term quitters were 60 percent less likely than smokers to suffer a heart attack; and nonsmokers were 85 percent less likely.

"We knew people gained weight after they stopped smoking," said senior study author researcher Dr. James B. Meigs of the general medicine unit at Massachusetts General Hospital and an associate professor of medicine at Harvard Medical School. "We didn't know if that would impact the size of the benefit of stopping smoking."

The findings suggest that the benefits of quitting trump weight gain. "From a public health perspective, people who stop smoking will gain a little weight, but it doesn't mitigate the benefits," added Meigs. "This study allows doctor to say to patients, 'If you stop smoking, within a few years, you'll have the same chance of dying from a heart attack as you would if you hadn’t smoked.' Stopping smoking is really beneficial and again, we can say this with certitude."

Of the major risk factors for cardiovascular disease — namely diabetes, smoking, high blood pressure, high cholesterol and age — weight gain usually influences only three of those,  Meigs said. "In people who gain weight, their blood pressure tends to go up and their cholesterol and blood sugar levels tend to get a little worse."

As it turns out, "in our study, the weight gain wasn't so big that people were going from Twiggy to Jumbo," Meigs said. "They were gaining a few pounds in the middle distribution of weight from kind of heavy to a little heavier." 

Indeed, the most overwhelming risk factor for having a heart attack or stroke is cigarette smoking. "A little weight gain that raises blood pressure, blood glucose or cholesterol isn’t nearly harmful enough to overcome the benefits of not smoking," Meigs said.

The study is published today (March 12) in the Journal of the American Medical Association.

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Getty Images / Frederick M. Brown

Debi Austin, shown here in 2004, became an influential anti-tobacco advocate in a series of TV ads that showed the dangers of smoking.

The California woman who appeared in the dramatic 1996 anti-smoking television commercial “Voicebox,” has died after a 20-year battle with cancer. Debi Austin was 62.

Austin, who was known as California's most well-known anti-smoking advocate, died on Feb. 22, public health director Dr. Ron Chapman announced on the state's website this week.

“We are saddened by Debi’s death,” Chapman said on the site. “She exemplified the real toll tobacco takes on a person’s body.”

In “Voicebox,” Austin, who had her larynx removed, inhales a cigarette through the surgical hole in her throat. She recalls smoking her first cigarette at age 13.

“When I found out how bad it was, I tried to quit,” she says. “But I couldn’t. They say nicotine isn’t addictive. How can they say that?”

“Voicebox,” Austin’s first ad for the California tobacco control program, also aired in New York and Hawaii. Austin, the woman the state calls its most well-known anti-smoking advocate, later appeared in other commercials in which she warned of the dangers of smoking.

“Gradually tobacco took not just my health but my dreams,” she says though gasps in “Candle.” “Think about what tobacco is taking from you. Quit not before it’s too late.”

“Debi was a pioneer in the fight against tobacco and showed tremendous courage by sharing her story to educate Californians on the dangers of smoking,” Chapman said. “She was an inspiration for Californians to quit smoking and also influenced countless others not to start. We trust she will continue to touch those that hear her story, particularly teens and young adults.”

In a family statement, loved ones mourned “our beloved sister, aunt and dear friend,” and noted her 20-year struggle against cancer.

“True to Debi’s spirit, she was a fighter to the end and leaves a big hole in our hearts and lives,” the statement said. “Debi will be remembered fondly by those who love her to be caring, courageous, very funny and always there to offer advice or lend a hand. She was passionate and outspoken about what she believed in and deeply touched all who knew her or heard her story.”

Though they can be hard to watch, commercials like Austin’s are effective in spreading the anti-smoking message, said Andrew Strasser, an associate professor of psychiatry at the University of Pennsylvania who studies the effectiveness of anti-smoking public service announcements.

“Even on just a simple level, it opens the dialog because you see how this can turn out for someone who chooses to smoke,” he said. “For youth, it might be a good method of prevention, so you don’t end up this way, and for current smokers, it’s a good reminder that it’s better to quit not and not end up here.

“Her message resonated for a lot of people, both at risk and current smokers,” Strasser said.

Strasser has used Austin’s ads in his research, in which asks people what they remember a week after seeing a public service announcement.

“Her message always scored very well,” he said. “Her story really stuck with people. It had good staying power so I think they were very effective.”

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More Americans know about and smoke electronic cigarettes in the U.S., the Centers for Disease Control and Prevention reported on Thursday -- something that highlights the need for government regulation and evaluation, the head of CDC's office on smoking and health said.

The CDC found the number of smokers who have tried them doubled in just a year amid heavy marketing -- from 10 percent in 2010 to about 21 percent in 2011. The numbers grew from 2.5 percent to 7.4 percent for former smokers, the report,  published in the journal Nicotine & Tobacco Research, finds.

Nearly six in 10 adults in the U.S. are aware of the battery-powered devices that heat a liquid nicotine solution and create vapor that users inhale, according the first study to assess the change in awareness and use of electronic cigarettes on a national level.

"These finding sort of tantalizingly underscore the need for more rigorous study of patterns of use of e-cigarettes and impacts," the CDC's Dr. Tim McAfee said in an interview with The Associated Press. "Until there's regulatory authority and oversight, it's going to be more difficult to be certainly reassuring around things like toxic effects."

Some of the nation's largest tobacco companies have gotten into the e-cig market as part of the industrywide push to diversify beyond the traditional cigarette business. Reynolds American Inc., the second-biggest U.S. cigarette maker, has begun limited distribution of its first electronic cigarette under the Vuse brand. Lorillard Inc., the nation's third-biggest tobacco company, acquired e-cigarette maker Blu Ecigs in April. Some e-cigarettes are made to look like a cigarette with a tiny light on the tip that glows like the real thing.

The Food and Drug Administration says e-cigarettes have not been fully studied. The federal agency is expected to assert regulatory authority over e-cigarettes later this year to treat them the same as traditional cigarettes and other tobacco products.

The FDA has said its tests found that the liquid in some electronic cigarettes contained toxins besides nicotine as well as cancer-causing substances that occur naturally in tobacco. But some public health experts say the level of carcinogens was comparable to those found in nicotine replacement therapy, because the nicotine in all of the products is extracted from tobacco.

According to the results of a series of online surveys, the CDC reported, awareness of electronic cigarettes increased from 40 percent in 2010 to nearly 60 percent in 2011, and use among adults doubled to 6 percent during that time. 

McAfee said the motivations behind e-cigarette use remain unclear. For example, a former smoker could be experimenting with them as a new nicotine delivery system, or could have used an electronic cigarette to quit smoking regular cigarettes. Current smokers might be using e-cigs in places where tobacco smoking isn't allowed.

More than 45 million Americans smoke cigarettes, and about half of smokers try to quit each year.

First marketed overseas in 2002, e-cigarettes didn't become easily available in the U.S. until late 2006. Now, the industry has grown from the thousands of users in 2006 to several million worldwide. Analysts estimate sales could double to $1 billion in 2013. Some companies have even started running TV commercials.

Devotees tout e-cigs as a way to break addiction to real cigarettes. They say the devices address both the nicotine addiction and the behavioral aspects of smoking — the holding of the cigarette, the puffing and exhaling something that looks like smoke — without the more than 4,000 chemicals found in cigarettes.

"The bottom line is ... the impact of e-cigarettes on public health remains uncertain," McAfee said.

By David Beasley
Reuters

Mentally ill adults in the United States smoke cigarettes at a 70 percent higher rate than adults without any kind of mental illness, according to a report released by federal health agencies on Tuesday.

Statistics show smoking by the mentally ill is a "very serious health issue that needs more attention" and should prompt mental health facilities to ban the habit, said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

"We need to do more to help smokers with mental illness quit," Frieden told reporters during a telephone briefing.

The CDC study found 36 percent of mentally ill adults smoke, compared with 21 percent of other adults. Those with mental illnesses also smoke more heavily, consuming an average of 331 cigarettes per month, compared with 310 for other smokers, the report found.

Tobacco can alter some aspects of mental illness, such as anxiety. But it can also lead to a long list of other health problems and should not be used as a form of self medication, Frieden said.

"There are very good treatments and very good counseling that, unlike cigarettes, don't take 10 years off your life," he said.

The study analyzed data from the 2009-2011 National Survey on Drug Use and Health, which involved interviews with 138,000 adults at their homes.

The survey by the Substance Abuse and Mental Health Services Administration did not include patients in mental hospitals or members of the U.S. military.

It defined a current smoker as someone who had smoked all or part of a cigarette in the prior 30 days, and defined mental illness as having a diagnosable mental, behavioral or emotional disorder in the past 12 months.

Among the mentally ill, smoking rates were higher in younger, poor and less-educated adults, Frieden said. The study found regional differences in smoking habits among the mentally ill, with rates ranging from 18.2 percent in Utah to 48.7 percent in West Virginia.

The CDC urged mental health facilities to ban smoking both by patients and staff, Frieden said.

Cigarette smoking contributes to approximately 443,000 U.S. deaths each year and is the leading cause of preventable death, the CDC said.

featurepics.com

About 13 percent of double-lung transplants in the U.S. came from donors who were heavy smokers, a new study finds.

Using lung transplants from heavy smokers may sound like a cruel joke, but a new study finds that organs taken from people who puffed a pack a day for more than 20 years are likely safe.

What’s more, the analysis of lung transplant data from the U.S. between 2005 and 2011 confirms what transplant experts say they already know: For some patients on a crowded organ waiting list, lungs from smokers are better than none.

“I think people are grateful just to have a shot at getting lungs,” said Dr. Sharven Taghavi, a cardiovascular surgical resident at Temple University Hospital in Philadelphia, who led the new study.

Surprisingly, however, organ recipients who do get smokers’ lungs often learn about it only afterward -- if at all, experts say.

“If someone had a transplant and after the transplant they say, ‘What can you tell me about the donor?' there are a limited number of characteristics we can tell them,” said Dr. Ramsey Hachem, a pulmonologist at Barnes-Jewish Hospital in St. Louis. “We don’t do that routinely before.”

About 13 percent of double-lung transplants in the U.S. came from donors with a heavy smoking history, according to Taghavi’s new study, presented Tuesday at the annual meeting of the Society of Thoracic Surgeons. He and his colleagues analyzed records of some 5,900 adult procedures in the database maintained by the United Network for Organ Sharing, or UNOS, which manages transplants in the U.S.

Typically, that meant smoking at least a pack of cigarettes a day for more than 20 years, or two packs a day for 10 years.

In the end, after all other variables were accounted for, people who got lungs from heavy smokers lived as long and as well as those who got lungs from the tobacco-free, Taghavi found. There was no significant difference in cancers, though the study didn’t specifically look at lung cancer.

“General guidelines say that donors that have smoked should be excluded, but there are certain circumstances in which they can be used,” Taghavi said. “That can be when the donors are otherwise very healthy and there’s no evidence of the really bad effects of smoking, like emphysema.”

Only about 20 percent of smokers actually develop the worst effects of smoking, noted Hachem.

“It is certainly counterintuitive to say we’re going to use lungs from a donor with a smoking history, but the majority of people who smoke do not have lung disease,” said Hachem, who was not involved in the study.

Some people may have smoked for a long time years ago, then stopped, vastly improving the health of the organs. Others could have been active smokers when they died. The data in the study didn’t include that history, Taghavi said.

Freeing up smokers’ lungs could help reduce a shortage that has left more than 1,650 people on the transplant waiting list -- the “last resort” for those with end-stage lung disease, according to the National Heart Lung and Blood Institute. There were nearly 5,200 liver transplants in the U.S. in 2012, but typically only half the people on the list receive lung transplants in a given year, the NHLBI said. 

Taghavi emphasized that transplant recipients who get lungs from heavy smokers ought to be told in advance.

“This is a very important point,” he said. “None of this should be done without a thorough discussion with the recipient. They have to be aware that there are risks with accepting these lungs, but there are benefits.”

But Hachem said current practice usually doesn’t include that discussion.

Recipients decide in advance whether to take organs from high-risk donors, including those with a history of infections such as viral hepatitis or HIV. But behavior habits, such as smoking, are almost never disclosed, Hachem said.

“I don’t know what other centers do, but at our center, we don’t get into those details,” he said.

Instead, the organs are inspected carefully and only those found free of disease or disability are approved for transplant. “We’ve sort of screened the organ pretty well,” he said.

Of course, problems can occur. Widespread media reports last year centered on Jennifer Wederell, a 27-year-old British woman with cystic fibrosis who died of lung cancer last year after receiving lungs from a heavy smoker. In 2007, the family of a New Jersey man, Tony Grier, sued the University of Pennsylvania Health System after they said Grier developed lung cancer a month after a 2005 lung transplant. Court records show the case was settled in 2010.

Such cases are very sad -- but also very rare, said Hachem, who noted that all transplants carry inherent risks. And, he said, most transplant recipients are like Randy Cooke, 52, of Chatham, Ill., who received a new set of lungs in 2011.

Cooke, who was diagnosed in 2008 with a degenerative lung disease, said that by the time he was placed on the transplant waiting list, he would have accepted lungs from a heavy smoker -- gladly.

“If I’d have waited another three months, I don’t know if I’d be here talking to you,” he said.

If his lungs had come from a smoker, Cooke trusted that his doctors would have screened out any potential problems.

“You have to take a lot of times what you can get,” he said. “You don’t have a choice. Time is not on your side.”

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By Rachael Rettner
MyHealthNewsDaily

A proposed bill in Oregon to make the possession of cigarettes illegal is well-intended, but from a practical standpoint, it's unlikely to happen, bioethicists and public health experts say.

The ban, sponsored by State Rep. Mitch Greenlick of Portland, would make nicotine a controlled substance, and says possessing more than 0.1 milligrams would be illegal, punishable by a year in prison or a $6,250 fine. Exceptions would be made for people who had a doctor's prescription for the drug,   according to the bill.

Tobacco clearly takes a significant toll on the lives of Americans, causing 450,000 premature deaths each year, and drastic measures should be taken to eliminate the habit from our lives, including, some say, banning cigarettes. But others argue that, in today's society, such a goal is overly idealistic, and would be extremely difficult to implement.

"As someone who's looking out for public health, I think it’s a great thing," said Dr. Bradley Flansbaum, a hospitalist at Lenox Hill Hospital in N.Y. "Knowing that tobacco is public enemy No. 1 in preventive illness...I don’t think I can endorse smoking for any reason," Flansbaum said.

However, "Politically, it's going to be a tough if not impossible sell," Flansbaum said.

In 2009, the Food and Drug Administration banned the manufacture and distribution of flavored cigarettes, such as chocolate and cherry, over concerns that the products encouraged youth smoking. However, banning all cigarette products is a different matter entirely. Barriers to passing such a ban include the power of big tobacco companies, the cost of enforcing such a law, and the rise of a black market for cigarettes, experts say.

"Once you have a substance out there like tobacco in wide use it's hard to turn around and make it illegal," said Arthur Caplan, a bioethicist at New York University School of Medicine's Division of Medical Ethics, "You can certainly tax it, you can certainly stigmatize it," and educate against its use.  But ban it?  "In reality, it's not going to happen," Caplan said.

"Smoking has been around too long, and the industries that profit from it are huge and will fight to the end," Caplan said.

Rosalie Liccardo Pacula, co-director of the Drug Policy Research Center at the RAND Corp., a nonprofit research organization, said she was surprised to hear of the bill. "The policy would require an enormous cost to enforce if it is to have any teeth, which most states are not in a position to absorb," Pacula said.

However, others argued such barriers should not deter the action.

"That's really the ultimate goal — to have the world free from the death and destruction it causes," said Dr. Amy Lukowski, clinical director of Health Initiatives Programs for the National Jewish Health Center in Denver. "How we do that? That's the million-dollar question." Although anti-smoking policies have made strides in reducing the number of people who smoke, "I think we have to do something drastic about this," Lukowski said. "[It's] taking the lives of Americans every day." Indeed, a study published today (Jan. 24) in the New England Journal of Medicine found that smoking takes at least 10 years off a person's life.

"I think we should try," said Dr. David Katz, director of the Prevention Research Center at Yale University School of Medicine. "What's possible begins with what we try to do. I think there is a strong argument for never allowing another child to become addicted to tobacco," Katz said. "This would never be approved for sale today, and we should get rid of it."

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