Afghanistan’s arts and architecture were once the pride of Asia. However, more than four decades of war have left many of the country’s traditional crafts on the verge of extinction. Now a Britain-based organization, Turquoise Mountain, is working to preserve Afghan heritage in the capital’s still surviving commercial district, Murad Khani. VOA Deewa service’s Munaza Shaheed reports from a recent trip to Kabul.
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From: MeNeedIt
Donald Trump, the presidential candidate, would not like the way Trump, the president, is crowing about today’s unemployment rate. He’d be calling the whole thing a “hoax.”
Trump raised a red flag about declining jobless numbers during his campaign, denying President Barack Obama any credit. Trump noted that the jobless rate masks the true employment picture by leaving out the millions who have given up looking for work.
But Trump is seeing red no more. The same stats he assailed in 2015 and 2016 now are his proof of “fantastic,” “terrific” economic progress, for which he wants the credit.
That disconnect is part of why Trump’s statements about the economy this past week, some accurate on their face, fall short of the whole truth.
Trump also made the far-fetched claim that the economy is better than it has ever been. And in a week consumed with the dustup over a government shutdown, Trump’s doctor stepped forward with a testament to the president’s health that other physicians found to be too rosy.
A look at some recent remarks away from the din of the budget battle:
Black unemployment
TRUMP: “Black unemployment is the best it’s ever been in recorded history. It’s been fantastic. And it’s the best number we’ve had with respect to black unemployment. We’ve never seen anything even close.” — remarks from Oval Office Tuesday.
THE FACTS: Yes, the black unemployment rate of 6.8 percent is the lowest on record. No, it’s not far and away superior to any time in the past. In 2000, it was within 1 point of today’s record for six months, and as low 7 percent.
As Trump was quick to note as a candidate, the unemployment rate only measures people without jobs who are searching for work. Like other demographic groups, fewer African-Americans are working or looking for work than in the past. Just 62.1 percent of blacks are employed or seeking a job, down from a peak of 66.4 percent in 1999.
The black unemployment rate would be much higher if the rate of black labor force participation was near its levels before the Great Recession.
During the campaign, Trump claimed that real unemployment then was a soaring 42 percent. It’s not quite clear, but he could have been referring to the percentage of the U.S. population without jobs — a figure that includes retirees, stay-at-home parents and students. At the time, he considered the official jobless rate a “phony set of numbers … one of the biggest hoaxes in modern politics.”
Women’s unemployment
TRUMP: “We’re making incredible progress. The women’s unemployment rate hit the lowest level that it’s been in 17 years. Well, that’s something. And women in the workforce reached a record high. … That’s really terrific, and especially since it’s on my watch.” — at women’s event Tuesday.
THE FACTS: Again — yes, but. The 4 percent jobless rate for women is at a 17-year low, just as it is for the overall population. But the labor force participation rate by women is lower today than in 2000. The proportion of women in the workforce is not at a record high.
Overall economy
TRUMP: “Our country is doing very well. Economically, we’ve never had anything like it.” — from Oval Office on Tuesday.
THE FACTS: Never say never. The U.S. economy had better employment stats during the 2000 tech boom, for one example. It’s enjoyed stock market surges before. It’s had blazing, double-digit annual growth, a far cry from the 3.2 percent achieved during the second and third quarters of 2017. That was the best six-month pace since 2014 — hardly the best ever.
The economy added about 170,000 new jobs a month during Trump’s first year. That was slightly below the average of 185,000 in Obama’s last year.
Trump checkup
DR. RONNY JACKSON, White House physician, on his examination of Trump: “I think he’ll remain fit for duty for the remainder of this term and even for the remainder of another term if he’s elected. … His cardiac health is excellent.” — White House briefing Tuesday.
THE FACTS: Physicians not connected with the White House have widely questioned that prediction of seven more years of healthy living and that conclusion about his heart. Cardiac functioning was indeed normal in the tests, according to the readings that were released. But Trump is borderline obese and largely sedentary, with a “bad” cholesterol reading above the norm despite taking medication for it. He’ll be 72 in June. It’s doubtful that most men that age with similar histories and findings would get such a glowing report from their doctors.
Trump has some things in his favor: “incredible genes, I just assume,” said his doctor, and no history of tobacco or alcohol use.
But “by virtue of his age and his gender and the fact he has high cholesterol and that he is in the overweight-borderline obese category, he is at a higher risk for cardiovascular disease,” said Dr. Ranit Mishori, a primary care physician and professor of family medicine at Georgetown University. “The physician was saying, yes he’s in excellent health — but yes he does have risk factors for cardiovascular disease. Which is why the comment he will remain healthy for the remainder of his term makes little sense to me. How you can make that kind of assessment from a one-point-in-time examination? Just from those four factors he is at a higher risk.”
Trump’s LDL, the bad cholesterol, registered at 143, a number his doctor wants below 120.
Jackson also said Trump has nonclinical coronary atherosclerosis, commonly known as hardening of the arteries from plaque, which is a combination of calcium and cholesterol.
That’s common in people older than 65 and can be a silent contributor to coronary heart disease. Jackson’s conclusion was based on a coronary calcium score of 133, which Mishori called “a little bit concerning” because it could show mild coronary artery disease, although how to interpret these scores isn’t clear-cut. Jackson said he consulted a variety of cardiologists about that calcium score and the consensus was reassuring.
Abortion viewpoints
TRUMP: “Americans are more and more pro-life. You see that all the time. In fact, only 12 percent of Americans support abortion on demand at any time.” — remarks Friday to opponents of abortion rights.
THE FACTS: Neither side of the abortion debate is scoring breakaway support in public opinion research. Gallup said in conjunction with its poll in June: “The dispersion of abortion views today, with the largest segment of Americans favoring the middle position, is broadly similar to what Gallup has found in four decades of measurement.” In short, half said abortion should be “legal only under certain circumstances,” identical to a year earlier, while 29 percent said it should be legal in all circumstances. The smallest proportion, 18 percent, said it should always be illegal.
Americans’ positions on abortion are sufficiently nuanced that both sides of the debate can find polling that supports their point of view. Polling responses on abortion are also highly sensitive to how the questions are asked.
But in the main, the public is not clamoring for abortion to be banned or to be allowed in all cases.
Trump’s claim that only 12 percent support abortion “on demand” may come from a Marist poll sponsored by the Knights of Columbus, which opposes abortion rights. In that poll, 12 percent said abortion should be “available to a woman any time during her entire pregnancy.”
Most polls have found that a distinct minority, though more than 12 percent, think the procedure should be legal in all cases. The percentage was 25 percent in an AP-NORC poll, 21 percent in a Quinnipiac poll, both done in December.
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From: MeNeedIt
A U.S.-based center says in a new report the eradication of the painful Guinea worm disease could be in sight.
The Carter Center, leader of the campaign to eliminate the disease, says there were only 30 identified cases of Guinea worm disease in isolated areas last year in Chad and Ethiopia – 15 in each country.
All the cases in Ethiopia occurred in migrant workers in the Oromia region who drank unfiltered water from a contaminated pond on an industrial farm.
Mali has not reported any cases of the disease in 25 months, while South Sudan, has not reported any cases in 13 months. The Carter Center labels those achievements by the two African countries as “major accomplishments.”
There is no known vaccine or medicine to control Guinea worm disease. It is eradicated by educating people on how to filter and drink clean water.
People with Guinea worm disease have no symptoms for about one year, the U.S. Centers for Disease Control says. Then, a meter-long worm begins to emerge painfully and slowly from a blister that can form anywhere on the body. In 80 to 90 percent of the cases, the blister forms on lower body parts.
“It was more painful than giving birth,” a South Sudan woman told the Associated Press last year. “Childbirth ends, but this pain persists.”
If the worm breaks during removal, it can cause intense inflammation as the remaining part of the worm degrades in the body.
The worm removal and recovery can disable people, sometimes permanently.
The Carter Center, founded by former U.S. president Jimmy Carter and his wife Rosalynn, reports that in 1986 Guinea worm disease affected an estimated 3.5 million people in 21 countries in Africa and Asia. The incidence of the disease has now been reduced by more than 99.999 percent “thanks to the work of strong partnerships, including the countries themselves,” the center said.
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From: MeNeedIt
The flu season in the U.S. is getting worse.
Health officials last week said flu was blanketing the country, but they thought there was a good chance the season was peaking. But the newest numbers out Friday show it grew even more intense.
“This is a season that has a lot more steam than we thought,” said Dr. Dan Jernigan of the U.S. Centers for Disease Control and Prevention.
One measure of the season is how many doctor or hospital visits are because of a high fever, cough and other flu symptoms. Thirty-two states reported high patient traffic last week, up from 26 the previous week. Overall, it was the busiest week for flu symptoms in nine years.
Hawaii is the only state that doesn’t have widespread illnesses.
This year’s flu season got off to an early start, and it’s been driven by a nasty type of flu that tends to put more people in the hospital and cause more deaths than other common flu bugs. In New York, state officials say a drastic rise in flu cases hospitalized more than 1,600 this past week.
The flu became intense last month in the U.S. The last two weekly report show flu widespread over the entire continental United States, which is unusual.
Usually, flu seasons start to wane after so much activity, but “it’s difficult to predict,” Jernigan said.
Flu is a contagious respiratory illness, spread by a virus. It can cause a miserable but relatively mild illness in many people but a more severe illness in others. Young children and the elderly are at greatest risk from flu and its complications. In a bad season, there are as many as 56,000 deaths connected to the flu. In the U.S., annual flu shots are recommended for everyone age 6 months or older.
In Oklahoma and Texas, some school districts canceled classes this week because so many students and teachers were sick with the flu and other illnesses. In Mississippi, flu outbreaks have hit more than 100 nursing homes and other long-term care places, resulting in some restricting visitors.
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From: MeNeedIt
Tom Petty died last year of an accidental drug overdose that his family said occurred the same day he found out his hip was broken. He had just finished a string of dozens of shows with a less serious injury.
His wife and daughter released the results of Petty’s autopsy via a statement Friday on his Facebook page, moments before coroner’s officials in Los Angeles released their findings and the rocker’s full autopsy report. Dana and Adria Petty say they got the results from the coroner’s office earlier in the day that the overdose was the result of a variety of medications.
Fentanyl among drugs
The coroner’s findings showed Petty had a mix of prescription painkillers, sedatives and an antidepressant. Among the medications found in his system were fentanyl and oxycodone. An accidental overdose of fentanyl was also determined to have killed Prince in April 2016.
Petty suffered from emphysema, a fractured hip and knee problems that caused him pain, the family said, but he was still committed to touring.
He had just wrapped up a tour a few days before he died in October at age 66.
“On the day he died he was informed his hip had graduated to a full-on break and it is our feeling that the pain was simply unbearable and was the cause for his overuse of medication,” his family’s statement said, adding that he performed more than 50 concerts with a fractured hip.
The family said Petty had been prescribed various pain medications for his multitude of issues, including fentanyl patches, and “we feel confident that this was, as the coroner found, an unfortunate accident.”
They added: “As a family we recognize this report may spark a further discussion on the opioid crisis and we feel that it is a healthy and necessary discussion and we hope in some way this report can save lives. Many people who overdose begin with a legitimate injury or simply do not understand the potency and deadly nature of these medications.”
Common prescriptions
Painkillers and sedatives are among the most commonly prescribed medications in the U.S., but both drug types slow users’ heart rate and breathing. The Food and Drug Administration has warned against mixing them because the combination can lead to breathing problems, coma and death.
Government figures released in December showed that for the first time, the powerful painkiller fentanyl and its close opioid cousins played a bigger role in the deaths than any other legal or illegal drug, surpassing prescription pain pills and heroin.
Petty was a rock superstar with the persona of an everyman who drew upon the Byrds, Beatles and other bands he worshipped as a boy in Gainesville, Florida. He produced classics that include Free Fallin’, Refugee and American Girl. He and his longtime band the Heartbreakers had recently completed a 40th-anniversary tour, one he hinted would be their last.
The shaggy-haired blond rose to success in the 1970s and went on to sell more than 80 million records. He was loved for his melodic hard rock, nasally vocals and down-to-earth style. The Rock and Roll Hall of Fame, which inducted Petty and the Heartbreakers in 2002, praised them as “durable, resourceful, hard-working, likable and unpretentious.”
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From: MeNeedIt
Oscar nominations balloting might be finished but Hollywood’s “Me Too” moment has kept right on going.
When Academy Awards nominations are announced Tuesday morning, it might be a brief, celebratory reprieve for an industry enflamed by sexual harassment scandals and gender equality protests.
Or it might just add more fuel to the fire.
Will the motion picture academy, as it has done in 85 out of 89 years, field an all-male field of film directors? Will James Franco squeak into the best actor category after several women made allegations against him of sexual impropriates while filming sex scenes? Franco denied the claims on late-night shows just days before nomination voting closed last Friday.
Either of those outcomes could make the Oscar nominations — a morning often dominated by Harvey Weinstein in the past — one more fraught chapter in the ongoing “Me Too” saga that has shaped and contorted an Oscar race unlike any before.
Here are four questions in the lead-up to Tuesday:
Is there a front-runner?
After winning four Golden Globe Awards, including best feature, drama, Martin McDonagh’s Three Billboards Outside Ebbing, Missouri may have finally taken the Oscar race position that no one wants: favorite. It has the most unblemished score card of all the contenders, including nine BAFTA nods, an ensemble nomination from the Screen Actors Guild (which hands out its awards Sunday), top award nods from the directors and producers guilds, and the often predictive Toronto Film Festival audience award.
But Three Billboards, which many have criticized for its portrayal of a racist police officer (played by Sam Rockwell), has proven a lightning rod, both celebrated for the timeliness of a tale about female vengeance and derided as out of touch. If Three Billboards is out in front, it’s only by a hair. Nearly its equal is Guillermo del Toro’s The Shape of Water, a much admired Cold War fable that may earn the most nominations Tuesday thanks to its lavish craft and celebrated ensemble cast. Yet it crucially missed out on a SAG ensemble nomination, which historically has been a must-have for any Oscar best-picture winner. Every best-picture winner in the last 22 years first landed SAG ensemble nod.
And still just as much in the mix are Greta Gerwig’s Lady Bird, Jordan Peele’s Get Out and Christopher Nolan’s Dunkirk. Each can stake its own claim. Lady Bird is the only top contender made by a woman, and is perhaps the most critically acclaimed movie of the year. Get Out is a landmark genre-bending film about racism, and for many a vital film for the Donald Trump era. Dunkirk is the lone big-screen, blockbuster spectacle of the bunch. While it has been quiet thus far in awards season, Dunkirk will get a boost in the technical categories Tuesday.
How will ‘Me Too’ alter things?
Oscar campaigns from Kevin Spacey to Dustin Hoffman have already bit the dust. Before Franco (The Disaster Artist) was awkwardly answering tough questions from Stephen Colbert he was a borderline best actor contender, slotting in behind Gary Oldman (Darkest Hour), Timothee Chalamet (Call Me By Your Name), Daniel Day-Lewis (Phantom Thread), Daniel Kaluuya (Get Out) and Tom Hanks (The Post). Many Oscar votes had been cast by the time allegations hit, but, then again, a lot of academy members wait until the last minute to send in their ballots. This year, with such a never-ending stream of revelations, voters would have been advised to wait until the very last second before one final Google search.
Particular attention, though, will be on the best director category, where only four women have ever been nominated. Among the many statistics that depict the imbalanced maleness of Hollywood, it’s among the most telling. Gerwig, who was nominated by the Director’s Guild, is poised to be the fifth. But it’s a competitive category, with five seats for the presumed final six: del Toro, Nolan, McDonagh, Spielberg, Peele and Gerwig.
A wildcard is Ridley Scott, who has won admiration for his last-minute reshoots on All the Money in the World, in order to replace the disgraced Spacey with Christopher Plummer. Plummer, too, could crash the best supporting actor category.
Could Oscars-so-white return?
Last year, Moonlight triumphed and films like Fences and Hidden Figures led a firm rebuke to two years straight of all-white acting nominees. Tuesday’s nominations aren’t likely to be a repeat of 2015 and 2016, but they also aren’t likely to overwhelm in their multicultural selections.
Kaluuya, Mary J. Blige (Mudbound) and Octavia Spencer (The Shape of Water) are all favored for nominations, but none are considered among their categories’ front-runners. Much will hinge on how the academy receives Get Out. It’s the only film currently handicapped for a best-picture nomination with a protagonist who’s a person of color. As a horror film from a first-time feature-film director, it’s far from a prototypical Oscar contender. Peele’s movie came out last year on Oscar weekend.
But even if all the above wins nods as expected on Tuesday, critics will wonder why Girls Trip breakout Tiffany Haddish or Downsizing scene-stealer Hong Chau were overlooked.
Can the Oscars top the Globes?
Whoever is nominated, an unusual question will hang in the air: Will the March 4 Oscars feel like merely a buttoned-down sequel to the Globes?
The Golden Globes are usually a frothy kind of dress rehearsal for the main event. But this year, thanks to the black-attired protest by female attendees and stirring speeches from the night’s female winners, the Globes had an almost Oscar-like veneer of importance. As the first major awards show to confront the post-Weinstein landscape, they may have stolen some of the Oscars’ thunder.
Jimmy Kimmel, who will host the ABC telecast for the second straight year, told reporters at the Television Critics Association press tour that, in the current climate, the two months between the Globes and the Academy Awards are a lifetime.
“I do thank (Globes host Seth Meyers) for being that litmus test,” Kimmel said. “As far as how I will handle it, the problem is it’s two months from now. So it’s almost like getting into a hot tub or something; you can’t really know what the temperature is until you get there.”
But the Oscars will lack one element the Globes had: Oprah. It will take more than an envelope flub to top that.
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From: MeNeedIt
A “Game of Thrones”-themed ice hotel complete with a bar and a chapel for weddings has opened in northern Finland in a joint effort by a local hotel chain and the U.S. producers of the hit TV series.
Lapland Hotels said Friday they chose “Game of Thrones” to be the theme for this season’s Snow Village, an annual ice-and-snow construction project covering 20,000 square meters (24,000 sq. yards) in Kittila, 150 kilometers (93 miles) above the Arctic Circle.
Snow Village operations manager Janne Pasma told Finnish national broadcaster YLE that he was a huge fan of the series and it was “a dream come true” that HBO Nordic agreed to go along.
The hotel, which stays open until April, suggests that guests stay only one night due to below-zero temperatures.
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From: MeNeedIt
Olympics organizers on Friday welcomed an agreement between North and South Korea to unite athletes at the upcoming Winter Games in Pyeongchang, and promised that “much more exciting initiatives” promoting Korean unity will emerge this weekend.
“Watch this space,” International Olympic Committee presidential spokesman Mark Adams told the Associated Press in an interview, a day before a crucial meeting of Korean delegations at Olympics headquarters in Lausanne. He declined to elaborate, saying the decisions would come Saturday.
Referring to a detailed peace-making agreement between the rival countries announced Thursday by South Korea’s Unification Ministry, including a joint team in the women’s hockey tournament, Adams said it was “great … but these are discussions.”
The announcement from South Korea, which hasn’t yet been finalized by the IOC, would mark the first time the two national Olympic committees would be competing together in a single team.
“I can tell you that there will also be some much more exciting initiatives coming through as well tomorrow,” Adams added.
Some have questioned the fine print of the agreement announced by the two Koreas, saying it gives the combined hockey squad a far larger roster than any other national team.
Asked how the IOC planned to maintain the integrity of the sport, Adams said: “People would say that these are exceptional circumstances, and we need exceptional measures.”
“This is about the Olympic spirit,” Adams added. “And the Olympic spirit is about nations competing, athletes competing, and we will do our best make sure that it sends a signal that sport can improve the world.”
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From: MeNeedIt
Christa McAuliffe’s lost lessons are finally getting taught in space.
Thirty-two years after the Challenger disaster, a pair of teachers-turned-astronauts will pay tribute to McAuliffe by carrying out her science classes on the International Space Station.
As NASA’s first designated teacher in space, McAuliffe was going to experiment with fluids and demonstrate Newton’s laws of motion for schoolchildren. She never made it to orbit: She and six crewmates were killed during liftoff of space shuttle Challenger on Jan. 28, 1986.
Astronauts Joe Acaba and Ricky Arnold will perform some of McAuliffe’s lessons over the next several months. Acaba planned to share the news during a TV linkup Friday with students at her alma mater, Framingham State University near Boston.
Four lessons — on effervescence or bubbles, chromatography, liquids and Newton’s laws — will be filmed by Acaba and Arnold, then posted online by the Challenger Center, a not-for-profit organization supporting science, technology, engineering and math education.
The center’s president, Lance Bush, said he’s thrilled “to bring Christa’s lessons to life.”
“We are honored to have the opportunity to complete Christa’s lessons and share them with students and teachers around the world,” Bush said in a statement.
NASA’s associate administrator for education, Mike Kincaid, said the lessons are “an incredible way to honor and remember” McAuliffe as well as the entire Challenger crew.
Four of the six lessons that McAuliffe planned to videotape during her space flight will be done. A few will be altered to take advantage of what’s available aboard the space station.
The lessons should be available online beginning this spring.
Acaba returns to Earth at the end of February. Arnold flies up in March. NASA is billing their back-to-back missions as “A Year of Education on Station.”
The two were teaching middle school math and science on opposite sides of the world — Acaba in Florida and Arnold in Romania — when NASA picked them as educator-astronauts in 2004. The idea to complete McAuliffe’s lesson plans came about last year.
“As former teachers, Ricky and Joe wanted to honor Christa McAuliffe,” said Challenger Center spokeswoman Lisa Vernal.
McAuliffe was teaching history, law and economics at Concord High School in New Hampshire when she was selected as the primary candidate for NASA’s teacher-in-space project in 1985.
Her backup, Barbara Morgan, is on the Challenger Center’s board of directors. Morgan was NASA’s first educator-astronaut, flying on shuttle Endeavour in 2007 and helping to build the space station.
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From: MeNeedIt
Imagine if cigarettes were no longer addictive and smoking itself became almost obsolete; only a tiny segment of Americans still lit up. That’s the goal of an unprecedented anti-smoking plan being carefully fashioned by U.S. health officials.
But the proposal from the Food and Drug Administration could have another unexpected effect: opening the door for companies to sell a new generation of alternative tobacco products, allowing the industry to survive — even thrive — for generations to come.
The plan puts the FDA at the center of a long-standing debate over so-called “reduced-risk” products, such as e-cigarettes, and whether they should have a role in anti-smoking efforts, which have long focused exclusively on getting smokers to quit.
“This is the single most controversial — and frankly, divisive — issue I’ve seen in my 40 years studying tobacco control policy,” said Kenneth Warner, professor emeritus at University of Michigan’s school of public health.
The FDA plan is two-fold: drastically cut nicotine levels in cigarettes so that they are essentially non-addictive. For those who can’t or won’t quit, allow lower-risk products that deliver nicotine without the deadly effects of traditional cigarettes.
This month the government effort is poised to take off. The FDA is expected to soon begin what will likely be a years-long process to control nicotine in cigarettes. And next week, the agency will hold a public meeting on a closely watched cigarette alternative from Philip Morris International, which, if granted FDA clearance, could launch as early as February.
The product, called iQOS, is a pen-like device that heats Marlboro-branded tobacco but stops short of burning it, an approach that Philip Morris says reduces exposure to tar and other toxic byproducts of burning cigarettes. This is different from e-cigarettes, which don’t use tobacco at all but instead vaporize liquid usually containing nicotine.
For anti-smoking activists, these new products may mean surrendering hopes of a knockout blow to the industry. They say there is no safe tobacco product and the focus should be on getting people to quit. But others are more open to the idea of alternatives to get people away from cigarettes, the deadliest form of tobacco.
Tobacco companies have made claims about “safer” cigarettes since the 1950s, all later proven false. In some cases the introduction of these products, such as filtered and “low tar” cigarettes, propped up cigarette sales and kept millions of Americans smoking. Although the adult smoking rate has fallen to an all-time low of 15 percent, smoking remains the nation’s leading preventable cause of death and illness, responsible for about one in five U.S. deaths.
Anti-smoking groups also point to Big Tobacco’s history of manipulating public opinion and government efforts against smoking: In 2006, a federal judge ruled that Big Tobacco had lied and deceived the American public about the effects of smoking for more than 50 years. The industry defeated a 2010 proposal by the FDA to add graphic warning labels to cigarette packs. And FDA scrutiny of menthol-flavored cigarettes — used disproportionately by young people and minorities — has been bogged down since 2011, due to legal challenges.
“We’re not talking about an industry that is legitimately interested in saving lives here,” said Erika Sward of the American Lung Association.
But some industry observers say this time will be different.
“The environment has changed, the technology has changed, the companies have changed — that is the reality,” said Scott Ballin, a health policy consultant who previously worked for the American Heart Association.
Under a 2009 law, the FDA gained authority to regulate certain parts of the tobacco industry, including nicotine in cigarettes, though it cannot remove the ingredient completely. The same law allows the agency to scientifically review and permit sales of new tobacco products, including e-cigarettes. Little has happened so far. Last year, the agency said it would delay the deadline for manufacturers to submit their vapor-emitting products for review until 2022.
The FDA says it wants to continue to help people quit by supporting a variety of approaches, including new quit-smoking aids and opening opportunities for a variety of companies, including drugmakers, to help attack the problem. As part of this, the FDA sees an important role for alternative products — but in a world where cigarettes contain such a small amount of nicotine that they become unappealing even to lifelong smokers.
“We still have to provide an opportunity for adults who want to get access to satisfying levels of nicotine,” but without the hazards of burning tobacco, said FDA Commissioner Dr. Scott Gottlieb. He estimates the FDA plan could eventually prevent 8 million smoking-related deaths.
’Smoke-free future’
Philip Morris International and its U.S. partner Altria will try to navigate the first steps of the new regulatory path next week.
At a two-day meeting before the FDA, company scientists will try and convince government experts that iQOS is less-harmful than cigarettes. If successful, iQOS could be advertised by Altria to U.S. consumers as a “reduced-risk” tobacco product, the first ever sanctioned by the FDA.
Because iQOS works with real tobacco, the company believes it will be more effective than e-cigarettes in getting smokers to switch.
Philip Morris already sells the product in about 30 countries, including Canada, Japan and the United Kingdom.
iQOS is part of an elaborate corporate makeover for Philip Morris, which last year rebranded its website with the slogan: “Designing a smoke-free future.” The cigarette giant says it has invested over $3 billion in iQOS and eventually plans to stop selling cigarettes worldwide — though it resists setting a deadline.
Philip Morris executives say they are offering millions of smokers a better, less-harmful product.
Matthew Myers of the Campaign for Tobacco-Free Kids still sees danger. He says FDA must strictly limit marketing of products like iQOS to adult smokers who are unable or unwilling to quit. Otherwise they may be used in combination with cigarettes or even picked up by nonsmokers or young people who might see the new devices as harmless enough to try.
“As a growing percentage of the world makes the decision that smoking is too dangerous and too risky, iQOS provides an alternative to quitting that keeps them in the market,” Myers says.
It’s unclear whether existing alternatives to cigarettes help smokers quit, a claim often made by e-cigarette supporters. Research from the Centers for Disease Control and Prevention suggests about 60 percent of adult e-cigarette users also smoke regular cigarettes.
The case for lower nicotine
Experts who study nicotine addiction say the FDA plan is grounded in the latest science.
Several recent studies have shown that when smokers switch to very low-nicotine cigarettes they smoke less and are more likely to try quitting. But they also seek nicotine from other sources, underscoring the need for alternatives. Without new options, smokers would likely seek regular-strength cigarettes on the black market.
Crucial to the FDA proposal is a simple fact: Nicotine is highly addictive, but not deadly. It’s the burning tobacco and other substances inhaled through smoking that cause cancer, heart disease and bronchitis.
“It’s hard to imagine that using nicotine and tobacco in a way that isn’t burned, in a non-combustible form, isn’t going to be much safer,” said Eric Donny, an addiction researcher at the University of Pittsburgh.
A study of 800 smokers by Donny and other researchers showed that when nicotine was limited to less than 1 milligram per gram of tobacco, users smoked fewer cigarettes. The study, funded by the FDA, was pivotal to showing that smokers won’t compensate by smoking more if nicotine intake is reduced enough. That was the case with “light” and “low-tar” cigarettes introduced in the 1960s and 1970s, when some smokers actually began smoking more cigarettes per day.
Still, many in the anti-smoking community say larger, longer studies are needed to predict how low-nicotine cigarettes would work in the real world.
Legal risks
Key to the FDA plan is the assumption that the two actions will happen at the same time: as regulators cut nicotine in conventional cigarettes, manufacturers will provide alternative products.
But that presumes that tobacco companies will willingly part with their flagship product, which remains enormously profitable.
Kenneth Warner, the public policy professor, said he would be “astonished” if industry cooperates on reducing nicotine levels.
“I don’t think they will. I think they will bring out all of their political guns against it and I’m quite certain they will sue to prevent it,” he said.
In that scenario, the FDA plan to make cigarettes less addictive could be stalled in court for years while companies begin launching FDA-sanctioned alternative products. Tobacco critics say that scenario would be the most profitable for industry.
“It’s like Coke, you can have regular Coke, Diet Coke, Coke Zero, we’ll sell you any Coke you like,” said Robin Koval, president of the Truth Initiative, which runs educational anti-tobacco campaigns.
But the FDA’s Gottlieb says the two parts of the plan must go together. “I’m not going to advance this in a piecemeal fashion,” he said.
When pressed about whether the industry will sue FDA over mandatory nicotine reductions, tobacco executives for Altria and other companies instead emphasized the long, complicated nature of the regulatory process.
“I’m not going to speculate about what may happen at the end of a multiyear process,” said Jose Murillo, an Altria vice president. “It will be science and evidence-based and we will be engaged at every step of the way.”
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From: MeNeedIt