NEWSSUBSTANCE ABUSE

It seems like a logical win-win plan to fight cancer. The California Cancer Research Act is advocating to raise the excise tax on a pack of cigarettes by $1 in a voter referendum scheduled for the next statewide ballot.

If approved, the initiative could raise between $600-$750 million per year for cancer research, education and smoking cessation programs for California residents. The vote could be as soon as June if there is a special election, otherwise it would appear on the February 2012 ballot. So, smokers paying for research and education that may save them in the long run seems to make sense, except to one group: cigarette makers.

Seven-time Tour de France winner and cancer survivor, Lance Armstrong, joined the cause last month. "Well, I continue to be a person, as a cancer survivor, who hates this disease," said Armstrong. "I hate cancer. It's real simple. And no matter what we have to do in any state, in any country, to help fight the disease, then we'll do it."

Facing backlash from states, the federal government and activists, the makers of Four Loko, the high-alcohol energy drink that's been implicated in hospitalizations and a recent death, have decided to remove the caffeine from their drinks.

Phusion Products, which makes Four Loko and other alcoholic energy drinks, announced yesterday that it intends to reformulate its products to remove caffeine, guarana and taurine and will only produce non-caffeinated versions of Four Loko.

Although their press release contends that they still believe their concoctions to be safe, they are "taking this step after trying -- unsuccessfully -- to navigate a difficult and politically-charged regulatory environment at both the state and federal levels."

What they really mean is that they had no choice.  Their product was rapidly becoming the poster child for youth-targeted marketing and binge drinking. After sickening college students at two campuses, the drink received national media attention, and called to question the ramifications of consuming the syrupy-sweet, high-octane beverages.

Yesterday, ABC carried a story about a Florida family that is suing Phusion Products, claiming that the drink caused their 20-year-old son to accidentally shoot and kill himself. In August, an 18-year-old from Long Island went into cardiac arrest after drinking Four Loko.

The Food and Drug Administration also made a move yesterday indicating it will notify companies that make caffeine-containing alcoholic beverages that their products are unsafe. The FDA has never formally approved the addition of caffeine to alcohol.

Four Loko, the high-alcohol, high-caffeine beverage, is rapidly becoming a household name, and not in a good way. After sickening college students at two campuses, it has received national media attention, bringing a firestorm of scrutiny to the syrupy-sweet, high-octane beverages and their effects. But while the Food and Drug Administration continues to investigate the safety of Loko and other Alcohol Energy Drinks (AEDs), activists and states aren't waiting around.

That's because they've done this before, succesfully campaigning to get major labels to pull their alcoholic energy drinks from the market. In 2007, the Marin Institute, an alcohol industry watchdog, issued a report entitled "Alcohol, Energy Drinks, and Youth: A Dangerous Mix." In it, they called attention to the marketing strategies of the drinks, specifically designed to target youth. In 2008, a group of state attorney generals, assisted by The Center for Science in the Public Interest and other alcohol advocacy groups, successfully pressured Anheuser-Busch and MillerCoors to end the sales of their alcoholic energy drinks.

But that didn't stop some companies, like Phusion Products, the makers of Four Loko, from producing even higher alcohol and caffeine containing energy drinks. They've become extremely popular on college campuses -- and are facing the backlash.

According to Join Together, a project of the Boston University School of Public Health, it didn't take long for colleges, advocacy groups and states to "spring into action" against the beverages, while waiting for the Food and Drug Administration to make a decision.

Colleges across the country are seeking to ban or limit the sale of Four Loko, the highly-caffeinated alcoholic beverage that's popular on campuses and with young people. Central Washington University and Ramapo College, which both had students go to the emergency room after consuming the beverage, have temporarily banned the drink. At Boston University, the Director of Student Health Services sent an email to the campus warning about the dangers of Four Loko. Harvard and Northeastern have followed suit.

In Pennsylvania, the state Liquor Control Board is asking beverage distributors to stop carrying the malt liquor drinks, which contains up to 12 percent alcohol per can. They're not outright banning the drink -- likely waiting for the FDA to finish a safety review -- but are hoping distributors will voluntarily remove it from shelves.

But what's the company's response? On October 26, "Phusion Products," the makers of Four Loko and other alcoholic energy drink, put up a statement on their website regarding the Central Washington University incident, where nine students were sent to the hospital after consuming the beverage.

"Again, the events in central Washington this month were inexcusable. And most would expect our company to disagree with recent decisions to ban our products from college campuses or otherwise restrict their use there.  We do not.  We agree with the goals that underlie those sentiments."

The company claims its product it markets the product responsibly and that caffeine and alcohol have been consumed safely for years.

Jack and coke. Red bull and vodka. Kahlua and coffee. There's nothing new about mixing alcohol and caffeine. But combining the extremes of both substances -- malt liquor and energy drinks -- has resulted in a toxic concoction that has sent college students to the hospital, sickened dozens and was the suspected cause of a heart attack in a 19-year-old.

One of the main high-octane culprits is Four Loko, affectionately nicknamed "blackout in a can" or "liquid cocaine." Containing up to 12 percent alcohol and around 135 milligrams of caffeine, the drink sent students at Ramapo College in New Jersey and Central Washington University to the emergency room. At CWU, blood alcohol levels ranged from 0.12 to 0.35 percent; one girl was in critical condition.

The drink is seen as a cheap, fast way to get drunk. A 23.5-ounce can of Four Loko is equivalent to drinking four to five beers. Although drinking caffeine is sometimes thought of a quick way to sober up, in actuality, it can mask alcohol's effects. This leads consumers to underestimate how drunk they really are, and results in excess drinking. It's sometimes described as "wide-awake drunk."

The feeling of sobriety in the face of blackout may be one reason why young people love it. On the "last thing I remember was opening the 4-loko" fan page on Facebook, which has 6,403 fans, posters note their various experiences:

Justin Redewonuk sates that "The first time i drank 4loko. I gave a girl two tattoos...i never tatted before that night." Another user posts "I love lokos." The host of the site asks "what's ur favorite blackout inducing flavor?!" On the "Four Loko" page, which has over 27,000 fans, people profess their love of Four Loko and call out the "people who don't know how to drink them."

Normally, when a celebrity promotes a product on screen, you can be sure they were paid to do so.

But that wasn't the case for Katherine Heigl, who whipped out her electronic cigarette, the SmokeStik, while on the David Letterman Show in late September. In addition to taking a few puffs herself, she even shows Dave how to use it.

Heigl credits the electronic cigarette with helping her to quit smoking, which she started in her twenties. Electronic cigarettes, or e-cigarettes, are battery-powered devices that provide an inhaled dose of nicotine. The devices looks like a cigarette -- it even has the glowing red tip -- and puffers exhale vaporized water as they would smoke.

But despite the actress's claim that "you aren't harming yourself or anyone else" while using the products, electronic cigarettes aren't considered safe.

The debate over California's Proposition 19 to legalize marijuana often centers around tax revenue, the effects on drug cartels and business concerns. But often missing in the conversation is the role that legalizing marijuana will have on the public's health.

There's little argument about the benefits of medical marijuana. It has been shown to be effective in reducing symptoms of glaucoma, reducing nausea and vomiting associated with chemotherapy, stimulating the appetite for patients living with AIDS  and decreasing chronic pain and neuropathy.

Studies have also pointed to marijuana to relieve symptoms of multiple sclerosis, seizure disorders and potential in anti-inflammation. Cannabinoids, the active ingredients in marijuana, are thought to confer most of the benefits. Two synthetic cannabinoid prescription drugs are approved in the U.S., but only for treating nausea and appetite loss.

Doctors may be more apt to prescribe medical marijuana than prescription drugs because of different or more tolerable side effects. In addition, rather than having to prescribe four or five different pills to deal with side effects, marijuana offers a chance for some patients to decrease their prescription drug use.

The American Public Health Association states that "marijuana has an extremely wide acute margin of safety for use under medical supervision and cannot cause lethal reactions."

Yet, as marijuana nears possible legalization for recreational use, safety and addiction fears still loom large.

It's no surprise that companies jump on breast cancer awareness month with a pink-infused fervor. Over 200,000 women are diagnosed with breast cancer each year. Add to that the thousands of cancer survivors and friends and families affected by the disease, and companies see consumers. A lot of them. Thus, the pink ribbon is everywhere. NFL players have pink ribbons on their helmets. The cosmetic counter is awash in pink lipsticks. Bars offer Drink for Pink nights. You can even purpotedly support breast cancer with your Facebook update.

The pinkwashing seems harmless. But what about the companies that don the pink color, but are actually selling products that contribute to the disease? Isn't that, like, just a tad hypocritical?

The biggest offenders are fast food and alcohol companies. According to the National Cancer Institute, both obesity and alcohol are associated with an increased breast cancer risk. Yet that hasn't stopped these companies from claiming their goods help support or even prevent the disease. First off is KFC, the company that seems to know no bounds when it comes to using women to sell their products. The last time we checked in with the fried-chicken-slinging folks, they were using college women's bums to promote their own buns. But they're also capitalizing on breast cancer by selling pink buckets and donating $0.50 to Susan G. Komen for the Cure.

Fast food isn't part of a healthy diet, but one could argue that eating fried chicken doesn't necessarily make a person obese. (It certainly doesn't help, however.) But there's little in the way of logic to justify alcohol companies going pink. Alcohol is a known risk factor for breast cancer, and according to the National Cancer Institute, it's risk follows a dose-dependent fashion, meaning the more alcohol a woman consumes, the greater her risk.

Yet it hasn't stopped Mike's Hard Lemonade from selling a pink-ribbon drink. And Chambord, which has an ad stating that saying that "by adding a splash of Chambord to any cocktail, you're supporting breast cancer awareness year-round."

How much of an impact does smart tobacco control make? A recent study looks to California, a 40-year leader in comprehensive tobacco control, for definitive answers. Researchers the University of California, San Diego, found that because the state has implemented effective tobacco control programs for the past four decades, its lung cancer rates are nearly 25 percent lower than those in other states.

"If you get the reduction in cigarette consumption, you get a reduction in lung cancer," says John P. Pierce, a Professor of Cancer Research in the Department of Family and Preventative Medicine at UCSD and the paper's lead author. Although the study only looked at lung cancer rates, it's clear that other diseases have been positively affected by a reduction in smoking. Annually, an estimated 443,000 people die prematurely in the U.S. due to tobacco use and about 8.6 million have a serious illness caused by smoking, according the Centers for Disease Control and Prevention (CDC).

Currently, smoking rates in California are about 12 percent, below the national average of 20 percent. But it wasn't always this way.

"California was quick off the mark; they aggressively increased taxes in the '60s and went from having a higher smoking rate to quickly dropping below that of the rest of the country ... [the gap] really widened after they started the California Tobacco Control Program. That doubled the rate of change, so California had this very aggressive campaign and its been effective in reducing cigarette consumption," says Pierce.

Two main variables explain the success of California's program, say the researchers.

What’s the second most common type of illicit drug use in the US? If you guessed methamphetamine, guess again. A new report from the White House reveals an astonishing fact – prescription pain medication is now the second highest form of illicit drug use, after marijuana. According to data compiled by the Substance Abuse and Mental Health Services Administration (SAMHSA), treatment admissions for abuse of prescription pain relievers spiked a whopping 400 percent between 1998 and 2008.

As Reuters reports, the study found that more than 6 million Americans abused prescription drugs, behind 15.2 million people who said they used marijuana. Prescription painkillers were responsible for 9.8 percent of hospital admissions for substance abuse in 2008. That’s up from 2.2 percent in 1998.

The most disturbing finding is how prescription drug abuse cuts across all demographic lines, from the wealthiest to the poorest Americans, from the most educated to the least, and has surged among all cultural, racial and age groups across the country. The largest spike in hospital admissions for abuse of prescription painkillers --13.7 percent--afflicted the 18 to 24 age group. This group made up only 1.5 percent of substance abuse admissions in 1998.