Friday Five: Cigarettes, taxes, cancelled insurance, krokodil, pre-term births

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. This time, it's Bloomberg-heavy!  

New Yorkers have to be 21 to buy cigarettes

In what may be his last public health move before leaving office, New York City mayor Michael Bloomberg is set to sign a bill that will raise the purchasing age of nicotine products to 21. The bill covers cigarettes, e-cigarettes, cigars, and cigarillos. About 90% of adult smokers become smokers before age 20, so I understand the public health rationale. However, I question whether it is ethical to make a product illegal for some adults to purchase based simply on the person’s age. The fallout from this soon-to-be law will help frame tobacco laws around the country, and I’m eager to see what happens next.

 

Mexico creates a junk food tax

Mexico has one of the highest rates of overweight and obese citizens—higher than even the United States. This week, the Mexican Congress approved a bill adding an 8% tax to all “high-calorie” foods like potato chips and sweets and a one peso/liter (about $0.08) tax to all soft drinks. The tax initiative was funded in part by Michael Bloomberg’s foundation. It is resolutely opposed by Femsa, the Mexican manufacturer and distributor of Coca-Cola, and Bimbo, which owns Sara Lee, Entenmann’s, and other processed food companies. Hopefully, when the costs inevitably are passed along to consumers, consumption of these items will fall and the population move toward a healthier weight.

 

Some health insurance plans have been cancelled due to the ACA

Before the implementation of the ACA, about 5% of Americans purchased health insurance individually. Many of these plans are now being cancelled because they do not fit the requirements all plans must meet under the new law. There’s lots of outrage, particularly at President Obama, because people feel misled. It’s pretty clear what’s happening: there’s a combination of insurance companies ended “grandfathered” plans early (which is their decision, not mandated by the ACA) and plans being cancelled because they were purchased after the “grandfathering” date and therefore are not legal. For an excellent flowchart showing how and why this is happening, Jon Lovett made an intricate one.

 

Pre-term birth rates fall again

The US pre-term birth rate fell to a 15 year low of 11.5%, or 1 in 9, in 2012. Although we still have the worst pre-term birth rate of all the industrialized nations, this is a positive development. This is the sixth year in which the rates declined, but the reasons why are not clear. Pre-term, low birth weight, and very low birth weight babies can have developmental delays, need more care, and cost more—on average, about $51,600. For more detailed information, see the March of Dimes 2013 Premature Birth Report Card.

 

Appearance of krokodil may be a false alarm in the US

(Warning: DO NOT Google image search for krokodil. Trust me.)

A month or two ago, the internet was abuzz with reports of people losing body parts to a new drug, krokodil. This homemade heroin substitute popular in rural Russia causes horrible sores that lead to severe disfigurement. A few cases popped up in a number of states earlier this year, but now the DEA suggests these were heroin use-related problems, like staph or MRSA infections at the users’ injection sites. Compounding the skepticism is the fact that in some places, a dose of heroin costs only $5 (!!!), virtually eliminating the need for even the most desperate user to knowingly inject his or herself with krokodil. Here’s to hoping that it really hasn’t shown up here, and that this interest we now have leads to getting actual krokodil users help.