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DOES JUDAISM need a theology of Christianity? The usual answer is no: Whereas without Jews and Judaism there is no Jesus--both historically and theologically--the reverse does not hold. And yet [...]

Background: Despite recent tobacco control efforts, adolescent vaping remains an epidemic in the United States. The purpose of our study was to understand high school student vaping behaviors using the perceptions of Massachusetts school personnel during the critical window from when the Massachusetts statewide flavor ban legislation was passed in November 2019 through the first year of the COVID-19 pandemic. Methods: High school personnel throughout Massachusetts were invited to complete a cross-sectional survey. Analysis of survey responses was conducted in R. Results: A total of 162 respondents completed the survey representing 137 schools that draw enrollments from 216 (61%) of the 352 cities and towns in Massachusetts. The most popular products that respondents believed their students were using were JUULs (95.7%), other e-cigarettes (85.3%), and disposable vapes (79.6%). Following the flavor ban, the majority (90.7%) did not report an increase in combusted tobacco product use. All participants (100%) reported wanting more access to prevention and treatment resources. Conclusions: Our findings suggest that a comprehensive flavor ban may be an effective tobacco control policy that does not appear to promote student switching from vaping products to combusted tobacco products. These data also indicate that schools report needing additional resources to address the vaping epidemic.

Introduction: The Massachusetts legislature passed An Act Modernizing Tobacco Control in November 2019 to restrict retail sales of flavored commercially manufactured tobacco products including menthol products, increase penalties for violating the law's provisions, and provide health insurance coverage for tobacco treatment. Aims and Methods: This study explores key informants' perceptions of intended and unintended impacts of implementation of the 2019 Massachusetts statewide law through a health equity and racial justice lens. We conducted in-depth interviews with 25 key informants from three key informant groups (public health officials and advocates, clinicians, and school staff) between March 2021 and April 2022. Using deductive codes on unintended impacts of the implementation of the law's policies, we conducted a focused analysis to identify impacts that were perceived and observed by informants from different key informant groups. Results: Perceived or observed impacts of the law were identified across multiple levels by key informants and included concerns related to three broad themes: 1) intended impacts on health equity and racial justice, 2) ongoing availability of restricted products undermining the intended impact of the law, and 3) inequitable targeting by the policies and enforcement among communities of color. Conclusions: Future evaluation is needed to assess the intended and unintended impacts of implementation of the Massachusetts law to maximize the potential of the policies to reduce tobacco-related health disparities. We discuss implications and recommendations for achieving a national policy and equitable enforcement of flavored tobacco sales restrictions. Implications: This qualitative study among 25 key informants including public health and tobacco control advocates, clinicians, and school staff obtained perspectives of intended and unintended health equity and racial justice impacts of the 2019 Massachusetts An Act Modernizing Tobacco Control. Findings and recommendations from this study can inform monitoring efforts to assess the law's impacts in Massachusetts and the adoption of similar flavored tobacco sales restrictions and other tobacco control policies in other states to maximize the health equity benefits and minimize unintended impacts. [ABSTRACT FROM AUTHOR]

Judaism Straight Up: Why Real Religion Endures BY MOSHE KOPPEL MAGGID BOOKS, 218 PAGES, $24.95 Seventy years ago, the European emigre Chaim Grade (pronounced 'GRAH-deh') published a short story that [...]

Abstract Cigarettes manufactured by fewer than half a dozen domestic companies cause approximately 440,000 deaths and $155 billion in medical and lost productivity costs each year in the United States. Despite this toll, Congress has not authorized the United States Food and Drug Administration to regulate cigarette design or marketing. Likewise, the Consumer Product Safety Commission cannot regulate cigarettes and the Federal Trade Commission has played a relatively passive role over the past two decades.Where legislative and regulatory approaches fail, courts have offered an alternative means of addressing the harm caused by cigarette manufacturers. Successful products liability lawsuits against cigarette manufacturers shift health and productivity costs of smoking from families and third-party payers back to cigarette companies, forcing increases in cigarette prices. Litigation thus has proven to be an effective public health strategy for reducing smoking.On September 22, 1999, the United States Department of Justice (“DOJ”) filed a lawsuit against the leading domestic cigarette manufacturers (collectively, “Defendants”) in the United States District Court for the District of Columbia. DOJ is seeking to stop the Defendants’ alleged decades-long misrepresentations and other fraudulent conduct under the Racketeer Influenced Corrupt Organizations Act (“RICO”). RICO authorizes DOJ to pursue criminal and civil sanctions against individuals and organizations that are engaged in a conspiracy involving certain federal felonies, including mail and wire fraud. DOJ is pursuing RICO’s civil sanctions only in this lawsuit. This law synopsis provides an overview of the lawsuit and its possible outcomes, reviews the basic allegations against Defendants and their responses, reviews the remedies DOJ seeks, and covers important events during the litigation’s pre-trial phase. The synopsis also summarizes the manner in which the trial will proceed, reports key testimony provided thus far, and outlines the impact of possible outcomes.

The article discusses the current law concerning residential smoking regulations and their implementation by public housing authorities (PHAs). The debate on whether a nationwide ban on smoking in public housing would be desirable in achieving the set results is also highlighted.

Over 18 months, Medical College of Wisconsin students identified what they had learned during their clerkships in each of seven learning settings; the 3,030 outcomes were divided into 48 categories, and the ten most-frequent learning outcomes are reported. No significant differences by time of year or rural vs. urban clerkships were found. (Author/MSE)

State governments should probably think twice before passing legislation to influence physicians' behavior. Researchers analyzed the use of breast-conserving therapy by women in Michigan, Georgia, New Mexico and Hawaii after these states passed laws requiring women to be given information about this treatment. The use of breast-conserving treatment in these states increased 6% to 13% in the 3 to 12 months following the passage of the law, but these rates dropped back down to the rate in states without such legislation shortly after.

Physicians have an important role to play in supporting patients' claims that they need a smoke-free workplace. Environmental tobacco smoke (ETS) is considered a health hazard, especially in people with chronic lung and heart disease. In 1995, a US appeals court ruled that Americans with chronic illness could use the Americans With Disabilities Act to encourage employers and owners of public businesses to ban smoking. Physicians will need to document that the patient requires a smoke-free environment and can also educate employers and businesspeople about the dangers of ETS., Many persons suffer from a variety of conditions that render them particularly vulnerable to injuries caused by environmental tobacco smoke. Fortunately, the Americans With Disabilities Act may provide such patients with a legal right to a smoke-free environment. We examine herein how the act can be used by these patients, how the act works, and how physicians, who often advise such patients to seek smoke-free environments, can help their patients obtain the clean air to which they are entitled under law. JAMA. 1996;276:909-913

The growing casino industry in the U.S. is built on a model of profitability that bears very close resemblance to two other industries: the tobacco industry and the opioid pain medication industry. While it is rather obvious that all three industries have demonstrated the ability to be consistently profitable, the models used to achieve that profitability are remarkably similar. All three industries began with addictive products. Through investments in research and development, they continually refined their product designs to emphasize and amplify addiction as a design element in order to increase profits. In each case, aggressive and deceptive marketing tactics were employed to target vulnerable populations and to normalize their addictive products despite the risks they posed to consumers. In each case, these products created substantial social costs. For the tobacco industry this includes the premature deaths of nearly half a million Americans annually, an enormous healthcare burden, and a substantial loss of productivity. For the opioid pain medication industry this includes thousands of deaths, tens of thousands of overdoses and an illicit market for other opioids that create enormous healthcare and criminal justice expenditures funded by tax dollars. The casino industry's products do not directly cause physical harm such as lung cancer or opioid overdose. Rather, this industry's products are designed to induce consumers to get in "the zone" and "play to extinction." The impacts on communities caused by casinos are latent, much like the lung cancer that appears in a smoker a quarter century after she takes her first of more than a million puffs. An addicted gambler will potentially experience bankruptcy, divorce, unemployment, and perhaps engage in embezzlement or larceny to keep gambling. The volume of such individuals reduces civic engagement and family stability in communities located in the vicinity of casinos. Other social costs include loss of productivity and healthcare costs associated with comorbidities related to the addiction to casino industry products. The accumulation of social costs and misery caused by highly profitable industries may provoke responses in social attitudes and policy. Over the past twenty-five years or so, federal, state, and local policies have regulated and reduced the impact of tobacco industry products. Litigation, too, has had an impact not only on tobacco industry profits but also in increasing transparency regarding tobacco industry behavior through discovery and whistleblower testimony. Such transparency has contributed to a denormalization of that industry's business model. More recently, the opioid crisis, driven by the opioid pain medication industry, has initiated policymaking as well as thousands of lawsuits against industry leaders. The casino industry, highly reliant upon electronic gambling machines designed to addict consumers may soon find itself in a very defensive legal and policy posture much like the tobacco and opioid pain medication industries which share its business model. [ABSTRACT FROM AUTHOR]

Differences in the use of breast-conserving surgery to treat breast cancer patients in different regions of the US cannot be explained by differences in hospital characteristics. Of 36,982 65- to 79-year-old female Medicare patients with breast cancer that had not spread or had spread only regionally into the lymph nodes, 12.1% underwent breast-conserving surgery; 87.9% underwent some type of total mastectomy. The percentage of women who underwent breast-conserving surgery varied from 3.5% in Kentucky to 21.2% in Massachusetts. Use of breast-conserving surgery was significantly higher in the New England and Middle Atlantic states, and significantly lower in the South Atlantic, South Central, and West North Central states. Women were more likely to undergo breast-conserving surgery in urban hospitals, in teaching hospitals, in larger hospitals and in hospitals with radiation therapy facilities, geriatric services or a cancer center. Variation in treatment of breast cancer patients in different regions remained after taking into account differences in hospital characteristics.