All posts by Pepe Lepew

Smoking can both cause arthritis and make it worse

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You know, when I first got into this racket five or six years ago, I would have never believed smoking — in particular heavy smoking — actually not only can cause arthritis, it makes arthritis far worse for the people who develop it.

This is something I’ve been meaning to touch on for weeks. This topic is an especially raw subject for me, because my mom is absolutely suffering from severe arthritis; she is diabetic and has COPD and high blood pressure, but honestly, the last year or so, it’s been the arthritis that has robbed her the most of her quality of life (And if anyone has witnessed the ravages of COPD, you know that to say that arthritis is wrecking her quality of life more than COPD is a hell of a claim, but it really is. The COPD is under control for the moment, but not the arthritis.)

She can sometimes barely move or walk because of the pain. When I last visited her, she could barely get in and out of bed and could barely use the restroom. She was in agony; it’s in her spine and most of her body, frankly. The only way she could function was by taking oxycontin and other heavy painkillers and they make her sick to her stomach, it’s terrible. When I last saw her, an epidermal had helped her, but she was still getting sick to the stomach from the oxycontin. It’s either throw up a lot or be in excruciating pain — that’s the choice she faces.

x-rayI hate to come off like, “she did it to herself,” because frankly, no one even really knew about the connection between smoking and rheumatoid arthritis (from now on, RA, because rheumatoid is a pain in the ass to spell) until a couple of years ago. Additionally, other studies have shown that smoking increases the risk for osteoarthritis (essentially the loss of cartilage — and smoking can cause a deterioration of cartilage, somewhat different from RA), as well. (I’ve had Mom’s arthritis described as both osteoarthritis and RA to me. The story has changed over the years. Her hands look like RA to me.) Anyway, Mom didn’t know, only a few people knew. And frankly, blaming her doesn’t do her or me or anyone any good.

So, to be clear, I am not point a finger and laying blame. Just simply trying to explain the staggering physical damage that smoking causes — and the damage I’ve seen with my own eyes.

I began reading a couple of years ago about the ties between smoking and arthritis. I dismissed it initially; you see a lot of articles splashed all over the Internet saying that smoking is a “risk factor” and , and since then, I’ve seen a literal cascade of information about how smoking both causes RA and makes it far worse. And all I can think of when I read this stories is my mom.

It’s important to remember that RA is an autoimmune disorder. While it is a genetic disorder (as is lung cancer), studies have show that smokers are three times as likely to develop RA as nonsmokers, in particular heavy smokers. So, like lung cancer, smoking is environment and genetics working together to ravage the body.

Earlier this year, the U.S. Surgeon General put out a report on the 50th anniversary on the landmark 1964 USSG report declaring that smoking causes lung cancer detailing all the other diseases believed to be caused or exacerbated by smoking, which people didn’t know in 1964. A the top of this list is diabetes, macular degeneration, erectile dysfunction … and arthritis.

From the 2014 U.s. Surgeon General report:

Immune and autoimmune disorders: This report finds that smoking is a cause of general adverse effects on the body, including systemic inflammation and impaired immune function (Chapter 10). One result of this altered immunity is increased risk for pulmonary infections among smokers. For example, risks for Mycobacterium tuberculosis and for death from tuberculosis disease are higher for smokers than nonsmokers (Chapter 7). Addi­tionally, smoking is known to compromise the equi­librium of the immune system, increasing the risk for several immune and autoimmune disorders. This report finds that smoking is a cause of rheumatoid arthritis, and that smoking interferes with the effectiveness of certain effectiveness of certain treatments for rheumatoid arthritis (Chapter 10).

This report finds that active smoking is now causally associated with age-related macular degeneration, diabetes, colorectal cancer, liver cancer, adverse health outcomes in cancer patients and survivors, tuberculosis, erectile dysfunction, orofacial clefts in infants, ectopic pregnancy, rheumatoid arthritis, inflammation, and impaired immune function.

Rheumatoid Arthritis

  1. The evidence is sufficient to infer a causal relationship between cigarette smoking and rheumatoid arthritis.

In addition, a recent Swedish study focused on smoking and RA among women. this study surveyed 34,000 people and found that women smoking as little as one to seven cigarettes a day more than double their risk of developing rheumatoid arthritis.

arthritic_joints

(My mom, at her heaviest smoking, probably smoked 30-plus cigarettes a day)

Not only does smoking increase the risk of RA, but it makes the arthritis worse and more difficult to treat, other studies have shown.

I mean, this is stuff I didn’t know as recently as a year ago, but the evidence is pretty overwhelming and pretty damning. Just part of the 20th century tobacco holocaust. Even if you are spared lung cancer, there’s so many other things that smoking does to the body. And not only does smoking kill people, it also destroys the quality of life through COPD and arthritis and other diseases. It’s a plague.

Great article comparing today’s e-cig ads to vintage cigarette ads

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This is a point I’ve been making for weeks now. E-cig companies are making their ads almost identical to cigarette ads from 40 and 50 years ago, using sex and sophistication to sell their products.

Business Insider came up with a feature showing the amazing similarity between today’s e-cig ads and vintage cigarette ads. The problem with this? Tobacco companies are on record using sex, sophistication and even cartoon characters with the expressed purpose of marketing those cigarettes to teens (or, what the industry liked to call “new smokers.”)

It’s no secret e-cig use has been growing exponentially the last couple of years, and in particular, it’s becoming increasingly popular with kids. One of the reasons for the use of e-cig among kids is that until now, it’s been legal to sell e-cigs and e-cig products to kids, so it’s a lot less hassle for kids to get their hands on them than cigarettes (and ultimately much cheaper, too).

It wouldn’t be that big of a deal except e-cigs contain nicotine and as we all know, nicotine is one of the most physically addictive products on Earth, so the e-cig companies can act all innocent, but they know damn well kids are buying their product and their product will addict kids to nicotine.

Anyway, here is the gallery from Business Insider with these amazing comparisons.

 

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Legacy puts out scathing report on e-cigarette marketing to kids

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Good. Apply the pressure to the FDA to crack down on e-cigarette advertising aimed at teens.

The Legacy Project put out a no-nonsense report this week taking the e-cigarette industry to task for pretty blatantly marketing e-cigs to kids.

I will quote from Legacy directly here:

Key findings include:

Use and Awareness among Teens and Young Adults:

  • Results indicate that awareness of e-cigarettes among young people is nearly ubiquitous, ranging from 89% for those ages 13-17 to 94% for young adults ages 18-21.
  • In addition to this extremely high awareness of e-cigarettes, ever-use (whether a product has ever been tried) among these age groups is also high, with 14% of those ages 13-17 and 39% of those ages 18-21 reporting having used e-cigarettes.
  • Results show that, among the major advertising channels, youth awareness of e-cigarette advertisements is highest at retail sites, with 60% of teens ages 13-17 and 69% of young adults ages 18-21 saying they always, most of the time, or some of the time see e-cigarette advertising at convenience stores, supermarkets, or gas stations.

Industry Advertising:

  • Overall, e-cigarette advertisers spent $39 million from June through November 2013, with magazine and national TV accounting for more than three-quarters of dollars spent.
    • Magazines made up the majority of the ad dollars spent ($23 million; 58%)
    • National TV ads were second, accounting for 19% of spending at $7.4 million.
  • From June through November 2013, the blu, NJOY and FIN brands put the most money towards advertising, accounting for 86% of the overall category spend.
    • Far and away, blu spent the most money on paid e-cigarette advertising during this time, accounting for 56% of all e-cigarette ad spending—more than all other brands combined.

Just two weeks ago (April 14), key Senate and House leaders released a similar report concluding that e-cigarette companies are aggressively promoting their products to young people – much like tobacco companies have in the past. The report surveyed nine e-cigarette companies and found that:

  • Many companies are promoting their products through sponsorship of youth-oriented events, and some companies are offering free samples of e-cigarettes.
  • E-cigarettes are available for purchase in stores and online by children and teenagers.
  • Surveyed e-cigarette companies extensively utilize social media and product websites to promote their products.
  • E-cigarette product warning labels lack uniformity and may confuse or mislead consumers.

These two complementary reports on e-cigarettes demonstrate that many of the tactics that have long-been banned or restricted by both the 1998 Master Settlement Agreement and the 2009 Family Smoking Prevention and Tobacco Control Act are now being utilized to market these emerging products to youth. Legacy’s report adds to the data Congress has already collected – showing that e-cigarette companies are aggressively promoting these products and reaching our nation’s young people.

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Pretty damning. I really hope the FDA reels in the e-cig industry. I don’t have a problem with e-cigs, but I’ve grown increasingly turned off with their advertising techniques and how they are obviously trying to make e-cigs look hip and sexy (rather than promoting them as a smoking cessation product.). The biggest problem with e-cigs is they do contain nicotine and nicotine is incredibly physically addictive. Physical addiction is not sexy or cool. It’s one thing if someone uses e-cigs to quit smoking, it’s quite another if a 16-year-old starts using them because they seem cool.

Legacy is a group formed as part of the 1998 Master Settlement Agreement and is the group behind those “Truth” TV ads you have probably seen over the years.

 

Great old Mad magazine anti-smoking ad

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Got this from Campaign for Tobacco-Free Kids. This is great! Really funny.

Mad magazine used to be famous for its fake ads (and some of them looked very real).

Here is a scathing ad from way back in 1965 just skewering Big Tobacco with a “Us Cigarette Makers Would Rather Fight than Quit” ad, mocking the old, long running Tareyton cigarette campaign of “I’d rather fight than switch.”

As a smoker smokes a dollar bill, the ad for “Carry On” reads:

“You think we’re going to let our billion-dollar industry go up in smoke? Sure those Gov’t reports linking cancer and smoking gave us a black eye! But just you wait! Our own scientists and public relations men are hard at work and we’ll be fighting back pretty soon!”

The ad concludes: “Coming Soon! Self serving reports to help the tobacco industry. Higher sales through statistical double talk.”

Wow, that is REALLY ahead of its time. I guess Mad magazine had no desire for any cigarette advertising.

 

Baseball stars who endorsed tobacco products — a lot of them died young

Roger Maris
Roger Maris died of cancer at 50

Again, another idea from Haruko.

She showed me an ad with Stan Musial, Joe DiMaggio and Ted Williams advertising cigarettes and I got the bright idea to see how many ads there had been with baseball stars hawking tobacco products.

And when I looked, I said, “WHOA!”

I found dozens upon dozens upon dozens of ads going all the way back to the early 1900s. I was really shocked. I had never seen these ads before. I knew full well that tobacco companies had used many, many movie stars over the years to sell cigarettes, but I wasn’t aware of all the baseball ads.

The first ad that popped up hit me like a ton of bricks — Roger Maris. Roger Maris, as we all know, smoked five packs a day to deal with the stress of going after Babe Ruth’s home run record. He also died at the age of 50 from cancer. (Strangely enough, his family has always been fiercely private about what exactly Maris died of. There’s been varying reports that he died either of head and neck cancer, lung cancer, lymph gland cancer or lymphoma; I’ve found articles saying all four. The family has always been reticent to discuss it and the story seems to have changed at times about what exact kind of cancer he had. All I can think of is they don’t want people saying, “Well, Maris did it to himself.” Anyway, I digress. He died of cancer. At the age of 50.)

Maris also had a fairly short career. He was basically done at 30 and completely out of baseball at 33. I’ve always wondered if his heavy smoking habit helped break his body down so quickly. It definitely couldn’t have helped.

Babe Ruth died of throat cancer at 53
Babe Ruth died of throat cancer at 53

Another ad that jumped out of me was Babe Ruth endorsing Old Gold. He was a smoker and chewer who died of throat cancer at 53. There’s more. DiMaggio was in a ton of cigarette ads. And while he lived into his 80s, he died of lung disease (likely COPD). Another one that jumped out at me — Jackie Robinson, who died at 52 of diabetes (and it’s known today, not then, that smoking is a risk factor for diabetes).

Another tobacco ad featured Harry Heilmann, a very good hitter in the 1920s. He died of lung cancer at the age of 56. Another chew ad featured Nellie Fox, a Hall of Famer who died at 47 of melanoma.

Anyway, here is a slideshow of these old baseball tobacco ads:

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“Rush” and the history of tobacco advertising in racing

Haruko and Chris Hemsworth
Haruko and James Hunt

 

We were watching Haruko’s new favourite movie, “Rush,” the other night and of course my one track mind got stuck on how James Hunt’s 1976 McClaren was splashed with advertising for Marlboro.

It got me thinking, that 1) Would the constant advertising for Marlboro make Rush an R-rated movie, or does this advertising fall into this vague category of “historical accuracy,” that allows some tobacco use and images in films (Somewhat of a mute question since Rush had enough sex and F-bombs to garner an R-rating anyway, but I did wonder.)

Secondly, I wondered if tobacco companies still advertise through automobile racing?

The short answer is apparently not, though I’m not a NASCAR fan and I wouldn’t have a clue if there’s still a Skoal car out there. But, according to Wikipedia , which had a pretty detailed entry about tobacco advertising and car racing, “tobacco was all but out of North American motorsport by 2013.” Tobacco advertising died out for two reasons — the 1998 Master Settlement Agreement forbid certain kinds of tobacco advertising (this apparently mostly affected IndyCar racing), and a number of countries around the world started forbidding tobacco advertising on cars.

According to Wikipedia, tobacco advertising was last used on vehicles in Formula One in 2008. A number of countries outright forbid tobacco advertising on vehicles. Marlboro still sponsored a Formula One team up until 2011, and while they couldn’t splash “Marlboro” on the car, the car was still painted Marlboro red and white.

Formula One World Championship
James Hunt’s McClaren M23 Marlboro car

Tobacco advertising in car racing used to be HUGE … remember the NASCAR championship was called the Winston Cup for many years … that didn’t stand for Winston, North Carolina, it stood for Winston cigarettes. It began slowly in the late 1960s, and as tobacco advertising was banned on television in the early 70, tobacco companies needed another outlet to advertise their products — so they poured millions of dollars into car racing in the U.S. and around the world. By the mid 70s, tobacco advertising was all over Formula One, Indy Car Racing and NASCAR. Not only were cigarettes advertised at races and on cars, but smokeless tobacco, too like Skoal and RedMan.

Hunt’s Marlboro McClaren was an iconic car in racing history. (As an aside, Hunt was a heavy smoker and died of a heart attack at 45. His use of cocaine may have contributed to his heart attack, as well.). Niki Lauda even drove a Marlboro McClaren after Hunt retired.

One thing that is interesting is there’s been at least two cars that have advertised Nicorette and Blu E-cigs. Products to help people quit smoking are getting into the racing racket.

Haruko’s review of “Rush.”

Rush is a surprisingly good and extremely exciting movie from Ron Howard. It was very surprising to me that this movie didn’t make that much money (only $27 million in the U.S. and $90 million worldwide — some Marvel movies make that much in a weekend) and didn’t garner more Oscar buzz. The movie is really that good and seemed to somehow fly under the radar last year. It’s simply the best car racing movie I’ve ever seen.

I think the movie got overlooked a bit because Ron Howard is still not taken that seriously by film critics. Like Steven Spielberg, he has a reputation for making good (and commercially successful), but not great movies, so I think a lot of film intelligentsia has a hard time giving him his due when he makes a genuinely great film like “Rush.”

Hunt and Lauda
Hunt and Lauda

Rush tells the story of 70s Formula One racers James Hunt and Niki Lauda and their rivalry. The movie remains pretty true to life, even copying some of the play-by-play announcers  from the 1970s. The one thing the movie embellished was the relationship between Hunt and Lauda. In the film, they hate each other, but become friends after a horrible accident to Lauda. In real life, they were always friends. Hyper-competitive rivals, but friends nonetheless. They didn’t hate each other, they just hated losing to each other.

What I loved most about this movie is that unlike a lot of movies made today, most of the driving scenes are for real, with real cameras placed strategically on the cars, instead of CGI cars. A couple of the accidents are obviously CGI (like one scene in which a vehicle flips in the air over Lauda’s head), but it’s done so well, it doesn’t look fake. Too many movies today rely on CGI technology, rather than going to the trouble of getting difficult shots. I was blown away by the racing scenes and wished I had seen them in the theatre. Real ’70s vintage cars, real footage, real stunt drivers. The lack of CGI really gives “Rush” a very 1970s feel. I honestly felt like I was watching a 40-year-old movie.

I was also surprised at the language and sex in a Ron Howard film (again, making it feel like a 70s movie, yeah, movies had a lot more sex in the 1970s.). This is very much an R-rated film (perhaps another reason why it didn’t do that great at the box office.)

I really hope this film becomes a cult classic on DVD like a lot of films that kind of got missed at the box office, like Big Lebowski or Apocalypse Now.

Photo gallery:

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FDA will ban e-cigarette sales to minors

These 13-year-olds legally bought their e-cigs (OK, they're from the UK, but you get the point)
These 13-year-olds legally bought their e-cigs (OK, they’re from the UK, but you get the point). No more e-cig sales to minors in the U.S.

Well, this came a lot faster than I expected. I expected the announcement next week.

As fully expected, the Food and Drug Administration today announced that it intends to ban the sales of e-cigarettes to minors. The sales ban is part of a series of e-cigarette regulations proposed by the FDA. The regulations will be finalized after a 75-day comment period, but I expect few changes.

Here is one story from NBC and here is another. Here is a CNN story.

Here’s the upshot of the new regulations.

The big one. No more e-cig sales to minors under the age of 18. This is really important. Because e-cigs have been completely unregulated, “vaping” has become more and more popular with kids, because frankly, it’s a lot less hassle for kids to get their hands on a e-cigs rather than cigarettes. According to the CDC, the percentage of kids under 18 using e-cigs double from around 5 percent in 2011 to around 10 percent in 2012. That’s alarming. I’m guessing that number is approaching 20 percent today.

While e-cigs may not be as toxic as cigarettes, they still contain nicotine, which is incredibly addictive, so c-cigs, when used by kids as a substitute for cigarettes, are addicting kids to nicotine. E-cigs might be fine for someone trying to quit smoking, but not for some 16-year-old to use instead of tobacco.

Other new regulations are no more free samples, a ban on vending machine sales in any business open to minors, a mandated disclosure of all ingredients in e-cigs and a mandated warning label that nicotine is physically addictive.

The one disappointment to me is there are no proposed restrictions on e-cigarette advertising. I think the advertising has been fairly out of control similar to what was going on with cigarettes 30 years ago. E-cigs are being made to look cool and sexy to kids, and there have even been e-cigs ads using women’s panties and Santa Claus.

Campaign for Tobacco Free Kids issued  a statement with understandably mixed sentiments, taking the FDA to task for taking so long to develop these regs (three years) and urging them to address marketing to kids in the future. However, CTFK is pleased that there is a ban for sales to kids.

However, I also acknowledge that restrictions on advertising may have run into some First Amendment issues. Perhaps the FDA didn’t want to deal with the headaches of First Amendment lawsuits. The FDA CAN enforce advertising restrictions for tobacco products because the tobacco companies agreed to those restrictions in the 1998 Master Settlement Agreement. In that agreement, Big Tobacco agreed to not use cartoon characters (like Joe Camel … or Santa Claus, etc.) to promote its products. I honestly do not know how much power they have to restrict marketing of e-cigs.

Anyway, like I said, the big one is ending the sales of e-cigs to minors. That crap had to be cracked down on. We don’t need a new generation of nicotine addicts being created, no matter what the delivery system. The other big fear I have with e-cigs being sold to kids, and I wonder how often this has happened, is kids getting the bright idea to directly use the liquid nicotine that comes in vials along with the e-cigs. Seriously, I could just see 13- and 14-year-olds trying that. That liquid nicotine in its concentrated form is highly poisonous and powerful.

 

 

Interview with Centers for Disease Control chief — Tobacco is still the No. 1 health issue in America

Thomas R. Frieden

Really good interview I saw on a site called Vox.com (was not familiar with it) with Tom Frieden, head of the Centers for Disease Control, about health in America. The headline talks about legalized pot, but honestly, I didn’t see pot mentioned in the article. Just trying to drive clicks, I guess. Hee, the interview room looks pretty spartan. Did they conduct this interview in an old parking garage somewhere?

Anyway, it’s a wide-ranging interview touching on  e-cigs, tobacco, vaccines, prescription drugs, etc. I’m going to focus on the tobacco and e-cig and pot part of the discussion. There’s a lot of other good stuff there if you want to read the whole thing.

Some excerpts:

Frieden’s comments on tobacco control, when asked if tobacco has become a passe public health issue. The message is, yeah, fewer people might be smoking today than in the past 100 years, but the health crisis caused by the smoking epidemic has not gone away, and we must remain continually vigilant to get the message out to kids that smoking isn’t cool:

What is the single biggest opportunity out there in health?

 I would start with tobacco control. You know what, people sometimes think, “Oh, tobacco. That’s yesterday’s issue.” It still kills more people than anything else in this country and around the world. And there’s a lot more that we can do about it. It doesn’t just kill people, it disables, disfigures, causes diseases. It increases our health care cost. Tobacco is really the number one enemy of health in this country and around the world.

When you say that a lot of people think that tobacco is yesterday’s news, what is the next step on policy? At this point you’re dealing with taxes in New York that are high enough that one out of three packs is basically smuggled into the state. When you say there’s a lot more to do, what is there more to do?

First off, there are a lot of places that haven’t yet implemented the things that we know will work, whether that’s protecting people from second-hand smoke at work or increasing tax or reducing smuggling, which there are ways to do. Or running hard hitting ads, which we know make a major impact – they save lives and save money. These are some of the things that work.

Health care system can do much better at helping people quit. Medications will double or triple the chances that you’ll succeed. But the things that are going to make the biggest impact are price, hard hitting ads and smoke-free laws.

Now, some interesting comments about e-cigs. Frieden actually mentions a couple of issues I hadn’t thought about much personally.

E-cigarettes may help in some ways but they are definitely harmful in many ways as well. If they get kids hooked on tobacco and nicotine, which they are doing. If they get smokers to continue smoking rather than quit. If they get smokers who quit to come back to smoking.

What’s your view of the evidence on whether they actually help people quit?

If they re-glamorize the act of smoking or confuse smokers at what works to quit. These are all real problems with only at this point potential benefits from e-cigarettes.

There’s one small well-done study that they helped a little bit. The patches helped a little bit in that study too. The two weren’t statistically different. We do know that people who are using e-cigarettes are not quitting at higher rates than people who aren’t using them now. As we learn more, I have no doubt that an individual here or there can be helped by them, that they might be helpful to some people. As a societal issue, they’re only going to be helpful if they’re well-regulated and if cigarettes are well-regulated.

 

FDA to issue regulations on e-cigarettes sometime next week

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NBC News image

I feel lately like I am writing more articles on e-cigs than cigarettes lately, but most of the articles I’ve seen on tobacco-related issues have been about e-cigs during the past six months. I’d hate for the Lounge to become a site about e-cigs rather than tobacco (especially since WordPress assumed that I was advertising e-cigs on my blog.).

Anyway, hopefuly the frenzy of coverage over e-cigs will die down a bit later this year as the Food and Drug Administration will be issuing regulations over the sales and marketing of e-cigs. The FDA, which has been taking its time working on these rules, ultimately has control over e-cigs because the FDA was given control several years ago to nicotine — the main ingredient of e-cigs.

I think two issues are paramount here 1) Ban e-cig sales to minors and 2) Control e-cig advertising the same way tobacco advertising is controlled. These are the two biggest problems I see with e-cigs … that in most states, it is legal for kids to buy them and use them, and e-cig companies have been downright brazen in marketing e-cigs to kids. (And the FDA can control e-cig advertising because of the nicotine. I know it sounds like a First Amendment issue, but this issue has already been settled with tobacco products.)

Maybe e-cigs serve some purpose in helping some people quit cigarettes, but, unfortunately, “vaping” has also become hip and cool for teenagers; one of the reasons why is because kids can legally buy and use e-cigs, but it’s a bigger hassle for them to get their hands on cigarettes. That stuff needs to be cracked down on, because kids are still becoming addicted to nicotine, it’s just a different nicotine delivery system then cigarettes or chew.

Anyway, I will be waiting for the news next week when the FDA makes its announcement and hopefully comes up with some common-sense rules for these issues.