Mark Zuckerberg Plans Fund-Raiser for Gov. Christie






Mel Evans/Associated Press

Gov. Chris Christie of New Jersey has found an unlikely ally in Mark Zuckerberg.







So much that Mr. Zuckerberg, a co-founder of Facebook, and his wife will hold a fund-raiser for him next month at their home in Palo Alto, Calif.


The fund-raiser is another reminder of the hurdles Democrats face in attempting to defeat Mr. Christie, who faces re-election in November and is often mentioned as a leading contender for the Republican presidential nomination in 2016.


Mr. Christie has increasingly tried to position himself as a kind of crossbreed politician, apart from the partisan politics that plague Washington, and able to appeal to a constituency beyond the Republican Party regulars. He took leaders of his own party to task this month when they failed to call a vote on a relief package for victims of Hurricane Sandy. His popularity has soared since the storm, even among Democrats — and apparently among at least some tech donors in Silicon Valley, where political contributions tend to flow toward more liberal causes.


A spokeswoman for Mr. Zuckerberg, who is the company’s chief executive, said he and his wife admired the governor’s work on education policy — Mr. Christie has pushed for vouchers, championed a new state law weakening tenure in public schools, and signed a contract with the teachers union in the state-run Newark schools that will allow performance bonuses. He also signed a law requiring teachers, among other public employees, to pay more toward their pension and benefits.


Mr. Zuckerberg showed his interest in education with a $100 million donation to the Newark schools in 2010. But he stood alongside a Democrat, Mayor Cory A. Booker of Newark, as well as Mr. Christie to make that announcement. And he has made few political contributions — federal records show only a $10,000 donation to Facebook’s political action committee.


Mike DuHaime, Mr. Christie’s chief political consultant, said the two men met in 2010, before Mr. Zuckerberg’s pledge to the Newark schools, became fast friends and have kept in touch. “Governor Christie was instrumental in giving Mark the confidence that the money in Newark was going to be used wisely,” Mr. DuHaime said.


“I think it demonstrates the kind of broad appeal that he has and support that he has, and part of it is taking on education reform. People took notice that the governor stood up and did the right thing.”


The Democratic Governors’ Association, which might be expected to dispute that characterization of some of Mr. Christie’s education policies, started an online petition Thursday calling on Mr. Zuckerberg to cancel the fund-raiser for “right-wing Republican darling Chris Christie.”


Mr. Christie has raised more than $2 million for his re-election, and announced that he would opt not to take public matching money for the primary, which would have required him to limit spending in the early stage of the race to $5 million. Some Democrats have said they need to raise close to $50 million to beat him. The only declared Democratic challenger so far, State Senator Barbara Buono, has raised about $250,000. (Mr. Booker, who was considered a favorite to challenge Mr. Christie, announced his interest in running for Senate in 2014 instead.)


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HCA Must Pay Kansas City Foundation $162 Million





HCA, the nation’s largest profit-making hospital chain, was ordered on Thursday to pay $162 million after a judge in Missouri ruled that it had failed to abide by an agreement to make improvements to dilapidated hospitals that it bought in the Kansas City area several years ago.




The judge also ordered a court-appointed accountant to determine whether HCA had actually provided the levels of charitable care that it agreed to at the time.


The ruling came in response to a suit filed in 2009 by a community foundation that was created when HCA acquired the hospitals. Among other things, the foundation was responsible for ensuring that HCA met the obligations outlined in the deal.


The dispute in Kansas City is the second time in recent years that HCA has come under legal fire from officials in communities that sold troubled nonprofit community hospitals to HCA.


In another dispute in New Hampshire in 2011, a judge ruled in HCA’s favor, deciding that Portsmouth Regional Hospital would remain part of HCA after community leaders tried to regain control. During testimony in a 2011 trial, a former hospital official claimed he had difficulties getting HCA to pay for what he and others described as critical equipment and facility upgrades.


In an e-mailed statement, a spokesman for HCA said the company was disappointed in the court’s ruling and intended to appeal. He also added that the two cases were “rare exceptions” and that the company had enjoyed positive relationships with communities across the country.


The suit is among several problems for HCA. The company disclosed last year, for example, that the United States attorney’s office in Miami had subpoenaed documents as part of an inquiry to determine whether unnecessary cardiology procedures had been performed at HCA hospitals in Florida and elsewhere. At stake in that case is whether HCA inappropriately billed Medicare and private insurers for the procedures. HCA has denied any wrongdoing.


Financially, Thursday’s judgment is a slap on the wrist for HCA, which posted net income of $360 million in just the third quarter of last year. But the ruling may reverberate beyond HCA as communities across the country put their troubled nonprofit hospitals up for sale.


In many cases, the buyers with the deepest pockets have been profit-making hospital chains that want to convert the community hospitals to profit status, typically agreeing to spend money to fix them and to maintain certain levels of charitable care in the community.


In 2011, for instance, Vanguard Health Systems, which went public that year and has as its largest shareholder the private equity firm Blackstone Group, bought eight hospitals in Detroit. As part of that deal, Vanguard Health agreed to spend $850 million over five years to fix and maintain the hospitals.


The trouble in the Kansas City area began a year after HCA acquired a dozen hospitals from Health Midwest in 2003 for $1.125 billion. As part of the deal, HCA agreed to make $300 million in capital improvements in the first two years and an additional $150 million in the following three. The hospital chain also agreed to maintain the levels of care that had been provided to low-income individuals and families in the area for 10 years.


But when the members of the Health Care Foundation of Greater Kansas City, a nonprofit created from the proceeds of the sale of the hospital, received their first report from HCA in 2004 they discovered the hospital was already way behind.


Of the $300 million it was supposed to spend in the first two years, its own documents showed it had spent only about $50 million, according to Mark G. Flaherty, one of the founding members of the foundation and its general counsel.


HCA’s reports to the foundation also indicated that the level of charitable care it provided at the system’s large inner-city hospital had fallen while charitable care provided at the more affluent suburban hospital had risen sharply, Mr. Flaherty said.


“That was a big red flag to us,” he said.


After repeatedly asking HCA executives for explanations but receiving none, the foundation sued HCA in 2009. The case went to trial for several weeks in 2011.


HCA argued in the trial that it had met its obligation to spend money on hospital facilities by building two new hospitals at a cost of hundreds of millions of dollars, rather than repairing older facilities. But Judge John Torrence of Jackson County Circuit Court ruled that the agreement called for improvements to existing hospitals.


He said HCA still owed $162 million of the $300 million it had agreed to spend between 2003 and 2005. He then named a court-appointed forensic accountant to determine whether HCA had met its other capital commitments and whether it provided the charitable care it had said it would.


HCA’s own written statements claimed “differing amounts,” the judge wrote in his ruling. One HCA report said it provided $48 million in charitable care to the area in 2009 while another report on its Web site said it provided more than $87 million. The annual report to the foundation claimed it provided $185 million in uncompensated and charity care that year, the judge wrote.


During the trial, when asked about the widely differing numbers, the president of HCA’s Midwest division and other HCA executives had no explanation.


The money will be paid to the foundation, which will use it to create grants to provide care for uninsured or underinsured families in the area. It is unclear whether the spending on improvements will occur.


Depending on what the court-appointed accountant discovers, HCA may owe even more money, said Paul Seyferth of Seyferth Blumenthal & Harris, which represents the foundation.


“We think they’re going to have a tremendously difficult time convincing anybody that they spent what they claim they spent,” Mr. Seyferth said.


Read More..

HCA Must Pay Kansas City Foundation $162 Million





HCA, the nation’s largest profit-making hospital chain, was ordered on Thursday to pay $162 million after a judge in Missouri ruled that it had failed to abide by an agreement to make improvements to dilapidated hospitals that it bought in the Kansas City area several years ago.




The judge also ordered a court-appointed accountant to determine whether HCA had actually provided the levels of charitable care that it agreed to at the time.


The ruling came in response to a suit filed in 2009 by a community foundation that was created when HCA acquired the hospitals. Among other things, the foundation was responsible for ensuring that HCA met the obligations outlined in the deal.


The dispute in Kansas City is the second time in recent years that HCA has come under legal fire from officials in communities that sold troubled nonprofit community hospitals to HCA.


In another dispute in New Hampshire in 2011, a judge ruled in HCA’s favor, deciding that Portsmouth Regional Hospital would remain part of HCA after community leaders tried to regain control. During testimony in a 2011 trial, a former hospital official claimed he had difficulties getting HCA to pay for what he and others described as critical equipment and facility upgrades.


In an e-mailed statement, a spokesman for HCA said the company was disappointed in the court’s ruling and intended to appeal. He also added that the two cases were “rare exceptions” and that the company had enjoyed positive relationships with communities across the country.


The suit is among several problems for HCA. The company disclosed last year, for example, that the United States attorney’s office in Miami had subpoenaed documents as part of an inquiry to determine whether unnecessary cardiology procedures had been performed at HCA hospitals in Florida and elsewhere. At stake in that case is whether HCA inappropriately billed Medicare and private insurers for the procedures. HCA has denied any wrongdoing.


Financially, Thursday’s judgment is a slap on the wrist for HCA, which posted net income of $360 million in just the third quarter of last year. But the ruling may reverberate beyond HCA as communities across the country put their troubled nonprofit hospitals up for sale.


In many cases, the buyers with the deepest pockets have been profit-making hospital chains that want to convert the community hospitals to profit status, typically agreeing to spend money to fix them and to maintain certain levels of charitable care in the community.


In 2011, for instance, Vanguard Health Systems, which went public that year and has as its largest shareholder the private equity firm Blackstone Group, bought eight hospitals in Detroit. As part of that deal, Vanguard Health agreed to spend $850 million over five years to fix and maintain the hospitals.


The trouble in the Kansas City area began a year after HCA acquired a dozen hospitals from Health Midwest in 2003 for $1.125 billion. As part of the deal, HCA agreed to make $300 million in capital improvements in the first two years and an additional $150 million in the following three. The hospital chain also agreed to maintain the levels of care that had been provided to low-income individuals and families in the area for 10 years.


But when the members of the Health Care Foundation of Greater Kansas City, a nonprofit created from the proceeds of the sale of the hospital, received their first report from HCA in 2004 they discovered the hospital was already way behind.


Of the $300 million it was supposed to spend in the first two years, its own documents showed it had spent only about $50 million, according to Mark G. Flaherty, one of the founding members of the foundation and its general counsel.


HCA’s reports to the foundation also indicated that the level of charitable care it provided at the system’s large inner-city hospital had fallen while charitable care provided at the more affluent suburban hospital had risen sharply, Mr. Flaherty said.


“That was a big red flag to us,” he said.


After repeatedly asking HCA executives for explanations but receiving none, the foundation sued HCA in 2009. The case went to trial for several weeks in 2011.


HCA argued in the trial that it had met its obligation to spend money on hospital facilities by building two new hospitals at a cost of hundreds of millions of dollars, rather than repairing older facilities. But Judge John Torrence of Jackson County Circuit Court ruled that the agreement called for improvements to existing hospitals.


He said HCA still owed $162 million of the $300 million it had agreed to spend between 2003 and 2005. He then named a court-appointed forensic accountant to determine whether HCA had met its other capital commitments and whether it provided the charitable care it had said it would.


HCA’s own written statements claimed “differing amounts,” the judge wrote in his ruling. One HCA report said it provided $48 million in charitable care to the area in 2009 while another report on its Web site said it provided more than $87 million. The annual report to the foundation claimed it provided $185 million in uncompensated and charity care that year, the judge wrote.


During the trial, when asked about the widely differing numbers, the president of HCA’s Midwest division and other HCA executives had no explanation.


The money will be paid to the foundation, which will use it to create grants to provide care for uninsured or underinsured families in the area. It is unclear whether the spending on improvements will occur.


Depending on what the court-appointed accountant discovers, HCA may owe even more money, said Paul Seyferth of Seyferth Blumenthal & Harris, which represents the foundation.


“We think they’re going to have a tremendously difficult time convincing anybody that they spent what they claim they spent,” Mr. Seyferth said.


Read More..

Media Decoder Blog: A Resurgent Netflix Beats Projections, Even Its Own

9:12 p.m. | Updated For all those who have doubted its business acumen, Netflix had a resounding answer on Wednesday: 27.15 million.

That’s the number of American homes that were subscribers to the streaming service by the end of 2012, beating the company’s own projections for the fourth quarter after a couple of quarters of underwhelming results.

Netflix’s growth spurt in streaming — up by 2.05 million customers in the United States, from 25.1 million in the third quarter — was its biggest in nearly three years, and helped the company report net income of $7.9 million, surprising many analysts who had predicted a loss.

The results reflected just how far Netflix has come since the turbulence of mid-2011, when its botched execution of a new pricing plan for its services — streaming and DVDs by mail — resulted in an online flogging by angry customers. Investors battered its stock price, sending it from a high of around $300 in 2011 to as low as $53 last year.

“It’s risen from the ashes,” said Barton Crockett, a senior analyst at Lazard Capital Markets. “A lot of investors have been very skeptical that Netflix will work. With this earnings report, they’re making a strong argument that the business is real, that it will work.”

Investors, cheered by the results, sent Netflix shares soaring more than 35 percent in after-hours trading Wednesday. The stock had ended regular trading at $103.26.

Netflix’s fourth-quarter success was a convenient reminder to the entertainment and technology industries that consumers increasingly want on-demand access to television shows and movies. Streaming services by Amazon, Hulu and Redbox are all competing on the same playing field, but for now Netflix remains the biggest such service, and thus a pioneer for all the others.

“Our growth and our competitors’ growth shows just how large the opportunity is for Internet TV, where people get to control their viewing experience,” Netflix’s chief executive, Reed Hastings, said in a telephone interview Wednesday evening.

Questions persist, though, about whether Netflix will be able to attract enough subscribers to keep paying its ever-rising bills to content providers, which total billions of dollars in the years to come. The company said on Wednesday that it might take on more debt to finance more original programs, the first of which, the political thriller “House of Cards,” will have its premiere on the service on Feb. 1. Netflix committed about $100 million to make two seasons of “House of Cards,” one of five original programs scheduled to come out on the service this year.

“The virtuous cycle for us is to gain more subscribers, get more content, gain more subscribers, get more content,” Mr. Hastings said in an earnings conference call.

The company’s $7.9 million profit for the quarter represented 13 cents a share, surprising analysts who had expected a loss of 12 cents a share. The company said revenue of $945 million, up from $875 million in the quarter in 2011, was driven in part by holiday sales of new tablets and television sets.

Netflix added nearly two million new subscribers in other countries, though it continued to lose money overseas, as expected, and said it would slow its international expansion plans in the first part of this year.

The “flix” in Netflix, its largely forgotten DVD-by-mail business, fared a bit better than the company had projected, posting a loss of just 380,000 subscribers in the quarter, to 8.22 million. The losses have slowed for four consecutive quarters, indicating that the homes that still want DVDs really want DVDs.

On the streaming side, Netflix’s retention rate improved in the fourth quarter, suggesting growing customer satisfaction.

Asked whether the company’s reputation had fully recovered after its missteps in 2011, Mr. Hastings said, “We’re on probation at this point, but we’re not out of jail.”

He has emphasized subscriber happiness, even going so far as to say on Wednesday that “we really want to make it easy to quit” Netflix. If the exit door is well marked, he asserted, subscribers will be more likely to come back.

The hope is that original programs like “House of Cards” and “Arrested Development” will lure both old and new subscribers to the service. Those programs, plus the film output deal with the Walt Disney Company announced in December, affirm that Netflix cares more and more about being a gallery — with showy pieces that cannot be seen anywhere else — and less about being a library of every film and TV show ever made.

“They’re morphing into something that people understand,” said Mr. Crockett of Lazard Capital.

Mr. Hastings said this had been happening for years, but that it was becoming more apparent now to consumers and investors.

Mr. Hastings’s letter to investors brought up the elephant in the room, the activist investor Carl C. Icahn, who acquired nearly 10 percent of the company’s stock last October. Mr. Icahn, known for his campaigns for corporate sales and revampings, stated then that Netflix “may hold significant strategic value for a variety of significantly larger companies.”

Netflix subsequently put into place a shareholder rights plan, known as a poison pill, to protect itself against a forced sale by Mr. Icahn.

The company said on Wednesday, “We have no further news about his intentions, but have had constructive conversations with him about building a more valuable company.”

Factoring in the stock’s 30 percent rise since November and the after-hours action on Wednesday, Mr. Icahn’s stake has now more than doubled in value, to more than $700 million from roughly $320 million.

Read More..

India Ink: Urging Action, Report on Brutal Rape Condemns India's Treatment of Women





NEW DELHI — Women in India face systemic discrimination and are regularly confronted with sexual harassment and violence, even as the police often fail to provide protection and the government has failed to enforce laws and policies intended to safeguard women’s rights, according to a scathing special report released on Wednesday.




The government report, drafted in response to the deadly gang rape of a young woman last month in New Delhi, amounted to a broad and damning indictment of the treatment of women by India’s democratic institutions. It also was intended as a call to action: the three-person commission, led by a former chief justice of India’s Supreme Court, challenged Parliament to act swiftly on its recommendations.


“We have submitted the report in 29 days,” the retired chief justice, J.S. Verma, said during a nationally televised news conference, noting that the commissioners worked quickly in order to present their findings before Parliament next meets in February. “If we are able to do it in half the time available, the government, with its might and resources, should also act fast.”


The commission recommended a number of far-reaching changes. Among them were requiring police officers to register every case of reported rape; punishing crimes like stalking and voyeurism with prison terms; changing the humiliating medical examinations endured by rape victims; re-examining every appointed state police chief in the country; cracking down on extralegal village councils, known as khap panchayats, which often issue edicts against women; and making new legal requirements so it is much more difficult for people charged with criminal offenses to hold political office.


India does not lack adequate laws on sexual violence or gender bias, the commissioners found, but rather lacks the political and bureaucratic will to enforce them.


“Failure of good governance is the obvious root cause for the current unsafe environment eroding the rule of law, and not the want of needed legislation,” the report said.


India’s government has often proved immutable to calls for progressive reform. Over the years, different commissions have issued recommendations on a variety of subjects, only to see their reports gather dust. Indeed, even a major 2006 Supreme Court ruling calling for significant changes in policing remains largely stalled, with its recommendations far from being put in place.


But public outrage over the brutal Dec. 16 gang rape of a young woman on a private bus moving through New Delhi has remained fierce, prompting political leaders to promise swift action. The trial of the five adult defendants in the case is expected to begin as soon as Thursday in a new fast-track court. Moreover, many lawmakers have promised legislative changes to address shortcomings in policing and gender bias.


“Women must enjoy freedom,” said Leila Seth, herself a former Supreme Court justice and one of the commission’s three members, speaking at the news conference. “The state must practice equality.”


The commission, with Justice Verma as chairman, was created last month by India’s Home Ministry and charged with making recommendations to improve laws dealing with sexual violence. Justice Verma said that public interest was extremely high and that the commission received more than 80,000 suggestions. He praised the youthful protesters whose demonstrations over the rape case created mounting pressure on the government.


Rather than focusing on narrow changes in criminal law, the commission’s sweeping report goes beyond the issue of rape to assess widespread discrimination against women, societal biases against daughters, workplace sexual harassment, child sexual abuse, the trafficking of women and children and the deep-rooted problems with Indian policing.


In particular, the commission said that many states still needed to comply with the 2006 Supreme Court ruling, which, among other mandates, called for eliminating political influence over police departments, notably in the appointment of police chiefs. Moreover, the commission called on the police to prevent stalking and other harassment on public transportation and urged the construction of separate facilities inside police precincts for women and improved officer training for investigating sex crimes.


But, most of all, the commission urged what it called holistic changes, including nationwide education campaigns on gender equity and related issues.


Indeed, blame was not affixed solely on the Indian state. Justice Verma said the Dec. 16 rape case also exposed a shameful public apathy, noting that many motorists drove past the half-naked victim and her beaten male friend after the suspects had dumped them on the side of a busy highway.


“The nation has to account for the tears of millions of women,” the report concluded.


Read More..

Media Decoder Blog: A Resurgent Netflix Beats Projections, Even Its Own

9:12 p.m. | Updated For all those who have doubted its business acumen, Netflix had a resounding answer on Wednesday: 27.15 million.

That’s the number of American homes that were subscribers to the streaming service by the end of 2012, beating the company’s own projections for the fourth quarter after a couple of quarters of underwhelming results.

Netflix’s growth spurt in streaming — up by 2.05 million customers in the United States, from 25.1 million in the third quarter — was its biggest in nearly three years, and helped the company report net income of $7.9 million, surprising many analysts who had predicted a loss.

The results reflected just how far Netflix has come since the turbulence of mid-2011, when its botched execution of a new pricing plan for its services — streaming and DVDs by mail — resulted in an online flogging by angry customers. Investors battered its stock price, sending it from a high of around $300 in 2011 to as low as $53 last year.

“It’s risen from the ashes,” said Barton Crockett, a senior analyst at Lazard Capital Markets. “A lot of investors have been very skeptical that Netflix will work. With this earnings report, they’re making a strong argument that the business is real, that it will work.”

Investors, cheered by the results, sent Netflix shares soaring more than 35 percent in after-hours trading Wednesday. The stock had ended regular trading at $103.26.

Netflix’s fourth-quarter success was a convenient reminder to the entertainment and technology industries that consumers increasingly want on-demand access to television shows and movies. Streaming services by Amazon, Hulu and Redbox are all competing on the same playing field, but for now Netflix remains the biggest such service, and thus a pioneer for all the others.

“Our growth and our competitors’ growth shows just how large the opportunity is for Internet TV, where people get to control their viewing experience,” Netflix’s chief executive, Reed Hastings, said in a telephone interview Wednesday evening.

Questions persist, though, about whether Netflix will be able to attract enough subscribers to keep paying its ever-rising bills to content providers, which total billions of dollars in the years to come. The company said on Wednesday that it might take on more debt to finance more original programs, the first of which, the political thriller “House of Cards,” will have its premiere on the service on Feb. 1. Netflix committed about $100 million to make two seasons of “House of Cards,” one of five original programs scheduled to come out on the service this year.

“The virtuous cycle for us is to gain more subscribers, get more content, gain more subscribers, get more content,” Mr. Hastings said in an earnings conference call.

The company’s $7.9 million profit for the quarter represented 13 cents a share, surprising analysts who had expected a loss of 12 cents a share. The company said revenue of $945 million, up from $875 million in the quarter in 2011, was driven in part by holiday sales of new tablets and television sets.

Netflix added nearly two million new subscribers in other countries, though it continued to lose money overseas, as expected, and said it would slow its international expansion plans in the first part of this year.

The “flix” in Netflix, its largely forgotten DVD-by-mail business, fared a bit better than the company had projected, posting a loss of just 380,000 subscribers in the quarter, to 8.22 million. The losses have slowed for four consecutive quarters, indicating that the homes that still want DVDs really want DVDs.

On the streaming side, Netflix’s retention rate improved in the fourth quarter, suggesting growing customer satisfaction.

Asked whether the company’s reputation had fully recovered after its missteps in 2011, Mr. Hastings said, “We’re on probation at this point, but we’re not out of jail.”

He has emphasized subscriber happiness, even going so far as to say on Wednesday that “we really want to make it easy to quit” Netflix. If the exit door is well marked, he asserted, subscribers will be more likely to come back.

The hope is that original programs like “House of Cards” and “Arrested Development” will lure both old and new subscribers to the service. Those programs, plus the film output deal with the Walt Disney Company announced in December, affirm that Netflix cares more and more about being a gallery — with showy pieces that cannot be seen anywhere else — and less about being a library of every film and TV show ever made.

“They’re morphing into something that people understand,” said Mr. Crockett of Lazard Capital.

Mr. Hastings said this had been happening for years, but that it was becoming more apparent now to consumers and investors.

Mr. Hastings’s letter to investors brought up the elephant in the room, the activist investor Carl C. Icahn, who acquired nearly 10 percent of the company’s stock last October. Mr. Icahn, known for his campaigns for corporate sales and revampings, stated then that Netflix “may hold significant strategic value for a variety of significantly larger companies.”

Netflix subsequently put into place a shareholder rights plan, known as a poison pill, to protect itself against a forced sale by Mr. Icahn.

The company said on Wednesday, “We have no further news about his intentions, but have had constructive conversations with him about building a more valuable company.”

Factoring in the stock’s 30 percent rise since November and the after-hours action on Wednesday, Mr. Icahn’s stake has now more than doubled in value, to more than $700 million from roughly $320 million.

Read More..

Well: Long Term Effects on Life Expectancy From Smoking

It is often said that smoking takes years off your life, and now a new study shows just how many: Longtime smokers can expect to lose about 10 years of life expectancy.

But amid those grim findings was some good news for former smokers. Those who quit before they turn 35 can gain most if not all of that decade back, and even those who wait until middle age to kick the habit can add about five years back to their life expectancies.

“There’s the old saw that everyone knows smoking is bad for you,” said Dr. Tim McAfee of the Centers for Disease Control and Prevention. “But this paints a much more dramatic picture of the horror of smoking. These are real people that are getting 10 years of life expectancy hacked off — and that’s just on average.”

The findings were part of research, published on Wednesday in The New England Journal of Medicine, that looked at government data on more than 200,000 Americans who were followed starting in 1997. Similar studies that were done in the 1980s and the decades prior had allowed scientists to predict the impact of smoking on mortality. But since then many population trends have changed, and it was unclear whether smokers today fared differently from smokers decades ago.

Since the 1960s, the prevalence of smoking over all has declined, falling from about 40 percent to 20 percent. Today more than half of people that ever smoked have quit, allowing researchers to compare the effects of stopping at various ages.

Modern cigarettes contain less tar and medical advances have cut the rates of death from vascular disease drastically. But have smokers benefited from these advances?

Women in the 1960s, ’70s and ’80s had lower rates of mortality from smoking than men. But it was largely unknown whether this was a biological difference or merely a matter of different habits: earlier generations of women smoked fewer cigarettes and tended to take up smoking at a later age than men.

Now that smoking habits among women today are similar to those of men, would mortality rates be the same as well?

“There was a big gap in our knowledge,” said Dr. McAfee, an author of the study and the director of the C.D.C.’s Office on Smoking and Public Health.

The new research showed that in fact women are no more protected from the consequences of smoking than men. The female smokers in the study represented the first generation of American women that generally began smoking early in life and continued the habit for decades, and the impact on life span was clear. The risk of death from smoking for these women was 50 percent higher than the risk reported for women in similar studies carried out in the 1980s.

“This sort of puts the nail in the coffin around the idea that women might somehow be different or that they suffer fewer effects of smoking,” Dr. McAfee said.

It also showed that differences between smokers and the population in general are becoming more and more stark. Over the last 20 years, advances in medicine and public health have improved life expectancy for the general public, but smokers have not benefited in the same way.

“If anything, this is accentuating the difference between being a smoker and a nonsmoker,” Dr. McAfee said.

The researchers had information about the participants’ smoking histories and other details about their health and backgrounds, including diet, alcohol consumption, education levels and weight and body fat. Using records from the National Death Index, they calculated their mortality rates over time.

People who had smoked fewer than 100 cigarettes in their lifetimes were not classified as smokers. Those who had smoked at least 100 cigarettes but had not had one within five years of the time the data was collected were classified as former smokers.

Not surprisingly, the study showed that the earlier a person quit smoking, the greater the impact. People who quit between 25 and 34 years of age gained about 10 years of life compared to those who continued to smoke. But there were benefits at many ages. People who quit between 35 and 44 gained about nine years, and those who stopped between 45 and 59 gained about four to six years of life expectancy.

From a public health perspective, those numbers are striking, particularly when juxtaposed with preventive measures like blood pressure screenings, colorectal screenings and mammography, the effects of which on life expectancy are more often viewed in terms of days or months, Dr. McAfee said.

“These things are very important, but the size of the benefit pales in comparison to what you can get from stopping smoking,” he said. “The notion that you could add 10 years to your life by something as straightforward as quitting smoking is just mind boggling.”

Read More..

Well: Long Term Effects on Life Expectancy From Smoking

It is often said that smoking takes years off your life, and now a new study shows just how many: Longtime smokers can expect to lose about 10 years of life expectancy.

But amid those grim findings was some good news for former smokers. Those who quit before they turn 35 can gain most if not all of that decade back, and even those who wait until middle age to kick the habit can add about five years back to their life expectancies.

“There’s the old saw that everyone knows smoking is bad for you,” said Dr. Tim McAfee of the Centers for Disease Control and Prevention. “But this paints a much more dramatic picture of the horror of smoking. These are real people that are getting 10 years of life expectancy hacked off — and that’s just on average.”

The findings were part of research, published on Wednesday in The New England Journal of Medicine, that looked at government data on more than 200,000 Americans who were followed starting in 1997. Similar studies that were done in the 1980s and the decades prior had allowed scientists to predict the impact of smoking on mortality. But since then many population trends have changed, and it was unclear whether smokers today fared differently from smokers decades ago.

Since the 1960s, the prevalence of smoking over all has declined, falling from about 40 percent to 20 percent. Today more than half of people that ever smoked have quit, allowing researchers to compare the effects of stopping at various ages.

Modern cigarettes contain less tar and medical advances have cut the rates of death from vascular disease drastically. But have smokers benefited from these advances?

Women in the 1960s, ’70s and ’80s had lower rates of mortality from smoking than men. But it was largely unknown whether this was a biological difference or merely a matter of different habits: earlier generations of women smoked fewer cigarettes and tended to take up smoking at a later age than men.

Now that smoking habits among women today are similar to those of men, would mortality rates be the same as well?

“There was a big gap in our knowledge,” said Dr. McAfee, an author of the study and the director of the C.D.C.’s Office on Smoking and Public Health.

The new research showed that in fact women are no more protected from the consequences of smoking than men. The female smokers in the study represented the first generation of American women that generally began smoking early in life and continued the habit for decades, and the impact on life span was clear. The risk of death from smoking for these women was 50 percent higher than the risk reported for women in similar studies carried out in the 1980s.

“This sort of puts the nail in the coffin around the idea that women might somehow be different or that they suffer fewer effects of smoking,” Dr. McAfee said.

It also showed that differences between smokers and the population in general are becoming more and more stark. Over the last 20 years, advances in medicine and public health have improved life expectancy for the general public, but smokers have not benefited in the same way.

“If anything, this is accentuating the difference between being a smoker and a nonsmoker,” Dr. McAfee said.

The researchers had information about the participants’ smoking histories and other details about their health and backgrounds, including diet, alcohol consumption, education levels and weight and body fat. Using records from the National Death Index, they calculated their mortality rates over time.

People who had smoked fewer than 100 cigarettes in their lifetimes were not classified as smokers. Those who had smoked at least 100 cigarettes but had not had one within five years of the time the data was collected were classified as former smokers.

Not surprisingly, the study showed that the earlier a person quit smoking, the greater the impact. People who quit between 25 and 34 years of age gained about 10 years of life compared to those who continued to smoke. But there were benefits at many ages. People who quit between 35 and 44 gained about nine years, and those who stopped between 45 and 59 gained about four to six years of life expectancy.

From a public health perspective, those numbers are striking, particularly when juxtaposed with preventive measures like blood pressure screenings, colorectal screenings and mammography, the effects of which on life expectancy are more often viewed in terms of days or months, Dr. McAfee said.

“These things are very important, but the size of the benefit pales in comparison to what you can get from stopping smoking,” he said. “The notion that you could add 10 years to your life by something as straightforward as quitting smoking is just mind boggling.”

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DealBook: Allergan to Buy MAP Pharmaceuticals for $958 Million

Allergan has agreed to pay nearly $1 billion to acquire MAP Pharmaceuticals and gain full control of its experimental treatment for migraine headaches, the two companies announced Tuesday night.

The purchase price of $25 a share in cash is a 60 percent premium over MAP’s closing price on Tuesday of $15.58 a share. The deal, valued at $958 million in total, suggests that Allergan has considerable faith that MAP’s new migraine treatment will win regulatory approval from the Food and Drug Administration by the agency’s deadline of April 15.

The two companies said the deal had been unanimously approved by the boards of both companies and was expected to close in the second quarter.

Allergan already had the rights to help market the migraine drug, known as Levadex, in the United States and Canada, but after an acquisition it would have control of all the profits and costs globally.

Allergan is most known for Botox, a form of the botulinum toxin, which is used for cosmetic purposes as well as medical ones, including the treatment of chronic migraines with the goal of reducing the frequency of headaches. By contrast, Levadex is meant to treat migraines after they occur, making it complementary to Botox, Allergan said.

Levadex is actually a new form of an old drug, known as dihydroergotamine, or DHE, which has been used to treat severe migraine attacks for decades. DHE is typically given by intravenous infusion, requiring patients to get to a hospital at a time when many would rather remain in a dark quiet room.

Levadex, by contrast, is breathed into the lungs using an inhaler similar to one used for asthma, allowing people to use it at home.

The F.D.A. declined to approve Levadex last March, though MAP said the rejection was related to manufacturing and questions about use of the inhaler, not the safety and efficacy of the drug. It resubmitted its application, with additional data and answers to questions from the F.D.A., in October.

Levadex would be the first approved product for MAP, which is based in Mountain View, Calif.

Allergan said that if Levadex is approved by April, the transaction would dilute earnings by about 7 cents a share in 2013 and add to earnings in the second half of 2014.

Allergan was advised by Goldman Sachs and the law firm Gibson, Dunn & Crutcher. MAP was advised by Centerview Partners and the law firm Latham & Watkins.

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India Ink: India Warns Kashmiris to Prepare for Nuclear War





NEW DELHI — Indian officials are advising residents of strife-torn Kashmir to prepare for a possible nuclear war by building bombproof basements and stockpiling food and water, adding to tensions between India and Pakistan, both nuclear powers, after deadly cross-border skirmishes in recent weeks.




“People should construct basements where the whole family can stay for a fortnight,” read the advisory, which was published Monday in the newspaper Greater Kashmir. It comes in the midst of the worst fighting in Kashmir between India and Pakistan since a cease-fire was signed in 2003. Three Pakistani and two Indian soldiers have been killed, and one of the Indian soldiers was found without his head.


News of the mutilation infuriated Indians, with Sushma Swaraj, the leader of the opposition in the lower house of Parliament, calling for India “to get at least 10 heads from their side” if the Pakistanis did not return the soldier’s head. After criticism that he was not doing enough, Prime Minister Manmohan Singh of India said he was reviewing ties with Pakistan. A special visa program between the two countries has been suspended, and Pakistani players in a new Indian field hockey league have been sent home.


Officials insisted that the advisory published Monday was unrelated to these developments. Yoginder Kaul, the inspector general of the Civil Defense and State Disaster Response Force, said the advisory was meant to commemorate the first anniversary of the creation of his unit.


“It has nothing to do with anything else,” Mr. Kaul said in a telephone interview. “It was a routine advisory issued on our raising day to create awareness among people.”


If so, it was remarkably ill timed. The advisory suggested that people build shelters in open spaces in front of their houses if they did not have basements because “some protection was better than no protection,” according to an article about the advisory in Greater Kashmir. Food and water should be restocked regularly, and ample candles and battery-operated lights should be included, it said.


If in the open during a nuclear attack, a person should “immediately drop to ground and remain in lying position,” the advisory said.


“Stay down after the initial shock wave, wait for the winds to die down and debris to stop falling. If blast wave does not arrive within five seconds of the flash, you were far enough from the ground zero.”


“Expect some initial disorientation,” the advisory added, “as the blast wave may blow down and carry away many prominent and familiar features.”


Abdul Qaiuum of Silikote, a village close to the dividing line on the Indian side, said in a telephone interview that neither he nor his neighbors were constructing new bunkers. “No firing is taking place,” he said. Besides, he added, “we are under two to three feet of snow in the village.”


Even after both governments embarked on efforts to improve ties after decades of war and recriminations, Kashmir remains a troubled region. India, heavily Hindu, controls the bulk of the predominantly Muslim region of Kashmir, which has been at the heart of disputes between the two nations since they won independence from Britain in 1947. The land along the cease-fire Line of Control is one of the most heavily militarized areas in the world.


The latest clashes started when an elderly woman on the Indian side decided to use a secret entrance into Pakistani territory so that she could see her children living on the other side, according to a report in The Hindu, an Indian newspaper. After the Indian military discovered the tunnel, it built emplacements to prevent its use.


But those emplacements violated the terms of the cease-fire with Pakistan, and Pakistani soldiers repeatedly warned their Indian counterparts to desist, which the Indians ignored.


Firing weapons across the cease-fire line is not unusual, but the beheading, which the Pakistan government denies responsibility for, added a volatile mix to the politically charged debate. Previous mutilations of soldiers’ bodies have generally been kept secret to avoid just the sort of news media firestorm that has erupted. National elections are scheduled to be held in Pakistan by May and in India by sometime in 2014.


Hari Kumar contributed reporting.



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