Longer tamoxifen use cuts breast cancer deaths

Breast cancer patients taking the drug tamoxifen can cut their chances of having the disease come back or kill them if they stay on the pills for 10 years instead of five years as doctors recommend now, a major study finds.

The results could change treatment, especially for younger women. The findings are a surprise because earlier research suggested that taking the hormone-blocking drug for longer than five years didn’t help and might even be harmful.

In the new study, researchers found that women who took tamoxifen for 10 years lowered their risk of a recurrence by 25 percent and of dying of breast cancer by 29 percent compared to those who took the pills for just five years.

In absolute terms, continuing on tamoxifen kept three additional women out of every 100 from dying of breast cancer within five to 14 years from when their disease was diagnosed. When added to the benefit from the first five years of use, a decade of tamoxifen can cut breast cancer mortality in half during the second decade after diagnosis, researchers estimate.

Some women balk at taking a preventive drug for so long, but for those at high risk of a recurrence, “this will be a convincer that they should continue,” said Dr. Peter Ravdin, director of the breast cancer program at the UT Health Science Center in San Antonio.

He reviewed results of the study, which was being presented Wednesday at a breast cancer conference in San Antonio and published by the British medical journal Lancet.

About 50,000 of the roughly 230,000 new cases of breast cancer in the United States each year occur in women before menopause. Most breast cancers are fueled by estrogen, and hormone blockers are known to cut the risk of recurrence in such cases.

Tamoxifen long was the top choice, but newer drugs called aromatase inhibitors — sold as Arimidex, Femara, Aromasin and in generic form — do the job with less risk of causing uterine cancer and other problems.

But the newer drugs don’t work well before menopause. Even some women past menopause choose tamoxifen over the newer drugs, which cost more and have different side effects such as joint pain, bone loss and sexual problems.

The new study aimed to see whether over a very long time, longer treatment with tamoxifen could help.

Dr. Christina Davies of the University of Oxford in England and other researchers assigned 6,846 women who already had taken tamoxifen for five years to either stay on it or take dummy pills for another five years.

Researchers saw little difference in the groups five to nine years after diagnosis. But beyond that time, 15 percent of women who had stopped taking tamoxifen after five years had died of breast cancer versus 12 percent of those who took it for 10 years. Cancer had returned in 25 percent of women on the shorter treatment versus 21 percent of those treated longer.

Tamoxifen had some troubling side effects: Longer use nearly doubled the risk of endometrial cancer. But it rarely proved fatal, and there was no increased risk among premenopausal women in the study — the very group tamoxifen helps most.

“Overall the benefits of extended tamoxifen seemed to outweigh the risks substantially,” Dr. Trevor Powles of the Cancer Centre London wrote in an editorial published with the study.

The study was sponsored by cancer research organizations in Britain and Europe, the United States Army, and AstraZeneca PLC, which makes Nolvadex, a brand of tamoxifen, which also is sold as a generic for 10 to 50 cents a day. Brand-name versions of the newer hormone blockers, aromatase inhibitors, are $ 300 or more per month, but generics are available for much less.

The results pose a quandary for breast cancer patients past menopause and those who become menopausal because of their treatment — the vast majority of cases. Previous studies found that starting on one of the newer hormone blockers led to fewer relapses than initial treatment with tamoxifen did.

Another study found that switching to one of the new drugs after five years of tamoxifen cut the risk of breast cancer recurrence nearly in half — more than what was seen in the new study of 10 years of tamoxifen.

“For postmenopausal women, the data still remain much stronger at this point for a switch to an aromatase inhibitor,” said that study’s leader, Dr. Paul Goss of Massachusetts General Hospital. He has been a paid speaker for a company that makes one of those drugs.

Women in his study have not been followed long enough to see whether switching cuts deaths from breast cancer, as 10 years of tamoxifen did. Results are expected in about a year.

The cancer conference is sponsored by the American Association for Cancer Research, Baylor College of Medicine and the UT Health Science Center.

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Amazon’s Holiday Run Helps Put UPS in Prime Position

Yeah, I’ll admit it: Not only do I read the Economist, I look forward to my weekly copy. It makes me look and feel smart, all that erudition and high-concept cheek, and no one writes a better obit. I imagine a bunch of Economist editors who look like Alistair Cooke teaching me SAT-busting words like “corpulent” and “eldritch.” I regret the gang feud between our magazines.

This week, the Economist crew ran a brilliant cover on the great tech wars of 2012. One doozy of an observation:

Rather than try to replicate [Amazon’s] extensive network of warehouses, Google is looking for partnerships with shipping companies and retailers instead. But if it is serious about taking on Amazon, it may ultimately have to buy a logistics firm. At $ 69 billion UPS has a market value less than a third of Google’s; it is valued at less than twice the search giant’s cash pile.

Google (GOOG) buying UPS (UPS) may sound ridiculous, but I got to thinking about the shipper’s cyberstrategic import the other day when I was returning two Amazon (AMZN) packages at the UPS Store. I waited in line behind a woman with multiple Zappos (Amazon) returns, and encountered UPS again that night when I went all Amazon Prime on orthotics and a new camera. And some mail-order Indian food for my brother. Shipping fees need not apply in this brave new world, where UPS gets paid on both ends, and solidly more next year than now.

I’m not an isolated example. According to ChannelAdvisor, in the five days from Thanksgiving through Cyber Monday, client sales on Amazon jumped 38 percent from a year earlier. Amazon played Cyber Monday like a 14th century cello, offering deals that leave brick-and-mortar stores struggling to compete. And if two-day UPS is now the Amazon Prime industry standard, local express delivery is its next big one.

Now, ponder the statistical impossibility of the U.S. Postal Service, which just registered a $ 15.9 billion annual loss and is begging to ditch Saturday delivery, provisioning same-day service. Tip your mailman well this Christmas, because the Postal Service is on track to have less than a four-day supply of cash on hand by the end of the fiscal year, one that is all but certain to see more post offices close.

That means opportunity, and pricing power, for UPS and FedEx (FDX). “They are the modern-day equivalents of the pick-and-shovel sellers to the old California gold rush,” says Paul Price, a former Merrill Lynch and A.G. Edwards broker who now manages his own money. “They win regardless of which Internet-related retailer makes the sale.” One UPS store manager I spoke with (off the record, per company policy) said customers have been asking him left and right about Saturday pricing.

Price says that UPS now trades at its second-lowest valuation in two decades, and with one of the highest current dividend yields ever. Since the start of the current bull market three and a half years ago, UPS, a true cyclical, has lagged the Standard & Poor’s 500-stock index’s total return by a hefty 12 percentage points. Price thinks UPS is primed to rally 25 percent to 30 percent in the year ahead.

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Officials: NATO to decide on missiles for Turkey

BRUSSELS (AP) — NATO foreign ministers are expected to approve Turkey‘s request for Patriot anti-missile systems to bolster its defense against possible strikes from neighboring Syria.

NATO foreign ministers are meeting on Tuesday and Wednesday in Brussels. Parliaments in both nations must approve the deployment, which would also involve several hundred soldiers.

Ankara, which has been highly supportive of the Syrian opposition, wants the Patriots to defend against possible retaliatory attacks by Syrian missiles carrying chemical warheads. NATO leaders have repeatedly said they would provide any assistance Turkey needs.

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“Boardwalk Empire” creator on legalizing drugs and making Nucky likeable again

NEW YORK (TheWrap.com) – The prohibition drama “Boardwalk Empire” wrapped its spectacular third season Sunday night just weeks after the states of Colorado and Washington voted to legalize marijuana.

To “Boardwalk” creator Terence Winter, who has immersed himself in the history of prohibition to research his gangster epic, the votes feel like a move in the right direction.

“It’s great. I think they should legalize drugs in general,” Winter told TheWrap. “The war on drugs is clearly not working, and I think they should take the profit motive out of being a drug dealer. And maybe kids will go to college and do something else.”

Winter, who reassembled his writers a few weeks ago to begin work on the show’s fourth season, talked to us about whether they ever go out of their way to slow down the action, making Nucky Thompson (Steve Buscemi) likable again, and whether things are worse today than they were in the 1920s.

TheWrap: Is ‘Boardwalk’ making a case for drug legalization?

Winter: Well, I think history made it for us with prohibition. We’re just reflecting the reality of how it went down. I’m not trying to bend the reality or the truth of what happened. It clearly didn’t work. I don’t think people were more disposed to drink when alcohol was legal.

Actually, it had the opposite effect. Women didn’t start drinking until prohibition was enacted and college students didn’t start drinking until prohibition was enacted. Leaving the mystery aside might have had a better impact on the country – keeping it legal. In my personal opinion I don’t think making drugs legal would make anybody more likely to become a heroin addict, for example.

This is going to sound strange, but I mean it as a compliment. “Boardwalk” has a way of lulling you into looking at the costumes, and listening to the dialogue, and marveling at how pretty everything is. There are times when I almost want to nod off, it’s so comforting – and then suddenly someone gets set on fire. I feel you’re making a conscious effort to use boredom to really shock us at other times. Do you ever put in a scene that’s deliberately slow?

No, we don’t. I would disagree and say – slow or boring – there is dialogue that needs to be attended to and I think you need to pay attention to what’s going on. The pacing can sometimes be slower than certainly an action scene or a scene with incredible violence. Because we have such wide-ranging characters and such wide-ranging circumstances, some things might seem slower by comparison.

Obviously a scene involving a political figure or Margaret’s storyline, as opposed to something Al Capone is doing, is just by the very nature of it going to feel slow. But no, none of it is done by design.

I mean it in a good way. If you think things are slowing down, they’re not. It’s almost a trick.

The audience is so wide-ranging, too. We have people who can’t stand the violence and they’re much more entertained by the family stuff. One person’s slow is another person’s fascinating.

With the final episodes we got to see Nucky become really likable again. He’s always been generous, but at times he seemed a little too caught up in himself to care about the people around him. Was there an effort to make him a good guy again?

One of the points of this season is that he does get caught up in himself. That all comes home to visit in a big way in episode 11. He doesn’t know anything about Eddie Kessler the guy who works really closely with him. He doesn’t know if he has a family. He doesn’t know Chalky White’s phone number. It becomes apparent that he’s spent way too much time concerned with himself and his own affairs.

If you depict any character honestly, and show all of their colors, you’re going to find something relatable or likeable with anybody. And that’s certainly the truth with Al Capone or Luciano or Tony Soprano or any other famous character.

And certainly Steve Buscemi has an inherent likable quality to him. So when you add that to the mix you can’t help but like the guy.

Imagery is so important to the show, and I feel like at one point this season you did something just because it was gorgeous. When Billie changes her hair color to blonde, was there any reason to do that besides how incredible it looked in the explosion?

Well, she was sort of finally coming to terms with who she really was. That was the episode where she dropped the façade of Billie Kent and told Nucky her real name. She was going through a metamorphosis and that sort of illustrated that a little bit. They were sort of not pretending with each other any more.

Is Billie a natural blonde?

That color wasn’t natural. She wasn’t being Billie Kent that night. She was being the real person underneath. … But I agree it did look great in the explosion. Meg Chambers Steedle, who plays Billie Kent, is absolutely one of those people the camera just falls in love with. Unfortunately the context was terrible. But it was extremely cinematic.

Harrow kind of became the hero of the show this season. His scene of taking down the entire house full of gangsters: Wow. We’ve always been fascinated with the character and for me this season I was more interested in seeing who he is as a person and seeing him take that journey and fall in love and really explore that side of him. Given the way the story was, we knew it would end in violence.

But following the trajectory from the end of season 2, we knew this guy was very loyal to Jimmy and Angela and we knew he would stick around and take care of that kid. And of course Gillian being who she is, it wasn’t going to end well.

Is Gillian kaput at this point? The last time we saw her she was in a heroin daze, and she’s kind of lost everything.

She will be back on the show. She’s certainly still alive.

Is there anybody on the show you think you can’t kill?

Nope. Everybody’s up for grabs and that’s from the top on down. Anything can happen.

We hear so much about how much trouble our country is in. Do you think things are worse than they were in the 1920s?

No, and if anything, reading about how bad things were in the 1920s is strangely comforting in terms of how we think about things today. The level of corruption and the whole idea of going to hell in a hand basket is certainly nothing new. You look back and think, this pales in comparison. I think the more things change the more they stay the same.

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Scientists find gene link to teenage binge drinking

LONDON (Reuters) – Scientists have unpicked the brain processes involved in teenage alcohol abuse and say their findings help explain why some young people have more of a tendency to binge drink.

A study published in the Proceedings of National Academy of Sciences (PNAS) journal found that a gene known as RASGRF-2 plays a crucial role in controlling how alcohol stimulates the brain to release dopamine, triggering feelings of reward.

“If people have a genetic variation of the RASGRF-2 gene, alcohol gives them a stronger sense of reward, making them more likely to be heavy drinkers,” said Gunter Schumann, who led the study at King’s College London’s Institute of Psychiatry.

Alcohol and other addictive drugs activate the brain’s dopamine systems, which induces feelings of pleasure and reward.

Worldwide, some 2.5 million people die each year from the harmful use of alcohol, accounting for about 3.8 percent of all deaths, according to the World Health Organisation.

Recent studies also carried out by scientists at the IoP have found that RASGRF-2 is a risk gene for alcohol abuse, but until now the mechanism involved in the process was not clear.

For this study, scientists initially looked at mice who had been modified to have the RASGRF2 gene removed, to see how they reacted to alcohol. They found the lack of RASGRF-2 was linked to a significant reduction in alcohol-seeking activity.

They also discovered that when the mice did consume alcohol, the absence of RASGRF-2 reduced the activity of dopamine-releasing neurons in a region of the brain called the ventral tegmental area (VTA) – preventing the brain from releasing dopamine and limiting any sense of reward.

The team then analyzed brain scans of 663 14-year old boys and found that when they were anticipating a reward in a mental test, those with genetic variations to the RASGRF2 gene had more activity in an area of the brain closely linked to the VTA and also involved in dopamine release.

This suggests people with a genetic variation on the RASGRF-2 gene release more dopamine when anticipating a reward, and hence derive more pleasure from it, the scientists said.

To confirm the findings, the team analyzed drinking behavior from the same group of boys two years later when many of them had already begun drinking frequently.

They found that those with the RASGRF-2 gene variation drank more often at the age of 16 than those without it.

“People seek out situations which fulfill their sense of reward and make them happy, so if your brain is wired to find alcohol rewarding, you will seek it out,” Schumann said in a statement about the research. “We now understand the chain of action: how our genes shape this function in our brains and how that, in turn, leads to human behavior.”

Experts writing in The Lancet journal in February said up to 210,000 people in England and Wales will be killed prematurely by alcohol in the next 20 years, with a third of those preventable deaths due to liver disease alone.

(Reporting by Kate Kelland)

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A Gambling Parlor on Your Smartphone

Speaking at his first casino conference in Copenhagen two years ago, Christopher Griffin wondered why every demonstration of online gambling looked like casino games that have been played for decades in Las Vegas. Casino executives, he realized, were unprepared for the threat posed by Zynga (ZNGA) and other social game developers intent on bringing elements of online games to gambling and putting their products on smartphones and tablets. “No one was talking about the social aspects of gambling, or the devices in everyone’s pockets,” says Griffin. “It struck me that this is an industry ripe to get its lunch eaten.”

Griffin decided to provide social game developers with tools to create betting games that can be played on mobile devices or a PC. His company, Betable, now lets game companies offer online gambling wherever it’s legal. He’s teamed up with game makers to produce online versions of poker, blackjack, and roulette, and is in the process of adding wagering to social media games.

Depending on the game, players compete with each other or against the game maker. Betable provides a platform for developers to create games in which players bet with real money, and handles the infrastructure, payment, licenses, antifraud procedures, and verification needed to prove a customer is located where online gambling is legal. When first-time players click to indicate they want to wager money, the game prompts them to create a Betable account, and the company’s U.K.-based servers handle all monetary transactions. Because the transactions take place on those servers, Betable’s license isn’t restricted to a physical location, allowing the company to provide a legal gambling platform in countries where gaming isn’t outlawed. Companies split proceeds 50/50 with Betable, say executives at the companies who declined to be identified because the contracts are private.

A Department of Justice opinion last year opened the door for states to legalize most forms of online gambling except sports betting. Many are scrambling to do so. Nevada has begun granting licenses for online poker, and Delaware and New Jersey are on track to follow next year, according to the American Gaming Association. Cowen analyst Doug Creutz says it could take five years before online wagering becomes legal nationwide.

The mobile-gambling business will grow to $ 100 billion worldwide by 2017, according to Juniper Research. With interest in social games showing signs of waning—the number of video game players in the U.S. declined by 5 percent in the last year, according to researcher NPD Group—Zynga and other developers don’t want to wait. Betable, funded by Greylock Partners, Founders Fund, and other venture capitalists, has signed with nearly a dozen companies to offer gambling on mobile devices in the U.K. and other markets. “The European market is fairly well-established, and it’s a market where there’s not been a lot of money invested,” Creutz says.

Typically it takes a minimum of 18 months to get licensed in each country a company wants to operate in and costs millions of dollars to navigate Byzantine rules. Paul Thelen, chief executive officer of Seattle-based game developer Big Fish Games, figures signing with Betable helped shave months off the company’s plan to deliver Big Fish’s slots app in the U.K. The game debuted on mobile devices in October.

Casino operators say they will roll out their own mobile games when they’re legal in the U.S., and some already accept real-money wagers on their websites elsewhere. The social game makers say they have a built-in customer base for real-money wagering. Sixty percent of people who play social games such as Bingo Blingo and Big Fish Casino live outside the U.S., says Josh Yguado, president of Social Gaming Network, a gaming company owned by the founders of Myspace, which announced a partnership with Betable on Nov. 29. “There’s a real art to making a great game that has all the social features around it,” Yguado says. “That’s what we’re good at.”

Big Fish’s Thelen also likes his chances against the incumbents. With Betable’s technology, he can devote resources to delivering features that many land-based casinos offer when they have a captive audience surrounded by bright lights and throngs of customers. A poker game could come with such options as letting players buy a round of virtual drinks for the table, he says. “We can build an experience around the games, with great casual twists that casino makers don’t understand,” he says.

Griffin says casino games are only the beginning for social game developers. At a recent hackathon, designers showed titles that included raising a horse in a fashion similar to FarmVille-type games, and then paying to enter a race against other players’ horses. “Real money resets everything and creates a level playing field,” Griffin says. “This is not an incremental change. This is really a tectonic shift.”

The bottom line: Developers of social games are trying to counter declining interest by bringing casino-style gambling to mobile devices

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Gunmen assassinate peasant leader in Paraguay

ASUNCION, Paraguay (AP) — Gunmen murdered one of the surviving leaders of a peasant movement whose land dispute with a powerful politician prompted the end of Fernando Lugo‘s presidency last June.

Vidal Vega, 48, was hit four times early Saturday by bullets from a 12-gauge shotgun and a .38-caliber revolver fired by two unidentified men who sped away on a motorcycle, according to an official report prepared at the police headquarters in the provincial capital of Curuguaty.

A friend, Mario Espinola, told The Associated Press that Vega was shot down when he stepped outside to feed his farm animals.

Vega was among the public faces of a commission of landless peasants from the settlement of Yby Pyta, which means Red Dirt in their native Guarani language.

He had lobbied the government for many years to redistribute some of the ranchland that Colorado Party Sen. Blas Riquelme began occupying in the 1960s.

By last May, the peasants finally lost patience and moved onto the land. A firefight during their eviction on June 15 killed 11 peasants and six police officers, prompting the Colorado Party and other leading parties to vote Lugo out of office for allegedly mismanaging the dispute.

Twelve suspects, nearly all of them peasants from Yby Pyta, have been jailed without formal charges since then on suspicion of murdering the officers, seizing property and resisting authority. The prosecutor had six months to develop the case and will present his findings Dec. 16.

Vega was expected to be a witness at the criminal trial, since he was among the few leaders who weren’t killed in the clash or jailed afterward.

He wasn’t charged because he was away getting supplies when the violence erupted at the settlement erected by the peasants inside Riquelme’s ranch, the Naranjaty Commission’s secretary, Martina Paredes, told the AP.

“We think he was assassinated by hit men who were sent, we don’t know by whom, perhaps to frighten us and frustrate our fight to recover the state lands that were illegally taken by Riquelme,” she said.

Riquelme, who died of natural causes about a month after the battle in June, occupied the land during the dictatorship of Alfredo Stroessner, whose government gave away land for free to anyone willing to put it to productive use.

A local court in Curuguaty upheld Riquelme’s claim to the land years later. Lugo’s government later sought to overturn the decision, but the case remains tied up in court.

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“Searching for Sugar Man” wins Producers Guild documentary nomination

LOS ANGELES (TheWrap.com) – “Searching for Sugar Man” is the best-known of the five films whose producers have been nominated for documentary motion pictures by Producers Guild of America, which announced its nominations on Friday.

Malik Bendjelloul’s film about the rediscovery of ’70s recording artist Rodriguez joined a slate of nominees that also includes Jon Shenk’s doc about the ousted president of the Maldives, “The Island President”; Marius A. Merkevicius‘ story of the 1992 Lithuanian Olympic basketball team, “The Other Dream Team”; Dror Moreh’s chronicle of some members of the Israeli intelligence services, “The Gatekeepers”; and Aaron Yeger’s film about the Roma (gypsies) in Europe, “A People Uncounted.”

The PGA bypassed number of the year’s high-profile docs, including “Bully,” “The Queen of Versailles,” “The Imposter,” “Samsara,” “West of Memphis” and “The Invisible War.”

Of the guild’s choices, only “Sugar Man” was also nominated in the top category at the IDA Awards and the Cinema Eye Honors, the two major awards in the documentary field.

The PGA release:

LOS ANGELES, CA (November 30, 2012) – The Producers Guild of America (PGA) announced today the Documentary Motion Picture nominees that will advance in the voting process for the 24th Annual Producers Guild Awards.

The nominated films, listed below in alphabetical order, are:

A PEOPLE UNCOUNTED

THE GATEKEEPERS

THE ISLAND PRESIDENT

THE OTHER DREAM TEAM

SEARCHING FOR SUGAR MAN

All other nominations for the 2013 Producers Guild Award categories will be announced on January 3, 2013, along with the individual producers.

All 2013 Producers Guild Award winners will be announced on January 26, 2013 at the Beverly Hilton Hotel. This year, the Producers Guild will also award special honors to Bob and Harvey Weinstein, J.J. Abrams, Tim Bevan and Eric Fellner and Russell Simmons, among others. The 2013 Producers Guild Awards Chair is Michael De Luca.

In 1990, the Producers Guild held the first-ever Golden Laurel Awards, which were renamed the Producers Guild Awards in 2002. Richard Zanuck and Lili Fini Zanuck took home the award for Best Produced Motion Picture for DRIVING MISS DAISY, establishing the Guild’s awards as a bellwether for the Oscars. Last year, the PGA awarded THE ARTIST with its Darryl F. Zanuck Producer of the Year Award in Theatrical Motion Pictures, marking the fifth consecutive year the Producers Guild has presaged the Academy of Motion Picture’s choice.

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Teens may buy less tobacco when displays are hidden

NEW YORK (Reuters Health) – A new study conducted using a virtual reality game suggests teens may be less likely to try to buy cigarettes at convenience stories if they aren’t sold in plain sight behind the counter.

Requiring stores to hide tobacco product displays is one option some states are considering to curb teen smoking after the Family Smoking Prevention and Tobacco Control Act of 2009 was passed, according to the study’s lead author.

“We know the retail environment is a very important place for tobacco companies to advertise and market their products,” said Annice Kim, from the independent research institute RTI International in Research Triangle Park, North Carolina.

“They’re prominently displayed at the point of sale, and it exposes all customers, including kids.”

Kim’s team wanted to test the effects of covering up such cigarette displays on teen shopping and opinion. But the researchers couldn’t conduct a real-world experiment because as of yet, no states have banned the displays.

So they designed a virtual reality game and sent more than 1,200 youth, between age 13 and 17, into a simulated online convenience store. Researchers asked the participants to select four items in the store: a snack from the aisles, a drink from the coolers and two products of their choice from the checkout counter.

In some scenarios, the cabinet behind the counter prominently displayed cigarettes, while other teens saw the cabinet closed and the display covered up.

Any teens that tried to ask the cashier for cigarettes were denied because of age – but what the researchers were interested in was how many asked.

Depending on other changes they made to the virtual convenience stores, the researchers found that 16 to 24 percent of teens tried to buy tobacco when the display was open, compared to 9 to 11 percent when it was closed.

In a post-virtual shopping survey, whether cigarettes were openly displayed wasn’t clearly tied to teens’ perceptions of how easy it would be to buy tobacco products if a similar store existed in their neighborhood.

However, 32 percent of youth said they were aware cigarettes were available for sale when the display case was closed in their virtual store, compared to 85 percent of those who had the open version, according to findings published Monday in Pediatrics.

“Policies that require retailers to store tobacco products out of view… could have a positive public health impact,” Kim told Reuters Health.

Still, she said this single study, funded by the New York State Department of Health, would have to be considered along with other evaluations of the display restrictions before making policy recommendations.

One tobacco control researcher not involved in the new study said he thinks there is “strong justification” for hiding cigarette displays from youth, but that this study doesn’t necessarily add much to that debate.

“It certainly shows that tobacco displays get people to think about cigarettes, which is what they’re for,” said Dr. Michael Siegel, from the Boston University School of Public Health.

But, “It can’t be extrapolated into real life, because in real life kids would go to a store when they want to buy cigarettes,” he told Reuters Health.

“I don’t know how many situations there are when a kid is hanging out in a convenience store with nothing to do and says, ‘Oh, I’ll just try a cigarette as long as they’re here.’”

Rather, he said, banning the displays could help prevent youth from being exposed to marketing by cigarette companies and influenced in their attitudes toward smoking.

SOURCE: http://bit.ly/cxXOG Pediatrics, online December 3, 2012.

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Global firms’ tax pay ‘an insult’

3 December 2012 Last updated at 05:44 ET

Global firms in the UK that pay little or no tax are an “insult” to British businesses, a committee of MPs says.

Public Accounts Committee chairwoman Margaret Hodge said HM Revenue and Customs (HMRC) needed to be “more aggressive and assertive in confronting corporate tax avoidance”.

Multinationals such as Starbucks and Amazon have come under fire for paying little or no tax.

They generate UK sales of hundreds of millions of pounds.

Starbucks, for example, sold nearly £400m worth of goods in the UK last year, but paid no corporation tax at all, because much of the money it earns in this country is transferred to a sister company in the Netherlands in the form of royalty payments.

HMRC said it already ensured that international companies paid the tax due “in accordance with UK tax law”.

UK-based companies pay corporation tax on their taxable profits wherever they are made. Companies based outside the UK must pay tax on profits made in this country.

Continue reading the main story

Multinationals in the tax spotlight

Starbucks’ UK sales last year were £400m but much of its earnings are paid as royalties to another part of the company.

Amazon generated sales of more than £3.3bn in the UK last year but paid no corporation tax on any of the profits, and is under investigation by the UK tax authorities, according to the Guardian newspaper.

Apple paid less than 2% corporation tax on its profits outside the US, paying $ 713m (£445m) on foreign pre-tax profits of $ 36.8bn.

Google’s UK unit paid £6m to the Treasury in 2011 on UK turnover of £395m, according to the Telegraph newspaper.

Source: Various

The influential committee’s report comes after it took evidence in November from executives from Starbucks, Google and Amazon about the amount of corporation tax the companies have paid in the UK.

‘Evasive evidence’

Margaret Hodge told the BBC that there was a danger corporation tax was becoming “voluntary” and that this had to change.

“These global companies are making money in the UK. All we are saying is that if you have economic activities in the UK you are making profits and tax is payable on that,” she said.

It emerged on Sunday that coffee shop chain Starbucks is in talks with HMRC about the amount of tax it pays.

Meanwhile, Chancellor George Osborne will unveil later details of £154m of funding to help tackle tax avoidance and evasion, amid public concern over the tax affairs of major international companies and wealthy individuals.

Continue reading the main story

“Start Quote

Although they employ many thousands of people in Britain, it is unclear whether collectively they are net creators or destroyers of employment”

End Quote

The money will be used to take on extra staff to investigate high earners who aggressively avoid or evade paying tax and global firms that use legal loopholes to move profits out of the UK.

The funding is expected to help bring in about £2bn a year for HMRC.

In the report, Mrs Hodge said the level of tax taken from multinational firms with large UK operations was, “outrageous and an insult to British businesses and individuals who pay their fair share”.

Public Accounts Committee chairwoman Margaret Hodge: “It is time for HMRC to get a grip”.

“The inescapable conclusion is that multinationals are using structures and exploiting current tax legislation to move offshore profits that are clearly generated from economic activity in the UK.

“HMRC should be challenging this, but its response so far to these big businesses and their aggressive tax planning has lacked determination and looks way too lenient. Policing the tax system must be at the heart of what HMRC does.

An HMRC spokesman said: “We relentlessly challenge those that persist in avoiding tax and have recovered £29bn additional revenues from large businesses in the last six years, including £4.1bn in the last four years from transfer pricing enquiries alone.”

‘Breathtaking hypocrisy’

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Analysis

Jonty Bloom Business correspondent, BBC News

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It is worth remembering that corporation tax is not the only tax that companies pay. Corporation tax does raise £50bn in the UK, but other taxes that cannot be avoided so easily include VAT; then there is the business rate, which raises some £25bn a year. The Institute for Economic Affairs says that is enough to pay for the secondary education system and the police and the fire service.

Also, companies pay National Insurance contributions for every worker they hire and fuel duty and vehicle excise duty which are one of the biggest revenue earners for the government.

That doesn’t mean that foreign companies aren’t doing their best to avoid paying corporation tax on the profits they make here, but then UK companies operating in France, China or the US are probably doing much the same there.

Laws on corporate taxation are extremely complex and often part of internationally negotiated treaties, one reason they are difficult to change and why companies have become very good at exploiting every legitimate and legal loophole that they can.

In a statement to coincide with the committee’s report, Amazon said it paid all applicable taxes in every jurisdiction that it operated in: “We have a single European headquarters in Luxembourg with hundreds of employees to manage this complex operation.”

Starbucks said in a statement: “We have listened to feedback from our customers and employees, and understand that to maintain and further build public trust we need to do more.

“As part of this we are looking at our tax approach in the UK. The company has been in discussions with HMRC for some time and is also in talks with the Treasury.”

‘Small fry’

The War on Want charity, which is campaigning for more to be done to tackle tax avoidance, accused the government of “breathtaking hypocrisy”.

It said: “Osborne and Cameron are happy to talk tough on tax. But, in reality, their plans will only go after the small fry on the fringes, while giving a green light to multinationals like Amazon, Google and Starbucks to continue avoiding billions in tax.”

Heather Self, a tax expert, told the BBC assessing tax for major companies was not simple.

“If you buy a book from Amazon you are actually buying from a Luxembourg company,” she said. “It decides how many books to buy and at what price they sell them for. All you have in the UK is a warehouse, a very big warehouse that employs a lot of people but that is all it does. The risk is taken in Luxembourg.

“Profits paid here are for the activities it undertakes here and that is not highly profitable. It is not as simple a situation as the Public Accounts Committee likes to make out sometimes.”

BBC News – Business

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