Monthly Archives: February 2011

Study IDs dysphagia risk after head/neck cancer treatment


February 28, 2011 — A team of Danish researchers has developed a predictive model for determining which head and neck cancer patients are at risk of developing dysphagia (swallowing disfunction) following intensity-modulated radiotherapy (IMRT).

Hanna Rahbek Mortensen, PhD, and colleagues presented results from a large prospective trial, the DAHANCA 6 & 7 study, at last week’s International Conference on Innovative Approaches in Head and Neck Oncology in Barcelona, Spain.

“We followed 1,476 patients with squamous cell carcinoma of the head and neck, and found out the existence of factors related to the cancer itself, to the patient and to the treatment influencing the development of dysphagia,” Mortensen said in a press release.

Dysphagia may be acute or late. Risk factors for developing severe acute dysphagia were large tumors, spreading of cancer cells to the lymph nodes, swallowing problems at the time of diagnosis, six treatments per week, and tumor location other than the vocal cords, the researchers noted. Risk factors for developing late dysphagia were large tumors, swallowing problems at the time of diagnosis, and tumor location other than the vocal cords.

Although 83% of all head and neck cancer patients develop some kind of dysphagia, this predictive model will have a major impact on patient quality of life, the researchers noted.

“These results are very important,” said Dr. J.A. Langendijk from the University Medical Center of Groningen. “Today, with the increasing use of IMRT, the dose to the salivary glands is reduced, resulting in lower risks on xerostomia. However, swallowing dysfunction is remaining an important side effect following irradiation in the head and neck region. Therefore, the identification of patients that are at highest risk for dysphagia, in particular late and persistent, is of major importance as this will help us to provide them with preventive measures.”

Gastric tubes insertion and swallowing exercises could be prescribed to prevent malnutrition and weight loss. “This study will be very helpful to improve the quality of life of patients,” Mortensen noted. “Indeed, these measures at an early stage of the treatment will considerably reduce swallowing disorders.”

The results could also lead to better treatments. “Dysphagia is a limiting factor for further intensification of head and neck radiotherapy. This is why the knowledge provided here may help us to better tailor treatments for the patients: It may allow us to increase the intensity of the treatment while maintaining their quality of life,” Mortensen concluded.

February, 2011|Oral Cancer News|

Adolescents and oral sex: is it really something to worry about?

Author: Bonnie Halpern-Felsher , University of California, San Francisco, CA

National studies show that the most common form of partnered sexual behavior among adolescents is oral sex. While oral sex does not result in pregnancy, it can lead to STIs. Most studies on adolescent sex have focused on vaginal sex, thus leaving important questions concerning adolescents’ attitudes, perceptions, and experiences with oral sex untapped. This presentation will utilize longitudinal data collected over the first three years of high school to address the following questions: 1) What are adolescents’ beliefs concerning the social, emotional and health consequences of oral compared to vaginal sex? 2) What is the relationship between adolescent oral and vaginal sex? 3) What are the positive and negative outcomes experienced by adolescents who have engaged in oral sex, vaginal sex, or both?

Beginning in the fall of 9th grade, 637 adolescents (56% female) were surveyed every 6 months for three years. Between 74% and 92% of the participants responded at each wave. Participants reported diverse ethnic and socioeconomic backgrounds.

Results showed adolescents: 1) perceived oral sex to entail less social, emotional and health risks than vaginal sex; 2) believed that oral sex was more prevalent and more acceptable than vaginal sex; 3) who reported only having engaged in oral sex experienced fewer STIs as well as fewer social and emotional consequences, compared to adolescents who had vaginal sex experience; 4) who only engaged in oral sex reported experiencing fewer benefits, including pleasure or feeling good about themselves, compared to adolescents who had vaginal sex; 5) generally initiated vaginal sex after or within the same 6-month time period of their first report of oral sex; and 6) who initiated oral sex at the end of 9th grade represented a high-risk group with a 50% chance of initiating vaginal sex by the end of 11th grade. In comparison, adolescents who abstained from oral sex or delayed until the end of 11th grade had a 7% and 16% chance of initiating vaginal sex by the end of 11th grade, respectively.

This study demonstrates that adolescents clearly view oral sex as less risky and more prevalent than vaginal sex, thus explaining in part the high prevalence rate of oral sex among adolescents. The first two years of high school appear to serve as a critical period in adolescent sexual behavior. Oral sex initiation during this period increases the risk of vaginal sex initiation, with nearly half of those initiates engaging in vaginal sex within six months. The findings from this study suggest that oral sex must be included in prevention messages.

February, 2011|Oral Cancer News|

Oral sex now main cause of oral cancer: Who faces biggest risk?

Author: David W Freeman

What’s the leading cause of oral cancer? Smoking? Heavy drinking?

Actually, it’s oral sex.

Scientists say that 64 percent of cancers of the oral cavity, head, and neck in the U.S. are caused by human papillomavirus (HPV), which is commonly spread via oral sex, NPR reported. The more oral sex you have – and the more oral sex partners you have – the greater the risk of developing these potentially deadly cancers.

“An individual who has six or more lifetime partners – on whom they’ve performed oral sex – has an eightfold increase in risk compared to someone who has never performed oral sex, Ohio University’s Dr. Maura Gillison, said at a recent scientific meeting, according to NPR.

It’s news that might alarm some parents, who worry about adolescents’ appetite for oral sex.

“Today’s teens consider oral sex to be casual, socially acceptable, inconsequential, and significantly less risky to their health than ‘real’ sex,” Dr. Gillison and colleagues said in a written statement released in conjunction with the meeting.

Teens simply think oral sex is “not that a big a deal,” Dr. Bonnie Halpern-Felsher, professor of pediatrics at the University of California, San Francisco, told NPR. “Parents and health educators are not talking to teens about oral sex. Period.”

But simply needling teens about the risks posed by oral sex and HPV – the same virus that causes cervical cancer – is no substitute for literally giving them the needle.

“When my patients ask whether they should vaccinate their sons, I say ‘certainly,” Gillison said, the Telegraph reported. “The vaccine will protect them against genital warts and anal cancer and also as a potential byproduct of that it may protect them against oral cancer caused by HPV.”

This year, 37,000 Americans will be diagnosed with oral or pharyngeal cancer this year, according to the Oral Cancer Foundation. Eight thousand will die from the cancers.

Virus passed during oral sex tops tobacco as throat cancer cause

Author: Peggy Girshman

If you’re keeping score, here’s even more evidence that HPV causes oral, head and neck cancers and that vaccines may be able to prevent it.

Researchers studying the human papilloma virus say that in the United States HPV causes 64 percent of oropharynxl cancers. In the rest of the world, tobacco remains the leading cause of oral cancer, Dr. Maura Gillison of Ohio State University told a meeting of the American Association for the Advancement of Science this past weekend.

And the more oral sex someone has had — and the more partners they’ve had — the greater their risk of getting these cancers, which grow in the middle part of the throat. “An individual who has six or more lifetime partners — on whom they’ve performed oral sex – has an eightfold increase in risk compared to someone who has never performed oral sex,” she said.

The recent rise in oropharnx cancer is predominantly among young, white men, she noted, though she says no one has figured out why yet. About 37,000 people in the United States were diagnosed with oral cancer in 2010, according to the Oral Cancer Foundation.

People with HPV-related throat cancer are more likely to survive their cancer than those who were heavy smokers or drinkers, the other big risk factors.

The message may be more critical for teens according to Bonnie Halpern-Felsher, professor of pediatrics at the University of California, San Francisco. She has studied 600 adolescents over 10 years and found that oral sex is much more common than vaginal sex and that “teens don’t consider oral sex to be sex,” that they think “it’s not that big a deal.” She adds: “Parents and health educators are not talking to teens about oral sex. Period.”

Worldwide, HPV-related cancers seem to be increasing. Gillison said that Swedish researchers looking back over 30 years found that 23 percent of oral cancer tumors in 1970 were positive for HPV, but in 2005, that number had risen to 93 percent.

The British newspaper The Guardian noted that Gillison said that “every birth cohort appears to be at greater risk from HPV and oral cancers than the group born before them.”

Over the past five years, health officials have been urging parents to make sure their daughters are vaccinated against HPV to help prevent cervical cancer. But these new results suggest that young men could also benefit from vaccination, though the costs would be substantial.

While none of the researchers could say definitively that the vaccines against HPV, Gardasil and Cervarix, would prevent throat cancer, they thought it could was reasonable to think the vaccine could reduce risks as well.

Note: Some of Gillison’s research is funded by Merck, the pharmaceutical company that makes Gardasil.

February, 2011|Oral Cancer News|

Popularity surges for e-cigarettes, but health questions unanswered


A closer look at the battery-powered cigarettes.

Misti Stewart of Gregor’s Eastside Liquor demonstrates an electronic cigarette. They have gained popularity since the smoking ban. / Elisha Page / Argus Leader

Jeff Mann has found a way to get his nicotine fix with no ash, no flame, no odor and no bad breath.

And he can do it legally inside businesses that are smoke free.

Mann, 40, smokes an electronic cigarette. It’s a battery-powered device that looks like a cigarette and emits cigarette-like smoke, but delivers nicotine in vapor form.

“You can get a nicotine level that you’re used to getting from a regular cigarette,” Mann said.

E-cigarettes have been available in the United States since 2006 and have grown in popularity in Sioux Falls since the smoking ban went into effect Nov. 10. They’re sold in bars, casinos and various retail shops. At least one local distributor has seen a 50 percent increase in sales.

But the federal Food and Drug Administration has not approved e-cigarettes. That raises red flags for some health professionals and has them questioning what risks might be associated with e-cigarettes.

Smoker says device helped him cut back

The FDA lost a court case last year after trying to treat e-cigarettes as drug-delivery devices instead of tobacco products because e-cigarettes heat nicotine extracted from tobacco.

But Mann, who owns Vishnu Bunny Tattoo and Piercing, views e-cigarettes as a healthier alternative to the traditional cigarettes he has smoked for 25 years. He said it has helped him cut down on smoking.

Prices range from less than $10 for disposable e-cigarettes to $100 for a kit with a lifetime warranty.

Critics say flavors can entice children

Users can buy cartridges with varying levels of nicotine, all the way down to a cartridge containing no nicotine. They also come in flavors such as chocolate and vanilla, which critics say can tempt children. OCF Because e-cigarettes are not FDA-approved, Dr. Jeffry Meyer of Sanford Health hesitates to tell patients it’s OK to use them.

“We rely on the FDA to research and give good advice,” Meyer said. “We believe they have good reason for coming out against something … there may be some potential harm or abuse potential.”

Deb Murray, a respiratory therapist at Avera Heart Hospital, heard about e-cigarettes a year ago but said patient interest peaked in November.

Murray is concerned about the mystery of what is in e-cigarettes.

E-cigarettes are advertised as a healthy alternative, and companies say they lack the carcinogens found in tobacco products.

“(People are) thinking it is a healthy alternative, but they need to be aware of the unknown nicotine amount, the unknown health effects and that they are not FDA approved,” Murray said. “There may be chemical contents that might affect their health. There are so many unknowns.”

The American Cancer Society also does not endorse or suggest people use e-cigarettes, said Jennifer Stalley, director of government relations for the American Cancer Society in South Dakota.

Sellers find raidly rising market

Kristi Englund, 45, has not smoked a traditional cigarette in three months, and she credits e-cigarettes. After smoking for 30 years, Englund said she’s tried other methods for quitting, but nothing worked.

“This is great. It stops that craving for inhaling, which is my big thing,” she said. “The inhaling is a stress reliever.”

Mike Wehrkamp, owner of M & M Distributing, has seen a 50 percent increase in sales of Fifty-One electronic cigarettes since the smoking ban went into effect Nov. 10. He distributes e-cigarettes to about 12 Sioux Falls retailers, and 25 retailers statewide.

He started distributing Fifty-One electronic cigarettes in May 2009.

“I thought it was a great opportunity,” Wehrkamp said. “When I first got into them, I figured, if this ain’t the wave of the future …”

Gregor’s Eastside Liquor has seen a 30 percent increase in Fifty-One electronic cigarette sales the smoking ban, owner Greg Stahl said.

A Fifty-One electronic cigarette kit sells for $100, and comes with two lifetime warrantied batteries, a cell phone-like wall charger and two cartridges, which are screwed onto the batteries.

The refill packs cost $20, and come with five cartridges, which Wehrkamp said is equivalent to a $50 carton of cigarettes.

“These are like your cell phone. You recharge them, they go forever,” Wehrkamp said.

Still, for longtime smoker Kay Johnson, 49, an e-cigarette is not the same as a traditional cigarette.

“The e-cigarette doesn’t give me the same effect. It helps abate the sensation, but it’s not the same,” she said. “It helps to quench your thirst, but that’s it, and not for long.”

February, 2011|Oral Cancer News|

Sweden wants the EU to legalize snus

Source: Stockholm News

The Swedish government is now urging the EU to legalise snus (moist powder tobacco). But this has led to a quarrel between the government and its own experts in the National Board of Health and Welfare and in the Swedish National Institute for Public Health.

Since some years back, the EU is overlooking its tobacco policy – the so called tobacco directive. In its answer to the EU, the Swedish government is now openly urging the EU to legalise snus.

The argument from the Swedish government is that the ban on snus goes against the free market. Sweden’s Minister for Health and Social Affairs, Göran Hägglund writes that “there is no argument at all which motivates a ban on snus” (quote from Svenska Dagbladet) and he continues that snus is clearly less dangerous than cigarettes. Therefore he claimst that the ban on snus “lacks logic”.

But at the same time, experts in Sweden do not agree with Minister Hägglund. OCF The Swedish argument of ‘harm reduction’ with convincing smokers to insted start with snus is “a myth” according to these experts.

Internal conflict in Sweden

The problem today is that the tobacco issue has become a health issue in the EU as it has been moved to the EU’s Directorate for health. This is why is the Swedish Minister for health and not for trade is answering the letter from the EU. This has created a conflict and a dilemma between Swedish authorities.

The government’s expert organs for health issues; the National Board of Health and Welfare and the Swedish National Institute for Public Health, are both strongly negative towards snus and have warned several times for its consequences. They are careful in openly criticising the government’s letter to the EU but they are against an increased market for snus.


Facts: Snus is a moist powder tobacco, not to be confused with the dry form of tobacco, snuff inhaled through the nose.  It is most common in Sweden and Norway. It is forbidden in the EU but Sweden has an exception.

February, 2011|Oral Cancer News|

Antibody as ‘smart bomb’ to fight cancer

Author: staff

A joint team of Indian and Australian scientists claims to have achieved a breakthrough by creating an antibody which could be used for developing a “medical smart bomb” that would help seek out and eradicate the root of cancer — the stem cells.

The international project is a collaboration between Australia’s Deakin University and Indian Institute of Science in Bangalore along with Barwon Health’s Andrew Love Cancer Centre and Chem Genex Pharmaceuticals.

The team has, in fact, created the world’s first RNA aptamer, a chemical antibody that acts like a guided missile to seek out and bind only to cancer stem cells, the Cancer Science journal reported.

The aptamer has the potential to deliver drugs directly to the stem cells and to be used to develop a more effective cancer imaging system for early detection of the disease, say the scientists. The Director of Deakin Medical School’s Nanomedicine Program , Professor Wei Duan, said that the development of the aptamer had huge implications for the way cancer is detected and then treated.

Duan said: “The survival rates for many cancers remain poor, due partly to the inability to detect cancer early. To provide a cure for cancer we must accurately detect and eliminate the cancer stem cells.”

February, 2011|Oral Cancer News|

Revealed: oral sex is ‘bigger cause of throat cancer than tobacco’

Author: staff

A virus spread during oral sex is now the main cause of throat cancer in people under 50, scientists have warned. They say the human papilloma virus spread during unprotected sex is to blame for a disturbing rise in potentially deadly oral cancers in the last few decades.

Doctors have called for boys to be vaccinated against HPV just like teenage girls to stop the spread of the disease.

HPV is best known as the cause of around 70 per cent of cervical cancers. Since 2008, girls have been vaccinated against the virus aged 12 and 13 in schools. However, it can also cause warts, verrucas and other cancers. Cancers of the mouth and oropharynx – the top of the throat – used to be mainly diagnosed in older men who drink or smoke. But increasingly, it is being seen in younger men.

Prof Maura Gillison of Ohio State University in Columbus said the sexually transmitted HPV was a bigger cause of some oral cancers than tobacco.

She said: ‘We don’t know from strict scientific evidence whether the vaccine will protect from oral HPV infections that lead to cancer. Those of us in the field are optimistic it will – the vaccines in every anatomical site looked at so far have been shown to be extraordinarily effective, about 90 per cent effective, at preventing infections.’

‘When one of my patients asks whether or not they sound vaccinate their sons, I say certainly.’

Girls aged 12 and 13 are offered the HPV vaccine on the NHS to protect against cervical cancer – a disease that kills nearly 1,000 women every year in the UK. The jab is given at school in three doses over six months. Doctors are increasingly concerned that the sexually transmitted virus is behind a rise in cancer.

Worrying: the sexually transmitted HPV was a bigger cause of some oral cancers than tobacco. In Britain the incidence of throat cancer is rising sharply while in the US the incidence of oral cancers linked to HPV have doubled in the last 20 years. In Sweden in the 1970s around a quarter of tonsil cancers were linked to HPV, but by the mid 2000s the figure was 90 per cent said Prof Gillison.

‘That’s the most compelling data in a population that the increase in tonsular cancer or oropharynx cancer incidence we’re seeing in a number of places worldwide is possible caused by HPV,’ she said.

Someone infected with HPV 16 – the strain linked to oral cancer- has a 14 fold increase in risk for getting oropharynx cancer, she said.

She added: ‘What is most strongly linked to oral HPV infection is the number of sexual partners someone has had in their lifetimes, in particular the number of individuals on whom they have performed oral sex.

‘The higher the number of partners that you’ve had, the greater the odds that you’d have an oral infection.’

Yesterday, researchers told the American Association for the Advancement of Science conference in Washington CD that teenagers consider oral sex to be ‘casual, socially acceptable, inconsequential and significantly less risk to their health than “real” sex.’

Last year a study at Johns Hopkins University found that HPV posed a greater risk in contracting cancer than smoking or alcohol. The American study of 300 people showed that those with more than six partners were almost nine times at greater risk of contracting the disease while those who had already experienced a previous oral HPV infection were 32 times more likely to develop cancer.

Most HPV infections have no symptoms and people often do not need treatment. Sara Hiom, Cancer Research UK’s director of health information, said: ‘Cancers in the mouth and throat are on the increase and rates have been rising dramatically in the UK since the mid 1980s, especially in people in their 40s, 50s and 60s.

‘The proportion of these cancers that appear to be related to infection by HPV is also increasing. But while it’s reasonable to assume that HPV vaccination in girls and boys would protect against these cancers, there is as yet no evidence as to whether the current HPV vaccines are effective at preventing them. The trials done to date have looked at cervical cancer or genital warts as endpoints, so we need new studies to show effectiveness against these HPV-related head and neck cancers. Yet most oral cancers diagnosed in people over 50 in the UK are still related to tobacco and alcohol use.’

February, 2011|Oral Cancer News|

Second primary cancers after an index head and neck cancer: subsite-specific trends in the era of human papillomavirus–associated oropharyngeal cancer

Authors: Luc G.T. Morris et al.

Patients with head and neck squamous cell carcinoma (HNSCC) are at elevated risk of second primary malignancies (SPM), most commonly of the head and neck (HN), lung, and esophagus. Our objectives were to identify HNSCC subsite-specific differences in SPM risk and distribution and to describe trends in risk over 3 decades, before and during the era of human papillomavirus (HPV) –associated oropharyngeal SCC.

Population-based cohort study of 75,087 patients with HNSCC in the Surveillance, Epidemiology, and End Results (SEER) program. SPM risk was quantified by using standardized incidence ratios (SIRs), excess absolute risk (EAR) per 10,000 person-years at risk (PYR), and number needed to observe. Trends in SPM risk were analyzed by using joinpoint log-linear regression.

In patients with HNSCC, the SIR of second primary solid tumor was 2.2 (95% CI, 2.1 to 2.2), and the EAR was 167.7 cancers per 10,000 PYR. The risk of SPM was highest for hypopharyngeal SCC (SIR, 3.5; EAR, 307.1 per 10,000 PYR) and lowest for laryngeal SCC (SIR, 1.9; EAR, 147.8 per 10,000 PYR). The most common SPM site for patients with oral cavity and oropharynx SCC was HN; for patients with laryngeal and hypopharyngeal cancer, it was the lung. Since 1991, SPM risk has decreased significantly among patients with oropharyngeal SCC (annual percentage change in EAR, −4.6%; P = .03).

In patients with HNSCC, the risk and distribution of SPM differ significantly according to subsite of the index cancer. Before the 1990s, hypopharynx and oropharynx cancers carried the highest excess risk of SPM. Since then, during the HPV era, SPM risk associated with oropharyngeal SCC has declined to the lowest risk level of any subsite.

Note: Supported by National Institutes of Health Grant No. T32 CA009685.

1. Luc G.T. Morris,
2. Andrew G. Sikora,
3. Snehal G. Patel,
4. Richard B. Hayes and
5. Ian Ganly

Authors’ affiliation:
From the Memorial Sloan-Kettering Cancer Center; Mount Sinai School of Medicine; and New York University School of Medicine, New York, NY.

February, 2011|Oral Cancer News|

Florida ruling Big Tobacco won comes back to bite it

Author: Curt Anderson

A Florida Supreme Court ruling that threw out a $145 billion award against cigarette makers is biting Big Tobacco back, making it dramatically easier for thousands of smokers to sue and turning the state into the nation’s hot spot for damage awards.

The 2006 ruling has helped generate more than $360 million in damage awards in only about two dozen cases. Thousands more cases are in the pipeline in Florida, which has far more smoking-related lawsuits pending than any other state.

Though the justices tossed the $145 billion class-action damage award, they allowed about 8,000 individual members of that class to pursue their own lawsuits. And in a critical decision, they allowed those plaintiffs to use the original jury’s findings from the class-action case.

That means the plaintiffs don’t have to prove that cigarette makers sold a defective and dangerous product, were negligent, hid the risks of smoking and that cigarettes cause illnesses such as lung cancer and heart disease. The plaintiffs must mainly show they were addicted to smoking and could not quit, and that their illness – or a smoker’s death – was caused by cigarettes.

Jurors have sided with smokers or their families in about two-thirds of the 34 cases tried since February 2009, when the first Florida lawsuit following the rules set by the Supreme Court decision went before a jury. Awards have ranged from $2 million or less to $80 million, though tobacco companies are appealing them all.

The successes by smokers or their survivors in Florida compares with just six wins between 1996 to 2006 in Florida. Before 1996, individual smokers won only a handful of cases nationwide.

Tobacco company lawyers insist the process is rigged.

“We believe the trial courts have used trial plans that are so fundamentally unfair they violate due process and Florida law,” said Murray Garnick of Altria Client Services, which represents Altria Group Inc. subsidiary Philip Morris USA. “Each case must be judged on its own facts.”

The tobacco companies, however, have lost their first appeal over how Florida courts are handling the cases. The state’s 1st District Court of Appeal ruled against R.J. Reynolds Tobacco Co. in December, upholding a $28.3 million verdict for a dead smoker’s wife and endorsing the way trial judges have interpreted the state Supreme Court’s decision.

Steven J. Hammer, an attorney whose Fort Lauderdale firm is handling hundreds of smoker lawsuits, said the Florida cases have changed the balance of power in the courtroom because tobacco companies are prevented from arguing that their products aren’t necessarily dangerous and addictive.

“As a result, the whole story is being told: how they lied to the public, all for the almighty dollar,” he said.

One of Hammer’s clients, 93-year-old Leon Barbanell, won a nearly $2 million verdict against Philip Morris USA for the 1996 death of his wife of 56 years from lung cancer. Shirley Barbanell smoked up to two packs of Chesterfields, Marlboros and other cigarettes a day for 50 years and could not quit despite many efforts, her husband said. He’s worried that, because of appeals, he may die before he ever sees a cent.

“I miss her company every day,” Barbanell said. “She was always there for me. We went everywhere together.”

A jury in northern Florida’s Levy County granted the largest award issued under the Supreme Court ruling, $80 million, to the daughter of a man who died of lung cancer in 1996 after smoking for decades. Others awarded $46.3 million for a widow in the Gainesville area who lost her husband to lung cancer; and almost $39 million for a Fort Lauderdale woman suffering from advanced emphysema after smoking Philip Morris’ Benson & Hedges brand for years.

The tobacco companies point out that during one stretch in 2010 they prevailed in eight of nine cases, although the trend later was reversed. Attorneys said cigarette makers often win when it is difficult to prove that cigarettes caused a particular illness, or when jurors decide that people who smoke must take responsibility and assume the consequences.

“There are some jurors who are really opposed to the idea of someone who smoked bringing a case against the cigarette manufacturer,” said Keith Mitnick, an Orlando attorney who won a multimillion-dollar verdict against R.J. Reynolds in April. “In jury selection, we target that very question. It doesn’t take but one strong-willed juror to make the difference in the outcome.”

Tobacco companies’ recent setbacks are not limited to Florida:

– In Boston, a jury in December awarded $152 million to the estate and son of a woman who died of lung cancer in 2002. The lawsuit claimed that Lorillard Tobacco Co. hooked the woman on smoking after giving away free samples of cigarettes in the Boston housing project where she lived as a child.

– In Connecticut, U.S. Smokeless Tobacco Co., maker of Skoal and Copenhagen, agreed in December to pay $5 million to the family of a man who died of mouth cancer in what was believed to be the first wrongful-death settlement won from a chewing tobacco company.

– Also in December, Minnesota’s appeals court allowed a class-action case to continue for people who claim Marlboro Light cigarettes, made by Philip Morris, were marketed as supposedly safer to smoke using false advertising and consumer fraud. Philip Morris is appealing that decision.

If the losing trend and multimillion-dollar verdicts continue, some legal experts said the tobacco companies may rethink their long-standing policy against settling the smoker lawsuits.

“When we get to the point that plaintiff verdicts are upheld, with the industry looking at thousands of additional trials and expenses, they would weigh all of that together and possibly settle later down the road,” said Edward Sweda, senior attorney for the Tobacco Products Liability Project at Northeastern University law school in Boston.

Lawsuits will likely end up before the U.S. Supreme Court before that has a chance of happening.

“We have a strong legal and factual basis to fight each of these cases. We will fight every adverse decision against us,” said Garnick, the Philip Morris attorney.

The tobacco companies have a long history of doing just that, but they have settled in the past. The biggest came in 1998, when four cigarette makers and 46 states settled for $206 billion a series of lawsuits claiming that smoking drove up public health costs.

In 2006, a federal judge in Washington, D.C., found the six largest tobacco companies guilty of racketeering and fraud for deceiving the public about the dangers of smoking.

The ruling, upheld by an appeals court in May 2009, requires that cigarette manufacturers change the way they market cigarettes. The requirements, since adopted by the U.S. Food and Drug Administration, ban labels such as “low tar,” “light,” “ultra light” or “mild,” since such cigarettes have been found no safer than others.

The ruling was appealed to the U.S. Supreme Court, but the justices declined to hear it.

February, 2011|Oral Cancer News|