Court Rejects Recess Appointments to Labor Board

In a ruling that called into question nearly two centuries of presidential “recess” appointments that bypass the Senate confirmation process, a federal appeals court ruled on Friday that President Obama violated the Constitution when he installed three officials on the National Labor Relations Board a year ago.

The ruling was a blow to the administration and a victory for Mr. Obama’s Republican critics – and a handful of liberal ones – who had accused Mr. Obama of improperly claiming that he could make the appointments under his executive powers. The administration had argued that the president could decide that senators were really on a lengthy recess even though the Senate considered itself to be meeting in “pro forma” sessions.

But the court went beyond the narrow dispute over pro forma sessions and issued a far more sweeping ruling than expected. Legal specialists said its reasoning would virtually eliminate the recess appointment power for all future presidents when it has become increasingly difficult for presidents to win Senate confirmation for their nominees. In recent years, senators have more frequently balked at consenting to executive appointments. President George W. Bush made about 170 such appointments, including John R. Bolton to be ambassador to the United Nations and two appeals court judges, William H. Pryor Jr. and Charles W. Pickering Sr.

“If this opinion stands, I think it will fundamentally alter the balance between the Senate and the president by limiting the president’s ability to keep offices filled,” said John P. Elwood, who handled recess appointment issues for the Justice Department during the Bush administration. “This is certainly a red-letter day in presidential appointment power.”

The ruling, if not overturned, could paralyze the National Labor Relations Board, an independent agency that oversees labor disputes, because it would lack a quorum without the three Obama appointments in January 2012.

The ruling’s immediate impact was to invalidate one action by the board involving a union fight with a Pepsi-Cola bottler in Washington State, but it raises the possibility that all the board’s decisions from the past year could be nullified. The decision also casts a legal cloud over Mr. Obama’s appointment that same day of Richard Cordray as the director of the Consumer Financial Protection Bureau.

A White House spokesman said, “We disagree strongly with the decision” by the United States Court of Appeals for the District of Columbia Circuit, adding that it conflicted with other court rulings and well over a century of government practice. Administration officials did not immediately say whether they would appeal the ruling or wait for other appeals courts to issue decisions in similar lawsuits filed across the country challenging other labor board actions.

The three judges on the appeals court panel, all of them appointed by Republicans, rejected the Justice Department’s argument that Mr. Obama could make the labor board appointments by declaring the Senate’s pro forma sessions during its winter break — in which a single senator came into the empty chamber every three days to bang the gavel — a sham. The Republican-controlled House of Representatives had refused to let the Democratic-controlled Senate adjourn for more than three days.

“An interpretation of ‘the Recess’ that permits the President to decide when the Senate is in recess would demolish the checks and balances inherent in the advice-and-consent requirement, giving the President free rein to appoint his desired nominees at any time he pleases, whether that time be a weekend, lunch, or even when the Senate is in session and he is merely displeased with its inaction,” wrote Judge David B. Sentelle. “This cannot be the law.”

The panel went on to significantly narrow the definition of “recess,” for purposes of the president’s appointment power. The judges held that presidents may invoke their recess appointment power only between formal sessions of Congress – a brief period that usually arises only once a year – rather than during breaks that arise during a session, like lawmakers’ annual August vacations. Two of the three judges also ruled that the president may also only use that power to fill a vacancy that opens during the same recess.

The ruling also called into question nearly 200 years of previous such appointments by administrations across the political spectrum. The executive branch has been making intrasession appointments since 1867 and has been using recess appointments to fill vacancies that opened before a recess since 1823. Among other things, Mr. Elwood noted, it called into question every ruling made by several federal appeals court judges who were installed by recess power.

“You know there are people sitting in prisons around the country who will become very excited when they learn of this ruling,” he said.

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American Mumbai Plotter Sentenced to 35 Years

CHICAGO (AP) — Minutes before an American was sentenced to 35 years in prison for helping plan an attack on Mumbai, India, one of his victims tearfully pleaded for a harsh punishment despite the terrorist plotter's widespread cooperation with U.S. investigators following his arrest.

David Coleman Headley, 52, shifted uncomfortably in a gray tracksuit and kept his eyes fixed on the Chicago courtroom floor Thursday as he listened to the American children's author describe the violent chaos during her 2008 vacation to India.

Bullets flew past her check and panicked diners dived under tables as gunmen burst into a hotel restaurant, then walked around executing people one by one, recalled Linda Ragsdale, at times almost shouting as she stood just a few feet from Headley during the sentencing hearing.

"I know the sweet sickening smell of gunfire and blood," said Ragsdale, 53, of Nashville, Tenn., who was shot through the chest — the bullet passing along her spine and then out her thigh. "I know what a bullet can do to every part of the human body ... These are things I never needed to know, never needed to experience."

She did not comment after the judge imposed the sentence, but others victimized by the attack that has been called India's 9/11 said they were disturbed and upset Headley did not get the maximum life sentence he faced. With credit for good behavior, he could walk out of prison before he turns 80.

"He lost his right to live life as a free man. He doesn't deserve to be let out. He gave up that right when he played a role in the attack," said Kia Scherr, whose husband Alan Scherr and 13-year-old daughter, Naomi, were at the same table as Ragsdale and died.

It was prosecutors who pressed for leniency, saying they wanted Headley to get no more than 35 years as credit for his almost immediate cooperation after his 2009 arrest and providing intelligence about terror networks, including the Pakistani-based group that mounted the attack. Rewarding Headley with the hope of at least a few years of freedom, the said, would encourage future suspects in terrorist cases to spill their secrets.

A somber Judge Harry Leinenweber sounded reluctant about imposing the lesser sentence, saying the Mumbai assault was so unfathomable and terrifying that, "perhaps the lucky ones were the ones who didn't survive."

"I don't have any faith in Mr. Headley when he says he's a changed person and believes in the American way of life," he said.

Ragsdale, the only victim to address the court during Thursday's hearing, also read a text message from Kia Scherr to the judge, in which Scherr implored the court not to give Headley less than life in prison and asserting that anything less "would be an appalling dishonor."

The attack heightened the strain in a historically antagonistic relationship between India and Pakistan, which have fought three major wars. Indian officials accuse Pakistani intelligence of helping to plan the assault — an allegation Pakistan denies.

It was Headley's meticulous scouting missions that helped make the assault by 10 gunmen from a Pakistani-based militant group on multiple targets in Mumbai so deadly. TV cameras captured much of the three-day rampage that including multiple targets, including the landmark Taj Mahal Hotel.

Ragsdale painted a detailed picture of the gory scene as she huddled under the table with Scherr's husband Alan and her daughter, Naomi. After the initial gunfire, they were all still alive, and she said she would have thrown her body across the teen to shield her.

"That moment still haunts me," she said, crying, as she looked straight at Headley. She said she passed out from her injuries under the table and "awoke to hear Naomi take her last breath."

Headley showed no emotion when the sentence was announced. Earlier, when the judge asked if him if he wanted to address the court, he leaned forward and said politely, "No your honor, I expressed everything in the letter I wrote you."

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AT&T Fourth-Quarter Earnings Hurt by Pensions and Storm

Over the holiday season, AT&T sold a record number of smartphones. But its quarterly earnings took a hit from pension costs and Hurricane Sandy.

On Thursday, AT&T reported a loss in the fourth quarter of $3.9 billion, or 68 cents a share, up from a loss of $6.7 billion, or $1.12 a share, from the same quarter a year earlier.

The company said revenue was essentially flat at $32.6 billion.

Its adjusted per-share earnings were 44 cents a share, excluding pension costs, the impact of Hurricane Sandy and the sale of its advertising units. Wall Street analysts had expected 45 cents a share on earnings of $32.2 billion, according to Thomson Reuters.

“We had an excellent 2012,” said Randall Stephenson, AT&T’s chief executive, in a statement. “Looking ahead, our key growth platforms — mobile data, U-verse and strategic business services — all have good momentum with a lot of headroom,” Mr. Stephenson added.

The company, based in Dallas, said that it sold 10.2 million smartphones over the quarter, the most ever sold by any American carrier. A majority of those smartphones were iPhones: AT&T sold 8.6 million iPhones, in contrast with Verizon’s 6.2 million iPhones. AT&T, the second biggest carrier after Verizon Wireless, is in the process of a major network expansion. It said late last year that it would invest an extra $14 billion to expand its wireless and broadband services through 2015. It expects that its fourth-generation network technology, called LTE, will cover 300 million people by the end of next year.

Beyond making upgrades to its wireless network, AT&T has plans to offer new services that might create new revenue streams. In March, it will begin selling its new wireless home security system, Digital Life, which will allow people to use tablets or phones to monitor their homes from afar. If a burglar trips a motion sensor in the house, for example, a user can receive a text message, then call the police. Ralph de la Vega, chief executive of AT&T Mobility, has said that he believes home security will be a big opportunity to increase revenue, because only 20 percent of American homes have security systems, leaving millions of homeowners as potential buyers.

This article has been revised to reflect the following correction:

Correction: January 24, 2013

An earlier version of this article published online misstated the expectation of Wall Street analysts for AT&T’s quarterly per-share earnings. It was 45 cents, not 48 cents.

Read More..

The New Old Age Blog: Grief Over New Depression Diagnosis

When the American Psychiatric Association unveils a proposed new version of its Diagnostic and Statistical Manual of Mental Disorders, the bible of psychiatric diagnoses, it expects controversy. Illnesses get added or deleted, acquire new definitions or lists of symptoms. Everyone from advocacy groups to insurance companies to litigators — all have an interest in what’s defined as mental illness — pays close attention. Invariably, complaints ensue.

“We asked for commentary,” said David Kupfer, the University of Pittsburgh psychiatrist who has spent six years as chairman of the task force that is updating the handbook. He sounded unruffled. “We asked for it and we got it. This was not going to be done in a dark room somewhere.”

But the D.S.M. 5, to be published in May, has generated an unusual amount of heat. Two changes, in particular, could have considerable impact on older people and their families.

First, the new volume revises some of the criteria for major depressive disorder. The D.S.M. IV (among other changes, the new manual swaps Roman numerals for Arabic ones) set out a list of symptoms that over a two-week period would trigger a diagnosis of major depression: either feelings of sadness or emptiness, or a loss of interest or pleasure in most daily activities, plus sleep disturbances, weight loss, fatigue, distraction or other problems, to the extent that they impair someone’s functioning.

Traditionally, depression has been underdiagnosed in older adults. When people’s health suffers and they lose friends and loved ones, the sentiment went, why wouldn’t they be depressed? A few decades back, Dr. Kupfer said, “what was striking to me was the lack of anyone getting a depression diagnosis, because that was ‘normal aging.’” We don’t find depression in old age normal any longer.

But critics of the D.S.M. 5 now argue that depression may become overdiagnosed, because this version removes the so-called “bereavement exclusion.” That was a paragraph that cautioned against diagnosing depression in someone for at least two months after loss of a loved one, unless that patient had severe symptoms like suicidal thoughts.

Without that exception, you could be diagnosed with this disorder if you are feeling empty, listless or distracted, a month after your parent or spouse dies.

“D.S.M. 5 is medicalizing the expected and probably necessary process of mourning that people go through,” said Allen Frances, a professor emeritus at Duke who chaired the D.S.M. IV task force and has denounced several of the changes in the new edition. “Most people get better with time and natural healing and resilience.”

If they are diagnosed with major depression before that can happen, he fears, they will be given antidepressants they may not need. “It gives the drug companies the right to peddle pills for grief,” he said.

An advisory committee to the Association for Death Education and Counseling also argued that bereaved people “will receive antidepressant medication because it is cheaper and ‘easier’ to medicate than to be involved therapeutically,” and noted that antidepressants, like all medications, have side effects.

“I can’t help but see this as a broad overreach by the APA,” Eric Widera, a geriatrician at the University of California, San Francisco, wrote on the GeriPal blog. “Grief is not a disorder and should be considered normal even if it is accompanied by some of the same symptoms seen in depression.”

But Dr. Kupfer said the panel worried that with the exclusion, too many cases of depression could be overlooked and go untreated. “If these things go on and get worse over time and begin to impair someone’s day to day function, we don’t want to use the excuse, ‘It’s bereavement — they’ll get over it,’” he said.

The new entry for major depressive disorder will include a note — the wording isn’t final — pointing out that while grief may be “understandable or appropriate” after a loss, professionals should also consider the possibility of a major depressive episode. Making that distinction, Dr. Kupfer said, will require “good solid clinical judgment.”

Initial field trials testing the reliability of D.S.M. 5 diagnoses, recently published in The American Journal of Psychiatry, don’t bolster confidence, however. An editorial remarked that “the end results are mixed, with both positive and disappointing findings.” Major depressive disorder, for instance, showed “questionable reliability.”

In an upcoming post, I’ll talk more about how patients might respond to the D.S.M. 5, and to a new diagnosis that might also affect a lot of older people — mild neurocognitive disorder.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

---

This post has been revised to reflect the following correction:

Correction: January 24, 2013

An earlier version of this post misspelled the surname of a professor emeritus at Duke who chaired the D.S.M. IV task force. He is Allen Frances, not Francis.

Read More..

The New Old Age Blog: Grief Over New Depression Diagnosis

When the American Psychiatric Association unveils a proposed new version of its Diagnostic and Statistical Manual of Mental Disorders, the bible of psychiatric diagnoses, it expects controversy. Illnesses get added or deleted, acquire new definitions or lists of symptoms. Everyone from advocacy groups to insurance companies to litigators — all have an interest in what’s defined as mental illness — pays close attention. Invariably, complaints ensue.

“We asked for commentary,” said David Kupfer, the University of Pittsburgh psychiatrist who has spent six years as chairman of the task force that is updating the handbook. He sounded unruffled. “We asked for it and we got it. This was not going to be done in a dark room somewhere.”

But the D.S.M. 5, to be published in May, has generated an unusual amount of heat. Two changes, in particular, could have considerable impact on older people and their families.

First, the new volume revises some of the criteria for major depressive disorder. The D.S.M. IV (among other changes, the new manual swaps Roman numerals for Arabic ones) set out a list of symptoms that over a two-week period would trigger a diagnosis of major depression: either feelings of sadness or emptiness, or a loss of interest or pleasure in most daily activities, plus sleep disturbances, weight loss, fatigue, distraction or other problems, to the extent that they impair someone’s functioning.

Traditionally, depression has been underdiagnosed in older adults. When people’s health suffers and they lose friends and loved ones, the sentiment went, why wouldn’t they be depressed? A few decades back, Dr. Kupfer said, “what was striking to me was the lack of anyone getting a depression diagnosis, because that was ‘normal aging.’” We don’t find depression in old age normal any longer.

But critics of the D.S.M. 5 now argue that depression may become overdiagnosed, because this version removes the so-called “bereavement exclusion.” That was a paragraph that cautioned against diagnosing depression in someone for at least two months after loss of a loved one, unless that patient had severe symptoms like suicidal thoughts.

Without that exception, you could be diagnosed with this disorder if you are feeling empty, listless or distracted, a month after your parent or spouse dies.

“D.S.M. 5 is medicalizing the expected and probably necessary process of mourning that people go through,” said Allen Frances, a professor emeritus at Duke who chaired the D.S.M. IV task force and has denounced several of the changes in the new edition. “Most people get better with time and natural healing and resilience.”

If they are diagnosed with major depression before that can happen, he fears, they will be given antidepressants they may not need. “It gives the drug companies the right to peddle pills for grief,” he said.

An advisory committee to the Association for Death Education and Counseling also argued that bereaved people “will receive antidepressant medication because it is cheaper and ‘easier’ to medicate than to be involved therapeutically,” and noted that antidepressants, like all medications, have side effects.

“I can’t help but see this as a broad overreach by the APA,” Eric Widera, a geriatrician at the University of California, San Francisco, wrote on the GeriPal blog. “Grief is not a disorder and should be considered normal even if it is accompanied by some of the same symptoms seen in depression.”

But Dr. Kupfer said the panel worried that with the exclusion, too many cases of depression could be overlooked and go untreated. “If these things go on and get worse over time and begin to impair someone’s day to day function, we don’t want to use the excuse, ‘It’s bereavement — they’ll get over it,’” he said.

The new entry for major depressive disorder will include a note — the wording isn’t final — pointing out that while grief may be “understandable or appropriate” after a loss, professionals should also consider the possibility of a major depressive episode. Making that distinction, Dr. Kupfer said, will require “good solid clinical judgment.”

Initial field trials testing the reliability of D.S.M. 5 diagnoses, recently published in The American Journal of Psychiatry, don’t bolster confidence, however. An editorial remarked that “the end results are mixed, with both positive and disappointing findings.” Major depressive disorder, for instance, showed “questionable reliability.”

In an upcoming post, I’ll talk more about how patients might respond to the D.S.M. 5, and to a new diagnosis that might also affect a lot of older people — mild neurocognitive disorder.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

---

This post has been revised to reflect the following correction:

Correction: January 24, 2013

An earlier version of this post misspelled the surname of a professor emeritus at Duke who chaired the D.S.M. IV task force. He is Allen Frances, not Francis.

Read More..

AT&T Fourth-Quarter Earnings Hurt by Pensions and Storm

Over the holiday season, AT&T sold a record number of smartphones. But its quarterly earnings took a hit from pension costs and Hurricane Sandy.

On Thursday, AT&T reported a loss in the fourth quarter of $3.9 billion, or 68 cents a share, up from a loss of $6.7 billion, or $1.12 a share, from the same quarter a year earlier.

The company said revenue was essentially flat at $32.6 billion.

Its adjusted per-share earnings were 44 cents a share, excluding pension costs, the impact of Hurricane Sandy and the sale of its advertising units. Wall Street analysts had expected 45 cents a share on earnings of $32.2 billion, according to Thomson Reuters.

“We had an excellent 2012,” said Randall Stephenson, AT&T’s chief executive, in a statement. “Looking ahead, our key growth platforms — mobile data, U-verse and strategic business services — all have good momentum with a lot of headroom,” Mr. Stephenson added.

The company, based in Dallas, said that it sold 10.2 million smartphones over the quarter, the most ever sold by any American carrier. A majority of those smartphones were iPhones: AT&T sold 8.6 million iPhones, in contrast with Verizon’s 6.2 million iPhones. AT&T, the second biggest carrier after Verizon Wireless, is in the process of a major network expansion. It said late last year that it would invest an extra $14 billion to expand its wireless and broadband services through 2015. It expects that its fourth-generation network technology, called LTE, will cover 300 million people by the end of next year.

Beyond making upgrades to its wireless network, AT&T has plans to offer new services that might create new revenue streams. In March, it will begin selling its new wireless home security system, Digital Life, which will allow people to use tablets or phones to monitor their homes from afar. If a burglar trips a motion sensor in the house, for example, a user can receive a text message, then call the police. Ralph de la Vega, chief executive of AT&T Mobility, has said that he believes home security will be a big opportunity to increase revenue, because only 20 percent of American homes have security systems, leaving millions of homeowners as potential buyers.

This article has been revised to reflect the following correction:

Correction: January 24, 2013

An earlier version of this article published online misstated the expectation of Wall Street analysts for AT&T’s quarterly per-share earnings. It was 45 cents, not 48 cents.

Read More..

The Lede Blog: Clinton Testifies on Benghazi Attacks

The Lede followed Secretary of State Hillary Rodham Clinton’s testimony Wednesday before the House Foreign Affairs Committee and Senate Foreign Relations Committee about the Sept. 11, 2012, attacks on the American Consulate in the eastern city of Benghazi, Libya, that killed Ambassador Chris Stevens and three other Americans.

At a House Committee hearing last October investigating the attack, as reported on The Lede, State Department officials and security experts who served on the ground offered conflicting assessments about what resources were requested and made available to deal with growing security concerns in Tripoli and Benghazi.

Mrs. Clinton had been scheduled to testify before Congress last month, but an illness, a concussion and a blood clot near her brain forced her to postpone her appearance.

As our colleagues Michael R. Gordon and Eric Schmitt reported, four State Department officials were removed from their posts on last month after an independent panel criticized the “grossly inadequate” security at a diplomatic compound in Benghazi.

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Gadgetwise Blog: A New Kind of Holster for iPhone

Unless you carry a Bushmaster Adaptive Combat Rifle around, the Sector 5 Black Ops iPhone cover from Element Case is likely to be the most polarizing accessory you own.

The case is made from a resin called G10 and designed by a company best known for its premium handgun grips, VZ Grips.

The back of the case bears a checkering pattern common to handguns, and it has a rim of machined aluminum that is anodized with a nonreflective coating.

They even throw in a back knurled power button and “tactical holster” for affixing your phone to your belt.

Like many Element Case products, the cost is high: $200. Element Case has made a business of creating expensive covers from premium and exotic materials, like its $200 Ronin case made with a bumper of resin-impregnated wood.

The weaponized iPhone case certainly courts controversy, but thanks to the remarkably grippy pattern on the Black Ops model, you may not give it up until they pry it from you cold, dead hands.

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.”

Read More..