Midwives support strike action








By James Gallagher
Health editor, BBC News website


Mum, baby and widwife


Midwives in England say they are prepared to take industrial action over pay.

More than 94% of midwives and maternity support workers taking part in a consultation said they would consider strike action.

The Royal College of Midwives (RCM) said there was a palpable “sense of anger and frustration” among members.

The RCM will now decide whether to formally ballot members on industrial action.

The NHS Pay Review Body had recommended a 1% pay rise for all staff.

In March, ministers announced a basic 1% pay rise, but added that staff receiving automatic “progression-in-job” increases would not get the 1% as well.

The RCM argue this does not meet the increasing cost of living and say the pay deal amounts to a pay cut.

Cathy Warwick, the chief executive of the RCM, said: “We knew midwives were angry about the derisory offer from the Government, but this response from our members highlights just how unfairly they have been treated.

“Such an unprecedented response with such a large number willing to consider action should ring alarm bells with the Government.

“Midwives and other health workers are seeing their pay falling in real terms as their pay stagnates, pension contributions increase and the cost of living rises.”

The Department of Health said it was “disappointed” and urged unions to “put patients first”.

A spokesperson said: “NHS staff are our greatest asset and we know that midwives across the country are working hard.

“That’s why they should receive at least one per cent additional pay this year and next.

“Since May 2010, there are 1,700 more midwives helping expectant mothers and we want to protect these increases.

“We cannot afford a general pay rise on top of incremental pay increases without risking the loss of frontline NHS jobs.”

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Older sperm donors 'just as good'








By James Gallagher
Health editor, BBC News online


Sperm


Women should not worry about using sperm from older donors as the success rate is the same as using a younger man’s sperm, researchers say.

The average age of donors has risen in the UK since the right to anonymity was removed in 2005.

Doctors said there was concern about the impact on the odds of a pregnancy.

Experts said only older men with the best sperm could donate, so men as a whole should not see the results as an excuse to delay fatherhood.

A presentation at the European Society of Human Reproduction and Embryology annual conference showed the average age of donors was 26 before the law change and 34 afterwards.

“It is a huge difference,” said Dr Meenakshi Choudhary from the Newcastle Fertility Centre.

“It may concern women, who are already older, who know their chances are lower, that if they go for an older sperm then their chance of a live birth will be further reduced and compromised.”


Sperm

She analysed data from 39,282 cycles of IVF between 1991 and 2012, concluding that older men had the same success rates as younger men.

Dr Meenakshi Choudhary told the BBC: “It doesn’t matter up to the age of 45 years, there was no decline observed in this study.

“Sperm donors are a select group of the population, they are healthy fertile donors who go through a stringent recruitment criteria.

“Based on this we can say that age does not matter as long as the sperm quality is good.”


‘Men not invincible’

Dr Allan Pacey, a senior lecturer in sperm at the University of Sheffield, said men should not be tempted by complacency.

He told the BBC: “I think there is a perception out there that men are invincible from reproductive ageing – we just need to look at Charlie Chaplin who was 73 when he had his eleventh child.

“We know that as men go above the age of 40 and go into their fifties, their chances of getting a woman pregnant does reduce as a consequence of age.

“I don’t think you can take this data and apply it uncritically to the general population, the advice would still be you should be trying to have a child before the age of 40 or 45.”

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'Supercooling' keeps organs fresh








By James Gallagher
Health editor, BBC News online


A 'supercooled' rat liverScientists have tested the technique on rats’ livers


A new technique can preserve organs for days before transplanting them, US researchers claim.

“Supercooling” combines chilling the organ and pumping nutrients and oxygen through its blood vessels.

Tests on animals, reported in the journal Nature Medicine, showed supercooled livers remained viable for three days, compared with less than 24 hours using current technology.

If it works on human organs, it has the potential to transform organ donation.

As soon as an organ is removed from the body, the individual cells it is made from begin to die.

Cooling helps slow the process as it reduces the metabolic rate of the cells.

Meanwhile, surgeons in the UK carried out the first “warm liver” transplant in March 2013 which used an organ kept at body temperature in a machine.

The technique being reported first hooks the organ up to a machine which perfuses the organ with nutrients.

It is then cooled to minus 6C.


Supercool

In experiments on rat livers, the organs could be preserved for three days.

One of the researchers, Dr Korkut Uygun, from the Harvard Medical School, told the BBC the technique could lead to donated organs being shared around the world.

“That would lead to better donor matching, which would reduce-long term organ rejection and complications, which is one of the major issues in organ transplant,” he said.

He also argued that organs which are normally rejected, as they would not survive to the transplant table, might be suitable if they were preserved by supercooling.

“That could basically eliminate waiting for a organ, but that is hugely optimistic,” Dr Uygun said.

Further experiments are now needed to see if the technology can be scaled up from preserving a 10g (0.35oz) rat liver to a 1.5kg (3.3lb) human liver.

The researchers believe the technology could work on other organs as well.

Dr Rosemarie Hunziker, from the US National Institute of Biomedical Imaging and Bioengineering, said: “It is exciting to see such an achievement in small animals by recombining and optimising existing technology.

“The longer we are able to store donated organs, the better the chance the patient will find the best match possible, with both doctors and patients fully prepared for surgery.

“This is a critically important step in advancing the practice of organ storage for transplantation.”

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UK facing 'major' sperm shortage








By James Gallagher
Health editor, BBC News online


Sperm


The UK is facing a major sperm shortage that may be tempting fertility clinics to accept poorer quality sperm, the British Fertility Society (BFS) warns.

Some clinics rely on imported sperm to keep up with demand.

However, the BFS chairman, Dr Allan Pacey, said he was “worried” that some clinics may be setting a lower bar to “get donors through the door”.

He said woman may be subjected to more invasive and expensive techniques if poor-quality sperm were used.

There are thought to have been fewer sperm donors after the right to anonymity was removed in 2005.

The demand for donors has been falling as advances in fertility treatment let more men father their own children.

However, a shortage of donors has still emerged.

Figures from the fertility regulator, the Human Fertilisation and Embryology Authority (HFEA), show nearly one in four donated sperm samples are from abroad.

The figure was one in 10 in 2005.

Sperm banks in Denmark and the US are the major suppliers.

Dr Pacey warned this was limiting patient choice and increasing waiting times, which led to potential risky practices, including DIY insemination with a friend’s sperm or seeking treatment in a country with less fertility regulation.


Sperm donorThe UK faces a sperm donor shortage

He told the BBC: “We do still have a major sperm shortage in the UK.

“The worry is clinics might decide to change the quality of sperm they are willing to accept in order to get donors through the door and I think that’s a very dangerous road to go down.”

He said one possible example was sperm being accepted that would be suitable only for injecting into an egg – intra-cytoplasmic sperm injection – rather than for artificial insemination.

“That is putting the woman through more procedures, in terms of eggs being collected, than would be done if sperm of higher quality was collected and she could be treated with a simple insemination.

“My worry is clinics may be tempted to bend the rules, I have no evidence that they are, but I think when we have a national sperm shortage they’re the kind of things we need to be looking for and warding against.”


‘Fully inform patients’

Professor Yakoub Khalaf, of the assisted conception unit at Guy’s Hospital in London, commented: “We are now more reliant on external sperm banks than ever before.

“I don’t think it is an issue as such, but what I have observed is that when people get sperm from abroad they can be given an option of ‘suitable for insemination’, or ‘suitable for IVF or ICSI’ [sperm injected to the egg].

“But how can donor sperm be less than adequate for all treatments?”

He said that based on his experience of the quality of imported sperm “the same could be happening here”.

A HFEA spokesperson said: “We expect our clinics to use only donor sperm of a quality that will ensure the best outcome for the patient, and under our code of practice clinics are required to fully inform patients of the different treatment options available to them.”

Have you donated to a fertility clinic in the past? Would you consider doing so in the future? If you are happy to speak to a BBC journalist, please email haveyoursay@bbc.co.uk with the word “fertility” in the subject heading.






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Pig virus shrinks March-May hog herd more than expected


(Reuters) – The U.S. hog herd shrank more than anticipated in the March-May quarter as a deadly pig virus swept through farms, a U.S. Department of Agriculture report showed on Friday.

The data also showed that despite higher hog prices in the wake of the deadly Porcine Epidemic Diarrhea virus (PEDv), producers had not expanded herds as much as expected, analysts said.

USDA’s data suggest hog numbers will remain tight through the rest of the year, sustaining already high prices for hogs and pork during the period, said analysts.

They added that Chicago Mercantile Exchange hog futures could climb as much as their 3-cents per lb daily price limit on Monday, based on Friday’s report.

The USDA report showed the U.S. hog herd as of June 1 at 95 percent of the year-ago level, at 62.128 million head. Analysts, on average, expected 63.200 million head, or 97.1 percent of the year-earlier herd. The U.S. hog herd for the same period last year was 65.188 million head.

The hog herd as of June 1 was the smallest for the period since the 61.701 million head in 2006.

The U.S. breeding herd was 100.0 percent of the year ago level, at 5.855 million head, compared with average trade expectations for 101.8 percent, or 5.990 million. A year ago the breeding herd was 5.884 million head.

“The report overall has a bullish slant because we thought high-priced hogs and cheap grain made producers profitable enough to expand herds, which was not the case,” said U.S. Commodities Inc analyst Don Roose.

Still, the ingredients are in place with respect to profitability to drive herd expansion in 2015, he said.

Ron Plain, a University of Missouri economist, attributed the unexpectedly restrained breeding herd result to possible reluctance by farmers to increase production given uncertainty about how to curb or control the virus spread.

Analysts estimated that 8 million pigs have died from PEDv since it was first detected in the country a year ago.

Dan Vaught, an economist with Doane Advisory Services, said producers may have diverted only a minimum number of young female pigs to the breeding herd rather then send them to slaughter.

The June 1 supply of market-ready hogs for sale to packers was 95 percent of a year earlier at 56.273 million head. Analysts, on average, expected a 3.2 percent decline, or 57.310 million. Last spring’s market hog supply was 59.304 million head.

The data showed 9.78 pigs per litter during the period, or 95.0 percent of the 10.31 in the year-ago period. Analysts expected an average 9.8 head.

“The pigs per litter figure indicates we’re continuing to struggle with PEDv, so that’s likely to keep inventories down and gives us a bullish outlook for the rest of this year,” said Plain.

(Reporting by Theopolis Waters; Editing by Dan Grebler and Richard Chang)

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Non-surgical gum disease treatment reduces thickness of wall of arteries

A simple non-surgical gum disease treatment markedly reduces the thickness of the wall of the arteries, a risk factor for heart disease, according to a first of its kind study among Aboriginal Australians.

The study findings may be of particular importance to Aboriginal Australians, who in general have poorer oral health and higher rates of cardiovascular disease.

Published in the latest issue of Hypertension, the study reports a significant decline in thickening of the wall of the carotid artery a year after a single session of gum treatment.

“The study shows that non-surgical periodontal therapy significantly reduced the progression of thickening of the carotid artery over a one-year period,” says study co-author, University of Sydney vascular disease expert Dr Michael Skilton.

“The magnitude of the reduction in thickening of the carotid artery in the treatment group, relative to the control group, is similar to what has been observed in other clinical trials in high risk populations.

“The effect is comparable to a 30 per cent fall in low-density lipoprotein cholesterol – commonly referred to as ‘bad’ cholesterol – which is associated with a decreased risk of heart disease.

“It’s also equivalent to the effects of reversing four years of aging, 8 kg/m2 lower body mass index, or 25 mm Hg lower systolic blood pressure.”

The study was prompted by conjecture about the causative relationship between periodontal (gum) disease and atherosclerotic vascular disease and is among the first using a randomised trial to investigate a periodontal intervention on atherosclerotic disease.

Periodontal disease is an inflammatory disease affecting the soft and hard structures that support the teeth. In its early stage, the gums become swollen and red due to inflammation, which is the body’s natural response to the presence of harmful bacteria.

In the more serious form of periodontal disease (periodontitis), the gums pull away from the tooth and supporting gum tissues are destroyed. Bone can be lost, and the teeth may loosen or eventually fall out.

Atherosclerosis is the most common cause of heart attacks, strokes, and peripheral vascular disease – collectively known as ‘cardiovascular disease’. It usually causes no symptoms until middle or older age but as narrowing and hardening of the arteries accelerates, they choke blood flow, causing pain and other serious cardiovascular complications.

Despite reducing thickening of the carotid artery, the study found no effect of periodontal therapy on arterial stiffness – another pre-clinical marker of atherosclerotic vascular disease and risk factor for cardiovascular disease.

“Future studies may tell us whether a more intensive approach to periodontal therapy, including regular periodontal maintenance schedules, can produce more marked improvements in vascular structure,” Dr Skilton says.

“The findings indicate that periodontal therapy has a systemic impact beyond treating gum disease.

“If further studies can confirm our report the treatment of periodontal disease may become reducing means by which to reduce the risk of cardiovascular disease, especially in high risk populations such as Indigenous Australians.”

Fast Facts – gum disease

  • Up to one in four adult Australians have moderate to severe periodontitis (gum disease)
  • Gum disease is twice as common in Aboriginal Australians as in non-Aboriginal Australians
  • Periodontitis is age related, with prevalence increasing from around three per cent in 18-24 year olds to about 60 per cent in those aged 75 years and older.
  • Periodontitis is more common in males (28 per cent) than females (20 per cent)
  • Several studies indicate that periodontal disease is connected to diseases such as heart disease, diabetes, and rheumatoid arthritis. Scientists believe that inflammation may be the basis for the link between these systemic diseases.

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Some cancer patients with aggressive tumors may benefit from anti-inflammatory drugs

New research raises the prospect that some cancer patients with aggressive tumors may benefit from a class of anti-inflammatory drugs used to treat rheumatoid arthritis.

Studying triple-negative breast cancer, researchers at Washington University School of Medicine in St. Louis found that some aggressive tumors rely on an antiviral pathway that appears to drive inflammation, widely recognized for roles in cancer, rheumatoid arthritis and other inflammatory diseases.

The tumors that activate this particular antiviral pathway always have dysfunctional forms of the proteins p53 and ARF, both encoded by genes known for being highly mutated in various cancers. The investigators found that the two genes compensate for each other. If both are mutated, the tumors that form are more aggressive than if only one of these genes is lost.

When both genes are lost and the antiviral pathway is activated, patients may benefit from a class of anti-inflammatory drugs called JAK inhibitors, currently prescribed for rheumatoid arthritis.

The investigators report their findings in a recent issue of the journal Cell Reports.

Until now, even though ARF was known to be expressed in some tumors with mutated p53, ARF largely was thought to be nonfunctional in this scenario. But the investigators showed that in the absence of p53, ARF actually protects against even more aggressive tumor formation.

“It’s probably inaccurate to say that ARF completely replaces p53, which is a robust tumor suppressor with multiple ways of working,” said senior author Jason D. Weber, PhD, associate professor of medicine. “But it appears the cell has set up a sort of backup system with ARF. It’s not surprising that these are the two most highly mutated tumor suppressors in cancer. Because they’re backing one another up, the most aggressive tumors form when you lose both.”

Weber and his colleagues studied triple-negative breast cancer because these tumors often show mutations in both p53 and ARF. Triple-negative breast tumors are treated with surgery, chemotherapy and radiation since targeted therapies commonly used against hormone-driven breast cancers are not effective.

In a finding Weber called surprising, the researchers showed that most triple-negative tumors lacking p53 and ARF turn on a pathway involved in the innate immune response to viral infection.

“It’s not the level of activation you would see in a true antiviral response, but it’s higher than normal,” Weber said. “We are interested in studying whether this antiviral response is creating a local environment of inflammation that supports more aggressive tumors.”

Weber and his colleagues knew that a signaling protein family known as JAK is upstream of the antiviral pathway they showed to be driving tumor growth.

“There are JAK inhibitors in use for rheumatoid arthritis and being tested against a number of other conditions,” Weber said. “Our data suggest that these anti-inflammatory drugs may be a way to treat some patients missing both p53 and ARF.”

The drugs potentially could benefit patients in whom both genes are lost, Weber added. If either p53 or ARF is present, this antiviral pathway is not active and therefore not playing a role in driving tumor growth.

Weber and his team are collaborating with specialists in lung, breast and pancreatic cancer to identify patients with mutations in both genes and to find out whether such patients might benefit from JAK inhibitors.

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Some aggressive cancers may respond to anti-inflammatory drugs

New research raises the prospect that some cancer patients with aggressive tumors may benefit from a class of anti-inflammatory drugs used to treat rheumatoid arthritis.

Studying triple-negative breast cancer, researchers at Washington University School of Medicine in St. Louis found that some aggressive tumors rely on an antiviral pathway that appears to drive inflammation, widely recognized for roles in cancer, rheumatoid arthritis and other inflammatory diseases.

The tumors that activate this particular antiviral pathway always have dysfunctional forms of the proteins p53 and ARF, both encoded by genes known for being highly mutated in various cancers. The investigators found that the two genes compensate for each other. If both are mutated, the tumors that form are more aggressive than if only one of these genes is lost.

When both genes are lost and the antiviral pathway is activated, patients may benefit from a class of anti-inflammatory drugs called JAK inhibitors, currently prescribed for rheumatoid arthritis.

The investigators report their findings in a recent issue of the journal Cell Reports.

Until now, even though ARF was known to be expressed in some tumors with mutated p53, ARF largely was thought to be nonfunctional in this scenario. But the investigators showed that in the absence of p53, ARF actually protects against even more aggressive tumor formation.

“It’s probably inaccurate to say that ARF completely replaces p53, which is a robust tumor suppressor with multiple ways of working,” said senior author Jason D. Weber, PhD, associate professor of medicine. “But it appears the cell has set up a sort of backup system with ARF. It’s not surprising that these are the two most highly mutated tumor suppressors in cancer. Because they’re backing one another up, the most aggressive tumors form when you lose both.”

Weber and his colleagues studied triple-negative breast cancer because these tumors often show mutations in both p53 and ARF. Triple-negative breast tumors are treated with surgery, chemotherapy and radiation since targeted therapies commonly used against hormone-driven breast cancers are not effective.

In a finding Weber called surprising, the researchers showed that most triple-negative tumors lacking p53 and ARF turn on a pathway involved in the innate immune response to viral infection.

“It’s not the level of activation you would see in a true antiviral response, but it’s higher than normal,” Weber said. “We are interested in studying whether this antiviral response is creating a local environment of inflammation that supports more aggressive tumors.”

Weber and his colleagues knew that a signaling protein family known as JAK is upstream of the antiviral pathway they showed to be driving tumor growth.

“There are JAK inhibitors in use for rheumatoid arthritis and being tested against a number of other conditions,” Weber said. “Our data suggest that these anti-inflammatory drugs may be a way to treat some patients missing both p53 and ARF.”

The drugs potentially could benefit patients in whom both genes are lost, Weber added. If either p53 or ARF is present, this antiviral pathway is not active and therefore not playing a role in driving tumor growth.

Weber and his team are collaborating with specialists in lung, breast and pancreatic cancer to identify patients with mutations in both genes and to find out whether such patients might benefit from JAK inhibitors.

Story Source:

The above story is based on materials provided by Washington University in St. Louis. The original article was written by Julia Evangelou Strait. Note: Materials may be edited for content and length.

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U.S. appeals court blocks lawsuits over Darvon, Darvocet painkillers


(Reuters) – A federal appeals court on Friday upheld the dismissal of nearly all claims in 68 cases seeking to hold drug makers liable for injuries from the use of the prescription painkillers Darvon and Darvocet, which were pulled from the U.S. market in 2010.

The plaintiffs, who used generic versions of the drugs, had invoked design defect laws in 22 U.S. states in claiming that generic drug makers misbranded the drugs. Many also sought to hold brand-name drug makers liable for alleged misrepresentations made to prescribing doctors.

A three-judge panel of the 6th U.S. Circuit Court of Appeals in Cincinnati rejected claims in 67 of the cases. One lawsuit, by a Mississippi woman who said her husband’s use of the drugs led to cardiac failure, was allowed to proceed.

Friday’s decision largely upheld rulings by U.S. District Judge Danny Reeves in Lexington, Kentucky, who oversees nationwide litigation over the drug propoxyphene, including Darvon and Darvocet.

Among the defendants in the various cases were Eli Lilly & Co, which won regulatory approval for Darvon in 1957 and Darvocet in 1972, and generic drug makers such as Mylan Inc and Teva Pharmaceutical Industries Ltd.

Louis Bograd, a lawyer at the Center for Constitutional Litigation who argued the plaintiffs’ appeals, said: “We are disappointed in the panel decision, and are considering our options.”

Lilly, in a statement, said it was pleased with the 6th Circuit’s “expansive decision.” Jay Lefkowitz, a partner at Kirkland & Ellis representing the generic drug makers, did not immediately respond to requests for comment.

The U.S. Food and Drug Administration in 2010 halted sales of products containing propoxyphene after a study by Xanodyne Pharmaceuticals Inc, which then held the rights to sell brand-name versions, suggested they might be linked to heart rhythm abnormalities.

Lawsuits ensued, but the plaintiffs suffered setbacks when the U.S. Supreme Court, in 2011 and 2013, shielded generic drug makers from state “failure-to-warn” claims and from state “design defect” claims that depended on the adequacy of a drug’s warnings.

In Friday’s decision, Circuit Judge Richard Suhrheinrich said the plaintiffs could not pursue misbranding claims against generic drug makers over propoxyphene, having failed to allege sufficient “new and scientifically significant information that was not before the FDA.”

He also said misrepresentation claims against the brand-name drug makers must be dismissed because courts in the 22 states would not recognize such claims under their respective laws.

The case is In re: Darvocet, Darvon, and Propoxyphene Products Liability Litigation, 6th U.S. Circuit Court of Appeals, No. 12-5368.

(Reporting by Jonathan Stempel in New York; editing by Matthew Lewis)

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New Jersey may be first state to ban smoking on beaches, in parks


Women smoke at an Independence Day party in Union Beach, New Jersey in a July 3, 2013 file photo. REUTERS/Eric Thaye/files


Women smoke at an Independence Day party in Union Beach, New Jersey in a July 3, 2013 file photo.

Credit: Reuters/Eric Thaye/files


(Reuters) – New Jersey could become the first state in the nation to ban cigarettes, cigars and other tobacco products in all public parks and beaches if Governor Chris Christie signs into law a sweeping anti-smoking bill approved by lawmakers.

The bill passed both houses of the New Jersey legislature with strong bipartisan support and was sitting on Chistie’s desk on Friday but the Republican presidential hopeful would not indicate his intentions.

The legislation would completely prohibit smoking inside all state, county and municipal parks. Public beaches would also be smoke-free, though local officials can opt to save 15 percent of beach land as a designated smoking section.

“This is definitely groundbreaking,” said Karen Blumenfeld, the executive director of Global Advisors on Smokefree Policy, a proponent of the New Jersey bill.

“We would be the first state to impose such a wide ban in all public outdoor spaces and the legislation will continue the trend of New Jersey being a model for other jurisdictions’ anti-smoking policies,” she said.

Smoking is the leading cause of preventable death in the United States, and second-hand smoke exposure has been linked to asthma, lung cancer, and stroke, according to the Centers for Disease Control and Prevention.

Supporters say the ban will allow New Jersey residents and visitors to enjoy parks and beaches without the distraction of wafting cigarette smoke and would drastically reduce litter, fire risks and children’s exposure to smoking.

“No one needs to sit in an ashtray when ?enjoying the beach,” state Senator Joseph Vitale, a sponsor of the bill, told local media.

Blumenfeld said the measure has a “critical mass” of support in the state. But some residents said the measure would trample on personal liberties.

“I don’t think the government needs to be involved,” said Bryan Adamson, 32, of Blairstown. “As a smoker I use common sense and respect for the environment and those around me,” he said.

Others said it was time to put an end to the outdoors as a last sanctuary for those who choose to light up.

“Even when I smoked and was on the beach next to a smoker I would be frustrated because frankly I don’t want to be stuck around it if I don’t have to be,” said Lauren DiGenova, 26, of Waldwick.

New Jersey has some of the strictest anti-smoking policies in the country. It was the first state to prohibit smoking in college dormitories in 2005, Blumenfeld said. A year later, Trenton banned indoor smoking in bars and restaurants.

More than 200 New Jersey cities, towns and boroughs have already passed their own restrictions on cigarette and tobacco use in parks and beaches. The legislation would cover outdoor public spaces across the state.

Offenders would face a $250 fine for the first offense, $500 for the second and $1,000 for each additional citation.

Christie’s office would not say where the governor stood on the bill.

(Reporting by Victoria Cavaliere; Editing by Peter Galloway)

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