cotinine

Seven facts for life insurers to know about vaping

by ExamOne on September 17, 2019

Is vaping impacting an individual’s health and the corresponding effect on life insurance?

Recently, the Centers for Disease Control and Prevention (CDC) announced their investigation of severe pulmonary disease among people who use e-cigarettes (also known as vaping). And tragically, multiple deaths linked to vaping have been reported across the country. These are a few examples of issues surfacing that may have previously gone unrecognized, as vaping is still a fairly new phenomenon. However, there are some things we know for sure about vaping that could impact life insurers.

Here are some vaping facts from MD Anderson Cancer Center:


 1. The liquids used in vaping are dangerous. E-cigarettes have been known to explode and the fluid is poisonous if it comes into contact with eyes or skin, or if you accidentally or deliberately drink it.


2. If you’re a smoker, vaping could support your habit, not break it. Instead of transitioning from cigarettes to e-cigarettes, some smokers end up using both. This can increase nicotine addiction instead of lessening it. E-cigarettes have not received Food and Drug Administration approval as smoking cessation devices.


3. Researchers know that e-cigarette aerosol contains toxic chemicals like those found in glue and paint. What is less clear is if the amounts are high enough to cause diseases like cancer.


4. The nicotine, regardless of the source, is addictive and toxic. E-cigarettes are used as a nicotine delivery system. In fact, nicotine is one of the most addictive substances available.

Other vaping facts for insurers to consider:


5. Nicotine is proven to cause multiple health problems, some fatal. John Hopkins Medicine reiterates the danger of nicotine, no matter in what form it is ingested. It can raise blood pressure and cause spikes in adrenaline, which increases the heart rate and the likelihood of having a heart attack.


6. E-cigarettes can also be used to vaporize cannabis and THC, with unknown long-term effects. The relationship between nicotine and cotinine has been thoroughly researched and analyzed over the years. However, information on the effects of cannabinoids is not as scientifically vetted.


7. There are also potentially toxic metal nanoparticles in some e-cig devices that can be harmful. A National Institute of Drug Abuse report shows that some devices contain high levels of nickel and chromium.

Laboratory testing and vaping

Another fact that we can all agree upon is that more research is needed to determine how vaping impacts an individual’s health and the corresponding effect for life insurers. The negative health consequences from long-term tobacco use and smoking either cigarettes or cigars took decades to prove. Extensive health data for vaping does not exist yet. In the meantime, ExamOne will continue to work with our life insurance clients to help build comprehensive cotinine and THC laboratory testing solutions to address their requirements concerning vaping.

cigarette and marijuana smoking

Smoking raises red flags for insurers across the board – applicants are usually rated if they produce a positive cotinine test. Further, tobacco use can lead to the potential onset of additional health risks, such as cancer, heart disease, stroke, diabetes and/or lung diseases. Aside from these health concerns, studies show a correlation of tobacco use and marijuana use. Statistics also reveal an increased risk of positivity for other drugs of abuse.

The likelihood of a tobacco user testing positive for marijuana

Our data scientist, Brian Lanzrath, extracted a sample of ExamOne applicant data to identify what, if any, correlation exists between the use of tobacco and marijuana. From 2017-2018, nearly 6.6% of ExamOne life insurance applicants tested positive for cotinine. You can see the states with the highest cotinine positivity rates on this map with Ohio, Kentucky, Indiana, Arkansas and Mississippi being among the five highest. Within each of those states, the positivity of those who tested positive for both THC and cotinine is as follows:

cotinine positivity by state

 

 

 

 

 

 

Overall, tobacco users are nearly 5 times as likely to test positive for THC as non-tobacco users.

Study finds tobacco users 25x more likely to test positive for PCP

Brian also discovered tobacco users were 5x more likely than non-tobacco users to test positive for methadone, PCP and cocaine. Further, marijuana users were nearly 25x more likely than non-marijuana users to test positive for PCP. They were also 15x more likely to test positive for cocaine and 10x more likely to test positive for methamphetamines. As the opioid epidemic continues to spread, it’s important for insurers to be diligent in their testing requirements. Laboratory expert, Betsy Sears, says as a result of the compelling data, there is a growing interest among carriers in using cotinine as a reflex for drug/expanded opioid screens.

Underwriting with precision

It’s important to understand that a positive cotinine test could mean more for insurers. Not only could it mean the applicant is at high risk for multiple health conditions, there is an increased risk the applicant could be misusing other substances that increase mortality. Navigate through the smoke by ensuring you are receiving a complete profile of your applicants.

To review your parameters, discuss reflex testing or to complete an analysis on your applicants, please contact us.

Industry survey insights: The impact of tobacco, alcohol, and drug use on anti-selection

November 2, 2017 Carriers

A recently commissioned study by Hank George, Inc. surveyed 110 direct-writing U.S. and Canadian life insurance carriers on fully underwritten businesses. The survey covered a variety of tobacco, alcohol, and drug use topics*. ExamOne asked consultant and former risk management director at Allstate Financial, Eric Hjerpe, to outline and expand upon some of the findings […]

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Debunking the myths: the facts about cotinine

September 21, 2017 Carriers

According to the Foundation for a Smokefree America, smoking is the single most preventable cause of death and disease causing more fatalities than cocaine, auto accidents, AIDS, alcohol, heroin, fire, suicide and homicide combined. The relationship between nicotine and cotinine Cigarettes are made up of tar, carbon monoxide, acetaldehyde, nitrosamines, nicotine and 4,000 different carcinogenic […]

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Cotinine positivity: Has it increased or decreased in the past 12 years?

July 2, 2013 Carriers

It is important to know the cotinine positivity rates of a life insurance applicant during a typical life insurance underwriting process. An applicant’s cotinine positivity rate, when correctly captured, is useful in classifying smoking and non-smoking premium rates. In most cases, smokers pay rates as high as three times the premium of non-smokers and this […]

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Smoking Tips and Health Benefits

November 29, 2012 Producers

In our previous blog, we gave a breakdown of the costs a smoker will spend on cigarettes alone. On top of spending nearly $20,000 in ten years on cigarettes alone, a smoker is paying a lot in their health risks. When an applicant quits smoking they will have money added to their pocket and potentially […]

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