cotinine

heart disease risks

The heart is a tiny but powerful organ whose work is indispensable to the rest of the body. This 1-pound organ pumps nearly 2,000 gallons of blood every day. This Heart Month, we examine three contributing factors insurers can consider when reviewing a life insurance applicant’s laboratory and medical history.

Smoking contributes to one-third of coronary heart disease deaths

Smoking has multiple health risk factors. In addition to lung and throat cancer, smoking can also lead to coronary heart disease, stroke and/or raised blood pressure. According to American Heart Association, smokers have a higher mortality risk than non-smokers and on average, die more than 10 years earlier than nonsmokers.

In a recent analysis, we discovered that 6.5% of all ExamOne life insurance applicants tested positive for cotinine from 2017 to 2019. Further, we saw a 36.4% non-disclosure rate–meaning cotinine-positive applicants denied their tobacco use, something we refer to as ‘smoker’s amnesia.’ We also found that smokers had an increased risk of positivity for other drugs of abuse:

High blood pressure increases the risk for heart disease and stroke.

It is estimated that tens of millions of adults in the United States have high blood pressure, and most do not have it under control. It can lead to heart disease and stroke, two leading causes of death for Americans.

Our examiners are trained to take three blood pressure readings during the paramedical exam. Per Mayo Clinic recommendations, documenting a blood pressure reading multiple times helps verify accuracy. Additionally, if an applicant is or has been prescribed a blood pressure medication, results will be found in a prescription history report (up to seven years look-back). This provides insurers with information including the prescribing doctor, prescription adherence, a drug summary and prescription detail.

An elevated A1c could indicate an applicant is prediabetic or diabetic.  

It’s estimated that in 2018, 34.1 million adults aged 18 years or older—or 13.0% of all US adults—had diabetes and over 21% were unaware. Many times, applicants may be unaware they have this condition because they have not been tested and/or diagnosed. In fact, 34% of applicants with tested A1c values of 6.5 or higher stated they did not have diabetes during their telephone interview or on their application. The CDC also states that the risk of death from heart disease for adults with diabetes is higher than for adults who do not have diabetes.

The heart is a vital organ. By keeping it healthy, individuals reduce the likelihood of developing a chronic medical condition(s) later in life. Insurers can use real-time health data and laboratory results during the risk assessment process to better understand potential health risks for their life insurance applicants.

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.

Seeing through the smoke: The correlation of tobacco, marijuana and drugs of abuse

November 15, 2018 Carriers

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 […]

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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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