Personal Health: Health Effects of Smoking for Women

The title of a recent report on smoking and health might well have paraphrased the popular ad campaign for Virginia Slims, introduced in 1968 by Philip Morris and aimed at young professional women: “You’ve come a long way, baby.”

Today that slogan should include: “. . . toward a shorter life.” Ten years shorter, in fact.

The new report is one of two rather shocking analyses of the hazards of smoking and the benefits of quitting published last month in The New England Journal of Medicine. The data show that “women who smoke like men die like men who smoke,” Dr. Steven A. Schroeder, a professor of health and health care at the University of California, San Francisco, wrote in an accompanying editorial.

That was not always the case. Half a century ago, the risk of death from lung cancer among men who smoked was five times higher than that among women smokers. But by the first decade of this century, that risk had equalized: for both men and women who smoked, the risk of death from lung cancer was 25 times greater than for nonsmokers, Dr. Michael J. Thun of the American Cancer Society and his colleagues reported.

Today, women who smoke are even more likely than men who smoke to die of lung cancer. According to a second study in the same journal, women smokers face a 17.8 times greater risk of dying of lung cancer, than women who do not smoke; men who smoke are at 14.6 times greater risk to die of lung cancer than men who don’t. Women who smoke now face a risk of death from lung cancer that is 50 percent higher than the estimates reported in the 1980s, according to Dr. Prabhat Jha of the Center for Global Health Research in Toronto and his colleagues.

After controlling for age, body weight, education level and alcohol use, the new analysis found something else: men and women who continue to smoke die on average more than 10 years sooner than those who never smoked.

Dramatic progress has been made in reducing the prevalence of smoking, which has fallen in the United States from 42 percent of adults in 1965 (the year after the first surgeon general’s report on smoking and health) to 19 percent in 2010. Yet smoking still results in nearly 200,000 deaths a year among people 35 to 69 years old in this country. A quarter of all deaths in this age group would not occur if smokers had the same risk of death as nonsmokers.

The risks are even greater among men 55 to 74 and women 60 to 74. More than two-thirds of all deaths among current smokers in these age groups are related to smoking. Over all, the death rate from all causes combined in these age groups “is now at least three times as high among current smokers as among those who have never smoked,” Dr. Thun’s team found.

While lung cancer is the most infamous hazard linked to smoking, the habit also raises the risk of death from heart disease, stroke, pulmonary disease and other cancers, including breast cancer.

Furthermore, changes in how cigarettes are manufactured may have increased the dangers of smoking. The use of perforated filters, tobacco blends that are less irritating, and paper that is more porous made it easier to inhale smoke and encouraged deeper inhalation to achieve satisfying blood levels of nicotine.

The result of deeper inhalation, Dr. Thun’s report suggests, has been an increased risk of chronic obstructive pulmonary disease, or C.O.P.D., and a shift in the kind of lung cancer linked to smoking. Among nonsmokers, the risk of death from C.O.P.D. has declined by 45 percent in men and has remained stable in women, but the death rate has more than doubled among smokers.

But there is good news, too: it’s never too late to reap the benefits of quitting. The younger you are when you stop smoking, the greater your chances of living a long and healthy life, according to the findings of Dr. Jha’s international team.

The team analyzed smoking and smoking-cessation histories of 113,752 women and 88,496 men 25 and older and linked them to causes of deaths in these groups through 2006.

Those who quit smoking by age 34 lived 10 years longer on average than those who continued to smoke, giving them a life expectancy comparable to people who never smoked. Smokers who quit between ages 35 and 44 lived nine years longer, and those who quit between 45 and 54 lived six years longer. Even quitting smoking between ages 55 and 64 resulted in a four-year gain in life expectancy.

The researchers emphasized, however, that the numbers do not mean it is safe to smoke until age 40 and then stop. Former smokers who quit by 40 still experienced a 20 percent greater risk of death than nonsmokers. About one in six former smokers who died before the age of 80 would not have died so young if he or she had never smoked, they reported.

Dr. Schroeder believes we can do a lot better to reduce the prevalence of smoking with the tools currently in hand if government agencies, medical insurers and the public cooperate.

Unlike the races, ribbons and fund-raisers for breast cancer, “there’s no public face for lung cancer, even though it kills more women than breast cancer does,” Dr. Schroeder said in an interview. Lung cancer is stigmatized as a disease people bring on themselves, even though many older victims were hooked on nicotine in the 1940s and 1950s, when little was known about the hazards of smoking and doctors appeared in ads assuring the public it was safe to smoke.

Raising taxes on cigarettes can help. The states with the highest prevalence of smoking have the lowest tax rates on cigarettes, Dr. Schroeder said. Also helpful would be prohibiting smoking in more public places like parks and beaches. Some states have criminalized smoking in cars when children are present.

More “countermarketing” of cigarettes is needed, he said, including antismoking public service ads on television and dramatic health warnings on cigarette packs, as is now done in Australia. But two American courts have ruled that the proposed label warnings infringed on the tobacco industry’s right to free speech.

Health insurers, both private and government, could broaden their coverage of stop-smoking aids and better publicize telephone quit lines, and doctors “should do more to stimulate quit attempts,” Dr. Schroeder said.

As Nicola Roxon, a former Australian health minister, put it, “We are killing people by not acting.”

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DealBook: Reader's Digest Files for Bankruptcy, Again

Executives at Reader’s Digest must be hoping that the magazine’s second trip to bankruptcy court in under four years will be its last.

The magazine’s parent, RDA Holding, filed for Chapter 11 protection late on Sunday in another effort to cut down the debt that has plagued the pocket-size publication for years. The company is hoping to convert about $465 million of its debt into equity held by its creditors.

In a court filing, Reader’s Digest said it held about $1.1 billion in assets and just under $1.2 billion in debt. It has provisionally lined up about $105 million in financing to keep it afloat during the Chapter 11 case.

This week’s filing is the latest effort by the 91-year-old publisher, whose magazine once resided on many American coffee tables, to fix itself in a difficult economic environment.

“After considering a wide range of alternatives, we believe this course of action will most effectively enable us to maintain our momentum in transforming the business and allow us to capitalize on the growing strength and presence of our outstanding brands and products,” Robert E. Guth, the company’s chief executive, said in a statement.

Reader’s Digest last filed for bankruptcy in 2009, emerging a year later under the control of lenders like JPMorgan Chase.

That reorganization substantially cut the publisher’s debt, and afterward the company worked to further shrink its footprint. It jettisoned nonessential publications in a series of deals, including the $180 million sale of Allrecipes.com and the $4.3 million sale of Every Day With Rachael Ray, both to the Meredith Corporation.

Most of the money from those transactions went to pay down a still significant debt burden. But the company remained pressured by what it described in a court filing as steep declines that still bedevil the media industry. Last year, the publisher began negotiating with its lenders, including Wells Fargo, about amending some of its debt obligations. That process eventually led to a “pre-negotiated agreement” with creditors, which will be put into effect by the bankruptcy filing.

This time, Reader’s Digest is hoping to spend even less time in court. Mr. Guth said in a court filing that the publisher aims to emerge from bankruptcy protection in about four months.

The company’s biggest unsecured creditors include firms represented by Luxor Capital. The Federal Trade Commission also contends that it is owed $8.8 million in a settlement claim.

Reader’s Digest is being advised by Evercore Partners and the law firm Weil, Gotshal & Manges.

Reader's Digest bankruptcy petition (2013) by

Declaration by Reader's Digest Chief Executive by

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Death Toll Grows in Pakistan Explosion

Agence France-Presse — Getty Images

A bomb killed scores of people on Saturday at a market in Quetta, Pakistan, in a Shiite minority neighborhood.

ISLAMABAD, Pakistan — Hundreds of Shiite women staged a sit-in in the western city of Quetta on Sunday evening to mourn the 84 people who were killed in an explosion a day earlier in a crowded market there, and they demanded that the government arrest the attackers.

Grieving relatives declined to bury their dead until the government promised to track down those responsible for carrying out brazen attacks against Hazaras, a Shiite ethnic minority, in the city.

Government officials said a team, led by a high-ranking police official, was investigating.

Protests and sit-ins were also held in other major cities on Sunday, as Shiite leaders condemned the government’s inability of the government to curb the killings.

The attack on Saturday took place in Hazara Town, one of two enclaves in Quetta for Hazaras, who have suffered numerous attacks at the hands of Sunni death squads in recent years.

The police said that explosives were hidden in a water-supply truck. It remained unclear how the truck had managed to enter the busy market, avoiding detection by police and intelligence specialists. The police said the bomb was apparently set off by a remote-controlled device, possibly hidden in a rickshaw. The explosion caused a building to collapse, and three other structures were heavily damaged.

Shiite leaders have also called for a strike in Karachi, the southern port city, on Monday. The Muttahida Qaumi Movement, Karachi’s most powerful political party, said it would support a strike.

The growing sense of insecurity and vulnerability felt by Shiites was evident in angry speeches by leaders across the country on Sunday.

Allama Asghar Askari, a Shiite leader, sharply criticized the country’s law enforcement authorities at a rally here in the nation’s capital. “If the law-enforcement forces had targeted the militant strongholds with real intent, people would not have seen such a day,” Mr. Askari said to hundreds of protesters. One was holding up a placard that said “Stop Shiite genocide.”

Some Shiites have suggested that Army troops should be sent to Quetta to quell the sectarian violence, but for now neither the government nor the military has given any indication of a deployment.

The police in Quetta and the Frontier Corps, a provincial paramilitary force, have come under heavy criticism as violence has escalated and militants belonging to Lashkar-e-Jhangvi, the largest sectarian group, have targeted Shiites with impunity in Baluchistan Province, where Quetta is the capital.

“Militants term Hazaras as ‘impure’ and have vowed to ‘cleanse Quetta of their presence,’ ” Tahir Hussain, the city’s representative for the Human Rights Commission of Pakistan, said in an interview.

The killings have forced at least 20,000 Hazaras to leave the city, Mr. Hussain said, adding that militants have a heavy presence in the Mastung district of Baluchistan Province. More than 300 Shiites, many of them Hazaras, have been killed in Baluchistan since 2008, according to Human Rights Watch.

The Frontier Corps and the police have shown little willingness to clamp down on militant strongholds in Mastung, Mr. Hussain said.

“They know who are the perpetrators,” he said. “But apart from giving empty assurances, the high-ups of law-enforcement have not done anything.”

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Danica Patrick wins pole for NASCAR's Daytona 500

DAYTONA BEACH, Fla. (AP) — Danica Patrick has made history before — as a woman and a racer, in Indianapolis and Japan.

The spotlight is nothing new. But never has it been this bright before.

Patrick won the Daytona 500 pole Sunday, becoming the first woman to secure the top spot for any race in NASCAR's premier circuit. It's by far the biggest achievement of her stock-car career.

"I was brought up to be the fastest driver, not the fastest girl," she said. "That was instilled in me from very young, from the beginning. Then I feel like thriving in those moments, where the pressure's on, has also been a help for me. I also feel like I've been lucky in my career to be with good teams and have good people around me. I don't think any of it would have been possible without that.

"For those reasons, I've been lucky enough to make history, be the first woman to do many things. I really just hope that I don't stop doing that. We have a lot more history to make. We are excited to do it."

Her latest stamp in the history books came with a lap at 196.434 mph around Daytona International Speedway. Patrick went out eighth in the qualifying session, then had to wait about two hours as 37 fellow drivers tried to take her spot.

Only four-time Cup champion Jeff Gordon even came close to knocking her off. Gordon was the only other driver who topped 196 mph in qualifying. He locked up the other guaranteed spot in next week's season-opening Daytona 500.

"It's great to be a part of history with Danica being on the pole," said Gordon, who joked that at least he was the fastest guy. "I think we all know how popular she is, what this will do for our sport. Congratulations to her. Proud to be on there with her."

The rest of the field will be set in duel qualifying races Thursday.

However the lineup unfolds, all drivers will line up behind Patrick's No. 10 Chevrolet SS.

And she knows her latest achievement will mean more public relations work.

The routine is nothing new for Patrick, who was the first woman to lead laps in the Indianapolis 500. She finished third in 2009, the highest finish in that illustrious race for a woman. And she became the only woman to win an IndyCar race when she did it in Japan in 2008.

Hardly anyone witnessed that victory.

Leading the field to the green flag in NASCAR's showcase event should be must-watch television.

"That's a huge accomplishment," team owner and fellow driver Tony Stewart said. "It's not like it's been 15 or 20 years she's been trying to do this. It's her second trip to Daytona here in a Cup car. She's made history in the sport. That's stuff that we're proud of being a part of with her. It's something she should have a huge amount of pride in.

"It's never been done. There's only one person that can be the first to do anything. Doesn't matter how many do it after you do, accomplish that same goal. The first one that does always has that little bit more significance to it because you were the first."

Even before her fast lap Sunday, Patrick was the talk of Speedweeks. Not only did she open up about her budding romance with fellow Sprint Cup rookie Ricky Stenhouse Jr., but she was considered the front-runner for the pole after leading practice sessions Saturday.

And she didn't disappoint.

She kept her car at or near the bottom of the famed track and gained ground on the straightaways, showing lots of power from a Hendrick Motorsports engine.

"It's easy to come down here in your first or second year as a driver and clip the apron trying to run too tight a line or do something and scrub speed off," Stewart said. "That's something she did an awesome job. Watching her lap, she runs so smooth. ... She did her job behind the wheel, for sure."

The result surely felt good for Patrick, especially considering the former IndyCar driver has mostly struggled in three NASCAR seasons. Her best finish in 10 Cup races is 17th, and she has one top-five in 58 starts in the second-tier Nationwide Series.

She raced part-time in 2010 and 2011 while still driving a full IndyCar slate. She switched solely to stock cars last season and finished 10th in the Nationwide standings.

She made the jump to Sprint Cup this season and will battle Stenhouse for Rookie of the Year honors.

Starting out front in an unpredictable, 500-mile race doesn't guarantee any sort of result, but securing the pole will put her in the limelight for at least the rest of the week.

She also won the pole at Daytona for last year's Nationwide race.

This is considerably bigger.

The previous highest female qualifier in a Cup race was Janet Guthrie. She started ninth at Bristol and Talladega in 1977.

"It's obviously a history-making event that will last a long, long time," Guthrie said, praising Patrick's feat. "It's a different era, of course. Different times. I can't imagine what I would do with a spotter or somebody telling me how to drive. It's rather a different sport now. Back then, there was a much greater difference from the front of the field to the back."

Guthrie received a lukewarm reception from fellow drivers back then.

Patrick was much more welcomed, undoubtedly because of her background and popularity.

She's comfortable being in the spotlight, evidenced by her racing career, her television commercials and her sudden openness about her personal life.

"I think when pressure's on and when the spotlight's on, I feel like it ultimately ends up becoming some of my better moments and my better races and better results," Patrick said. "I just understand that if you put the hard work in before you go out there that you can have a little peace and a little peace of mind knowing that you've done everything you can and just let it happen."

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Cuomo Bucks Tide With Bill to Lift Abortion Limits

ALBANY — Bucking a trend in which states have been seeking to restrict abortion, Gov. Andrew M. Cuomo is putting the finishing touches on legislation that would guarantee women in New York the right to late-term abortions when their health is in danger or the fetus is not viable.

Mr. Cuomo, seeking to deliver on a promise he made in his recent State of the State address, would rewrite a law that currently allows abortions after 24 weeks of pregnancy only if the pregnant woman’s life is at risk. The law is not enforced, because it is superseded by federal court rulings that allow late-term abortions to protect a woman’s health, even if her life is not in jeopardy. But abortion rights advocates say the existence of the more restrictive state law has a chilling effect on some doctors and prompts some women to leave the state for late-term abortions.

Mr. Cuomo’s proposal, which has not yet been made public, would also clarify that licensed health care practitioners, and not only physicians, can perform abortions. It would remove abortion from the state’s penal law and regulate it through the state’s public health law.

Abortion rights advocates have welcomed Mr. Cuomo’s plan, which he outlined in general terms as part of a broader package of women’s rights initiatives in his State of the State address in January. But the Roman Catholic Church and anti-abortion groups are dismayed; opponents have labeled the legislation the Abortion Expansion Act.

The prospects for Mr. Cuomo’s effort are uncertain. The State Assembly is controlled by Democrats who support abortion rights; the Senate is more difficult to predict because this year it is controlled by a coalition of Republicans who have tended to oppose new abortion rights laws and breakaway Democrats who support abortion rights.

New York legalized abortion in 1970, three years before it was legalized nationally by the Supreme Court in Roe v. Wade. Mr. Cuomo’s proposal would update the state law so that it could stand alone if the broader federal standard set by Roe were to be undone.

“Why are we doing this? The Supreme Court could change,” said a senior Cuomo administration official, who spoke on the condition of anonymity because the governor had not formally introduced his proposal.

But opponents of abortion rights, already upset at the high rate of abortions in New York State, worry that rewriting the abortion law would encourage an even greater number of abortions. For example, they suggest that the provision to allow abortions late in a woman’s pregnancy for health reasons could be used as a loophole to allow unchecked late-term abortions.

“I am hard pressed to think of a piece of legislation that is less needed or more harmful than this one,” the archbishop of New York, Cardinal Timothy M. Dolan, wrote in a letter to Mr. Cuomo last month. Referring to Albany lawmakers in a subsequent column, he added, “It’s as though, in their minds, our state motto, ‘Excelsior’ (‘Ever Upward’), applies to the abortion rate.”

National abortion rights groups have sought for years to persuade state legislatures to adopt laws guaranteeing abortion rights as a backup to Roe. But they have had limited success: Only seven states have such measures in place, including California, Connecticut and Maryland; the most recent state to adopt such a law is Hawaii, which did so in 2006.

“Pretty much all of the energy, all of the momentum, has been to restrict abortion, which makes what could potentially happen in New York so interesting,” said Elizabeth Nash, state issues manager at the Guttmacher Institute, a research group that supports abortion rights. “There’s no other state that’s even contemplating this right now.”

In most statehouses, the push by lawmakers has been in the opposite direction. The past two years has seen more provisions adopted at the state level to restrict abortion rights than in any two-year period in decades, according to the Guttmacher Institute; last year, 19 states adopted 43 new provisions restricting abortion access, while not a single significant measure was adopted to expand access to abortion or to comprehensive sex education.

“It’s an extraordinary moment in terms of the degree to which there is government interference in a woman’s ability to make these basic health care decisions,” said Andrea Miller, the president of NARAL Pro-Choice New York. “For New York to be able to send a signal, a hopeful sign, a sense of the turning of the tide, we think is really important.”

Abortion rights advocates say that even though the Roe decision supersedes state law, some doctors are hesitant to perform late-term abortions when a woman’s health is at risk because the criminal statutes remain on the books.

“Doctors and hospitals shouldn’t be reading criminal laws to determine what types of health services they can offer and provide to their patients,” said M. Tracey Brooks, the president of Family Planning Advocates of New York State.

For Mr. Cuomo, the debate over passing a new abortion law presents an opportunity to appeal to women as well as to liberals, who have sought action in Albany without success since Eliot Spitzer made a similar proposal when he was governor. But it also poses a challenge to the coalition of Republicans and a few Democrats that controls the State Senate, the chamber that has in the past stood as the primary obstacle to passing abortion legislation in the capital.

The governor has said that his Reproductive Health Act would be one plank of a 10-part Women’s Equality Act that also would include equal pay and anti-discrimination provisions. Conservative groups, still stinging from the willingness of Republican lawmakers to go along with Mr. Cuomo’s push to legalize same-sex marriage in 2011, are mobilizing against the proposal. Seven thousand New Yorkers who oppose the measure have sent messages to Mr. Cuomo and legislators via the Web site of the New York State Catholic Conference.

A number of anti-abortion groups have also formed a coalition called New Yorkers for Life, which is seeking to rally opposition to the governor’s proposal using social media.

“If you ask anyone on the street, ‘Is there enough abortion in New York?’ no one in their right mind would say we need more abortion,” said the Rev. Jason J. McGuire, the executive director of New Yorkers for Constitutional Freedoms, which is part of the coalition.

Members of both parties say that the issue of reproductive rights was a significant one in November’s legislative elections. Democrats, who were bolstered by an independent expenditure campaign by NARAL, credit their victories in several key Senate races in part to their pledge to fight for legislation similar to what Mr. Cuomo is planning to propose.

Republicans, who make up most of the coalition that controls the Senate, have generally opposed new abortion rights measures. Speaking with reporters recently, the leader of the Republicans, Dean G. Skelos of Long Island, strenuously objected to rewriting the state’s abortion laws, especially in a manner similar to what the governor is seeking.

“You could have an abortion up until the day the child would be born, and I think that’s just wrong,” Mr. Skelos said. He suggested that the entire debate was unnecessary, noting that abortion is legal in New York State and saying that is “not going to be changed.”

The Senate Democratic leader, Andrea Stewart-Cousins of Yonkers, who is the sponsor of a bill that is similar to the legislation the governor is drafting, said she was optimistic that an abortion measure would reach the Senate floor this year.

“New York State’s abortion laws were passed in 1970 in a bipartisan fashion,” she said. “It would be a sad commentary that over 40 years later we could not manage to do the same thing.”

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S.E.C. Inquiry Into China Film Trade Unnerves Hollywood

LOS ANGELES — Hunkered down. Lawyered up. Looking over your shoulder for the prosecutors.

That is a not a comfortable way to do business. But it may become business as usual for those who have been struggling to make China both a customer for Hollywood films and a partner in the production of them.

Last March, word reached several studios of a confidential inquiry by the Securities and Exchange Commission and the Justice Department into possible violations of the Foreign Corrupt Practices Act by people or companies involved in the China film trade. Since then, executives and their advisers have been waiting for some public sign of the scope or focus of the government’s interest.

So far, there has been none.

But official silence has not kept the investigation from casting a chill over dealings between Hollywood and China. At a discussion in August sponsored by the Beverly Hills Bar Association, some panel members said deal-making had been complicated by the investigation. This concern was repeated in recent interviews by people involved in the Chinese-American film trade, though only on the condition of anonymity to avoid attracting the attention of regulators.

The legal concern is arising precisely as Chinese consumers — once presumed to be an easy audience for American-made films like “Skyfall” or “The Dark Knight Rises” — have been showing a preference for homegrown, Chinese-language blockbusters.

Those include the comedy “Lost in Thailand,” which surpassed American films to collect more than $200 million in China’s theaters after it opened last year, and the action-fantasy “Journey to the West: Conquering the Demons,” which had sales of $50 million in its first four days this month, according to the China Film Biz blog.

Asked last week about the corrupt practices inquiry, spokesmen for the Justice Department and the Securities and Exchange Commission declined to comment. All the major studios, in addition to DreamWorks Animation and Marvel Entertainment, which have extensive dealings in China, either did not respond or declined to comment.

Last April, people briefed on the inquiry said virtually every Hollywood company with significant dealings in China had been notified in prior weeks of the inquiry into possible violations of the Foreign Corrupt Practices Act, which forbids American companies from making illegal payments to government officials or others to ease the way for operations abroad.

Last week, a government official close to the inquiry, who spoke on the condition of anonymity in order not to prejudice the investigation, said the inquiry was continuing.

Bethany L. Hengsbach, a lawyer in Los Angeles versed in China dealings, said last week that she could not discuss the action because she had been retained by an involved party.

At the Beverly Hills Bar Association panel in August, Ms. Hengsbach spoke publicly of indications that federal officials were involved in “an industry sweep of the studios,” while warning that it was rare for such investigations “to turn up nothing.”

In the meantime, business has moved forward on projects like “Kung Fu Panda 3,” a Chinese coproduction from DreamWorks Animation, and “Iron Man 3,” which Marvel, a Walt Disney Company unit, has shot partly in China.

Thomas E. McLain, the chairman of the Asia Society Southern California, said he had not seen evidence that deals were being put on the back burner until the inquiry was resolved. But he acknowledged that the investigation was a topic of conversation at the society’s annual U.S.-China Film Summit. The event was held here last October, and drew some important figures from the Chinese film industry, including Han Sanping, the chairman of the China Film Group.

To keep Washington focused less on fears of corruption than on the possible benefits of film trade with China — where the growing box office reached $2.7 billion last year — the U.S.-Asia Institute, a policy-oriented nonprofit, has begun including movie operations among the stops made by lawmakers and their staff on institute-sponsored trips to China.

Kent A. Lucken, the institute’s president, said in an interview last week, “They need to see that there are American companies operating in China, fully regulated and under the law, conducting business, and thriving.”

Some who are involved in Hollywood’s entry into China are privately expressing hope that the Justice Department inquiry will be resolved before they run out of time on what one of them last week called a “ticking clock,” as Chinese consumers outgrow their receptivity to Hollywood fare.

The squeeze started last year when they began to spend more money on some homegrown films than on the American blockbusters.

But Michael W. Emmick, who was formerly a prosecutor with the Justice Department, and now focuses on the corrupt practices cases, among other things, in his private law practice, said a resolution could be a long time coming.

“This is still early in the game,” he said.

While Mr. Emmick is not representing clients in the investigation, and said he had no direct knowledge of it, he said that regulators sometimes use such industrywide inquiries as a “cost effective” way of putting an entire business sector — like the pharmaceuticals industry or the portion of the financial industry dealing in sovereign debt — on notice.

“Sometimes, they’re trying to send a message, to make companies keep their records, beyond the usual document retention policy,” Mr. Emmick said. He cautioned against characterizing the Hollywood action as a “sweep,” which he said might indicate imminent civil suits or arrests.

In a summary published this month, lawyers for the WilmerHale law firm said that new foreign corrupt practices enforcement cases by the S.E.C. and the Justice Department declined to just 27 last year, after spiking to a recent high of 90 in 2010, though violations of the act remain a stated priority for both agencies.

Looking ahead at the rest of the year, the lawyers predicted the “continuation and outcome” of industrywide government examinations of “financial institutions’ dealings with sovereign wealth funds, movie studios’ operations in China, and oil and gas companies’ business in Libya.”

Asked to elaborate on his expectations for the film industry investigation, Roger M. Witten, one of the authors of the report, in an e-mail last week echoed what those hunkered-down studio representatives have been saying for the last year.

“Unfortunately, I’m not in a position to talk about this on or off the record,” he said.

Brooks Barnes contributed reporting from Los Angeles, and Edward Wyatt from Washington.

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Karzai to Forbid His Forces to Request Foreign Airstrikes

KABUL, Afghanistan — President Hamid Karzai said Saturday that he would issue a decree forbidding his military forces from turning to NATO or American forces to conduct airstrikes, and he condemned the use of torture on detainees by his security forces.

He made his comments in a speech at the Afghan National Military Academy in Kabul. It was the first time he had dwelt at such length and with such passion on human rights.

His proposed ban on Afghan troops from calling in airstrikes came after a joint Afghan-NATO attack last week in Kunar Province, in eastern Afghanistan, that killed four women, one man and five children, all of them civilians, according to local officials.

Mr. Karzai said Gen. Joseph F. Dunford Jr., the commander of the international coalition forces fighting the Taliban and other insurgents in Afghanistan, told him that the airstrike had been requested by the National Directorate of Security, the country’s intelligence service. The attack took place in the Shigal district, an area where two known Taliban commanders were visiting family members, Afghan officials have said.

“Our N.D.S. in their own country calls foreigners to assist them and bombard four or five Al Qaeda or Taliban,” Mr. Karzai said.

“It is very regrettable to hear this,” he added. “You are representing Afghan pride. How do you call for an airstrike from foreigners on your people?”

Civilian casualties in the war on the Taliban has long vexed Mr. Karzai and has been a major point of contention with American and NATO troops. New rules instituted by commanders from the International Security Assistance Force have minimized the loss of life, and the coalition has all but stopped air attacks on populated areas and on homes. The result has been a dramatic drop in civilian casualties caused by foreign forces.

Nevertheless, Afghan troops, who lack their own air support, still turn to foreign forces for help during pitched battles with the Taliban and other insurgents. It was not clear whether there would be exceptions to Mr. Karzai’s decree, but he was clearly dismayed that his own forces would be employing the very techniques he had worked so hard to persuade the West to abandon.

In an unusual move, the Afghan president also publicly acknowledged that torture was a problem in Afghan detention centers and pledged to halt it. In the past, the government has largely deflected charges of torture raised by human rights organizations, contending that any abuse was the work of a few bad actors.

But after a United Nations report released in January detailed abuses or torture at a number of detention sites around the country, Mr. Karzai took a closer and more independent look at the complaints.

He appointed a delegation to investigate the report’s validity, and when the inquiry confirmed many of the allegations, he ordered the security ministries to implement the team’s recommendations. He reiterated that order on Saturday. The recommendations include prosecuting perpetrators of torture, giving detainees access to defense lawyers, providing medical treatment for detainees who are ill or have been beaten, and videotaping all interrogations.

“Not only have foreigners tormented and punished Afghans, but our people have been terrorized and punished by our own sons too,” Mr. Karzai said. “The U.N. report showed that even after 10 years, our people are tortured and mistreated in prisons.”

The United Nations’ human rights office here emphasized the importance of Mr. Karzai’s attention to the issue.

“It is encouraging that the president appears to be personally taking the issue of human rights of all Afghans seriously,” said Georgette Gagnon, the office’s director of human rights. She added that the government should act immediately on the delegation’s recommendations. “We urge them to do so without delay,” she said.

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Hunter voted out as head of NBA players' union

HOUSTON (AP) — Billy Hunter was ousted unanimously as executive director of the union by NBA players who said Saturday they will "no longer be divided, misled, misinformed."

"This is our union and we have taken it back," players' association president Derek Fisher said.

Fisher said it was a day of change for the union, which has seemed inevitable since a review of the union last month was critical of Hunter's leadership and urged players to consider whether they wanted to keep him.

They didn't.

"We want to make it clear that we are here to serve only the best interests of the players," Fisher said. "No threats, no lies, no distractions will stop us from serving our memberships."

In brief remarks, Fisher said a new executive committee was elected and he will remain as president. The Spurs' Matt Bonner is vice president, Miami's James Jones is secretary-treasurer and the Nets' Jerry Stackhouse the first vice president. The Clippers' Chris Paul, Golden State's Stephen Curry, Denver's Andre Iguodala, the Hornets' Roger Mason, Jr. and the Clippers' Willie Green are vice presidents.

Hunter had led the union since 1996, guiding the players through three collective bargaining agreements and helping bring their average salaries to more than $5 million, highest in team sports. But Fisher pushed for the review after a falling out between the two leaders, and though it found Hunter wasn't guilty of any criminal activity involving union funds, it cited him for a number of conflicts of interests and poor choices that led the players to remove him.

Released in January, the review conducted by the law firm Paul, Weiss, Rifkind, Wharton & Garrison LLP criticized Hunter for hiring family members and friends. It said he knew his 2010 contract extension wasn't properly ratified by union rules, and raised questions about everything from travel expenses to the amount he spent on gifts.

Players acted quickly, putting Hunter on a leave of absence on Feb. 1. He hoped to be invited to Saturday's annual meeting, which included about 35 players, superstar LeBron James among them.

But Hunter's attorneys said their client was told he wouldn't be welcomed. They said his contract was legal and indicated there could be a lawsuit if the players removed him and attempted to withhold the more than $10 million that remains on his salary.

"We do not doubt that this process will possibly continue in an ugly way," said Fisher, who then reminded reporters that there are three ongoing government investigations into Hunter, likely the reason he didn't take questions after his remarks.

It's a swift fall for the 70-year-old Hunter, a former athlete who was well-respected by many players. But agents didn't like him, questioning his bargaining strategies and frustrated they didn't have a bigger role in his union.

Hunter's family did, and that was another central issue of the report. He had since fired his daughter and daughter-in-law, and cut ties with a financial institution that employed his son. He also instituted an anti-nepotism policy at the NPBA.

Fisher, Paul, Bonner, Mason and Jones were holdovers from the previous executive committee. Stackhouse, who along with James was vocal during the meeting, joins Iguodala, Curry and Green among the newcomers.

Fisher and Hunter clashed during the 2011 lockout and their fractured relationship divided the union. Hunter originally persuaded the executive committee to vote to request Fisher's resignation last year. Fisher did not resign and instead pushed for the outside review, which lasted more than eight months and cost the union more than $4 million.

The law firm reviewed NBPA documents and emails, and interviewed more than three dozen witnesses. It found that Hunter spent more than $100,000 on gifts for executive committee members — including a watch worth more than $20,000 for Fisher before their falling out — and accepted a payout of $1.3 million for unused vacation time when records made it unclear how his time off was kept.

Fisher remains president even though he isn't on an NBA roster, having asked the Dallas Mavericks for his release after a brief stint earlier this season. He gave no update on what would happen to the executive director position. Union attorney Ron Klempner was appointed to the position on an interim basis when Hunter was placed on leave.

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Livestrong Tattoos as Reminder of Personal Connections, Not Tarnished Brand

As Jax Mariash went under the tattoo needle to have “Livestrong” emblazoned on her wrist in bold black letters, she did not think about Lance Armstrong or doping allegations, but rather the 10 people affected by cancer she wanted to commemorate in ink. It was Jan. 22, 2010, exactly a year since the disease had taken the life of her stepfather. After years of wearing yellow Livestrong wristbands, she wanted something permanent.

A lifelong runner, Mariash got the tattoo to mark her 10-10-10 goal to run the Chicago Marathon on Oct. 10, 2010, and fund-raising efforts for Livestrong. Less than three years later, antidoping officials laid out their case against Armstrong — a lengthy account of his practice of doping and bullying. He did not contest the charges and was barred for life from competing in Olympic sports.

“It’s heartbreaking,” Mariash, of Wilson, Wyo., said of the antidoping officials’ report, released in October, and Armstrong’s subsequent confession to Oprah Winfrey. “When I look at the tattoo now, I just think of living strong, and it’s more connected to the cancer fight and optimal health than Lance.”

Mariash is among those dealing with the fallout from Armstrong’s descent. She is not alone in having Livestrong permanently emblazoned on her skin.

Now the tattoos are a complicated, internationally recognized symbol of both an epic crusade against cancer and a cyclist who stood defiant in the face of accusations for years but ultimately admitted to lying.

The Internet abounds with epidermal reminders of the power of the Armstrong and Livestrong brands: the iconic yellow bracelet permanently wrapped around a wrist; block letters stretching along a rib cage; a heart on a foot bearing the word Livestrong; a mural on a back depicting Armstrong with the years of his now-stripped seven Tour de France victories and the phrase “ride with pride.”

While history has provided numerous examples of ill-fated tattoos to commemorate lovers, sports teams, gang membership and bands that break up, the Livestrong image is a complex one, said Michael Atkinson, a sociologist at the University of Toronto who has studied tattoos.

“People often regret the pop culture tattoos, the mass commodified tattoos,” said Atkinson, who has a Guns N’ Roses tattoo as a marker of his younger days. “A lot of people can’t divorce the movement from Lance Armstrong, and the Livestrong movement is a social movement. It’s very real and visceral and embodied in narrative survivorship. But we’re still not at a place where we look at a tattoo on the body and say that it’s a meaningful thing to someone.”

Geoff Livingston, a 40-year-old marketing professional in Washington, D.C., said that since Armstrong’s confession to Winfrey, he has received taunts on Twitter and inquiries at the gym regarding the yellow Livestrong armband tattoo that curls around his right bicep.

“People see it and go, ‘Wow,’ ” he said, “But I’m not going to get rid of it, and I’m not going to stop wearing short sleeves because of it. It’s about my family, not Lance Armstrong.”

Livingston got the tattoo in 2010 to commemorate his brother-in-law, who was told he had cancer and embarked on a fund-raising campaign for the charity. If he could raise $5,000, he agreed to get a tattoo. Within four days, the goal was exceeded, and Livingston went to a tattoo parlor to get his seventh tattoo.

“It’s actually grown in emotional significance for me,” Livingston said of the tattoo. “It brought me closer to my sister. It was a big statement of support.”

For Eddie Bonds, co-owner of Rabbit Bicycle in Hill City, S.D., getting a Livestrong tattoo was also a reflection of the growth of the sport of cycling. His wife, Joey, operates a tattoo parlor in front of their store, and in 2006 she designed a yellow Livestrong band that wraps around his right calf, topped off with a series of small cyclists.

“He kept breaking the Livestrong bands,” Joey Bonds said. “So it made more sense to tattoo it on him.”

“It’s about the cancer, not Lance,” Eddie Bonds said.

That was also the case for Jeremy Nienhouse, a 37-year old in Denver, Colo., who used a Livestrong tattoo to commemorate his own triumph over testicular cancer.

Given the diagnosis in 2004, Nienhouse had three rounds of chemotherapy, which ended on March 15, 2005, the date he had tattooed on his left arm the day after his five-year anniversary of being cancer free in 2010. It reads: “3-15-05” and “LIVESTRONG” on the image of a yellow band.

Nienhouse said he had heard about Livestrong and Armstrong’s own battle with the cancer around the time he learned he had cancer, which alerted him to the fact that even though he was young and healthy, he, too, could have cancer.

“On a personal level,” Nienhouse said, “he sounds like kind of a jerk. But if he hadn’t been in the public eye, I don’t know if I would have been diagnosed when I had been.”

Nienhouse said he had no plans to have the tattoo removed.

As for Mariash, she said she read every page of the antidoping officials’ report. She soon donated her Livestrong shirts, shorts and running gear. She watched Armstrong’s confession to Winfrey and wondered if his apology was an effort to reduce his ban from the sport or a genuine appeal to those who showed their support to him and now wear a visible sign of it.

“People called me ‘Miss Livestrong,’ ” Mariash said. “It was part of my identity.”

She also said she did not plan to have her tattoo removed.

“I wanted to show it’s forever,” she said. “Cancer isn’t something that just goes away from people. I wanted to show this is permanent and keep people remembering the fight.”

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The Education Revolution: In China, Families Bet It All on a Child in College

Chang W. Lee/The New York Times

Wu Caoying studied English under her father’s watchful eye in 2006. She is now a sophomore in college. More Photos »

HANJING, China — Wu Yiebing has been going down coal shafts practically every workday of his life, wrestling an electric drill for $500 a month in the choking dust of claustrophobic tunnels, with one goal in mind: paying for his daughter’s education.

His wife, Cao Weiping, toils from dawn to sunset in orchards every day during apple season in May and June. She earns $12 a day tying little plastic bags one at a time around 3,000 young apples on trees, to protect them from insects. The rest of the year she works as a substitute store clerk, earning several dollars a day, all going toward their daughter’s education.

Many families in the West sacrifice to put their children through school, saving for college educations that they hope will lead to a better life. Few efforts can compare with the heavy financial burden that millions of lower-income Chinese parents now endure as they push their children to obtain as much education as possible.

Yet a college degree no longer ensures a well-paying job, because the number of graduates in China has quadrupled in the last decade.

Mr. Wu and Mrs. Cao, who grew up in tiny villages in western China and became migrants in search of better-paying work, have scrimped their entire lives. For nearly two decades, they have lived in a cramped and drafty 200-square-foot house with a thatch roof. They have never owned a car. They do not take vacations — they have never seen the ocean. They have skipped traditional New Year trips to their ancestral village for up to five straight years to save on bus fares and gifts, and for Mr. Wu to earn extra holiday pay in the mines. Despite their frugality, they have essentially no retirement savings.

Thanks to these sacrifices, their daughter, Wu Caoying, is now a 19-year-old college sophomore. She is among the growing millions of Chinese college students who have gone much farther than their parents could have dreamed when they were growing up. For all the hard work of Ms. Wu’s father and mother, however, they aren’t certain it will pay off. Their daughter is ambivalent about staying in school, where the tuition, room and board cost more than half her parents’ combined annual income. A slightly above-average student, she thinks of dropping out, finding a job and earning money.

“Every time my daughter calls home, she says, ‘I don’t want to continue this,’ ” Mrs. Cao said. “And I say, ‘You’ve got to keep studying to take care of us when we get old’, and she says, ‘That’s too much pressure, I don’t want to think about all that responsibility.’ ”

Ms. Wu dreams of working at a big company, but knows that many graduates end up jobless. “I think I may start my own small company,” she says, while acknowledging she doesn’t have the money or experience to run one.

For a rural parent in China, each year of higher education costs six to 15 months’ labor, and it is hard for children from poor families to get scholarships or other government financial support. A year at the average private university in the United States similarly equals almost a year’s income for the average wage earner, while an in-state public university costs about six months’ pay, but financial aid is generally easier to obtain than in China. Moreover, an American family that spends half its income helping a child through college has more spending power with the other half of its income than a rural Chinese family earning less than $5,000 a year.

It isn’t just the cost of college that burdens Chinese parents. They face many fees associated with sending their children to elementary, middle and high schools. Many parents also hire tutors, so their children can score high enough on entrance exams to get into college. American families that invest heavily in their children’s educations can fall back on Medicare, Social Security and other social programs in their old age. Chinese citizens who bet all of their savings on their children’s educations have far fewer options if their offspring are unable to find a job on graduation.

The experiences of Wu Caoying, whose family The New York Times has tracked for seven years, are a window into the expanding educational opportunities and the financial obstacles faced by families all over China.

Her parents’ sacrifices to educate their daughter explain how the country has managed to leap far ahead of the United States in producing college graduates over the last decade, with eight million Chinese now getting degrees annually from universities and community colleges.

But high education costs coincide with slower growth of the Chinese economy and surging unemployment among recent college graduates. Whether young people like Ms. Wu find jobs on graduation that allow them to earn a living, much less support their parents, could test China’s ability to maintain rapid economic growth and preserve political and social stability in the years ahead.

Leaving the Village

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