Vaping, the jury’s out on its long-term effects

For most smokers keen on quitting, the battle is ongoing. And while there is an array of tools, gadgets, nicotine patches, gum and self-help books out there to discourage smokers from lighting up, some still struggle, writes Angelique Ruzicka.

However, many have given electronic cigarettes (e-cigarettes) a go and believe this is the panacea to giving up the real thing.

Vapers here in South Africa and abroad are spoilt for choice, with a reported 450 brands and more than 7 700 flavours to choose from. According to one report, vaping has soared, with 10% of US adults now using e-cigarettes. Undoubtedly, many of them are doing so in an effort to quit tobacco smoking.

Even children are getting in on the act and, according to the Washington Post, it is estimated that more than 13% of high school pupils and nearly 5% of middle school pupils also use e-cigarettes.

Vaping is marketed as a safer alternative to smoking and many people believe that it is harmless. However, you may be surprised to learn that a number of insurance companies still view vaping in the same light as they do smoking.

While insurers do not claim that vaping is as damaging as smoking traditional cigarettes, vapers will still be charged more.

City Press approached Discovery Life, BrightRock, Liberty, Standard Bank Insurance and brokerage Insurance Busters, all of which verified that if you have life cover, insurers put the same loading on to the premium as they would for a smoker, if you declare that you vape.

The same, but different

“The most recent information I got from insurers was that they still did not have sufficient proof that vaping does not have a similar effect as smoking on clients’ health. Therefore, most still view it as smoking,” explains Will Keevy, head of the insurance division of Insurance Busters.

Dr Maritha van der Walt, chief medical officer at Discovery Life, says: “From an underwriting and pricing perspective on life insurance, you are either a smoker or a nonsmoker. Using a vaporiser [that is, vaping] is certainly a higher risk than being a nonsmoker. Smokers are often dual users, meaning that they smoke and vape.

“There are challenges in being able to verify how much a person smokes; it is also not possible to distinguish on testing between vaping and smoking. Therefore, smokers and vapers are regarded as smokers, and it is unlikely that this underwriting practice will change soon.”

BrightRock’s underwriters also apply the smoker rates to users of e-cigarettes.

“To date, there has been no study to indicate any different outcome in using e-cigarettes or tobacco cigarettes when it comes to the increased risk associated with diseases related to smoking. In fact, some institutions view vaping as even more harmful than smoking, but this is still unconfirmed,” says a spokesperson from BrightRock.

Meanwhile, Standard Bank Insurance admits it does things slightly differently. It focuses on the consumption of nicotine, which, it says, is the component that has had a quantified effect on mortality.

“Clients who take up products that have this kind of underwriting are normally taken through the appropriate tests which determine if there is nicotine in their system,” says Felix Kagura, head of long-term insurance propositions at Standard Bank.

Unfortunately for vapers, a number of e-cigarette brands contain nicotine, but there are some reports claiming that certain brands do not. So, perhaps there may be some vapers who use nicotine-free brands that would go undetected by Standard Bank’s tests. Hence, they would not be deemed to be smokers by the bank’s underwriters.

Ultimately, the jury is still out on whether vaping is better than smoking. This is probably why insurers are hesitant about making a distinction between the two.

In a report released last year, titled Nicotine Without Smoke: Tobacco Harm Reduction, the UK-based Royal College of Physicians says that although it is impossible to precisely quantify the long-term health risks associated with
e-cigarettes, the available data suggests that the risks are unlikely to exceed 5% of those associated with smoked tobacco products, and may well be substantially lower than this figure.

But many still insist that vaping is as bad as smoking.

Last year, a report in the UK’s Independent newspaper quoted researchers at the European Society of Cardiology Congress, which took place in Rome. They claimed that the average vaping session had a similar effect on the stiffness of the heart’s aorta (its main artery) as smoking a normal cigarette.

It’s best to declare that you vape

Should companies and academics eventually deduce that vaping is safe, or safer than smoking, they may offer premiums to smokers who have opted to vape.

But until then, it is best to declare to your insurer that you are a vaper if you use e-cigarettes.

If you do not declare it, your dread disease claim or your family’s claim on your life insurance policy may be repudiated.

It is important to read the fine print of your policies, and if you are unsure, find out if you are covered even if you vape.

“BrightRock upholds the right to apply loadings and deny the claims of policyholders who do not disclose any conditions, hobbies or habits that could affect their risk profiles,” warns the insurer.

And if you find that life cover has become unaffordable because of the extra you are paying in premiums, consider giving up smoking and vaping altogether.

“The best advice is not to smoke any substance and not to vape,” recommends Van der Walt.

Should you smoke cannabis instead?

There was much excitement following the recent Western Cape High Court ruling that deemed the prohibition of cannabis to be unconstitutional. But this does not mean you should ditch your e-cigarettes in favour of dagga – as insurers do not approve of it.

“BrightRock does not offer recreational drug users life cover. This extends to the use of dagga, and the policy will remain in place until this matter has been confirmed by Parliament,” says a spokesperson for the insurer.

“Dagga will have the same effect as smoking and could even lead to a client being declined cover if it is habitual, because of the view that it is an entry-level drug, even if legalised,” says Will Keevy, head of the insurance division of Insurance Busters.

Insurers say cannabis can be the gateway to other drugs and have undesirable side effects. Keevy warns: “There has been an increase in dread disease and death claims in younger clients which can relate back to drug use in their teens and student years. The fact is, drugs have a significant effect on one’s system, which only reveals itself in later life – for instance, the strain amphetamines have on the heart, which leads to heart attacks in people in their mid-thirties.”

This article was first published in the 21 April 2017 edition of City Press. You can read the original article here.

How Saying No to Takeaways Totally Changed My Life

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Jolted into action by a Spring-clean of wasted food in a fridge, a lover of takeaways decides to eat at home for a change. The benefits are plain to see, not just in a  leaner credit card bill, but a pair of too-tight jeans that finally fit. Are you brave enough to give it a try? 

By Dave Luis

Three packets of bacon: eighty-seven ZAR. One delightfully pungent brie: thirty bucks. Roughly two hundred ronts’ worth of free range lamb loin chops and the same amount again of prosciutto. Throw in a hundred rands’ veg and an unopened two litre milk.

This is not some bizarre recipe for a heart-attack inducing meal for the most indelicate of palates. It is the expired food I tossed out when I was forced to spring clean my fridge because it was too full and starting to smell less than welcoming.

y pattern is this: after a long day at the office, I stop at the grocery store on the way home.

I pick up the ingredients for a sumptuous dinner, but as I am so exhausted by this stage of the day, the thought of slaving over a hot stove is torture, and so I also stop at the drive-through and pick up takeaways, telling myself “Self, tomorrow you don’t need to shop because you have enough food!”

Except that the next day I do shop, and I go through the same routine. And I always pick up a takeaway dinner.

Added to that the takeaway lunches I buy at work, and I am spending around R150 – R200 every day of the week on takeaways and I pack all that unused grocery shopping in my fridge and leaving it to rot. Shameful. I know. And a ridiculous waste of money.

So I have put myself and my credit card on a diet. I’ve even hashtagged it, because that seems the popular and responsible thing to do these days, to show you’re serious about something. For the month ahead, I am #NotEatingOut.

No takeaways. No light and fluffy melt-in-your-mouth cronuts at the office from the patisserie over the road (this is the difficult part of the challenge.)

There is so much good food at home, that all I’ve needed to do was to occasionally pick up a couple of tomatoes and onions or a fresh loaf of free-range, organic, banting-paleo bread. (Just kidding! Standard government-issue white loaf for me, thanks.)

I have planned my menus and cooked at night, even when I was tired and really, really didn’t want to. In fact, especially then. And each time I cooked I made a little extra to fill my lunch box for work the next day.

Soon I had to pack in a little extra on top of that because my work mates really took to my cooking and I am by nature a gregarious, sharing kind of guy.

Ultimately, once the sixty days of #NotEatingOut are done, I want that regime to become my monthly habit. It just makes financial and wellbeing sense.

I’ve learned a few valuable lessons along the way. Curry cannot be hurried along in an electric frying pan. Fresh garlic is better than that tasteless rubbish in a jar.

Frying bacon in a bit of olive oil is perfectly acceptable, and of course, you can never have too much bacon. But I knew that last point already.

So what’s changed? Well, there has been an unexpected health benefit. I have lost the horrible bloated feeling that a diet of mostly processed foods gives me, and the size 42 Levi’s I bought in November 2015 that I could never fit into now actually close.

Also, I’m not throwing out hundreds of rands of spoiled luxury foods, so that’s a win.

But mostly, the change that I am most impressed with is that I saved between R3000 and R4000 just in October. And that means my credit card will hate me less with each passing month.

And that means that when friends suggest a sushi dinner at that quaint place in Sea Point, I can legitimately enjoy a night out without any guilt or credit limit anxiety, and I get to actually enjoy the food as a treat and a change from my daily routine.

This article first appeared in The Comet, an online platform by BrightRock, provider of the first-ever life insurance that changes as your life changes. The opinions expressed in this piece are the writer’s own and don’t necessarily reflect the views of BrightRock.

 

 

Life cover isn’t only for the healthy

You don’t have to be in perfect health to take out life cover, but you may pay a higher premium or have specific exclusions applied to your policy if your risk of claiming is higher than average, writes Patricia Holburn

PersonalFinance

If you are worried that poor health may disqualify you from taking out life, disability or critical illness cover, take heart: life assurers won’t automatically decline your application, but will assess your individual risk factors and decide what cover to offer and the premium.

Less than two percent of applications for cover are rejected, Dr Marion Morkel, the medical officer at Sanlam, says.

“We realise people need long-term insurance, because it protects their financial interests. We are here to offer that service. We decline reluctantly,” Dr Dominique Stott, the executive of medical standards and services at PPS, says.

When you apply for life assurance, the provider assesses the likelihood that you will claim for specific benefits. This assessment is based on the information you provide in the application form and on medical tests or records.

If the risk factors for developing a disease are present, or you have had a serious illness, such as cancer, your case – known as a non-standard life – will be individually assessed to determine the benefits you can be offered and at what rates.
An assurer has several options if you are a non-standard life, Schalk Malan, the executive director of actuarial at BrightRock, says. These include premium loadings and excluding certain activities, health conditions and benefits from being covered.

Cover at a higher rate

“A loading is an additional cost applied to your premium when a life assurer believes that, statistically, you are more likely to claim than the average person,” Hayley Taylor, the head of underwriting at Hollard Life, says.

Loadings are a certain percentage above the rate for clients with a standard rate profile, usually expressed in increments of 25 percent, Morkel says.

Loadings of 50, 100 and 200 percent are common.

“Every company determines the level or threshold at which they would not offer above this rate. This threshold is usually determined by affordability. It makes no sense offering a product that is completely unaffordable and that, over time, costs more than the potential benefits embedded in the products offered,” Morkel says.

She says that, as general rule, an application is declined when the rate is three-and-a-half times the basic premium.

Gareth Friedlander, the head of research and development at Discovery Life, says Discovery generally declines policies when the mortality risk is greater than 400 percent of the standard rate.

The cost of a loading is not just the higher premium; there is also an opportunity cost. For example, you will have less money to contribute to retirement savings if your life cover is expensive. However, you have to weigh up the extra cost against the financial risk of not having cover at all.

Exclusions

“An exclusion is applied to your policy if an assurer determines that the risk of you making a claim related to a medical condition, dangerous hobby or risky occupation is too great. In that case, an assurer would provide you with cover with no additional cost, but let you know upfront that it won’t pay a claim related to that specific condition, hobby or occupation. Exclusions can be permanent or for a specific period of time,” Taylor says.

You may be concerned that excluding claims for certain conditions negates the point of having cover in the first place, but Taylor disagrees.

“Exclusions are often very specific, which means they limit your ability to claim as little as is reasonably possible,” she says.

Malan says: “We try not to prejudice the client against injuries that would have occurred irrespective of the condition. An example of our approach was where we had a client with an existing back condition that resulted in an exclusion on the existing back ailments. The client sustained a new injury to the back in a car accident, and, as a result, the cover paid out for this injury, as it was in no way a result of, or aggravated by the existing condition, and the exclusion did not apply.”

Individual risk assessment

Because each non-standard life is assessed individually, there are no set rates for certain conditions. An assurance company will be able to tell you what benefits it will offer once it has assessed your application.

“Rates differ from case to case and depend on numerous factors, including age, risk factors and what type of cover is applied for. Insurers are very individual in their treatment of non-standard lives,” Hesta van der Westhuizen, an advisory partner at Citadel Wealth Management, says.

In her experience, Van der Westhuizen says life companies have become more willing to consider offering cover to clients who are not in perfect health, or who are at risk of developing a condition, or who have suffered an illness.

Stott uses the example of a person who had a minor heart attack five years ago. Since then, he has followed treatment and lifestyle programmes to reduce his risk factors – for example, controlling his cholesterol and weight. An underwriter would take this into account when assessing his risk, and although it is unlikely that he will be offered cover at standard rates, he is likely to be offered cover with a loading on his premium, Stott says.

The principles are similar where an applicant had cancer, but is now in remission.

“The underwriter would need to assess the long-term outcome (which is key to the decision-making process) based on various pieces of supporting information, like the type and stage of cancer at diagnosis, type of treatment received and time elapsed since completion of treatment,” Dr Philippa Peil, the chief medical officer at Liberty, says.

The type of treatment is also important in assessing risk, because certain treatments for cancer have long-term side-effects that increase the risk of developing other conditions, such as heart disease, Stott says.

Some assurers will provide cover for certain types of cancer if the remission period has been longer than two years, whereas others require remission of five to seven years before they will consider an application for cover.

If the risk factors for developing a serious illness are present, your risk and rating will be assessed based on the information provided.

Taylor cites the example of a 40-year-old man who has high cholesterol, a family history of high cholesterol and a father who suffered a fatal heart attack before the age of 50. This would place him in a high-risk category, and an assurer would apply a loading to his premiums for life, critical illness or disability cover.

But there are cases where the presence of risk factors does not mean that the risk is higher. Dr Morkel uses the example of breast cancer.

“If we are aware that a female applicant has a strong family history of breast cancer as a result of a specific gene mutation, this would place her in a sub-standard rates pool. However, on closer inspection, we discover that she has tested negative for this gene mutation and she has regular breast check-ups, all of which have been normal.”

These are regarded as merits that would change the initial risk assessment, she says.

Reviewing a premium loading

Most life assurers are prepared to review premium loadings and exclusions if there has been a significant change in your health, Van der Westhuizen says. This includes evidence that your current state of health is not as it was assumed to be when you were assessed initially, or that your condition has improved – for example, you had excessively high blood pressure, but it has been brought under control.

Some assurers may require you to monitor your condition, while others have programmes that are designed to control your medical condition.

Friedlander says Discovery Life will soon introduce a Managed Care Integrator that will enable certain policyholders to reduce and ultimately remove their premium loadings if they manage their health conditions via a managed-care programme provided by Discovery Health or Vitality. However, loadings for certain conditions – for example, coronary artery disease – are not reviewable, he says.

If your policy has a loading or exclusion, ask your assurer or financial adviser when and under what circumstances it can be reviewed. Remember, that if you have to undergo a medical test, the cost is likely to be for your account.

Should you try to obtain a lower rate if your premium has been loaded?

Van der Westhuizen says that, when you apply for cover and have to undergo a medical test, the results are stored in a central information register that is accessible to all assurers. Therefore, all life assurers will make similar decisions about the premium charged.

Loadings are pretty standard across the industry, Carina Knill, a financial planner at the Hereford Group, says.

Malan, however, believes it is worthwhile to shop around.

He says there are providers that use the latest needs-matched pricing technologies to better match cover to clients’ needs and deliver more value – an average of about 40 percent more cover per premium rand.

“This saving extends to non-standard lives, and is perhaps even more important where loadings impact on traditional policies, as efficiently priced premiums can serve to negate or reduce the impact of loadings significantly,” Malan says.

  • This article was originally published in Independent Newspapers and IOL.co.za on Saturday, 1 October 2016. Click here to view the original version.

Smoke signals of danger

It is always fascinating to watch a movie from the 1970s or 1980s to see how fashionable smoking actually was. Every leading man, and some of the leading ladies, were quick to light up while on set

If we fast-forward a few decades, we now live in an age where smoking is just not fashionable anymore. This however has given rise to a new form of tobacco use which is deemed healthier alternatives to conventional cigarettes. E-cigarettes (or Twisps) advertise that they are 95% healthier than conventional cigarettes and users of the hubbly bubbly argue that all of the toxins are filtered through the water.

Inconclusive data

While you cannot physically stop your client from smoking, you need to make them aware how their life insurers regard their smoking habits. FAnews caught up with a few life insurers to find out what their views on the matter are.

The first matter that we need to deal with is the issue of whether e-cigarettes and hubbly bubblies s are less harmful than normal smoking. According to Schalk Malan, Executive Director at Bright-Rock, while evidence is inconclusive, indications point to the so called alternatives being just as harmful.

Proponents of e-cigarettes believe it is an effective smoking cessation measure and much less harmful than cigarettes. It is commonly argued that tobacco cigarettes release nicotine in smoke containing 7 000 harmful chemicals (of which 70 cause cancer), while e-cigarettes deliver only one potentially harmful chemical, known as propylene-glycol (PG).

The decision makers

However, a recent report by reinsurer Gen Re argues the long-term risks of inhaling PG remain unknown and scientific evidence to support the view that smoking e-cigarettes aids in quitting smoking is inconclusive. In fact, many smokers do not stop smoking, but instead become dual-users of tobacco and e-cigarettes. Gen Re also believes more and larger long-term trials are urgently needed to establish whether smoking e-cigarettes can be an effective aid to smoking cessation.

In line with international insurance industry practice, BrightRock’s underwriters apply smoker rates to users of e-cigarettes. BrightRock’s underwriters follow a similar approach with smokers of hubbly bubblies.

No innocent plea

It seems as if there is no leg to stand on for people who want to argue that the effects of their habits are any better or worse than others. At the end of the day, a habit is a habit.

Dr Jack van Zyl, Sanlam Medical Adviser, explains the life insurer’s stance very clearly. He says that alternative cigarette smokers are not able to plead innocence anymore when answering the question about their smoking habits. The underwriting question concerning smoking habits is more explicit now.

The life insurance industry has always applied the same underwriting yardstick to these alternative tobacco products but the difference now is that the underwriting question specifically asks whether a person smokes cigarettes, e-cigarettes, chewing tobacco or hubbly bubbly.

So while in the past hubbly bubbly smokers might have answered no to the smoking question, they cannot do so anymore. The implication of this underwriting question is that when your answer is yes, your risk is rated the same as a general smoker.

Words to your clients

Advisers have always played a crucial role in communicating information from insurers to clients. So what should advisers be saying to clients?

Dr Van Zyl points out that advisers should be telling clients that e-cigarette and hubbly bubble smoking is a potential harmful activity that should be declared. It is not a safe alternative to smoking.

From an individual risk perspective, it might be a less harmful activity if it reduces the concentration absorbed, but the habit may increase. It is possible that more quantitative tests will come on the market to monitor exposure but cost will determine the implementation.

* This article was first published in the March edition of FA News on page 38.