Well: 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 10 years sooner than those who never smoked.

Dramatic progress has been made in reducing the prevalence of smoking, which has fallen 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 the United States. 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 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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Tech Industry Sets Its Sights on Gambling

Jim Wilson/The New York Times

Cesar Miranda, left, and his brother, Edgar, working on their claw crane game in San Jose, Calif.

SAN FRANCISCO — Look out Las Vegas, here comes FarmVille.

Silicon Valley is betting that online gambling is its next billion-dollar business, with developers across the industry turning casual games into occasions for adults to wager.

At the moment these games are aimed overseas, where attitudes toward gambling are more relaxed and online betting is generally legal, and extremely lucrative. But game companies, from small teams to Facebook and Zynga, have their eye on the ultimate prize: the rich American market, where most types of real-money online wagers have been cleared by the Justice Department.

Two states, Nevada and Delaware, are already laying the groundwork for virtual gambling. Within months they will most likely be joined by New Jersey.

Bills have also been introduced in Mississippi, Iowa, California and other states, driven by the realization that online gambling could bring in streams of tax revenue. In Iowa alone, online gambling proponents estimated that 150,000 residents were playing poker illegally.

Legislative progress, though, is slow. Opponents include an influential casino industry wary of competition and the traditional antigambling factions, who oppose it on moral grounds.

Silicon Valley is hardly discouraged. Companies here believe that online gambling will soon become as simple as buying an e-book or streaming a movie, and that the convenience of being able to bet from your couch, surrounded by virtual friends, will offset the lack of glittering ambience found in a real-world casino. Think you can get a field of corn in FarmVille, the popular Facebook game, to grow faster than your brother-in-law’s? Five bucks says you cannot.

“Gambling in the U.S. is controlled by a few land-based casinos and some powerful Indian casinos,” said Chris Griffin, chief executive of Betable, a London gambling start-up that handles the gaming licenses and betting mechanics of the business for developers. “What potentially becomes an interesting counterweight is all of a sudden thousands of developers in Silicon Valley making money overseas and wanting to turn their efforts inward and make money in the U.S.”

Betable has set up shop in San Francisco, where 15 studios are now using its back-end platform. “This is the next evolution in games, and kind of ground zero for the developer community,” Mr. Griffin said.

Overseas, online betting is generating an estimated $32 billion in annual revenue — nearly the size of the United States casino market. Juniper Research estimates that betting on mobile devices alone will be a $100 billion worldwide industry by 2017.

“Everyone is really anticipating this becoming a huge business,” said Chris DeWolfe, a co-founder of the pioneering social site Myspace, who is throwing his energies into a gaming studio with a gambling component backed by, among others, the personal investment funds of Jeff Bezos, Amazon’s founder, and Eric E. Schmidt, Google’s executive chairman.

As companies eagerly wait for the American market to open up, they are introducing betting games in Britain, where Apple has tweaked the iPhone software to accommodate them. Facebook began allowing online gambling for British users last summer with Jackpotjoy, a bingo site; deals with other developers followed in December and this month.

Zynga, the company that developed FarmVille, Mafia Wars, Words With Friends and many other popular casual games, is advertising the imminent release of its first betting games in Britain. “All your favorite Zynga game characters will be there, except this time they’ll have real money prizes to offer you,” an ad says. “Play online casino games for pennies and live the dream!”

Mr. DeWolfe’s studio, SGN, is also on the verge of starting its first real-money games in Britain. “Those companies that have a critical mass of users that are interested in playing real-money games are going to be incredibly valuable,” he said.

Mark Pincus, the chief executive of Zynga, said the company was just following the market. “There is no question there is great interest from all kinds of people in games of chance, whether it is for real money or virtual rewards,” he said. Zynga, which has missed revenue expectations in the last year, is making gambling a centerpiece of its new strategy. It has just applied to Nevada for a gambling license.

Casual gaming first blossomed on Facebook’s Web site, where players could readily corral friends into their games. It is now being rethought for mobile devices, so people can play in brief snippets as they wait for a bus or a sandwich.

Some games mimic the slots and poker found in casinos; others emphasize considerably more creativity. The vast majority of casual game players play at no charge. A small number buy virtual objects in the game to speed their play or increase their status.

Tech executives expect an equally small number to play for real money but believe they will bet heavily, making them much more valuable to the gaming companies. By Betable’s estimate, the lifetime value of a casual player is $2 versus $1,800 for a real-money player.

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India Ink: Thomas Friedman Answers Your Questions

New York Times op-ed columnist and author Thomas L. Friedman recently wrapped up a week-long trip to India, where he met with business executives, government ministers and other officials, entrepreneurs and development groups. Even as India’s economy has slowed considerably, Mr. Friedman remains a big believer in what he calls the “miracle of India.’’

Earlier we asked India Ink readers for their questions for Mr. Friedman about India’s changing role in the world economy. Here are his answers to a select few:

By far the most popular reader question was: Is the world still flat?

I wrote the “World Is Flat” in 2004.

I have to confess, I now realize the book was wrong. The world is so much flatter than I thought.

When I wrote “The World Is Flat,” Facebook didn’t exist, Twitter was still a sound, the cloud was still in the sky, 4G was a parking place, LinkedIn was a prison, applications were what you sent to college, Big Data was a rap star and Skype was a typo. All of that came after I wrote “The World Is Flat.”

And so what it tells you is all those trends have actually taken us from a connected world to what we’re now in, which is a hyper-connected world. It’s a difference of degree. It’s a difference in kind.

I believe it is changing every job, every industry and every market.

The trends I identified have only intensified in every direction, enabling individuals to complete, connect and collaborate so much faster, farther cheaper and deeper.

Venkat from N. J. said: The globalization of business is basically finding a way to justify exploitation of labor, resulting in an enormous concentration of wealth in fewer hands. The majority of labor working for low-end manufacturing work in pathetic conditions, while workers in the U.S. face layoffs, particularly the elderly. Who is paying for this social cost, and should globalization be regulated, somehow?

The first thing you need to understand about globalization is that it is everything and its opposite. So it is take it with one hand and give it with another hand.

On the one hand it is automating more things faster. On the other hand I met with young Indian entrepreneurs who are leveraging the cloud, open-source tools and very small amounts of capital, and are able to invent companies that can complete globally like never before.

So, who is the exploiter and who is the exploitee in this system? If horses could vote, there never would have been cars.

What we’re getting here is rapid change. The question the reader raises, though, is a very important one, because something has changed which we have not figured out how to adjust to. This is a point that Erik Brynjolfsson and Andrew McAfee make in their book “The Race Against the Machine,” which I wrote my last column about.

The point they make is that over the last 200 hundred years, three things grew together: productivity, median income and employment. Whether you were an Indian or an American, productivity grew, median income grew and employment grew, and inequality tended to shrink.

That’s a good thing.

Once we hit the flattening of the world, and now the hyper-flattening of the world, those three things are splitting apart. And that’s what the reader is, rightly, concerned about.

I’m concerned about it too.

So what happens when the world gets this hyper-connected? Well, first of all, the returns to education grow enormously. To be able to use these new technologies properly, you need to be educated.

In America today, unemployment for people with four-year college degrees is 3.6 percent, basically nothing. Unemployment for someone who dropped out of high school is now infinity. I exaggerate but you get the point.
It’s called skills-bias polarization.

If you want to have a factory job in America today, doing high-end manufacturing, you need to know algebra and calculus. It’s not just a repetitive motion any more, you need to program the robot.

Second thing is the returns to capital are so much more than the returns to labor. If I have a lot of capital and I can buy a lot of machines, the returns are so much more than if I hire a lot of people.

The third thing causing this phenomenon is in a hyper-connected world, the returns to superstar talent are just staggering. If you are, say, Madonna, well, every Indian kid who has an iPad can now download your songs. That wasn’t the case 10 years ago. You couldn’t reach this market.

So all three of these things are creating much bigger income gaps, much lower employment for people with lower skills, yet much higher productivity and great wealth for owners of capital.

That’s the big change.

The challenge for every developed and developing society is how do you maintain a middle class in such a world. That’s what I’m thinking about for the topic of my next book.

D.C. Agrawal from Princeton, New Jersey, asks: “How would you rate India on governance and public institutional structures compared to other democratic countries?’’

Let’s look at the countries I visited in the last six months: India, China and Egypt. India in my mind has relatively weak governance in terms of delivering services, but a very strong civil society — very vibrant active, social movements, whether it’s Anna Hazare or reaction to the rape case.

China has a very muscular government, in terms of delivering infrastructure and education, but a very weak civil society, although it is getting stronger. And Egypt has a very flabby, overweight government and a very weak civil society. That’s why when the government collapsed — you got the Muslim Brotherhood taking advantage of the revolution, not strong-rooted democratic movements.

I think India’s governance will improve. The government here is not utterly ineffective. It does do some things very well, but clearly it has weaknesses around policing, infrastructure building and providing consistent education. It holds elections very well, it does the census very well.

Let’s remember it is still a billion people. I don’t want to be too hard on it, but people want more, they want better.

India today has, because of hyper-connection of the world, and diffusion of technology, experienced the pushing down to lower and lower income levels more technology empowerment and education. That’s why India today seems like it has a 300 million-person middle class and a 300 million-person virtual middle class.

These are people who now have available to them, whether it’s a cell phone or other technologies, things that you would normally have to have a middle-class income to have. And they have access to certain learning opportunities.

So they’re actually in their minds middle class, thinking like middle class and putting middle-class demands on the government. I think the young woman who was raped in this terrible tragedy was a member of that virtual middle class – the tools she had, what she was doing, expectations of the government.

That’s a big change. It’s putting more pressure on the government. And the government will eventually respond because it has to.

Jason Richardson-White from Bethlehem, Georgia, said: Studies indicate that equal treatment between the sexes is important to slowing the birth rate. I don’t see that globalization is contributing significantly to that end in India. An argument can be made that globalization has made it possible for the people who are most likely to start egalitarian families to leave India for the West?

First let me make a general response:

I did not invent globalization. I promise you. I just wrote about it.

I wrote about the upsides and the downsides. I didn’t start it and I can’t stop it. I have my own problems with it.

Having said that, I profile in my column an N.G.O. that is providing cell phone-based SMS messaging to alert women about their menstrual cycle, on when exactly they are fertile and when they should not be having unprotected sex, if they want to do family planning.

This is totally based on cloud computing. Without globalization it doesn’t exist. It allows a woman in a remote place to do this. There’s privacy to it. You do one interview on the phone to set it up.

People need to keep in mind, globalization giveth and globalization taketh. The biggest revolution about to hit India, in the next two years, is distance learning. Any woman from any village who knows English will be able to take courses from Harvard, Stanford and M.I.T.

Do you know what this means for women in conservative families, who don’t want them to go to school? It’s going to be a revolution. I’m very excited about the kind of educational empowerment that is going to be coming the way of Indian women that will give them greater earning power, greater control over their own bodies and greater ability to negotiate with their sexual partners.

Anand Kumar from Chicago, Illinois, asks: Tom, China may not be loved in the West, but is respected and admired for its accomplishments. How do you think India ranks on the loved vs. respected and admired spectrum?

What an interesting question.

I think India’s brand remains very strong around the world. I appreciate India’s democracy.

What if 1 billion 50 million Indians were living like Syria today? The whole world would be different. Literally, the whole world would feel different today.

So to me India is a miracle. One billion fifty million people holding free and fair elections, just about every day, in the country. We now take it for granted because it has gone on for so long. I think it’s amazing.

I can’t generalize about the whole world, but I’m still enormously optimistic about what I see here.

Zaigum Kashmiri from Clarence, New York, asks: Tom, I know you are an Indophile and write great things about India. But, honestly, how can anybody be hopeful about India’s economic and social progress, keeping in view the lawlessness, dysfunctional government, corrupt police, a huge incompetent and corrupt bureaucracy and poverty?

I think the important thing to always remember when you look at India is not the snapshot, but the slope of the change.

If you take a snapshot, those will be some of the things you see.

But if you came with me to my meeting with NASSCOM [National Association of Software and Services Companies, India's technology industry association] this week, you’d see eight young entrepreneurs leveraging the flat world to start global businesses that not only contribute to the world but that make Indians unpoor.

They’re amazing.

So you always have to keep these things in balance. What excites me most about India today is the trend line. Every time I come here, I see more and more Indians starting things, collaborating on things and inventing things to make Indians unpoor. And to me that’s the most important thing you have to keep in mind.

By the way, everything the reader cited there, you could say that about America. We have all that, plus guns.

No country is a paradise. Everyone is a work in progress. You have to think about where the thrust is.

I’d like to think that with all our problems in America, we’re still tilted in a positive direction. I’d like to say the same about India.

(Interview has been lightly edited and condensed.)

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Dismissed as Doomsayers, Advocates for Meteor Detection Feel Vindicated

For decades, scientists have been on the lookout for killer objects from outer space that could devastate the planet. But warnings that they lacked the tools to detect the most serious threats were largely ignored, even as skeptics mocked the worriers as Chicken Littles.

Jim Watson/Agence France-Presse — Getty Images

Dr. Edward Lu, a former NASA astronaut and Google executive, has warned about space threats.

No more. The meteor that rattled Siberia on Friday, injuring hundreds of people and traumatizing thousands, has suddenly brought new life to efforts to deploy adequate detection tools, in particular a space telescope that would scan the solar system for dangers.

A group of young Silicon Valley entrepreneurs who helped build thriving companies like eBay, Google and Facebook has already put millions of dollars into the effort and saw Friday’s shock wave as a turning point in raising hundreds of millions more.

“Wouldn’t it be silly if we got wiped out because we weren’t looking?” said Edward Lu, a former NASA astronaut and Google executive who leads the detection effort. “This is a wake-up call from space. We’ve got to pay attention to what’s out there.”

Astronomers know of no asteroids or comets that pose a major threat to the planet. But NASA estimates that fewer than 10 percent of the big dangers have been discovered.

Dr. Lu’s group, called the B612 Foundation after the imaginary asteroid on which the Little Prince lived, is one team of several pursuing ways to ward off extraterrestrial threats. NASA is another, and other private groups are emerging, like Planetary Resources, which wants not only to identify asteroids near Earth but also to mine them.

“Our job is to be the first line of defense, and we take that very seriously,” James Green, the director of planetary science at NASA headquarters, said in an interview Friday after the Russian strike. “No one living on this planet has ever before been hurt. That’s historic.”

Dr. Green added that the Russian episode was sure to energize the field and that an even analysis of the meteor’s remains could help reveal clues about future threats.

“Our scientists are excited,” he said. “Russian planetary scientists are already collecting meteorites from this event.”

The slow awakening to the danger began long ago, as scientists found hundreds of rocky scars indicating that cosmic intruders had periodically reshaped the planet.

The discoveries included not just obvious features like Meteor Crater in Arizona, but wide zones of upheaval. A crater more than a hundred miles wide beneath the Yucatán Peninsula in Mexico suggested that, 65 million years ago, a speeding rock from outer space had raised enough planetary mayhem to end the reign of the dinosaurs.

Some people remain skeptical of the cosmic threat and are glad for taxpayer money to go toward urgent problems on Earth rather than outer space. But many scientists who have examined the issues have become convinced that better precautions are warranted in much the same way that homeowners buy insurance for unlikely events that can result in severe damage to life and property.

Starting in the 1980s and 1990s, astronomers turned their telescopes on the sky with increasing vigor to look for killer rocks. The rationale was statistical. They knew about a number of near misses and calculated that many other rocky threats whirling about the solar system had gone undetected.

In 1996, with little fanfare, the Air Force also began scanning the skies for speeding rocks, giving credibility to an activity once seen as reserved for doomsday enthusiasts. It was the world’s first known government search.

The National Aeronautics and Space Administration took a lead role with what it called the Spaceguard Survey. In 2007, it issued a report estimating that 20,000 asteroids and comets orbited close enough to the planet to deliver blows that could destroy cities or even end all life. Today, with limited financing, NASA supports modest telescopes in the southwestern United States and in Hawaii that make more than 95 percent of the discoveries of the objects coming near the Earth.

Scientists lobbied hard for a space telescope that would get high above the distorting effects of the Earth’s atmosphere. It would orbit the Sun, peering across the solar system, and would have a much better chance of finding large space rocks.

But with the nation immersed in two wars and other earthly priorities, the government financing never materialized. Last year, Dr. Lu, who left the NASA astronaut corps in 2007 to work for Google, joined with veterans of the space program and Silicon Valley entrepreneurs to accelerate the asteroid hunt.

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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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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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Dismissed as Doomsayers, Advocates for Meteor Detection Feel Vindicated

For decades, scientists have been on the lookout for killer objects from outer space that could devastate the planet. But warnings that they lacked the tools to detect the most serious threats were largely ignored, even as skeptics mocked the worriers as Chicken Littles.

Jim Watson/Agence France-Presse — Getty Images

Dr. Edward Lu, a former NASA astronaut and Google executive, has warned about space threats.

No more. The meteor that rattled Siberia on Friday, injuring hundreds of people and traumatizing thousands, has suddenly brought new life to efforts to deploy adequate detection tools, in particular a space telescope that would scan the solar system for dangers.

A group of young Silicon Valley entrepreneurs who helped build thriving companies like eBay, Google and Facebook has already put millions of dollars into the effort and saw Friday’s shock wave as a turning point in raising hundreds of millions more.

“Wouldn’t it be silly if we got wiped out because we weren’t looking?” said Edward Lu, a former NASA astronaut and Google executive who leads the detection effort. “This is a wake-up call from space. We’ve got to pay attention to what’s out there.”

Astronomers know of no asteroids or comets that pose a major threat to the planet. But NASA estimates that fewer than 10 percent of the big dangers have been discovered.

Dr. Lu’s group, called the B612 Foundation after the imaginary asteroid on which the Little Prince lived, is one team of several pursuing ways to ward off extraterrestrial threats. NASA is another, and other private groups are emerging, like Planetary Resources, which wants not only to identify asteroids near Earth but also to mine them.

“Our job is to be the first line of defense, and we take that very seriously,” James Green, the director of planetary science at NASA headquarters, said in an interview Friday after the Russian strike. “No one living on this planet has ever before been hurt. That’s historic.”

Dr. Green added that the Russian episode was sure to energize the field and that an even analysis of the meteor’s remains could help reveal clues about future threats.

“Our scientists are excited,” he said. “Russian planetary scientists are already collecting meteorites from this event.”

The slow awakening to the danger began long ago, as scientists found hundreds of rocky scars indicating that cosmic intruders had periodically reshaped the planet.

The discoveries included not just obvious features like Meteor Crater in Arizona, but wide zones of upheaval. A crater more than a hundred miles wide beneath the Yucatán Peninsula in Mexico suggested that, 65 million years ago, a speeding rock from outer space had raised enough planetary mayhem to end the reign of the dinosaurs.

Some people remain skeptical of the cosmic threat and are glad for taxpayer money to go toward urgent problems on Earth rather than outer space. But many scientists who have examined the issues have become convinced that better precautions are warranted in much the same way that homeowners buy insurance for unlikely events that can result in severe damage to life and property.

Starting in the 1980s and 1990s, astronomers turned their telescopes on the sky with increasing vigor to look for killer rocks. The rationale was statistical. They knew about a number of near misses and calculated that many other rocky threats whirling about the solar system had gone undetected.

In 1996, with little fanfare, the Air Force also began scanning the skies for speeding rocks, giving credibility to an activity once seen as reserved for doomsday enthusiasts. It was the world’s first known government search.

The National Aeronautics and Space Administration took a lead role with what it called the Spaceguard Survey. In 2007, it issued a report estimating that 20,000 asteroids and comets orbited close enough to the planet to deliver blows that could destroy cities or even end all life. Today, with limited financing, NASA supports modest telescopes in the southwestern United States and in Hawaii that make more than 95 percent of the discoveries of the objects coming near the Earth.

Scientists lobbied hard for a space telescope that would get high above the distorting effects of the Earth’s atmosphere. It would orbit the Sun, peering across the solar system, and would have a much better chance of finding large space rocks.

But with the nation immersed in two wars and other earthly priorities, the government financing never materialized. Last year, Dr. Lu, who left the NASA astronaut corps in 2007 to work for Google, joined with veterans of the space program and Silicon Valley entrepreneurs to accelerate the asteroid hunt.

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IHT Rendezvous: In Singapore's Immigration Debate, Sign of Asia's Slipping Middle Class?

BEIJING — Immigration is a hot-button issue nearly everywhere in the world, though the contours of the debate vary from place to place. In the United States, sweeping changes to the law may offer legal residency for millions of people who have entered the country illegally, my colleague Ashley Parker reports.

Here in Asia, in the nation of Singapore, the debate looks somewhat different: The government plans to increase the population from just over five million to a possible high of nearly seven million by 2030, via regulated, legal immigration. It’s provoking opposition.

So much so that on Saturday, about 3,000 people turned out for what some commentators said was one of the biggest demonstrations in the nation’s history. (If the number seems small, it reflects the tight political control exerted over Singapore life by the People’s Action Party, which has run the country for about half a century and discourages public protest.)

What are the contours of the debate in Singapore?

Concern over booming immigration, often focused on new arrivals from increasingly rich China, has been simmering in the nation, with many feeling that the immigrants don’t play by the same rules, that their manners are poor and that they are pushing up prices. That feeling crystallized last year when a wealthy Chinese man driving a Ferrari at high speed killed three people (including himself) in a nighttime accident.

(Similar sentiments are found in Hong Kong, as my colleagues Bettina Wassener and Gerry Mullany wrote.)

Vividly illustrating the resentment, Singaporeans sometimes call the wealthy immigrants “rich Chinese locusts,” according to an article in the Economic Observer’s Worldcrunch.

Less controversially, the article quoted Peng Hui, a professor of sociology at National Singapore University, as saying: “Singaporeans do not discriminate against the Chinese. On the contrary, they very much identify with their Chinese ancestry.” (Of course, rich Chinese are not the only new immigrants, but they are a major group, many commentators have pointed out.) “What the local people do not appreciate is the fact that Chinese people talk loudly in public, eat on the subway and like to squeeze through in a crowd or grab things,” Mr. Peng was quoted as saying.

So the Singapore government’s Population White Paper that passed in Parliament earlier this month, just before Chinese New Year, was bound to stir things up.

The government is presenting the rise in immigration as a target that is needed if Singapore, where immigrants already make up about 40 percent of the population, and which has the highest concentration of millionaires in the world, is to continue to flourish, reports said. Singaporeans just aren’t having enough children, said the prime minister, Lee Hsien Loong.

“In my view, in 2030, I think 6 million will not be enough to meet Singaporeans’ needs as our population ages because of this problem of the baby boomers and bulge of aging people,” Mr. Lee said in Parliament, adding that 6.9 million was not a target but a number to be used to help plan for infrastructure.

“Do we really need to increase our population by that much?” wrote a person called Chang Wei Meng in a letter to The Straits Times, according to Reuters. “What happened to achieving the Swiss standard of living?”

Gilbert Goh, a main organizer of the rally Saturday at Singapore’s Speaker’s Corner in a public park, said the protesters had a message: “They want to tell the government, please reconsider this policy. The turnout is a testimony that this policy is flawed and unpopular on the ground,” The Associated Press quoted Mr. Goh as saying.

Yet amid the familiar rhetoric about immigrants, heard around the world – they don’t fit in, they’re rude, they’re different – might something more important be going on here?

In a blog post on Singapore News Alternative, Nicole Seah, a politician who has run for Parliament and comments on social issues, wrote: “Along with many other Singaporeans, I oppose the White Paper.”

Why? She is looking for “a society that lives in harmony, rather than tense and overcrowded conditions,” she writes.

“Not the Singapore Inc. that has been aggressively forced down our throats the past few years – a Singapore which is in danger of becoming a transient state where people from all over, come, make their fortunes, and leave.”

Not “a Singapore that has become a playground for the rich and the people who can afford it. A Singapore where the middle class is increasingly drowned out because they do not have the social clout or sufficient representatives in Parliament to voice their concerns.”

Ms. Seah’s statements raise an interesting question: Is this part of a phenomenon that the columnist Chrystia Freeland has written about so ably for this newspaper, the ascendancy of a wealthy, “plutocrat” class and the slipping status of the middle class?

As Ms. Freeland wrote last week: “The most important fact about the United States in this century is that middle-class incomes are stagnating. The financial crisis has revealed an equally stark structural problem in much of Europe.” Is it hitting Asia, too, and does Singapore’s protest speak, at least in part, to this? Hong Kong’s dissatisfaction too?

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Common Sense: High Taxes Are Not a Prime Reason for Relocation, Studies Say

Pool photo by Mikhail Klimentyev

Gerard Depardieu with Vladimir Putin in January. Russia granted Mr. Depardieu a passport after his spat with France over taxes.

Last month, Vladimir V. Putin hugged his newly minted fellow Russian citizen, the actor Gerard Depardieu, posing for cameras at the Black Sea port of Sochi. “I adore your country,” Mr. Depardieu gushed — especially its 13 percent flat tax on personal income.

Sochi may not be St. Tropez, but it does have winter temperatures in the 60s and even palm trees. Mr. Putin’s deputy prime minister confidently predicted a “mass migration of wealthy Europeans to Russia.”

Here in the United States, the three-time Masters champion Phil Mickelson recently walked off the 18th hole at Humana Challenge and said he might move from California because the state increased its top income tax rate to 13.3 percent from 10.3 percent.

“Hey Phil,” Gov. Rick Perry of Texas wrote in a Twitter message, “Texas is home to liberty and low taxes ... we would love to have you as well!!” Tiger Woods later said that he had left California for Florida for just that reason years ago. Mr. Mickelson can “vote with his Gulfstream,” a Wall Street Journal editorial noted, and warned California to “expect a continued migration.”

It’s an article of faith among low-tax advocates that income tax increases aimed at the rich simply drive them away. As Stuart Varney put it on Fox News: “Look at what happened in Britain. They raised the top tax rate to 50 percent, and two-thirds of the millionaires disappeared in the next tax year. Same things are happening in France. People are leaving where the top tax rate is 75 percent. Same thing happened in Maryland a few years ago. New millionaire’s tax, the millionaires disappeared. You’ve got exactly the same thing in California.”

That, at least, is what low-tax advocates want us to think, and on its face, it seems to make sense. But it’s not the case. It turns out that a large majority of people move for far more compelling reasons, like jobs, the cost of housing, family ties or a warmer climate. At least three recent academic studies have demonstrated that the number of people who move for tax reasons is negligible, even among the wealthy.

Cristobal Young, an assistant professor of sociology at Stanford, studied the effects of recent tax increases in New Jersey and California.

“It’s very clear that, over all, modest changes in top tax rates do not affect millionaire migration,” he told me this week. “Neither tax increases nor tax cuts on the rich have affected their migration rates.”

The notion of tax flight “is almost entirely bogus — it’s a myth,” said Jon Shure, director of state fiscal studies at the Center on Budget and Policy Priorities, a nonprofit research group in Washington. “The anecdotal coverage makes it seem like people are leaving in droves because of high taxes. They’re not. There are a lot of low-tax states, and you don’t see millionaires flocking there.”

Despite the allure of low taxes, Mr. Depardieu hasn’t been seen in Russia since picking up his passport and seems to be hedging his bets by maintaining a residence in Belgium. Meanwhile, Russian billionaires are snapping up trophy properties in high-tax London, New York and Beverly Hills, Calif.

“I don’t hear about many billionaires moving to Moscow,” said Robert Tannenwald, a lecturer in economic policy at Brandeis University and former Federal Reserve economist. Along with Nicholas Johnson, he and Mr. Shure are co-authors of “Tax Flight Is a Myth,” a 2011 research paper.

Of course, some people do move for tax reasons, especially wealthy retirees, athletes and other celebrities without strong ties to high-tax locations, like jobs and families. In renouncing his French citizenship, Mr. Depardieu follows other French celebrities, the chef Alain Ducasse, the singer Johnny Hallyday and Yannick Noah, a former tennis star. Several Paris hedge fund managers have decamped to London and the fashion mogul Bernard Arnault applied for Belgian citizenship, though not, he has said, for tax reasons.

Stars like Mr. Depardieu and Mr. Mickelson certainly have incentives to move. Mr. Depardieu complained that he paid 85 percent of his income in taxes in France last year and has paid 145 million euros over 45 years. France has a top rate of 41 percent as well as a wealth tax, and the Socialist president, François Hollande, is trying to impose a temporary surcharge of 75 percent on incomes over 1 million euros. Mr. Mickelson earned more than $60 million last year, Sports Illustrated estimates, which means the three-percentage-point California tax increase could add up to an additional $1.8 million in tax.

This article has been revised to reflect the following correction:

Correction: February 15, 2013

An earlier version of this column misstated Mr. Depardieu’s citizenship. He has applied for residency in Belgium; he is not a citizen of that nation. The earlier version also misidentified the golf tournament at which the golfer Phil Mickelson said he might move from California to escape its taxes. It was the Humana Challenge, not Pebble Beach.

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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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