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The ferry that sank off South Korea’s south coast on Wednesday was named Sewol, or “time and tide.” Rescue workers on Thursday fought both as they raced to save hundreds believed to be still trapped inside the vessel. Boats and helicopters searched the sea, while divers worked to free people from inside the submerged hulk. According to the latest figures, nine are dead, 288 missing and 179 rescued. Given the freezing water temperature and the state of the ship, the death toll is expected to rise. n

Sewol was making its twice weekly journey from the port city of Incheon to the resort island of Jeju when it sent a distress signal at 8 58 a.m., Wednesday, local time. There were more than 400 aboard the ship, including 340 teenagers and teachers from a high school near the capital, Seoul, setting off on a four day field trip. Several survivors told local press they heard a loud noise before the ship started tilting. An announcement urged passengers to stay put. For some, it was an impossible choice do as asked, or disobey and leap into the frigid water. n

The incident is already being called one of the country’s worst peacetime disasters, and may be the worst South Korean ferry disaster since 1993, when 292 people were killed. It is still unclear what caused the ship to sink, and so quickly. Early speculation focused on the possibility that Sewol hit a rock, although one rescuer, citing surviving members of Sewol u2019s crew, told Reuters the area was free of major obstacles. n

Another theory is that cargo on board somehow shifted, causing the vessel to list and eventually sink. South Korean officials said the captain and crew are being questioned, but have not offered a theory of what happened. With most of the ship underwater, piecing together what happened will take time. n

The rescue effort and its aftermath will no doubt challenge the government of President Park Geun hye. “We must not give up,” Park declared on Wednesday. Speaking at the Ministry of Security and Public Administration, she said “We must do our best to rescue even one of those passengers and students who may not have escaped from the ship. u201d But those affected have been critical of the operation, claiming the government should be doing more, and doing it faster, to save those trapped inside. When Premier Jung Hong won visited families waiting for news, someone threw a water bottle at him, Yonhap News Agency reported. n

Survivors and families are also furious about the decision to keep passengers on board as the vessel listed. CNN reports that there were 46 lifeboats on the sunken ferry Sewol, but only one was deployed. n

Survivor Koo Bon hee, 36, criticized the crew for telling them to stay seated. “We were wearing life jackets. We had time, u201d he told the Associated Press. On April 17, the AP reported an immediate evacuation order wasn’t issued u2014instead about 30 minutes after the captain requested passengers to put on life jackets u2014because the ship’s officers were trying to stabilize it. u201cIf people had jumped into the water &#8230 they would have been rescued. But we were told not to go out. u201d n

South Korean students are accustomed to strict discipline, which may have made them more likely to follow the crew’s order. “We were asking ourselves, ‘Shouldn’t we move? Shouldn’t we try and get out?'” survivor Huh Young ki told AFP. “But the announcement was saying help would be there in 10 minutes.” n

For too many, help did not come. n

u2014 With reporting by Per Liljas / Hong Kong”,”section” “name” “World”,”slug” “world”,”url” “http / / /world /” ,”tag” “name” “Asia”,”slug” “time region asia”,”url” “http / / /tag /time region asia /” ,”tags” “Asia Disaster ferry Jeju Sewol South Korea”,”hero” “class” “landscape”,”thumbnail” “http / / /2014 /04 / “,”src” “small” “http / / /2014 /04 / “,”small 2x” “http / / /2014 /04 / “,”large” “http / / /2014 /04 / “,”large 2x” “http / / /2014 /04 / ” ,”credit” “Chung Sung Jun Getty Images”,”caption” “Family members of missing ferry passengers weep as they wait for news near the site where the Sewol sank. Almost 300 passengers are still missing”,”alt” “Family Members At South Korean Ferry Disaster Rescue Site” ,”id” 66170,”encoded url” “http%3A%2F% “,”encoded shortlink” “http%3A%2F% “,”encoded title” “South Korea Ferry Disaster%3A A Nation Searches for Answers”,”twitter text” “South%20Korea%20Ferry%20Disaster%3A%20A%20Nation%20Searches%20for%20Answers”,”twitter via” “TIMEWorld”,”related posts” “id” 64472,”title” “PHOTOS Daring Rescue as Ferry Sinks off South Korea”,”url” “http / / /64472 /photos daring rescue as south korea ferry sinks carrying 475 people /”,”format” “gallery”,”paid” “0”,”edit link” null,”hero” “class” “landscape”,”thumbnail” “http / / /2014 /04 / “,”src” “small” “http / / /2014 /04 / “,”small 2x” “http / / /2014 /04 / “,”large” “http / / /2014 /04 / “,”large 2x” “http / / /2014 /04 / ” ,”credit” “Kim Hong Ki u2014Reuters”,”caption” “Maritime police search for missing passengers in front of the South Korean ferry Sewol which sank at the sea off Jindo April 16, 2014. “,”alt” “Maritime police search for missing passengers in front of the South Korean ferry “Sewol ” which sank at the sea off Jindo April 16, 2014.” , “id” 64440,”title” “Hope Diminishes for About 300 Missing on Sunken Korean Ferry”,”url” “http / / /64440 /south korea ferry sinks /”,”format” “article”,”paid” “0”,”edit link” null ,”email title” “South%20Korea%20Ferry%20Disaster%3A%20A%20Nation%20Searches%20for%20Answers%20%7C%20TIME”,”email body” “South%20Korea%20Ferry%20Disaster%3A%20A%20Nation%20Searches%20for%20Answers%0A%0AThe%20sinking%20of%20the%20%3Ci%3ESewol%3C%2Fi%3E%20is%20being%20called%20one%20of%20South%20Korea%27s%20worst%20peacetime%20disasters%20as%20survivors%20question%20why%20the%20captain%20didn%27t%20immediately%20issue%20an%20evacuation%20order.%20Nine%20people%20are%20confirmed%20dead%20and%20rescuers%20are%20looking%20for%20nearly%20300%20missing%20passengers%0A%0Ahttp%3A%2F% “,”omniture” rr partner” , “url” “http / / /66367 /putin eastern ukraine russia snowden /”,”right now” true,”shortlink” “http / / /1eMTvvd”,”title” “Putin ‘God Knows’ Why Eastern Ukraine Isn’t Part of Russia”,”post type” “post”,”comments allowed” true,”short title” “Putin Admits Sending Troops”,”excerpt” “The Russian leader says in a televised Q&A that he sent forces to Crimea and hopes he won’t need to do the same in eastern Ukraine”,”format” “brief”,”time” “pretty” “8 09 AM ET”,”published” “2014 04 17 08 09 38″,”updated” “2014 04 17 12 09 38″,”minute” “8 09 am”,”short” “8 09 AM ET” ,”authors” “id” 207038551,”url” “http / / /author /noah rayman /”,”name” “Noah Rayman”,”twitter” “noahrayman”,”gplus” “117697492771572550962”,”email” “”,”thumbnail” “http / / / /2014 /03 / “,”bio” “

Noah Rayman is a writer based in New York City. n” ,”content” “

Are e-cigarettes a path to quitting? –

Morality and marketing

The Case for Tolerating E Cigarettes, by Amy L. Fairchild and James Colgrove (Op Ed, Dec. 9), and Two Cheers for E Cigarettes, by Joe Nocera (column, Dec. 7), argue that e cigarettes should be regulated by the Food and Drug Administration as drug delivery devices. I agree. Tellingly, it is the e cigarette companies themselves that have blocked this.

For e cigarettes to be approved by the F.D.A. as drug delivery devices, manufacturers would have to conduct rigorous studies to demonstrate that e cigarettes are both safe and effective for smoking cessation. Either because they didn t want to do these studies or because they feared the results, manufacturers instead sued the drug agency in federal court, arguing that e cigarettes should instead be regulated as tobacco products. They won.

Big Tobacco, which now owns many e cigarette companies, can t have it both ways. If it wants to avoid antismoking regulations, it should do the studies to prove that these devices are safe and effective in helping smokers quit.

Commissioner, Department of Health and Mental Hygiene
New York, Dec. 9, 2013

To the Editor

In the 1978 speech in which I called smoking Public Health Enemy No. 1 and slow motion suicide, and announced the first national antismoking program, I said research into the harmful and fatal effects of smoking would continue, including, as Amy L. Fairchild and James Colgrove quote me, research aimed at creating a less hazardous cigarette. But I do not support exempting e cigarettes from restrictions applied to regular cigarettes.

I believe that smoking e cigarettes should be banned in public places, that sales to minors should be prohibited, and that appropriate labeling and point of sale restrictions should be required.

The already sharp increase in teenage use of e cigarettes, with the potential of nicotine addiction to encourage smoking tobacco burning cigarettes, signals the danger ahead for our youth and the country s health. Indeed, tobacco companies are reported to see the potential of e cigarettes to make smoking once again commonplace and socially acceptable.

Subjecting e cigarettes to restrictions similar to those on smoked cigarettes would in no way limit their use to reduce harm from tobacco related disease for example, to help adults like those unable to quit smoking after lung or esophageal cancer surgery.

New York, Dec. 9, 2013

The writer, secretary of health, education and welfare in the Carter administration, is the founder and chairman emeritus at CASA Columbia.

To the Editor

Re Joe Nocera s column about e cigarettes

Because e cigarettes are not approved and marketed as a medicine to quit smoking, it is unclear if they are meant to help smokers quit or to be just an additional way to get nicotine in environments where smoking is prohibited.

According to the only two well designed published trials studying e cigarettes, well over 90 percent of smokers who used them did not quit smoking. E cigarettes also did not outperform the nicotine patch.

Unlike e cigarettes, nicotine patches are marketed with the intent to be used with psychosocial treatments to boost their effectiveness. For many smokers, quitting is not just about nicotine. It is equally, if not more, crucial to also address ingrained behavioral, emotional and social aspects of cigarette addiction.

Unfortunately, Mr. Nocera gives little consideration to the long term unknown health effects of e cigarettes. Given the uncertainties and the lack of proven benefit beyond medicines already on the market, it is difficult to justify recommending e cigarettes.

New York, Dec. 7, 2013

The writer is the director of Smoking Cessation Services at Columbia University Medical Center and the author of the book Smoke Free in 30 Days.

To the Editor

Three cheers for Joe Nocera s column. As an ex smoker, 37 years and counting, I appreciate the fact that many smokers just can t quit successfully. All the smokers I know have tried many times. Most who succeeded did so after more than 10 tries.

A person who has never tried quitting smoking cannot appreciate the fact that a huge number will die of it before they succeed (400,000 a year, according to Mr. Nocera). To place barriers between these people and what is clearly a less deadly maintenance approach is morally repugnant.

Sterling, Mass., Dec. 7, 2013