We have notified doctors of this outbreak and urged them to be on the lookout for additional cases. It's important that they voluntarily report any suspected illnesses to their local health department.

DHS' role is that of a steward of data about the use of the law. This is a law, not a DHS program, and our only legal role is to report accurate aggregate data about the use of the law. It is critical that we have accurate data so that informed ethical, legal and medical decisions can be made.

Every day in Oregon 20 kids start smoking. One-third of them will eventually die of a tobacco-related disease. Most adult smokers started using tobacco before they turned 18, which underscores the significance of this new policy.

The idea that tobacco use is normal and that it is socially acceptable because respected adults and others do it encourages kids to pick up the habit. Tobacco-free school policies are helping change the perception that smoking and chew are okay.

Once again, our report shows little change in the demographics and characteristics among those who are using this law. And again, these deaths reflect a very small portion of the average 31,000 annual deaths in Oregon.

It's also important for people to understand that mumps can sometimes develop into serious complications, including deafness, sterility and even death.

So think about that as an opportunity for intervention. Perhaps there were some cues that were missed.

The reasons for why this patient woke up are still unknown.

Simply telling people to eat less and exercise more is not enough. Decades of tobacco prevention efforts have taught us that focusing on an individual's behavior ignores the fact that we all make choices within a broader social, environmental, and public policy context.

This is something we need to do a lot more talking about.