The Washington Post: New, sweeping federal rules bar e-cigarette sales to teens younger than 18

By Laurie McGinley and Brady Dennis

The Obama administration on Thursday announced controversial new rules for electronic cigarettes, cigars, hookahs and pipe tobacco, including barring the sales of the products to teens under 18 years old.

The new requirements, which go into effect in 90 days, mark the first time the Food and Drug Administration has regulated any of the items.

The rules compel retailers to verify the age of purchasers by photo identification and bar sales of the products in vending machines that are accessible to minors. They also ban the distribution of free samples.

In addition, the FDA is generally requiring manufacturers whose products went on sale after Feb. 15, 2007, to get approval from the agency to continue selling their products. These product reviews will allow the FDA to scrutinize ingredients, product design and health risks, the agency said. It added that it will allow the companies to keep selling their products for two years while they submit their applications and then for an additional year while the FDA reviews the submissions.

The requirements, which have been the focus of intense lobbying from the industry on one side and tobacco-control advocates on the other, are likely to only intensify the debate over whether the devices are a dangerous gateway to traditional tar-laden, chemical-filled cigarettes or a helpful smoking-cessation tool.

“As cigarette smoking among those under 18 has fallen, the use of other nicotine products, including e-cigarettes, has taken a drastic leap,” said Sylvia Mathews Burwell, secretary of health and human services, in announcing the new rules. “All of this is creating a new generation of Americans who are at risk of addiction.”

She said the new regulations were an “important step in the fight for a tobacco-free generation — it will help us catch up with changes in the marketplace, put into place rules that protect our kids and give adults information they need to make informed decisions.”

E-cigarettes are battery-powered devices that heat flavored, nicotine-laced liquid, turning it into a vapor that the user inhales, or “vapes.” The flavors can come in a wide range, from mango to margarita to mocha.

The FDA’s authority to regulate the products stems from a 2009 law that gave the agency broad power over traditional cigarettes, as well as jurisdiction over other tobacco-related products.

In recent weeks, the e-cigarette industry has gotten support from some public health experts. In late April, a group of tobacco-control experts, writing in the journal Addiction, urged the FDA to be “open-minded” about e-cigarettes, saying that the products are more beneficial than harmful and can result in a reduction in traditional smoking.

“We’re concerned the FDA, which has asserted its right to regulate e-cigarettes, will focus solely on the possibility that e-cigarettes and other vapor nicotine products might act as a gateway to cigarette use,” David Levy, the lead author and a professor in the department of oncology at the Georgetown Lombardi Comprehensive Cancer Center, said at the time.

He added that the “big picture tells us that these products appear to be used mostly by people who already are or who are likely to become cigarette smokers.”

And recently, the Royal College of Physicians concluded that e-cigarettes were likely to be beneficial to public health in Britain.

But many anti-smoking advocates disagree. They say that e-cigarettes could be harmful, that the long-term health risks are unknown and that companies are marketing their products to younger and younger teens. They say the companies are using the same tactics and themes that the traditional cigarette makers used years ago.

The number of middle and high school students using electronic cigarettes tripled between 2013 and 2014, according to a study by the Centers for Disease Control and Prevention.

https://www.washingtonpost.com/news/to-your-health/wp/2016/05/05/obama-administration-announces-controversial-new-rules-for-e-cigarettes/

WebMD News from HealthDay: FDA Launches Ad Campaign Against Chewing Tobacco

By Dennis Thompson

HealthDay Reporter

TUESDAY, April 19, 2016 (HealthDay News) — U.S. health officials said Tuesday that they are targeting rural teenagers with a new $36 million ad campaign that highlights the health risks associated with chewing tobacco.

The campaign’s message — “smokeless doesn’t mean harmless” — will challenge a habit that has become a tradition in the rural United States, said Mitch Zeller, director of the Center for Tobacco Products at the U.S. Food and Drug Administration.

“It is culturally ingrained in many rural communities, and can be seen as a rite of passage and an acceptable societal norm,” Zeller said during a Tuesday morning news conference. He noted that smokeless tobacco use is more than twice as common in rural areas as it is in urban settings.

Chewing tobacco, snuff and other smokeless tobacco products have been linked to multiple kinds of cancer, gum disease, tooth loss and nicotine addiction, Zeller said.

Nevertheless, smokeless tobacco use has become increasingly popular among rural male teenagers, according to FDA research.

Every day in the United States, nearly 1,000 males younger than 18 try smokeless tobacco for the first time, outpacing those who take their first puff on a cigarette, Zeller said. About one-third of rural white males aged 12 to 17 have tried or are at risk of trying smokeless tobacco, totaling approximately 629,000 male youth nationwide.

Rural teens are used to seeing role models use smokeless tobacco, including fathers, grandfathers, older brothers and community leaders, Zeller explained.

“When people who these teens most trust and admire openly use and share smokeless tobacco, the product is seen as acceptable, and even as an expected part of growing up and belonging,” Zeller said.

This is the first time the FDA has focused on smokeless tobacco in an ad campaign, said Kathy Crosby, director of the FDA’s Office of Health Communication and Education.

Crosby said the campaign will focus on 35 rural markets across the United States, including: Albany, Ga.; Billings, Mont.; Flint, Mich.; Medford, Ore.; Monroe, La.; Sioux Falls, S.D.; Little Rock, Ark.; and Tri-Cities, Tenn.

Ads linked to the campaign show young men with ugly lip sores and horrific facial scars caused by mouth cancer, and a football player being tossed around by a nicotine addiction “monster.” The ads will run on local television and in print, while others appear on local radio and through social media.

The new campaign will also collaborate with select Minor League Baseball teams to help combat the link between baseball and smokeless tobacco use among the campaign’s target audience, Crosby said.

This summer, stadiums across the country will display campaign advertising and provide opportunities for fans to meet players who support the campaign’s public health message, she said.

The FDA also is in ongoing talks with Major League Baseball about joining the campaign, and Zeller said he is “optimistic” that a partnership will be announced sometime this season.

Major cities such as Boston, Los Angeles, New York City and San Francisco have banned smokeless tobacco products at ballparks and other sports venues. Major League Baseball has warned that players caught violating the ban in these cities will be subject to discipline from the commissioner.

The smokeless tobacco campaign is an offshoot of the FDA’s award-winning “The Real Cost” campaign, which since 2014 has been warning teenagers about the health effects of smoking.

http://www.webmd.com/smoking-cessation/news/20160419/fda-launches-ad-campaign-against-chewing-tobacco

Opinion: No place in baseball for smokeless tobacco

By: Dick Durbin | As published in the Chicago Tribune

My feelings about tobacco took shape at the bedside of my father in November 1959. I was a sophomore in high school when lung cancer took his life. He was 53 and had smoked two packs of Camels a day.

As a member of Congress I first went up against the powerful tobacco lobby in 1987 and shocked myself and my colleagues by passing a bill banning smoking on airplanes on domestic flights of less than two hours. That measure turned out to be a tipping point. A series of local, state and federal laws followed, leading to restricting tobacco use on all flights, on trains and in hospitals, offices, restaurants and malls.

Despite all these victories, my battle against tobacco consistently struck out in one key area. For over 20 years I have been trying to get spit tobacco out of Major League Baseball.

Just as youth players wear their socks and sweatbands like the pros, or mimic the swing or windup of their favorite star, they are watching as baseball players slip a wad of tobacco in their cheek or under their lip. That sends a visual message, leading teenage boys to imitate this dangerous habit.

The numbers tell the story. While use of cigarettes and cigars among high school athletes declined from 30 percent to 18 percent between 2001 and 2013, use of smokeless tobacco increased by 10 percent in that population over the same period.

Among 8th grade students, the use of smokeless tobacco increased 14 percent between 2013 and 2015. Each year, nearly half a million kids age 12-17 use smokeless tobacco for the first time.

Tony Gwynn, the legendary San Diego hitter, was the most well-known baseball victim of salivary gland cancer caused by spit tobacco. Before his death in 2014, Gwynn attributed his oral cancer to his chewing tobacco use, “Of course it caused it … I always dipped on my right side,” he remarked. He and his family were honest about the cause of his death and reminded us of the real danger of this deadly habit.

Baseball owners such as Jerry Reinsdorf of the Chicago White Sox are outspoken opponents of spit tobacco. They remind me that all forms of tobacco are banned in the minors. Bobby Brown, a former Yankee and a medical doctor, became president of the American League. He joined the late Joe Garagiola, the former St. Louis Cardinal player and announcer, in leading the fight against spit tobacco. Despite all this opposition, the owners ran into a brick wall negotiating the issue with the players’ organization. I remember calling the players’ lead negotiator, Donald Fehr, many years ago. When I raised the danger of spit tobacco to the health of his players, he said: “It’s a negotiable item” and hung up.

The 2016 baseball season marks a long-anticipated breakthrough.

With the leadership of the Campaign for Tobacco-Free Kids, five major league cities (New York, Chicago, Boston, Los Angeles and San Francisco) have enacted ordinances banning spit tobacco at their ballparks, and Toronto and Washington, D.C., are considering similar bans. When I met Tony Clark, the head of the Players Association, at a Major League Baseball event in Havana a few weeks ago, I reminded him that his players have to live in this new world. I don’t want to see any player embarrassed or fined. I just want a sport I love to stop promoting a deadly tobacco habit.

Democrat Dick Durbin is the senior U.S. senator from Illinois.

http://www.chicagotribune.com/news/opinion/commentary/ct-durbin-baseball-smokeless-tobacco-perspec-0331-md-20160415-story.html

CBS News: New York teen badly injured by exploding e-cigarette

A teenage boy suffered serious injuries when an e-cigarette vaporizer he was holding blew up in his face.
The 14-year-old, who spent five days in the hospital, was left with permanent injuries after his attorney said he was maimed and blinded by an exploding e-cigarette or vape pen, CBS New York reports.
“I was shocked. I was bleeding out of my nose,” Leor Domatov said.
Domatov said he was at the Kings Plaza Shopping Center in Brooklyn with friends when they approached a kiosk called Plaza Vapes.
“The guy was showing me different products of the vaporizers. He connected one of the vaporizers to the battery at the store,” he said. “When he gave it to me to hold, it exploded in my hands and my face.”
Domatov now wears sunglasses after the explosion sent shrapnel flying into his eyes.
“My left eye, I can’t see anything right now cause I got a cut through my cornea, and in my right eye I have a little bit of vision,” he said.
At first, Domatov wasn’t sure what had happened. Then he realized he was bleeding.
“I see like red stuff on the floor, and I’m like, ‘Oh my God, is this blood?’ So I start crying, why does it hurt me in my hands?” he said.
Domatov’s attorney Marc Freund intends to sue both the shopping center and the kiosk.
“They don’t ask him for any ID, nothing, and they’re showing different types of products. There are no signs up that reflect the New York state and city law. It’s illegal to sell these products to anyone under the age of 21,” he said.
The kiosk now has a sign posted that reads, “Must be 21 to purchase any product, we ID all.”
Freund claims the notice went up after the incident.
The corporate management offices for Kings Plaza did not reply to a request for comment. The kiosk worker there on Thursday said he could not speak to the incident or provide a phone number for the manager.
This isn’t the first report of e-cigarettes malfunctioning and injuring people.
In January, an Orange County, California, teen suffered first- and second-degree burns when an e-cigarette exploded in his pocket.
A man from Colorado Springs was severely injured in November when an e-cigarette exploded in his face, leaving him with a broken neck, facial fractures, burns to his mouth, and shattered teeth.
And last spring, CBS Los Angeles reported that a Santa Ana man was injured after his e-cigarette blew up in his hands. The explosion sent half of the device into the ceiling, starting a fire at his apartment.
Last year, the federal government banned e-cigarettes from checked luggage on aircraft because of the potential fire hazard. The Department of Transportation said it had reports of least 26 incidents since 2009 in which e-cigarettes had caused explosions or fires.
http://www.cbsnews.com/news/new-york-teen-badly-injured-by-exploding-e-cigarette/?linkId=23480569

The New York Times: E-Cigarette Use by U.S. Teenagers Rose Last Year, Report Says

By SABRINA TAVERNISE

WASHINGTON — E-cigarette use continued to rise among young teenagers and preteens in the United States last year, according to new federal data, but cigarette smoking overall did not increase, suggesting that, at least so far, fears that the devices would hook a new generation on traditional cigarettes have not come to pass.

Experts said it was too soon to answer the essential question about e-cigarettes: Will they cause more or fewer people to smoke? But the broad trend in youth cigarette smoking has been down in recent years, and researchers have been taking note of that.

“We do not have any strong evidence that it is encouraging smoking among kids but neither do we have good evidence that it won’t over time,” said Kenneth E. Warner, a professor of public health at the University of Michigan.

About 5 percent of middle-school students reported using e-cigarettes in 2015, up from about 4 percent in 2014, according to data from the Centers for Disease Control and Prevention. That is a substantial increase from 2011, when less than 1 percent of middle schoolers used the devices.

Use for high-school students was also trending up, with 16 percent reporting using the devices in 2015, up from 13 percent in 2014. But the change was not statistically significant because of technical reasons having to do with the sizes and distributions of the samples. In 2011, the rate was just 1.5 percent for high schoolers.

Policy makers have worried that increased e-cigarette use could make it more likely young people would shift to traditional tobacco cigarettes, which are more toxic. But that does not seem to be happening yet. About 9 percent of high schoolers reported smoking cigarettes in 2015, unchanged from 2014, and down from 16 percent in 2011.

Among middle schoolers, about 2 percent reported smoking traditional cigarettes in 2015, statistically unchanged from 2014. In 2011, about 4 percent of middle schoolers smoked traditional cigarettes.

The popularity of electronic cigarettes has soared since they were introduced in the mid-2000s and the devices have swept through the market so quickly that they have outpaced the federal government’s intention to regulate them. (Final rules from the Food and Drug Administration, which regulates tobacco products, have been expected for months.) Bonnie Herzog, an analyst with Wells Fargo, estimates the total vapor market, including e-cigarettes and other related products, such as liquids and personal vaporizers, totaled about $3.3 billion in the United States 2015.

E-cigarettes, designed to deliver nicotine without the toxic tar of conventional cigarettes, have prompted a split among public health experts with some saying the devices will hook new generations of smokers and undo hard-won progress on smoking rates and others saying they will help older, addicted smokers quit.

The answer is not yet clear, in part because there is not enough data on use to tell. But it is important: Cigarette smoking is still the single largest cause of preventable death in the United States, killing about 480,000 people a year. While smoking rates have dropped drastically since the 1960s, there are still more than 40 million Americans who smoke.

Professor Warner said what stood out was the fact that the rate of e-cigarette use had slowed from its earlier more rapid rise, a shift that he said was too early to interpret and that smoking of traditional cigarettes, after many years of declines, had not gone down.

“I’m disappointed, and a bit surprised, not to see another decline in cigarette smoking, even if small,” he said. As for e-cigarettes, If anything, use seems to be flattening out.”

Young people are a particularly vulnerable bunch, and many public health experts agree that with so little known about the long-term effects of e-cigarettes, the fact that so many youths have started using them is worrying, even if they do not use them as a bridge to traditional cigarettes. Others argue that even nicotine can be harmful. In all, about three million middle and high school students used e-cigarettes in 2015, the data showed, up from 2.46 million in 2014.

“No form of youth tobacco use is safe,” said Dr. Thomas R. Frieden, the director of the C.D.C. in a statement. “Nicotine is an addictive drug and use during adolescence may cause lasting harm to brain development.”

The data, from the National Youth Tobacco Survey, which is a pencil-and-paper questionnaire administered to a large sample of middle- and high-school students across the country, had a bright spot: Hookah use declined for high school students, falling to about 7 percent from about 9 percent in 2014.

http://www.nytimes.com/2016/04/15/health/e-cigarettes-smoking-teenagers.html?_r=3

Reuters: No change in tobacco use among U.S. youth; e-cigarettes preferred

CHICAGO (Reuters) – Overall tobacco use among U.S. middle and high school students has not changed since 2011, a period in which use of electronic cigarettes increased dramatically, U.S. health officials said on Thursday.

Given that most adult smokers begin using tobacco before age 20, health officials are concerned over the lack of progress in reducing tobacco use among U.S. youth.

According to the latest data from the U.S. Centers for Disease Control and Prevention and the U.S. Food and Drug Administration’s Center for Tobacco Products, 3 million middle and high school students reported using e-cigarettes in 2015, compared with 2.46 million in 2014.

“E-cigarettes are now the most commonly used tobacco product among youth, and use continues to climb,” CDC Director Dr. Tom Frieden said in a statement.

“No form of youth tobacco use is safe. Nicotine is an addictive drug and use during adolescence may cause lasting harm to brain development.”

The FDA, which currently regulates most conventional tobacco products, is finalizing regulations that would bring e-cigarettes under its authority.

Mitch Zeller, of the FDA’s Center for Tobacco Products, said the agency “remains deeply concerned” about the overall high rate at tobacco use among youth and said finalizing those regulations “is one of FDA’s highest priorities.”

Increases in e-cigarette use in 2015 were largely driven by higher use among middle school students, a group in which use of the devices climbed to 5.3 percent in 2015 from 3.9 percent in 2014. There was no change in e-cigarette use among high school students between 2014 and 2015, following a dramatic 13.4 percent increase in 2014.

Overall, data from the 2015 survey show that 4.7 million middle and high school students used at least one tobacco product in the past 30 days, and more than 2.3 million of those students used two or more tobacco products.

There was no significant change in cigarette smoking habits among middle and high school students between 2014 and 2015, with 9.3 percent of high school students and 2.3 percent of middle school students saying they smoked cigarettes.

“Given that the use of e-cigarettes is on the rise among middle and high school students and nicotine exposure from any source is dangerous for youths, it is critical that comprehensive tobacco control and prevention strategies for youths address all tobacco products and not just cigarettes,” study authors wrote in the CDC’s weekly Morbidity and Mortality report.

(Reporting by Julie Steenhuysen; Editing by Dan Grebler)

http://newsdaily.com/2016/04/no-change-in-tobacco-use-among-u-s-youth-e-cigarettes-preferred/#yH3zqGy4RVGtYeVG.99

USA Today Column: Past time for MLB to ban smokeless tobacco

Use among teen athletes is rising and won’t fall until their MLB role models give it up.

By: Frank Pallone

The first pitches of the new Major League Baseball season in Boston, Los Angeles and San Francisco mark the moment players there must abide by local laws that ban chewing tobacco use in ballparks. Similar restrictions in Chicago and New York will go into effect later this season. This is a first in the major leagues, and a welcome change, but it’s long past time to get chewing tobacco out of America’s pastime.

Chewing tobacco has been pervasive in the game since the rules of modern baseball were first written in 1845.

What’s different today is that the dangers are well known. The use of chewing tobacco has devastating health effects, including oral, pancreatic, and esophageal cancer. It also leads to heart and gum disease, tooth decay, and the loss of jaws, chins, cheeks and noses.

After years of suffering through a difficult and painful battle with cancer, former San Diego Padres Hall of Famer Tony Gwynn died in June 2014 of salivary gland cancer. While there’s no definitive way to pin down cause and effect, Gwynn said the cancer was located exactly where he placed his chew.

Six years ago, at a congressional hearing in Washington, I demanded that chewing tobacco be banned from baseball. That hearing was followed by multiple letters to MLB and to individual teams asking them to take action to get chewing tobacco out of the game. MLB responded to that request by proposing a ban during the last contract negotiations with the players, but the final agreement fell short.  That’s why on Monday, in letters to MLB and the MLB Players Association, I’ll once again demand that they finally ban chewing tobacco completely from the game.

Some argue that professional players are adults and chewing tobacco is a personal choice. But these players are role models and their behavior and habits are often copied by young players and fans alike.

At the 2010 congressional hearing, Dr. Gregory Connolly of the Harvard School of Public Health testified that “there can be no doubt that public use by MLB players directly contributes to youth smokeless tobacco use in the United States.”

Today, millions of teenagers and young adults in the U.S. use smokeless tobacco.  According to the Centers for Disease Control and Prevention, the use of smokeless tobacco by youth athletes increased from 2001 to 2013. Young athletes are almost 80 percent more likely to use smokeless tobacco products than non-athletes.

These trends will not stop until MLB players stop using chewing tobacco. It’s encouraging to see city governments in Boston, Chicago, Los Angeles and San Francisco banning the use of chewing tobacco at ballparks in those cities. Letters posted in every clubhouse during spring training from both MLB and the MLB Players Association explained that players are expected to comply with the new laws.  It’s also encouraging that a number of players have voluntarily stopped chewing.

But it’s not enough.  We need to change the culture of baseball at all levels, and that starts at the major league level.  As Los Angeles Dodgers manager Dave Roberts recently said, “like it or not, players are role models, and we have a platform as coaches and players.”

It’s been more than 30 years since players were first banned from smoking cigarettes in uniform and in view of the public. MLB banned chewing tobacco in the minor leagues in the early 1990s, as did the NCAA. Baseball legend Joe Garagiola, who died last month, testified at our 2010 hearing as the longtime chair of the National Spit Tobacco Education Program. He told the committee, “I would like to see the Major League players agree to the terms of the Minor League Tobacco Policy, which bans Club personnel from using and possessing tobacco products in ballparks and during team travel.”

MLB and the MLB Players Association must finally ban the use of smokeless tobacco. It’s time to get chewing tobacco out of baseball for good. That would be a home run for the health of our nation.

Rep. Frank Pallone represents New Jersey’s 6th Congressional District and is the senior Democrat on the House Energy and Commerce Committee.

In addition to its own editorials, USA TODAY publishes diverse opinions from outside writers, including our Board of Contributors. To read more columns like this, go to the Opinion front page.

http://www.usatoday.com/story/opinion/2016/04/03/past-time-mlb-ban-smokeless-tobacco-column/82477512/

Reuters: Tobacco Companies Would Rather Your E-Cigarettes Contained Tobacco

Two tobacco giants are seeing strong demand for their reboots of the e-cigarette in Japan, with Philip Morris International twice postponing a nationwide rollout and Japan Tobacco suspending shipments – both due to supply shortages.

Japan has become a key testing ground for the two companies and their new, real tobacco e-smokes as they grapple with shrinking demand for traditional cigarettes in other developed countries.

Philip Morris, the world’s largest tobacco company, has postponed the nationwide rollout of its iQOS to April 18.

“We believe that the success of iQOS commercialisation in Japan will accelerate its global expansion,” Philip Morris Japan president Paul Riley told Reuters.

Japan Tobacco CEO Mitsuomi Koizumi told an earnings briefing in February: “We have very high expectations for growth of the so-called tobacco vapor category in five years or so from now.”

The iQOS is a tobacco stick that is heated just enough to produce an aerosol but not combust. The company is betting the presence of real tobacco will make it more satisfying to smokers than existing e-cigarettes.

The new device, priced at 9,980 yen ($89), appears similar to other e-cigarettes in that it is pen-shaped and battery-powered, and is heated to release tobacco vapor.

A key distinction is the refills, sold as Marlboro HeatSticks. Most e-cigarettes sold elsewhere use nicotine-laced liquid, which is heavily regulated in Japan. A pack of 20 HeatSticks sells for 460 yen, the same as regular Marlboro cigarettes.

Philip Morris has introduced the products in major cities in Switzerland, Italy and other countries, but Japan is the first country it plans a nationwide release.

The company had originally planned to sell the product throughout Japan on March 1, but postponed the launch to the end of the month due to a potential supply shortage after it saw stronger-than-expected sales in 12 prefectures where it has been test marketing.

The company estimates the market share of Marlboro HeatSticks reached 2.4 percent in Tokyo at the end of January.

Japan Tobacco, which commands about 60 percent of Japan’s cigarette market and is the world’s third-largest tobacco maker, has also got in on the action by acquiring two overseas e-cigarette makers in the past two years.

In Japan, it has launched the Ploom TECH, priced at 4,000 yen and sold with 460-yen packs of five capsules. Ploom TECH’s selling point is that vapor generated from a liquid cartridge passes through the capsules’ granulated tobacco, creating a taste the company says is close to the real thing.

“There is definitely a need for products that are smokeless but are still satisfying as cigarettes,” said Masanao Takahashi, director at Japan Tobacco’s emerging products marketing division.

Like iQOS, Ploom TECH’s initial launch in the southern Japanese city of Fukuoka proved so popular that the shipment of the device were suspended after a week due to a supply shortage.

It is currently working on a nationwide launch and is also eyeing a global expansion later this year.

http://www.nbcnews.com/business/business-news/tobacco-companies-would-rather-your-e-cigarettes-contained-tobacco-n547111