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E-cigarette regulation and taxes once again on the front burner at the Capitol

By WAYNE GREENE World Senior Writer
OKLAHOMA CITY – Three lawmakers are renewing the fight over an issue that lit up the state House last year – electronic cigarettes.
Last week, Speaker of the House T.W. Shannon approved so-called “e-cigarette” study proposals by Speaker Pro Tem Mike Jackson, Rep. Mike Turner and Rep. David Derby.
Jackson, R-Enid, is the second-ranking member of the House leadership. Derby, R-Owasso, is chairman of the House Public Health Committee and will oversee the studies.
An e-cigarette is an electronic inhaler that vaporizes a liquid nicotine solution, simulating the act of tobacco smoking. Like cigarettes, users get a nicotine fix. Unlike cigarettes, there is no smoke.
During the final days of the Legislature’s last session, the House rejected a bill backed by Jackson to deal with the same issue on a 66-29 vote after nearly three hours of questioning and debate.
At issue in the interim studies is how the devices are taxed and how their sales are regulated.
Derby’s study would investigate “regulation of vapor and other emerging nicotine products.”
The Jackson-Turner study would look into “taxation, tobacco harm reduction, and youth access to electronic cigarettes.”
Currently, state law doesn’t adequately address sales of e-cigarettes to minors, and “youth access is definitely something we need to address,” Jackson said.
The U.S. Food and Drug Administration is considering classifying the devices as tobacco products, a move that could result in a significant tax burden on people using them, he said.
If FDA action made the devices subject to the state’s tobacco tax, it could make the e-cigarette equivalent of a pack of cigarettes taxed at $8.50 to $9, Jackson said.
“What we don’t want to do is put a higher tax on a less-harmful product,” he said.
Jackson said his brother has used an e-cigarette to gradually reduce his nicotine dependency. He hasn’t used a cigarette in three or four months, Jackson said.
“I have seen first-hand how they can help,” he said.
The American Cancer Society opposed Jackson’s efforts last year and will continue to fight against efforts to reduce taxes on e-cigarettes, said James Gray, director of government relations for the Cancer Action Network.
There is no scientific evidence to back claims that e-cigarettes are an effective means of weening smokers from their habit.
No other state has taken the actions Jackson has proposed for Oklahoma, Gray said.
“I think this is a new direction of Big Tobacco, and (legislators are) really cautious about doing anything that provides a new market to Big Tobacco,” he said.
Doug Matheny of tobaccomoney.com said the claim that an FDA regulation could lead to a dramatic state tax hike is a “scare tactic.”
“It’s one of those classic examples of the tobacco industry – and I do believe the tobacco industry is behind this – to make legislators feel like they have to do something – they have to act,” Matheny said. “And actually they don’t need to at all in Oklahoma.”
A simple bill to restrict youth access to e-cigarettes should take less than one page, but the design here is about expanding markets for nicotine, not reducing smoking, Matheny said.
“These companies don’t really care what you buy from them as long as you continue to buy from them. They’re selling an addictive product that contains nicotine. As long as you don’t quit altogether, they’re happy.”
Tobacco lobbyists are a powerful force at the state Capitol, Matheny said.
According to Oklahoma Ethics Commission reports, contributions to Oklahoma state legislative campaigns from the Reynolds American Inc. political action committee increased by 70 percent in the 2012 election cycle. Meals purchased by lobbyists on behalf of Reynolds American Inc. increased by more than 50 percent, Matheny said.
http://www.tulsaworld.com/article.aspx/E_cigarette_regulation_and_taxes_once_again_on_the/20130716_11_A1_CUTLIN990334?subj=1

New tobacco products lure younger smokers

By Adelaide Effie Beckman
For The TimesDaily
It remains illegal to market tobacco products to teenagers, but some health experts argue it hasn’t stopped some companies from finding a way around the law.
Tobacco companies are now targeting teens with cheap nicotine products in colorful packaging, according to Melanie Dickens, tobacco prevention and control coordinator for the Lauderdale County Health Department.
Dickens said teens are more susceptible to the new flavored tobacco products such as nicotine sticks and orbs.
However data collected by the Alabama Department of Public Health shows that the number of high schools students who smoke has significantly decreased. Nearly 19 percent of high school students in Alabama smoked in 2010, compared to 30.2 percent in 2000.
Nicotine sticks look like toothpicks, but they are pure nicotine. Dickens said teenagers can easily have them in their mouths without attracting attention from their parents or their teachers. She added nicotine orbs are small dissolvable tablets of nicotine that come in different flavors, which “look like little Tic-Tacs.”
Dickens said parents don’t always know if their children are using tobacco because the new nicotine products don’t create the smoke or smell of cigarettes and cigars.
“A lot of times if the kids are not using cigarettes . . . mom and dad might not be aware,” she said.
Dickens said teens often don’t realize how much nicotine they’re using. One Black and Mild cigar has the same amount of nicotine as 10 cigarettes, and one pinch of smokeless tobacco has the same amount of nicotine as three or four cigarettes. Both products are popular with teens, she said.
“They feel invincible; that’s why they don’t want to quit,” she said. “It’s an addiction and a habit.”
Talking to children early on about the dangers of tobacco use is the best way to keep them from becoming smokers, according to Valerie Thigpen, prevention specialist for the Lauderdale County schools district.
“If you wait until they’re in the sixth grade, they’ve already been exposed,” she said.
Thigpen said children need to be taught the risks associated with tobacco and how to say no to peer pressure.
“I am a major believer in if you can prevent someone from starting, it’s a whole lot easier than getting someone to stop once they’ve started,” Thigpen said.
There are lots of reasons teens smoke or use smokeless tobacco, Dickens said. Peer pressure, boredom and marketing all play a role. Thigpen said teens often smoke because their parents do.
University of North Alabama student Jestin Coats said he only smokes when he’s stressed after a long day. He said he rarely smokes, maybe once every nine months, and he has no trouble stopping once he’s started.
Coats said he had his first cigarette when he was 19 and his parents didn’t know. “I don’t want them to.”
The Centers for Disease Control and Prevention say other factors that contribute to tobacco use in teens are low socioeconomic status, lack of parental support or involvement, low self-image or self-esteem, low levels of academic achievement and exposure to tobacco advertising.
Religious participation, racial/ethnic pride and higher academic achievement or aspirations are factors that have been found to protect teens from tobacco use.
“Tobacco is a huge issue with a lot of our high school students,” Thigpen said. “They tell me, ‘I just like it. I like the way it makes me feel. It calms me down.’ The kids seem to live by ‘if it feels good, do it,’ because if it brings them pleasure they can’t get enough of it.”
Officials with the disease control center say tobacco use in teens is associated with high-risk sexual behavior, use of alcohol and use of marijuana and other drugs.
“Tobacco is still truly the gateway drug,” Thigpen said.
“We’re not saying that everyone who uses tobacco is going to use bigger things,” Dickens said, adding it’s a risky behavior that leads to other risky behaviors.
Katelyn Cosby, 22, a resident of Rogersville, said she started smoking when she was 14 or 15.
“My mom was not happy,” Cosby said. “She used to steal my cigarettes out of my purse and put ‘how to quit smoking’ pamphlets in my purse. I usually just gave them back to her.”
Cosby said she started smoking because many of her friends were smoking. She quit smoking while she was pregnant with her children, but she said she hasn’t made the effort to quit permanently because it’s too much of a habit.
“It’s weird to try not to (smoke),” she said.
Dickens said 6.3 million children who are alive today will eventually die of tobacco related illnesses if the current rates of tobacco use do not change.
“(Not using tobacco) is the one thing you can do to reduce your risk of cancer,” said Amy Fields, a spokeswoman for the American Cancer Society. “People who quit at any age, whether they’re young or old, they’re going to live longer.”
Fields said as many as one-third of cancer deaths could be prevented if people avoided tobacco products. Lung cancer is the cancer most commonly associated with smoking, but using tobacco products increase a person’s risk of developing all types of cancer.
“Kids have no idea the damage they do to themselves (by smoking),” Thigpen said.
Dickens said teens should try to break their smoking habits as soon as possible because the longer a person smokes, the harder it is to quit.
For information on how to quit, Dickens suggested calling 1-800-QUIT-NOW or talking to a health care provider.
Fields said her advice to parents whose children smoke is to do everything possible to help their children kick the habit immediately.
http://www.timesdaily.com/news/local/article_4488ab9a-ec3a-11e2-bb9b-10604b9f6eda.html

E-cigarette maker targets Colorado

By Carol McKinley
Colorado Public News
The arrival of electronic cigarettes has raised a red flag for health officials and others who worry the activity of “vaping” nicotine will hook young people into a new addiction that could last a lifetime.

In Colorado, the concern is heightened by the arrival of tobacco giant R.J. Reynolds Tobacco Co. Beginning this month, the maker of Camel cigarettes and other tobacco products began selling its new e-cigarette – called Vuse – along Colorado’s Front Range as one of four test markets.
“We’ve done a lot of work to make it not cool to smoke, and we’d hate to see that rolled back,” said Stephanie Walton, youth policy coordinator for the Colorado Department of Public Health and Environment.
Pat Senecal, director of health policy and systems at San Juan Basin Health Department in Durango, said Friday that the Federal Drug Administration is worried about test marketing and availability of e-cigarettes.
“The FDA has no regulatory authority yet over e-cigarettes, so the risks aren’t known,” Senecal said. “E-cigarettes have flavoring, and studies of other tobacco products show that flavoring appeals to youths.”
The Colorado Department of Public Health and Environment said in a statement Friday: “Too much remains unknown about the potential health risks of these new nicotine products. We are concerned that the tobacco industry is introducing yet another product to Coloradans that is addictive and potentially harmful to their health.”
Also known as personal vaporizers, e-cigarettes broke into the American market six years ago. They look like cigarettes, but do not contain tobacco. They actually are battery-operated inhalers that turn nicotine into a vapor. The liquid, or “E-Juice” that is vaporized can carry a range of tasty-sounding flavors such as cotton candy and peach and names like “Bikini Martini” and “Choco Loco.” E-cigarettes aren’t “smoked,” they are “vaped.”
Studies long have determined that nicotine is as addictive as heroin and cocaine, leaving health officials such as Walton concerned.
“If children see e-cigarettes as popular and fun and start using them, that can lead to a lifetime of nicotine addiction,” she said.
Many Americans report they’ve never heard of e-cigarettes, but the industry now is generating $500 million in sales annually. Business is expected to surpass $1 billion annually within the next couple of years.
E-cigarettes generally are sold in places where tobacco products are available, as well as in specialty shops and in shopping malls. Since at least 2009, the federal Food and Drug Administration has warned about potential health risks associated with e-cigarettes. In addition to nicotine, the products contain substances such as propylene glycol and artificial flavors that might, the agency warns, penetrate deeply into the lungs. However, the products – at least for now – are not regulated.
More than a dozen states, including Colorado, have banned the sale of e-cigarettes to minors. But Walton and others are concerned that advertising, and the tasty-sounding flavors, will directly appeal to young people.
“We would love to see the FDA look into this, especially with some of the larger tobacco companies really taking an interest in these products now,” Walton said.
But some vendors who sell e-cigarettes say they promote the product as a healthier alternative to traditional cigarettes and a way to wean people off of tobacco products.
Within three days of last summer’s mass shooting in Aurora, Colorado-based e-cigarette company VeppoCig.com began offering trial kits for free to anyone who had been at the theater and was suffering from post-traumatic stress disorder.
“Above all, we are a company that cares for the health of our customers. We understand that they are going through a difficult time, and we want to help,” the company announced.
John Paul Pollock of The Vapor Store in Golden described e-cigarettes as “a dignified alternative for people who smoke.”
However, Walton rejects comparison to other stop-smoking products – such as the FDA-approved nicotine patch and nicotine-infused gum.
“There is no research that shows that (e-cigarettes) are an effective cessation or stop-smoking aid or device,” she said.
Still, e-cigarettes are catching on worldwide. A recent survey found that nearly 10 percent of Parisian schoolchildren between the ages of 12 and 17 have tried them. There are many active e-cigarette forums and Facebook pages. One website discussion in Colorado asks if people can “vape” in casinos in the mountain gambling town of Black Hawk and advertises meet-ups where fellow “vapors” can connect.
Because e-cigarettes are not a tobacco product, companies can get around 42-year-old laws that ban cigarette advertising. Currently, the largest concentration of e-cigarette ads is online. But with big companies such as R.J. Reynolds entering the marketplace, some predict advertising on TV, radio and billboards is not far behind.
“By around August, we should start seeing significant TV advertising, as well as online,” said Colorado-based marketing executive Brent Green. In addition, he said, “there will be live sampling at nightclubs and festivals where people gather.”
Green, a critic of e-cigarettes, highlighted the dangers of romanticizing e-cigarettes. For example, recently, actor Leonardo DiCaprio was seen vaping in public.
“You show celebrities, you show cool adults using the product – kids always aspire to act and react like adults. They want to be grown up,” said Green.
It is unclear why R.J. Reynolds selected Colorado as its test market for the new product. During a recent press conference, R.J. Reynolds Vapor Co. president Stephanie Cordisco would say only that “Colorado represents just one of our major states as we are rolling this out.”
Company officials did not return subsequent calls from Colorado Public News.
Even the Colorado Department of Public Health and Environment says it can’t get a definitive answer as to why Colorado was selected.
“We’re not sure why. We would love to know,” said Walton.
The Centers for Disease Control and Prevention reports nearly 1 in 5 Coloradans smoke cigarettes, ranking the state 10th nationally.
Durango Herald Staff Writer Dale Rodebaugh contributed to this report. Colorado Public News, a nonprofit news organization, reports on issues of statewide interest. It partners with Colorado Public Television 12, Denver’s independent PBS station.
http://durangoherald.com/article/20130713/NEWS01/130719776/E-cigarette-maker-targets-Colorado

Cigarette smoking at new low among youths, survey finds

Cigarette smoking hit the lowest point ever recorded among American eighth-graders and high school sophomores and seniors last year, a newly released report shows.

Last year, only 5% of high school sophomores said they had smoked cigarettes daily in the previous 30 days, compared with 18% of sophomores who were smoking daily at one point in the 1990s. The numbers have also plunged for eighth-graders and high school seniors, hitting their lowest point since the surveys began.
The change is just one of the findings in a vast new report on the well-being of American children, compiled by the Federal Interagency Forum on Child and Family Statistics. The report draws together research from a host of government agencies and research groups, including smoking surveys from the National Institute on Drug Abuse.
Besides being less likely to smoke, U.S. children are also less likely to be exposed to secondhand smoke than in the past, the report showed.
Danny McGoldrick, vice president for research for the Campaign for Tobacco-Free Kids, credited tobacco taxes, laws limiting where people can smoke and smoking prevention programs with reducing the numbers. However, the surveys show progress has slowed in recent years, with teenage smoking rates falling only slightly from 2011 to 2012.
“We need to invest in more of what has worked in the past to accelerate these declines,” McGoldrick said.
Other findings from the report included:
• Birth rates have continued to drop among teenagers, falling for the fourth year in a row, according to preliminary data. As of two years ago, there were 15 births for every 1,000 teenagers ages 15 to 17 — a striking decrease from four years earlier, when the rate was 22 per 1,000.
• Last year, nearly a quarter of high school seniors reported binge drinking in the previous two weeks, a slight increase after earlier declines.
http://www.latimes.com/news/local/la-me-0712-kids-wellbeing-20130712,0,7542363.story

Smoking banned on Bismarck’s playgrounds

BISMARCK, N.D. – In a 5-0 vote on Thursday, the Bismarck Park Board took swift action to ban smoking on the 44 playgrounds and play areas it manages. People must step 20 feet away from the playground before they light up.
Alecia Uhde, chairwoman of the Go! Bismarck Mandan coalition, said she made the request as part of the group’s goal to improve the health, fitness and quality of life for people.
“One of those (goals) was to increase the number of tobacco-free designated areas for children, specifically outdoors,” she said. “Young children are impressible. … Secondhand smoke, even in outdoor settings, is a true health hazard and harms everyone.”
Uhde said discarded tobacco products in play areas may be ingested by toddlers.
“I believe we set an example for the children of this community,” park board President Mike Schwartz said after the meeting.
Bismarck Parks and Recreation Executive Director Randy Bina said the smoking ban will create a better awareness of healthy lifestyles and examples for children.
“All we’re saying is, if someone does want to smoke, just step away 20 feet from the playground and just don’t smoke inside the playground,” he said.
Bina said Go! Bismarck Mandan will help the park district pay for new signs explaining the tobacco bans in playgrounds. He didn’t think there would be an enforcement issue.
“This policy is dependent upon people self-policing the playgrounds. We need the cooperation of all of the users that if they see someone smoking, make the individual aware of the policy and ask them to move 20 feet away from the playground,” he said.
Two proposals to further limit tobacco use in Mandan parks failed on Monday. Tobacco use is already barred at several park locations and events throughout the Mandan park system.
In separate action, the Bismarck Park Board:

  • Agreed to advertise for bids for the Hoge Island boat ramp. It also entered into an agreement with the state Game and Fish Department to replace the ramp.
  • Received a final facilities report from JLG Architects that gave them several options for replacing Hillside Pool and making it a year-round meeting facility, improving the World Memorial Building and adding at least one more sheet of ice for hockey programs. Bina said the options will be discussed in the 2014 budgeting process this summer. For more information about the proposals, visithttp://bisparks.org.
  • Awarded Northwest Contracting the bid for the Schaumberg Arena work to remove its sand base floor and replace it with concrete, and install new refrigeration piping, ceiling work and an overhead door on the east side. The low bid is $587,200. The project will be finished by Oct. 1, Bina said.

http://bismarcktribune.com/news/local/govt-and-politics/smoking-banned-on-bismarck-s-playgrounds/article_2e55767c-be8c-11e2-9916-001a4bcf887a.html#.UZY87qvHp4c.facebook

New tobacco limits fail in Mandan parks

Two attempts to tighten tobacco limits in Mandan’s park system failed Monday. In the end, the Mandan Park Board voted to support keeping several locations where tobacco is already banned by park staff.
The Go! Bismarck Mandan Coalition in April proposed that tobacco use be banned in all playgrounds in the district.
Based on survey results and comments, Parks and Recreation Director Cole Higlin proposed prohibiting tobacco use everywhere but in parking lots and the golf courses on Mandan park property.
“I do not like people to smoke near parks because I like to play and want everyone to be safe,” said 10-year-old Zara Laber, a park user.
Her mother, Shawna Laber, said allowing smoking where children gather is “not positive role modeling for anyone under (age) 18 … and a fire safety (issue).” She said smokeless tobacco is unsanitary near children.
Jack Jones of the Mandan Softball Association said the adults already police themselves in ball games.
“If golf is left out this, I would appreciate if the softball complex was as well,” he said. “It is against (American Softball Association) rules to smoke while playing. … Occasionally, there are players between innings and between games that will step out of the dugout, walk down a ways and have a cigarette. In 25 years, I’ve never seen anybody smoke in the bleachers.”
Vice Park Board President Tracy Porter made a motion to ban smoking in parks and shelters, soccer field at Dacotah Centennial and its dog park. The motion died for a lack of a second.
Park board member Kevin Allan made a motion that prohibited tobacco use on all park district properties, except for the golf courses and parking lots.
“Common sense prevails. If it’s not broke don’t fix it,” said Park Board President Jason Arenz. Allan’s motion failed in a 4-1 vote. Allan was the only park board member to vote yes.
Arenz briefly stepped down as president so he could make a motion endorse the parks policy, which now bans tobacco at youth baseball, Dacotah Centennial Park and its seating, Memorial Ballpark and the Raging Rivers. All five park board members approved it.
Park board member Wanda Knoll said she’d like to revisit tobacco policy in four months and see if there is an issue. Higlin said there had been no complaints about current tobacco policy.
http://bismarcktribune.com/news/local/govt-and-politics/new-tobacco-limits-fail-in-mandan-parks/article_8bad7bbe-bc3c-11e2-b616-0019bb2963f4.html

Parks ponder playground tobacco ban

Mandan and Bismarck park systems will consider making their green space smoke-free next week.
The Mandan Park Board, which surveyed its park users, will revisit the issue at 5:30 p.m. Monday.
Both park entities were approached by the Go! Bismarck-Mandan Coalition to remove tobacco from the play areas.
The group will make its pitch to the Bismarck Park Board at its 5:15 p.m. Thursday meeting at the City/County Building.
A Mandan park committee recommendation favors banning smoking everywhere but parking lots and the golf course, Mandan Parks and Recreation Director Cole Higlin said Friday. The Mandan Park Board will make the final decision on what tobacco limits to set.
Higlin said tobacco use is already prohibited at most Mandan park facilities and there are signs posted. He said the new proposal also will keep it off park trails, adult softball areas and the Dacotah Centennial Park area.
He doesn’t expect expansion will cause a bigger maintenance issue for staff.
“It probably causes no more or less littering,” he said. “Receptacles could be added (for the cigarette butts).”
Higlin said 292 park system users responded to a survey about a tobacco ban for facilities, either online or using one that had been sent to them by email.
Nearly 44 percent said second-hand smoke at outdoor park facilities bothered them a lot. Twenty percent said it bothered them a little and 29.2 percent said it didn’t bother them at all.
Those polled also were asked if they were bothered by smokeless or spit tobacco. Of the responders, 26.6 percent said it bothered them a lot, 37.2 percent said it bothered them a little and 36.2 percent they weren’t bothered.
Of the Mandan park system users polled, 61 percent favored banning it at the golf courses and 38 percent said they were opposed. Nearly 60 percent wanted it banned on trails and 40 percent were against barring tobacco on trails.
About 80 percent said they wanted tobacco use banned on athletic fields and playgrounds. Eighty-one percent wanted its use banned at concession areas and 67 percent wanted tobacco off Dacotah Centennial Park, according to the Mandan poll.
Higlin said common sense would come into play, and people would follow the rules without staff intervention to enforce it.
“We hope this serves as a possible message to the youth,” said Higlin.
“Go! Bismarck-Mandan is asking us to do this in the playgrounds only,” said Bismarck Park Board member Wayne Munson. “Personally, I favor that idea.”
He said there could be issues with enforcement.
Bismarck Parks and Recreation Executive Director Randy Bina said the proposal sounds reasonable.
He doesn’t expect the park district will incur many extra costs for its 44 playgrounds. Go! Bismarck-Mandan has offered to pay for stickers for both park entities.
“Most park users are respectful of others (in their tobacco use),” he said.
Bina said, if approved, the park district might model the playground policy after the state smoking ban for buildings and keep tobacco use 20 feet away from a playground.
http://bismarcktribune.com/news/local/govt-and-politics/parks-ponder-playground-tobacco-ban/article_541f0f6e-b9bc-11e2-9dd2-001a4bcf887a.html

How Obama’s tobacco tax would drive down smoking rates

By Sarah Kliff, Washington Post
President Obama’s proposal to nearly double the federal tobacco tax would help fund a universal pre-K program. And, if history is any guide, it would likely have a marked impact on driving down the country’s smoking rates.
“Increasing the price of tobacco is the single most effective way to discourage kids from smoking,” CDC director Tom Frieden told reporters Tuesday afternoon. “We estimate this would result in at least 230,000 fewer kids smoking than would have smoked if the tobacco tax does not go into effect.”
Researchers have conducted over 100 studies that have “clearly and consistently demonstrated that higher cigarette and other tobacco product prices reduce tobacco use,” Frank Chaloupka, a professor at the University of Illinois in Chicago, writes. While tobacco is an addictive substance, demand tends to be surprisingly elastic: Price increases have reliably shown to decrease cigarette purchases.
The Congressional Budget Office recently looked at what would happen if the country implemented a 50-cent per pack tax on cigarettes. It estimates, given the research we have on tobacco taxes, that the price increase would lead to 1.4 million fewer smokers by 2021.
Many of those gains would be concentrated among younger Americans, who would take up smoking at lower rates:
A few years after the hypothetical tax increase took effect, the number of 12- to 17-year-olds who smoked cigarettes would be about 5 percent lower than it would be otherwise, the number of 18-year-old smokers would be 4.5 percent lower, the number of 19- to 39-year-old smokers would be almost 4 percent lower, and the number of smokers age 40 or older would be about 1.5 percent lower.
The CBO data suggests that a cigarette tax is more successful at reducing tobacco use among shorter-term smokers, vs. older Americans who may have been smokers for a longer period of time.
Even among those who don’t fully quit, tobacco taxes do appear to effect the intensity of smoking. A 2012 study in the journal Tobacco Control interviewed thousands of smokers over a time period where states increased their tobacco taxes. It found that the most intense smokers — those who smoked 40 or more cigarettes per day — saw the steepest decline in cigarette consumption.
“The dramatic reductions in daily smoking might be driven,at least in part, by heavier smokers’ desire to reduce the number of cigarettes they smoke per day,” lead study author Patricia A Cavazos-Rehg writes. “This could be because of their comorbid health problems and/or advice from influential persons (eg, doctors/friends/family) to try to quit and/or reduce smoking.”
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/04/11/how-obamas-tobacco-tax-would-drive-down-smoking-rates/