Letter: Use all anti-tobacco strategies

By: Rep. Blair Thoreson, Fargo, N.D., INFORUM
Several weeks ago, a letter from Dr. Eric Johnson appeared in The Forum in which Johnson made inaccurate accusations regarding a resolution I introduced in the 2013 North Dakota Legislature aimed at reducing the risk of death and disease among smokers. By attempting to distort my motives and tie me to special-interest groups with which I have never had any affiliations, the letter’s author distracted from what should be a productive conversation.
Because smoking harms us all, the state ought to pursue an all-of-the-above strategy to reduce cigarette consumption. In addition to conventional anti-smoking measures, like messaging to youths and promoting smoking cessation, one strategy our state should consider is tobacco harm reduction, which seeks to minimize the damage tobacco does to users and society alike.
Tobacco harm reduction is a secondary strategy that could be used when traditional anti-smoking measures fail. It’s not in question that quitting is the single best thing smokers can do for both themselves and society, but despite our efforts to encourage quitting, thousands of smokers remain unable or unwilling to snuff out their addiction. Tobacco harm reduction targets these individuals by accepting that they will continue to use nicotine, and explores ways to reduce the costs and harmful effects of their nicotine usage.
One alternate product current smokers could turn to is the electronic cigarette, which delivers nicotine without the toxic carcinogens and doesn’t produce secondhand smoke. In fact, a study by the Boston University School of Public Health found that electronic cigarettes are significantly safer than conventional ones, with carcinogen levels 1,000 times lower. If smokers who refuse to quit entirely could be persuaded to switch to electronic cigarettes, North Dakota would pay less in smoking-related health costs, and our children would be at less risk of secondhand smoke exposure.
It may seem like an unconventional method of reducing risk, but studies have shown that smokeless tobacco carries significantly lower health risks than cigarettes. No one should mistake smokeless tobacco for a healthy product, but compared to smoking, it may be less deadly and a better choice.
National and state anti-smoking campaigns have been highly effective, as the smoking rate is half of what it was 50 years ago, and smoking among teenagers is at an all-time low. Yet there remains a persistent minority of nicotine users for whom our conventional outreach has failed. In efforts to promote public health, cut health care costs and reduce preventable deaths, we can’t afford to give up on messaging to these smokers.
It’s clear, however, that we need to think outside the box to reach them. Tobacco harm reduction, endorsed by the American Association of Public Health Physicians, won’t eliminate all the health risks created by persistent smokers, but it could lower their death rate and medical expenses, and take secondhand smoke out of the air.
Instead of making false claims, I believe it would be much more productive to work together and address the public health problems created by smoking on as many fronts as possible. The Legislature’s interim Health Services Committee recently launched a study of the overall effectiveness of North Dakota’s tobacco control programs, which gives us the opportunity to expand and improve our outreach. As we move forward with developing the next generation of public health strategies, tobacco harm reduction should at least be part of the conversation.
Thoreson, R-Fargo, is a small-business owner and represents District 44 in the North Dakota House.

Are E-Cigarettes a Boon, a Menace or Both?

By THE NY TIMES EDITORIAL BOARD

Rapidly growing numbers of consumers are turning to electronic cigarettes to satisfy their nicotine addiction without inhaling the carcinogens and toxic chemicals found in tobacco smoke. Buyers need to beware. Unlike nicotine gum and skin patches, electronic cigarettes have not been evaluated for safety or effectiveness.

Global sales of electronic cigarettes, although small compared with overall tobacco sales, have been rising quickly in both Europe and the United States. Several major tobacco companies have announced plans to introduce new or revamped e-cigarettes. And regulators for the European Union and Britain have released plans to regulate e-cigarettes more stringently, possibly starting in 2016.

Electronic cigarettes turn liquid nicotine into a vapor inhaled by the user. The liquid comes in dozens of flavors, mimicking everything from a standard cigarette to a piña colada or bubble gum. Smoking the devices is undeniably safer than inhaling tobacco smoke, a carcinogen, but there are some risks. Nicotine is extremely addictive, and very high doses can be dangerous. Toxic chemicals have been found in some devices, suggesting serious quality control problems at the factories.

Health officials also fear that flavored vapors coupled with advertising aimed at young people might induce them to start smoking and then move on to traditional cigarettes.

The Food and Drug Administration has two avenues for regulating e-cigarettes. If a manufacturer claims its device will help smokers quit smoking, the agency can demand proof that it is safe and effective for that purpose. However, if a manufacturer makes no such claim and leaves it to smokers to infer that the devices will help them kick the habit, courts have held that the F.D.A. must regulate under a different law that doesn’t require the same level of proof.

Even under that weaker standard, the agency has broad powers to protect public health. It could ban flavorings (like fruit or candy) that make products appeal to youngsters and even ban sales or marketing to buyers under 18. It could ensure that advertising is not deceptive and that factories follow good manufacturing practices.

The F.D.A. has been working since 2011 to draft new regulations to exert its authority over nontraditional tobacco products, potentially including electronic cigarettes. It needs to move as aggressively as possible to protect the public in this rapidly expanding market.

Letter: Cigarettes kill more than wars do

By: Jay Taylor, Durbin, N.D., INFORUM
As I write this, I’m looking at a Forum editorial reminding me to take time to honor the war dead, and in my heart and head, I do that. I’m writing this after Memorial Day as I would not want to take one bit of respect away from the brave soldiers who have defended our country.
I am writing this to honor one particular World War II veteran who served in Germany and came home with stories that he couldn’t even bear to tell until shortly before his death at the age of 56. The war couldn’t kill him; the memories couldn’t kill him; working six to seven days a week couldn’t kill him. Cigarettes did! He was tough but not tough enough. He died from his addiction to smoking cigarettes. So as we honor those who fought for our country’s freedom, let’s take a moment to honor those who fought addictions fed by serving in the military, among other places.
Cigarettes and tobacco products are killing more people than wars ever could. Let’s fight that battle, too.
http://www.inforum.com/event/article/id/401383/