Forum editorial: Prohibit smoking in all parks

Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.
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All metro area communities, large and small, should follow the lead of Dilworth and Moorhead and ban smoking in public parks. Dilworth took the smart step last week. Moorhead parks have been smoke-free since 2011. The Fargo Park District has a limited ban that allows smoking 25 feet away from playgrounds. West Fargo allows smoking in parks.
Parks primarily are venues for families and children. Moreover, park officials champion healthy lifestyles. The sports activities that take place on park fields comport with fitness and health. Smoking should be anathema.
In addition to bans and partial bans in the metro, nearby cities that ban smoking in parks include Mayville, Kindred, Valley City, Cooperstown and Wahpeton, all in North Dakota. Dozens of Minnesota cities have bans in place.
While some smokers might see the closing off of more public spaces as a violation of their rights, that argument is nonsense. There remains a plethora of places where smokers can indulge their habit, as long as it does not threaten the health of others. The many voter-approved bans in place reflect recognition that smoking and secondhand smoke are health issues, not rights issues. Some smokers will debate that unassailable premise until they cough their lungs out, but as a matter of public policy the debate is over.
Therefore, the Fargo Park District should extend its limited ban to every square foot of park land, and West Fargo should ban smoking in every one of its beautiful, allegedly family-friendly parks.
http://www.inforum.com/event/article/id/433907/

Higher taxes on cigarettes make good sense

Washington Post Editorial Board
Maryland has one of the highest state-imposed cigarette tax rates in the nation ($2 per pack) and, unsurprisingly, one of the lowest smoking rates. Virginia has one of the lowest cigarette tax rates in the nation (30 cents per pack); its smoking rate is almost 20 percent higher than Maryland’s.
America is well past the debate about the health effects of smoking, but tobacco taxes in many states remain low, thanks largely to the influence of tobacco companies. Yet it is clear that higher cigarette taxes have a direct effect on smoking rates, and they are particularly effective in dissuading young people from taking up the habit.
In Maryland, where the tax on a pack of cigarettes was raised in 1999 (to 36 cents), 2002 (to $1) and 2008 (to the current rate of $2), smoking rates have fallen by about a third, much faster than the national average. At the time of the last increase, Maryland’s tobacco tax was 6th-highest in the nation; since then it has slipped to 12th as other states have leapfrogged each other in an effort to further discourage smoking — and raise revenue in the process.
In Annapolis, public health advocates and other groups are now pushing for another $1 increase, which would bump the state tax in Maryland to $3 per pack. Depending on how much of the increase tobacco companies decide to absorb, that could raise the average retail price of cigarettes above $7; it’s currently around $6.40.
The projected benefits of a $1 increase in Maryland make a persuasive case. They include $95 million in additional revenue (which health advocates would like to use to extend Medicaid health coverage to the poor); a 10 percent decrease in the rate of youth smoking; thousands of adults who would be persuaded to quit; and the prevention of thousands of premature deaths, which in turn would produce considerable economic benefits.
It’s true that raising the tax would cause more Marylanders to cross the border to buy cigarettes in Virginia or North Carolina. But cigarette sales fell much more dramatically in 2008 in Maryland, the District and Delaware, all of which raised their tobacco taxes that year, than they rose in Pennsylvania, West Virginia and Virginia, which did not. And while cigarette smuggling remains an unquantifiable challenge, declining smoking rates and the associated public health payoffs are real.
Legislation to raise the tax went nowhere in Annapolis this year, possibly because the state has raised so many other taxes in the last few years. Advocates are mounting a push to gather pledges of support from lawmakers to enact the increase next year.
Meanwhile, in Virginia, where the tobacco lobby remains virtually unchallenged, the average price of a pack of cigarettes, about $4.60, is among the lowest in the nation. If Virginia lawmakers want to encourage children to take up the habit, they’re doing a great job.
http://www.washingtonpost.com/opinions/higher-taxes-on-cigarettes-make-good-sense/2014/04/20/aa90bd08-c716-11e3-9f37-7ce307c56815_story.html

Other Views: E-cigarette sellers take page from Big Tobacco’s book

— USA Today
Just when smoking has finally lost its glamour, along come electronic cigarettes and an avalanche of sexy new ads that promote “vaping.”
In one, actor Stephen Dorff, shirtless, talks about taking “back your freedom” while inhaling vapor on Lorillard’s blu eCig. (Can anyone say Marlboro Man?) In another ad for blu, former Playboy centerfold Jenny McCarthy leans forward seductively into the camera before saying: “I feel free to have one almost anywhere.”
For a product whose main appeal is supposed to be that it’s not a traditional cigarette, e-cigarette makers have sure taken a lot of pages from Big Tobacco’s playbook. Which is not surprising. Many of the sellers are the same companies that made billions of dollars addicting people to a product that kills 480,000 a year.
The marketing push is enough to trouble anyone who believed that, after a half-century battle, the nation finally had smoking on the run and that fewer teenagers would get hooked and die prematurely.
E-cigarettes — battery-operated nicotine inhalers that contain no tobacco — have the potential to help some smokers quit. But the jury is still out on whether and how well they may work. In the meantime, the potential for nicotine addiction is high, and there’s no good reason to use e-cigarettes other than trying to quit smoking.
Federal law prohibits cigarette makers from sponsoring sports and entertainment events, handing out free samples and selling certain flavored cigarettes. TV ads were banned in 1970.
But for e-cigarettes, it’s open season. Makers have sponsored music festivals, fashion shows and IndyCar racing. You can buy e-cigarettes or liquid refills in everything from Cherry Blast to Gummy Bear. Is the public really supposed to believe that e-cigarettes are not being marketed to minors?
The dangers of e-cigarettes may not be as obvious as those of traditional smokes, but new problems are emerging.
For example, the nicotine-laced liquid the devices use, which comes in small vials and large containers, can be toxic if touched or consumed. Calls to poison control centers about misuse, mostly by children, have risen to 217 a month this year, almost 10 times the number in 2011.
Also troubling is that more teenagers are experimenting with e-cigarettes. In 2012, 1.8 million middle-school and high-school students tried them, double the number the year before. One in five of the middle-schoolers who experimented said they’d never smoked before. It doesn’t help that about 20 states allow sales of e-cigarettes to minors.
So what’s the right response? At least until more studies are done, all states should treat the new devices as they treat cigarettes, with bans on youth sales and indoor use. And the Food and Drug Administration, which has been slow to assert its authority to regulate e-cigarettes, ought to get on with it.
More independent research would determine if e-cigarettes really can help smokers quit. Or if they carry other health risks. For now, the nation ought to ensure that a new generation doesn’t get hooked on a different and potentially dangerous product.
http://www.theadvertiser.com/story/opinion/2014/04/20/other-views-e-cigarette-sellers-take-page-from-big-tobaccos-book/7951623/

ERIC JOHNSON: E-cigs’ risks are real while benefits are scant

By Eric Johnson, Op-Ed, Grand Forks Herald
GRAND FORKS — According to the Centers for Disease Control and the U.S. Surgeon General, tobacco kills about 480,000 persons every year in the United States.
In 1964, about 41 percent of adults were cigarette smokers. Today, that rate is down to a little more than 18 percent. Significant strides have been made over the past five decades to reduce smoking and the tremendous health and financial burden it puts on our society.
In North Dakota alone, tobacco use still contributes to about $250 million in health care expenditures.
Encouraging people to quit tobacco remains a high priority with regard to the health of Americans, yet only two states in the nation — Alaska and North Dakota — fund anti-tobacco programs at levels recommended by the CDC.
In North Dakota, our efforts continue to be supported by the public. Public sentiment, expressed at the ballot box and in polling, shows that reducing tobacco use remains a high priority for North Dakotans. In 2008, voters approved Measure 3 to support funding of anti-tobacco programs; and in 2012, the statewide smoke-free law — passed as a ballot measure — got 67 percent of the vote, winning support from a majority of voters in every legislative district.
Some 89 percent of North Dakotans polled in 2013 think the funds designated for tobacco control should stay there.
What works to help people quit tobacco? The U.S. Preventive Task Force and the Surgeon General endorse medications that have proven effectiveness with a known, Food and Drug Administration-approved, safety and side-effect profile.
These include nicotine replacement products such as gum, patches or lozenges, as well as prescription medications such as Chantix (Varenicline) or Wellbutrin (Buproprion).
Proven counseling programs, such as NDQuits (available free to all North Dakotans who use tobacco), also are very effective, particularly when combined with an FDA-approved medication.
Electronic cigarettes (e-cigs) are increasingly popular products that fall into the unproven category. First invented in the 1960s, their popularity has continued to increase as large tobacco companies buy small “mom-and-pop” manufacturers. With more than 250 brands on the market, (“Blu,” “NJOY” and “Vuse” popular in America), e-cigs are battery-powered (some disposable, some rechargeable) with a vaporizer and mouthpiece attached.
When used, commonly referred to as “vaping,” the vaporizer boils the liquid inside, which most frequently contains three major ingredients — humectants (propylene glycol/glycerin, used in fog and smoke machines and antifreeze), nicotine (at varying levels) and flavoring (fruit flavors, bubble gum, cotton candy, bacon and coffee, to name a few).
Unlike other medications that are used to promote quitting tobacco, e-cigs are largely unregulated by the Food and Drug Administration; and to date, we have no real data to show that they are effective as a cessation product nor any data to show that they are safe.
Furthermore, some of these manufacturers have been cited for contaminants in their products, including nickel, arsenic and chromium.
Without FDA oversight, these products aren’t taxed, they can be sold to anyone of any age, and there are no restrictions on advertising, which is why we see and hear ads on TV, in magazines and on the radio.
Though the industry denies it, it’s apparent that these products are being marketed to children (unless we’re supposed to believe that “Hello Kitty” e-cigs are popular among adult users).
E-cig manufacturers, rather than relying on science, really are trying to “normalize” smoking again for the next generation. The recent national Youth Tobacco Survey showed a spike in use of e-cigs by youth, doubling to more than 10 percent in just one year.
In addition, many who use e-cigs become dual users, continuing to use other tobacco products at the same time.
Last but not least, the industry is playing on the desperate idea that anything else would be better than smoking traditional cigarettes. If that’s true, ask yourself why these same companies are so resistant to producing the data to back up their claims.
It’s disappointing that e-cigs have been marketed for more than 35 years and have yet to collect or publish any significant data to show they are safe for users or that they actually help people quit.
Considering these products increasingly are manufactured and marketed by Big Tobacco, I’m not anticipating we’ll see such data any time soon.
The FDA has made it very clear that e-cigs cannot be marketed as smoking cessation products as a result.
As a health care provider, I would love a good, new and novel option to help people quit smoking. Like other conditions I treat as a physician, I want to provide the best possible treatment for my patients, and that means practicing strategies and using medications that have scientific proof that they work and have an established safety profile.
To date, when it comes to quitting tobacco, that answer is not found in electronic cigarettes.
Dr. Johnson is a family physician at Altru Health System in Grand Forks.
http://www.grandforksherald.com/content/eric-johnson-e-cigs-risks-are-real-while-benefits-are-scant

Smokeless tobacco: Strike out a harmful habit

(AP) Arizona Diamondbacks catcher Miguel Montero smiled with a mouthful of smokeless tobacco during spring training last month.
Boston Globe Editorial
As long as smokeless tobacco remains ingrained in baseball culture, there’s always the likelihood that much younger players will mimic their heroes from the diamond — and pick up a habit that increases the risk of cancer. The Globe recently reported that of the 58 Red Sox players who were invited to spring training, 21 of them, including stars David Ortiz, Jonny Gomes, Clay Buchholz, and Mike Napoli, acknowledged using either chewing tobacco or snuff. These were hardly ringing endorsements: Ortiz, who said he uses a pinch of tobacco as a stimulant when he hits, also notes that he doesn’t use it in the offseason. Gomes said, “Once I stop playing, I’ll never do it again. I know it’s a bad idea.” Manager John Farrell said, “It’s a nasty habit, but it’s one of those traditions in baseball.”
While Major League Baseball has taken some steps to limit the visibility of tobacco in the sport — for instance, by prohibiting tobacco tins in uniform pockets — players opposed an effort in 2011 to ban it altogether. Unfortunately, only an outright ban will dislodge the idea that tobacco, in some intangible way, is an acceptable part of the sport. The league and the players’ association should embrace such a policy, not only for the health of today’s athletes but also to model cancer prevention to their youthful fans.
http://www.bostonglobe.com/opinion/editorials/2014/03/22/baseball-should-finally-strike-out-smokeless-tobacco/rePA1m0B9JXMJ6siZSDMcI/story.html

Letter: Commending CVS for tobacco policy

By: Keely Ihry, Moorhead, INFORUM
As a public health agency we are always educating on the harms of tobacco-use and exposure. We know that smoking kills nearly 500,000 Americans each year, and costs $289 billion in health care costs. Even with the dangers of tobacco use being well documented, the pharmacy industry has continued to sell tobacco products, and as a health care organization this has started to raise some ethical questions. Pharmacies are seen by people as places they go to get better when sick, and to stay healthy during the year, not as a place that should be profiting off products that are the leading cause of preventable death in the U.S.
This is why we truly commend CVS for taking one of the strongest actions any business has ever taken to address the public health problems caused by tobacco use. CVS recognized that selling tobacco products did not align with their commitment to improving the health and wellness of its customers. It should also be noted that CVS chooses not to sell e-cigarettes because they are not FDA approved.
This came at a great time with the momentum of the 50th anniversary of the first ever surgeon general’s warning on smoking and health. In the release the surgeon general called for continued work towards encouraging smokers to quit and preventing youth from starting to use tobacco. We know that nearly 90 percent of youth start smoking before the age of 18. CVS’ decision to stop selling tobacco is a huge statement to Americans, especially youth that tobacco use is harmful to their health.
We hope that this will encourage other pharmacies who are selling tobacco to take notice and take similar action. Removing the sale of tobacco products from a healthcare organization just makes good sense.
Ihry is PartnerSHIP 4 Health tobacco coordinator, Clay County Public Health.
http://www.inforum.com/event/article/id/429362/group/Opinion/

Letter: Big tobacco goes after ‘replacement smokers’

By: Beth Hughes, Bismarck, INFORUM
Even though the risks of using tobacco are well documented, it remains the No. 1 cause of preventable death and disease in the country. This year alone, nearly 500,000 Americans will die prematurely because of smoking. Unfortunately, tobacco marketing efforts recruit two new young smokers to replace each tobacco user who dies.
It’s well documented that tobacco companies market to youth in an effort to recruit “replacement smokers.” Research from the Centers for Disease Control and Prevention tells us that smoking and smokeless tobacco use are initiated and established primarily during adolescence. In fact, nearly 9 out of 10 smokers start smoking by the age of 18. Tobacco companies know this and continually look for new ways to hook our youth.
Tobacco companies pay convenience stores – many located near schools – and other tobacco retailers to prominently display advertisements for their products near the entrances, exits and checkouts. Tobacco companies also target a new generation of potential tobacco users by designing items to appeal to youth, such as fruit-flavored products in colorful packaging that make tobacco look and smell like candy.
In addition to new flavors and packaging, price is another factor that affects tobacco use. In states with low tobacco taxes, like North Dakota, it’s easier to make tobacco products affordable, and that makes it easier for youth to obtain tobacco. Research supported by the CDC and the American Lung Association shows that increasing a tobacco tax is one of the most effective ways to reduce youth tobacco use; by making tobacco less affordable, kids are less likely to buy it.
The Center for Tobacco Prevention and Control Policy uses media campaigns to educate the public about the dangers of tobacco use. The Center also works with local public health units across the state to educate our communities on tobacco prevention so our children live healthier lives as fewer of them become addicted to nicotine.
We are committed to preventing tobacco use among our youth and adult populations. We’ve made great progress, but there is more work to be done. Showing support for tobacco prevention efforts in your community is a great start to help reduce youth tobacco use rates. Here is what you can do:
• Support tobacco-free and smoke-free policies within your community. When youth are not exposed to tobacco, it increases their chance to remain tobacco free.
• Support policies that restrict how tobacco is marketed. Tobacco companies are aggressive marketers that target youth through retail displays, internet marketing and magazines that are popular with teens.
• Support tobacco tax increases. Our youth are less likely to use tobacco if it is less affordable.
These strategies are CDC Best Practice strategies – strategies that are proven to reduce youth tobacco use rates. We ask the community to join us in this fight by showing your support for tobacco prevention.

Hughes, Ph.D., is a registered respiratory therapist, and chairwomen, North Dakota Tobacco Prevention and Control Committee.
http://www.inforum.com/event/article/id/428702/group/Opinion/

To the Editor: Curbs on E-Cigarettes

To the Editor:

Re “Hot Debate Over E-Cigarettes as Path to Tobacco, or From It” (“The New Smoke” series, front page, Feb. 23):

As you note, the health effects of e-cigarette use remain unknown, and their use may actually be leading to greater smoking of traditional cigarettes, especially among children.

In fact, a recent study of 76,000 South Korean teenagers indicates that users of e-cigarettes were less likely to succeed in quitting smoking and were more likely to be heavy smokers.

The availability of e-cigarette flavored vapors (mango and watermelon) enhances the attraction. The troubling increase in the use of e-cigarettes among American teenagers found in the survey by the Centers for Disease Control and Prevention, also reported in the article, suggests that e-cigarettes are a gateway to tobacco addiction.

The American Thoracic Society, as a member of the Forum of International Respiratory Societies, supports an age restriction and government regulation of the sale of e-cigarettes, which in many states do not exist. Until more research is done, it is dangerous to promote their widespread use.

PATRICIA FINN
Chicago, Feb. 24, 2014

The writer is president of the American Thoracic Society and chairwoman of the department of medicine at the University of Illinois Chicago.

http://www.nytimes.com/2014/02/28/opinion/curbs-on-e-cigarettes.html?_r=0

Kathleen Sebelius column: Working toward a tobacco-free generation

For Press-Gazette Media

Here’s a sobering statistic about the tobacco epidemic — a battle many Americans think is already won: If we continue at current smoking rates, 5.6 million children alive today will ultimately die prematurely from smoking. That’s one in 13 kids gone too early due to an entirely preventable cause. That is unacceptable.
That’s why we are asking every American to join our efforts to make the next generation tobacco-free.
Today, we are at a crossroads. In the past 50 years, we’ve more than cut the adult smoking rate in half from nearly 43 percent down to 18 percent, and we’ve reduced 12th-grade students’ smoking rate to 16 percent in 2013 from a high of 38 percent in l976.
Yet nearly 500,000 Americans die of smoking-related disease each year. What’s more, the tobacco epidemic costs us nearly $300 billion in productivity and direct medical costs annually.
I believe a tobacco-free generation is within our reach, but it will take commitment from across the spectrum — from federal, state and local governments, but also from businesses, educators, the entertainment industry and beyond.
Already, we are seeing leadership from the private sector. This month, CVS, the second largest pharmacy chain in the country, announced it will no longer sell tobacco products. In doing so, CVS it is at once reducing access to these harmful products and helping to make smoking less attractive.
We know that consumers, especially children, are influenced by pro-smoking messages when they shop in stores that sell tobacco products. This includes the display of cigarettes behind the register known as the “power wall.” For young people, power walls help shape cigarette brand awareness and the sense that smoking is normal and accepted.
In multiple ways, CVS’ decision will have impact. I applaud this private sector health leader for taking an important new step to curtail tobacco use. I hope that other retailers will take up this pro-health mantle.
The stakes are high. Each day, more than 3,200 youth under age 18 in the United States try their first cigarette, and another 700 kids under age 18 who’ve been occasional smokers become daily smokers.
I am thrilled that earlier this month, the Food and Drug Administration launched its first national tobacco education campaign, TheRealCost.gov. The campaign is targeting on-the-cusp youth –— the 12- to 17-year-old kids who are open to smoking or have experimented with cigarettes, but are not regular smokers.
But creating a tobacco-free generation cannot start and end with our youngest citizens: working toward this goal begins in the present, and reaching adult smokers is essential.
In that light, I’m very pleased the Centers for Disease Control and Prevention has started the third season of its impactful Tips From Former Smokers campaign. The 2012 tips series alone prompted an estimated 1.6 million smokers to try to quit, resulting in more than 200,000 additional calls to 1-800-QUIT-NOW, and helped at least 100,000 smokers quit for good.
I am inspired by the ongoing work that is necessary to drastically reduce smoking rates in our country. Whether it’s other retailers following CVS’ lead, more colleges and universities joining the 2,000 schools that are part of the Department of Health and Human Services’ National Tobacco-Free College Campus Initiative (tobaccofreecampus.org), or movie studios taking tobacco use and imagery out of youth-rated films, I encourage new partners to help us stop the cycle of sickness, disability and death caused by tobacco.
Victory will require bold action. What will you do to help make the next generation tobacco-free?
Kathleen Sebelius is secretary of the U.S. Department of Health and Human Services.
http://www.greenbaypressgazette.com/article/20140220/GPG06/302200419/Kathleen-Sebelius-column-Working-toward-tobacco-free-generation?nclick_check=1

EDITORIAL: Raise Colorado's minimum age for buying cigarettes to 21

By The Denver Post Editorial Board
Teen smoking is not a right, it is a horrible choice that is addictive and incredibly damaging to the young brain.
The federal government has left it up to local and state governments to raise the legal age to buy cigarettes, and Colorado is looking to do just that.
Sen. Steve King, R-Grand Junction, is pushing a bill that will be introduced soon to increase the cigarette-buying age from 18 to 21 — a move he says would add consistency to vice laws that set a 21 age limit to buy recreational marijuana, gamble and buy alcohol.
New York City last year raised the tobacco buying age to 21 and so did Utah— dismissing the argument that 18-year-olds who are old enough to fight in wars and vote should be allowed to buy cigarettes.
That is a bad position when you are talking about the supremely addictive substance of nicotine and what it does to teens.
Research shows adolescent smokers are more likely to become heavy smokers, are much less likely to quit smoking later in life, and are more likely to die from smoking-related illnesses.
Additionally, nicotine has more deleterious effects on developing brain of an 18-year-old than a 21-year-old.
Though the numbers of teen smokers have declined, research shows virtually all new users of tobacco products are under 18.
History also shows raising age limits works. It did with alcohol.
In the 1970s, states lowered the legal age to buy alcohol to 18, a major mistake that resulted in more drunken-driving deaths.
In the 1980s, Congress passed the Uniform Minimum Drinking Age Act, giving states a financial incentive to raise the drinking age to 21. States began reporting fewer drunken-driving deaths, and youth usage and binge drinking fell by a third.
In 2005, the town of Needham, Mass., raised the age to buy cigarettes to 21. The result has been a dramatic local decline in smoking.
Society has said teens can’t smoke recreational pot; we should be consistent with tobacco.
http://www.denverpost.com/editorials/ci_25054723/raise-colorados-minimum-age-buying-cigarettes-21#ixzz2sOZXWxRI