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

Grand Forks Herald: Ballot proposal would raise taxes on electronic cigarettes in North Dakota

By John Hageman

Heather Nelson is well-versed in the arguments over electronic cigarettes.

Armed with a stack of printed news clippings behind the glass counter at her Grand Forks shop, SnG Vapor, she’s adamant that the products her business sells helps smokers quit traditional cigarettes.

But Nelson worries that a proposed tax in North Dakota will harm her business and present an obstacle for those looking to stop smoking.

“I don’t think it’s fair to boost the tax on something that’s actually helping them,” she said.

But public health officials and backers of the proposed ballot measure argue the liquid nicotine used in electronic cigarettes is a tobacco product, and therefore it should be taxed as such. Moreover, they say the U.S. Food and Drug Administration has not identified electronic cigarettes as a smoking cessation product.

The proposal to tax vaping products is included in the ballot language put forth by Raise it for Health North Dakota, which is focused on increasing the state’s cigarette tax from 44 cents a pack to $2.20 a pack. The measure would classify liquid nicotine that’s derived from tobacco as a tobacco product and would raise the tax on it and other items from 28 percent to 56 percent of the wholesale purchase price.

Aside from the larger debate over raising taxes on traditional cigarettes, the proposal is likely to open discussion on the merits of electronic cigarettes, a relatively new product that has grown rapidly in popularity. Though it is much smaller than the traditional cigarette market, the vapor market grew by 23 percent in 2014, according to a Tax Foundation report released earlier this week, and several shops selling e-cigarettes have opened in Grand Forks in recent years.

Dr. Eric Johnson, a Grand Forks physician and chairman of the committee organizing the ballot measure, said electronic cigarettes are subject to sales tax in North Dakota but not a specific tobacco tax. He pointed out that more than 20 North Dakota cities, including Grand Forks, consider electronic cigarettes tobacco products for the purposes of preventing their sale to minors.

“It’s just kind of an example of the law not really keeping up with technology,” Johnson said. “The e-cig vape technology, they’re tobacco products by about just any medical definition.”

Looking at the data

Mike Jacobs smoked cigarettes for more than 20 years before picking up an e-cigarette last year.

“My last cigarette was Nov. 11,” he said from the other side of the counter at SnG Vapor, which is on South 18th Street just south of DeMers Avenue.

Nelson points to Jacobs as one story of how the products at her store can help people dump traditional cigarettes. She also cited the Public Health England’s statement last year that vaping is safer than smoking, though the agency stressed the products aren’t without risk, according to the Guardian.

That was echoed in the Tax Foundation’s report, which argued “vapor products have the potential to be a boon to public health by acting as a less risky alternative to traditional incinerated cigarettes.”

“Further, to the extent that smoking cessation is a stipulated goal of tobacco taxation, exposing vapor products, which many see as a promising cessation method, to such hefty tax rates as traditional tobacco would be counterproductive,” the report added.

But not everyone is convinced.

Johnson said electronic cigarettes are not FDA-approved as smoking cessation devices and there isn’t sufficient evidence that they help people quit traditional cigarettes. Indeed, a study published in the Lancet Respiratory Medicine in January found adult smokers who use e-cigarettes were less likely to quit smoking, according to CBS News.

“If they had data, I would recommend them just like any other stop-smoking product,” Johnson said. “Since we don’t really know whether these help or promote use, it’s very difficult as a health care provider to recommend them at this time.”

Moreover, Johnson is worried that they act as a gateway for young people to move on to other tobacco products. While the percentage of North Dakota high school students who smoke has dropped substantially over the past 20 years, roughly 20 percent of Grand Forks students use electronic vapor products, according to survey results previously provided by the Grand Forks Public Health Department.

“We’re kind of wondering, ‘Is what we’re doing in public health working or are they switching from one product to another?'” said Haley Thorson, tobacco prevention coordinator with the health department, who added they’ve “also accomplished some very successful policy initiatives in our state.”

Becoming law

Raise it for Health submitted its petition to the North Dakota Secretary of State’s office last week. Supporters will need to collect 13,452 signatures to get the measure on November’s ballot.

Minnesota became the first state to tax vapor products in 2012 by imposing a tax of 95 percent of their wholesale price, and only a handful of other states have similar policies in place, according to the Tax Foundation.

Meanwhile, at least 25 states and the District of Columbia considered legislation to tax vapor products in 2015. North Dakota was among them, but the bill ultimately failed to become law.

“We want all of those products taxed at the same rate so one addiction doesn’t cost less than the other,” said Sen. Tim Mathern, D-Fargo, who was a sponsor of the bill last year to raise tobacco taxes and is a member of the ballot measure’s sponsoring committee. “The goal really here in this measure is to reduce the amount of people who are addicted to these products in order to keep them healthy and in order to keep our society healthy.”

But for Nelson, the tax “will put a damper” on a product she argues is helping people move away from more dangerous traditional cigarettes. She said it may prompt shops like hers to unite in opposition.

“We want to get organized and we want to be heard,” Nelson said.

http://www.grandforksherald.com/news/business/3995243-ballot-proposal-would-raise-taxes-electronic-cigarettes-north-dakota

WDAY/WDAZ: North Dakota may soon have to decide to increase taxes on tobacco products, including e-cigarettes

By WDAY / WDAZ Staff

Grand Forks, ND (WDAY/WDAZ TV) – North Dakota will have to decide on whether to increase taxes on not only tobacco products, but also e-cigs.

If passed, traditional cigarette tax will go from $0.44 a pack to $2.20.

Vaping product liquid tax would then increase from 28% to 56%.

Owners of SNG Vapor in Grand Forks say e-cigs have helped many people quit smoking traditional cigarettes.

A question that many people have is whether or not E-Cigs are considered tobacco products.

Public health officials and backers of the measure argue that liquid nicotine used in electronic cigarettes is but, users disagree saying that the two very different

“The FDA hasn’t made their deeming regulations. It’s not fair to lump us in with tobacco. Tobacco is combustion, tobacco is a leaf, it’s the grainy portion you know it’s the physical part it’s not a liquid. It’s not creating any fire it’s not creating a spark it’s not burning anything that’s bad for you and we’ve taken all the excess junk out of all of the between  4000 to 6000 chemicals in a normal cigarette and we dumbed it down to just four things,” said Heather Nelson of SNG Vapor.

Minnesota became the first state to tax vapor products in 2012 by imposing a tax of 95% of their wholesale price.

http://www.wday.com/news/3995693-north-dakota-may-soon-have-decide-increase-taxes-tobacco-products-including-e

Drug Store News: CDC's latest anti-smoking campaign inspired 104,000 smokers to quit

BY MICHAEL JOHNSEN

ATLANTA – The latest outcomes measuring the impact of CDC’s national tobacco education campaign are as strong as those achieved in its first year, and suggest that three years into the campaign, the ads were still having a significant impact.

More than 1.8 million smokers attempted to quit smoking because of the nine-week-long 2014 Tips From Former Smokers ( Tips ) campaign. An estimated 104,000 Americans quit smoking for good as a result of the 2014 campaign.

The survey results are published in the March 24 release of the journal Preventing Chronic Disease.

Unlike the 2012 campaign, which aired for 12 consecutive weeks, the 2014 campaign aired in two phases, from Feb. 3 to April 6 and from July 7 to Sept. 7. Phase 1 of the 2014 campaign ran ads primarily from the 2012 and 2013 campaigns; Phase 2 contained new ads. Those new ads featured people and their struggles with smoking-related health issues, including cancer, gum disease, premature birth and stroke caused by smoking combined with HIV. About 80% of U.S. adult cigarette smokers who were surveyed reported seeing at least one television ad from Phase 2 of the 2014 campaign.

“CDC’s Tips campaign has helped at least 400,000 smokers quit smoking for good since 2012,” stated CDC Director Tom Frieden.  “Tips is also extremely cost-effective and a best buy, saving both lives and money. With a year-round campaign we could save even more lives and money.”

Tips, the first federally funded anti-smoking paid media campaign, features former smokers talking about their smoking-related illnesses. Smoking-related diseases cost the United States more than $300 billion a year, including nearly $170 billion in direct health care costs and more than $156 billion in lost productivity.

“The Tips campaign is an important counter measure to the $1 million that the tobacco industry spends each hour on cigarette advertising and promotion,” said Corinne Graffunder, director of CDC’s Office on Smoking and Health. “The money spent in one year on Tips is less than the amount the tobacco industry spends on advertising and promotion in just 3 days.”

The most recent Surgeon General’s Report, The Health Consequences of Smoking—50 Years of Progress, called for airing effective messages such as the Tips ads with high frequency and exposure for 12 months a year for a decade or more. Cigarette smoking is the leading preventable cause of disease and death in the United States, killing about 480,000 Americans each year.

For every American who dies from a smoking-related disease, about 30 more suffer at least one serious illness from smoking. And while the percentage of American adults who smoke is at the lowest level since the CDC began tracking such data, there are still an estimated 40 million adult smokers in the U.S.  Surveys show about 70% of all smokers want to quit, and research shows quitting completely at any age has significant health benefits.

http://www.drugstorenews.com/article/cdcs-latest-anti-smoking-campaign-inspired-10000-smokers-quit

Drug Store News: CDC's latest anti-smoking campaign inspired 104,000 smokers to quit

BY MICHAEL JOHNSEN

ATLANTA – The latest outcomes measuring the impact of CDC’s national tobacco education campaign are as strong as those achieved in its first year, and suggest that three years into the campaign, the ads were still having a significant impact.

More than 1.8 million smokers attempted to quit smoking because of the nine-week-long 2014 Tips From Former Smokers ( Tips ) campaign. An estimated 104,000 Americans quit smoking for good as a result of the 2014 campaign.

The survey results are published in the March 24 release of the journal Preventing Chronic Disease.

Unlike the 2012 campaign, which aired for 12 consecutive weeks, the 2014 campaign aired in two phases, from Feb. 3 to April 6 and from July 7 to Sept. 7. Phase 1 of the 2014 campaign ran ads primarily from the 2012 and 2013 campaigns; Phase 2 contained new ads. Those new ads featured people and their struggles with smoking-related health issues, including cancer, gum disease, premature birth and stroke caused by smoking combined with HIV. About 80% of U.S. adult cigarette smokers who were surveyed reported seeing at least one television ad from Phase 2 of the 2014 campaign.

“CDC’s Tips campaign has helped at least 400,000 smokers quit smoking for good since 2012,” stated CDC Director Tom Frieden.  “Tips is also extremely cost-effective and a best buy, saving both lives and money. With a year-round campaign we could save even more lives and money.”

Tips, the first federally funded anti-smoking paid media campaign, features former smokers talking about their smoking-related illnesses. Smoking-related diseases cost the United States more than $300 billion a year, including nearly $170 billion in direct health care costs and more than $156 billion in lost productivity.

“The Tips campaign is an important counter measure to the $1 million that the tobacco industry spends each hour on cigarette advertising and promotion,” said Corinne Graffunder, director of CDC’s Office on Smoking and Health. “The money spent in one year on Tips is less than the amount the tobacco industry spends on advertising and promotion in just 3 days.”

The most recent Surgeon General’s Report, The Health Consequences of Smoking—50 Years of Progress, called for airing effective messages such as the Tips ads with high frequency and exposure for 12 months a year for a decade or more. Cigarette smoking is the leading preventable cause of disease and death in the United States, killing about 480,000 Americans each year.

For every American who dies from a smoking-related disease, about 30 more suffer at least one serious illness from smoking. And while the percentage of American adults who smoke is at the lowest level since the CDC began tracking such data, there are still an estimated 40 million adult smokers in the U.S.  Surveys show about 70% of all smokers want to quit, and research shows quitting completely at any age has significant health benefits.

http://www.drugstorenews.com/article/cdcs-latest-anti-smoking-campaign-inspired-10000-smokers-quit

ESPN: New York approves smokeless tobacco ban at sporting events

Adam Rubin, ESPN Staff Writer

Smokeless tobacco will soon be off-limits for players and patrons at Citi Field and Yankee Stadium.

The New York City Council approved a ban on smokeless tobacco at ticketed sporting events on Tuesday afternoon by a vote of 44-3. The law is due to take effect immediately once Mayor Bill de Blasio signs the bill, which is expected to be a formality.

“Today we’re taking tobacco out of baseball in New York City,” council member Corey Johnson said. “In New York City we’ve seen smoking rates precipitously decline, but chewing tobacco use has remained steady. When athletes who are role models to children are regularly shown on TV using smokeless tobacco, that sends a harmful message.

“By allowing smokeless tobacco at the ballparks, we are sending mixed signals about the dangers of tobacco use. There may not be many baseball issues where Mets and Yankees fans can agree, but this certainly is one of them.”

Chicago last week joined San Francisco, Boston and Los Angeles in enacting a similar ban.

Yankees setup man Andrew Miller said players will not picket over the issue, but he did allude to some players being addicted to the otherwise legal substance, which makes the situation tricky.

“It is what it is,” said Miller, who once chewed tobacco but says he doesn’t anymore. “I didn’t vote on it. I didn’t put it into effect. I didn’t publicly ask one way or the other for it. It is just something we are going to have to deal with. People will have to find a way to approach it and how strictly it will be enforced.”

The penalty in New York is expected to match the fine for smoking where it is prohibited in the city, roughly $100.

“There are different tobacco laws in place for multiple different states — obviously smoking and smokeless,” New York Mets outfielder Curtis Granderson said. “So it’s not something that surprises me if New York or Citi Field were to go ahead and pass something like this. The only question we have is, the guys who do it, how do they know what’s going on?

“The Players’ Association is going to provide alternatives for them. But if a player accidentally chooses to do it, will he get a citation? Will we stop the game? And will the same thing happen to the fans in attendance? That hasn’t been identified yet, so we’re still waiting to hear that.”

ESPN’s Andrew Marchand contributed to this report.

http://espn.go.com/mlb/story/_/id/15045514/new-york-city-approves-smokeless-tobacco-ban-sporting-events

AP: Ohio’s infant mortality panel recommends tobacco tax hike

ANN SANNER, Associated Press

COLUMBUS – Ohio lawmakers should increase the tobacco tax, raise the tobacco-buying age to 21 and ban the sale of crib bumpers, according to a state panel tasked with addressing infant mortality.

The recommendations are among dozens in a report by the Ohio Commission on Infant Mortality released Tuesday.

Ohio’s infant mortality rate has been among the worst in the nation. Infant mortality is measured as deaths of live-born babies before their first birthdays. The three leading causes in Ohio are pre-term births, sleep-related deaths and birth defects.

The state’s overall infant mortality rate was 6.8 deaths per 1,000 live births, according the most recent data from 2014. And the rate for black babies was roughly three times that of whites.

Lawmakers created the commission last year to take an inventory of state programs that seek to combat infant mortality. Its recommendations come as the state has been working with hospitals, community groups, local health departments and others in nine urban areas with high rates of infant deaths. Such partnerships seek to address issues high-risk groups face, such as access to food, health care, transportation and social supports.

State Sen. Shannon Jones, a Springboro Republican who co-chaired the commission, said Ohio’s infant mortality problem disproportionately affects low-income black families in urban neighborhoods that have “largely been left behind as the economy has grown.”

“Birth outcomes simply cannot improve unless we address these adverse conditions and underlying inequities found in the places where many of these families live,” Jones said in releasing the commission’s report at a Statehouse press conference.

The report includes policy recommendations for state lawmakers, state agencies, infant mortality collaborative organizations and state grantees.

The commission did not call for a specific tobacco tax increase, though Jones said she plans to include the idea in legislation she and Democratic Sen. Charleta Tavares of Columbus are expected to introduce.

Other recommendations from the commission include:

— Publishing statewide infant mortality data each quarter.

— Requiring cultural competency training for health care providers.

— Permitting pharmacists to administer the hormone progesterone and contraceptive injections of Depo-Provera.

— Specifying pregnancy as a priority in emergency shelter and housing tax credit programs.

— Placing pregnant women in family homeless shelters rather than single adult shelters.

Online:

Ohio Commission on Infant Mortality: http://1.usa.gov/1LEtZbZ

http://www.cincinnati.com/story/news/politics/2016/03/22/ohios-infant-mortality-panel-recommends-tobacco-tax-hike/82140650/