USA Today: Teens find a new use for e-cigarettes: Vaping marijuana

, USA TODAY
Teenagers have discovered a new way to inhale marijuana — e-cigarette vaporizers, according to a study released Monday.
About 27% of high school students who have used both marijuana and e-cigarettes reported using the devices to vaporize cannabis. Those most likely to vaporize pot with e-cigarettes included males and younger students.
E-cigarettes are designed to vaporize solutions containing nicotine, said co-author Meghan Rabbitt Morean. But, she noted, “teenagers are resourceful, and it was only a matter of time.”
Vaporizers give kids a better way to hide what they’re inhaling.
“It’s so much easier to conceal e-cigarette pot use,” said Morean, an assistant professor at Oberlin College. “Everybody knows that characteristic smell of marijuana, but this vapor is different. It’s possible that teenagers are using pot in a much less detectable way.”
Researchers at Yale University based their findings on answers from a survey sent to nearly 4,000 Connecticut students. The study was published Monday in Pediatrics.
About 28% of students in the study had tried e-cigarettes.
Morean said people should remember to be cautious when interpreting her findings. There haven’t been any other studies showing teens are using e-cigs to vaporize marijuana. She noted that scientists don’t fully understand the health effects of e-cig-vaporized cannabis.
Marijuana use in other forms can cause several health problems such as short-term memory loss, slow learning, decreased sperm count and lung damage, according to the Centers for Disease Control and Prevention.
“We now know it’s happening, but there are more questions about who is using and how damaging it is,” Morean said.
E-cigarette use among youth increased more than 200% from 2011 to 2013, according to a report in the journal Nicotine and Tobacco Research. Those surveyed had not tried regular cigarettes.
“Unfortunately, there is really no end for what can be vaporized in these devices,” said Erika Sward, a spokeswoman for the American Lung Association.
Supporters of e-cigarettes, who describe them as a healthier alternative to regular cigarettes, found fault with the new survey. The study may not accurately reflect what teens across the country are doing because it surveyed students in only one state, said Phil Daman, president of the Smoke-Free Alternatives Trade Association and attorney for Daman & Associates.
His group strongly discourages underage use of vapor products.
“While some teens experiment, it’s vital that parents and guardians talk to their children about not using any age-restricted products including vapor products,” Daman said.
Morean said she and her colleagues plan to conduct additional studies.
She hopes researchers in other states will provide additional data, to provide a clearer picture of national trends.
“This research is so new,” Morean said.
http://www.usatoday.com/story/news/2015/09/04/e-cigarettes-vape-marijuana-students-connecticut/71703472/

USA Today: A year later, CVS says stopping tobacco sales made a big difference

Jayne O’Donnell, USA TODAY
The decision to stop tobacco sales at all of its drugstores a year ago caused people to buy 95 million fewer packs of cigarettes in 13 states, CVS Health says in a new study out Thursday.
The new study compared total sales of tobacco products at all types of stores in the 13 states where CVS has more than 15% of market share with sales in states that don’t have any CVS stores.
The study, conducted by CVS’ Health Research Institute, evaluated cigarette pack purchases at drug, food, mass merchandise, dollar, convenience and gas station stores in the eight months after CVS stopped selling tobacco products. Over the same period, the average smoker in these states purchased five fewer cigarette packs. The 95 million fewer packs sold, CVS said, was a 1% decrease in the number of packs sold.
During 2014, nearly 264 billion cigarettes were sold in the United States, a decrease from approximately 273 billion sold in 2013, according to the Centers for Disease Control.
The CVS study also showed a 4% increase in nicotine patch purchases in the 13 states in the period immediately following the end of tobacco sales, which the company says shows there also was “a positive effect on attempts to quit smoking.”
CVS and its foundation also announced Thursday that it is funding a new school-based tobacco-prevention curriculum through the textbook company Scholastic.
The effort might have been able to influence Troyen Brennan, a physician who is CVS Health’s chief medical officer. In an interview, Brennan said he smoked for a few years while in his teens.
Brennan says he expects the study results should address critics who said CVS’ move was “not going to make a difference overall.”
But at least one critic says CVS is making a questionable leap by taking credit.
“CVS only sold a very small percentage of the nation’s cigarettes to start with, and financial analysts have said the impact of CVS’ move wouldn’t have a major impact on smoking rates,” says Jeff Stier, a senior fellow at the free market-oriented National Center for Public Policy Research. “But the bold claim that its decision to stop selling cigarettes actually got a significant number of smokers to just buy the mostly ineffective nicotine patches and quit smoking only illustrates how little the company knows about the difficulty of quitting.”
Stier’s group receives 1.4% of its funding from the tobacco and e-cigarette industry.
“We know that more than two-thirds of smokers want to quit – and that half of smokers try to quit each year,” Brennan says. “We also know that cigarette purchases are often spontaneous. And so we reasoned that removing a convenient location to buy cigarettes could decrease overall tobacco use.”
The new data, Brennan says, show CVS’ decision “did indeed have a real public health impact.”.
Junk food often is an impulse purchase as well. CVS spokeswoman Carolyn Castel says the company also is placing healthier foods —such as yogurt and fresh fruit — in key locations in the front of the store.
http://www.kare11.com/story/news/2015/09/02/cvs-stopping-tobacco-sales/71606590/

Number of cigarette smokers drops to 15%: CDC

The number of cigarette smokers in the United States has dropped to about 15 percent of the population, its lowest point in decades, U.S. health authorities said Tuesday.
“The prevalence of current cigarette smoking among U.S. adults declined from 24.7 percent in 1997 to 15.2 percent in January-March 2015,” said the report by the Centers for Disease Control and Prevention’s National Center for Health Statistics.
The figures will be updated once the entire year’s data is available.
Smoking continues to be more common among men (17.4 percent) than women (13.0 percent), the report found.
Smoking is most common among African Americans (18.1 percent), followed by whites (17.1 percent) and Hispanics (10.4 percent).
According to the U.S. surgeon general, smoking is known to cause “a host of cancers and other illnesses and is still the leading preventable cause of death in the United States, killing 480,000 people each year.”
Smokers made up 42 percent of the U.S. population in 1965, a fraction that has dropped steadily over the years, according to the CDC.
http://www.nydailynews.com/life-style/health/number-cigarette-smokers-drops-15-cdc-article-1.2344374

FDA issues warning letters to 3 tobacco companies over "additive-free" claims

Associated Press
NEW YORK (AP) — The Food and Drug Administration issued warning letters to the makers of Winston, Natural Spirit and Nat Sherman cigarettes over their “additive-free” and “natural” label claims.
The agency issued the warnings to ITG Brands LLC, Santa Fe Natural Tobacco Company Inc. and Sherman’s 1400 Broadway N.Y.C. Ltd. The issue over the claims is that they may lead consumers to believe the products pose a lower risk. That claim has to be scientifically proven.
In a statement, the FDA said it has determined that the products under the warning letter need what is called a “modified risk tobacco product order” before they can be marketed in that way. It has not issued any orders for modified-risk products to the market and this is the first time it is using its authority to take action against “natural” or “additive-free” claims.
The companies have 15 days to respond with a plan or dispute the warnings.
There was no immediate response from the companies.
Imperial Tobacco Group Plc. owns ITG Brands, which also makes Kool cigarettes and USA Gold. Reynolds American Inc. owns Santa Fe Natural Tobacco.
The warning comes several days after a large group of anti-tobacco organizations sent the FDA a letter urging the agency to enforce regulations against Santa Fe Natural Tobacco over marketing claims. That letter, sent on Monday, was signed by 29 groups including the American Heart Association, American Legacy Foundation and Campaign for Tobacco-Free Kids.
The anti-tobacco group’s letter alleged that Natural American Spirit’s advertising in magazines such as Sports Illustrated and Vanity Fair violated the Smoking Prevention and Tobacco Control Act.
“The potential for irreparable damage to public health from the marketing of tobacco products with modified risk claims is well illustrated by the industry’s years of deceptive advertising of ‘light’ and ‘low-tar’ cigarettes,” the letter stated.
http://www.usnews.com/news/business/articles/2015/08/27/fda-issues-warning-letters-to-natural-tobacco-makers

LA Times: $2 more for cigarettes? California tobacco tax proposal revived in special session

A proposal to raise the tobacco tax by $2 per pack of cigarettes in California was given new life Wednesday when legislation was announced as part of a special session on healthcare.
Supporters say the new bill has a better chance of passing than one that stalled in the regular session because the $1.5 billion raised by such a tax could help the state pay for healthcare costs for low-income residents, a key goal of the special session.
Sen. Richard Pan (D-Sacramento) said he will introduce the tobacco tax, noting that California’s current 87-cent-per-pack tobacco tax makes the state 33rd in the nation, far below New York, which charges a tax of $4.35 a pack. There is also a $1.01 federal tax on cigarettes.
A rally for the proposal was held Wednesday next to the Capitol by the Save Lives California coalition, made up of groups including the California Medical Assn., the American Cancer Society, the American Lung Assn. and the Service Employees International Union.
The coalition said that if the Legislature fails to muster the two-thirds vote to pass the tax, it will put the tax proposal on the 2016 ballot.
“We know raising the tobacco tax has been proven to prevent and reduce smoking, especially among young people,” Pan told the nearly 100 people at the rally. He said 40,000 people die each year in California from tobacco-related diseases, and treating such illnesses costs taxpayers $18.1 billion annually.
A Field Poll released Wednesday indicates a $2 tobacco tax to pay for healthcare costs is supported by 67% of Californians.
The tax is one of several anti-tobacco bills being considered during the special session, including one raising the smoking age to 21 and another restricting the use of electronic cigarettes in public.
“The special session is an opportunity for lawmakers to take long-overdue action to prevent young people from falling prey to the No. 1 cause of preventable death in California: tobacco addiction,” said Claudia Alvarez, an SEIU delegate and family medicine resident at Harbor-UCLA Medical Center.
Those in the audience at the rally included Jennifer Kent, the governor’s appointee as director of the California Department of Health Care Services.
“To the extent we have an ongoing need for revenues we’re obviously willing to consider both this tax and any other revenue sources,” Kent said in an interview afterward. “We’re here and interested and willing and able to partner” with the coalition.
She said there is a strong link between tobacco use and illnesses covered by Medi-Cal.
The regular-session tobacco tax bill was opposed by groups including the Cigar Assn. of America and the Howard Jarvis Taxpayers Assn., which argued it creates a regressive tax on a declining revenue source.
“At a time when state revenue has recovered and the governor says there is even a surplus, there is no reason for a tax increase,” said Jon Coupal, president of the taxpayers group.
Proponents of the bill estimate 295,000 smokers will kick the habit the first year if the tax goes up $2 per pack, and many others will not start smoking to begin with.
http://www.latimes.com/local/political/la-me-pc-california-tobacco-tax-proposal-revived-for-special-session-20150826-story.html

NY Times Opinion: Clashing Views on E-Cigarettes

By

A British government agency has issued a bullish assessment of the value of electronic cigarettes in helping people to quit smoking. It found that e-cigarettes can reduce the health risks of smoking by 95 percent because they deliver nicotine to satisfy an addiction, but far fewer harmful chemicals than regular cigarettes. It also found little evidence that large numbers of consumers who had never smoked were taking up e-cigarettes. That seemed to challenge the notion that e-cigarettes would be a gateway to more dangerous products.

But the study is hardly definitive; experts in America have drawn different conclusions on usage and on the gateway issue.

The British assessment, commissioned by Public Health England and conducted by academic experts, was cautious in its claims. It noted that the best results are obtained when e-cigarettes are used in combination with professional counseling and smoking-cessation medication.

In the United States, according to the Campaign for Tobacco-Free Kids, e-cigarette use by young people has grown more rapidly than in Britain. The user population includes many children who have never smoked and thus may be vulnerable to being hooked by nicotine and later moving to traditional cigarettes.

By coincidence, a day before the British study was issued, a study tracking more than 2,500 students at 10 Los Angeles schools who had never smoked tobacco, published in the Journal of the American Medical Association, came to the opposite conclusion. It said ninth graders who had tried e-cigarettes were far more likely than other students to start smoking “combustible tobacco” (cigarettes, cigars, hookahs) within a year.

Strong regulation is needed in Europe and the United States to protect young people from advertising and promotions designed to lure them into trying e-cigarettes and perhaps getting hooked on them. America’s Food and Drug Administration needs to issue rules it proposed last year and make them even stronger by banning flavors that appeal to youngsters.

http://www.nytimes.com/2015/08/24/opinion/clashing-views-on-e-cigarettes.html?_r=0

AP: Teens' E-Cigarette Use Linked With Later Smoking

By LINDSEY TANNER AP Medical Writer
Teens who use e-cigarettes are more likely than others to later smoke conventional cigarettes and other tobacco products, a study at 10 Los Angeles high schools suggests.
The study doesn’t prove that electronic cigarettes are a “gateway drug” but some doctors say it bolsters arguments that the devices should be strictly regulated as proposed by the Food and Drug Administration.
Whether teens had tried just one e-cigarette or were habitual users isn’t known, nor is whether they became heavy smokers or just had a few puffs. That information would be needed to help determine whether nicotine from e-cigarettes predisposed users to seek out other sources.
Despite those limitations, the study “is the strongest evidence to date that e-cigarettes might pose a health hazard by encouraging adolescents to start smoking conventional tobacco products,” said Dr. Nancy Rigotti, director of a tobacco research and treatment center at Massachusetts General Hospital. Her commentary and the study were both published in Tuesday’s Journal of the American Medical Association.
E-cigarettes haven’t been extensively studied and there’s no scientific consensus on any potential benefits or harms, including whether they lead kids to become regular smokers.
The new, government-funded study involved about 2,500 14-year-olds who had never used conventional tobacco products including cigarettes. Students were first surveyed in fall 2013. The Los Angeles study population was diverse but whether the same results would be found nationwide is uncertain.
At the start, about 9 percent — 222 kids — said they had used e-cigarettes at least once, similar to rates seen in a recent national survey. Almost one-third of them tried cigarettes, cigars or water pipes within the following six months, versus just 8 percent of the kids who’d never tried e-cigarettes. The gap persisted when students were surveyed again, a year after the study began.
Hookahs and cigars were more popular than regular cigarettes in both groups.
The researchers considered traits that might make teens more likely to use tobacco, including impulsiveness, delinquent behavior and parents’ smoking habits. Their analysis showed those traits played a role but didn’t fully explain the link between e-cigarettes and later tobacco use.
University of Southern California researcher Adam Leventhal, the study’s lead author, noted that e-cigarettes were initially introduced as a potentially safer alternative to tobacco for smokers who were trying to cut down, but they have evolved into a recreational product for some users.
Available for nearly a decade, e-cigarettes are battery-powered devices that turn nicotine-containing liquid into vapor that is inhaled. Though nicotine can be addictive, e-cigarettes lack the chemicals and tars of burning tobacco.
National data show e-cigarettes have become more popular among teens than regular cigarettes.
Leventhal said his study “does little to dispel concerns that recreational e-cigarette use might be associated with moving on to these very harmful tobacco products.” But he said more research is needed to determine if e-cigarettes are really the culprit.
University of Rochester tobacco researcher Deborah Ossip said because teens’ brains are still developing, they’re more sensitive to the effects of nicotine, and that using just a few e-cigarettes could make them vulnerable to using nicotine in other forms. She had no role in the research.
The FDA in 2014 proposed rules that would ban the sale of electronic cigarettes to minors and would add the devices to the list of tobacco products it regulates. Laws banning the sale of e-cigarettes to minors have been enacted or proposed in several states.
———
Online:
JAMA: http://jama.ama-assn.org
FDA: http://tinyurl.com/pe7nqtl
http://abcnews.go.com/Health/wireStory/teens-cigarette-linked-smoking-33155901

Opinion: Chamber's tobacco tax stance flawed

By John LaChance from Fargo

I used to believe smoking was just a part of life. My parents, grandparents, uncles, aunts, cousins, neighbors, doctors, nurses, teachers, etc. all smoked around me as I was growing up.
For years, I worked in bars and restaurants where people smoked. The more they smoked, the more they drank. The more they drank, the more they spent. The more they spent, the more I made. Simple.
I even participated in a public service announcement urging people to vote against banning smoking in bars in restaurants many years ago. I would be a hypocrite if I did not disclose that information.
I was dead wrong.
State Chamber executive Andy Peterson’s opinion piece in The Forum (Sunday, July 12) offering a rationale that it’s “free enterprise” for the Greater ND Chamber of Commerce’s stance on lobbying against a cigarette tax increase prompted me to research what this stance may be costing his members.
North Dakota has the sixth-lowest cigarette tax per pack in the United States, $0.44 per pack. Montana, $1.70 per pack. South Dakota, $1.53 per pack. Minnesota, $2.90 per pack. Canada, $2.80 per pack.
Statistically, there are more than 440,000 workers in North Dakota (Bureau of Labor Statistics, U.S. Department of Labor).
I couldn’t find exact numbers but let’s say, conservatively, half of those workers, 220,000, work for the 1,037 member businesses listed on the Chamber’s website. Four of the top five largest employers in the state are also members of the Greater ND Chamber of Commerce. The fifth employer was not disclosed.
The average cost to a business per employee who smokes is $5,816 a year, per a 2013 Ohio State University study. A Gallup poll from 2013, “estimates that 19 percent of workers still smoke and that workers who smoke cost the U.S. economy $278 billion annually in lost productivity due to absenteeism and extra health care costs. This figure is based on an analysis of the cost of extra missed workdays due to poor health, partial absenteeism due to smoke breaks, and additional health care costs compared with workers who do not smoke.”
So let’s say, conservatively, 41,800 workers (220,000 x 19 percent) employed by the Greater ND Chamber businesses still smoke. That is potentially costing these member businesses $243,108,800 ($5,816 x 41,800).
The most recent revenue numbers I could find from cigarette sales in North Dakota was $68,951,521 for 2009.
Hmm?
Now I’m just beginning my graduate studies in business, but it appears it would be in the Greater ND Chamber’s best interest to encourage a cigarette tax increase.
Not only would an increase in the cigarette tax raise revenue for some of Peterson’s members, it would decrease the amount of money most if not all of his member businesses are losing out on paying for smoking- related costs.
Simple.
http://www.inforum.com/letters/3799718-letter-chambers-tobacco-tax-stance-flawed

Opinion: Does the ND State Chamber side with the U.S. Chamber on Opposing Tobacco Prevention?

By: Dr. Eric Johnson, Grand Forks
President, Tobacco Free North Dakota
If you have not read the June 30, 2015 New York Times article titled, “U.S. Chamber of Commerce Works Globally to Fight Antismoking Measures”, please do so. While we acknowledge there is, at times, a disconnect between national, state and local organizations such as the Chambers of Commerce organizations, I couldn’t help but recognize some similarities between Chamber international efforts as detailed in the article referenced above and the actions of the Greater North Dakota Chamber here in our state.
Even as an active member of the Healthy North Dakota Summit, a public health initiative established by then-Governor John Hoeven and whose statewide plan identifies strategies to “support North Dakotans who make healthy choices – in schools, workplaces, senior centers, homes and anywhere people live, learn, work and play,” the GNDC has not only been absent in supporting tobacco prevention efforts in our state, it has actively opposed them.
With the goal to “reduce tobacco use in North Dakota” on paper in their statewide plan and in mind, we are troubled to see efforts of the Chambers of Commerce – whether internationally or here at the state level – combat proven prevention strategies that save both lives and money.
We call on North Dakotans to demand better and challenge the GNDC to accept what the numbers have long confirmed – that comprehensive tobacco prevention practices are fiscally responsible to taxpayers, health care systems, and ultimately, our workforce and employers in the business community.
——-
Click here to read Mr. Andy Peterson’s letter to the editor in response.
And click here to read Dr. Eric Johnson’s corrections to the inaccuracies of Mr. Peterson’s letter.

Reuters: States target e-cigarette sales to minors amid slow federal action

NEW YORK – Frustrated by the slow pace of federal action, state attorneys general are waging their own campaigns against the sale and advertising of e-cigarettes to minors.

More than a dozen AGs, including those in New York, California, Indiana and Ohio, are using new state and local laws – some of which they helped craft – to put pressure on the industry at all levels, from neighborhood vape shops to big tobacco companies like Altria Group and Reynolds American Inc.

Much of the campaign so far has involved threats to sue violators or appeals to a company’s sense of responsibility, though some lawsuits have been filed, too.

State actions have accelerated in the wake of government data released in April, which showed that teen use of e-cigarettes tripled in 2014 alone, making them more common for youngsters than tobacco.

North Dakota passed its own bill to combat e-cigarettes this legislative session. House Bill 1186, which was signed by Gov. Jack Dalrymple on April 9, outlaws the sale of e-cigarettes to minors in the state. Minors are not allowed to buy, possess or use electronic smoking devices, and those who sell or give e-cigarettes to anyone under 18 is guilty of an infraction.

“The key is to avoid another generation being addicted to nicotine,” Indiana Attorney General Greg Zoeller said in an interview.

State attorneys general played a pivotal role during the 1990s in battling tobacco companies over conventional cigarettes.

The Master Settlement Agreement (MSA), an accord reached in November 1998 between the state attorneys general of 46 states, five U.S. territories, the District of Columbia and the five largest tobacco companies, resulted in significant changes to cigarette marketing and required the tobacco industry to pay the states about $10 billion annually for the indefinite future.

Nearly a year ago, a group of AGs asked the U.S. Food and Drug Administration to take a tougher line on e-cigarettes, the risks and benefits of which are still being studied.

In April of 2014, the agency proposed banning the sale of e-cigarettes to people under the age of 18, but did not recommend prohibiting advertising, flavored products or online sales – all of which help make the devices attractive to youngsters, according to public health advocates.

The FDA proposal has been under review ever since, which has meant that vaping remains legal for youths in states that haven’t passed laws banning it. The agency is likely to finalize its new e-cigarette regulations later this summer, though it could be several years before the federal rules go into effect.

Federal regulations and the 1998 Master Settlement prohibit makers of conventional cigarettes from targeting youth and from advertising on television, billboards and mass transit, but the rules don’t apply to e-cigarettes.

So far, however, 46 states have passed laws banning their sale to minors. Twelve of those states have also passed laws requiring child-proof packaging for e-liquids and e-cigarettes, according to the Campaign for Tobacco-Free Kids.

AGs are using these laws, as well as others not directly tied to e-cigarettes, to force companies to drop ads appealing to teens, switch to child-proof packaging and spend thousands of dollars on more vigilant age verification systems for their websites and online deliveries.

In June, New York Attorney General Eric Schneiderman announced settlements with four companies that were not complying with the state’s rule about child resistant packaging for nicotine liquids.

Reuters spoke with more than 10 e-cigarette and vaping companies – including Reynolds American, which sells Vuse, and Altria Group, which sells MarkTen and Green Smoke – that acknowledged they have been contacted by state law enforcers or by the National Associations of Attorneys General. Reynolds and Altria say their brands were not in violation of local laws.

Some of the AGs have coordinated their efforts. One group is pressuring certain e-cigarette manufacturers and vendors to limit ads that appeal to teens, especially on company websites and places like YouTube.

Ohio Attorney General Mike DeWine, along with colleagues from several other states, sent a letter in April to privately-held manufacturer NJOY, asking it to “immediately instruct YouTube to restrict” access to its advertisements to adults.

NJOY said in an April letter to DeWine that more than 90 percent of the U.S. viewers who have watched its hosted YouTube videos are at least 18, and the company said it would suspend videos if that figure fell to 85 percent or less.

NJOY, which previously settled a case with California over allegations of targeting minors and deceptive marketing, would not comment further.

California has sent letters to more than 150 e-cigarette and vaping companies in recent years “to encourage voluntary compliance with applicable state and federal laws,” including a ban on sales to youth, according to documents reviewed by Reuters.

The state is also pursuing companies that sell fruit-flavored vaping liquids that appeal to teens and those that make false or misleading statements in their advertisements. One letter sent by the state asked a manufacturer to quit claiming that “electronic cigarettes are one of the safest forms of nicotine available” and that “when you exhale, you are exhaling harmless water vapor.”

“Many companies have taken some or all of our recommended steps,” said Kristin Ford, a spokeswoman for Attorney General Kamala Harris.

AGs are paying particular attention to sales on websites, a popular source of vaping materials for teens, who trade information about which ones require little proof of age.

Jan Verleur, CEO and co-founder of electronic cigarette company VMR Products, said his company changed its age verification system in some states after being contacted by a state AG. He estimated the cost per order would increase by about 50 cents, but would not say if VMR would absorb any of that. The company makes about half its sales online.

“This is bad news for the smaller players and good news for the tobacco companies, whose business model relied on mass manufacturing, not personalized products,” said Philip Gorham, an equity analyst at Morningstar who covers consumer products.

http://www.grandforksherald.com/news/business/3783488-states-target-e-cigarette-sales-minors-amid-slow-federal-action