Devils Lake Park Board: Tobacco use policy to be drawn up

The Devils Lake Park Board is one step closer to solidifying guidelines for the use of tobacco products at its outdoor facilities.

By Harry Lipsiea, Devils Lake Journal Reporter

The Devils Lake Park Board is one step closer to solidifying guidelines for the use of tobacco products at its outdoor facilities.

At Monday’s regularly-scheduled meeting, the board voted unanimously to have director Terry Wallace write up a proposed policy and present it to the board for its approval.

Last month, Liz Bonney, Ramsey County Tobacco Prevention Coordinator with Lake Region District Health, brought the idea of a policy to limit areas in which tobacco products could be used at city parks.

The board looked at models currently placed in communities throughout the state of North Dakota. Ultimately, one seemed to jump out to board members as a policy that could fit well in Devils Lake.

“I like what Williston has done with its policy,” board member Kale Stromme stated. “It’s pretty cut and dry specifically when it talks about banning cigarettes in any area where youth are playing.”

The board agreed noting that the policy should include a ban of tobacco products near playground equipment. The board also felt that at baseball and softball diamonds, tobacco will be off limits during youth activities.

The only concern about such a policy was how to enforce the rules.

“There is no way to police the use of tobacco products at the park 100 percent of the time,” Bonney stated.

She pointed out that the policy would inform the public of rules in place. Bonney feels signage, to potentially be provided by Lake Region District Health, would be extremely beneficial.

“I don’t expect anyone to be out there at all times and stop what they are doing if they see someone smoking. That’s not realistic,” Bonney added. “This is a self-policing policy. I think the public will be compliant once they know there are guidelines in place.”

The board then voted for Wallace to form a policy similar to the one in Williston. It is expected to be presented for board approval at a future meeting.

In other business, the park board looked over an initial agreement proposal for the Creel Bay Golf Course. The golf course committee is set meet to go over items on a one-on-one basis later this week.

Also, the newly-added viewing area at the Mike Dosch Memorial Pool has been a hit, manager David Kerlin told the board.

“We have a gotten a lot of positive comments on it,” he stated.

http://www.devilslakejournal.com/article/20150616/NEWS/150619231

Reuters: Half of deaths from 12 common cancers directly linked to cigarette use

By Lisa Rapaport / Reuters Media

Roughly half of deaths from 12 smoking-related cancers may be linked directly to cigarette use, a U.S. study estimates.
While the largest proportion of deaths associated with smoking were for cancers of the lung, bronchus, trachea and larynx, about half of fatalities from tumors of the oral cavity, esophagus and bladder were also tied to cigarettes, the study found.
“The bottom line is that while we’ve made a lot of progress against the tobacco epidemic in the United States, there’s still much work to do,” lead study author Rebecca Siegel, a researcher at the American Cancer Society in Atlanta, said by email.
Siegel and colleagues estimated that out of 345,962 cancer deaths in 2011 among U.S. adults 35 and older, 167,805 were associated with smoking.
To estimate the proportion of cancer deaths attributable to smoking, the researchers used a standard formula to calculate the fraction of cases of specific cancer types that would not have occurred if there were no smoking.
Then they analyzed data from national surveys and in-person interviews asking people about their health history and tobacco habits. They adjusted their estimates to account for age, race, education level and alcohol use.
Based on smoking habits in the population and the proportion of cancer cases attributable to smoking, the researchers estimated that 125,799 lung, bronchus and trachea cancer deaths, representing 80 percent of the total, were linked to smoking. So were 50 percent of deaths from esophagus tumors and 45 percent of deaths from bladder malignancies.
The researchers also credit smoking with 17 percent of kidney cancer deaths, 20 percent of stomach cancer deaths, 22 percent of cervical cancer deaths and 24 percent of liver and bile duct cancer deaths in 2011.
One limitation of the study is that the survey and interview participants were generally more educated and less racially diverse than the U.S. population as a whole, the researchers acknowledge in JAMA Internal Medicine.
It’s also possible, however, that they underestimated cancer deaths tied to smoking because they didn’t have data on second-hand smoke exposure, which may cause an additional 5 percent of lung cancer deaths, or on use of cigars, pipes, or smokeless tobacco.
“While smoking prevalence continues to slowly decline, the use of alternative tobacco products is on the rise,” Siegel said.
Use of combustible forms of tobacco other than cigarettes, such as cigars and hookahs, doubled from the equivalent of 15.2 billion cigarettes in 2000 to the equivalent of 33.8 billion cigarettes in 2011, Siegel said.
“Although we can’t know exactly how many people are not starting to smoke cigarettes because they are using other tobacco products, e-cigarettes are now the most common form of tobacco use among high school students,” Siegel said.
Evidence doesn’t suggest that people who use alternative tobacco products are more likely to quit smoking or avoid starting on cigarettes, Dr. Michael Ong, author of a tobacco cessation editorial accompanying the study, said by email.
If there’s an upside to alternatives, though, it may be seen in the declining proportion of lung cancer deaths attributable to cigarettes, said Ong, a researcher at the University of California, Los Angeles and the Veterans Affairs Greater Los Angeles HealthCare System.
“But most of all lung cancer deaths are still attributable to smoking, and lung cancer makes up the largest cause of cancer-related mortality,” he said.
In an indication of the uphill battle smoking cessation can be, another study also published in JAMA Internal Medicine found that clinicians simply asking patients to quit and advising them of the lung cancer risks isn’t enough motivation to make it more likely that patients successfully quit.
Researchers followed more than 3,000 smokers for one year after lung cancer screenings to see if the amount of cessation support they received from clinicians might influence their odds of quitting.
The smokers who received assistance such as referrals to counseling or prescriptions for smoking-cessation drugs were 40 percent more likely to quit, while those who received follow-up care to monitor their progress were 46 percent more likely to stop smoking.
“Smokers face physical, environmental and social barriers to quitting,” lead study author Elyse Park, a researcher at Massachusetts General Hospital in Boston, said by email. “Primary care providers can assist smokers, particularly smokers with a heavy smoking history, to boost their confidence and obtain the counseling and medication support that can help them improve their odds of successful quitting.”
http://www.inforum.com/news/3766802-half-deaths-12-common-cancers-directly-linked-cigarette-use

E-cig shop fails smoke-free compliance check

By Anne Millerbernd, Fargo Forum

FARGO – One of five Fargo businesses failed a smoke-free law compliance check Thursday.

Fargo police checked the shops to ensure that electronic cigarettes weren’t being used in a prohibited area, and E-Cig Empire at 4900 13th Ave. S. failed, according to a release from Fargo Cass Public Health.

It’s the second time the business has failed a compliance probe within 12 months. A report was sent to the Cass County State’s Attorney’s office for consideration of charges.

People who smoke in prohibited areas can be fined up to $50. Business owners who fail to comply can be fined up to $100 on the first violation, $200 the second time and up to $500 each time after within the same year. A business owner could also lose his or her permit or license.

The state’s smoke-free law includes vaping and Fargo police conduct compliance checks quarterly or on a need basis.

http://www.inforum.com/news/3766136-e-cig-shop-fails-smoke-free-compliance-check

Cases of kids poisoned by e-cigs increasing in Minnesota

By Andy Rathbun / St. Paul Pioneer Press
Minnesota has seen a jump in the number of children poisoned by e-cigarettes and their liquid refillables, the Minnesota Department of Health said Wednesday.
From 2013 to 2014, the number of e-cigarette and e-liquid poisonings among Minnesota children 5 and younger rose 35 percent — the second year the Minnesota Poison Control System has seen a significant increase of nicotine poisonings related to e-cigarette products, the health department said in a news release. Poisonings from these products rose from three in 2012 to 62 in 2014.
E-cigarette products can contain a fatal amount of nicotine for a child, and about half of the cases last year were treated at emergency departments. Children can confuse the products, which are often flavored, with a candy or drink, the department of health said.
In January, a new state law took effect requiring child-resistant packaging for e-liquid products.
“This past year Minnesota took a big step to keep kids from accidently ingesting these potentially fatal e-liquids,” Minnesota Health Commissioner Ed Ehlinger said in a statement. “But parents should still use caution and store the products out of the reach of children.”
The symptoms that can result from nicotine poisoning include nausea, seizures, diarrhea, vomiting and difficulty breathing.
The department of health issued a nicotine heath advisory Wednesday that also warns teens and pregnant women of possible nicotine effects.
The drug can harm brain development during adolescence and harm fetal brain and lung development, the department said.
http://www.inforum.com/news/3763762-cases-kids-poisoned-e-cigs-increasing-minnesota

Star Tribune: Mpls. considers restrictions on flavored tobacco products

By Eric Roper Star Tribune

The sale of flavored cigars in convenience stores could soon come to an end in Minneapolis, where city officials are mulling the state’s first ban on the products at most traditional locations to curb youth tobacco use.

Anti-smoking advocates and small retailers squared off at a packed City Council hearing Monday over a proposal that would restrict sales of flavored tobacco products from more than 300 allowed locations to just under two dozen specialty tobacco shops. Similar bans have been enacted in New York City and Providence, R.I.

A council committee delayed a vote on the proposal, which targets flavored cigars, smokeless tobacco, shisha for hookahs and e-cigarette juice — but excludes menthol flavors. It would also set a minimum price on all cigars at $2.60 — echoing measures passed in Bloomington, St. Paul, Maplewood and Brooklyn Center.

Supporters said low-cost flavored cigars, sold under brands like White Owl and Swisher Sweets, are especially harmful because they entice young people to start smoking. A recent study of 530 underage youth in north Minneapolis found that more than half of the 313 who had used tobacco reported at one point smoking a cigar or cigarillo.

“Luring people to an addictive product with cheap prices and candy flavors before they’re old enough to know better doesn’t … give kids much choice,” testified Latrisha Vetaw of Northpoint Health and Wellness Center. Some of the non-tobacco flavors mentioned in the ordinance include chocolate, honey and vanilla, as well as fruits, herbs and candy.

City records show that 362 businesses are currently authorized to sell tobacco products in Minneapolis, though about a quarter of them are bars that largely sell cigarettes. The proposal would limit flavored tobacco sales to approximately 21 “tobacco products shops,” which generate 90 percent of their revenue from tobacco-related sales. It also clarifies that customers must be 18 to enter those stores.

Convenience store owners at Monday’s hearing challenged the necessity of the change, noting that it is already illegal for them to sell tobacco to minors. City records show that out of more than 350 undercover compliance checks each year, only about 6 to 7 percent result in violations for selling to a minor.

They also said that restricting tobacco sales threatens one of their core revenue streams. “Forty percent of our sales in the convenience store industry comes from tobacco. … That’s the industry average: 40 percent,” said Steve Williams, owner of Bobby and Steve’s Auto World, which has several locations. “So we’re affecting the viability of a lot of convenience stores.”

Ahmad Al-Hawari, who owns four convenience stores around the city, said while flavored cigars account for less than 5 percent of their business, the change could result in lost customers.

“A customer will walk or drive to a smoke shop, buy his flavored tobacco as he wishes … and then he’s going to buy cigarettes and pop from there,” Al-Hawari said. “He’s not going to go back to the convenience store.”

The federal government banned all flavored cigarettes except for menthol in 2009, but did not apply the same restrictions to cigars. Cigars may also be sold individually, versus in packs like cigarettes, making a common price about 99 cents each, according to a city staff report.

Paul Pentel, an internist at Hennepin County Medical Center, said their low cost also makes cigars an appealing option for adults who already smoke.

“In my clinic, I am very alarmed by the number of patients I see who have switched to cheap cigars because of the cost of cigarettes,” Pentel said. “For these patients, cheap cigars are a missed opportunity to quit smoking.”

New York City banned the sale of flavored tobacco products in 2009, except for at a handful of tobacco bars. A ban in Providence, R.I., went into effect in 2013. The state of Maine has also enacted a ban on small, flavored cigars.

Four Minnesota cities have already established minimum cigar prices. The minimum is $2.10 in St. Paul and Brooklyn Center, and $2.60 in Bloomington and Maplewood, city staff said.

Council Member Blong Yang, a cosponsor of the ordinance change, said he was drawn to the issue after seeing in the recent study from Breathe Free North, a program of Northpoint, that children have too much access to flavored tobacco. It also appears to be disproportionately affecting minority communities, he said.

“Every single convenience store that you go to it seems has all this stuff right in front of people, basically,” Yang said. “And it’s screaming for people to buy it because it’s there.”

The council’s health, environment and community engagement committee is expected to vote on the measure in two weeks, with a final vote before the full council possible in July.

http://www.startribune.com/minneapolis-mulls-restrictions-on-flavored-tobacco-products/306572261/

Reuters: US tobacco companies drop lawsuit vs FDA over labeling

The three largest U.S. tobacco companies on Tuesday dropped their lawsuit accusing the U.S. Food and Drug Administration of exceeding its authority by closely monitoring the content of their product labels after the agency said it would reconsider its rules.

Altria Group Inc, Reynolds American Inc and Lorillard Inc dismissed their case after the FDA on May 29 said it would review whether to mandate advance approval for label alterations such as changes to logos and background colors, or the use of descriptors such as “premium tobacco.”

In their April lawsuit filed in federal court in Washington, D.C., the companies said the 2009 Tobacco Control Act limited FDA authority to pre-approve label changes to two “narrow” circumstances: products claiming to lower tobacco-related risks, or when prior approval is required by regulation.

By expanding its oversight to cover how labels look, the FDA violated the tobacco companies’ commercial speech rights under the First Amendment, the complaint said.

The plaintiffs included Altria’s Philip Morris USA, Reynolds American’s RJ Reynolds and Lorillard Tobacco, whose respective cigarette brands include Marlboro, Camel and Newport, and some of their smokeless tobacco units.

In its May 29 statement, the FDA said it would not act against tobacco companies that do not seek pre-approval for label changes that create “distinct” products otherwise identical to those being sold, or where the only change is the quantity in each package.

The FDA said the interim policy would remain in place while the agency decides whether to adopt new label approval procedures.

Altria spokesman Brian May said there was no need to pursue the lawsuit in light of the FDA’s announcement. Reynolds American spokesman David Howard declined to comment. Lorillard did not respond to a request for comment.

FDA spokesman Michael Felberbaum declined to comment.

On May 26, Reynolds American won U.S. antitrust approval to buy Lorillard, combining the second- and third-largest U.S. cigarette companies.

The case is Philip Morris USA Inc et al v. FDA et al, U.S. District Court, District of Columbia, No. 15-00544.

http://www.foxnews.com/health/2015/06/03/us-tobacco-companies-drop-lawsuit-vs-fda-over-labeling/

U.S. News: Nevada Republican Gov. Brian Sandoval secures unlikely win with approval of big tax increase

By MICHELLE RINDELS, Associated Press

CARSON CITY, Nev. (AP) — Nevada’s Republican governor, Brian Sandoval, secured an unlikely victory Monday when the conservative state Legislature approved a huge tax increase at his urging as part of a plan to boost education spending.

The $1.1 billion package raises taxes on businesses and cigarettes, and it makes permanent a $500 million bundle of temporary payroll and sales taxes.

Sandoval’s win comes on the last day of the legislative session, and the proposal’s fate had been in doubt until late Sunday when several skeptical Republicans in the state Assembly pledged support.

The plan had faced vocal resistance for months, led by anti-tax conservatives emboldened by election victories in November that increased their majorities in both chambers.

Many critics noted that Nevada voters had overwhelmingly rejected a similar business tax plan and said the lawmakers shouldn’t go against their wishes.

Sen. Don Gustavson said legislators “should be ashamed of themselves to force through the largest tax increase in Nevada’s history that includes the type of tax that voters did not support.”

“And you wonder why our constituents distrust politicians?” he added.

Gustavson and Sens. Pete Goicoechea and James Settelmeyer, all rural Republicans, were the only opposition in the Senate, which passed the tax plan 18-3 Monday.

That vote came after the Assembly passed the plan 30-10 Sunday night after heavy-hitting business groups lined up behind it.

The tax increase will allow Sandoval to pump millions of dollars into programs for poor students and children learning English. The state has lagged behind others for years in education rankings and on school funding, but it has consistently rejected efforts to raise revenue.

Republican Sen. Scott Hammond had been among the skeptics, but he said his concerns about accountability had been eased, in part by the passage of his bill allowing students to use public funds at private schools.

“I can assure you that there have been significant reforms. We have one of the best, if not the best, school choice reform programs now in the nation,” Hammond said. “For that reason, I can support this.”

Elements of the plan include:

— A hike in the business license fee. The fee for corporations would rise from the existing $200 a year to $500, while the fee for the rest of the business entities would remain at $200.

— A hike in the payroll tax. Sandoval’s plan raises the state’s existing modified business tax from 1.17 percent to 1.475 percent of wages beyond the first $200,000 a company pays out each year and sets the rate at 2 percent of those wages for the mining industry and financial institutions. Companies would still get to deduct health care premiums for employees from the calculation.

— A “Commerce Tax” on gross revenue. Industry-specific tax rates will apply to businesses with more than $4 million in Nevada revenue each year. Businesses can count 50 percent of their commerce tax bill as a credit against their modified business tax bill — a provision that’s intended as a perk to those who employ people. The commerce tax aims to capture more money from capital-intensive businesses such as mines and those that do business in Nevada but aren’t based here.

— A flexible payroll tax rate. The plan allows the state to lower the modified business tax rate if revenues from the new commerce tax and MBT rate bring in more revenue than projected.

— An extension of “sunset taxes.” More than $500 million of the plan comes from making a set of expiring payroll and sales taxes permanent.

— Cigarette taxes. The bill raises a tax on cigarette packs by $1, which is expected to generate about $100 million over two years.

http://www.usnews.com/news/politics/articles/2015/06/01/nevada-gop-governor-secures-unlikely-win-with-tax-increase

Reuters: Cigarette warnings work better with pictures, study shows

By Lisa Rapaport, Reuters

Gruesome photographs on cigarette packages may deliver more effective anti-smoking messages than words, a new analysis finds.

Researchers reviewed previous studies comparing images to text warnings on cigarette boxes and found pictures commanded more attention, elicited stronger emotional reactions, summoned more negative attitudes and made it more likely that smokers would vow to quit.

“They say a picture is worth a thousand words — that really seems to be the case here,” said lead study author Seth Noar, co-director of the interdisciplinary health communication program at the University of North Carolina at Chapel Hill.

Globally, tobacco kills about six million people a year, and the annual death tally is expected to reach eight million by 2020, according to the World Health Organization. Smoking can cause heart disease and lung cancer, even when exposure is second-hand, and it can lead to asthma and other breathing difficulties in children who live with smokers.

Just 30 countries, representing about 14 percent of the world’s population, require warning images on at least half of the front and back of cigarette packages with anti-smoking messages in the local language, according to the WHO.

In Australia, for example, cigarette packages have graphic images of sick or dying smokers on the wrappers.

To see how well grotesque images on cigarette packages work as a deterrent, Noar and colleagues analyzed data from 37 experiments involving more than 33,000 people. Every study included in the analysis showed participants both words and pictures to measure which approach was better at discouraging smoking.

The studies reviewed were done in 16 different countries, though most were in the U.S., Canada or Germany, and were published between 2000 and 2013.

Relative to text, images convinced people to think more about the effects of smoking, lowered cravings and increased aversion to cigarettes, the analysis found.

Eight of the studies examined whether participants thought the pictures were effective. This subset of experiments found smokers and nonsmokers thought pictures would encourage them not to start smoking or motivate them to cut back and urge others to quit as well.

When the researchers analyzed data across all of these studies, they found pictures were significantly better than text alone at motivating people to avoid cigarette use.

“Smokers know that cigarettes are bad for them, but they likely tune out vague warnings that they have seen for years, such as ‘smoking causes cancer,’” Noar said by email. “Seeing images of diseased lungs and people suffering from the negative health impacts of smoking appear to affect smokers in ways that simple text-only messages cannot achieve.”

All but one of the studies included in the review lacked data on how the images or texts might impact behavior, the researchers acknowledge in the journal Tobacco Control. The studies also didn’t follow people over long periods of time or measure how repeated exposures to the images might influence behavior, the authors note.

Because smoking is often a social behavior, more research is needed on how social interactions might influence the impact of anti-smoking images on packages, the researchers wrote.

Images may help reach an audience that’s particularly vulnerable — people with lower literacy or education levels, said Jim Thrasher, a researcher in health behavior at the Arnold School of Public Health at the University of South Carolina in Columbia.

“Even among these disadvantaged groups where smoking rates are highest, pictorial warnings are a promising way to stimulate smoking cessation,” Thrasher, who wasn’t involved in the study, said by email.

They may also help young people get the message about smoking, said David Hammond, who researches addiction and cigarette packaging at the University of Waterloo in Ontario, Canada.

“One of the challenges for cigarette warnings is that many of the most severe health consequences don’t appear for a number of years,” Hammond, who wasn’t involved in the study, said by email. “Images help to make these health consequences more salient and real for youth and young adults.”

http://www.duluthnewstribune.com/features/3756926-cigarette-warnings-work-better-pictures-study-shows

LA Times: California Senate votes to restrict e-cigarettes as tobacco products

By PATRICK MCGREEVY

The state Senate on Tuesday approved a bill that would ban electronic cigarettes from restaurants, theaters and other public places in California where smoking is prohibited to address health concerns.

Sen. Mark Leno (D-San Francisco) said his bill would treat e-cigarettes, also known as “vaping” devices, as tobacco products because they often use nicotine and are popular with teenagers.

Youth e-cigarette use rising; heart group calls for regulation

“Of great concern is that the fastest growth segment of new users is among middle and high school students who are now smoking electronic cigarettes,” Leno told his colleagues. “They are advertised on television. They are advertised on billboards.”

The measure, which would also subject e-cigarettes to the same licensing requirements as tobacco, was approved by a 24-12 vote, with Sen. Jeff Stone of Murrietta the only Republican to vote for the bill.

Senate Republican leader Bob Huff of Diamond Bar said e-cigarettes work on vapor that does not spread as much as tobacco smoke, so they should be treated differently in public.

“E-cigs are used by people trying to kick the tobacco habit,” Huff said. He voted against the bill, saying the state should wait until the federal government takes action.

Stone noted that his mother was a former smoker who died of cancer. He said the tobacco and vaping industries are marketing e-cigarettes to young people with flavors including watermelon, tutti frutti and cotton candy while the vapor has nicotine derived from tobacco. He said “vaping” is a gateway to cigarette smoking.

“Now we are exposing a whole new generation of millenials to this fashionable way of smoking tobacco in a way that is going to jeopardize their lives,” Stone said. The measure next goes to the Assembly for consideration.

http://www.latimes.com/local/political/la-me-pc-california-senate-votes-to-restrict-ecigarettes-like-tobacco-products-20150602-story.html

Reuters: California Senate votes to raise smoking age to 21 from 18

LOS ANGELES | BY ALEX DOBUZINSKIS
The California Senate voted on Tuesday to raise the legal smoking age in the most populous U.S. state to 21 from 18, in a move that could make California one of the states with the highest smoking age.
The measure was approved by the Senate 26-8 and must now be approved by the state Assembly.
“We will not sit on the sidelines while big tobacco markets to our kids and gets another generation of young people hooked on a product that will ultimately kill them,” Senator Ed Hernandez, a Democrat and the bill’s author, said.
“Tobacco companies know that people are more likely to become addicted to smoking if they start at a young age,” Hernandez added in a statement.
The Institute of Medicine, the health arm of the National Academy of Sciences, has said that increasing the smoking age to 21 would result in more than 200,000 fewer premature deaths nationally for those born between 2000 and 2019.
The Cigar Association of America opposed the bill, contending that 18-year-olds can serve in the military, vote and sign contracts and should thus enjoy the right to smoke, according to the Los Angeles Times.
David Sutton, a spokesman for Altria Group Inc, the parent of Philip Morris USA, said in an emailed statement that Altria believed states should defer to the federal government and “allow FDA and Congress the opportunity to think through this issue further before enacting different minimum age laws.”
Representatives for R.J. Reynolds Tobacco Company, a unit of Reynolds American Inc, did not return calls seeking comment.
Hawaii lawmakers approved a measure in April to raise the smoking age to 21, and that is awaiting the state governor’s signature. Democratic Governor David Ige has not indicated whether he will sign the measure, and has until June 29 to decide whether to veto it, a spokeswoman for his office said.
Since 2013, New York City has required tobacco purchasers to be 21 or older, according to the National Conference of State Legislatures. No state has a smoking age that high, but Alabama, Alaska, Utah and New Jersey set it at 19.
(Reporting by Alex Dobuzinskis and Cynthia Johnston; Editing by Sandra Maler)
http://www.reuters.com/article/2015/06/02/us-usa-smoking-california-idUSKBN0OI2EI20150602