Forum editorial: Don’t be fooled by e-cig hype

The North Dakota Legislature is buying into Big Tobacco’s clever but dishonest narrative about e-cigarettes. Lawmakers would be better served by paying attention to Dr. Terry Dwelle, the state’s chief health officer.
In comments published a few days ago, Dwelle said without equivocation that, given current research and information, the “cons” of e-cigs outweigh the “pros.” He said more work is needed to further define the risks and any potential benefits of the nicotine-delivery devices. He said the assumption that vapors produced by e-cigs are less risky than smoke from traditional tobacco products is not backed up by sound research.
Lawmakers likely will ban e-cig sales to minors, as several North Dakota cities have done already. But there is wrong-headed sentiment among some lawmakers that the devices should not be taxed and otherwise treated the same way tobacco is. Under the state’s smoking ban law, e-cigs are treated like cigarettes and other tobacco products. The e-cig provision was part of a voter-approved smoking and secondhand smoke measure. The measure passed with 66 percent approval.
Yet, lawmakers have smoke in their eyes when it comes to the clear message North Dakotans sent about tobacco use – and the stealth campaign to paint vaping with e-cigs as an innocent tobacco-free option.
There is nothing innocent about it. Big Tobacco has become Big Vaping. The companies have jumped into the e-cig market with slick advertising campaigns and legitimate-sounding claims about the safety and efficacy of e-cigarettes. The push has all the elements that peddlers of tobacco used a generation ago to convince the gullible that cigarettes did not cause cancer. The lie then has morphed into the lie now.
There is less-than-definitive indication that e-cigs help smokers quit. If it’s true, it’s a good thing. But that unproved aspect of e-cigs has nothing to do with taxing a nicotine-delivery device that by some studies can be a gateway for young people to tobacco use. It is counterintuitive to grant a tax break to devices and substances that use candy flavors and faux fashion to attract users of all ages to a nicotine-delivery tube. It’s also stupid policy. It’s playing into the dirty hands of the folks who for years peddled the fiction that tobacco was good for us.
Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.
http://www.inforum.com/opinion/editorials/3711115-forum-editorial-dont-be-fooled-e-cig-hype

Fargo Forum: Bill banning e-cigarette sales to minors in ND passes Senate

By Mike Nowatzki

BISMARCK – A bill outlawing e-cigarette sales to minors in North Dakota unanimously passed the Senate on Tuesday, though one lawmaker warned that not defining the nicotine-delivery devices as tobacco products will make it more difficult to enforce the law and protect minors.

“Sometimes the good outweighs the flaws, and that’s precisely how I view this bill,” said Sen. Erin Oban, D-Bismarck, executive director of Tobacco Free North Dakota.

Senators voted 46-0 in favor of House Bill 1186, which makes it an infraction to sell or give anyone under 18 an electronic smoking device or alternative nicotine product, or for minors to buy, possess or use them.

Introduced by Rep. Kim Koppelman, R-West Fargo, the bill also requires child-resistant packaging for liquid nicotine containers and bans self-service displays for e-cigarettes.

The Senate didn’t change the bill as approved by the House 71-20 last month, so it will soon head to Gov. Jack Dalrymple for his signature.

Sen. John Grabinger, D-Jamestown, who carried the bill from the Senate Judiciary Committee with a 6-0 do-pass recommendation, said the committee heard a lot of testimony and efforts to amend the bill but couldn’t decide on any changes that would make it better.

“Your committee decided rather than trying to fix the bill that really was getting these products out of the reach of the young, we should support the present bill,” he said.

Health advocacy groups and the state Department of Health have urged lawmakers to define e-cigarettes as tobacco products because the nicotine in the liquid vaporized by the battery-powered devices is derived from tobacco plants.

The definition would make e-cigarettes subject to tobacco excise taxes and require those who sell them to obtain a tobacco retailer license, as three North Dakota cities – Wahpeton, West Fargo and Grand Forks – have mandated through their city ordinances.

Twenty-three cities have updated their ordinances to prohibit e-cigarette sales to minors, according to the North Dakota Center for Tobacco Prevention and Control Policy.

Oban raised concern about using terms like “alternative nicotine product” for products “that are indeed tobacco products and should be treated as such under the law.”

“Creating multiple definitions makes enforcement and compliance more difficult and protection for minors less effective,” she said. “In addition, currently we have no idea who’s even selling products like electronic cigarettes, and unfortunately this bill doesn’t help us to address that concern, either.”

Still, she encouraged a yes vote with the understanding “that we may need to make some improvements in the future.”

Sen. Jonathan Casper, R-Fargo, said the debate over whether to classify e-cigarettes as tobacco products will continue as the U.S. Food and Drug Administration develops regulations for the devices. He said HB1186 struck a “middle-ground balance” between interests on both sides.

Senators also voted 9-37 Tuesday to defeat HB1078, which would have made it illegal for minors to use or be sold nicotine devices. Grabinger said committee members felt the bill introduced by Rep. Diane Larson, R-Bismarck, didn’t go far enough.

http://www.inforum.com/news/3712175-bill-banning-e-cigarette-sales-minors-nd-passes-senate

Letter to the Editor: Letter: Big tobacco companies still trying to hook kids

By Jason McCoy from Moorhead

I  applaud the new TV ad airing locally that highlights Big Tobacco’s continued targeting of children. You may have seen this ad featuring an ice cream truck driving through a kid-filled neighborhood drawing lots of pint-sized customers to its menu of “31 flavors.” Only it turns out a tobacco executive is behind the wheel and the flavors disguise deadly products.
Tobacco companies have clearly come up with ways to get to kids around the 2009 ban on flavored cigarettes by pushing flavored cigars, cigarillos, smokeless tobacco and e-cigarettes.
When the U.S. Food and Drug Administration banned the sale of flavored cigarettes, it did so to reduce smoking, a leading preventable cause of death and disease in our country.
In particular, the FDA wanted to reduce the number of children who start to smoke. Almost 90 percent of adult smokers start smoking as teenagers. And nicotine, which is in all tobacco products, is shown to be not only highly addictive and carcinogenic but also detrimental to adolescent brain development.
Flavorings including menthol, which is still available in cigarettes, mask the harsh taste of tobacco and are shown to be attractive to young people. Research shows that young people believe flavored tobacco products are less dangerous than nonflavored tobacco. As of last year, 44 percent of Minnesota high school smokers used menthol, according to the Minnesota Department of Health. That’s double the percentage in 2000. The same study by MDH also found that 35 percent of Minnesota students have tried flavored cigars and 13 percent of Minnesota kids use flavored e-cigarettes.
Do we really need more evidence that kids are attracted to flavored tobacco products, including menthol? Do we have any reason to believe that tobacco companies aren’t exploiting this attraction to hook more kids on their deadly products? The answer to both questions is a resounding “no.”
It’s time we say “no” to Big Tobacco’s continued marketing to our kids! Ask your lawmakers what they plan to do to stop young people from getting their hands on these tempting threats to their health.
McCoy, Moorhead, is tobacco coordinator for Clay County Public Health.
http://www.inforum.com/letters/3709662-letter-big-tobacco-companies-still-trying-hook-kids

CBS MoneyWatch: As e-cigarette sales soar, critics eye regulations

By JONATHAN BERR | MONEYWATCH
The Food and Drug Administration expects to publish its much-anticipated regulations for e-cigarettes in June, as the products are surging in popularity. In fact, sales are expanding so rapidly that some experts predict e-cigs will overtake sales of conventional smokes within the next decade.
“From our perspective, the rules are long overdue,” said Erika Sward, assistant vice president of national advocacy at the American Lung Association, who noted the regulations have been in the works for about a year.
The FDA already regulates cigarettes, cigarette tobacco, roll-your-own tobacco and smokeless tobacco. Under the 2009 Family Smoking and Tobacco Control Act, the FDA can “deem” additional tobacco products to be subject to the Federal Food, Drug, and Cosmetic Act. Among other things, firms would be required to register with the FDA and submit product and ingredient listings, and include health warnings and take steps to prevent sales to underage consumers.
“To date, FDA has not been able to fully assess the public health impacts of unregulated tobacco products,” the FDA said in a statement sent to CBS MoneyWatch. “For example, some testing of e-cigarette cartridges has revealed significant variability in nicotine content and the presence of chemical constituents that raise concerns of toxicity.”
Altria Group (MO) and Reynolds American (RAI), two of the biggest tobacco companies, are welcoming the FDA’s efforts, arguing that the patchwork of existing state regulations fails to protect consumers against defective products, some of which have even exploded. The companies are lobbying the FDA to treat e-cigarettes differently than conventional smokes.
Some proponents of e-cigaretttes have claimed that they can be an effective smoking cessation tool. A study published last year found that people who wanted to quit smoking were about 60 percent more likely to be successful if they used e-cigarettes as opposed to other products such as nicotine patches or gum.
Industry critics, including the American Lung Association, counter that the evidence to back up these claims is inconclusive. A study released last month by the Johns Hopkins Bloomberg School of Public Health found that e-cigarettes generate some of the same dangerous chemicals found in traditional smokes.
“There is absolutely no federal oversight of e-cigarettes in terms of what is in them, how they are being marketed,” said Sward of the American Lung Association, adding that e-cigarette makers are “following the Big Tobacco playbook” by offering flavored e-cigarettes that would appeal to underage smokers. “Really, what we are seeing are the same tactics that we saw 30, 40 years ago.”
Altria, which is based in Richmond, Virginia, has put a 116-word warning on packs of its MarkTen e-cigarettes even though it wasn’t legally obligated to do so. AsReuters noted, it said nicotine is “addictive and habit-forming” and that MarkTen isn’t intended for women who are pregnant or breast-feeding or people being treated for depression or asthma. Spokesman Steve Callahan said the wording on the company’s label was based the “available science.”
In a statement to CBS MoneyWatch, Reynolds argued that the FDA needed to regulate e-cigarettes fairly.
“We believe if (the) FDA is going to regulate vapor products, then it should regulate all vapor products — including open systems and the vape shops in which the liquid nicotine used in open systems is mixed or compounded — to create a level playing field where all manufacturers are subject to equal treatment, including FDA inspection/registration/regulation, manufacturing standards and product clearance requirements,” writes Richard J. Smith, a spokesman, in an email.
Whenever the regulations are issued, it will open another front in the decades-long battle that pits people trying to protect the public health against the rights of an industry selling an otherwise lawful product.

Men's Journal: E-Cigarettes May Be Just as Bad as The Real Thing

Two new studies have turned out some scary findings about e-cigarettes. The first one, published in the New England Journal of Medicine, revealed that e-cigarette vapor can harbor hidden formaldehyde — a known carcinogen — at levels up to 15 times greater than regular cigarettes. “We discovered this form of formaldehyde hidden in the tiny liquid droplets of the vapor, where it hadn’t been detected before,” says lead researcher David Peyton, a chemistry professor at Portland State University in Oregon. “It has the potential to distribute deeply into the lungs and collect there.”
The second study showed that e-cigarette vapors directly harm human lung tissue. Researchers from the University of Rochester Medical Center in New York found that when the aerosol produced by heated liquid nicotine hits lung cells, it churns up disease-causing free radicals and triggers marked inflammation; they also found the presence of up to six times the level of heavy metals, like copper. What’s more, they discovered that various flavor additives, which are often added to e-cigs, cause additional oxidative damage to lung tissue. This isn’t after years of e-cig use, either. The negative effects “occurred after a few days of vaping,” he says. “Chronic exposure may lead to even more damage.”
These findings add to the fast-amassing stack of research revealing the many potential hazards of e-cigarettes. Since these smokeless devices are not regulated by the Food and Drug Administration, they can contain any number of toxins, carcinogens, or other mystery chemicals. And because e-cigarettes are so new, the long-term health consequences of using them are unknown.
Even so, many people assume that, compared to regular tobacco cigarettes, e-cigs are the lesser of two evils. But that’s not necessarily the case, says Dr. Roy Herbst, chief of medical oncology at Yale Cancer Center and a spokesman for the American Association for Cancer Research. “In the oncology community, we feel they are both evil,” he says. “The big concern with e-cigarettes is lung tissue damage. Regular cigarette smoke contains 60 to 80 known carcinogens, which makes it very bad for the lungs too. However, hot e-cigarette vapor going straight to the lungs can cause actual burning and injury. It’s a different type of damage — but it’s still significant.”
And that’s just their immediate impact. “We still don’t know the long-term effects that e-cigarettes can have on the body,” Herbst says. “There is still so much to learn about them.”
Herbst also thinks e-cigs are an unproven and even detrimental smoking cessation tool — which is, of course, a huge reason why people puff on them. “I treat people with lung cancer, so certainly my goal is to stop people from smoking,” he says. “But these devices deliver such high concentrations of nicotine that they get people very addicted to the drug. If you need help with smoking cessation, there are other, FDA-approved forms of nicotine, such patches or lozenges, that would much better than e-cigarettes.”
And because e-cigs crank out so much nicotine, Herbst also fears that they can be a gateway to tobacco cigarettes. “E-cigarettes are very expensive, so we worry that people will start on them, get addicted to nicotine, and then move on to regular cigarettes, which are generally less expensive and easier to get,” he adds.

–

Read more: http://www.mensjournal.com/health-fitness/nutrition/e-cigarettes-may-be-just-as-bad-as-the-real-thing-20150324#ixzz3Vo1Fhu6J

CNN: E-cigarettes: Helping smokers quit, or fueling a new addiction?

By Meera Senthilingam, for CNN

(CNN) It’s a portable piece of technology providing seemingly bottomless access to a drug craved by more than 1 billion people worldwide — nicotine. That craving is caused by smoking tobacco but is now being increasingly satisfied by e-cigarettes and the trend to “vape” instead of smoke.

The selling point is the clean image e-cigarettes purvey by removing the simultaneous exposure to the tar and thousands of chemicals found in the tobacco smoke of regular cigarettes — removing the cause of lung diseases as well as other tobacco-related conditions.

Tobacco kills almost 6 million people each year, according to the World Health Organization (WHO), and a growing number of people are now “vaping” instead of smoking, resulting in industry worth $2.7 billion worldwide.

Since their introduction in 2006, e-cigarettes have become commonplace among smokers trying to kick their habit, with a third of smokers trying to quit in the United Kingdom turning to e-cigarettes to aid them, according to one study. But some critics argue these electronic nicotine delivery systems (ENDS) are fueling a new addiction to nicotine — particularly among young people experimenting with them.

Allure for adolescents

“While ENDS may have the potential to benefit established adult smokers … [they] should not be used by youth and adult non-tobacco users because of the harmful effects of nicotine and other risk exposures,” says Tim McAfee, director the Office on Smoking and Health at the U.S. Centers for Disease Control and Prevention. “Exposure to nicotine can harm adolescent brain development.”

Studies conducted by the CDC through its Adult and Youth National Tobacco Surveys found increased experimentation by youth trying out e-cigarettes but not conventional cigarettes. The gadgetry and flavors associated with the devices is suggested as a reason behind this, with fears of them acting as a gateway into real tobacco smoking.

Screen Shot 2015-03-29 at 2.49.51 PM

But others in the field of tobacco control disagree, stating that whilst people — including youth — may have tried e-cigarettes, the evidence is lacking for their regular use. “Kids like new technology and just experiment or use it once or twice,” says Jean-Francois Etter, professor of Public Health at the University of Geneva.

Etter has been researching the use of e-cigarettes since 2009 and believes they are much safer than conventional cigarettes. “The most dangerous way of consuming nicotine is to smoke it,” he says. Etter argued this point last week at the World Conference of Tobacco or Health in Abu Dhabi.

Whilst Etter says that use among young people should be monitored, he believes the role of e-cigarettes in reducing global tobacco consumption is more important. “They are a gateway out of smoking,” says Etter. The number of people using a combination of tobacco and e-cigarettes is on the rise, according to Etter, resulting in smokers switching and consuming less tobacco each day. “[They have] the same level of nicotine but people are less exposed to toxins … nicotine is not a health problem,” he says. However, further evidence on the long-term health effects of e-cigarettes or nicotine is needed.

Satisfying the craving

Nicotine is the main substance keeping people addicted to smoking tobacco and consequently exposing them to the tar and toxins found in cigarettes. Whilst many people try to kick the habit cold turkey, nicotine replacement through gums and patches has long been advocated as a helping hand. “Nicotine withdrawal is a very unpleasant process,” says Linda Bauld, professor of Health Policy at the University of Stirling, whose recent report for Public Health England identified an extensive and growing market for e-cigarettes worldwide.

“The vast number of people using e-cigarettes are using them to stop smoking; [they’re] about 60% more effective than going cold turkey or buying nicotine replacement therapy over the counter.”

Bauld’s research hasn’t identified a dependence on nicotine with e-cigarettes in the same way as the addiction resulting from regular cigarettes. “E-cigarettes are not the best nicotine delivery devices,” she says referring to the fact nicotine is not seen to enter the bloodstream as readily when using e-cigarettes. That’s backed up by Etter’s research as well as a recent study by researchers at Penn State College of Medicine, in which e-cigarettes were found to be less addictive than tobacco cigarettes.

Screen Shot 2015-03-29 at 2.50.46 PM

They do, however, provide nicotine more effectively than aids such as patches or gums, according to Bauld.

“Patches and gums are a very small market,” says Etter about the quitting devices which first came onto the market 40 years ago. He fears too much restriction on e-cigarettes will limit their impact in achieving a world free of tobacco.

Both Bauld and Etter recognize the need to monitor the consumption of nicotine among teenagers but feel the value of e-cigarettes among adult smokers and their potential to save lives by reducing tobacco consumption should not be underestimated — a sentiment recognized by the World Health Organization.

“[E-cigarettes] could be a way to help people quit but we need more evidence and regulation,” says Armand Peruga, program manager for the WHO’s Tobacco Free Initiative, which has celebrated 10 years of its Framework for Tobacco Control whilst at the conference in Abu Dhabi.

Legislate and regulate

The greatest impact to date in reducing the number of smokers worldwide has been the taxation and legislation restricting tobacco advertising and increasing prices. “For every 10% increase in tax you have 4% reduction in tobacco consumption,” says Peruga.

The growing fear is the increasing domination of big tobacco in the e-cigarette market, which was once seen as a competitor. Their ownerships of popular e-cigarette brands could push out smaller companies in the field, reminiscent of the original tobacco epidemic.

“The intent of big tobacco is to sell their product,” concludes Peruga. “[They may] expand their market to other customers who didn’t use cigarettes but might consider nicotine use.”

But as it seems e-cigarettes are here to stay, most calls are for informed regulation rather than prohibition. “The majority of e-cigarettes — especially when they are well regulated — are likely to be less toxic than cigarettes — and that for smokers is an advantage,” says Peruga.

http://www.cnn.com/2015/03/23/health/e-cigarettes-smoking-addiction-nicotine/

Fargo Forum: Trygve Olson Cartoon

0322-1
 
http://www.inforum.com/opinion/cartoons/3704759-trygve-olson-cartoon-032215

Dickinson Press: Debate over on e-cigs as tobacco products overshadows bills restricting sales to minors

By Mike Nowatzki, Forum News Service

BISMARCK – Two bills being heard at the Legislature this week aim to keep e-cigarettes out of the hands of minors, but the burning issue is whether the nicotine-delivery devices should be classified as tobacco products, which would make them subject to additional taxes.

The North Dakota Department of Health believes e-cigarettes should be considered tobacco products because the nicotine contained in the liquid that’s vaporized by the battery-powered devices is derived from tobacco plants, said Krista Fremming, director of the department’s chronic disease division.

“Defining nicotine devices as tobacco products would allow the state to treat and regulate the sale of these products to minors in the same way the state treats and regulates the sale to minors of other tobacco products, such as conventional cigarettes,” she testified to the Senate Judiciary Committee on Tuesday.

Rep. Diane Johnson, R-Bismarck, prefers not to bring the tobacco-product issue into the debate. Her House Bill 1078 – one of two bills the House passed last month to ban the use of e-cigarettes by minors – refers simply to “nicotine devices,” defining them as “any noncombustible product that can be used by an individual to simulate smoking through inhalation of a substance that contains or delivers nicotine or any other ingredient.”

The bill had its first hearing before the Senate Judiciary Committee on Tuesday.

On Wednesday – the annual nationwide “Kick Butts Day” – committee members will take up the other House bill, HB 1186, which would make it an infraction to sell or give anyone under 18 an electronic smoking device or alternative nicotine product, or for minors to buy, possess or use them.

Fremming said the health department supports that bill’s requirements for child-resistant packaging and salesperson-assisted sales to limit e-cigarettes from being marketing to youths. But it’s still concerned that the bill defines e-cigarettes as non-tobacco products.

The bill’s prime sponsor, Rep. Kim Koppelman, R-West Fargo, has argued that while e-cigarettes use nicotine extracted from tobacco, they’re not tobacco products.

Koppelman was among the House lawmakers who voted to defeat a House bill that would have increased the excise tax on a pack of cigarettes from 44 cents to $1.54 while also defining e-cigarettes as tobacco products. He called it a back-door way to taxing e-cigarettes.

Mike Rud, president of the North Dakota Petroleum Marketers Association, said Tuesday the group supports Koppelman’s bill because it’s more comprehensive and opposes classifying e-cigarettes as tobacco products because the U.S. Food and Drug Administration is developing regulations for e-cigarettes.

“I think we’re going to see a lot of changes when those come out. There’s no sense in muddying the waters right now,” he said.

As of December, Minnesota and Vermont were the only states that taxed e-cigarettes and e-vapor products. Twelve state legislatures considered bills last year taxing e-cigarettes but didn’t pass them, according to Tobacco E-News, an industry publication.

In North Dakota, 23 cities have updated their ordinances to prohibit e-cigarette sales to minors, according to the North Dakota Center for Tobacco Prevention and Control Policy.

Three of those cities – Wahpeton, West Fargo and Grand Forks – require those who sell e-cigarettes to obtain a tobacco retailer license. That could become a state requirement if lawmakers classify e-cigarettes as tobacco products, which supporters say would reduce e-cigarette sales to minors.

Rud said most retailers have made a conscious decision not to sell e-cigarettes to minors, already treating them as tobacco products.

E-cigarette users argue the devices are safer than traditional cigarettes, are a useful tool for those trying to quit smoking and shouldn’t be subject to tobacco excise taxes. Fremming said the health department feels nicotine products approved by the FDA for tobacco cessation – which currently doesn’t include e-cigarettes – should be excluded from the definition of nicotine devices because their safety and efficacy is proven.

While the tobacco products definition will continue to be a source of debate, no opposition has surfaced so far to the idea of restricting e-cigarette sales to minors.

Fremming said the rate of North Dakota high school students who reported trying e-cigarettes nearly tripled from 2011 to 2013, from 4.5 percent to 13.4 percent, and high school students who have tried e-cigarettes are almost twice as likely to try conventional cigarettes.

At least 41 states currently prohibit sales of electronic cigarettes or vaping/alternative tobacco products to minors, including Minnesota and South Dakota, according to the National Conference of State Legislatures.

Whitney Klym, a senior at St. Mary’s Central High School in Bismarck and a member of its SADD group, told the committee Tuesday she has seen e-cigarettes used at school, parties and other events by students as young as 14.

“It is becoming a dangerous social norm among youth,” she said.

http://www.thedickinsonpress.com/news/legislature/3702058-debate-over-e-cigs-tobacco-products-overshadows-bills-restricting-sales

Teens can easily buy e-cigarettes online, study says

Liz Szabo, USA TODAY
Teens can easily buy e-cigarettes online even though sales to minors are banned in 41 states, a new study shows.
Teens in the study were able to buy e-cigarettes online in 94% of attempts, according to a report published today in JAMA Pediatrics.
Internet retailers rejected only five out of 98 attempted purchases because of age, according to the study, in which researchers closely supervised 11 teen participants. Five attempts were blocked by parental control settings on the computers.
None of the teens were asked to show proof of age when the packages were delivered. In fact, 95% of orders were left at the doorstep, the study says.
Researchers, whose previous studies have shown that young people can easily order alcohol online, say they were careful to make sure that the study didn’t encourage kids to break the law.
Parents of the teens, ages 14 to 17, gave consent for kids to join the study and use their credit cards for the e-cigarette purchases. Researchers also cleared the study with local law enforcement.
Kids today have greater access to credit cards than many people realize, says the American Lung Association’s Erika Sward. Many teens routinely use family credit cards to buy online music, games and apps.
Previous studies have found that teens can easily buy conventional cigarettes online, Williams says. About 1 million young people reported buying tobacco online in 2012.
Although the Food and Drug Administration has proposed regulations for e-cigarettes, including a ban on selling them to minors, it has has not finalized these rules. The proposed rule does not ban Internet sales.
E-cigarettes use a battery to heat liquid nicotine into a vapor that can be inhaled. They don’t produce smoke.
E-cigarettes are increasingly popular with young people. A 2014 study found that 17% of high school seniors used e-cigarettes, more than twice as many as used conventional cigarettes.
States have been racing to regulate e-cigarettes out of concern that they will addict young people to nicotine.
North Carolina requires online retailers to verify e-cigarette customers’ ages with a government records database, says Rebecca Williams, the study’s lead author and a research associate at the University of North Carolina-Chapel Hill.
Harold Farber, a pediatric pulmonologist at Texas Children’s Hospital in Houston, says he’s not surprised by the study’s findings. He notes that e-cigarettes are marketed in ways that appeal to teens, with flavors such as grape, cotton candy and bubble gum. He’s concerned that e-cigarettes will addict young people to nicotine, which could lead them to regular tobacco.
“Ninety percent of adult smokers start before age 18,” says Farber, who was not involved in the new study. “The industry knows very well that in order to get their next generation of customers, they need to get them before they become adults. We’re seeing the e-cig industry follow the tobacco industry’s playbook.”
Without regulation by the FDA, the market for e-cigarettes is akin to the “wild West,” says Sward. She calls the study’s findings “extraordinarily troubling.”
“The status quo is benefitting the e-cigarette industry and the tobacco industry,” which has become a powerful force in the e-cigarette market, says Sward, who was not involved in the new study. “We need the Obama administration to act now to protect kids.”
A spokesman for the Smoke-Free Alternatives Trade Association, an e-cigarette industry group, says its members take the responsibility to protect kids very seriously.
“We certainly don’t want teenagers to have access to them,” says Phil Daman, president of the e-cigarette association.
R.J. Reynolds Vapor Co. does not sell e-cigarettes online, spokesman Richard Smith says. “Face-to-face sales allow for greater security against youth access to tobacco products, as clerks can check IDs,” Smith says.
Daman says his organization encourages members to use age verification software when selling e-cigarettes online.
“Implementing the use of age verification software is a reasonable, highly effective and cost-efficient way for the vapor products industry to prevent minors from making unauthorized purchases online,” Daman says.
In the new study, conducted from February 2014 to June 2014, seven of 98 online e-cigarette vendors claimed to use age verification techniques capable of complying with North Carolina law. Yet teens were able to place orders at six of those seven websites, showing that the retailer’s age verification systems didn’t work, Williams says.
“If people aren’t using age verification software, if they’re not doing what they’re supposed to be doing, there’s no excuse for it,” Daman says. “Responsible corporate citizens should be ensuring that they use this age verification software.”
http://www.usatoday.com/story/news/2015/03/02/teens-buy-e-cigarettes-online/24118331/

Clearing the smoke around teen e-cigarette use

Shari Rudavsky, The Indianapolis Star
INDIANAPOLIS — No one says publicly that they want teens to start using e-cigarettes. Nor do most argue about statistics that show that youth have been flocking to this funky alternative to tobacco.
The controversy in many state legislatures centers on what to do about it.
Last year, for the first time, more U.S. teens used e-cigarettes than smoked, 17% vs. 14%, according to a University of Michigan study, making it clear that state-enforced age limits alone don’t work.
Thus far, the Food and Drug Administration has opted not to act. So some states, including Indiana, are trying piecemeal solutions to keep vaping out of young hands, from increasing taxes to closer regulation of the industry.
In Indiana, an effort to tax the products went nowhere. A measure that would increase strictures of so-called vape shops is moving through the Indiana General Assembly. The question is whether it would produce the desired effect.
Vape shop owners argue they are not the problem and that too much regulation would only limit access for former smokers who have replaced their nicotine habit with vaping.
One shop owner told The Star he has no interest in the youth market. At the Indy Vapor Shop on the Westside, the first in Indiana, owner Mike Cline displays a sign announcing no sales to anyone under age 18 and rarely does one cross the threshold. In the five years his shop has been open, he’s denied service to fewer than 10 teens because of age.
“Really I think the idea of minors trying to buy from vape shops is way overblown,” Cline said. “We don’t do sales to minors.”
Someone, however, is selling to minors.
In 2013 more than a quarter-million middle and high school students who had never smoked tried e-cigarettes, according to a Centers for Disease Control and Prevention study that appeared in August. That number had tripled since 2011.
Still, most students don’t head to vape shops, many agree. Instead, they can pick them up at gas station convenience stores, raising health concerns.
Concerned about what we don’t know
E-liquids in sweet flavors, such as candy cane or bubble gum, may draw youth, as will delivery systems that can resemble a variety of other products, such as video game controllers, pens or soda cans, said Earnest Davis, a tobacco health educator for the Marion County Public Health Department.
Some may not realize that when they partake, they’re doing something akin to smoking.
“A lot of youth high schoolers that I talk to, say, ‘I’m not smoking cigarettes; I’m just using a flavored e-juice,'” Davis said. “Right now, they’re just in a wow factor…. It’s one of the scarier things we’re seeing, that everyone thinks it’s cool.”
Health officials say that they are particularly concerned not just with what we know about e-cigarettes but also about what we don’t know.
E-cigarettes do not contain tobacco, but the liquids involved can contain a number of other products, including formaldehyde and metals such as nickel, lead and chromium, whose effect on health is not known, said Dr. Aasha Trowbridge, a family medicine physician with Franciscan St. Francis Health.
“What we do know is that e-cigarettes release chemicals; they’re not harmless,” said Trowbridge, also medical director of the Aspire Tobacco-Free Program. “We know enough to say that the products that are released with burning the liquid are certainly of concern.”
Consuming nicotine in any form, including e-liquids, can be addictive and have detrimental effects on brain development, Trowbridge said.
What concerns Trowbridge most, however, is that many of her young patients tell her they have experimented with e-cigarettes, which suggests they may be more likely to start smoking.
The CDC study published earlier this year found that teens who had never smoked, but had vaped, were twice as willing to try conventional cigarettes.
“That is one of my greatest concerns; are we introducing a product that may not have been something a child would have looked at before and would now say, ‘Hey let me try this,'” Trowbridge said. “It is a perfect gateway drug to conventional cigarettes…. We’re giving our teenagers and youth one more way to be introduced to tobacco.”
For some, a way to quit smoking
Supporters of vaping point to other research that suggests that teens who do experiment with e-cigarettes do not partake regularly. In addition, none of the studies has asked whether teens actually use nicotine products when they vape, said Gregory Conley, president of the American Vaping Association, based in New Jersey.
The fruity flavors may sound designed to appeal to teens, but they also have adult fans, said Conley, who credits a watermelon-flavored vapor product with his own success quitting tobacco. He cites studies that show that 60% to 70% of adult vapers use fruity or sweet flavors.
Cline, who opened his own vape shop six years ago, claims vaping has helped many a smoker kick that bad habit. Cline said he has not smoked conventional cigarettes since he started vaping. Over time, he’s gradually weaned down the nicotine strength of what he vapes.
While Cline said he’s not averse to some tweaks to the law to protect minors and other consumers, he’s wary of going too far.
“We’re trying to reach a level that we as an industry can comply with and support and at the same time protect the consumer,” he said. “We do believe that regulation is both needed and necessary, we just don’t want to be regulated to the point where we can’t do business.”
‘I see it as very similar to cigarettes’
In Indiana, only the bill increasing regulations on the industry progressed. It would give the state the ability to check whether stores sell to minors.
Attorney General Greg Zoeller at the start of this legislative session had proposed a number of measures, including taxing the products and including e-cigarettes in the state’s smoking ban.
Tobacco’s history and the lack of solid data on the health effects of e-cigarettes prompted him to call for the actions on e-cigarettes, Zoeller said.
“Frankly I see it as very similar to cigarettes in the past,” he said. “I do think that these things should not be seen as socially acceptable. There’s unknown risks here.”
Health officials like Davis agree that it would be a shame if e-cigarette use continues to rise among teens at the same time as conventional cigarette use finally falls.
“We worked so hard to eradicate the use of traditional cigarettes among youth, just to have it replaced by something else,” he said.
http://www.usatoday.com/story/news/nation/2015/03/01/clearing-the-smoke-around-teen-e-cigarette-use/24228671/