Forum editorial: Close off e-cig sales to minors

Fargo Forum Editorial

The Legislature should follow the lead of several North Dakota cities and ban the sale of e-cigarettes to minors. As it stands now, even with sales bans in Fargo, Bismarck, Casselton, Mapleton and other cities, e-cigs can be (and likely are being) sold to minors all over the state. It’s a gaping loophole in a state law that in every other way treats e-cigs like tobacco products.

E-cigs are touted as an effective option for tobacco users to get off cigarettes, although the research is inconclusive. But they also appeal to kids because they are used by some minors for “vaping,” which kids think is “cool,” according to public health experts. E-cigs don’t contain tobacco, but they can be nicotine delivery devices. Often the substances in e-cigs include candy flavors. There is little doubt the products are aimed at adolescents, according to new research. And kids are taking them up at alarming rates.

That being said, e-cig sellers in Fargo insist it is against company policy to sell to anyone under age 18, no matter what a state’s law or city’s ordinances allow or prohibit. In fact, e-cig retailers say they want a state law that bans sales to minors, and will work with legislators in the upcoming session.

While the retailers’ public attitude is good news, questions remain. Where are kids getting e-cigs? Why is use up among minors? Who is policing what?

Most troubling: There is no question e-cigs are a gateway to smoking among teens. New studies indicate that as more minors try e-cigs (up in several states), chances increase that they will try tobacco and get hooked. Nicotine, whether in an e-cig or a cigarette, is addictive. It should come as no surprise that big tobacco companies are in the e-cig business.

The state of North Dakota, with what appears to be support from e-cig sellers, should close the sales-to-minors loophole. Without informed and firm action, e-cigs could erode the progress that’s been made to reduce tobacco use in the 50 years since the first surgeon general’s report revealed the health risks of smoking.

Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.

http://www.inforum.com/opinion/3637026-forum-editorial-close-e-cig-sales-minors

E-Cigarette Use on Rise for Teenagers, Study Finds

The New York Times, By SABRINA TAVERNISE

WASHINGTON — A new federal survey has found that e-cigarette use among teenagers has surpassed the use of traditional cigarettes, even as smoking of traditional cigarettes has continued to decline. Health advocates say the upward trend for e-cigarette use is dangerous because it is making smoking seem normal again. They also worry it could lead to an increase in smoking of traditional cigarettes, though the new data do not show that.

The survey, released Tuesday by the National Institute on Drug Abuse, measured drug and alcohol use this year among middle and high school students across the country. More than 41,000 students from 377 public and private schools participated. It is one of several such national surveys, and the most up-to-date.

It was the first time this survey measured e-cigarette use, so there were no comparative data on the change over time. Other surveys have shown e-cigarette use among middle and high school students to be much lower, but increasing fast.

“The numbers are stunning,” said Matthew L. Myers, president of the Campaign for Tobacco Free Kids, an advocacy group.

The survey found that 17 percent of 12th graders reported using an e-cigarette in the last month, compared with 13.6 percent who reported having an traditional cigarette. Among 10th graders, the reported use of e-cigarettes was 16 percent, compared with 7 percent for cigarettes. And among 8th graders, reported e-cigarette use was 8.7 percent, compared with just 4 percent who said they had smoked a cigarette in the last month.

A 2013 youth tobacco survey by the federal Centers for Disease Control and Prevention released in November found that the share of American high school students who use e-cigarettes rose to 4.5 percent in 2013 from 2.8 percent in 2012. The share of middle school students who use e-cigarettes remained flat at 1.1 percent over the same period.

The gap between the two sets of findings was substantial, and researchers struggled to explain it. Both are broad, reliable federal surveys that go back years, and their methodologies do not differ greatly. The drug abuse institute uses individual school grades, while the disease centers combine grades, which may account for some of the difference.

Some experts said that the new data suggested the rate may have increased substantially since 2013, though it will be impossible to know for sure until the C.D.C. releases its 2014 data sometime next year.

E-cigarettes have split the public health world, with some experts arguing that they are the best hope in generations for the 18 percent of Americans who still smoke to quit. Others say that people are using them not to quit but to keep smoking, and that they could become a gateway for young people to take up real cigarettes.

But that does not seem to be happening, at least so far. Daily cigarette use among teenagers continued to decline in 2014, the survey found, dropping across all grades by nearly half over the past five years. Among high school seniors, for example, 6.7 percent reported smoking cigarettes daily in 2014, compared with 11 percent five years ago.

Most experts agree that e-cigarettes are far less harmful than traditional cigarettes. But they contain nicotine, an addictive substance that some experts contend is potentially harmful for brain development. Some experts also warn that nicotine use could establish patterns that leave young people more vulnerable to addiction to other substances.

The survey found significant declines in the use of other drugs. Among high school seniors, about 6 percent reported having taken a prescription drug, substantially down from the peak of 9.5 percent in 2004. Abuse of Vicodin, the opioid pain reliever, declined by nearly half among 12th graders over five years.

In states with medical marijuana laws, 40 percent of high school seniors who reported using marijuana in the past year said they had consumed it in food, compared with 26 percent in states without such laws.

http://www.nytimes.com/2014/12/17/science/national-institute-on-drug-abuse-e-cigarette-study.html?_r=0

USA Today – Our View: E-cigarettes cloud progress on teen smoking

USA Today Editorial Board

E-cigarettes, once seen as a harmless alternative to tobacco smoking, are beginning to look more like a new gateway to addiction.

This year, for the first time, more teens used electronic cigarettes than traditional ones: 17% of high school seniors used the devices, vs. 14% who smoked cigarettes. Kids in eighth and 10th grades favored them 2-to-1 over traditional smokes, according to an eye-opening University of Michigan survey released Tuesday.

In one sense, there is good news. Teen smoking hit a record low last year after a steady decline since the late 1990s, leaving fewer teens vulnerable to the risk of cancer, heart disease and emphysema that comes with tobacco use. But e-cigarettes are a troubling alternative.

Just as scientists didn’t grasp the danger of tobacco when the nation was becoming addicted, they don’t fully understand the risks posed by e-cigarettes now.

One is obvious: addiction.

E-cigs, battery-powered nicotine inhalers that produce a vapor cloud, could be every bit as addictive as tobacco. With sales skyrocketing to $754 million, 30 times five-year-ago levels, and tobacco giants Altria and Reynolds entering the business, millions of people are getting hooked.

This is particularly a problem during the teen years because that is when nearly all smokers pick up their habit.

For manufacturers, the logic is inescapable: Addict a teenager and you could have a customer for life; miss the moment and you have no customer at all. So in ways subtle and not so subtle, e-cigarette makers have applied Big Tobacco’s advertising and marketing practices.

One prominent tactic is their use of celebrities — including former Playboy centerfold Jenny McCarthy, singer Courtney Love, actor Stephen Dorff and teen heartthrob Robert Pattinson of Twilight fame — to make “vaping” look sexy and rebellious.

No one knows how dangerous this is because with federal oversight missing, no one knows exactly what’s in the devices, some made in China. A Japanese study found hazardous substances in the vapor at higher levels than in cigarette smoke.

There are obvious ways to address the problem, starting with attention from the newly confirmed surgeon general, Vivek Murthy, and analysis by the Food and Drug Administration of e-cigarette content. Both worked with tobacco but could be thwarted by a Congress rigidly opposed to regulation.

Alternatively, states could fill the breach. Nearly a dozen still allow e-cigarette sales to minors when they plainly should not. They could also use the 1998 tobacco settlement negotiated with the industry long before e-cigarettes existed. The accord defines covered products in a way that includes e-cigarettes, because nicotine is derived from tobacco.

By invoking the settlement, state attorneys general would be able to clamp down on marketing that’s targeted at youth, including certain celebrity promotions, concert sponsorships and access to free samples.

After a decades-long battle against youth smoking, it would be tragic to see a new generation of teens hooked on a different but potentially dangerous substitute.

USA TODAY’s editorial opinions are decided by its Editorial Board, separate from the news staff. Most editorials are coupled with an opposing view — a unique USA TODAY feature.

http://www.usatoday.com/story/opinion/2014/12/16/e-cigarettes-teen-smoking-university-of-michigan-editorials-debates/20485297/

E-cigarettes usually aren’t taxed like regular tobacco products. Utah’s governor wants to change that.

By Hunter Schwarz | The Washington Post

Utah Gov. Gary Herbert wants e-cigarettes to be taxed, and his office thinks it could bring in $10 million for the state annually.

“The governor feels strongly we should tax e-cigarettes the same way as other tobacco products,” said Marty Carpenter, a Herbert spokesman, in an interview with the Washington Post. “We don’t want to be in the business of incentivizing” e-cigarettes, he said.

The tax was included as a footnote in Herbert’s budget proposal released Thursday, and first reported by the Salt Lake Tribune. Herbert tweeted about the tax Monday.

While cigarettes are taxed in every state — from a high of $4.35 in New York to $.17 in Missouri — Utah would be among the first to tax e-cigarettes. According to the National Conference of State Legislatures, only Minnesota and North Carolina currently tax e-cigarettes, but Carpenter said he “wouldn’t surprise me if other states were to look at something similar.”

For e-cigarettes to be taxed, the legislature would need to create and pass a bill. Carpenter said he doesn’t anticipate much opposition to such the proposed tax.

http://www.washingtonpost.com/blogs/govbeat/wp/2014/12/15/e-cigarettes-usually-arent-taxed-like-regular-tobacco-products-utahs-governor-wants-to-change-that/

KX News: Students Help Draft E-Cigarette Bill

By Steph Scheurer, Reporter

The CDC reports more than 16 million minors live in states where they can buy e-cigarettes legally.

The topic of age limits on e-cigarettes is one that will be brought up during the 2015 legislative session.

Braden Will and Ashti Ali are 7th graders.

But even at a young age, they’re thinking about their safety.

“It’s kind of scary that 12 year olds, even 10 year olds can buy e-cigarettes,” says Braden Will, Simle 7th Grader, SADD.

“We don’t think it’s right that kids our age and younger can buy e-cigarettes because they’re just as harmful as regular cigarettes and so if they start now, then they’ll just get addicted for their whole life and we don’t want that to happen,” says Ashti Ali, Simle 7th Grader, SADD.

So, they decided to do something about it.

“The Simle SADD chapter wrote Representative Larson and said, you know what, we want a bill to protect our youth,” says Kristie Wolff, Program Manager, American Lung Association, ND.

Representative Diane Larson went to Simle, met with the students, and got a bill drafted that would restrict the sale of e-cigarettes to minors across the state of North Dakota.

“Currently several communities across the state have already developed city ordinances that are in place but statewide we do not have an e-cigarette ordinance so it is legal for minors not only to purchase but possess e-cigarettes across much of the state,” says Wolff.

Wolff says e-cigarette use among the youth has tripled since 2011. Currently 40 states prohibit the sale of e-cigarettes to minors. North Dakota is not one of them.

“One of the reasons could be because we only have session every other year and so this is one of the first times that our legislators, you know, are going to be addressing it,” says Wolff.

As of September, 18 cities across the state have developed city ordinances that are in place, but Braden, Ashti, and the rest of their SADD chapter hopes their voice will help make this change statewide.

“I like the feeling that we actually kind of get to help with this because it just makes me feel good,” says Ali.

“I think the way the bill came about is amazing because it’s coming directly from those we want to protect,” says Wolff.

E-cigarettes are included in North Dakota’s Smoke Free Law.

Anywhere that traditional tobacco cannot be used, e-cigarettes also cannot be used.

According to a list from the American Lung Association in North Dakota, Dickinson is just one city where e-cigarettes are not restricted from being sold to minors.

http://www.kxnet.com/story/27634626/students-help-draft-e-cigarette-bill

Governor Herbert wants to tax e-cigarette sales in Utah, bring in $10M

By ROBERT GEHRKE | The Salt Lake Tribune

Buried in Gov. Gary Herbert’s budget blueprint is a proposal that is sure to have the users of e-cigarettes fuming.

In a footnote on page 22 of his outline, Herbert is proposing a new tax on e-cigarettes that his office predicts will raise $10 million next year.

Herbert, who boasted his budget is free of tax increases, says he doesn’t consider the new e-cigarette tax to be a tax hike, but rather a change in the way the state treats the products.

“It’s just saying, ‘Here’s a product that should fit under the umbrella of tobacco,’ ” Herbert said in an interview with The Tribune. “It’s a health issue and there are some that think this new e-cigarette that young people are getting hooked on, that’s straight nicotine with good flavors and all that stuff that makes it attractive, should be taxed just like we tax tobacco.”

The governor’s office could not provide specific details of how the new e-cigarette tax would work. There are several options, said Herbert’s spokesman Marty Carpenter, and the governor is willing to work with legislators to find the best one.

Rep. Paul Ray, R-Clearfield, an anti-tobacco crusader in the Legislature, said he has met with the governor and representatives from the “vaping” industry and believes the best option would be to tax the e-cigarette liquid, or e-juice, at a lower rate than regular tobacco products, but that it should still be taxed.

Typically, tobacco products other than cigarettes are taxed at 87.5 percent of the wholesale price in Utah. Ray is proposing a rate of about half that for the e-juice. That would add several dollars to the cost of the average bottle of e-juice he said.

“What we have to look at is a fair tax, because tobacco is being taxed and this is a tobacco derivative,” Ray said. “I’ve approached the industry and said, ‘OK, you’re claiming this is less harmful, so let’s go somewhere in the middle, somewhere around 40 percent.’ “

The e-cigarette vaporizers, that turn the juice into steam to be inhaled, would not be taxed. Ray said he hopes the increase in price would be enough to discourage young people from picking up vaping in the first place.

But Aaron Frazier, executive director of the Utah Smoke-free Association, said that upping the price of e-cigarette liquid will mean people will just keep smoking more harmful cigarettes.

“What that’s going to do is protect the tobacco market and drive the price of the e-liquid above and beyond what the price of tobacco cigarettes are,” Frazier said. “Basically, what they’re doing is removing any benefit for a smoker to move over to a scientifically documented less-harmful product and drive them back to smoking tobacco cigarettes.”

Ray said he believes that, within a few years, science will show the health benefits that supporters of e-cigarettes boast about are fiction.

“I think it’s going to be as bad as tobacco down the road,” he said. “People will realize this stuff is not as good as we were told and we’re going to have health problems down the road.”

Frazier said several states have looked at imposing e-cigarette taxes as a cash cow to make up for the tobacco-tax revenue they’re losing because people are using e-cigarettes to quit smoking.

According to the group Americans for Tax Reform, which opposes e-cigarette taxes, Washington, Oregon, Hawaii, Oklahoma, Wisconsin, Indiana, Kentucky, South Carolina, New York, Delaware, Vermont, Massachusetts and Maine have all considered legislation looking to tax e-cigarettes, but it has been defeated. In Arizona, an e-cigarette tax is still pending.

Only two states — Minnesota and North Carolina — have an e-cigarette tax in place, according to the National Conference of State Legislatures. Minnesota taxes the liquids at 95 percent of the wholesale price of the liquids. North Carolina imposes a tax of a nickel per milliliter.

Ray also is planning to once again sponsor legislation to regulate the sales of e-cigarettes. Last session, he ran a bill that got worked over with multiple amendments and was up for passage on the final night when the Legislature adjourned without voting on it.

The bill would require businesses that sell e-cigarettes to be licensed by the state and the retailer could lose its license if it sold e-cigarettes to anyone under the age of 19.

http://www.sltrib.com/news/1941695-155/governor-wants-to-tax-e-cigarette-sales

First Child's Death From Liquid Nicotine Reported as 'Vaping' Gains Popularity

By GILLIAN MOHNEY, ABC News

A toddler from upstate New York could be the first child to die from liquid nicotine, the substance used in e-cigarettes, poisoning in the U.S., concerning health officials as e-cigarettes continue to rise in popularity.

Police reported that the 1-year-old child died after ingesting liquid nicotine at a home in Fort Plain, New York, on Tuesday. The child was found unresponsive and rushed to a hospital where he was later pronounced dead.

Fort Plain police released a statement saying the death is believed to be a “tragic accident.” They declined to say whether the liquid nicotine was associated with an e-cigarette.

But health officials are concerned if steps aren’t taken to protect children, they could see more fatal accidents similar to this one.

The rise of e-cigarettes and “vaping” in recent years has also meant a rise in the purchase of liquid nicotine. Coming in flavors like cotton candy or gummy bear, health officials say that the brightly colored liquid could appeal to young children.

“One teaspoon of liquid nicotine could be lethal to a child, and smaller amounts can cause severe illness, often requiring trips to the emergency department,” the American Association of Poison Control centers in a statement today. “Despite the dangers these products pose to children, there are currently no standards set in place that require child-proof packaging.”

In November the American Association of Poison Control Centers announced that the number of dangerous “exposures” to liquid nicotine has skyrocketed in recent years with 3,638 exposures as of Nov. 30. An exposure means coming into contact with liquid nicotine through ingestion, inhalation or by absorbing the substance through the skin.

The number is more than double the 1,543 exposures reported in 2013 and exponentially higher than in 2011 when 271 exposures were reported.

Before this week, the only confirmed death related to liquid nicotine happened in 2012 when a man injected himself with the substance, according to the American Association of Poison Control Centers.

Dr. Donna Seger, director of the poison control center at Vanderbilt University Medical Center, said her center has started to get more calls about exposure to e-cigarettes or liquid nicotine.

“They’re not that difficult to get into,” Seger said of the vials that contain the nicotine. “The issue is once the exposure occurs, it could be bad.”

Seger said just a small amount of nicotine can cause dangerous symptoms in children, including seizures.

Phil Daman, president of the Smoke-Free Alternatives Trade Association, said he was “saddened to hear the terrible news.”

“[We] want to always be mindful to put safe products on the market,” said Daman, who said the trade association recommends childproofing products to “err on the side of caution.”

Daman questioned if the child could have gotten a hold of a high-grade liquid nicotine that could be a much higher concentration than what is in many common e-cigarette products. Because e-cigarettes are not federally regulated there is a wide-range of liquid that could be purchased to use in e-cigarette products, ranging from potent high grade liquid nicotine to material that has an extremely small amount of nicotine.

In April the U.S. Centers of Disease Control and Prevention warned they were seeing an increase of calls to poison control centers for liquid nicotine exposure and children were becoming sick after ingesting, inhaling or absorbing the chemical through their skin. The most common symptoms were vomiting, nausea or eye irritation.

“Use of these products is skyrocketing and these poisonings will continue,” U.S. Centers for Disease Control and Prevention Director Dr. Tom Frieden said in April. “E-cigarette liquids as currently sold are a threat to small children because they are not required to be childproof, and they come in candy and fruit flavors that are appealing to children.”

To combat these cases of increased exposure some state lawmakers have introduced bills that would require e-cigarette companies to put child-resistant caps on bottles of liquid nicotine.

In New York State, a bill passed earlier in the year that would require child resistant containers for liquid nicotine. Gov. Andrew Cuomo is set to sign the bill in the next few weeks, according to ABC News affiliate WABC-TV.

At least one e-cigarette, Vapor World, changed their packaging this year so that bottles of liquid nicotine are more child resistant.

http://abcnews.go.com/Health/childs-death-liquid-nicotine-reported-vaping-gains-popularity/story?id=27563788

Smoking not 'lesser evil' in mental health treatment settings

By: Maiken Scott, Newsworks
Picture an AA meeting, and a gigantic coffee urn and a cloud of smoke come to mind.
In fact, the two men who started AA, Dr. Bob and Bill W. both died from tobacco-related illnesses.
Public health experts say smoking is still pervasive among people living with addiction and mental illness, and it’s often not seen as a priority in treatment settings.
For example, smoking rates in Philadelphia have dropped significantly over 10 years, but haven’t budged among people with mental illnesses and substance-abuse issues.
Smoking is often seen as a “lesser evil” in mental health and addiction treatment settings, explained Ryan Coffman, tobacco policy manager for Philadelphia’s Department of Public Health. It’s not a priority, and some providers assume it helps their clients cope.
Research shows the opposite to be true, says Coffman. “Individuals living with mental illness and substance-abuse disorders who smoke have more severe symptoms, poorer well-being and functioning, they have more hospitalizations, and are at a greater risk for suicide,” he said.
Research also shows that people who quit smoking along with quitting other drugs have better recovery outcomes.
Philadelphia is increasing efforts to train mental health providers on tobacco-cessation programs, and to provide them with the most up-to-date resources available to their clients, Coffman said.
But for these efforts to really take root, a major cultural shift will have to occur, said University of Pennsylvania psychiatrist Robert Schnoll, who studies tobacco cessation.
“Research indicates that upwards of 25 percent of mental health care facilities still permit smoking on the grounds and on the premises,” he explained. “There’s pervasive use of cigarettes, or cigarette breaks, as a reward for pro-social behavior, so that’s certainly one of the issues we need to address going forward.”
Some providers think their clients don’t care about tobacco cessation, he said, or don’t understand the benefits. Some also simply don’t see it as their responsibility.
Research also indicates that smoking rates are high among people who work in mental health treatment settings, Schnoll said.
http://www.newsworks.org/index.php/homepage-feature/item/75483-smoking-not-lesser-evil-in-mental-health-treatment-settings?linktype=hp_impact

Don't fall for tobacco industry e-cigarette smokescreen

By Michaeline Fedder, Deborah P. Brown and Bonita Pennino
No one should have to choose between their health and a paycheck. Which is why, with all that is still unknown about the dangers of e-cigarette use, we must put public health first and prohibit the use of these unregulated products in all workplaces, including restaurants, bars and casinos. Unfortunately a bill recently passed by the Baltimore City Council purporting to ban e-cigarette use in the city allows restaurants, taverns and casinos to opt out, which not only weakens Baltimore and Maryland’s longstanding and popular smoke-free laws, it threatens the health of many city workers. We urge Mayor Rawlings-Blake to see through the tobacco industry smokescreen and use her power to veto this ordinance.
Turning the clock back by allowing the use of e-cigarettes in public places could create a host of new problems — encouraging new tobacco users, reversing efforts that have made smoking socially unacceptable, creating enforcement confusion for business owners and the public, and potentially putting the health of Baltimore’s restaurant, bar and casino workers and patrons at risk.
While e-cigarette manufacturers may make unverified claims that the ingredients are just “water vapor” or “safe,” without further research and federal regulation there is no sure way for e-cigarette users to know what they are consuming. Nor is there any way of knowing what nonusers are exposed to and the extent of the risk to their health. There are hundreds of types of e-cigarettes on the market today, and the products vary considerably by ingredients and quality control and assurance. Prohibiting the use of e-cigarettes in workplaces, restaurants and bars can protect the public health by preventing nonusers from being exposed to the potentially harmful chemicals in these products.
An increasing number of studies have examined the contents of e-cigarette aerosol. Unlike a vapor, an aerosol contains fine particles of liquid, solid or both. Propylene glycol, nicotine and flavorings were most commonly found in e-cigarette aerosol. Other studies have found the aerosol to contain heavy metals, volatile organic compounds and tobacco-specific nitrosamines, among other potentially harmful chemicals. A 2009 study done by the U.S. Food and Drug Administration (FDA) found cancer-causing substances in several of the e-cigarette samples tested. FDA tests also found nicotine in some e-cigarettes that claimed to contain no nicotine.
The public should know more about e-cigarettes before allowing users to expose others to potential dangers. Studies have already shown that the use of e-cigarettes can cause short-term lung changes and irritations, while the long-term health effects are unknown.Both exposure to and health effects of secondhand aerosol from e-cigarettes require further research, but preliminary studies indicate nonusers can be exposed to the same potentially harmful chemicals as users, including nicotine, ultrafine particles and volatile organic compounds. This exposure could be especially problematic for vulnerable populations such as children, pregnant women and people with heart disease. No worker or patron should be subject to inhaling the unknown aerosol emitted from electronic smoking devices.
By passing this reckless measure allowing the use of e-cigarettes in workplaces, Baltimore City Council members have fallen for the tobacco industry’s tricks. We are all too familiar with the age-old tactics of the tobacco industry such as designating smoking areas and notifying the public when smoking is allowed. We learned the hard way that these strategies do nothing to protect the health of workers and patrons from the dangers of secondhand smoke. These tactics are nothing but a ruse to promote smoking in public places, thus continuing addiction to a deadly product and guaranteeing sales of cigarettes well into the future. We should not repeat the same mistake now in Baltimore with e-cigarettes. No one, regardless in which section of a restaurant, tavern or casino they are working, dining or gaming, should have to choose between their health and a good job or a good time.
It is well understood that smoke-free laws are popular in Maryland and should not be weakened. And laws prohibiting the use of e-cigarettes in public places are steadily on the rise — with 156 municipalities and counting already prohibiting the use of e-cigarettes in all workplaces, including restaurants, bars and gaming facilities. Everyone has the right to breathe safe smoke-free and aerosol-free air in their place of work or leisure, and Mayor Rawlings-Blake should protect that right by vetoing this ordinance.
Michaeline Fedder is director of government relations in Maryland for the American Heart Association; Deborah P. Brown is president and CEO of the American Lung Association of the Mid-Atlantic; Bonita Pennino is the Maryland government relations director for the American Cancer Society Cancer Action Network.

​Hookahs deliver toxic benzene in every puff

Many young people consider hookahs a hip and safer way to smoke, but a new study finds fumes from the water pipes contain the toxin benzene.
Benzene has been linked to an increased risk for leukemia in prior research, according to a scientific team reporting Nov. 21 in the journal Cancer Epidemiology, Biomarkers & Prevention.
“In contrast to what is believed, hookah tobacco smoking is not a safe alternative to smoking other forms of tobacco,” study author Nada Kassem, associate director of the Center for Behavioral Epidemiology and Community Health at San Diego State University, said in a journal news release.
Researchers analyzed levels of S-phenylmercapturic acid (SPMA) — a metabolite (byproduct) of benzene — in the urine of 105 hookah smokers and 103 nonsmokers exposed to smoke from the water pipes.
After an event in a hookah lounge, SPMA levels were four times higher than normal in hookah smokers and 2.6 times higher than normal among people who had attended but hadn’t puffed on a hookah. After a hookah-smoking event in a private home, SPMA levels were two times higher among hookah smokers, but normal among nonsmokers.
“Hookah tobacco smoking involves the use of burning charcoal that is needed to heat the hookah tobacco to generate the smoke that the smoker inhales,” Kassem explained.
“In addition to inhaling toxicants and carcinogens found in the hookah tobacco smoke, hookah smokers and nonsmokers who socialize with hookah smokers also inhale large quantities of charcoal combustion-generated toxic and carcinogenic emissions,” she said.
Kassem believes that “because there is no safe level of exposure to benzene, our results call for interventions to reduce or prevent hookah tobacco use, regulatory actions to limit hookah-related exposure to toxicants including benzene, and include hookah smoking in clean indoor air legislation.”
http://www.nlm.nih.gov/medlineplus/news/fullstory_149609.html
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