World Health Organization: Public Health Rules Needed to Curb E-Cigarette Risks

by Katie Weatherford, Center for Effective Government

Contrary to industry advertising, a new report by the World Health Organization (WHO) finds that electronic cigarettes (e-cigarettes) and other electronic nicotine delivery systems pose significant public health hazards because of toxins emitted from the devices. The agency recommends that countries adopt e-cigarette rules to prevent misleading marketing of the products and to educate the public about the potential health risks involved.

E-Cigarettes Emit Dangerous Toxins

E-cigarettes contain a battery that heats a nicotine fluid inside the device until it produces a mist-like aerosol that the user can inhale. According to the WHO report, the aerosol contains “nicotine and a number of toxicants” that pose health hazards to users and non-users, especially pregnant women and children, contrary to claims that these devices release nothing more than water vapor. Nicotine use is linked to long-term adverse effects on brain development. Moreover, the aerosol typically contains “some carcinogenic compounds,” including formaldehyde.

Although the report finds that adult smokers who completely switch from regular cigarettes to e-cigarettes will be exposed to lower levels of toxins, WHO warns that the “amount of risk reduction . . . is presently unknown.” The report also notes uncertainty about whether second-hand exposure risks from e-cigarettes are lower than regular cigarettes.

Marketing Contains Unsubstantiated Claims, Targets Children

The WHO report also takes misleading marketing to task, noting the frequent use of unsubstantiated claims about e-cigarettes in product ads. According to the report, there is insufficient evidence that using e-cigarettes will help people quit smoking, yet ads commonly market e-cigarettes as a smoking-cessation device. Other marketing tactics may even encourage more frequent smoking.

For example, many ads promote using e-cigarettes in places where regular smoking is banned. WHO cautions that this could interfere with the intent of smoke-free policies, which “are designed not only to protect non-smokers from second-hand smoke, but also to provide incentives to quit smoking and to denormalize smoking . . . .”

Moreover, e-cigarette marketing has “the potential to glamorize smoking,” which may encourage nonsmokers and children to start using e-cigarettes. The endless variety of designs and flavor options can also appeal to adolescents.

WHO Recommends Developing Public Safeguards

The WHO report says, “Regulation of [e-cigarettes] is a necessary precondition for establishing a scientific basis on which to judge the effects of their use, and for ensuring that adequate research is conducted, that the public has current, reliable information as to the potential risks and benefits of [e-cigarettes], and that the health of the public is protected.”

The report will be a topic of discussion this October at the Sixth Conference of the Parties to the WHO Framework Convention on Tobacco Control. The Convention is an international effort to address global tobacco use. The report calls on the 179 countries that are parties to the Convention to adopt new standards to protect the public from the hazards associated with e-cigarettes. Such safeguards would:

  • Prohibit claims that these products can help people quit smoking until manufacturers provide sufficient scientific evidence to support the claim and gain regulatory approval

  • Ban indoor use of e-cigarettes unless it is proven there are no health effects from second-hand exposure

  • Restrict marketing by requiring that all ads, promotions, or sponsorships provide warnings, encourage people to quit smoking, in no way promote use by nonsmokers or adolescents, contain no images, words, etc. associated with a tobacco product, and more

  • Require that manufacturers design products to reduce exposure to toxins, make information about contents and exposure levels available to users, register products with a governmental body, and report design and emissions information to a governmental body

  • Prohibit sales to people under the age of 18 and ban fruit, candy-like, and alcohol-drink flavors unless and until it is proven that these flavors do not appeal to minors

To ensure strong public health protections, the global community must adopt WHO’s recommendations so that people understand the risks associated with e-cigarettes and adults can make informed choices about whether or not to use them.

Protecting Public Health in the U.S.

Although the U.S. is a signatory to the Convention, it has not yet ratified the tobacco control treaty. However, the U.S. Food and Drug Administration (FDA) is taking some steps similar to WHO’s recommendations.

FDA proposed a rule in April that would ban the sale of e-cigarettes to anyone under the age of 18. The rule would also require e-cigarette manufacturers to register with the agency and report the manufacturing process and ingredients used in their products. Moreover, companies would be required to place health-warning labels on e-cigarettes.

However, some tobacco control advocates believe the proposal does not go far enough and are urging FDA to prohibit manufacturers from marketing candy-flavored options that attract children. The Center for Effective Government and other health and safety groups also heavily criticized the FDA’s decision to discount the benefits of the proposed rule by 70 percent, which the agency claims is necessary to account for the “lost pleasure” from reducing tobacco use.

FDA is currently reviewing public comments and considering any changes to its draft rule. We hope the agency will correct its flawed benefit calculation and move forward with strong safeguards without delay. The U.S. should also ratify the treaty and communicate its support for global efforts to combat the tobacco use epidemic.

http://www.foreffectivegov.org/node/13198

Q: Is hookah or water pipe smoking a safe alternative to cigarettes?

By Sanjay Gupta, MD

A: Absolutely not. In fact, as Daniel Neides, MD, medical director of the Wellness Institute at Cleveland Clinic points out, hookah smoking “may actually be worse than smoking.”

Hookahs are water pipes in which charcoal is used to heat up flavored tobacco. An ancient form of smoking that originated in the Middle East and India, it has become increasingly popular among American adolescents and young adults. Roughly 1 out of 5 U.S. high school seniors had smoked a hookah in the past year, according to recent data.

The hookah’s gaining popularity is largely due to the misconception that it’s not harmful. That’s not the case. “First, the tobacco used in hookah contains the same cancer-causing agents found in cigarettes,” Dr. Neides says. “Secondly, there is charcoal that is used to heat the tobacco, which gives off carbon monoxide and heavy metals as a by-product when it is heated.”

A hookah session usually lasts longer than time spent smoking cigarettes, with hookah smokers puffing more frequently and inhaling more deeply. A 2010 study reported the amount of smoke inhaled during a hookah session can be nearly 200 times the amount inhaled when smoking a cigarette. Earlier this year, researchers at the University of California, San Francisco, found that hookah smoking raised nicotine urine levels as much as 73 times.

Neides adds that because water pipes are usually smoked in specialty hookah shops or bars and shared among friends, users are exposed to greater levels of secondhand smoke and are at a higher risk of contracting viruses or infections.

The bottom line, Neides says, is that “hookah smoke should be considered the same as cigarettes and cigars – a very unhealthy habit that leads to chronic disease and death.”

http://www.everydayhealth.com/columns/paging-dr-gupta/is-hookah-or-water-pipe-smoking-a-safe-alternative-to-cigarettes/

The Health Claims Of E-Cigarettes Are Going Up In Smoke

Jasper Hamill, Contributor | Forbes

The sales pitch of electronic cigarette manufacturers seemed too good to be true. Could nicotine addicts around the world really get their fix whilst dodging the health risks of puffing away on cancer sticks?

Sadly for smokers and “vapers”, the answer is far from clear. Over the past week, new evidence has emerged which suggests that E-Cigarettes can be dangerous too – in some cases carrying higher amounts of certain toxins than the blazing tobacco of old.

Researchers at the University of South California have found that although E-Cigarettes are less harmful than ordinary smokes, the vapour emitted by the gadgets contains the toxic element chromium, which is not found in traditional cigarettes, as well as levels of nickel four times higher than in real tobacco. The electronic replacements also contain lead, zinc and other toxic metals, although in lower levels than cigarettes.

English: Two electronic cigarette models. Self...

Two electronic cigarette models. (Photo credit: Wikipedia)

“Our results demonstrate that overall electronic cigarettes seem to be less harmful than regular cigarettes, but their elevated content of toxic metals such as nickel and chromium do raise concerns,” said Constantinos Sioutas, professor at the USC Viterbi School of Engineering.

There is a bit of good news for reforming smokers, as E-Cigarettes contain virtually no detectable polycyclic aromatic hydrocarbons, which are known to cause cancer. The researchers also said the metal particles were likely to come from the cartridge of the E-Cigarette devices, opening up the possibility that a change in the production process could eliminate the dangerous chemicals.

But this isn’t the only bit of bad news for vape inhalers. In the UK, the BBC reported that E-Cigarette liquid sold in the north east of England was found to contain a chemical called diacetyl, which is used to add butterscotch flavor to liquid tobacco.

Whilst this substance is harmless to eat, it is extremely dangerous to inhale. The chemical is known to cause a serious condition called popcorn lung, orbronchiolitis obliterans, an irreversible disease which scars the lung and makes it impossible to breathe properly. This illness has struck workers in popcorn factories, who are known to breathe in vast quantities of diacetyl, as well as ordinary people who eat a lot of popcorn.

Commenting on the report, Dr Graham Burns, a respiratory expert at Newcastle’s Royal Victoria Infirmary, said the illness is often “serious enough to warrant lung transplantation”.

VP, the firm which manufactured the cigarettes, immediately withdrew the liquid from sale, and Lynne White, head of retail distribution, admitted there were concerns about inhaling the liquid on a long-term basis.

“We are very sorry it has happened, we are investigating how it has happened,” she added.

“Because of the small amount the vaper would actually consume it was deemed in the short term there would be no health concerns.

“Long-term yes there could well be, however we decided it was a withdrawal rather than a recall of the product and that was based on Ecita’s (Electronic Cigarette Industry Trade Association) guidelines.”

But for many health-conscious people, the damage is likely to have been done. Once upon a time, the world didn’t know about the many terrible effects of cigarettes. It was only after a concerted campaign by scientists, doctors and activists that the risks began to be publicized and governments began to act on them. The long term implications of switching to E-Cigarettes have not yet been tested, so anyone using the devices has to ask themselves if they are willing to take the risk of becoming a guinea pig.

Marlboro Cigarettes

Marlboro Cigarettes (Photo credit: Wikipedia)

The World Health Organisation has issued a report advising that use of E-Cigarettes should be banned indoors and and all advertising stopped until the emerging industry produces “convincing supporting scientific evidence and obtains regulatory approval”.
Backing this call, the British Medical Association board of science deputy chair Ram Moorth said “tighter controls are needed to ensure their use does not undermine current tobacco control measures and reinforces the normalcy of smoking behaviour”.

‘There is a need for research to understand the health impacts of E-Cigarettes on both the user and bystanders, and it is vital that the sale of e-cigarettes is appropriately regulated to ensure they are not sold to minors, and are not aggressively marketed to young people as tobacco was in the past,” he continued.

“Any health claims must be substantiated by robust independent scientific evidence to ensure that the consumer is fully informed regarding potential benefits and risks of E-Cigarettes.”
Are you willing to take the chance and keep on vaping?
For more news and comment, follow me on Twitter @jasperhamill
http://www.forbes.com/sites/jasperhamill/2014/08/31/the-health-claims-of-e-cigarettes-are-going-up-in-smoke/

Letter to the Editor: Stop glamorizing the role of tobacco in baseball

Chris Hansen, Washington | The Washington Post

Just weeks after the early death of beloved baseball star Tony Gwynn from cancer likely caused by chewing tobacco, and just days after World Series-winning pitcher Curt Schilling told the world he attributes his cancer to years of chewing tobacco, The Post irresponsibly leads an article about the Washington Nationals with the portrayal of chewing tobacco use as a rally-inducing, lucky superstition [“Nationals’ luck runs out against Phillies thanks to stellar performance by Burnett,” Sports, Aug. 27].

To all the young baseball fans who look to The Post each morning to see if their heroes won last night: Tobacco causes those heroes to suffer nicotine addiction, disease and death. Stephen Strasburg recently stated publicly that he is trying to quit using chewing tobacco but that it is very hard to quit. It is time for the team owners and the players association to eliminate tobacco from baseball, and it is time for the media to stop characterizing tobacco as a quaint part of baseball culture.

Instead of inducing winning rallies, tobacco in baseball induces life-shortening defeats — and that is the only coverage it deserves on the sports page of The Post.

The writer is president of the American Cancer Society Cancer Action Network .

http://www.washingtonpost.com/opinions/stop-glamorizing-the-role-of-tobacco-in-baseball/2014/08/31/cdd004dc-2e08-11e4-be9e-60cc44c01e7f_story.html

St. Paul OKs ordinance targeting sale of cheap cigars

Article by: PAUL WALSH and KEVIN DUCHSCHERE , Star Tribune staff writers

Over the objections of retailers, St. Paul has approved an ordinance that targets the sale of inexpensive cigars that appeal to young smokers.

The ordinance, passed unanimously Wednesday by the City Council, sets a minimum price of $2.10 each for single cigars, whether sold individually or in packs up to four; for example, a three-pack would have to sell for at least $6.30.

Packs of five or more cigars would not be subject to price regulation.

Currently, cigars can be bought for far less — sometimes for as little as three for $1 and in flavors that make them particularly appealing to young people.

In June, Brooklyn Center became the first municipality in the state to pass such an ordinance. The city has seen a sharp decline in cigar sales since the ordinance took effect.

“This issue is about the underlying problem of the tobacco companies’ intentional marketing to youth and communities of color,” Council Member Dai Thao said during last week’s hearing on the ordinance, which he sponsored.

Jack McNaney, a freshman at Cretin-Derham Hall High School in St. Paul and a member of the Ramsey Tobacco Coalition, said, “It’s not right that you can buy three cigarillos for less than the price of a bottle of Mountain Dew.”

Alicia Leizinger, a coalition program and policy specialist, said Thursday that “St. Paul has taken a strong stand against the tobacco industry’s relentless efforts to addict young people to their deadly products. By raising the price of cheap cigars, they took an important step in breaking the cycle of addiction for the next generation.”

A state Health Department survey revealed that cigars rival cigarettes in popularity among underage smokers.

Steve Rush, director of government relations for Holiday convenience stores, countered last week that the ordinance “will cause us to remove about 70 categories of cigar products” from its 10 stores in the city. “The loss of these sales can be quite serious,” Rush added.

Tom Briant, executive director of the National Association of Tobacco Outlets, added that the ordinance will punish retailers in St. Paul, where stores have a “virtually perfect compliance” record of not selling tobacco products to minors.

“Consumers who are of legal age to buy cigars will simply go elsewhere,” Rush said. “This is simply harming the honest, ethical St. Paul retailers who are enforcing the law.”

St. Paul retailers have about 30 days to change the prices on cigars covered by the ordinance.

In 2009, a unanimous City Council vote outlawed candy cigarettes and cartoon character lighters. The council cited a study showing that these products encouraged youngsters to take up smoking tobacco.

http://www.startribune.com/lifestyle/health/273072601.html

WHO urges stiff regulatory curbs on e-cigarettes

BY STEPHANIE NEBEHAY, Geneva
(Reuters) – The World Health Organization (WHO) stepped up its war on “Big Tobacco” on Tuesday, calling for stiff regulation of electronic cigarettes as well as bans on indoor use, advertising and sales to minors.

In a long-awaited report that will be debated by member states at a meeting in October in Moscow, the United Nations health agency also voiced concern at the concentration of the $3 billion market in the hands of transnational tobacco companies.

The WHO launched a public health campaign against tobacco a decade ago, clinching the WHO Framework Convention on Tobacco Control. Since entering into force in 2005, it has been ratified by 179 states but the United States has not joined it.

The treaty recommends price and tax measures to curb demand as well as bans on tobacco advertising and illicit trade in tobacco products. Prior to Tuesday’s report the WHO had indicated it would favor applying similar restrictions to all nicotine-containing products including smokeless ones.

In the report, the WHO said there are 466 brands of e-cigarettes and the industry represents “an evolving frontier filled with promise and threat for tobacco control”.

It urged a range of regulatory options, including banning e-cigarette makers from making health claims such as that they help people quit smoking, until they provide convincing supporting scientific evidence.

Smokers should use a combination of already-approved treatments for kicking the habit, it said.

While evidence indicates that they are likely to be less toxic than conventional cigarettes, the use of e-cigarettes poses a threat to adolescents and the fetuses of pregnant women using them, it said.

“NOT MERELY WATER VAPOR”

E-cigarettes also increase the exposure of bystanders and non-smokers to nicotine and other toxicants, it said regarding Electronic Nicotine Delivery Systems that it calls ENDS.

“In summary, existing evidence shows that ENDS aerosol is not merely ‘water vapor’ as is often claimed in the marketing for these products,” the WHO said in the 13-page report.

E-cigarettes should be regulated to “minimize content and emissions of toxicants”, and those solutions with fruit, candy-like and alcohol-drinks flavors should be banned until proven they are not attractive to children and adolescents, it said.

Adolescents are increasingly experimenting with e-cigarettes, with their use in this age group doubling between 2008 and 2012, it said.

Vending machines should be removed in almost all locations, it added.

Scientists are divided on the risks and potential benefits of e-cigarettes, which are widely considered to be a lot less harmful than conventional cigarettes.

One group of researchers warned the WHO in May not to classify them as tobacco products, arguing that doing so would jeopardize an opportunity to slash disease and deaths caused by smoking.

Opposing experts argued a month later that the WHO should hold firm to its plan for strict regulations.

Major tobacco companies including Imperial Tobacco (IMT.L), Altria Group (MO.N), Philip Morris International (PM.N) and British American Tobacco (BATS.L) are increasingly launching their own e-cigarette brands as sales of conventional products stall in Western markets.

A Wells Fargo analyst report in July projected that U.S. sales of e-cigarettes would outpace conventional ones by 2020.

Uptake of electronic cigarettes, which use battery-powered cartridges to produce a nicotine-laced inhalable vapor, has rocketed in the last two years and analysts estimate the industry had worldwide sales of some $3 billion in 2013.

But the devices are controversial. Because they are so new there is a lack of long-term scientific evidence to support their safety and some fear they could be “gateway” products to nicotine addiction and tobacco smoking.

The American Heart Association said in a report on Monday that it considered e-cigarettes that contain nicotine to be tobacco products and therefore supports their regulation under existing laws on the use and marketing of tobacco products.

“Although the levels of toxic constituents in e-cigarette aerosol are much lower than those in cigarette smoke, there is still some level of passive exposure,” the AHA said.

(Reporting by Stephanie Nebehay in Geneva; additional reporting by Ben Hirschler and Martinne Geller in London, Editing by Angus MacSwan)

http://www.reuters.com/article/2014/08/26/us-health-who-ecigarettes-idUSKBN0GQ0PF20140826

CDC: E-cigs may be tempting non-smoking youths to smoke

By Reuters Media

CHICAGO – Electronic cigarettes may be more tempting to non-smoking youths than conventional cigarettes, and once young people have tried e-cigarettes they are more inclined to give regular cigarettes a try, U.S. researchers said on Monday. A report, released by a team at the U.S. Centers for Disease Control and Prevention, lends evidence to the argument that electronic cigarettes encourage youth smoking.

The study, based on nationally representative youth surveys, found that more than a quarter-million adolescents and teens who had never smoked used an electronic cigarette in 2013, a threefold increase from 2011.

Youths who had tried e-cigarettes were nearly twice as likely to say they would try a conventional cigarette in the next year compared with those who had never tried an e-cigarette, according to the study in the journal Nicotine and Tobacco Research.

E-cigarettes are slim, reusable, metal-tube devices containing nicotine-laced liquids that come in exotic flavors. When users puff, the nicotine is heated and released as a vapor containing no tar, unlike conventional cigarette smoke.

Health experts have raised concerns that the burgeoning $2 billion e-cigarette industry, which has been virtually unregulated, would reverse gains in the decades-long effort to curb youth smoking in the United States. Just 15.7 percent of U.S. teenagers reported smoking in 2013, the lowest rate on record.

In April, the U.S. Food and Drug Administration proposed rules that would ban the sale of e-cigarettes to anyone under 18 but would not restrict flavored products, online sales or advertising, which public health advocates say attract children.

Earlier this month, attorneys general from 29 states urged the FDA to strengthen those rules to better protect young people from nicotine addiction.

“We are very concerned about nicotine use among our youth, regardless of whether it comes from conventional cigarettes, e-cigarettes or other tobacco products,” Dr. Tim McAfee, director of CDC’s Office on Smoking and Health, said in a statement.

“Not only is nicotine highly addictive, it can harm adolescent brain development.”

In the CDC study, researchers analyzed data from the 2011, 2012, and 2013 National Youth Tobacco Surveys of students in grades 6-12. They found that more than 263,000 who had never smoked a conventional cigarette used e-cigarettes in 2013, up from 79,000 in 2011.

Among non-smoking youth who had tried electronic cigarettes, 43.9 percent said they intended to smoke conventional cigarettes within the next year, compared with 21.5 percent of those who had never used e-cigarettes.

Lorillard Inc leads the U.S. e-cigarette market, while Reynolds American Inc and Altria Group Inc are rolling out their own brands nationwide this summer. A Wells Fargo analyst report in July projected that U.S. sales of e-cigarettes would outpace conventional ones by 2020.

http://www.inforum.com/content/cdc-e-cigs-may-be-tempting-non-smoking-youths-smoke

Schilling: Tobacco gave me cancer

Former Boston Red Sox pitcher Curt Schilling revealed Wednesday for the first time the type of cancer he was battling — squamous cell carcinoma, a type of mouth cancer — and detailed the painful treatment and recovery process that caused him to lose 75 pounds.

Telling his story for the WEEI/NESN Jimmy Fund Radio-Telethon on Wednesday morning, Schilling said he believes that a 30-year habit of chewing tobacco is what caused the cancer.

“I do believe, without a doubt, unquestionably that chewing was what gave me cancer,” he said. “I’m not going to sit up here from the pedestal and preach about chewing.”
The 47-year-old Schilling said he spent six months in the hospital with a feeding tube, undergoing chemotherapy and painful radiation treatment. During that time, he said, he developed a staph infection and there was a week of his life he doesn’t remember.
“I got chemo and radiation for [seven] weeks, and I came back to my room and my family was sitting there and I thought, ‘You know what, this could be so much worse. This could be one of my kids,'” Schilling said. “I’m the one guy in this family that can handle this. From that perspective, I’ve never said ‘Why me?’ and I never will.”
The most painful part of the treatment, he said, was the radiation, which he received five days per week for seven weeks. Schilling said doctors created a pliable mask to put on his face, an implement the former pitcher said was “the straitjacket for when they are giving you radiation.”
“The first day I went in, they clamped [the mask] down, they do the radiation into the tumors,” Schilling said. “The second day they did it. And about the third day I started developing almost a phobia and I literally had to be medicated for the seven weeks to go and do that. I couldn’t control myself under the mask.”
He added: “If this happened again, I’m not sure if I would go through the treatment again, it was that painful.”
Schilling said he’s lost so much weight because it is still painful to swallow — “I can’t put enough calories in my body” — and he is still shaky and weak at times.
He paused several times during the interview to take sips of water (he says he still does not have any saliva), and his voice sounded different than we’re used to hearing from Schilling. He is currently on leave from his job as an analyst on ESPN’s Sunday Night Baseball telecast.

“Recovery is a challenge,” Schilling said. “There are so many things that are damaged during the process. I don’t have any salivary glands, I can’t taste anything and I can’t smell anything right now. And there’s no guarantee they’ll come back.”

Schilling reiterated that the cancer was in remission, a statement he tweeted to the world for the first time in June, and that his follow-up care includes doctor visits every 1-2 months and scans every few months to determine if the cancer has returned.

He described how he first discovered the cancer over the winter.

“This all came about from a dog bite,” Schilling explained.

He said the dog bite damaged his finger enough to send him to the doctor. On his way to see the physician, he felt a lump on the left side of his neck and decided to get it checked out with a nearby ear, nose and throat specialist.

“He did a biopsy and two days later he diagnosed me with squamous cell carcinoma,” Schilling said.

It is the same type of cancer former Buffalo Bills quarterback Jim Kelly is suffering from.

“Commonly this is known as mouth cancer … cancer of the lining of the mouth,” said Schilling’s physician, Dr. Robert Haddad of the Dana Farber Cancer Institute. “The lump in the neck is why most patients go to the doctor first because they feel the lump in the neck, that’s the lymph node that’s enlarged.”

This was Schilling’s second public appearance since the cancer diagnosis. In May, he appeared at Fenway Park as the Red Sox celebrated the 2004 World Series-winning team.

“It was weird,” Schilling explained of the appearance. “I was in the hospital at the time. They wouldn’t let me come over [to Fenway] and go back [to the hospital]. So I had to determine if I was OK and ready to be discharged. I said ‘Yeah, yeah, OK.’ And two days later I was back in the hospital. That’s why [my son] Gehrig walked out with me, because I was afraid I was going to fall on the way in because I was so discombobulated.”

He was asked Wednesday why he has stayed out of the spotlight in recent months, choosing only now to talk about it for the first time.

“I didn’t want people feeling sorry for me,” he said. “I didn’t want the pity, I didn’t want any of that stuff.”

Schilling pitched in the majors for 20 seasons with the Baltimore Orioles, Houston Astros,Philadelphia Phillies, Arizona Diamondbacks and Red Sox. The six-time All-Star finished with a career record of 216-146 and a 3.46 ERA. His 3,116 strikeouts rank 15th all time. He won two World Series titles with the Red Sox and one with the Diamondbacks.

Red Sox manager John Farrell noted how the use of smokeless tobacco is not prohibited on the big-league level, protected by the players’ collective bargaining agreement with Major League Baseball.

“MLB has taken steps to dissuade players from using it through educational programs that are administered to every team,” Farrell said. “It’s even got to the point [in the minor leagues] now where players can be fined if smokeless tobacco is in view of the general public. There have been some of those warnings and penalties levied on some of our players.

“I think we all recognize that it’s addictive and causes cancer. That’s proven. [But] at this time, it’s upon the player to make the conscious decision for himself to use it or not. All we can do is continue educate guys what the ramifications are. … On the heels of the unfortunate passing of Tony Gwynn and what Curt is going through, you would think this would be a current beacon for guys to take note that there’s a price to be paid, if you’re one of the unfortunate ones stricken by cancer.”

http://espn.go.com/boston/mlb/story/_/id/11380584/curt-schilling-former-boston-red-sox-pitcher-says-chewing-tobacco-led-mouth-cancer

Why Can’t the Pentagon Stop Smoking?

By The Editors

Even the most oblivious member of Congress knows that smoking is bad for you. As it turns out, it’s even worse for you if you happen to be a soldier. So why would Congress insist that the Pentagon sell cigarettes — at a discount, no less?

The rationale has long been that members of the military have to smoke because their jobs are so stressful. There’s no denying the stress of military service, or that troops who smoke experience more of it than their comrades who don’t (though it may come more from their nicotine addiction than from their work).

Yet soldiers who smoke are not immune to lung cancer and the other lethal pulmonary illnesses that smoking causes. And like all smokers, they face an increased risk of cardiovascular disease. In fact, as an article in the current New England Journal of Medicine points out, smoking is especially harmful to soldiers because it lowers their fitness for service: It makes them more susceptible to injuries and infections, slows the time it takes for their wounds to heal, and leads them to take more frequent breaks than nonsmoking soldiers take.

The Pentagon, to its credit, has been trying for decades to restrict smoking. Most recently, Navy Secretary Ray Mabus said he’s considering banning tobacco sales on Navy ships and Navy and Marine Corps bases. Defense Secretary Chuck Hagel has asked for a Defense Department-wide review of tobacco policies.

Sadly and predictably, political forces are fighting back. In response to the Navy’s possible sales ban, Representative Duncan Hunter, Republican of California, has inserted language in the defense authorization bill that would require military commissaries to keep selling tobacco products. Congress responded the same way in the early 1990s after the captain of the USS Roosevelt said he planned to make that aircraft carrier smoke-free.

So it’s little wonder the military has continued to have a smoking problem. The Defense Department spends more than $1.6 billion a year on medical care and lost days of work due to smoking, and the Veterans Administration spends billions more treating ex-soldiers with lung disease.

About 1 in 4 members of all branches of the U.S. military smoke, compared with about 1 in 5 of the general population. But the percentages differ across the military: While about 30 percent of Marines smoke, members of the Air Force and Coast Guard smoke less than the national average, as do officers in all branches.

Millions of troops, in other words, have found more healthy ways to deal with the stress that inevitably accompanies military service. Nor are smoking bans especially difficult to impose or enforce: There is no smoking allowed during basic training, for example, and a 2010 ban on smoking on submarines — instituted after a warning period, to allow sailors time to quit — went off with no trouble.

The policy review Hagel has requested is expected to be finished within a couple of months, and it can be expected to take account of the Institute of Medicine’s 2009 recommendation to work toward a tobacco-free military. That need not result in an immediate ban on all smoking. But gradual limitations on where and when troops are allowed to smoke are necessary, as are greater efforts to help them quit.

In the meantime, the military is right to want to get out of the cigarette-sales business — and Congress should let it.

To contact the senior editor responsible for Bloomberg View’s editorials: David Shipley at davidshipley@bloomberg.net.

Letter: Tobacco taxes should be raised

By Jay Taylor from Durbin, N.D.

Hey! I have a great idea! Let’s raise a tax on something,” said no North Dakota legislator ever.

Wow! Raising a tax on anything, with North Dakota being so flush from oil money, just doesn’t make any sense at all.

And yet, taxes (or fees if you want a more politically correct term) do continue to inch up here and there.

During the 2013 legislative session, North Dakota lawmakers passed a bill that increased fees for many hunting and fishing licenses.

A tax is generally imposed to gain funds to pay for specific services or products: “It is a compulsory contribution to state revenue, levied by the government on workers’ income and business profits or added to the cost of some goods, services, and transactions.”

As said, to raise a tax in North Dakota today just doesn’t seem to make any sense, unless it’s a tax to protect the health of our residents, prevent disease and thwart kids from starting a path of extremely unhealthy behavior.

OK, I’ve beat around the bush long enough. I have read a lot about the idea of increasing the tobacco tax in North Dakota, and I am totally in favor of such an action. Here’s why:

The tobacco tax in North Dakota is one of the lowest in the nation (we are 46th at 44 cents per pack of 20 cigarettes), the lower-than-us states include: Missouri at 17 cents; Louisiana at 36 cents; Georgia at 37 cents and Alabama at 42 cents.

Our tobacco tax hasn’t increased since 1993.

The effects of North Dakotans’ tobacco use also affects the wallets of those who don’t use tobacco. North Dakota’s annual health care costs directly caused by smoking are $326 million. The portion covered by state Medicaid is $47 million.

But the most important reason is that a higher tobacco tax encourages people to quit and discourages younger folks from starting. According to the Tobacco Free Kids organization, “tobacco tax increases are one of the most effective ways to reduce smoking and other tobacco use, especially among kids. Every 10 percent increase in cigarette prices reduces youth smoking by about seven percent and total cigarette consumption by about four percent.”

For all the work being done by public health and health advocacy organizations, raising the tobacco tax is win-win.

I think it’s about time the North Dakota legislators started having a serious talk about this rather serious idea.

http://www.westfargopioneer.com/content/letter-tobacco-taxes-should-be-raised