Nicotine in e-cigs, tobacco linked to heart disease

By Jen Christensen, CNN
(CNN) — The nicotine delivered by cigarettes — even the electronic versions — may still contribute to heart disease, a new study suggests.
A new paper delivered at the American Society of Cell Biologyannual meeting in New Orleans on Sunday suggests that nicotine can cause direct harm to cells in the heart.
Nicotine is an highly addictive substance found in tobacco and is also found in vegetables in the nightshade family like eggplant and tomatoes.
The substance itself has a powerful impact on the body. It elevates your mood, suppresses your appetite and stimulates your memory; however, it also speeds up your heart rate and blood pressure.
E-cigarettes satisfy a smoker’s craving for nicotine and mimic the physical movements of smoking, but were viewed as a healthier alternative by some since they don’t contain the cancer-causing toxins of regular cigarettes.
Previous studies, such as one published in the journal The Lancet in September, have suggested e-cigarettes may be a more effective way for smokers to quit than nicotine patches or the “cold turkey” method.
In 2007, the Royal College of Physicians concluded, “If nicotine could be provided in a form that is acceptable and effective as a cigarette substitute, millions of lives could be saved.”
Smoking is the leading preventable cause of premature death, according to the American Heart Association.
For years, doctors have also known that smokers often develop heart problems in addition to lung problems.
Smoking increases a person’s risk of developing atherosclerosis, a disease in which plaque, a waxy substance, builds up in the arteries, narrowing and hardening them over time and limiting blood flow.
Atherosclerosis can cause heart attacks, strokes, and can even lead to death. The connection between smoking and atherosclerosis has been unclear, but scientist Chi Ming Hai may have discovered the root cause of the problem in the new study.
The molecular pharmacology professor at Brown Universityexposed cells found in the heart to nicotine. After only six hours, a kind of cellular drill, called podosome rosettes formed and ate through tissue.
When this happens in the vascular smooth muscle cells which are in the middle layer of the arterial wall to the inner layer, this can cause plaque to form in atherosclerosis. This happened when Hai exposed human and rat cells to nicotine.
What that means is that the nicotine is acting like “a kind of cancer of the blood vessel which is waking up these cells and breaking them away from their surrounding matric and then migrating having an effect like it is almost like digging a hole through the wall,” Hai said. “I think this is potentially very interesting and significant.”
It also means that the nicotine substitute of an e-cigarette may reduce a person’s chance of having lung cancer, but it does not mean that their risk of heart disease will go away.
Research is still in the very early stages, Hai said, but he believes it would be a good area for the government to invest in to better understand the connection between smoking and heart disease.
“We have certain pillars in this data that shows something significant is going on here and we need to understand it better,” Hai said.
http://www.cnn.com/2013/12/16/health/nicotine-e-cigarettes/

Homeless North Texans being weaned from tobacco

ARLINGTON, Texas (AP) — When he was sent to Vietnam in 1970, Travis Dorsey quickly picked up a smoking habit.
As the stress of being in a war zone took its toll, Dorsey found comfort in cigarettes.
“They started giving them to us with our meals, they called them C-rations, and the next thing you know I was buying them,” Dorsey told the Fort Worth Star-Telegram (http://bit.ly/1cXO5HL). “I didn’t drink. I didn’t do drugs. The cigarette helped me deal with the stress during the day.”
Life hasn’t been easy for Dorsey since returning, and through it all he has continued to smoke.
Sixteen years ago, he was diagnosed with post-traumatic stress disorder and lost his job as an aircraft mechanic. Two years ago, his wife died from breast cancer, triggering a downward spiral.
“I tried to commit suicide here about three months ago,” Dorsey said. “I ran off the cliff and tore up my truck. I was in the hospital about 2½ months.”
Dorsey, 62, who is now staying at the Arlington Life Shelter, says he’s beginning to turn his life around. He’s resumed taking insulin for his diabetes, received counseling to cope with his wife’s loss and found a church in Arlington where he feels at home.
And he’s now looking at quitting smoking through a program started in November by Tarrant County Public Health at the Arlington Life Shelter.
“I know it’s easier to quit now because I’m not under the stress I’ve been under the last two years,” Dorsey said. “I’m laying down at night and I’m not afraid.”
The county health department plans to eventually expand the program to other homeless shelters across Tarrant County, including the Patriot House, a shelter for homeless veterans.
“I wanted to reach an audience that wasn’t already being reached,” said Vanessa Ayala, a community health worker with the department. “We try to help them manage the stress from quitting smoking and understand the effects of nicotine withdrawal and dealing with weight gain.”
Michael Businelle, an assistant professor at the University of Texas School of Public Health in Dallas, said more should be done to encourage those who are homeless to quit smoking.
Tobacco-related deaths in the U.S. are about 440,000 annually, which include deaths from secondhand smoke, according to the federal Centers for Disease Control and Prevention.
“These tobacco cessation services are generally not offered at homeless shelters while substance abuse programs are generally ubiquitous,” Businelle said. “Smokers don’t go and rob their neighbors or sell their VCRs for cigarettes like someone would do for crack, but smoking is responsible for way more deaths than drugs and alcohol combined.”
Businelle helped conduct a study with several other researchers for publication in the American Journal of Public Health, comparing homeless smokers with economically disadvantaged smokers who have a home. The study, conducted from August 2011 to November 2012, found that the homeless smoking rate of 70 percent was twice that of those living in poverty (34.7 percent).
One of the challenges Businelle found was that homeless people were exposed to as many 40 smokers a day compared with three or four among those who are not homeless.
Those who run area shelters agree that efforts to curb smoking among homeless people are needed.
“The majority of the homeless population does smoke,” said Toby Owen, executive director of the Presbyterian Night Shelter. “Offering programs would certainly be most beneficial but it’s going to have to provide more than just going cold turkey.”
In Businelle’s study, 10 participants received small incentives — gift cards — and their carbon monoxide levels were tested to see whether they had actually quit. A larger group of 58 homeless people did not receive gift cards.
The quit rate four weeks after stopping smoking was 30 percent among the group that got gift cards versus 1.7 percent among those who didn’t receive gift cards.
“The findings of this pilot study are important because smoking cessation interventions that have worked in the general population are not as effective in homeless smokers,” Businelle said. “Offering small financial incentives for smoking cessation may be a novel way to have an impact on smoking in this vulnerable population.”
Businelle has applied for a National Institutes of Health grant that would pay for a five-year study and is still waiting to see whether it gets approved. The most recent study didn’t cover enough time to draw definitive conclusions. But Businelle said it is worth exploring because of the extensive costs associated with tobacco-related illnesses.
“The study is so small you can’t really make any broad generalizations,” Businelle said. “It is a pilot study that shows there is potential.”
The Bridge homeless recovery center in Dallas has been offering smoking cessation classes and modified its courtyard this summer to include a nonsmoking area for those who want to quit. With a day shelter that brings in as many as 1,200 people daily, along with a transitional shelter and an emergency shelter, the Bridge is trying to find ways to reach as many people as possible, President and CEO Jay Dunn said.
“We’re learning about the need for smoking cessation medication and brainstorming about how to make that more accessible,” Dunn said.
At the Arlington Life Shelter, Dorsey can get nicotine replacement medication through the Veterans Administration Hospital in Dallas.
Another shelter resident, Dennis Bell, said he can get a prescription through the JPS Connection Program if he needs one.
“I don’t know that I’ll need the medication,” Bell said. “I think I can do it with just the knowledge I’ve learned in the classes. That’s my goal. Now if my body says otherwise, that’s another thing.”
Bell, 45, ended up at the Arlington Life Shelter after his home was foreclosed on and he went through a difficult divorce.
But he said he was receptive to quitting smoking after Ayala pointed out how much money it would save him.
“I knew some of the health issues but the cost of smoking wasn’t something I had really thought about,” Bell said. “It was good information.”
Bell started smoking at 19 to fit in with his friends.
“To be honest with you, it was peer pressure,” Bell said. “I guess I wanted to be in the cool crowd.”
Karen Caston, director of shelter operations at the Arlington Life Shelter, said the classes can have an impact.
“They come here to become self-sufficient,” Caston said. “Anything that helps their health, their mental state and their financial state, can’t help but be a good thing.”
http://www.fosters.com/apps/pbcs.dll/article?AID=/20131216/GJLIFESTYLES/131209301/-1/SANNEWS

E-cigs may deliver more toxins than smoke, researchers say

By Andy Soltis
Don’t make that nicotine switch just yet.
E-cigarette users may be getting higher concentrations of toxins than regular smokers because they inhale deeper and more frequently when they puff, NYU researchers say.
Although they are often touted as a safer alternative, e-cigs, introduced in the States in 2007, haven’t been in use long enough to determine their health effects, said Dr. Deepak Saxena, of NYU’s College of Dentistry.
“We have no scientific data to show that nicotine at this concentration is safe,” said Saxena, an associate professor of basic science and craniofacial biology.
Each e-cig nicotine cartridge provides 200 to 400 puffs, equal to two to three packs of regular cigarettes.
Saxena says e-cigs, which deliver nicotine in a vapor form, must be studied as their popularity grows.
“They are designed for new smokers, to bring up a new generation,” he said.
The City Council is now weighing a proposal to place e-cigs under the same restrictions as regular cigs. Former tobacco smokers oppose it, saying e-cigs helped them kick regular puffing.
“People are saying, ‘Now I am smoking and happy with my addiction,’ ” Saxena said.
“But the problem is that if you want to get out of the addiction, you may become more addicted.”
http://nypost.com/2013/12/14/e-cigs-may-deliver-more-toxins-than-smoke-researchers-say/

Forum editorial: Progress in tobacco cessation

North Dakota was recognized last week as leader among states meeting national standards for funding anti-smoking programs. It’s a welcome designation. Moreover, it’s more evidence the state is doing an excellent job with the resources it has to educate about the risks of smoking and secondhand smoke and provide programs to help smokers quit.
No thanks to the Legislature.
At nearly every turn in the smoking debate during the last decade, lawmakers, particularly those in the Republican majority, have done the bidding of the smoking lobby and hospitality industry. Lobbyists worked to scuttle statewide smoking curbs, and their legislative allies fell into line, despite clear indications that a majority of North Dakotans wanted a smoking ban. Indeed, several cities, large and small, were ahead of the Legislature in imposing smoking restrictions, most of them via the ballot.
As in the cities, it took the ballot box to spank the Legislature. Two measures did what the legislators refused to do. The first in 2008 established a tobacco prevention and cessation program funded in large part by tobacco lawsuit settlement money. The second passed by a landslide in 2012 with every county voting “yes.” It made all public places 100 percent smoke free.
Despite dire predictions from fans of poisoning their customers (it’s their “right,” you know), the sky did not fall on the bar scene or the hospitality sector. Instead, smoking levels among adults are down significantly. There is more work to do among the state’s youth, and that’s where education programs are focused.
It’s good news. It’s good for the state’s long term public health, which, in turn, is a plus for everything else in North Dakota.
————-
Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.
http://www.inforum.com/event/article/id/421219/

Smoke from E-Cigs Still Poses Some Second-Hand Risk

By  @acsifferlin , TIME Health & Family
It’s not real tobacco smoke, but the emissions from electronic cigarettes can still contain harmful ingredients.
A new study published in the journal Nicotine and Tobacco Research shows that e-cigarettes generate enough nicotine emissions that they can be inhaled by those near a smoker. The researchers conducted two studies on three brands of e-cigarettes that investigated what the devices emitted into the surrounding air.
In the first study, the scientists used a smoke machine to “smoke” the cigarettes and then measure the concentrations of nicotine and other volatile organic compounds such as carbon monoxide released. They compared these emissions to those of standard cigarettes. Then, the team asked five male participants to smoke both tobacco and e-cigarettes in a room that measured contaminant exposure.
The found that e-cigarettes are a source of second-hand exposure to nicotine, but not of other compounds released when tobacco is burned. And the nicotine exposure was 10 times less than that from tobacco smoke.
However, another recent study from New York University researchers reported that e-cigarette smokers may not be spared such exposures. They inhale more nicotine because they puff more often and tend to breathe in more deeply than regular cigarette smokers. So higher nicotine consumption may be a risk for e-cig smokers.
Both studies suggest there’s much still to be learned about the health risks of e-cigarettes, including their effect not just on smokers but on those around them. The Food and Drug Administration currently does not regulate e-cigarettes, but has proposed a rule that would give the agency more regulatory power over the devices.
http://healthland.time.com/2013/12/13/smoke-from-e-cigs-still-poses-some-second-hand-risk/#ixzz2nfw3Jckr

CHART OF THE DAY: How Cigarettes Became Bigger Than Spitting Tobacco 100 Years Ago

, Business Insider
These days, you can’t talk about tobacco without talking about the rise of e-cigarettes.
“By year-end 2013, the e-cigarette category is expected to have doubled to over $1B from $500MM in 2012, according to various industry sources,” noted RBC Capital analyst Nik Modi.
Still, e-cigarettes represent a very tiny fraction of the tobacco business.  Tobacco giant Lorillard recently said that e-cigarettes may have taken 1% of the U.S. cigarette volume.
However, there was once a time when the cigarette wasn’t the dominant product in the tobacco business.
“We point out that it took 45 years for tobacco consumers to transition from smokeless to cigarettes during the late 1800s and early 1900s,” added Modi. “The cigarette’s popularity among tobacco consumers as we know it today was helped by two key catalysts: 1) spitting tobacco was declared unsanitary and disease spreading, leading to spittoons being removed from public places in 1915; and 2) during the Second World War, soldiers were given cigarettes as part of their rations.”
The removal of spittoons a hundred years ago isn’t unlike the bans on smoking we see today.
Who knows where we’ll be 45 years from now?

cotd tobaccoRBC Capital Markets

http://www.businessinsider.com/historical-share-of-tobacco-2013-12#ixzz2nekV5FUw

E-cigarettes: a burning question for U.S. regulators

Marina Lopes, Reuters
NEW YORK (Reuters) – At the Henley Vaporium, one of a growing number of e-cigarette lounges sprouting up in New York and other U.S. cities, patrons can indulge in their choice of more than 90 flavors of nicotine-infused vapor, ranging from bacon to bubble gum.
The lounge, located in Manhattan’s trendy Lower East Side, features plush seating, blaring rock music, and fresh juice and coffee. A sprawling sign on one wall lists all the carcinogens that e-cigarette users avoid by kicking their smoking habits and using the e-devices instead.
But the growing popularity of e-cigarettes has not escaped the notice of the industry’s critics, who have stepped up calls for new regulations, including bans on their use in public places, even though the scientific evidence about exposure to their vapors remains inconclusive.
Selling for about $30 to $50 each, e-cigarettes are slim, reusable, metal tubes containing nicotine-laced liquids that come in exotic flavors. When users puff on the device, the nicotine is heated and releases a vapor that, unlike cigarette smoke, contains no tar, which causes cancer and other diseases.
The product, introduced in China in 2006, has become a worldwide trend at least in part because it may help smokers of regular cigarettes break the habit.
“It’s an addiction – not everyone can quit cold turkey,” said Nick Edwards, 34, a Henley employee who says he kicked a 15-year cigarette habit the day he tried his first e-cigarette. “E-cigarettes give you a harm-reduction option.”
That’s one reason why the market for e-cigarettes is expected to surge, reaching $2 billion by the end of 2013 and $10 billion by 2017, according to Bonnie Herzog, an analyst at Wells Fargo Bank in New York.
Herzog said the U.S. market alone could top $1 billion this year. She predicts that by 2017 e-cigarettes sales will overtake sales of regular cigarettes. That estimate does not take into account the impact of potential government regulations on sales.
E-cigarettes may help smokers save money too. Edwards, for one, says he cut his $60 monthly cigarette bill in half when he switched. On top of the cost of the device, the smoking liquids cost around $10 per refill.
Despite the perceived benefits, critics worry that the addictive nicotine found in e-cigarettes could lure more people into smoking and discourage others from quitting all together.
“Essentially e-cigarette companies are selling nicotine addiction,” said Dr. Neil Schluger, chief scientific officer for the World Lung Foundation, which advocates for tobacco control.
“Once you have them addicted to nicotine, you can sell them all sorts of things, including conventional cigarettes,” he said. “This is a giant Trojan horse.”
In the United States, such concerns have led to calls for increased government regulation.
The U.S. Food and Drug Administration currently has no regulations on e-cigarettes, but it is expected to release rules this month that would extend its “tobacco product” authority over the devices. New FDA rules could follow.
“Further research is needed to assess the potential public health benefits and risks of electronic cigarettes and other novel tobacco products,” said Jenny Haliski, an FDA spokeswoman.
To be sure, no one is expecting the federal government to go as far as Brazil, Norway and Singapore, where the devices are banned outright.
In the United States, Utah, North Dakota, Arkansas and New Jersey have already passed legislation outlawing e-cigarettes wherever smoking is prohibited.
Other jurisdictions are considering new rules of their own. New York City could decide as early as next week whether to prohibit e-cigarette use in public places.
Under Mayor Michael Bloomberg, who leaves office January 1, New York was one of the first cities to ban cigarette smoking in public places, and its decision could influence Chicago and other cities that are considering a similar controls.
The outcome is crucial for tobacco companies, which are banking on the devices to make up for a sharp decline in sales of regular cigarettes in the United States. Smoking among U.S. adults dropped to 18 percent in 2012 from 24.7 percent in 1997, according to the Centers for Disease Control and Prevention.
Reynolds American Inc, which makes Camel cigarettes, began selling its Vuse vapor cigarettes in Colorado retail stores in July and plans on expanding nationwide by mid-2014.
Other companies have also dipped into the e-cigarette business, too. Last year Lorillard Inc, maker of Newport cigarettes, acquired the best-selling blu eCigs brand, while Altria Group Inc, best known for the Marlboro brand, followed suit in August with the launch of MarkTen e-cigarettes.
“As society is transforming, so must the tobacco industry,” said Reynolds spokesman Richard Smith. “It’s just good business sense.”
The arrival of Big Tobacco could mean fierce competition for small e-cigarette companies that do not have the resources or experience to deal with tight government regulation.
But many e-cigarette companies say Big Tobacco is late to the game and has a lot to catch up on. “They are going to need to boost up their game if they want to compete,” said Christina Lopez, a saleswoman at Smokeless Image, an e-cigarette shop that sells smaller brands in Hoboken, New Jersey.
HEALTH RISKS UNCERTAIN
To be sure, there is still a dearth of scientific evidence about the safety of e-cigarettes and their effectiveness in helping smokers quit. For regulators, the big question is, are e-cigarettes a treatment for would-be quitters or “gateway” products to nicotine addiction?
Supporters say some e-cigarettes allow users to slowly reduce their nicotine intake and wean themselves off nicotine completely. A study published in the September issue in Lancet, the British medical journal, said the e-cigarettes are as effective as nicotine patches for smokers trying to quit.
Worldwide, conventional cigarette addictions kill 6 million people a year, in part because of the 250 harmful chemicals found in tobacco smoke, which can cause cancer, heart disease and stroke, says the Centers for Disease Control and Prevention.
But e-cigarettes may not be harmless, either. Nicotine addictions, fed by smoking, chewing tobacco or e-cigarettes, can cause high blood pressure, disrupt heart rhythms and lead to obesity and diabetes.
Electronic devices that feature fruit and candy flavors are even more worrying, critics say, because they could introduce children to smoking.
E-cigarette vendors say the sweet flavors make the process of quitting smoking less painful.
“By taking a sort of ‘Willy Wonka,’ fun approach to a serious matter, it breaks down people’s perceptions of e-cigarettes,” said Talia Eisenberg, owner of the Henley Vaporium, referring to the fictional candy maker.
The Centers for Disease Control and Prevention said 10 percent of high school students surveyed reported using e-cigarettes in 2012, up from 4.7 percent in 2011.
About 60 percent of current users are over 35 years old, and 43 percent are college-educated, according to Reynolds American.
Twelve states, including New York, have passed laws preventing e-cigarette sales to minors.
At a hearing on the proposed New York City ban on e-cigarette use in public places, Health Commissioner Thomas Farley said allowing it could glamorize all types of smoking and encourage teenagers and children to take up the cigarette habit.
“While more research is needed on electronic cigarettes, waiting to act could jeopardize the progress we have made over the last few years,” he said.
(Reporting By Marina Lopes; Editing by Jilian Mincer and Tim Dobbyn)
http://www.chicagotribune.com/news/sns-rt-us-usa-ecigarettes-20131211,0,720952.story?page=2

Will your children buy candy, gum or little cigars?

By Dr. Tom Frieden, Special to CNN
Editor’s note: Dr. Tom Frieden is director of the Centers for Disease Control and Prevention.
(CNN) — They’re on display at cash registers all across America: Candy bars, packs of gum — and little cigars.
In some cases, those cigars aren’t tucked away behind the counter where only the attendant can get to them but right in front for anyone to pick up.
Traditional fat cigars are a small part of today’s cigar industry. Newer types of cancer sticks include cigarette-sized cigars, or little cigars, designed to look like a typical cigarette but which evade cigarette taxes and regulations.
Flavored little cigars can be sold virtually anywhere, and kids are a prime target of these new products.
Unlike cigarettes, many are sold singly or in small, low-priced packs, at a fraction of the cost of a cigarette in most states.
These little cigars have names like “Da Bomb Blueberry” and “Swagberry.” The flavors themselves — chocolate mint, watermelon, wild cherry and more — can mask the harsh taste of tobacco and are clearly attractive to children.
The Food and Drug Administration banned candy and fruit flavors in cigarettes so young people would not be enticed. But cigars weren’t covered.
The tobacco industry claims that its marketing efforts are solely aimed at adults. It has long argued that its marketing doesn’t increase demand or cause young people to smoke but instead is intended to increase brand appeal and market share among existing adult smokers.
How many grown-ups do you know who smoke grape-flavored cigars?
Little cigars have become more popular in recent years. Flavored brands have almost 80% of the market share.
In 2011, among middle school and high school students who currently smoke cigars, more than one in three reported using flavored little cigars.
Six states — Florida, Georgia, Maryland, Massachusetts, Rhode Island and Wisconsin — have youth cigar smoking rates the same as or higher than those of youth cigarette smoking.
Despite industry statements to the contrary, the link between marketing and youth tobacco use is clear.
Some legislative and regulatory actions that tackle elements of tax discrepancies, youth appeal and marketing are in place or under consideration.
New York and Providence, Rhode Island, have enacted city-wide ordinances prohibiting the sale of flavored tobacco products, including flavored little cigars. Both ordinances have been challenged and upheld in U.S. District Court.
In April, the Tobacco Tax and Enforcement Reform Act was introduced in the Senate. This bill aims to eliminate tax disparities between different tobacco products, reduce illegal tobacco trade and increase the federal excise tax on tobacco products.
Based on decades of evidence, the 2012 surgeon general’s reporton tobacco use among youth and young adults concluded that tobacco industry marketing causes youths to smoke, and nicotine addiction keeps them smoking.
This sobering fact holds true in spite of bans on advertising and promotions that target children and youths, and restrictions on certain other marketing activities.
Nearly 90% of smokers started before they were 18 years old, and almost no one starts smoking after age 25.
To prevent the needless death, disability and illness caused by smoking, we must stop young people from even starting to smoke.
A key part of prevention efforts must be action that will eliminate loopholes in restrictions on tobacco marketing, pricing and products that encourage children and youth to smoke.
I don’t think it’s too much to expect of our society that we protect our kids so they can reach adulthood without an addiction that can harm or kill them.
– – – –
The opinions expressed are solely those of Dr. Tom Frieden.
http://www.cnn.com/2013/12/11/health/frieden-little-cigars/

E-cigs: Just how safe are they?

Article by: JEREMY OLSON , Star Tribune
One of the great unanswered questions for smokers who are trying to quit — and for the advocacy groups trying to help them — is whether electronic cigarettes are friends or foes.
University of Minnesota researchers aim to address that dilemma with a study examining exactly what smokers inhale when they breathe e-cigarette vapors and how “vaping” affects the body. Researchers will collect blood, urine and saliva samples from at least 25 smokers who use only e-cigarettes and at least 25 who use them with traditional cigarettes.
“The first step is to say, ‘Well, how toxic are these products? What is actually in them?’ ” said Dorothy Hatsukami, associate director for cancer prevention and control in the U’s Masonic Cancer Center.
E-cigarettes, rechargeable devices that heat liquid nicotine or other flavored substances into a vapor that the user inhales, have been marketed as a safer alternative to tobacco. Yet a lack of regulation on their manufacture and contents makes it hard to know if they’re safer than traditional cigarettes and whether they can be used to safely help wean people off tobacco, Hatsukami said.
“It’s like a Wild West out there,” she said.
Some e-cigarettes that are promoted as nicotine-free, for example, have been found to contain the addictive substance, while others contain little or no nicotine despite claims to the contrary.
Some previous studies have chemically analyzed the contents of e-cigarettes. The Minnesota study aims to go a step further by examining how the contents of different kinds of e-cigarettes affect the body.
The market for e-cigarettes has grown rapidly — sales have doubled annually since 2008 and are expected to reach $1.6 billion this year. About 6 percent of adults have tried them, and the share of high school students who have tried them hit 10 percent last year, according to the U.S. Centers for Disease Control and Prevention.
Heidi Scholtz, 20, a German and theater student at Hamline University, tried her first one two years ago because she was tired of going outside in the snow and cold to smoke. Before long, she said, she was using only e-cigarettes and was surprised at what happened when the weather warmed up and she tried a cigarette.
“It tasted disgusting,” she said.
Now Scholtz uses only e-cigarettes, and has kicked a cigarette habit that started when she was 15. A close friend tried them at her urging, but now uses both.
Help smokers quit?
Studies nationally have produced mixed results about whether e-cigarettes help people quit or reduce smoking — or simply supplement real tobacco. Clearway Minnesota, a nonprofit quit-smoking group, has taken a noncommittal stance on them.
Spokesman Mike Sheldon said it’s great if they help some people quit. But, he added, the lack of science about their contents makes it hard to endorse them over proven stop-smoking strategies of counseling combined with such well-studied supplements as nicotine patches or gum.
The recent increase in youth use of e-cigarettes also is troubling, Sheldon said. “We just don’t know enough about these,” he said.
The Minnesota Clean Indoor Air Act does not apply to e-cigarettes, which can be smoked indoors unless banned by local laws or individual establishments. The city of Duluth banned them from public indoor locations because so little is known about their effect on people who inhale the vapors secondarily.
Clearway would support extending the state ban to e-cigarettes, Sheldon said. However, a group of former cigarette smokers have formed the Minnesota Vapers Advocacy Group to fight the idea.
The group’s president, Matt Black, said his first e-cigarette meant his last real cigarette. A device that physically mimicked his smoking mannerisms was key to to quitting.
“For 17 years, I was constantly hand to mouth (with a cigarette),” Black said. “I was blowing out smoke. I was breathing differently. All of those things play a role in that addiction. We found a way to maintain those habits in a way that’s not going to kill us.”
Black said he hopes the U study will ultimately find e-cigarettes safe, so more people would use them to quit real cigarettes.
Hatsukami said a key aspect of the study is looking at the different types of e-cigarettes to see if some are more harmful than others. (To enroll, call 612-624-4568.)
“Although the majority of the products don’t contain toxicants that are cancer-causing, there are a few that do,” she said. “There is a lot of variability out there.”
http://www.startribune.com/lifestyle/health/235430591.html?page=2&c=y

FDA’s anti-smoking campaign to target teens

By 

Early next year, half a century after the U.S. surgeon general first proclaimed the deadly effects of smoking, the Food and Drug Administration will launch a public health campaign unlike any the federal government has ever attempted.
Slick, data-driven and well-funded, the effort could cost up to $600 million over the next five years, all of it paid for by the tobacco industry under a 2009 law.
It will feature carefully crafted anti-smoking messages targeting specific types of teenagers, from rural kids who watch “Duck Dynasty” and drive pickups to gay and lesbian teens who prefer the nightclub scene.
In contracting with top-flight advertising firms, conducting intense demographic research and micro-targeting subsets of the 12-to-17-year-old crowd, the FDA is hoping to take a page from the marketing playbook of corporate America.
“It’s the federal government going to ad firms of the quality and ability that the tobacco industry has always used,” said Matthew Myers, president of the Campaign for Tobacco-Free Kids, a national advocacy group. “They’re ensuring that the media designed to educate and reach at-risk young people is of the same quality that the tobacco industry has used to attract them.”
The federal government can scarcely compete with the tobacco industry, whichspent more than $8 billion on advertising and promotions during 2011, according to the most recent data available from the Federal Trade Commission.
But Mitch Zeller, head of the FDA’s Center for Tobacco Products, said he hopes that in undertaking the first federally funded anti-smoking campaign aimed exclusively at young people, the government can put a dent in the number of teenagers who smoke their first cigarette each day — now roughly 3,300, with an estimated 700 to 800 becoming addicted.
“Once they become regular smokers or regular tobacco users, then it’s the progression to addiction, disease and premature death,” Zeller said. “We have a responsibility . . . to reduce the death and disease toll from tobacco use. That includes educating kids about the harms of tobacco use in an effective way, in a way that will reach them.”
Previous government-backed anti-smoking initiatives have not been on this scale. Some individual states have run campaigns designed to discourage youth smoking — efforts largely financed by a 1998 settlement under which tobacco companies paid states billions of dollars to settle Medicaid claims for tobacco-related health-care costs.
Last year, the Centers for Disease Control and Prevention launched the first federally funded national anti-smoking campaign, but that was geared toward getting existing smokers to stop, not toward teen prevention.
For the new campaign, the FDA is turning to people such as Jeff Jordan, 29. The agency has given him $152 million and a mission: Find a way to cut through the cluttered modern media landscape and persuade teenagers to steer clear of tobacco. And not just any teenagers, but those particularly at risk for becoming smokers, such as Hispanics, Asian Americans, African Americans, gays and lesbians.
Jordan’s San Diego-based firm, Rescue Social Change Group, has spent years developing anti-smoking campaigns that target slivers of youth culture, from teens in Northern Virginia’s alternative rock scene to gay, lesbian, bisexual and transgender teens in Las Vegas. He said he believes that to have any chance of reaching those and other at-risk populations, the government must break free of generic messages aimed at reaching all teens.
“If half the population likes blue, and the other half likes yellow, a government agency will make their campaign green,” Jordan told an audience in Finland in 2012. “But they need to realize that being everything to everyone doesn’t work in marketing. They need to segment their audience and tailor their campaigns to be effective.”
The FDA has committed $300 million to the anti-smoking ad blitz in 2014 and 2015, with the possibility of doubling that in coming years. While a chunk of the money will initially be used to target teens who have never smoked or are intermittent tobacco users, most will be aimed at young people with higher risks of becoming addicted to tobacco.
Kathy Crosby, an FDA official and advertising industry veteran overseeing the campaigns, said the agency hopes to replicate the ways in which corporate America focuses on certain demographic groups, including notoriously hard-to-reach teenagers.
“Brands are masters at understanding the marketplace, understanding the dynamics of the marketplace and carving out a way to reach their target audiences,” Crosby said. “That’s what we’re trying to do.”
Neither the FDA nor the firms it has hired have offered specifics about the campaigns, saying they are a work in progress. But Jordan said the first and most important step is researching which teens to target, then crafting messages that ring true to that group.
“No public health effort before has truly fit into a youth culture, the way they see their culture,” said Jordan, whose small firm has doubled in size to nearly 60 employees and opened a Washington office since starting to work on the FDA project. “The most important part is to be authentic and credible. . . . If we can make a campaign that’s specifically designed for a group, that looks like them, sounds like them, identified with them, we can help them see that people like them are deciding smoking is unhealthy.”
He calls the approach “creating bull’s-eyes” at the fringes of youth culture. “If it actually works,” he said, “we’re talking about reducing [smoking] rates among the groups that are most resistant to a generally targeted message.”
Previous anti-smoking campaigns created by the various firms hired by the FDA offer hints about what to expect. The ads tend to be more edgy than people might expect from a government-backed campaign and often feature young people talking in blunt terms to peers about the consequences of tobacco use.
The firms involved also are adept at getting messages out in ways beyond traditional television and radio advertising, such as creating specialized Web sites and blogs, using Twitter and Facebook, hosting events at bars and staging concerts headlined by bands popular among target audiences.
Better World Advertising, a firm that the FDA has hired to target Native American teens, created a campaign in New York to encourage doctors to talk more with patients about the risks of tobacco, and another in California reminding parents of the dangers of secondhand smoke. The slogan for the latter: “When you smoke, they smoke.”
Another firm working with the FDA, Draftfcb, recently helped the government revamp the image of Smokey Bear.
Zeller, the FDA’s top tobacco official, knows a thing or two about the potential benefits of an aggressive anti-smoking campaign. In the early 2000s, he spent time as an executive at the nonprofit American Legacy Foundation, where he oversaw the “Truth Campaign.”
Funded by a massive tobacco-industry settlement in 1998, the campaign was characterized by in-your-face ads meant to educate teens about the tobacco industry’s misleading marketing practices.
“I know how to do this, and I know what works,” Zeller said in an interview with The Washington Post earlier this year. “And what works is, get really smart people from the outside, do it under contract, do the right research, develop the right messages, have a laser beam focus on who your target is and then buy your media correctly. And then spend money. Because it’s a dose response. Once you’ve done those first three or four things, the more you invest, the more impact you will have.”
Studies have concluded that the “truth” campaign had a tangible effect, discouraging some young people from starting to smoke and prompting others to think twice about their habit.
Another recent study estimated that 1.6 million Americans tried to quit smoking after last year’s CDC campaign, which featured stark images and pleas from adult ex-smokers suffering from a variety of ailments, including amputated limbs and throat cancer.
Whatever shape the FDA’s anti-smoking ads take, Jordan said he’s encouraged to see the government trying to reach teenagers in new and creative ways, in part by taking a chance on firms like his, which aren’t exactly mainstream.
“From the perspective of a federal agency, we’re by no means a quiet company,” he said. “Our work is risque and really in your face, and it’s meant to really cause change. I’m thankful they were willing to take the risk.”
http://www.washingtonpost.com/national/health-science/fdas-anti-smoking-campaign-to-target-teens/2013/12/09/5b24030a-4d73-11e3-be6b-d3d28122e6d4_story.html