Editorial: Kids and e-cigs

Gainsville Sun Editorial:
As anti-smoking campaigns reduce tobacco use among young people, public health advocates see a new threat in electronic cigarettes.

E-cigarettes convert liquid nicotine into a vapor that users inhale. They come in flavors such as various types of fruits and candies, potentially attracting children to use them.
The 2013 Florida Youth Tobacco Survey found that 12 percent of high school students had tried e-cigarettes, an increase of 102 percent since 2011.
Alachua County Commissioner Robert Hutchinson asked staff to draft an ordinance to ban the sale of e-cigarettes to minors, require them to be placed behind counters in stores and prohibit their use in non-smoking areas. Clay County has enacted and Marion County is considering similar measures.
The U.S. Food and Drug Administration is also considering the regulation of e-cigarettes. A federal rule would be more effective than a patchwork of local ordinances.
In the meantime, Alachua County and other municipalities are right to work to keep e-cigarettes out of the hands of minors. Yet the county should resist the urge to regulate the personal behavior of adults that doesn’t affect others.
Some research suggests that e-cigarettes help a small percentage of tobacco users quit. But the health effects of inhaling nicotine vapor are unclear, and the track record of the tobacco companies that sell some e-cigarette brands gives reason to be skeptical of claims that it is a safe alternative to smoking.
It’s reasonable to regulate an addictive product that poses potential health risks. Hopefully the FDA soon does it job and prevents the need for Alachua County to act.
http://www.gainesville.com/article/20131102/OPINION01/131039866/-1/entertainment?Title=Editorial-Kids-and-e-cigs&tc=ar

Nationwide Fight Begins Over Raising Tobacco Age to 21

By 
New York City councilmen voted Wednesday to raise the legal age for purchasing tobacco from 18 to 21, a measure that will go into effect six months after it’s signed into law by Mayor Michael Bloomberg, a zealous anti-smoking advocate.
The Big Apple measure – which soared 35-10 through the city council – is part of a nationwide effort that seeks to make illegal the sale of tobacco to young adults.
In New Jersey, legislators are likely to debate a bill soon that would raise that state’s age limit to 21. New Jersey is currently tied for the highest statewide tobacco age limit, at 19.
Richard Codey, governor of New Jersey from 2004 to 2006, helped bump the state’s age limit from 18 to 19 less than 10 years ago. He’s now a state senator and the sponsor of new age limit legislation, which he is confident will prevail – and possibly help start a chain-reaction.
“Someone is going to read this in Connecticut or Illinois or somewhere else and go, yeah that’s a good idea,” Codey told U.S. News. “The only people who are opposed, obviously, are the tobacco companies. As far as I’m concerned, I’m on the side of the angels.”
Codey expects his bill to pass and take effect in early 2014. He hasn’t heard from Gov. Chris Christie, R-N.J., but he expects the prospective presidential candidate to consent to the change.
“Are some people going to get someone to buy cigarettes for them when they are not 21? Of course,” he said. “But there are other people who are not going to do that and obey the law and by the time they’re 21 are more mature and rational will realize that it’s not a good thing to do.”
Codey says his legislation was inspired by a phone conversation earlier this year with New York City Council Speaker Christine Quinn, then a candidate for mayor, who called him and shared her plan for the higher age limit. After some conversation, he joined on.
Codey’s not sure if his bill would affect electronic cigarette sales – as New York City’s law does – but he’s opposed to young smokers adopting that technology.
“It’s like someone who starts on marijuana, then they want a better high – it’s just a reality of life,” he said. Electronic cigarette advocates vehemently disagree with such arguments and say the vast majority of users are conventional smokers seeking a healthier alternative.
One of the largest national anti-tobacco organizations fully supports banning 18-to-21-year-olds from buying cigarettes.
“As states and localities have looked into this, we’ve begun to get involved,” said Danny McGoldrick, vice president for research at the Campaign for Tobacco-Free Kids.
McGoldrick said his organization generally supports a “tried and true trifecta” of anti-tobacco policies – higher taxes, public smoking bans and educational campaigns – but will also advocate for raising tobacco age limits to 21 in any jurisdiction considering it.
The Campaign for Tobacco-Free Kids is currently supporting an attempt to raise the smoking age to 21 at the county level on Hawaii’s largest island and has been involved in generalized efforts to raise the age to 21 for around a year.
A fact sheet from the group says around 50 percent of smokers begin using cigarettes daily before they turn 18 and that more than 75 percent of adult smokers do so before they turn 21, arguing that cutting off access at a young age may drop future adult smoking rates.
“To the degree we wouldn’t be involved, it would only be a resource question,” McGoldrick said. “We certainly support it from a policy perspective. We’re just going to have to see what the landscape looks like in terms of the biggest opportunities for success.”
In New York City, one unhappy activist who organizes smokers to push back against tough laws says politicians can expect a black market boom with the new age limit.
“They are not stopping anyone in that age group who wants to smoke,” said Audrey Silk, founder of New York City Citizens Lobbying Against Smoker Harassment. “These young adults know very well where to get their cigarettes. The ones who have already been doing that will have more joining them to get their cigarettes from the ‘buttleggers,'” a term for smugglers who avoid high city taxes.
As the city government increased taxes on tobacco, Silk said, “a huge enterprise sprung up” and now many smokers have learned through word of mouth of illicit, less expensive cigarette dealers.
Silk, a former New York City cop, defiantly smokes cigarettes in city parks – deliberately violating Mayor Bloomberg’s ban by doing so – and her group won a rare victory Oct. 11 when a judge ruled against a statewide ban on smoking in parks.
“This one has no room for a lawsuit, unfortunately,” she concedes.
It’s unclear how city policy might change under Bloomberg’s successor, who will be selected in November. Neither Democrat Bill de Blasio nor Republican Joe Lhota have gone out of their way to advertise a position on the new age restriction.
“The lines have become blurred party wise because you can’t depend on any one party to defend our civil liberties,” Silk said. “My question to them is: Will you decline to accept the votes of this age group if they’re not smart enough [to decide whether or not to smoke]?”
Silk says it’s possible the age restriction will one day be reversed, but it’ll be an uphill climb.
“Prohibition [of alcohol] was reversed,” she said. “It took 13 years for that, so is it possible the age will be reduced one day? Yeah, it’s possible.” But, in the meantime, she admits “New York is a trendsetter” and will likely inspire young adult bans elsewhere.
http://www.usnews.com/news/articles/2013/10/31/nationwide-fight-begins-over-raising-tobacco-age-to-21

Tobacco Marketing Costs Exceed Those of Prevention Efforts

By Marisa DeCandido – email
There’s been a statewide effort over the past several years to cut down on tobacco use in North Dakota. And state lawmakers now know exactly how much those prevention programs are costing.
It’s not easy for smokers in North Dakota to find a place to light up, and state lawmakers now know just how much it costs to keep it that way.
The Center for Tobacco Prevention and Control Policy says it spends about fifty-five dollars on each North Dakota Tobacco user. That money goes towards programs that help users break the habit.
“A great portion of the program is focused on preventing young people, youth and young adults, from ever using tobacco so we don’t have to spend as much on cessation, or getting them to quit later in life,” says Prom
And Prom says youth smoking rates have gone down in the last year. Even though the tobacco industry spends about one-hundred and ninety five dollars a year marketing to North Dakotans.
“It’s odd that we have a situation today where we have an industry, the tobacco industry, who promote a product that when used as intended kills. There’s really nothing normal about that. So we want to change that to where not using tobacco is the norm,” says Jeanne Prom, North Dakota Tobacco Prevention.
Prom presented these numbers on the same day that New York City proposed a law that would change the tobacco buying age from eighteen to twenty-one. But North Dakotans don’t thing that will happen here.
“North Dakota, at this time, we need to focus on our taxes and raising that, and that is going to make the biggest impact for stopping our youth from starting and helping others to quit,” says Kim Schneider, American Lung Association.
That’s because the tobacco tax here is only forty-four cents, one of the lowest in the country.
“We’ve spent a lot of time in the past year just educating again on the smoke-free law and on the tobacco tax. It’s a big issue in North Dakota,” says Schneider.
Tobacco prevention groups in the state say raising the tax is the next step towards fighting tobacco use.
For more information on how much smoking costs North Dakotans, visit breathend.com.
http://www.kumv.com/story/23842127/tobacco-marketing-costs-exceed-those-of-prevention-efforts

Regulators unsure how to treat electronic cigarettes

By Nathan Porter – The Washington Times
The questions concerning the safety of electronic cigarette use are neatly matched by the questions concerning how — and even whether — governments should regulate the product.
Having long strictly limited marketing and use of traditional tobacco products, the Food and Drug Administration is expected in the coming days to propose its first rules and restrictions on electronic cigarettes.
About half of the states, including Colorado, Maryland, Minnesota and New Hampshire, haven’t waited for federal action and have banned the sale of e-cigarettes to minors. A group of 41 state attorneys general wrote to the FDA urging the federal government to “take all available measures” to regulate the product.
The U.S. Department of Transportation has said that federal regulations that prohibit smoking on airplanes will be extended to e-cigarettes.
But the industry is arguing that e-cigarettes are fundamentally different from traditional cigarettes and shouldn’t face the same one-size-fits-all restrictions. Some companies go further, saying e-cigarettes can lower smoking rates for more dangerous tobacco products and should, in certain circumstances, be encouraged.

Critics say that when it comes to regulation — and, just as important, taxation — the booming e-cigarette industry is trying to have it both ways as the government considers its regulatory approach.
“When it’s convenient to be like tobacco, they’re like tobacco,” Stanton A. Glantz, director of the University of California-San Francisco’s Center for Tobacco Control Research and Education, recently told The New York Times. “And when it’s not convenient, they’re not.”
The regulatory mishmash is not limited to the United States.
In Germany, Norway, Ireland, Poland and Portugal, the sale and use of electronic cigarettes is completely legal. In a closely watched vote last month, the European Parliament decided to regulate e-cigarette marketing the same as regular tobacco products, forbidding sales to minors and most advertisements in the economic bloc.
But EU legislators rejected a proposal to regulate e-cigarettes with the same stringency as medical devices, which would have put a major crimp in a product that is gaining increasing popularity in markets such as France. If the measure passed, e-cigarettes could have been sold only in pharmacies.
Charles Hamshaw-Thomas, spokesman for E-Lites, Britain’s biggest e-cigarette seller, called the Parliament’s vote a “fantastic result for public health and the millions of smokers around Europe who are switching to e-cigarettes.”
“Common sense,” he added, “has prevailed.”
In Britain, e-cigarettes are not subject to the same use, sale and advertising regulations as traditional tobacco products. Three e-cigarette commercials, however, were aired by E-Lites, and its rivals were banned last month.
The Canadian government has stated that officials do not endorse e-cigarettes but that the sale and use of the product are legal. South Korea also has deemed e-cigarettes legal, but the government has imposed heavy taxes on e-cigarettes to discourage use, particularly among teenagers.
Switzerland has adopted a split approach: While nicotine-free e-cigarettes are legal nationwide, e-cigarettes containing nicotine cannot be sold within the country. They can, however, be imported.
Dubai, Lebanon, Mexico, Panama and Singapore are among the many countries that have adopted outright bans on the e-cigarette use.
http://www.washingtontimes.com/news/2013/oct/31/regulators-unsure-how-to-treat-electronic-cigarett/?page=2&utm_medium=RSS&utm_source=RSS_Feed

Electronic cigarette peddlers are just blowing smoke, health officials say

By Nathan Porter – The Washington Times
That cloud hanging over electronic cigarettes these days isn’t just from the nicotine-laced vapor that the newfangled butts emit.
As big tobacco companies rush to cash in on e-cigarettes and governments scramble to regulate their use, the nation’s top researchers say basic questions about the safety and long-term effects of e-cigarettes have yet to be answered. They also caution that regulators may be about to go too far without knowing what they are dealing with.
At a gathering of the nation’s leading cancer specialists outside Washington this week, a panel on e-cigarette smoking, or “vaping” as it is often called, cast a skeptical eye on the intense regulatory interest in the e-cigarette phenomenon.
“One of the problems and challenges with the regulation will be how to not overregulate the product,” said Maciej Goniewicz, assistant professor of oncology at the Roswell Park Cancer Institute in Buffalo, N.Y. “We want the regulation to provide safer, better products, and this is a huge challenge.”
E-cigarettes are battery-powered electronic inhalers designed to resemble and function much like traditional tobacco cigarettes. Many electronic cigarettes release nicotine like tobacco cigarettes, but some release just flavored vapor. Because they do not use tobacco, e-cigarettes are viewed by many as less harmful than traditional cigarettes and a way for smokers to transition to a less-dangerous alternative.

Still, no conclusive long-term research has been conducted on the effects of vaping, and critics and many health officials warn that e-cigarettes can be a “gateway drug” to the real thing, especially among younger users.

The Food and Drug Administration has been forced to address the issue in large part because of the market excitement generated by e-cigarette sales.
Although still a fraction of the $90 billion U.S. tobacco market, annual e-cigarette sales have gone from $20 million five years ago to as much as $1.7 billion this year, according to analysts. North Carolina-based Lorillard said its market-leading Blu e-cigarette brand recorded $63 million in sales in the most recent quarter, a fivefold increase aided in part by a national television ad campaign featuring model and actress Jenny McCarthy.
The increasingly large sums involved also have sparked a lobbying battle. The Smoke Free Alternatives Trade Association — the “voice of the electronic cigarette industry” — plans a Capitol Hill “fly-in” next week to talk to lawmakers and staffers about the potential negative effects of state and federal regulatory initiatives.
“While our industry understands reasonable and appropriate regulation is needed, it is vital our young industry not be grouped with combustible cigarettes” as federal guidelines are drafted, said Cynthia Cabrera, executive director of the trade association. “Excessive regulation could limit adult access to e-cigs and stifle growth and innovation in the segment.”
Many industry watchers say e-cigarettes’ popularity may override concerns over their health effects.
“The challenge here is that big tobacco companies now have their own brands of electronic cigarettes. What drives this? Of course, the market,” Mr. Goniewicz said.
Some CEOs of e-cigarette companies have said that their goal is to make tobacco cigarettes obsolete. Government regulation, they fear, could undercut the market before it can truly take off.
Because of the lack of research, there is no way of knowing whether e-cigarettes help smokers quit or whether they merely cause smokers to switch, and only temporarily, to a less-harmful habit.
“The whole point here is that people who are addicted to tobacco are switching. This notion of switching from one thing to another is cognitively very different than quitting,” said Scott Leischow, a senior associate consultant at the Mayo Clinic’s Cancer Prevention and Control Program.
http://www.washingtontimes.com/news/2013/oct/31/electronic-cigarette-peddlers-are-just-blowing-smo/

Maryland cigarette sales down 17% since tobacco tax hike, report says

, Reporter-Baltimore Business Journal
The number of cigarette packs sold in Maryland has declined 17 percent since 2008, according to a new report released Wednesday by a health care advocacy group.
A total of 200 million packs of cigarettes were sold in Maryland in fiscal 2012, down from 243 million in 2008, according to data compiled by Maryland Citizens’ Health Initiative that analyzes data from the national Campaign for Tobacco-Free Kids. The report is intended to highlight improvements in combatting smoking among teens and adults since Maryland raised a tax on cigarette packs in 2008 to $2.
The report comes as the Citizens’ Health Initiative and other health care organizations prepare to lobby for another $1 increase on the cigarette tax. If successful in the Maryland General Assembly, the tax would rise to $3 a pack.
The total number of cigarette packs sold in Maryland has been declining for more than a decade, according to the report. Back in 1995, 389 million packs of cigarettes were sold in the state.
Maryland’s General Assembly in 2012 increased the tax on mini cigars (which come in fruit flavors and have become popular among teenagers) to 70 percent of wholesale price, up from 15 percent. The assembly also increased the tax on smokeless tobacco to 30 percent of wholesale price, up from 15 percent.
In the assembly’s next session, which starts in January, health advocates will also be seeking another increase to the tax on smokeless tobacco and mini cigars.

City Council to Vote on Raising Cigarette Purchase Age

In the latest move to snuff out smoking in New York, the City Council could vote Wednesday to bar anyone under the age of 21 from buying cigarettes and e-cigarettes.

Under federal law, no one under 18 can buy tobacco anywhere in the country, but some states and localities have raised it to 19.

Public health advocates say a higher minimum age discourages, or at least delays, young people from starting smoking and thereby limits their health risks. But opponents of such measures have said 18-year-olds, legally considered adults, should be able to make their own decisions about whether or not to smoke.

Some communities, including Needham, Mass., have raised the minimum age to 21, but New York would be the biggest city to do so.

Officials say 80 percent of NYC smokers started before age 21, and an estimated 20,000 New York City public high school students now smoke. While it’s already illegal for many of them to buy cigarettes, officials say this measure would play a key role by making it illegal for them to turn to slightly older friends to buy smokes for them. The vast majority of people who get asked to do that favor are between 18 and 21 themselves, city officials say.

Under Mayor Bloomberg and the health commissioners he has appointed, including Farley, New York has rolled out a slate of anti-smoking initiatives.

Bloomberg, a billionaire who has given $600 million of his own money to anti-smoking efforts around the world, began taking on tobacco use in the city shortly after he became mayor in 2002.

Over his years in office, the city — at times with the council’s involvement — helped impose the highest cigarette taxes in the country, barred smoking at parks and on beaches and conducted sometimes graphic advertising campaigns about the hazards of smoking.

Earlier this year, the Bloomberg administration unveiled a proposal to keep cigarettes out of sight in stores until an adult customer asks for a pack, as well as stopping shops from taking cigarette coupons and honoring discounts, but the proposal was dropped earlier this week, according to the New York Times.

Bloomberg’s administration and public health advocates praise the initiatives as bold moves to help people live better. Adult smoking rates in the city have fallen from 21.5 percent in 2002 to 14.8 percent in 2011, Farley has said.

http://www.nbcnewyork.com/news/local/Cigarettes-Vote-New-York-Wednesday-229822281.html

Lawmakers updated on efforts to fight tobacco use

By Nick Smith
BISMARCK, N.D. _ A statewide effort to fight tobacco use is spending about $55.60 on each North Dakota adult who uses tobacco products, the director of the agency behind that effort says.
State lawmakers got an update Wednesday from Jeanne Prom, the executive director of the North Dakota Center for Prevention and Control Policy, on how much her agency spends.
With an average annual budget of about $10.7 million, it amounts to $55.59 spent on each adult tobacco user in the state, or $14.57 per capita, Prom told lawmakers. But she said that is much less than the tobacco industry spends on marketing.
“It takes a lot more to market it (tobacco),” Prom said.
In North Dakota, it cost approximately $40 per capita in 2009-11 — the most recent available estimate — for the tobacco industry to market its products, Prom said. She called it a positive sign that combating tobacco use is cheaper than marketing it.
The tobacco prevention center, using an annual state Health Department survey, estimated the state’s adult tobacco-using population at 192,105.
Krista Fremming, Tobacco Prevention and Control Program director for the state Health Department, said the department had expanded its advertising efforts for the NDQuits program this past June and July, something that had not been done in years past. The advertising campaign cost approximately $467,000.
The NDQuits program pushes to keep people from starting to smoke and helping people quit, using online sources, counselors and other services.
Fremming said the program served 341 people in July, up from 255 in June. But she said the program has not seen an increase in the number of people who use or want to quit e-cigarettes, possibly because people mistakenly think they are safe.
“There has been a lot of activity over the past couple of years … regarding e-cigarettes being used as a cessation aid,” Fremming said. “The truth is, we just don’t know if they’re safe.”
Fremming added that e-cigarettes are not approved by the U.S. Food and Drug Administration for that purpose. She said a large number of NDQuits members who reported e-cigarette use also smoke traditional cigarettes.
“A large portion of the upcoming NDQuits media campaign will focus on reaching smokeless and dual tobacco users,” Fremming said.
http://bismarcktribune.com/news/local/govt-and-politics/lawmakers-updated-on-efforts-to-fight-tobacco-use/article_7275a6e4-41ac-11e3-b615-0019bb2963f4.html

Conceal and carry: kids with e-cigarettes

By KEPR-TV, Pasco, WA
KEPR went to Kennewick High School to talk candidly with your kids; they say electronic cigarettes and pocket vaporizers are in their peers’ pockets and right under parents’ noses.
What you need to know about this growing trend.
“Is it here in the Tri-Cities,” KEPR asked a high school student, “yeah, definitely,” he replied.
We’re not just talking tobacco, we’re talking pot smoked through e-cigarettes. Within a minute of school getting out, KEPR found out not just if kids were using it, but where to go. “Go over there to the park,” another student told us.
A park, car, even your house to smoke and you probably won’t know. “The house won’t stink, clothes won’t stink, car won’t stink,” said Randy Schiewe, the owner of 9’s Electronic Cigarette shop in Kennewick. The same reason many adults are switching from a cigarette to an electronic smoker, but for kids consider it conceal and carry.
“It probably looks like a pen to them,” said Schiewe about parents who don’t know. He says it’s not the intent for electronic smokers to look like something they’re not. They were never intended for kids, and you have to be 18 to buy them. But just like kids can get their hands on alcohol, Schiewe says kids can get their hands on these and that’s why he wants to make sure you know what to look for.
The pens are elongated and most have a tapered end. “This would be the easiest way you would see liquid marijuana being used,” he said. People put liquid THC, the active ingredient of pot, or hash oil in the vaporizer instead of tobacco. As a parent, he says you might not find the vaporizer laying around, but you might find the charger and dismiss it. It looks like a cell phone charger, USB port on one end, a small box with a female screw port on the other. “You might find it plugged into a wall, computer or car,” he said.
Pull up You-Tube and in less than two minutes, a kid has a way to smoke pot without a trace.
“If there’s a way to do something bad with it, they will find a way,” said Schiewe. The one benefit says Schiewe, right now liquid THC isn’t as easy to get. “I am in the business and I don’t know how to get it,” he said. It’s a matter of being informed of the new trends hitting your kids to keep them safe. Schiewe hopes it’s a conversation you’ll now be ready to have.
Reporter’s notes:  However you feel on the electronic cigarette issue, I did find when talking to kids one overwhelming trend.  All the kids who knew teens who smoked e-cigs, called it a safe alternative.
http://www.keprtv.com/Conceal-and-carry-kids-with-e-cigarettes-229818931.html

Latest Research on Tobacco Use and Health Care Cost Has Global Implications

By Derek Yach, Executive Director, The Vitality Institute, and a former executive director of the World Health Organization (WHO), and Katie Tryon, M.D., Clinical Director, The Vitality Institute.
This month’s articles on health care costs and tobacco control in the South African Medical Journal (SAMJ) have far reaching implications beyond the shores of South Africa. The latest Global Burden of Disease data (Lancet, 2012) show that two of the top three risk factors that contribute to the highest burden of disease in Western Europe and the U.S. are tobacco and high Body Mass Index (BMI). This not only has serious health consequences, it has significant financial implications for governments, businesses and individuals — both in terms of direct health care costs and indirect costs such as work productivity.
One of the papers, published by RAND Corporation and Vitality, looks at the direct health care cost impact of these two risk factors. They show that severely obese individuals have a 23 percent higher health expenditure than those at a healthy weight, and moderately obese individuals have an 11 percent higher health cost. Furthermore, current or past smokers have an 11 percent higher health expenditure. The research was carried out on an insured South African population with similar demographic and health care profiles to counterparts in Western Europe and the US. It supports recent research carried out by Pandya et al. in the U.S. (Health Affairs, 2013) which predicted a significant increase in healthcare costs in the U.S. from cardiovascular disease due to the aging population, declining mortality and ever increasing obesity rates.
While Pandya et al. research highlighted declining smoking rates in the U.S. as positively influencing cardiovascular disease cost projections, they were not outweighed by the other pressures increasing the costs. An additional paper published by Reddy et al. also adds caution to the enthusiasm over declining smoking rates. It shows that while there has been a significant decline in smoking in school age children in South Africa between 1999 and 2008, there has been a marginal increase between 2008 and 2011 (to 16.9 percent in 2011). This has been mirrored in the U.S. by the CDC Youth Risks Behavior Surveillance that showed a significant decline in youth smoking rates between 1997 and 2009, but no significant decline between 2009 and 2011 (remaining at 18.1 percent in 2011). As today’s young smokers are our tomorrow’s smoking adults, a leveling of the decline, or even a potential increase could have significant impact on future health care costs.
Continued cigarette consumption worldwide, despite all interventions that have been tried, argues for a look at new breakthrough interventions to prevent the inevitable future costs.The editorial co-authored by David Sweanor of the University of Ottawa highlights the need to provide smokers with alternative viable options, rather than continuing along the same lines of controlling combustion cigarette supply and demand. Taxes have played a key role in getting smoking rates down across the world but an improved approach, complimentary to accepted policies in place, is needed to better tackle addiction. E-cigarettes have been a consumer breakthrough that should be embraced by public health personnel and governments rather than vilified. As they state, “We can still strive for complete nicotine cessation… but we are currently presented with the very real prospect of massively reducing the individual and population risks of smoking by something in the range of two orders of magnitude.”
High BMI and smoking remain among the top three risk factors that contribute to the highest burden of disease in Western Europe and the U.S., and the research mentioned above highlights this issue and discusses potential solutions, with implications far beyond South Africa.
The Vitality Institute is a global health think tank with the mission to advance knowledge about the evolving science and art of prevention and health promotion in order to build healthier societies. To join the conversation, follow us on Twitter at The Vitality Institute @VitalityInst.
http://www.huffingtonpost.com/dr-derek-yach/tobacco-use-research_b_4164593.html