Letter: Harm-reduction not best public policy for tobacco

There has been a good deal of talk about “harm-reduction” strategies (promoting alternative tobacco products, such as chewing tobacco or e-cigarettes, as safer alternatives to smoking cigarettes) as being good options for tobacco users to reduce the risk of using tobacco while maintaining the addiction to nicotine.
Reducing-harm strategies can be an option for an individual who wants to try to reduce his or her own risk of harm while maintaining an addiction. However, when it comes to tobacco use, harm-reduction strategies are not the best public policy to use to address the population-based well-being that public health strategies must address.
• How would it be if the public health professionals advocated for food handlers to wash their hands most of the time after using the bathroom rather than every time? After all, it would reduce the chances of contracting disease from someone who never washed his/her hands. One could say it is better than never washing one’s hands. The public policy must continue to be the best method of preventing disease transmission, that is: wash one’s hands every time, not just sometimes.
• I hear a lot about smokeless tobacco being a good alternative for adult smokers who don’t want to quit using tobacco. Consider this: It is not just adults who use chew. The sweeteners added and new products that have come on the market make it an easy way to addict our next generation to tobacco. North Dakota’s youth consume smokeless tobacco at a rate almost twice the national average (N.D., 13.6 percent, U.S., 7.7 percent). In addition, smokeless tobacco is not without its health hazards.
• E-cigarettes are often touted as a good alternative to tobacco use. We are told by some that the vapor is harmless. This is not true. It has not been regulated or studied enough to know how dangerous it is, but it is not harmless. There is another issue to consider. Have you ever noticed how candy cigarettes and now e-cigarettes mimic the activity a smoker would do with a cigarette? It models the smoking behavior and should not be discounted as harmless.
One of the core functions of public health is to promote strategies that protect the health and safety of the community. Public health providers are accountable to the community to provide up-to-date information and advocate for tried-and-true strategies to improve or maintain a community’s health status.
As a public health nurse, I cannot support harm-reduction policies that supports maintaining one’s addiction to tobacco. Harm- reduction policy is not sound public health policy.
The rationale that was brought up recently in a letter to the editor, that the tobacco user who is not willing or able to quit should have chewing tobacco or e-cigarettes researched and funded with tobacco prevention dollars in the state of North Dakota, falls short. The evidence is readily available regarding what works and how to gain access to help. The options are available, and they are FDA-approved and researched for safety and effectiveness. They are called nicotine replacement therapy and NDQuits at (800)-QUIT-NOW.
Knox, RN, is master of public health and certified tobacco treatment specialist with the Grand Forks Public Health Department Tobacco Prevention Program.
http://www.inforum.com/event/article/id/408308/

'Cowboys get cancer, too,' says speaker at smokeless tobacco summit in Missoula

By Alice Miller
For nine months, James Capps didn’t have a bite of food. He had to pour nutrition drinks into a feeding tube to get nourishment while he underwent and recovered from treatment for oral cancer.
Smokeless tobacco is dangerous, and Capps’ story is the testament.
Capps is featured in a short video and advertising campaign in Oklahoma that shares his story. After the video’s first week on television, the number of people requesting tobacco-cessation aids jumped 300 percent.
Capps said he loves his new role as an advocate and hopes his story gives people the push they need to quit.
“You don’t need that crutch to be someone you want to be,” he said. “You should do it without tobacco.”
Capps traveled to Missoula from his hometown of Atoka, Okla., to receive the Cliff Niles Creative Media Award during the seventh National Smokeless and Spit Tobacco Summit, held at the University of Montana this week.
The summit, held every other year, focuses on prevention and research about smokeless tobacco. Hundreds of people from around the country are attending the summit, which features more than 70 presentations.
UM’s College of Health Professions and Biomedical Sciences hosted the event and received $32,250 from the National Association of Chronic Disease to plan the summit, which is the only national conference of its kind.
Smoking takes center stage when people talk about tobacco use, said Patricia Nichols, an independent consultant for Montana’s Tobacco Use Prevention Program and co-chairperson of the summit’s smokeless advisory board.
However, smokeless tobacco is just as dangerous. It causes cancer and contributes to cardiovascular disease, Nichols said.
“We want people to know that this isn’t a safe habit, even if your grandpa did it,” she said.
Smokeless tobacco use tends to be more common in rural areas because it allows manual laborers to get the kick tobacco provides without tying up their hands, she said.
And smokeless tobacco requires people to spit.
“Which is a lot easier in rural locations,” she said.
***
Tobacco companies are constantly putting new products on the market, she said, and the rise in smoke-free public spaces and businesses equates to a resurgence in use of smokeless tobacco products.
As with other tobacco products, companies are targeting the younger generation, because they need more people to replace those who have quit or died, Nichols said.
One way Montana is fighting back against tobacco company advertising to younger people is through a tobacco-free rodeo program.
In 2010, the Montana High School Rodeo Association agreed to the Montana Tobacco Use Prevention Program’s request for the organization to adopt a more stringent tobacco-free policy, said Crissie Hansen, a prevention specialist out of Dillon.
Most parents, rodeo workers and fans abide by the policy, which prohibits tobacco use by anyone during rodeo events.
“We really have not had any friction on it,” Hansen said in response to a question about community feedback on the policy during a presentation Tuesday at the summit.
In addition to the policy, about 200 rodeo athletes have taken a pledge not to use tobacco. Athletes must sign the pledge if they want to participate in the reACT rodeo series and have a chance at end-of-season prizes. reACT is a student-based program advocating against tobacco use.
The rodeo program is a way for health workers to reach kids where they play – venues where tobacco companies have traditionally excelled, said Alison Reidmohr, a health educator with the Montana Tobacco Use Prevention Program.
Changing how kids look at tobacco and its use helps alleviate peer pressure to do something that has been associated with the rodeo scene, she said, adding some athletes are sharing their personal stories through commercials.
***
Capps, the Oklahoman who’s speaking out against smokeless tobacco, said he knows well the pressure cowboys feel to use tobacco.
Capps was hooked by the time he was 15, and he began dipping because that’s what every good Oklahoma cowboy did.
“So I thought dipping snuff was the way to fit in,” he said.
Girls thought it was nasty.
“Well, we’d just get another girlfriend,” he said.
Thirty years after he began dipping snuff, Capps got oral cancer at the base of his tongue. Because doctors couldn’t get to the tumor surgically, they put a port in his neck and pumped chemotherapy drugs directly to the tumor – 24 hours a day, seven days a week for seven weeks.
He received radiation therapy five days a week over the same time. Now, he has difficultly speaking, suffers from dry mouth and must wash down every bite of food with water.
The risks of getting cancer were there for him to see.
“I believe everybody knows there’s that chance,” he said. “But the key thing is this: It will never happen to me.”
Today, Capps knows differently.
“Now I know cowboys get cancer, too,” he said.
http://missoulian.com/news/local/cowboys-get-cancer-too-says-speaker-at-smokeless-tobacco-summit/article_5445e1e2-ff04-11e2-b71d-0019bb2963f4.html

Smoking Ban Tilts Odds Against Ambulance Calls From Casinos

by DEBORAH FRANKLIN
Public health advocates have lobbied hard in recent years to clear restaurants, bars and other workplaces of tobacco smoke, and the winds seem to be at their back.
Already, 36 states and the District of Columbia have enacted some version of an indoor smoking ban to protect the health of workers and patrons, and many local communities in other states have followed suit.
But state-regulated casinos are often exempted from such restrictions (as are, of course, the casinos on tribal lands).
“It’s politics,” says the University of California, San Francisco’s Stanton Glantz, who has spent decades tracing the damaging effects of secondhand smoke to the heart and lungs. “Tobacco and gaming interests really fight for these exemptions,” he tells Shots.
To get a rough measure of whether those exemptions for casinos actually hurt health, Glantz and a colleague scrutinized 13 years’ worth of ambulance call data from Colorado. In particular, they focused on Gilpin County — the high-country home to more than two dozen casinos within about three square miles. The researchers compared the number of calls for ambulances in the county before and after Colorado extended its workplace smoking bans to include casinos in 2008.
The effect seemed “surprisingly strong,” Glantz says of his finding published online this week in the journal Circulation. After the smoking ban in restaurants, bars and most other workplaces was initially enacted in 2006, the number of ambulance-summoning phone calls that were made from any location but casinos dropped by 22.8 percent.
But the number of such calls made from casinos stayed as high as it had been the year before. Then, two years later — after casinos banned smoking, too — the number of such emergency calls made from the grounds of a casino dropped by a little over 19 percent. Such calls from all locations have continued to stay down, years after the implementation of the smoking ban.
Considered in isolation the findings confirm only a correlation, not a causal link, Glantz says. Other factors, such as high gas prices, for example, or tough economic times could have slightly reduced the number of patrons who visited casinos during some of the years studied. Fewer patrons might need fewer emergency calls.
Plus, the database Glantz looked at didn’t reveal the nature of each emergency. Surely some childbirths, dizzy spells and panic attacks were mixed in with the heart attacks, asthma attacks and strokes.
But a study of nine other states, published last week and covering much the same time period, suggests that, contrary to the fears of some business owners, “smoke-free laws did not have an adverse economic impact on restaurants or bars in any of the states studied,” according to the authors.
And in the context of what’s known about how smoke affects physiology, the way the number of calls decreased after each ban makes it “very likely,” Glantz says, that curtailing smoking inside the casinos was what reduced the phone calls about health emergencies.
“All the pieces fit together,” he says.
Many other studies have shown that, in addition to aggravating lung conditions, inhaled smoke can very quickly make platelets stickier and irritate the lining of blood vessels in ways that can lead to the sudden formation of artery-clogging clots that can cause strokes or heart attacks, Glantz says. Last fall two other studies showed that once smoking was banned in bars and workplaces, the number of deaths from heart attacks dropped within months.
http://www.npr.org/blogs/health/2013/08/05/209149956/smoking-ban-in-casinos-linked-to-fewer-caller-for-ambulances

1 in 20 School-Aged Kids Use Smokeless Tobacco

Susan E. Matthews, Everyday Health Staff Writer
Approximately 1 in 20 school-aged U.S. kids use smokeless tobacco products such as dip, chewing tobacco or snuff, a new study found. While smokeless products are often promoted by tobacco companies as “healthier” options, the study also found that teens who use them are not replacing traditional tobacco with smokeless tobacco, but instead are using both.
Since young people aren’t switching products and are instead combining them, any potential health benefits associated with switching to smokeless brands are lost. In fact, by using both types of products, young adults may actually be increasing their risks for tobacco-associated illnesses.
And in a blow to the idea that transitioning to smokeless products might help teens quit tobacco, the survey showed that less than half — 40.1 percent — of smokeless tobacco users intended to quit.
Researchers from the Harvard School of Public Health used data from the 2011 National Youth Tobacco Survey, which included more than 18,000 students in grades 6 through 12 who were asked about their use of a variety of tobacco products over the previous 30 days. Of the surveyed students, 5.6 percent used smokeless tobacco products, and 72.1 percent of these students also used conventional tobacco products including cigarettes, cigars, and water pipes.
In recent years, several novel forms of smokeless tobacco have come onto the market, such as snus, which is moist snuff, and dissolvable tobacco. Of the students using smokeless tobacco, 5 percent used traditional products, while 1.9 percent used snus, and 0.3 percent used the dissolvable tobacco. Compared to traditional smokeless tobacco and cigarettes, these products contain fewer carcinogenic nitrosamines, and may pose less health risk. As a result, tobacco companies have promoted them as a better tobacco alternative.
Males in the survey more likely to use smokeless tobacco products than females (9 percent versus 2 percent), and students over 18 were also more likely to use them than students aged 9 to 11 (10.8 percent compared to 2.2 percent). Smokeless tobacco use has stayed relatively consistent, at around 5 percent, while cigarette use has declined over the past decade, the researchers noted.
“Promotion of snus or dissolvable tobacco products at a population level may not have benefits and might even cause harm from dual use with combustible and/or conventional smokeless tobacco products,” the researcher wrote in the study, published in Pediatrics. Student who reported noticing warning labels on the products were actually more likely to use tobacco, suggesting that these warning aren’t effective, according to researchers.
The American Academy of Pediatrics has called for further regulation of novel tobacco. The study authors suggested more effective warning labels on smokeless products, and that physicians take more initiative in bringing up the harms of smokeless tobacco in consultations with young adults.
Based on the survey results, the researchers concluded that peer pressure was the most likely influence on smokeless tobacco use. If a close friend used these products, an individual was almost 10 times more likely to also use them, the study found.
Another study out today in Pediatrics found that children of smokers were 3.2 times more likely to smoke than children of non-smokers, even if the smoking parent had quit before the child was born. For children over age 11, smoking prevalence ranged from 23 to 29 percent of children whose parents had once smoked, compared to 8 percent of children of parents who had never smoked. The researchers, from Purdue University and Pennsylvania State University, suggested the study supported the idea of genetic predisposition towards smoking.
http://www.everydayhealth.com/stop-smoking/1-in-20-school-aged-kids-use-smokeless-tobacco-7884.aspx

Parental smoking tied to kids' risk of lighting up

By Andrew M. Seaman
NEW YORK (Reuters Health) – Children born to parents with a history of cigarette smoking are more likely to light up than kids of people who never smoked, according to a new U.S. study.
Despite falling smoking rates across age groups, researchers found that children raised by current or even former smokers were about three times more likely to be smokers themselves during their teenage years than kids raised by parents who never smoked.
“Things are getting better, but we can see it’s best among the consistent non-smoking households,” said Mike Vuolo, the study’s lead author from Purdue University in West Lafayette, Indiana.
Previous research has produced similar results, but the new study was based on 23 years of data on the smoking patterns of the parents in the study – 214 people who were ninth grade students in 1988 – to see whether their habits from adolescence onward were tied to their children’s risk of smoking.
For example, Vuolo and his colleague, who published their findings in Pediatrics, were able to compare the children of never-smokers and people who had smoked consistently since high school.
They had data on 314 children of the original group of teens. In 2011, the kids of the second generation – all at least 11 years old – were asked if they had smoked cigarettes within the last year. Sixteen percent said yes.
Among the children of parents who had never smoked, about 8 percent reported smoking cigarettes during the past year.
That compared to between 23 percent and 29 percent of the children of current or former smokers.
The researchers also looked at the parents’ “trajectories” of smoking for clues about the parental influence on the children’s behavior.
They found that 23 percent of kids whose parents had smoked as adolescents but quit or reduced their smoking as young adults were smokers themselves.
Among kids whose parents had smoked little or not at all in high school but started smoking in adulthood, 29 percent were smokers.
And 25 percent of children whose parents had smoked consistently since high school were smokers.
In addition, children who said they had smoked during the last year were more likely to be older, to display more symptoms of depression and to have low grades and low self-esteem. They were also more likely to feel distant from their parents and to have an older sibling who smoked.
While the study can’t prove that parental smoking caused the children to adopt the habit, Dr. Jonathan Winickoff, who has studied teen smoking behavior but wasn’t involved in the new research, said the new results support past findings.
“I think the first confirmatory result is that if you are a parent who smokes, your teenage child has a three-fold increased risk of smoking,” Winickoff, an associate professor in Harvard Medical School’s Department of Pediatrics in Boston, said.
He added that there are several theories on why children of smokers may be at an increased risk of picking up the habit, including modeling their parents’ behaviors, easy access to cigarettes and being “primed” for an addiction through second-hand smoke exposure.
He cautioned, however, that the new study can’t determine whether a child’s risk of becoming a smoker falls if the parents stop smoking early-on, such as in their early adult years, because the group that contained those early quitters also included some current light smokers.
“They can’t say – based on these data – whether earlier parental quitting is associated with less smoking in their kids,” he said.
The researchers also warn that their findings may not apply to all smokers, because only 15 percent of the people included in their survey had a bachelor’s degree or more education and most had their first child at a fairly young age.
Vuolo added that they don’t know whether these smoking rates in the second generation are an improvement over the past because they’re only looking at one point in time. Going forward, they will be able to look at smoking rates over time as they collect more data.
“We’re going to be able to answer that question,” he said.
http://kfgo.com/news/articles/2013/aug/05/parental-smoking-tied-to-kids-risk-of-lighting-up/

Higher Minn. cigarette prices drive more to try to quit

by Mark Zdechlik, Minnesota Public Radio
MAPLEWOOD, Minn. — Anan Barbarawi expected cigarette sales at his store to drop once Minnesota’s $1.60 a pack tax increase took hold in July. But Barbarawi, manager at Maplewood Tobacco, was shocked to see his numbers plunge “50 to 70 percent.”
On the bright side, Barbarawi said, sales of electronic cigarettes have taken off.
A month into the tax increase, it’s not clear yet how much cash Minnesota is collecting. The stiff tobacco levy, though, is changing behavior.
Programs that help people quit smoking say they’ve seen a dramatic increase in the number of Minnesotans contacting them for help because of the higher prices. Demand for tobacco alternatives is up.
State officials maintain that was always the goal when they pushed the total tax to $2.83 per pack. They say they’d be happy if they didn’t get any tax revenue from tobacco and argue the state would save huge amounts of money on health care if Minnesotans didn’t smoke.
There’s no doubt cost led Bob Holmes to stop at the end of May — a month before the cigarette tax increase took effect.
“Yeah, it might have helped push me into quitting smoking,” said Holmes of St. Paul, who’d driven his friend to the Maplewood smoke shop to pick up some cheap cigars.
It’s good the higher tax is getting people to stop smoking, he said. Still, he and many other smokers thinks it’s not fair that many of those hardest hit by the tax can least afford it.
Tobacco tax figures from July on are not yet available, but anti-smoking advocates say the effects are visible already.
Calls to Minnesota’s QUITPLAN program were up more than 250 percent over the same time last year and website hits were up almost 300 percent, for the first half of July, said Mike Sheldon, spokesman for ClearWay Minnesota, the group that runs QUITPLAN.
ClearWay offers free quit-smoking counseling using $202 million from Minnesota’s 1998 legal settlement with tobacco companies. Summer is usually not a busy time, he said.
The group says about 625,000 adults in Minnesota smoke. About three of every 10 QUITPLAN clients abstain from tobacco for at least six months, Sheldon added.
The tobacco tax increase inspired Erik Nordstrom, 38, to look for options. The St. Paul man, a smoker since age 14, hopes to wean himself from nicotine with e-cigarettes. That’s what brought him to the tobacco store in Maplewood.
Quitting tobacco is the ultimate goal, but there was an immediate need to cut spending. He was fed up with paying almost $300 for his monthly cigarette fix.
“When I go into a store and I’m paying $7.75 (for cigarettes), there’s something seriously wrong with that picture,” he said. “I had a pack of Newports on me which is the last pack I’ll be smoking.”
http://minnesota.publicradio.org/display/web/2013/08/02/health/cigarette-prices

Very little is known about the health effects of e-cigarettes

DEAR MAYO CLINIC: I’ve been a smoker for years. I’m thinking about switching to electronic cigarettes or to a nicotine inhaler because I’ve heard they aren’t as bad for you as regular cigarettes. Is that true?
ANSWER: Electronic cigarettes and nicotine inhalers both deliver nicotine to your body without tobacco. But that’s where the similarity ends. The two are quite different when it comes to how they’re used and how much doctors know about their safety. Nicotine inhalers are a proven safe and effective way to help people stop smoking. In contrast, very little is known about the health effects of electronic cigarettes.
Electronic cigarettes, or e-cigarettes, are battery-operated devices that look like regular cigarettes. Like traditional tobacco cigarettes, they contain nicotine. When you use an e-cigarette, a liquid inside it that includes nicotine is heated and turns into a vapor you inhale. It also makes a vapor cloud that looks like cigarette smoke.
The manufacturers claim that e-cigarettes are a safe alternative to tobacco cigarettes. But there are significant questions about the safety of these products. When the U.S. Food and Drug Administration (FDA) analyzed samples of two popular brands of e-cigarettes, they found varying amounts of nicotine and traces of toxic chemicals, including substances that are known to cause cancer.
The liquid inside many e-cigarettes contains a substance called propylene glycol. It creates the e-cigarette’s vapor. Other common uses of propylene glycol are in cosmetics and as an ingredient in fog machines and antifreeze. The specific health effects of this product are not clear.
No studies have been done to examine the safety of e-cigarettes. As a result, there is no evidence that doctors can use to assess the impact this product may have on a person’s body. Also, no convincing evidence shows that e-cigarettes are useful in helping people to eventually stop smoking.
It is also important to note that e-cigarettes are not regulated by the FDA. E-cigarettes are currently regulated as a tobacco product — even though they contain no tobacco. Because of this classification, there’s no oversight from the FDA to ensure they are safe. Like regular cigarettes, you can buy e-cigarettes without a prescription.
Nicotine inhalers, on the other hand, are classified as a type of medicine. They are regulated by the FDA and available by prescription only. They fall into a class of drugs known as nicotine replacement therapy, and they are used as part of stop-smoking treatment plans.
As with e-cigarettes, nicotine inhalers give you a dose of nicotine when you puff on them. Unlike e-cigarettes, the amount of nicotine you receive is controlled and small. And with nicotine inhalers you receive only nicotine. No other ingredients are included.
Nicotine inhalers have been carefully studied in controlled clinical research trials. They are safe and proven to be effective in helping people stop smoking. If you’re interested in using nicotine inhalers as part of a program to help you stop smoking, talk to your doctor. He or she can discuss the inhalers with you in more detail, as well as provide information about other medications and resources available to help you quit.
With the data available now, Mayo Clinic does not recommend the use of e-cigarettes. At this time, we simply don’t know enough about them. They have not been proven safe, nor have they been shown to be effective in helping people stop smoking. — Jon Ebbert, M.D., Nicotine Dependence Center, Mayo Clinic, Rochester, Minn.
(Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. E-mail a question to medicaledge@mayo.edu. For more information, visit http://www.mayoclinic.org.)
http://www.chicagotribune.com/health/sns-201308011500–tms–mayoclnctnmc-a20130801-20130801,0,536387.story

R.J. Reynolds Pulling Back on Dissolvable Tobacco Products

WINSTON-SALEM, N.C. – R.J. Reynolds Tobacco Co. is cutting back on the marketing and sales of its dissolvable tobacco products after more than four and a half years in test markets.
According to a report by the Winston-Salem Journal, Camel Orbs, Camel Sticks and Camel Strips will remain in limited distribution at point-of-sale sites in Denver and Charlotte, N.C., as well as on the age-verified website www.cameldissolvables.com.
“At this time, there are no plans for any marketing beyond these channels,” said Richard Smith, spokesman for Reynolds. “We’ve found in our conversations with adult tobacco consumers that while there’s strong interest in the category, a different product form may present a better option over the long term. Though for now, Camel Sticks, Strips and Orbs will remain available while we continue to gather learnings.”
Dissolvable tobacco products have garnered criticism from organizations such as the Campaign for Tobacco-Free Kids, which believe that they will appeal to children due to their flavoring and packaging. Reynolds offered these products in child-resistant packaging, but some analysts have speculated that the difficulty in opening them may have had a detrimental effect, according to the report.
Others speculated that the market for dissolvables may already prefer other products. “My thought would be that the market for spit-less, non-combustible tobacco is probably already taken up by snus,” John Spangler, a professor of family and community medicine at Wake Forest School of Medicine, told the news outlet. Reynolds took just two and a half years to move Camel Snus from test markets to national distribution after its April 2006 debut.
Reynolds initially offered its dissolvables for sale in Columbus, Ohio; Portland, Ore.; and Indianapolis before moving them to Denver and Charlotte. The company did not dictate retail prices, but suggested that they sell at a comparable price to a tin of Camel Snus, or between $4 and $4.50.
http://www.csnews.com/top-story-supplier_news-r.j._reynolds_pulling_back_on_dissolvable_tobacco_products-64184.html

NC law takes effect banning e-cigarettes to minors

MITCH WEISS
Associated Press
CHARLOTTE, NC (AP) — At North Carolina smoke shops and other retailers, the warning signs are going up.
A law banning the sale of e-cigarettes to minors takes effect Thursday.
Retailers now face the same misdemeanor charge if they sell e-cigarettes to a minor as they already did for other tobacco products. Penalties can be as high as a $1,000 fine.
So retailers say they’ll be careful.
E-cigarettes are battery-powered devices that heat a liquid nicotine solution, creating vapor that users inhale. Some are made to look like a real cigarette with a tiny light on the tip that glows.
Devotees tout them as a way to break addiction to real cigarettes.
But public health officials say the safety of e-cigarettes and their effectiveness in helping people quit regular smokes haven’t been fully studied.
http://www.wwaytv3.com/2013/07/31/nc-law-takes-effect-banning-e-cigarettes-to-minors

E-Cigarette Sales to Hit $1 Billion

By ALAN FARNHAM
E-cigarettes—a relative novelty three years ago–are about to hit $1 billion in sales, according to Wells Fargo securities analysts.
While that’s only 1 percent of sales of traditional cigarettes, the number of consumers who say they’ve tried e-smokes is growing fast. The sale of e-cigarettes totaled just $500 million last year.
According to the most recent survey by the Centers For Disease Control and Prevention, in 2011 about 21 percent of adults who smoke traditional cigarettes said they had tried the electronic alternative, up from about 10 percent in 2010.
“Overall,” says a CDC press release, “about 6 percent of all adults have tried e-cigarettes, with estimates nearly doubling from 2010.”
“E-cigarette use is growing rapidly,” said CDC director Tom Frieden in a February 2013 release announcing the survey’s findings. “There is still we do not know about these products.”
E-cigarettes, in their most popular form, look like conventional tobacco cigarettes. They do not, however, contain leaf tobacco and they do not burn. As described by CDC, they are battery-powered devices that provide inhaled doses of nicotine vapor and flavorings. Because they do not burn and do not produce smoke, their advocates consider them more socially acceptable than traditional cigarettes.
Their detractors do not. The Long Island Rail Road declared earlier this month that e-cigarettes violate LIRR’s smoking ban, which declares it unlawful for railroad patrons to “burn a lighted cigarette, cigar, pipe or any other matter or substance which contains tobacco or any tobacco substitute.”
SAFER SMOKE OR NEW BAD HABIT?
In the eyes of some, the mere appearance of someone smoking—even smoking a non-tobacco, electronic substitute—creates the dangerous impression that smoking is okay.
“The use of e-cigarettes in public areas in which cigarette smoking is prohibited could counter the effectiveness of [smoke-free compliance] policies by complicating enforcement and giving the appearance that smoking is acceptable,” the CDC report says.
Gregory Conley, legislative director at the Consumer Advocates for Smoke-Free Alternatives Association, scoffs at that attitude, saying, “It looks like smoking…so it must be evil.”
Conley’s association, he says, represents some 5,000 e-cigarette users. Conley says e-cigarettes “annoy people who don’t understand that they’re a great advertisement for smoking-cessation” and “people who believe no one should be allowed to have nicotine in any form.”
NO PROOF E-CIGARETTES COMBAT ADDICTION
The question whether e-cigarettes can be viewed as an aide to quitting smoking, for conventional tobacco users, is a contentious one. Eli Alelov, CEO of LOGIC Technology, makers of LOGIC e-cigarettes, says e-cigarettes are not a health product, and that he’s not claiming they are. At the same time, however, he points out, an e-cigarette contains no tar and no tobacco. It produces no second-hand smoke. Regulations prevent his suggesting that his product is healthier or safer, he says. “So, we leave that up to the public: they can use their logic.”
Alelov says that the people who hate e-cigarettes most include both big tobacco and the tax man. E-cigarettes aren’t taxed the same as regular cigarettes, so “the states hate us, because they’re losing money,” Alelov said.
Five years from now, he thinks, 30 to 40 percent of traditional smokers will have switched to e-cigarettes—perhaps as many as 20 million customers. In five years e-cigarette sales will grow to $15 billion to $20 billion a year, he thinks.
As for what further restrictions might be coming down the pike, Alelov says he’s not particularly worried about any regulations the FDA may eventually promulgate. (The FDA currently does not regulate e-cigarettes, but it is expected to in the future.) He expects the FDA’s regulations, when they come, would apply to packaging, labeling, and minimum age of the buyer.
Alelov says there are some venues where he, personally, won’t smoke an e-cigarette. They include McDonalds, movie theaters and children’s playgrounds. Everywhere else, however — everywhere that nicotine gum or nicotine patches are permitted — he feels e-smokes should be, too.
http://abcnews.go.com/Business/electronic-cigarette-sales-billion/story?id=19815486