Study: People with Diabetes who Smoke Have Higher Risk of Unplanned Medical Visits

TFND’s former president Dr. Eric Johnson was among the authors published in a study showing adult patients with diabetes who smoke have a higher risk of unplanned medical visits. Dr. Johnson says the study was a “Collaboration between University of North Dakota School of Medicine and Health Sciences Department of Family and Community Medicine, UND Masters of Public Health Program, and Sanford Health recently published.”

To read the study, click here

Community Readiness Survey Shows Startling Concerns About Tobacco in North Dakota

The 2019 Community Readiness Survey of North Dakota is showing adults across the state are deeply worried about tobacco use, particularly among youth.

Just a few numbers in the survey show:

  • 3 out of 4 (75 percent) of ND adults believe tobacco use is a moderate or serious problem among youth.
  • Nearly 92 percent of adults don’t believe kids should be using e-cigarette products
  • Nearly 57 percent of adults say the tobacco taxes in North Dakota should be increased, something that hasn’t happened since 1993.
  • 82 percent of people say e-cigarettes should be taxed at the same rate as other tobacco products

To read the full survey, click here

NY Ban on Flavored Tobacco Now Active

New York state’s law banning the sale of flavored tobacco went into effect on Monday, May 18. Below is a  statement from Matthew L. Myers, President, Campaign for Tobacco-Free Kids:

“New York’s historic law prohibiting the sale of all flavored e-cigarettes takes effect today. This action is the right move to reverse skyrocketing youth use of e-cigarettes and couldn’t come at a better time as health experts are warning that smoking and vaping can worsen the effects of COVID-19. It’s more critical than ever to keep our lungs healthy. This measure is necessary to prevent e-cigarettes from addicting a new generation of kids and reversing the enormous progress we have made in reducing youth tobacco use.

Also going into effect is a statewide ban on the sale of all tobacco products at pharmacies. New York follows Massachusetts in taking this important action, and the city of Oakland did the same just last week. We applaud Gov. Andrew Cuomo for his strong leadership in pushing for these measures.

Especially during the COVID-19 pandemic, we urge Governor Cuomo and state lawmakers to continue and step up the state’s efforts to prevent kids from using any tobacco products and help current tobacco users quit. That includes providing robust funding for the state’s tobacco prevention and cessation programs.

The New York legislature should also tackle the serious problem of other flavored tobacco products – especially menthol cigarettes and flavored cigars – when they next return to session. It’s time to stop tobacco companies from targeting and addicting kids with flavored products once and for all and put an end to the tobacco industry’s long and harmful history of targeting kids and African Americans with menthol cigarettes. The coronavirus pandemic should serve as a wakeup call to make our lungs healthier now and for the future.

New York is one of four states that have prohibited the sale of flavored e-cigarettes, along with Massachusetts, New Jersey and Rhode Island (Massachusetts prohibited the sale of all flavored tobacco products). We strongly urge other states – including neighboring Connecticut and Vermont – to join in protecting the health of our kids by ending the sale of flavored tobacco products.

There is no time to waste as the youth e-cigarette epidemic has gone from bad to worse. According to the 2019 National Youth Tobacco Survey (2019 NYTS), e-cigarette use among high school students nationwide increased to 27.5% in 2019 compared to 11.7% in 2017. Altogether, more than 5.3 million middle and high school students now use e-cigarettes. In New York, 27.4% of high school students use e-cigarettes, compared to 4.8% who smoke cigarettes. The evidence is clear that flavored e-cigarettes have fueled this epidemic – 97% of youth e-cigarette users report using a flavored product in the past month, and 70% cite flavors as the reason for their use.”

WHO Statement on Tobacco Use and Covid-19

WHO statement: Tobacco use and COVID-19

Tobacco kills more than 8 million people globally every year. More than 7 million of these deaths are from direct tobacco use and around 1.2 million are due to non-smokers being exposed to second-hand smoke.

Tobacco smoking is a known risk factor for many respiratory infections and increases the severity of respiratory diseases. A review of studies by public health experts convened by WHO on 29 April 2020 found that smokers are more likely to develop severe disease with COVID-19, compared to non-smokers.

COVID-19 is an infectious disease that primarily attacks the lungs. Smoking impairs lung function making it harder for the body to fight off coronaviruses and other diseases. Tobacco is also a major risk factor for noncommunicable diseases like cardiovascular disease, cancer, respiratory disease and diabetes which put people with these conditions at higher risk for developing severe illness when affected by COVID-19. Available research suggests that smokers are at higher risk of developing severe disease and death.

WHO is constantly evaluating new research, including research that examines the link between tobacco use, nicotine use, and COVID-19. WHO urges researchers, scientists and the media to be cautious about amplifying unproven claims that tobacco or nicotine could reduce the risk of COVID-19.  There is currently insufficient information to confirm any link between tobacco or nicotine in the prevention or treatment of COVID-19.

Nicotine replacement therapies, such as gum and patches are designed to help smokers quit tobacco. WHO recommends that smokers take immediate steps to quit by using proven methods such as toll-free quit lines, mobile text-messaging programs, and nicotine replacement therapies.

Within 20 minutes of quitting, elevated heart rate and blood pressure drop. After 12 hours, the carbon monoxide level in the bloodstream drops to normal. Within 2-12 weeks, circulation improves and lung function increases. After 1-9 months, coughing and shortness of breath decrease.

WHO stresses the importance of ethically approved, high-quality, systematic research that will contribute to advancing individual and public health, emphasizing that promotion of unproven interventions could have a negative effect on health.

Oakland Bans Sale of Flavored Tobacco

The City of Oakland (CA) unanimously approved a measure to bans the sale of all flavored tobacco products at all locations within the city. Matthew L. Myers, President, Campaign for Tobacco-Free Kids, posted this statement about the decision:

“Oakland’s City Council today took an important step to protect the health of its kids by unanimously (8-0) ending the sale of all flavored tobacco products at all locations with no exemptions. This action – which covers flavored e-cigarettes, cigars and menthol cigarettes – is the right move to reverse skyrocketing youth use of e-cigarettes and stop tobacco companies from targeting and addicting kids with flavored products. It also couldn’t come at a better time as health experts are warning that smoking and vaping can worsen the effects of COVID-19. It’s more critical than ever to keep our lungs healthy. This measure is necessary to prevent flavored tobacco products from addicting a new generation of kids and reversing the enormous progress we have made in reducing youth tobacco use.

Oakland was one of the first cities to prohibit most sales of flavored tobacco products when it acted in 2017. But its exemption for so-called adult-only tobacco stores created a loophole that the tobacco industry has shamelessly exploited. While just a handful of such shops existed before the law, more than 55 currently operate in the city, with some of these “adult-only tobacco stores” simply being walled-off areas in a store or gas station.

There is no time to waste as the youth e-cigarette epidemic has gone from bad to worse. According to the 2019 National Youth Tobacco Survey (2019 NYTS), e-cigarette use among high school students nationwide increased to 27.5% in 2019 compared to 11.7% in 2017. Altogether, more than 5.3 million middle and high school students now use e-cigarettes. The evidence is clear that flavored e-cigarettes have fueled this epidemic – 97% of youth e-cigarette users report using a flavored product in the past month, and 70% cite flavors as the reason for their use.

Flavored products have long been a favorite tobacco industry strategy for targeting kids. In addition to e-cigarettes, flavored cigars have proliferated in recent years and become popular with kids, while more than half of youth smokers – including seven out of ten African-American youth smokers – smoke menthol cigarettes. The evidence shows that menthol makes it easier for kids to start smoking and harder for smokers to quit. Oakland’s law helps put an end once and for all to the tobacco industry’s long and harmful history of targeting kids and African Americans with menthol cigarettes. The city of Los Angeles, the state of California and others should follow suit by also ending the sale of all flavored tobacco products with no exemptions.

The Oakland City Council also voted to prohibit the sale of tobacco products at pharmacies, provide stronger compliance and enforcement of the law prohibiting the sale of flavored tobacco products, and clarify that the law penalizes retailers who violate the law and does not penalize youth for possession, use or purchase of tobacco products.”

Dr. Stanton Glantz- Puff Bar continues to thumb its nose at FDA

Here’s a post from Dr. Stanton Glantz, the Director of the Center for Tobacco Research Control & Education, about loopholes in regulations allowing products like Puff Bars to continue to be marketed to kids.

You can read his post here.

City of Lincoln Passes T21 ordinance

The city of Lincoln passed a T21 ordinance during their April 30 meeting. TFND supports this measure for all of North Dakota’s cities and counties. The vote to change ordinance 12-07-12 Sale of Tobacco To and Possession, Sale or use by a person under the age of 21 ordinance was unanimous.

The age for purchase and possession of all tobacco products was increased to age 21 to match federal laws and allow for local enforcement of those laws. If cities don’t have local ordinances recognizing age 21 for tobacco products, it makes it difficult to enforce because violators will go to Federal Court instead of local. It is important for all cities to pass local ordinances for age 21.

Below are additional updates to ordinance:

  • Electronic Nicotine Devices (ENDS) will be now be categorized as tobacco products in Lincoln. Currently, state law for tobacco products does not include ENDS products and ENDS do not have a tobacco tax.
  • Child-resistant packaging requirements in accordance to ND State Law
  • Penalties for purchase and possession of tobacco have been increased. State law is $25, and Lincoln’s is going to be $100/$50.
  • Retailers (as well as the clerks) will now be able to be fined for selling tobacco to youth. Current ND law does not do penalize the retail establishment but rather the clerk. Lincoln’s ordinance will now do both. Structure fines for tobacco retailers.
  • Lincoln will implement a local retailer tobacco license to know who is currently selling tobacco.
  • Lincoln will also implement a ban on mobile retailers selling tobacco products to protect youth and easier to conduct a compliance checks at bricks and mortar buildings.

 

Thank you to our friends at the Bismarck Tobacco Free Coalition and the Lincoln City Council for their support and work on this important issue!

 

FDA Warns Manufacturers and Retailers to Remove Certain E-Cigarette Products Targeted to Youth from the Market

The Food and Drug Administration (FDA) sent warnings to 10 different retailers and manufacturers on April 27 to pull e-cigarette products because they were marketing to youth. Below is the full press release from the FDA, as well as a link to their website by clicking here.

 

FDA Warns Manufacturers and Retailers to Remove Certain E-cigarette Products Targeted to Youth from the Market

Agency Continues to Target the Sale of Unauthorized, Flavored E-cigarette Products That Appeal to Youth

Today, the U.S. Food and Drug Administration issued ten warning letters to retailers and manufacturers who sell, manufacture and/or import unauthorized electronic nicotine delivery system (ENDS) products targeted to youth or likely to promote use by youth. The warning letters were sent to establishments marketing unauthorized products, such as a backpack and sweatshirt designed with stealth pockets to hold and conceal an e-cigarette, ENDS products that resemble smartwatches, or devices appearing as children’s toys such as a portable video game system or fidget spinner. Warning letters were also issued to companies marketing e-liquids that imitate packaging for food products that often are marketed and appeal to youth, such as candy, or feature cartoon characters like SpongeBob SquarePants.

These warning letters are part of the FDA’s ongoing enforcement efforts against ENDS and other deemed tobacco products illegally on the market. The warning letters are also in line with the agency’s stated enforcement priorities against any ENDS product targeted to youth or likely to promote use by youth. If the recipients of these warning letters do not cease the manufacture, distribution and/or sale of these unauthorized tobacco products, they risk additional FDA action such as an injunction, seizure and/or civil money penalty actions.

“The FDA is focused on manufacturers and retailers that make and sell ENDS products that are targeted to youth and increase their appeal. The public should really be outraged by these products. The FDA is especially disturbed by some of these new products being marketed to children and teens by promoting the ease with which they can be used to conceal product use, which appeals to kids because it allows them to conceal tobacco product use from parents, teachers, law enforcement or other adults,” said Mitch Zeller, J.D., director of the FDA’s Center for Tobacco Products. “Even in the midst of the COVID-19 pandemic, we have not lost our focus on protecting youth against the dangers of e-cigarettes and will do everything we can to take action. These warning letters should send a clear message to all tobacco product manufacturers and retailers that the FDA is keeping a close watch on the marketplace. If you’re marketing or selling these products to youth, the FDA will not tolerate it.”

The following retailers and/or manufacturers or importers received a warning letter:

  • Vaprwear Gear, LLC (manufacturer, online retailer)
  • Vapewear, LLC (manufacturer, online retailer)
  • Wizman Limited (manufacturer, online retailer)
  • EightCig, LLC (online retailer)
  • Ejuicepack, LLC (online retailer)
  • Vape Royalty, LLC (online retailer)
  • VapeCentric, Inc. (online retailer)
  • Dukhan Store (online retailer)
  • VapeSourcing (online retailer)
  • Shenzhen Uwell Technology Co., Ltd. d/b/a DTD Distribution Inc. (importer, retailer)

These products appeal to youth in the way they are designed and labeled. For example, Vaprwear Gear’s pullover and backpack products hold pod systems that deliver vapor through hosing discreetly woven through hidden pockets. This design allows the products to be used for vaping without raising the attention of parents, teachers or other adults. Similarly, the Vapewear vWaTch Starter Kit, Wizman Puff Boy Mod and VooPoo Rota 340mAh Pod System Kit look like products that are popular with kids, such as smartwatches, video game systems and fidget spinners, that can be carried or worn without revealing they are tobacco products. Under the Federal Food, Drug, and Cosmetic Act (FD&C Act), all these products are considered tobacco products because they are made or derived from tobacco and intended for human consumption or components or parts of such products. Images and additional details of each product are included in the individual warning letters available on CTP’s website.

The FDA has also issued warning letters to 73 brick-and-mortar retailers for selling unauthorized flavored, cartridge-based ENDS products. This follows 22 warning letters that FDA issued last month for similar violations to online and brick-and-mortar retailers and manufacturers across the country. These warning letters are part of a series of ongoing actions consistent with the FDA’s recently issued policy of enforcement priorities for e-cigarettes and other deemed products on the market.

Last month, in line with the agency’s actions to protect the health and well-being of staff during the COVID-19 outbreak, the FDA issued a partial stop work order to the entities the agency contracts with at the state level for activities such as compliance checks and vape shop inspections. The inspections related to the actions announced today occurred before the stop work order. The FDA continues to evaluate the effect of COVID-19 on its programmatic activities and will continue to communicate any changes as they occur. Guided by health and safety considerations, the FDA will continue taking appropriate actions, as outlined by its priorities, on a rolling basis.

These warning letters notify the retailers and manufacturers that new ENDS products without a marketing authorization order are adulterated and misbranded, and selling or distributing these products to customers in the U.S. is prohibited under the FD&C Act. Retailers and distributors are encouraged to communicate with their suppliers to discuss possible options for the unauthorized products in their inventory.

Additionally, as part of the agency’s efforts, the FDA has issued import alerts (here and here) for unauthorized tobacco products, including certain unauthorized ENDS products, imported into the U.S. informed by the agency’s enforcement priorities outlined in FDA’s guidance. Adulterated and misbranded tobacco products offered for import into the United States are subject to detention and refusal of admission. The FDA has also issued letters to more than 110 companies seeking information about the legal marketing status of more than 140 ENDS products.

Ultimately, manufacturers that intend to continue marketing any deemed, new tobacco product on the market as of Aug. 8, 2016—including ENDS products—must submit an application to the FDA by Sept. 9, 2020 that demonstrates that the product meets the applicable standard in the law, such as whether the product is appropriate for the protection of the public health. This date was recently extended (from May 12, 2020) due to the impact of the coronavirus pandemic. As a resource for manufacturers preparing and submitting tobacco product applications for new deemed products, the FDA recently launched a new webpage to provide a single location for all relevant information, including tips and resources on the application submission processes. For certain deemed tobacco products, the FDA is already prioritizing its enforcement, as outlined in its guidance on enforcement priorities for ENDS and other deemed tobacco products.

All of these efforts, in addition to enforcement of the new law raising the federal minimum age for sale of tobacco products from 18 to 21 years and the recent expansion of the FDA’s public education campaign to include videos featuring teenagers sharing cautionary tales about their e-cigarette addiction, are aimed at keeping these products out of the hands of youth. The agency also recently released new resources with ScholasticExternal Link Disclaimer for middle and high-school educators and school administrators. The materials, which include new lessons, worksheets and videos, are available online for free and are adaptable for virtual learning.

The FDA continues to monitor youth use of all e-cigarette products and will continue to expand its public education efforts and use the agency’s regulatory authority—changing course as necessary—to further ensure all tobacco products, and e-cigarette products in particular, are not marketed to, sold to, or used by youth.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

BBC News: France bans online sales of nicotine products

This article appeared in the BBC News on April 24. It describes why France is banning internet sales of tobacco products.

CTFK on New Jersey Flavored E-Cigarette Ban

This statement is from Campaign for Tobacco-Free Kids on April 20 as a New Jersey law banning the sale of flavored e-cigarettes became active.

This article from January further explains the ban and provides a link to the language of the bill.

New Jersey Ban on Sale of All Flavored E-Cigarettes Takes Effect Today

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
April 20, 2020

WASHINGTON, D.C. – New Jersey’s historic law prohibiting the sale of all flavored e-cigarettes takes effect today. This action is the right move to reverse skyrocketing youth use of e-cigarettes and couldn’t come at a better time as health experts are warning that smoking and vaping can worsen the effects of COVID-19. It’s more critical than ever to keep our lungs healthy. This measure is necessary to prevent e-cigarettes from addicting a new generation of kids and reversing the enormous progress we have made in reducing youth tobacco use.

New Jersey is one of four states that have prohibited the sale of flavored e-cigarettes, along with Massachusetts, New York and Rhode Island (Massachusetts prohibited the sale of all flavored tobacco products). The recently passed New York law will be implemented May 18. We strongly urge other states to join protecting the health of our kids by ending the sale of flavored tobacco products.

There is no time to waste as the youth e-cigarette epidemic has gone from bad to worse. According to the 2019 National Youth Tobacco Survey (2019 NYTS), e-cigarette use among high school students nationwide increased to 27.5% in 2019 compared to 11.7% in 2017. Altogether, more than 5.3 million middle and high school students now use e-cigarettes. The evidence is clear that flavored e-cigarettes have fueled this epidemic – 97% of youth e-cigarette users report using a flavored product in the past month, and 70% cite flavors as the reason for their use.