FDA.gov: FDA takes significant steps to protect Americans from dangers of tobacco through new regulation

For Immediate Release: May 5, 2016

Today, the U.S. Food and Drug Administration finalized a rule extending its authority to all tobacco products, including e-cigarettes, cigars, hookah tobacco and pipe tobacco, among others. This historic rule helps implement the bipartisan Family Smoking Prevention and Tobacco Control Act of 2009 and allows the FDA to improve public health and protect future generations from the dangers of tobacco use through a variety of steps, including restricting the sale of these tobacco products to minors nationwide.

“We have more to do to help protect Americans from the dangers of tobacco and nicotine, especially our youth. As cigarette smoking among those under 18 has fallen, the use of other nicotine products, including e-cigarettes, has taken a drastic leap. All of this is creating a new generation of Americans who are at risk of addiction,” said HHS Secretary Sylvia Burwell. “Today’s announcement is an important step in the fight for a tobacco-free generation – it will help us catch up with changes in the marketplace, put into place rules that protect our kids and give adults information they need to make informed decisions.”

Tobacco use is a significant public health threat. In fact, smoking is the leading cause of preventable disease and death in the United States and responsible for 480,000 deaths per year. While there has been a significant decline in the use of traditional cigarettes among youth over the past decade, their use of other tobacco products continues to climb. A recent survey supported by the FDA and the Centers for Disease Control and Prevention shows current e-cigarette use among high school students has skyrocketed from 1.5 percent in 2011 to 16 percent in 2015 (an over 900 percent increase) and hookah use has risen significantly. In 2015, 3 million middle and high school students were current e-cigarette users, and data showed high school boys smoked cigars at about the same rate as cigarettes. Additionally, a joint study by the FDA and the National Institutes of Health shows that in 2013-2014, nearly 80 percent of current youth tobacco users reported using a flavored tobacco product in the past 30 days – with the availability of appealing flavors consistently cited as a reason for use.

Before today, there was no federal law prohibiting retailers from selling e-cigarettes, hookah tobacco or cigars to people under age 18. Today’s rule changes that with provisions aimed at restricting youth access, which go into effect in 90 days, including:

  • Not allowing products to be sold to persons under the age of 18 years (both in person and online);
  • Requiring age verification by photo ID;
  • Not allowing the selling of covered tobacco products in vending machines (unless in an adult-only facility); and
  • Not allowing the distribution of free samples.

The actions being taken today will help the FDA prevent misleading claims by tobacco product manufacturers, evaluate the ingredients of tobacco products and how they are made, as well as communicate their potential risks.

Today’s rule also requires manufacturers of all newly-regulated products, to show that the products meet the applicable public health standard set forth in the law and receive marketing authorization from the FDA, unless the product was on the market as of Feb. 15, 2007. The tobacco product review process gives the agency the ability to evaluate important factors such as ingredients, product design and health risks, as well as their appeal to youth and non-users.

Under staggered timelines, the FDA expects that manufacturers will continue selling their products for up to two years while they submit – and an additional year while the FDA reviews – a new tobacco product application. The FDA will issue an order granting marketing authorization where appropriate; otherwise, the product will face FDA enforcement.

For decades, the federal government and the public health community have fought to protect people from the dangers of tobacco use. Since the first Surgeon General’s report on Smoking and Health in 1964, which warned Americans about the risks associated with smoking, significant progress has been made to reduce smoking rates among Americans. In fact, tobacco prevention and control efforts have saved at least 8 million lives in the last 50 years, according to the 2014 Surgeon General’s Report on the Health Consequences of Smoking. In 2009, Congress took a historic step in the fight for public health by passing the bipartisan Family Smoking Prevention and Tobacco Control Act (TCA) giving the FDA authority to regulate the manufacturing, distribution and marketing of tobacco products to protect the public health.

Today’s action marks a new chapter in the FDA’s efforts to end preventable tobacco-related disease and death and is a milestone in consumer protection.

“As a physician, I’ve seen first-hand the devastating health effects of tobacco use,” said FDA Commissioner Robert M. Califf, M.D. “At the FDA, we must do our job under the Tobacco Control Act to reduce the harms caused by tobacco. That includes ensuring consumers have the information they need to make informed decisions about tobacco use and making sure that new tobacco products for purchase come under comprehensive FDA review.”

Today’s actions will subject all manufacturers, importers and/or retailers of newly- regulated tobacco products to any applicable provisions, bringing them in line with other tobacco products the FDA has regulated under the TCA since 2009.

These requirements include:

  • Registering manufacturing establishments and providing product listings to the FDA;
  • Reporting ingredients, and harmful and potentially harmful constituents;
  • Requiring premarket review and authorization of new tobacco products by the FDA;
  • Placing health warnings on product packages and advertisements; and
  • Not selling modified risk tobacco products (including those described as “light,” “low,” or “mild”) unless authorized by the FDA.

“This final rule is a foundational step that enables the FDA to regulate products young people were using at alarming rates, like e-cigarettes, cigars and hookah tobacco, that had gone largely unregulated,” said Mitch Zeller, J.D., director of the FDA’s Center for Tobacco Products. “The agency considered a number of factors in developing the rule and believes our approach is reasonable and balanced. Ultimately our job is to assess what’s happening at the population level before figuring out how to use all of the regulatory tools Congress gave the FDA.”

To assist the newly-regulated tobacco industry in complying with the requirements being announced today, the FDA is also publishing several other regulatory documents that provide additional clarity, instructions and/or the FDA’s current thinking on issues specific to the newly-regulated products.

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.


CDC: No decline in overall youth tobacco use since 2011

Overall tobacco use by middle and high school students has not changed since 2011, according to new data published by the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration’s (FDA) Center for Tobacco Products in today’s Morbidity and Mortality Weekly Report (MMWR).

Data from the 2015 National Youth Tobacco Survey show that 4.7 million middle and high school students were current users (at least once in the past 30 days) of a tobacco product in 2015, and more than 2.3 million of those students were current users of two or more tobacco products. Three million middle and high school students were current users of e-cigarettes in 2015, up from 2.46 million in 2014.

Sixteen percent of high school and 5.3 percent of middle school students were current users of e-cigarettes in 2015, making e-cigarettes the most commonly used tobacco product among youth for the second consecutive year. During 2011 through 2015, e-cigarette use rose from 1.5 percent to 16.0 percent among high school students and from 0.6 percent to 5.3 percent among middle school students.

From 2011 through 2015, significant decreases in current cigarette smoking occurred among youth, but there was no significant change in the prevalence of current cigarette smoking among this group during 2014 – 2015. In 2015, 9.3 percent of high school students and 2.3 percent of middle school students reported current cigarette use, making cigarettes the second-most-used tobacco product among both middle and high school students.

“E-cigarettes are now the most commonly used tobacco product among youth, and use continues to climb,” said CDC Director Tom Frieden, M.D., M.P.H. “No form of youth tobacco use is safe. Nicotine is an addictive drug and use during adolescence may cause lasting harm to brain development.”

Students use many forms of tobacco

In addition to e-cigarettes and cigarettes, high school students used other tobacco products:

  • 8.6 percent smoked cigars,
  • 7.2 percent used hookahs,
  • 6.0 percent used smokeless tobacco,
  • percent smoked pipe tobacco, and
  • 0.6 percent smoked bidis.

After e-cigarettes and cigarettes, middle school students reported using these products:

  • 2.0 percent used hookahs,
  • 1.8 percent used smokeless tobacco,
  • 1.6 percent smoked cigars,
  • 0.4 percent smoked pipe tobacco, and
  • 0.2 percent smoked bidis.

Among non-Hispanic white and Hispanic high school students, e-cigarettes were the most commonly used tobacco product. Among non-Hispanic black high school students, cigars were the most commonly used tobacco product. Cigarette use was higher among non-Hispanic whites than among non-Hispanic blacks. Smokeless tobacco use was higher among non-Hispanic whites than students of other races.

“We’re very concerned that one in four high school students use tobacco, and that almost half of those use more than one product,” said Corinne Graffunder, Dr.P.H., M.P.H., director of CDC’s Office on Smoking and Health. “We know about 90 percent of all adult smokers first try cigarettes as teens. Fully implementing proven tobacco control strategies could prevent another generation of Americans from suffering from tobacco-related diseases and premature deaths.”

FDA has regulatory authority over cigarettes, cigarette tobacco, roll-your-own tobacco, and smokeless tobacco. The agency is finalizing the rule to bring additional tobacco products such as e-cigarettes, hookahs, and some or all cigars under that same authority.

“The FDA remains deeply concerned about the overall high rate at which children and adolescents use tobacco products, including novel products such as e-cigarettes and hookah,” said Mitch Zeller, J.D., director of the FDA’s Center for Tobacco Products. “Finalizing the rule to bring additional products under the agency’s tobacco authority is one of our highest priorities, and we look forward to a day in the near future when such products are properly regulated and responsibly marketed.”

Regulating the manufacturing, distribution, and marketing of tobacco products – coupled with proven population-based strategies – can reduce youth tobacco use and initiation. These strategies include funding tobacco control programs at CDC-recommended levels, increasing prices of tobacco products, implementing and enforcing comprehensive smoke-free laws, and sustaining hard-hitting media campaigns.

To learn more about quitting and preventing children from using tobacco, visit www.BeTobaccoFree.gov.


30 Health Groups Urge President Obama to End Delays and Issue Overdue Rule Regulating All Tobacco Products, Including E-Cigarettes and Cigars

WASHINGTON, DC – Expressing alarm about repeated delays that have endangered the health of children, 30 leading public health and medical groups today urged President Barack Obama to promptly issue a final rule providing for Food and Drug Administration (FDA) oversight of all tobacco products, including electronic cigarettes and cigars.

In a letter to the President, the groups pointed out it has been five years since the FDA first indicated it would seek to regulate all tobacco products, nearly two years since the FDA issued a proposed rule on April 24, 2014, and almost six months since the FDA sent the White House Office of Management and Budget a final rule for review on Oct. 19, 2015 (by executive order, OMB review is supposed to take no more than 90 days). In testimony before Congress in April 2015, the Administration indicated the rule would be finalized by the end of last summer.

“Every one of these delays comes with a cost to public health,” the health groups wrote to President Obama. “We ask for your leadership in ensuring prompt Administration action to finalize this regulation in the interest of public health and especially for the protection of our children.”

In the absence of regulation, youth use of e-cigarettes has skyrocketed. From 2013 to 2014, youth use of e-cigarettes tripled, from 4.5 percent to 13.4 percent among high school students and from 1.1 percent to 3.9 percent among middle school students, according to the Centers for Disease Control and Prevention. In addition, high school boys now smoke cigars at the same rate as cigarettes (10.8 percent for cigars and 10.6 percent for cigarettes).

Here is the full letter to President Obama and list of groups signing it:

Dear Mr. President:

It has been five years since the Food and Drug Administration first indicated it would take action to regulate all tobacco products and almost two years since the Food and Drug Administration (FDA) formally proposed a regulation to extend its authority over all currently unregulated tobacco products, including e-cigarettes and cigars.

More than a year ago at a Congressional hearing, the Secretary of Health and Human Services indicated that the rule would be finalized by the end of last summer.  That did not happen.  Last fall, Shaun Donovan, the Director of the Office of Management and Budget, Howard Shelanski, the head of the Office of Information and Regulatory Affairs at OMB, Cecelia Munoz, the Director of the Domestic Policy Council and others met with the leaders of a number of public health organizations and assured us that they understood the urgency of the need to act quickly.  More than four months later the rule has not been finalized.  Every one of these delays comes with a cost to public health.

Your leadership is needed to finish the task and ensure that all tobacco products are regulated.

Even though we have known for decades the enormous harm that tobacco products cause, until recently FDA was powerless to regulate them.  When you signed the Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act) into law in 2009, FDA finally was given the tools to significantly reduce the 480,000 deaths caused by tobacco products each year and the $170 billion in health care costs attributable to treating tobacco-caused disease.  Yet it is now seven years since the statute was enacted and your Administration has yet to assert its regulatory authority over all tobacco products.

The Tobacco Control Act gave the FDA immediate authority over cigarettes, smokeless and roll-your-own tobacco, and authorized the Secretary of Health and Human Services to deem other tobacco products subject to FDA’s jurisdiction.  Until this occurs, there can be no federal oversight of e-cigarettes, cigars and other tobacco products that have serious public health consequences.  There are no restrictions in place to protect public health against the risks these products pose, particularly to the health of our children.  For example, at present, FDA has no authority to stop manufacturers from using candy and fruit flavors in these tobacco products, or even to disclose their ingredients.

The consequences of not quickly applying FDA’s regulatory authority to all tobacco products have been serious.  In the absence of regulation, we have seen irresponsible marketing of unregulated products such as cigars and electronic cigarettes and the use of sweet flavors that clearly appeal to youth.  E-cigarettes come in more than 7,000 flavors, including cotton candy, gummy bear, bubble gum, and other flavors that appeal to kids.  It’s no wonder use of e-cigarettes by youth has skyrocketed.  According to the Centers for Disease Control and Prevention and the FDA, youth use of e-cigarettes tripled between 2013 and 2014, from 4.5 percent to 13.4 percent among high school students and from 1.1 percent to 3.9 percent among middle school students.  The CDC estimates that there were 2.4 million youth e-cigarette users in 2014.  The unregulated cigar industry is also using candy and fruit flavors to make their products more attractive to youth.  High school boys now smoke cigars at the same rate as cigarettes (10.8 percent for cigars and 10.6 percent for cigarettes).

Your Administration’s delay in finalizing this regulation has been so great that Congress finally stepped in to address the dramatic increase in poisonings involving liquid nicotine containers for e-cigarettes by enacting legislation to give the Consumer Product Safety Commission the authority to require manufacturers to use childproof packaging for liquid nicotine rather than wait for FDA to respond to this public health concern.  The fact that Congress took this action speaks volumes about the level of frustration over FDA’s failure to act in a timely manner to protect children.

Your Administration’s final regulation asserting jurisdiction over all tobacco products is long overdue.  The Office of Management and Budget has been reviewing the final rule for almost six months. This delay is serving the interests of the tobacco companies, which have a long history of using product design and marketing tactics to attract children to harmful and addictive products.  We ask for your leadership in ensuring prompt Administration action to finalize this regulation in the interest of public health and especially for the protection of our children.

Academy of General Dentistry
American Academy of Family Physicians
American Academy of Pediatrics
American Association for Respiratory Care
American Cancer Society Cancer Action Network
American College of Cardiology
American Heart Association
American Lung Association
American Medical Student Association
American Psychological Association
American Public Health Association
American School Health Association
American Thoracic Society
Americans for Nonsmokers’ Rights
Association of Women’s Health, Obstetric and Neonatal Nurses
Campaign for Tobacco Free Kids
Cancer Prevention and Treatment Fund
Lung Cancer Alliance
March of Dimes
National African American Tobacco Prevention Network
National Association of County and City Health Officials
National Association of School Nurses
National Network of Public Health Institutes
Oncology Nursing Society
Prevention Institute
Prevention Partners
Society for Cardiovascular Angiography and Intervention
Tobacco Control Legal Consortium at the Public Health Law Center
Trust for America’s Health
Truth Initiative

National Survey Shows Youth Cigarette Smoking Again Falls to Record Low, but E-Cigarettes and Cigars Threaten Progress

FOR IMMEDIATE RELEASE:            December 16, 2015
National Survey Shows Youth Cigarette Smoking Again Falls to Record Low, but E-Cigarettes and Cigars Threaten Progress
Results Show Why FDA Must Act Now to Regulate E-Cigarettes and Cigars 
Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
WASHINGTON, DC – In terrific news for the nation’s health, the government-sponsored Monitoring the Future survey released today shows that the steep, decades-long decline in youth cigarette smoking continues, with smoking rates falling to record lows in 2015 among all three grades surveyed (grades 8, 10 and 12). Cigarette use among 12th graders fell to just 11.4 percent from 13.6 percent last year and 36.5 percent in 1997, representing extraordinary and historic progress.
However, the survey also contains fresh warning signs that other tobacco products – electronic cigarettes and cigars that are sold in an array of sweet, kid-friendly flavors – may be undermining these gains and luring kids into nicotine addiction. For the second year in a row, the survey finds that significantly more teens reported using e-cigarettes than regular cigarettes in the past 30 days. In addition, teens reported using flavored little cigars at the same rate as cigarettes, and the percentage of teens who smoked tobacco in the past 30 days increased by more than half when cigarillos are included with regular cigarettes.
These findings should spur the White House to quickly issue a long-overdue rule providing for Food and Drug Administration regulation of all tobacco products, including e-cigarettes and cigars. It has been nearly 20 months since the FDA issued its proposed rule and nearly two months since the FDA sent the final rule to the White House for review. We cannot afford further delays that allow the tobacco industry to continue targeting our kids with a new generation of tobacco products. In addition, Congress must let the FDA do its job and reject proposals to weaken the FDA’s authority over e-cigarettes, cigars or any tobacco product.
The continuing decline in youth cigarette smoking is unquestionably good news that will improve the nation’s health and save lives:

  • For all three grades combined, the percentage of students who reporting smoking cigarettes in the prior 30 days fell from 8 percent in 2014 to 7 percent in 2015 – a statistically significant drop. Past-month smoking fell to 3.6 percent among 8th graders, 6.3 percent among 10th graders and 11.4 percent among 12th graders, all record lows.
  • Long-term trends are especially dramatic. Since peaking around 1996-1997, smoking rates have fallen by 83 percent among 8th graders, 79 percent among 10th graders and 69 percent among 12th graders. Daily cigarette use has fallen even more steeply, with just 5.5 percent of 12th graders reporting daily smoking in 2015.

These results demonstrate that we know how to win the fight against tobacco by implementing science-based strategies. These include higher tobacco taxes, strong smoke-free laws, well-funded tobacco prevention and cessation programs that include mass media campaigns, increasing the tobacco sale age to 21 and effective FDA regulation of tobacco products. Progress has accelerated following the largest-ever increase in the federal cigarette tax (a 62-cent increase implemented in 2009) and unprecedented national media campaigns launched by the CDC, the FDA and Truth Initiative. Rather than breeding complacency, our progress should spur elected officials to step up these proven measures and end the tobacco epidemic for good.
The survey’s findings on e-cigarettes and cigars are deeply troubling:

  • In all three grades, e-cigarette use far exceeded regular cigarette use in the past 30 days – 9.5 percent to 3.6 percent among 8th graders, 14 percent to 6.3 percent among 10th graders and 16.2 percent to 11.4 percent among 12th graders. These results also indicate e-cigarettes are more likely to be a pathway to tobacco addiction than away from it. More than half of students said their primary reasons for using e-cigarettes was to experiment and more than 30 percent said it was because they tasted good, while less than 10 percent said they used e-cigarettes to help quit regular cigarettes.
  • Teens reported smoking flavored little cigars at the same rate as cigarettes, with 11.4 percent of 12th graders reporting use of flavored little cigars in the past 30 days. When both cigarettes and flavored cigarillos are included, smoking rates in the past 30 days increased to 6.6 percent among 8th graders, 9.8 percent among 10th graders and 17.8 percent among 12th graders.

These findings are not surprising given the irresponsible marketing of e-cigarettes and cigars in a wide variety of kid-friendly flavors, such as gummy bear, cotton candy and watermelon.  E-cigarette makers have marketed their products with the same tactics long used to market regular cigarettes to kids, including celebrity endorsements, slick TV and magazine ads, and sponsorships of race cars and concerts.
Despite our progress, we cannot let up in the fight against tobacco because the tobacco industry never lets up. The industry spends $9.6 billion a year – more than $1 million every hour – to market its deadly products, and it is constantly seeking innovative ways to entice our kids. It’s no wonder tobacco use is still the number one cause of preventable death in our country, killing more than 480,000 people and costing about $170 billion in health care expenses each year. We cannot win the fight against tobacco unless elected officials put our nation’s kids and health before the special interests of the tobacco industry.
The Monitoring the Future survey has been conducted annually since 1975 by researchers at the University of Michigan and is funded by the National Institute on Drug Abuse.

BreatheND Comments re: ND 2015 YRBS Results

Comments from Jeanne Prom, Executive Director, North Dakota Center for Tobacco Prevention and Control Policy – “BreatheND”
News conference on 2015 N.D. Youth Risk Behavior Survey, November 2, 2015
2015 YRBS news conferece -Tobacco Use by ND High School Students 11-2
2015 YRBS news conference -Smoked a Whole Cigarette Before Age 13
The drop in North Dakota’s high school smoking rate to 11.7% is a significant achievement and it shows that North Dakota’s comprehensive tobacco prevention efforts are working.
This work in every county and outreach to every school district is possible because in 2008, North Dakota voters passed a measure funding a comprehensive tobacco prevention program and agency. Since the law took effect in 2009, the new state agency, North Dakota Center for Tobacco Prevention and Control Policy, also known as BreatheND, distributed money from the state’s tobacco settlement to every county for a comprehensive program funded at a level recommended by the U.S. Centers for Disease Control and Prevention (CDC).
In all counties, funds are used by local public health units to work with school districts to establish comprehensive policies. The policies make all school property and events completely tobacco-free at all times for students, staff and the public. BreatheND funding also makes it possible for communities to make their parks, daycares, apartments and businesses completely smoke-free and tobacco-free indoors and out. Over the past six years, more schools and other places have become completely tobacco-free.
Today, North Dakota youth are growing up surrounded by healthy, tobacco-free schools, parks and businesses in many cities. Tobacco-free places help kids stay tobacco-free.
But we have more work to do to make sure all kids in North Dakota are protected from the dangers of tobacco use, including electronic cigarettes.
For the first time this year, the Youth Risk Behavior Survey asked students if they used electronic cigarettes, which are devices that convert a nicotine liquid into an aerosol that is inhaled. 22.3 percent of high school students had used these “e-cigarettes” or “vaping” products in the past month.
Using nicotine at a young age can cause lasting harm to the brain, which isn’t fully developed until age 26. Nicotine is one of the most highly addictive drugs, and a curious experiment with an e-cigarette could lead kids into an addiction to any form of nicotine, whether in an e-cigarette, smokeless tobacco or cigarettes.
The CDC recently reported that e-cigarette use tripled among middle and high school students within one year. A study published in the Journal of American Medical Association showed that high school students using electronic cigarettes were more likely to begin smoking regular cigarettes. The e-cigarette use among youth is alarming.
The good news is that North Dakota is dealing with this emerging problem. BreatheND and our state and local partners supported the N.D. legislature in their efforts to regulate these otherwise unregulated products. The 2015 legislature passed a law prohibiting e-cigarette sales to minors and use by minors. The law also requires child-resistant packaging for e-cigarette liquids. Several cities, including most recently Grand Forks and Bismarck, have passed even stronger local ordinances requiring tobacco licenses for all stores selling e-cigarettes and “vape” products, and requiring products be placed behind-the-counter.
We also worked with the N.D. legislature to try to raise the price of tobacco. Our efforts were not successful, and tobacco in our state continues to be some of the cheapest in the country. This makes tobacco very affordable for our kids, who have never seen the N.D. tobacco tax increase in their lifetime. When tobacco is cheap, more people – especially kids – smoke.
The goal of BreatheND and its state and local partners is to move all tobacco use rates – including e-cigarettes and any new form of nicotine product – as close to zero as we can get. With continued funding of our comprehensive program that reaches all our counties, we will continue making progress and I’m confident we can get there.

Press Release: Heitkamp Announces Significant Federal Funding for Tobacco Prevention

WASHINGTON, D.C. – U.S. Senator Heidi Heitkamp today announced nearly $914,000 in federal funding to support statewide efforts to prevent tobacco use.

These funds, awarded to the North Dakota Department of Health, will be used to support its Tobacco Prevention and Control program, which includes information for schools and health care providers, programs to help North Dakotans quit smoking, data collection and trainings.

“Over the past several decades, the devastating health effects caused by tobacco use have become more and more clear,” said Heitkamp. “As North Dakota’s Attorney General in the 1990s, I led the charge to hold tobacco companies responsible for what their products were doing to North Dakotans, so I understand the importance of investing in tobacco prevention efforts and providing resources to help folks quit smoking. These funds will help the North Dakota Department of Health continue its great work to stop tobacco use and help make sure the next generation of North Dakotans are tobacco-free.”

While Attorney General, Heitkamp helped to broker an agreement between 46 states and the tobacco industry, which forced the tobacco industry to tell the truth about smoking and health. The settlement resulted in the award of about $336 million to North Dakota taxpayers to date and was one of the largest civil settlements in U.S. history.


New CDC Report Shows Big Drop in Secondhand Smoke Exposure Among Americans, But 58 Million Still Exposed – Every State and Community Should be Smoke-Free

Statement of Susan M. Liss, Executive Director, Campaign for Tobacco-Free Kids

WASHINGTON, DC – The percentage of Americans exposed to secondhand smoke has fallen by more than half since 1999, but one in four non-smokers – 58 million people altogether – was still exposed in 2011-2012, according to a new report issued today by the Centers for Disease Control and Prevention (CDC). It is especially troubling that children have the highest levels of exposure, with 40.6 percent of children aged 3-11 and 67.9 percent of African-American children in that age group still exposed to secondhand smoke. While the sharp decline in exposure to secondhand smoke is great news, it is unacceptable that 58 million Americans, including so many children, are still exposed to this serious and entirely preventable health threat.

The CDC report demonstrates both the effectiveness of and continuing need for comprehensive smoke-free laws that apply to all workplaces and public places, including restaurants and bars. To date, 24 states, Washington, DC, and hundreds of cities have enacted such laws, protecting about half the U.S. population (an additional six states have laws that apply to all restaurants and bars, but not all other workplaces). It’s time for every state and community to go smoke-free and protect everyone’s right to breathe clean air, free from the serious health hazards of secondhand smoke.

States in the South have lagged behind in providing this important public health protection, which is easy and cost-effective to implement and very popular with the public. New Orleans set a terrific example for southern states and cities last month when it enacted a comprehensive smoke-free ordinance. The Kentucky Legislature should quickly follow suit and finally approve comprehensive, statewide smoke-free legislation that has been under consideration for several years.

The high level of child exposure to secondhand smoke also underscores the need for parents to take additional steps to protect children, such as ensuring that homes, cars and other places frequented by children are smoke-free. It is encouraging that the proportion of U.S. households with voluntary smoke-free rules has increased from 43 percent to 83 percent in the last two decades. For parents who smoke, the best step to protect children is to quit smoking.

Overall, the CDC reported that the percentage of non-smokers exposed to secondhand smoke fell from 52.5 percent during 1999-2000 to 25.3 percent during 2011-2012. Exposure was higher among children, African Americans, those living in poverty and those who live in rental housing. Secondhand smoke exposure was determined based on blood levels of cotinine, a nicotine byproduct.

“Continued efforts to promote implementation of comprehensive statewide laws prohibiting smoking in workplaces and public places, smoke-free policies in multiunit housing, and voluntary smoke-free home and vehicle rules are critical to protect nonsmokers from this preventable health hazard in the places they live, work, and gather,” the CDC concludes. The report provides support for growing efforts to make public and subsidized housing smoke-free, with the report noting, “The potential for SHS [secondhand smoke] exposure in subsidized housing is particularly concerning because a large proportion of these units are occupied by persons who are especially sensitive to the effects of SHS, including children, the elderly and the disabled.”

Secondhand smoke contains more than 7,000 chemicals, including hundreds that are toxic and at least 69 that cause cancer. According to the U.S. Surgeon General, secondhand smoke causes lung cancer, heart disease and stroke in non-smoking adults and sudden infant death syndrome (SIDS), low birth weight, respiratory problems, ear infections and more severe asthma in infants and children.

The Surgeon General also found that secondhand smoke is responsible for tens of thousands of deaths in the United States each year, there is no safe level of exposure, and only smoke-free laws provide effective protection. The evidence is also clear that smoke-free laws protect health without harming business.

The CDC’s report was published in the agency’s Morbidity and Mortality Weekly Report.

Congress Should Back President Obama’s Tobacco Tax Plan – It Will Protect Kids, Save Lives and Cut Health Care Costs

Statement of Susan M. Liss, Executive Director, Campaign for Tobacco-Free Kids

WASHINGTON, DC – The Campaign for Tobacco-Free Kids strongly supports President Obama’s proposal to increase the federal tobacco tax, which is a proven way to prevent kids from smoking, save lives and reduce tobacco-related health care costs.

In his FY 2016 budget released today, President Obama urged Congress to increase the federal cigarette tax by 94 cents per pack and also increase taxes on other tobacco products. The tobacco tax changes would raise $95.1 billion in new revenue over 10 years.  The budget proposes to use these funds to pay for an extension of the Children’s Health Insurance program (CHIP) and fund early childhood education initiatives proposed by the President.

This proposal would do more to reduce tobacco use among kids than any other single action the federal government can take. It is also a fiscally responsible proposal that will help to reduce the huge financial burden that tobacco use imposes on governments, businesses and families.  A new CDC study issued in December found that smoking costs our nation about $170 billion a year in health care spending – far more than previously thought. More than 60 percent of these costs are paid by taxpayers through government programs such as Medicare and Medicaid.

Congress should embrace this proposal enthusiastically. It will save lives and money. And it will help millions of kids live longer, healthier lives free of tobacco addiction.

The evidence is clear that increasing the tobacco tax is one of the most effective ways to reduce smoking and other tobacco use, especially among kids. Economic research shows that every 10 percent increase in the price of cigarettes reduces youth smoking by about seven percent and overall cigarette consumption by three to five percent. We estimate that a 94-cent increase in the federal cigarette tax would:

·        Prevent 1.2 million kids from becoming smokers;

·        Prompt 2.6 million adult smokers to quit

·        Prevent 444,100 premature deaths as a result of these reductions in youth smoking

·        Save $51.9 billion in future health care costs.

Numerous public health and economic authorities have found that increasing the tobacco tax is effective at both reducing smoking and raising revenue. Last year’s Surgeon General’s report reaffirmed that. “Raising prices on cigarettes is one of the most effective tobacco control interventions,” the report concludes. “The evidence is sufficient to conclude that increases in the prices of tobacco products, including those resulting from excise tax increases, prevent initiation of tobacco use, promote cessation, and reduce the prevalence and intensity of tobacco use among youth and adults.”

The highly respected Congressional Budget Office has also concluded that increasing the federal tobacco tax would raise substantial new revenue, prompt millions of smokers to quit, save lives and reduce health care costs.

Furthermore, national and state polls consistently show strong public support for substantial increases in tobacco taxes, with most polls showing voters favoring tobacco tax increases by more than a two-to-one margin. Polls have found that large majorities of Democrats, Republicans and Independents and voters from a broad range of demographic and ethnic groups all support tobacco tax increases – as do significant numbers of smokers.

In short, a significant tobacco tax increase is a win-win-win for the country – a health win that will reduce tobacco use and save lives, a financial win that will reduce health care costs and raise revenue to fund an important initiative, and a win among voters.

The budget proposal also includes a measure that would ensure “full coverage of preventive health and tobacco cessation services for adults in traditional Medicaid.”  Tobacco cessation services have been proven to reduce smoking and are cost-effective. After Massachusetts implemented tobacco cessation coverage for all state Medicaid beneficiaries, smoking among the state’s Medicaid population declined by 26 percent and the state saved more than $3 for every $1 it spent to help beneficiaries quit smoking.

The need for Congress to act to increase tobacco taxes and expand cessation services is clear.  While our nation has made tremendous progress in reducing smoking, tobacco use remains the number one cause of preventable death in our country. Smoking annually kills 480,000 Americans – causing one in every five deaths.  Without urgent action, 5.6 million kids alive today will die prematurely from smoking-caused disease.

The President’s proposal represents exactly the kind of bold action needed to accelerate progress against tobacco and make the next generation tobacco-free.

ALA, TFND partner with Country House Deli to encourage tobacco users to “Quit Cold Turkey (With Help)”

PRESS ADVISORY:  ALA, TFND partner with Country House Deli to encourage tobacco users to “Quit Cold Turkey (With Help)”
In celebration of “Great American Smokeout” Day, Thursday, November 20, 2014, the American Lung Association in North Dakota (ALA) and Tobacco Free North Dakota (TFND) is partnering with a Bismarck business, Country House Deli, in support of the mission of this nationally recognized day.
Together, these non-profit organizations and this local business will encourage tobacco users to “quit cold turkey (with help)” by offering quit information and a turkey sandwich lunch special in Country House Deli’s location. ALA and TFND will be on-hand providing information to the public on the dangers of tobacco use as well as NDQuits, North Dakota’s state program which offers several free options – free counseling, advice, support, and nicotine replacement products – to help North Dakotans quit their tobacco addiction.
In addition, tobacco users will be given an opportunity to trade their possession of tobacco products in return for an entry into a drawing for a Quit Cold Turkey (With Help) Thanksgiving meal package (frozen turkey, potatoes, beans, stuffing, etc.).
“Quit Cold Turkey (With Help)” for the 2014 Great American Smokeout
sponsored by ALA, TFND, and Country House Deli
Thursday, November 20, 2014
11:00 am – 2:00 pm
1045 E Interstate Ave, Bismarck


The American Cancer Society marks the Great American Smokeout on the third Thursday of November each year by encouraging smokers to use the date to make a plan to quit, or to plan in advance and quit smoking that day. By quitting — even for one day — smokers will be taking an important step towards a healthier life – one that can lead to reducing cancer risk.
Tobacco use remains the single largest preventable cause of disease and premature death in the US, yet about 42 million Americans still smoke cigarettes — a bit under 1 in every 5 adults. As of 2012, there were also 13.4 million cigar smokers in the US, and 2.3 million who smoke tobacco in pipes — other dangerous and addictive forms of tobacco.
For more information, CLICK HERE.

UTTC to renew tobacco-free status

BISMARCK (UTN) – When the national day to quit smoking comes up next week, United Tribes Technical College will fortify its ban on commercial tobacco use and emphasize the college’s cultural heritage.

UTTC President Leander “Russ” McDonald will proclaim November 20 as “Honoring Tobacco Day” on campus, the same day as the American Cancer Society’s “Great American Smokeout.”

A proclamation signing is set for 9 a.m. on Wednesday, November 19 in the college cafeteria.

One year ago during the annual smoke out, United Tribes became the first tribal college in North Dakota to adopt a comprehensive Tobacco-Free Campus Policy. It prohibits the use of all tobacco-derived products sold commercially, including e-cigarettes, to counteract their lethal and addictive affects.

The policy makes one culturally significant exception. Traditional tobacco uses that have been observed in Native American settings for generations are permitted. UTTC honors spiritual, cultural and ceremonial tobacco uses as “keeping tobacco sacred.”

            Attending the proclamation signing will be students from Theodore Jamerson Elementary School on the college campus. Prizes will be awarded to youngsters in grades K to 8 who designed the best anti-smoking posters to help observe the smoke out. Light refreshments will also be served.

UTTC’s Tobacco-Free Policy was developed by the college’s Wellness Circle. The group was named the 2014 “Public Health Team of the Year” by the North Dakota Public Health Association, in recognition of the initiative.

For more information about the United Tribes Tobacco-Free Policy, visit the college’s website: http://www.uttc.edu/tfree/.