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Reuters: California Senate votes to raise smoking age to 21 from 18

LOS ANGELES | BY ALEX DOBUZINSKIS
The California Senate voted on Tuesday to raise the legal smoking age in the most populous U.S. state to 21 from 18, in a move that could make California one of the states with the highest smoking age.
The measure was approved by the Senate 26-8 and must now be approved by the state Assembly.
“We will not sit on the sidelines while big tobacco markets to our kids and gets another generation of young people hooked on a product that will ultimately kill them,” Senator Ed Hernandez, a Democrat and the bill’s author, said.
“Tobacco companies know that people are more likely to become addicted to smoking if they start at a young age,” Hernandez added in a statement.
The Institute of Medicine, the health arm of the National Academy of Sciences, has said that increasing the smoking age to 21 would result in more than 200,000 fewer premature deaths nationally for those born between 2000 and 2019.
The Cigar Association of America opposed the bill, contending that 18-year-olds can serve in the military, vote and sign contracts and should thus enjoy the right to smoke, according to the Los Angeles Times.
David Sutton, a spokesman for Altria Group Inc, the parent of Philip Morris USA, said in an emailed statement that Altria believed states should defer to the federal government and “allow FDA and Congress the opportunity to think through this issue further before enacting different minimum age laws.”
Representatives for R.J. Reynolds Tobacco Company, a unit of Reynolds American Inc, did not return calls seeking comment.
Hawaii lawmakers approved a measure in April to raise the smoking age to 21, and that is awaiting the state governor’s signature. Democratic Governor David Ige has not indicated whether he will sign the measure, and has until June 29 to decide whether to veto it, a spokeswoman for his office said.
Since 2013, New York City has required tobacco purchasers to be 21 or older, according to the National Conference of State Legislatures. No state has a smoking age that high, but Alabama, Alaska, Utah and New Jersey set it at 19.
(Reporting by Alex Dobuzinskis and Cynthia Johnston; Editing by Sandra Maler)
http://www.reuters.com/article/2015/06/02/us-usa-smoking-california-idUSKBN0OI2EI20150602

Opinion: Cigarette smoking’s growing income gap

By: Peter Orszag

The income gap between smokers and nonsmokers has grown. And it’s something companies may need to address directly in their efforts to help employees kick the habit.

Over the past several decades, smoking rates have fallen sharply among high-income, highly educated Americans and not as much for less educated, low-income people. The result is that, in 2013, the smoking rate exceeded 20 percent for people with a high school degree or less while among those with a graduate degree it was just 5.6 percent. Among people living in poverty, smoking was almost twice as common (29 percent) as among those at or above the poverty line (16 percent).

The good news is that the financial incentives many companies are considering, and some are now using, to help people quit smoking can work, as a new study in the New England Journal of Medicine shows. The researchers randomly assigned employees of CVS Caremark and their relatives and friends to different groups, which were given various financial incentives to stop smoking. This study did two fabulous things that are unfortunately quite unusual in the corporate wellness field: It used a randomized controlled trial (to boost confidence in the causality of its results), and it paid careful attention to the teachings of behavioral economics – testing, for example, whether carrots or sticks were more effective.

The results were encouraging. People who were told they would receive an individual bonus of $800 for quitting stopped at almost three times the rate of those not offered any direct financial inventive. Behavioral theory generally suggests, though, that loss aversion would work even better. In other words, if subjects made an initial deposit that they would stand to lose if they failed to quit, that would provide an even stronger incentive. And that was indeed the case, the researchers found, but people had to be willing to make the deposit in the first place. And because many were not willing to do that, the bonus approach was more effective overall. So unless a company finds a way to force its employees to follow the stick approach, the bonus works better.

These findings were widely reported in the news, but one thing went largely if not entirely unnoticed: A table in the appendix to the study showed that, for each of the four kinds of interventions studied, the share of high-income smokers who quit – those earning $60,000 or more – was larger than that of lower-income smokers. The reason, according to the study’s lead author, is that lower-income smokers were less willing to participate under any of the incentive programs offered. That was true despite the bonus or deposit being the same dollar amount for everyone, and therefore a higher share of income for lower-paid workers.

Reducing smoking among any group of employees is a good thing, and companies should act on this new research. At the same time, it is reasonable to be concerned about the gap in smoking rates by socioeconomic status, which is one of the forces widening the gaps in life expectancy by education and income. To reverse this trend, disproportionately larger dollar bonuses may be needed to get lower earners to quit.

Contact Peter Orszag at porszag3@bloomberg.net

http://www.delawareonline.com/story/opinion/contributors/2015/05/26/cigarette-smokings-growing-income-gap/27977649/

Forum editorial: Minnesota tobacco use down

The anti-tobacco work of ClearWay Minnesota in conjunction with other tobacco cessation efforts has had remarkable results in reducing smoking rates among all age groups in Minnesota. It’s a record worthy of high praise. It’s unambiguous evidence that focused, science-based anti-tobacco campaigns can work.

Numbers released last week by ClearWay show only 14.4 percent of Minnesotans smoke cigarettes, down from 22.1 percent in 1999. The decline through the time period has been steady, and corresponds to increased education and imposition of legal restrictions on smoking in public places. Add new medical research about second-hand smoke, and graphic anti-smoking television advertising, and it appears the multi-faceted message is getting through.

But not to every age cohort.

In ClearWay statistics from 2010 to 2014, smoking hardly dipped at all (1 percent) in the 25-44 year-old group, from 19.7 percent to 18.7 percent. A similar slight improvement was measured in the 45-64 year-old cohort, compared with a huge drop (from 21.8 percent to 15.3 percent) in Minnesotans age 18-24. Which could lead to the conclusion that some Minnesotans don’t get smarter as they age. But whatever the reason, the overall percentages of all Minnesotans who smoke is down over the longer study period, and that’s good news for smokers who quit, non-smokers and reduced impacts on health costs associated with tobacco use. The trends are good.

ClearWay is not resting on its excellent record. In the eight years it has left in its mandate (funded by the national tobacco settlement of a few years back), the agency’s agenda includes raising cigarette taxes, which all studies show discourage young people from purchasing tobacco, and raising the age for tobacco purchases from 18 to 21. Again, research finds that raising the age to beyond high school age contributes to fewer high school students trying tobacco. New York City and Hawaii have already taken that step.

There is still much to be accomplished to achieve as smoke-free a society as possible. A lot has been done, often led by private sector companies that banned smoking from the workplace before cities and states enacted overall smoking bans in buildings and, in many instances, outdoor public spaces. Decades of research into smoking-related illness and death, and the proven health hazards of secondhand smoke, have been the underpinnings of changing public policy. ClearWay’s work and similar complementary efforts have been pivotal in changing the way enlightened Americans view tobacco use.

Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.

http://www.inforum.com/opinion/editorials/3751883-forum-editorial-minnesota-tobacco-use-down

NPR: Smokers More Likely To Quit If Their Own Cash Is On The Line

Richard Harris

Screen Shot 2015-06-03 at 2.19.15 PM

A new study finds that employer-based programs to help people stop smoking would work better if they tapped into highly motivating feelings — such as the fear of losing money.

This conclusion flows from a study involving the employees of CVS/Caremark. Some workers got postcards asking them if they wanted a cash reward to quit smoking. One card ended up in the hands of Camelia Escarcega in Rialto, Calif., whose sister works for CVS.

Escarcega says she had smoked for many years and wanted to quit, and figured money would be a good incentive. Her sister told her she was welcome to enroll in the study, so she did.

Screen Shot 2015-06-03 at 2.15.01 PMEscarcega didn’t know it at the time, but the study was comparing different financial incentives to help people quit smoking. Hers was straightforward: Over a span of six months, she’d get up to $800 if she quit and didn’t start again.

She did pretty well, she says. “I’ve been smoke-free for a year and a half now.” The program offered her free nicotine patches, but Escarcega says she didn’t even need that added help.

Dr. Scott Halpern, a professor of medicine, epidemiology, medical ethics and health policy at the University of Pennsylvania, worked with colleagues to design the study, as a way of exploring the best way to entice people to quit tobacco, using financial incentives.

“A dollar is not a dollar,” Halpern says, “and how you design smoking cessation programs of the same approximate value goes a long way toward determining how effective these programs will be.”

The researchers compared a few approaches. Some people simply got cash for quitting. Others were offered a carrot-and-stick approach. They’d get a similar financial reward if they quit, but they’d also lose $150 of their own money if they started smoking again.

“People are much more afraid of losing $5 than they are motivated to earn $5,” Halpern says. “And so people’s actions go with their psychology.”

It came as no surprise that the researchers found it a lot harder to convince people to put down a deposit of their own money. But when they did, the results were remarkable.

“The deposit programs were twice as effective as rewards, and five times more effective than providing free smoking cessation aids like nicotine replacement therapy,” Halpern says.

More than half of the people who had money on the line stopped smoking for at least six months. These results are reported Wednesday in the latest New England Journal of Medicine. And Halpern argues the approach is much more effective than what most companies do now.

“Many programs are structured such that employees who stop smoking are rewarded by having less money taken out of their paychecks for insurance premiums the following year,” Halpern notes. “But by bundling the rewards into paychecks they’re relatively invisible to people — and the fact that they occur in the future — makes it less influential than if people were handed the same amount of money more quickly.”

Mercer, a benefits consulting company, reports that 21 percent of large employers currently offer financial incentives to workers who quit smoking or don’t start — primarily by reducing their health-insurance premiums. (An additional 5 percent of those companies offer other incentives). And more than half of the nation’s biggest employers use incentives.

Halpern says insurance premium rebates aren’t the best way to go.

“Employers and insurers could do a whole lot more to curb smoking than they currently are,” he says. “And doing so, they would reduce costs to themselves and improve public health.” Each employee who smokes costs a company more than $5,000 extra a year, due to health care costs and other expenses.

This is potentially tricky ground to navigate, though.

“Companies may have a concern that if they sign people into this kind of a wellness program and [the employees] lose that deposit, they’re going to feel really badly,” says Oleg Urminsky, at the University of Chicago’s Booth School of Business.

The worry is that those bad feelings “may spill into other things,” Urminsky says. “Are they going to resent the employer? Are they going to be complaining? It’s a powerful tool but it’s one that has to be used carefully.”

http://www.npr.org/sections/health-shots/2015/05/13/406459255/smokers-more-likely-to-quit-if-their-own-cash-is-on-the-line?utm_source=facebook.com&utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_content=20150513

Opinion: E-cigarettes: Doctors' View: E-cigarette, tobacco smoke enough alike to warrant regulation

By Terry Clark, Mary J. Boylan and Joseph Bianco

What are e-cigarettes? Have you ever seen one? Do you know how they work? Are they as bad for your health as traditional cigarettes?

It is fair to say that three or four years ago these were new questions and we did not know the answers. But now we do, and it is certainly time for you to know — and for our St. Louis County Board of Commissioners to know as they consider a vote to help protect citizens of our county from the “invisible” harm caused by these gadgets if being used indoors.

Details about e-cigarettes and their health effects are well-described in a recent report from the California Department of Health, and even more recent good information on e-cigarettes can be found in the News Tribune’s “Our View” editorial on Friday, headlined, “County up next in quest for clear air.”

E-cigarettes is a good news/bad news story. Are they less toxic than traditional cigarettes? Likely. Are they really safe to use? Not likely.

First, how do they work? With no tobacco or cigarette paper to burn, there’s no smoke. They really are electronic gadgets with several sections, one with a small battery, one with a small amount of fluid usually containing some nicotine as well as flavoring and other chemicals, and a high-temperature chamber that converts the liquid into an aerosol or fog to be inhaled by the user (an action called vaping) and then exhaled where it is readily inhaled by those around the user.

What is in this aerosol emitted by the e-cigarette? At least 10 chemicals known to cause cancer, birth defects or other reproductive harm, including nicotine, formaldehyde, heavy metals and volatile organic compounds, according to the report. It’s not what you or your favorite teenager should be exposed to.

Nicotine, a key ingredient in the aerosol, is highly addictive. Of course, that is why so many users of traditional cigarettes said for years that they could quit whenever they wanted but usually never could.

We should all wonder why the three major tobacco companies purchased start-up e-cigarette companies. What do they know that we do not? One thing is this: Kids who start using purportedly safer e-cigarettes often switch and become traditional smokers or, even worse, dual smokers who use both e-cigs and traditional tobacco cigarettes. They are then addicted to nicotine for decades. Is that what the big tobacco companies are banking on?

Our elected county leaders soon will vote on this simple question: Should e-cigarette use indoors be regulated as a public health hazard just like traditional tobacco smoke? That is, no smoking in indoor places such as worksites, bars, restaurants, stores, arenas, etc.

The city of Duluth and many other communities in Minnesota already have answered this question in the affirmative: Yes, e-cigarette aerosol and tobacco smoke have enough in common to warrant being regulated in the same way under the Minnesota Clean Air Act.

In short, keep them outside.

Terry Clark and Mary J. Boylan are doctors from Duluth. Joseph Bianco is a doctor from Ely.

http://www.duluthnewstribune.com/opinion/columns/3742094-e-cigarettes-doctors-view-e-cigarette-tobacco-smoke-enough-alike-warrant

Forum editorial: Don’t be fooled by e-cig hype

The North Dakota Legislature is buying into Big Tobacco’s clever but dishonest narrative about e-cigarettes. Lawmakers would be better served by paying attention to Dr. Terry Dwelle, the state’s chief health officer.
In comments published a few days ago, Dwelle said without equivocation that, given current research and information, the “cons” of e-cigs outweigh the “pros.” He said more work is needed to further define the risks and any potential benefits of the nicotine-delivery devices. He said the assumption that vapors produced by e-cigs are less risky than smoke from traditional tobacco products is not backed up by sound research.
Lawmakers likely will ban e-cig sales to minors, as several North Dakota cities have done already. But there is wrong-headed sentiment among some lawmakers that the devices should not be taxed and otherwise treated the same way tobacco is. Under the state’s smoking ban law, e-cigs are treated like cigarettes and other tobacco products. The e-cig provision was part of a voter-approved smoking and secondhand smoke measure. The measure passed with 66 percent approval.
Yet, lawmakers have smoke in their eyes when it comes to the clear message North Dakotans sent about tobacco use – and the stealth campaign to paint vaping with e-cigs as an innocent tobacco-free option.
There is nothing innocent about it. Big Tobacco has become Big Vaping. The companies have jumped into the e-cig market with slick advertising campaigns and legitimate-sounding claims about the safety and efficacy of e-cigarettes. The push has all the elements that peddlers of tobacco used a generation ago to convince the gullible that cigarettes did not cause cancer. The lie then has morphed into the lie now.
There is less-than-definitive indication that e-cigs help smokers quit. If it’s true, it’s a good thing. But that unproved aspect of e-cigs has nothing to do with taxing a nicotine-delivery device that by some studies can be a gateway for young people to tobacco use. It is counterintuitive to grant a tax break to devices and substances that use candy flavors and faux fashion to attract users of all ages to a nicotine-delivery tube. It’s also stupid policy. It’s playing into the dirty hands of the folks who for years peddled the fiction that tobacco was good for us.
Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.
http://www.inforum.com/opinion/editorials/3711115-forum-editorial-dont-be-fooled-e-cig-hype

Letter to the Editor: Letter: Big tobacco companies still trying to hook kids

By Jason McCoy from Moorhead

I  applaud the new TV ad airing locally that highlights Big Tobacco’s continued targeting of children. You may have seen this ad featuring an ice cream truck driving through a kid-filled neighborhood drawing lots of pint-sized customers to its menu of “31 flavors.” Only it turns out a tobacco executive is behind the wheel and the flavors disguise deadly products.
Tobacco companies have clearly come up with ways to get to kids around the 2009 ban on flavored cigarettes by pushing flavored cigars, cigarillos, smokeless tobacco and e-cigarettes.
When the U.S. Food and Drug Administration banned the sale of flavored cigarettes, it did so to reduce smoking, a leading preventable cause of death and disease in our country.
In particular, the FDA wanted to reduce the number of children who start to smoke. Almost 90 percent of adult smokers start smoking as teenagers. And nicotine, which is in all tobacco products, is shown to be not only highly addictive and carcinogenic but also detrimental to adolescent brain development.
Flavorings including menthol, which is still available in cigarettes, mask the harsh taste of tobacco and are shown to be attractive to young people. Research shows that young people believe flavored tobacco products are less dangerous than nonflavored tobacco. As of last year, 44 percent of Minnesota high school smokers used menthol, according to the Minnesota Department of Health. That’s double the percentage in 2000. The same study by MDH also found that 35 percent of Minnesota students have tried flavored cigars and 13 percent of Minnesota kids use flavored e-cigarettes.
Do we really need more evidence that kids are attracted to flavored tobacco products, including menthol? Do we have any reason to believe that tobacco companies aren’t exploiting this attraction to hook more kids on their deadly products? The answer to both questions is a resounding “no.”
It’s time we say “no” to Big Tobacco’s continued marketing to our kids! Ask your lawmakers what they plan to do to stop young people from getting their hands on these tempting threats to their health.
McCoy, Moorhead, is tobacco coordinator for Clay County Public Health.
http://www.inforum.com/letters/3709662-letter-big-tobacco-companies-still-trying-hook-kids

Men's Journal: E-Cigarettes May Be Just as Bad as The Real Thing

Two new studies have turned out some scary findings about e-cigarettes. The first one, published in the New England Journal of Medicine, revealed that e-cigarette vapor can harbor hidden formaldehyde — a known carcinogen — at levels up to 15 times greater than regular cigarettes. “We discovered this form of formaldehyde hidden in the tiny liquid droplets of the vapor, where it hadn’t been detected before,” says lead researcher David Peyton, a chemistry professor at Portland State University in Oregon. “It has the potential to distribute deeply into the lungs and collect there.”
The second study showed that e-cigarette vapors directly harm human lung tissue. Researchers from the University of Rochester Medical Center in New York found that when the aerosol produced by heated liquid nicotine hits lung cells, it churns up disease-causing free radicals and triggers marked inflammation; they also found the presence of up to six times the level of heavy metals, like copper. What’s more, they discovered that various flavor additives, which are often added to e-cigs, cause additional oxidative damage to lung tissue. This isn’t after years of e-cig use, either. The negative effects “occurred after a few days of vaping,” he says. “Chronic exposure may lead to even more damage.”
These findings add to the fast-amassing stack of research revealing the many potential hazards of e-cigarettes. Since these smokeless devices are not regulated by the Food and Drug Administration, they can contain any number of toxins, carcinogens, or other mystery chemicals. And because e-cigarettes are so new, the long-term health consequences of using them are unknown.
Even so, many people assume that, compared to regular tobacco cigarettes, e-cigs are the lesser of two evils. But that’s not necessarily the case, says Dr. Roy Herbst, chief of medical oncology at Yale Cancer Center and a spokesman for the American Association for Cancer Research. “In the oncology community, we feel they are both evil,” he says. “The big concern with e-cigarettes is lung tissue damage. Regular cigarette smoke contains 60 to 80 known carcinogens, which makes it very bad for the lungs too. However, hot e-cigarette vapor going straight to the lungs can cause actual burning and injury. It’s a different type of damage — but it’s still significant.”
And that’s just their immediate impact. “We still don’t know the long-term effects that e-cigarettes can have on the body,” Herbst says. “There is still so much to learn about them.”
Herbst also thinks e-cigs are an unproven and even detrimental smoking cessation tool — which is, of course, a huge reason why people puff on them. “I treat people with lung cancer, so certainly my goal is to stop people from smoking,” he says. “But these devices deliver such high concentrations of nicotine that they get people very addicted to the drug. If you need help with smoking cessation, there are other, FDA-approved forms of nicotine, such patches or lozenges, that would much better than e-cigarettes.”
And because e-cigs crank out so much nicotine, Herbst also fears that they can be a gateway to tobacco cigarettes. “E-cigarettes are very expensive, so we worry that people will start on them, get addicted to nicotine, and then move on to regular cigarettes, which are generally less expensive and easier to get,” he adds.

–

Read more: http://www.mensjournal.com/health-fitness/nutrition/e-cigarettes-may-be-just-as-bad-as-the-real-thing-20150324#ixzz3Vo1Fhu6J

CNN: E-cigarettes: Helping smokers quit, or fueling a new addiction?

By Meera Senthilingam, for CNN

(CNN) It’s a portable piece of technology providing seemingly bottomless access to a drug craved by more than 1 billion people worldwide — nicotine. That craving is caused by smoking tobacco but is now being increasingly satisfied by e-cigarettes and the trend to “vape” instead of smoke.

The selling point is the clean image e-cigarettes purvey by removing the simultaneous exposure to the tar and thousands of chemicals found in the tobacco smoke of regular cigarettes — removing the cause of lung diseases as well as other tobacco-related conditions.

Tobacco kills almost 6 million people each year, according to the World Health Organization (WHO), and a growing number of people are now “vaping” instead of smoking, resulting in industry worth $2.7 billion worldwide.

Since their introduction in 2006, e-cigarettes have become commonplace among smokers trying to kick their habit, with a third of smokers trying to quit in the United Kingdom turning to e-cigarettes to aid them, according to one study. But some critics argue these electronic nicotine delivery systems (ENDS) are fueling a new addiction to nicotine — particularly among young people experimenting with them.

Allure for adolescents

“While ENDS may have the potential to benefit established adult smokers … [they] should not be used by youth and adult non-tobacco users because of the harmful effects of nicotine and other risk exposures,” says Tim McAfee, director the Office on Smoking and Health at the U.S. Centers for Disease Control and Prevention. “Exposure to nicotine can harm adolescent brain development.”

Studies conducted by the CDC through its Adult and Youth National Tobacco Surveys found increased experimentation by youth trying out e-cigarettes but not conventional cigarettes. The gadgetry and flavors associated with the devices is suggested as a reason behind this, with fears of them acting as a gateway into real tobacco smoking.

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But others in the field of tobacco control disagree, stating that whilst people — including youth — may have tried e-cigarettes, the evidence is lacking for their regular use. “Kids like new technology and just experiment or use it once or twice,” says Jean-Francois Etter, professor of Public Health at the University of Geneva.

Etter has been researching the use of e-cigarettes since 2009 and believes they are much safer than conventional cigarettes. “The most dangerous way of consuming nicotine is to smoke it,” he says. Etter argued this point last week at the World Conference of Tobacco or Health in Abu Dhabi.

Whilst Etter says that use among young people should be monitored, he believes the role of e-cigarettes in reducing global tobacco consumption is more important. “They are a gateway out of smoking,” says Etter. The number of people using a combination of tobacco and e-cigarettes is on the rise, according to Etter, resulting in smokers switching and consuming less tobacco each day. “[They have] the same level of nicotine but people are less exposed to toxins … nicotine is not a health problem,” he says. However, further evidence on the long-term health effects of e-cigarettes or nicotine is needed.

Satisfying the craving

Nicotine is the main substance keeping people addicted to smoking tobacco and consequently exposing them to the tar and toxins found in cigarettes. Whilst many people try to kick the habit cold turkey, nicotine replacement through gums and patches has long been advocated as a helping hand. “Nicotine withdrawal is a very unpleasant process,” says Linda Bauld, professor of Health Policy at the University of Stirling, whose recent report for Public Health England identified an extensive and growing market for e-cigarettes worldwide.

“The vast number of people using e-cigarettes are using them to stop smoking; [they’re] about 60% more effective than going cold turkey or buying nicotine replacement therapy over the counter.”

Bauld’s research hasn’t identified a dependence on nicotine with e-cigarettes in the same way as the addiction resulting from regular cigarettes. “E-cigarettes are not the best nicotine delivery devices,” she says referring to the fact nicotine is not seen to enter the bloodstream as readily when using e-cigarettes. That’s backed up by Etter’s research as well as a recent study by researchers at Penn State College of Medicine, in which e-cigarettes were found to be less addictive than tobacco cigarettes.

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They do, however, provide nicotine more effectively than aids such as patches or gums, according to Bauld.

“Patches and gums are a very small market,” says Etter about the quitting devices which first came onto the market 40 years ago. He fears too much restriction on e-cigarettes will limit their impact in achieving a world free of tobacco.

Both Bauld and Etter recognize the need to monitor the consumption of nicotine among teenagers but feel the value of e-cigarettes among adult smokers and their potential to save lives by reducing tobacco consumption should not be underestimated — a sentiment recognized by the World Health Organization.

“[E-cigarettes] could be a way to help people quit but we need more evidence and regulation,” says Armand Peruga, program manager for the WHO’s Tobacco Free Initiative, which has celebrated 10 years of its Framework for Tobacco Control whilst at the conference in Abu Dhabi.

Legislate and regulate

The greatest impact to date in reducing the number of smokers worldwide has been the taxation and legislation restricting tobacco advertising and increasing prices. “For every 10% increase in tax you have 4% reduction in tobacco consumption,” says Peruga.

The growing fear is the increasing domination of big tobacco in the e-cigarette market, which was once seen as a competitor. Their ownerships of popular e-cigarette brands could push out smaller companies in the field, reminiscent of the original tobacco epidemic.

“The intent of big tobacco is to sell their product,” concludes Peruga. “[They may] expand their market to other customers who didn’t use cigarettes but might consider nicotine use.”

But as it seems e-cigarettes are here to stay, most calls are for informed regulation rather than prohibition. “The majority of e-cigarettes — especially when they are well regulated — are likely to be less toxic than cigarettes — and that for smokers is an advantage,” says Peruga.

http://www.cnn.com/2015/03/23/health/e-cigarettes-smoking-addiction-nicotine/

Op Ed: How to lower Grand Forks’ high tobacco-use rates

By: Theresa Knox

On Feb. 23, the Herald ran a story about the dismal rates among adults of chewing tobacco use (“N.D. ranks highly in smokeless tobacco use,” Page A1).

As the story reported, North Dakota was ranked 49th out of 50 states and District of Columbia, with 7.6 percent of its adults using smokeless tobacco.

The story went on to interview several people with personal stories about the toll of tobacco in their lives. It ended with the quote, “They all know someone who’s died from tobacco-related cancer.”

These statistics are terrible. And they are not just statistics. As the article referenced, each number represents a person. These are people we know and love — people we work with, and people whom we don’t want to see sick and dying from the No. 1 cause of preventable death: tobacco use.

Nearly one quarter of high school boys in North Dakota use smokeless tobacco (22 percent). That is higher than the adult use rate and the fifth worst in the country.

We know that most smokers begin their addictive habit before the age of 18, and nearly 4,000 kids try their first cigarette every day. That’s almost 1.5 million young people per year.

The tobacco industry pours billions into advertising to create a perception that tobacco use is fun and glamorous.

But, guess what? We don’t have billions to counteract that type of messaging — and we don’t need it.

There is a solution that is nearly free of charge; and it works. Research bears out this claim.

I will tell you what that solution is, but first, ask yourself this question: Is it easier to quit using tobacco or to avoid ever taking up the habit?

It is easier (and cheaper) to avoid taking up this addictive habit.

Second, I ask you to rethink your attitudes about tobacco use and why it is not acceptable in indoor and outdoor public places. There is no denying that second-hand smoke and toxic litter from cigarette butts and spitting on the ground are bad for people and animals. But there is an even more important reason to prohibit tobacco use in indoor and outdoor public places: Public policy that keeps kids from seeing tobacco use as a normal activity will decrease youth initiation of tobacco use.

Remember, most people don’t chew or smoke tobacco.

An effective way to keep our next generation of North Dakotans from ever taking up using tobacco is to pass laws that keep tobacco use –including e-cigarettes, cigarettes and smokeless tobacco — out of our parks.

We can pass public policy that creates tobacco free environments. These policies don’t tell people they can’t use tobacco, if they choose to use. People are still free to smoke or chew. These policies prevent the use of products in otherwise safe and healthy places.

Grand Forks Park Board commissioners have the chance to take a deliberate and determined step to protect the health and safety of Grand Forks youth by adopting a comprehensive tobacco-free parks policy. They can take the lead to separate the connection between sports and chew, parks and tobacco.

And the result?

We know the result. A comprehensive tobacco-free parks policy, prohibiting use of all tobacco products in all Park District parks, grounds and facilities will result in cleaner parks and less secondhand smoke exposure.

And the most celebrated result?

Fewer Grand Forks youth will start using tobacco, and fewer among the next generation of North Dakotans will struggle with tobacco addiction and the toll of the illness and death that result from tobacco.

That is the solution. And it costs next to nothing.
http://www.grandforksherald.com/opinion/op-ed-columns/3688567-theresa-knox-how-lower-grand-forks-high-tobacco-use-rates