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E-cigarettes: Should They Be Regulated as Cigarettes?

., Commissioner, Chicago Department of Public Health

Should e-cigarettes be regulated as cigarettes?
I think so.
E-cigarettes are designed to look like cigarettes. They are labeled and marketed like cigarettes. They contain nicotine like cigarettes. They should be regulated like cigarettes.
The single most important reason a regulation on e-cigarettes is vital at this time is to protect kids from a product that we know is addictive. Electronic cigarettes now come in dozens of flavors like passion fruit, cotton candy, bubble gum, gummy bear, Atomic Fireball, and orange cream soda. These kid-friendly flavors are an enticing “starter” for youth and non-smokers, increasing nicotine addiction and frequently lead to use of combustible cigarettes.
Like other gateway products Big Tobacco has masked to entice its next generation of smokers, e-cigarettes follow suit as its popularity with youth nationwide more than doubledfrom 2011 to 2012. Ten percent of our students have already used these addictive products — and they have only been on the market for a few years. This meteoric rise in popularity among youth is concerning. It is also the main reason Mayor Rahm Emanuel has introduced a new ordinance to regulate e-cigarettes as tobacco products.
Simply put, kids should not have easy access to e-cigarettes any longer. Right now in Chicago, a 14-year-old can walk into a store and purchase an e-cigarette with no question asked. This is unacceptable. Retailers should be required to have a tobacco-retail license in order to sell e-cigarettes, which would place these products behind the counter with the other tobacco products and out of arms reach of our children. The government has a duty to protect children from ever picking up a nicotine habit. The preventive action Mayor Emanuel is taking right now is a long-term investment in the health and well-being of Chicago’s youth.
Some might argue that e-cigarettes should not be regulated because they are safer than regular cigarettes. While it’s true that they may be safer than regular cigarettes, they have not been proven to be safe. The truth is e-cigarette companies have not provided any scientific studies or toxicity analysis to the FDA to show that e-cigarettes pose any reduced health risk over conventional cigarettes, nor have they demonstrated that e-cigarettes are safe. Laboratory tests have found that the so-called “water vapor” from some e-cigarettes can contain nicotine and volatile organic compounds like benzene and toluene; heavy metals like nickel and arsenic; carbon compounds like formaldehyde and acrolein, in addition to tobacco specific nitrosamines.
Moreover, no federal regulations have been imposed on e-cigarettes, which means that there currently are no restrictions on ingredients manufacturers can or cannot use and no restrictions on the kinds of chemicals they can emit into the indoor environment. Until more is known about these products, limiting their use in indoor areas is just good common sense.
I am also concerned that widespread use of e-cigarettes is re-normalizing smoking in our society, which in turn, makes this a very pertinent public health issue. E-cigarettes intentionally were developed to mimic the act of smoking. This distorted reinforcement of smoking as cool and acceptable sends the wrong message to our youth and undermines the existing smoking bans put in place to protect the health of the public.
In Chicago, smoking rates are lower than ever. This progress is a direct result of life-saving policies like the Chicago Clean Indoor Air Act. Health advocates worked tirelessly to ensure we all have the right to breathe clean in-door air. We’re not turning our backs on their hard work to promote clean air.
Our residents expect a healthy environment when they walk into a restaurant, bar or theater. We can’t allow any regression in our progress to change the landscape of public health by reverting back to a culture we’ve worked so hard to change. We need to, and can do, better for the children in our city.
Chicago’s new ordinances are part of an overall comprehensive strategy to reduce the negative consequences tobacco use has on our youth.
With the introduction of these expanded tobacco-control policies, Mayor Emanuel is inspiring cities across the nation to take action to ensure that residents avoid preventable disease and live healthy and productive lives.
http://www.huffingtonpost.com/bechara-choucair-md/e-cigarettes_b_4352410.html

The Truth About The Safety Of E-Cigarettes

By Christopher Wanjek, Columnist
At first, electronic cigarettes were a novelty — something a braggart in a bar might puff to challenge the established no-smoking policy, marveling bystanders with the fact that the smoke released from the device was merely harmless vapor.
Now, e-cigarettes are poised to be a billion-dollar industry, claimed as the solution to bring in smokers from out of the cold, both figuratively and literally, as e-cigarettes promise to lift the stigma of smoking and are increasingly permitted at indoor facilities where smoking is banned.
So, are e-cigarettes safe? Well, they’re not great for you, doctors say. What’s being debated is the degree to which they are less dangerous than traditional cigarettes.
1940 revisited
E-cigarettes are battery-powered devices, often shaped like traditional cigarettes, with a heating element that vaporizes a liquid nicotine solution, which must be replaced every few hundred puffs. Nicotine is inhaled into the lungs, and a largely odorless water vapor comes out of the device. Puffing an e-cigarette is called vaping.
Yet the industry’s duplicity is clear to medical experts: E-cigarettes are marketed to smokers as a means to wean them off of tobacco (although studies show they don’t help much); yet the same devices, some with fruity flavors, are marketed to young people who don’t smoke, which could get them hooked.
Hooked? Yes, e-cigarettes are a nicotine-delivery system, highly addictive and ultimately harmful because of their nicotine.
Cancer and respiratory experts see the same ploy being played out today with e-cigarettes as was done in the 1940s with cigarettes, when America started smoking en masse. They often are distributed for free and pitched by celebrities and even doctors as cool, liberating and safe.
In an ad for a product called blu eCigs, celebrity Jenny McCarthy, infamous for encouraging parents not to vaccinate their children, encourages young adults to vape, enlisting words such as “freedom” and the promise of sex. In another ad, for V2 Cigs, a medical doctor named Matthew Huebner — who is presented without affiliation but is associated with a Cleveland Clinic facility in Weston, Fla. — implies that vaping is as harmless as boiling water.
As for the notion of e-cigs as liberating, the cost of a year’s worth of e-cigarette nicotine cartridges is about $600, compared with $1,000 yearly for a half-pack a day of regular cigarettes.
As for whether they’re safe, it’s a matter of comparing the advantages of one addiction over another.
E-cigarettes not a patch
One would think that vaping has to be safer than smoking real cigarettes. Experts say they are probably safer, but safer doesn’t mean safe.
“Cigarettes have their risk profile,” said Dr. Frank Leone, a pulmonary expert at the University of Pennsylvania Medical Center in Philadelphia. And just about everyone who breathes understands the risks: circulatory disease and myriad cancers, for starters. “E-cigarettes might be better off compared to that profile. But that doesn’t mean they don’t have their own risk profile.”
A top concern is the nicotine delivery rate, Leone said. With nicotine patches and gum, the nicotine delivery is regulated, with small amounts of nicotine released slowly into the bloodstream. But with traditional cigarettes and now e-cigarettes, heat creates a freebase form of nicotine that is more addictive — or what smokers would call more satisfying. The nicotine goes right into the lungs, where it is quickly channeled into the heart and then pumped into the brain.
Once addicted, the body will crave nicotine. And although nicotine isn’t the most dangerous toxin in tobacco’s arsenal, this chemical nevertheless is a cancer-promoting agent, and is associated with birth defects and developmental disorders.
A study published in 2006 in the journal Obstetrics and Gynecology, for example, found that women who chewed nicotine gum during pregnancy had a higher risk of birth defects compared to other nonsmokers.
Great unknowns
This great unknown of possible negative health effects, along with the lack of regulation of e-cigarettes, scares experts like Leone. The products come bereft of health warnings. How many pregnant women will vape following McCarthy’s promotion?
As for their merits in smoking cessation, e-cigarettes don’t appear very helpful. A study published last month in the journal Addictive Behaviors found that most smokers who used them while they tried to quit either became hooked on vaping, or reverted back to smoking cigarettes. A study published Nov. 16 in the journal The Lancet found no statistically significant difference in the merits of the e-cigarette over the nicotine patch in terms of helping people quit.
Leone said that e-cigarettes might not help people quit smoking because the device keeps addicts in a state of ambivalence — the illusion of doing something positive to mitigate the guilt that comes from smoking, but all the while maintaining the ritual of smoking.
The Jenny McCarthy blu eCigs ad hints at this notion, with such phrases as “smarter alternative to cigarettes,” “without the guilt” and “now that I switched…I feel better about myself.”
Editors of The Lancet called promotion of e-cigarettes “a moral quandary” because of this potential to replace harmful cigarettes with something slightly less harmful yet just as addictive. Other researchers agree that e-cigarettes might help some people quit, but at a population level, converting millions of smokers into vapers still addicted to nicotine might not lead to the cleaner, greener, healthier world implied by e-cigarette manufacturers.
And then there’s the issue of not knowing what’s in the e-cigarette nicotine cartridge.
“It’s an amazing thing to watch a new product like that just kind of appear; there’s no quality control,” said Dr. Richard Hurt, director of the Mayo Clinic’s Nicotine Dependence Center in Rochester, Minn. “Many of them are manufactured in China under no control conditions, so the story is yet to be completely told.”
The authors of The Lancet study, all based in New Zealand, called for countries to regulate the manufacturing and sale of e-cigarettes. The U.S. Food and Drug Administration, which does not approve any e-cigarettes for therapeutic purpose, said it plans to propose a regulation to extend the definition of “tobacco product” under the Tobacco Control Act to gain more authority to regulate products such as e-cigarettes.
http://www.huffingtonpost.com/2013/11/22/ecigarettes-safety-health-risks-electronic-cigarettes_n_4323231.html
 

E-cigarettes: Do benefits outweigh risks?

by Natalie Brand / KTVK
More and more tobacco companies are jumping into the “e-cigarette” market, considered the “wild, wild west,” since it’s without FDA regulations.
From celebrity commercials to candy flavors, some health officials worry who e-cigarette manufacturers may be targeting.
“You see all the commercials that cigarettes are so bad, which is true, then they say, it’s a new, safe alternative,” said Matt Majd who admitted e-cigarettes were popular at his high school.
“People think it’s cool to do it in class and try not to let teachers see,” said Majd who has also tried e-cigarettes himself.  “Just gives you somewhat of a buzz, somewhat of a head rush, kinda similar to the effect of cigarettes.”
“It’s still troubling to see some actors in the industry real actively trying to recruit kids to their product,” said Arizona Department of Health Services Director Will Humble.
Humble says the jury’s still out as to whether e-cigarettes will serve their purpose as a safer alternative for smokers, or inadvertently get a new generation hooked.
“What I don’t know yet is where electronic cigarettes lie on the scale; are there more benefits than risks?”
A recent CDC study found e-cigarette experimentation and use among middle and high school students doubled last year.  It’s too early to know if that will eventually lead them to smoking tobacco cigarettes.
“Once you’ve got a kid addicted to nicotine, now you’ve got an active potential smoker for the rest of their lives, because their brains get hardwired when they start smoking,” said Humble.
Craig Weiss, President and CEO of Scottsdale based NJOY says his company goes out of its way to play by the rules from verifying age to advertising to smokers and smokers only.
Former Surgeon General Richard Carmona of Tucson sits on NJOY’s Board of Directors.
“We’re not interested in people who are underage,” said Weiss.  He said his target is the public health epidemic of smoking.
“We feel we’re helping people,” said Weiss.  “Smokers are already addicted to nicotine, and that’s the only customer I’m interested in.”
Weiss said his end game is a place with no tobacco.
“We want there to be reasonable regulation by the FDA, so everyone is playing by the same rules,” said Weiss.
When asked if he fears e-cigarette commercials are glamorizing smokers:
“I think of it as advertising,” said Weiss.  “It’s important for us to communicate to our smokers that they have an alternative.”
But health leaders worry what could happen if this now billion dollar business is left unregulated.
“The potential is there for these products to really do a lot of good, I honestly believe that,” said Will Humble.  “But not if they’re going to go after kids, not if they’re going to go after people who don’t smoke.”
http://www.kvue.com/news/232829891.html

A case against e-cigarettes

By MANDY JORDAN, Bismarck
Today we celebrate the Great American Smokeout. It is a national campaign that brings awareness to the dangers of tobacco and secondhand smoke, and encourages people who smoke to quit.
According to statistics from BreatheND, this year in North Dakota 19.4 percent of high school students will smoke and will purchase 1.9 million packs of cigarettes. In our community, 42,000 kids are exposed to secondhand smoke on a daily basis.
Last year, Century SADD testified in front of legislators regarding the new threat to our young people’s health called e-cigarettes. These are electronic devices that deliver nicotine to the body through vapor. Not only can these be candy-flavored, you can now buy cartoon wraps for them to make them visually pleasing. They are not regulated by the Food and Drug Administration and contain carcinogens and toxic chemicals such as diethylene glycol, which is found in antifreeze.
Although the carton says that you need to be 18 to purchase these, we have seen our peers who are under 18 using this product. They are now being sold at a kiosk in a local mall, which is cleverly located by stores where young people shop.
The tobacco industry is trying to say that this is a “harms reduction” product that is intended to help people quit smoking. It is even trying to get North Dakota taxpayers to pay for research that benefits the industry. (Keep in mind that tobacco companies own this product.) It is our strong belief that “harms reduction” is a lie and that e-cigs are a gateway drug that will ultimately create long-term addiction versus reduction. Please join us in our effort to put an end to not only tobacco use, but the new threat of e-cigarettes.
(This letter was signed by Mandy Jordan and members of Century High School SADD. Laurie Foerderer is the adviser.)
http://bismarcktribune.com/news/opinion/mailbag/a-case-against-e-cigarettes/article_fe0eb3b8-522c-11e3-827c-0019bb2963f4.html

Tobacco Myths Persist 50 Years After US Surgeon General Warned Americans of Smoking Dangers

Tobacco misconceptions prevail in the United States despite the dramatic drop in smoking rates since the release of the first Surgeon General’s Report on smoking and health in January 1964. Experts at The University of Texas MD Anderson Cancer Center dispel common myths and share new educational resources to address this persistent challenge.
“Since 1964, smoking rates have dropped by more than half as a result of successful education, legislative and smoking cessation efforts,” said Lewis Foxhall, M.D., vice president for health policy at MD Anderson. “Still, lung cancer remains the number one cancer killer and the leading preventable cause of death in the United States.”
With the approaching 50th anniversary of the Surgeon General’s Report, Foxhall and other MD Anderson experts urge the public to take a proactive stance against this pervasive health issue by gaining insight on current tobacco issues including information that disproves the following myths.
Tobacco Myth #1: Almost no one smokes any more.
Fact: About 43.8 million people still smoke. That’s almost one in five people in the United States.
“The current percentage of smokers is 19%. That’s significantly lower than the 42% in 1965,” Foxhall said. “However, the actual number of people smoking today is close to the same.” About 50 million people smoked in 1965. “Because our population is much larger, it just seems like we have a lot fewer smokers,” Foxhall explained.
“We have a lot of work ahead to prevent new smokers and help existing smokers quit,” said Ellen R. Gritz, Ph.D., professor and chair of behavioral science at MD Anderson. “Thanks to programs like the American Legacy Foundation’s truth national anti-smoking campaign, we have been able to achieve fewer youths smoking,” Gritz said, a previous vice chair on the Legacy board. “But funding for these campaigns is limited and unable to compete with the exorbitant and seemingly unlimited advertising dollars spent by tobacco companies.”
Tobacco Myth #2: e-Cigarettes, cigars and hookahs are safe alternatives.
Fact: All tobacco products, including e-cigarettes and hookahs, have nicotine. And it’s nicotine’s highly addictive properties that make these products harmful.
In 2008, the five largest cigarette companies spent $9.94 billion dollars on advertising and marketing products like e-cigarettes, flavored cigars, cigarillos and hookahs.
“The tobacco industry comes up with these new products to recruit new, younger smokers,” said Alexander Prokhorov, M.D., Ph.D., director of the Tobacco Outreach Education Program at MD Anderson. “And, they advertise them as less harmful than conventional cigarettes. But once a young person gets acquainted with nicotine, it’s more likely he or she will try other tobacco products.”
“While e-cigarettes may contain less harmful substances than combustible tobacco, they’re presently unregulated so quality control over the nicotine content and other components is left to the manufacturer,” said Paul Cinciripini, Ph.D., professor and deputy chair of behavioral science and director of the Tobacco Treatment Program at MD Anderson.
“At this time, it’s far too early to tell whether or not e-cigarettes can be used effectively as a smoking cessation device,” Cinciripini said.
Tobacco Myth #3: Infrequent, social smoking is harmless.
Fact: Any smoking, even social smoking, is dangerous.
“Science has not identified a safe level of smoking, and even a few cigarettes here and there can maintain addiction,” said David Wetter, Ph.D., chair of health disparities research at MD Anderson. “If you are a former smoker, data suggests that having just a single puff can send you back to smoking.”
Tobacco Myth #4: Smoking outside eliminates the dangers of secondhand smoke.
Fact: There is no risk-free level of exposure to secondhand smoke. Even brief secondhand smoke exposure can cause harm. Exposure to secondhand smoke at home or work increases a person’s risk of heart disease by 25 to 30% and lung cancer by 20 to 30%. That’s because the amount of cancer-causing chemicals is higher in secondhand smoke than in the smoke inhaled by smokers. Families that prohibit smoking in and around the home are on the right path, said Wetter.
Stay informed and take action
“Being educated and sharing this knowledge with others are ways to action,” said Ernest Hawk, M.D., vice president of cancer prevention and population sciences at MD Anderson. “For smokers, it’s never too late to quit smoking and reap health benefits.”
As part of MD Anderson’s Moon Shot program to end cancer, Hawk and other experts have developed a comprehensive plan that addresses the burden of tobacco use in institutions, communities, states and nations.
“The End Tobacco plan recommends more than 100 actions in the areas of policy, education and community-based services that MD Anderson can lead to end tobacco at the institutional, local, regional, state national and international levels,” Hawk said. “As a leader in the field of tobacco research, it’s vital we take a leadership role to confront the use of tobacco in any form.”
More than 200,000 people are diagnosed with lung cancer each year in the United States and about 150,000 people die as a result of this disease. Smoking contributes to almost 90% of lung cancer deaths and 30% of all cancer deaths.
Story Source:
The above story is based on materials provided by University of Texas M. D. Anderson Cancer Center.
Note: Materials may be edited for content and length. For further information, please contact the source cited above.
http://www.sciencedaily.com/releases/2013/11/131107142436.htm

Reynolds Launches E-Mail Alert Feature

Published in Tobacco E-News
Melissa Vonder Haar, Tobacco Editor
WINSTON-SALEM, N.C. —Today, R.J. Reynolds Tobacco Co. has announced a new feature on its Transform Tobacco website to immediately notify retailers, wholesalers and adult tobacco consumers when a tobacco-related issue arises in their state.
Instead of checking the website, individuals can now sign up to receive electronic notifications via email when an alert in their area is issued.
“This new feature will make it much easier for people to stay informed and take action on tobacco-related issues that affect them,” said Bryan Hatchell, Reynolds’ director of communications. “We are continuously searching for ways to transform the tobacco industry, and making it easier for people’s voices to be heard will certainly help achieve that goal.”
The Transform Tobacco site also features regularly updated information on tobacco issues, including an interactive state-by-state map that provides key points on important tobacco-related matters, links to Transform Tobacco’s Twitter and Facebook pages and an easy outlet for visitors to the site to connect to their legislators by phone or via email.
Reynolds has previously used the site in conjunction with the Save Our Stores Coalition to educate and encourage retailers to fight back against a series of anti-smoking bills being considered by the New York City Council. While the City Council did raise the minimum age to purchase tobacco products to 21, the proposal to ban tobacco displays was dropped from the bill.
Winston-Salem, N.J.-based R.J. Reynolds Tobacco, an indirect subsidiary of Reynolds American Inc., is the second-largest tobacco company in the United States.
http://www.cspnet.com/category-management-news-data/tobacco-news-data/articles/reynolds-launches-e-mail-alert-feature

Tobacco Marketing Costs Exceed Those of Prevention Efforts

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

Camels: 100 years and still killing

By Robert N. Proctor
We’re quietly approaching the 100th anniversary of the modern cigarette, but don’t expect much in the way of fanfare. Cigarette sales have been falling since 1981, when 630 billion were smoked in the United States. Now we smoke only about 300 billion in any given year, mostly in the style of the “American blend” introduced by Camels.
Camels were first sold in October 1913. Only 1 million were sold that first year, but this quickly grew to 425 million in 1914 and to 6.5 billion two years later. Twenty-one billion were sold in 1919, and by the early 1920s, nearly half of all cigarettes sold in the U.S. were Camels.
And though other “standard brands” were soon introduced — Chesterfields, Lucky Strikes and Old Golds — Camels still had a 30 percent share of the cigarette market in the late 1940s. By its 65th anniversary in 1978, the brand had sold more than 3 trillion sticks. Camel still holds the record for the most cigarettes sold in a single year: 105 billion in 1952.
The success of the brand is traceable partly to marketing genius. N.W. Ayer & Son was the agency hired to handle the launch, which began with a teaser campaign. Newspapers nationwide announced “the Camels are coming,” with no hint that the blitz was for a new brand of cigarettes. (Reynolds had not even sold cigarettes before 1912.) One ad crowed that “Tomorrow there’ll be more CAMELS in this town than in all Asia and Africa combined!”
The cigarettes came in a new kind of packaging. Camels were the first cigarette sold in that boxy “cup” we now identify as a cigarette pack, with 20 cigarettes per. Camels were also the first smoke to be sold in cartons of 200, and the first sold coast to coast. And (crucially) the first to incorporate what came to be known as “the American blend,” a juiced-up concoction of flue-cured and burley tobacco leaf that was both mild enough to be inhaled and sweet from sugars added to the mix.
A lot has changed since then. The machines that produced those early Camels could manage only seven or eight per second; today’s machines spit out 20,000 sticks per minute, or about 330 per second. And cigarettes today are far more affordable, even with all those taxes going to governments (“the second addiction”). Cigarettes used to be a luxury smoked by dandies and the effete; now they are more likely to be smoked by the mentally ill and destitute.
Some things, though, haven’t changed. Cigarettes still kill about half their long-term users, despite industry bluster about filters, low tars and lights, none of which has made smoking safer. Cigarettes still contain arsenic and cyanide and radioactive polonium-210, the poison used to kill that Russian spy in London a few years back. Cigarettes cause one death for every million smoked, which means that the 4 trillion Camels consumed over the last 100 years have probably caused about 4 million deaths.
And it would be wrong to think of the cigarette business as moribund. Shareholders of the three largest makers in the U.S. all earn dividends in excess of 4 percent, and those holding stock in Altria (parent company of Philip Morris) earn closer to 6 percent.
Youth is still key to the business because most smokers start in their teens and stay fiercely brand loyal. Joe Camel was retired in 1997, but until 2009 (when Congress passed the Family Smoking Prevention and Tobacco Control Act), Camels came in candy-fruit-tropical flavors, including Camel Mandarin Mint and Camel Mandalay Lime. Camel No. 9s, advertised as “light and luscious” and sold in feminine black and pink packs, are still allowed on the market, despite fears that this “Barbie cigarette” targets girls. And Camel Crush offers a hit of mint to those who like menthol “refreshment.” Advertising for such products has increased in recent months, and on my last trip to the dentist, I found four different ads for cigarettes in magazines in the waiting room.
Camel’s anniversary is really only being celebrated overseas, where cigarettes sales remain robust. Worldwide, 6 trillion cigarettes (of all brands) were sold in 2012, which explains why smoking remains the leading preventable cause of death. JTI, the company that owns rights to the Camel brand abroad, is celebrating with a giant “iPad controlled video jukebox” in the shape of a camel, with slogans such as “Discover more” and “Inspiring creativity since 1913.” Most Europeans can buy packs celebrating the anniversary, and Mexico City has held brand-themed events. All of which helps keep Camels among the five bestselling brands in the world.
Here in the birthplace of Camels, though, things are quieter. The cigarette is something of a cardiopulmonary anachronism, and not much to party about. Camel’s success has been literally breathtaking, caravaning millions into that sleep from which we never awake.
Robert N. Proctor is a professor of the history of science at Stanford University. He wrote this for the LA Times.
http://www.denverpost.com/opinion/ci_24381870/camels-100-years-and-still-killing
 

The E-Cigarette Industry, Waiting to Exhale

By , New York Times
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Geoff Vuleta was in the crowd at a Rolling Stones concert last year when Keith Richards lit up a cigarette on stage, the arena’s no-smoking policy be damned. Feeling inspired, Mr. Vuleta, a longtime smoker, reached into his pocket and pulled one out himself. People seated nearby shot him scolding glances as he inhaled. So he withdrew the cigarette from his mouth and pressed the glowing end to his cheek.

His was an electronic cigarette, a look-alike that delivers nicotine without combusting tobacco and produces a vapor, not smoke. Mr. Vuleta, 51, who has a sardonic humor, clearly relished recounting this story. He is the chief marketing officer for NJOY, an electronic cigarette company based in Scottsdale, Ariz., and it is his job to reframe how everyone, nonsmokers included, view the habit of inhaling from a thin stick and blowing out a visible cloud.

Mr. Vuleta, who told his tale in the office of Craig Weiss, the NJOY chief executive, calls this a process of “renormalizing,” so that smokers can come back in from the cold. He means that literally — allowing people now exiled to the sidewalks back into buildings with e-cigarettes. But he also means it metaphorically. Early in the last century, smoking was an accepted alternative for men to chewing tobacco; for women, it was daring and transgressive. Then, in midcentury, it became the norm. As the dangers of tobacco — and the scandalous behavior of tobacco companies in concealing those dangers — became impossible to ignore, smoking took on a new identity: societal evil.

Mr. Vuleta and Mr. Weiss want to make “vaping,” as e-cigarette smoking is known in the industry, acceptable. Keith Richards might still be smoking tobacco, but in Mr. Vuleta’s vision, that grizzled guitarist’s gesture could inspire the audience, en masse, to pull out e-cigarettes. “The moment Keith Richards does it,” he said, “everyone else does, too.”

Mr. Vuleta’s words are more exuberant than the official company line, which is that NJOY doesn’t want everyone to smoke e-cigarettes but only to convert the 40 million Americans who now smoke tobacco. The customers NJOY attracts, and how it attracts them, are at the center of a new public health debate, not to mention a rush to control the e-cigarette business.

At stake is a vaping market that has grown in a few short years to around $1.7 billion in sales in the United States. That is tiny when compared to the nation’s $90 billion cigarette market. But one particularly bullish Wall Street analyst projects that consumption of e-cigarettes will outstrip regular ones in the next decade.

NJOY was one of the first companies to sell e-cigarettes; now there are 200 in the United States, most of them small. Just last year, however, Big Tobacco got into the game when Lorillard acquired Blu, an e-cigarette brand, and demonstrated its economic power. Within months, relying on Lorillard’s decades-old distribution channels, Blu displaced NJOY as the market leader.

Mr. Weiss still sees NJOY as having an advantage — in building e-cigarettes that look, feel and perform like the real thing. It’s a different strategy than that of competing products that look like long silver tubes or sleek, blinking fountain pens.

“We’re trying to do something very challenging: change a habit that is not only entrenched but one people are willing to take to their grave,” said Mr. Weiss, who is not a smoker but has tried both regular and e-cigarettes. “To accomplish that, we have to narrow as much as possible the bridge to familiarity. We have to make it easy for smokers to cross it.”

To some, though not all, in public health, that vision sounds ill-conceived, if not threatening. Among their concerns is that making smoking-like behavior O.K. again will undo decades of work demonizing smoking itself. Far from leading to more smoking cessation, they argue, e-cigarettes will ultimately revive it, and abet new cases ofemphysema, heart disease and lung cancer.

“The very thing that could make them effective is also their greatest danger,” said Dr. Tim McAfee, director of Office on Smoking and Health at the Centers for Disease Control and Prevention.

To achieve his ends, Mr. Weiss is building a company of strange bedfellows. He has hired former top tobacco industry executives, but also attracted a former surgeon general, Dr. Richard H. Carmona, who has joined the board. NJOY recently hired away a prominent professor of chemistry and genomics from Princeton to be the company’s chief scientist. The company has attracted investment from Sean Parker, the former Facebook president, and Peter Thiel, the PayPal co-founder. There has also been a celebrity endorsement from the singer Bruno Mars.

Mr. Weiss sees his company as doing something epic. Not long after he was named its president in June 2010, he asked his psychologist if he might record his regular sessions. It was an unusual request, but he thinks that recording his thoughts might ultimately help him write a book or movie script about how he and the company made the cigarette obsolete.

“We’re at this incredible inflection point in history,” he said, adding that the company has a chance to “make the single most beneficial impact on society in this century.”

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Over dinner at Federal Pizza, a trendy place in Phoenix owned by a close friend, Mr. Weiss put a Camel Crush cigarette onto a table beside an NJOY King. “These are almost identical,” he says, “but we still have a ways to go.”

The two sticks on the table were roughly the same size. But NJOY’s weighs around 5 grams, more than twice as much as the Camel. When squeezed, the NJOY isn’t as spongy, and it lacks the Camel’s fragrance (though a nimbus of tobacco bouquet emerges when you open the pack). The tip is plastic with an LED glow, not real fire, and it produces no ash.

These distinctions can mean everything to heavy smokers for whom each detail in the smoking ritual — a “moment in the day,” as Mr. Vuleta summarizes the experience of each cigarette — adds up to something exquisite.

“Smokers talk about a ‘throat hit,’ ” Mr. Weiss explained as he sipped a strawberry wine cooler over pizza, referring to a tickle or slight burn at the back of the throat, a part of the overall Pavlovian experience that comes before the nicotine rush. It’s something, he said, that the company’s products are becoming better at imitating, along with changing the chemistry inside the e-cigarette so that nicotine is absorbed more quickly by the body, more like the real thing. But it is not there yet.

The NJOY King, which sells for $7.99, is disposable and tries to deliver as much nicotine as a pack of 20 cigarettes; other kinds of e-cigarettes are rechargeable, their nicotine fluid refills costing around $3 or $4.

If the NJOY and a regular cigarette look similar on the outside, the inside is another story. Inside the e-cigarette’s polycarbonate tube casing is an integrated circuit, a small computer chip. Then comes a lithium-ion battery and a wick wrapped in cotton soaked in a mixture of nicotine and a carrier liquid of glycerol and propylene glycol. The battery is turned on when the user drags on the stick, heating the gadget’s inside to around 180 degrees and turning the nicotine into vapor. When inhaled, it leaves the throat with an “ambient feel,” Mr. Weiss calls it — a caress, not the desired throat hit.

Not all e-cigarette companies embrace experiential authenticity the way NJOY does, and some make a deliberate effort at difference. NJOY executives like to mock the more exotic efforts. “An e-cigarette that doesn’t look like a cigarette, but looks like a silver tube with a white light at the end, is anything but an exquisite experience,” said Roy Anise, NJOY’s executive vice president in charge of sales, who came to the company from Philip Morris, the tobacco company whose parent is Altria. Mr. Anise worked in the tobacco industry for 24 years, eventually in the division that sold smokeless products.

Blu eCigs, NJOY’s biggest competition, are slender black tubes, with tips that glow blue, not ember-red. Murray S. Kessler, the C.E.O. of Lorillard, which sells Blu, described the look as “edgy” and “cool” and said that, with such a look, there is a better chance to make it a “complete replacement” to the cigarette. “I don’t want to emulate a cigarette,” Mr. Kessler said. “The big idea isn’t to try to keep people in cigarettes, but to normalize smoking e-cigarettes and vaping as the next generation.”

E-cigarettes that look different, he said, could “solve the social stigma issue” and erase the tension of smoking in public places.

Doesn’t that cannibalize his tobacco business? Yes, he said, it might, but he added that his shareholders “don’t care whether we sell cigarettes or e-cigarettes” so long as the company maintains profits. Right now, though, real cigarettes are much more profitable, as Mr. Kessler conceded, but he said he thought that e-cigarette profit margins could grow.

Bonnie Herzog, a tobacco industry analyst at Wells Fargo who is particularly bullish on e-cigarettes, said that there was room for different e-cigarette styles. But tobacco companies have a decided edge over small companies like NJOY, she said, because of their entrenched distribution, deep pockets and databases of contact information for millions of customers.

Her assertion seems to be borne out by the success of Blu. Since being acquired by Lorillard, Blu has a convenience-store market share that has climbed to 39 percent from 12 percent in a little more than a year, while NJOY’s has fallen to 30 percent from 48 percent. (NJOY expects its revenue to triple over this year to more than $100 million; Mr. Weiss declined to be more specific about sales.)

Lorillard is pushing hard, saying it will spend $40 million this year on marketing — a budget that amounts to 35 percent of the $114 million in Blu sales in the first half of the year.

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Two other big tobacco companies are exploring the market. The MarkTen, from Altria, can be recharged; it is being sold in Indiana in a test. The Vuse, from the R. J. Reynolds Tobacco Company, is a long, silver model that is being tried in Colorado.

If those large companies decide to go full force into the market, they could further erode NJOY’s market share, adding a business reason for Mr. Weiss to vilify the tobacco giants. One selling point of NJOY may be its likeness to real cigarettes, but another could be that it was never a tobacco company. He has brought on Mr. Anise and others with tobacco experience, he said, because success depends on relationships with convenience stores that sell cigarettes. But, unlike Mr. Kessler, Mr. Weiss can still rail against the companies that “kill half their customers.”

Mr. Weiss, who turned 40 in July, didn’t come to NJOY as a public health advocate or even as someone whose life was touched by the hazards of smoking. “I have no personal ‘my dad died of lung cancer’ type of story,’ ” he said. Rather, his zeal seems to be equal parts outrage and inborn entrepreneurial excitation. He obtained the first of his three patents at age 15 — it was for a net to catch tennis balls — and went on to become a lawyer before starting a hedge fund.

NJOY was started by Mr. Weiss’s brother, Mark Weiss, a lawyer in Scottsdale, who was inspired by a crude version of an electronic cigar at a trade show in China in 2005. In 2009, the company faced a near-death experience when a shipment from China, where the NJOY cigarettes are made, was seized at the port of Long Beach, Calif. The Food and Drug Administration charged that the e-cigarettes were an unapproved drug-delivery device.

NJOY initially argued that it had made no health claims and therefore shouldn’t be regulated. But just months after the seizure, the Family Smoking Prevention and Tobacco Control Act was passed. It gave the F.D.A. the power to regulate tobacco products, but not to ban them. (At the time, Craig Weiss was a shareholder but not part of management; he did weigh in on legal matters.) After the change in federal law, NJOY updated its legal position, arguing that nicotine is derived from tobacco, and therefore that the F.D.A. had the power to regulate e-cigarettes under the new law. In a 2010 ruling, a federal district court in Washington accepted that argument, preventing an outright ban of NJOY’s product as an unregulated drug delivery device and punting the specifics of how the products should be regulated over to the F.D.A.

The F.D.A. has said it plans to issue preliminary rules for public comment on e-cigarette regulations as soon as the end of this month, but the partial government shutdown appears to have delayed that process. Earlier this month, the European Parliament endorsed limits on sponsorship and advertising of e-cigarettes, and on their sale to minors, but scrapped tougher regulations favored by some in public health that would have regulated them as tightly as medical devices.

Some critics say NJOY and other e-cigarette companies are trying to have it both ways. “When it’s convenient to be like tobacco, they’re like tobacco,” says Stanton A. Glantz, director of the Center for Tobacco Control Research and Education at the University of California, San Francisco, “and when it’s not convenient, they’re not.”

One day in mid-August, Dr. McAfee, the tobacco expert from the C.D.C., received an e-mail with statistics about e-cigarette use among young people. The statistics compared e-cigarette experimentation in 2012 with that of 2011, the first year the C.D.C. had collected data on the phenomenon.

Alarm bells went off the instant Dr. McAfee saw the numbers: among students in grades 6 to 12, experimentation with e-cigarettes had doubled, to 6.8 percent from 3.3 percent. Not surprisingly, the numbers were higher among high school students, 10 percent of whom reported trying an e-cigarette, more than double the share in 2011.

Within hours, Dr. McAfee called Mitch Zeller, the director of the Center for Tobacco Products of the F.D.A. As Dr. McAfee recounted his conversation, he told Mr. Zeller: “This is not business as usual.”

One of the strongest predictors of whether someone becomes a lifelong smoker is how early he or she starts experimenting, and Dr. McAfee saw experimentation with e-cigarettes as a gateway to tobacco. Three weeks later, the C.D.C. issued an “emergency note from the field,” a communication typically reserved for acute disease outbreaks.

From a public health perspective, e-cigarettes raise two questions: How harmful are they? And, regardless, will they lead to smoking cessation or, perversely, reinforce the tobacco smoking habit?

Most public health officials seem to agree that the levels of toxins in e-cigarettes are far lower than those in traditional cigarettes. But they also say that far too little is known, not just about potentially harmful aspects of particular brands of e-cigarettes, but also about whether there is harm from “secondhand vapor.” Dr. Glantz of U.C.S.F. says that in the absence of data, indoor smoking bans should also cover e-cigarettes.

Mr. Weiss asserted that such indoor bans would eliminate a competitive advantage for e-cigarettes and thus harm the effort to normalize this alternative behavior. More broadly, he said, public policy should err on the side of giving e-cigarettes a chance, even if everything about the health effects isn’t known. “This idea of saying we don’t have data — that ‘in the absence of data we’re going to act’ — is potentially condemning people to a painful and early death,” he said. Public health officials who want more research before accepting vaping, he said, are “suffering from P.T.S.D. from the lies they were told by tobacco companies.”

The public health officials don’t disagree; in fact, they say they blew it with cigarettes by ignoring warning signs, waiting years to mount ironclad scientific proof and thus allowing a deadly habit to take hold. They are trying to learn from the past. “We can’t allow e-cigarettes to establish themselves the way cigarettes did and, five years from now when all the scientific questions are answered, try to stuff the genie back in the bottle,” said Dr. Glantz, who advocates tighter regulation.

Another area of sharp disagreement is the question of whether e-cigarettes really help people quit smoking. Given that electronic cigarettes aren’t considered as satisfying a nicotine rush, skeptics worry further that if the e-cigarette takes hold, it will lead people to using the tobacco version.

There is no data to validate that concern, just as there is little data on cessation. Surveys suggest that e-cigarette users are quitting or cutting down on cigarettes. But one scientific study, published in September in The Lancet, a British medical journal, found that six months into smoking e-cigarettes, 7.3 percent of users had quit smoking tobacco. That was the statistical equivalent to the modestly effective patch (a quit rate of 5.8 percent).

“We were hoping for the magic bullet,” said Natalie Walker, director of addiction research at the National Institute for Health Innovation in New Zealand, and one of the study’s authors. “We were surprised by the low quit rate.” Still, she says she thinks e-cigarettes have potential as “another tool” and notes that they have a crucial advantage over other nicotine replacement strategies: “E-cigs have a large and dedicated fan club.”

Dr. Carmona, the former surgeon general who has joined NJOY’s board, is not willing to accept defeat. As surgeon general, he emphasized the dangers of secondhand smoke, and e-cigarettes seem to him the best bet for a cessation device. “We don’t have all the answers” he said, “but we see there is potential for this to be a very disruptive force in cessation.”

Mr. Weiss favors regulation that would require companies to disclose ingredients, set manufacturing standards and prohibit sales to minors, but he objects to restrictions on marketing. At the moment, absent F.D.A. regulations, e-cigarette companies, unlike tobacco companies, can sponsor sports and entertainment events, or advertise on television.

What they can’t do is make health claims; if they did, they would face regulation as a drug company. So the ads tend to be implicit, as in one that ran during the Super Bowl last year. In it, a handsome man smoked an NJOY with a voice-over that said: “You know what the most amazing thing about this cigarette is? It isn’t one,” and then continued, “The first electronic cigarette with the look, feel and flavor of the real thing.”

Reynolds, the maker of Vuse, has a commercial that sounds much like old TV ads for cigarettes, promising “a perfect puff, first time, every time.” A commercial for Blu features Jenny McCarthy complaining she doesn’t like a kiss “that tastes like an ashtray.”

Mr. Weiss said NJoy’s Super Bowl ad prompted a 40 percent uptick in sales in the five markets where it ran. That kind of impact is why he doesn’t want the F.D.A. to forbid television advertising. “Any ad restrictions that limit our ability to let smokers know they have an alternative only serves the interest of Big Tobacco,” he said, because tobacco companies have such an edge on the traditional channels of distribution. He does agree, however, that there should be no advertising during children’s TV shows. He declined to say how much the company spends on marketing.

The push for regulation is coming from many quarters, including a majority of the state attorneys general. Forty of them wrote a letter in September to the F.D.A., seeking “immediate regulatory  oversight of e-cigarettes, an increasingly widespread, addictive product.” The letter said that the nicotine in e-cigarettes “has immediate biochemical effects on the brain and body at any dosage, and is toxic in high doses.”

Then, last week, the group sent a second letter reiterating its position, urging rules that would “ensure that companies do not continue to sell or advertise to our nation’s youth.”

In the first letter, the state attorneys general singled out NJOY’s Super Bowl ad, not in its appeal to youth but the way it looked just like the thing it seeks to replace: “The advertisement depicted an attractive man smoking an e-cigarette that looked just like a real cigarette.”

Mr. Weiss doesn’t see a problem with this. “We want it to look exactly like a cigarette because that’s how we’re going to get smokers to change behavior,” he said. For decades, he noted, there have been smoking alternatives, like patches and pills and gum, that were nothing like cigarettes. Going down that road, he said, is “Einstein’s definition of insanity — doing the same thing over and over again and expecting a different result.”

At the same time, he conceded that his strategy “creates some confusion” that “is not irrational to me, and just requires education.”

“People say, if it looks like a duck, and quacks like a duck, it must be a duck.”

Mr. Weiss’s challenge, if he’s to reach what he envisions as a place in history, will be to prove that looks can be deceiving.

http://www.nytimes.com/2013/10/27/business/the-e-cigarette-industry-waiting-to-exhale.html?pagewanted=1&_r=1

Marlboro Maker Altria 3Q Profit More Than Doubles

By MICHAEL FELBERBAUM AP, Tobacco Writer

Altria Group’s third-quarter profit more than doubled as the Marlboro maker paid out less in legal settlements and freed itself from charges related to paying off debt early last year.

Higher prices and volumes for both cigarettes and smokeless tobacco bolstered its underlying results, which topped Wall Street expectations.

The owner of the nation’s biggest cigarette maker, Philip Morris USA, posted earnings Thursday of $1.39 billion, or 70 cents per share. That’s up from $657 million, or 32 cents a share, in the year-ago period, which included a $874 million charge for a loss on early extinguishment of debt.

Excluding one-time items, earnings were 65 cents per share, beating analyst estimates by a penny. That excludes a $145 million benefit from credits for disputed payments under the 1998 Master Settlement Agreement in which some cigarette makers are paying states for smoking-related health care costs.

Revenue for the Richmond, Va., company, excluding excise taxes, increased 6.6 percent to $4.8 billion. Analysts expected $4.53 billion, according to FactSet.

Its shares fell 13 cents to $36.25 in early morning trading Thursday.

Volumes increased more than one percent to 34.1 billion cigarettes compared with a year ago. Adjusting for trade inventory changes, cigarette volumes fell 3 percent during the quarter, compared with a total industry decline of 3.5 percent.

Marlboro volumes grew 1.5 percent, while volume for its other premium brands fell by more than 7 percent, and volumes for discount cigarette brands like L&M increased 5 percent.

Its share of the U.S. retail market rose 0.2 percentage points to 50.7 percent. Marlboro’s share of the U.S. market was flat at 43.7 percent.

The Marlboro brand has been under pressure from competitors and lower-priced cigarette brands amide economic uncertainty and high unemployment.

That’s on top of the tax hikes, smoking bans and a social stigma that have made the cigarette business tougher.

The Marlboro brand sold for an average of $5.86 per pack during the third quarter, compared with an average of $4.36 per pack for the cheapest brand.

The company has introduced several new products with the Marlboro brand, often with lower promotional pricing, to try to keep the brand growing and to lure smokers away from its competitors.

Altria and others are focusing on cigarette alternatives — such as electronic cigarettes, cigars, snuff and chewing tobacco — for future sales growth because the decline in cigarette smoking is expected to continue.

After launching its first electronic cigarette under the MarkTen brand in Indiana in August, Altria said Thursday that its NuMark subsidiary plans to expand into Arizona in December.

Volumes of Altria’s smokeless tobacco brands such as Copenhagen and Skoal rose 9.5 percent from a year ago. Adjusting for an extra shipping day and trade inventory changes, Altria says its smokeless volumes grew about 4 percent. For the quarter, the company’s smokeless tobacco brands had about 55 percent of the market, though smokeless tobacco is a tiny market compared with cigarettes.

Volumes for its Black & Mild cigars rose 6 percent during the quarter.

Altria Group Inc. also owns a wine business, holds a voting stake in brewer SABMiller, and has a financial services division.

 http://abcnews.go.com/Business/wireStory/marlboro-maker-altria-3q-profit-doubles-20666767