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WebMD News from HealthDay: FDA Launches Ad Campaign Against Chewing Tobacco

By Dennis Thompson

HealthDay Reporter

TUESDAY, April 19, 2016 (HealthDay News) — U.S. health officials said Tuesday that they are targeting rural teenagers with a new $36 million ad campaign that highlights the health risks associated with chewing tobacco.

The campaign’s message — “smokeless doesn’t mean harmless” — will challenge a habit that has become a tradition in the rural United States, said Mitch Zeller, director of the Center for Tobacco Products at the U.S. Food and Drug Administration.

“It is culturally ingrained in many rural communities, and can be seen as a rite of passage and an acceptable societal norm,” Zeller said during a Tuesday morning news conference. He noted that smokeless tobacco use is more than twice as common in rural areas as it is in urban settings.

Chewing tobacco, snuff and other smokeless tobacco products have been linked to multiple kinds of cancer, gum disease, tooth loss and nicotine addiction, Zeller said.

Nevertheless, smokeless tobacco use has become increasingly popular among rural male teenagers, according to FDA research.

Every day in the United States, nearly 1,000 males younger than 18 try smokeless tobacco for the first time, outpacing those who take their first puff on a cigarette, Zeller said. About one-third of rural white males aged 12 to 17 have tried or are at risk of trying smokeless tobacco, totaling approximately 629,000 male youth nationwide.

Rural teens are used to seeing role models use smokeless tobacco, including fathers, grandfathers, older brothers and community leaders, Zeller explained.

“When people who these teens most trust and admire openly use and share smokeless tobacco, the product is seen as acceptable, and even as an expected part of growing up and belonging,” Zeller said.

This is the first time the FDA has focused on smokeless tobacco in an ad campaign, said Kathy Crosby, director of the FDA’s Office of Health Communication and Education.

Crosby said the campaign will focus on 35 rural markets across the United States, including: Albany, Ga.; Billings, Mont.; Flint, Mich.; Medford, Ore.; Monroe, La.; Sioux Falls, S.D.; Little Rock, Ark.; and Tri-Cities, Tenn.

Ads linked to the campaign show young men with ugly lip sores and horrific facial scars caused by mouth cancer, and a football player being tossed around by a nicotine addiction “monster.” The ads will run on local television and in print, while others appear on local radio and through social media.

The new campaign will also collaborate with select Minor League Baseball teams to help combat the link between baseball and smokeless tobacco use among the campaign’s target audience, Crosby said.

This summer, stadiums across the country will display campaign advertising and provide opportunities for fans to meet players who support the campaign’s public health message, she said.

The FDA also is in ongoing talks with Major League Baseball about joining the campaign, and Zeller said he is “optimistic” that a partnership will be announced sometime this season.

Major cities such as Boston, Los Angeles, New York City and San Francisco have banned smokeless tobacco products at ballparks and other sports venues. Major League Baseball has warned that players caught violating the ban in these cities will be subject to discipline from the commissioner.

The smokeless tobacco campaign is an offshoot of the FDA’s award-winning “The Real Cost” campaign, which since 2014 has been warning teenagers about the health effects of smoking.

http://www.webmd.com/smoking-cessation/news/20160419/fda-launches-ad-campaign-against-chewing-tobacco

Reuters: No change in tobacco use among U.S. youth; e-cigarettes preferred

CHICAGO (Reuters) – Overall tobacco use among U.S. middle and high school students has not changed since 2011, a period in which use of electronic cigarettes increased dramatically, U.S. health officials said on Thursday.

Given that most adult smokers begin using tobacco before age 20, health officials are concerned over the lack of progress in reducing tobacco use among U.S. youth.

According to the latest data from the U.S. Centers for Disease Control and Prevention and the U.S. Food and Drug Administration’s Center for Tobacco Products, 3 million middle and high school students reported using e-cigarettes in 2015, compared with 2.46 million in 2014.

“E-cigarettes are now the most commonly used tobacco product among youth, and use continues to climb,” CDC Director Dr. Tom Frieden said in a statement.

“No form of youth tobacco use is safe. Nicotine is an addictive drug and use during adolescence may cause lasting harm to brain development.”

The FDA, which currently regulates most conventional tobacco products, is finalizing regulations that would bring e-cigarettes under its authority.

Mitch Zeller, of the FDA’s Center for Tobacco Products, said the agency “remains deeply concerned” about the overall high rate at tobacco use among youth and said finalizing those regulations “is one of FDA’s highest priorities.”

Increases in e-cigarette use in 2015 were largely driven by higher use among middle school students, a group in which use of the devices climbed to 5.3 percent in 2015 from 3.9 percent in 2014. There was no change in e-cigarette use among high school students between 2014 and 2015, following a dramatic 13.4 percent increase in 2014.

Overall, data from the 2015 survey show that 4.7 million middle and high school students used at least one tobacco product in the past 30 days, and more than 2.3 million of those students used two or more tobacco products.

There was no significant change in cigarette smoking habits among middle and high school students between 2014 and 2015, with 9.3 percent of high school students and 2.3 percent of middle school students saying they smoked cigarettes.

“Given that the use of e-cigarettes is on the rise among middle and high school students and nicotine exposure from any source is dangerous for youths, it is critical that comprehensive tobacco control and prevention strategies for youths address all tobacco products and not just cigarettes,” study authors wrote in the CDC’s weekly Morbidity and Mortality report.

(Reporting by Julie Steenhuysen; Editing by Dan Grebler)

http://newsdaily.com/2016/04/no-change-in-tobacco-use-among-u-s-youth-e-cigarettes-preferred/#yH3zqGy4RVGtYeVG.99

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.

http://www.cdc.gov/media/releases/2016/p0414-youth-tobacco.html

Drug Store News: CDC's latest anti-smoking campaign inspired 104,000 smokers to quit

BY MICHAEL JOHNSEN

ATLANTA – The latest outcomes measuring the impact of CDC’s national tobacco education campaign are as strong as those achieved in its first year, and suggest that three years into the campaign, the ads were still having a significant impact.

More than 1.8 million smokers attempted to quit smoking because of the nine-week-long 2014 Tips From Former Smokers ( Tips ) campaign. An estimated 104,000 Americans quit smoking for good as a result of the 2014 campaign.

The survey results are published in the March 24 release of the journal Preventing Chronic Disease.

Unlike the 2012 campaign, which aired for 12 consecutive weeks, the 2014 campaign aired in two phases, from Feb. 3 to April 6 and from July 7 to Sept. 7. Phase 1 of the 2014 campaign ran ads primarily from the 2012 and 2013 campaigns; Phase 2 contained new ads. Those new ads featured people and their struggles with smoking-related health issues, including cancer, gum disease, premature birth and stroke caused by smoking combined with HIV. About 80% of U.S. adult cigarette smokers who were surveyed reported seeing at least one television ad from Phase 2 of the 2014 campaign.

“CDC’s Tips campaign has helped at least 400,000 smokers quit smoking for good since 2012,” stated CDC Director Tom Frieden.  “Tips is also extremely cost-effective and a best buy, saving both lives and money. With a year-round campaign we could save even more lives and money.”

Tips, the first federally funded anti-smoking paid media campaign, features former smokers talking about their smoking-related illnesses. Smoking-related diseases cost the United States more than $300 billion a year, including nearly $170 billion in direct health care costs and more than $156 billion in lost productivity.

“The Tips campaign is an important counter measure to the $1 million that the tobacco industry spends each hour on cigarette advertising and promotion,” said Corinne Graffunder, director of CDC’s Office on Smoking and Health. “The money spent in one year on Tips is less than the amount the tobacco industry spends on advertising and promotion in just 3 days.”

The most recent Surgeon General’s Report, The Health Consequences of Smoking—50 Years of Progress, called for airing effective messages such as the Tips ads with high frequency and exposure for 12 months a year for a decade or more. Cigarette smoking is the leading preventable cause of disease and death in the United States, killing about 480,000 Americans each year.

For every American who dies from a smoking-related disease, about 30 more suffer at least one serious illness from smoking. And while the percentage of American adults who smoke is at the lowest level since the CDC began tracking such data, there are still an estimated 40 million adult smokers in the U.S.  Surveys show about 70% of all smokers want to quit, and research shows quitting completely at any age has significant health benefits.

http://www.drugstorenews.com/article/cdcs-latest-anti-smoking-campaign-inspired-10000-smokers-quit

Drug Store News: CDC's latest anti-smoking campaign inspired 104,000 smokers to quit

BY MICHAEL JOHNSEN

ATLANTA – The latest outcomes measuring the impact of CDC’s national tobacco education campaign are as strong as those achieved in its first year, and suggest that three years into the campaign, the ads were still having a significant impact.

More than 1.8 million smokers attempted to quit smoking because of the nine-week-long 2014 Tips From Former Smokers ( Tips ) campaign. An estimated 104,000 Americans quit smoking for good as a result of the 2014 campaign.

The survey results are published in the March 24 release of the journal Preventing Chronic Disease.

Unlike the 2012 campaign, which aired for 12 consecutive weeks, the 2014 campaign aired in two phases, from Feb. 3 to April 6 and from July 7 to Sept. 7. Phase 1 of the 2014 campaign ran ads primarily from the 2012 and 2013 campaigns; Phase 2 contained new ads. Those new ads featured people and their struggles with smoking-related health issues, including cancer, gum disease, premature birth and stroke caused by smoking combined with HIV. About 80% of U.S. adult cigarette smokers who were surveyed reported seeing at least one television ad from Phase 2 of the 2014 campaign.

“CDC’s Tips campaign has helped at least 400,000 smokers quit smoking for good since 2012,” stated CDC Director Tom Frieden.  “Tips is also extremely cost-effective and a best buy, saving both lives and money. With a year-round campaign we could save even more lives and money.”

Tips, the first federally funded anti-smoking paid media campaign, features former smokers talking about their smoking-related illnesses. Smoking-related diseases cost the United States more than $300 billion a year, including nearly $170 billion in direct health care costs and more than $156 billion in lost productivity.

“The Tips campaign is an important counter measure to the $1 million that the tobacco industry spends each hour on cigarette advertising and promotion,” said Corinne Graffunder, director of CDC’s Office on Smoking and Health. “The money spent in one year on Tips is less than the amount the tobacco industry spends on advertising and promotion in just 3 days.”

The most recent Surgeon General’s Report, The Health Consequences of Smoking—50 Years of Progress, called for airing effective messages such as the Tips ads with high frequency and exposure for 12 months a year for a decade or more. Cigarette smoking is the leading preventable cause of disease and death in the United States, killing about 480,000 Americans each year.

For every American who dies from a smoking-related disease, about 30 more suffer at least one serious illness from smoking. And while the percentage of American adults who smoke is at the lowest level since the CDC began tracking such data, there are still an estimated 40 million adult smokers in the U.S.  Surveys show about 70% of all smokers want to quit, and research shows quitting completely at any age has significant health benefits.

http://www.drugstorenews.com/article/cdcs-latest-anti-smoking-campaign-inspired-10000-smokers-quit

Bismarck Tribune Editorial: N.D. becomes leader in tobacco fight

North Dakota has garnered praise for its spending efforts to reduce tobacco use. There’s a little irony in this since the Legislature in the past has questioned the amount of spending.
The Campaign for Tobacco-Free Kids looked at how states used the billions of dollars received from lawsuits settled with major tobacco companies in 1998.
According to the Centers for Disease Control and Prevention, North Dakota is the only state to spend at levels it recommended. The state also was one of five states to spend at least 50 percent of what the CDC recommends.
Spending by states on tobacco prevention programs bottomed out at $459.5 million in 2013, according to the campaign’s report, and is expected to reach $468 million in 2016. At the same time, an estimated $25.8 billion will be collected in settlement funds and tobacco taxes. Tobacco companies reportedly spend about $9.6 billion a year on marketing. North Dakota has $10 million planned for fiscal year 2016.
The anti-tobacco campaign appears to be working.
A survey conducted by the state Department of Public Instruction and the Department of Health shows 80 percent of the students responding said they did not use cigarettes, cigars or smokeless tobacco, an increase from 74 percent two years ago. The percentage of high school students who said they had smoked a cigarette at least once in the month dropped from 19 percent to 12 percent. The percentage of high school students who said they had ever tried to smoke a cigarette was 35 percent, down from 41 percent in 2013. Smokeless tobacco use declined from 14 percent to 11 percent this year.

The anti-tobacco effort emphasizes keeping kids from using tobacco and if they do, getting them to quit. The numbers indicate they are being successful. Some have questioned the amount of money being spent and how it’s being used. While the campaign may appear heavy-handed at times, it’s getting the point across. In the past some legislators wanted to spend less on anti-tobacco efforts and divert the tobacco settlement money to other programs. In 2008 North Dakotans passed a measure requiring a portion of the settlement funds be used for tobacco prevention.
Even a tobacco company favors the spending. “We believe states should use (settlement) payments to fund tobacco cessation and underage tobacco prevention programs at levels recommended by the Centers for Disease Control,” Brian May, a spokesman for Philip Morris, told the Forum News Service.
The anti-tobacco effort has been successful in other areas with smoking banned in public areas. And now the efforts go beyond traditional forms of tobacco to vaporing products. The dangers of second-hand smoke is another focus, with apartment residents being urged to demand a smoke-free environment. Some may think this is going too far, but anti-tobacco campaign is on a roll and has the money to keep going.
Society is getting closer to being smoke-free, too fast for some and too slowly for others.
http://bismarcktribune.com/news/opinion/editorial/n-d-becomes-leader-in-tobacco-fight/article_ed7dc472-6eb0-5e6d-b63b-51c4cd23e599.html

Grand Forks Herald: Report: North Dakota only state spending enough on tobacco prevention

By John Hageman, Grand Forks Herald
A report released this week argues almost every state in the country is not spending enough money on tobacco prevention and cessation programs—every state, that is, except for North Dakota.
The report, released by the Campaign for Tobacco-Free Kids, focuses in part on the billions of dollars states have received since they settled lawsuits against major tobacco companies in 1998. With $10 million set aside for fiscal year 2016, North Dakota is the only state to spend at levels recommended by the Centers for Disease Control and Prevention and was one of five states to spend at least 50 percent of what the CDC recommends.
 
“It’s so frustrating because it’s such a critical investment, and we’re talking about such a small amount of money,” said John Schachter, director of state communications for the Campaign for Tobacco-Free Kids. “When there’s a pot from which to draw from logically—tobacco taxes and the settlement—as we say, it’s a no-brainer.”
States spent as much as $717.2 million on tobacco prevention programs in fiscal year 2008, but that dropped during the recession and bottomed out at $459.5 million in 2013, according to the campaign’s report. Spending will reach $468 million in fiscal year 2016, a fraction of the estimated $25.8 billion they will collect in settlement funds and tobacco taxes, though the budgets for two states were not yet available.
Tobacco companies spend about $9.6 billion a year on marketing, according to the campaign’s report.
“We believe states should use (settlement) payments to fund tobacco cessation and underage tobacco prevention programs at levels recommended by the Centers for Disease Control,” Brian May, a spokesman for tobacco giant Philip Morris, wrote in an email to the Herald.
While tobacco companies cannot advertise on television or the radio, Schacter said “it’s pretty clear the industry is out there in force.” He said the industry spends most of its marketing dollars at “point of sale,” such as displays at convenience stores and gas stations.
“The states still know it’s an issue, but for whatever reason, they’re deciding to spend the money elsewhere,” Schachter said.

N.D. in the lead

The campaign’s report highlights North Dakota as an example for the rest of the states to follow, citing a drop in high school student smoking rates in recent years.
But North Dakota hasn’t always been a leader in tobacco prevention spending. In fiscal year 2009, it spent just $3.1 million on those programs, or one-third of CDC-recommended funding. That changed with the passing of a measure in 2008 requiring a portion of the settlement dollars be used to reduce tobacco use.
“The settlement did not dictate how the money from the settlement was spent, but it did point out that the settlement was entered into because of the unacceptable behavior of the tobacco industry,” said Jeanne Prom, executive director of the North Dakota Center for Tobacco Prevention and Control Policy.
North Dakota’s tobacco tax revenue is not used for prevention efforts, she said.
Minnesota will receive $791.7 million in total tobacco revenue in fiscal year 2016 but will spend only $21.5 million on prevention programs, less than half of what the CDC recommends, according to the campaign’s report.
Laura Oliven, the tobacco control manager at the Minnesota Department of Health, called the CDC recommendations “aspirational.” She also pointed out the campaign’s figures don’t capture Blue Cross Blue Shield’s Center for Prevention in Minnesota.
Minnesota’s adult smoking rate has dropped to 14.4 percent, the lowest it has ever recorded, the health department announced in January.
“We do a lot to maximize the funds we have,” Oliven said. “I guess the theme here really is that while we’ve made a lot of great strides, there’s still considerable work to be done.”

Local outcomes

Haley Thorson, a tobacco prevention coordinator at the Grand Forks Public Health Department, said tobacco settlement dollars helped fund a study asking residents about second-hand smoke. She called that a “pivotal piece of information” in Grand Forks passing a law in 2010 that outlawed smoking in bars, casinos and truck stops.
“That policy was passed by the City Council because we really did have the pulse of how the community supported that policy,” she said.
North Dakota passed a similar statewide law in 2012.
The health department receives about $300,000 annually from the Center for Tobacco Prevention and Control Policy, or BreatheND. Thorson said it focuses much of its efforts on tobacco-related policies.
“We used to go into schools and educate kids on the harms of tobacco use, but the better bang for our buck is to establish a comprehensive tobacco-free school policy that allows them to be educated in an environment where they’re not exposed to tobacco use,” she said.
Those efforts appear to be working.
The percentage of North Dakota high school students who smoked at least once in the past month plunged to 11.7 percent this year after hovering around 20 percent for the eight previous years, according to survey results provided by Thorson.
“For the states that aren’t spending anything or next to nothing, they need to see results like these,” Thorson said.
http://www.grandforksherald.com/news/region/3900310-report-north-dakota-only-state-spending-enough-tobacco-prevention

Wahpeton Daily News: Study: More nicotine found in smokeless tobacco

By Carrie McDermott • Daily News

Users of smokeless tobacco are exposed to equal or higher levels of nicotine and NNK, a cancer-causing chemical in tobacco products, than cigarette smokers, according to a study from the federal government.
Researchers from the Food and Drug Administration and the Centers for Disease Control and Prevention say more data is needed on the toxic components of smokeless tobacco products and the health of those who use them.
In the study, researchers analyzed information from more than 23,000 participants in national health surveys between 1999 and 2012. They looked for markers used to measure the addictive stimulant nicotine and cancer-causing NNK from blood and urine samples. They found the level of cotinine, the marker for nicotine exposure, to be .043 nanograms/milliliter in nonsmokers compared to 180 ng/ml among smokeless tobacco users, about 131 ng/ml in cigarette users and 184 ng/ml among people who used both smokeless tobacco and cigarettes.

Jason McCoy, tobacco prevention coordinator at PartnerSHIP 4 Health in Moorhead, Minnesota, said he’s eager to get this surprising information out to the public.
“We know that in rural parts of the state, one in 10 young white men, basically high school boys, are using Snus and chewing tobacco, thinking it’s less dangerous than smoking,” he said.
He said the only difference is when they use chewing tobacco, they aren’t affecting others with secondhand smoke.
“The individual is potentially damaging themselves more,” he said. “It’s surprising.”
And many young smokeless tobacco users are choosing flavored products, which make it more attractive.
“This ties into other research we have that shows flavored tobacco is viewed, in self reports by teens, as less addictive than regular tobacco,” McCoy said. “On the other end, we know the flavoring makes it more addictive. The part of the brain that ties into the flavor of the product, similar to why you may like Coke over Pepsi, it’s the same triggering mechanism that happens. The flavor gets assigned in your brain along with the nicotine.”
McCoy works with four counties — Becker, Clay, Otter Tail and Wilkin — and gets reports showing that often high school athletes know they don’t want to smoke because of the smell, so they choose smokeless tobacco, also thinking it won’t affect their athletic performance.
“We know that short term, it’s going to cause gum disease and tooth decay, long term, possible mouth, throat and stomach cancers,” he said. “It’s every bit as dangerous as cigarettes.”
He said he’s been told by teachers that students are taking the Ice Breakers mints and filling those containers with Snus, so they can surreptitiously carry the smokeless tobacco around with them.
“When they open it up, it just looks like they’re getting a mint,” he said.
About 3.6 percent of Minnesotans regularly use smokeless tobacco, according to the latest Minnesota Adult Tobacco survey.
For those wanting to quit their nicotine use, the state of Minnesota offers QUITPLAN which provides proven methods of quitting successfully. The program offers phone counseling and nicotine replacement tools at no cost. To find out more, visit www.quitplan.com or call 1-888-354-7526.
http://www.wahpetondailynews.com/news/study-more-nicotine-found-in-smokeless-tobacco/article_a81d5b36-9a9f-11e5-9849-3facbacf33f9.html

New York Times: U.S. Smoking Rate Declines, but Poor Remain at Higher Risk

By SABRINA TAVERNISE

WASHINGTON — Smoking, the leading cause of preventable death in the United States, continued to decline last year, federal health authorities reported Thursday, with the share of American adults who smoke dropping to 16.8 percent, down from 17.8 percent in 2013.

Smoking has been one of the brightest public health successes of recent history. Nearly half of all Americans smoked in the 1960s, but a broad push against the habit, starting with the surgeon general’s warning in 1964, helped bring rates down. The rate has dropped by about a fifth since 2005, when it was 21 percent.

But the national numbers mask deep trouble spots within the American population. About 43 percent of less educated Americans smoked in 2014, compared with just 5 percent of those with a graduate degree. About a third of Americans insured by Medicaid, the health insurance program for the poor, smoked, compared with 13 percent of Americans with private insurance.

The figures, reported by the Centers for Disease Control and Prevention, underscored the extent to which smoking in America has become a problem of the poor. Nearly six million Americans covered by Medicaid smoke, as well as almost nine million uninsured Americans, or about a third of the uninsured population.

Smoking-related diseases accounted for more than 15 percent of annual Medicaid spending from 2006 to 2010, or about $39 billion a year, according to the American Lung Association.

“Disparities are the single most important issue in smoking,” said Kenneth E. Warner, a professor of public health at the University of Michigan School of Public Health.

Dr. Warner added: “The people who are politically influential believe the smoking problem has been solved. It’s not in their neighborhoods. Their friends don’t smoke. Those who still smoke are the poor, the disenfranchised, the mentally ill. That’s who we need to focus on.”

On Thursday, the federal government appeared to take aim at that problem by proposing a rule that would prohibit smoking in public housing nationwide.

Nationally, success of the antismoking campaign has been striking. Progress among the poor and less educated, however, has been far slower.

About 43 percent of people with only a high school equivalency diploma smoke, virtually unchanged from 2005. In comparison, smoking declined by about 26 percent among people with college degrees, to 8 percent from 11 percent. For people with a high school diploma only, smoking declined by about 12 percent, to 22 percent.

Smoking among people who live at or above the poverty line declined by about 26 percent, to 15 percent from about 21 percent in 2005. Those below the poverty line declined by about 12 percent, to 26 percent from 30 percent, the report found.

American Indians and Alaskan Natives had the highest smoking rate, about 29 percent, followed by Americans of more than one race, about 28 percent of whom smoked.

Whites and blacks smoked at about the same rate in 2014 — about 18 percent — while Hispanics had a much lower rate, 11 percent.

http://mobile.nytimes.com/2015/11/13/health/us-smoking-rate-cdc-report.html?_r=0

WebMD: E-Cigarette Use Highest Among Young Adults: Report

Almost 4 percent of all adult Americans use them, new survey shows

WebMD News from HealthDay

By Alan Mozes, HealthDay Reporter

WEDNESDAY, Oct. 28, 2015 (HealthDay News) — In a first-of-its-kind look at electronic cigarettes, a new U.S. government study reports that nearly 13 percent of American adults have tried e-cigarettes at least once and almost 4 percent use them.

According to the 2014 National Health Interview Survey by the U.S. Centers for Disease Control and Prevention, the popularity of e-cigarettes rose slightly among men (about 14 percent) and dipped among women (about 11 percent).

But the most dramatic usage differences break along age lines, the poll of nearly 37,000 adults found. Almost 22 percent of Americans between the ages of 18 and 24 said they had tried the battery-powered aerosol nicotine-delivery device, while usage among those 65 and older was less than 4 percent.

Current users also tend to be younger, the report noted, with more than 5 percent of those 18 to 24 saying they now use e-cigarettes, compared with just over 1 percent of those 65 and older.

And among never-smokers, the usage was also highest among the 18-to-24 age group.

The report found that e-cigarette popularity is greatest among white and Native American adults, with nearly 5 and 11 percent, respectively, now using them. Only about 2 percent of blacks and Hispanics use them.

E-cigs also seem to curry much more favor among those who now smoke traditional cigarettes, or those who only recently kicked the habit: About 48 percent of current smokers have tried an e-cigarette and one in six currently use them. About 55 percent of those who stopped smoking just in the last year have tried them, and 22 percent said they currently use them.

By contrast, only about 3 percent of never-smoking adults said they’ve tried an e-cigarette, and less than half of 1 percent said they use them now. Among young (aged 18 to 24) never-smokers, however, almost 10 percent said they’ve tried one out.

So what’s driving the numbers?

“We really can’t answer that question,” said study co-author Charlotte Schoenborn, a statistician with the U.S. National Center for Health Statistics in the CDC’s division of health interview statistics. “This was the first year that the NCHS has even asked these questions. So we can only speculate as to why, as we watch to see how the trends unfold over time.”

Schoenborn and her colleague Renee Gindi outline their findings in the CDC’s October NCHS report released Oct. 28.
Erika Sward, assistant vice president for national advocacy with the American Lung Association, suggested that the CDC data will end up becoming a “very useful and much needed benchmark” for monitoring e-cigarettes.
“Electronic cigarettes are really the wild, wild West,” Sward said. “There’s absolutely no federal oversight of e-cigarettes, even though the FDA [U.S. Food and Drug Administration] has not found any e-cig to be safe or effective in helping smokers quit. And to our knowledge, no e-cigarette company has even applied to the FDA for approval as a smoking cessation product.”
But many manufacturers market the devices that way anyway, she said.
“So the real take-away message is that the people who are most likely to use e-cigs are our most vulnerable adults: the young, current smokers, and those who have recently quit or are trying to quit,” she said.
Sward added, “So just as we’re seeing traditional cigarette use decline — after years of FDA regulation and state smoke-free policies and taxation — we’re now seeing the tobacco industry continue its narrative of aggressively marketing e-cigarettes to younger people in the hopes of developing a whole new lifelong user.
“And until we act,” she said, “troubling studies like this one suggest that we’re on a path to a real public health crisis that will undo much of the progress that has been made to reduce tobacco use in the U.S.”
The report comes on the heels of a recommendation by the nation’s leading pediatricians group to raise the minimum age for purchasing tobacco products and e-cigarettes to 21 across the United States.
The new policy recommendation by the American Academy of Pediatrics, released Oct. 26, also called for the FDA to regulate e-cigarettes the same way it regulates other tobacco products.
http://www.webmd.com/smoking-cessation/news/20151028/e-cigarette-use-highest-among-young-adults-us-report-finds