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HuffPo: The U.S. Smoking Rate Just Hit A Historic Low

, Senior National Correspondent, The Huffington Post
Chalk up another big win for public health: The smoking rate among U.S. adults appears to have hit a new low.
New survey data, which the U.S. Centers for Disease Control and Prevention released Tuesday morning, suggests that just 15.2 percent of American adults are now using cigarettes on a regular basis. That smoking rate is nearly 2 percentage points lower than what the same survey reported for calendar year 2014.
The basis for the findings are responses to the National Health Interview Survey, which the Census Bureau operates on behalf of the CDC and is among the most reliable instruments government has for measuring health habits and status. The data is preliminary, because it comes from January through March and the smoking rate might yet creep up before the year ends. Among other factors, people have been known to quit in January, after making a New Year’s resolution, and then resume a few months later.
But even allowing for that possibility, and the margin of error that all surveys have, it’s likely the adult smoking rate for the full 2015 calendar year will be lower than it was in 2014.
“This result is absolutely exciting and maybe even astonishing, if this decrease holds up when we see data for the full year,” Kenneth Warner, a professor of health policy and management at the University of Michigan, told The Huffington Post.
http://www.huffingtonpost.com/entry/us-smoking-rate-historic-low_55e4a96be4b0b7a96339de51?ncid=fcbklnkushpmg00000063

Reminder: Smoking Hookah For An Hour Is Like Smoking 100 Cigarettes

By Kate Bratskeir, Food and Health Editor, The Huffington Post
You hopefully wouldn’t smoke 100 cigarettes in 60 minutes — that’s five entire packs of so-called cancer sticks.
If you casually dabble with hookah, however, you might not bat an eye at an hour-long smoking session. New research shows lots of young people don’t know that 100 cigarettes and an hour of hookah are about equal in terms of the amount of smoke inhaled — and therefore in the damage they can cause to a person’s health, including increased risk for heart disease, cancers, stroke, blood clots and death, to name a few.
A 2005 report by the World Health Organization found that hookah smokers typically take 200 puffs during an hour-long smoking session, while people take an average of 8-12 puffs per cigarette. Considering the amount of smoke inhaled per method, the organization wrote, a 60-minute water pipe session may be the same as smoking 100 cigarettes or more.
Yikes. If the parallel is surprising to you, you’re not alone. A study just published in the journal Health Education & Behavior found that many young adults believe smoking hookah and cigarette alternatives is a less risky behavior than smoking cigarettes. Researchers analyzed data from 2,871 smoking and non-smoking millennials, roughly 25 percent of whom said they believe hookah is safer than cigarettes. Once again, this is false.
Americans are smoking standard cigarettes at a lower rate than ever before. This is good news. Still, the message that smoking is bad has clearly not effectively carried over to all nicotine-based products. Earlier this year, the Centers for Disease Control and Prevention reported that for the first time, hookah and e-cigarette use is more popular among young people than traditional cigarettes, and the more recent study showed 62 percent of young adults believe e-cigarettes are less harmful than standard cigarettes.
“This might be associated with differences in advertising messages these groups are exposed to, the variety of flavors these different products are offered in, and in the case of e-cigarettes, possibly an inclination for younger people to attribute more positive feelings toward newer products that are seen as new and ‘techy,’” said the study’s authors, Olivia A. Wackowski and Cristine D. Delnevo of the Rutgers School of Public Health, in a press release.
For now, there’s an ashtray’s worth of contradicting information about e-cigarettes. Electronic cigarettes may be less hazardous than cigarettes because they release vapor instead of smoke, and they don’t burn. Some experts argue that they are safer — though not “safe” — and can help smokers eventually quit their smoking habit altogether. But a recent study revealed that e-cigs can also be a catalyst for conventional smoking: they’re a gateway drug.
While the safety of e-cigarettes continues to be explored, anyone considering picking up the habit should know that they won’t be doing themselves any favors. The same goes for smoking hookah: Both hookah and e-cigs can be addictive, and both transfer cancer-causing chemicals into the mouth and lungs of a smoker.
http://www.huffingtonpost.com/entry/smoking-hookah-like-100-cigarettes_55db7783e4b08cd3359ce8af

AP: Teens' E-Cigarette Use Linked With Later Smoking

By LINDSEY TANNER AP Medical Writer
Teens who use e-cigarettes are more likely than others to later smoke conventional cigarettes and other tobacco products, a study at 10 Los Angeles high schools suggests.
The study doesn’t prove that electronic cigarettes are a “gateway drug” but some doctors say it bolsters arguments that the devices should be strictly regulated as proposed by the Food and Drug Administration.
Whether teens had tried just one e-cigarette or were habitual users isn’t known, nor is whether they became heavy smokers or just had a few puffs. That information would be needed to help determine whether nicotine from e-cigarettes predisposed users to seek out other sources.
Despite those limitations, the study “is the strongest evidence to date that e-cigarettes might pose a health hazard by encouraging adolescents to start smoking conventional tobacco products,” said Dr. Nancy Rigotti, director of a tobacco research and treatment center at Massachusetts General Hospital. Her commentary and the study were both published in Tuesday’s Journal of the American Medical Association.
E-cigarettes haven’t been extensively studied and there’s no scientific consensus on any potential benefits or harms, including whether they lead kids to become regular smokers.
The new, government-funded study involved about 2,500 14-year-olds who had never used conventional tobacco products including cigarettes. Students were first surveyed in fall 2013. The Los Angeles study population was diverse but whether the same results would be found nationwide is uncertain.
At the start, about 9 percent — 222 kids — said they had used e-cigarettes at least once, similar to rates seen in a recent national survey. Almost one-third of them tried cigarettes, cigars or water pipes within the following six months, versus just 8 percent of the kids who’d never tried e-cigarettes. The gap persisted when students were surveyed again, a year after the study began.
Hookahs and cigars were more popular than regular cigarettes in both groups.
The researchers considered traits that might make teens more likely to use tobacco, including impulsiveness, delinquent behavior and parents’ smoking habits. Their analysis showed those traits played a role but didn’t fully explain the link between e-cigarettes and later tobacco use.
University of Southern California researcher Adam Leventhal, the study’s lead author, noted that e-cigarettes were initially introduced as a potentially safer alternative to tobacco for smokers who were trying to cut down, but they have evolved into a recreational product for some users.
Available for nearly a decade, e-cigarettes are battery-powered devices that turn nicotine-containing liquid into vapor that is inhaled. Though nicotine can be addictive, e-cigarettes lack the chemicals and tars of burning tobacco.
National data show e-cigarettes have become more popular among teens than regular cigarettes.
Leventhal said his study “does little to dispel concerns that recreational e-cigarette use might be associated with moving on to these very harmful tobacco products.” But he said more research is needed to determine if e-cigarettes are really the culprit.
University of Rochester tobacco researcher Deborah Ossip said because teens’ brains are still developing, they’re more sensitive to the effects of nicotine, and that using just a few e-cigarettes could make them vulnerable to using nicotine in other forms. She had no role in the research.
The FDA in 2014 proposed rules that would ban the sale of electronic cigarettes to minors and would add the devices to the list of tobacco products it regulates. Laws banning the sale of e-cigarettes to minors have been enacted or proposed in several states.
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Online:
JAMA: http://jama.ama-assn.org
FDA: http://tinyurl.com/pe7nqtl
http://abcnews.go.com/Health/wireStory/teens-cigarette-linked-smoking-33155901

AARC Times: Cigarette Smoke Makes MRSA Stronger

From the AARC Times, July Issue, Pg. 49

Methicillin-resistant Staphylococcus aureus (MRSA) is already an aggressive bacteria.  Now researchers from the University of California San Diego find that cigarette smoke just ups the ante.  MRSA bacteria exposed to cigarette smoke in their study were more resistant to reactive oxygen species and antimicrobial peptides, as well as better at sticking to and invading human cells grown in the lab.  In a mouse modes, MRSA bacteria exposed to cigarette smoke were more likely to survive, and they also led to pneumonias with a higher mortality rate.

The investigators believe cigarette smoke strengthens MRSA bacteria by altering their cell walls in such a way that they are better able to repel antimicrobial peptides and other charged particles.  “Cigarette smokers are known to be more susceptible to infectious diseases.  Now we have evidence that cigarette smoke-induced resistance in MRSA may be an additional contributing factor, “ study author Laura E Crotty Alexander, MD was quoted as saying.

Reuters: Half of deaths from 12 common cancers directly linked to cigarette use

By Lisa Rapaport / Reuters Media

Roughly half of deaths from 12 smoking-related cancers may be linked directly to cigarette use, a U.S. study estimates.
While the largest proportion of deaths associated with smoking were for cancers of the lung, bronchus, trachea and larynx, about half of fatalities from tumors of the oral cavity, esophagus and bladder were also tied to cigarettes, the study found.
“The bottom line is that while we’ve made a lot of progress against the tobacco epidemic in the United States, there’s still much work to do,” lead study author Rebecca Siegel, a researcher at the American Cancer Society in Atlanta, said by email.
Siegel and colleagues estimated that out of 345,962 cancer deaths in 2011 among U.S. adults 35 and older, 167,805 were associated with smoking.
To estimate the proportion of cancer deaths attributable to smoking, the researchers used a standard formula to calculate the fraction of cases of specific cancer types that would not have occurred if there were no smoking.
Then they analyzed data from national surveys and in-person interviews asking people about their health history and tobacco habits. They adjusted their estimates to account for age, race, education level and alcohol use.
Based on smoking habits in the population and the proportion of cancer cases attributable to smoking, the researchers estimated that 125,799 lung, bronchus and trachea cancer deaths, representing 80 percent of the total, were linked to smoking. So were 50 percent of deaths from esophagus tumors and 45 percent of deaths from bladder malignancies.
The researchers also credit smoking with 17 percent of kidney cancer deaths, 20 percent of stomach cancer deaths, 22 percent of cervical cancer deaths and 24 percent of liver and bile duct cancer deaths in 2011.
One limitation of the study is that the survey and interview participants were generally more educated and less racially diverse than the U.S. population as a whole, the researchers acknowledge in JAMA Internal Medicine.
It’s also possible, however, that they underestimated cancer deaths tied to smoking because they didn’t have data on second-hand smoke exposure, which may cause an additional 5 percent of lung cancer deaths, or on use of cigars, pipes, or smokeless tobacco.
“While smoking prevalence continues to slowly decline, the use of alternative tobacco products is on the rise,” Siegel said.
Use of combustible forms of tobacco other than cigarettes, such as cigars and hookahs, doubled from the equivalent of 15.2 billion cigarettes in 2000 to the equivalent of 33.8 billion cigarettes in 2011, Siegel said.
“Although we can’t know exactly how many people are not starting to smoke cigarettes because they are using other tobacco products, e-cigarettes are now the most common form of tobacco use among high school students,” Siegel said.
Evidence doesn’t suggest that people who use alternative tobacco products are more likely to quit smoking or avoid starting on cigarettes, Dr. Michael Ong, author of a tobacco cessation editorial accompanying the study, said by email.
If there’s an upside to alternatives, though, it may be seen in the declining proportion of lung cancer deaths attributable to cigarettes, said Ong, a researcher at the University of California, Los Angeles and the Veterans Affairs Greater Los Angeles HealthCare System.
“But most of all lung cancer deaths are still attributable to smoking, and lung cancer makes up the largest cause of cancer-related mortality,” he said.
In an indication of the uphill battle smoking cessation can be, another study also published in JAMA Internal Medicine found that clinicians simply asking patients to quit and advising them of the lung cancer risks isn’t enough motivation to make it more likely that patients successfully quit.
Researchers followed more than 3,000 smokers for one year after lung cancer screenings to see if the amount of cessation support they received from clinicians might influence their odds of quitting.
The smokers who received assistance such as referrals to counseling or prescriptions for smoking-cessation drugs were 40 percent more likely to quit, while those who received follow-up care to monitor their progress were 46 percent more likely to stop smoking.
“Smokers face physical, environmental and social barriers to quitting,” lead study author Elyse Park, a researcher at Massachusetts General Hospital in Boston, said by email. “Primary care providers can assist smokers, particularly smokers with a heavy smoking history, to boost their confidence and obtain the counseling and medication support that can help them improve their odds of successful quitting.”
http://www.inforum.com/news/3766802-half-deaths-12-common-cancers-directly-linked-cigarette-use

U.S. News: Nevada Republican Gov. Brian Sandoval secures unlikely win with approval of big tax increase

By MICHELLE RINDELS, Associated Press

CARSON CITY, Nev. (AP) — Nevada’s Republican governor, Brian Sandoval, secured an unlikely victory Monday when the conservative state Legislature approved a huge tax increase at his urging as part of a plan to boost education spending.

The $1.1 billion package raises taxes on businesses and cigarettes, and it makes permanent a $500 million bundle of temporary payroll and sales taxes.

Sandoval’s win comes on the last day of the legislative session, and the proposal’s fate had been in doubt until late Sunday when several skeptical Republicans in the state Assembly pledged support.

The plan had faced vocal resistance for months, led by anti-tax conservatives emboldened by election victories in November that increased their majorities in both chambers.

Many critics noted that Nevada voters had overwhelmingly rejected a similar business tax plan and said the lawmakers shouldn’t go against their wishes.

Sen. Don Gustavson said legislators “should be ashamed of themselves to force through the largest tax increase in Nevada’s history that includes the type of tax that voters did not support.”

“And you wonder why our constituents distrust politicians?” he added.

Gustavson and Sens. Pete Goicoechea and James Settelmeyer, all rural Republicans, were the only opposition in the Senate, which passed the tax plan 18-3 Monday.

That vote came after the Assembly passed the plan 30-10 Sunday night after heavy-hitting business groups lined up behind it.

The tax increase will allow Sandoval to pump millions of dollars into programs for poor students and children learning English. The state has lagged behind others for years in education rankings and on school funding, but it has consistently rejected efforts to raise revenue.

Republican Sen. Scott Hammond had been among the skeptics, but he said his concerns about accountability had been eased, in part by the passage of his bill allowing students to use public funds at private schools.

“I can assure you that there have been significant reforms. We have one of the best, if not the best, school choice reform programs now in the nation,” Hammond said. “For that reason, I can support this.”

Elements of the plan include:

— A hike in the business license fee. The fee for corporations would rise from the existing $200 a year to $500, while the fee for the rest of the business entities would remain at $200.

— A hike in the payroll tax. Sandoval’s plan raises the state’s existing modified business tax from 1.17 percent to 1.475 percent of wages beyond the first $200,000 a company pays out each year and sets the rate at 2 percent of those wages for the mining industry and financial institutions. Companies would still get to deduct health care premiums for employees from the calculation.

— A “Commerce Tax” on gross revenue. Industry-specific tax rates will apply to businesses with more than $4 million in Nevada revenue each year. Businesses can count 50 percent of their commerce tax bill as a credit against their modified business tax bill — a provision that’s intended as a perk to those who employ people. The commerce tax aims to capture more money from capital-intensive businesses such as mines and those that do business in Nevada but aren’t based here.

— A flexible payroll tax rate. The plan allows the state to lower the modified business tax rate if revenues from the new commerce tax and MBT rate bring in more revenue than projected.

— An extension of “sunset taxes.” More than $500 million of the plan comes from making a set of expiring payroll and sales taxes permanent.

— Cigarette taxes. The bill raises a tax on cigarette packs by $1, which is expected to generate about $100 million over two years.

http://www.usnews.com/news/politics/articles/2015/06/01/nevada-gop-governor-secures-unlikely-win-with-tax-increase

Reuters: Cigarette warnings work better with pictures, study shows

By Lisa Rapaport, Reuters

Gruesome photographs on cigarette packages may deliver more effective anti-smoking messages than words, a new analysis finds.

Researchers reviewed previous studies comparing images to text warnings on cigarette boxes and found pictures commanded more attention, elicited stronger emotional reactions, summoned more negative attitudes and made it more likely that smokers would vow to quit.

“They say a picture is worth a thousand words — that really seems to be the case here,” said lead study author Seth Noar, co-director of the interdisciplinary health communication program at the University of North Carolina at Chapel Hill.

Globally, tobacco kills about six million people a year, and the annual death tally is expected to reach eight million by 2020, according to the World Health Organization. Smoking can cause heart disease and lung cancer, even when exposure is second-hand, and it can lead to asthma and other breathing difficulties in children who live with smokers.

Just 30 countries, representing about 14 percent of the world’s population, require warning images on at least half of the front and back of cigarette packages with anti-smoking messages in the local language, according to the WHO.

In Australia, for example, cigarette packages have graphic images of sick or dying smokers on the wrappers.

To see how well grotesque images on cigarette packages work as a deterrent, Noar and colleagues analyzed data from 37 experiments involving more than 33,000 people. Every study included in the analysis showed participants both words and pictures to measure which approach was better at discouraging smoking.

The studies reviewed were done in 16 different countries, though most were in the U.S., Canada or Germany, and were published between 2000 and 2013.

Relative to text, images convinced people to think more about the effects of smoking, lowered cravings and increased aversion to cigarettes, the analysis found.

Eight of the studies examined whether participants thought the pictures were effective. This subset of experiments found smokers and nonsmokers thought pictures would encourage them not to start smoking or motivate them to cut back and urge others to quit as well.

When the researchers analyzed data across all of these studies, they found pictures were significantly better than text alone at motivating people to avoid cigarette use.

“Smokers know that cigarettes are bad for them, but they likely tune out vague warnings that they have seen for years, such as ‘smoking causes cancer,’” Noar said by email. “Seeing images of diseased lungs and people suffering from the negative health impacts of smoking appear to affect smokers in ways that simple text-only messages cannot achieve.”

All but one of the studies included in the review lacked data on how the images or texts might impact behavior, the researchers acknowledge in the journal Tobacco Control. The studies also didn’t follow people over long periods of time or measure how repeated exposures to the images might influence behavior, the authors note.

Because smoking is often a social behavior, more research is needed on how social interactions might influence the impact of anti-smoking images on packages, the researchers wrote.

Images may help reach an audience that’s particularly vulnerable — people with lower literacy or education levels, said Jim Thrasher, a researcher in health behavior at the Arnold School of Public Health at the University of South Carolina in Columbia.

“Even among these disadvantaged groups where smoking rates are highest, pictorial warnings are a promising way to stimulate smoking cessation,” Thrasher, who wasn’t involved in the study, said by email.

They may also help young people get the message about smoking, said David Hammond, who researches addiction and cigarette packaging at the University of Waterloo in Ontario, Canada.

“One of the challenges for cigarette warnings is that many of the most severe health consequences don’t appear for a number of years,” Hammond, who wasn’t involved in the study, said by email. “Images help to make these health consequences more salient and real for youth and young adults.”

http://www.duluthnewstribune.com/features/3756926-cigarette-warnings-work-better-pictures-study-shows

Today's Smokers Are Having a Harder Time Quitting — What Changed?

Dr. Daniel Seidman,  Smoking cessation expert | From HuffPost Healthy Living Blog

Over the last 25 years, cigarette consumption by smokers in the United States decreased by almost one-third. Over that same period, however, many tobacco companies reengineered cigarettes to more efficiently deliver the nicotine that keeps their customers coming back (1,2). This is called the “yield.” Increased yield means smokers, even if they smoke fewer cigarettes per day, still get plenty of nicotine. In other words, most of today’s cigarettes are not the same ones your mother or father smoked.

Not only are today’s cigarettes different — so are smokers. They are more likely to experience stress, worry, and depression regardless of their income (3). Recent research shows that it is quitting that brings stress relief rather than the other way around; cigarette addiction itself is a source of stress, anxiety, and depression (4,5) As the number of smoke-free environments increased, and because smokers smoke fewer cigarettes on average, today’s smokers generally wait longer between cigarettes. This delay increases the psychological and emotional reward value of each cigarette. At the same time, because they can’t smoke whenever they want, the timing is often uncertain, and the payoff — being able to light up — is irregular. Paradoxically, this sort of “intermittent” sporadic or random reinforcement is actually the strongest form of psychological reinforcement, thus making current patterns of smoking behavior harder to extinguish. Waiting to smoke is not quitting smoking!

Another factor making it harder to quit smoking today is that funding for tobacco prevention has been cut significantly. This illustrates the diminished importance society places on efforts to help smokers. Meanwhile, tobacco companies spend $18 to market their products for every dollar spent to support smokers and reduce smoking (6). Ostracized from private homes, work, cars, and public spaces, many smokers report high levels of shame when they leave social gatherings to get a nicotine fix. Our cultural norm of self-help places the burden of quitting, and blame of failure, squarely on smokers’ shoulders. Self-help, however, is clearly not working for many struggling to quit.

The United States has made remarkable progress against smoking, but most of that progress occurred in the 40 years before 2004, when the adult smoking rate was cut about in half to 20.9 percent. The most recent data, released by the Centers for Disease Control (CDC) on May 22, 2015 (7), is that the median prevalence of cigarette smoking in 2011 was 21.2 percent. Even adjusting for changes in the way smoking rates are being measured, this is higher, not lower, than the 20.9 percent reported 7 years earlier! For 2012, the smoking rate was 19.6, and for 2013 it was 19.0, barely budging from a decade earlier!

As we observed World No Tobacco Day 2015 this past Sunday, May 31, many smokers continued to find themselves in a trap set for them by cigarettes. Cigarettes are designed for addiction and not for recreational “take it or leave it” use. Many of today’s smokers therefore find themselves caught between a lack of constructive social and psychological support, and the destructive effects of highly nicotine-efficient cigarettes, creating a tobacco control stalemate.

What can be done?

We can start by requiring manufacturers to limit or taper permitted nicotine levels in cigarettes. All tobacco and nicotine products should be standardized and openly disclose their nicotine levels, and how much is absorbed into smokers’ bodies the same way people track calories or carbohydrates.

Here are five quick tips for smokers trying to quit:

  • Try to challenge beliefs that justify smoking. Beliefs such as “I smoke because I’m stressed,” “I’ll quit tomorrow,” “I’ll only smoke one,” and “I’m not strong enough to quit” are common and tend to cement smoking as a behavior.
  • Consider these three “triggers” to smoking, and be prepared with strategies to cope with them: 1) Other smokers: Avoid other smokers or ask them not to smoke around you, 2) Alcohol: Avoid alcohol or limit drinks as necessary, and 3) Emotional stress: Learn to adjust to situations without smoking.
  • With cigarettes delivering a stronger dose of nicotine, consider using two forms of NRT. The combined NRT approach not only delivers nicotine more aggressively to replace that from cigarettes, the U.S public Health Service 2008 update (8) found this to be the best of the medical options available for helping smokers quit.
  • Beware of cutting down as a strategy to quit unless you schedule your reduction of smoking in advance for a limited and specific amount of time prior to a target quit date. Stalling, delaying, or reducing smoking are tactics to avoid smoking, but are also ways to avoid quitting. Randomly reducing to quit is a common cessation strategy which recent research suggests is associated with lower cessation success rates. A 2013 Gallup poll (9) found smokers who succeed are more likely to quit abruptly (48 percent) vs. gradually (2 percent). A short-term technique for building confidence to prepare a successful quit day is smoking by the clock, otherwise known as “scheduled smoking” (10).
  • Download an app on your smartphone so you always have access to scientifically supported psychological and behavioral techniques. Such an app should help you prepare for and plan a successful quit day, as well as offer relapse prevention tools. It is critical that the app address not only the physical ties to your smoking addiction, but also the emotional side. Of course, I would like to highlight my own Up in Smoke app for iPhone, iPad Android, and the web!

Dr. Daniel Seidman, a clinical psychologist, is director of smoking cessation services at Columbia University Medical Center. He is author of the book Smoke-Free in 30 Days and of the “Up in Smoke” app from Mental Workout for iPhone, iPad, Android, Mac, and PC.

References:

  • Variation in nicotine intake in U.S. Cigarette smokers Over the Past 25 Years: evidence From nHanes surveys. Martin J. Jarvis, Gary A.Giovino, Richard J. O’Connor, Lynn T. Kozlowski, John T. Bernert.
  • SRNT Journal Research Advance Access published July 25, 2014
  • Recent increases in efficiency in cigarette nicotine delivery:implications for tobacco Control. Thomas Land, Lois Keithly, Kevin Kane, Lili Chen, Mark Paskowsky , Doris Cullen, Rashelle B. Hayes, Wenjun Li. SRNT Journal Advance Access published January 13, 2014
  • 2013 Gallup-Healthways Well-Being Index.
  • Tanya R. Schlam, Megan E. Piper, Jessica W. Cook, Michael C. Fiore and Timothy B. Baker. “Life 1 Year After a Quit Attempt: Real-Time Reports of Quitters and Continuing Smokers.” Annals of Behavioral Medicine, Vol. 44, Issue 3, 309-319. December, 2012.
  • West R, Brown J (2015) How much improvement in mental health can be expected when people stop smoking? Findings from a national survey, Smoking in Britain, 3,6. http://www.smokinginbritain.co.uk/read
  • Campaign for Tobacco Free Kids. Broken Promises to Our Children: The 1998 State Tobacco Settlement Fourteen Years Later (Updated in 2014).
  • State-Specific Prevalence of Current Cigarette Smoking and Smokeless Tobacco Use Among Adults Aged ≥18 years -United States, 2011-2013. CDC, Morbidity and Mortality Weekly Report (MMWR) May 22, 2015 / Vol. 64 / 19. See Table 1. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6419a6.htm?s_cid=mm6419a6
  • The 2008 update to Treating Tobacco Use and Dependence, U.S. Department of Health and Human Services Public Health Service May 2008. See page 109 http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/clinicians/update/treating_tobacco_use08.pdf
  • http://www.gallup.com/poll/163763/smokers-quit-tried-multiple-times.aspxhttp://www.gallup.com/poll/163763/smokers-quit-tried-multiple-times.aspxThe effects of smoking schedules on cessation outcome: Can we improve on common methods of gradual and abrupt nicotine withdrawal? Cinciripini, Paul M.; Lapitsky, Lynn; Seay, Sheila; Wallfisch, Annette; Kitchens, Karen; Van Vunakis, Helen. Journal of Consulting and Clinical Psychology, Vol 63(3), Jun 1995, 388-399.

http://www.huffingtonpost.com/daniel-seidman/todays-smokers-are-having_b_7471194.html

Press Release: Heitkamp Announces Significant Federal Funding for Tobacco Prevention

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

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

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

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

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Cigarette tax and e cigarettes debated in ND legislature

By KX News

Bismarck, ND -A bill that would have substantially raised taxes on cigarettes in North Dakota failed Friday afternoon.
But two others limiting access to electronic cigarettes passed.
The proposed cigarette tax would have raised taxes more than 200 percent on a package of cigarettes.
Currently the cigarette tax in North Dakota is 44 cents.
By contrast, the tax in Minnesota is 2.90 and in South Dakota it’s a 1.53.
Supporters of the bill say the increase would reduce the number of smokers and lower health care costs.
“Whenever a tobacco tax is increased, smoking, especially youth smoking goes down and it goes down dramatically. That I believe is undeniable,” says Rep. Jon Nelson, R – Rugby.
Bill opponents argued that a tax won’t stop smoking, and burdens business.
“If it truly is our duty to coerce people into a healthy lifestyle through taxation, why don’t we tax fast food with high fat content and high cholesterol, all things supersized and salt,” says Rep. Rick Becker, R – Bismarck.
The cigarette tax bill failed by a 56-34 vote.
The house passed two bills designed to keep e-cigarettes away from kids.
The two bills differ in these ways —
One labels e-cigarettes as tobacco products, tying them to the laws and enforcement already in place for cigarettes.
Those laws include things like compliance checks from local police and how cigarettes are displayed in stores.
The other bill separates e-cigarettes into their own category with their own set of enforcement laws.
“I don’t know how we can separate the idea of discussing e-cigarettes and then we’re going to talk about the taxing of tobacco when it’s clearly a tobacco product,” says Rep. Kenton Onstad, D – Parshall.
“We do not want kids under the age of 18 to buy cigarettes, whether it be on the internet, whether it be in the store. E-cigarettes, anywhere. We don’t want them to by regular cigarettes, we don’t want them to buy e-cigarettes,” says Rep. Al Carlson, R – Fargo.
Both bills now move to the Senate where only one, if any, is likely to pass.
http://www.wdaz.com/news/north-dakota/3679119-cigarette-tax-and-e-cigarettes-debated-nd-legislature