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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

The Hill: FDA sends e-cigarette regs to White House for review

By Lydia Wheeler
The Food and Drug Administration (FDA) has sent its final rule to regulate additional tobacco products, including electronic cigarettes and cigars, for White House review.
The rule, which was first proposed more than a year ago, was sent to the White House Office of Management and Budget’s Office of Information and Regulatory Affairs on Monday, but it could be weeks before the rule is actually released.
FDA spokesman Michael Felberbaum said the Office of Management and Budget is required to review all significant regulatory actions and has 90 calendar days to do so.
“However, this timeframe can be extended to allow for additional interagency discussion,” he said. “At this time, the FDA cannot provide any further comment until the final rule is published.”
The American Lung Association is hoping for an expedited review.
“We remain deeply troubled that it’s taken 18 months from the time the proposal was released to now,” said Erika Sward, the group’s assistant vice president of national advocacy. “We need to move forward in protecting kids and public heath.”
Sward said the lung association is hoping the final rule will give FDA the authority to truly regulate all tobacco products. Under the proposed rule, she said, there was a loophole for certain “premium” cigars.
“There’s no such thing as a safe tobacco product and certainly not a safe cigar,” she said. “FDA needs to have the basic authority over all tobacco products to make sure kids aren’t buying them and warning labels are required.”
http://thehill.com/regulation/pending-regs/257920-fdas-tobacco-deeming-rule-under-final-review

AP: House bill aims for less e-cigarette regulation

WASHINGTON — House Republicans are pushing to ease proposed government regulations for companies that sell e-cigarettes and other new tobacco products, a move that Democrats charge could lead to unsafe products on the market.

A spending bill approved by a House subcommittee Thursday would prevent the Food and Drug Administration from requiring pre-market reviews of e-cigarettes that already are on the market.

As part of a broader rule regulating e-cigarettes for the first time, the agency has proposed that e-cigarette brands marketed since February 2007 undergo those pre-market reviews retroactively once the final rule is approved. Companies would have to submit the applications within two years of the final rule, and then the FDA would ensure that the product is “appropriate for the protection of the public health.” If not, the agency could take it off the market.

In addition to e-cigarettes, the FDA rules and the House legislation would apply to other unregulated tobacco products such as cigars, hookahs, nicotine gels, waterpipe tobacco and dissolvable tobacco products. The FDA already regulates cigarettes, smokeless tobacco and roll-your-own tobacco products.

Republicans said the pre-market review would be a lengthy and expensive process that could drive companies out of business. Alabama Republican Rep. Robert Aderholt, who sponsored the bill, said the provision is just a technical change that would keep the newer products under FDA oversight but allow them to be regulated in the same way as older tobacco products. The legislation would not affect the FDA’s proposal to ban the sales of the products to minors and would still allow certain product standards.

Public health groups said the legislation would hamper the FDA’s ability to prevent tobacco companies from marketing the new products to kids, and Democrats said before the panel’s vote that the change would reduce regulation on the industry at the same time that e-cigarette use is skyrocketing.

The bill “is nothing short of a giveaway to the tobacco industry,” said New York Rep. Nita Lowey, the top Democrat on the Appropriations Committee.

FDA’s proposed rules, expected to be finalized in the coming months, are aimed at eventually taming the fast-growing e-cigarette industry.

E-cigarettes are plastic or metal tubes, usually the size of a cigarette, that heat a liquid nicotine solution instead of burning tobacco. That creates vapor the user inhales.

The nicotine-infused vapor of e-cigarettes looks like smoke but doesn’t contain all of the chemicals, tar or odor of regular cigarettes. Some smokers use e-cigarettes as a way to quit smoking tobacco, or to cut down. However, there’s not much scientific evidence showing e-cigarettes help smokers quit or smoke less, and it’s unclear how safe they are.

Matthew Myers, president of the Campaign for Tobacco-Free Kids, said the House language could keep products on the market that appear to be targeted to children, like cigars and e-cigarettes in a variety of candy and fruit flavors.

Gregory Conley, president of the American Vaping Association, said the FDA regulations could hurt small businesses.

“This proposal does not remove the FDA’s ability to regulate vapor products,” Conley said. “The FDA will still have the full authority to make science-based regulatory decisions on the manufacturing, marketing and sale of these products.”

The FDA would not comment on the legislation, but FDA spokesman Michael Felberbaum said the rules are important consumer protections.

“When finalized, the rule will represent a significant first step in the agency’s ability to effectively regulate tobacco products and, as we learn more about these products, the agency will have additional opportunities over the long term to make a positive difference in the public health burden of tobacco use in this country,” Felberbaum said.

http://www.cbsnews.com/news/house-bill-aims-for-less-e-cigarette-regulation/

MINNPOST: Proposed Minneapolis tobacco licensing changes will help curb youth smoking

By Jan Malcolm | 06/19/15

Imagine a future when tobacco is no longer the leading cause of preventable death and disease. To make this vision a reality, we must prevent more young people from getting hooked by deadly tobacco products. The Minneapolis City Council is poised to do just that by considering changes to the licensing ordinance to restrict the sale of all flavored tobacco (other than menthol) to adult-only tobacco stores and set minimum price limits for cigars. These measures strike at the heart of the tobacco industry’s strategy to sell their products to kids: flavoring and price.

While Big Tobacco is supposed to be prohibited from marketing to kids, it finds many ways around that ban. Tobacco executives know that unless they get to kids before they reach their 20s they’ve lost a customer. Documents released during the tobacco trials of the 1990s reveal how deliberately tobacco companies target young people. On the witness stand, the chairman of the Liggett & Myers Tobacco Co. said, “If you are really and truly not going to sell to children, you are going to be out of business in 30 years.” A Lorillard executive wrote that he wanted to exchange research data with Life Savers to figure out what tastes kids want. And a marketing plan from U.S. Smokeless Tobacco showed a deliberate strategy to start users on sweet flavors, then “graduate” them to plain tobacco.

Candy and fruit flavors

The appeal of flavoring to young people is the reason the FDA banned cigarettes in flavors other than menthol in 2009. Unfortunately, products such as little cigars, cigarillos, chew, e-cigarettes and others are still widely available in candy and fruit flavors such as bubble gum, grape and gummy bear – flavors that clearly appeal to youth. These flavored products are for sale in more than 250 stores throughout Minneapolis alone, and they are easy for children to purchase. One-third of Minneapolis boys under 18 report buying tobacco from a convenience store or gas station.

Research shows that young people mistakenly believe that flavored tobacco products are less dangerous than other tobacco products. In fact, they are just as dangerous, with the same health risks of cancer, heart disease and chronic obstructive pulmonary disease. Candy and fruit flavored tobacco products just mask the harsh taste and feel of tobacco.

Nearly 20 percent of Minnesota high school students have tried a water pipe or hookah, and almost all shisha (hookah tobacco) is flavored. More than 25 percent of Minnesota high school students have used an e-cigarette, and most e-cigarette liquid is flavored. More than 35 percent of Minnesota high school students report that they have tried flavored cigars, cigarillos or little cigars at some point in their lives. In fact, kids are now twice as likely as older people to be cigar smokers. Almost 20 percent of Minneapolis 12th-graders say they smoke cigar products like cigarillos regularly.

Young people known to be price sensitive

Nearly 75 percent of Minneapolis tobacco retailers currently sell cigars and cigarillos, many for less than a dollar. The proposed changes to our city’s tobacco licensing ordinance would set a minimum price of $2.60 for each cigar. Research shows that young people are very sensitive to price increases and are more likely to just quit using a product they can’t afford than adults are.

Flavored tobacco restrictions and price minimum requirements have been successfully implemented in other communities around the country – and right here in Minnesota. No one wants our young people to face a lifetime of addiction and other health problems. We know that policies that restrict access to flavored tobacco and raise tobacco prices keep kids from starting to smoke and help them to quit.

Support the proposed changes to the Minneapolis tobacco licensing ordinance. Stand up for our kids against Big Tobacco.

Jan Malcolm is the vice president of public affairs for Allina Health. She served as Minnesota state health commissioner from 1999 to 2003. Malcolm lives in Minneapolis.

https://www.minnpost.com/community-voices/2015/06/proposed-minneapolis-tobacco-licensing-changes-will-help-curb-youth-smoking

Star Tribune: Mpls. considers restrictions on flavored tobacco products

By Eric Roper Star Tribune

The sale of flavored cigars in convenience stores could soon come to an end in Minneapolis, where city officials are mulling the state’s first ban on the products at most traditional locations to curb youth tobacco use.

Anti-smoking advocates and small retailers squared off at a packed City Council hearing Monday over a proposal that would restrict sales of flavored tobacco products from more than 300 allowed locations to just under two dozen specialty tobacco shops. Similar bans have been enacted in New York City and Providence, R.I.

A council committee delayed a vote on the proposal, which targets flavored cigars, smokeless tobacco, shisha for hookahs and e-cigarette juice — but excludes menthol flavors. It would also set a minimum price on all cigars at $2.60 — echoing measures passed in Bloomington, St. Paul, Maplewood and Brooklyn Center.

Supporters said low-cost flavored cigars, sold under brands like White Owl and Swisher Sweets, are especially harmful because they entice young people to start smoking. A recent study of 530 underage youth in north Minneapolis found that more than half of the 313 who had used tobacco reported at one point smoking a cigar or cigarillo.

“Luring people to an addictive product with cheap prices and candy flavors before they’re old enough to know better doesn’t … give kids much choice,” testified Latrisha Vetaw of Northpoint Health and Wellness Center. Some of the non-tobacco flavors mentioned in the ordinance include chocolate, honey and vanilla, as well as fruits, herbs and candy.

City records show that 362 businesses are currently authorized to sell tobacco products in Minneapolis, though about a quarter of them are bars that largely sell cigarettes. The proposal would limit flavored tobacco sales to approximately 21 “tobacco products shops,” which generate 90 percent of their revenue from tobacco-related sales. It also clarifies that customers must be 18 to enter those stores.

Convenience store owners at Monday’s hearing challenged the necessity of the change, noting that it is already illegal for them to sell tobacco to minors. City records show that out of more than 350 undercover compliance checks each year, only about 6 to 7 percent result in violations for selling to a minor.

They also said that restricting tobacco sales threatens one of their core revenue streams. “Forty percent of our sales in the convenience store industry comes from tobacco. … That’s the industry average: 40 percent,” said Steve Williams, owner of Bobby and Steve’s Auto World, which has several locations. “So we’re affecting the viability of a lot of convenience stores.”

Ahmad Al-Hawari, who owns four convenience stores around the city, said while flavored cigars account for less than 5 percent of their business, the change could result in lost customers.

“A customer will walk or drive to a smoke shop, buy his flavored tobacco as he wishes … and then he’s going to buy cigarettes and pop from there,” Al-Hawari said. “He’s not going to go back to the convenience store.”

The federal government banned all flavored cigarettes except for menthol in 2009, but did not apply the same restrictions to cigars. Cigars may also be sold individually, versus in packs like cigarettes, making a common price about 99 cents each, according to a city staff report.

Paul Pentel, an internist at Hennepin County Medical Center, said their low cost also makes cigars an appealing option for adults who already smoke.

“In my clinic, I am very alarmed by the number of patients I see who have switched to cheap cigars because of the cost of cigarettes,” Pentel said. “For these patients, cheap cigars are a missed opportunity to quit smoking.”

New York City banned the sale of flavored tobacco products in 2009, except for at a handful of tobacco bars. A ban in Providence, R.I., went into effect in 2013. The state of Maine has also enacted a ban on small, flavored cigars.

Four Minnesota cities have already established minimum cigar prices. The minimum is $2.10 in St. Paul and Brooklyn Center, and $2.60 in Bloomington and Maplewood, city staff said.

Council Member Blong Yang, a cosponsor of the ordinance change, said he was drawn to the issue after seeing in the recent study from Breathe Free North, a program of Northpoint, that children have too much access to flavored tobacco. It also appears to be disproportionately affecting minority communities, he said.

“Every single convenience store that you go to it seems has all this stuff right in front of people, basically,” Yang said. “And it’s screaming for people to buy it because it’s there.”

The council’s health, environment and community engagement committee is expected to vote on the measure in two weeks, with a final vote before the full council possible in July.

http://www.startribune.com/minneapolis-mulls-restrictions-on-flavored-tobacco-products/306572261/

Teen tobacco users likely to use it in multiple forms

By Reuters Media

A national survey of U.S. middle and high school students finds that those who use tobacco or nicotine products are likely to also use more than one type of product.

About 15 percent of the adolescents reported smoking cigarettes, cigars, pipes, bidis, hookahs or water pipes, using dissolvable forms of tobacco or “vaping” e-cigarettes. And twice as many in that group used two or more of these product types compared to those who said they used only one.

“Our study really shows that kids are using more than one of these products at the same time,” said Youn Ok Lee of RTI International in Research Triangle Park, North Carolina, the report’s lead author.

Lee said there are many varieties of tobacco products available. And each type of product also has a diverse range of options, such as flavors.

“So we don’t really know a lot about how this range of products might affect kids’ use of tobacco,” she told Reuters Health.

Using data from a 2012 national survey of nearly 25,000 U.S. students, researchers found that about 7 percent reported using one tobacco product in the past 30 days. About 4 percent said they used two tobacco products in that time. Another 4 percent said they used three or more products.

“I was a little bit surprised by just how many kids were using more than one product,” Lee said. “Even more surprising was that using three or more products is more popular than using cigarettes alone.”

Overall, about 3 percent of kids exclusively used cigarettes and about 2 percent exclusively used cigars. Those products were the most popular and their use increased with age.

The study team also found that almost 1 percent of students reported exclusively using e-cigarettes, which contain no tobacco but deliver a vapor laced with nicotine, the addictive substance in tobacco.

That’s more than the 0.4 percent who reported using e-cigarettes in combination with traditional cigarettes.

The increasing popularity of e-cigarettes is a concern for U.S. health officials as use has tripled between 2013 and 2014.

Lee noted that the results don’t tell why young people are using more than one form of tobacco, or how often the survey participants had used the products.

The researchers did find that being a boy, using flavored products, being dependent on nicotine, being receptive to advertising and having friends who used any tobacco products were all factors linked to an increased risk of using more than one product.

Policymakers and researchers should look at how these products affect tobacco use among middle and high school students, said Lee, because little is known about the influence of non-cigarette products.

Moreover, these products may create a public health issue by introducing people who would never have smoked cigarettes to nicotine, she said.

Lee emphasized that it’s important to look at all tobacco products together – not individually.

SOURCE: http://bit.ly/1za0ykL Pediatrics, online February 2, 2015.

http://www.inforum.com/news/3671610-teen-tobacco-users-likely-use-it-multiple-forms

Higher tobacco taxes save lives

By: Vincent DeMarco, Baltimore

A recent op-ed criticizing Maryland’s tobacco tax increases ignores the most important consequence of these measures: a dramatic decrease in tobacco use by teens that has saved thousands of young people from preventable tobacco-related deaths and serious illnesses (“Md. cigarette taxes have unintended consequences,” Dec. 18).

According to data compiled by the Campaign For Tobacco Free kids, within two years after the 2008 increase in the state cigarette tax, from $1 per pack to $2 per pack, there was a 29 percent drop in teen smoking in Maryland.

That translated into 15,000 fewer high school smokers (some of whom have become non-smoking young adults by now); more than 70,000 kids today who will not become adult smokers; more than 30,000 kids alive today who will avoid future premature smoking-related deaths; and more than $1.5 billion in long-term health care cost savings tp the state.

The Maryland Department of Health and Mental Hygiene recently released a study showing that between 2010 and 2013 there was an 18 percent drop in Maryland teens smoking cigars. This happened at a time when nationally there was no statistically significant change in teen cigar smoking.

This progress, which also resulted in saving thousands of Maryland youth from tobacco addiction and preventable death and illnesses, occurred in part because of the 2012 increase in the state tax on cigars, along with an effective public education campaign by the state health department.

Granted, there will always be some people who will seek to avoid the tobacco tax by going to other states or resorting to smuggling. But very seldom will this involve children, whose lives we are saving in record numbers.

And we know from experience that the drop in cigarette sales in Maryland far outweighed the increase in sales in neighboring states that didn’t increase their tobacco tax. And were are fully confident in Maryland Comptroller Peter Franchot’s ability to prevent and prosecute those who would try to illegally smuggle cigarettes into the state.

In addition to saving lives, tobacco tax increases are good for Maryland taxpayers because they both reduce the health-care cost for tobacco-related illnesses and help fund critical health care programs. The 2008 tobacco tax increase partially funded the expansion of health care to over 100,000 uninsured Marylanders.

Although the Maryland Taxpayers’ Association doesn’t seem to want Marylanders to have these benefits, many independent polls show the vast majority of Marylanders clearly understand these benefits and would strongly support further increases in the tobacco tax to save more lives and money for the state.

-The writer is president of the Maryland Citizens’ Health Initiative.

http://www.baltimoresun.com/news/opinion/bs-ed-tobacco-letter-20141222-story.html

New CDC Youth Tobacco Survey Should Spur FDA to Finalize Rule Regulating All Tobacco Products, Including E-Cigarettes and Cigars

New CDC Youth Tobacco Survey Should Spur FDA to Finalize Rule Regulating All Tobacco Products, Including E-Cigarettes and Cigars

Teen E-Cigarette Use Triples, Cigar Use Stays Steady Even While Cigarette Smoking Continues to Drop 

WASHINGTON, DC – The 2013 National Youth Tobacco Survey released today by the CDC shows that while youth cigarette smoking continues to decline, electronic cigarette use among high school students tripled from 2011 to 2013 and there has been no progress in reducing youth cigar smoking.

These findings underscore the urgent need for the Food and Drug Administration to finalize its proposed rule to regulate all tobacco products, including e-cigarettes and cigars, in order to prevent youth use of these products.  We again call on the FDA to issue a final rule by April 25, 2015 – one year after the FDA issued a proposed rule – and to close gaps in the rule by cracking down on marketing and flavors that appeal to kids.  The FDA first announced in early 2011 that it planned to regulate e-cigarettes, cigars and other unregulated tobacco products, so these important public health protections are long overdue.  We cannot afford more delays that allow the tobacco industry to continue targeting our kids with a new generation of unregulated tobacco products.

The FDA currently regulates cigarettes, smokeless tobacco and roll-your-own tobacco under a landmark 2009 law, the Family Smoking Prevention and Tobacco Control Act.  But the FDA must assert jurisdiction over other tobacco products, including e-cigarettes and cigars, before it can regulate them, which is what the proposed rule would do.

Key findings of the new survey include:

·        Youth cigarette smoking continues a steady, long-term decline, again reaching a record low.  In 2013, the cigarette smoking rate among high school students was 12.7 percent, down from 14 percent in 2012 and 15.8 percent in 2011 (the CDC last year published results of the 2011 and 2012 National Youth Tobacco Surveys). Since 2000, cigarette smoking among high school students has been cut by more than half (from 28 to 12.7 percent), while middle school smoking has fallen by 74 percent (from 11 to 2.9 percent).

·        In 2013, 4.5 percent of high school students reported using e-cigarettes in the past 30 days. That is triple the 1.5 percent who reported doing so in 2011 and up from 2.8 percent in 2012. This increase comes as e-cigarette makers have marketed their products with the same tactics long used to market regular cigarettes to kids, including celebrity endorsements, slick TV and magazine ads, sponsorships of race cars and concerts, and sweet flavors such as gummi bear and cotton candy.

·        There has been no progress in reducing youth cigar smoking in recent years.  In 2013, 11.9 percent of high school students were cigar smokers, compared to 11.6 percent in 2011.  In 2013, high school boys smoked cigars at higher rates than cigarettes – 15.4 percent vs. 14.1 percent, while African-American high school students smoked cigars at much higher rates than cigarettes – 14.7 percent vs. 9 percent.  Because cigars are unregulated, often taxed at lower rates than cigarettes and can be sold individually, tobacco companies have been able to market an array of cheap, sweet cigars that appeal to kids.

As the CDC noted in its report on the survey results, nicotine use by youths in any form is unsafe and can harm adolescent brain development.  It is critical that the FDA act to regulate all tobacco products and prevent youth use of any tobacco product.

The big drops in cigarette smoking demonstrate that we know how to win the fight against tobacco by implementing scientifically proven strategies. These include higher tobacco taxes, strong smoke-free laws, well-funded tobacco prevention and cessation programs that include mass media campaigns, and effective FDA regulation of all tobacco products.

Tobacco use is the number one cause of preventable death in our country, killing 480,000 people and costing at least $289 billion in health care bills and economic losses each year.  It is within our reach to win this fight and make the next generation tobacco-free, but only if we have the political will to fully implement what we know works.

The National Youth Tobacco Survey results were published in the CDC’s Morbidity and Mortality Weekly Report.

NOTE: In addition to the increase in youth use of e-cigarettes, poison control centers across the country continue to report soaring numbers of accidental poisonings related to e-cigarettes and the  nicotine liquids used in them.  The American Association of Poison Control Centers reports that, through October 31, there have been 3,353 calls so far this year involving exposures to e-cigarette devices and nicotine liquids.  This is more than double the 1,543 calls in all of 2013 and more than 12 times the 271 calls in 2011. The huge increase in poisoning incidents related to e-cigarettes is one more reason why the FDA must quickly finalize its rule, including requiring child-resistant packaging of nicotine liquids.

Cigars Loaded With Harmful Toxins, Study Shows

(HealthDay News) — Some cigar smokers may believe they face less health risk than if they were smoking cigarettes, but a new study casts doubt on that notion.
Researchers say that cigar smokers are exposed to high levels of cancer-causing agents and other toxic substances, which suggests that the habit is as risky as smoking cigarettes.
None of this came as much surprise to lung experts.
“In spite of the fact that cigar smokers don’t inhale, more attention needs to be paid to the damages of secondhand smoke, and to acknowledge that no smoking is safe,” said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City.
“It is well known that secondhand smoking causes asthma, as well as a possible increase in the risk for lung cancer. The cloud around a cigar smoker’s respiratory system is tantamount to this phenomenon,” Horovitz said.
Cigar use in the United States more than doubled from 2000 to 2011, according to the U.S. Centers for Disease Control and Prevention.
The findings are reported Nov. 7 in the journal Cancer Epidemiology, Biomarkers & Prevention.
In the new study, researchers analyzed the presence of five chemical signals of tobacco exposure in tests conducted on more than 25,500 Americans.
Two of the biomarkers — cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) — are specific to tobacco. The other biomarkers — lead, cadmium and arsenic — are not tobacco-specific and can come from other sources.
The study found that cigar smokers — whether or not they also smoked cigarettes — carried higher levels of cotinine, NNAL, cadmium and lead than people who did not use tobacco. Cigar smokers with a history of cigarette use had much higher levels of cotinine and NNAL than cigar smokers who did not smoke cigarettes.
Also, levels of NNAL in daily cigar smokers were similar to those of daily cigarette smokers, according to the study.
“Cigar smoking exposes users to similar types of harmful and cancer-causing agents as cigarette smoking,” lead author Dr. Jiping Chen, an epidemiologist at the U.S. Food and Drug Administration’s Office of Science, Center for Tobacco Products, said in a journal news release.
“Once differences are accounted for in frequency of use, the levels of NNAL, a strong carcinogen, are comparable in cigar and cigarette smokers,” Chen said.
Another expert in respiratory health agreed that cigars are probably no better than cigarettes when it comes to health.
“This is especially significant because, although youth cigarette smoking has decreased, high school students in the U.S. are twice as likely as adults to smoke cigars,” noted Patrician Folan, director of the Center for Tobacco Control at North Shore-LIJ Health System in Great Neck, NY.
“Frequently, cigars are cheaper and are available in a wide variety of flavors that appeal to adolescents and young adults,” she said. “This combination of factors makes cigar smoking more attractive to young people, who may have the perception that cigar smoking is less harmful, especially due to flavors like chocolate, grape, strawberry and peach.”
More information
The American Cancer Society has more about cigar smoking.

SOURCES: Len Horovitz, M.D., pulmonary specialist, Lenox Hill Hospital, New York City; Patricia Folan, RN, director, Center for Tobacco Control, North Shore-LIJ Health System, Great Neck, N.Y.;Cancer Epidemiology, Biomarkers & Prevention, news release, Nov. 7, 2014

http://consumer.healthday.com/cancer-information-5/smoking-cessation-news-628/cigars-loaded-with-harmful-toxins-study-shows-693504.html

Fewer Fargo High School students smoking, binge drinking

By Helmut Schmidt | Fargo Forum
FARGO – The percentage of Fargo High School students taking up cigarette smoking is dropping fast, and fewer students are binge drinking.

But other risks are coming to the fore, including what appears to be higher rates of depression and thoughts of suicide. Students also report a high rate of texting, emailing and talking on cellphones as they drive.

One out of five Fargo high school students polled were bullied electronically, while nearly one in 10 students said they were physically hurt by someone they were dating.

Statistics from the 2013 Youth Risk Behavior Survey paint a stark picture of the challenges faced by youths today, said Ron Schneider, a counselor at Fargo’s Woodrow Wilson High School.

Presenting the survey results and trend data to the School Board Tuesday, Schneider said it’s vital for family, teachers and school officials to make connections with young people.

“The more connections, the more relationships, the less likely they get involved with negative behavior,” Schneider said.

Among the findings:

  • Depression is a problem that’s either on the rise, or it has become more acceptable to talk about, Schneider said. “My guess is it’s a little of both,” he said. In 2013, 26.9 percent of Fargo students polled in grades 9-12 felt sad or hopeless almost every day for two or more weeks straight, up from 22.7 percent in 2009, the survey showed.
  • Of those surveyed, 16.8 percent had seriously considered suicide in the previous year, 12.4 percent had made a plan about how they would attempt suicide and 11.6 percent had attempted suicide one or more times in that year.
  • About two out of three young drivers are so hooked on their cellphones they can’t put them down when driving. Among Fargo students surveyed, 57.3 percent said they had texted or emailed while driving in 2013. Meanwhile, 67 percent of Fargo students said they had talked on a cellphone while driving in 2013.
  • In Fargo, 8.6 percent of students surveyed in 2013 reported being hurt by someone they dated, with that rising to 9.7 percent statewide.
  • Also, 10.1 percent of Fargo high school students in 2013 said they had been physically forced to have sexual intercourse, compared with 7.7 percent of those polled statewide.
  • About 20.1 percent of Fargo students said they had been electronically bullied, compared with 17.1 percent statewide.
  • Nearly a third of Fargo students, 28.7 percent, said they had an alcoholic drink in the last 30 days. It was 35.3 percent statewide.

Drug use

Schneider said it appears that the use of other chemicals has stabilized.

  • In 2013, 19.6 percent of Fargo students had tried marijuana in the last 30 days, compared with 15.9 percent statewide.
  • About 10.7 percent of Fargo students said they had sniffed glue, huffed from aerosol cans, or inhaled paints or spray to get high, while 5.6 percent said they had used methamphetamines.
  • In 2013, 20.5 percent of Fargo students said they had illegally used prescription drugs such as OxyContin, Percocet, Vicodin, codeine, Adderall, Ritalin or Xanax.
  • About 13.5 percent of Fargo high school students used over-the-counter drugs to get high in 2013, while 10.8 percent said they had used synthetic drugs such as K2, Spice or bath salts.
  • About 12.5 percent of students polled in 2013 said they had attended school drunk or high in the last 30 days.

Some positives

  • Regular smokers, Fargo teens who had smoked a cigarette on 20 of the last 30 days before the 2013 poll, dropped significantly, from 11.1 percent in 2009 to 3.9 percent in 2013.
  • About 21 percent of Fargo students reported smoking cigarettes, cigars or using chewing tobacco, snuff or dip in the last 30 days in the 2013 poll.
  • Binge drinking declined, as 17.7 percent of Fargo students in 2013 said they had five or more drinks in a couple of hours, compared with 23.9 percent in 2009. Statewide, 21.9 percent reported binge drinking in 2013, compared with 30.7 percent in 2009.

Sexually active

Many young people reported that they were sexually active. Of the students surveyed in 2013:

  • 39.7 percent of Fargo high school students reported that they had sexual intercourse, compared with 44.9 percent statewide.
  • 12.4 percent of Fargo students said they had sex with four or more partners during their lives.
  • 51.7 percent of Fargo students said they had used a condom during their last sexual experience, compared with 56.3 percent statewide.

http://www.inforum.com/content/fewer-fargo-high-school-students-smoking-binge-drinking