Center for Public Integrity: How Big Tobacco lobbies to safeguard e-cigarettes

By Nicholas Kusnetz
SACRAMENTO, Calif. ­— In the Golden State, home to healthy living, progressive politics and one of the lowest smoking rates in the nation, cigarettes can seem like a relic of the past, barred long ago from restaurants, bars and even some city parks.
And yet within the walls of California’s high-domed capitol, tobacco companies continue to wield surprising power. After a recent loss on a slate of tobacco control bills headed to the governor’s desk, they are gearing up for a bigger test looming at the ballot this fall. With money to spend, they have threatened to sabotage a planned ballot measure to raise the cigarette tax.
The battles aren’t just here. Despite the tobacco industry’s tarnished public image, it is operating a powerful and massive influence machine in statehouses from Salt Lake City to Topeka. With a playbook crafted nearly 20 years ago, the tobacco firms use direct lobbying, third-party allies and “grassroots” advocacy campaigns to spread model legislation and mobilize smokers against proposed regulations and tax hikes across the country. And they are taking up the mantle to defend a burgeoning electronic cigarette market as well.
Today, tobacco companies maintain some of the mostextensive state lobbying networks in the country, totaling hundreds of lobbyists. Altria Group Inc. and Reynolds American Inc., which control the vast majority of the American tobacco market, are among just 21 entities that had registered lobbyists in every state at one point from 2010 through 2014, according to a Center for Public Integrity analysis of lobbyist registrations collected by the National Institute on Money in State Politics.
They’ve also given at least $63 million to state candidates, committees and ballot initiatives nationwide over the past five years.
Their chief opponents, the American Cancer Society and American Heart Association, also have similarly broad lobbying networks, but the health associations have given hardly any money to state politicians.
With such extensive reach, tobacco companies have continued to fight off the simplest means of cutting smoking rates: higher taxes. Out of 24 states to propose higher cigarette taxes last year just eight passed increases, according to a tobacco industry group. And only Nevada, with a $1-per-pack hike, raised them by more than 50 cents. Health groups say incremental tax hikes of less than $1 are much less effective at cutting smoking rates because tobacco companies can easily counteract them with rebates and discounts.
E-cigarettes are the newest front in this multi-faceted war. While the Food and Drug Administration has announced plans to regulate e-cigarettes, for now it remains up to states to impose any regulations or taxes on the emerging products. So far, e-cigarette taxes have passed in only four states, while proposals have been defeated in at least 21 others. The tobacco industry, which is increasing its share of the new market, has also won language in at least 19 states in recent years making it harder to regulate and tax e-cigarettes under existing anti-smoking laws.
David Sutton, a spokesman for Altria, the parent company of Philip Morris, said his firm is generally opposed to taxes on its products and becomes politically active where necessary. Reynolds declined to answer specific questions for this article, pointing instead to its website, which says the company engages in lobbying and makes lawful political contributions to protect the interests of its business.
“The tobacco companies never give up,” said Stanton Glantz, a professor at the University of California, San Francisco’s Center for Tobacco Control Research and Education. “They’re like the Borg,” the indomitable alien horde of “Star Trek” lore.
‘Where tobacco bills go to die’
Nowhere has the tobacco fight been bigger, or more expensive, than in California, which has attracted at least two-thirds of tobacco companies’ state-level political donations since 2011. Public health advocates here say tobacco companies have used a potent combination of campaign contributions and behind-the-scenes lobbying to win enough friends in key places.
The strategy is most apparent on the Assembly’s Governmental Organization Committee, which oversees an odd combination of issues, including public records, state holidays, gambling, alcohol and tobacco.
Its chairman, Assembly member Adam C. Gray, a Democrat from Merced who has served on the committee since 2013, has accepted $88,100 in political contributions from Altria and Reynolds since he began campaigning for office in 2011, far more than any other member of the Legislature.
The two companies have directed some $390,000 in total to members who sat on that Assembly committee, a quarter of the money they’ve given to all legislative candidates and their committees in California over that period.
The large amount of money given to its members has prompted some to call it the “Juice Committee.” Health advocates call it “the committee where tobacco bills go to die.”
The committee has watered down or killed nearly every major tobacco bill that’s come through it in recent years, anti-smoking advocates say, including a recent attempt in July to regulate e-cigarettes.
In an unusual move, an identical e-cigarette bill and five other tobacco measures were reintroduced in a special session the following month to allow the legislation to sidestep Gray’s committee. They passed the Legislature this month, the first significant tobacco control bills to pass since the 1990s, a marked blow to the usually successful tobacco industry.
“Money has no influence on what goes on with policy. It just doesn’t,” Gray said. “Raising money to get into elected office is a component of what we have to do… And frankly, I’m a pretty aggressive fundraiser.”
Lawmakers and other Sacramento insiders point out that the direct contributions, which are subject to strict limits, are minimal compared to the money spent by independent political groups, which can raise and spend unlimited sums to support or oppose candidates as long as they do not coordinate with the candidates. Tobacco companies have given some $4.8 million to such independent political committees and parties in California since 2011, nearly three times as much as they gave directly to candidates.
“We provide contributions to candidates and elected officials who, in their work legislatively are at work on issues that have an impact on our business,” said Sutton, the Altria spokesman.
Altria and Reynolds have also spent some $5.4 million on lobbying in California since 2011. By comparison, the health groups that supported stronger tobacco regulation have spent some $2.7 million over the same period, though they lobby on many other issues as well.
“There’s a reason people spend money on that,” said Gary Winuk, who served for six years as the state’s lobbying and campaign finance enforcement officer before leaving for private practice last year. Winuk began his career working for a lawmaker on the Governmental Organization Committee decades ago, and said it was the behind-the-scenes maneuvering and power plays he saw there that made him want to work for the state ethics agency.
Preserving tobacco’s role
In 1999, R.J. Reynolds, now a division of Reynolds American, produced a memo describing a strategy to “preserve the company’s role and participation in U.S. commerce.” The document, archived at the University of California, San Francisco, included the company’s state lobbying objectives, chief among which was a plan to hire lobbyists in “as many states as possible,” as the company’s first “line of defense.”
Next was a commitment to make “appropriate political contributions and support key trade groups and allies,” adding, “there is an old saying in politics. ‘Money talks and bullshit walks’… It is especially true when dealing with tobacco issues.”
The third component of the lobbying strategy was to “execute grassroots mobilization of trade groups, smokers and other allies.”
Nearly two decades later, the company is still using the same roadmap. And smoking continues to be the leading cause of preventable deaths, killing nearly half a million Americans every year, according to the Centers for Disease Control and Prevention.
Reynolds and Altria employed a team of more than 450 state lobbyists in 2014, together retaining representatives everywhere but Nevada, according to an analysis of state records and data collected by the National Institute on Money in State Politics. They’ve also continued to work through trade organizations and advocacy groups.
When Kansas Gov. Sam Brownback proposed an increase of $1.50 per pack for traditional cigarettes last year to help fill a budget gap, Reynolds hired David Kensinger, who had served as the Republican governor’s chief of staff until leaving to work as a lobbyist in 2012. Weeks earlier, Kensinger was among a select group of insiders who received advance copies of Brownback’s proposed budget, which included the tax hike, before lawmakers did, according to The Wichita Eagle. Both Kensinger and Reynolds declined to comment on what happened.
Reynolds reported buying more than 350 meals for public officials and giving e-cigarettes to four House members in Kansas last year, according to state lobbying records, while Altria spent $283,000 on advertising and other outreach.
Meanwhile, a group called Citizens for Tobacco Rights, an advocacy campaign run by Altria, blasted emails to its members, in one instance urging them to fight the tax by posting messages on the Facebook pages of their lawmakers. It’s a standard tactic of the group, which claimed to have generated more than 33,000 phone calls and 52,000 emails and letters to legislators in 2014.
Lawmakers eventually approved a tax increase of only 50 cents, a third of the original proposal. Kansas continues to struggle with a $46 million budget deficit this fiscal year.
Protecting a smokeless future
Reynolds, too, has its own “grassroots” advocacy campaign, called Transform Tobacco.  And as the name suggests, a new product is increasingly drawing the company’s focus.
The e-cigarette was invented in 2003 in China and started appearing in this country not long after. It’s gained an enthusiastic community of users, and by 2013 some 20 million adult Americans reported trying e-cigarettes, which vaporize a liquid such as propylene glycol mixed with flavorings and usually nicotine, the key addictive chemical in cigarettes that is generally derived from tobacco.
E-cigarettes come in a huge range of varieties. One major brand charges about $10 for a disposable sleek black pen-like device that lasts about as long as two packs of cigarettes. But many “vapers” use so-called mods or tanks, bulkier refillable devices that can cost anywhere from $30 to well over $100. Users then buy separate vials of “e-juice,” with names like Cinnamon Crumble and Unicorn Milk, which typically sell for about $20 per 30-milliliter vial.
Sales of e-cigarettes reached $3.3 billion last year, according to Wells Fargo Securities, and may surpass those of traditional cigarettes within a decade. While tobacco companies still control less than half of this market, they’ve begun buying up or starting their own e-cigarette brands in recent years, rapidly increasing their share.
Reynolds, a leader in the e-cigarette market, has promoted model legislation that says explicitly that e-cigarettes are not tobacco products. The Center for Public Integrity obtained a template copy of the model language that was circulated at one of dozens of youth tobacco prevention “dialogues” that Reynolds has held around the country in recent years for local health officials and advocates. The company offered to pay as much as $1,000, plus lodging, to those who attended, according to invitations the Center obtained.
So far, such model language has passed in at least 19 states, written into laws banning sales to minors. At least 11 of those passed laws that pull nearly verbatim from the Reynolds template, while at least eight others have enacted similar language that health groups say was promoted by Lorillard Tobacco, which Reynolds bought last year.

Pennsylvania and Michigan, the only states that do not prohibit sales to minors, have two bills pending with similar language.
Although Reynolds’ model language asserts that e-cigarettes are not tobacco products, the company’s own website describes its VUSE e-cigarette as exactly that.
The most immediate effect of the bills is to protect e-cigarettes from existing tobacco control programs and taxes. E-cigarette proponents say the alternate definitions are warranted because the products do not burn tobacco. But health groups warn that the definitions pushed by the industry will harm the public.
“You build this infrastructure for regulating e-cigarettes on a faulty promise that they’re somehow a healthy product,” said Timothy Gibbs, a lobbyist for the American Cancer Society Cancer Action Network in California and a chief shepherd of the tobacco control bills there. “While the scientific consensus is that they may be safer than traditional cigarettes, that doesn’t mean they’re safe.”
It seems likely that “vaping” is less harmful than smoking. The question is by how much. The Centers for Disease Control says e-cigarettes “generally emit lower levels of dangerous toxins” than cigarettes, but can also release carcinogenic compounds and heavy metals. The agency says that e-cigarettes could provide a public health benefit if they lead smokers to quit. But it suggests that isn’t happening — about three-quarters of e-cigarette users also smoke cigarettes — and the products may be harmful if they prolong smokers’ addiction.

State Sen. Mark Leno, a Democrat who sponsored the recently approved California bill that defines e-cigarettes as tobacco products, said their popularity among youth — some 2.4 million middle and high school students were using e-cigarettes nationally in 2014 — means the devices present a new health crisis. He likens today’s fight to what happened with smoking in the mid-20th century, when tobacco companies began a decades-long campaign to discredit the emerging science showing the lethal and addictive qualities of cigarettes.
“They knew 50 years ago what they were doing,” Leno said. “And they’re doing it again today.”
Reynolds declined to answer questions about the model legislation or the dialogues, pointing instead to a company webpage that explains its “transforming tobacco” initiative, which promotes youth prevention programs and argues that smoke-free products, including e-cigarettes, can reduce “the death and disease caused by cigarettes.” Health advocates say the company has insidiously used this campaign in its efforts to win legislation protecting e-cigarettes from harsher regulation.
Altria declined to answer whether it has lobbied in favor of the language.
Vapers fight back
In California, the full weight of state government has gotten behind a campaign to rein in e-cigarette use. Last year, the state public health department warned of the dangers of the product and recommended strict regulations, launching a website and ad campaign called Still Blowing Smoke. This month, with passage of Leno’s bill, the Legislature took a big step in that direction.
Yet the state has met formidable resistance not just from the tobacco industry but also from a fledgling industry of smaller e-cigarette manufacturers and retailers backed by a passionate movement of vapers. Mobilized around the country, these e-cig aficionados have protested in Salt Lake, circulated petitions in Washington state and flown to the nation’s capital to push their position with congressional leaders.
Within hours of the launch of the state’s Still Blowing Smoke campaign last March, for example, another website called NOT Blowing Smoke popped up, using a similar font and logo but blasting the department for peddling misinformation.
Stefan Didak, a 44-year-old software engineer and co-president of the Northern California chapter of the Smoke-Free Alternatives Trade Association, a vaping industry group, had learned that the health department was planning the campaign and spent 36 hours holed up in his home office, a dark room with an array of 12 monitors, 14 computers and a plastic rack holding dozens of e-cigarettes. In a savvy guerrilla tactic, he beat the department to registering social media accounts, so the Still Blowing Smoke Facebook page and Twitter handle lead to content by NOT Blowing Smoke.
“Yeah, that was fun,” Didak said from his split-level home in Oakley, a city on the eastern edge of the Bay Area. Didak, dressed all in black, wore a NOT Blowing Smoke T-shirt and held a black mod e-cigarette, the type preferred by hard-core vapers. The blinds were drawn and the air held the faint sweet odor emitted by his mod, which he sucked on periodically, blowing out thick clouds of “ripe strawberry shortcake” flavored vapor.
SFATA Executive Director Cynthia Cabrera says her group was not affiliated with the counter-campaign. The association hired lobbyists in Sacramento to oppose Leno’s bill and has urged Gov. Jerry Brown, a Democrat, to issue a veto.
Didak said that bill would drive small vape shops and liquids manufacturers out of the state — or out of business — by applying the various licensure and regulatory requirements that apply to tobacco. As someone who quit cigarettes thanks to vaping, he said that restricting the industry would harm public health.
Didak and other vapers stress that they are not “big tobacco” and that SFATA does not receive money from tobacco companies. “We don’t regard them as part of us,” Didak said.
In coming months, however, they’ll be on the same side.
A bold threat
Whether Brown signs Leno’s e-cigarette bill, part of the package of six tobacco measures the Legislature passed this month, an expensive fight looms in California’s freewheeling ballot initiative process.
A coalition of health and labor groups, with support from liberal billionaire Tom Steyer, is currently gathering signatures for a ballot initiative that would hike the state’s cigarette tax by $2 and levy an equivalent tax on e-cigarettes. At 87 cents, California’s current tax is well below the national average.
Yet that effort may be in jeopardy.
This month, a lobbyist for Altria sent a bold threat in an email first published by The Sacramento Bee: the company plans to try to repeal some of the tobacco bills it had opposed by putting them before voters in a referendum on this fall’s ballot. In a calculating political move, it also threatened to corner the all-important ballot measure market of professional signature gatherers by paying top dollar. That could price out the health groups from their cigarette tax campaign and imperil all other measures trying to make the ballot, including an extension of a key tax increase known as Proposition 30.
“When we hit the street with referendum paying $10 per signature, Prop 30 is dead as well as $2 a pack tax,” warned Altria lobbyist George Miller IV, son of the former Democratic California congressman. “We will have every signature gatherer on an exclusive. Just letting you know so you can’t say you were not warned.”
The health groups say they could be forced to either up their own prices, which are now about $4 per signature, or rally volunteers instead.
“We’re appalled but not surprised,” said Gibbs, the Cancer Society lobbyist, adding that tobacco companies have a history of particularly ruthless tactics. “They seem to be throwing a fit.”
Miller did not respond to requests for comment. Sutton, Altria’s spokesman, called Miller’s message “simply a friendly heads-up email between long-time colleagues.”
No matter whether Altria follows through on its threat, the coming months are sure to see many millions of dollars spent on all sides. Health groups have already raised $4 million for their campaign. During two previous attempts to raise cigarette taxes at the ballot, in 2006 and 2012, Reynolds and Altria spent more than $113 million and defeated both measures.
This story was co-published with Vice.

ADA News: ADA, others "concerned" about tobacco products

By Jennifer Garvin, American Dental Association News

Silver Spring, Md. — The ADA and 35 other health organizations have asked the Food and Drug Administration to be more diligent about requiring tobacco companies to obtain approval before introducing new tobacco products to market.

In a Feb. 26 letter to Mitchell Zeller, director, Center for Tobacco Products, the organizations shared that they are “increasingly concerned” that tobacco companies are introducing new tobacco products into the marketplace without proper regulatory review.

The Family Smoking Prevention and Tobacco Control Act of 2009 gave the FDA unprecedented authority to regulate the manufacturing, distribution and marketing of tobacco products. It also requires tobacco companies to seek FDA approval before introducing new tobacco products to the market.

“The premarket review provisions of the Tobacco Control Act are intended to prevent the tobacco industry from continuing to introduce new tobacco products that are more harmful, more addictive and more appealing, particularly to young people,” stated the letter.

The letter also points out that the Tobacco Control Act prohibits commercial marketing of a new tobacco product unless FDA has issued an order finding the product “appropriate for the protection of the public health.” It singles out several new products it claims are non-compliant with the act. These products include:

  • Marlboro Midnight, a menthol cigarette;
  • Grizzly Wintergreen, a new snuff;
  • Three new brands of snus from Kretek International Inc: Thunder Xtreme, Offroad and Oden’s Extreme;
  • Marlboro Black NXT, a crushable menthol capsule.

“FDA’s failure to take the actions necessary to remove these products from the market represents a serious failure to protect the public health,” the letter stated.

“Given that the avoidance of premarket review seriously undercuts the public health protections of the Tobacco Control Act, please explain why no enforcement actions have been taken by FDA against these products and indicate what the agency plans to do to prevent additional products from entering the market without the required regulatory review.”

Read the entire letter here.

Today Show: Video: E-cigarette explodes in pocket, man left with second-degree burns

A frightening explosion of an e-cigarette in a Kentucky man’s pocket was caught on camera in a convenience store. The man was hospitalized Tuesday with second-degree burns after the battery in his electronic cigarette exploded in his pants pocket.

To see the video:

Medical News Today: E-cigarettes impair immune responses more than tobacco

Written by Yvette Brazier

As evidence emerges that e-cigarettes are not as safe as advertisers claim, a new study shows that flavorings classed as “Generally Recognized as Safe” by the US Food and Drug Administration are best avoided in smoking. The findings are presented at the American Association for the Advancement of Science annual meeting in Washington, DC.

Cigarettes kill more than 480,000 people annually in the US. Since e-cigarettes appeared on the scene, many assume them to be a safer alternative, because smokers are not inhaling known carcinogens.

But as researchers analyze the contents of e-cigarettes, they are finding that some of them could be as risky as tobacco.

Ilona Jaspers, PhD, professor of pediatrics and director of the curriculum in toxicology at the University of North Carolina (UNC) School of Medicine has been researching new and emerging tobacco products, including e-cigarettes.

Having already found that cigarette smoking significantly impairs the immune responses of mucosal cells in the respiratory system, Jaspers’ lab is now looking at how e-cigarette chemicals affect immune responses in smokers’ airways.

E-cigarette flavorings not ‘recognized as safe’ for inhalation

But people do not consume e-cigarette flavorings orally, they inhale them. And the potential for toxic effects of inhalation have not been assessed, in most cases.While the Food and Drug Administration (FDA) may class e-cigarette flavorings “Generally Recognized as Safe,” Jaspers points out that this classification means they are safe for oral consumption.

Jaspers, who is also deputy director of the UNC Center for Environmental Medicine, Asthma and Lung Biology, explains:

“The digestive systems and respiratory systems are very different. Our stomachs are full of acids and enzymes that break down food and deal with chemicals; this environment is very different than our respiratory systems. We simply don’t know what effects, if any, e-cigarettes have on our lungs.”

Researchers studied the effects on smokers of cinnamon-flavored e-liquids and cinnamaldehyde, the chemical that gives cinnamon flavor to an e-cigarette.

Results showed that the cinnamaldehyde e-liquids had a significant negative impact on epithelial cells that could set off a chain of cellular mechanisms potentially leading to impaired immune responses in the lung.

Jaspers elaborates: “The chemicals compromise the immune function of key respiratory immune cells, such as macrophages, natural killer cells and neutrophils.”

Negative effect of e-cigarettes on respiratory immune system

The team also obtained tissue samples from the epithelial layer inside the nasal cavities of smokers, non-smokers and e-cigarette users, to analyze changes in the expressions of nearly 600 genes involved in immune responses.

They then tested nasal lavage fluid, urine and blood samples obtained from participants to detect changes in genetic and proteomic markers of tobacco and nicotine exposure and other markers of inflammation or immune responses.

In conventional cigarette smokers, they observed signs that a number of key immune genes in the nasal mucosa were suppressed.

In e-cigarette users, they found the same genetic changes, as well as suppression of additional immune genes. The findings imply that e-cigarettes have an even broader effect on the respiratory mucosal immune response system than conventional cigarettes.

The next step will involve in-vitro and in-vivo studies into the effects of chemicals on long-term e-cigarette smokers. Research will focus on immune suppression in the respiratory mucosa, with particular focus on cinnamon-flavored e-liquids.

Further evidence that e-cigarette smoking weakens the immune system was published recently in Medical News Today.

Bismarck Tribune: Study links chemical in e-cigs to lung cancer

BLAIR EMERSON Bismarck Tribune
A new study found e-cigarettes may not be a safer alternative to smoking tobacco.
Harvard T.H. Chan School of Public Health recently published the results of a study that found popular e-cigarette flavors contain diacetyl, a chemical linked to a severe lung disease.
“This latest study … is yet another reminder that e-cigarettes are not a safe alternative to tobacco use,” said Jeanne Prom, executive director of the North Dakota Center for Tobacco Prevention and Control Policy.
Researchers studied 51 types of flavored e-cigarettes that appeal to youths. Many E-cigarette brands offer fruit and candy flavors, which Prom said are unique and target kids.
The North Dakota 2015 Youth Risk Behavior Survey reports that 22 percent of high school students report using e-cigarettes at least once in the month prior to taking the survey.
“Our own North Dakota high school students have tried these products,” Prom said. “It’s not a safe alternative. … You’re really just swapping out one poison for another.”

Diacetyl is a flavoring chemical linked to a type of lung disease called bronchiolitis obliterans, or “popcorn lung,” which got its name after workers contracted the lung disease while working in microwave popcorn factories.
Currently, e-cigarettes are unregulated, but the U.S. Food and Drug Administration has proposed a rule to regulate e-cigarettes just as the agency regulates cigarettes and other tobacco products.
“It is our hope that the FDA’s final rules are released very soon and can provide some regulatory framework that can lead to these products being more properly regulated and less available to kids,” she said.

National Survey Shows Youth Cigarette Smoking Again Falls to Record Low, but E-Cigarettes and Cigars Threaten Progress

FOR IMMEDIATE RELEASE:            December 16, 2015
National Survey Shows Youth Cigarette Smoking Again Falls to Record Low, but E-Cigarettes and Cigars Threaten Progress
Results Show Why FDA Must Act Now to Regulate E-Cigarettes and Cigars 
Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
WASHINGTON, DC – In terrific news for the nation’s health, the government-sponsored Monitoring the Future survey released today shows that the steep, decades-long decline in youth cigarette smoking continues, with smoking rates falling to record lows in 2015 among all three grades surveyed (grades 8, 10 and 12). Cigarette use among 12th graders fell to just 11.4 percent from 13.6 percent last year and 36.5 percent in 1997, representing extraordinary and historic progress.
However, the survey also contains fresh warning signs that other tobacco products – electronic cigarettes and cigars that are sold in an array of sweet, kid-friendly flavors – may be undermining these gains and luring kids into nicotine addiction. For the second year in a row, the survey finds that significantly more teens reported using e-cigarettes than regular cigarettes in the past 30 days. In addition, teens reported using flavored little cigars at the same rate as cigarettes, and the percentage of teens who smoked tobacco in the past 30 days increased by more than half when cigarillos are included with regular cigarettes.
These findings should spur the White House to quickly issue a long-overdue rule providing for Food and Drug Administration regulation of all tobacco products, including e-cigarettes and cigars. It has been nearly 20 months since the FDA issued its proposed rule and nearly two months since the FDA sent the final rule to the White House for review. We cannot afford further delays that allow the tobacco industry to continue targeting our kids with a new generation of tobacco products. In addition, Congress must let the FDA do its job and reject proposals to weaken the FDA’s authority over e-cigarettes, cigars or any tobacco product.
The continuing decline in youth cigarette smoking is unquestionably good news that will improve the nation’s health and save lives:

  • For all three grades combined, the percentage of students who reporting smoking cigarettes in the prior 30 days fell from 8 percent in 2014 to 7 percent in 2015 – a statistically significant drop. Past-month smoking fell to 3.6 percent among 8th graders, 6.3 percent among 10th graders and 11.4 percent among 12th graders, all record lows.
  • Long-term trends are especially dramatic. Since peaking around 1996-1997, smoking rates have fallen by 83 percent among 8th graders, 79 percent among 10th graders and 69 percent among 12th graders. Daily cigarette use has fallen even more steeply, with just 5.5 percent of 12th graders reporting daily smoking in 2015.

These results demonstrate that we know how to win the fight against tobacco by implementing science-based strategies. These include higher tobacco taxes, strong smoke-free laws, well-funded tobacco prevention and cessation programs that include mass media campaigns, increasing the tobacco sale age to 21 and effective FDA regulation of tobacco products. Progress has accelerated following the largest-ever increase in the federal cigarette tax (a 62-cent increase implemented in 2009) and unprecedented national media campaigns launched by the CDC, the FDA and Truth Initiative. Rather than breeding complacency, our progress should spur elected officials to step up these proven measures and end the tobacco epidemic for good.
The survey’s findings on e-cigarettes and cigars are deeply troubling:

  • In all three grades, e-cigarette use far exceeded regular cigarette use in the past 30 days – 9.5 percent to 3.6 percent among 8th graders, 14 percent to 6.3 percent among 10th graders and 16.2 percent to 11.4 percent among 12th graders. These results also indicate e-cigarettes are more likely to be a pathway to tobacco addiction than away from it. More than half of students said their primary reasons for using e-cigarettes was to experiment and more than 30 percent said it was because they tasted good, while less than 10 percent said they used e-cigarettes to help quit regular cigarettes.
  • Teens reported smoking flavored little cigars at the same rate as cigarettes, with 11.4 percent of 12th graders reporting use of flavored little cigars in the past 30 days. When both cigarettes and flavored cigarillos are included, smoking rates in the past 30 days increased to 6.6 percent among 8th graders, 9.8 percent among 10th graders and 17.8 percent among 12th graders.

These findings are not surprising given the irresponsible marketing of e-cigarettes and cigars in a wide variety of kid-friendly flavors, such as gummy bear, cotton candy and watermelon.  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, and sponsorships of race cars and concerts.
Despite our progress, we cannot let up in the fight against tobacco because the tobacco industry never lets up. The industry spends $9.6 billion a year – more than $1 million every hour – to market its deadly products, and it is constantly seeking innovative ways to entice our kids. It’s no wonder tobacco use is still the number one cause of preventable death in our country, killing more than 480,000 people and costing about $170 billion in health care expenses each year. We cannot win the fight against tobacco unless elected officials put our nation’s kids and health before the special interests of the tobacco industry.
The Monitoring the Future survey has been conducted annually since 1975 by researchers at the University of Michigan and is funded by the National Institute on Drug Abuse.

USA Today Network: Study suggests link between flavor in e-cigarettes and lung disease

, USA TODAY Network
Flavored e-cigarettes may seem like an alternative to smoking, but researchers warn that flavored e-cigarettes may not be worth the unknown long-term risks.
Researchers at the Harvard University T.H. Chan School of Public Health tested 51 types of flavored e-cigarettes and flavor canisters for diacetyl, acetoin, and 2,3-pentanedione; three chemicals known to cause respiratory problems in factory workers.
The study tested popular e-cigarette flavors like bubble gum, cotton candy and tutti frutti, and found, at least one of the three chemicals were present in 47 of the 51 products they tested.
With around 7,000 e-cigarette flavors on the market, consumers are essentially at the mercy of the manufacturers, with little hope of knowing what chemicals are used in the products, according to Taylor Hays, director of Mayo Clinic Nicotine Dependence Center.
“There are no FDA regulations on these products. It’s the Wild West of e-cigarettes,” Hays told USA TODAY Network.
He says the popularity of e-cigarettes continues to grow among adults that think the products will wean them off of regular cigarettes and among younger users. The percentage of teens using e-cigarettes tripled from 2013 to 2014, according to an April report from the Centers for Disease Control and Prevention (CDC).
The study was published Wednesday in the journal Environmental Health Prospectives.
Diacetyl has been directly linked to “bronchiolitis obliterans,” which in serious cases can require lung transplants, according to Robert Kotloff, chair of pulmonary medicine at Cleveland Clinic.
The disease, also known as “popcorn lung,” got its name from workers who developed the disease after inhaling diacetyl while working in popcorn factories, according to Kotloff.
While the study doesn’t provide a concrete link between flavored e-cigarette use and lung disease, it does further the debate over the unknown long-term consequences of e-cigarettes use.
“[The study] is an intermediary step showing the presence of a compound which could potentially predispose individuals to develop bronchiolitis obliterans,” Kotloff told USA TODAY Network.

Penn State News: Potentially dangerous molecules detected in e-cigarette aerosols

By Scott Gilbert

HERSHEY, Pa. — Electronic cigarettes produce highly-reactive free radicals — molecules associated with cell damage and cancer — and may pose a health risk to users, according to researchers at Penn State College of Medicine.
The use of e-cigarettes is on the rise. According to the Centers for Disease Control and Prevention, more than 20 percent of young adults have tried e-cigarettes, and current smokers and recent former smokers are most likely to have used them.
E-cigarettes deliver nicotine in water vapor instead of by burning tobacco. The battery-operated devices have been marketed as an alternative to traditional cigarettes.
Despite their growing popularity, very little is known about toxic substances produced by e-cigarettes and their health effects.
“There’s a perception that e-cigarettes are healthier than regular cigarettes, or at least not as harmful as regular cigarettes,” said John P. Richie Jr., professor of public health sciences and pharmacology. “While e-cigarette vapor does not contain many of the toxic substances that are known to be present in cigarette smoke,  it’s still important for us to figure out and to minimize the potential dangers that are associated with e-cigarettes.”
Previous studies have found low levels of aldehydes, chemical compounds that can cause oxidative stress and cell damage, in e-cigarette “smoke.” But until now, no one has looked for free radicals, the main source of oxidative stress from cigarette smoke. Highly reactive free radicals are a leading culprit in smoking-related cancer, cardiovascular disease and chronic obstructive pulmonary disease.
Instead of smoke, e-cigarettes produce aerosols, tiny liquid particles suspended in a puff of air. The researchers measured free radicals in e-cigarette aerosols.
They found that e-cigarettes produce high levels of highly reactive free radicals that fall in the range of 1,000- to 100-times less than levels in regular cigarettes.
“This is the first study that demonstrates the fact that we have these highly reactive agents in e-cigarette aerosols,” Richie said. Results were published in the journal Chemical Research in Toxicology.
“The levels of radicals that we’re seeing are more than what you might get from a heavily air-polluted area but less than what you might find in cigarette smoke,” Richie said. The radicals are produced when the device’s heating coil heats the nicotine solution to very high temperatures.
Further research is needed to determine the health effects of highly reactive free radicals from e-cigarettes.
“This is the first step,” Richie said. “The identification of these radicals in the aerosols means that we can’t just say e-cigarettes are safe because they don’t contain tobacco. They are potentially harmful. Now we have to find out what the harmful effects are.”
Richie is currently conducting studies to carefully measure total numbers of free radicals in e-cigarette aerosols and to identify their chemical structures.
“That will help us interpret the data better to know how dangerous they are,” he said.
Other investigators on this project were Reema Goel and Jonathan Foulds, Department of Public Health Sciences, and Neil Trushin and Bogdan Prokopczyk, Department of Pharmacology, all at Penn State; Erwann Durand and Ryan J. Elias, Penn State College of Agricultural Sciences.
National Institute on Drug Abuse of the National Institutes of Health and the Center for Tobacco Products of the U.S. Food and Drug Administration funded this research. (P50-DA-036107)

Healthline News: Teen E-Cigarette Use Linked to Breathing Problems

A study of adolescents in Hong Kong found respiratory issues were 30 percent more likely in vapers than non-vapers.
Written by Roberta Alexander

E-cigarettes and vaporizers, widely touted as a way to quit smoking, remain controversial. For every supporter who sees them as useful, there is a health expert suggesting that these products are dangerous in their own way.
A new study out of Hong Kong is not likely to settle the issue any time soon.
Researchers looked at the respiratory health of Chinese adolescents, both those who use e-cigarettes and those who do not. The results, published in JAMA Pediatrics, have raised concerns about the impact of e-cigarettes on the health of minors.

Ecig Teen
Indeed, one of the authors of the study, Daniel Ho, Ph.D., of the University of Hong Kong, said in a press release, “E-cigarettes are certainly not harmless and serious health problems of long-term use will probably emerge with time.”
Ho is an associate professor in the School of Public Health whose main research interests are in adolescent health in relation to tobacco, alcohol, and obesity.
He and fellow researchers found that adolescents who use e-cigarettes were approximately 30 percent more likely to report respiratory symptoms than adolescents who do not use them.

Thousands of Students Studied

More than 45,000 students in Hong Kong participated in the study. Data was collected between 2012 and 2013.
Of the sample population, 1.1 percent of students reported e-cigarette use within the past 30 days. Those students were 30 percent more likely than their peers to report respiratory problems.
The results are suggestive but not definitive. Dr. Norman H. Edelman, senior consultant for scientific affairs for the American Lung Association, found the study intriguing.
“It’s important [but] we need to know if the lungs are injured. It’s not clear if this really affects the lungs. We’re not sure what the symptoms are,” Edelman told Healthline.
He wondered if the young subjects were reporting soreness in their throats, excessive coughing, or difficulty breathing. He would like to see a follow-up study, perhaps in the United States.
“We need to do lung function tests,” he said.
“Whenever you breathe in something, you don’t know what’s in it. Some of the data suggest irritation,” Edelman said. “We don’t know what the negative effects are. This is just a beginning.”
E-cigarettes and vaporizers use liquids that have varying amounts of nicotine or none at all. These liquids are not regulated by the U.S. Food and Drug Administration (FDA), but generally also contain propylene glycol, a suspected lung irritant, and vegetable glycerin.
“While supporters [of e-cigarette use] are optimistic about the potential for harm reduction in the minority of established cigarette smokers, [for] which convincing evidence is lacking, this does not seem to justify the potential harm of renormalizing cigarette smoking, delaying smoking cessation, and escalating to real cigarette smoking, especially among the majority of non-smoking young people,” Edelman said.

E-Cigarettes Gaining in Popularity

The use of e-cigarettes have surpassed the use of conventional cigarettes among young people in the United States.

Mitch Zeller, director of the Center for Tobacco Products at the FDA, called those numbers “astounding and concerning” in an interview earlier this year.
“Nicotine is very harmful to the developing child and adolescent brain,” Zeller said. “Parents should take no comfort in the fact that their kids are using an e-cigarette rather than a burning cigarette because of the presence of nicotine.”

STAT: E-cigarettes widely seen as harmful in STAT-Harvard poll

WASHINGTON — Most Americans believe electronic cigarettes are harmful to people’s health, according to a new national poll — even though scientists have not reached a consensus on the risks of the increasingly popular products.
The results of the poll, by STAT and the Harvard T.H. Chan School of Public Health, could bolster the Food and Drug Administration as it moves to regulate e-cigarettes for the first time. There is solid support for a broad range of government restrictions among both Democrats and Republicans, with virtually no partisan differences to be found.
E-cigarettes have been around only since 2004 — too little time for researchers to have completed definitive studies on their health effects — but already they are more popular among teenagers than conventional cigarettes.
Manufacturers market the products as safer than tobacco cigarettes and as an effective way to help people stop smoking. The poll results, however, suggest that the public isn’t buying this pitch.

Read the full poll results here

E-cigarette users don’t inhale cancer-causing tobacco smoke. Instead, the devices produce a vapor from heated liquid nicotine. For many public health experts, though, the concern is that they still contain nicotine — which is addictive — and may expose users to various toxic chemicals.
Americans do think they’re less dangerous than tobacco cigarettes, but that doesn’t mean they think the products are safe. The survey found that 65 percent of adults believe e-cigarettes are harmful to the people who use them. That’s less than the 96 percent who say tobacco cigarettes are harmful, but more than the 58 percent who say the same thing about marijuana.
Those results appear to be the main reason the public is ready to embrace regulations that would treat e-cigarettes largely like tobacco cigarettes, including rules that go beyond what are actively being considered at the federal level.
“They believe it’s less harmful than tobacco, but they do think it is harmful, and that sets off all the other answers,” said Robert Blendon, a professor of health policy and political analysis at Harvard who directed the poll.

Roughly 9 out of 10 Americans support banning the sale of e-cigarettes to minors under age 18 — a law already passed in most states. A similar number favor requiring warning labels stating that e-cigarettes contain nicotine.
About 7 out of 10 say people shouldn’t be allowed to use e-cigarettes indoors in public places like restaurants and workplaces, and 6 out of 10 say the government should ban e-cigarette ads on TV, just as it bans ads for tobacco cigarettes.
Even the biggest partisan differences are slight. The warning labels on e-cigarette packages are supported by 98 percent of Democrats and 87 percent of Republicans.
And on taxes — a subject that usually sets off food fights in Washington — there is solid support from both parties: 63 percent of Republicans and 72 percent of Democrats say they support taxing e-cigarettes in the same way that tobacco cigarettes are taxed.
The results suggest that Americans have largely made up their minds on how e-cigarettes should be treated, and that they’re using tobacco cigarettes as their frame of reference — even as scientists are still trying to determine what the health consequences of e-cigarettes are.
“For a new product … you wouldn’t have expected that people would have reached as firm a judgment about this as they have,” said Blendon. On the proposed policies the poll asked about, he added, “their responses are nearly identical to what you find asking about tobacco cigarettes.”
That’s how Anna Glasscock, a Republican retiree who lives near Springfield, Ill., decided her views on e-cigarettes. She’s a former smoker who knows the health risks of tobacco and said e-cigarettes “shouldn’t even exist” because “any addictions are not good.”
Glasscock, one of the people in the poll who agreed to a follow-up interview, said e-cigarettes should be regulated and taxed — she considers it a “sin tax.” Even though e-cigarettes are different from tobacco cigarettes, she said, “I don’t see that replacing one with the other makes any difference.”
Gregory Conley, president of the American Vaping Association, the main advocacy group for e-cigarette makers, blamed the poll results on “unethical propaganda campaigns” against e-cigarettes that have led to “a confused populace.”
“This poll is not measuring public opinion, but the effectiveness of a well-funded corporate strategy to destroy a category that is eroding a cash cow for Big Pharma,” he said.
But Vince Willmore, a spokesman for the Campaign for Tobacco-Free Kids, said it was “not surprising that the public wants to apply common-sense regulations to e-cigarettes” and urged the Obama administration to issue the FDA’s e-cigarette regulations as soon as possible.
The one issue the public is split on is whether to ban the sale of flavored nicotine cartridges — an issue that doesn’t have any parallel with tobacco cigarettes. Fewer than half of Americans think that’s a good idea.
Supporters argue that flavored cartridges attract young people to start using e-cigarettes, and that they will later move on to tobacco cigarettes.
The telephone poll of 1,014 adults was conducted Oct. 7-11 and has a margin of error of 3.7 percentage points.
John Dunn of Garland, Texas, a suburb of Dallas, said he has used e-cigarettes to quit smoking tobacco cigarettes. But a friend who tried the same thing got hooked on e-cigarettes.
“I think they’re pretty different, but also I’ve seen people get on the vapors and not be able to stop,” said Dunn, 33, a Democrat. He’s in favor of some regulation, including warning labels: “They should know they might get addicted.”
E-cigarette makers say that e-cigarettes help smokers quit, and there is some evidence from a small number of studies that they do — although scientists say more research is needed. The survey found that 38 percent of Americans believe e-cigarettes can help people quit smoking, but that 47 percent don’t think they’re effective.
At the same time, public health advocates — and government regulators such as the FDA and the Centers for Disease Control and Prevention — have strong concerns that e-cigarettes serve as a “gateway” for non-smokers to start using tobacco products. More than half of Americans — 56 percent — believe e-cigarettes make teenagers more likely to try tobacco cigarettes, according to the poll.
At a panel discussion on e-cigarettes last month, CDC Director Tom Frieden declared that e-cigarettes are “highly addictive” and that the goal should be to “keep kids away from all forms of nicotine.” The CDC reported earlier this year that e-cigarette use tripled among high-school and middle-school students from 2013 to 2014.
The FDA is preparing to issue a final version of a rule that would extend the agency’s authority to regulate e-cigarettes. The proposal, recently submitted to the White House Office of Management and Budget for final revisions, would likely require pre-market reviews of e-cigarettes — a process that is used to prove whether potentially risky products are safe. The FDA is also expected to ban e-cigarette sales to minors under age 18 and require warning labels stating that the products contain nicotine. The regulation drew 135,000 comments from the public when the original proposal was published.
The agency is also considering a separate proposal that could require broader warnings about the dangers of nicotine — especially accidental exposure to infants and children — and possibly require child-resistant packages for e-liquids, which are liquid nicotine combined with colorings and flavorings.
Some in Congress, however, are trying to prevent the FDA from taking action that might damage the industry. A House spending bill includes a provision by Representative Robert Aderholt (R-Ala.) that would keep the FDA from requiring premarket review for e-cigarettes that are already being sold in stores. Aderholt’s office did not respond to requests for comment.
Even if much of the public is ready to regulate e-cigarettes, Aderholt will find at least some support from those who don’t think they are dangerous enough to need new rules.
“They’re not a cigarette. The only thing you’re inhaling is vapor,” said Chris Grieser, a Republican from Cheyenne, Wyo. who participated in the survey. “That’s no different from standing over a pot of boiling water.”
Researchers aren’t so sure about that, though. One study earlier this year found that e-cigarette vapor can contain cancer-causing formaldehyde at levels far higher than those found in tobacco cigarettes.
The original e-cigarettes were manufactured by small companies, but when it became clear that they were catching on, the more established tobacco companies such as RJ Reynolds and British American Tobacco bought out or partnered with some of these smaller businesses, or launched their own divisions. This has given more clout to industry groups such as the American Vaping Association.
This is the first of a series of monthly polls being conducted by STAT and the Harvard T.H. Chan School of Public Health.