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Letter to the Editor: Another sound step toward good health

Opinion: No place in baseball for smokeless tobacco

By: Dick Durbin | As published in the Chicago Tribune

My feelings about tobacco took shape at the bedside of my father in November 1959. I was a sophomore in high school when lung cancer took his life. He was 53 and had smoked two packs of Camels a day.

As a member of Congress I first went up against the powerful tobacco lobby in 1987 and shocked myself and my colleagues by passing a bill banning smoking on airplanes on domestic flights of less than two hours. That measure turned out to be a tipping point. A series of local, state and federal laws followed, leading to restricting tobacco use on all flights, on trains and in hospitals, offices, restaurants and malls.

Despite all these victories, my battle against tobacco consistently struck out in one key area. For over 20 years I have been trying to get spit tobacco out of Major League Baseball.

Just as youth players wear their socks and sweatbands like the pros, or mimic the swing or windup of their favorite star, they are watching as baseball players slip a wad of tobacco in their cheek or under their lip. That sends a visual message, leading teenage boys to imitate this dangerous habit.

The numbers tell the story. While use of cigarettes and cigars among high school athletes declined from 30 percent to 18 percent between 2001 and 2013, use of smokeless tobacco increased by 10 percent in that population over the same period.

Among 8th grade students, the use of smokeless tobacco increased 14 percent between 2013 and 2015. Each year, nearly half a million kids age 12-17 use smokeless tobacco for the first time.

Tony Gwynn, the legendary San Diego hitter, was the most well-known baseball victim of salivary gland cancer caused by spit tobacco. Before his death in 2014, Gwynn attributed his oral cancer to his chewing tobacco use, “Of course it caused it … I always dipped on my right side,” he remarked. He and his family were honest about the cause of his death and reminded us of the real danger of this deadly habit.

Baseball owners such as Jerry Reinsdorf of the Chicago White Sox are outspoken opponents of spit tobacco. They remind me that all forms of tobacco are banned in the minors. Bobby Brown, a former Yankee and a medical doctor, became president of the American League. He joined the late Joe Garagiola, the former St. Louis Cardinal player and announcer, in leading the fight against spit tobacco. Despite all this opposition, the owners ran into a brick wall negotiating the issue with the players’ organization. I remember calling the players’ lead negotiator, Donald Fehr, many years ago. When I raised the danger of spit tobacco to the health of his players, he said: “It’s a negotiable item” and hung up.

The 2016 baseball season marks a long-anticipated breakthrough.

With the leadership of the Campaign for Tobacco-Free Kids, five major league cities (New York, Chicago, Boston, Los Angeles and San Francisco) have enacted ordinances banning spit tobacco at their ballparks, and Toronto and Washington, D.C., are considering similar bans. When I met Tony Clark, the head of the Players Association, at a Major League Baseball event in Havana a few weeks ago, I reminded him that his players have to live in this new world. I don’t want to see any player embarrassed or fined. I just want a sport I love to stop promoting a deadly tobacco habit.

Democrat Dick Durbin is the senior U.S. senator from Illinois.

http://www.chicagotribune.com/news/opinion/commentary/ct-durbin-baseball-smokeless-tobacco-perspec-0331-md-20160415-story.html

Dr. Eric Johnson: Tobacco tax will deter young people from using products

By Dr. Eric Johnson, Grand Forks – Jamestown Sun

As a Grand Forks physician and chairman of the recently announced efforts to initiate a ballot measure to increase North Dakota’s tobacco taxes, it’s important the public be given the facts right off the bat.

First, North Dakota’s tobacco taxes have not been increased since 1993, ranking us 47th in the nation for cigarette tax rates. If passed, this measure would bring North Dakota’s cigarette tax from 44 cents per pack to $2.20 per pack, just slightly above the average of $2.08 per pack of our neighboring states.

Second, it will treat the liquid nicotine drug (smoked via electronic cigarettes) and those who sell it exactly the same as all other tobacco products.

Third, it will dedicate current revenues exactly where they currently are: to the state’s general fund and back to North Dakota’s cities. New revenues generated from the increase will be split evening between a fund created to support the unmet needs of North Dakota’s veterans and a fund to support health programs associated with chronic disease treatment, county health programs and the mental health and addiction crisis facing our state.

Luckily, North Dakota already fully funds a tobacco prevention program utilizing a small portion of the money won by the state of North Dakota when it sued tobacco companies in 1998 for lying to the public and to Congress about the deadly impacts of tobacco. No moneys from this measure will go toward these efforts.

These are the facts. Seventy-five percent of adult tobacco users started before the age of 18. Significant tobacco tax increases are proven as the most effective way to keep young people from ever starting tobacco. That’s an effort we can all support.

http://www.jamestownsun.com/letters/3990656-tobacco-tax-will-deter-young-people-using-products

Bismarck Tribune: Coalition pushes tobacco tax measure

Photo by Tom Stromme, Bismarck Tribune

Photo by Tom Stromme, Bismarck Tribune


Members of a coalition seeking an increase in the state’s tobacco tax say their proposed increase would reduce smoking rates as well as state health care costs among other benefits.
“That’s the missing leg of the three-legged stool,” Eric Johnson, a Grand Forks physician and head of the measure’s sponsoring committee, Raise It for Health North Dakota.
Two-thirds of North Dakota voters in 2012 approved a ballot measure making public places smoke-free. In 2008, nearly 54 percent of voters approved the creation of a state tobacco prevention and control program.
Other states that have raised the tax have seen decreases in smoking, according to Johnson, adding that the measure will help beef up the state’s tobacco prevention efforts.
“This is a tax nobody has to pay. It’s a product that creates death,” Johnson said.
Kristie Wolff, with the American Lung Association in North Dakota, said the measure would increase the tobacco tax for cigarettes in North Dakota from 44 cents per pack to $2.20. Taxes on liquid nicotine products would be increased from 28 percent of the wholesale purchase price to 56 percent.
The national average tax on a pack of cigarettes is $1.61.
New tax revenues created through the measure, estimated at about $100 million per biennium, would be split between health-related programs in the state’s Community Health Trust Fund as well as a newly created Veterans Tobacco Tax Trust Fund.
“We’re confident that North Dakota voters will respond positively yet again,” Wolff said.
Only Georgia, Missouri and Virginia have lower tobacco taxes than North Dakota. The tobacco tax in North Dakota hasn’t been raised since 1993.
Being a statutory initiative, 13,452 legitimate signatures will be required at least 120 days before the election. The deadline for turning in signatures for the Nov. 8 election is July 11.
Several unsuccessful attempts have been legislatively in the year since the last tax increase.
Wolff said the increase would bring North Dakota in line with the surrounding states in the tax per pack of cigarettes. The tax in Minnesota is $3 per pack, in Montana it’s $1.70 and in South Dakota it’s $1.53.
“We based it on polling we’ve done,” Wolff told reporters when asked how the group came to the $1.76 per pack increase being proposed.
According to the Campaign for Tobacco-Free Kids, the tax increase could result in a 20 percent drop in youth smoking, preventing about 5,800 youths from becoming adult smokers, Johnson said.
North Dakota Retail Association president Mike Rud said the group he leads will need to review the measure language and watch to see if it gets the necessary signatures for a vote. The group opposed both 2015 bills.
Rud said on first glance the proposed increase is substantial, adding that taxing cigarettes would negatively impact lower-income smokers.
“Taxing a group that can least afford it? It’s a bit troublesome to us,” said Rud, clarifying that tobacco products aren’t illegal and retailers sell them to meet demand among legal buyers.
“There’s got to be a limit to how involved we get with these things,” Rud said.

Bismarck Tribune: Group proposes to raise tax on tobacco

NICK SMITH, Bismarck Tribune

A coalition seeking to reduce tobacco use in North Dakota will unveil a proposed ballot measure Wednesday, which would raise the state’s tobacco tax — one of the lowest in the nation.
The group, Raise it for Health North Dakota, will make its announcement in Memorial Hall inside the state Capitol on Wednesday.
A spokeswoman for the group said details of the proposed measure wouldn’t be disclosed until the announcement.
As of January, data from the tobacco prevention group Campaign for Tobacco-Free Kids showed that North Dakota’s tobacco taxes are at 44 cents per pack. Only Georgia, Missouri and Virginia are lower. The tobacco tax in North Dakota hasn’t been raised since 1993.
Two bills proposing tobacco tax increases in the 2015 session failed.
House Bill 1421 would have raised the state’s cigarette tax to $1.54 per pack. It would also have raised the excise tax on other tobacco products from 28 percent of the wholesale purchase price to 43.5 percent. House lawmakers killed it by a 34-56 vote.
Senate Bill 2322 would have raised the cigarette tax in the state to $2 per pack; it failed in the Senate by a 17-30 vote.
Last session, health care officials supported the bills while retail groups opposed it. Several legislative attempts to raise the tax have failed since 1993.
Opponents of the 2015 bills used 2012 data from the Centers for Disease Control and Prevention to argue tobacco use isn’t a major problem in North Dakota. The data showed that North Dakota in 2012 ranked 37th in adult smoking and 49th in smokeless tobacco use. Among youth smokers, North Dakota ranked 34th among 44 states reporting data.
North Dakota voters in November 2012 approved a ballot measure making public places smoke-free. Two-thirds of voters supported the measure.
http://bismarcktribune.com/news/local/govt-and-politics/group-proposes-to-raise-tax-on-tobacco/article_4bd0f2cc-48bf-5e23-9008-be55a0db7268.html

U.S. News/HealthDay: Graphic Cigarette Warnings May Target Brain's 'Quit Centers'

By Robert Preidt, HealthDay Reporter

FRIDAY, Feb. 26, 2016 (HealthDay News) — Disturbing images on cigarette pack warning labels activate brain regions crucial in quitting smoking, a new study suggests.

“Regulators can and should use this research to craft more effective warning labels and messages to smokers that both deliver facts about the negative effects of smoking and trigger thoughts and actions that move smokers toward quitting,” said study senior author Raymond Niaura. He is director of science at the Schroeder Institute for Tobacco Research and Policy Studies at the Truth Initiative in Washington, D.C.

“Tobacco is still the leading preventable cause of death in the U.S., and the growing body of research showing the effectiveness of warning labels should energize policymaking,” Niaura said in a news release from Georgetown University Medical Center, in Washington, D.C.

For the study, the researchers conducted brain scans on 19 young adult smokers. During the scans, the smokers were shown non-graphic and graphic pictures used on cigarette pack warning labels. For example, one image included an open mouth with rotten teeth and a tumor on the lower lip. The images were accompanied by the text: “WARNING: Cigarettes cause cancer.”

Seeing the graphic pictures triggered activity in areas of the brain called the amygdala and medial prefrontal region, the study showed. These areas are involved in emotion, decision-making and memory, the researchers said.

“The amygdala responds to emotionally powerful stimuli, especially fear and disgust. And experiences that have a strong emotional impact tend to impact our decision-making,” said study co-lead author Adama Green, a cognitive neuroscientist at the Georgetown University Medical Center and the Truth Initiative.

The study was published online recently in the journal Addictive Behaviors Reports.

“What we found in this study reinforces findings from previous research where scientists have asked participants to report how they think and feel in response to graphic warnings on cigarettes,” said co-lead author Darren Mays, an assistant professor of oncology at Georgetown’s Lombardi Comprehensive Cancer Center.

This study should help researchers understand the biological factors underlying responses to such warnings. And it may help them learn how these warnings can work to motivate a change in behavior, Mays said.

http://health.usnews.com/health-news/articles/2016-02-26/graphic-cigarette-warnings-may-target-brains-quit-centers

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.

http://www.medicalnewstoday.com/articles/306444.php