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

By Lisa Rapaport / Reuters Media

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

Reuters: Cigarette warnings work better with pictures, study shows

By Lisa Rapaport, Reuters

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

CSPI: Big Food: Sounds a Lot Like Big Tobacco

Michael F. Jacobson, Executive Director, Center for Science in the Public Interest

Food is not tobacco. From birth, we need food to sustain us. On the other hand, no one needs to smoke. But the public health community is concerned about both diet and tobacco use for a very good reason: Over a lifetime, poor diets and smoking both cause serious health problems, including diabetes, heart disease, and cancer.

1

The similarities between unhealthy food and tobacco go beyond the health effects. When it comes to corporate responsibility, executives at some of the nation’s largest food and beverage companies seem to have learned a lot from their counterparts at Big Tobacco in aggressively promoting consumption of unhealthy foods and, in the same breath, blaming the consumer.

Big Food and Big Tobacco share some common bloodlines. It wasn’t very long ago that some of these companies were one and the same. RJR Nabisco, for instance, once simultaneously contained the companies that made Camel cigarettes and Chips Ahoy! cookies. Until the mid-2000s, the companies that manufacture Marlboro and Virginia Slims cigarettes were part of the same conglomerate, Philip Morris (now Altria), which manufactured Kraft Macaroni & Cheese and Kool Aid. Those companies have since split their tobacco businesses from their food businesses, but heavy-handed product marketing may be ingrained in the companies’ DNA.

2

While we need food to live, we certainly don’t need many of the junk foods — many aimed at kids — served up by food processors and restaurants. Soda and other sugary drinks, in particular, are one category of food that does far more harm than good. Sugary drinks are the single biggest source of calories in the American diet and prime culprits when it comes to diabetes, heart disease, obesity, and other health problems.

Like Big Tobacco, Big Food goes to great lengths to muddy the waters and obscure the connections between soda and disease. “The products we make are not injurious to health,” is how the Tobacco Industry Research Committee put it in a 1954 advertisement. In 2012 the American Beverage Association opined, “Sugar-sweetened beverages are not driving obesity.” Coca-Cola executive Katie Bayne told this whopper to USA Today: “There is no scientific evidence that connects sugary beverages to obesity.”

3

Besides denying the connections between their products and disease, food and tobacco companies both use the same language to blame their customers for the harm caused by their products. “What people want to do is their own decision,” said American Tobacco CEO Robert Heimann in 1988. More recently, Don Thompson, then CEO of McDonald’s, said “All of us have to make personal choices.” Those statements may be literally true, but ignore the extent to which companies persuade, lure, and manipulate customers — including children — into making the very decisions that companies say should be up to them.

Though both food and tobacco companies have been notorious marketers to children, they both like to lecture parents: “It is the responsibility of every parent to encourage their children to make proper choices about lifestyle decisions,” is how RJ Reynolds Tobacco Company put it in the mid-1990s. It’s not the role of the federal government to discourage kids from smoking, it went on to say. In 2011, McDonald’s CEO Jim Skinner said “It is up to [kids] to choose and their parents to choose, and it is their responsibility to do so.”

4

Joe Camel, the cartoon animal used to attract children to cigarettes, was retired in 1997, under pressure from state attorneys general. A master settlement agreement between the AGs and the tobacco industry eliminated much of that industry’s advertising to children, and even disbanded the Tobacco Institute, an aggressive industry lobbying force. But the food industry still uses cartoon characters to market disease-causing products to children, and food industry trade groups still devote millions to block progress and defend the status quo.

Big Tobacco and Big Food are now separate industries, but the playbook is much the same. How the game ends is up to us.

http://www.huffingtonpost.com/michael-f-jacobson/big-food-big-tobacco_b_7486934.html
http://cspinet.org/bigtobaccoORbigfood.html

Forum editorial: Minnesota tobacco use down

The anti-tobacco work of ClearWay Minnesota in conjunction with other tobacco cessation efforts has had remarkable results in reducing smoking rates among all age groups in Minnesota. It’s a record worthy of high praise. It’s unambiguous evidence that focused, science-based anti-tobacco campaigns can work.

Numbers released last week by ClearWay show only 14.4 percent of Minnesotans smoke cigarettes, down from 22.1 percent in 1999. The decline through the time period has been steady, and corresponds to increased education and imposition of legal restrictions on smoking in public places. Add new medical research about second-hand smoke, and graphic anti-smoking television advertising, and it appears the multi-faceted message is getting through.

But not to every age cohort.

In ClearWay statistics from 2010 to 2014, smoking hardly dipped at all (1 percent) in the 25-44 year-old group, from 19.7 percent to 18.7 percent. A similar slight improvement was measured in the 45-64 year-old cohort, compared with a huge drop (from 21.8 percent to 15.3 percent) in Minnesotans age 18-24. Which could lead to the conclusion that some Minnesotans don’t get smarter as they age. But whatever the reason, the overall percentages of all Minnesotans who smoke is down over the longer study period, and that’s good news for smokers who quit, non-smokers and reduced impacts on health costs associated with tobacco use. The trends are good.

ClearWay is not resting on its excellent record. In the eight years it has left in its mandate (funded by the national tobacco settlement of a few years back), the agency’s agenda includes raising cigarette taxes, which all studies show discourage young people from purchasing tobacco, and raising the age for tobacco purchases from 18 to 21. Again, research finds that raising the age to beyond high school age contributes to fewer high school students trying tobacco. New York City and Hawaii have already taken that step.

There is still much to be accomplished to achieve as smoke-free a society as possible. A lot has been done, often led by private sector companies that banned smoking from the workplace before cities and states enacted overall smoking bans in buildings and, in many instances, outdoor public spaces. Decades of research into smoking-related illness and death, and the proven health hazards of secondhand smoke, have been the underpinnings of changing public policy. ClearWay’s work and similar complementary efforts have been pivotal in changing the way enlightened Americans view tobacco use.

Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.

http://www.inforum.com/opinion/editorials/3751883-forum-editorial-minnesota-tobacco-use-down

MEDPAGE TODAY: E-Cigs Hamper Ability to Cough

Just one exposure significantly diminished cough reflex sensitivity.

by Nancy Walsh, Senior Staff Writer, MedPage Today

DENVER — Exposure to electronic cigarette vapors significantly diminished cough reflex sensitivity in a group of healthy volunteers, a researcher reported here.

Using a capsaicin cough challenge, the time until the concentration of capsaicin that can induce five or more coughs (C5) was significantly longer after an electronic cigarette “vaping” session, rising from a mean log C5 of 0.50 at baseline to 0.79 15 minutes after exposure (P<0.0001), according to Peter V. Dicpinigaitis, MD, of Albert Einstein College of Medicine in New York City.

“We have previously shown that chronic smokers of tobacco cigarettes have reduced cough reflex sensitivity to capsaicin compared with healthy nonsmokers, presumably on the basis of chronic cigarette smoke-induced desensitization of airway cough receptors,” he said.

“What impressed us in this study what that this was just one exposure, and there was a real effect, a significant effect,” he said in a press conference at the annual meeting of the American Thoracic Society.

Electronic cigarettes are increasingly popular devices that are intended to deliver vapor containing nicotine to the lungs without exposing the lung tissue to the damaging products of tobacco combustion. However, little is known about their effects on the respiratory system, and even less is known about their effects on the sensitivity of the cough reflex.

Cough sensitivity is important in that coughing is a very important protective mechanism for eliminating foreign particles, and suppression of this could render someone more susceptible to respiratory tract infection, he explained.

Capsaicin challenge has become a standard research tool for investigating the effects of various exposures on cough reflex sensitivity, in that the challenge is safe, dose-dependent, and reproducible.

To explore these effects, Dicpinigaitis and his colleagues enrolled 30 lifetime nonsmokers who each underwent a single session of vaping, which consisted of 30 puffs on a disposable device at 30-second intervals. This provided an exposure to nicotine of 1.5 to 1.8 mg, which approximates that of a single tobacco cigarette.

The effects on C5 were transient, as was shown by the fact that 24 hours after the exposure, there was a decline in mean log C5 to 0.55 (P=0.0002).

The clinical significance, if any, of this transient, acute effect and the consequences of chronic exposure remain to be elucidated.

But the take-home messages of the study, he said, were that the vapor in e-cigarettes is not simply a benign, inert vapor, and it may have not only this acute, peripheral effect, but it also may have a delayed central brain effect.

Also, the results raise the question of what might happen with prolonged, chronic exposure, given the physiologic effect of just one exposure, Dicpinigaitis added.

http://www.medpagetoday.com/MeetingCoverage/ATS/51600

TIME Health|Research: 4 Weird Health Effects of E-Cigarettes

Justin Worland

Banana pudding-flavored ecigs disturbed the lungs, one study found

E-cigarette research is heating up, and scientists are starting to show that using e-cigarettes can have some surprising health effects, according to new findings presented at the meeting of the American Thoracic Society.

“Millions of people around the world that are puffing e-cigs,” says Peter Dicpinigaitis, professor at Albert Einstein College of Medicine and one of the authors of new e-cigarette research, “but when you look at the scientific literature about the effects of e-cigs, there’s nothing out there.”

Here are some of the newest findings:

Using e-cigarettes suppresses your ability to cough

Smoking an e-cigarette makes you less likely to cough, even when coughing would benefit your health, according to research by Dicpinigaitis. Researchers asked 30 nonsmokers to puff an e-cigarette 30 times in a 15-minute period. After puffing, people in the study were less sensitive to capsaicin, a component of chili peppers that induces coughing. You might think stopping a cough would be a positive side effect, but coughing keeps you from choking and removes agents that may cause infection, says Dicpinigaitis. He presumes that those the effects would continue throughout the day for someone who uses an e-cigarette frequently.

E-cigarette temperature may affect how many chemicals you’re exposed to

People tend to think about the effects of cigarette smoke or e-cigarette vapor when they consider how the products harm their health. But the mechanics of e-cigarettes may also contribute to how much smoking harms your health, according to new research from University of Alabama School of Medicine professor Daniel Sullivan. His research found a correlation between coil temperature and the creation of harmful chemicals like acrolein, acetaldehyde and formaldehyde in the e-cigarette. There are no configuration standards for e-cigarettes, and Sullivan’s research suggests that the lack of consistency makes it hard to assess uniformly the health effects of smoking e-cigarettes.

E-cigarette flavors may have different effects

Researchers tested the effects of flavored e-cigarette liquid on calcium in the lungs and found that not all flavors had the same effect. Five of 13 flavors tested caused changes to calcium signaling in the lungs, according to a study by University of North Carolina at Chapel Hill researcher Temperance Rowell. Hot cinnamon candies, banana pudding and menthol tobacco were among the flavors that disturbed the lungs.

Evidence is growing that e-cigarettes probably aren’t an effective way to quit smoking

E-cigarettes are a popular tool people use to stop smoking, but they may not be the best way, suggests one research review. Using e-cigarettes improved the likelihood that a smoker would quit smoking cigarettes for the first month on the new technology, but the effect dissipated at 3 and 6-month followups, according to a meta-analysis of four studies by University of Toronto researcher Riyad al-Lehebi. He recommended that people who want to quit smoking consider “other more well-established options.”

http://time.com/3860166/ecigs-research/?xid=emailshare

Bill Palmiscno: Tobacco limits in parks will make Grand Forks a better place

By Bill Palmiscno
GRAND FORKS—At the April 6 meeting of the Grand Forks Park Board, the Park Board commissioners passed the first reading of the Park District Tobacco Usage Policy.
It reads as follows:
“No person shall use, chew, smoke, inhale e-cigarettes, or otherwise engage in the usage of tobacco or tobacco products within or on any playground, fitness center, arena, pool, Park District parks, baseball diamonds and outdoor tennis courts. Except for chewing tobacco products at Lincoln Golf Course, King Walk Golf Course and Ulland Park, all tobacco products and all tobacco usage is banned on all property owned, leased or managed by the Park District.”
The decision to implement the Tobacco Usage Ban Policy was not taken lightly. For the past two years, multiple concerned groups, including the Grand Forks Public Health Department, have been requesting a tobacco-free parks ordinance. The issue has been carefully reviewed and analyzed by the Park Board for years.
Here are three major factors that lead to the passing of the first reading of the Park District Tobacco Usage Policy.
▇ Grand Forks City Council ruling on Ordinance 4393
On Dec. 3, 2012, the city of Grand Forks passed the Smoke Free Workplace Ordinance 4393; the ordinance went into effect a few days later. This Grand Forks ordinance and the state of North Dakota’s ruling prohibits smoking on golf courses and softball fields.
Ordinance 4393 also includes “public places,” which made reference to public parks but not playgrounds.
▇ Overwhelming community support for tobacco-free parks
In April 2014, the Park Board was presented with a third-party, scientific survey showing community attitudes and perceptions towards a Comprehensive Tobacco-Free Parks Policy. Key findings can be found in the appendix or online at tobaccobytes.com, the website of the Grand Forks Tobacco Free Coalition.
▇ Commitment to being community leaders in health and wellness
The mission of the Grand Forks Park District is to provide the best parks, programs, facilities, forestry services and other services possible to promote a healthy and enjoyable lifestyle for all citizens of Grand Forks. The Park Board is committed to keeping our mission at the heart of every decision made.
The goal of implementing the Tobacco Usage Policy is to prevent our children from being exposed to addictive behavior in public areas where families frequent, such as parks, playgrounds and youth fields. The Park Board does not want to restrict the rights of adults, hence the decision to allow chewing tobacco products in our adult-focused activity areas such as Lincoln Golf Course, King’s Walk Golf Course and Ulland Park.
We truly believe the decision to implement the Tobacco Usage Policy is in the best interest of Grand Forks residents.
http://www.grandforksherald.com/opinion/op-ed-columns/3728966-bill-palmiscno-tobacco-limits-parks-will-make-grand-forks-better-place

Forum editorial: Don’t be fooled by e-cig hype

The North Dakota Legislature is buying into Big Tobacco’s clever but dishonest narrative about e-cigarettes. Lawmakers would be better served by paying attention to Dr. Terry Dwelle, the state’s chief health officer.
In comments published a few days ago, Dwelle said without equivocation that, given current research and information, the “cons” of e-cigs outweigh the “pros.” He said more work is needed to further define the risks and any potential benefits of the nicotine-delivery devices. He said the assumption that vapors produced by e-cigs are less risky than smoke from traditional tobacco products is not backed up by sound research.
Lawmakers likely will ban e-cig sales to minors, as several North Dakota cities have done already. But there is wrong-headed sentiment among some lawmakers that the devices should not be taxed and otherwise treated the same way tobacco is. Under the state’s smoking ban law, e-cigs are treated like cigarettes and other tobacco products. The e-cig provision was part of a voter-approved smoking and secondhand smoke measure. The measure passed with 66 percent approval.
Yet, lawmakers have smoke in their eyes when it comes to the clear message North Dakotans sent about tobacco use – and the stealth campaign to paint vaping with e-cigs as an innocent tobacco-free option.
There is nothing innocent about it. Big Tobacco has become Big Vaping. The companies have jumped into the e-cig market with slick advertising campaigns and legitimate-sounding claims about the safety and efficacy of e-cigarettes. The push has all the elements that peddlers of tobacco used a generation ago to convince the gullible that cigarettes did not cause cancer. The lie then has morphed into the lie now.
There is less-than-definitive indication that e-cigs help smokers quit. If it’s true, it’s a good thing. But that unproved aspect of e-cigs has nothing to do with taxing a nicotine-delivery device that by some studies can be a gateway for young people to tobacco use. It is counterintuitive to grant a tax break to devices and substances that use candy flavors and faux fashion to attract users of all ages to a nicotine-delivery tube. It’s also stupid policy. It’s playing into the dirty hands of the folks who for years peddled the fiction that tobacco was good for us.
Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.
http://www.inforum.com/opinion/editorials/3711115-forum-editorial-dont-be-fooled-e-cig-hype

CBS MoneyWatch: As e-cigarette sales soar, critics eye regulations

By JONATHAN BERR | MONEYWATCH
The Food and Drug Administration expects to publish its much-anticipated regulations for e-cigarettes in June, as the products are surging in popularity. In fact, sales are expanding so rapidly that some experts predict e-cigs will overtake sales of conventional smokes within the next decade.
“From our perspective, the rules are long overdue,” said Erika Sward, assistant vice president of national advocacy at the American Lung Association, who noted the regulations have been in the works for about a year.
The FDA already regulates cigarettes, cigarette tobacco, roll-your-own tobacco and smokeless tobacco. Under the 2009 Family Smoking and Tobacco Control Act, the FDA can “deem” additional tobacco products to be subject to the Federal Food, Drug, and Cosmetic Act. Among other things, firms would be required to register with the FDA and submit product and ingredient listings, and include health warnings and take steps to prevent sales to underage consumers.
“To date, FDA has not been able to fully assess the public health impacts of unregulated tobacco products,” the FDA said in a statement sent to CBS MoneyWatch. “For example, some testing of e-cigarette cartridges has revealed significant variability in nicotine content and the presence of chemical constituents that raise concerns of toxicity.”
Altria Group (MO) and Reynolds American (RAI), two of the biggest tobacco companies, are welcoming the FDA’s efforts, arguing that the patchwork of existing state regulations fails to protect consumers against defective products, some of which have even exploded. The companies are lobbying the FDA to treat e-cigarettes differently than conventional smokes.
Some proponents of e-cigaretttes have claimed that they can be an effective smoking cessation tool. A study published last year found that people who wanted to quit smoking were about 60 percent more likely to be successful if they used e-cigarettes as opposed to other products such as nicotine patches or gum.
Industry critics, including the American Lung Association, counter that the evidence to back up these claims is inconclusive. A study released last month by the Johns Hopkins Bloomberg School of Public Health found that e-cigarettes generate some of the same dangerous chemicals found in traditional smokes.
“There is absolutely no federal oversight of e-cigarettes in terms of what is in them, how they are being marketed,” said Sward of the American Lung Association, adding that e-cigarette makers are “following the Big Tobacco playbook” by offering flavored e-cigarettes that would appeal to underage smokers. “Really, what we are seeing are the same tactics that we saw 30, 40 years ago.”
Altria, which is based in Richmond, Virginia, has put a 116-word warning on packs of its MarkTen e-cigarettes even though it wasn’t legally obligated to do so. AsReuters noted, it said nicotine is “addictive and habit-forming” and that MarkTen isn’t intended for women who are pregnant or breast-feeding or people being treated for depression or asthma. Spokesman Steve Callahan said the wording on the company’s label was based the “available science.”
In a statement to CBS MoneyWatch, Reynolds argued that the FDA needed to regulate e-cigarettes fairly.
“We believe if (the) FDA is going to regulate vapor products, then it should regulate all vapor products — including open systems and the vape shops in which the liquid nicotine used in open systems is mixed or compounded — to create a level playing field where all manufacturers are subject to equal treatment, including FDA inspection/registration/regulation, manufacturing standards and product clearance requirements,” writes Richard J. Smith, a spokesman, in an email.
Whenever the regulations are issued, it will open another front in the decades-long battle that pits people trying to protect the public health against the rights of an industry selling an otherwise lawful product.

Men's Journal: E-Cigarettes May Be Just as Bad as The Real Thing

Two new studies have turned out some scary findings about e-cigarettes. The first one, published in the New England Journal of Medicine, revealed that e-cigarette vapor can harbor hidden formaldehyde — a known carcinogen — at levels up to 15 times greater than regular cigarettes. “We discovered this form of formaldehyde hidden in the tiny liquid droplets of the vapor, where it hadn’t been detected before,” says lead researcher David Peyton, a chemistry professor at Portland State University in Oregon. “It has the potential to distribute deeply into the lungs and collect there.”
The second study showed that e-cigarette vapors directly harm human lung tissue. Researchers from the University of Rochester Medical Center in New York found that when the aerosol produced by heated liquid nicotine hits lung cells, it churns up disease-causing free radicals and triggers marked inflammation; they also found the presence of up to six times the level of heavy metals, like copper. What’s more, they discovered that various flavor additives, which are often added to e-cigs, cause additional oxidative damage to lung tissue. This isn’t after years of e-cig use, either. The negative effects “occurred after a few days of vaping,” he says. “Chronic exposure may lead to even more damage.”
These findings add to the fast-amassing stack of research revealing the many potential hazards of e-cigarettes. Since these smokeless devices are not regulated by the Food and Drug Administration, they can contain any number of toxins, carcinogens, or other mystery chemicals. And because e-cigarettes are so new, the long-term health consequences of using them are unknown.
Even so, many people assume that, compared to regular tobacco cigarettes, e-cigs are the lesser of two evils. But that’s not necessarily the case, says Dr. Roy Herbst, chief of medical oncology at Yale Cancer Center and a spokesman for the American Association for Cancer Research. “In the oncology community, we feel they are both evil,” he says. “The big concern with e-cigarettes is lung tissue damage. Regular cigarette smoke contains 60 to 80 known carcinogens, which makes it very bad for the lungs too. However, hot e-cigarette vapor going straight to the lungs can cause actual burning and injury. It’s a different type of damage — but it’s still significant.”
And that’s just their immediate impact. “We still don’t know the long-term effects that e-cigarettes can have on the body,” Herbst says. “There is still so much to learn about them.”
Herbst also thinks e-cigs are an unproven and even detrimental smoking cessation tool — which is, of course, a huge reason why people puff on them. “I treat people with lung cancer, so certainly my goal is to stop people from smoking,” he says. “But these devices deliver such high concentrations of nicotine that they get people very addicted to the drug. If you need help with smoking cessation, there are other, FDA-approved forms of nicotine, such patches or lozenges, that would much better than e-cigarettes.”
And because e-cigs crank out so much nicotine, Herbst also fears that they can be a gateway to tobacco cigarettes. “E-cigarettes are very expensive, so we worry that people will start on them, get addicted to nicotine, and then move on to regular cigarettes, which are generally less expensive and easier to get,” he adds.

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Read more: http://www.mensjournal.com/health-fitness/nutrition/e-cigarettes-may-be-just-as-bad-as-the-real-thing-20150324#ixzz3Vo1Fhu6J