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Congress Should Back President Obama’s Tobacco Tax Plan – It Will Protect Kids, Save Lives and Cut Health Care Costs

Statement of Susan M. Liss, Executive Director, Campaign for Tobacco-Free Kids

WASHINGTON, DC – The Campaign for Tobacco-Free Kids strongly supports President Obama’s proposal to increase the federal tobacco tax, which is a proven way to prevent kids from smoking, save lives and reduce tobacco-related health care costs.

In his FY 2016 budget released today, President Obama urged Congress to increase the federal cigarette tax by 94 cents per pack and also increase taxes on other tobacco products. The tobacco tax changes would raise $95.1 billion in new revenue over 10 years.  The budget proposes to use these funds to pay for an extension of the Children’s Health Insurance program (CHIP) and fund early childhood education initiatives proposed by the President.

This proposal would do more to reduce tobacco use among kids than any other single action the federal government can take. It is also a fiscally responsible proposal that will help to reduce the huge financial burden that tobacco use imposes on governments, businesses and families.  A new CDC study issued in December found that smoking costs our nation about $170 billion a year in health care spending – far more than previously thought. More than 60 percent of these costs are paid by taxpayers through government programs such as Medicare and Medicaid.

Congress should embrace this proposal enthusiastically. It will save lives and money. And it will help millions of kids live longer, healthier lives free of tobacco addiction.

The evidence is clear that increasing the tobacco tax is one of the most effective ways to reduce smoking and other tobacco use, especially among kids. Economic research shows that every 10 percent increase in the price of cigarettes reduces youth smoking by about seven percent and overall cigarette consumption by three to five percent. We estimate that a 94-cent increase in the federal cigarette tax would:

·        Prevent 1.2 million kids from becoming smokers;

·        Prompt 2.6 million adult smokers to quit

·        Prevent 444,100 premature deaths as a result of these reductions in youth smoking

·        Save $51.9 billion in future health care costs.

Numerous public health and economic authorities have found that increasing the tobacco tax is effective at both reducing smoking and raising revenue. Last year’s Surgeon General’s report reaffirmed that. “Raising prices on cigarettes is one of the most effective tobacco control interventions,” the report concludes. “The evidence is sufficient to conclude that increases in the prices of tobacco products, including those resulting from excise tax increases, prevent initiation of tobacco use, promote cessation, and reduce the prevalence and intensity of tobacco use among youth and adults.”

The highly respected Congressional Budget Office has also concluded that increasing the federal tobacco tax would raise substantial new revenue, prompt millions of smokers to quit, save lives and reduce health care costs.

Furthermore, national and state polls consistently show strong public support for substantial increases in tobacco taxes, with most polls showing voters favoring tobacco tax increases by more than a two-to-one margin. Polls have found that large majorities of Democrats, Republicans and Independents and voters from a broad range of demographic and ethnic groups all support tobacco tax increases – as do significant numbers of smokers.

In short, a significant tobacco tax increase is a win-win-win for the country – a health win that will reduce tobacco use and save lives, a financial win that will reduce health care costs and raise revenue to fund an important initiative, and a win among voters.

The budget proposal also includes a measure that would ensure “full coverage of preventive health and tobacco cessation services for adults in traditional Medicaid.”  Tobacco cessation services have been proven to reduce smoking and are cost-effective. After Massachusetts implemented tobacco cessation coverage for all state Medicaid beneficiaries, smoking among the state’s Medicaid population declined by 26 percent and the state saved more than $3 for every $1 it spent to help beneficiaries quit smoking.

The need for Congress to act to increase tobacco taxes and expand cessation services is clear.  While our nation has made tremendous progress in reducing smoking, tobacco use remains the number one cause of preventable death in our country. Smoking annually kills 480,000 Americans – causing one in every five deaths.  Without urgent action, 5.6 million kids alive today will die prematurely from smoking-caused disease.

The President’s proposal represents exactly the kind of bold action needed to accelerate progress against tobacco and make the next generation tobacco-free.

OFFICIALS DECLARE E-CIGARETTES A HEALTH THREAT FOR CALIFORNIA

By , ABC News
SHERMAN OAKS, LOS ANGELES (KABC) —

Health officials have declared electronic cigarettes a health threat for California, and they are seeking statewide regulations.
The use of electronic cigarettes is growing. It’s called vaping, and there’s new shops opening up all over.
The California Department of Public Health released a report saying e-cigarettes emit cancer-causing chemicals and get users hooked on nicotine, but officials acknowledged that more research needs to be done.
“There’s a misnomer that e-cigarettes emit just water vapor, and that’s not true. They actually admit aerosol that contains particulate matter,” said Timothy Gibbs of the American Cancer Society.
California Health Officer Ron Chapman said if the products remain largely unregulated, new generations of young people will become nicotine addicts.
“There is propyleneglycol, which is a food substance. They have actually used it as medication. However, when it’s heated up, if it’s heated up high enough, it becomes ethylene glycol, that’s anti-freeze,” said Dr. Brian Tiep of City of Hope.
But proponents say it is never heated that much.
“There is a dangerous part when you are heating up … but we don’t do that. Usually vape shops don’t sell those kinds of things,” said Mike Mailyan, who owns the Vapor Shop in Sherman Oaks.
He says electronic cigarettes do not contain tobacco, and there is nothing burning like a cigarette. Instead, a heating element vaporizes a liquid that can have different flavorings.
“Basically it’s boiled water with vegetable glycerine,” Mailyan said.
California banned the sale of e-cigarettes to minors in 2010, but the report raises concerns about children consuming liquid nicotine with flavors such as cotton candy and gummy bear. Reports of children under 5 with e-cigarette poisoning jumped from seven in 2012 to 154 last year.
There’s a proposal in the state legislature that would define e-cigarettes as a tobacco product and would prohibit its use in public places. A similar bill was defeated last year over opposition from tobacco companies.
The U.S. Food and Drug Administration is also proposing regulations that include warning labels and ingredient lists on e-cigarettes, although enactment could take years.
The Associated Press contributed to this report.

http://abc7.com/health/officials-declare-e-cigarettes-a-health-threat-for-california/495375/

 

Lab tests imply formaldehyde risk in some e-cigarette vapor

By Marilynn Marchione, The Washington Post
Using certain electronic cigarettes at high temperature settings may release more formaldehyde, a cancer-causing chemical, than smoking traditional cigarettes does, new lab tests suggest.
The research does not prove a health risk — it involved limited testing on just one brand of e-cigarettes and was done in test tubes, not people. It also does not mean e-cigarettes are better or worse than regular ones; tobacco smoke contains dozens of things that can cause cancer.
But it does highlight how little is known about the safety of the battery-powered devices, which heat liquid to deliver nicotine in a vapor rather than from burning tobacco.
“It’s a potential red flag,” one independent expert — Stephen Hecht, a tobacco researcher at the University of Minnesota — said of the study. “Under some conditions, e-cigarettes might be generating more formaldehyde than you’d want to be exposed to. But I don’t think we know enough yet. There’s a huge variety in the makeup of these cigarettes and how they are used.”
The study was published last week as a letter in the New England Journal of Medicine. The journal said it had been reviewed by experts in the field.
Formaldehyde is found in many things, including building materials and disinfectants. An earlier study found e-cigarettes generated less formaldehyde than regular ones, but that study looked at just the gas portion of the vapor. The new one looked at the liquid particles in the vapor, like the spray from an aerosol can.
Some e-cigarette systems let users turn up the voltage to increase the heat and the amount of liquid in the vapor. David Peyton, a chemist at Portland State University, and colleagues tested one brand with two voltage settings. They used a syringe to collect vapor from 10 samples, each one representing several puffs, at both voltage levels.
They measured formaldehyde hemiacetal — a compound that can release formaldehyde — in the liquid portion of the vapor.
At low voltage, the chemical was not detected. But at the high setting, levels were five to 15 times as great as the amount of formaldehyde users would get from traditional cigarettes.
Virtually all e-cigarettes use similar materials in the heated liquid, so the formaldehyde finding “is not brand-dependent,” Peyton said.
However, Gregory Conley, a lawyer with the American Vaping Association, an advocacy group for e-cigarettes, criticized the study methods. “They use the device in a manner that no one does,” he said.
What the researchers did, he said, is like leaving a steak on a grill all day: Many cancer-causing substances might be formed, but no one would eat such charred meat.
— Associated Press
http://www.washingtonpost.com/national/health-science/lab-tests-imply-formaldehyde-risk-in-some-e-cigarette-vapor/2015/01/26/6f36fd9a-a266-11e4-b146-577832eafcb4_story.html

Surgeon general says e-cigarette safety needs "clarity"

TIM IRELAND/PA WIRE, CBS/AP

The U.S. surgeon general says officials are “in desperate need of clarity” on electronic cigarettes to help guide public health policies.
Dr. Vivek Murthy, the country’s senior public health official, addressed the battery-powered devices that heat liquid nicotine during a stop Tuesday in Richmond. The U.S. Senate confirmed the 37-year-old physician and Harvard Medical School instructor’s nomination in December. The surgeon general’s office has previously been instrumental in guiding tobacco control.
The newly-appointed Murthy says the technology should be embraced if evidence shows e-cigarettes are able to help those who otherwise have trouble quitting smoking. However, research has found that e-cigarettes won’t necessarily help smokers quit. Last year, researchers surveyed nearly 1,000 smokers and found that while 13.5 percent of the total study pool quit smoking, only nine of the 88 e-cigarette smokers quit.
As is the case with all health officials, Murthy also expressed concern about the safety of the product. E-cigarette companies have used social media to market their product and appeal to young people, who are picking up vaping in surprising numbers. Companies claim they safer to use than standard tobacco. However, a study published last week found e-cigarette smokers are five to 15 times more likely to get formaldehyde-related cancers.
Last year, the FDA drafted recommendations to regulate marketing and sales of electronic cigarettes, though the laws have yet to be passed.
http://www.cbsnews.com/news/surgeon-general-dr-vivek-murthy-says-e-cigarette-safety-needs-clarity/

What to Know About the Science of E-Cigarettes

 
Eliza Gray & Alexandra Sifferlin | TIME Magazine

A guide to understanding conflicting and ongoing research

Two Columbia University professors warned in a new study Thursday that the health fears over electronic cigarettes are hindering research. The very same day, another new study showed that smoking e-cigs, or “vaping,” can produce cancer-causing formaldehyde.
Clearly there’s some disagreement among scientists about the risks and benefits of a product that’s growing in popularity. Here’s what you need to know about the latest science.
What’s with the latest disagreement?
Columbia public health professors Amy Fairchild and Ronald Bayer argue in Science magazine that the staunchest opponents of electronic cigarettes are so concerned about the potential downsides that they advocate for an anti-e-cigarette regulatory and research approach that may be bad for public health. This approach of “deep precaution,” they argue, “has served as a kind of trump argument, hostile to the notion of trade-offs, seeing in them perilous compromise. Such a posture does not serve either science or policy well.”
It “may be years before the disagreements over the evidence” about the effects of electronic cigarettes can be resolved, Fairchild and Bayer wrote. On the one hand, electronic cigarettes may serve as gateway drugs for young people to start smoking cigarettes, and “dual” use of electronic cigarettes with tobacco cigarettes may stop some smokers from quitting. Electronic cigarettes may also carry unknown health consequences of their own. On the other hand, they may provide harm reduction for people who have been unable to quit any other way.
Given these two competing possibilities, the authors argued that the best formula for public health is to acknowledge the possibility for costs and benefits and to push for a regulatory scheme that is flexible enough to account for both outcomes. It is better to make public policy and execute scientific research under the assumption that e-cigarettes could bring good as well as bad.
But also on Thursday, the New England Journal of Medicine published a new study reporting that chemicals inside e-cigarettes—like propylene glycol and glycerol—can produce a type of the cancer-causing chemical called formaldehyde when heated during the vaping process. The researchers report that when testing samples of the aerosol from vaped e-cigs, they found that the e-cigs can contain formaldehyde-releasing agents slightly different from regular formaldehyde, and that the levels are especially high when a user vapes at high voltages. Scientists don’t yet know if formaldehyde-releasing agents carry the same risk as pure formaldehyde, but the researchers said in their report that if they assume the substances do carry the same risks, then long-term vaping could be associated with a significantly higher risk for cancer compared to long-term smoking. The researchers said formaldehyde-releasing agents may actually burrow into the respiratory tract more efficiently than regular formaldehyde, though the observation wasn’t confirmed.
Are there other reasons experts are concerned?

There’s also debate over the safety of the liquid nicotine inside e-cigarettes. In April 2014, the Centers for Disease Control and Prevention (CDC) released a report showing what they called a “dramatic” rise in e-cigarette-related calls to U.S. poison centers. Calls went from one a month in September 2010 to 215 calls a month in February 2014, and more than half of the calls involved children age five and under. Forty-two percent involved people age 20 and older. Symptoms of liquid nicotine ingestion are known to be vomiting, nausea and eye irritation.

Researchers are also wary of the long term effects of inhaling propylene glycol, one of the main ingredients in e-cigarettes. The jury is still out, but some physicians are concerned. “As for long-term effects, we don’t know what happens when you breathe the vapor into the lungs regularly,” Thomas Glynn, the director of science and trends at the American Cancer Society, told ABC News. “No one knows the answer to that.”

Are they really attracting young people?

Several recent—but fairly small—studies say yes. A December 2o14 study in the journal Pediatrics surveyed 1,941 Hawaii high school students and found that about 17% of the high schoolers smoked e-cigarettes only, 12% smoked both e-cigarettes and conventional cigarettes, and only 3% smoked conventional cigarettes. The findings suggested that kids who smoked e-cigarettes scored lower on outside risk factors to pick up a conventional smoking habit. “The fact that e-cigarette only users were intermediate in risk status between nonusers and dual users raises the possibility that e-cigarettes are recruiting medium-risk adolescents, who otherwise would be less susceptible to tobacco product use,” the authors wrote. Numbers released in 2013 from the National Youth Tobacco Survey showedthat the percentage of middle school and high school students who have tried e-cigarettes doubled from 3.3% in 2011 to 6.8% in 2012.

What’s the argument in favor of e-cigarettes?

Some smokers use e-cigarettes to help them curb their traditional cigarette habit, or even quit. An August 2014 study that surveyed over 20,000 Americans showed that among adults who used a product to help them quit smoking, 57% chose e-cigarettes. That’s compared to the 39% who used prescription drugs like Chantix and the 39% who used other over-the-counter methods like patches or nicotine gum. Another study from July 2014, which reviewed 80 studies on e-cigarettes’ safety and their effects on users, revealed that not only can e-cigarettes help smokers quit, but they are less harmful to smokers and bystanders’ health compared to regular cigarettes.

What’s the FDA doing about it?

The U.S. Food and Drug Administration (FDA) only regulates e-cigarettes that are marketed for therapeutic purposes, though the agency has proposed a rule that would give it more regulatory power over e-cigarettes but that has not yet been implemented. The FDA has suggested a ban on sale of e-cigarettes to minors, and admits that there is a lot consumers don’t know about the product like whether they attract kids and teens or just how much nicotine is inhaled when a person vapes.

http://time.com/3678402/electronic-cigarettes-ecigs-health-science-research/
 

Lab tests suggest some e-cigarette use may release high levels of cancer-causing formaldehyde

By MARILYNN MARCHIONE, AP Chief Medical Writer
Using certain electronic cigarettes at high temperature settings could potentially release more formaldehyde, a cancer-causing chemical, than smoking traditional cigarettes does, new lab tests suggest.
The research does not prove a health risk — it involved limited testing on just one brand of e-cigarettes and was done in test tubes, not people. It also does not mean e-cigarettes are better or worse than regular ones; tobacco smoke contains dozens of things that can cause cancer.
But it does highlight how little is known about the safety of e-cigarettes — battery-powered devices that heat liquid to deliver nicotine in a vapor rather than from burning tobacco.
“It’s a potential red flag,” one independent expert — Stephen Hecht, a chemist and tobacco researcher at the University of Minnesota — said of the study. “Under some conditions, e-cigarettes might be generating more formaldehyde than you’d want to be exposed to. But I don’t think we know enough yet. There’s a huge variety in the makeup of these cigarettes and how they are used.”
The study was published Wednesday as a letter in the New England Journal of Medicine. The journal said it had been reviewed by experts in the field.
Formaldehyde is found in many things — certain building materials, disinfectants and embalming fluid. An earlier study found e-cigarettes generated less formaldehyde than regular cigarettes do, but that study looked at just the gas portion of the vapor. The new one looked at the liquid particles in the vapor, like the spray from an aerosol can.
Some tank system e-cigarettes let users turn up the voltage to increase the heat and the amount of liquid, which contains the nicotine and flavorings, in the vapor. David Peyton, a chemist at Portland State University, and colleagues tested one brand with two voltage settings. They used a syringe to collect vapor from 10 samples, each one representing several puffs, at both voltage levels.
They measured formaldehyde hemiacetal — a compound created during the vaping process that under certain conditions can release formaldehyde — in the liquid portion of the vapor.
At low voltage the chemical was not detected. But at the high voltage setting, levels of that compound were five to 15 times greater than the amount of formaldehyde users would get from traditional cigarettes.
Virtually all e-cigarettes use similar materials in the heated liquid, so the finding on formaldehyde “is not brand-dependent,” said Peyton, who plans more extensive tests.
However, Gregory Conley, a lawyer with the American Vaping Association, an advocacy group for e-cigarettes, criticized the study methods.
“They use the device in a manner that no one does,” he said.
Using the high voltage for as long as the researchers mimicked in the study “creates a burning, acrid taste” called a “dry puff” that would cause users to adjust the e-cigarette, Conley said.
What the researchers did is like leaving a steak on a grill all day — many cancer-causing substances might be formed but no one would eat such charred meat, he said.
Eric Jacobs, a biologist at the American Cancer Society, said a biochemist at the society looked at the work and “was reasonably convinced” that the chemical researchers measured would break down into formaldehyde in the user’s lungs.
“No one should conclude from this that e-cigarettes used at high voltage are worse than combustible tobacco cigarettes,” because of all the other toxins in tobacco smoke, Jacobs said.
The society’s advocacy affiliate, the Cancer Action Network, said the research “should raise serious concerns” about the lack of regulation of e-cigarettes, and urged the Food and Drug Administration to quickly finalize the proposal announced last spring to do so.
 
http://www.usnews.com/news/us/articles/2015/01/21/lab-tests-imply-formaldehyde-risk-in-some-e-cigarette-vapor

E-cigarettes may promote lung infections

By Dennis Thompson, HealthDay News

Vapor from electronic cigarettes may increase young people’s risk of respiratory infections, whether or not it contains nicotine, a new laboratory study has found.

Lung tissue samples from deceased children appeared to suffer damage when exposed to e-cigarette vapor in the laboratory, researchers reported in a recent issue of the journal PLOS One. The vapor triggered a strong immune response in epithelial cells, which are cells that line the inside of the lung and protect the organ from harm, said lead author Dr. Qun Wu, a lung disease researcher at National Jewish Health in Denver.

Once exposed to e-cigarette vapor, these cells also became more susceptible to infection by rhinovirus, the virus that’s the predominant cause of the common cold, the researchers found.

“Epithelial cells are the first line of defense in our airways,” Wu said. “They protect our bodies from anything dangerous we might inhale. Even without nicotine, this liquid can hurt your epithelial defense system, and you will be more likely to get sick.”

The new report comes amid a surge in the popularity of e-cigarettes, which are being promoted by manufacturers as a safer alternative to traditional tobacco cigarettes and a possible smoking-cessation aid.

Nearly 1.8 million children and teens in the United States had tried e-cigarettes by 2012, the study authors said in background information. Less than 2 percent of American adults had tried e-cigarettes in 2010, but by last year the number had topped 40 million, an increase of 620 percent.

For the study, researchers obtained respiratory system tissue from children aged 8 to 10 who had passed away and donated their organs to medical science. Researchers specifically looked for tissue from young donors because they wanted to focus on the effects of e-cigarettes on kids, Wu said.

The human cells were placed in a sterile container at one end of a machine, with an e-cigarette at the other end. The machine applied suction to the e-cigarette to simulate the act of using the device, with the vapors produced by that suction traveling through tubes to the container holding the human cells.

The vapor spurred the release of IL-6, a signaling protein that promotes inflammation and an immune system response. This occurred whether or not the vapor contained nicotine, although nicotine appeared to slightly enhance the release of IL-6, the researchers said.

The exposed lung tissue also appeared more susceptible to the common cold virus, developing higher amounts of virus compared to healthy cells that had not been exposed to the vapor, the investigators found. In follow-up testing, lab mice exposed to e-cigarette vapor also appeared more likely to come down with a cold from rhinovirus, compared with unexposed mice.

The American Vaping Association, an industry group representing e-cigarette makers, said the study findings were limited because the tests involved cells in a laboratory, not actual people using e-cigarettes. The tests also failed to compare the effects of the vapor to other inhalants, the group said.

“Many in public health agree that the risks of vaping must always be considered in the context of the risks of cigarette smoking and traditional stop-smoking therapies,” said Gregory Conley, president of the American Vaping Association.

“Unlike past studies, this study provides the reader with no data to compare the liquid results to. What would happen if these same cells were exposed to combustible cigarettes, nicotine gum, or the smoking cessation drug varenicline (Chantix)? That is an important — and unanswered — question that the authors don’t appear to have great interest in answering,” Conley said.

Dr. Norman Edelman, senior medical adviser for the American Lung Association, agreed that people should be cautious in drawing conclusions based on lab tests using cell cultures.

At the same time, Edelman said, the study findings are “interesting and provocative” and fit in with prior research on the effects of e-cigarette use.

“We already know that if you have someone smoke an e-cigarette and then test them, they show airway inflammation,” Edelman said. “The susceptibility to viral infection is brand new and interesting.”

http://www.chicagotribune.com/lifestyles/health/sc-health-0121-e-cigarette-infections-20150109-story.html

Major cancer groups call for e-cigarette research, regulation

By John Nielsen, ScienceInsider

One telling sign of the popularity of electronic cigarettes, or e-cigarettes, which allow users to inhale nicotine vapors without other harmful chemicals, arrived late last year: The editors of the Oxford Dictionaries declared “vape” their Word of the Year for 2014.

Today, e-cigarettes earned another kind of notice: Two of the largest cancer science and treatment groups in the United States called on the government to start regulating “electronic nicotine delivery systems” and step up research on the health effects of vaping.

“While e-cigarettes may reduce smoking rates and attendant adverse health risks, we will not know for sure until these products are researched and regulated,” said Peter Paul Yu, president of the 35,000-member American Society of Clinical Oncology, in a statement. “We are concerned that e-cigarettes may encourage nonsmokers, particularly children, to start smoking and develop nicotine addiction.” His group was joined by the American Association for Cancer Research, which has more than 33,000 members.

The joint statement endorsed the urgent need for new research into the health effects of e-cigarettes and using tobacco tax revenues to help fund studies. It also included a long list of recommended actions by state and federal government agencies. They include requiring makers of e-cigarettes to register their products with the Food and Drug Administration (FDA), to identify the chemicals and levels of nicotine in various brands, and to agree to help stop teenagers from vaping.

In April 2014, FDA issued a proposal to start regulating e-cigarettes. The proposal would require FDA reviews of e-cigarette products and force makers to stop claiming health benefits until the science is in. The rule would also ban the distribution of free samples of e-cigarettes and vending machine sales. Health warnings would be mandatory. FDA has not finalized the rules, however, and researchers and health professionals say they hope today’s statement will highlight the need to move quickly.

“As someone who runs a treatment program for tobacco addicts, I would love to be able to endorse the use of e-cigarettes as an alternative,” says Michael Steinberg of the Robert Wood Johnson Medical School at Rutgers University, New Brunswick, in New Jersey. “But I cannot do that because we don’t know the risks involved, nor can we be sure that moving to e-cigarettes really helps people stop smoking.” Steinberg says it could turn out that smokers who start vaping tend to end up using both e-cigarettes and flammable ones or that the nicotine produced by e-cigarettes is unexpectedly toxic.

Some researchers worry that any new rules won’t go far enough, soon enough. Neither the FDA proposal nor today’s joint statement calls for a ban on television advertising by e-cigarette makers, for example, notes Stanton Glantz, director of the Center for Tobacco Control Research and Education at the University of California, San Francisco. (Glantz, a frequent critic of the health claims made by makers of e-cigarettes, says he supports such a ban.) There’s also no mention of regulating e-cigarette “flavorings,” such as minty or fruity flavors, which were banned from cigarettes after they were linked to elevated smoking rates among teenagers.

Glantz also worries that it could be years before FDA fully regulates the devices. “It’s an especially torturous political and legal process at the federal level,” he says. Regulations may be easier to finalize on the state and local level, he adds, noting that several states and cities have already imposed restrictions. “I would look for progress at the local level,” Glantz says. “I expect that in this case the most important changes will start at the bottom, not the top.”

In the meantime, e-cigarettes are becoming increasingly mainstream. The small, battery-powered devices first became readily available in the United States in 2006, and sales rose to about $2 billion in 2014 alone. “Vaping” bars where people speak of “vapers’ rights” are popping up in towns and cities. Movie stars have advertised their vaping skills on late-night television talk shows.

This past December, a survey released by the National Institute on Drug Abuse reported that 17% of high school seniors said they’d vaped at least once a month, compared with 14% percent who admitted to smoking. Vaping among 10 graders, at 16%, was more than twice the rate of smoking. Antismoking activists found these reports alarming, arguing that vaping could become a “gateway habit” that could draw nonsmokers toward cigarette use.

http://news.sciencemag.org/health/2015/01/major-cancer-groups-call-e-cigarette-research-regulation

The Post's View: Maryland’s cigarette tax is saving lives

By Editorial Board, The Washington Post

AMID AN electoral backlash against high taxes in Maryland, anti-smoking advocates have abandoned a campaign to raise the state-imposed levy on cigarettes. Politically, that makes perfect sense. As public-health policy, it is foolish.

A new study by Maryland’s Department of Health and Mental Hygiene shows that the state’s drop in teen smoking rates, already steep following three sharp tax increases since 1999 on a pack of cigarettes, has continued in the past few years.

The rate of cigarette smoking among underage youth in the state has fallen from 23 percent in 2000 to just 11 percent last year. Since 2008, when the per-pack levy was doubled, to $2, smoking among high school youth has fallen by about a third; according to the state study, for the first time, slightly more teenagers now smoke cigars than smoke cigarettes.

Adult smoking has also fallen by about a fifth since 2000. Smoking among both youth and adults in Maryland is considerably below the national average, which is about 16 percent for youth and 18 percent for adults.

No doubt, the anti-tax mood in Maryland was central to Republican Larry Hogan’s upset victory in November’s gubernatorial election. That sentiment notwithstanding, the smoking numbers are a strong argument for leaving in place the state’s relatively high levies on tobacco products, which are not just a revenue source but also a means of saving lives.

According to the state study, hospital admissions to treat tobacco-related cancers in Maryland have fallen by 11 percent from 2000 to 2011, saving more than $102 million in hospital charges in 2011 alone.

The state study also showed a strong link between youth smoking and other forms of substance abuse. Minors who smoked were three times more likely than non-smokers to have used alcohol in the past 30 days, five times more likely to have used marijuana, six times more likely to have used other illegal drugs, and nine times more likely to have used — or, more likely, abused — prescription drugs.

It’s no coincidence that states that have been loath to offend the tobacco or anti-tax lobbies by raising the tax on cigarettes have significantly higher smoking rates. As we’ve noted before, a case in point is Virginia, where the per-pack levy is among the lowest in the nation, the price of a pack of cigarettes is $2 lower than in Maryland and the smoking rate is much higher. For continuing to bow before the throne of King Tobacco, the Old Dominion will pay a price in the public health of its citizens.

As smoking rates nationally have fallen, the use of e-cigarettes among high school-age youth appears to be rising. That’s a worrying trend, given that e-cigarettes also contain nicotine, which is highly addictive, and could promote the use of cigarettes and other harmful substances.

You don’t have to be enamored of the nanny state to recognize that tobacco use, especially cigarette smoking, correlates directly with lung cancer and other diseases and is a major threat to public health. Nor is there any serious doubt that tax increases have played a critical role in cutting cigarette use, especially among price-sensitive teens.

If Mr. Hogan intends to cut taxes, as he has promised, the tobacco tax is one he’d be well advised to leave intact.

http://www.washingtonpost.com/opinions/marylands-cigarette-tax-is-saving-lives/2014/12/27/36f2818a-8573-11e4-9534-f79a23c40e6c_story.html

Tobacco tax: Move for $2 per pack gains momentum in CA

By Dr. Nicholas Leeper | Special to the Mercury News

The changing of the New Year brings about a fresh start. If you are one of the estimated 46.6 million Americans who smoke cigarettes, quitting the habit is likely being considered for a New Year’s resolution. Polls have shown that a vast majority of smokers would like to quit, and we at the American Heart Association are dedicated to giving smokers every edge we can to put their habit in the past. One such proven way to encourage quitting is a tobacco tax.

This is why we are joining with doctors, health care workers, taxpayers and other nonprofit health organizations to support a $2-per-package tax on the cost of tobacco.

The benefits to our state would be enormous and would more accurately account for the true cost of tobacco. Currently, California spends about $9 billion a year on tobacco-related medical care, with taxpayers footing about a third of that. In fact, in data compiled from the Centers for Disease Control, the true cost to society in California is $15 for every pack sold. Our current tobacco tax is 87 cents.

A tobacco tax is also a particularly effective way to prevent younger people from ever taking up the habit. A staggering 80 percent of smokers start before they are 18, while only one in 100 begin at age 26 or older. The Congressional Budget Office estimates that, based on previous research, a 10 percent increase in the cost of tobacco will result in a five to 15 percent decrease in youth tobacco usage. This compares to three to seven percent for adults.

Education about the ill effects of tobacco over the past several decades has been instrumental in lowering the rate of smoking in the United States. Toward that end, the tax would bolster proven youth prevention programs to deter smoking. A few years ago, it was estimated that even the $1 added tobacco tax then proposed in California would have prevented 200,000 children in California from becoming adult smokers.

Given that tobacco is a major contributor to coronary disease in our nation, we at the American Heart Association are always looking at effective policies that result in fewer smokers. The Congressional Budget Office estimates that if even a roughly $1 per package tax were to be instituted on cigarettes next year, there would be 2.6 million fewer adult smokers over the age of 18 by 2021. This would certainly be helpful in a nation where 443,000 people die from smoking-related diseases yearly, including 46,000 heart-related deaths attributed to secondhand smoke.

If these statistics just seem like numbers on a page, just think about the intangibles, such as the value added from having more years with a grandparent, or not watching a loved one suffer through the pain of emphysema, heart disease or cancer. These are things on which it’s impossible to place a monetary value, but with an estimated 100,000 California lives that will be saved in future years through a tobacco tax, they are nonetheless primary benefits.

So, in the New Year, if you need help to quit smoking, please visit our website, http://www.heart.org, for more information. And please join with us at http://www.savelivesca.com and support a $2-per-package tobacco tax next year. The life you save may be yours or a loved one’s.

Dr. Nicholas Leeper is Assistant Professor of Cardiovascular Surgery and Medicine at Stanford University Medical Center and president of the American Heart Association, Silicon Valley Division. He wrote this for this newspaper.

http://www.mercurynews.com/opinion/ci_27190645/tobacco-tax-move-2-per-pack-gains-momentum