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Hindsight, MN 2020: Cigarette Tax Increase Succeeds in Reducing Tobacco Usage

By Jeff Van Wychen, Fellow and Director of Tax Policy & Analysis
From Hindsight, Minnesota 2020 Blog

One of the reasons for increasing Minnesota’s cigarette tax was to incentivize current smokers to “kick the habit.” It appears that the cigarette tax increase is already having the desired effect. According to information from ClearWay Minnesota, “Quit attempts by Minnesotans have increased dramatically since the cigarette tax increased by $1.60 per pack on July 1, 2013. During the first two weeks of July 2013, QUITPLAN® Services received 256 percent more calls than in the first two weeks in July 2012, and saw a 289 percent increase in visits to quitplan.com.”

Long term, ClearWay projects that the tobacco tax increase enacted in 2013 will lead to a 47,800 reduction in the number of children who become addicted, a 16 percent reduction in youth smoking rates, incentivize 36,600 Minnesotans to quit smoking, and a 25,700 reduction in premature smoking related deaths.

A reduction in tobacco usage was incorporated into projections of how much revenue the 2013 tobacco tax increase would generate. As a result, the tobacco tax increase is generating about as much new revenue as it was expected to. According the most recent economic update from Minnesota Management & Budget, net tobacco tax collections are within three percent of their projected target since the tax increase took effect (through March 2014).

It is true that tobacco taxes are regressive, falling most heavily on low income households. However, the long-term health effects of the tobacco tax increase outweigh concerns over regressivity. After all, the positive health effects of the tobacco tax increase will likely be concentrated among low income smokers, since they are most sensitive to cigarette price increases and will be most incentivized to quit as a result. There are many ways we can change the tax code to help low income households; giving them access to cheap carcinogens should not be one of them.

http://www.mn2020hindsight.org/view/cigarette-tax-increase-succeeds-in-reducing-tobacco-usage

Further Review: Hey, baseball, time to quit the spit

By Steve Hummer

The Atlanta Journal-Constitution

Tony Gwynn, hitter nonpareil, died in mid-June of the kind of cancer that should have sent a chill through every clubhouse in baseball. A member of the dip-and-spit set when he played, Gwynn suffered salivary gland cancer. He was only 54 at his death.
In a story looking at baseball’s and the Braves’ reaction to Gwynn’s death — to appear in Sunday’s print edition of the AJC, as well as on myajc.com — it was necessary to include the disclaimer that there was no precise science connecting Gwynn’s cancer to his past use of smokeless tobacco.
But, c’mon, a little common sense here. Gwynn had said the cancer begin very near the area of his mouth where he once loaded his dip. He blamed his fate on his tobacco use. Even without the seal of definitive medical proof, that should be good enough for the third of baseball that still spews foul brown juice.
The use of chewing and dipping tobacco has been a stain on baseball, literally, since forever. Trying it is a rite of passage for every young player — the nausea and the dizziness that the first-timer experiences, that’s just all good fun. Staying with it is a sort of concession, a player admitting he can figure no better way to spend his many idle hours than to stuff a caustic weed in his mouth and spit it out one dirty dribble at a time.
And once they get hooked, good luck trying to get off the nicotine dragon.
An athlete faces so many risks that he or she is powerless to avoid. Each sport takes its own kind of toll on joint and organ. Why in the name of Nike — the winged goddess of victory, not the shoe — would anyone willingly add to the potential harm by taking up such a frivolous, filthy habit?
Not as many in baseball use the stuff now as 20 years ago. And some have been forced to a reckoning by the news of last month. Braves closer Craig Kimbrel for one seemed genuinely motivated to quit his dipping when the season is done.
But I fear too many players will put off the hard work of quitting until the season passes, gradually set aside the lesson of this summer and stay with the slow, comfortable slide that smokeless tobacco provides. Then it will be just the same ol’ spit from there.
Gwynn’s legacy deserves so much more than that.
http://www.ajc.com/news/sports/further-review-hey-baseball-time-to-quit-the-spit/ngYZ5/

Increasing popularity of smokeless tobacco poses cancer risk to young men

By , FOXNews.com

Though rates of cigarette smoking in America continue to decline, smokeless tobacco use remains popular, especially among young men — and with potentially dangerous health consequences.

A recent report from the U.S. Centers for Disease Control and Prevention (CDC) revealed that the use of smokeless tobacco among workers in the U.S. has held steady since 2005 – with rates of smokeless tobacco use being highest among males ages 25 – 44.

“In recent years there have been declines in cigarette smoking, but there’s really other tobacco products making up a large proportion of tobacco use in certain populations,” Brian King, scientific advisor at the CDC’s office of smoking and health, and lead author of the study, told FoxNews.com.
The dangers of smokeless tobacco use recently entered the national spotlight after the death of baseball hall-of-fame player Tony Gwynn, who died of salivary gland cancer after spending years dipping tobacco on the field.
According to the CDC, more than 30,000 people in the U.S are diagnosed with oral cancer every year. And every year, over 8,000 die of the disease, which has only a 50 percent five-year survival rate. A 2008 study from the World Health Organization indicated that smokeless tobacco users have an 80 percent greater chance of developing oral cancer than a non-user.
“Smokeless tobacco is a proven cause of oral cancer, including of the lips, throat and lining of the cheeks,” King said. “…With combustible tobacco the primary cancer is lung because people are inhaling, but with smokeless use, it’s primarily in the oral region, [which is] why we’re seeing a lot of cancers associated with smokeless tobacco around the oral cavity.”
In addition to being deadly, oral cancers often have devastating effects on a person’s appearance, as surgeries to remove cancerous lesions often require removal of portions of the face. Smokeless tobacco has also been associated with an increased risk of pancreatic cancer and heart disease.
The CDC’s study utilized data from the National Health Interview Survey to compare rates of smokeless tobacco use in 2005 and 2010. In 2005, 2.7 percent of U.S. workers admitted to using smokeless tobacco, compared to 3 percent in 2010.

“In terms of major findings, it primarily is that we haven’t seen any change, so that is concerning to us because obviously we’d like to see it decline over time,” King said. “So that finding is potentially a useful tool to inform strategies to start to address all forms of tobacco use, not just cigarette smoking.”
Another recent study by the CDC indicated that 2.6 percent of the population uses smokeless tobacco on some days, or every day, while 9.6 percent admitted ever having used these products, according to data from the 2012-2013 National Adult Tobacco Survey.

King said a lack of research on the effects of smokeless tobacco, combined with fewer public health initiatives geared towards this form of tobacco use, may be contributing to the steady use of these products in the U.S.
“A lot of campaigns and interventions have focused on combustible tobacco, and smoke-free policies have proliferated,” King said. “But all forms of smokeless tobacco use are really permitted in a lot of areas.”
Furthermore, loopholes in laws regulating cigarette use allow smokeless tobacco to be more accessible – and cheaper to the majority of the population.
“Cigarettes are taxed pretty uniformly in every state, but in most cases smokeless tobacco is taxed considerably lower than cigarettes in most states,” King said. “And we know increasing price is the single most effective way to reduce consumption, so the fact that these are available cheaper obviously increases the potential for people to use them.”
As the CDC continues to monitor the growing landscape of nicotine and tobacco products, they also have an eye on new products coming to the marketplace – including spit-less smokeless tobacco, tobacco sticks, orbs and strips and tobacco products featuring kid-friendly flavors.
While evidence is still emerging on the ill effects of smokeless tobacco, and how to curb its use, one thing is certain: quitting will benefit your health.
“Given the adverse health effects associated with smokeless tobacco, quitting is beneficial and since we know there’s no safe form of tobacco, if you were to quit completely that would considerably improve your health and potential for future disease and death,” King said. “There are a lot of evidence-based treatments to help people quit, and those are same as for cigarettes. The FDA has also approved seven medications including nicotine replacement therapy, and those can be used for smokeless tobacco as well.”

http://www.foxnews.com/health/2014/07/02/smokeless-tobacco-rates-remain-steady-in-us-as-cigarette-use-declines/

With few regulations, e-cigs grow in popularity throughout area

By: Patrick Springer, INFORUM

MOORHEAD – Aaron Templin tried quitting smoking multiple times but his efforts always fizzled after a matter of days.

Nicotine patches or gum never appealed to him as the path to cessation. Then, at a friend’s suggestion, he tried one of the much-in-vogue electronic cigarettes, which are tobacco-free but allow users to inhale a vapor, usually containing nicotine.

Two months later, he and his fiancée consider themselves ex-smokers on the way to breaking free from nicotine altogether.

“It was really easy,” Templin said. “Whenever we had a craving, we’d have an e-cigarette.”

E-cigarettes find themselves under a cloud – enthusiastically embraced by some as a safer alternative to conventional cigarettes, while under fire from health officials who vehemently warn the unregulated products can make no scientifically valid safety claims.

The Food and Drug Administration is taking steps to regulate e-cigarettes, including banning their sale to those under the age of 18 and requiring makers to disclose ingredients.

“I can’t stress enough that there are a lot of unknowns and there isn’t enough scientific evidence” to prove the safety of e-cigarettes and similar devices, said Jeanne Prom, executive director of BreatheND.

Three recent studies cast doubt on the safety or effectiveness of e-cigarettes as alternatives to smoking, she said.

One published in the Journal of the American Medical Association found that e-cigarettes did not help smokers quit or reduce their use of conventional cigarettes.

Another study published in JAMA concluded that e-cigarettes did not discourage tobacco use, while the journal Nicotine and Tobacco Research suggest that some e-cigarettes yield formaldehyde, a known carcinogen, with their nicotine-laden vapor.

“Until they’re proven to be great, we’ll treat them with caution,” said Prom, who urges users or those considering e-cigarettes to do the same. She stressed that multiple proven smoking cessation methods are available, including over-the-counter options.

Templin, a Moorhead resident who smoked for nine years, has read news reports about health concerns regarding e-cigarettes. But his experience persuades him that their benefits outweigh possible risks as a safer alternative to conventional cigarettes.

“They are obviously a healthier alternative to analog cigarettes, and an excellent way to kick the habit,” he said. “It worked for me and my fiancée, and it was almost effortless.”

The nicotine potency of the e-cigarette “juice” that Templin uses has diminished dramatically, he said, as he weans himself. He also uses the device less often.

His fiancée, Linsey Kneisl, rarely uses hers, he said.

Inhaling the vapor is a lot like smoking a cigarette, which makes it an attractive substitute for someone trying to quit, Templin said.

“It’s just like smoking,” he said. “That helps.”

Others have embraced e-cigarettes as less bothersome than secondhand smoke.

Lindzee Morgan of Fargo is not an e-cigarette user, but persuaded her boyfriend, a smoker, to switch to the vapor-emitting alternative.

“I hate cigarette smoke and having to be around it,” she said, “but now I don’t have to worry about it. The e-cigs don’t have a terrible smell and actually some of them smell quite pleasant.”

As for health effects, Morgan said she is much less concerned for herself and her boyfriend “even after reading the numerous articles out there.”

Because e-cigarettes are unregulated, consumers can’t be certain what they contain, regardless of what manufacturers list, said Holly Scott, tobacco prevention coordinator at Fargo Cass Public Health.

Although some e-cigarette juice is billed as nicotine-free, “What guarantee do you have as a consumer that there’s no nicotine?” she asked.

Darius Endres, co-owner of Sports Vape, a vendor of e-cigarettes and juice on South University Drive in Fargo, said regulation is inevitable, including banning the sale to minors and requiring ingredients to be listed.

North Dakota already includes e-cigarettes in its smoke-free law, which prohibits smoking in public buildings. A growing number of cities ban the sale of e-cigarettes or juice to those under 18 and require behind-the-counter sales.

“I am completely done with smoking, Enders said, adding that he uses only nicotine-free juice.

Sports Vape is one of a growing number of e-cigarette sellers in Fargo-Moorhead, reflecting the rapidly growing adoption of the smoking alternative.

Although at least a handful of specialty shops have opened, Scott said most e-cigarettes and juice probably are sold at gas stations and convenience stores, where they are commonly featured alongside tobacco products.

Both Prom and Scott worry that e-cigarettes, with their fruity flavor options and bright packaging, are being marketed to children.

The significant drop in prices also is of concern, said Prom, who noted that the cost of a “starter kit” when look-alike e-cigarettes first appeared on the market was $50 to $100.

Now a bottle of juice that can last a week costs $7, she said.

Anecdotally, both Scott and Prom have received reports that e-cigarettes are being used by schoolchildren around the state.

A check with school administrators in the Fargo, West Fargo, Moorhead and Northern Cass public school districts, however, indicates that no reports have reached the central school offices.

Moorhead has added e-cigarettes to its anti-tobacco policy, and Northern Cass will do so soon, according to school officials. Scott predicts that most school districts will follow.

The claims by e-cigarette proponents that they provide a safe alternative to tobacco echo earlier claims, including filtered and menthol cigarettes, Prom said. Studies later debunked those claims.

Meanwhile, e-cigarette backers say they have studies to show the safety of the products. Those on both sides of the debate agree that science has more work to do to settle the issue.

“We’re actually still probably rounding first base right now as far as the studies go,” Endres said.

http://www.inforum.com/event/article/id/435123/group/homepage/

Are Electronic Cigarettes A Public Good Or A Health Hazard?

BY MICHAEL BLANDING, Forbes

When electronic cigarettes first appeared a little over a decade ago, they were hailed by public health advocates-as well as some smokers-as a godsend: a tool to help smokers quit while mitigating the most harmful effects of tobacco. “The [e-cigarette] market is producing, at no cost to the taxpayer, an emerging triumph of public health,” one health advocate said.

Consisting of a small barrel-shaped design that mimics an actual cigarette, the devices vaporize a liquid nicotine solution, which is then inhaled without the tar and carcinogens found in smoke. Powered by a battery and controlled with a microchip, users can adjust the amount of nicotine they inhale, gradually weaning themselves off of their addiction if they choose.
“The value proposition of e-cigarettes is clear,” saysJohn A. Quelch, Charles Edward Wilson Professor of Business Administration at Harvard Business School. “They provide the dubious pleasure of nicotine without all the cancer-inducing toxins associated with tobacco.”
Very quickly, however, enthusiasm faded, when some public health advocates began worrying that the cure was worse than the disease.
The very fact users could control the amount of nicotine they ingested led to worry that e-cigarettes would cause smokers to take in more nicotine, rather than less. Even more worrisome, “eCigs” could provide a gateway for young people to start smoking tobacco cigarettes, or even lure ex-smokers back to the habit.

Electronic Cigarette Smoking(Photo credit: planetc1) 

This has created a dilemma for health regulators, says Quelch. Do they regulate e-cigarettes in order to decrease the number of new smokers who may pick up the habit, or do they apply a light hand in order to increase the number of existing smokers who will quit.
“Put crudely,” says Quelch, “how many nicotine addicts is it worth the risk of creating to have one tobacco smoker quit?”

That is one of the many dilemmas Quelch explores in the HBS case, E-Cigarettes: Marketing Versus Public Health, written with HBS Research Associate Margaret L. Rodriguez. It examines the consequences of the products as they have become more popular — and as the big tobacco companies have gotten in on the game. Quelch, who holds a joint appointment at HBS and Harvard School of Public Health, wrote the case for a new course debuting next year called “Consumers, Corporations, and Public Health,” which will enroll both MBA and MPH students to consider the intersections of business and health.
“One of the themes in the course is the tension that exists, quite understandably, between regulators and commercial interests,” says Quelch. “Most people are used to hearing about that in the context of financial regulation, but similar issues apply in other sectors of the economy including health care.”
In the case of electronic cigarettes, existing evidence indicates that they have led to a net decrease in smoking. Of the 43.8 million smokers in the United States in 2012, 3.5 million converted to eCigs; during the same period only 1.3 million eCig smokers converted to tobacco. That means a net decrease of cigarette smokers of 2.2 million, or 5%.
At the same time, 2.8 million nonsmokers converted to electronic smokes. But even that doesn’t tell the whole story, says Quelch, since it leaves out the number of smokers who would have taken up smoking tobacco if e-cigarettes didn’t exist, as well as the number of smokers who would have quit cold turkey without the availability of electronic products. “To really determine the public health impact of e-cigarettes requires a lot of sophisticated market research and analysis,” says Quelch.
A Smoking Market

Uncertainty over health data hasn’t hurt the product’s popularity. In 2013, electronic cigarettes tripled in sales in the U.S. to approximately $3 billion. (The overall tobacco retail market in the US is valued at around $100 billion.) Almost 10% of high school students have tried them, according to the Centers for Disease Control, and a growing percentage of middle school students are joining the parade. In 2012, Goldman Sachs declared electronic cigarettes one of the top 10 disruptive technologies to watch.
Like most disruptive technologies, electronic cigarettes were developed by small entrepreneurs with brand names like Logic eCig (founded 2010), Blu (2009) and NJOY (2006). By 2013, according to the case study, the e-cigarette category featured more than 200 brands and their growth was threatening sales of tobacco cigarettes.
“If I am a tobacco manufacturer seeing my sales cannibalized by e-cigarettes, I have two choices: develop my own e-cigarette brand or buy an e-cigarette company,” says Quelch.
Number three tobacco company Lorillard LO -2.47%was the first to blink, buying up Blu in 2012 for $135 million and aggressively pushing them at convenience store counters. “Distribution of Blu immediately increased by a factor of three,” says Quelch. Other top manufacturers Phillip Morris and Altria followed suit, acquiring their own brands and using their shelf-space clout to increase visibility of the alternative products.
The growing sales of electronic cigarettes also caught the attention of regulators. The products had been completely unregulated–they could be advertised on TV and sold to buyers of any age on the Internet. But once the major tobacco brands began acquiring e-cigarette makers and displaying those products alongside their mainstay cigarettes, regulators took particular notice.
Public health advocates and parents alike worried about the variety of flavors, including cotton candy, that might make “vapes” attractive to children. Some states and cities responded with restrictions on sales and advertising, and, in April, the Financial Times reported that the World Health Organization will call for e-cigarettes to be regulated just like tobacco cigarettes. The US Food and Drug Administration, under mounting pressure to act, plans to offer marketing and product regulations for electronic cigarettes in the near future.
Ironically, if regulation does go forward, it might help the major tobacco companies, by limiting the marketing playbook of the competitors that were cannibalizing sales of their products.
“Altria or Phillip Morris know how to deal with regulators,” says Quelch, “but with all those entrepreneurs coming out with flavors and advertising, they would no longer be able to get traction in their business.”

Tobacco Companies Take Control 
Quelch predicts the big three tobacco companies will gain control of the eCigs market and then undermarket their electronic products in order to retain market share for their more profitable tobacco cigarettes. “Cigarette companies will manage the marketing of e-cigarette brands to maximize profitability for their shareholders,” says Quelch. “Meaning they’ll be able to manipulate prices in order to control the speed with which tobacco users migrate to e-cigarette brands.”
That means that electronic cigarettes, which are now significantly cheaper on a smoke-per-smoke basis than heavily taxed tobacco competitors, will probably start climbing in price and eventually become equal to tobacco brands. That could create an even bigger windfall for Phillip Morris, Altria, and Lorillard. Even if eCigs are regulated like regular cigarettes, they probably won’t be taxed like regular cigarettes, since the tax is on tobacco, not nicotine (and doesn’t apply, for example, to nicotine gum or nicotine patches)-and any new taxes are a nonstarter these days in Congress.
By pricing electronic and tobacco cigarettes to sell similarly at retail, the tobacco companies could reap enormous profits, concludes Quelch-at the same time giving them cover against criticism by allowing them to point to “healthier alternatives” in their product portfolios.
When entrepreneurs first created e-cigarettes and marketed them as a way to quit smoking, they probably didn’t intend to eventually pad the bottom line of mainstream big tobacco companies. But playing out the scenario to the end, that is exactly what may happen-and all in the absence of any definitive data showing whether e-cigarettes are more or less harmful to public health than tobacco smokes.
By pointing out such dichotomies and unintended consequences, Quelch hopes he can motivate MBA students to think more deeply about the public health impacts of business decisions-as well as getting MPH students to think about the business forces that shape public health. Only then will decisions be made that properly balance the greatest good of the public with the ability for entrepreneurs to turn a profit.

Higher taxes on cigarettes make good sense

Washington Post Editorial Board
Maryland has one of the highest state-imposed cigarette tax rates in the nation ($2 per pack) and, unsurprisingly, one of the lowest smoking rates. Virginia has one of the lowest cigarette tax rates in the nation (30 cents per pack); its smoking rate is almost 20 percent higher than Maryland’s.
America is well past the debate about the health effects of smoking, but tobacco taxes in many states remain low, thanks largely to the influence of tobacco companies. Yet it is clear that higher cigarette taxes have a direct effect on smoking rates, and they are particularly effective in dissuading young people from taking up the habit.
In Maryland, where the tax on a pack of cigarettes was raised in 1999 (to 36 cents), 2002 (to $1) and 2008 (to the current rate of $2), smoking rates have fallen by about a third, much faster than the national average. At the time of the last increase, Maryland’s tobacco tax was 6th-highest in the nation; since then it has slipped to 12th as other states have leapfrogged each other in an effort to further discourage smoking — and raise revenue in the process.
In Annapolis, public health advocates and other groups are now pushing for another $1 increase, which would bump the state tax in Maryland to $3 per pack. Depending on how much of the increase tobacco companies decide to absorb, that could raise the average retail price of cigarettes above $7; it’s currently around $6.40.
The projected benefits of a $1 increase in Maryland make a persuasive case. They include $95 million in additional revenue (which health advocates would like to use to extend Medicaid health coverage to the poor); a 10 percent decrease in the rate of youth smoking; thousands of adults who would be persuaded to quit; and the prevention of thousands of premature deaths, which in turn would produce considerable economic benefits.
It’s true that raising the tax would cause more Marylanders to cross the border to buy cigarettes in Virginia or North Carolina. But cigarette sales fell much more dramatically in 2008 in Maryland, the District and Delaware, all of which raised their tobacco taxes that year, than they rose in Pennsylvania, West Virginia and Virginia, which did not. And while cigarette smuggling remains an unquantifiable challenge, declining smoking rates and the associated public health payoffs are real.
Legislation to raise the tax went nowhere in Annapolis this year, possibly because the state has raised so many other taxes in the last few years. Advocates are mounting a push to gather pledges of support from lawmakers to enact the increase next year.
Meanwhile, in Virginia, where the tobacco lobby remains virtually unchallenged, the average price of a pack of cigarettes, about $4.60, is among the lowest in the nation. If Virginia lawmakers want to encourage children to take up the habit, they’re doing a great job.
http://www.washingtonpost.com/opinions/higher-taxes-on-cigarettes-make-good-sense/2014/04/20/aa90bd08-c716-11e3-9f37-7ce307c56815_story.html

Do e-cigarettes help smokers quit?

By Deborah Kotz  | THE BOSTON GLOBE STAFF

Electronic cigarettes are certainly trendy — look no further than the Vapefest in the nation’s capital last week — but whether inhaling nicotine vapors actually helps smokers quit traditional cigarettes remains a subject of fierce debate.
A new study is bound to add fuel to the fire. Researchers followed nearly 1,000 smokers for a year and found that those who used e-cigarettes were no more likely to quit smoking or reduce their dependence on tobacco cigarettes than those who weren’t using the products at the beginning of the study. About 14 percent of those who didn’t use e-cigarettes quit smoking compared to 10 percent of those used the products.
But the research, published last Monday in the journal JAMA Internal Medicine, raises more questions than it answers because only 88 of the 949 smokers in the study reported using e-cigarettes.
That small sample size makes it difficult to draw firm conclusions, admits study leader Dr. Pamela Ling, an associate professor of medicine at University of California, San Francisco. “We also looked at a broad population of smokers,” she said, “not just those who were specifically interested in quitting.”
In fact, only 8 percent of e-cigarette users reported that they were trying to quit when they were surveyed, and only 40 percent had any intention of quitting in the next six months.
“This means that we actually know for a fact that the majority of e-cigarette users in this study were not using these products as part of a quit attempt,” Dr. Michael Siegel, a tobacco control researcher at Boston University School of Public Health, wrote in a post on his blog. “Rather, it is a deliberate attempt on the part of the investigators to misuse data.”
Setting those fighting words aside, the study highlights the lack of evidence to determine whether e-cigarettes are a good smoking cessation aid — even though some smokers swear by them for helping them ease off their habit.
Only one clinical trial compared e-cigarettes with nicotine patches to help smokers quit, Ling said, and it found that both were about equally effective — or rather, equally ineffective since neither worked particularly well. Only 5 to 7 percent of the smokers in the study were able to completely stop lighting up regardless of which method they used.
“Although there are no data showing that e-cigarette use helps with cessation, there is potential harm,” wrote Dr. Mitchell Katz, the deputy editor of JAMA Internal Medicine in an editorial that accompanied the new study.
The products — which contain nicotine in liquid form mixed with flavorings, colorings, and various chemicals — remain unregulated, though the US Food and Drug Administration might move this year to put them under the same rules as other tobacco products. Even more concerning are recent modifications that have turned once disposable e-cigarettes into larger, reusable gadgets that users fill with highly potent liquid nicotine. Such handling can be very hazardous since liquid nicotine can be toxic if applied to the skin or ingested, according to an article in The New York Times.
Last year, the American Association of Poison Control Centers received 1,414 calls regarding accidental exposures and poisoning linked to liquid nicotine or e-cigarette devices — a 300 percent increase from 2012. Poison control centers have already received 651 calls through March 24 of this year and urged parents last week to keep the devices and liquid nicotine away from children. Whether vaping poses health risks remains unknown, though that hasn’t stopped e-cigarette makers from proclaiming that the product provides the “freedom to have a cigarette without the guilt,” as actress Jenny McCarthy states on the blu eCigs website.
In a study published earlier this month, Ling and her colleagues reviewed 59 websites selling e-cigarette products and found that 95 percent of them made health-related claims: more than half claimed the product helped with smoking cessation, and three-quarters claimed the product does not produce secondhand smoke. (It does, though, produce vapor that others can inhale and which may pose health risks to bystanders.)
Some manufacturers claimed on websites that their products were toxin free and didn’t contain the kinds of cancer-causing chemicals found in tar-ridden cigarettes. That’s something that requires more study to determine.
“Right now, we have an unusual situation with a product allowed on the market that’s making health and smoking cessation claims,” Ling said, “and manufacturers shouldn’t be allowed to make those claims without the science to support them.”
http://www.bostonglobe.com/lifestyle/health-wellness/2014/03/30/cigarettes-help-smokers-quit/yzMFrfhjw3ZqKbjHP2vMTL/story.html

Study Looking To See If E-Cigs Curb Smoking Habits

WCCO, CBS Minnesota
MINNEAPOLIS (WCCO) – A new study is looking into whether or not electronic cigarettes are an effective way to stop, or cut back on smoking as many smokers turn to them as an alternative.
E-cigarettes turn a liquid solution into a vapor, and some contain nicotine.
Researchers at the University of California, San Francisco followed nearly 1,000 smokers for a year. During which time they found no link between e-cigarettes and quitting, or cutting down on smoking.
“There was no association between having tried an e-cigarette and using an e-cigarette and quitting smoking at one year follow up,” Dr. Rachel Grana of the UCSF said.
The study also found that women are more likely to use e-cigarettes than men.
The Tobacco Vapor Electronic Cigarette Association is criticizing the study for its limited data.
http://minnesota.cbslocal.com/2014/03/24/study-looking-to-see-if-e-cigs-curb-smoking-habits/

5 Things to Know About E-Cigarettes

By , ABC News

Los Angeles is the latest city to outlaw e-cigarette smoking in some public places.

The L.A. City Council voted 14-0 in favor of the “vaping” ban, following in the footsteps of New York City and Chicago.

E-Cigarette Health Row Catches Fire

The electronic cigarette was invented in the 1960s, but it didn’t really take off until a decade ago. The Tobacco Vapor Electronic Cigarette Association now estimates that roughly 4 million Americans use the battery-powered cigs.

Here’s a look at the e-smoke trend: the good, the bad and the unknown.

What are e-cigarettes?

E-cigarettes are battery operated nicotine inhalers that consist of a rechargeable lithium battery, a cartridge called a cartomizer and an LED that lights up at the end when you puff on the e-cigarette to simulate the burn of a tobacco cigarette. The cartomizer is filled with an e-liquid that typically contains the chemical propylene glycol along with nicotine, flavoring and other additives.

The device works much like a miniature version of the smoke machines that operate behind rock bands. When you “vape” — that’s the term for puffing on an e-cig — a heating element boils the e-liquid until it produces a vapor. A device creates the same amount of vapor no matter how hard you puff until the battery or e-liquid runs down.

How much do they cost?

Starter kits usually run between $30 and $100. The estimated cost of replacement cartridges is about $600, compared with the more than $1,000 a year it costs to feed a pack-a-day tobacco cigarette habit, according to the Tobacco Vapor Electronic Cigarette Association. Discount coupons and promotional codes are available online.

Are e-cigarettes regulated?

The decision in a 2011 federal court case gives the Food and Drug Administration the authority to regulate e-smokes under existing tobacco laws rather than as a medication or medical device, presumably because they deliver nicotine, which is derived from tobacco. The agency has hinted it will begin to regulate e-smokes as soon as this year but so far, the only action the agency has taken is issuing a letter in 2010 to electronic cigarette distributors warning them to cease making various unsubstantiated marketing claims.

For now, the devices remain uncontrolled by any governmental agency, a fact that worries experts like Erika Seward, the assistant vice president of national advocacy for the American Lung Association.

“With e-cigarettes, we see a new product within the same industry — tobacco — using the same old tactics to glamorize their products,” she said. “They use candy and fruit flavors to hook kids, they make implied health claims to encourage smokers to switch to their product instead of quitting all together, and they sponsor research to use that as a front for their claims.”

Thomas Kiklas, co-owner of e-cigarette maker inLife and co-founder of the Tobacco Vapor Electronic Cigarette Association, countered that the device performs the same essential function as a tobacco cigarette but with far fewer toxins. He said he would welcome any independent study of the products to prove how safe they are compared to traditional smokes.

The number of e-smokers is expected to quadruple in the next few years as smokers move away from the centuries old tobacco cigarette so there is certainly no lack of subjects,” he said.

What are the health risks of vaping?

The jury is out. The phenomenon of vaping is so new that science has barely had a chance to catch up on questions of safety, but some initial small studies have begun to highlight the pros and cons.

The most widely publicized study into the safety of e-cigarettes was done when researchers analyzed two leading brands and concluded the devices did contain trace elements of hazardous compounds, including a chemical which is the main ingredient found in antifreeze. But Kiklas, whose brand of e-cigarettes were not included in the study, pointed out that the FDA report found nine contaminates versus the 11,000 contained in a tobacco cigarette and noted that the level of toxicity was shown to be far lower than those of tobacco cigarettes.

However, Seward said because e-cigarettes remain unregulated, it’s impossible to draw conclusions about all the brands based on an analysis of two.

“To say they are all safe because a few have been shown to contain fewer toxins is troubling,” she said. “We also don’t know how harmful trace levels can be.”

Thomas Glynn, the director of science and trends at the American Cancer Society, said there were always risks when one inhaled anything other than fresh, clean air, but he said there was a great likelihood that e-cigarettes would prove considerably less harmful than traditional smokes, at least in the short term.

“As for long-term effects, we don’t know what happens when you breathe the vapor into the lungs regularly,” Glynn said. “No one knows the answer to that.”

Do e-cigarettes help tobacco smokers quit?

Because they preserve the hand-to-mouth ritual of smoking, Kiklas said e-cigarettes might help transform a smoker’s harmful tobacco habits to a potentially less harmful e-smoking habit. As of yet, though, little evidence exists to support this theory.

In a first of its kind study published last week in the medical journal Lancet, researchers compared e-cigarettes to nicotine patches and other smoking cessation methods and found them statistically comparable in helping smokers quit over a six-month period. For this reason, Glynn said he viewed the devices as promising though probably no magic bullet. For now, FDA regulations forbid e-cigarette marketers from touting their devices as a way to kick the habit.

Seward said many of her worries center on e-cigarettes being a gateway to smoking, given that many popular brands come in flavors and colors that seem designed to appeal to a younger generation of smokers.

“We’re concerned about the potential for kids to start a lifetime of nicotine use by starting with e-cigarettes,” she said.

Though the National Association of Attorneys General today called on the FDA to immediately regulate the sale and advertising of electronic cigarettes, there were no federal age restrictions to prevent kids from obtaining e-cigarettes. Most e-cigarette companies voluntarily do not sell to minors yet vaping among young people is on the rise.

A Centers for Disease Control and Prevention study found nearly 1.8 million young people had tried e-cigarettes and the number of U.S. middle and high school students e-smokers doubled between 2011 and 2012.

A version of this story previously ran on ABCNews.com.

http://abcnews.go.com/Health/things-cigarettes/story?id=22782568#5

ACS CAN: President Renews Call for Stronger Tobacco Control in FY 15 Budget Proposal

WASHINGTON, D.C. – March 4, 2014 – President Obama today unveiled an FY15 budget proposal that prioritizes tobacco control with an increase in the federal tobacco tax, emphasizes the importance of primary care with an investment in workforce training for new doctors and signals his ongoing support for increased investment in medical research.
A statement from Chris Hansen, president of the American Cancer Society Cancer Action Network (ACS CAN), follows:
“The president’s budget proposal shows that he remains committed to increasing the federal cigarette tax by an unprecedented 94 cents, which would save lives and reduce long-term health care costs. Increasing tobacco taxes is one of the most effective ways to keep kids from smoking and encourage people to quit. ACS CAN estimates that nearly doubling the federal cigarette tax would prevent about 493,000 children from premature death, reduce the number of adult smokers by 2.6 million over 10 years and lower health care costs by $55 billion.
“ACS CAN applauds the President’s proposal to invest more than $14.6 billion to expand and train the nation’s healthcare workforce – and investment that is vital to our ability to emphasize prevention and wellness in the health care system.  This proposal builds upon the efforts included in the health care law and will further help cancer patients and their families, especially those in rural and underserved areas, to get the health care they need.
“We are disappointed that the president’s proposal reduces funding for critical breast, cervical and colorectal cancer screenings, offered through the Centers for Disease Control and Prevention to low-income and uninsured. While the Affordable Care Act makes strides in improving access to these proven prevention measures than can help to detect cancer at its earliest most treatable stages, millions of people will still need access to these critical programs in coming years.
“We are pleased that the budget proposal increases funding for medical research at the National Institutes of Health, but disappointed that the National Cancer Institute would receive only a nominal increase under the President’s budget.  We hope that cancer research will be prioritized as details emerge about the proposed $970 million in supplemental funding for the NIH. Investment in cancer-specific research and proven cancer screening programs for low-income and uninsured are essential to eliminating death and suffering from a disease that will kill an estimated 585,000 people in America and cost the economy $216 billion this year.”
ACS CAN, the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society, supports evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem. ACS CAN works to encourage elected officials and candidates to make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer with the training and tools they need to make their voices heard. For more information, visit www.acscan.org.

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