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Letter: Support e-cigarette age restrictions

House Bill 1265 would require e-vapor products (commonly referred to as e-cigarettes) to be sold only to adults 18 years of age and above, an important goal that we should all agree on. We support enactment of underage access prevention for e-vapors and alternative nicotine products, which is why we support House Bill 1265.
This bill includes broad definitions to ensure that these new product forms are included in North Dakota’s existing underage access prevention laws.
Products that contain nicotine, whether they are traditional tobacco products like cigarettes, cigars or smokeless tobacco or new e-vapor products, are for adults only. We don’t believe people who are under legal age should be purchasing these products. Currently, 41 states prohibit sale of e-vapor products to minors.
The bill would also establish statewide policy regarding sales of these new types of products such as e-vapor. This bill would provide uniform policy for e-vapor and alternative nicotine product sales across North Dakota and avoid a patchwork of differing local restrictions or ordinances that could cause confusion among adult consumers and retailers.
That’s why we support this legislation to help ensure that e-vapor products are only available to adult consumers and to support retailers in having uniform state standards for tobacco and alternative nicotine product sales to continue to help address underage access to all types of products that contain nicotine.
Let’s do the right thing and pass House Bill 1265. It’s the responsible approach that will help make these products only available to adults and out of kids’ hands.
Woodmansee is with the North Dakota Grocers Association.
http://www.inforum.com/letters/3684232-letter-support-e-cigarette-age-restrictions

Valley City considering restrictions on e-cigarette sales; proposal would require licensing

THE ASSOCIATED PRESS
VALLEY CITY, North Dakota — Officials in Valley City are considering measures that would restrict the sales of e-cigarettes in the city.
The Valley City Times-Record reports the ordinances could ban the sale of e-cigarettes to minors as well as the self-service sales of e-cigarettes. They would also require local licensing for sellers of e-cigarettes.
Members of the City County Board of Health say they want an ordinance that would not allow flavored e-cigarettes, in liquid nicotine or any other form, to be sold to anyone in Valley City.
Tobacco prevention coordinator Vicki Roseneau says “flavors are aimed at enticing youth to buy” e-cigarettes.
Thirteen businesses currently sale tobacco products in Valley City.
http://www.dailyjournal.net/view/story/6b8c1cd5f84948b39918751389336537/ND–Smoking-Ordinances-Valley-City/

OFFICIALS DECLARE E-CIGARETTES A HEALTH THREAT FOR CALIFORNIA

 

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.

What to Know About the Science of E-Cigarettes

 

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/
 

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

Salt Lake County health study reveals big problem with inaccurate e-liquid labeling

By , Deseret News
SALT LAKE CITY — An increase in emergency room visits and calls to the local poison control hotline has Salt Lake County Health Department officials concerned about e-liquid used in battery-operated electronic cigarettes.
“You really have to treat it as a drug because it is fatal to a small child,” said Kathy Garrett, tobacco prevention and cessation manager for the Salt Lake County Health Department.
The health department, Garrett said, is encouraging users to put e-cigarettes and the “enticing candy-flavored cartridges” out of the reach of young people.
It is also seeking to pass new regulations to keep manufacturers in check.
“E-liquid is a serious poisoning threat to children,” Garrett said, adding that the United States Food and Drug Administration does not regulate e-liquid manufacturing at all. “If they drink enough of it, it can be fatal to small children.”
The Salt Lake County Health Department recently concluded its own study, where undercover workers visited all 14 vape shops and 16 of the 80 tobacco specialty stores in the county to purchase a variety of e-liquid cartridges for testing at the Center for Human Toxicology at the University of Utah.
Health officials found that 61 percent of the e-liquid cartridges collected strayed at least 10 percent from what was indicated on the labels, with either more or less nicotine content than expected.
Garrett said even the samples that listed no nicotine content had trace amounts, and at least one variety had 7.35 miligrams per milliliter.
1467294“Both specialty stores and vape shops are inconsistent with their labeling,” she said. “These findings support the need for local policy that requires licensing for the manufacturing of e-liquid, and also we’d like to regulate the sale of e-cigarettes to ensure safety standards that include accurate labeling and ingredients with nicotine levels.”
The Utah Legislature has yet to pass legislation that would govern any part of the surging electronic cigarette industry in the state, and the federal government is just beginning to assess the issues surrounding production and sales.
Last year, the number of adults using e-cigarettes topped 40 million nationwide, an increase of more than 620 percent over the previous year. The number of children and teens who use them is on the rise as well, health officials said.
The Utah Department of Health reports that 4.8 percent of adults and 5.8 percent of teens routinely use the nicotine vapor product, according to 2013 data, the latest available. The rate of regular e-cigarette use in Utah more than doubled from 2012 to 2013, and it tripled among Utah students from 2011 to 2013.
Without state or federal laws to govern e-cigarette and e-liquid production and sales, local jurisdictions have taken it upon themselves to protect Utahns, and Garrett said Salt Lake County will be the next to enact a policy.
She expects the board to vote on something as early as next month. If a policy is adopted, the health department would be responsible for enforcing it through random inspections and monitoring of local manufacturing activity.
Garrett said there are several manufacturers in the valley that the health department would love to keep its eye on to make sure they’re following the rules.
“Inaccurate labeling is alarming because consumers don’t know exactly what they’re taking into their bodies or at what level,” she said. “It’s also a real concern for poison control and emergency room staff, who don’t know if the labeled amount of nicotine in a bottle a child has ingested is accurate.”
Nicotine in e-liquids was to blame for 131 calls to theUtah Poison Control Center in 2014, according to the health department.
Health officials also reviewed the availability of child-proof lids for e-liquid cartridges and found that more than a quarter of the samples containing a listed amount of nicotine did not have safety caps.
There are 12 local health departments in the state, and at least Davis, Weber and Utah counties have adopted regulations, while Summit County has an ordinance, but Garrett said most if not all departments would be on board for statewide legislation, which may be presented in the upcoming session of the Utah Legislature.
In the meantime, Garrett said, “if you have e-cigarettes of e-juice lying around, lock it up where a child can’t get into it. Just like any medication, you should lock it up and keep it out of reach.”
http://www.deseretnews.com/article/865619211/Salt-Lake-County-health-study-reveals-big-problem-with-inaccurate-e-liquid-labeling.html?pg=all

Forum editorial: Close off e-cig sales to minors

Fargo Forum Editorial

The Legislature should follow the lead of several North Dakota cities and ban the sale of e-cigarettes to minors. As it stands now, even with sales bans in Fargo, Bismarck, Casselton, Mapleton and other cities, e-cigs can be (and likely are being) sold to minors all over the state. It’s a gaping loophole in a state law that in every other way treats e-cigs like tobacco products.

E-cigs are touted as an effective option for tobacco users to get off cigarettes, although the research is inconclusive. But they also appeal to kids because they are used by some minors for “vaping,” which kids think is “cool,” according to public health experts. E-cigs don’t contain tobacco, but they can be nicotine delivery devices. Often the substances in e-cigs include candy flavors. There is little doubt the products are aimed at adolescents, according to new research. And kids are taking them up at alarming rates.

That being said, e-cig sellers in Fargo insist it is against company policy to sell to anyone under age 18, no matter what a state’s law or city’s ordinances allow or prohibit. In fact, e-cig retailers say they want a state law that bans sales to minors, and will work with legislators in the upcoming session.

While the retailers’ public attitude is good news, questions remain. Where are kids getting e-cigs? Why is use up among minors? Who is policing what?

Most troubling: There is no question e-cigs are a gateway to smoking among teens. New studies indicate that as more minors try e-cigs (up in several states), chances increase that they will try tobacco and get hooked. Nicotine, whether in an e-cig or a cigarette, is addictive. It should come as no surprise that big tobacco companies are in the e-cig business.

The state of North Dakota, with what appears to be support from e-cig sellers, should close the sales-to-minors loophole. Without informed and firm action, e-cigs could erode the progress that’s been made to reduce tobacco use in the 50 years since the first surgeon general’s report revealed the health risks of smoking.

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

http://www.inforum.com/opinion/3637026-forum-editorial-close-e-cig-sales-minors

USA Today – Our View: E-cigarettes cloud progress on teen smoking

USA Today Editorial Board

E-cigarettes, once seen as a harmless alternative to tobacco smoking, are beginning to look more like a new gateway to addiction.

This year, for the first time, more teens used electronic cigarettes than traditional ones: 17% of high school seniors used the devices, vs. 14% who smoked cigarettes. Kids in eighth and 10th grades favored them 2-to-1 over traditional smokes, according to an eye-opening University of Michigan survey released Tuesday.

In one sense, there is good news. Teen smoking hit a record low last year after a steady decline since the late 1990s, leaving fewer teens vulnerable to the risk of cancer, heart disease and emphysema that comes with tobacco use. But e-cigarettes are a troubling alternative.

Just as scientists didn’t grasp the danger of tobacco when the nation was becoming addicted, they don’t fully understand the risks posed by e-cigarettes now.

One is obvious: addiction.

E-cigs, battery-powered nicotine inhalers that produce a vapor cloud, could be every bit as addictive as tobacco. With sales skyrocketing to $754 million, 30 times five-year-ago levels, and tobacco giants Altria and Reynolds entering the business, millions of people are getting hooked.

This is particularly a problem during the teen years because that is when nearly all smokers pick up their habit.

For manufacturers, the logic is inescapable: Addict a teenager and you could have a customer for life; miss the moment and you have no customer at all. So in ways subtle and not so subtle, e-cigarette makers have applied Big Tobacco’s advertising and marketing practices.

One prominent tactic is their use of celebrities — including former Playboy centerfold Jenny McCarthy, singer Courtney Love, actor Stephen Dorff and teen heartthrob Robert Pattinson of Twilight fame — to make “vaping” look sexy and rebellious.

No one knows how dangerous this is because with federal oversight missing, no one knows exactly what’s in the devices, some made in China. A Japanese study found hazardous substances in the vapor at higher levels than in cigarette smoke.

There are obvious ways to address the problem, starting with attention from the newly confirmed surgeon general, Vivek Murthy, and analysis by the Food and Drug Administration of e-cigarette content. Both worked with tobacco but could be thwarted by a Congress rigidly opposed to regulation.

Alternatively, states could fill the breach. Nearly a dozen still allow e-cigarette sales to minors when they plainly should not. They could also use the 1998 tobacco settlement negotiated with the industry long before e-cigarettes existed. The accord defines covered products in a way that includes e-cigarettes, because nicotine is derived from tobacco.

By invoking the settlement, state attorneys general would be able to clamp down on marketing that’s targeted at youth, including certain celebrity promotions, concert sponsorships and access to free samples.

After a decades-long battle against youth smoking, it would be tragic to see a new generation of teens hooked on a different but potentially dangerous substitute.

USA TODAY’s editorial opinions are decided by its Editorial Board, separate from the news staff. Most editorials are coupled with an opposing view — a unique USA TODAY feature.

http://www.usatoday.com/story/opinion/2014/12/16/e-cigarettes-teen-smoking-university-of-michigan-editorials-debates/20485297/

Our View: Do more to keep e-cigs, youths apart

The Times Editorial Board, SC Times

Surveys of Minnesota and U.S. youth show alarming increase in e-cigarette use. Lawmakers can slow this increase by immediately acting to limit access.

Two surveys released the past week — one state and one national — deliver a powerful message about the most pressing issue regarding e-cigarettes:
Government needs to lead a stronger charge to keep them out of the hands — and bodies — of minors.
To this point, most of the e-cigarette debate has been about whether e-cigarettes — which electronically convert liquid nicotine into vapor to be inhaled — are as harmful as traditional tobacco and secondhand smoke.
That debate has raged for years, even decades. A resolution seems months, or more likely, years away.
What’s more pressing to resolve — as evidenced by two surveys of youths’ nicotine use — is slowing the fast-rising number of minors who are trying these devices.
How fast?
The 2014 Minnesota Youth Tobacco Survey released Monday found 28 percent of high school students have tried e-cigarettes. On Thursday, the Centers for Disease Control and Prevention reported 4.5 percent of high school students nationally used e-cigarettes regularly in 2013 — triple the percent from 2011. Equally disturbing: 12 percent of U.S. high school students and 3 percent of middle-schoolers had tried them at least once.
And remember, e-cigarettes have been widely available in America for only about seven years.
Such findings make it clear e-cigarettes hold potential for creating countless new generations with unhealthy and high rates of nicotine addiction.
Hasn’t America learned enough hard lessons from 50 years of tobacco-based nicotine addiction to know it needs to snuff out that potential now instead of waiting for more research?
Ultimately, there is no debate that nicotine is a potent, addictive drug. E-cigarettes are simply a delivery mechanism.
So lawmakers should act now to keep the drug and the delivery system out of the hands of minors.
An easy decision is to enact a federal ban on selling minors e-cigarettes, “e-juice” and related products. Minnesota is one of about 35 states with such bans. However, sales via the Internet still provide youth access.
Another important step is to apply the same rules to the marketing of e-cigarettes that are applied to traditional tobacco.
After all, even a cursory glance at products and advertising makes it clear many producers are targeting youth. Think everything from trendy-looking e-cigarettes (and accessories) to bubble-gum flavored e-juice.
Finally, there is merit in increasing the taxes paid on all e-cigarette products.
Such an approach proved successful in reducing youth use of traditional tobacco. And it might even dissuade adults from nicotine addiction.
Again, too much of the debate about whether and how to regulate e-cigarettes remains focused on comparisons to traditional tobacco.
Seeing how e-cigarettes are gaining traction among youth, the focus needs to shift to keeping these nicotine-delivery devices out of their hands — at least until they are legal adults.
http://www.sctimes.com/story/opinion/2014/11/16/view-keep-e-cigs-youths-apart/19089759/