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Teenage E-Cigarette Use Likely Gateway to Smoking

By Caroline Chen, Bloomberg News
E-cigarettes facing municipal bans and scrutiny by U.S. regulators received a new slap on the wrist from scientists: A report today suggests the devices may be a gateway to old-fashioned, cancer-causing smokes for teens.
Youths who reported ever using an e-cigarette had six times the odds of smoking a traditional cigarette than those who never tried the device, according to a study published today in the journal JAMA Pediatrics. E-cigarette use didn’t stop young smokers from partaking in regular cigarettes as well.
The global market for e-cigarettes may top $5 billion this year, according to Euromonitor International Ltd. estimates. Makers of the devices, including Altria Group Inc. (MO), the largest U.S. tobacco company, market them online and on TV, where traditional tobacco ads are banned, and some have added flavors such as bubble gum to the nicotine vapor that may have extra appeal for youths. That allure is why the U.S. Food and Drug Administration needs to restrict the devices, opponents say.
“The FDA needs to act now,” Vince Willmore, spokesman for the Washington-based Campaign for Tobacco-Free Kids, said in a telephone interview. “We think it’s overdue.”
Concerns about underage use of e-cigarettes were raised last year when the U.S. Centers for Disease Control and Prevention in Atlanta reported that use of the devices by youths doubled in 2012 from a year earlier.
“E-cigarettes are likely to be gateway devices for nicotine addiction among youth, opening up a whole new market for tobacco,” said Lauren Dutra, a post-doctoral fellow at the University of California at San Francisco and the report’s lead author. “We’re most worried about nicotine addiction initiation in youth.”

Enticing Product

E-cigarettes “are enticing for kids,” said Donovan Robinson, dean of students at Chicago’s Lincoln Park High School. He said today’s findings weren’t surprising. “They’ll say, ‘Hey, now let’s try the real thing.’”
Children in middle and high school, the target of the research, don’t think about health consequences, he said.
“Everything is a fad with teenagers,” Robinson said. They use e-cigarettes “because it looks cool. Teenagers see somebody doing something cool, and they want to do it.”
The latest research analyzed data from the 2011 and 2012 National Youth Tobacco Survey, conducted by the Centers for Disease Control and Prevention. Almost 40,000 middle and high school students from about 200 schools across the U.S. participated in the survey. Students were asked about their frequency of use of e-cigarettes, conventional cigarettes, cigars, pipes, and other tobacco products.

No Tar

While battery-powered e-cigarettes enable the ingestion of heated nicotine, users avoid the tars, arsenic and other chemicals common in tobacco products that have been linked to cancer, supporters have said.
The study today shows correlation, not causation, said Cynthia Cabrera, executive director of Smoke-Free Alternatives Trade Association, the Washington-based e-cigarette association.
“I’ve yet to see any science that shows there’s a gateway effect,” Cabrera said in a telephone interview. “We want to work with facts and science, we don’t want to make knee-jerk decisions based on emotional responses.”
Cabrera warned against drawing inferences on teen use based on the use of flavors in e-cigarettes.
“We do know that thousands of people were able to switch over to vapor products because of the flavors,” she said in a telephone interview. “Would we deny people who were in a group who could die from tobacco to use flavors that helped them get off killer tobacco?”

Nicotine Effects

Opponents have countered that nicotine alone is so toxic it’s been used in the past as a pesticide. They say the health effects of nicotine, which has proven to be habit forming, are unclear and deserve more study. Until that’s done, they’ve said, advertising of the devices should be closely monitored to make sure it isn’t aimed at underage smokers.
“We’re concerned that the marketing for e-cigarettes risks re-glamorizing smoking” among youths who won’t make the distinction between electronic and conventional cigarettes, Willmore said.
In December, a billboard in Miami used Santa Claus to market e-cigarettes and in the recent Sports Illustrated bathing suit issue there was an ad for one of the devices “right in the middle of a bikini bottom,” he said.
“You couldn’t design an ad more appealing to a teenage boy,” Willmore said.

Pivotal Year

This is expected to a pivotal year for producers of electronic cigarettes, with all major tobacco companies either launching new products or expanding their e-cigarette sales exposure, said Kenneth Shea, a Bloomberg analyst. Altria, Reynolds American Inc. and Lorillard Inc. are all expected to pursue U.S. exposure for their e-cigarettes, while closely held Logic Technology Development LLC and Sottera Inc., the maker of the e-cigarette NJoy, try to keep pace, Shea wrote in a report this month.
While tobacco companies have been under the FDA’s watchful eye since Congress gave the agency authority over the $90 billion industry in 2009, e-cigarettes haven’t been subject to the same oversight. The agency is now in the process of readying new rules for the industry designed to establish clear manufacturing standards and set boundaries for how the products can be marketed.
Federal regulators aren’t the only government officials moving to control use of e-cigarettes. On March 4, the Los Angeles City Council voted to join New York and Chicago in banning the use of the electronic products in in workplaces, restaurants and many public areas.

Bans Criticized

The municipal restrictions were criticized by Miguel Martin, president of Logic Technology, the second-largest independent e-cigarette maker in the U.S. Localities should wait for the FDA to make its views known before taking action, Martin said in an interview before the council vote.
“I find it odd that everybody looks to the FDA for guidance on everything else, but because it’s politically expedient, they don’t on this,” Martin said.
http://www.bloomberg.com/news/2014-03-06/teenage-e-cigarette-use-likely-gateway-to-smoking.html

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

Doctor Wants Lawmakers to Classify E-Cigarettes as Tobacco

By: WILX NEWS 10
Michigan’s top doctor is calling on state lawmakers to classify e-cigarettes as tobacco products. Legislation currently in the Senate would make it a crime to sell the devices to minors. But Dr. Matthew Davis, Chief Medical Executive with the Michigan Department of Community Health says the bi-partisan package of bills doesn’t go far enough.
E-cigarettes are electronic devices that heat up liquid and allow the user to inhale a vapor. Davis says, “What we’re seeing is that kids are trying these in higher and higher numbers and many parents are concerned. We know this from national research, that their kids may get addicted to nicotine and end up using traditional cigarettes down the road.” Republican Senator Rick Jones of Grand Ledge agrees. “We have a problem in this state. Any 10 year-old can go in and buy electronic cigarettes. Some are flavored like root beer, orange, even cheesecake. and children are getting addicted to nicotine.”
Jones has sponsored Senate Bills 667 & 668. The legislation would make it immediately illegal for retailers to sell e-cigarettes to minors. But Davis says, that isn’t good enough. He wants lawmakers to protect everyone from the dangers of e-cigarettes by taxing them, and banning them from restaurants, bars and other public places. Davis says, “After all, liquid in e-cigarettes is extracted from tobacco and so therefore, they are essentially tobacco products . And certainly tobacco-derived products, it would make sense to use the existing regulations that we have about tobacco products and classify e-cigarettes under that existing regulation.” Jones says, he’s more concerned about limiting access to children. “I understand that they want the moon, and they want to be able to tax these devices just like cigarettes but that will have to wait for an FDA decision. Anything the federal government does will override Michigan law so there is no problem.”
While retailers can sell e-cigarettes to anyone, many say they treat them just like cigarettes and don’t sell to minors. Many restaurants also ban the devices. The legislation is now in a Senate committee.
http://www.wilx.com/home/headlines/Doctor-Wants-Lawmakers-to-Classify-E-Cigarettes-as-Tobacco-248439351.html?ref=351

Poll: Minnesotans strongly support prohibiting e-cigarette use indoors

MINNEAPOLIS, Feb. 26, 2014 /PRNewswire/ — A poll released today shows that a strong majority of Minnesotans (79 percent) support prohibiting e-cigarette use indoors in places where smoking is prohibited. Other regulations to prevent youth from using e-cigarettes are also overwhelmingly supported by Minnesotans.
“This new poll shows that a strong majority of Minnesotans – 79 percent – support prohibiting e-cigarette use in indoor public places, including workplaces,” said Janelle Waldock, Director of the Center for Prevention at Blue Cross and Blue Shield of Minnesota. “E-cigarette use threatens our high standard of clean indoor air. Limiting their use the same way we limit conventional cigarettes will protect the clean air that Minnesotans have come to expect and support.”
To continue reading, visit: http://www.digitaljournal.com/pr/1758111#ixzz2uT8Px5H7

Senators look for e-cigarette marketing limits

By MICHAEL FELBERBAUM AP Tobacco Writer
RICHMOND, Va.—Several U.S. senators on Wednesday introduced a bill that would curb electronic cigarette marketing while the fast-growing industry awaits regulation by the Food and Drug Administration.
The bill is co-sponsored by California Sen. Barbara Boxer, Iowa Sen. Tom Harkin, both Democrats, and others. It would ban marketing to children based on standards set by the Federal Trade Commission and allow the agency to work with state attorneys general to enforce the ban on advertising. The battery-powered devices heat a liquid nicotine solution and create vapor that’s inhaled.
Companies vying for a stake in the electronic cigarette business are reviving the decades-old marketing tactics the tobacco industry used to hook generations of Americans on regular smokes. Those tactics, such as running TV commercials and sponsoring race cars and other events, are raising worries that e-cigarette makers could tempt young people to take up something that could prove addictive.
While the FDA plans to set marketing and product regulations for electronic cigarettes in the near future, for now, almost anything goes.
And Harkin said e-cigarette makers are attempting to create “a new generation of nicotine addicts.”
“When it comes to the marketing of e-cigarettes to children and teens, it’s ‘Joe Camel’ all over again,” Harkin said in a statement.
A 2009 law gave the FDA the power to regulate a number of aspects of tobacco marketing and manufacturing, though it cannot ban nicotine or cigarettes outright.
The agency first said it planned to assert authority over e-cigarettes in 2011 but hasn’t yet. The proposed FDA regulation was submitted to the Office of Management and Budget for review in October.
While FDA regulation of these products remains critical, Harkin said the legislation would complement the agency’s oversight.
http://www.twincities.com/nation/ci_25233292/senators-look-e-cigarette-marketing-limits

FDA issues first orders to stop sale, distribution of tobacco products

FDA NEWS RELEASE

For Immediate Release: Feb. 21, 2014 

The U.S. Food and Drug Administration issued orders today to stop the further sale and distribution of four tobacco products currently on the market. The action marks the first time the FDA has used its authority under the Family Smoking Prevention and Tobacco Control Act to order a manufacturer of currently available tobacco products to stop selling and distributing them.
The products – Sutra Bidis Red, Sutra Bidis Menthol, Sutra Bidis Red Cone, and Sutra Bidis Menthol Cone – were found to be not substantially equivalent to tobacco products commercially marketed as of February 15, 2007, also known as predicate products. This means they can no longer be sold or distributed in interstate commerce or imported into the United States.
Bidis are thin, hand-rolled cigarettes filled with tobacco and wrapped in leaves from a tendu tree that are tied with string. The manufacturer, Jash International, did not meet the requirements of the Tobacco Control Act to be able to continue selling these products.
“Historically, tobacco companies controlled which products came on and off the market without any oversight,” said Mitch Zeller, J.D., director of the FDA’s Center for Tobacco Products. “But the Tobacco Control Act gave the FDA, a science-based regulatory agency, the authority to review applications and determine which new tobacco products may be sold and distributed under the law in order to protect public health.”
Under the Tobacco Control Act, regulated products were allowed to stay on the market if companies submitted an application to the FDA by March 22, 2011. The law requires the FDA to review product applications so the agency can decide whether the products are substantially equivalent (SE) to valid predicate products. If a company fails to provide the necessary information to show that their product is SE to a predicate product, the FDA has the authority to declare a product not substantially equivalent, which means that it can no longer be sold or distributed in interstate commerce.
In this case, Jash International did not identify eligible predicate tobacco products as required for the FDA to perform an SE review. Also, the company did not provide information necessary to determine whether the new products had the same characteristics as a predicate product, or had different characteristics but did not raise different questions of public health, the basis used by the FDA to review SE applications for tobacco products.
“Companies have an obligation to comply with the law – in this case, by providing evidence to support an SE application,” said Zeller. “Because the company failed to meet the requirement of the Tobacco Control Act, the FDA’s decision means that, regardless of when the products were manufactured, these four products can no longer be legally imported or sold or distributed through interstate commerce in the United States.”
Existing inventory may be subject to enforcement action, including seizure, without further notice. Companies that continue to sell and distribute these products in the United States may be subject to enforcement actions by the FDA.
With regard to retailers, FDA does not intend to take enforcement action for 30 days on previously purchased products that a retailer has in its inventory.  This policy does not apply to inventory purchased by retailers after the date of the order. FDA has issued draft guidance containing more information on the agency’s enforcement policy for certain tobacco products that the FDA finds not substantially equivalent. It will be open for public comment for 60 days, beginning Tuesday, February 25.
The FDA encourages retailers to contact their supplier or the manufacturer to discuss possible options for the misbranded and adulterated product or products that the retailers have in current inventory.
Consumers and other interested parties can report a potential tobacco-related violation of the Food, Drug & Cosmetic Act, including NSE products that continue to be sold or distributed in the United States, by using the FDA’s Potential Tobacco Product Violation Reporting Form.

For more information:

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

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http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm386707.htm

E-Cigarette Makers Give Public the Finger

Rob Waters, Contributor, Forbes
With Sarah Mittermaier and Lily Swartz
In 1964, smoking was everywhere: on television, on airplanes, in workplaces and movie theatres, college campuses, doctors’ offices, restaurants and bars. In the 50 years since the first Surgeon General’s report on smoking and health was released, smoking has gradually faded to the margins of public life. TheMarlboro man was bounced from the airwaves, comprehensive smoking bans were passed in hundreds of cities and 28 states, and smoking rates were cut almost in half. The struggle to protect the public’s health is far from over—and shocking disparities in tobacco use and exposure to tobacco marketing remain—but we’re now reaping some rewards, with eight million lives saved over the past half-century.
But now a new threat is emerging. The use of e-cigarettes is rising rapidly, with teenagers a key target of marketing efforts. “Vaping” is making smoking acceptable—even cool—once again as the tobacco industry returns to its old ways, putting e-cigarette commercials back on the airwaves for the first time since the 1970s.

Right now, e-cigarettes exist in what tobacco control researcher Stanton Glanz calls a regulatory “Wild West,” with no federal regulation of the manufacturing, marketing and sales of these products. This regulatory vacuum threatens to undo the hard-won victories of the past 50 years in tobacco control.
E-cigarette companies are taking a page right out of Big Tobacco’s old-school playbook: marketing their products with sex appeal, celebrity endorsements, even cartoons. The companies argue that “vaping” is safer than traditional smoking and that may or may not be true—there are far too few studies to back up that claim or refute it. But it’s also a smokescreen.
The tobacco industry is out to hook kids, and it’s working. E-cigarettes come in an array of kid-friendly flavors, from“Cherry Crush” to “Coca Cola.” And unlike conventional cigarettes, e-cigarettes can legally be sold to kids in most US states. Data released last year by the Centers for Disease Control and Prevention showed that e-cigarette use more than doubled among middle and high school students in the previous year. For 20 percent of the middle schoolers, e-cigarettes were their first experience with smoking, raising concerns that e-cigarettes may act as a gateway to the use of other tobacco products.
E-cigarettes also threaten to reintroduce smoking to workplaces, restaurants, bars and other public spaces where hard-fought public health campaigns have succeeded in banning cigarettes. These policies have changed our communities from the ground up, creating new expectations and norms around smoking. The science is still out on whether e-cigarettes threaten non-smokers with toxic exposure, but their use in public legitimizes their use, making them seem acceptable, even Golden Globes-glamorous. We can’t let e-cigarettes undo the hard work tobacco control advocates have achieved over the past 50 years.
Some cities and states are pushing back against e-cigarettes, taking steps to regulate the sale and public use of e-cigarettes. Over the past few months, New York and Chicago city councils voted to regulate e-cigarettes as tobacco products, extending existing smoking bans to cover vaping. The Los Angeles City Council voted unanimously to regulate the sales of e-cigarettes. Boston has banned e-cigarette smoking in workplaces. States such as Utah, New Jersey, and North Dakota ban the use of e-cigarettes in indoor public spaces.
These local and state efforts should be followed—and strengthened—by federal action. Attorneys general from 40 states have called on the Food and Drug Administration to regulate e-cigarettes as tobacco products, a move that would give the FDA the power to impose age restrictions and limit marketing of e-cigarettes. Proposed rules drafted by the agency have not yet been released publicly.
We can’t wait years for scientists to conduct new studies on the health risks of vaping before we take action. We know better than to trust the tobacco industry’s health claims about their products—or to trust the industry with our children’s future. The time for action is now. To paraphrase one anti-cigarette commercial in California: “Some people will say anything to sell (e-) cigarettes.”
http://www.forbes.com/sites/robwaters/2014/01/27/e-cigarette-makers-give-public-the-finger/

Are e-cigarettes dangerous?

By Harold P. Wimmer
Editor’s note: Harold P. Wimmer is the president and CEO of the American Lung Association.
(CNN) — For the makers of electronic cigarettes, today we are living in the Wild West — a lawless frontier where they can say or do whatever they want, no matter what the consequences. They are free to make unsubstantiated therapeutic claims and include myriad chemicals and additives in e-cigarettes.
Big Tobacco desperately needs new nicotine addicts and is up to its old tricks to make sure it gets them. E-cigarettes are being aggressively marketed to children with flavors like Bazooka Bubble Gum, Cap’n Crunch and Cotton Candy. Joe Camel was killed in the 1990s, but cartoon characters are back promoting e-cigarettes.
Many e-cigarettes look like Marlboro or Camel cigarettes. Like their old-Hollywood counterparts, glamorous and attractive celebrities are appearing on TV promoting specific e-cigarette brands. Free samples are even being handed out on street corners.

A report from the Centers for Disease Control and Prevention shows the promotion of e-cigarettes is reaching our children with alarming success. In just one year, e-cigarette use doubled among high school and middle school students, and 1 in 10 high school students have used an e-cigarette. Altogether, 1.78 million middle and high school students nationwide use e-cigarettes.

The three largest cigarette companies are all selling e-cigarettes. Because tobacco use kills more than 400,000 people each year and thousands more successfully quit, the industry needs to attract and addict thousands of children each day, as well as keep adults dependent to maintain its huge profits.
Nicotine is a highly addictive substance, whether delivered in a conventional cigarette or their electronic counterparts. The potential harm from exposure to secondhand emissions from e-cigarettes is unknown. Two initial studies have found formaldehyde, benzene and tobacco-specific nitrosamines (a well-known carcinogen) coming from those secondhand emissions. We commend New York City recently for banning the use of e-cigarettes indoors.
No e-cigarette has been approved by the FDA as a safe and effective product to help people quit smoking. Yet many companies are making claims that e-cigarettes help smokers quit. When smokers are ready to quit, they should call 1-800-QUIT NOW or talk with their doctors about using one of the seven FDA-approved medications proven to be safe and effective in helping smokers quit.
According to one study, there are 250 different e-cigarette brands for sale in the U.S. today. With so many brands, there is likely to be wide variation in the chemicals — intended and unintended — that each contain.
In 2009, lab tests conducted by the FDA found detectable levels of toxic cancer-causing chemicals — including an ingredient used in anti-freeze — in two leading brands of e-cigarettes and 18 various e-cigarette cartridges.
There is no safe form of tobacco. Right now, the public health and medical community or consumers have no way of knowing what chemicals are contained in an e-cigarette or what the short and long term health implications might be.
Commonsense regulation of e-cigarettes by the U.S. Food and Drug Administration is urgently needed. In the absence of meaningful oversight, the tobacco industry has free rein to promote their products as “safe” without any proof.
A proposal to regulate e-cigarettes and other tobacco products has been under review at the White House Office of Management and Budget since October 1, 2013. The Obama administration must move forward with these rules to protect the health of everyone, especially our children.
The opinions expressed in this commentary are solely those of Harold P. Wimmer.
http://www.cnn.com/2014/01/06/opinion/wimmer-ecigarette-danger/

Fargo City Commissioners look to update tobacco ordinances

Fargo, ND (WDAY TV) – Fargo city commissioners are taking a step to stop the increase of e-cigarette use among minors.
Right now, electronic cigarettes are not regulated by the FDA, meaning there are no laws about their use.
In the last year, the percentage of US middle and high school students who reported using them has doubled.
Even though most Fargo businesses have their own rules prohibiting minors, legally anyone can buy them.
Monday night the city council plans to update its tobacco ordinances to include e-cigarettes and all its parts; so that no one can sell to anyone under 18, and minors cannot purchase them.
Holly Scott/Tobacco Prevention Coordinator: “I would venture a guess that most places would not sell to a minor, but by having it written in city ordinance, that way we just ensure that all businesses are following the same set of rules, in that, kinds can’t have access to these products.”
http://www.wday.com/event/article/id/92153/

US is marking 50th anniversary of surgeon general report that turned the tide against smoking

Article by: MIKE STOBBE , Associated Press
ATLANTA — Fifty years ago, ashtrays seemed to be on every table and desk. Athletes and even Fred Flintstone endorsed cigarettes in TV commercials. Smoke hung in the air in restaurants, offices and airplane cabins. More than 42 percent of U.S. adults smoked, and there was a good chance your doctor was among them.
The turning point came on Jan. 11, 1964. It was on that Saturday morning that U.S. Surgeon General Luther Terry released an emphatic and authoritative report that said smoking causes illness and death — and the government should do something about it.
In the decades that followed, warning labels were put on cigarette packs, cigarette commercials were banned, taxes were raised and new restrictions were placed on where people could light up.
“It was the beginning,” said Kenneth Warner, a University of Michigan public health professor who is a leading authority on smoking and health.
It was not the end. While the U.S. smoking rate has fallen by more than half to 18 percent, that still translates to more than 43 million smokers. Smoking is still far and away the leading preventable cause of death in the U.S. Some experts predict large numbers of Americans will puff away for decades to come.
Nevertheless, the Terry report has been called one of the most important documents in U.S. public health history, and on its 50th anniversary, officials are not only rolling out new anti-smoking campaigns but reflecting on what the nation did right that day.
The report’s bottom-line message was hardly revolutionary. Since 1950, head-turning studies that found higher rates of lung cancer in heavy smokers had been appearing in medical journals. A widely read article in Reader’s Digest in 1952, “Cancer by the Carton,” contributed to the largest drop in cigarette consumption since the Depression. In 1954, the American Cancer Society announced that smokers had a higher cancer risk.
But the tobacco industry fought back. Manufacturers came out with cigarettes with filters that they claimed would trap toxins before they settled into smokers’ lungs. And in 1954, they placed a full-page ad in hundreds of newspapers in which they argued that research linking their products and cancer was inconclusive.
It was a brilliant counter-offensive that left physicians and the public unsure how dangerous smoking really was. Cigarette sales rebounded.
In 1957 and 1959, Surgeon General Leroy Burney issued statements that heavy smoking causes lung cancer. But they had little impact.
Amid pressure from health advocates, President John F. Kennedy’s surgeon general, Dr. Luther Terry, announced in 1962 that he was convening an expert panel to examine all the evidence and issue a comprehensive, debate-settling report. To ensure the panel was unimpeachable, he let the tobacco industry veto any proposed members it regarded as biased.
Surveys indicated a third to a half of all physicians smoked tobacco products at the time, and the committee reflected the culture: Half its 10 members were smokers, who puffed away during committee meetings. Terry himself was a cigarette smoker.
Dr. Eugene Guthrie, an assistant surgeon general, helped persuade Terry to kick the habit a few months before the press conference releasing the report.
“I told him, ‘You gotta quit that. I think you can get away with a pipe — if you don’t do it openly.’ He said, ‘You gotta be kidding!’ I said, ‘No, I’m not. It just wouldn’t do. If you smoke any cigarettes, you better do it in a closet,'” Guthrie recalled in a recent interview with The Associated Press.
The press conference was held on a Saturday partly out of concern about its effect on the stock market. About 200 reporters attended.
The committee said cigarette smoking clearly did cause lung cancer and was responsible for the nation’s escalating male cancer death rate. It also said there was no valid evidence filters were reducing the danger. The committee also said — more vaguely — that the government should address the problem.
“This was front-page news, and every American knew it,” said Robin Koval, president of Legacy, an anti-smoking organization.
Cigarette consumption dropped a whopping 15 percent over the next three months but then began to rebound. Health officials realized it would take more than one report.
In 1965, Congress required cigarette packs to carry warning labels. Two years later, the Federal Communications Commission ordered TV and radio stations to provide free air time for anti-smoking public service announcements. Cigarette commercials were banned in 1971.
Still, progress was slow. Warner recalled teaching at the University of Michigan in 1972, when nearly half the faculty members at the school of public health were smokers. He was one of them.
“I felt like a hypocrite and an idiot,” he said. But smoking was still the norm, and it was difficult to quit, he said.
The 1970s also saw the birth of a movement to protect nonsmokers from cigarette fumes, with no-smoking sections on airplanes, in restaurants and in other places. Those eventually gave way to complete smoking bans. Cigarette machines disappeared, cigarette taxes rose, and restrictions on the sale of cigarettes to minors got tougher.
Tobacco companies also came under increasing legal attack. In the biggest case of them all, more than 40 states brought lawsuits demanding compensation for the costs of treating smoking-related illnesses. Big Tobacco settled in 1998 by agreeing to pay about $200 billion and curtail marketing of cigarettes to youths.
In 1998, while the settlement was being completed, tobacco executives appeared before Congress and publicly acknowledged for the first time that their products can cause lung cancer and be addictive.
Experts agree the Terry report clearly triggered decades of changes that whittled the smoking rate down. But it was based on data that was already out there. Why, then, did it make such a difference?
For one thing, the drumbeat about the dangers of smoking was getting louder in 1964, experts said. But the way the committee was assembled and the carefully neutral manner in which it reached its conclusion were at least as important, said Dr. Tim McAfee, director of the Office on Smoking and Health at the Centers for Disease Control and Prevention.
At the same time, he and others said any celebration of the anniversary must be tempered by the size of the problem that still exists.
Each year, an estimated 443,000 people die prematurely from smoking or exposure to secondhand smoke, and 8.6 million live with a serious illness caused by smoking, according to the CDC.
Donald Shopland finds that depressing.
Fifty years ago, he was a 19-year-old who smoked two packs a day while working as a clerk for the surgeon general’s committee. He quit cigarettes right after the 1964 report came out, and went on to a long and distinguished public health career in which he wrote or edited scores of books and reports on smoking’s effects.
“We should be much further along than we are,” the Georgia retiree lamented.
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