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WebMD News from HealthDay: Tobacco Exposure and Infertility, Early Menopause

By Kathleen Doheny, HealthDay Reporter

Smoking and being exposed to secondhand smoke may trigger early menopause and infertility in women, a new study suggests.
Other research has linked smoking with higher rates of infertility and perhaps earlier menopause. However, “secondhand smoke is less researched,” especially among never-smoking women, said study author Andrew Hyland, chair of health behavior at Roswell Park Cancer Institute, in Buffalo, N.Y.
In the study, Hyland and his colleagues evaluated women enrolled in the Women’s Health Initiative, a large study launched in 1991 to look at a variety of health issues in more than 160,000 generally healthy, postmenopausal women.
Hyland’s team looked at information about age of menopause and fertility, along with tobacco exposure, among some of the women enrolled in the study. The investigators evaluated information available on about 88,000 women to look at the fertility effects. They also looked at information on about 80,000 to examine onset of natural, or nonsurgical, menopause.
Both smoking and exposure to secondhand smoke were linked to fertility issues and early menopause (before the typical age of 50), the researchers found.
Compared with never smokers, current or former smokers were 14 percent more likely to be infertile and 26 percent more likely to have early menopause. Early menopause has been linked with a higher risk of death from all causes, Hyland pointed out.
Among never smokers, those exposed to the highest level of secondhand smoke (such as living with a smoker for 10 years or more) were 18 percent more likely to have fertility problems and early menopause, the study found.
Women who had ever smoked reached menopause about 22 months before those who never smoked or never were exposed to smoke. Those exposed to the highest level of passive smoke reached menopause 13 months earlier than those not exposed, the findings showed.
But the study cannot prove cause and effect, Hyland added. “This is an observational study looking at data already collected,” he said. “It [the link] could be something associated with early development and exposure as a young child.”

Smoke interacts with hormones and can have adverse effects as well, he added.

The study was published online Dec. 15 in the journal Tobacco Control.

The findings are a valuable reminder to avoid all smoke, said Patricia Folan, director of the Center for Tobacco Control at North Shore-LIJ Health System in Great Neck, N.Y.

“This study provides additional motivation and incentive for women of all ages to avoid smoking and exposure to secondhand smoke, as well as to quit smoking,” she said. Both are associated with premature birth, low birth weight, infant death and certain birth defects, she added.

“This evidence, in addition to the data from the current study, offers health care providers, particularly ob-gyn practitioners, the information needed to counsel women about the hazards of smoking and secondhand smoke, and to encourage cessation,” Folan said.

http://www.webmd.com/smoking-cessation/news/20151215/active-passive-smoking-tied-to-infertility-early-menopause-study

NBC News: Cigarette Smoke Might Cause Infertility, Early Menopause, Study Shows

by Maggie Fox

Tobacco smoke might do more than cause cancer, heart disease and lung damage. It might also injure fertility in women, researchers reported Tuesday.
Women who smoked the most, and who started at the youngest ages, went through menopause almost two years earlier than women who never smoked, Danielle Smith of the Roswell Park Cancer Institute in Buffalo and colleagues reported.
Women who remembered breathing in the most secondhand smoke went through menopause an average of 13 months earlier than women who didn’t think they’d ever breathed any in, the team reported in the journal Tobacco Control.
The team studied more than 93,000 women taking part in the Women’s Health Initiative Observational Study between 1993 and 1998. They filled out very detailed questionnaires on lifestyle habits, health problems and medical diagnoses.
They found that women who smoked 100 cigarettes or more in their lives had a 14 percent greater risk of infertility and a 26 percent greater risk of going through menopause before they turned 50.
The study helps confirm other studies that have linked smoking with early menopause.
Women who grew up with a smoker in the house for 10 years or more, those who lived with a spouse who smoked for 20 years or more, and those who worked with smokers for 10 years or more were 18 percent more likely to have had infertility problems than women who had never been passive smokers.
Overall, about 15 percent of the women said they had struggled to conceive for a year at a stretch or more, and 45 percent said they went through menopause before they turned 50.
There’s a debate over whether fertility rates have fallen, and many people have blamed chemicals known as endocrine disruptors in cans, bottles and in water supplies. But tobacco also contains these.
The toxins in tobacco smoke can interfere with the production of hormones related to fertility cycles, they can damage the production of egg cells, they can hurt the embryo before it gets implanted in the wall of the uterus, and they can restrict the processes that prepare a womb for pregnancy, the researchers said.
“Tobacco toxins also seem to lower the age of natural menopause by reducing circulating estrogen,” they wrote.
Smoking can also affect men in specific ways. For instance, it seems to damage the male Y chromosome especially badly.
Smoking is on the wane in the U.S. Last month, the Centers for Disease Control and Prevention reported the percentage of U.S. adults who smoke cigarettes declined from 20.9 percent in 2005 to 16.8 percent in 2014.
And smoking bans have made secondhand smoke in the workplace and public areas a thing of the past in most states.
http://www.nbcnews.com/health/womens-health/cigarette-smoke-might-cause-infertility-early-menopause-study-shows-n480661

Fargo Forum editorial: Tobacco cessation succeeds

There is good news in the war against tobacco use: North Dakota is winning.
The Campaign for Tobacco-Free Kids said last week that North Dakota is the only state spending at levels recommended by the U.S. Centers for Disease Control and Prevention on tobacco cessation programs. That level is 50 percent of funds designated from the 1998 tobacco settlement lawsuits.

But it’s about more than spending dollars where they were meant to be spent. It’s about results, and on that score North Dakota is a leader. For example, a portion of the money was spent to fund a study of secondhand smoke’s effects in Grand Forks, the results of which were pivotal in that city passing a 2010 law that outlawed smoking in bars, casinos and truck stops. Several North Dakota cities, using information compiled locally and by the North Dakota Center for Tobacco Prevention and Control Policy, easily approved ordinances directed at ending secondhand smoke in public places and businesses. Most of the cities were ahead of a Legislature that remained in the thrall of the state’s tobacco lobby, and it took a 2012 ballot measure to impose statewide restrictions on smoking and secondhand smoke.
There has been some grousing and whining about how tobacco settlement money is being spent in North Dakota. It’s come mostly from special interests that lost the tobacco cessation battle years ago. They were wrong then and are wrong now about the effects of the expenditures. For example, during the time that education and public service efforts were ratcheted up, smoking among youths plunged to 11.7 percent this year after hovering at about 20 percent the eight previous years.
Anti-tobacco programs work. The statistics are unambiguous. Tobacco settlement money has been well-spent in North Dakota, and the CDC and others recognize the state’s success. That’s good news.
Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board
http://www.inforum.com/opinion/editorials/3903588-forum-editorial-tobacco-cessation-succeeds

Inquisitr: 7 Reasons E-Cigarettes Are Bad

By Dieter Holger
E-cigarettes, also known as electronic cigarettes, have become a popular alternative to smoking the real deal, but the pros and cons of turning to this futuristic alternative are still under debate. Are e-cigarettes really any better than smoking a cigarette? Here are seven reasons e-cigarettes pose dangers to our health.
The effects of e-cigarettes are nowhere near as well-documented as cigarettes.
The e-cigarette industry is already worth billions of dollars, but there is nowhere near as much information on e-cigarettes as tobacco products. This should raise alarms, as the tobacco industry lived under a veil of scientific obscurity for decades until the detrimental health effects of cigarettes became well-known. Many people think e-cigarettes are a safer alternative, but that belief remains scientifically unproven, and evidence continues to come out saying e-cigarettes have toxic effects.
E-cigarettes contain plenty of cancerous chemicals.

By smoking e-cigarette vapor, people hope to avoid the cancerous chemicals inhaled from burning tobacco. Yet, e-cigarettes carry their fair share of toxic chemicals, too. Here’s a summary from the American Lung Association.

“In 2009, the FDA conducted lab tests and found detectable levels of toxic cancer-causing chemicals, including an ingredient used in antifreeze, in two leading brands of e-cigarettes and 18 various cartridges. A 2014 study found that e-cigarettes with a higher voltage level have higher amounts of formaldehyde, a carcinogen. It is urgent for FDA to begin its regulatory oversight of e-cigarettes, which would require ingredient disclosure to FDA, warning labels and youth access restrictions.”

Also, a 2013 study from the German Cancer Institute detected 8 different toxic chemicals in various e-cigarette liquids. And because the e-cigarette industry remains largely unregulated, the chemicals found in e-cigarettes aren’t uniform across the market. Some products may be less toxic than others, but without enough research or regulation it’s hard to know.
E-cigarettes are just as addictive as smoking tobacco.
E-cigarettes and tobacco products have the same highly addictive drug: nicotine. E-cigarettes derive nicotine from traditional cigarettes, delivering the same drug in a smokeless (vapor) form. In July, Daily Mail reported on a study by the American University of Beirut and the Center for the Study of Tobacco Products which demonstrated e-cigarettes contained highly addictive forms of nicotine. E-cigarettes might not have the same carcinogenic materials as cigarettes (like tar), but its nicotine still fosters addiction.
E-cigarettes have negative effects on lungs.
A supposed benefit of e-cigarettes is inhaling vapor instead of smoke. However, e-cigarette vapor is turning out to have a destructive effect on lungs. A recent July analysis by the University of Athens claimed that “using an e-cigarette caused an instant increase in airway resistance that lasted for 10 minutes.” Put simply, smoking e-cigarettes unhealthily constrains your airways.
Additionally, a study published in May by Indiana University showed that even nicotine-free e-cigarette vapor had damaging effects on the endothelial cells of the lungs. Endothelial cells protect the lungs from infections, so damaging them can’t be good for your immune system.
E-cigarettes won’t help you quit.
A lot of people vape e-cigarettes because they think it will help them kick their addiction. But recent research, including a comprehensive study by UC San Francisco, show that e-cigarettes don’t provide any extra help in quitting smoking. After surveying 849 smokers, the researchers found that users of e-cigarettes weren’t more likely to quit smoking.
“We found that there was no difference in the rate of quitting between smokers who used an e-cigarette and those who did not,” said head researcher Dr. Pamela Ling, a professor at the Center for Tobacco Control Research and Education at UC San Francisco.
E-cigarettes might create the equivalent of secondhand smoke.
Even if you don’t smoke, avoiding smokers is good for your health. But the American Lung Association point out e-cigarettes can also create the equivalent of toxic secondhand smoke, secondhand vapor.

“Also unknown is what the potential harm may be to people exposed to secondhand emissions from e-cigarettes. Two initial studies have found formaldehyde, benzene and tobacco-specific nitrosamines (all carcinogens) coming from those secondhand emissions. Other studies have shown that chemicals exhaled by users also contain formaldehyde, acetaldehyde and other potential irritants. While there is a great deal more to learn about these products, it is clear that there is much to be concerned about, especially in the absence of FDA oversight.”

E-cigarettes could be a gateway into tobacco products for youth.
The tobacco industry spends millions of dollars advertising to youth, and it turns out e-cigarettes might be helping convince young people to smoke nicotine. Here’s a summary of studies from the American Lung Association.

“The American Lung Association is concerned about e-cigarettes becoming a gateway to regular cigarettes, especially in light of the aggressive industry marketing tactics targeted at youth—including the use of candy flavors and the glamorization of e-cigarette use. Studies are showing a dramatic increase in usage of e-cigarettes, especially among youth. For the first time ever, a national study released in December 2014 found e-cigarette use among teens exceeds traditional cigarette smoking. The study also found that e-cigarette use among 8th and 10th graders was double that of traditional cigarette smoking. CDC studies have also shown e-cigarette use among high school students increased by 61 percent from 2012 to 2013.”

Another study, conducted this August by the University of Southern California, found that teenagers who try e-cigarettes are more likely to smoke tobacco. The researchers sampled 2,500 9th graders who had never had smoked a cigarette, finding those who tried vaping e-cigarettes were 23 percent more likely to smoke a tobacco cigarette over those who had never tried an e-cig. On top of that, one-fourth of the surveyed youth who tried e-cigarettes admitted to smoking tobacco cigarettes within the last 6 months.
http://www.inquisitr.com/2378144/7-reasons-e-cigarettes-are-bad/

New CDC Report Shows Big Drop in Secondhand Smoke Exposure Among Americans, But 58 Million Still Exposed – Every State and Community Should be Smoke-Free

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

WASHINGTON, DC – The percentage of Americans exposed to secondhand smoke has fallen by more than half since 1999, but one in four non-smokers – 58 million people altogether – was still exposed in 2011-2012, according to a new report issued today by the Centers for Disease Control and Prevention (CDC). It is especially troubling that children have the highest levels of exposure, with 40.6 percent of children aged 3-11 and 67.9 percent of African-American children in that age group still exposed to secondhand smoke. While the sharp decline in exposure to secondhand smoke is great news, it is unacceptable that 58 million Americans, including so many children, are still exposed to this serious and entirely preventable health threat.

The CDC report demonstrates both the effectiveness of and continuing need for comprehensive smoke-free laws that apply to all workplaces and public places, including restaurants and bars. To date, 24 states, Washington, DC, and hundreds of cities have enacted such laws, protecting about half the U.S. population (an additional six states have laws that apply to all restaurants and bars, but not all other workplaces). It’s time for every state and community to go smoke-free and protect everyone’s right to breathe clean air, free from the serious health hazards of secondhand smoke.

States in the South have lagged behind in providing this important public health protection, which is easy and cost-effective to implement and very popular with the public. New Orleans set a terrific example for southern states and cities last month when it enacted a comprehensive smoke-free ordinance. The Kentucky Legislature should quickly follow suit and finally approve comprehensive, statewide smoke-free legislation that has been under consideration for several years.

The high level of child exposure to secondhand smoke also underscores the need for parents to take additional steps to protect children, such as ensuring that homes, cars and other places frequented by children are smoke-free. It is encouraging that the proportion of U.S. households with voluntary smoke-free rules has increased from 43 percent to 83 percent in the last two decades. For parents who smoke, the best step to protect children is to quit smoking.

Overall, the CDC reported that the percentage of non-smokers exposed to secondhand smoke fell from 52.5 percent during 1999-2000 to 25.3 percent during 2011-2012. Exposure was higher among children, African Americans, those living in poverty and those who live in rental housing. Secondhand smoke exposure was determined based on blood levels of cotinine, a nicotine byproduct.

“Continued efforts to promote implementation of comprehensive statewide laws prohibiting smoking in workplaces and public places, smoke-free policies in multiunit housing, and voluntary smoke-free home and vehicle rules are critical to protect nonsmokers from this preventable health hazard in the places they live, work, and gather,” the CDC concludes. The report provides support for growing efforts to make public and subsidized housing smoke-free, with the report noting, “The potential for SHS [secondhand smoke] exposure in subsidized housing is particularly concerning because a large proportion of these units are occupied by persons who are especially sensitive to the effects of SHS, including children, the elderly and the disabled.”

Secondhand smoke contains more than 7,000 chemicals, including hundreds that are toxic and at least 69 that cause cancer. According to the U.S. Surgeon General, secondhand smoke causes lung cancer, heart disease and stroke in non-smoking adults and sudden infant death syndrome (SIDS), low birth weight, respiratory problems, ear infections and more severe asthma in infants and children.

The Surgeon General also found that secondhand smoke is responsible for tens of thousands of deaths in the United States each year, there is no safe level of exposure, and only smoke-free laws provide effective protection. The evidence is also clear that smoke-free laws protect health without harming business.

The CDC’s report was published in the agency’s Morbidity and Mortality Weekly Report.

Don't fall for tobacco industry e-cigarette smokescreen

By Michaeline Fedder, Deborah P. Brown and Bonita Pennino
No one should have to choose between their health and a paycheck. Which is why, with all that is still unknown about the dangers of e-cigarette use, we must put public health first and prohibit the use of these unregulated products in all workplaces, including restaurants, bars and casinos. Unfortunately a bill recently passed by the Baltimore City Council purporting to ban e-cigarette use in the city allows restaurants, taverns and casinos to opt out, which not only weakens Baltimore and Maryland’s longstanding and popular smoke-free laws, it threatens the health of many city workers. We urge Mayor Rawlings-Blake to see through the tobacco industry smokescreen and use her power to veto this ordinance.
Turning the clock back by allowing the use of e-cigarettes in public places could create a host of new problems — encouraging new tobacco users, reversing efforts that have made smoking socially unacceptable, creating enforcement confusion for business owners and the public, and potentially putting the health of Baltimore’s restaurant, bar and casino workers and patrons at risk.
While e-cigarette manufacturers may make unverified claims that the ingredients are just “water vapor” or “safe,” without further research and federal regulation there is no sure way for e-cigarette users to know what they are consuming. Nor is there any way of knowing what nonusers are exposed to and the extent of the risk to their health. There are hundreds of types of e-cigarettes on the market today, and the products vary considerably by ingredients and quality control and assurance. Prohibiting the use of e-cigarettes in workplaces, restaurants and bars can protect the public health by preventing nonusers from being exposed to the potentially harmful chemicals in these products.
An increasing number of studies have examined the contents of e-cigarette aerosol. Unlike a vapor, an aerosol contains fine particles of liquid, solid or both. Propylene glycol, nicotine and flavorings were most commonly found in e-cigarette aerosol. Other studies have found the aerosol to contain heavy metals, volatile organic compounds and tobacco-specific nitrosamines, among other potentially harmful chemicals. A 2009 study done by the U.S. Food and Drug Administration (FDA) found cancer-causing substances in several of the e-cigarette samples tested. FDA tests also found nicotine in some e-cigarettes that claimed to contain no nicotine.
The public should know more about e-cigarettes before allowing users to expose others to potential dangers. Studies have already shown that the use of e-cigarettes can cause short-term lung changes and irritations, while the long-term health effects are unknown.Both exposure to and health effects of secondhand aerosol from e-cigarettes require further research, but preliminary studies indicate nonusers can be exposed to the same potentially harmful chemicals as users, including nicotine, ultrafine particles and volatile organic compounds. This exposure could be especially problematic for vulnerable populations such as children, pregnant women and people with heart disease. No worker or patron should be subject to inhaling the unknown aerosol emitted from electronic smoking devices.
By passing this reckless measure allowing the use of e-cigarettes in workplaces, Baltimore City Council members have fallen for the tobacco industry’s tricks. We are all too familiar with the age-old tactics of the tobacco industry such as designating smoking areas and notifying the public when smoking is allowed. We learned the hard way that these strategies do nothing to protect the health of workers and patrons from the dangers of secondhand smoke. These tactics are nothing but a ruse to promote smoking in public places, thus continuing addiction to a deadly product and guaranteeing sales of cigarettes well into the future. We should not repeat the same mistake now in Baltimore with e-cigarettes. No one, regardless in which section of a restaurant, tavern or casino they are working, dining or gaming, should have to choose between their health and a good job or a good time.
It is well understood that smoke-free laws are popular in Maryland and should not be weakened. And laws prohibiting the use of e-cigarettes in public places are steadily on the rise — with 156 municipalities and counting already prohibiting the use of e-cigarettes in all workplaces, including restaurants, bars and gaming facilities. Everyone has the right to breathe safe smoke-free and aerosol-free air in their place of work or leisure, and Mayor Rawlings-Blake should protect that right by vetoing this ordinance.
Michaeline Fedder is director of government relations in Maryland for the American Heart Association; Deborah P. Brown is president and CEO of the American Lung Association of the Mid-Atlantic; Bonita Pennino is the Maryland government relations director for the American Cancer Society Cancer Action Network.

​Hookahs deliver toxic benzene in every puff

Many young people consider hookahs a hip and safer way to smoke, but a new study finds fumes from the water pipes contain the toxin benzene.
Benzene has been linked to an increased risk for leukemia in prior research, according to a scientific team reporting Nov. 21 in the journal Cancer Epidemiology, Biomarkers & Prevention.
“In contrast to what is believed, hookah tobacco smoking is not a safe alternative to smoking other forms of tobacco,” study author Nada Kassem, associate director of the Center for Behavioral Epidemiology and Community Health at San Diego State University, said in a journal news release.
Researchers analyzed levels of S-phenylmercapturic acid (SPMA) — a metabolite (byproduct) of benzene — in the urine of 105 hookah smokers and 103 nonsmokers exposed to smoke from the water pipes.
After an event in a hookah lounge, SPMA levels were four times higher than normal in hookah smokers and 2.6 times higher than normal among people who had attended but hadn’t puffed on a hookah. After a hookah-smoking event in a private home, SPMA levels were two times higher among hookah smokers, but normal among nonsmokers.
“Hookah tobacco smoking involves the use of burning charcoal that is needed to heat the hookah tobacco to generate the smoke that the smoker inhales,” Kassem explained.
“In addition to inhaling toxicants and carcinogens found in the hookah tobacco smoke, hookah smokers and nonsmokers who socialize with hookah smokers also inhale large quantities of charcoal combustion-generated toxic and carcinogenic emissions,” she said.
Kassem believes that “because there is no safe level of exposure to benzene, our results call for interventions to reduce or prevent hookah tobacco use, regulatory actions to limit hookah-related exposure to toxicants including benzene, and include hookah smoking in clean indoor air legislation.”
http://www.nlm.nih.gov/medlineplus/news/fullstory_149609.html
Copyright © 2014 HealthDay. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
HealthDay

World Health Organization: Public Health Rules Needed to Curb E-Cigarette Risks

by Katie Weatherford, Center for Effective Government

Contrary to industry advertising, a new report by the World Health Organization (WHO) finds that electronic cigarettes (e-cigarettes) and other electronic nicotine delivery systems pose significant public health hazards because of toxins emitted from the devices. The agency recommends that countries adopt e-cigarette rules to prevent misleading marketing of the products and to educate the public about the potential health risks involved.

E-Cigarettes Emit Dangerous Toxins

E-cigarettes contain a battery that heats a nicotine fluid inside the device until it produces a mist-like aerosol that the user can inhale. According to the WHO report, the aerosol contains “nicotine and a number of toxicants” that pose health hazards to users and non-users, especially pregnant women and children, contrary to claims that these devices release nothing more than water vapor. Nicotine use is linked to long-term adverse effects on brain development. Moreover, the aerosol typically contains “some carcinogenic compounds,” including formaldehyde.

Although the report finds that adult smokers who completely switch from regular cigarettes to e-cigarettes will be exposed to lower levels of toxins, WHO warns that the “amount of risk reduction . . . is presently unknown.” The report also notes uncertainty about whether second-hand exposure risks from e-cigarettes are lower than regular cigarettes.

Marketing Contains Unsubstantiated Claims, Targets Children

The WHO report also takes misleading marketing to task, noting the frequent use of unsubstantiated claims about e-cigarettes in product ads. According to the report, there is insufficient evidence that using e-cigarettes will help people quit smoking, yet ads commonly market e-cigarettes as a smoking-cessation device. Other marketing tactics may even encourage more frequent smoking.

For example, many ads promote using e-cigarettes in places where regular smoking is banned. WHO cautions that this could interfere with the intent of smoke-free policies, which “are designed not only to protect non-smokers from second-hand smoke, but also to provide incentives to quit smoking and to denormalize smoking . . . .”

Moreover, e-cigarette marketing has “the potential to glamorize smoking,” which may encourage nonsmokers and children to start using e-cigarettes. The endless variety of designs and flavor options can also appeal to adolescents.

WHO Recommends Developing Public Safeguards

The WHO report says, “Regulation of [e-cigarettes] is a necessary precondition for establishing a scientific basis on which to judge the effects of their use, and for ensuring that adequate research is conducted, that the public has current, reliable information as to the potential risks and benefits of [e-cigarettes], and that the health of the public is protected.”

The report will be a topic of discussion this October at the Sixth Conference of the Parties to the WHO Framework Convention on Tobacco Control. The Convention is an international effort to address global tobacco use. The report calls on the 179 countries that are parties to the Convention to adopt new standards to protect the public from the hazards associated with e-cigarettes. Such safeguards would:

  • Prohibit claims that these products can help people quit smoking until manufacturers provide sufficient scientific evidence to support the claim and gain regulatory approval

  • Ban indoor use of e-cigarettes unless it is proven there are no health effects from second-hand exposure

  • Restrict marketing by requiring that all ads, promotions, or sponsorships provide warnings, encourage people to quit smoking, in no way promote use by nonsmokers or adolescents, contain no images, words, etc. associated with a tobacco product, and more

  • Require that manufacturers design products to reduce exposure to toxins, make information about contents and exposure levels available to users, register products with a governmental body, and report design and emissions information to a governmental body

  • Prohibit sales to people under the age of 18 and ban fruit, candy-like, and alcohol-drink flavors unless and until it is proven that these flavors do not appeal to minors

To ensure strong public health protections, the global community must adopt WHO’s recommendations so that people understand the risks associated with e-cigarettes and adults can make informed choices about whether or not to use them.

Protecting Public Health in the U.S.

Although the U.S. is a signatory to the Convention, it has not yet ratified the tobacco control treaty. However, the U.S. Food and Drug Administration (FDA) is taking some steps similar to WHO’s recommendations.

FDA proposed a rule in April that would ban the sale of e-cigarettes to anyone under the age of 18. The rule would also require e-cigarette manufacturers to register with the agency and report the manufacturing process and ingredients used in their products. Moreover, companies would be required to place health-warning labels on e-cigarettes.

However, some tobacco control advocates believe the proposal does not go far enough and are urging FDA to prohibit manufacturers from marketing candy-flavored options that attract children. The Center for Effective Government and other health and safety groups also heavily criticized the FDA’s decision to discount the benefits of the proposed rule by 70 percent, which the agency claims is necessary to account for the “lost pleasure” from reducing tobacco use.

FDA is currently reviewing public comments and considering any changes to its draft rule. We hope the agency will correct its flawed benefit calculation and move forward with strong safeguards without delay. The U.S. should also ratify the treaty and communicate its support for global efforts to combat the tobacco use epidemic.

http://www.foreffectivegov.org/node/13198

The Health Claims Of E-Cigarettes Are Going Up In Smoke

Jasper Hamill, Contributor | Forbes

The sales pitch of electronic cigarette manufacturers seemed too good to be true. Could nicotine addicts around the world really get their fix whilst dodging the health risks of puffing away on cancer sticks?

Sadly for smokers and “vapers”, the answer is far from clear. Over the past week, new evidence has emerged which suggests that E-Cigarettes can be dangerous too – in some cases carrying higher amounts of certain toxins than the blazing tobacco of old.

Researchers at the University of South California have found that although E-Cigarettes are less harmful than ordinary smokes, the vapour emitted by the gadgets contains the toxic element chromium, which is not found in traditional cigarettes, as well as levels of nickel four times higher than in real tobacco. The electronic replacements also contain lead, zinc and other toxic metals, although in lower levels than cigarettes.

English: Two electronic cigarette models. Self...

Two electronic cigarette models. (Photo credit: Wikipedia)

“Our results demonstrate that overall electronic cigarettes seem to be less harmful than regular cigarettes, but their elevated content of toxic metals such as nickel and chromium do raise concerns,” said Constantinos Sioutas, professor at the USC Viterbi School of Engineering.

There is a bit of good news for reforming smokers, as E-Cigarettes contain virtually no detectable polycyclic aromatic hydrocarbons, which are known to cause cancer. The researchers also said the metal particles were likely to come from the cartridge of the E-Cigarette devices, opening up the possibility that a change in the production process could eliminate the dangerous chemicals.

But this isn’t the only bit of bad news for vape inhalers. In the UK, the BBC reported that E-Cigarette liquid sold in the north east of England was found to contain a chemical called diacetyl, which is used to add butterscotch flavor to liquid tobacco.

Whilst this substance is harmless to eat, it is extremely dangerous to inhale. The chemical is known to cause a serious condition called popcorn lung, orbronchiolitis obliterans, an irreversible disease which scars the lung and makes it impossible to breathe properly. This illness has struck workers in popcorn factories, who are known to breathe in vast quantities of diacetyl, as well as ordinary people who eat a lot of popcorn.

Commenting on the report, Dr Graham Burns, a respiratory expert at Newcastle’s Royal Victoria Infirmary, said the illness is often “serious enough to warrant lung transplantation”.

VP, the firm which manufactured the cigarettes, immediately withdrew the liquid from sale, and Lynne White, head of retail distribution, admitted there were concerns about inhaling the liquid on a long-term basis.

“We are very sorry it has happened, we are investigating how it has happened,” she added.

“Because of the small amount the vaper would actually consume it was deemed in the short term there would be no health concerns.

“Long-term yes there could well be, however we decided it was a withdrawal rather than a recall of the product and that was based on Ecita’s (Electronic Cigarette Industry Trade Association) guidelines.”

But for many health-conscious people, the damage is likely to have been done. Once upon a time, the world didn’t know about the many terrible effects of cigarettes. It was only after a concerted campaign by scientists, doctors and activists that the risks began to be publicized and governments began to act on them. The long term implications of switching to E-Cigarettes have not yet been tested, so anyone using the devices has to ask themselves if they are willing to take the risk of becoming a guinea pig.

Marlboro Cigarettes

Marlboro Cigarettes (Photo credit: Wikipedia)

The World Health Organisation has issued a report advising that use of E-Cigarettes should be banned indoors and and all advertising stopped until the emerging industry produces “convincing supporting scientific evidence and obtains regulatory approval”.
Backing this call, the British Medical Association board of science deputy chair Ram Moorth said “tighter controls are needed to ensure their use does not undermine current tobacco control measures and reinforces the normalcy of smoking behaviour”.

‘There is a need for research to understand the health impacts of E-Cigarettes on both the user and bystanders, and it is vital that the sale of e-cigarettes is appropriately regulated to ensure they are not sold to minors, and are not aggressively marketed to young people as tobacco was in the past,” he continued.

“Any health claims must be substantiated by robust independent scientific evidence to ensure that the consumer is fully informed regarding potential benefits and risks of E-Cigarettes.”
Are you willing to take the chance and keep on vaping?
For more news and comment, follow me on Twitter @jasperhamill
http://www.forbes.com/sites/jasperhamill/2014/08/31/the-health-claims-of-e-cigarettes-are-going-up-in-smoke/

WHO urges stiff regulatory curbs on e-cigarettes

BY STEPHANIE NEBEHAY, Geneva
(Reuters) – The World Health Organization (WHO) stepped up its war on “Big Tobacco” on Tuesday, calling for stiff regulation of electronic cigarettes as well as bans on indoor use, advertising and sales to minors.

In a long-awaited report that will be debated by member states at a meeting in October in Moscow, the United Nations health agency also voiced concern at the concentration of the $3 billion market in the hands of transnational tobacco companies.

The WHO launched a public health campaign against tobacco a decade ago, clinching the WHO Framework Convention on Tobacco Control. Since entering into force in 2005, it has been ratified by 179 states but the United States has not joined it.

The treaty recommends price and tax measures to curb demand as well as bans on tobacco advertising and illicit trade in tobacco products. Prior to Tuesday’s report the WHO had indicated it would favor applying similar restrictions to all nicotine-containing products including smokeless ones.

In the report, the WHO said there are 466 brands of e-cigarettes and the industry represents “an evolving frontier filled with promise and threat for tobacco control”.

It urged a range of regulatory options, including banning e-cigarette makers from making health claims such as that they help people quit smoking, until they provide convincing supporting scientific evidence.

Smokers should use a combination of already-approved treatments for kicking the habit, it said.

While evidence indicates that they are likely to be less toxic than conventional cigarettes, the use of e-cigarettes poses a threat to adolescents and the fetuses of pregnant women using them, it said.

“NOT MERELY WATER VAPOR”

E-cigarettes also increase the exposure of bystanders and non-smokers to nicotine and other toxicants, it said regarding Electronic Nicotine Delivery Systems that it calls ENDS.

“In summary, existing evidence shows that ENDS aerosol is not merely ‘water vapor’ as is often claimed in the marketing for these products,” the WHO said in the 13-page report.

E-cigarettes should be regulated to “minimize content and emissions of toxicants”, and those solutions with fruit, candy-like and alcohol-drinks flavors should be banned until proven they are not attractive to children and adolescents, it said.

Adolescents are increasingly experimenting with e-cigarettes, with their use in this age group doubling between 2008 and 2012, it said.

Vending machines should be removed in almost all locations, it added.

Scientists are divided on the risks and potential benefits of e-cigarettes, which are widely considered to be a lot less harmful than conventional cigarettes.

One group of researchers warned the WHO in May not to classify them as tobacco products, arguing that doing so would jeopardize an opportunity to slash disease and deaths caused by smoking.

Opposing experts argued a month later that the WHO should hold firm to its plan for strict regulations.

Major tobacco companies including Imperial Tobacco (IMT.L), Altria Group (MO.N), Philip Morris International (PM.N) and British American Tobacco (BATS.L) are increasingly launching their own e-cigarette brands as sales of conventional products stall in Western markets.

A Wells Fargo analyst report in July projected that U.S. sales of e-cigarettes would outpace conventional ones by 2020.

Uptake of electronic cigarettes, which use battery-powered cartridges to produce a nicotine-laced inhalable vapor, has rocketed in the last two years and analysts estimate the industry had worldwide sales of some $3 billion in 2013.

But the devices are controversial. Because they are so new there is a lack of long-term scientific evidence to support their safety and some fear they could be “gateway” products to nicotine addiction and tobacco smoking.

The American Heart Association said in a report on Monday that it considered e-cigarettes that contain nicotine to be tobacco products and therefore supports their regulation under existing laws on the use and marketing of tobacco products.

“Although the levels of toxic constituents in e-cigarette aerosol are much lower than those in cigarette smoke, there is still some level of passive exposure,” the AHA said.

(Reporting by Stephanie Nebehay in Geneva; additional reporting by Ben Hirschler and Martinne Geller in London, Editing by Angus MacSwan)

http://www.reuters.com/article/2014/08/26/us-health-who-ecigarettes-idUSKBN0GQ0PF20140826