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Forum editorial: Minnesota tobacco use down

The anti-tobacco work of ClearWay Minnesota in conjunction with other tobacco cessation efforts has had remarkable results in reducing smoking rates among all age groups in Minnesota. It’s a record worthy of high praise. It’s unambiguous evidence that focused, science-based anti-tobacco campaigns can work.

Numbers released last week by ClearWay show only 14.4 percent of Minnesotans smoke cigarettes, down from 22.1 percent in 1999. The decline through the time period has been steady, and corresponds to increased education and imposition of legal restrictions on smoking in public places. Add new medical research about second-hand smoke, and graphic anti-smoking television advertising, and it appears the multi-faceted message is getting through.

But not to every age cohort.

In ClearWay statistics from 2010 to 2014, smoking hardly dipped at all (1 percent) in the 25-44 year-old group, from 19.7 percent to 18.7 percent. A similar slight improvement was measured in the 45-64 year-old cohort, compared with a huge drop (from 21.8 percent to 15.3 percent) in Minnesotans age 18-24. Which could lead to the conclusion that some Minnesotans don’t get smarter as they age. But whatever the reason, the overall percentages of all Minnesotans who smoke is down over the longer study period, and that’s good news for smokers who quit, non-smokers and reduced impacts on health costs associated with tobacco use. The trends are good.

ClearWay is not resting on its excellent record. In the eight years it has left in its mandate (funded by the national tobacco settlement of a few years back), the agency’s agenda includes raising cigarette taxes, which all studies show discourage young people from purchasing tobacco, and raising the age for tobacco purchases from 18 to 21. Again, research finds that raising the age to beyond high school age contributes to fewer high school students trying tobacco. New York City and Hawaii have already taken that step.

There is still much to be accomplished to achieve as smoke-free a society as possible. A lot has been done, often led by private sector companies that banned smoking from the workplace before cities and states enacted overall smoking bans in buildings and, in many instances, outdoor public spaces. Decades of research into smoking-related illness and death, and the proven health hazards of secondhand smoke, have been the underpinnings of changing public policy. ClearWay’s work and similar complementary efforts have been pivotal in changing the way enlightened Americans view tobacco use.

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

http://www.inforum.com/opinion/editorials/3751883-forum-editorial-minnesota-tobacco-use-down

Opinion: E-cigarettes: Doctors' View: E-cigarette, tobacco smoke enough alike to warrant regulation

By Terry Clark, Mary J. Boylan and Joseph Bianco

What are e-cigarettes? Have you ever seen one? Do you know how they work? Are they as bad for your health as traditional cigarettes?

It is fair to say that three or four years ago these were new questions and we did not know the answers. But now we do, and it is certainly time for you to know — and for our St. Louis County Board of Commissioners to know as they consider a vote to help protect citizens of our county from the “invisible” harm caused by these gadgets if being used indoors.

Details about e-cigarettes and their health effects are well-described in a recent report from the California Department of Health, and even more recent good information on e-cigarettes can be found in the News Tribune’s “Our View” editorial on Friday, headlined, “County up next in quest for clear air.”

E-cigarettes is a good news/bad news story. Are they less toxic than traditional cigarettes? Likely. Are they really safe to use? Not likely.

First, how do they work? With no tobacco or cigarette paper to burn, there’s no smoke. They really are electronic gadgets with several sections, one with a small battery, one with a small amount of fluid usually containing some nicotine as well as flavoring and other chemicals, and a high-temperature chamber that converts the liquid into an aerosol or fog to be inhaled by the user (an action called vaping) and then exhaled where it is readily inhaled by those around the user.

What is in this aerosol emitted by the e-cigarette? At least 10 chemicals known to cause cancer, birth defects or other reproductive harm, including nicotine, formaldehyde, heavy metals and volatile organic compounds, according to the report. It’s not what you or your favorite teenager should be exposed to.

Nicotine, a key ingredient in the aerosol, is highly addictive. Of course, that is why so many users of traditional cigarettes said for years that they could quit whenever they wanted but usually never could.

We should all wonder why the three major tobacco companies purchased start-up e-cigarette companies. What do they know that we do not? One thing is this: Kids who start using purportedly safer e-cigarettes often switch and become traditional smokers or, even worse, dual smokers who use both e-cigs and traditional tobacco cigarettes. They are then addicted to nicotine for decades. Is that what the big tobacco companies are banking on?

Our elected county leaders soon will vote on this simple question: Should e-cigarette use indoors be regulated as a public health hazard just like traditional tobacco smoke? That is, no smoking in indoor places such as worksites, bars, restaurants, stores, arenas, etc.

The city of Duluth and many other communities in Minnesota already have answered this question in the affirmative: Yes, e-cigarette aerosol and tobacco smoke have enough in common to warrant being regulated in the same way under the Minnesota Clean Air Act.

In short, keep them outside.

Terry Clark and Mary J. Boylan are doctors from Duluth. Joseph Bianco is a doctor from Ely.

http://www.duluthnewstribune.com/opinion/columns/3742094-e-cigarettes-doctors-view-e-cigarette-tobacco-smoke-enough-alike-warrant

Forum editorial: Don’t be fooled by e-cig hype

The North Dakota Legislature is buying into Big Tobacco’s clever but dishonest narrative about e-cigarettes. Lawmakers would be better served by paying attention to Dr. Terry Dwelle, the state’s chief health officer.
In comments published a few days ago, Dwelle said without equivocation that, given current research and information, the “cons” of e-cigs outweigh the “pros.” He said more work is needed to further define the risks and any potential benefits of the nicotine-delivery devices. He said the assumption that vapors produced by e-cigs are less risky than smoke from traditional tobacco products is not backed up by sound research.
Lawmakers likely will ban e-cig sales to minors, as several North Dakota cities have done already. But there is wrong-headed sentiment among some lawmakers that the devices should not be taxed and otherwise treated the same way tobacco is. Under the state’s smoking ban law, e-cigs are treated like cigarettes and other tobacco products. The e-cig provision was part of a voter-approved smoking and secondhand smoke measure. The measure passed with 66 percent approval.
Yet, lawmakers have smoke in their eyes when it comes to the clear message North Dakotans sent about tobacco use – and the stealth campaign to paint vaping with e-cigs as an innocent tobacco-free option.
There is nothing innocent about it. Big Tobacco has become Big Vaping. The companies have jumped into the e-cig market with slick advertising campaigns and legitimate-sounding claims about the safety and efficacy of e-cigarettes. The push has all the elements that peddlers of tobacco used a generation ago to convince the gullible that cigarettes did not cause cancer. The lie then has morphed into the lie now.
There is less-than-definitive indication that e-cigs help smokers quit. If it’s true, it’s a good thing. But that unproved aspect of e-cigs has nothing to do with taxing a nicotine-delivery device that by some studies can be a gateway for young people to tobacco use. It is counterintuitive to grant a tax break to devices and substances that use candy flavors and faux fashion to attract users of all ages to a nicotine-delivery tube. It’s also stupid policy. It’s playing into the dirty hands of the folks who for years peddled the fiction that tobacco was good for us.
Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.
http://www.inforum.com/opinion/editorials/3711115-forum-editorial-dont-be-fooled-e-cig-hype

Op Ed: How to lower Grand Forks’ high tobacco-use rates

By: Theresa Knox

On Feb. 23, the Herald ran a story about the dismal rates among adults of chewing tobacco use (“N.D. ranks highly in smokeless tobacco use,” Page A1).

As the story reported, North Dakota was ranked 49th out of 50 states and District of Columbia, with 7.6 percent of its adults using smokeless tobacco.

The story went on to interview several people with personal stories about the toll of tobacco in their lives. It ended with the quote, “They all know someone who’s died from tobacco-related cancer.”

These statistics are terrible. And they are not just statistics. As the article referenced, each number represents a person. These are people we know and love — people we work with, and people whom we don’t want to see sick and dying from the No. 1 cause of preventable death: tobacco use.

Nearly one quarter of high school boys in North Dakota use smokeless tobacco (22 percent). That is higher than the adult use rate and the fifth worst in the country.

We know that most smokers begin their addictive habit before the age of 18, and nearly 4,000 kids try their first cigarette every day. That’s almost 1.5 million young people per year.

The tobacco industry pours billions into advertising to create a perception that tobacco use is fun and glamorous.

But, guess what? We don’t have billions to counteract that type of messaging — and we don’t need it.

There is a solution that is nearly free of charge; and it works. Research bears out this claim.

I will tell you what that solution is, but first, ask yourself this question: Is it easier to quit using tobacco or to avoid ever taking up the habit?

It is easier (and cheaper) to avoid taking up this addictive habit.

Second, I ask you to rethink your attitudes about tobacco use and why it is not acceptable in indoor and outdoor public places. There is no denying that second-hand smoke and toxic litter from cigarette butts and spitting on the ground are bad for people and animals. But there is an even more important reason to prohibit tobacco use in indoor and outdoor public places: Public policy that keeps kids from seeing tobacco use as a normal activity will decrease youth initiation of tobacco use.

Remember, most people don’t chew or smoke tobacco.

An effective way to keep our next generation of North Dakotans from ever taking up using tobacco is to pass laws that keep tobacco use –including e-cigarettes, cigarettes and smokeless tobacco — out of our parks.

We can pass public policy that creates tobacco free environments. These policies don’t tell people they can’t use tobacco, if they choose to use. People are still free to smoke or chew. These policies prevent the use of products in otherwise safe and healthy places.

Grand Forks Park Board commissioners have the chance to take a deliberate and determined step to protect the health and safety of Grand Forks youth by adopting a comprehensive tobacco-free parks policy. They can take the lead to separate the connection between sports and chew, parks and tobacco.

And the result?

We know the result. A comprehensive tobacco-free parks policy, prohibiting use of all tobacco products in all Park District parks, grounds and facilities will result in cleaner parks and less secondhand smoke exposure.

And the most celebrated result?

Fewer Grand Forks youth will start using tobacco, and fewer among the next generation of North Dakotans will struggle with tobacco addiction and the toll of the illness and death that result from tobacco.

That is the solution. And it costs next to nothing.
http://www.grandforksherald.com/opinion/op-ed-columns/3688567-theresa-knox-how-lower-grand-forks-high-tobacco-use-rates

North Dakota ranks poorly in smokeless tobacco use

By Robin Huebner Forum News Service
FARGO — Chris Carlson’s nicotine habit started with chewing tobacco and his college fraternity brothers.
He really got hooked in the mid ’80s as an exchange student in Sweden, where he says everyone – including his female classmates – chewed the smokeless tobacco known as “snus.”
“I’ve got warm, sweet memories of the time,” said Carlson, 51, Fargo, who teaches college public speaking courses and is an adjunct instructor of Norwegian and Scandinavian studies at Concordia College.
While Carlson fondly recalls the rituals and relaxed feelings he said went along with using smokeless tobacco, his memory of that 24-year period is selective.
“You don’t remember all the times it made you nauseous,” he said.
Carlson also smoked cigarettes, but at the urging of his children, gave up both vices about eight years ago with the help of nicotine gum.
He fully understands the difficulty in quitting a substance that is highly addicting and deeply rooted in culture.
At a time when anti-smoking laws have carved out a strong foothold in North Dakota, the state is at the other end of the spectrum with smokeless tobacco.
Statistics from the U.S. Centers for Disease Control and Prevention show that North Dakota is in the middle of the pack for cigarette smoking, but is third worst – behind Wyoming and Mississippi – in the percentage of adults who use chewing tobacco or snuff.
The ranking lists all 50 states and the District of Columbia.
North Dakota was ranked 49th with 7.6 percent of its adults using smokeless tobacco in 2011 – the most recent year for which numbers are available.
South Dakota ranked 43rd with 6.8 percent, and Minnesota was 32nd with 4.8 percent of adults using smokeless tobacco.
The highest percentage of smokeless tobacco users in North Dakota by race are American Indians, who double up on the number of Caucasians using it.
A tribal tradition
Neil Charvat is a former smoker and smokeless tobacco user whose career now focuses on preventing people from picking up the habit.
Charvat, 44, works closely with the state’s Indian reservations as director of the tobacco prevention and control program for the North Dakota Department of Health in Bismarck.
While the state’s smoke-free laws don’t apply to reservations because of their sovereign nation status, the state does fund tribal tobacco prevention programs.
Charvat said it can be tricky educating American Indians about tobacco because the traditional form of it is often central to their religious beliefs.
“If we say, ‘Tobacco is bad,’ that’s a direct insult to their religion,” he said.
So when tribal educators go into schools on the reservation, they make an important distinction from the very start.
“We teach from the viewpoint of it being commercial vs. traditional tobacco,” said Jackie Giron, tobacco prevention coordinator for the Turtle Mountain Band of Chippewa.
Charvat said traditional tobacco grown by tribes doesn’t contain the additives and chemicals that commercial tobacco contains.
In addition, it’s meant for ceremonial use only – not recreation.
In some cases, addictions took hold after tribes began using commercial tobacco for those ceremonies when they weren’t able to obtain traditional tobacco, Charvat said.
As years went on, some commercial tobacco companies even sponsored powwows.
“They portrayed it as something sacred and not harmful to you, which it is,” Giron said.
She said she sees both adults and children chewing tobacco at Turtle Mountain. It means the education process needs to start early, in kids as young as 3 and 4 – and continue through high school and college, she said.
“All you can do is take baby steps sometimes,” Giron said.
Just as dangerous
One challenge in keeping people from starting with smokeless tobacco and helping them quit involves a common, but mistaken belief.
“Some of that has to do with the misconception that if you don’t inhale, it might be somewhat safer,” said Holly Scott, a tobacco prevention coordinator at Fargo Cass Public Health.
In fact, it’s equally as risky.
“When chewing, they’re actually getting more nicotine than in cigarettes, increasing their nicotine addiction,” said Melissa Markegard, who is also a tobacco prevention coordinator at Fargo Cass Public Health.
The incidence of many types of cancer and other diseases can be attributed to smoking and/or chewing tobacco, but combining the products makes it even worse.
“It greatly increases (the risk of lung cancer) if they use both together,” Markegard said.
While there are fewer opportunities than ever to smoke in North Dakota, the same restrictions don’t apply to chewing tobacco because it’s easier to hide.
Charvat said as a teen, he used to smoke a cigarette outside of his school, and then tuck a chew into his mouth before going to class.
Youth at risk
A survey of more than 10,500 North Dakota high school students in 2013 found 13.8 percent of them had used chewing tobacco, snuff or dip during the past 30 days.
It also found chewing tobacco is more often used in smaller towns than in urban centers – 15.1 percent to 11.2 percent, respectively.
“In Western and rural cultures, it’s more commonplace and accepted,” Charvat said.
According to the survey, the Williston area had the highest incidence of chewing tobacco use in high school students, while the Grand Forks area had the lowest.
The Youth Risk Behavior Survey, a collaboration of federal, state and local health education agencies, will be conducted again this spring.
Scott said her overall goal is to “de-normalize” all tobacco use because it’s the state’s No. 1 cause of preventable disease and death.
Charvat is optimistic North Dakota will show up better the next time rankings are compiled because the people he’s working with are motivated.
“They all know someone who’s died from tobacco- related cancer,” he said.
http://bismarcktribune.com/news/state-and-regional/north-dakota-ranks-poorly-in-smokeless-tobacco-use/article_86fa27cb-e925-5210-9ee7-2456e943dbde.html

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.

Smoking Rates Continue to Decline

MMWR – MORBIDITY AND MORTALITY WEEKLY REPORT

The CDC recently updated its statistics about current cigarette smoking among adults. In its MMWR article of November 28, 2014, it tracked changes in smoking between 2005 and 2013. In general, the trends of previous years continued. Here are some of the results:

  • The proportion of U.S. adults who smoke declined from 20.9% to 17.8%, a 15% decline during that period. The 17.8% is a modern low in adult smoking prevalence.
  • The proportion of daily smokers declined from 16.9% to 13.7%, a 19% decline and another all time low.
  • Among daily smokers, the proportion who smoked at least one pack per day decreased from 52.1% to 36.4%, a 30% decline. And daily smokers now average 14.2 cigarettes, down from 16.7, a 15% decline.

Thus, there has been a decline in overall smokers, a slightly greater decline in daily smokers and in number of cigarettes smoked by daily smokers, and a major decline in the number of cigarettes consumed by daily smokers.

The profile of smokers is relatively unchanged:

  • Men (20.5%) are more likely to be smokers than women (15.3%)
  • Smoking prevalence is higher among adults aged 25-44 years (20.1%) and lowest among those over age 65 (8.8%)
  • Among ethnic groups, multiple race groups had the highest rates (26.8%), followed by American Indian/Native Alaskan (26.1%), Whites (19.4%), Blacks (18.3%), Hispanics (12.1%), and Asians (9.6%).
  • Smokers continue to be stratified by education level, often used as a marker for social class. Those without a high school diploma had smoking rates of 24.2%, followed by those with high school diplomas (22%), undergraduate college degrees (9.1%), and graduate degrees (5.6%). Those who obtained General Education Development (GED) certificates in lieu of high school graduation had the highest rates (41.4%). It is likely that many of these persons were incarcerated and thus also had medical conditions associated with high smoking rates, such as mental illness and substance use disorders.
  • Persons living below the federal poverty level had higher rates (29.2%) than those above that level (16.2%).
  • LGB adults were more likely to be smokers (26.6%) than straight adults (17.6%).

Thus, the trend of smoking to be concentrated among the less educated, the poor, and the LGB population continued. Not included in this report, but summarized previously by a special MMWR are recent data documenting the much higher rates among persons with behavioral health issues, the groups with the highest smoking rates in the entire population. Notably, those working in the health professions in the United States have some of the lowest smoking rates in the world, with some surveys showing that only 1% of physicians are smokers.

This new report should encourage us that progress, indeed, is happening. But, the slow rate of decline, in the face of all the evidence about the harms of smoking and the accumulating tobacco control policies such as taxes, clean indoor air laws, counter-marketing, and coverage for smoking cessation therapies, is sobering. As smokers increasingly resemble members of marginalized parts of the American community, the risk is that resources for tobacco control will be diverted to other causes. Yet, over 40 million people still smoke, including many of the most vulnerable of us. And close to 500,000 people die each year from smoking-associated illnesses. We need to capture better the sense of urgency buried in those statistics.

Finally, it is important to recognize two new potential threats to the health of the nation—electronic cigarettes and marijuana. Right now the rhetoric about the benefits and harms of these two commodities outstrips the evidence. We do know that the use of the e-cigarette is climbing, and it is highly likely that marijuana use is also increasing in the wake of state legalization efforts. We also know that because these commodities contain immense potential for profit, marketing efforts to promote usage are certain to increase. As we continue our efforts against the harm from using combustible tobacco, we need to track the use of these new potential threats, as well as to assemble evidence about what happens to those who use them.

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.

Smoking while using oxygen blamed for fire at Fargo's Sanford Medical Center

FARGO (KFGO-AM) — Investigators say a patient who was smoking while using oxygen caused a fire that injured both the patient and a staff member at Sanford Medical Center in downtown Fargo last week.
Fire chief Steve Dirksen says the combination of pure oxygen and open flame is extremely volatile.  He says it was quick response by hospital employees that prevented a much more serious situation.
The exact nature of the injuries has not been disclosed because of the patient confidentiality law.
Hospital employees who responded to a smoke alarm early Thursday in the room rescued the patient, had the fire out when firefighters arrived and evacuated patients in nearby rooms.
Damage to the room was minor.
http://kfgo.com/news/articles/2014/nov/17/smoking-while-using-oxygen-blamed-for-fire-at-fargos-sanford-medical-center/

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