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Forum editorial: The ‘no’ applies to e-cigs

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

Under the smoke-free law approved by North Dakota voters in 2012 the use of
so-called electronic cigarettes is prohibited in all places where smoking tobacco is not allowed. It’s that simple. The law, which won voter support in every county in the state, is unequivocal. No spinning by the tobacco lobby and its lackeys can make North Dakota’s e-cig prohibition less clear.
One argument for treating e-cigs differently than tobacco cigarettes is the devices do not generate secondhand smoke, and that they help smokers who want to quit tobacco. Therefore, e-cig advocates contend they should not be in the same banned-nearly-everywhere classification as other tobacco-based smoking products.
It’s all smoke and mirrors promulgated by Big Tobacco and others who know e-cigs can be (and early research shows they are) gateways for young people to start smoking tobacco.
First, the claim the vapors produced by e-cigs are harmless has no good science behind it. Rather, the substances generated include humectants used in fog and smoke machines, and vaporized nicotine and artificial flavors. Manufacturers have been cited for contaminants, including nickel, arsenic and chromium. There is no FDA oversight, no product-specific taxes and no restrictions on age of buyers.
No matter how dressed up they are, e-cigs are simply a nicotine-delivery device. The dangers of nicotine, a poisonous water-soluble alkaloid, are known. Furthermore, e-cigs are being marketed by emphasizing their candy-like flavors and seemingly benign brand names. Young people are responding as expected. A recent Youth Tobacco Survey showed a spike in e-cig use by youth, doubling to 10 percent in one year.
Also, the claim that e-cigs help cigarette smokers quit, and therefore should be unregulated, is a phony argument. There is nothing in law that prevents smokers from using e-cigs, as long as used in compliance with North Dakota’s smoke-free laws.
E-cigarettes represent the latest attempt by tobacco companies and their allies to hook more young smokers, and thus ensure a nicotine-addicted customer base into the future. The effort to characterize the devices as a way to help smokers quit is cynical and predicated on a falsehood. That effort has wormed its way into legislatures, including the North Dakota Legislature, where a handful of lawmakers have bought into the lie.
Voters overwhelming said “no” to cigarettes in 2012. That “no” included e-cigarettes. Legislators who don’t get it might want to find other work.
http://www.inforum.com/event/article/id/432045/group/Opinion/

Tobacco control group promoting smoke-free apartments

By Bismarck Tribune
BISMARCK, N.D. _ The North Dakota Center for Tobacco Prevention and Control Policy is promoting smoke-free apartments.
The center has launched an education campaign encouraging smoke-free housing policies.
“In North Dakota, 24 percent of residents live in apartments and many of these residents continue to be exposed to secondhand smoke,” Executive Director Jeanne Prom said in a statement.
The center cited a 2006 surgeon general’s report that said air-cleaning technologies and ventilating buildings do not eliminate smoke because conventional systems cannot remove all the toxins. Heating, ventilation and air conditioning systems also can distribute secondhand smoke throughout a building.
Prom said there are high costs to landlords associated with allowing smoking in apartments, like painting and replacing carpeting.
The center cited a Centers for Disease Control and Prevention report that estimated the annual cost savings of eliminating smoking in subsidized housing nationwide would be $108 million in annual renovation expenses and $72 million in annual smoking-related fire losses.
For more information go to www.smokefreehousingND.com.
http://bismarcktribune.com/news/state-and-regional/tobacco-control-group-promoting-smoke-free-apartments/article_a39a5b62-be9c-11e3-bd9c-0019bb2963f4.html

Letter: Big tobacco goes after ‘replacement smokers’

By: Beth Hughes, Bismarck, INFORUM
Even though the risks of using tobacco are well documented, it remains the No. 1 cause of preventable death and disease in the country. This year alone, nearly 500,000 Americans will die prematurely because of smoking. Unfortunately, tobacco marketing efforts recruit two new young smokers to replace each tobacco user who dies.
It’s well documented that tobacco companies market to youth in an effort to recruit “replacement smokers.” Research from the Centers for Disease Control and Prevention tells us that smoking and smokeless tobacco use are initiated and established primarily during adolescence. In fact, nearly 9 out of 10 smokers start smoking by the age of 18. Tobacco companies know this and continually look for new ways to hook our youth.
Tobacco companies pay convenience stores – many located near schools – and other tobacco retailers to prominently display advertisements for their products near the entrances, exits and checkouts. Tobacco companies also target a new generation of potential tobacco users by designing items to appeal to youth, such as fruit-flavored products in colorful packaging that make tobacco look and smell like candy.
In addition to new flavors and packaging, price is another factor that affects tobacco use. In states with low tobacco taxes, like North Dakota, it’s easier to make tobacco products affordable, and that makes it easier for youth to obtain tobacco. Research supported by the CDC and the American Lung Association shows that increasing a tobacco tax is one of the most effective ways to reduce youth tobacco use; by making tobacco less affordable, kids are less likely to buy it.
The Center for Tobacco Prevention and Control Policy uses media campaigns to educate the public about the dangers of tobacco use. The Center also works with local public health units across the state to educate our communities on tobacco prevention so our children live healthier lives as fewer of them become addicted to nicotine.
We are committed to preventing tobacco use among our youth and adult populations. We’ve made great progress, but there is more work to be done. Showing support for tobacco prevention efforts in your community is a great start to help reduce youth tobacco use rates. Here is what you can do:
• Support tobacco-free and smoke-free policies within your community. When youth are not exposed to tobacco, it increases their chance to remain tobacco free.
• Support policies that restrict how tobacco is marketed. Tobacco companies are aggressive marketers that target youth through retail displays, internet marketing and magazines that are popular with teens.
• Support tobacco tax increases. Our youth are less likely to use tobacco if it is less affordable.
These strategies are CDC Best Practice strategies – strategies that are proven to reduce youth tobacco use rates. We ask the community to join us in this fight by showing your support for tobacco prevention.

Hughes, Ph.D., is a registered respiratory therapist, and chairwomen, North Dakota Tobacco Prevention and Control Committee.
http://www.inforum.com/event/article/id/428702/group/Opinion/

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

Library may take action on e-cigarettes

By LeAnn Eckroth, Bismarck Tribune
BISMARCK, N.D. –The Bismarck Public Library board of directors will consider a change to its policy to specify patrons cannot use e-cigarettes in the library.
The topic will be discussed at its noon meeting Feb. 27 at the library.
Mary Jane Schmaltz, library director, said e-cigarettes are already banned in public buildings under city tobacco ordinances and state law, but the law may not be clear in the library patron code.
“We caught someone smoking an e-cigarette in the library last week. Our patron conduct code already says we do not allow the use of tobacco or chewing tobacco in the library,” she said. “We just want to get our patron conduct code in line with city ordinances.”
To read more, visit http://bismarcktribune.com/news/local/govt-and-politics/library-may-take-action-on-e-cigarettes/article_735dd1ba-9a73-11e3-9436-001a4bcf887a.html

Safety of e-cigarette vapors questioned

, Buffalo Business First Reporter-Business First
It’s been years since viewers have sat through a cigarette commercial during the Super Bowl, with commercials for beer and cars dominating advertising.
But this weekend’s game included for the second consecutive year an ad for NJOY King, an electronic cigarette, with a theme of friends helping friends.
The response has been mixed from health advocates. While some say inhaling vapors or “vaping” is safer than smoking traditional tobacco cigarettes, others insist quitting entirely is the healthiest course of action. And it turns out vaping also exposes non-users to nicotine in the same way secondhand smoke affects those who spend time around smokers, though at much lower levels.
That’s according to research by Maciej Goniewicz, an assistant professor of oncology at Roswell Park Cancer Institute’sDepartment of Health Behavior, published by the journal Nicotine and Tobacco Research.
Goniewicz and his team studied vapor from three different brands of e-cigarettes, as well as secondhand smoke exposure of vapors and tobacco smoke generated by dual users. The results showed the e-cigarettes emit nicotine at levels of about 10 times less than conventional tobacco cigarettes, though they did not emit substantial amounts of carbon monoxide and toxic volatile organic compounds.
The study was a collaboration between Roswell Park and researchers at the Medical University of Silesia in Poland.
Though exposure to toxins is substantially lower, there’s still no definitive data on short and longterm health: The U.S. Surgeon General has not yet evaluated the short and longterm health risk from secondhand exposure to vapors.
“We don’t know yet the longterm affects of using these products,” Goniewicz said. “We know there are some traces of some potentially dangerous chemicals in the vapor. We don’t know what will happen after 10-20 years of inhaling this vapor.”
Still, vaping is considerably less dangerous than regular cigarettes, since users and those around them are exposed to significantly less toxins.
“The clear conclusion is that these products are safer than tobacco cigarettes. When you compare them, we believe these products are safer than tobacco cigarettes, but there is no doubt for smokers that quitting is the best way,” he said.
The other growing issue is how to handle vaping indoors, including in public places, restaurants and the workplace. The Food & Drug Administration and individual states place limits on advertising and how and where tobacco cigarettes are sold, but there have not yet been any rulings on exactly whether e-cigarettes fall into the same category.
A number of companies have already taken steps to limit vaping in the workplace, while in other places, it’s the state or municipality making the rules: New York City Council in December voted to ban the use of e-cigarettes in all places where smoking is prohibited. The Niagara Frontier Transportation Authority is now considering a ban on its transit vehicles and within its properties.
Goniewicz said he believes vaping should be limited as well to protect non-users, but it’s a difficult question.
“The main reason we have the indoor smoke-free law is to protect non smokers from being exposed to tobacco smoke,” he said. “We should protect these people from being exposed to vapor. But some people also believe that since we know this product is safer for smokers and it has the potential to save the lives of smokers, how can we encourage smokers to use electronic cigarettes instead of smoking? Any regulation should balance between the potential benefits and harm from the products.”
http://www.bizjournals.com/buffalo/blog/health_matters/2014/02/safety-of-e-cigarette-vapors-questioned.html

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/

The 50-year war on smoking

By The Times editorial board, Los Angeles Times
The 1964 U.S. Surgeon General’s report on smoking — the first official acknowledgment by the federal government that smoking kills — was an extraordinarily progressive document for its time. It swiftly led to a federal law that restricted tobacco advertising and required the now-familiar warning label on each pack of cigarettes.
Yet there was nothing truly surprising about the conclusion of the report. Throughout the 1950s, scientists had been discovering various ways in which smoking took a toll on people’s health. Britain issued its own report, with the same findings, two years before ours. Intense lobbying by the tobacco industry slowed the U.S. attack on smoking. And even when then-Surgeon General Luther Terry convened a panel before the report was issued to make sure its findings were unimpeachable, he felt compelled to allow tobacco companies to rule out any members of whom they disapproved.
Saturday marks the report’s 50th anniversary. The intervening decades have seen remarkable progress against smoking in the United States, despite the stubborn efforts of the tobacco industry, which lobbied, obfuscated and sometimes lied outright to the public about the dangers of its products. During those years, though, independent research tied smoking and secondhand smoke to an ever-wider range of ailments. According to the U.S. Centers for Disease Control and Prevention, smoking causes cancer of the lungs, larynx, bladder, bone marrow, blood, esophagus, kidneys and several other organs. It increases the risk of stroke, heart disease and cataracts. It can damage fetuses, weaken bones and harm teeth and gums. The list goes on.
The growing body of evidence bolstered important policies to combat tobacco use and the injury to nonsmokers barraged by the damaging effects of secondhand smoke. It can be hard for young Californians today to fathom that smoking was once practically ubiquitous throughout government buildings, restaurants and workplaces. In the 1970s, during hearings on legislation to curb smoking in public buildings, some legislators puffed away even as speakers described the asthma attacks they sometimes suffered from secondhand smoke. New restrictions helped smokers as well; if they could do without a cigarette for hours at a time at their jobs, many discovered, they could do without them entirely.
Limits on cigarette advertisements, rules that prevented sales to minors and new taxes on cigarettes helped bring smoking rates down.
In 1964, 42% of Americans smoked. Half the people on the panel that produced the surgeon general’s report smoked. Today, the U.S. smoking rate is 18%. Teen smoking rates fell to below 10% after the federal tax on cigarettes was increased by 62 cents a pack in 2009.
As smoking rates have declined, lung cancer rates have fallen as well. According to a report this week from the CDC, the rate among men ages 35 to 41 dropped by 6.5% per year from 2005 to 2009. One study just published in the Journal of the American Medical Assn. estimated that 8 million premature deaths from all smoking-related causes have been prevented since the surgeon general’s report was issued in 1964.
Despite the good news, smoking is still the No. 1 cause of preventable death in this country. Smoking-related disease costs $183 billion a year in medical expenses and lost productivity.
We know what works against this: research, education, limits on secondhand smoke and higher cigarette taxes. But the tactics of tobacco companies continue to hold the nation back.
Knowing how heedless of our well-being they have been all along, we should ignore their ads and their lobbyists and take the following steps:
• Raise tobacco taxes, preferably at the federal level to avoid black-market sales across state lines. According to a 2012 report by the U.S. Surgeon General, every 10% increase in the cost of smoking leads to a 4% drop in smoking rates.
President Obama has proposed increasing the federal excise tax by 94 cents a pack, nearly doubling it from the current $1.01, and using the resulting revenue stream — an estimated $78 billion over the next decade — to fund pre-kindergarten education. The tax is a good idea, but we have concerns about using the money for preschool. If smokers are paying the tax, the revenue ideally should go toward education, research, affordable cessation programs, enforcement of existing laws and healthcare costs related to tobacco use.
• Place increased emphasis on reducing teen smoking. If there’s one thing all Americans, including staunch defenders of the right to smoke, should agree on, it’s that minors should be protected from smoking. According to the American Lung Assn., more than two-thirds of adult smokers developed the habit as teenagers. Studies have shown that many retailers don’t check identification and sell even when the ID shows the buyer to be underage.
In addition, the U.S. Food and Drug Administration should immediately impose a ban on sales and marketing of e-cigarettes to minors, including Internet sales. E-cigarettes, which allow users to inhale nicotine-laced vapor rather than tobacco smoke, may turn out to be significantly more healthful than regular cigarettes, but studies are still underway about their long-term effects, and there’s no question that they encourage nicotine addiction. They have been heavily marketed to minors, who are allowed to buy them without restriction in most states. Further research is necessary as the e-cigarette market expands dramatically.
• Push for indoor-smoking restrictions in all states. It may surprise Californians, who now face smoking bans in parks, open eating areas and beaches, to learn that some states lack smoking bans even in workplaces, bars and restaurants. Kentucky, for example, restricts smoking only in government and university buildings.
Smoking is and should remain a personal choice among adults, but the nonsmokers around them have the right not to be sickened by the choices of others.
http://www.latimes.com/opinion/editorials/la-ed-smoking-50th-anniversary-of-surgeon-general–20140110,0,3302586.story#ixzz2q27cKUYc

Fitful Progress in the Antismoking Wars

By THE EDITORIAL BOARD, New York Times
Fifty years ago this Saturday, on Jan. 11, 1964, a myth-shattering surgeon general’s report on smoking and health brushed aside years of obfuscation by tobacco companies and asserted, based on 7,000 scientific articles, that smoking caused lung cancer and was linked to other serious diseases. Those findings expanded as more data was gathered.
Research since then has shown that tobacco can cause or exacerbate a wide range of diseases, including heart disease, stroke, multiple kinds of cancer, chronic obstructive pulmonary disease, emphysema, asthma and diabetes, and can injure nonsmokers who breathe in the toxic fumes secondhand. The death toll from tobacco remains stubbornly high but can be driven down by using a range of new and proven tactics.
By some measures, the 50-year campaign to rein in tobacco use has been an enormous success. The percentage of American adults who smoke dropped from 42 percent in 1965 to 18 percent in 2012. A study published in the Journal of the American Medical Association this week estimated that tobacco control measures adopted since 1964 have saved eight million Americans from premature death and extended their lives by an average of almost 20 years.
Experts attribute the gains to vigorous campaigns to educate people about the dangers of smoking; increases in cigarette taxes; state and local laws that protect half the nation’s population from tobacco fumes in workplaces, bars and restaurants; restrictions on advertising; prohibition of sales to minors; and various prevention and cessation programs financed by states or private insurance.
Despite these gains, nearly 44 million American adults still smoke, more than 440,000 Americans die every year from smoking, and eight million Americans live with at least one serious chronic disease from smoking. Medical costs connected to smoking are nearly $96 billion a year, with an additional $97 billion lost in productivity because of illness.
On Wednesday, several health organizations, including the American Heart Association, the American Lung Association, the American Cancer Society, the American Academy of Pediatrics, and the Campaign for Tobacco-Free Kids called for a new national commitment to drive smoking among adults down to less than 10 percent over the next decade; protect all Americans from secondhand smoke within five years by having every state enact laws against smoking in all workplaces, bars and restaurants; and ultimately eliminate death and disease caused by tobacco.
It won’t be easy. The tobacco industry spends more than $8 billion a year to market cigarettes and other tobacco products in this country, with much of its marketing slyly aimed at young people.
The industry is also invading foreign markets, often in less developed countries, in an effort to make addicts of millions more customers to replace those in industrialized nations. Although smoking rates among adults around the globe have fallen sharply since 1980, the number of smokers has increased significantly along with population growth and will continue to increase as national incomes and populations rise. The United States government must help counter the tobacco industry’s efforts to spread its noxious products around the world.
http://www.nytimes.com/2014/01/10/opinion/fitful-progress-in-the-antismoking-wars.html?_r=0

Local doctor’s view e-cigarettes

By Diane Miller, High Plains Reader, Fargo
Sales of electronic cigarettes are expected to reach $1.7 billion this year. Many smokers are turning to this odor-free, vapor-releasing instrument as a safer alternative to cigarettes, but many health experts are skeptical.
HPR turned to local e-cig expert Dr. Brody Maack from Family HealthCare to answer a few questions this new product.
HPR: Why are the FDA and health experts so concerned about a product that seems like a much safer alternative to cigarettes?
Dr. Brody Maack: The main concern revolves around the fact that e-cigarettes currently have no manufacturing standards and are unregulated. This means that there have been no well done, long term safety studies in which the products are tested to see if there are any harmful effects.
Also, as far back as 2009, the FDA did laboratory analysis of some e-cigarettes, which showed that they contained carcinogens (cancer-causing chemicals) as well as diethylene glycol (which is found in anti-freeze).
The FDA also found that quality control in manufacturing the e-cigarettes is either poor or non-existent in laboratory studies.
It is also unknown as to the risks of inhaling the “vapor” which is let off by the products, and we don’t know if there is a risk for second-hand exposure to the vapor. Because e-cigarettes all contain different amounts of their ingredients, including nicotine, in addition to these other safety concerns, we cannot say that they are “safer” than cigarettes.
Another concern is that we are seeing a rapid increase in the use of e-cigarettes in our youth, due to various flavors which are attractive to a younger crowd, and intensive marketing of the products. Also, there is no restriction to e-cigarette sales to minors in North Dakota. Minnesota, however, does prohibit the sale and possession of e-cigarettes to minors.
HPR: What would be your response to this statement made by Craig Youngblood, president of the InLife e-cigarette company:
In our product you have nicotine or no nicotine, PEG, and some flavoring. In cigarettes you have nicotine, PEG, and 4,000 chemicals and 43 carcinogens. There are 45 to 50 million people already addicted to nicotine.
Should they have the choice to satisfy their addiction by other means? … I am a proponent of harm reduction. People have rights and choices and should be allowed to make them.
BM: Mr. Youngblood states that his product contains various ingredients (i.e. “nicotine or no nicotine”), also admitting that his product includes “some flavoring.” As I stated before, there are no e-cigarette manufacturers that are currently being held to any manufacturing standards or regulations, so the InLife product, like other e-cigarette products, may contain various amounts of its stated ingredients.
Also, the fact that InLife is promoting its product as containing flavoring may be increasing exposure of this product with unknown safety to our youth. This is why the FDA has banned flavoring in cigarettes. The CDC released data in October of this year which showed that 40 percent of middle and high schoolers who smoke, smoke flavored tobacco products.
I agree with Mr. Youngblood when he states that “people have rights and choices and should be allowed to make them,” but I believe that people’s decisions should therefore be well-informed, and not subject them, or their children, to potential health risk. Also, the issue of “harm reduction” is typically promoted by tobacco product supporters, however it is felt by most of the tobacco cessation expert community that complete abstinence from tobacco is the only way to reduce the number of people who will die in the next 100 years from tobacco related disease, which is expected to be 1 billion!
HPR: Many community citizens are upset that the city of Fargo banned the use of e-cigs in indoor public places. Do you foresee this rule changing and why?
BM: The banning of e-cigarettes in Fargo is actually a statewide law, which went into effect December 6, 2012. I don’t see this changing, simply because of concerns we have discussed—lack of manufacturing standards, lack of safety proof, potentially harmful ingredients and concerns for turning our youth on to tobacco products. Considering that e-cigarettes look similar to regular cigarettes, prohibiting their use indoors also eliminates any confusion about what’s acceptable under the statewide law.
HPR: In your opinion, what is the best method to quitting smoking?
BM: The best method of quitting smoking has been proven countless times to be a method which includes behavioral counseling along with medications, such as the nicotine patches, gum or lozenges. This method is recommended by the US Public Health Service, and is available in many communities through doctors’ offices, pharmacies and through state telephone quitline services, such as ND Quits (1-800-QUIT-NOW) or internet quit services. Many of these programs are free!
HPR: Anything you’d like to add?
BM: As of right now, e-cigarettes are too much of an “unknown” with regards to safety and whether or not they help people to quit smoking, and with concerns for the products being a gateway to youth tobacco use, they simply cannot be recommended for use. There have been no respectable studies showing that e-cigarettes are better, or safer, than any of our seven FDA-approved medications for quitting smoking.
We have a large amount of safety data and data to show that the FDA-approved options work very well to help people quit tobacco. These options include three over-the-counter options (nicotine patches, gum and lozenges), and four prescription products (Chantix, Zyban, nicotine inhaler and nicotine nasal spray). In fact, the nicotine inhaler is a proven, safe option for people who want to quit in a similar way as e-cigarettes, without the unknown risks of “vapor” exposure and other potentially harmful ingredients.
Also, the nicotine inhaler, along with the other FDA-approved options, is legal to use in any indoor space in North Dakota. I personally recommend this option for patients of mine who show interest in e-cigarette products as a safe alternative to e-cigarettes.
Brody Maack, PharmD, CTTS, is a clinical pharmacist who provides medication management services, including tobacco cessation, at Family HealthCare in Fargo. He also serves as Assistant Professor of Pharmacy Practice at the NDSU College of Pharmacy, Nursing and Allied Sciences, where he teaches the subjects of heart and lung diseases, which includes tobacco related disease, prevention and cessation.
http://hpr1.com/wellness/article/local_doctors_view_e-cigarettes/