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WebMD News from HealthDay: FDA Launches Ad Campaign Against Chewing Tobacco

By Dennis Thompson

HealthDay Reporter

TUESDAY, April 19, 2016 (HealthDay News) — U.S. health officials said Tuesday that they are targeting rural teenagers with a new $36 million ad campaign that highlights the health risks associated with chewing tobacco.

The campaign’s message — “smokeless doesn’t mean harmless” — will challenge a habit that has become a tradition in the rural United States, said Mitch Zeller, director of the Center for Tobacco Products at the U.S. Food and Drug Administration.

“It is culturally ingrained in many rural communities, and can be seen as a rite of passage and an acceptable societal norm,” Zeller said during a Tuesday morning news conference. He noted that smokeless tobacco use is more than twice as common in rural areas as it is in urban settings.

Chewing tobacco, snuff and other smokeless tobacco products have been linked to multiple kinds of cancer, gum disease, tooth loss and nicotine addiction, Zeller said.

Nevertheless, smokeless tobacco use has become increasingly popular among rural male teenagers, according to FDA research.

Every day in the United States, nearly 1,000 males younger than 18 try smokeless tobacco for the first time, outpacing those who take their first puff on a cigarette, Zeller said. About one-third of rural white males aged 12 to 17 have tried or are at risk of trying smokeless tobacco, totaling approximately 629,000 male youth nationwide.

Rural teens are used to seeing role models use smokeless tobacco, including fathers, grandfathers, older brothers and community leaders, Zeller explained.

“When people who these teens most trust and admire openly use and share smokeless tobacco, the product is seen as acceptable, and even as an expected part of growing up and belonging,” Zeller said.

This is the first time the FDA has focused on smokeless tobacco in an ad campaign, said Kathy Crosby, director of the FDA’s Office of Health Communication and Education.

Crosby said the campaign will focus on 35 rural markets across the United States, including: Albany, Ga.; Billings, Mont.; Flint, Mich.; Medford, Ore.; Monroe, La.; Sioux Falls, S.D.; Little Rock, Ark.; and Tri-Cities, Tenn.

Ads linked to the campaign show young men with ugly lip sores and horrific facial scars caused by mouth cancer, and a football player being tossed around by a nicotine addiction “monster.” The ads will run on local television and in print, while others appear on local radio and through social media.

The new campaign will also collaborate with select Minor League Baseball teams to help combat the link between baseball and smokeless tobacco use among the campaign’s target audience, Crosby said.

This summer, stadiums across the country will display campaign advertising and provide opportunities for fans to meet players who support the campaign’s public health message, she said.

The FDA also is in ongoing talks with Major League Baseball about joining the campaign, and Zeller said he is “optimistic” that a partnership will be announced sometime this season.

Major cities such as Boston, Los Angeles, New York City and San Francisco have banned smokeless tobacco products at ballparks and other sports venues. Major League Baseball has warned that players caught violating the ban in these cities will be subject to discipline from the commissioner.

The smokeless tobacco campaign is an offshoot of the FDA’s award-winning “The Real Cost” campaign, which since 2014 has been warning teenagers about the health effects of smoking.

http://www.webmd.com/smoking-cessation/news/20160419/fda-launches-ad-campaign-against-chewing-tobacco

Opinion: No place in baseball for smokeless tobacco

By: Dick Durbin | As published in the Chicago Tribune

My feelings about tobacco took shape at the bedside of my father in November 1959. I was a sophomore in high school when lung cancer took his life. He was 53 and had smoked two packs of Camels a day.

As a member of Congress I first went up against the powerful tobacco lobby in 1987 and shocked myself and my colleagues by passing a bill banning smoking on airplanes on domestic flights of less than two hours. That measure turned out to be a tipping point. A series of local, state and federal laws followed, leading to restricting tobacco use on all flights, on trains and in hospitals, offices, restaurants and malls.

Despite all these victories, my battle against tobacco consistently struck out in one key area. For over 20 years I have been trying to get spit tobacco out of Major League Baseball.

Just as youth players wear their socks and sweatbands like the pros, or mimic the swing or windup of their favorite star, they are watching as baseball players slip a wad of tobacco in their cheek or under their lip. That sends a visual message, leading teenage boys to imitate this dangerous habit.

The numbers tell the story. While use of cigarettes and cigars among high school athletes declined from 30 percent to 18 percent between 2001 and 2013, use of smokeless tobacco increased by 10 percent in that population over the same period.

Among 8th grade students, the use of smokeless tobacco increased 14 percent between 2013 and 2015. Each year, nearly half a million kids age 12-17 use smokeless tobacco for the first time.

Tony Gwynn, the legendary San Diego hitter, was the most well-known baseball victim of salivary gland cancer caused by spit tobacco. Before his death in 2014, Gwynn attributed his oral cancer to his chewing tobacco use, “Of course it caused it … I always dipped on my right side,” he remarked. He and his family were honest about the cause of his death and reminded us of the real danger of this deadly habit.

Baseball owners such as Jerry Reinsdorf of the Chicago White Sox are outspoken opponents of spit tobacco. They remind me that all forms of tobacco are banned in the minors. Bobby Brown, a former Yankee and a medical doctor, became president of the American League. He joined the late Joe Garagiola, the former St. Louis Cardinal player and announcer, in leading the fight against spit tobacco. Despite all this opposition, the owners ran into a brick wall negotiating the issue with the players’ organization. I remember calling the players’ lead negotiator, Donald Fehr, many years ago. When I raised the danger of spit tobacco to the health of his players, he said: “It’s a negotiable item” and hung up.

The 2016 baseball season marks a long-anticipated breakthrough.

With the leadership of the Campaign for Tobacco-Free Kids, five major league cities (New York, Chicago, Boston, Los Angeles and San Francisco) have enacted ordinances banning spit tobacco at their ballparks, and Toronto and Washington, D.C., are considering similar bans. When I met Tony Clark, the head of the Players Association, at a Major League Baseball event in Havana a few weeks ago, I reminded him that his players have to live in this new world. I don’t want to see any player embarrassed or fined. I just want a sport I love to stop promoting a deadly tobacco habit.

Democrat Dick Durbin is the senior U.S. senator from Illinois.

http://www.chicagotribune.com/news/opinion/commentary/ct-durbin-baseball-smokeless-tobacco-perspec-0331-md-20160415-story.html

CDC: No decline in overall youth tobacco use since 2011

Overall tobacco use by middle and high school students has not changed since 2011, according to new data published by the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration’s (FDA) Center for Tobacco Products in today’s Morbidity and Mortality Weekly Report (MMWR).

Data from the 2015 National Youth Tobacco Survey show that 4.7 million middle and high school students were current users (at least once in the past 30 days) of a tobacco product in 2015, and more than 2.3 million of those students were current users of two or more tobacco products. Three million middle and high school students were current users of e-cigarettes in 2015, up from 2.46 million in 2014.

Sixteen percent of high school and 5.3 percent of middle school students were current users of e-cigarettes in 2015, making e-cigarettes the most commonly used tobacco product among youth for the second consecutive year. During 2011 through 2015, e-cigarette use rose from 1.5 percent to 16.0 percent among high school students and from 0.6 percent to 5.3 percent among middle school students.

From 2011 through 2015, significant decreases in current cigarette smoking occurred among youth, but there was no significant change in the prevalence of current cigarette smoking among this group during 2014 – 2015. In 2015, 9.3 percent of high school students and 2.3 percent of middle school students reported current cigarette use, making cigarettes the second-most-used tobacco product among both middle and high school students.

“E-cigarettes are now the most commonly used tobacco product among youth, and use continues to climb,” said CDC Director Tom Frieden, M.D., M.P.H. “No form of youth tobacco use is safe. Nicotine is an addictive drug and use during adolescence may cause lasting harm to brain development.”

Students use many forms of tobacco

In addition to e-cigarettes and cigarettes, high school students used other tobacco products:

  • 8.6 percent smoked cigars,
  • 7.2 percent used hookahs,
  • 6.0 percent used smokeless tobacco,
  • percent smoked pipe tobacco, and
  • 0.6 percent smoked bidis.

After e-cigarettes and cigarettes, middle school students reported using these products:

  • 2.0 percent used hookahs,
  • 1.8 percent used smokeless tobacco,
  • 1.6 percent smoked cigars,
  • 0.4 percent smoked pipe tobacco, and
  • 0.2 percent smoked bidis.

Among non-Hispanic white and Hispanic high school students, e-cigarettes were the most commonly used tobacco product. Among non-Hispanic black high school students, cigars were the most commonly used tobacco product. Cigarette use was higher among non-Hispanic whites than among non-Hispanic blacks. Smokeless tobacco use was higher among non-Hispanic whites than students of other races.

“We’re very concerned that one in four high school students use tobacco, and that almost half of those use more than one product,” said Corinne Graffunder, Dr.P.H., M.P.H., director of CDC’s Office on Smoking and Health. “We know about 90 percent of all adult smokers first try cigarettes as teens. Fully implementing proven tobacco control strategies could prevent another generation of Americans from suffering from tobacco-related diseases and premature deaths.”

FDA has regulatory authority over cigarettes, cigarette tobacco, roll-your-own tobacco, and smokeless tobacco. The agency is finalizing the rule to bring additional tobacco products such as e-cigarettes, hookahs, and some or all cigars under that same authority.

“The FDA remains deeply concerned about the overall high rate at which children and adolescents use tobacco products, including novel products such as e-cigarettes and hookah,” said Mitch Zeller, J.D., director of the FDA’s Center for Tobacco Products. “Finalizing the rule to bring additional products under the agency’s tobacco authority is one of our highest priorities, and we look forward to a day in the near future when such products are properly regulated and responsibly marketed.”

Regulating the manufacturing, distribution, and marketing of tobacco products – coupled with proven population-based strategies – can reduce youth tobacco use and initiation. These strategies include funding tobacco control programs at CDC-recommended levels, increasing prices of tobacco products, implementing and enforcing comprehensive smoke-free laws, and sustaining hard-hitting media campaigns.

To learn more about quitting and preventing children from using tobacco, visit www.BeTobaccoFree.gov.

http://www.cdc.gov/media/releases/2016/p0414-youth-tobacco.html

ESPN: New York approves smokeless tobacco ban at sporting events

Adam Rubin, ESPN Staff Writer

Smokeless tobacco will soon be off-limits for players and patrons at Citi Field and Yankee Stadium.

The New York City Council approved a ban on smokeless tobacco at ticketed sporting events on Tuesday afternoon by a vote of 44-3. The law is due to take effect immediately once Mayor Bill de Blasio signs the bill, which is expected to be a formality.

“Today we’re taking tobacco out of baseball in New York City,” council member Corey Johnson said. “In New York City we’ve seen smoking rates precipitously decline, but chewing tobacco use has remained steady. When athletes who are role models to children are regularly shown on TV using smokeless tobacco, that sends a harmful message.

“By allowing smokeless tobacco at the ballparks, we are sending mixed signals about the dangers of tobacco use. There may not be many baseball issues where Mets and Yankees fans can agree, but this certainly is one of them.”

Chicago last week joined San Francisco, Boston and Los Angeles in enacting a similar ban.

Yankees setup man Andrew Miller said players will not picket over the issue, but he did allude to some players being addicted to the otherwise legal substance, which makes the situation tricky.

“It is what it is,” said Miller, who once chewed tobacco but says he doesn’t anymore. “I didn’t vote on it. I didn’t put it into effect. I didn’t publicly ask one way or the other for it. It is just something we are going to have to deal with. People will have to find a way to approach it and how strictly it will be enforced.”

The penalty in New York is expected to match the fine for smoking where it is prohibited in the city, roughly $100.

“There are different tobacco laws in place for multiple different states — obviously smoking and smokeless,” New York Mets outfielder Curtis Granderson said. “So it’s not something that surprises me if New York or Citi Field were to go ahead and pass something like this. The only question we have is, the guys who do it, how do they know what’s going on?

“The Players’ Association is going to provide alternatives for them. But if a player accidentally chooses to do it, will he get a citation? Will we stop the game? And will the same thing happen to the fans in attendance? That hasn’t been identified yet, so we’re still waiting to hear that.”

ESPN’s Andrew Marchand contributed to this report.

http://espn.go.com/mlb/story/_/id/15045514/new-york-city-approves-smokeless-tobacco-ban-sporting-events

Wahpeton Daily News: Study: More nicotine found in smokeless tobacco

By Carrie McDermott • Daily News

Users of smokeless tobacco are exposed to equal or higher levels of nicotine and NNK, a cancer-causing chemical in tobacco products, than cigarette smokers, according to a study from the federal government.
Researchers from the Food and Drug Administration and the Centers for Disease Control and Prevention say more data is needed on the toxic components of smokeless tobacco products and the health of those who use them.
In the study, researchers analyzed information from more than 23,000 participants in national health surveys between 1999 and 2012. They looked for markers used to measure the addictive stimulant nicotine and cancer-causing NNK from blood and urine samples. They found the level of cotinine, the marker for nicotine exposure, to be .043 nanograms/milliliter in nonsmokers compared to 180 ng/ml among smokeless tobacco users, about 131 ng/ml in cigarette users and 184 ng/ml among people who used both smokeless tobacco and cigarettes.

Jason McCoy, tobacco prevention coordinator at PartnerSHIP 4 Health in Moorhead, Minnesota, said he’s eager to get this surprising information out to the public.
“We know that in rural parts of the state, one in 10 young white men, basically high school boys, are using Snus and chewing tobacco, thinking it’s less dangerous than smoking,” he said.
He said the only difference is when they use chewing tobacco, they aren’t affecting others with secondhand smoke.
“The individual is potentially damaging themselves more,” he said. “It’s surprising.”
And many young smokeless tobacco users are choosing flavored products, which make it more attractive.
“This ties into other research we have that shows flavored tobacco is viewed, in self reports by teens, as less addictive than regular tobacco,” McCoy said. “On the other end, we know the flavoring makes it more addictive. The part of the brain that ties into the flavor of the product, similar to why you may like Coke over Pepsi, it’s the same triggering mechanism that happens. The flavor gets assigned in your brain along with the nicotine.”
McCoy works with four counties — Becker, Clay, Otter Tail and Wilkin — and gets reports showing that often high school athletes know they don’t want to smoke because of the smell, so they choose smokeless tobacco, also thinking it won’t affect their athletic performance.
“We know that short term, it’s going to cause gum disease and tooth decay, long term, possible mouth, throat and stomach cancers,” he said. “It’s every bit as dangerous as cigarettes.”
He said he’s been told by teachers that students are taking the Ice Breakers mints and filling those containers with Snus, so they can surreptitiously carry the smokeless tobacco around with them.
“When they open it up, it just looks like they’re getting a mint,” he said.
About 3.6 percent of Minnesotans regularly use smokeless tobacco, according to the latest Minnesota Adult Tobacco survey.
For those wanting to quit their nicotine use, the state of Minnesota offers QUITPLAN which provides proven methods of quitting successfully. The program offers phone counseling and nicotine replacement tools at no cost. To find out more, visit www.quitplan.com or call 1-888-354-7526.
http://www.wahpetondailynews.com/news/study-more-nicotine-found-in-smokeless-tobacco/article_a81d5b36-9a9f-11e5-9849-3facbacf33f9.html

MINNPOST: Proposed Minneapolis tobacco licensing changes will help curb youth smoking

By Jan Malcolm | 06/19/15

Imagine a future when tobacco is no longer the leading cause of preventable death and disease. To make this vision a reality, we must prevent more young people from getting hooked by deadly tobacco products. The Minneapolis City Council is poised to do just that by considering changes to the licensing ordinance to restrict the sale of all flavored tobacco (other than menthol) to adult-only tobacco stores and set minimum price limits for cigars. These measures strike at the heart of the tobacco industry’s strategy to sell their products to kids: flavoring and price.

While Big Tobacco is supposed to be prohibited from marketing to kids, it finds many ways around that ban. Tobacco executives know that unless they get to kids before they reach their 20s they’ve lost a customer. Documents released during the tobacco trials of the 1990s reveal how deliberately tobacco companies target young people. On the witness stand, the chairman of the Liggett & Myers Tobacco Co. said, “If you are really and truly not going to sell to children, you are going to be out of business in 30 years.” A Lorillard executive wrote that he wanted to exchange research data with Life Savers to figure out what tastes kids want. And a marketing plan from U.S. Smokeless Tobacco showed a deliberate strategy to start users on sweet flavors, then “graduate” them to plain tobacco.

Candy and fruit flavors

The appeal of flavoring to young people is the reason the FDA banned cigarettes in flavors other than menthol in 2009. Unfortunately, products such as little cigars, cigarillos, chew, e-cigarettes and others are still widely available in candy and fruit flavors such as bubble gum, grape and gummy bear – flavors that clearly appeal to youth. These flavored products are for sale in more than 250 stores throughout Minneapolis alone, and they are easy for children to purchase. One-third of Minneapolis boys under 18 report buying tobacco from a convenience store or gas station.

Research shows that young people mistakenly believe that flavored tobacco products are less dangerous than other tobacco products. In fact, they are just as dangerous, with the same health risks of cancer, heart disease and chronic obstructive pulmonary disease. Candy and fruit flavored tobacco products just mask the harsh taste and feel of tobacco.

Nearly 20 percent of Minnesota high school students have tried a water pipe or hookah, and almost all shisha (hookah tobacco) is flavored. More than 25 percent of Minnesota high school students have used an e-cigarette, and most e-cigarette liquid is flavored. More than 35 percent of Minnesota high school students report that they have tried flavored cigars, cigarillos or little cigars at some point in their lives. In fact, kids are now twice as likely as older people to be cigar smokers. Almost 20 percent of Minneapolis 12th-graders say they smoke cigar products like cigarillos regularly.

Young people known to be price sensitive

Nearly 75 percent of Minneapolis tobacco retailers currently sell cigars and cigarillos, many for less than a dollar. The proposed changes to our city’s tobacco licensing ordinance would set a minimum price of $2.60 for each cigar. Research shows that young people are very sensitive to price increases and are more likely to just quit using a product they can’t afford than adults are.

Flavored tobacco restrictions and price minimum requirements have been successfully implemented in other communities around the country – and right here in Minnesota. No one wants our young people to face a lifetime of addiction and other health problems. We know that policies that restrict access to flavored tobacco and raise tobacco prices keep kids from starting to smoke and help them to quit.

Support the proposed changes to the Minneapolis tobacco licensing ordinance. Stand up for our kids against Big Tobacco.

Jan Malcolm is the vice president of public affairs for Allina Health. She served as Minnesota state health commissioner from 1999 to 2003. Malcolm lives in Minneapolis.

https://www.minnpost.com/community-voices/2015/06/proposed-minneapolis-tobacco-licensing-changes-will-help-curb-youth-smoking

TIME: San Francisco Bans Chewing Tobacco at Sports Venues

By Olivia B. Waxman

Effective Jan. 1, 2016

On Friday, San Francisco became the first American city to ban smokeless tobacco—chewing tobacco and “moist inhalable snuff”—at sports venues.

The new ordinance, signed by Mayor Ed Lee, goes into effect on Jan. 1, 2016. Violators will be asked to leave the playing fields (where cigarette and cigar smoking is already banned), the Associated Press reports.

Anti-smoking groups argue that a ban on smokeless tobacco—which has been linked to cancer and nicotine addiction—sends the right message to kids who look up to the players. But San Francisco Giants pitcher Matt Cain said the measure may be hard to enforce, noting that coffee pouches resemble tobacco pouches, according to an article on the team’s website.

The state Assembly is still considering a bill banning tobacco use—electronic cigarettes included—wherever there’s a baseball game, the AP reports.

To read more or watch video: http://time.com/3852742/san-francisco-bans-chewing-tobacco/

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

Cigarette tax and e cigarettes debated in ND legislature

By KX News

Bismarck, ND -A bill that would have substantially raised taxes on cigarettes in North Dakota failed Friday afternoon.
But two others limiting access to electronic cigarettes passed.
The proposed cigarette tax would have raised taxes more than 200 percent on a package of cigarettes.
Currently the cigarette tax in North Dakota is 44 cents.
By contrast, the tax in Minnesota is 2.90 and in South Dakota it’s a 1.53.
Supporters of the bill say the increase would reduce the number of smokers and lower health care costs.
“Whenever a tobacco tax is increased, smoking, especially youth smoking goes down and it goes down dramatically. That I believe is undeniable,” says Rep. Jon Nelson, R – Rugby.
Bill opponents argued that a tax won’t stop smoking, and burdens business.
“If it truly is our duty to coerce people into a healthy lifestyle through taxation, why don’t we tax fast food with high fat content and high cholesterol, all things supersized and salt,” says Rep. Rick Becker, R – Bismarck.
The cigarette tax bill failed by a 56-34 vote.
The house passed two bills designed to keep e-cigarettes away from kids.
The two bills differ in these ways —
One labels e-cigarettes as tobacco products, tying them to the laws and enforcement already in place for cigarettes.
Those laws include things like compliance checks from local police and how cigarettes are displayed in stores.
The other bill separates e-cigarettes into their own category with their own set of enforcement laws.
“I don’t know how we can separate the idea of discussing e-cigarettes and then we’re going to talk about the taxing of tobacco when it’s clearly a tobacco product,” says Rep. Kenton Onstad, D – Parshall.
“We do not want kids under the age of 18 to buy cigarettes, whether it be on the internet, whether it be in the store. E-cigarettes, anywhere. We don’t want them to by regular cigarettes, we don’t want them to buy e-cigarettes,” says Rep. Al Carlson, R – Fargo.
Both bills now move to the Senate where only one, if any, is likely to pass.
http://www.wdaz.com/news/north-dakota/3679119-cigarette-tax-and-e-cigarettes-debated-nd-legislature