WASHINGTON — E-cigarette use continued to rise among young teenagers and preteens in the United States last year, according to new federal data, but cigarette smoking overall did not increase, suggesting that, at least so far, fears that the devices would hook a new generation on traditional cigarettes have not come to pass.
Experts said it was too soon to answer the essential question about e-cigarettes: Will they cause more or fewer people to smoke? But the broad trend in youth cigarette smoking has been down in recent years, and researchers have been taking note of that.
“We do not have any strong evidence that it is encouraging smoking among kids but neither do we have good evidence that it won’t over time,” said Kenneth E. Warner, a professor of public health at the University of Michigan.
About 5 percent of middle-school students reported using e-cigarettes in 2015, up from about 4 percent in 2014, according to data from the Centers for Disease Control and Prevention. That is a substantial increase from 2011, when less than 1 percent of middle schoolers used the devices.
Use for high-school students was also trending up, with 16 percent reporting using the devices in 2015, up from 13 percent in 2014. But the change was not statistically significant because of technical reasons having to do with the sizes and distributions of the samples. In 2011, the rate was just 1.5 percent for high schoolers.
Policy makers have worried that increased e-cigarette use could make it more likely young people would shift to traditional tobacco cigarettes, which are more toxic. But that does not seem to be happening yet. About 9 percent of high schoolers reported smoking cigarettes in 2015, unchanged from 2014, and down from 16 percent in 2011.
Among middle schoolers, about 2 percent reported smoking traditional cigarettes in 2015, statistically unchanged from 2014. In 2011, about 4 percent of middle schoolers smoked traditional cigarettes.
The popularity of electronic cigarettes has soared since they were introduced in the mid-2000s and the devices have swept through the market so quickly that they have outpaced the federal government’s intention to regulate them. (Final rules from the Food and Drug Administration, which regulates tobacco products, have been expected for months.) Bonnie Herzog, an analyst with Wells Fargo, estimates the total vapor market, including e-cigarettes and other related products, such as liquids and personal vaporizers, totaled about $3.3 billion in the United States 2015.
E-cigarettes, designed to deliver nicotine without the toxic tar of conventional cigarettes, have prompted a split among public health experts with some saying the devices will hook new generations of smokers and undo hard-won progress on smoking rates and others saying they will help older, addicted smokers quit.
The answer is not yet clear, in part because there is not enough data on use to tell. But it is important: Cigarette smoking is still the single largest cause of preventable death in the United States, killing about 480,000 people a year. While smoking rates have dropped drastically since the 1960s, there are still more than 40 million Americans who smoke.
Professor Warner said what stood out was the fact that the rate of e-cigarette use had slowed from its earlier more rapid rise, a shift that he said was too early to interpret and that smoking of traditional cigarettes, after many years of declines, had not gone down.
“I’m disappointed, and a bit surprised, not to see another decline in cigarette smoking, even if small,” he said. As for e-cigarettes, If anything, use seems to be flattening out.”
Young people are a particularly vulnerable bunch, and many public health experts agree that with so little known about the long-term effects of e-cigarettes, the fact that so many youths have started using them is worrying, even if they do not use them as a bridge to traditional cigarettes. Others argue that even nicotine can be harmful. In all, about three million middle and high school students used e-cigarettes in 2015, the data showed, up from 2.46 million in 2014.
“No form of youth tobacco use is safe,” said Dr. Thomas R. Frieden, the director of the C.D.C. in a statement. “Nicotine is an addictive drug and use during adolescence may cause lasting harm to brain development.”
The data, from the National Youth Tobacco Survey, which is a pencil-and-paper questionnaire administered to a large sample of middle- and high-school students across the country, had a bright spot: Hookah use declined for high school students, falling to about 7 percent from about 9 percent in 2014.
Two tobacco giants are seeing strong demand for their reboots of the e-cigarette in Japan, with Philip Morris International twice postponing a nationwide rollout and Japan Tobacco suspending shipments – both due to supply shortages.
Japan has become a key testing ground for the two companies and their new, real tobacco e-smokes as they grapple with shrinking demand for traditional cigarettes in other developed countries.
Philip Morris, the world’s largest tobacco company, has postponed the nationwide rollout of its iQOS to April 18.
“We believe that the success of iQOS commercialisation in Japan will accelerate its global expansion,” Philip Morris Japan president Paul Riley told Reuters.
Japan Tobacco CEO Mitsuomi Koizumi told an earnings briefing in February: “We have very high expectations for growth of the so-called tobacco vapor category in five years or so from now.”
The iQOS is a tobacco stick that is heated just enough to produce an aerosol but not combust. The company is betting the presence of real tobacco will make it more satisfying to smokers than existing e-cigarettes.
The new device, priced at 9,980 yen ($89), appears similar to other e-cigarettes in that it is pen-shaped and battery-powered, and is heated to release tobacco vapor.
A key distinction is the refills, sold as Marlboro HeatSticks. Most e-cigarettes sold elsewhere use nicotine-laced liquid, which is heavily regulated in Japan. A pack of 20 HeatSticks sells for 460 yen, the same as regular Marlboro cigarettes.
Philip Morris has introduced the products in major cities in Switzerland, Italy and other countries, but Japan is the first country it plans a nationwide release.
The company had originally planned to sell the product throughout Japan on March 1, but postponed the launch to the end of the month due to a potential supply shortage after it saw stronger-than-expected sales in 12 prefectures where it has been test marketing.
The company estimates the market share of Marlboro HeatSticks reached 2.4 percent in Tokyo at the end of January.
Japan Tobacco, which commands about 60 percent of Japan’s cigarette market and is the world’s third-largest tobacco maker, has also got in on the action by acquiring two overseas e-cigarette makers in the past two years.
In Japan, it has launched the Ploom TECH, priced at 4,000 yen and sold with 460-yen packs of five capsules. Ploom TECH’s selling point is that vapor generated from a liquid cartridge passes through the capsules’ granulated tobacco, creating a taste the company says is close to the real thing.
“There is definitely a need for products that are smokeless but are still satisfying as cigarettes,” said Masanao Takahashi, director at Japan Tobacco’s emerging products marketing division.
Like iQOS, Ploom TECH’s initial launch in the southern Japanese city of Fukuoka proved so popular that the shipment of the device were suspended after a week due to a supply shortage.
It is currently working on a nationwide launch and is also eyeing a global expansion later this year.
By John Hageman
Heather Nelson is well-versed in the arguments over electronic cigarettes.
Armed with a stack of printed news clippings behind the glass counter at her Grand Forks shop, SnG Vapor, she’s adamant that the products her business sells helps smokers quit traditional cigarettes.
But Nelson worries that a proposed tax in North Dakota will harm her business and present an obstacle for those looking to stop smoking.
“I don’t think it’s fair to boost the tax on something that’s actually helping them,” she said.
But public health officials and backers of the proposed ballot measure argue the liquid nicotine used in electronic cigarettes is a tobacco product, and therefore it should be taxed as such. Moreover, they say the U.S. Food and Drug Administration has not identified electronic cigarettes as a smoking cessation product.
The proposal to tax vaping products is included in the ballot language put forth by Raise it for Health North Dakota, which is focused on increasing the state’s cigarette tax from 44 cents a pack to $2.20 a pack. The measure would classify liquid nicotine that’s derived from tobacco as a tobacco product and would raise the tax on it and other items from 28 percent to 56 percent of the wholesale purchase price.
Aside from the larger debate over raising taxes on traditional cigarettes, the proposal is likely to open discussion on the merits of electronic cigarettes, a relatively new product that has grown rapidly in popularity. Though it is much smaller than the traditional cigarette market, the vapor market grew by 23 percent in 2014, according to a Tax Foundation report released earlier this week, and several shops selling e-cigarettes have opened in Grand Forks in recent years.
Dr. Eric Johnson, a Grand Forks physician and chairman of the committee organizing the ballot measure, said electronic cigarettes are subject to sales tax in North Dakota but not a specific tobacco tax. He pointed out that more than 20 North Dakota cities, including Grand Forks, consider electronic cigarettes tobacco products for the purposes of preventing their sale to minors.
“It’s just kind of an example of the law not really keeping up with technology,” Johnson said. “The e-cig vape technology, they’re tobacco products by about just any medical definition.”
Looking at the data
Mike Jacobs smoked cigarettes for more than 20 years before picking up an e-cigarette last year.
“My last cigarette was Nov. 11,” he said from the other side of the counter at SnG Vapor, which is on South 18th Street just south of DeMers Avenue.
Nelson points to Jacobs as one story of how the products at her store can help people dump traditional cigarettes. She also cited the Public Health England’s statement last year that vaping is safer than smoking, though the agency stressed the products aren’t without risk, according to the Guardian.
That was echoed in the Tax Foundation’s report, which argued “vapor products have the potential to be a boon to public health by acting as a less risky alternative to traditional incinerated cigarettes.”
“Further, to the extent that smoking cessation is a stipulated goal of tobacco taxation, exposing vapor products, which many see as a promising cessation method, to such hefty tax rates as traditional tobacco would be counterproductive,” the report added.
But not everyone is convinced.
Johnson said electronic cigarettes are not FDA-approved as smoking cessation devices and there isn’t sufficient evidence that they help people quit traditional cigarettes. Indeed, a study published in the Lancet Respiratory Medicine in January found adult smokers who use e-cigarettes were less likely to quit smoking, according to CBS News.
“If they had data, I would recommend them just like any other stop-smoking product,” Johnson said. “Since we don’t really know whether these help or promote use, it’s very difficult as a health care provider to recommend them at this time.”
Moreover, Johnson is worried that they act as a gateway for young people to move on to other tobacco products. While the percentage of North Dakota high school students who smoke has dropped substantially over the past 20 years, roughly 20 percent of Grand Forks students use electronic vapor products, according to survey results previously provided by the Grand Forks Public Health Department.
“We’re kind of wondering, ‘Is what we’re doing in public health working or are they switching from one product to another?'” said Haley Thorson, tobacco prevention coordinator with the health department, who added they’ve “also accomplished some very successful policy initiatives in our state.”
Raise it for Health submitted its petition to the North Dakota Secretary of State’s office last week. Supporters will need to collect 13,452 signatures to get the measure on November’s ballot.
Minnesota became the first state to tax vapor products in 2012 by imposing a tax of 95 percent of their wholesale price, and only a handful of other states have similar policies in place, according to the Tax Foundation.
Meanwhile, at least 25 states and the District of Columbia considered legislation to tax vapor products in 2015. North Dakota was among them, but the bill ultimately failed to become law.
“We want all of those products taxed at the same rate so one addiction doesn’t cost less than the other,” said Sen. Tim Mathern, D-Fargo, who was a sponsor of the bill last year to raise tobacco taxes and is a member of the ballot measure’s sponsoring committee. “The goal really here in this measure is to reduce the amount of people who are addicted to these products in order to keep them healthy and in order to keep our society healthy.”
But for Nelson, the tax “will put a damper” on a product she argues is helping people move away from more dangerous traditional cigarettes. She said it may prompt shops like hers to unite in opposition.
“We want to get organized and we want to be heard,” Nelson said.
By Nicholas Kusnetz
SACRAMENTO, Calif. — In the Golden State, home to healthy living, progressive politics and one of the lowest smoking rates in the nation, cigarettes can seem like a relic of the past, barred long ago from restaurants, bars and even some city parks.
And yet within the walls of California’s high-domed capitol, tobacco companies continue to wield surprising power. After a recent loss on a slate of tobacco control bills headed to the governor’s desk, they are gearing up for a bigger test looming at the ballot this fall. With money to spend, they have threatened to sabotage a planned ballot measure to raise the cigarette tax.
The battles aren’t just here. Despite the tobacco industry’s tarnished public image, it is operating a powerful and massive influence machine in statehouses from Salt Lake City to Topeka. With a playbook crafted nearly 20 years ago, the tobacco firms use direct lobbying, third-party allies and “grassroots” advocacy campaigns to spread model legislation and mobilize smokers against proposed regulations and tax hikes across the country. And they are taking up the mantle to defend a burgeoning electronic cigarette market as well.
Today, tobacco companies maintain some of the mostextensive state lobbying networks in the country, totaling hundreds of lobbyists. Altria Group Inc. and Reynolds American Inc., which control the vast majority of the American tobacco market, are among just 21 entities that had registered lobbyists in every state at one point from 2010 through 2014, according to a Center for Public Integrity analysis of lobbyist registrations collected by the National Institute on Money in State Politics.
They’ve also given at least $63 million to state candidates, committees and ballot initiatives nationwide over the past five years.
Their chief opponents, the American Cancer Society and American Heart Association, also have similarly broad lobbying networks, but the health associations have given hardly any money to state politicians.
With such extensive reach, tobacco companies have continued to fight off the simplest means of cutting smoking rates: higher taxes. Out of 24 states to propose higher cigarette taxes last year just eight passed increases, according to a tobacco industry group. And only Nevada, with a $1-per-pack hike, raised them by more than 50 cents. Health groups say incremental tax hikes of less than $1 are much less effective at cutting smoking rates because tobacco companies can easily counteract them with rebates and discounts.
E-cigarettes are the newest front in this multi-faceted war. While the Food and Drug Administration has announced plans to regulate e-cigarettes, for now it remains up to states to impose any regulations or taxes on the emerging products. So far, e-cigarette taxes have passed in only four states, while proposals have been defeated in at least 21 others. The tobacco industry, which is increasing its share of the new market, has also won language in at least 19 states in recent years making it harder to regulate and tax e-cigarettes under existing anti-smoking laws.
David Sutton, a spokesman for Altria, the parent company of Philip Morris, said his firm is generally opposed to taxes on its products and becomes politically active where necessary. Reynolds declined to answer specific questions for this article, pointing instead to its website, which says the company engages in lobbying and makes lawful political contributions to protect the interests of its business.
“The tobacco companies never give up,” said Stanton Glantz, a professor at the University of California, San Francisco’s Center for Tobacco Control Research and Education. “They’re like the Borg,” the indomitable alien horde of “Star Trek” lore.
‘Where tobacco bills go to die’
Nowhere has the tobacco fight been bigger, or more expensive, than in California, which has attracted at least two-thirds of tobacco companies’ state-level political donations since 2011. Public health advocates here say tobacco companies have used a potent combination of campaign contributions and behind-the-scenes lobbying to win enough friends in key places.
The strategy is most apparent on the Assembly’s Governmental Organization Committee, which oversees an odd combination of issues, including public records, state holidays, gambling, alcohol and tobacco.
Its chairman, Assembly member Adam C. Gray, a Democrat from Merced who has served on the committee since 2013, has accepted $88,100 in political contributions from Altria and Reynolds since he began campaigning for office in 2011, far more than any other member of the Legislature.
The two companies have directed some $390,000 in total to members who sat on that Assembly committee, a quarter of the money they’ve given to all legislative candidates and their committees in California over that period.
The large amount of money given to its members has prompted some to call it the “Juice Committee.” Health advocates call it “the committee where tobacco bills go to die.”
The committee has watered down or killed nearly every major tobacco bill that’s come through it in recent years, anti-smoking advocates say, including a recent attempt in July to regulate e-cigarettes.
In an unusual move, an identical e-cigarette bill and five other tobacco measures were reintroduced in a special session the following month to allow the legislation to sidestep Gray’s committee. They passed the Legislature this month, the first significant tobacco control bills to pass since the 1990s, a marked blow to the usually successful tobacco industry.
“Money has no influence on what goes on with policy. It just doesn’t,” Gray said. “Raising money to get into elected office is a component of what we have to do… And frankly, I’m a pretty aggressive fundraiser.”
Lawmakers and other Sacramento insiders point out that the direct contributions, which are subject to strict limits, are minimal compared to the money spent by independent political groups, which can raise and spend unlimited sums to support or oppose candidates as long as they do not coordinate with the candidates. Tobacco companies have given some $4.8 million to such independent political committees and parties in California since 2011, nearly three times as much as they gave directly to candidates.
“We provide contributions to candidates and elected officials who, in their work legislatively are at work on issues that have an impact on our business,” said Sutton, the Altria spokesman.
Altria and Reynolds have also spent some $5.4 million on lobbying in California since 2011. By comparison, the health groups that supported stronger tobacco regulation have spent some $2.7 million over the same period, though they lobby on many other issues as well.
“There’s a reason people spend money on that,” said Gary Winuk, who served for six years as the state’s lobbying and campaign finance enforcement officer before leaving for private practice last year. Winuk began his career working for a lawmaker on the Governmental Organization Committee decades ago, and said it was the behind-the-scenes maneuvering and power plays he saw there that made him want to work for the state ethics agency.
Preserving tobacco’s role
In 1999, R.J. Reynolds, now a division of Reynolds American, produced a memo describing a strategy to “preserve the company’s role and participation in U.S. commerce.” The document, archived at the University of California, San Francisco, included the company’s state lobbying objectives, chief among which was a plan to hire lobbyists in “as many states as possible,” as the company’s first “line of defense.”
Next was a commitment to make “appropriate political contributions and support key trade groups and allies,” adding, “there is an old saying in politics. ‘Money talks and bullshit walks’… It is especially true when dealing with tobacco issues.”
The third component of the lobbying strategy was to “execute grassroots mobilization of trade groups, smokers and other allies.”
Nearly two decades later, the company is still using the same roadmap. And smoking continues to be the leading cause of preventable deaths, killing nearly half a million Americans every year, according to the Centers for Disease Control and Prevention.
Reynolds and Altria employed a team of more than 450 state lobbyists in 2014, together retaining representatives everywhere but Nevada, according to an analysis of state records and data collected by the National Institute on Money in State Politics. They’ve also continued to work through trade organizations and advocacy groups.
When Kansas Gov. Sam Brownback proposed an increase of $1.50 per pack for traditional cigarettes last year to help fill a budget gap, Reynolds hired David Kensinger, who had served as the Republican governor’s chief of staff until leaving to work as a lobbyist in 2012. Weeks earlier, Kensinger was among a select group of insiders who received advance copies of Brownback’s proposed budget, which included the tax hike, before lawmakers did, according to The Wichita Eagle. Both Kensinger and Reynolds declined to comment on what happened.
Reynolds reported buying more than 350 meals for public officials and giving e-cigarettes to four House members in Kansas last year, according to state lobbying records, while Altria spent $283,000 on advertising and other outreach.
Meanwhile, a group called Citizens for Tobacco Rights, an advocacy campaign run by Altria, blasted emails to its members, in one instance urging them to fight the tax by posting messages on the Facebook pages of their lawmakers. It’s a standard tactic of the group, which claimed to have generated more than 33,000 phone calls and 52,000 emails and letters to legislators in 2014.
Lawmakers eventually approved a tax increase of only 50 cents, a third of the original proposal. Kansas continues to struggle with a $46 million budget deficit this fiscal year.
Protecting a smokeless future
Reynolds, too, has its own “grassroots” advocacy campaign, called Transform Tobacco. And as the name suggests, a new product is increasingly drawing the company’s focus.
The e-cigarette was invented in 2003 in China and started appearing in this country not long after. It’s gained an enthusiastic community of users, and by 2013 some 20 million adult Americans reported trying e-cigarettes, which vaporize a liquid such as propylene glycol mixed with flavorings and usually nicotine, the key addictive chemical in cigarettes that is generally derived from tobacco.
E-cigarettes come in a huge range of varieties. One major brand charges about $10 for a disposable sleek black pen-like device that lasts about as long as two packs of cigarettes. But many “vapers” use so-called mods or tanks, bulkier refillable devices that can cost anywhere from $30 to well over $100. Users then buy separate vials of “e-juice,” with names like Cinnamon Crumble and Unicorn Milk, which typically sell for about $20 per 30-milliliter vial.
Sales of e-cigarettes reached $3.3 billion last year, according to Wells Fargo Securities, and may surpass those of traditional cigarettes within a decade. While tobacco companies still control less than half of this market, they’ve begun buying up or starting their own e-cigarette brands in recent years, rapidly increasing their share.
Reynolds, a leader in the e-cigarette market, has promoted model legislation that says explicitly that e-cigarettes are not tobacco products. The Center for Public Integrity obtained a template copy of the model language that was circulated at one of dozens of youth tobacco prevention “dialogues” that Reynolds has held around the country in recent years for local health officials and advocates. The company offered to pay as much as $1,000, plus lodging, to those who attended, according to invitations the Center obtained.
So far, such model language has passed in at least 19 states, written into laws banning sales to minors. At least 11 of those passed laws that pull nearly verbatim from the Reynolds template, while at least eight others have enacted similar language that health groups say was promoted by Lorillard Tobacco, which Reynolds bought last year.
Pennsylvania and Michigan, the only states that do not prohibit sales to minors, have two bills pending with similar language.
Although Reynolds’ model language asserts that e-cigarettes are not tobacco products, the company’s own website describes its VUSE e-cigarette as exactly that.
The most immediate effect of the bills is to protect e-cigarettes from existing tobacco control programs and taxes. E-cigarette proponents say the alternate definitions are warranted because the products do not burn tobacco. But health groups warn that the definitions pushed by the industry will harm the public.
“You build this infrastructure for regulating e-cigarettes on a faulty promise that they’re somehow a healthy product,” said Timothy Gibbs, a lobbyist for the American Cancer Society Cancer Action Network in California and a chief shepherd of the tobacco control bills there. “While the scientific consensus is that they may be safer than traditional cigarettes, that doesn’t mean they’re safe.”
It seems likely that “vaping” is less harmful than smoking. The question is by how much. The Centers for Disease Control says e-cigarettes “generally emit lower levels of dangerous toxins” than cigarettes, but can also release carcinogenic compounds and heavy metals. The agency says that e-cigarettes could provide a public health benefit if they lead smokers to quit. But it suggests that isn’t happening — about three-quarters of e-cigarette users also smoke cigarettes — and the products may be harmful if they prolong smokers’ addiction.
“They knew 50 years ago what they were doing,” Leno said. “And they’re doing it again today.”
Reynolds declined to answer questions about the model legislation or the dialogues, pointing instead to a company webpage that explains its “transforming tobacco” initiative, which promotes youth prevention programs and argues that smoke-free products, including e-cigarettes, can reduce “the death and disease caused by cigarettes.” Health advocates say the company has insidiously used this campaign in its efforts to win legislation protecting e-cigarettes from harsher regulation.
Altria declined to answer whether it has lobbied in favor of the language.
In California, the full weight of state government has gotten behind a campaign to rein in e-cigarette use. Last year, the state public health department warned of the dangers of the product and recommended strict regulations, launching a website and ad campaign called Still Blowing Smoke. This month, with passage of Leno’s bill, the Legislature took a big step in that direction.
Yet the state has met formidable resistance not just from the tobacco industry but also from a fledgling industry of smaller e-cigarette manufacturers and retailers backed by a passionate movement of vapers. Mobilized around the country, these e-cig aficionados have protested in Salt Lake, circulated petitions in Washington state and flown to the nation’s capital to push their position with congressional leaders.
Within hours of the launch of the state’s Still Blowing Smoke campaign last March, for example, another website called NOT Blowing Smoke popped up, using a similar font and logo but blasting the department for peddling misinformation.
“Yeah, that was fun,” Didak said from his split-level home in Oakley, a city on the eastern edge of the Bay Area. Didak, dressed all in black, wore a NOT Blowing Smoke T-shirt and held a black mod e-cigarette, the type preferred by hard-core vapers. The blinds were drawn and the air held the faint sweet odor emitted by his mod, which he sucked on periodically, blowing out thick clouds of “ripe strawberry shortcake” flavored vapor.
SFATA Executive Director Cynthia Cabrera says her group was not affiliated with the counter-campaign. The association hired lobbyists in Sacramento to oppose Leno’s bill and has urged Gov. Jerry Brown, a Democrat, to issue a veto.
Didak said that bill would drive small vape shops and liquids manufacturers out of the state — or out of business — by applying the various licensure and regulatory requirements that apply to tobacco. As someone who quit cigarettes thanks to vaping, he said that restricting the industry would harm public health.
Didak and other vapers stress that they are not “big tobacco” and that SFATA does not receive money from tobacco companies. “We don’t regard them as part of us,” Didak said.
In coming months, however, they’ll be on the same side.
A bold threat
Whether Brown signs Leno’s e-cigarette bill, part of the package of six tobacco measures the Legislature passed this month, an expensive fight looms in California’s freewheeling ballot initiative process.
A coalition of health and labor groups, with support from liberal billionaire Tom Steyer, is currently gathering signatures for a ballot initiative that would hike the state’s cigarette tax by $2 and levy an equivalent tax on e-cigarettes. At 87 cents, California’s current tax is well below the national average.
Yet that effort may be in jeopardy.
This month, a lobbyist for Altria sent a bold threat in an email first published by The Sacramento Bee: the company plans to try to repeal some of the tobacco bills it had opposed by putting them before voters in a referendum on this fall’s ballot. In a calculating political move, it also threatened to corner the all-important ballot measure market of professional signature gatherers by paying top dollar. That could price out the health groups from their cigarette tax campaign and imperil all other measures trying to make the ballot, including an extension of a key tax increase known as Proposition 30.
“When we hit the street with referendum paying $10 per signature, Prop 30 is dead as well as $2 a pack tax,” warned Altria lobbyist George Miller IV, son of the former Democratic California congressman. “We will have every signature gatherer on an exclusive. Just letting you know so you can’t say you were not warned.”
The health groups say they could be forced to either up their own prices, which are now about $4 per signature, or rally volunteers instead.
“We’re appalled but not surprised,” said Gibbs, the Cancer Society lobbyist, adding that tobacco companies have a history of particularly ruthless tactics. “They seem to be throwing a fit.”
Miller did not respond to requests for comment. Sutton, Altria’s spokesman, called Miller’s message “simply a friendly heads-up email between long-time colleagues.”
No matter whether Altria follows through on its threat, the coming months are sure to see many millions of dollars spent on all sides. Health groups have already raised $4 million for their campaign. During two previous attempts to raise cigarette taxes at the ballot, in 2006 and 2012, Reynolds and Altria spent more than $113 million and defeated both measures.
This story was co-published with Vice.
A study of adolescents in Hong Kong found respiratory issues were 30 percent more likely in vapers than non-vapers.
Written by Roberta Alexander
A new study out of Hong Kong is not likely to settle the issue any time soon.
Researchers looked at the respiratory health of Chinese adolescents, both those who use e-cigarettes and those who do not. The results, published in JAMA Pediatrics, have raised concerns about the impact of e-cigarettes on the health of minors.
Ho is an associate professor in the School of Public Health whose main research interests are in adolescent health in relation to tobacco, alcohol, and obesity.
He and fellow researchers found that adolescents who use e-cigarettes were approximately 30 percent more likely to report respiratory symptoms than adolescents who do not use them.
Thousands of Students Studied
More than 45,000 students in Hong Kong participated in the study. Data was collected between 2012 and 2013.
Of the sample population, 1.1 percent of students reported e-cigarette use within the past 30 days. Those students were 30 percent more likely than their peers to report respiratory problems.
The results are suggestive but not definitive. Dr. Norman H. Edelman, senior consultant for scientific affairs for the American Lung Association, found the study intriguing.
“It’s important [but] we need to know if the lungs are injured. It’s not clear if this really affects the lungs. We’re not sure what the symptoms are,” Edelman told Healthline.
He wondered if the young subjects were reporting soreness in their throats, excessive coughing, or difficulty breathing. He would like to see a follow-up study, perhaps in the United States.
“We need to do lung function tests,” he said.
“Whenever you breathe in something, you don’t know what’s in it. Some of the data suggest irritation,” Edelman said. “We don’t know what the negative effects are. This is just a beginning.”
E-cigarettes and vaporizers use liquids that have varying amounts of nicotine or none at all. These liquids are not regulated by the U.S. Food and Drug Administration (FDA), but generally also contain propylene glycol, a suspected lung irritant, and vegetable glycerin.
“While supporters [of e-cigarette use] are optimistic about the potential for harm reduction in the minority of established cigarette smokers, [for] which convincing evidence is lacking, this does not seem to justify the potential harm of renormalizing cigarette smoking, delaying smoking cessation, and escalating to real cigarette smoking, especially among the majority of non-smoking young people,” Edelman said.
E-Cigarettes Gaining in Popularity
The use of e-cigarettes have surpassed the use of conventional cigarettes among young people in the United States.
“Nicotine is very harmful to the developing child and adolescent brain,” Zeller said. “Parents should take no comfort in the fact that their kids are using an e-cigarette rather than a burning cigarette because of the presence of nicotine.”
By Alicia Ewen
North Dakota kids smoke cigarettes less than they used to…far less.
But they are dabbling in some other risky behaviors.
The state asked high school students across the state about their habits. It found that fewer kids smoke.
In fact, 80% of kids said they hadn’t smoked or used smokeless tobacco in the previous month.
Only 3% of high school students say they smoke cigarettes daily.
For the first time though electronic cigarette use was surveyed.
22% of students surveyed say they tried an e-cigarette in the month before they took the survey…
“That’s another misconception, that kids think they are safer than traditional smoking but really there are still chemicals in these vaping products that will harm your body. There hasn’t been as much research done on them as we should have so I’ll be really excited to see what comes out in the next couple of years about these vaping products,” says Hannah Rexine, CHS student and member of the tobacco policy board.
Rexine is the only youth member on the state tobacco policy board. She’s a senior at Century High School in Bismarck.
WASHINGTON — House Republicans are pushing to ease proposed government regulations for companies that sell e-cigarettes and other new tobacco products, a move that Democrats charge could lead to unsafe products on the market.
A spending bill approved by a House subcommittee Thursday would prevent the Food and Drug Administration from requiring pre-market reviews of e-cigarettes that already are on the market.
As part of a broader rule regulating e-cigarettes for the first time, the agency has proposed that e-cigarette brands marketed since February 2007 undergo those pre-market reviews retroactively once the final rule is approved. Companies would have to submit the applications within two years of the final rule, and then the FDA would ensure that the product is “appropriate for the protection of the public health.” If not, the agency could take it off the market.
In addition to e-cigarettes, the FDA rules and the House legislation would apply to other unregulated tobacco products such as cigars, hookahs, nicotine gels, waterpipe tobacco and dissolvable tobacco products. The FDA already regulates cigarettes, smokeless tobacco and roll-your-own tobacco products.
Republicans said the pre-market review would be a lengthy and expensive process that could drive companies out of business. Alabama Republican Rep. Robert Aderholt, who sponsored the bill, said the provision is just a technical change that would keep the newer products under FDA oversight but allow them to be regulated in the same way as older tobacco products. The legislation would not affect the FDA’s proposal to ban the sales of the products to minors and would still allow certain product standards.
Public health groups said the legislation would hamper the FDA’s ability to prevent tobacco companies from marketing the new products to kids, and Democrats said before the panel’s vote that the change would reduce regulation on the industry at the same time that e-cigarette use is skyrocketing.
The bill “is nothing short of a giveaway to the tobacco industry,” said New York Rep. Nita Lowey, the top Democrat on the Appropriations Committee.
FDA’s proposed rules, expected to be finalized in the coming months, are aimed at eventually taming the fast-growing e-cigarette industry.
E-cigarettes are plastic or metal tubes, usually the size of a cigarette, that heat a liquid nicotine solution instead of burning tobacco. That creates vapor the user inhales.
The nicotine-infused vapor of e-cigarettes looks like smoke but doesn’t contain all of the chemicals, tar or odor of regular cigarettes. Some smokers use e-cigarettes as a way to quit smoking tobacco, or to cut down. However, there’s not much scientific evidence showing e-cigarettes help smokers quit or smoke less, and it’s unclear how safe they are.
Matthew Myers, president of the Campaign for Tobacco-Free Kids, said the House language could keep products on the market that appear to be targeted to children, like cigars and e-cigarettes in a variety of candy and fruit flavors.
Gregory Conley, president of the American Vaping Association, said the FDA regulations could hurt small businesses.
“This proposal does not remove the FDA’s ability to regulate vapor products,” Conley said. “The FDA will still have the full authority to make science-based regulatory decisions on the manufacturing, marketing and sale of these products.”
The FDA would not comment on the legislation, but FDA spokesman Michael Felberbaum said the rules are important consumer protections.
“When finalized, the rule will represent a significant first step in the agency’s ability to effectively regulate tobacco products and, as we learn more about these products, the agency will have additional opportunities over the long term to make a positive difference in the public health burden of tobacco use in this country,” Felberbaum said.
Banana pudding-flavored ecigs disturbed the lungs, one study found
E-cigarette research is heating up, and scientists are starting to show that using e-cigarettes can have some surprising health effects, according to new findings presented at the meeting of the American Thoracic Society.
“Millions of people around the world that are puffing e-cigs,” says Peter Dicpinigaitis, professor at Albert Einstein College of Medicine and one of the authors of new e-cigarette research, “but when you look at the scientific literature about the effects of e-cigs, there’s nothing out there.”
Here are some of the newest findings:
Using e-cigarettes suppresses your ability to cough
Smoking an e-cigarette makes you less likely to cough, even when coughing would benefit your health, according to research by Dicpinigaitis. Researchers asked 30 nonsmokers to puff an e-cigarette 30 times in a 15-minute period. After puffing, people in the study were less sensitive to capsaicin, a component of chili peppers that induces coughing. You might think stopping a cough would be a positive side effect, but coughing keeps you from choking and removes agents that may cause infection, says Dicpinigaitis. He presumes that those the effects would continue throughout the day for someone who uses an e-cigarette frequently.
E-cigarette temperature may affect how many chemicals you’re exposed to
People tend to think about the effects of cigarette smoke or e-cigarette vapor when they consider how the products harm their health. But the mechanics of e-cigarettes may also contribute to how much smoking harms your health, according to new research from University of Alabama School of Medicine professor Daniel Sullivan. His research found a correlation between coil temperature and the creation of harmful chemicals like acrolein, acetaldehyde and formaldehyde in the e-cigarette. There are no configuration standards for e-cigarettes, and Sullivan’s research suggests that the lack of consistency makes it hard to assess uniformly the health effects of smoking e-cigarettes.
E-cigarette flavors may have different effects
Researchers tested the effects of flavored e-cigarette liquid on calcium in the lungs and found that not all flavors had the same effect. Five of 13 flavors tested caused changes to calcium signaling in the lungs, according to a study by University of North Carolina at Chapel Hill researcher Temperance Rowell. Hot cinnamon candies, banana pudding and menthol tobacco were among the flavors that disturbed the lungs.
Evidence is growing that e-cigarettes probably aren’t an effective way to quit smoking
E-cigarettes are a popular tool people use to stop smoking, but they may not be the best way, suggests one research review. Using e-cigarettes improved the likelihood that a smoker would quit smoking cigarettes for the first month on the new technology, but the effect dissipated at 3 and 6-month followups, according to a meta-analysis of four studies by University of Toronto researcher Riyad al-Lehebi. He recommended that people who want to quit smoking consider “other more well-established options.”
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.