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Study: Teens using e-cigs much more likely to start smoking cigarettes

By Lena H. Sun, Washington Post
More bad news for young people who smoke e-cigarettes.
Doing so makes them much more likely to start smoking traditional cigarettes within a year than peers who don’t smoke e-cigarettes, according to a new analysis published online Tuesday and scheduled for the November issue of JAMA Pediatrics.
The latest news about e-cigarettes comes at a time when their use is soaring among youngsters. The number of middle school and high school students using electronic cigarettes tripled from 2013 to 2014, according to government figures released this spring, a startling increase that public health officials fear could reverse decades of efforts combating the scourge of smoking.
The popularity of e-cigarettes among teenagers now eclipses that of traditional cigarettes, the use of which has fallen to the lowest level in years.
In the latest study, researchers analyzed data from a national sample of nearly 700 nonsmokers who were between ages 16 and 26 in 2012, and again in 2013. All of them said “definitely no” when they were asked if they would try a cigarette offered by a friend or believed they would smoke a cigarette within the next year.
Only 16 of the participants used e-cigarettes when they were initially surveyed, but six of them had progressed to cigarette smoking by the next year, or about 38 percent. By contrast, only 10 percent of the youths who were not e-cigarette users  started smoking traditional cigarettes.
The study was conducted by the University of Pittsburgh Center for Research on Media, Technology and Health and the Dartmouth-Hitchcock Norris Cotton Cancer Center.
In the past, few studies looked at whether e-cigarette users who initially did not smoke were at risk for taking up both the use of e-cigarettes and traditional cigarettes, or the exclusive use of cigarettes. Previous studies could not determine whether e-cigarette use preceded cigarette use, researchers said. Those studies also looked at different youngsters over different time periods.
The latest study analyzed the same individuals over time.
“This is the first longitudinal, national study to show that e-cigarette use among youth directly leads to regular cigarette use, even among people who insist at baseline that they never will smoke regular cigarettes,” said lead author Brian Primack, who is assistant vice chancellor for health and society at Pittsburgh’s Schools of the Health Sciences. “It is also the first to include young adults, as opposed to strictly teenagers.”
Researchers said one limitation was the relatively small number in the sample size. The findings need to be replicated with larger samples. Even so, after controlling for well-known risk factors, such as age, sex, socioeconomic status and risk-taking, “we think the effect is real,” said Samir Soneji, an assistant professor at the Dartmouth Institute for Health Policy and Clinical Practice and one of the authors.
E-cigarettes accelerate the progression to traditional cigarette smoking, he said.
The quandary for public health officials is this, he said. “Are they more dangerous for kids than they are helpful for adults who are trying to quit smoking?”
http://www.washingtonpost.com/news/to-your-health/wp/2015/09/08/study-teens-using-e-cigs-much-more-likely-to-start-smoking-cigarettes/

USA Today: Teens find a new use for e-cigarettes: Vaping marijuana

, USA TODAY
Teenagers have discovered a new way to inhale marijuana — e-cigarette vaporizers, according to a study released Monday.
About 27% of high school students who have used both marijuana and e-cigarettes reported using the devices to vaporize cannabis. Those most likely to vaporize pot with e-cigarettes included males and younger students.
E-cigarettes are designed to vaporize solutions containing nicotine, said co-author Meghan Rabbitt Morean. But, she noted, “teenagers are resourceful, and it was only a matter of time.”
Vaporizers give kids a better way to hide what they’re inhaling.
“It’s so much easier to conceal e-cigarette pot use,” said Morean, an assistant professor at Oberlin College. “Everybody knows that characteristic smell of marijuana, but this vapor is different. It’s possible that teenagers are using pot in a much less detectable way.”
Researchers at Yale University based their findings on answers from a survey sent to nearly 4,000 Connecticut students. The study was published Monday in Pediatrics.
About 28% of students in the study had tried e-cigarettes.
Morean said people should remember to be cautious when interpreting her findings. There haven’t been any other studies showing teens are using e-cigs to vaporize marijuana. She noted that scientists don’t fully understand the health effects of e-cig-vaporized cannabis.
Marijuana use in other forms can cause several health problems such as short-term memory loss, slow learning, decreased sperm count and lung damage, according to the Centers for Disease Control and Prevention.
“We now know it’s happening, but there are more questions about who is using and how damaging it is,” Morean said.
E-cigarette use among youth increased more than 200% from 2011 to 2013, according to a report in the journal Nicotine and Tobacco Research. Those surveyed had not tried regular cigarettes.
“Unfortunately, there is really no end for what can be vaporized in these devices,” said Erika Sward, a spokeswoman for the American Lung Association.
Supporters of e-cigarettes, who describe them as a healthier alternative to regular cigarettes, found fault with the new survey. The study may not accurately reflect what teens across the country are doing because it surveyed students in only one state, said Phil Daman, president of the Smoke-Free Alternatives Trade Association and attorney for Daman & Associates.
His group strongly discourages underage use of vapor products.
“While some teens experiment, it’s vital that parents and guardians talk to their children about not using any age-restricted products including vapor products,” Daman said.
Morean said she and her colleagues plan to conduct additional studies.
She hopes researchers in other states will provide additional data, to provide a clearer picture of national trends.
“This research is so new,” Morean said.
http://www.usatoday.com/story/news/2015/09/04/e-cigarettes-vape-marijuana-students-connecticut/71703472/

Inquisitr: 7 Reasons E-Cigarettes Are Bad

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

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

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

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

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

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

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

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

NDSU Study: "Tobacco Goes to College" Shows Battle for Youth Market Began Early

Source Newsroom: North Dakota State University
Newswise — While the character Don Draper in the television show Mad Men looked for a way to first save his cigarette advertising accounts, and then to distance himself from them, a new book—“Tobacco Goes to College”—shows the power of advertising impacted would-be-smokers long before the Mad Men era.
Elizabeth Crisp Crawford, associate professor in the Department of Communication at North Dakota State University, Fargo, studied how tobacco advertising from 1920 to 1980 targeted college students.
“The tobacco industry had a strong presence on campus and an influence on college media,” said Crawford. “Tobacco’s influence on college media included campus newspapers, radio, and sporting events. This influence affected students on campus the most—due to a high level of advertising exposure. However, the viewing audiences for college sports also were exposed to cigarette promotion facilitated by the NCAA.”
In her research for “Tobacco Goes to College: Cigarette Advertising in Student Media, 1920-1980,” Crawford found the advertising plans and creative tactics to be extremely strategic over the six decades studied. Social pressure and social appeals hit the mark with potential college consumers.
“The advertising campaigns were well organized and sophisticated,” said Crawford. “In this way, tobacco was ahead of its time. The ads are really an important piece of advertising history for these reasons.”
The successful advertising tactics, said Crawford, are still being used today for a variety of products.
“I see the industry using many of the same tactics it used 50 years ago with cigarettes—especially the filtered brands. When we discuss the promotion of e-cigarettes, I think that we need to look at the history of tobacco advertising,” said Crawford.
Key insights into the target market make these ads successful.
“The tobacco industry has an excellent understanding of the psychology of human need,” said Crawford. “People use substances to cope with their lives. Sometimes life can be stressful and people lack the needed human support. Tobacco has always positioned itself as a way to fill a social or emotional void.”
Crawford’s book contains an in-depth analysis of vintage cigarette ads.
“Jane Wyman – famous Barnard Alumna says: ‘Chesterfields always give me a lift. They’re wonderfully mild and taste so good. They’re my favorite cigarette,’” according to an ad which ran in NDSU’s student newspaper, The Spectrum, on April 7, 1950.
Similar ads ran in student newspapers across the country including Smith College, University of Portland, Elon University, and in football programs at colleges, including the University of Tennessee at Knoxville (Crawford’s alma mater), at Chattanooga, and Illinois vs. Stanford.
“Tobacco advertisers knew college students’ needs and positioned their product in a way that could help fulfill these needs,” said Crawford.
In 1963, the Tobacco Institute pulled tobacco advertising from college publications. Crawford points out that nearly 2,000 publications then looked for ways to recover what amounted to as much as 50 percent of lost revenue from the ads.
Crawford’s interest in this particular area of research also has a personal link. “Of my four grandparents, the two that attended college smoked. I found this connection to be interesting,” she said.
“Tobacco Goes to College” was named an Outstanding Academic Title by Choice Magazine in 2014. The list comprises about 10 percent of more than 7,000 titles reviewed by Choice each year. According to Choice reviewer N.E. Furlow, “In short, the book offers a detailed inside look at the tobacco industry’s calculating strategy to entice a young population to use its products.” The book is published by McFarland & Company, Inc.
In reviewing the book in American Journalism, Stephen Siff wrote: “It is on the final point, about the quality and inventiveness of cigarette advertising, that the book is most effective and, ultimately, makes its greatest contribution.”
In Journalism History, reviewer Kari Hollerbach wrote: “By examining the broader social and legal trends that buffeted the tobacco industry, the targeted effort to recruit and retain college-age smokers, and the actual advertisements and their thematic narratives, she offers a very compelling explanation as to how and why several generations of American youth were persuaded to smoke, smoke, smoke that cigarette.”
Figures show the continued compelling force of advertising. According to a CDC report, tobacco companies spent $9.6 billion marketing cigarettes and smokeless tobacco in the United States alone in 2012. That’s equivalent to more than $1 million every hour, based on $26 million daily. A Federal Trade Commission report shows $9.2 billion spent on cigarette advertising and promotion in 2012. The report notes the expenses include magazine ads, distribution of samples and coupons, retail ads, discounts, retailer payments, rebates and direct-mail advertising.
A Gallup-Healthways Well-Being Index showed the national smoking rate at 19.7 percent in 2013, with North Dakota’s smoking rate dropping from 24.1 percent in 2008 to 18.5 percent in 2013. Kaiser Family Foundation data show the national smoking rate at 18.1 percent in 2013 and North Dakota at 21.2 percent.
Crawford’s research has been published in Journalism and Mass Communication Educator, Social Marketing Quarterly, and the Journal of Health and Mass Communication. Crawford joined NDSU in 2009. She received a doctorate degree in communication and information from the University of Tennessee, Knoxville, and a master’s degree in advertising and public relations from Marquette University, Milwaukee, Wisconsin.
About NDSU
NDSU, Fargo, North Dakota, USA, is notably listed among the top 108 U.S. public and private universities in the Carnegie Commission on Higher Education’s category of “Research Universities/Very High Research Activity.” NDSU is listed in the top 100 research universities in the U.S. for R&D in agricultural sciences, chemistry, computer science, physical sciences, psychology, and social sciences, based on research expenditures reported to the National Science Foundation. As a student-focused, land grant, research institution, NDSU serves the state’s citizens. www.ndsu.edu/research
http://newswise.com/articles/tobacco-goes-to-college-shows-battle-for-youth-market-began-early

AP: Teens' E-Cigarette Use Linked With Later Smoking

By LINDSEY TANNER AP Medical Writer
Teens who use e-cigarettes are more likely than others to later smoke conventional cigarettes and other tobacco products, a study at 10 Los Angeles high schools suggests.
The study doesn’t prove that electronic cigarettes are a “gateway drug” but some doctors say it bolsters arguments that the devices should be strictly regulated as proposed by the Food and Drug Administration.
Whether teens had tried just one e-cigarette or were habitual users isn’t known, nor is whether they became heavy smokers or just had a few puffs. That information would be needed to help determine whether nicotine from e-cigarettes predisposed users to seek out other sources.
Despite those limitations, the study “is the strongest evidence to date that e-cigarettes might pose a health hazard by encouraging adolescents to start smoking conventional tobacco products,” said Dr. Nancy Rigotti, director of a tobacco research and treatment center at Massachusetts General Hospital. Her commentary and the study were both published in Tuesday’s Journal of the American Medical Association.
E-cigarettes haven’t been extensively studied and there’s no scientific consensus on any potential benefits or harms, including whether they lead kids to become regular smokers.
The new, government-funded study involved about 2,500 14-year-olds who had never used conventional tobacco products including cigarettes. Students were first surveyed in fall 2013. The Los Angeles study population was diverse but whether the same results would be found nationwide is uncertain.
At the start, about 9 percent — 222 kids — said they had used e-cigarettes at least once, similar to rates seen in a recent national survey. Almost one-third of them tried cigarettes, cigars or water pipes within the following six months, versus just 8 percent of the kids who’d never tried e-cigarettes. The gap persisted when students were surveyed again, a year after the study began.
Hookahs and cigars were more popular than regular cigarettes in both groups.
The researchers considered traits that might make teens more likely to use tobacco, including impulsiveness, delinquent behavior and parents’ smoking habits. Their analysis showed those traits played a role but didn’t fully explain the link between e-cigarettes and later tobacco use.
University of Southern California researcher Adam Leventhal, the study’s lead author, noted that e-cigarettes were initially introduced as a potentially safer alternative to tobacco for smokers who were trying to cut down, but they have evolved into a recreational product for some users.
Available for nearly a decade, e-cigarettes are battery-powered devices that turn nicotine-containing liquid into vapor that is inhaled. Though nicotine can be addictive, e-cigarettes lack the chemicals and tars of burning tobacco.
National data show e-cigarettes have become more popular among teens than regular cigarettes.
Leventhal said his study “does little to dispel concerns that recreational e-cigarette use might be associated with moving on to these very harmful tobacco products.” But he said more research is needed to determine if e-cigarettes are really the culprit.
University of Rochester tobacco researcher Deborah Ossip said because teens’ brains are still developing, they’re more sensitive to the effects of nicotine, and that using just a few e-cigarettes could make them vulnerable to using nicotine in other forms. She had no role in the research.
The FDA in 2014 proposed rules that would ban the sale of electronic cigarettes to minors and would add the devices to the list of tobacco products it regulates. Laws banning the sale of e-cigarettes to minors have been enacted or proposed in several states.
———
Online:
JAMA: http://jama.ama-assn.org
FDA: http://tinyurl.com/pe7nqtl
http://abcnews.go.com/Health/wireStory/teens-cigarette-linked-smoking-33155901

Reuters: States target e-cigarette sales to minors amid slow federal action

NEW YORK – Frustrated by the slow pace of federal action, state attorneys general are waging their own campaigns against the sale and advertising of e-cigarettes to minors.

More than a dozen AGs, including those in New York, California, Indiana and Ohio, are using new state and local laws – some of which they helped craft – to put pressure on the industry at all levels, from neighborhood vape shops to big tobacco companies like Altria Group and Reynolds American Inc.

Much of the campaign so far has involved threats to sue violators or appeals to a company’s sense of responsibility, though some lawsuits have been filed, too.

State actions have accelerated in the wake of government data released in April, which showed that teen use of e-cigarettes tripled in 2014 alone, making them more common for youngsters than tobacco.

North Dakota passed its own bill to combat e-cigarettes this legislative session. House Bill 1186, which was signed by Gov. Jack Dalrymple on April 9, outlaws the sale of e-cigarettes to minors in the state. Minors are not allowed to buy, possess or use electronic smoking devices, and those who sell or give e-cigarettes to anyone under 18 is guilty of an infraction.

“The key is to avoid another generation being addicted to nicotine,” Indiana Attorney General Greg Zoeller said in an interview.

State attorneys general played a pivotal role during the 1990s in battling tobacco companies over conventional cigarettes.

The Master Settlement Agreement (MSA), an accord reached in November 1998 between the state attorneys general of 46 states, five U.S. territories, the District of Columbia and the five largest tobacco companies, resulted in significant changes to cigarette marketing and required the tobacco industry to pay the states about $10 billion annually for the indefinite future.

Nearly a year ago, a group of AGs asked the U.S. Food and Drug Administration to take a tougher line on e-cigarettes, the risks and benefits of which are still being studied.

In April of 2014, the agency proposed banning the sale of e-cigarettes to people under the age of 18, but did not recommend prohibiting advertising, flavored products or online sales – all of which help make the devices attractive to youngsters, according to public health advocates.

The FDA proposal has been under review ever since, which has meant that vaping remains legal for youths in states that haven’t passed laws banning it. The agency is likely to finalize its new e-cigarette regulations later this summer, though it could be several years before the federal rules go into effect.

Federal regulations and the 1998 Master Settlement prohibit makers of conventional cigarettes from targeting youth and from advertising on television, billboards and mass transit, but the rules don’t apply to e-cigarettes.

So far, however, 46 states have passed laws banning their sale to minors. Twelve of those states have also passed laws requiring child-proof packaging for e-liquids and e-cigarettes, according to the Campaign for Tobacco-Free Kids.

AGs are using these laws, as well as others not directly tied to e-cigarettes, to force companies to drop ads appealing to teens, switch to child-proof packaging and spend thousands of dollars on more vigilant age verification systems for their websites and online deliveries.

In June, New York Attorney General Eric Schneiderman announced settlements with four companies that were not complying with the state’s rule about child resistant packaging for nicotine liquids.

Reuters spoke with more than 10 e-cigarette and vaping companies – including Reynolds American, which sells Vuse, and Altria Group, which sells MarkTen and Green Smoke – that acknowledged they have been contacted by state law enforcers or by the National Associations of Attorneys General. Reynolds and Altria say their brands were not in violation of local laws.

Some of the AGs have coordinated their efforts. One group is pressuring certain e-cigarette manufacturers and vendors to limit ads that appeal to teens, especially on company websites and places like YouTube.

Ohio Attorney General Mike DeWine, along with colleagues from several other states, sent a letter in April to privately-held manufacturer NJOY, asking it to “immediately instruct YouTube to restrict” access to its advertisements to adults.

NJOY said in an April letter to DeWine that more than 90 percent of the U.S. viewers who have watched its hosted YouTube videos are at least 18, and the company said it would suspend videos if that figure fell to 85 percent or less.

NJOY, which previously settled a case with California over allegations of targeting minors and deceptive marketing, would not comment further.

California has sent letters to more than 150 e-cigarette and vaping companies in recent years “to encourage voluntary compliance with applicable state and federal laws,” including a ban on sales to youth, according to documents reviewed by Reuters.

The state is also pursuing companies that sell fruit-flavored vaping liquids that appeal to teens and those that make false or misleading statements in their advertisements. One letter sent by the state asked a manufacturer to quit claiming that “electronic cigarettes are one of the safest forms of nicotine available” and that “when you exhale, you are exhaling harmless water vapor.”

“Many companies have taken some or all of our recommended steps,” said Kristin Ford, a spokeswoman for Attorney General Kamala Harris.

AGs are paying particular attention to sales on websites, a popular source of vaping materials for teens, who trade information about which ones require little proof of age.

Jan Verleur, CEO and co-founder of electronic cigarette company VMR Products, said his company changed its age verification system in some states after being contacted by a state AG. He estimated the cost per order would increase by about 50 cents, but would not say if VMR would absorb any of that. The company makes about half its sales online.

“This is bad news for the smaller players and good news for the tobacco companies, whose business model relied on mass manufacturing, not personalized products,” said Philip Gorham, an equity analyst at Morningstar who covers consumer products.

http://www.grandforksherald.com/news/business/3783488-states-target-e-cigarette-sales-minors-amid-slow-federal-action

Reuters: FDA seeks data on e-cigarettes after surge in poisoning cases

The U.S. Food and Drug Administration said it is seeking additional data and comments on liquid nicotine as it considers warning the public about the dangers of its exposure amid a rise in electronic cigarette use.

The agency has evaluated data and science on the risks, especially to infants and children, from accidental exposure to nicotine and liquid nicotine that is used in e-cigarettes. (1.usa.gov/1GXeSo4)

More Americans are using e-cigarettes and other vaporizing devices than a year ago, a Reuters/Ipsos poll showed in June.

ADVERTISING

The surge in e-cigarette use comes as conventional cigarette smoking has declined in the United States to about 19 percent of adults, prompting tobacco companies such as Altria Group Inc, Philip Morris International Inc and Reynolds American Inc to rush into the e-cigarette market.

(Graphic on global market: link.reuters.com/kuk83w)

Recent increases in calls and visits to poison control centers and emergency rooms involving liquid nicotine poisoning have raised public health concerns, FDA said.

The health regulator is now considering if it should warn the public about the dangers of nicotine exposure and require that some tobacco products be sold in child-resistant packaging.

Among high school students, e-cigarette use jumped to 13.4 percent in 2014 from 4.5 percent in 2013, according to the Centers for Disease Control and Prevention. Cigarette use over the same period fell to 9.2 percent from 12.7 percent, the largest year-over-year decline in more than a decade.

(Reporting By Samantha Kareen Nair in Bengaluru; Editing by Don Sebastian)

http://www.reuters.com/article/2015/06/30/us-fda-ecigarettes-idUSKCN0PA2SD20150630

The Dickinson Press: Several businesses caught selling tobacco to minors

By Andrew Haffner

The Southwestern District Unit Health caught six Dickinson businesses selling tobacco to a minor Monday in a quarterly compliance check of 25 city retailers.

The businesses that failed the check are M & H Gas Station, Cenex Convenience Store on Villard Street, Simonson’s Store on Villard Street, Rosie’s Food & Gas, and Family Fare supermarkets at both 18th Street West and Roughrider Boulevard.

Tobacco Treatment Specialist Jennifer Schaeffer said in a release that compliance checks are conducted with a trained minor student with a police officer present. Dickinson municipal code prohibits selling tobacco to minors, with punishments tiered to the persistence of retailer offenses.

First-time offenders can face a fine of $100, while those who sell illegally three times within two years may receive a $500 fine and tobacco license revocation.

Schaeffer said in the release that the Southwestern District Unit Health offered a training course for tobacco retailers to prepare them for subsequent compliance checks.

“We are trying to educate them and the public that this is an important issue in keeping our children safe,” she said in the release.

http://www.thedickinsonpress.com/news/local/3777389-several-businesses-caught-selling-tobacco-minors

HealthlineNews: Is 18 Too Young to Buy Tobacco Products? Some States Think So.

California is on the verge of joining other states in raising the minimum age to purchase tobacco, sparking more debate about what privileges and responsibilities fall on young adults.

How old should you be to purchase tobacco?

Some legislative leaders in the United States apparently think 18 is too young.

On Friday, Hawaii’s governor signed a bill raising the minimum age to buy tobacco to 21. The law takes effect next year.

Four states — Alabama, Alaska, New Jersey, and Utah — have raised the minimum age to buy tobacco to 19, while some local municipalities have raised it to 21.

And, earlier this month, the California State Senate overwhelmingly voted to increase the age at which a person can buy tobacco products from 18 to 21. The bill still needs Assembly approval and the governor’s signature.

The goal is to further limit access to tobacco products to young smokers. The move is backed by several health groups, including the American Cancer Society and the California Medical Association.

Dr. Jack Jacoub, an oncologist and director of thoracic oncology at the Memorial Care Cancer Institute at Orange Coast Memorial Medical Center in Fountain Valley, California, says with decades of data available, it’s clear the age increase is a sound move to prevent people from starting lifelong habits.

“It’s still a risk factor for a host of different cancers, not just lung cancer,” he said. “If you separate the legal aspect of it, it makes the most sense to raise the minimum age to 21.”

A Measure Aimed at Delaying the Start

A study by the Institute of Medicine (IOM) published in March found that increasing the minimum legal age to 21 would likely prevent or delay when people would begin smoking, specifically children aged 15 to 17.

About 90 percent of smokers now start before 19 years old, so the argument is the 21-year minimum would reduce teens’ access to tobacco because it’s unlikely they would be in the same social circle as people old enough to purchase tobacco.

The U.S. Food and Drug Administration (FDA) doesn’t have the authority to raise the legal smoking age to 21, so it’s an issue that must be dealt with at the state level. The federal government, however, does have a law that withholds federal highway funds to states that don’t have their minimum drinking age at 21.

The town of Needham, Massachusetts, raised its smoking age to 21 in 2005. Over the next decade, teenage rates of smoking dropped from 13 to 7 percent, according to the Education Development Center, which conducted the study.

In California, smoking has been banned in enclosed workspaces since 1995, and smoking in a vehicle with a minor has been illegal since 2008. This was done to prevent exposure to secondhand smoke, but the new proposed law would affect young smokers directly.

“The group where smokers usually start is the highest impact group,” Jacoub said. “I don’t know of anyone who would be against it.”

A handful of trade groups, such as the Cigar Association of America and the California Retailers Association, oppose the change on the grounds that Americans are considered adults under the eyes of the law, so that’s also when they should have the right to make their own decisions.

Personal choice is the crux of the argument the tobacco industry uses when opposing stricter legislation.

This new legislation has lit up an ongoing debate over when a person is considered a legal adult and what that entails.

When Are Americans Adults?

When the federal drinking age was pushed back from 18 to 21 in 1984, it was backed by health concerns, mainly the high rate at which minors were being killed in traffic accidents while under the influence.

Research shows the parts of the brain most responsible for decision-making, impulse control, sensation seeking, and susceptibility to peer pressure are still developing and changing between the ages of 18 and 21. The IOM study notes, “Adolescent brains are uniquely vulnerable to the effects of nicotine.”

Jamie Miller, a political consultant and e-cigarette lobbyist from Florida, likened the California legislation to the change in voting age in 1971 when young men were being drafted to serve in Vietnam.

The thought was that men and women old enough to serve in the armed forces should be able to vote for the people who decide to go to war.

“We’re looking at the unintended consequences of passing laws under public pressure at the moment. I personally believe we, as a society, made a mistake when we changed the Constitution to allow those who are 18 to vote just so we could draft those who are 18,” he said.

Saying he believes the fewer people who have access to addictive substances the better, Miller also says there needs to be some kind of uniformity to when young people are considered adults.

“If the age to drink and smoke is 21, we should change the draft and voting age to 21 as well,” he said. “In other words, full, legal adulthood would be 21.”

http://www.healthline.com/health-news/some-states-think-18-is-too-young-to-buy-tobacco-products-062015#5

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