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Jim Whitehead: The evidence is in: Ban tobacco use in GF parks

By Jim Whitehead

GRAND FORKS—It seems that the proposed Park Board tobacco policy has some folks blowing more than smoke.
Among the assertions are the following:
▇ The policy is not based on good science.
▇ Youth are not influenced by the behavior of others.
▇ It will be unpopular in Grand Forks.
▇ It is paternalistic and a misuse of power.
▇ Golf and softball are adult activities and should be exempt from a chewing tobacco ban.
Let’s start by stating what is well known: First, tobacco products are harmful when used as intended; second, nicotine is highly addictive; third, most tobacco users start before the age of 18; and fourth, North Dakota has a major problem with youth smoking and chewing tobacco use.
Thus, it behooves local public health professionals and civic leaders to take reasonable action to address the issue—which, of course, begs the question of what is “reasonable.”
Well, is it reasonable to assume that the Grand Forks Park District should be interested in regulating unhealthy behaviors? Given that the district’s mission is “to provide the best parks, programs, facilities, forestry services and other services possible to promote a healthy and enjoyable lifestyle for all citizens of Grand Forks,” I would submit that it is quite reasonable to adopt policies that promote fidelity to its mission.
Is the proposed policy based on good science? Note that the risks of secondhand smoke have not been advocated as the basis for the proposed policy. In contrast, the rationale is far more about social norm issues such as the effects of role modeling and peer influence.
Of course, not all scientists agree, and I could certainly cherry-pick research papers that challenge their effects; but the weight of evidence seems to have impressed the scientists and public health professionals at the Centers for Disease Control and local public health departments.
Moreover, the science has been deemed good enough to underpin similar policies that have already been adopted by other local agencies and institutions that claim health-related missions, including Altru, UND and Grand Forks schools.
This is not “paternalism” in action. It is an objective and evidence-based attempt to address a serious public health concern.
The “good science” issue also is pertinent to the notion that the proposed policy “will be unpopular.” Those who have made that criticism may not be aware of the solid research design behind the two recent studies conducted on Grand Forks residents and on softball-team managers and golf-course users. The data shows that 78 percent of residents support the comprehensive tobacco-free policy (90 percent of frequent park users), and 84 percent of softball and golf participants are in favor. This is hardly an unpopular policy.
Moreover, when asked whether the proposed policy would “discourage youth from starting to use tobacco products, promote positive role-modeling” or “create an environment that promotes a healthy and enjoyable lifestyle,” well over 90 percent of respondents agreed.
Again, these data (obtained using good scientific methodology) overwhelmingly refute the notion that the policy will be “unpopular.”
Will this policy, if adopted, cause some people to bypass the city for destinations further south? Given that Manitoba intends to fine smokers $300 if they are caught puffing in provincial parks, beaches or playgrounds, it could be that hardened tobacco-using golfers might pass us by. But I doubt that will constitute enough of a revenue loss to Grand Forks to outweigh the health and health care cost-savings that will accrue from what is demonstrably a popular and science-based policy.
Thus, I hope that the Park District board will ignore these “smoke screens” and adopt the proposed tobacco policy at its meeting on Monday (May 4).
But I also hope that the board will recognize that golf and softball are not exclusively the domain of adults, and consequently, will be amenable to revisiting the chewing tobacco exemption sometime in the near future.
Given the alarming data on all forms of tobacco use by North Dakota’s youth, plus the near-overwhelming support for an all-inclusive comprehensive policy by Grand Forks’ residents and the city’s golfers and softball-team managers, I suggest that this is not an issue that can be “chewed over” and delayed too much longer.
http://www.grandforksherald.com/opinion/op-ed-columns/3734294-jim-whitehead-evidence-ban-tobacco-use-gf-parks

Bill Palmiscno: Tobacco limits in parks will make Grand Forks a better place

By Bill Palmiscno
GRAND FORKS—At the April 6 meeting of the Grand Forks Park Board, the Park Board commissioners passed the first reading of the Park District Tobacco Usage Policy.
It reads as follows:
“No person shall use, chew, smoke, inhale e-cigarettes, or otherwise engage in the usage of tobacco or tobacco products within or on any playground, fitness center, arena, pool, Park District parks, baseball diamonds and outdoor tennis courts. Except for chewing tobacco products at Lincoln Golf Course, King Walk Golf Course and Ulland Park, all tobacco products and all tobacco usage is banned on all property owned, leased or managed by the Park District.”
The decision to implement the Tobacco Usage Ban Policy was not taken lightly. For the past two years, multiple concerned groups, including the Grand Forks Public Health Department, have been requesting a tobacco-free parks ordinance. The issue has been carefully reviewed and analyzed by the Park Board for years.
Here are three major factors that lead to the passing of the first reading of the Park District Tobacco Usage Policy.
▇ Grand Forks City Council ruling on Ordinance 4393
On Dec. 3, 2012, the city of Grand Forks passed the Smoke Free Workplace Ordinance 4393; the ordinance went into effect a few days later. This Grand Forks ordinance and the state of North Dakota’s ruling prohibits smoking on golf courses and softball fields.
Ordinance 4393 also includes “public places,” which made reference to public parks but not playgrounds.
▇ Overwhelming community support for tobacco-free parks
In April 2014, the Park Board was presented with a third-party, scientific survey showing community attitudes and perceptions towards a Comprehensive Tobacco-Free Parks Policy. Key findings can be found in the appendix or online at tobaccobytes.com, the website of the Grand Forks Tobacco Free Coalition.
▇ Commitment to being community leaders in health and wellness
The mission of the Grand Forks Park District is to provide the best parks, programs, facilities, forestry services and other services possible to promote a healthy and enjoyable lifestyle for all citizens of Grand Forks. The Park Board is committed to keeping our mission at the heart of every decision made.
The goal of implementing the Tobacco Usage Policy is to prevent our children from being exposed to addictive behavior in public areas where families frequent, such as parks, playgrounds and youth fields. The Park Board does not want to restrict the rights of adults, hence the decision to allow chewing tobacco products in our adult-focused activity areas such as Lincoln Golf Course, King’s Walk Golf Course and Ulland Park.
We truly believe the decision to implement the Tobacco Usage Policy is in the best interest of Grand Forks residents.
http://www.grandforksherald.com/opinion/op-ed-columns/3728966-bill-palmiscno-tobacco-limits-parks-will-make-grand-forks-better-place

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

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

Fargo Forum: Bill banning e-cigarette sales to minors in ND passes Senate

By Mike Nowatzki

BISMARCK – A bill outlawing e-cigarette sales to minors in North Dakota unanimously passed the Senate on Tuesday, though one lawmaker warned that not defining the nicotine-delivery devices as tobacco products will make it more difficult to enforce the law and protect minors.

“Sometimes the good outweighs the flaws, and that’s precisely how I view this bill,” said Sen. Erin Oban, D-Bismarck, executive director of Tobacco Free North Dakota.

Senators voted 46-0 in favor of House Bill 1186, which makes it an infraction to sell or give anyone under 18 an electronic smoking device or alternative nicotine product, or for minors to buy, possess or use them.

Introduced by Rep. Kim Koppelman, R-West Fargo, the bill also requires child-resistant packaging for liquid nicotine containers and bans self-service displays for e-cigarettes.

The Senate didn’t change the bill as approved by the House 71-20 last month, so it will soon head to Gov. Jack Dalrymple for his signature.

Sen. John Grabinger, D-Jamestown, who carried the bill from the Senate Judiciary Committee with a 6-0 do-pass recommendation, said the committee heard a lot of testimony and efforts to amend the bill but couldn’t decide on any changes that would make it better.

“Your committee decided rather than trying to fix the bill that really was getting these products out of the reach of the young, we should support the present bill,” he said.

Health advocacy groups and the state Department of Health have urged lawmakers to define e-cigarettes as tobacco products because the nicotine in the liquid vaporized by the battery-powered devices is derived from tobacco plants.

The definition would make e-cigarettes subject to tobacco excise taxes and require those who sell them to obtain a tobacco retailer license, as three North Dakota cities – Wahpeton, West Fargo and Grand Forks – have mandated through their city ordinances.

Twenty-three cities have updated their ordinances to prohibit e-cigarette sales to minors, according to the North Dakota Center for Tobacco Prevention and Control Policy.

Oban raised concern about using terms like “alternative nicotine product” for products “that are indeed tobacco products and should be treated as such under the law.”

“Creating multiple definitions makes enforcement and compliance more difficult and protection for minors less effective,” she said. “In addition, currently we have no idea who’s even selling products like electronic cigarettes, and unfortunately this bill doesn’t help us to address that concern, either.”

Still, she encouraged a yes vote with the understanding “that we may need to make some improvements in the future.”

Sen. Jonathan Casper, R-Fargo, said the debate over whether to classify e-cigarettes as tobacco products will continue as the U.S. Food and Drug Administration develops regulations for the devices. He said HB1186 struck a “middle-ground balance” between interests on both sides.

Senators also voted 9-37 Tuesday to defeat HB1078, which would have made it illegal for minors to use or be sold nicotine devices. Grabinger said committee members felt the bill introduced by Rep. Diane Larson, R-Bismarck, didn’t go far enough.

http://www.inforum.com/news/3712175-bill-banning-e-cigarette-sales-minors-nd-passes-senate

Letter to the Editor: Letter: Big tobacco companies still trying to hook kids

By Jason McCoy from Moorhead

I  applaud the new TV ad airing locally that highlights Big Tobacco’s continued targeting of children. You may have seen this ad featuring an ice cream truck driving through a kid-filled neighborhood drawing lots of pint-sized customers to its menu of “31 flavors.” Only it turns out a tobacco executive is behind the wheel and the flavors disguise deadly products.
Tobacco companies have clearly come up with ways to get to kids around the 2009 ban on flavored cigarettes by pushing flavored cigars, cigarillos, smokeless tobacco and e-cigarettes.
When the U.S. Food and Drug Administration banned the sale of flavored cigarettes, it did so to reduce smoking, a leading preventable cause of death and disease in our country.
In particular, the FDA wanted to reduce the number of children who start to smoke. Almost 90 percent of adult smokers start smoking as teenagers. And nicotine, which is in all tobacco products, is shown to be not only highly addictive and carcinogenic but also detrimental to adolescent brain development.
Flavorings including menthol, which is still available in cigarettes, mask the harsh taste of tobacco and are shown to be attractive to young people. Research shows that young people believe flavored tobacco products are less dangerous than nonflavored tobacco. As of last year, 44 percent of Minnesota high school smokers used menthol, according to the Minnesota Department of Health. That’s double the percentage in 2000. The same study by MDH also found that 35 percent of Minnesota students have tried flavored cigars and 13 percent of Minnesota kids use flavored e-cigarettes.
Do we really need more evidence that kids are attracted to flavored tobacco products, including menthol? Do we have any reason to believe that tobacco companies aren’t exploiting this attraction to hook more kids on their deadly products? The answer to both questions is a resounding “no.”
It’s time we say “no” to Big Tobacco’s continued marketing to our kids! Ask your lawmakers what they plan to do to stop young people from getting their hands on these tempting threats to their health.
McCoy, Moorhead, is tobacco coordinator for Clay County Public Health.
http://www.inforum.com/letters/3709662-letter-big-tobacco-companies-still-trying-hook-kids

Dickinson Press: Debate over on e-cigs as tobacco products overshadows bills restricting sales to minors

By Mike Nowatzki, Forum News Service

BISMARCK – Two bills being heard at the Legislature this week aim to keep e-cigarettes out of the hands of minors, but the burning issue is whether the nicotine-delivery devices should be classified as tobacco products, which would make them subject to additional taxes.

The North Dakota Department of Health believes e-cigarettes should be considered tobacco products because the nicotine contained in the liquid that’s vaporized by the battery-powered devices is derived from tobacco plants, said Krista Fremming, director of the department’s chronic disease division.

“Defining nicotine devices as tobacco products would allow the state to treat and regulate the sale of these products to minors in the same way the state treats and regulates the sale to minors of other tobacco products, such as conventional cigarettes,” she testified to the Senate Judiciary Committee on Tuesday.

Rep. Diane Johnson, R-Bismarck, prefers not to bring the tobacco-product issue into the debate. Her House Bill 1078 – one of two bills the House passed last month to ban the use of e-cigarettes by minors – refers simply to “nicotine devices,” defining them as “any noncombustible product that can be used by an individual to simulate smoking through inhalation of a substance that contains or delivers nicotine or any other ingredient.”

The bill had its first hearing before the Senate Judiciary Committee on Tuesday.

On Wednesday – the annual nationwide “Kick Butts Day” – committee members will take up the other House bill, HB 1186, which would make it an infraction to sell or give anyone under 18 an electronic smoking device or alternative nicotine product, or for minors to buy, possess or use them.

Fremming said the health department supports that bill’s requirements for child-resistant packaging and salesperson-assisted sales to limit e-cigarettes from being marketing to youths. But it’s still concerned that the bill defines e-cigarettes as non-tobacco products.

The bill’s prime sponsor, Rep. Kim Koppelman, R-West Fargo, has argued that while e-cigarettes use nicotine extracted from tobacco, they’re not tobacco products.

Koppelman was among the House lawmakers who voted to defeat a House bill that would have increased the excise tax on a pack of cigarettes from 44 cents to $1.54 while also defining e-cigarettes as tobacco products. He called it a back-door way to taxing e-cigarettes.

Mike Rud, president of the North Dakota Petroleum Marketers Association, said Tuesday the group supports Koppelman’s bill because it’s more comprehensive and opposes classifying e-cigarettes as tobacco products because the U.S. Food and Drug Administration is developing regulations for e-cigarettes.

“I think we’re going to see a lot of changes when those come out. There’s no sense in muddying the waters right now,” he said.

As of December, Minnesota and Vermont were the only states that taxed e-cigarettes and e-vapor products. Twelve state legislatures considered bills last year taxing e-cigarettes but didn’t pass them, according to Tobacco E-News, an industry publication.

In North Dakota, 23 cities have updated their ordinances to prohibit e-cigarette sales to minors, according to the North Dakota Center for Tobacco Prevention and Control Policy.

Three of those cities – Wahpeton, West Fargo and Grand Forks – require those who sell e-cigarettes to obtain a tobacco retailer license. That could become a state requirement if lawmakers classify e-cigarettes as tobacco products, which supporters say would reduce e-cigarette sales to minors.

Rud said most retailers have made a conscious decision not to sell e-cigarettes to minors, already treating them as tobacco products.

E-cigarette users argue the devices are safer than traditional cigarettes, are a useful tool for those trying to quit smoking and shouldn’t be subject to tobacco excise taxes. Fremming said the health department feels nicotine products approved by the FDA for tobacco cessation – which currently doesn’t include e-cigarettes – should be excluded from the definition of nicotine devices because their safety and efficacy is proven.

While the tobacco products definition will continue to be a source of debate, no opposition has surfaced so far to the idea of restricting e-cigarette sales to minors.

Fremming said the rate of North Dakota high school students who reported trying e-cigarettes nearly tripled from 2011 to 2013, from 4.5 percent to 13.4 percent, and high school students who have tried e-cigarettes are almost twice as likely to try conventional cigarettes.

At least 41 states currently prohibit sales of electronic cigarettes or vaping/alternative tobacco products to minors, including Minnesota and South Dakota, according to the National Conference of State Legislatures.

Whitney Klym, a senior at St. Mary’s Central High School in Bismarck and a member of its SADD group, told the committee Tuesday she has seen e-cigarettes used at school, parties and other events by students as young as 14.

“It is becoming a dangerous social norm among youth,” she said.

http://www.thedickinsonpress.com/news/legislature/3702058-debate-over-e-cigs-tobacco-products-overshadows-bills-restricting-sales

Teens can easily buy e-cigarettes online, study says

Liz Szabo, USA TODAY
Teens can easily buy e-cigarettes online even though sales to minors are banned in 41 states, a new study shows.
Teens in the study were able to buy e-cigarettes online in 94% of attempts, according to a report published today in JAMA Pediatrics.
Internet retailers rejected only five out of 98 attempted purchases because of age, according to the study, in which researchers closely supervised 11 teen participants. Five attempts were blocked by parental control settings on the computers.
None of the teens were asked to show proof of age when the packages were delivered. In fact, 95% of orders were left at the doorstep, the study says.
Researchers, whose previous studies have shown that young people can easily order alcohol online, say they were careful to make sure that the study didn’t encourage kids to break the law.
Parents of the teens, ages 14 to 17, gave consent for kids to join the study and use their credit cards for the e-cigarette purchases. Researchers also cleared the study with local law enforcement.
Kids today have greater access to credit cards than many people realize, says the American Lung Association’s Erika Sward. Many teens routinely use family credit cards to buy online music, games and apps.
Previous studies have found that teens can easily buy conventional cigarettes online, Williams says. About 1 million young people reported buying tobacco online in 2012.
Although the Food and Drug Administration has proposed regulations for e-cigarettes, including a ban on selling them to minors, it has has not finalized these rules. The proposed rule does not ban Internet sales.
E-cigarettes use a battery to heat liquid nicotine into a vapor that can be inhaled. They don’t produce smoke.
E-cigarettes are increasingly popular with young people. A 2014 study found that 17% of high school seniors used e-cigarettes, more than twice as many as used conventional cigarettes.
States have been racing to regulate e-cigarettes out of concern that they will addict young people to nicotine.
North Carolina requires online retailers to verify e-cigarette customers’ ages with a government records database, says Rebecca Williams, the study’s lead author and a research associate at the University of North Carolina-Chapel Hill.
Harold Farber, a pediatric pulmonologist at Texas Children’s Hospital in Houston, says he’s not surprised by the study’s findings. He notes that e-cigarettes are marketed in ways that appeal to teens, with flavors such as grape, cotton candy and bubble gum. He’s concerned that e-cigarettes will addict young people to nicotine, which could lead them to regular tobacco.
“Ninety percent of adult smokers start before age 18,” says Farber, who was not involved in the new study. “The industry knows very well that in order to get their next generation of customers, they need to get them before they become adults. We’re seeing the e-cig industry follow the tobacco industry’s playbook.”
Without regulation by the FDA, the market for e-cigarettes is akin to the “wild West,” says Sward. She calls the study’s findings “extraordinarily troubling.”
“The status quo is benefitting the e-cigarette industry and the tobacco industry,” which has become a powerful force in the e-cigarette market, says Sward, who was not involved in the new study. “We need the Obama administration to act now to protect kids.”
A spokesman for the Smoke-Free Alternatives Trade Association, an e-cigarette industry group, says its members take the responsibility to protect kids very seriously.
“We certainly don’t want teenagers to have access to them,” says Phil Daman, president of the e-cigarette association.
R.J. Reynolds Vapor Co. does not sell e-cigarettes online, spokesman Richard Smith says. “Face-to-face sales allow for greater security against youth access to tobacco products, as clerks can check IDs,” Smith says.
Daman says his organization encourages members to use age verification software when selling e-cigarettes online.
“Implementing the use of age verification software is a reasonable, highly effective and cost-efficient way for the vapor products industry to prevent minors from making unauthorized purchases online,” Daman says.
In the new study, conducted from February 2014 to June 2014, seven of 98 online e-cigarette vendors claimed to use age verification techniques capable of complying with North Carolina law. Yet teens were able to place orders at six of those seven websites, showing that the retailer’s age verification systems didn’t work, Williams says.
“If people aren’t using age verification software, if they’re not doing what they’re supposed to be doing, there’s no excuse for it,” Daman says. “Responsible corporate citizens should be ensuring that they use this age verification software.”
http://www.usatoday.com/story/news/2015/03/02/teens-buy-e-cigarettes-online/24118331/

Clearing the smoke around teen e-cigarette use

Shari Rudavsky, The Indianapolis Star
INDIANAPOLIS — No one says publicly that they want teens to start using e-cigarettes. Nor do most argue about statistics that show that youth have been flocking to this funky alternative to tobacco.
The controversy in many state legislatures centers on what to do about it.
Last year, for the first time, more U.S. teens used e-cigarettes than smoked, 17% vs. 14%, according to a University of Michigan study, making it clear that state-enforced age limits alone don’t work.
Thus far, the Food and Drug Administration has opted not to act. So some states, including Indiana, are trying piecemeal solutions to keep vaping out of young hands, from increasing taxes to closer regulation of the industry.
In Indiana, an effort to tax the products went nowhere. A measure that would increase strictures of so-called vape shops is moving through the Indiana General Assembly. The question is whether it would produce the desired effect.
Vape shop owners argue they are not the problem and that too much regulation would only limit access for former smokers who have replaced their nicotine habit with vaping.
One shop owner told The Star he has no interest in the youth market. At the Indy Vapor Shop on the Westside, the first in Indiana, owner Mike Cline displays a sign announcing no sales to anyone under age 18 and rarely does one cross the threshold. In the five years his shop has been open, he’s denied service to fewer than 10 teens because of age.
“Really I think the idea of minors trying to buy from vape shops is way overblown,” Cline said. “We don’t do sales to minors.”
Someone, however, is selling to minors.
In 2013 more than a quarter-million middle and high school students who had never smoked tried e-cigarettes, according to a Centers for Disease Control and Prevention study that appeared in August. That number had tripled since 2011.
Still, most students don’t head to vape shops, many agree. Instead, they can pick them up at gas station convenience stores, raising health concerns.
Concerned about what we don’t know
E-liquids in sweet flavors, such as candy cane or bubble gum, may draw youth, as will delivery systems that can resemble a variety of other products, such as video game controllers, pens or soda cans, said Earnest Davis, a tobacco health educator for the Marion County Public Health Department.
Some may not realize that when they partake, they’re doing something akin to smoking.
“A lot of youth high schoolers that I talk to, say, ‘I’m not smoking cigarettes; I’m just using a flavored e-juice,'” Davis said. “Right now, they’re just in a wow factor…. It’s one of the scarier things we’re seeing, that everyone thinks it’s cool.”
Health officials say that they are particularly concerned not just with what we know about e-cigarettes but also about what we don’t know.
E-cigarettes do not contain tobacco, but the liquids involved can contain a number of other products, including formaldehyde and metals such as nickel, lead and chromium, whose effect on health is not known, said Dr. Aasha Trowbridge, a family medicine physician with Franciscan St. Francis Health.
“What we do know is that e-cigarettes release chemicals; they’re not harmless,” said Trowbridge, also medical director of the Aspire Tobacco-Free Program. “We know enough to say that the products that are released with burning the liquid are certainly of concern.”
Consuming nicotine in any form, including e-liquids, can be addictive and have detrimental effects on brain development, Trowbridge said.
What concerns Trowbridge most, however, is that many of her young patients tell her they have experimented with e-cigarettes, which suggests they may be more likely to start smoking.
The CDC study published earlier this year found that teens who had never smoked, but had vaped, were twice as willing to try conventional cigarettes.
“That is one of my greatest concerns; are we introducing a product that may not have been something a child would have looked at before and would now say, ‘Hey let me try this,'” Trowbridge said. “It is a perfect gateway drug to conventional cigarettes…. We’re giving our teenagers and youth one more way to be introduced to tobacco.”
For some, a way to quit smoking
Supporters of vaping point to other research that suggests that teens who do experiment with e-cigarettes do not partake regularly. In addition, none of the studies has asked whether teens actually use nicotine products when they vape, said Gregory Conley, president of the American Vaping Association, based in New Jersey.
The fruity flavors may sound designed to appeal to teens, but they also have adult fans, said Conley, who credits a watermelon-flavored vapor product with his own success quitting tobacco. He cites studies that show that 60% to 70% of adult vapers use fruity or sweet flavors.
Cline, who opened his own vape shop six years ago, claims vaping has helped many a smoker kick that bad habit. Cline said he has not smoked conventional cigarettes since he started vaping. Over time, he’s gradually weaned down the nicotine strength of what he vapes.
While Cline said he’s not averse to some tweaks to the law to protect minors and other consumers, he’s wary of going too far.
“We’re trying to reach a level that we as an industry can comply with and support and at the same time protect the consumer,” he said. “We do believe that regulation is both needed and necessary, we just don’t want to be regulated to the point where we can’t do business.”
‘I see it as very similar to cigarettes’
In Indiana, only the bill increasing regulations on the industry progressed. It would give the state the ability to check whether stores sell to minors.
Attorney General Greg Zoeller at the start of this legislative session had proposed a number of measures, including taxing the products and including e-cigarettes in the state’s smoking ban.
Tobacco’s history and the lack of solid data on the health effects of e-cigarettes prompted him to call for the actions on e-cigarettes, Zoeller said.
“Frankly I see it as very similar to cigarettes in the past,” he said. “I do think that these things should not be seen as socially acceptable. There’s unknown risks here.”
Health officials like Davis agree that it would be a shame if e-cigarette use continues to rise among teens at the same time as conventional cigarette use finally falls.
“We worked so hard to eradicate the use of traditional cigarettes among youth, just to have it replaced by something else,” he said.
http://www.usatoday.com/story/news/nation/2015/03/01/clearing-the-smoke-around-teen-e-cigarette-use/24228671/

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