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New CDC Report Shows Big Drop in Secondhand Smoke Exposure Among Americans, But 58 Million Still Exposed – Every State and Community Should be Smoke-Free

Statement of Susan M. Liss, Executive Director, Campaign for Tobacco-Free Kids

WASHINGTON, DC – The percentage of Americans exposed to secondhand smoke has fallen by more than half since 1999, but one in four non-smokers – 58 million people altogether – was still exposed in 2011-2012, according to a new report issued today by the Centers for Disease Control and Prevention (CDC). It is especially troubling that children have the highest levels of exposure, with 40.6 percent of children aged 3-11 and 67.9 percent of African-American children in that age group still exposed to secondhand smoke. While the sharp decline in exposure to secondhand smoke is great news, it is unacceptable that 58 million Americans, including so many children, are still exposed to this serious and entirely preventable health threat.

The CDC report demonstrates both the effectiveness of and continuing need for comprehensive smoke-free laws that apply to all workplaces and public places, including restaurants and bars. To date, 24 states, Washington, DC, and hundreds of cities have enacted such laws, protecting about half the U.S. population (an additional six states have laws that apply to all restaurants and bars, but not all other workplaces). It’s time for every state and community to go smoke-free and protect everyone’s right to breathe clean air, free from the serious health hazards of secondhand smoke.

States in the South have lagged behind in providing this important public health protection, which is easy and cost-effective to implement and very popular with the public. New Orleans set a terrific example for southern states and cities last month when it enacted a comprehensive smoke-free ordinance. The Kentucky Legislature should quickly follow suit and finally approve comprehensive, statewide smoke-free legislation that has been under consideration for several years.

The high level of child exposure to secondhand smoke also underscores the need for parents to take additional steps to protect children, such as ensuring that homes, cars and other places frequented by children are smoke-free. It is encouraging that the proportion of U.S. households with voluntary smoke-free rules has increased from 43 percent to 83 percent in the last two decades. For parents who smoke, the best step to protect children is to quit smoking.

Overall, the CDC reported that the percentage of non-smokers exposed to secondhand smoke fell from 52.5 percent during 1999-2000 to 25.3 percent during 2011-2012. Exposure was higher among children, African Americans, those living in poverty and those who live in rental housing. Secondhand smoke exposure was determined based on blood levels of cotinine, a nicotine byproduct.

“Continued efforts to promote implementation of comprehensive statewide laws prohibiting smoking in workplaces and public places, smoke-free policies in multiunit housing, and voluntary smoke-free home and vehicle rules are critical to protect nonsmokers from this preventable health hazard in the places they live, work, and gather,” the CDC concludes. The report provides support for growing efforts to make public and subsidized housing smoke-free, with the report noting, “The potential for SHS [secondhand smoke] exposure in subsidized housing is particularly concerning because a large proportion of these units are occupied by persons who are especially sensitive to the effects of SHS, including children, the elderly and the disabled.”

Secondhand smoke contains more than 7,000 chemicals, including hundreds that are toxic and at least 69 that cause cancer. According to the U.S. Surgeon General, secondhand smoke causes lung cancer, heart disease and stroke in non-smoking adults and sudden infant death syndrome (SIDS), low birth weight, respiratory problems, ear infections and more severe asthma in infants and children.

The Surgeon General also found that secondhand smoke is responsible for tens of thousands of deaths in the United States each year, there is no safe level of exposure, and only smoke-free laws provide effective protection. The evidence is also clear that smoke-free laws protect health without harming business.

The CDC’s report was published in the agency’s Morbidity and Mortality Weekly Report.

Pro-business lobby speaks out against ND tobacco tax bills

By Nick Smith / Bismarck Tribune

BISMARCK – Lawmakers attempting to raise the state’s tax on tobacco products for the first time in more than two decades acknowledge long odds as they face off with business groups that have successfully beaten back previous efforts.

One tobacco tax bill has been introduced in each chamber. The head of a state retail association says lawmakers’ efforts are misguided and would hurt businesses when the state is wrestling with a potentially tough budgeting effort due to slowing oil activity.

North Dakota ranks 46th nationally in tobacco taxes at 44 cents per pack, higher than Alabama, Georgia, Louisiana and Virginia. The price hasn’t been raised since 1993.

The two pieces of legislation aimed at tobacco taxes are House Bill 1421 and Senate Bill 2322.

HB1421 would raise the state’s cigarette tax to $1.54 per pack. It would also raise the excise tax on other tobacco products from 28 percent of the wholesale purchase price to 43.5 percent. The House Finance and Taxation Committee picks up the bill at 9:30 a.m. Tuesday.

SB2322 would raise the cigarette tax in the state to $2 per pack.

North Dakota Retail Association President Mike Rud is adamant in his opposition.

“This isn’t the time to tax any business in North Dakota,” Rud said. “The idea that a tax increase is going to help people not smoke, it doesn’t hold any water.”

HB1421 prime sponsor Rep. Jon Nelson, R-Rugby, disagreed.

“We’ll just present factual data that should support the fact that this will decrease the number of smokers,” Nelson said.

The recently unveiled legislation was touted along with data from the Campaign for Tobacco-Free Kids.

The organization’s data says a cigarette tax of $2 per pack would prevent an estimated 7,500 people younger than 18 to not smoke and prompt an estimated 8,000 adult smokers to kick the habit. The organization also claims this could result in $300 million in savings in future health care expenditures.

Long odds

Nelson admitted the tobacco tax bills face long odds: Similar legislation failed in 2013.

“We’re going to need a lot of help from our stakeholder groups to get over the hill,” Nelson said.

He said HB1421 would generate an estimated $103.5 million during the 2015-17 biennium. This doesn’t include the $50 million per biennium the state’s general fund would still receive in tobacco taxes.

“I think public sentiment is the main thing,” Nelson said. “We need the public to weigh in.”

Through HB1421, 60 percent of the new revenue would go toward health-related programs in the state’s Community Health Trust Fund, Nelson said. The rest would go to local communities for health-related programs.

Low smoking rates

Rud countered with 2012 data from the Centers for Disease control and prevention that shows tobacco use isn’t a major problem in North Dakota.

“North Dakota’s smoking rates are very low despite the state having some of the lowest tobacco taxes in the nation,” Rud said.

He said North Dakota in 2012 ranked 37th in adult smoking and 49th in smokeless tobacco use. Rud said among youth smokers, North Dakota ranked 34th among 44 states reporting data.

“Proponents of raising the state’s tobacco taxes would have us believe that low taxes are encouraging more tobacco use. But that contention isn’t supported by the data,” Rud said.

SB2322 prime sponsor Sen. Tim Mathern, D-Fargo, said the key target in tobacco tax legislation is youth.

“If we can keep them from smoking up to age 18, the odds of them ever smoking is close to zero,” Mathern said.

Mathern said North Dakotans have had smoke-free public places since June 2012. He said arguments against smoke-free public places were that it would negatively impact restaurants and bars.

“The scares that were around before … have proven not to be the case,” Mathern said.

He said retailers, such as gas stations, also have little to worry about.

“I would say to all these store owners: Do they want their children to smoke? Do they smoke? Consider the broader implications,” Mathern said.

Mathern said he believed the savings on health care to employees and having more healthy customers alive and able to come into their stores for other purchases would offset the losses in tobacco sales.

http://www.inforum.com/news/3670143-pro-business-lobby-speaks-out-against-nd-tobacco-tax-bills

What to Know About the Science of E-Cigarettes

 
Eliza Gray & Alexandra Sifferlin | TIME Magazine

A guide to understanding conflicting and ongoing research

Two Columbia University professors warned in a new study Thursday that the health fears over electronic cigarettes are hindering research. The very same day, another new study showed that smoking e-cigs, or “vaping,” can produce cancer-causing formaldehyde.
Clearly there’s some disagreement among scientists about the risks and benefits of a product that’s growing in popularity. Here’s what you need to know about the latest science.
What’s with the latest disagreement?
Columbia public health professors Amy Fairchild and Ronald Bayer argue in Science magazine that the staunchest opponents of electronic cigarettes are so concerned about the potential downsides that they advocate for an anti-e-cigarette regulatory and research approach that may be bad for public health. This approach of “deep precaution,” they argue, “has served as a kind of trump argument, hostile to the notion of trade-offs, seeing in them perilous compromise. Such a posture does not serve either science or policy well.”
It “may be years before the disagreements over the evidence” about the effects of electronic cigarettes can be resolved, Fairchild and Bayer wrote. On the one hand, electronic cigarettes may serve as gateway drugs for young people to start smoking cigarettes, and “dual” use of electronic cigarettes with tobacco cigarettes may stop some smokers from quitting. Electronic cigarettes may also carry unknown health consequences of their own. On the other hand, they may provide harm reduction for people who have been unable to quit any other way.
Given these two competing possibilities, the authors argued that the best formula for public health is to acknowledge the possibility for costs and benefits and to push for a regulatory scheme that is flexible enough to account for both outcomes. It is better to make public policy and execute scientific research under the assumption that e-cigarettes could bring good as well as bad.
But also on Thursday, the New England Journal of Medicine published a new study reporting that chemicals inside e-cigarettes—like propylene glycol and glycerol—can produce a type of the cancer-causing chemical called formaldehyde when heated during the vaping process. The researchers report that when testing samples of the aerosol from vaped e-cigs, they found that the e-cigs can contain formaldehyde-releasing agents slightly different from regular formaldehyde, and that the levels are especially high when a user vapes at high voltages. Scientists don’t yet know if formaldehyde-releasing agents carry the same risk as pure formaldehyde, but the researchers said in their report that if they assume the substances do carry the same risks, then long-term vaping could be associated with a significantly higher risk for cancer compared to long-term smoking. The researchers said formaldehyde-releasing agents may actually burrow into the respiratory tract more efficiently than regular formaldehyde, though the observation wasn’t confirmed.
Are there other reasons experts are concerned?

There’s also debate over the safety of the liquid nicotine inside e-cigarettes. In April 2014, the Centers for Disease Control and Prevention (CDC) released a report showing what they called a “dramatic” rise in e-cigarette-related calls to U.S. poison centers. Calls went from one a month in September 2010 to 215 calls a month in February 2014, and more than half of the calls involved children age five and under. Forty-two percent involved people age 20 and older. Symptoms of liquid nicotine ingestion are known to be vomiting, nausea and eye irritation.

Researchers are also wary of the long term effects of inhaling propylene glycol, one of the main ingredients in e-cigarettes. The jury is still out, but some physicians are concerned. “As for long-term effects, we don’t know what happens when you breathe the vapor into the lungs regularly,” Thomas Glynn, the director of science and trends at the American Cancer Society, told ABC News. “No one knows the answer to that.”

Are they really attracting young people?

Several recent—but fairly small—studies say yes. A December 2o14 study in the journal Pediatrics surveyed 1,941 Hawaii high school students and found that about 17% of the high schoolers smoked e-cigarettes only, 12% smoked both e-cigarettes and conventional cigarettes, and only 3% smoked conventional cigarettes. The findings suggested that kids who smoked e-cigarettes scored lower on outside risk factors to pick up a conventional smoking habit. “The fact that e-cigarette only users were intermediate in risk status between nonusers and dual users raises the possibility that e-cigarettes are recruiting medium-risk adolescents, who otherwise would be less susceptible to tobacco product use,” the authors wrote. Numbers released in 2013 from the National Youth Tobacco Survey showedthat the percentage of middle school and high school students who have tried e-cigarettes doubled from 3.3% in 2011 to 6.8% in 2012.

What’s the argument in favor of e-cigarettes?

Some smokers use e-cigarettes to help them curb their traditional cigarette habit, or even quit. An August 2014 study that surveyed over 20,000 Americans showed that among adults who used a product to help them quit smoking, 57% chose e-cigarettes. That’s compared to the 39% who used prescription drugs like Chantix and the 39% who used other over-the-counter methods like patches or nicotine gum. Another study from July 2014, which reviewed 80 studies on e-cigarettes’ safety and their effects on users, revealed that not only can e-cigarettes help smokers quit, but they are less harmful to smokers and bystanders’ health compared to regular cigarettes.

What’s the FDA doing about it?

The U.S. Food and Drug Administration (FDA) only regulates e-cigarettes that are marketed for therapeutic purposes, though the agency has proposed a rule that would give it more regulatory power over e-cigarettes but that has not yet been implemented. The FDA has suggested a ban on sale of e-cigarettes to minors, and admits that there is a lot consumers don’t know about the product like whether they attract kids and teens or just how much nicotine is inhaled when a person vapes.

http://time.com/3678402/electronic-cigarettes-ecigs-health-science-research/
 

SAVE OUR SCOUTS – A CALL TO END PARTNERSHIP WITH BIG TOBACCO

The following post was written collaboratively by the 2014-2015 Legacy Youth Activism Fellows, in an effort to call for the end of the partnership between the Boy Scouts of America and R.J. Reynolds Tobacco.

Each day, we interact with a world full of seemingly static realities. Because facets of the world we live in appear the same day after day, it is easy to accept them. The natural inclination to go on autopilot prevents us from questioning the realities created around us. As youth activists engaged in the 2014-2015 Legacy Youth Activism Fellowship Program, we feel a deep-rooted sense of questioning when it comes to facing the seeds of Big Tobacco that are planted all around us. We are baffled by the way tobacco is a reality of our world, despite the unnecessary disease and death it causes, and the evidence that the tobacco industry has acted on a vested interest in attracting youth to its products.

On November 25, 2014, three U.S. Senators took a stand to question the status quo of Big Tobacco’s presence in youth tobacco prevention programs. We applaud U.S. Senator Richard Blumenthal (D-Conn.), Senator Sherrod Brown (D-Ohio), and Senator Tom Harkin (D-Iowa) for urging the Boy Scouts of America to put an end to their partnership with Right Decisions Right Now (RDRN), a youth tobacco prevention program funded by R.J. Reynolds Tobacco Company.  These leaders are not buying Big Tobacco’s efforts to insinuate themselves into youth-focused programs – and neither are we.

Other tobacco prevention programs funded by tobacco companies have been found to be ineffective. When we take a step back to question the presence of Big Tobacco in uncanny places like prevention programs, we can evaluate the reality of their drive. Big Tobacco is maintaining a presence with young people, who are key to keeping their business going as older smokers pass due to tobacco-related illness. In fact, the very company that is sponsoring this prevention program once stated that “younger adult smokers are the only source of replacement smokers… if younger adults turn away from smoking, the industry must decline…”

Inconspicuously, Big Tobacco continues to place its image in front of youth such as through prevention programs like RDRN, and offering funding to after-school programs. In addition to the Boys Scouts of America, some youth-serving groups are partnering with other industry-sponsored prevention programs. Philip Morris USA and other Altria companies are also supporting groups that provide youth-targeted services through the Success360 prevention program. For an industry that has a history of deceitful marketing, it’s shocking that we are continuing to see their involvement with these national organizations and the youth that they serve.

As nearly 9 out of 10 smokers start before the age of 18, the tobacco epidemic can be halted by removing these influences and preventing youth from starting to use tobacco. We urge schools and youth programs like the Boy Scouts of America to divest from their partnerships with Big Tobacco. Prevention programs and funding from tobacco companies undermine efforts such as our own to end youth tobacco use. As Legacy Youth Activism Fellows, we are taking a stand in our own communities to challenge the norms that keep tobacco use prevalent, including: evaluating point of sale tobacco advertising, exploring use of emerging tobacco products on college campuses, supporting tobacco cessation in mental health settings, and engaging youth in promoting smoke-free policies in apartments. Through each of our local efforts, we are striving to place an image in front of youth and our communities that encourages people to live free of tobacco.

We encourage youth-serving groups to join us in questioning the presence of Big Tobacco in their midst. Youth should seek to interact with the many great tobacco prevention programs in their state. With their help and the support of bold leaders like Senators Blumenthal, Brown, and Harkin, we can challenge the status quo and create an environment that gives our communities, especially youth, the tools to thrive. Together, we can #FINISHIT.

http://www.legacyforhealth.org/newsroom/blog-making-waves/save-our-scouts-a-call-to-end-partnership-with-big-tobacco

E-cigarettes may promote lung infections

By Dennis Thompson, HealthDay News

Vapor from electronic cigarettes may increase young people’s risk of respiratory infections, whether or not it contains nicotine, a new laboratory study has found.

Lung tissue samples from deceased children appeared to suffer damage when exposed to e-cigarette vapor in the laboratory, researchers reported in a recent issue of the journal PLOS One. The vapor triggered a strong immune response in epithelial cells, which are cells that line the inside of the lung and protect the organ from harm, said lead author Dr. Qun Wu, a lung disease researcher at National Jewish Health in Denver.

Once exposed to e-cigarette vapor, these cells also became more susceptible to infection by rhinovirus, the virus that’s the predominant cause of the common cold, the researchers found.

“Epithelial cells are the first line of defense in our airways,” Wu said. “They protect our bodies from anything dangerous we might inhale. Even without nicotine, this liquid can hurt your epithelial defense system, and you will be more likely to get sick.”

The new report comes amid a surge in the popularity of e-cigarettes, which are being promoted by manufacturers as a safer alternative to traditional tobacco cigarettes and a possible smoking-cessation aid.

Nearly 1.8 million children and teens in the United States had tried e-cigarettes by 2012, the study authors said in background information. Less than 2 percent of American adults had tried e-cigarettes in 2010, but by last year the number had topped 40 million, an increase of 620 percent.

For the study, researchers obtained respiratory system tissue from children aged 8 to 10 who had passed away and donated their organs to medical science. Researchers specifically looked for tissue from young donors because they wanted to focus on the effects of e-cigarettes on kids, Wu said.

The human cells were placed in a sterile container at one end of a machine, with an e-cigarette at the other end. The machine applied suction to the e-cigarette to simulate the act of using the device, with the vapors produced by that suction traveling through tubes to the container holding the human cells.

The vapor spurred the release of IL-6, a signaling protein that promotes inflammation and an immune system response. This occurred whether or not the vapor contained nicotine, although nicotine appeared to slightly enhance the release of IL-6, the researchers said.

The exposed lung tissue also appeared more susceptible to the common cold virus, developing higher amounts of virus compared to healthy cells that had not been exposed to the vapor, the investigators found. In follow-up testing, lab mice exposed to e-cigarette vapor also appeared more likely to come down with a cold from rhinovirus, compared with unexposed mice.

The American Vaping Association, an industry group representing e-cigarette makers, said the study findings were limited because the tests involved cells in a laboratory, not actual people using e-cigarettes. The tests also failed to compare the effects of the vapor to other inhalants, the group said.

“Many in public health agree that the risks of vaping must always be considered in the context of the risks of cigarette smoking and traditional stop-smoking therapies,” said Gregory Conley, president of the American Vaping Association.

“Unlike past studies, this study provides the reader with no data to compare the liquid results to. What would happen if these same cells were exposed to combustible cigarettes, nicotine gum, or the smoking cessation drug varenicline (Chantix)? That is an important — and unanswered — question that the authors don’t appear to have great interest in answering,” Conley said.

Dr. Norman Edelman, senior medical adviser for the American Lung Association, agreed that people should be cautious in drawing conclusions based on lab tests using cell cultures.

At the same time, Edelman said, the study findings are “interesting and provocative” and fit in with prior research on the effects of e-cigarette use.

“We already know that if you have someone smoke an e-cigarette and then test them, they show airway inflammation,” Edelman said. “The susceptibility to viral infection is brand new and interesting.”

http://www.chicagotribune.com/lifestyles/health/sc-health-0121-e-cigarette-infections-20150109-story.html

Major cancer groups call for e-cigarette research, regulation

By John Nielsen, ScienceInsider

One telling sign of the popularity of electronic cigarettes, or e-cigarettes, which allow users to inhale nicotine vapors without other harmful chemicals, arrived late last year: The editors of the Oxford Dictionaries declared “vape” their Word of the Year for 2014.

Today, e-cigarettes earned another kind of notice: Two of the largest cancer science and treatment groups in the United States called on the government to start regulating “electronic nicotine delivery systems” and step up research on the health effects of vaping.

“While e-cigarettes may reduce smoking rates and attendant adverse health risks, we will not know for sure until these products are researched and regulated,” said Peter Paul Yu, president of the 35,000-member American Society of Clinical Oncology, in a statement. “We are concerned that e-cigarettes may encourage nonsmokers, particularly children, to start smoking and develop nicotine addiction.” His group was joined by the American Association for Cancer Research, which has more than 33,000 members.

The joint statement endorsed the urgent need for new research into the health effects of e-cigarettes and using tobacco tax revenues to help fund studies. It also included a long list of recommended actions by state and federal government agencies. They include requiring makers of e-cigarettes to register their products with the Food and Drug Administration (FDA), to identify the chemicals and levels of nicotine in various brands, and to agree to help stop teenagers from vaping.

In April 2014, FDA issued a proposal to start regulating e-cigarettes. The proposal would require FDA reviews of e-cigarette products and force makers to stop claiming health benefits until the science is in. The rule would also ban the distribution of free samples of e-cigarettes and vending machine sales. Health warnings would be mandatory. FDA has not finalized the rules, however, and researchers and health professionals say they hope today’s statement will highlight the need to move quickly.

“As someone who runs a treatment program for tobacco addicts, I would love to be able to endorse the use of e-cigarettes as an alternative,” says Michael Steinberg of the Robert Wood Johnson Medical School at Rutgers University, New Brunswick, in New Jersey. “But I cannot do that because we don’t know the risks involved, nor can we be sure that moving to e-cigarettes really helps people stop smoking.” Steinberg says it could turn out that smokers who start vaping tend to end up using both e-cigarettes and flammable ones or that the nicotine produced by e-cigarettes is unexpectedly toxic.

Some researchers worry that any new rules won’t go far enough, soon enough. Neither the FDA proposal nor today’s joint statement calls for a ban on television advertising by e-cigarette makers, for example, notes Stanton Glantz, director of the Center for Tobacco Control Research and Education at the University of California, San Francisco. (Glantz, a frequent critic of the health claims made by makers of e-cigarettes, says he supports such a ban.) There’s also no mention of regulating e-cigarette “flavorings,” such as minty or fruity flavors, which were banned from cigarettes after they were linked to elevated smoking rates among teenagers.

Glantz also worries that it could be years before FDA fully regulates the devices. “It’s an especially torturous political and legal process at the federal level,” he says. Regulations may be easier to finalize on the state and local level, he adds, noting that several states and cities have already imposed restrictions. “I would look for progress at the local level,” Glantz says. “I expect that in this case the most important changes will start at the bottom, not the top.”

In the meantime, e-cigarettes are becoming increasingly mainstream. The small, battery-powered devices first became readily available in the United States in 2006, and sales rose to about $2 billion in 2014 alone. “Vaping” bars where people speak of “vapers’ rights” are popping up in towns and cities. Movie stars have advertised their vaping skills on late-night television talk shows.

This past December, a survey released by the National Institute on Drug Abuse reported that 17% of high school seniors said they’d vaped at least once a month, compared with 14% percent who admitted to smoking. Vaping among 10 graders, at 16%, was more than twice the rate of smoking. Antismoking activists found these reports alarming, arguing that vaping could become a “gateway habit” that could draw nonsmokers toward cigarette use.

http://news.sciencemag.org/health/2015/01/major-cancer-groups-call-e-cigarette-research-regulation

Opinion: A tobacco tax increase would make Maryland healthier

Matthew L. Myers, Washington – The Washington Post

The Dec. 28 editorial “A tax that saves lives” pointed out that Maryland’s push to reduce smoking is not only good public health policy but also good fiscal policy. It helps reduce tobacco-related health-care costs, which total $2.7 billion a year in Maryland, including $476 million paid by the state’s Medicaid program.

That should spur Gov.-elect Larry Hogan (R) and legislators to step up efforts to prevent kids from using tobacco and to help users quit.

Ideally, Maryland would increase its tobacco tax. The last tobacco tax increase, in 2008, helped reduce smoking among youth and adults.

Maryland must also increase funding for its tobacco prevention and cessation programs, which have been cut by more than half in recent years. Maryland will receive $543 million from the 1998 tobacco settlement and tobacco taxes this year, but it will spend just $8.5 million on tobacco prevention. This paltry sum is less than 18 percent of what the Centers for Disease Control and Prevention recommends. These programs save lives and money. Washington state saves more than $5 in health-care costs for every $1 spent on its program.

Maryland can’t let up; the tobacco industry isn’t letting up in promoting its products. Nationwide, Big Tobacco spends $8.8 billion a year on marketing, including more than $120 million in Maryland. The result: Tobacco remains the No. 1 cause of preventable death. Unless Maryland’s leaders continue to fight this scourge, the state will pay a high price in lives and dollars.

Matthew L. Myers, Washington

The writer is president of the Campaign for Tobacco-Free Kids.

http://www.washingtonpost.com/opinions/a-tobacco-tax-increase-would-make-maryland-healthier/2014/12/31/0cbfb454-905a-11e4-a66f-0ca5037a597d_story.html

Tobacco tax: Move for $2 per pack gains momentum in CA

By Dr. Nicholas Leeper | Special to the Mercury News

The changing of the New Year brings about a fresh start. If you are one of the estimated 46.6 million Americans who smoke cigarettes, quitting the habit is likely being considered for a New Year’s resolution. Polls have shown that a vast majority of smokers would like to quit, and we at the American Heart Association are dedicated to giving smokers every edge we can to put their habit in the past. One such proven way to encourage quitting is a tobacco tax.

This is why we are joining with doctors, health care workers, taxpayers and other nonprofit health organizations to support a $2-per-package tax on the cost of tobacco.

The benefits to our state would be enormous and would more accurately account for the true cost of tobacco. Currently, California spends about $9 billion a year on tobacco-related medical care, with taxpayers footing about a third of that. In fact, in data compiled from the Centers for Disease Control, the true cost to society in California is $15 for every pack sold. Our current tobacco tax is 87 cents.

A tobacco tax is also a particularly effective way to prevent younger people from ever taking up the habit. A staggering 80 percent of smokers start before they are 18, while only one in 100 begin at age 26 or older. The Congressional Budget Office estimates that, based on previous research, a 10 percent increase in the cost of tobacco will result in a five to 15 percent decrease in youth tobacco usage. This compares to three to seven percent for adults.

Education about the ill effects of tobacco over the past several decades has been instrumental in lowering the rate of smoking in the United States. Toward that end, the tax would bolster proven youth prevention programs to deter smoking. A few years ago, it was estimated that even the $1 added tobacco tax then proposed in California would have prevented 200,000 children in California from becoming adult smokers.

Given that tobacco is a major contributor to coronary disease in our nation, we at the American Heart Association are always looking at effective policies that result in fewer smokers. The Congressional Budget Office estimates that if even a roughly $1 per package tax were to be instituted on cigarettes next year, there would be 2.6 million fewer adult smokers over the age of 18 by 2021. This would certainly be helpful in a nation where 443,000 people die from smoking-related diseases yearly, including 46,000 heart-related deaths attributed to secondhand smoke.

If these statistics just seem like numbers on a page, just think about the intangibles, such as the value added from having more years with a grandparent, or not watching a loved one suffer through the pain of emphysema, heart disease or cancer. These are things on which it’s impossible to place a monetary value, but with an estimated 100,000 California lives that will be saved in future years through a tobacco tax, they are nonetheless primary benefits.

So, in the New Year, if you need help to quit smoking, please visit our website, http://www.heart.org, for more information. And please join with us at http://www.savelivesca.com and support a $2-per-package tobacco tax next year. The life you save may be yours or a loved one’s.

Dr. Nicholas Leeper is Assistant Professor of Cardiovascular Surgery and Medicine at Stanford University Medical Center and president of the American Heart Association, Silicon Valley Division. He wrote this for this newspaper.

http://www.mercurynews.com/opinion/ci_27190645/tobacco-tax-move-2-per-pack-gains-momentum

Higher tobacco taxes save lives

By: Vincent DeMarco, Baltimore

A recent op-ed criticizing Maryland’s tobacco tax increases ignores the most important consequence of these measures: a dramatic decrease in tobacco use by teens that has saved thousands of young people from preventable tobacco-related deaths and serious illnesses (“Md. cigarette taxes have unintended consequences,” Dec. 18).

According to data compiled by the Campaign For Tobacco Free kids, within two years after the 2008 increase in the state cigarette tax, from $1 per pack to $2 per pack, there was a 29 percent drop in teen smoking in Maryland.

That translated into 15,000 fewer high school smokers (some of whom have become non-smoking young adults by now); more than 70,000 kids today who will not become adult smokers; more than 30,000 kids alive today who will avoid future premature smoking-related deaths; and more than $1.5 billion in long-term health care cost savings tp the state.

The Maryland Department of Health and Mental Hygiene recently released a study showing that between 2010 and 2013 there was an 18 percent drop in Maryland teens smoking cigars. This happened at a time when nationally there was no statistically significant change in teen cigar smoking.

This progress, which also resulted in saving thousands of Maryland youth from tobacco addiction and preventable death and illnesses, occurred in part because of the 2012 increase in the state tax on cigars, along with an effective public education campaign by the state health department.

Granted, there will always be some people who will seek to avoid the tobacco tax by going to other states or resorting to smuggling. But very seldom will this involve children, whose lives we are saving in record numbers.

And we know from experience that the drop in cigarette sales in Maryland far outweighed the increase in sales in neighboring states that didn’t increase their tobacco tax. And were are fully confident in Maryland Comptroller Peter Franchot’s ability to prevent and prosecute those who would try to illegally smuggle cigarettes into the state.

In addition to saving lives, tobacco tax increases are good for Maryland taxpayers because they both reduce the health-care cost for tobacco-related illnesses and help fund critical health care programs. The 2008 tobacco tax increase partially funded the expansion of health care to over 100,000 uninsured Marylanders.

Although the Maryland Taxpayers’ Association doesn’t seem to want Marylanders to have these benefits, many independent polls show the vast majority of Marylanders clearly understand these benefits and would strongly support further increases in the tobacco tax to save more lives and money for the state.

-The writer is president of the Maryland Citizens’ Health Initiative.

http://www.baltimoresun.com/news/opinion/bs-ed-tobacco-letter-20141222-story.html

Forum editorial: Close off e-cig sales to minors

Fargo Forum Editorial

The Legislature should follow the lead of several North Dakota cities and ban the sale of e-cigarettes to minors. As it stands now, even with sales bans in Fargo, Bismarck, Casselton, Mapleton and other cities, e-cigs can be (and likely are being) sold to minors all over the state. It’s a gaping loophole in a state law that in every other way treats e-cigs like tobacco products.

E-cigs are touted as an effective option for tobacco users to get off cigarettes, although the research is inconclusive. But they also appeal to kids because they are used by some minors for “vaping,” which kids think is “cool,” according to public health experts. E-cigs don’t contain tobacco, but they can be nicotine delivery devices. Often the substances in e-cigs include candy flavors. There is little doubt the products are aimed at adolescents, according to new research. And kids are taking them up at alarming rates.

That being said, e-cig sellers in Fargo insist it is against company policy to sell to anyone under age 18, no matter what a state’s law or city’s ordinances allow or prohibit. In fact, e-cig retailers say they want a state law that bans sales to minors, and will work with legislators in the upcoming session.

While the retailers’ public attitude is good news, questions remain. Where are kids getting e-cigs? Why is use up among minors? Who is policing what?

Most troubling: There is no question e-cigs are a gateway to smoking among teens. New studies indicate that as more minors try e-cigs (up in several states), chances increase that they will try tobacco and get hooked. Nicotine, whether in an e-cig or a cigarette, is addictive. It should come as no surprise that big tobacco companies are in the e-cig business.

The state of North Dakota, with what appears to be support from e-cig sellers, should close the sales-to-minors loophole. Without informed and firm action, e-cigs could erode the progress that’s been made to reduce tobacco use in the 50 years since the first surgeon general’s report revealed the health risks of smoking.

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

http://www.inforum.com/opinion/3637026-forum-editorial-close-e-cig-sales-minors