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Nicotine Addiction

One More Reason To Swear Off Tobacco: The Inflammatory Trap Induced By Nicotine

An Umeå-based team in collaboration with US researchers reveals a new link between nicotine and inflammation. They report that nicotine strongly activates immune cells to release DNA fibres decorated with pro-inflammatory molecules, so called neutrophil extracellular traps (NETs). The continuous exposure to these NETs can harm the tissue and could explain the hazardous consequences of tobacco consumption for human health.

Tobacco use causes death of nearly six million people annually according to WHO. Nicotine is the major addictive and toxic component in tobacco products. In cells, nicotine signals via nicotine acetylcholine receptors to mediate dangerous effects on the consumer’s body. Nicotine is a major cause of inflammatory diseases among smokers and also non-smokers by passive inhalation, such as for instance chronic obstructive lung disease (COPD). COPD is widely spread and affects more than 10 percent of the adult population in westernised countries. The molecular mechanisms underlying this inflammatory activity of nicotine are not well understood.

In a recently published article in the Journal of Leukocyte Biology, researchers at the Laboratory for Molecular Infection Medicine Sweden (MIMS) at Umeå University reveal a novel link between nicotine and inflammation. They found that nicotine activates neutrophils, in an undesirable fashion.

Neutrophils are the most abundant type of white blood cells that circulate in the blood stream ready to attack invading microbes with an arsenal of antimicrobial compounds. Neutrophils are essential to prevent infection by engulfing invading microbes, or by releasing reactive oxygen species as well as DNA fibres from their own nuclei, termed neutrophil extracellular traps (NETs). NET release is a mixed blessing. Loaded with antimicrobial enzymes and pro-inflammatory molecules NETs are harmful to invading microbes, however, they can also potently harm the host’s own tissue, if not controlled in the right manner. In recent years, NETs have been attributed to be mediators of tissue damage in several inflammatory diseases, such as for instance small vessel vasculitis, arthritis and cancer.

For the first time, Ava Hosseinzadeh and colleagues at MIMS show that nicotine triggers NET release. The signal to trigger NETs is mediated by a specific acetylcholine receptor found on neutrophils and further signalled into the cell via a protein kinase known as Akt.

“This particular finding explains the missing piece of the puzzle of tobacco usage and inflammation,” says Ava Hosseinzadeh, who worked on this project during her doctoral dissertation. “This novel finding opens new avenues to understand the consequences of tobacco usage for human health and should be seen as one more convincing argument to quit nicotine usage in any form.”

“The next evident step is to demonstrate the NET-inducing capacity of nicotine in animal models and human samples,” says Constantin Urban, associate professor and project leader at Umeå University. “Such ‘in vivo’ studies will enable us to attract new funders and potentially interest of the pharma industry. Our finding could hopefully lead to novel anti-inflammatory therapies of tobacco usage related diseases.”

Think e-cigs are safe for kids? You’ll think twice after reading this

A study found 75 percent of flavored e-cigarettes contain a chemical linked to severe respiratory disease

The teenage brain is particularly vulnerable to addiction

“Popcorn lung’’ can develop

Electronic cigarettes, or e-cigarettes, have become so popular that they surpassed conventional cigarettes as the most commonly used tobacco product among youth in 2014, according to the Centers for Disease Control and Prevention.

E-cigarette use among youth has soared — from 1.5 percent in 2011 to 13.4 percent in 2014 among high school students, and from 0.6 percent in 2011 to 3.9 percent in 2014 among middle school students, according to the CDC.

E-cigarettes, battery-powered devices that provide doses of nicotine and other additives to the user in an aerosol, are often falsely viewed as a harmless alternative to conventional cigarettes because e-cigarettes do not contain tar, which can lead to tobacco-related diseases.

But, there are real dangers for users of e-cigarettes, especially for youth, medical experts say.

An adolescent brain is particularly vulnerable to addiction because it is still developing, said Dr. Judy Schaechter, chair of the department of pediatrics at UHealth — University of Miami Health System. Nicotine addiction can then become more severe and difficult to break.

Nicotine addiction can also become a gateway to conventional cigarettes and other substances, said Dr. Loretta Duggan, an adolescent medicine fellow at Nicklaus Children’s Hospital. A person with a family history of addiction or an addictive personality can also be very vulnerable.

“It can make it easier to lead to illicit drug use,” Duggan said.

Nicotine can increase heart rate and blood pressure as well as contribute to cardiovascular and heart disease, Duggan said. E-cigarettes can cause strokes and cancer because nicotine can negatively affect blood vessels.

“Even though e-cigarettes seem harmless, a real risk exists,” Duggan said.

There is very little research about other effects that e-cigarettes, which include other additives, can have on the body, Schaechter said. But, e-cigarettes can have a negative effect on the brain, causing inflammation to the lungs and developing tissue.

Schaechter noted reports of e-cigarette users suffering from “popcorn lung” or bronchiolitis obliterans. That is an irreversible life-threatening disease that causes scarring within small air sacs in the lungs, resulting in a severe cough and shortness of breath that gets progressively worse over time.

According to a study released by the Harvard School of Public Health, 75 percent of flavored e-cigarettes and their refill liquids were found to contain diacetyl, a flavoring chemical linked to cases of severe respiratory disease such as “popcorn lung.”

E-cigarettes are often attractive to adolescents because of their kid-friendly flavors, packaging and advertisements.

According to a CDC study released in April, there is a link between exposure to e-cigarette advertisements and the use of e-cigarettes by middle and high school students. Spending on e-cigarette advertising rose from $6.4 million in 2011 to an estimated $115 million in 2014.

The high rate of e-cigarette use among adolescents suggests that adolescents who would not have otherwise used tobacco products are picking up the habit, according to a study released this summer by the American Academy of Pediatrics.

Parents can guard against these dangers. Talk to children as young as 6, before they are influenced by their peers, Duggan said.

Parents should also not indulge in e-cigarette use, Schaechter said.

“We know children of smokers are more likely to smoke,” Schaechter said. “If parents don’t want their children to pick up addictive habits, they shouldn’t do it.”

Also, monitor their social media, TV and cellphone usage, where adolescents can view e-cigarette advertisements.

The Food and Drug Administration (FDA) issued new rules in May that for the first time extend federal regulatory authority to e-cigarettes, banning their sale to anyone under 18 and requiring that adults under the age of 26 show a photo identification to buy them.

The new rules also require manufacturers to register with the FDA, disclose detailed reports of their products’ ingredients and obtain permission to sell their products.

“We can work with teens to break addiction, unlike with our parents and grandparents, who didn’t have the type of knowledge that we have today,” Duggan said.


Nicotine Addiction Clinical Presentation

Nicotine addiction is now referred to as tobacco use disorder in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). [2]

There are 11 possible criteria, of which at least 2 must be present in the last 12 months:

1. Tobacco taken in larger amounts or over longer periods of time
2. Persistent desire or unsuccessful efforts to cut down or control use
3. A great deal of time is spent on activities necessary to obtain or use tobacco
4. Craving or a strong desire or urge to use tobacco
5. Recurrent tobacco use resulting in a failure to fulfill major role obligations at work, school, or home
6. Continued tobacco use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by effects of tobacco (eg, arguments with others about tobacco use)
7. Important social, occupational, or recreational activities are given up or reduced because of tobacco use
8. Recurrent tobacco use in situations in which it is physically hazardous (eg, smoking in bed)
9. Tobacco use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by tobacco
10. Tolerance, as defined by either the need for markedly increased amounts of tobacco to achieve the desired effect or a markedly diminished effect with continued use of the same amount of tobacco.
11. Withdrawal, as manifested by either the characteristic withdrawal syndrome or the use of tobacco to relieve or avoid withdrawal symptoms.

Symptoms of withdrawal include difficulty concentrating, nervousness, headaches, weight gain due to increased appetite, decreased heart rate, insomnia, irritability, and depression. These symptoms peak in the first few days but eventually disappear within a month.

Symptoms of nicotine toxicity, otherwise known as acute nicotine poisoning, include nausea, vomiting, salivation, pallor, abdominal pain, diarrhea, and cold sweat.

A previous history of depression, use of antidepressants in the past, and onset of depression during previous attempts to quit smoking should be obtained.

The time to first cigarette and total cigarettes per day are the 2 strongest predictors of nicotine addiction. The nicotine dependence and nicotine withdrawal could be treated by means of the following [4, 29] :

• Other forms of nicotine delivery
• Drugs that selectively target one or more of the underlying mechanisms
• Behavioral treatments, acupuncture, and other therapies

Teen vaping could reverse progress in the control of tobacco

Nicotine experimentation could become nicotine addiction for youth who never used any other tobacco products, USC study suggests

A new USC study debunks the popular belief that electronic cigarettes are merely a substitute for cigarettes among teens. Instead, the study suggests that some teens who never would have smoked cigarettes are now vaping.

E-cigarettes, which entered the U.S. market in 2007, vaporize liquids that may or may not contain nicotine. In 2011, about 1.5 percent of high schoolers had vaped in the past 30 days, according to the National Youth Tobacco Survey. Four years later, that number skyrocketed to 16 percent.

A USC study of 5,490 high school juniors and seniors shows tobacco use among teens in Southern California is on the rise.

In 2014, about 14 percent of 12th-graders said they had either smoked or vaped in the previous 30 days. A decade earlier — before e-cigarettes were sold in the United States — 9 percent of surveyed teens in this age group reported that they had smoked, said Jessica Barrington-Trimis, lead author and a postdoctoral scholar research associate in the Department of Preventive Medicine at the Keck School of Medicine of USC.

“If teenagers who vape are using e-cigarettes instead of cigarettes, we would have expected to see the decline in smoking rates continue through 2014,” Barrington-Trimis said. “But what we’ve seen is a downward trend in cigarette use from 1995 to 2004 but no further decrease in cigarette smoking rates in 2014. The combined e-cigarette and cigarette use in 2014 far exceeded what we would have expected if teens were simply substituting cigarettes with e-cigarettes. The data suggest that at least some of the teens who are vaping would not have smoked cigarettes.”

The study, published on July 11 in the journal Pediatrics, followed five groups of high schoolers who graduated in 1995, 1998, 2001, 2004 and 2014. Researchers collected the history of tobacco use in an individually administered questionnaire.

Cigarette use is the largest preventable cause of death and disease in the United States. Cigarette smoking kills more than 480,000 Americans annually, according to the Centers for Disease Control.

“An important question in the rapidly evolving landscape of youth tobacco product use is whether e-cigarettes are replacing cigarettes,” said Rob McConnell, the study’s senior author and professor of preventive medicine at Keck Medicine of USC. “However, use of e-cigarettes by youth who would not otherwise have smoked results in exposure to the hazards of inhaled vaporized liquids and flavorings in e-cigarettes and may result in exposure to nicotine that can damage the adolescent brain.”

USC is one of 14 U.S. research institutions that received National Institutes of Health funding to establish the Tobacco Centers of Regulatory Science.

What the numbers suggest

The National Youth Tobacco Survey has reported a long-term decline in teen smoking rates followed by a leveling off between 2014 and 2015.

The USC study found that the number of 12th-graders in Southern California who had smoked in the past 30 days dropped from 19 percent in 1995 to about 9 percent in 2004 and then leveled off, with the rate of smoking just under 8 percent in 2014.

But when cigarettes and e-cigarettes were combined, some 14 percent of high school seniors in 2014 said they had smoked or vaped in the last 30 days.

“Because e-cigarettes are perceived as less harmful and less dangerous than combustible cigarettes, another concern is that teens may be introduced to nicotine use via e-cigarettes,” Barrington-Trimis said. “In California, where smoking rates are among the lowest in the country, the increase in vaping, possibly followed by increases in smoking, could erode the progress that has been made over the last several decades in tobacco control.”

A perilous experiment

In fact, older teens who experiment with electronic cigarettes are six times more likely to try regular cigarettes within about a year when compared to those who have never vaped, reported Barrington-Trimis and her USC colleagues in a study published last month in Pediatrics.

Although some e-liquid providers say their products do not contain nicotine, this industry has not been regulated until just recently. The U.S. Food and Drug Administration announced plans to regulate all tobacco products — including e-cigarettes, cigars and hookah tobacco — in May. Last month, California became the second state, behind Hawaii, to raise the age of tobacco purchase — including e-cigarettes — from 18 to 21.

“E-cigarettes may be recruiting a new group of kids to tobacco use,” Barrington-Trimis said. “E-cigarettes may be safer than regular cigarettes for adults who are transitioning from smoking to vaping, but for youth who have never used any other tobacco products, nicotine experimentation could become nicotine addiction.”


The study was supported by the National Institutes of Health National Cancer Institute and the Food and Drug Administration Center for Tobacco Products (P50CA180905).

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Teens Are Vaping Themselves Into Nicotine Addiction

Teens: can’t trust them to do anything right. First it was hoverboards, then it was following in Justin Bieber’s teenage dirtbag footsteps, and now it seems that modern-day teens, who might not otherwise have been susceptible to nicotine addiction, are vaping themselves silly.

A new study published Monday in the journal Pediatrics found that teens are still ingesting nicotine at a higher rate than experts expected. The study tracked “the use of cigarettes and e-cigarettes among 5,490 California high school seniors who graduated between 1995 and 2014″ and found that because of vaping, teens report inhaling nicotine at rates researchers haven’t seen since the ’90s. Remember how much people smoked in the ’90s? From the Times:

But the rate of teenagers using nicotine — either through tobacco cigarettes or ecigarettes — is on the rise. About 14 percent of Southern California high school seniors in 2014 said they had smoked or vaped in the last 30 days. Researchers say they have not seen similar levels of nicotine use among teenagers since 1995, when 12th-grade smoking rates were 19 percent.

Teens who wouldn’t have otherwise smoked cigarettes are instead getting nicotine by vaping, the study found, and “while earlier studies have suggested that some teens are using nicotine-free vaping liquids,” researchers said that most teens appear to use vape juice infused with nicotine.

A professor of pediatrics at MassGeneral Hospital for Children and Harvard Medical School, Dr. Jonathan Wickoff, told the New York Times that the dangers of nicotine addiction are still very real, even in vaping: “The F.D.A. has done tests on these vaping products that supposedly do and do not contain nicotine, and what is advertised is really not what’s in the product.” Get it together, teens. The vape life isn’t for you.

Treat e-cigs like tobacco

A new study by researchers at the University of Southern California finds that adolescents who use electronic cigarettes are six times more likely than their peers to smoke tobacco later.

Promoters of electronic cigarettes have tried to minimize their regulation by contending that the devices primarily are an aid to help people stop smoking tobacco cigarettes.

Many people do indeed use the devices to satisfy their nicotine addiction without ingesting the remainder of the carcinogenic chemical mix in tobacco.

But that is only one part of the market. The industry, much like the tobacco industry itself, markets to young people who never have smoked. New research, demonstrating that teenagers who “vape” are more likely than their nonvaping peers to smoke tobacco later, demonstrates that e-cigarettes should be regulated much like tobacco.

The study, by researchers from the Department of Preventive Medicine at the University of Southern California, was published recently in the journal Pediatrics. It found that 40.4 percent of adolescents who reported that they had vaped in 11th and 12th grades went on to smoke tobacco cigarettes, as opposed to 10.4 percent of their peers who had not used e-cigarettes. The researchers adjusted for a variety of factors relative to smoking, and found that young vapers overall were 6.17 times more likely than their peer group nonvapers to smoke cigarettes later.

Most important, the researchers said that vaping was a contributing factor to later tobacco use, not simply a way station for younger users who would have started smoking tobacco later in any case, when they were old enough to legally do so.

The findings call for the state and federal government to treat e-cigarettes like tobacco cigarettes for the purpose of public health policy.

How One Man and His Team Brought about a Complete Ban on Gutka Sales in Odisha

Meet Imran, a young Odisha resident who has taken the battle against tobacco addiction in the state as a personal crusade and is fighting it with all his might.

“This campaign is like our addiction in the fight against addiction. We have decided to donate one rupee and one hour for the country each day,” says Md. Imran Ali about his crusade against tobacco and alcohol addiction in Odisha.

Imran came across the menace of tobacco in the city while pursuing his Master’s in Social Work degree. During one of his field visits to the Shantipali slum in Bhubaneshwar, he was shocked to see kids as young as 10 years old addicted to tobacco products, especially gutka. On further investigation, he found that the easy availability of tobacco products in the market and ignorance of parents make it easy for children to access these items. This addiction, in turn, becomes a stepping stone to other addictions, like alcohol and drugs, as the children grow up.

The gravity of the situation and its irredeemable impact stuck with Imran. He ended up writing and self-publishing a book named Bloody Gutka, in which he talks about the immense harm done by tobacco products.


This was followed by awareness programmes that he organised with his friends in the slums, where they talked to parents about this problem. Gradually, he brought together some like-minded young people in Bhubaneshwar to form Nasha Mukti Yuva Sankalp (NMYS), a voluntary campaign against tobacco/alcohol addiction and substance abuse.

The group comprises about 30 young people who work on a voluntary basis to contribute towards the cause whenever they can. They started by conducting awareness programmes in schools and colleges across the city, slowly moving on to advocacy in a planned manner.

“We noticed that many OMFED (Orissa State Cooperative Milk Producers’ Federation Limited) booths in the state were turning into tobacco and smoking hubs. One could find tobacco products more than milk in many of these booths. I, along with a friend Jitendra Kumar Sahoo, filed a PIL in the Odisha High Court, seeking a ban on the sale of tobacco products at milk parlours,” says Imran.

A senior HC advocate, Biren Tripathi, agreed to take up the case for free and it resulted in victory. The court ordered a ban on the sale of tobacco products in Odisha milk parlours in 2011.


“Winning the case gave us a lot of confidence. I felt that when you are doing some good work, it gets noticed and recognised,” says Imran.

Soon, the group started campaigning for a complete ban on the sale and business of gutka in the state to address the rising number of mouth cancer cases. According to reports, smokeless tobacco accounts for more than 40% of all cancers in Odisha. Over 43% of the population consumes smokeless tobacco in one form or the other.

When awareness drives and online campaigns did not lead to any positive impact, they filed another PIL in the High Court. This time, an NGO named CLAP (Committee for Legal Aid to Poor) stepped forward to help them. NMYS was successful once again and the state implemented a complete ban in 2013.

Continuing with his mission to make people aware about the hazards of tobacco, Imran directed an Odiya documentary called Salaam Jeevan, addressing the health, economic and environmental hazards of tobacco.


It was shown in 2,500 colleges in the state with the help of the youth wing of the Odisha government. Imran also wrote a book with the same name, which was followed by yet another documentary called Silent Killer. It is a short documentary that shows the effect of tobacco consumption on families in general and Imran circulated it on WhatsApp to reach more people.

Members of NMYS also assist mouth cancer patients by directing them to the Acharya Harihar Regional Cancer Centre that treats underprivileged people for free. Imran has started a counselling centre for tobacco users with one of his friends B Nayak, who is a doctor.


“Mouth cancer does not develop suddenly. It has many warning signs and symptoms, which if caught and medicated early, can help in the treatment of the disease. We focus on the preventive part of the disease at the counselling centre,” he says.

Imran feels blessed that he has people who are willing to help his team by contributing towards the cause in kind. Professional editors, voice-over artists, cameramen, etc., agree to volunteer for his movies for free.


All the members of the group work on a voluntary basis. They come from varying backgrounds – education, health, business, etc. Imran too works part time as a teacher in a college. He is originally from the Bhadrak district of Odisha but moved to Bhubaneshwar after completing his graduation in sociology.

Imran decided to dedicate his life to social work when he applied for a post-graduation course. No bank was willing to give him an education loan. He wrote to the then President of India, APJ Abdul Kalam, seeking help. And the President’s office replied with a notice to the bank demanding immediate attention. “I received the loan within two days. The incident made me think that if the first citizen of the country is so dedicated towards the welfare of common people like me, then my duty and responsibility toward the country become even greater,” he says.

“Every time we take patients to the hospital and help in their treatment, they show so much gratitude that I feel richer than any millionaire. It is a traumatising experience for people when they come to know about cancer. It is important for someone to support them and give them courage in such times. That is why I have decided to keep doing what I am doing,” he concludes with a smile.

E-Cigarettes Are No Safer, Study Shows

People get addicted on cigarettes and enjoy them up to the cigarette butt because of the nicotine craze. Although the nicotine doesn’t promote lung cancer and diseases, it’s the tar and other chemicals that do most of the damage.

A vigorous debate has been going on among public health officials if electronic cigarettes or e-cigarettes can reduce the dangers of smoking tobacco or id they should be dealt as negatively as conventional cigarettes. Countries such as Britain, authorities prefer e-cigarettes more, enticing smokers to transition to electronic from conventional.

The Food and Drug Administration issued last week new rules on e-cigarettes, prohibiting their sale to people less than 18 years of age and required adults under the age of 26 to present a photo identification to buy them, according to The New York Times.

Producers will be required to reveal the ingredients in the liquid nicotine used in “vaping” and permit government review on how the devices are manufactured before they can be sold to adults in the U.S.

Presently, anything could be concealed inside the liquid and isn’t the only fact why children are not allowed to use e-cigarettes. Since it still contain nicotine which is an addictive ingredient associated to heart disease, it doesn’t mean even without the carcinogenic tar and smoke it is already safe to use. Harmful substances are discovered in e-cigarette “juice” like the flavoring Diacetyl linked to lung diseases, as reported by timesunion.

While tobacco products are responsible for the huge majority of the exposures, e-cigarettes are held accountable for 14% of them. But what is most worrying is the increased scale at which most young children are exposed with e-cigarettes and the serious incidents compared to tobacco product exposures, the Medical News Today reported.

Nicotine is an impetus that exists naturally in tobacco plants affecting the heart and nervous system. Even so, being exposed to small amounts can be quickly fatal.

Studies showed that using e-cigarettes is still dangerous even without the tar or even the smoke especially if young children are exposed to it meaning it was ingested, inhaled or absorbed by eyes or skin. The nicotine found in juice and other ingredients can still do harm to everyone’s health.


E-cigarette exposure in children rises 1400% in pediatrics study, vaping industry feels the FDA heat

E-cigarette exposure in children rises 1400 percent in pediatrics study, even as vaping industry feels the heat from the FDA. There has been a long-running debate on whether vaping and the use of e-cigarettes is a safer alternative to traditional tobacco cigarettes. Unfortunately, the answer is yet to be known, as e-cigarettes are still a new phenomenon and research is lagging behind the instant craze of vaping. Between 2011 and 2012, the number of teens and tweens using these products has doubled, so there has been a strong push to obtain as much information as possible regarding this style of smoking.

E-cigarettes mimic traditional cigarettes as their end glows on the inhale and a cloud of smoke follows on the exhale. Inside an e-cigarette, there is a battery, a heating element, and a cartridge that holds nicotine and other liquids and flavorings.

If nicotine is used, then e-cigarettes are still addicting, and quitting e-cigarettes with nicotine can yield similar withdrawal symptoms. Some evidence supports the argument that e-cigarettes may be safer than traditional cigarettes, but other research shows they pose a risk, especially in those with heart problems. Although research suggests that e-cigarettes are less harmful than traditional cigarettes, they carry their own risk.

E-cigarettes raise the risk of nicotine poisoning in children

There is a raised risk of nicotine poisoning in children associated with e-cigarettes, according to a new study. Researcher Alisha Kamboj wrote, “The frequency of exposures to e-cigarettes and nicotine liquid among young children reported to US [Poison Control Centers] is rising rapidly. Children exposed to e-cigarette devices and nicotine liquid are 2.5 times more likely to have a severe outcome than children exposed to cigarettes, and lethal exposure has occurred.”

The researchers examined the data from the National Poison Data System (NPDS) on single exposures involving nicotine and tobacco products from January 2012 through April 2015 among children under the age of six.

During that time period, the NPDS received 29,141 calls related to exposure. E-cigarette exposure accounted for 14.2 percent of these exposures, cigarettes accounted for 60.1 percent, and other tobacco products accounted for 16.4 percent.

The researchers noted that exposure to e-cigarettes had increased by 1492.9 percent during the study period, while exposure to traditional tobacco remained the same.

Common routes of exposure as noted by the authors were ingestion, dermal, and inhalation/nasal. Children in particular may be specifically vulnerable due to their curiosity and the enticing packaging of e-cigarettes.

FDA extends regulations on all tobacco products including e-cigarettes, cigars, and hookah

The FDA has extended regulations on all tobacco products including e-cigarettes, cigars, and hookah. In the next year or so, minors will not be allowed to purchase e-cigarettes and all ingredients will have to pass FDA approval. Some vaping liquids, although they don’t contain typical cancer-causing ingredients seen in traditional tobacco products, still contain harmful chemicals.

Shop owners will now have to send applications to the FDA to have their product approved, which is not only timely but costly as well. Application estimates can range from several hundreds of dollars to the millions.

The new FDA guidelines include:

Registering manufacturing establishments and providing product listings to the FDA
Reporting ingredients, as well as harmful and potentially harmful constituents
Requiring premarket review and authorization of new tobacco products by the FDA
Placing health warnings on product packages and advertisements
Not selling modified risk tobacco products (including those described as light, low, or mild) unless authorized by the FDA
Not allowing products to be sold to persons under the age of 18 years (both in-person and online)
Requiring age verification by photo ID
Not allowing the selling of tobacco products in vending machines (unless in an adult-only facility)
Not allowing the distribution of free samples.

On the other hand, in the U.K., the e-cigarettes are deemed safe, because – unlike in America – teenagers in the U.K. have not jumped ship on them.

The new FDA rules will be implemented by August.


The fight against tobacco is not over

The Boston Globe presents the Harvard Kennedy School PolicyCast, a weekly podcast on public policy, politics, and global issues. HKS PolicyCast is hosted by Matt Cadwallader.

At this point, efforts to end tobacco use seem almost passe.

While it wasn’t so long ago that smoking was ubiquitous, most millennials, the largest generation in the country, have never been able to smoke in a Massachusetts bar or restaurant, much less in an office or on an airplane.

For many of us, the fight against tobacco has fallen off the radar. But that doesn’t mean the problem has been solved.

“Tobacco’s going to kill 1 billion people in the 21st century,” says Dr. Howard Koh on this week’s Harvard Kennedy School PolicyCast podcast. “There’s no other condition that reaches those extraordinary figures.”

Dr. Koh, a professor at the Harvard TH Chan School of Public Health and former assistant secretary for health at the US Department of Health and Human Services, says that it’s not yet time to declare mission accomplished.

“We have to keep talking about this huge issue because so many people are suffering and dying preventable deaths due to tobacco dependence. . . . We still have young people trying cigarettes every day. Several thousand a day, in fact, start for the first time.”

Efforts to curb nicotine addiction have taken on new dimensions in recent years, and in several ways Massachusetts has been at the forefront.

The national movement to raise the minimum age to buy tobacco from 18 to 21 began in Needham back in 2005, and has been picking up steam. Earlier this year Boston followed suit.

Just recently, the Massachusetts State Senate passed a bill that would raise the age statewide, and Governor Baker has indicated that he supports the idea “conceptually.”

Passing such a law would make Massachusetts just the thirdstate to do so after Hawaii enacted the change in January and California passed its law in May.

This year another big change came on opening day at Fenway Park. While smoking has been banned in the park for many years, the use of smokeless tobacco, nicknamed spit or chew, has long been a part of baseball culture.

Now due to new regulations enacted by the city of Boston, Fenway is one of a handful of Major League Baseball stadiums where even smokeless tobacco is unwelcome. This was in response to a study released last year by the US Centers for Disease Control and Prevention, which found that the use of chew among baseball players has a significant impact on whether high school athletes pick up the same habit.

Perhaps the most intriguing issue in tobacco control has been the rising popularity of e-cigarettes.

Koh describes e-cigarettes as a “double-edged sword” that have added an unexpected twist to public health officials’ efforts. Two camps have emerged, one arguing that e-cigarettes can be a useful tool in helping smokers quit, and the other taking a more cautious approach, worried that they may be used by teenagers as a stepping stone into further tobacco use.

So far the data have been inconclusive. A recent study found that 16 percent of US high schoolers had tried e-cigarettes, a more-than tenfold increase over the last five years, but it also came at a time when cigarette use among the same group had dropped significantly.

Tobacco control isn’t a new topic, but in the effort to stop 1 billion preventable deaths, we still have a long way to go.