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E-cig studies provide more conflicting outcomes on potential harm

http://www.journalnow.com/news/local/e-cig-studies-provide-more-conflicting-outcomes-on-potential-harm/article_f1bf6e4b-90e8-5c52-86c5-f845e4808150.html

Another week, another release of studies that have conflicting outcomes on the attractiveness and potential risk of electronic cigarettes, particularly to young adults.

One report, from researchers at Georgia State University’s School of Public Health, determined that government agencies and public-health advocates may be providing an incomplete assessment of smoking e-cigs and vaporizers.

“The proportion of American adults who perceive e-cigarettes to be equally or more harmful than traditional cigarettes has tripled over the last few years (from 12 percent to 35 percent), highlighting the need for more accurate public-health messaging,” according to the researchers. Their study was published in the American Journal of Preventive Medicine.

The other report, from the federal Centers for Disease Control and Prevention, found that 40 percent of current e-cigs smokers ages 18 to 24 had never tried traditional cigarettes before consuming e-cigs and vaporizers, while 43 percent were current traditional cigarette smokers.

By comparison, nearly all adults at least 45 years old were listed as a current or former traditional cigarette consumer.

The CDC report determined that 3.5 percent of adult Americans, or about 8.7 million, were current e-cig users in 2015. The report did not provide how many young adults were current e-cig users.

E-cigs, such as the top-selling Vuse brand by R.J. Reynolds Vapor Co., typically are battery-powered devices that heat a liquid nicotine solution in a disposable cartridge and create a vapor that is inhaled. Vaporizers can be supplied and reused through the insertion of a liquid capsule.

Neither report broke new ground per se.

But until a universally accepted definitive study is released, the two reports add more evidence to support either anti-tobacco advocates, who promote a “quit or die” approach to tobacco products, or anti-smoking advocates, who believe reduced-risk tobacco and nicotine products can play a pivotal role in decreasing the number of traditional cigarette consumers.

For example, anti-smoking advocates have explained the increase in young adults consuming e-cigs as experimentation typical of individuals their age, and a better alternative than traditional cigarettes.

The Georgia State researchers based their report on data from the Tobacco Products and Risk Perception surveys from 2012 through 2015. Nearly 16,000 adults completed the surveys.

Researchers said the proportion of adult smokers who thought e-cigs were addictive more than doubled from 25 percent in 2012 to nearly 57 percent in 2015. Similar trends were seen in non-smoking adults.

“Although the impact of long-term use of e-cigarettes on health is still unknown, the available scientific evidence indicates that e-cigarettes are less harmful than combustible cigarettes,” the researchers said.

Some studies, including from the Royal College of Physicians, have claimed that e-cigs and vaporizers are up to 95 percent less harmful than traditional cigarettes.

However, a pivotal component of the Food and Drug Administration’s tighter e-cig and vaporizer regulations was that they were necessary to limit or thwart the use of nicotine and tobacco products by youth. The regulations, which went into effect Aug. 8, ban the sale nationwide of those products to anyone under age 18.

Mitch Zeller, director of the FDA’s Center for Tobacco Products, said May 5 that “there are still many open questions about are e-cigarettes a gateway to smoking more harmful products.”

However, most recent federal reports have shown a significant decline in youth smoking of traditional cigarettes in the past 10 years.

Interestingly, among the sponsors of the Georgia State study is the FDA’s Center for Tobacco Products.

“Our public health messages should accurately convey to cigarette smokers that switching completely to e-cigarettes would reduce their risks even if e-cigarettes are addictive and not risk-free,” said Dr. Michael Eriksen, dean of Georgia State’s School of Public Health.

Matt Myers, president of the Campaign for Tobacco-Free Kids, responded to the CDC data by saying it “raises fresh concerns that a large majority of adult e-cigarette users are using e-cigarettes in addition to regular cigarettes rather than in place of them.”

“If there is a public health benefit to the emergence of e-cigarettes, it will come only if they are effective at helping smokers stop using cigarettes completely, responsibly marketed to adult smokers and properly regulated to achieve these goals.”

In August, a national study on youth vaporizer use determined that up to 65 percent of students consume the products for flavor, compared with 20 percent for nicotine.

University of Michigan researchers said the results “challenge the common assumption that all vaporizer users inhale nicotine.” The results were published in the publication Tobacco Control.

Patrick Miech, the lead Michigan researcher, said in an email to the Journal that “vaping is a case where the science has yet to catch up with policy, which seems to be guided more by emotion and anecdote than hard facts.”

Scott Ballin, past chairman of the Coalition on Smoking or Health, has called for “all stakeholders to curtail their public relations efforts and call for scientific cooperation, monitoring and surveillance.”

Scientists stunned by new report about smoking

http://www.morningticker.com/2016/10/scientists-stunned-by-new-report-about-smoking/

A new report about smoking suggests that the effects of vaping on the habit may be completely misunderstood.

An alarming new report from the Centers for Disease Control and Prevention indicates that vaping might not be the easy cure to smoking that we thought it was, because many adults who use e-cigarettes also smoke tobacco cigarettes.

A total of 59 percent of all adult e-cigarette users also smoke cigarettes, and just 30 percent of e-cigarette users were former smokers, with the remaining 11 percent made up of people who had never smoked before.

A total of 40 percent of e-cig users between the ages of 18-24 were never-smokers, indicating this actually may be a new way to get people hooked on smoking or vaping, especially for young people. About 43 percent were current smokers and 17 percent were former smokers in that age group.

The new report follows a September statement from the CDC showing a rise in vaping in teens.

“The increased use of e-cigarettes by teens is deeply troubling,” said CDC Director Tom Frieden, M.D., M.P.H., in the statement. “Nicotine is a highly addictive drug. Many teens who start with e-cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes.”

“About 90 percent of all smokers begin smoking as teenagers,” said Tim McAfee, M.D., M.P.H., director of the CDC Office on Smoking and Health. “We must keep our youth from experimenting or using any tobacco product. These dramatic increases suggest that developing strategies to prevent marketing, sales, and use of e-cigarettes among youth is critical.”

QuickStats: Cigarette Smoking Status Among Current Adult E-cigarette Users, by Age Group

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CDC: Majority of e-cigarette users also smoke cigarettes

http://thehill.com/regulation/healthcare/303120-majority-of-e-cigarette-users-also-smoke-cigarettes-cdc-finds

A majority of adults who use electronic cigarettes also smoke traditional cigarettes, according to a federal survey released Thursday.

The Centers of Disease Control and Prevention found that 58.8 percent of adult e-cigarette users in 2015 were also current cigarette smokers and another 29.8 percent were former cigarette smokers.

Older e-cigarette users were more likely to have been cigarette smokers, according to the survey.

Among e-cigarette users 45 years or older, 98.7 percent were either current or former cigarette smokers while 1.3 percent had never been a cigarette smoker before. Among adults ages 18 to 24, 40 percent had never been smokers before.

The data is raising new concerns among health advocacy groups.

The Campaign for Tobacco-Free Kids said the data shows a large majority of adult e-cigarette users in the U.S. are using e-cigarettes in addition to regular cigarettes, rather than in place of them, and that e-cigarettes may be introducing young non-smokers to tobacco use and nicotine addiction.

“If there is a public health benefit to the emergence of e-cigarettes, it will come only if they are effective at helping smokers stop using cigarettes completely, responsibly marketed to adult smokers and properly regulated to achieve these goals,” Matthew Myers, the group’s president, said in a statement.

“They will not benefit public health if smokers use them in addition to cigarettes instead of quitting or if they re-glamorize tobacco use among young people and attract non-smokers,” he added.

MMWR- Morbidity and Mortality Weekly Report

Disparities in Adult Cigarette Smoking — United States, 2002–2005 and 2010–2013

Proven interventions, including increasing the price of tobacco products, coupled with evidence-based cessation services, comprehensive smoke-free policies, high-impact media campaigns, and promotion of cessation treatment in clinical settings, are effective strategies in reducing the prevalence of tobacco use and tobacco-related disease and death in all racial/ethnic populations. To assess the prevalence of, and changes in, cigarette smoking among persons ages ≥18 years in six racial/ethnic populations and 10 select subgroups in the U.S., CDC analyzed self-reported data collected during 2002–2005 and 2010–2013 from the National Survey on Drug Use and Health and compared differences between the two periods. During 2010–2013, the overall prevalence of cigarette smoking among the racial/ethnic populations and subgroups ranged from 38.9 percent for American Indian/American Nativesto 7.6 percent for Chinese and Asian Indians. Differences might be due, in part, to variations in socioeconomic status, acculturation, targeted advertising, price of tobacco products, and practices related to the acceptability of tobacco use across population groups. These findings highlight the importance of looking at tobacco use estimates by smaller racial/ethnic subgroups and by sex to better understand and address disparities in tobacco use among U.S. adults.

Some racial, ethnic groups continue smoking cigarettes at higher rates

Substantial disparities found among American Indians/Alaska Natives, Korean and Puerto Rican Americans

Despite a significant decline in overall adult cigarette smoking since 1964, disparities in cigarette smoking remain among racial and ethnic population groups, according to a new study from the Centers for Disease Control and Prevention (CDC) published in today’s Morbidity and Mortality Weekly Report (MMWR).

For example, current (past 30-day) cigarette smoking during 2010-2013 was lower among Asians overall (10.9 percent) compared with Whites (24.9 percent). But among Asian sub-groups, the prevalence of current cigarette smoking ranged from 7.6 percent among Chinese and Asian Indians to 20.0 percent among Korean Americans. The American Indian/Alaska Native population had the highest prevalence of cigarette smoking at 38.9 percent. The findings in this study show the importance of identifying higher rates of tobacco use across and within racial/ethnic population groups to better understand and address differences in tobacco use among U.S. adults.

Larger sample size for racial/ethnic subgroups

Estimates of cigarette smoking prevalence are usually presented in aggregate for racial or ethnic populations, such as Asian or Hispanic, because sample sizes are too small to provide estimates among racial/ethnic subgroups within these populations. To get a large enough sample size for this study, researchers aggregated data from the National Survey on Drug Use and Health collected between 2002-2005 and 2010-2013 to assess cigarette-smoking prevalence among 6 racial and ethnic population groups and 10 select subgroups in the United States.

“Even though the overall cigarette-smoking rate is declining, disparities remain among racial and ethnic groups and within subgroups,” said Bridgette Garrett, Ph.D., associate director for health equity in the CDC’s Office on Smoking and Health. “Looking beyond broad racial and ethnic population categories can help better focus the strategies that we know work to reduce tobacco use among sub-groups with higher rates of use.”

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

http://www.miamiherald.com/living/health-fitness/article91033197.html

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.

 

MPAA: Cigarette ban in movies in an infringement of free speech

http://www.local8now.com/content/news/MPAA-Cigarette-ban-in-movies-in-an-infringement-of-free-speech-387810002.html

(WVLT) — According to the Hollywood Reporter, the Motion Picture Association of America is reponding to a lawsuit, saying the restriction of tobacco imagery in movies is an infringement on free speech.

You can read the original report on hollywoodreporter.com.

The plaintiffs want any movie with tobacco imagery to be rated R.

According to the CDC, the more smoking young people see on the screen, the more likely they are to start smoking themselves. The CDC cited a Surgeon General’s Report that showed an industry-wide standard of rating movies that show tobacco use as R-rated could result in reductions in youth smoking. It could reduce the number of teen smokers by nearly one in five and prevent 1 million deaths from smoking among children alive today.

You can read the full CDC report on cdc.gov.

Letter on $110 million funding cut for CDC and OSH

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E-Cigarettes May Be Getting More Kids to Smoke

Including teens who may have avoided tobacco products entirely.

http://fortune.com/2016/07/11/e-cigarettes-teen-use-growing/

Cigarette smoking among American teens is on the decline. But adolescents who may have never tried cigarettes are now vaping with e-cigarettes, new research suggests.

E-cigarettes’ popularity has soared in the past five years and ballooned into a $3.5 billion market. But while manufacturers claim that the products are healthier alternatives to traditional tobacco, public health officials have questioned their safety and pushed for regulations.

Much of the concern has centered on younger Americans who may be drawn to the high-tech smoking devices which often come with flavored nicotine. The Centers for Disease Control (CDC) recently found that an alarming 5.3% of middle school students and 16% of high school students reported using e-cigarettes in 2015—sharp rises from the figures reported at the beginning of the decade.

The new study by the American Academy of Pediatrics (AAP) tracked nearly 5,500 Southern California teens over the course of 20 years (1995-2014) and measured their smoking habits. In 2004, before vaping technology was around, 9% of 11th and 12th grade students were “current smokers,” meaning they’d smoked in the past 30 days.

Fast-forward to 2014 and 13.7% of those students currently smoke cigarettes or e-cigarettes. That sharp spike in the combined smoking data, the researchers wrote, “suggests that e-cigarettes are not merely substituting for cigarettes and indicates that e-cigarette use is occurring in adolescents who would not otherwise have used tobacco products.”

Trends like these, as well as research showing that some vaping products contain high amounts of carcinogens like formaldehyde and acetaldehye, have spurred federal officials to crack down on the industry.

In May, the Food and Drug Administration (FDA) finalized new regulations treating e-cigarettes, hookah, and cigars like traditional cigarettes. That means that any e-cigarette manufacturer whose products weren’t already on the market by February 15, 2007 will have to seek marketing approval from the FDA. They’ll also have to put labels on the devices’ packaging warning about nicotine’s addictive properties, and states will be strictly prohibited from allowing e-cigarette sales to minors (a practice that was previously permitted in several places).

But the rules have drawn sharp rebukes from the industry. Smaller e-cigarette manufacturers say that the types of studies required to pass the FDA’s regulatory muster will favor Big Tobacco companies like Imperial Tobacco and Reynolds American, which also make popular vaping brands like blu and VUSE.

A final resolution over the rules, as The Hill notes, may be determined in the courts. A compendium of e-cigarette companies and trade organizations including Nicopure Labs, the American Vaping Association, and the Right to be Smoke-Free Coalition, among others, have recently filed complaints against the FDA and the Department of Health and Human Services (HHS) calling the regulations “unreasonable” since vaping products contain just nicotine and not tobacco.