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Youth Vaping

Trajectories of E-Cigarette and Conventional Cigarette Use Among Youth

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Studying the interactive effects of menthol and nicotine among youth

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Investors Demand Action from Hollywood on Smoking in Youth-Rated Films

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E-cigarette use and asthma in a multiethnic sample of adolescents

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Pulmonary toxicity of e-cigarettes

https://www.ncbi.nlm.nih.gov/pubmed/28522559

Abstract

Electronic cigarettes (e-cigarettes or e-cigs) are designed to heat and aerosolize mixtures of vegetable glycerin, propylene glycol, nicotine, and flavoring additives, thus delivering nicotine by inhalation in the absence of combustion. These devices were originally developed to facilitate smoking cessation and have been available in the United States for over a decade. Since 2010, e-cig use has expanded rapidly, especially among adolescents, despite a paucity of short- and long-term safety data. Patterns of use have shifted to include never smokers and many dual users of e-cigs and combustible tobacco products. Over the last several years, research into the potential toxicities of e-cig aerosols has grown exponentially. In the interim, regulatory policymakers across the world have struggled with how to regulate an increasingly diverse array of suppliers and products, against a backdrop of strong advocacy from users, manufacturers, and tobacco control experts. Herein we provide an updated review of the pulmonary toxicity profile of these devices, summarizing evidence from cell culture, animal models, and human subjects. We highlight the major gaps in our current understanding, emphasize the challenges confronting the scientific and regulatory communities, and identify areas that require more research in this important and rapidly evolving field.

Association Between Initial Use of e-Cigarettes and Subsequent Cigarette Smoking Among Adolescents and Young Adults

A Systematic Review and Meta-analysis.

https://www.ncbi.nlm.nih.gov/pubmed?term=Association%20Between%20Initial%20Use%20of%20e-Cigarettes%20and%20Subsequent%20Cigarette%20Smoking%20Among%20Adolescents%20and%20Young%20Adults%3A%20A%20Systematic%20Review%20and%20Meta-analysis.&holding=ucsflib&otool=cdlotool&cmd=search

Abstract

IMPORTANCE:

The public health implications of e-cigarettes depend, in part, on whether e-cigarette use affects the risk of cigarette smoking.

OBJECTIVE:

To perform a systematic review and meta-analysis of longitudinal studies that assessed initial use of e-cigarettes and subsequent cigarette smoking.

DATA SOURCES:

PubMed, EMBASE, Cochrane Library, Web of Science, the 2016 Society for Research on Nicotine and Tobacco 22nd Annual Meeting abstracts, the 2016 Society of Behavioral Medicine 37th Annual Meeting & Scientific Sessions abstracts, and the 2016 National Institutes of Health Tobacco Regulatory Science Program Conference were searched between February 7 and February 17, 2017. The search included indexed terms and text words to capture concepts associated with e-cigarettes and traditional cigarettes in articles published from database inception to the date of the search.

STUDY SELECTION:

Longitudinal studies reporting odds ratios for cigarette smoking initiation associated with ever use of e-cigarettes or past 30-day cigarette smoking associated with past 30-day e-cigarette use. Searches yielded 6959 unique studies, of which 9 met inclusion criteria (comprising 17 389 adolescents and young adults).

DATA EXTRACTION AND SYNTHESIS:

Study quality and risk of bias were assessed using the Newcastle-Ottawa Scale and the Risk of Bias in Non-randomized Studies of Interventions tool, respectively. Data and estimates were pooled using random-effects meta-analysis.

MAIN OUTCOMES AND MEASURES:

Among baseline never cigarette smokers, cigarette smoking initiation between baseline and follow-up. Among baseline non-past 30-day cigarette smokers who were past 30-day e-cigarette users, past 30-day cigarette smoking at follow-up.

RESULTS:

Among 17 389 adolescents and young adults, the ages ranged between 14 and 30 years at baseline, and 56.0% were female. The pooled probabilities of cigarette smoking initiation were 30.4% for baseline ever e-cigarette users and 7.9% for baseline never e-cigarette users. The pooled probabilities of past 30-day cigarette smoking at follow-up were 21.5% for baseline past 30-day e-cigarette users and 4.6% for baseline non-past 30-day e-cigarette users. Adjusting for known demographic, psychosocial, and behavioral risk factors for cigarette smoking, the pooled odds ratio for subsequent cigarette smoking initiation was 3.62 (95% CI, 2.42-5.41) for ever vs never e-cigarette users, and the pooled odds ratio for past 30-day cigarette smoking at follow-up was 4.28 (95% CI, 2.52-7.27) for past 30-day e-cigarette vs non-past 30-day e-cigarette users at baseline. A moderate level of heterogeneity was observed among studies (I2 = 60.1%).

CONCLUSIONS AND RELEVANCE:

e-Cigarette use was associated with greater risk for subsequent cigarette smoking initiation and past 30-day cigarette smoking. Strong e-cigarette regulation could potentially curb use among youth and possibly limit the future population-level burden of cigarette smoking.

How e-cigarette ads might sway teens to try tobacco products

When non-smoking teens see ads for e-cigarettes, and are curious about the products advertised, perhaps even identifying with a favorite brand, they might also be more susceptible to taking up cigarettes, a new study finds.

http://www.businessinsider.com/r-how-e-cigarette-ads-might-sway-teens-to-try-tobacco-products-2017-5?IR=T

For the study, researchers showed a nationally representative sample of 10,751 U.S. teens advertisements for a wide variety of tobacco products including traditional cigarettes, cigars, chewing tobacco and e-cigarettes. Overall, the teens were more receptive to ads for e-cigarettes than other products and television ads were most likely to prompt brand recall.

“The imagery used by tobacco companies focuses on the aspirations of young people including having fun, being independent, sophisticated, socially accepted, popular, etc.,” said lead study author John Pierce of the University of California, San Diego.

“Those who have an emotive response to these aspirational images are more likely to see use of the product as a way to achieve their aspirations,” Pierce said by email. “It is hypothesized that in adolescents who are committed never smokers, recall of tobacco product advertising will be associated with first movement toward product use within a one-year time frame.”

Big U.S. tobacco companies are all developing e-cigarettes, battery-powered gadgets with a heating element that turns liquid nicotine and flavorings into a cloud of vapor that users inhale.

For the past decade, public health experts have debated whether the devices might help with smoking cessation or at least be a safer alternative to smoking traditional combustible cigarettes, or whether they might lure a new generation into nicotine addiction.

Fewer teens smoke today than a generation ago, but declines in traditional cigarette use have stalled and e-cigarettes have become increasingly popular in recent years. As of 2015, an estimated 16 percent of U.S. high school students used e-cigarettes, compared with about 9 percent for traditional cigarettes, according to the U.S. Centers for Disease Control and Prevention.

While television ads for traditional cigarettes have been illegal in the U.S. for decades, e-cigarette ads are currently allowed on TV, researchers note in Pediatrics.

In the study, Pierce and his colleagues examined how receptive or curious non-smoking teens were about different tobacco products and whether they had a favorite image or advertisement. They also looked at how susceptible the adolescents might be to trying tobacco products based on their ability to recall specific brands they saw in the ads.

The researchers showed each study participant a random selection of five ads each for cigarettes, e-cigarettes smokeless tobacco and cigars based on 959 different promotions that had recently been used to advertise these products.

Overall, 41 percent of the younger teens in the study and half of older adolescents were receptive to at least one tobacco advertisement, the study found.

Across each age group, teens were most receptive to ads for e-cigarettes, followed by traditional cigarettes and smokeless tobacco.

E-cigarette ads shown on television had the highest recall.

Compared to teens in the study who were not at all receptive to the ads, youth who had the highest level of engagement with the promotions were more than six times more likely to be susceptible to trying tobacco products, the study found.

The study isn’t a controlled experiment designed to prove whether or how ads may directly influence tobacco use.

Another limitation is that researchers didn’t have data to show whether or not teens actually used tobacco products after viewing these ads, the authors note.

Even so, the findings suggest that non-cigarette ads for tobacco-related products may be damaging for adolescent health, Rebecca Collins of Rand Corporation in Santa Monica, California, writes in an accompanying editorial.

“This study provides some very provocative data suggesting that the marketing of e-cigarettes, which is not regulated, might be leading to cigarette smoking among teens,” Collins said by email.

California targets candy-flavored tobacco as teen ‘gateway’ to cigarette smoking

More teens are turning to fruit- and candy-flavored tobacco, raising concerns that sweetened e-cigarettes and cigarillos are a gateway to nicotine addiction. A California anti-tobacco campaign targeting teens has ramped up in high schools and at a recent state Capitol rally on Kick Butts Day. Claudia Buck cbuck@sacbee.com

http://www.sacbee.com/news/local/health-and-medicine/article140622513.html

At the checkout counter, the flavors are sweet and enticing: Banana Smash. Twisted Berry. Berry Honey. Cherry Dynamite.

They aren’t in the candy aisle but on the tobacco shelf, often sold in 99-cent two-pack mini-cigars or liquid cartridges for e-cigarettes.

While fewer young Americans are puffing on cigarettes, more teens are using flavored tobacco, typically by vaping with electronic cigarettes or smoking tiny cigars known as cigarillos.

This year, there’s a renewed push to banish flavored tobacco products, which health officials and others fear are luring the next generation of nicotine addicts by targeting teens and kids.

The sweetened flavors are “a gateway to traditional cigarette smoking,” said Scott Gerber, a wellness program director with the Alameda County Office of Education, who attended a recent anti-tobacco state Capitol rally with a handful of high school students from Berkeley and Fremont. Tobacco companies, he said, “are targeting young people with cherry, strawberry, piña colada flavors. … Gummi bears? That’s a youth-friendly flavor, not an adult-friendly flavor.”

Gerber was among about 250 high school students and chaperones who attended the anti-tobacco rally, chanting slogans and carrying signs with messages such as “We want to see a new light, not a lighter” and “We want 7,700 flavors of ice cream, not tobacco!” The rally was part of national Kick Butts Day, co-sponsored by the California Youth Advocacy Network and the Campaign for Tobacco-Free Kids.

In 2014, 73 percent of high school students and 56 percent of middle school students who used tobacco products in the past 30 days reported using a flavored tobacco product, according to the federal Centers for Disease Control and Prevention.

Wheatland High School student Angelina Hom, 15, who belongs to a campus group called SOWHAT (Students Of Wheatland High Against Tobacco), said she’s seen the negative impacts of tobacco firsthand in family members and hopes more of her peers get the message to avoid tobacco.

Convenience stores near her Northern California school have prominent displays of brightly colored, fruity-flavored tobacco products positioned close to the checkout counter, she said. “You go to pay for your food and there’s a wall full of of tobacco and cigarettes. It targets kids into thinking it’s cool.”

E-cigarettes are the most commonly used tobacco product among middle and high school teens in California. An estimated 217,000 Californians between the ages of 12 and 17 currently smoke traditional cigarettes or e-cigarettes, according to state health officials.

In stores, although tobacco products by law must be behind glass, it’s not unusual to find Swisher Sweets, candy-flavored cigarillos sold in two-packs for less than a dollar, sitting near candy bars and snacks, at eye level of young customers.

“Having it advertised as candy unlocks the door to the world of addiction,” said shopper Jenni Richardson, 24, in a midtown Sacramento convenience store where Swisher Sweets sit directly above the ice cream freezer case. A self-described recovering heroin addict, Richardson said tobacco products are dangerously addictive, noting it was far easier for her to quit narcotics than nicotine.

Last summer, the growth in e-cigarette use helped prompt California to toughen state tobacco laws, raising the minimum age for legally buying cigarettes and cigars from 18 to 21, the first change since tobacco control laws went into effect 144 years ago. Also for the first time, those laws now apply to e-cigarettes, which have become hugely popular for their myriad fruit and candy-scented flavors, with names such as Watermelon Krush, Apple Pie a la Mode and Blueberry Cotton Candy.

Some counties have banned all sales of flavored tobacco, including Yolo County, which prohibits sales in the county’s unincorporated areas, starting May 1. The intent was to deter use by youths, said Keri Hess, the county’s tobacco prevention youth coordinator.

“Lots of kids who use e-cigarettes would never dream of trying a regular cigarette because they say it tastes gross. They know the hazards of regular cigarettes and tobacco, but they don’t recognize the health hazards of e-cigarettes,” Hess said.

In Yolo County, 73 percent of stores carried e-cigarettes last year compared with 46 percent in 2013.

The state’s crackdown came as illegal sales of tobacco to minors were up last year by more than a third from 2015, according to the state Department of Public Health’s annual survey, which took place before the legal age was changed. Using teenage decoys trying to buy smokes, the annual survey found that 10.3 percent of 793 stores sold tobacco to underage buyers, the highest rate in eight years.

Citing research that shows brain development continues until around age 25, state health officials say nicotine is a “highly addictive neurotoxin” that can permanently damage adolescent and young adult brains.

“The younger people are when they start smoking or using nicotine, the more likely they are to become addicted,” said State Public Health Officer Dr. Karen Smith during a news conference last summer. Every year in California, she noted, 34,000 people die of tobacco-related diseases.

She said the surge of teens vaping with e-cigarettes is no accident, given the “aggressive marketing” and the proliferation of gadgets and flavors by tobacco companies. Calling them “enticing gateway products,” Smith said e-cigarettes are “fueling the addiction” to nicotine.

Since 2009, the U.S. Food and Drug Administration has banned the sale of cigarettes with fruit and candy flavors, part of federal efforts to reduce tobacco addiction among youths. More recently, the FDA is focusing on cigars and cigarillos (mini-cigars). In December, it issued warning letters to four tobacco companies, including Swisher International Inc., maker of Swisher Sweets, for selling cigars in “youth-appealing” flavors, such as grape, wild cherry and strawberry.

If the companies don’t take action, they could face civil penalties, criminal prosecution and seizure of products, according to the FDA.

“Flavored cigarettes appeal to kids and disguise the bad taste of tobacco, but they are just as addictive as regular tobacco products and have the same harmful health effects,” said Mitch Zeller, director of the FDA’s Center for Tobacco Products, in a statement. He said continued bans on flavored tobacco are essential to “protect future generations from a lifetime of addiction.”

To students at the recent state Capitol rally, the brightly colored packaging and sweetened flavors are “like candy,” enticing teens and kids to get hooked on nicotine at an early age, said Naphatsorn Kaewwanna, 18, a high school senior with the Asian American Drug Abuse Program in Los Angeles County.

“We should put a stop to it,” she said.

 

AAP, public health organizations call for FDA ban of all flavored tobacco products

Five health care organizations have urged the FDA to prohibit all candy- and fruit-flavored tobacco products, including e-cigarettes, cigars and hookah tobacco, asserting that these products are undermining national efforts to reduce youth tobacco use and placing children at health risks from tobacco use and nicotine addiction.

http://www.healio.com/pediatrics/school-health/news/online/%7Baf2b3993-2fb7-48e8-afee-325363abd6d4%7D/aap-public-health-organizations-call-for-fda-ban-of-all-flavored-tobacco-products

The joint report released by the AAP, American Lung Association, the American Heart Association, the American Cancer Society’s Cancer Action Network and Campaign for Tobacco-Free Kids also criticized recent legislation introduced in Congress that could limit FDA oversight of e-cigarettes and cigars, as well as the growing market of flavored products.

“Despite the FDA’s ban on flavored cigarettes, the overall market for flavored tobacco products is growing. Continuing a long tradition of designing products that appeal explicitly to new users, tobacco companies in recent years have significantly stepped up the introduction and marketing of flavored other tobacco products — OTPs — particularly e-cigarettes and cigars, as well as smokeless tobacco and hookah,” the organizations wrote. “Although tobacco companies claim to be responding to adult tobacco users’ demand for variety, flavored tobacco products play a key role in enticing new users, particularly kids, to a lifetime of addiction.”

The report highlights data from the 2013-2014 Population Assessment of Tobacco and Health (PATH) demonstrating the prevalence of flavored OTP use in youth demographics.

According to this study, two-thirds of children who currently use tobacco products claim enticing flavors, including gummy bear, cotton candy, peanut butter cup and cookies ‘n cream, as their reason for use.

Additionally, 80.8% of children aged between 12 and 17 years who have ever used a tobacco product began using with flavored products.

In May 2016, the FDA issued a deeming rule in which its authority on tobacco products would stretch to include all previously unregulated OTPs, including e-cigarettes, cigars and water pipes. This rule included several additional provisions, including refusal of sale to those under 18 in the U.S., vending machine sales in adult-only facilities, required addiction and health warnings, and disclosure of ingredients.

The deeming rule also allows the FDA to control the contents of tobacco products and forbids introducing OTPs without FDA review and additional scientific support of public health benefits. However, the White House Office of Management and Budget deleted a suggested provision that prohibited characterizing flavors.

E-cigarette use involves inhaling nicotine, a solvent (such as glycerin) and other additives. Although there are limited studies on the long-term effects of their use, studies have revealed that toxins such as formaldehyde, acrolein, toluene, tobacco-specific nitrosamines, and metals like lead and nickel are found in their make-up.

OTP use can lead to cancer of the oral cavity, larynx, esophagus and lung; aortic aneurysms; COPD; and increased risk of poisoning due to varying levels of nicotine. The effects of inhaling the flavoring in these products is unknown, according to the 2016 Surgeon General’s report.

“Congress must reject any proposals to weaken FDA oversight of these products. In fact, the FDA should strengthen its new rule by prohibiting all flavored tobacco products, including menthol products,” the organizations wrote. “As the FDA itself has demonstrated and as this report documents, there is more than sufficient scientific evidence to support such a prohibition. Eliminating all flavored tobacco products is a critical step in preventing tobacco companies from addicting another generation of kids and reversing our nation’s progress in the fight against tobacco.” — by Katherine Bortz

Alert: Just 10 Puffs Of an E-Cigarette As Deadly As a Regular Fag

“Quitting smoking is the easiest thing in the world. I know it because I’ve done it thousands of times. Mark Twain

https://www.thequint.com/fitness/2016/12/21/just-10-puffs-of-e-cigarette-are-as-deadly-as-regular-cigarette-vaping-is-not-safer-than-smoking-quit-smoking-2017

Bang on! Science says that 9 out of 10 people who try to kick the butt fail miserably. Perhaps that is why, practically overnight, e-cigarettes have come into their own as the new in thing.

And now an independent study done by USA’s biggest child health body, the American Academy of Pediatrics, finds that e-cigarettes could be the gateway to lifelong nicotine addiction, hinder brain development, give you ‘popcorn lungs’ (an irreversible and fatal condition where the airways are narrowed and weakened) – and all this combined can threaten decades of anti-smoking gains.

If you think that e-cigarettes are an American phenomenon, smoke on this: In the last 3 years, the e-cigarette market has shot up to a $3-4 billion industry and the US contributes to only a quarter of it. In 2014, ITC started manufacturing e-cigarettes in India when most of the Chinese e-cigarette brands were readily available, and obviously, the cigarette giant will not invest millions in a tobacco cessation tool.

Before You Start Vaping, Here’s What You Need To Know

An alarming new study by Swedish scientists found that just 10 puffs of an e-fag can set the heart disease ball rolling, just like a regular cigarette.

It increases the risk of high blood pressure, hardens arteries and makes it harder for people to quit smoking. All this for the popular perception that e-cigarettes are a smoking cessation tool, but contrary to popular perception, it does contain nicotine.

Nicotine is as addictive as heroin, precisely why these vaping devices will never help anyone wean themselves off smoking.

An e-cigarette is a terrible alternative to smoking. In fact, they are much more sinister than tobacco cigarettes – even the World Health Organisation doesn’t buy it.

Nicotine poses several health hazards of varying severity and promotes the growth of tumours.

Dr Pankaj Chaturvedi, Senior Oncologist Surgeon, Head and Neck Cancer Surgery, Tata Memorial Hospital

According to Dr Chaturvedi, e-cigarettes also pose the threat of nicotine poisoning – if you inhale three cartridges in a row, you can die. One cartridge has roughly 11 milligrams of nicotine, three would be over 30, which is a fatal dose. The World Health Organisation says reports of nicotine poisoning have increased manyfold in the US and UK where the popularity of e-cigarettes is soaring.

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Where Does India Stand On E-Cigarette Regulations?

Like with most subjects to do with ‘health’, India does not have a national policy on e-cigarettes yet.

The problem is that e-cigarettes are not mandated by law, and they don’t come under the jurisdiction of the Drugs and Cosmetics Act or fall in the Cigarette and Other Tobacco Products Act. Companies can openly flout the tobacco control provisions, which means they can sell it to kids under the age of 18, skip the gory pictorial warnings on packaging, and openly advertise it.

In 2013, the then Union Health Minister Dr Harsh Vardhan called a closed door meeting of public health activists and FDA officials to completely ban the sale and supply of e-cigarettes in the country.

He was motivated by the news that 13 of the 59 countries that regulate e-cigarettes banned them after compelling scientific evidence that these sticks do more harm than good. But since then, the Health Minister changed and the issue has been put on the back-burner.

A new drug is being freely and openly being sold to people and that drug is nicotine. We don’t know how healthy or unhealthy these are over the long term. But the question is this: if in the next 5 years, we find out these are as deadly as cigarettes for your health, what happens then?

Dr Pankaj Chaturvedi, Senior Oncologist Surgeon, Head and Neck Cancer Surgery, Tata Memorial Hospital

The problem is that Big Tobacco has not revealed exactly what kinds of chemicals there are in the vapour liquid.

And that is concerning.

Health experts don’t trust them. Nobody should trust them. Their only motive is profit. Will you be naive enough to think that big tobacco firms want to help smokers quit?