Youth Vaping
Surgeon General calls youth vaping a public health threat
http://www.usatoday.com/story/news/nation-now/2016/12/08/surgeon-general-calls-youth-vaping-public-health-threat/95134890/
E-cigarette use among young people is a major health concern, according to a new report from the U.S. Surgeon General on Thursday.
Surgeon General Vivek Murthy said in the report that not enough research has been conducted to prove that use of e-cigarettes among youth are harmless.
“E-cigarettes went from being rare in 2010 to being the most common tobacco product used by our nation’s youth,” Murthy said during a press conference. “This represents a staggering development in a relatively short period of time, and it threatens 50 years of hard-fought progress we have made curbing tobacco use and puts a new generation at risk for … addiction.”
According to the U.S. Centers for Disease Control and Prevention, e-cigarette use among high school students rose from 1.5% in 2011 to 16% in 2015. Federal health officials estimate that about 3 million middle and high school students use e-cigarettes.
The potential safety of e-cigarettes, devices that heat a liquid consisting of nicotine, flavorings and other chemicals to create a vapor, is hotly debated. Unlike traditional cigarettes, e-cigarettes do not contain tar or other chemicals generated by the combustion of tobacco that are responsible for harmful tobacco-related diseases. Proponents of e-cigarettes say they are a safer alternative to traditional cigarettes and can help people quit smoking.
Nicotine is harmful to the developing brain regardless of whether it’s smoked through a traditional cigarette or an e-cigarette, Benard Dreyer, President of American Academy of Pediatrics, said during the press conference.
“Nicotine… regardless of its source is highly addictive and has clear neurotoxic effects especially on the developing brains of adolescent and even into early adulthood,” Dryer said.
For years, e-cigarettes have been largely unregulated, with many consumers unaware of what chemicals are used in their e-cigarette products. In May, the Food and Drug Administration released a rule that requires electronic cigarettes to be regulated much like tobacco cigarettes. The rule requires nearly every e-cigarette on the market — and every different flavor and nicotine level — to submit a separate application for federal approval.
While many may believe that e-cigarettes emit a harmless aerosol, that’s not the case, Dreyer said.
“Aerosol from e-cigarettes is not harmless, it includes nicotine and other potentially harmful chemicals including heavy metals and carcinogens,” Dreyer said, adding that second-hand inhalation should also be avoided. “Because there is no safe level of exposure, it is extremely important to protect children from these.”
E-cigarette use threatens years of US anti-smoking gains, says report
Top US health officials have war ned that the gr owing use of e-cigarettes among young adults will undo decades of pr ogr ess in ending the ‘tobacco epidemic’
Growing e-cigarette use among young people threatens decades of progress in shrinking tobacco use, top US health officials warned in a report released on Thursday.
The US surgeon general’s report is the first federal government review of the public health impact of e-cigarettes on young people across the country.
“Preventing tobacco use in any form among youth and young adults is critical to ending the tobacco epidemic in the United States,” said surgeon general Vivek Murthy.
E-cigarettes don’t contain tobacco, but do contain nicotine and are considered “tobacco products” by the US government.
Advocates say e-cigarettes could replace traditional cigarettes, while critics are concerned they are a gateway to tobacco use – especially in young people, who are more vulnerable to the addictive impact of nicotine.
The debate over the potential harms and benefits of e-cigarettes is a live one in the US and the UK. Many public health professionals in the UK believe that vaping is the best available option for those who would otherwise smoke tobacco, and that it is saving thousands of lives by enabling hardened smokers to quit. Public Health England has said it is 95% safer, and that the young people experimenting with e-cigarettes are the same people who try smoking tobacco.
“Evidence from the US is the same as in the UK in crucial respects,” said Professor John Britton, director of the UK Centre for Tobacco and Alcohol Studies at Nottingham University. “Children experimenting with e-cigarettes are by and large those who are already experimenting with cigarettes or are smokers.”
The surgeon general’s report said e-cigarettes are the most commonly used tobacco product among the young and are more popular than cigarettes, cigars and hookahs in the US. The use of e-cigarettes and other nicotine products by under-18s has jumped significantly after decades of declining rates of cigarette smoking.
Young people are not using the products for the same reasons as adults, the report said: “Although adults report using e-cigarettes as a cessation device, the evidence supporting the effectiveness of e-cigarettes as an aid for quitting conventional cigarettes remains unproven and nonexistent among youth.”
The most common reasons for young people to use e-cigarettes are curiosity, to avoid indoor smoking restrictions and as a less harmful alternative to conventional cigarettes, according to the report.
In 2014, use of e-cigarettes by young adults aged 18 to 24 surpassed that of adults aged 25 and older.
Sylvia Burwell, the US Department of Health and Human Services secretary, said the US must ensure progress in combatting traditional cigarette use isn’t compromised by the use of new tobacco products like e-cigarettes.
“The findings from this report reinforce the need to support evidence-based programs to prevent youth and young adults from using tobacco in any form, including e-cigarettes,” Burwell wrote. “The health and wellbeing of our nation’s young people depend on it.”
Kevin Fenton, national director of health and wellbeing at Public Health England, said the group recognised the concern in the US, where it had proved difficult to impose restrictions on the marketing of e-cigarettes. By contrast, England had put in place a ban on marketing to under-18s, advertising controls and quality standards. But, he said, “our review of the evidence found e-cigarette use carries a fraction of the risk of smoking, a conclusion reiterated by the Royal College of Physicians earlier this year.
No new evidence has been published to contradict this, however we are closely monitoring any emerging evidence.”
The US report’s findings pull from existing research on e-cigarette use among people aged between 11 and 24 to show patterns of use and how it affects health.
This report was crafted in a similar vein to earlier surgeon general reports on youth tobacco use. The most recent of those was released in 2012, when e-cigarettes were less popular than they are now.
E-cigarette sales in the US grew to an estimated $3.5bn in 2015, according to Nielsen, but have been falling significantly since the end of last year.
The e-cigarette industry is dominated by traditional tobacco companies, who were targeted in the report for using similar tactics as those used to lure young users to tobacco. “Companies are promoting their products through television and radio advertisements that use celebrities, sexual content, and claims of independence to glamorize these addictive products and make them appealing to young people,” said Centers for Disease Control and Prevention director, Thomas Frieden, in the report’s foreword.
The report concludes with recommendations for combatting e-cigarette use among young people, including incorporating e-cigarettes into smoke-free policies, preventing youth access to e-cigarettes and significant increases to taxes and prices affiliated with e-cigarettes.
Murthy said: “Preventing tobacco use in any form among youth and young adults is critical to ending the tobacco epidemic in the United States.”
The report was launched on Thursday morning in Washington DC at an event where the surgeon general unveiled a new e-cigarette website and public service announcement. Speakers included Murthy, 16-year-old health activist Tyra Nicolay and American Academy of Pediatrics president Benard Dreyer.
Tyra, a member of the Navajo Nation, described how she was first introduced to e-cigarettes with a sour green apple flavored product but has since quit using e-cigarettes.
“Today, I call on my peers to reject tobacco products, including e-cigarettes,” she said.
Dreyer said e-cigarette use “has raised alarm among pediatricians, tremendously”.
In October 2015, the AAP issued recommendations for e-cigarette public policy and regulations and guidance for physicians on how to speak with families about tobacco and “nicotine delivery devices” such as e-cigarettes.
“That’s why this report is so necessary and welcome at this time,” Dreyer said. “Because as you’ve heard, e-cigarettes have the potential to addict the next generation of children. It’s a major public health crisis, as far as we’re concerned.”
The British campaigning organisation Action on Smoking and Health said it was puzzled by the surgeon general’s concerns. “In the US as in the UK, young people are experimenting with e-cigarettes but vaping has not been associated with an increase in smoking, a point which is not made sufficiently clear in the report,” it said.
“While nicotine is not completely harmless, it is smoking that is lethal. In the UK we have a regulatory system that restricts advertising and controls sales to young people.
There is no evidence of significant regular use by nonsmoking children and, as in the US, smoking rates are going down, not up.”
Britton, the Nottingham University academic, attributed a drop in the UK smoking rate, down three percentage points in three years, to people taking up e-cigarettes in order to quit. “It is falling fast in the UK, almost certainly related to e-cigarettes.”
National view: Lung cancer battle raises concerns about e-cigs, other ‘nicotine-delivery devices’
November has been Lung Cancer Awareness Month and a good time to recall an old saying in the lung cancer community: “If you’ve got lungs, you can get lung cancer.” Lung cancer is everybody’s fight.
http://www.duluthnewstribune.com/opinion/national-view/4168141-national-view-lung-cancer-battle-raises-concerns-about-e-cigs-other
It’s the deadliest cancer in America, accounting for 25 percent of all cancer deaths. Lung cancer is also the leading cause of cancer deaths among women. The National Cancer Institute estimates that 71,600 women will die of lung cancer this year. And you may be surprised to learn that of the women who get lung cancer, approximately 1 in 5 are nonsmokers.
Unfortunately, the false stigma that automatically ties smoking to lung cancer has severely hindered life-saving lung cancer research. In fact, of the $5.3 billion the National Cancer Institute receives every year from the federal government, only 6.5 percent is devoted to lung cancer.
That’s a big part of the reason my husband, U.S. Rep. Rick Nolan, is a founder and co-chairman of the bipartisan Congressional Lung Cancer Caucus. For us, and for millions of other families, lung cancer and the need for more federal support for prevention, treatment and, ultimately, a cure, is personal. Our youngest daughter, Katherine, is battling nonsmoking stage 4 small cell lung cancer. And Rick’s father and aunt both had lung cancer.
Of course, the battle against lung cancer is being waged on many fronts, including efforts to discourage young people from smoking. In that regard, experts increasingly are concerned that hard-won progress against lung cancer could be curbed by the growing popularity of “nicotine-delivery devices,” particularly electronic cigarettes, or e-cigarettes, that turn nicotine into an inhalable liquid vapor, and hookah, which are water pipes used to smoke flavored tobacco.
Simply stated, we don’t really know how dangerous these products are or what chemicals and components users are taking into their bodies. For example, we know little about the safety of propylene glycol, a substance contained in many e-cigarettes. And tests have found that some e-cigarettes contain small amounts of nitrosamines and formaldehyde, both cancer-causing agents.
Thankfully, after years of public review and comment, new Food and Drug Administration regulations are being rolled out to address these concerns. Over the next two years, the FDA will be given more authority to require manufacturers to report the content of their products to the public.
Until then, though, the chemicals — and the potential health effects — will remain largely unknown.
Young people are particularly attracted to the exotic and fruity flavors available in e-cigarettes and specialty tobaccos. In fact, a 2014 Minnesota Department of Health survey of more than 70 schools revealed that 13 percent of high school students and 3 percent of middle school students had used e-cigarettes. Those figures are even higher nationwide as these nicotine-delivery devices have become big business. By some estimates, U.S. sales of e-cigarettes and other more-specialized e-smoking products reached $5.5 billion in 2015.
The new FDA regulations will make it harder for children and teenagers to obtain e-cigarettes, hookah tobacco and cigars. Even now, it’s illegal to sell these products to anyone younger than 18 or in vending machines accessible to minors. The FDA also no longer allows stores to give away samples of new tobacco products.
These measures will help in the battle against lung cancer, but we all need to take our own steps to promote tobacco-free families, homes and communities.
Remember, if you’ve got lungs, you can get lung cancer. We’ve all got lungs, so we all have a stake in this fight.
Mary Nolan of Crosby, Minn., is a member of the Congressional Families Cancer Prevention Program of the Prevent Cancer Foundation and is the wife of U.S. Rep. Rick Nolan. She wrote this for the News Tribune
E-cigarettes raise teens’ risk of persistent cough and wheeze, study finds
Teenagers who use e-cigarettes have twice the risk of respiratory symptoms such as persistent cough, bronchitis, and wheeze as those who have never used the devices, a large US study has found.1
Use of e-cigarettes among teenagers is increasing dramatically, and public health experts are concerned that these devices may increase cigarette smoking. But there has been limited information on the effect of chronic e-cigarette use on respiratory health.
Researchers analysed responses to a questionnaire from 2086 teenagers aged 16 to 18 years who were taking part in the ongoing Southern California Children’s Health study, to investigate the long term effects of air pollution on respiratory health in young people. Respondents to the 2014 questionnaire were asked about use of e-cigarettes and chronic cough, phlegm, bronchitis, and wheeze in the previous 12 months.
The results showed that the risk of bronchitic symptoms was twice as high in teenagers who said that they were currently using e-cigarettes as in those who had never tried them (odds ratio 2.02 (95% confidence interval 1.42 to 2.88)).
Risk of bronchitis symptoms rose with frequency of current use, from a two thirds higher risk in teenagers who used e-cigarettes for 1-2 days in the previous month (odds ratio 1.66 (1.02 to 2.68)) to two and a half times the risk in those using them on three or more days (odds ratio 2.52 (1.56 to 4.08)), when compared with never users.
And the risk of respiratory symptoms was 85% higher in teenagers who said that they had used e-cigarettes than in those who had never used them (odds ratio 1.85 (1.37 to 2.49)). This increased risk remained even after adjustment for relevant potential confounding factors. Associations were slightly reduced when data were adjusted for lifetime number of cigarettes smoked and secondhand smoke exposure. But the risk of bronchitic symptoms among past e-cigarette users remained higher after adjustment for relevant potential confounders and was also seen among those who had never smoked cigarettes (odds ratio 1.70 (1.11 to 2.59)).
Just under a 10th (9.6% (201)) of the adolescents who responded to the survey were current users of e-cigarettes, having used them at least once in the previous 30 days.
An eighth (14.4%) were past users, reporting that they had used e-cigarettes previously but not in the past month. And three quarters (76%) said that they had never used e-cigarettes.
“E-cigarettes are known to deliver chemicals toxic to the lungs, including oxidant metals, glycerol vapour, diketone flavouring compounds, and nicotine,” said the study’s lead author, Rob McConnell, professor of preventive medicine at the Keck School of Medicine at the University of Southern California, Los Angeles.
He noted, “The Food and Drug Administration recently banned the sale of e-cigarettes to children under 18 years of age, and California just prohibited sale to young adults under 21.
“Our results suggest that these regulations and an environment that discourages the initiation of any tobacco product may reduce the burden of chronic respiratory symptoms in youth.” He added that further studies were needed to better understand the long term effects of e-cigarette use.
1 McConnell R, Barrington-Trimis JL, Wang K, et al. Electronic-cigarette use and respiratory symptoms in adolescents. Am J Respir Crit Care Med 2016; doi:10.1164/rccm.201604-0804OC.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions
E-cigarette use linked to permanent lung damage in teenagers
http://www.grimsbytelegraph.co.uk/e-cigarette-use-linked-to-permanent-lung-damage-in-teenagers/story-29919152-detail/story.html
E-cigarette use has been linked to bronchitis in teenagers.
E-cigarettes have become ever-more popular in recent years with stores popping up all over North East Lincolnshire but teenagers who use them are far more likely to get bronchitis, a study has found.
Young people who vape have a 71 per cent higher risk of developing the condition than those who have never used an e-cig.
Researchers at the University Of Southern California analysed responses from more than 2,000 older teenagers asking for symptoms of chronic bronchitis, such as a regular cough for three months straight.
The study found that those who were using e-cigarettes were 85 per cent more likely to have had the lung infection. This dropped to 71 per cent when those who smoked regular cigarettes or were exposed to tobacco smoke were taken into account.
It is thought the chemical diacetyl, which is used to create e-cigarette flavourings, could be partly to blame.
Even teenagers who had used e-cigarettes but had stopped doing so were still 41 per cent more likely to report symptoms of bronchitis.
The findings are apparently similar to “popcorn lung” – a condition reported by popcorn factory workers who developed an incurable condition scarring their lungs due to exposure to diaceyl, which was used to give the snack its buttery flavour.
Dr Rob McConnell, professor of preventive medicine at the Keck School of Medicine, within the University of Southern California, said: “E-cigarettes are known to deliver chemicals toxic to the lungs, including oxidant metals, glycerol vapour, diketone flavouring compounds and nicotine.
“However, there has been little study of the chronic health effects of e-cigarettes.
“The Children’s Health Study provided an opportunity to examine bronchitic symptoms common among smokers to see if the risk was also increased in users of e-cigarettes.”
Researchers added that “additional study is needed to fully understand their long-term effects”.
Last year, Public Health England published a study saying vaping is 95 per cent less harmful than tobacco. They even went so far as to call for GPs to be able to prescribe e-cigarettes on the NHS to help people quit smoking.
E-cigs hurt teens’ lungs even a month after use — study
Vaping can have long-term health effects on teens, research shows.
http://www.nydailynews.com/life-style/health/e-cigs-hurt-teens-lungs-month-study-article-1.2879010
Teens are getting burned by e-cigarettes even after they stop using them.
Adolescents who currently vape are twice as likely to suffer respiratory symptoms like persistent cough, bronchitis, congestion and phlegm as those who have never used e-cigs, according to a study published in the American Journal of Respiratory and Critical Care this week.
But researchers at the Keck School of Medicine at the University of Southern California were even more alarmed to find that past users, who smoked an e-cig more than 30 days earlier, showed an 85% greater risk of these symptoms over teens who never tried vaping.
“E-cigarettes are known to deliver chemicals toxic to the lungs, including oxidant metals, glycerol vapor, diketone flavoring compounds and nicotine,” explained lead author Dr. Rob McConnell. “However, there has been little study of the chronic health effects of e-cigarettes.”
New study dismisses e-cigs effect on quitting
Vaping is increasingly popular among adolescents. The CDC recently reported that e-cig use among middle and high school students tripled in 2014, even as traditional cigarette use declined.
There’s also evidence to suggest e-cigs could be a gateway drug. Another recent study out of the University of Southern California found that teens who start vaping are 10 times more likely to smoke regular cigarettes.
The Food and Drug has banned selling e-cigarettes to those under 18. In California, you have to be 21 to buy an e-cig.
“Our results suggest that these regulations and an environment that discourages the initiation of any tobacco product may reduce the burden of chronic respiratory symptoms in youth,” said Dr. McConnell. “However, because e-cigarettes are relatively new, additional study is needed to fully understand their long-term effects.”
Big Tobacco wins big with vaping
http://www.heraldnet.com/opinion/big-tobacco-wins-big-with-vaping/
Big Tobacco, with its legion of lobbyists, and evil geniuses, is almost always a step ahead of regulators and health officials. It wasn’t until May of this year that the FDA finally finalized a rule extending its authority to all nicotine products — including e-cigarettes, cigars, hookah and pipe tobacco, among others. The lack of such authority is why we saw ads for nicotine vaping products on TV, and such products sold legally to teens and kids.
When cigarette smoking rates among teens hit historic lows in the past decade, flavored products (from cigars to vaping) filled the void. When the FDA announced the oversight change, it cited research by the agency and the CDC showing current e-cigarette use among high school students has skyrocketed from 1.5 percent in 2011 to 16 percent in 2015 (an over 900 percent increase) and hookah use has risen significantly. In 2015, 3 million middle and high school students were current e-cigarette users, and data showed high school boys smoked cigars at about the same rate as cigarettes.
A separate study by the FDA and the National Institutes of Health shows that in 2013-2014, nearly 80 percent of current youth tobacco users reported using a flavored tobacco product in the past 30 days – with the availability of appealing flavors consistently cited as a reason for use, the FDA reported.
And now, a new, disturbing study shows just how successfully Big Tobacco is cultivating more nicotine addicts, and how belated the FDA was to take action to oversee the new products. The research, published in the Journal of the American Medical Association, found that teenagers with a regular vaping habit aren’t just more likely to take up smoking — they have higher odds of developing a heavy cigarette habit, Reuters reported.
Vaping devices have been advertised as way to help smokers quit, but the lead author of the study says his findings call that cessation claim into question.
“Our most recent study is the first to show that teenagers who vape not only experiment with cigarettes, but are also more likely to become regular smokers,” said Adam Leventhal, director of the University of Southern California’s Emotion and Addiction Laboratory in Los Angeles.
Rather than keeping kids and teens from smoking, the flavored nicotine products can act as bridge to smoking, said Dr. Brian Primack, a University of Pittsburgh researcher who wasn’t involved in the study.
“… young people who may not have otherwise ended up smoking started with palatable, flavored e-cigarettes — and then after they became accustomed to e-cigarette use, many transitioned to traditional cigarette smoking,” Primack told Reuters. Which is exactly what is happening.