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August 23rd, 2015:

Ohio A-G issues e-cigarette risk warning

Ohio Attorney General’s information

COLUMBUS — Ohio Attorney General Mike DeWine and Peter Shields, MD, deputy director of The Ohio State University Comprehensive Cancer Center-James Cancer Hospital and Solove Research Institute (OSUCCC-James) warn parents about the risks of e-cigarette use among children and young adults.

“The beginning of a new school year is a perfect time to ask parents this question: ‘Do you know what’s in your child’s backpack?’” Attorney General DeWine said. “E-cigarettes are now likely to be found among the school supplies of an increasing number of kids. Many e-cigarette products could be easily mistaken for pens, highlighters, or other common school supplies. We want to alert parents and protect young people.”

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“We know that tobacco addiction often begins in youth — nine out of 10 adult smokers in Ohio began smoking before age 18,” said Dr. Shields, of the OSUCCC-James. “Smokeless tobacco products are especially concerning because they are very attractive to youth and tobacco companies actively deploy marketing tactics aimed at encouraging dual use of smokeless tobacco with cigarettes to this audience. In addition, e-cigarettes have gained such rapid popularity that the medical community hasn’t had time to assess their health risks.”

E-cigarettes, or electronic cigarettes, are battery-operated products that heat liquid nicotine and other chemicals into a vapor that is inhaled by the user (sometimes called “vaping”).

In the last few years, e-cigarette use by young people has skyrocketed. According to the National Youth Tobacco Survey, e-cigarette use among high school students increased nearly 800 percent from 2011 to 2014. Similar increases were observed among middle school students.

At the same time, calls to poison control centers about e-cigarette and liquid nicotine exposure increased more than 1,200 percent, from 271 calls in 2011 to 3,738 calls in 2014, according to the American Association of Poison Control Centers. More than half of reported exposures involved children under the age of 6.

Children who drink or are exposed to liquid nicotine can experience nausea, vomiting, or other serious illness. One teaspoon of concentrated liquid nicotine could kill a 1-year-old child. Last December, a 1-year-old in New York died after swallowing liquid nicotine.

Additionally, studies suggest that teenage brains are permanently affected by nicotine exposure, with possible long-term cognitive and mood results.

In recent years, e-cigarette marketing expenditures have increased from an estimated $6.4 million in 2011 to more than $59.3 million in 2013, and e-cigarette marketers employ many of the same techniques that big tobacco companies used to sell cigarettes to young people, including:

Appealing flavors, including candy and fruit flavors
Cartoon advertisements
Placement in social media, movies, and TV
Event sponsorships, including music festivals, NASCAR, and the World Series of Poker
Free samples
Celebrity endorsements

Eight side-by-side comparisons of an e-cigarette product (left side of each pair) next to a similar-looking school supply or household item (right side of each pair).

Eight side-by-side comparisons of an e-cigarette product (left side of each pair) next to a similar-looking school supply or household item (right side of each pair).

Attorney General DeWine has led a bipartisan coalition of attorneys general in urging the U.S. Food and Drug Administration (FDA) to regulate e-cigarettes and related products in the same way cigarette and other tobacco-product advertising is regulated. He also has urged companies selling e-cigarettes to act in a responsible manner, including limiting youth exposure to e-cigarette marketing.

DeWine has a long record of protecting Ohio kids from underage tobacco use. As a U.S. Senator, he sponsored legislation granting the FDA authority over the marketing of tobacco products to kids. As Ohio Attorney General, he supported legislation in the Ohio General Assembly to ban the sale of e-cigarettes to those under age 18, a measure Gov. John Kasich signed into law in 2014.

Ohio State University Center of Excellence in Regulatory Tobacco Science (CERTS) is one of 14 centers nationwide dually funded by the National Institutes of Health and FDA through a new federal initiative aimed at putting science behind the FDA’s role in regulating tobacco.

The university-wide research program takes into account the biological, psychological, economic, and public health implications associated with tobacco use and the industry’s marketing of products to consumers. CERTS includes a total of 18 scientists from six colleges and The OSUCCC-James.

Through CERTS, Ohio State aims to reduce tobacco addiction and shed light on health problems arising from tobacco use among youths and adults in rural and urban settings, and to decrease tobacco-related harm by studying individual disease risk and the prevalence of product use — with a focus on dual use (smokeless tobacco and cigarettes) and new and emerging tobacco products like e-cigarettes.

Queensland considers ban on smoking at skate parks, pools and bus stops

Bill to be introduced by Liberal National party also prevents sale of cigarettes at music festivals in bid to keep young people from developing smoking habits

Breaching the bans, which are enforced by local governments, can attract an on-the-spot fine of $152, with a maximum penalty of $758.

Professor of health policy at Curtin University and president of the Australian Council on Smoking and Health, Mike Daube, said with close to 90% of the Australian population now non-smokers it was hard to see why Victoria was slow on implementing the outdoor dining ban.

“It isn’t rocket science – Victoria could simply follow the example of the other states where this legislation has been in place for years,” Daube said.

“It is a concern that a two-year delay gives the tobacco industry and its allies time to lobby for more delays and exemptions.”

A study of 10 million births published last week in the journal Nature Scientific Reports found the introduction of smoke-free legislation in England in 2007 was associated with clinically important reductions in stillbirth, low birth weight, and neonatal and infant mortality by 2011. Almost 1500 stillbirths and newborn deaths were avoided in the first four years after the laws prohibiting smoking in public places was introduced, the study found

Smoking ban in outdoor areas the ‘next logical step’, says Melbourne lord mayor

Melbourne city council set to discuss a ban for outdoor dining areas, an initiative that would bring Victoria into line with other states

Greens MP Colleen Hartland described Wooldridge’s comments as “hypocritical,” given the Coalition voted against a private members’ bill introduced by Hartland in 2012 to ban smoking in outdoor areas. The bill did not get the numbers to pass through the house at the time.

Hennessy said the almost two-year period between announcing the ban and implementing it was necessary so that businesses would have enough time to prepare for the changes.

“We want to work with businesses and consult with them to ensure this important reform is introduced and implemented effectively,” she said. “We don’t want to jeopardise jobs.”

However, it will put Victoria behind all other states. New South Wales last month implemented a smoking ban for all commercial outdoor dining areas, including hotels, clubs, restaurants and cafes. Queensland banned smoking in outdoor dining areas in 2006, and the ACT in 2010.

Earlier this year, the Victorian government brought forward bans on smoking within 4m of the entrances to public hospitals and community health services, schools, childcare centres, kindergartens and preschools, and government buildings.

Cancer Council unaware tobacco giant behind FOI request on child smoking habits

British American Tobacco criticised in Australia for not being ‘upfront about its involvement’ in freedom of information request for survey data

According to the most recently available statistics from the Victorian Cancer Council, about 13% of Victorians smoke, and about 4,000 lives are lost in the state each year due to smoking, costing the healthcare system $2.4bn.

Its chief executive, Todd Harper, said the council had been advocating for the ban for years, but that its strength would come down to how well hospitality workers were protected from tobacco smoke.

“We haven’t seen the detail yet, and that’s because there is a consulation period,” Harper said.

“Ultimately, how effective the smoke-free laws are will be seen in how well they protect hospitality workers from tobacco smoke, because they are the ones who spend the most time in these environments.

“We’re not concerned that it will take until 2017 to implement this ban, so long as that time is well spent properly consulting to ensure the legislation, when implemented, protects workers as effectively as possible.”

Community support for smoke-free outdoor dining is high. Cancer Council Victoria research showed 73% of Victorians support the ban. Smoking bans in enclosed restaurants were introduced in 2001.

However, opposition health spokeswoman, Mary Wooldridge asked why the outdoor smoking ban was taking the government so long to introduce, given the Coalition announced the policy over a year ago when it was still in government.

Outdoor areas in Victorian restaurants to be a smoke-free zone from mid-2017

Anti-smoking groups express concern over two-year delay but health minister says businesses need time to make changes before tobacco ban comes into place

Melissa Davey

Recent statistics by Victorian Cancer Council estimates about 4,000 lives are lost in each state each year due to smoking

Smoking will be banned in the outdoor dining areas of all restaurants, cafes, take-away shops and licensed premises in Victoria, the state’s health minister, Jill Hennessy, announced on Sunday.

But the ban won’t take effect until August 2017, with the government set to consult with health and industry groups over the coming months to flesh out the detail of the reforms.


E-cigarettes: an evidence update

Download (PDF, 2.07MB)

Something to chew on: Is smokeless tobacco more harmful than believed?

More than a quarter of a million people die each year from using smokeless tobacco, say scholars from the University of York, University of Edinburgh and Imperial College, London. Millions more have their lives shortened by ill health due to the effects of chewing tobacco-based products, they say, stating they are the first to assess the global impact of smokeless tobacco consumption on adults.

The team says governments and public health bodies need to consider incorporating the regulation of smokeless tobacco into policy frameworks.

Dr Kamran Siddiqi, senior lecturer in epidemiology and public health at the Department of Health Sciences/Hull York Medical School, said: “It is possible that these figures are underestimated and future studies may reveal that the impact is even bigger. We need a global effort to try and address and control smokeless tobacco.”

The study, which was funded by Leeds City Council and the Medical Research Council, estimates that in 2010 alone smokeless tobacco resulted in more than 62,000 deaths due to cancers of the mouth, pharynx and oesophagus and accounted for more than 200,00 deaths from heart disease.

Researchers compiled the figures using data from 113 countries and extracted from the 2010 Global Burden of Disease Study and surveys such as Global Adult Tobacco Survey. The results are published in BMC Medicine.

The team says that more research is needed in countries with high levels of consumption but where figures for the relative risk of acquiring smoking-related cancers are not available.

Dr Siddiqi said South-East Asia was a hotspot and in particular India which accounts for 74 per cent of the global disease burden.

He added: “Smokeless tobacco is used by almost a quarter of tobacco users and most of them live in South-East Asia. But even in this country there are communities in east London, Leicester, Birmingham, Leeds, Bradford and Birmingham using it.

“We have got no international policy on how to regulate the production, composition, sale, labelling, packaging and marketing of smokeless tobacco products.

“The international framework to control tobacco doesn’t seem to work to control smokeless tobacco. It doesn’t get the same regulation as cigarettes.

“There is a need to build on the insights obtained from efforts to reduce cigarette smoking and to investigate strategies to reduce the use of smokeless tobacco.”