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A Cigarette by any other name is still a cigarette

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Online Pro-Tobacco Marketing Exposure Is Associated With Dual Tobacco Product Use Among Underage US Students



To understand the effect of pro-tobacco marketing on electronic cigarette and combustible cigarette dual use among US middle and high school students under 18 years of age.


Data were derived from the 2018 National Youth Tobacco Survey, an annual self-administered school-based cross-sectional survey.


The survey was administered in public and private middle and high schools across the United States.


The probability sample size was 15 238 middle and high school students with complete responses who were under 18 years of age during the study period.


The study measured self-reported exposure to online combustible and electronic cigarette advertisements, dual use of combustible and electronic cigarettes during the past 30 days, exposure to the Real Cost antitobacco campaign advertisements, and other sociodemographic factors (eg, race/ethnicity, gender, and grade).


Logistic regressions were used to measure pro-tobacco marketing exposure and dual use as a function of pro-tobacco marketing exposure.


Descriptive analyses show that 59.0% of respondents were exposed to pro-tobacco online marketing, and 2.9% were dual users. Dual users (odds ratio [OR] = 1.73) and high school students (OR = 1.43) were more likely to report exposure to online pro-tobacco marketing.


Findings indicate that a gap in electronic cigarette pro-tobacco marketing regulatory oversight may exist. Further policy action may be warranted to protect the public health of minors and other vulnerable populations who are most susceptible to pro-tobacco marketing.

$26.75M Award in Retrial Over Smoker’s Death More Than Doubles Original Trial Verdict

St. Petersburg, FL— A Florida state court jury awarded $26.75 million to the family of a Florida smoker after finding the nation’s two largest tobacco companies responsible for his cancer death. Duignan v. R.J. Reynolds and Philip Morris, 13-010978-CI.

The award includes $2.75 million in compensatory damages handed down last week and $24 million in punitives imposed equally against R.J. Reynolds and Philip Morris Tuesday for the 1992 cancer death of Douglas Duignan.

Duignan, 42 when he died, smoked up to two packs of cigarettes a day for more than 25 years. His family contends Reynolds and Philip Morris’s role in a conspiracy to hide the dangers of cigarettes hooked Duignan to nicotine and caused his fatal cancer.

The award more than doubles the $12 million handed down in a 2015 trial in the case. That verdict was thrown out two years later, however, after the Florida Court of Appeals for the Second District found the trial judge in the case improperly discouraged a jury readback request.

The case is among thousands that stem from Engle v. Liggett Group Inc., a 1994 Florida state court class-action lawsuit against tobacco companies. The state’s supreme court later decertified the class, but ruled Engle progeny cases may be tried individually. Plaintiffs are entitled to the benefit of the jury’s findings in the original verdict, including the determination that tobacco companies placed a dangerous, addictive product on the market and hid the dangers of smoking.

To be entitled to those findings, however, each plaintiff must prove the smoker at the heart of their case suffered from nicotine addiction that was the legal cause of a smoking-related disease.

After Friday’s verdict finding class membership and awarding compensatories, the two-day punitive phase of trial turned on whether harsh financial punishment should be imposed in light of broad changes by the companies, and the industry at-large, over the last two decades.

During Tuesday’s closing statements, Shook Hardy & Bacon’s Kenneth Reilly reminded jurors that the tobacco industry now faced strict oversight by the U.S. Food and Drug Administration, or FDA, while Philip Morris had paid billions of dollars under a settlement with states’ attorneys-general. Meanwhile, he said, the company had gone farther than required in restricting their marketing.

“What message are you guys going to send to the people who are operating the business today and have been for a quarter of a century?” Reilly asked jurors. “They’ve never failed to comply with the FDA requirements. They’ve never failed to comply with the attorneys-general requirements. They’ve never been criticized, and look at all the voluntary things they did.”

Jones Day’s Jack Williams, representing Reynolds, agreed, and argued Reynolds now sent clear messages about smoking’s dangers while spending decades and billions of dollars trying to make a safer cigarette. “Punishing Reynolds now would… be saying that if a company changes and becomes more responsible and tries to do more of the right thing, it’s still… going to get punished,” Williams said.

But Searcy Denney’s James Gustafson argued that none of the changes the companies detailed affected Duignan’s ultimate end.

“Nothing that the defendants brought you… mitigated, or made less severe, what they did to Douglas Duignan,” Gustafson said. “If they don’t get punished for what they did, what does that do to deter others from doing the same thing?”

Tobacco Retail Density and Initiation of Alternative Tobacco Product Use Among Teens


The rise of noncigarette, alternative tobacco product (ATP) use among adolescents may be due in part to an increase in retail availability of ATPs. We examined whether proximity and density of tobacco retailers near students’ homes are associated with a higher likelihood of initiating ATP use over time.


Using data from 728 adolescents (aged 13–19 years at baseline) residing in 191 different neighborhoods and attending 10 different California high schools, longitudinal multilevel and cross-classified random effect models evaluated individual-level, neighborhood-level, and school-level risk factors for ATP initiation after 1 year. Covariates were obtained from the American Community Survey and the California Department of Education.


The sample was predominantly female (63.5%) and was racially and ethnically diverse. Approximately one third of participants (32.5%) reported ever ATP use at baseline, with 106 (14.5%) initiating ATP use within 1 year. The mean number of tobacco retailers per square mile within a tract was 5.66 (standard deviation = 6.3), and the average distance from each participant’s residence to the nearest tobacco retailer was .61 miles (standard deviation = .4). Living in neighborhoods with greater tobacco retailer density at baseline was associated with higher odds of ATP initiation (odds ratio = 1.22, 95% confidence interval = 1.07–2.12), controlling for individual and school factors.


Tobacco retailers clustered in students’ home neighborhood may be an environmental influence on adolescents’ ATP use. Policy efforts to reduce adolescent ATP use should aim to reduce the density of tobacco retailers and limit the proximity of tobacco retailers near adolescents’ homes and schools.

Scientists are working hard to dismiss the anti-vaping argument

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Spinning a New Tobacco Industry

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Parental Tobacco Counseling in the Well-Child Visit—A Method With Enhanced Effectiveness but Nowhere to Go

Exposure to tobacco is the leading preventable cause of disease and death in the United States and as such was noted in the recent US Surgeon General’s report, “The Health Consequences of Smoking: 50 Years of Progress”: “The epidemic of smoking-caused disease in the 20th century ranks among the greatest public health catastrophes of the century, while the decline of smoking consequent to tobacco control is surely one of public health’s greatest successes.”1(p33) As the documented consequences of passive tobacco exposure make clear, these observations are as relevant for the pediatric population of this country as they are for adults.

Nearly 2 million U.S. adult nonsmokers vape

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San Francisco Voters End the Sale of Flavored Tobacco Products

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Electronic cigarette explosion and burn injuries, US Emergency Departments 2015–2017

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