Tag Archives: nicotine

Doctors, industry locked in vape debate over youth use

Cool Vapes on Pittsburgh’s McKnight Road is in an average-looking storefront at the foot of Ross Park Mall, sandwiched between a bridal shop and a cellphone outlet.

Inside, the place bustles with customers peering into glass cases full of flavored liquid nicotine with names like Strawberry Cheesecake, Fruity Fun and Crunchberry. Buyers heat the liquids with battery-operated devices and inhale the vapor in a process known as vaping.

The store contains several prominently placed signs warning: “You must be 18 years old to make a purchase.”

Legally, Cool Vapes does not need the signs. Pennsylvania is one of four states without age restrictions for purchasing electronic vaporizers, e-cigarettes and liquid nicotine, according to the American Vaping Association, an industry trade group.

Still, most vape shop owners in Western Pennsylvania maintain a casual agreement not to sell to minors.

“Selling to kids under 18 doesn’t send a good message,” said Cool Vapes owner R.J. Marino. “It’s a personal decision, and I think most vape shop owners agree. But do I have that legal right? Absolutely, at least for now.”

Anthony Fricchione, owner of Villain Vape Shop, which has stores in Lawrenceville, Cheswick and Butler, agreed.

“You would be hard-pressed to go into a vape shop and find an owner selling to teens,” he said. “Our goal is to help people quit smoking. Selling to minors is the last thing we want to deal with _ we’re already battling so much.”

One of those battles is Gov. Tom Wolf’s proposed 40 percent tax on e-cigarettes and vaporizers. On a national level, the Food and Drug Administration might soon classify liquid nicotine as a tobacco product, which members of the vaping industry say will lead to overregulation, hidden costs and red tape that could put them out of business.

“This industry is under consistent attack,” said Greg Conley, president of the AVA. “It’s new technology and confusing to some, so they’d just like to altogether eliminate it. We’re dealing with the toxic legacy of the tobacco industry.”

A recent study by JAMA Pediatrics said teenagers who try vaping or e-cigarettes are more likely to turn to traditional cigarettes for their nicotine fix and become addicted smokers. Researchers from the University of Pittsburgh, Dartmouth University and the University of Oregon surveyed young people from across the country.

A U.S. Centers for Disease Control and Prevention study produced similar results and indicated e-cigarette use among middle and high schoolers tripled from 2013 to 2014.

“In many ways, it’s the perfect starter cigarette for teens. It comes in flavors like chocolate or mango,” said Dr. Brian Primack, director of Pitt’s Center for Research on Media, Technology and Health and lead author of the JAMA Pediatrics study. “It’s electronic, it’s cool-looking, and it’s new. The problem is nicotine is one of the most addictive chemicals known to humans. Once you get addicted, you run the risk of needing more in the form of a traditional cigarette.”

Critics believe the e-cigarette industry markets to younger users with sleekly designed vaporizers and flavored juices.

“As a parent of an 8-year-old son, this stuff really scares me,” said Dr. Anil Singh, director of the breathing disorders center at Allegheny General Hospital. “If used in the right way and regulated, I can see some potential benefit for adults trying to quit smoking. But with the flavors and tools, it’s a great way for hooking young people in. I’d say it’s pretty dangerous.”

Bill Godshall, executive director of Smokefree Pennsylvania, scoffed at the JAMA Pediatrics study. He pointed to a recent CDC study that indicates teen smoking is at an all-time low.

“Cigarette smoking among youths is plummeting every year, but they say vaping is a gateway?” he said. “C’mon. I can’t believe JAMA is pushing this theory.”

As school let out at Taylor Allderdice High School in Squirrel Hill on a recent afternoon, a few students lit cigarettes as they walked down Forward Avenue. Oskar Porter, 15, a sophomore who was not smoking, said it’s not uncommon to see students vaping.

“I think some of the kids do it to be edgy,” he said. “And they can get away with it easier in the bathroom or the back of a classroom.”

Porter said he’s unsure whether vaping is a gateway to cigarettes, as studies suggest.

“I’ve seen plenty of kids who both vape and smoke cigarettes,” he said. “I’m not sure one leads to the other. They’re both pretty common.”

Published via the AP member exchange.

Wisconsin lawmakers to take up bill to ban vaping indoors

Wisconsin lawmakers are set to reignite conversations about whether vaping — using electronic cigarettes and other vapor smoking devices — should be included in Wisconsin’s smoking ban.

The ban took effect in 2010 and it outlaws smoking in all public indoor locations, including restaurants and bars.

But the ban does not currently apply to vaping, giving venue owners the right to decide whether or not to permit e-cigarettes.

Democratic Rep. Debra Kolste of Janesville says because the indoor smoking ban has been so successful, the bill seemed like common sense.

But the bill will face Republican opposition.

State Rep. Joel Kleefisch, a Republican from Oconomowoc, says he will introduce a bill to protect e-cigarettes from the ban.

What do you know about e-cigarettes? At a glance…

ELECTRONIC CIGARETTES: The battery-powered devices made of plastic or metal heat a liquid nicotine solution, creating vapor that users inhale. Some models are disposable, and some are designed to be refilled with cartridges or tanks containing what enthusiasts call “e-juice.” Some e-cigarettes are made to look like a real cigarette with a tiny light on the tip that glows like the real thing.

WHAT’S IN THEM: The ingredients in the liquid used in most e-cigarettes include nicotine, water, glycerol, propylene glycol and flavorings. Propylene glycol is a thick fluid sometimes used in antifreeze but also used as a food ingredient.

SELLING POINTS: Users say e-cigarettes address both the addictive and behavioral aspects of smoking. Smokers get their nicotine without the thousands of chemicals found in regular cigarettes. And they get to hold something shaped like a cigarette, while puffing and exhaling something that looks like smoke without the ash, odor and tar.

THE WORRIES: Scientists haven’t finished much research on e-cigarettes, their safety and whether they help smokers quit, and the studies that have been done have been inconclusive. The federal government is pouring millions of dollars into research to supplement independent and company studies looking at the health risks of e-cigarettes and other tobacco products – as well as who uses them and why.

GROWING MARKET: The industry has rocketed from thousands of users in 2006 to several million worldwide, leading to the rise of more than 200 brands. Sales have been estimated to reach nearly $2 billion in 2013.

ARRAY OF FLAVORS: While some e-cigarette makers are limiting offerings to tobacco and menthol flavors, others are selling candy-like flavors like cherry and strawberry – barred for use in regular cigarettes because of the worry that the flavors are used to appeal to children.

Historic smoking report marks 50th anniversary

Fifty years ago, ashtrays seemed to be on every table and desk. Athletes and even Fred Flintstone endorsed cigarettes in TV commercials. Smoke hung in the air in restaurants, offices and airplane cabins. More than 42 percent of U.S. adults smoked, and there was a good chance your doctor was among them.

The turning point came on Jan. 11, 1964. It was on that Saturday morning that U.S. Surgeon General Luther Terry released an emphatic and authoritative report that said smoking causes illness and death — and the government should do something about it.

In the decades that followed, warning labels were put on cigarette packs, cigarette commercials were banned, taxes were raised and new restrictions were placed on where people could light up.

“It was the beginning,” said Kenneth Warner, a University of Michigan public health professor who is a leading authority on smoking and health.

It was not the end. While the U.S. smoking rate has fallen by more than half to 18 percent, that still translates to more than 43 million smokers. Smoking is still far and away the leading preventable cause of death in the U.S. Some experts predict large numbers of Americans will puff away for decades to come.

Nevertheless, the Terry report has been called one of the most important documents in U.S. public health history, and on its 50th anniversary, officials are not only rolling out new anti-smoking campaigns but reflecting on what the nation did right that day.

The report’s bottom-line message was hardly revolutionary. Since 1950, head-turning studies that found higher rates of lung cancer in heavy smokers had been appearing in medical journals. A widely read article in Reader’s Digest in 1952, “Cancer by the Carton,” contributed to the largest drop in cigarette consumption since the Depression. In 1954, the American Cancer Society announced that smokers had a higher cancer risk.

But the tobacco industry fought back. Manufacturers came out with cigarettes with filters that they claimed would trap toxins before they settled into smokers’ lungs. And in 1954, they placed a full-page ad in hundreds of newspapers in which they argued that research linking their products and cancer was inconclusive.

It was a brilliant counter-offensive that left physicians and the public unsure how dangerous smoking really was. Cigarette sales rebounded.

In 1957 and 1959, Surgeon General Leroy Burney issued statements that heavy smoking causes lung cancer. But they had little impact.

Amid pressure from health advocates, President John F. Kennedy’s surgeon general, Dr. Luther Terry, announced in 1962 that he was convening an expert panel to examine all the evidence and issue a comprehensive, debate-settling report. To ensure the panel was unimpeachable, he let the tobacco industry veto any proposed members it regarded as biased.

Surveys indicated a third to a half of all physicians smoked tobacco products at the time, and the committee reflected the culture: Half its 10 members were smokers, who puffed away during committee meetings. Terry himself was a cigarette smoker.

Dr. Eugene Guthrie, an assistant surgeon general, helped persuade Terry to kick the habit a few months before the press conference releasing the report.

“I told him, ‘You gotta quit that. I think you can get away with a pipe — if you don’t do it openly.’ He said, ‘You gotta be kidding!’ I said, ‘No, I’m not. It just wouldn’t do. If you smoke any cigarettes, you better do it in a closet,”” Guthrie recalled in a recent interview with The Associated Press.

The press conference was held on a Saturday partly out of concern about its effect on the stock market. About 200 reporters attended.

The committee said cigarette smoking clearly did cause lung cancer and was responsible for the nation’s escalating male cancer death rate. It also said there was no valid evidence filters were reducing the danger. The committee also said — more vaguely — that the government should address the problem.

“This was front-page news, and every American knew it,” said Robin Koval, president of Legacy, an anti-smoking organization.

Cigarette consumption dropped a whopping 15 percent over the next three months but then began to rebound. Health officials realized it would take more than one report.

In 1965, Congress required cigarette packs to carry warning labels. Two years later, the Federal Communications Commission ordered TV and radio stations to provide free air time for anti-smoking public service announcements. Cigarette commercials were banned in 1971.

Still, progress was slow. Warner recalled teaching at the University of Michigan in 1972, when nearly half the faculty members at the school of public health were smokers. He was one of them.

“I felt like a hypocrite and an idiot,” he said. But smoking was still the norm, and it was difficult to quit, he said.

The 1970s also saw the birth of a movement to protect nonsmokers from cigarette fumes, with no-smoking sections on airplanes, in restaurants and in other places. Those eventually gave way to complete smoking bans. Cigarette machines disappeared, cigarette taxes rose, and restrictions on the sale of cigarettes to minors got tougher.

Tobacco companies also came under increasing legal attack. In the biggest case of them all, more than 40 states brought lawsuits demanding compensation for the costs of treating smoking-related illnesses. Big Tobacco settled in 1998 by agreeing to pay about $200 billion and curtail marketing of cigarettes to youths.

In 1998, while the settlement was being completed, tobacco executives appeared before Congress and publicly acknowledged for the first time that their products can cause lung cancer and be addictive.

Experts agree that the Terry report clearly triggered decades of changes that whittled the smoking rate down. But it was based on data that was already out there. Why, then, did it make such a difference?

For one thing, the drumbeat about the dangers of smoking was getting louder in 1964, experts said. But the way the committee was assembled and the carefully neutral manner in which it reached its conclusion were at least as important, said Dr. Tim McAfee, director of the Office on Smoking and Health at the Centers for Disease Control and Prevention.

At the same time, he and others said any celebration of the anniversary must be tempered by the size of the problem that still exists.

Each year, an estimated 443,000 people die prematurely from smoking or exposure to secondhand smoke, and 8.6 million live with a serious illness caused by smoking, according to the CDC.

Donald Shopland finds that depressing.

Fifty years ago, he was a 19-year-old who smoked two packs a day while working as a clerk for the surgeon general’s committee. He quit cigarettes right after the 1964 report came out, and went on to a long and distinguished public health career in which he wrote or edited scores of books and reports on smoking’s effects.

“We should be much further along than we are,” the Georgia retiree lamented.