Vaping Contributing To Smoking, Addiction Among Teens

Report Fails To Call Vaping Safe

By Sheila Kaplan, New York Times

A national panel of public health experts concluded in a report released on Tuesday that vaping with e-cigarettes that contain nicotine can be addictive and that teenagers who use the devices may be put at higher risk of switching to traditional smoking.

Whether teenage use of e-cigarettes may lead to conventional smoking has been intensely debated in the United States and elsewhere. While the industry argues that vaping is not a stepping stone to conventional cigarettes or addiction, some anti-smoking advocates contend that young people become hooked on nicotine, and are enticed to cancer-causing tobacco-based cigarettes over time.

The new report by the National Academies of Sciences, Engineering and Medicine is the most comprehensive analysis of existing research on e-cigarettes. It concluded the devices are safer than traditional smoking products and that they do help smokers quit, citing conclusive proof that switching can reduce smokers’ exposure to deadly tar, numerous dangerous chemicals and other carcinogens.

teen smoking e-cigarette

But it stopped short of declaring e-cigarettes as safe, noting that there are no long-term scientific studies of the devices’ addictive potential or their effects on the heart, lungs or on reproduction.

The panel found evidence among studies it reviewed that vaping may prompt teenagers or young adults to try regular cigarettes, putting them at higher risk for addiction, but that any significant linkage between e-cigarettes and long-term smoking has not been established. It said it was unable to determine whether young people were just trying cigarettes or becoming habitual smokers.

“When it got down to answering the questions about what the impacts on health are, there is still a lot to be learned,” said David Eaton, of the University of Washington, who led the committee that reviewed existing research and issued the report. “E-cigarettes cannot be simply categorized as either beneficial or harmful.”

The report was commissioned in 2016, after the F.D.A. gained the authority to regulate tobacco products that had previously been outside its jurisdiction, such as e-cigarettes, cigars and other goods.

Mitch Zeller, head of the agency’s tobacco division, said the committee was assigned to assess the existing science, and to point out where research gaps suggest more study was needed. The report will aid the agency in its review of applications for lower-risk tobacco products and the potential harm or benefits those pose to individuals and the public.

On Wednesday, an F.D.A. advisory panel will review an application from Philip Morris International for iQOS, an electronic device that unlike e-cigarettes, contains tobacco in a stick that the company says heats it but does not burn it. It releases nicotine vapor the company says is less hazardous than smoke. If approved, it would be the first company allowed by the government to claim its product is less harmful than cigarettes.

lung cancer and smoking tobacco

Also this week, on Friday, the agency’s new nicotine steering committee will hold a public hearing on over-the-counter therapeutic products, among them gums, patches and lozenges, designed to help smokers quit.

Cessation was one area where the committee’s report did give the booming e-cigarette industry some good news. It pointed out the benefits for smokers of tobacco-based cigarettes who are trying to quit. and. But people who continue to smoke cigarettes, alternating with e-cigarettes, do not gain the same health benefits, the committee said. That’s especially important given that most adults who vape also still smoke or use other tobacco products.

While there is no evidence at this time that e-cigarettes or their components cause cancer, the committee recommended more long-term research. Some e-cigarettes do contain chemicals and metals whose long-term effects — including on pregnancy — also require additional research, the committee said.

Smoking rates among adults and teenagers have declined significantly over the last few decades. In 2015, the last year for which the Centers for Disease Control and Prevention has statistics, about 37 million Americans, 15 percent of adults aged 18 and older, smoked cigarettes. The number has declined from nearly 21 percent of every 100 adults in 2005; and 42 percent in 1965.

healthcare costs and smoking

With that decline, the e-cigarette industry has emerged as a potential substitute and Big Tobacco has been among the device developers enjoying new profits from the tobacco alternatives. Bonnie Herzog, a well-known Wells Fargo tobacco analyst, predicted the industry will grow about 15 percent to $5.1 billion in retail sales in the United States, in 2018. Of that, she noted that $1.6 billion will be spent on the pre-filled cartridges sold mostly by the big tobacco companies, and $3.5 billion on open vapor systems; the liquid refill products, most of which are sold at vape shops.

The vaping industry, as well as traditional tobacco companies, are also gearing up for a lengthy fight with the F.D.A. over the campaign by the agency’s commissioner, Dr. Scott Gottlieb, to slash levels of nicotine in traditional cigarettes to nonaddictive or minimally addictive levels.

Dr. Gottlieb is expected to issue an initial proposal, calling for public comment on lower nicotine levels, in the near future.

The new report reflects the complexity of the issues surrounding e-cigarettes and the balancing act tobacco regulators face over the pros and cons of the many alternatives to conventional cigarettes. The notion of e-cigarettes as a gateway to conventional cigarettes for youths has been a sticking point.

Adam Leventhal, a professor of preventive medicine at the University of Southern California, and an author of the report, said his group did an exhaustive literature search, reviewing all studies on youths and e-cigarette use from around the world. Of those, they found 10 studies that they deemed strong enough to address the question. But these studies did not show that using e-cigarettes caused teens to move on to tobacco, only that the use of e-cigarettes was associated with later smoking of at least one traditional cigarette. The report noted that more than 11 percent of all high school students had used e-cigarettes within the past month, a total of nearly 1.7 million youths.

“The evidence was substantial that this association was consistent across a number of research methodologies, age ranges, locations, and research groups in and outside the U.S.,” Mr. Leventhal said.

More intriguing was the report’s finding of moderate evidence that youths who use e-cigarettes before trying tobacco, are more likely to become more frequent and intense smokers.

Critics have long contended that the flavored liquids for the devices are luring adolescents to the habit, at a time when nicotine is especially hazardous for their brain development. Three of the top-selling flavors at, a large online retailer, include “Unicorn Milk” (strawberries and cream), “TNT” (strawberry, apple and peach) and “I Love Donuts” (blueberries and pastry).

The authors of the new report cite conclusive evidence that vaping can be addictive, and that exposure to nicotine from e-cigarettes is highly variable, depends on the characteristics of the device, as well as how it is used. They also cited conclusive proof that in addition to nicotine, most e-cigarettes also contain and emit numerous potentially toxic substances.

In terms of second hand vapor, the committee said there was conclusive evidence that e-cigarette use increases airborne concentrations of particulate matter and nicotine indoors.

The report concluded that much of the current research on e-cigarettes is lacking by scientific standards and that many important areas have not yet been studied. Dr. Eaton, in an interview, said that the authors did not distinguish between industry-funded, and independent research.

Many of the existing studies were also flawed, either in methodology or because of industry-financed bias. In addition, the levels of nicotine and other chemicals, including metals, vary in e-cigarettes from brand to brand, which has complicated some research findings.

Mr. Zeller praised the report and stressed its strong findings that youths who start on e-cigarettes are more likely to become heavier users of tobacco.

“And for kids who initiate on e-cigarettes, there’s a great chance of intensive use of cigarettes. As the regulator, we’ve got to factor all that in,” Mr. Zeller said.

In July, the F.D.A. delayed the deadline at least four years for e-cigarette companies to submit applications for currently marketed products to demonstrate that their public health benefit warrants agency approval. The agency did not delay other aspects of its tobacco control work, including requirements for mandatory age and photo-ID checks to prevent illegal sales to minors and the banning of free samples.

Public health advocates who objected to the July delay, said this report gave them further concern.

“What the report demonstrates is that despite the popularity of e-cigarettes, little is known about their overall health effects, and there is wide variability from product to product,” said Matthew L. Myers, President of Campaign for Tobacco-Free Kids. “That makes the case even stronger for F.D.A. regulation. This report makes very real the concern that e-cigarettes may well increase the use of combustive tobacco products.’’

The vaping industry was cautiously optimistic about the influence of the report. Gregory Conley, president of the American Vaping Association, a nonprofit that advocates for vapor products, said it was good news. He said the findings were consistent with those reached by the Royal College of Physicians and other institutions in Britain that have issued reports indicating e-cigarettes are less dangerous than traditional smoking and help with cessation.

“The committee’s findings also fall in line with F.D.A. Director Scott Gottlieb’s nicotine strategy, a key element of which involves adult smokers switching to lower risk products,” he said. “In the wake of this report, it is more apparent than ever that true leadership is needed in public health to ensure that adult smokers have access to truthful information about the benefits of switching to smoke-free products.”

Read The Full Story About Vaping and Teen Smoking

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Crossbow Communications is a full-service advertising agency and public relations firm in Denver, Colorado and Phoenix, Arizona. The PR firm specializes in issue management and public affairs. Write to Gary Chandler to learn more how we can help build your brand, your bottom line and a better world.

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The History Of Tobacco Lawsuits

Lawsuits Against Tobacco Companies An Uphill Battle

Smokers, their families, and government entities have been filing lawsuits against tobacco companies for more than half a century. Over the years, tobacco litigation has seen a number of changes — from the theories of liability used by plaintiffs to the legal defenses mounted by cigarette manufacturers. Read on to learn the history of tobacco litigation and to get an idea of the types of smoking-related lawsuits being brought today.

When the first reports emerged linking cigarettes to cancer emerged in the 1950s, plaintiffs began suing cigarette manufacturers. Plaintiffs in these early cases — usually smokers with lung cancer — typically employed several legal theories in their lawsuits:

  • negligent manufacture – the tobacco companies failed to act with reasonable care in making and marketing cigarettes;
  • product liability – the tobacco companies made and marketed a product that was unfit to use;
  • negligent advertising – the tobacco companies failed to warn consumers of the risks of smoking cigarettes;
  • fraud; and
  • violation of state consumer protection statutes (most of which prohibit unfair and deceptive business practices).

lung cancer and smoking

Tobacco manufacturers responded in full force, fighting each lawsuit and refusing to settle out of court. They relied on several defense strategies, arguing that:

  • Tobacco was not harmful to smokers.
  • Smokers’ cancer was caused by other factors.
  • Smokers assumed the risk of cancer when they decided to smoke.

The tobacco companies prevailed in all of these early lawsuits. (To learn more about product liability, negligence, and fraud, see Nolo’s articles Toxic Torts: Legal Theories of Liability andDefective Product Claims: Theories of Liability.)

Litigation Based On Addiction

In the 1980s, a new wave of lawsuits emerged. In the landmark case of that time, Cipollone v. Liggett, the plaintiff and her family alleged that cigarette manufacturers knew — but did not warn consumers — that smoking caused lung cancer and that cigarettes were addictive. Although Rose Cipollone’s husband was awarded $400,000, an appellate court reversed the decision. Other plaintiffs also sued, claiming that tobacco companies knew cigarettes were addictive and caused cancer.

In defending these lawsuits, the tobacco companies argued that smokers had knowingly assumed the risks of cancer and other health problems when they began smoking. The companies also argued that various state laws were preempted by federal laws. That is, that federal laws governing tobacco advertising superseded state laws regarding the same thing, and plaintiff’s couldn’t sue under the state law. For the most part, the tobacco industry was successful in these lawsuits.

smoking and lung cancer

Plaintiff Successes & Lawsuits by the States

In the 1990s, plaintiffs began to have limited success in tobacco lawsuits, partly because some cigarette company documents were leaked showing the companies were aware of the addictive nature of tobacco. The first big win for plaintiffs in a tobacco lawsuit occurred in February 2000, when a California jury ordered Philip Morris to pay $51.5 million to a California smoker with inoperable lung cancer.

Around this time, more than 40 states sued the tobacco companies under state consumer protection and antitrust laws. These states argued that cigarettes contributed to health problems that triggered significant costs for public health systems. In these lawsuits, the tobacco companies could not use the defense that had proven so successful in lawsuits brought by individuals — that the smoker was aware of the risks and decided to smoke anyway.

In November 1998, the attorneys general of 46 states and four of the largest tobacco companies agreed to settle the state cases. Terms of the settlement are referred to as the Master Settlement Agreement.

Highlights include:

  • Tobacco companies agreed to refrain from engaging in certain advertising practices, particularly ad campaigns that marketed cigarettes towards kids.
  • Tobacco companies agreed to pay annual sums of money to the states to compensate them for health-care costs related to smoking (a minimum of $206 billion over the first twenty-five years).
  • The settlement created and funded the National Public Education Foundation, dedicated to reducing youth smoking and preventing diseases associated with smoking.
  • Tobacco companies dissolved three of the biggest tobacco industry organizations.

Recent Developments in Tobacco Litigation

In recent years, several key court decisions have paved the way for a raft of individual lawsuits against tobacco companies and have opened the door for class action lawsuits that focus on light cigarettes.

Individual Lawsuits in Florida

In 2006, the Florida Supreme Court threw out a class action lawsuit brought on behalf of 700,000 smokers and their families against tobacco companies. In its ruling, the court found that tobacco companies knowingly sold dangerous products and kept smoking health risks concealed, but that the case could not proceed as a class action. Instead, the court ruled that each case must be proven individually.

This ruling paved the way for over 8,000 smokers and their families to bring individual lawsuits against the tobacco companies. By 2015, according to RJ Reynolds regulatory filings, the company faced jury verdicts totaling almost $300 million, although many of those cases are in various stages of appeal.

lung cancer and smoking tobacco

Light Cigarettes

Another batch of tobacco lawsuits focuses on light cigarettes. Light cigarettes have special filters designed to dilute the smoke inhaled by smokers. Plaintiffs in these cases allege that tobacco companies advertise light cigarettes as being healthier than regular cigarettes, when in fact they are no safer than non-light cigarettes.

Tobacco companies respond that “light” refers to the taste of the cigarettes, not the amount of nicotine ingested, and that consumers should understand what “light” means. They have also raised federal preemption as a defense against state class action lawsuits, arguing that federal legislation regarding cigarette advertising supersedes state laws that prohibit deceptive advertising practices.

In December 2008, the U.S. Supreme Court threw out the tobacco companies’ preemption arguments in a class action light cigarette lawsuit brought in Maine. In allowing the Maine case to proceed, the Supreme Court ruled that federal legislation does not preempt plaintiffs from suing under certain state unfair business practice laws. This will open the door for similar lawsuits against tobacco companies. The Supreme Court, however, didn’t rule on any of the underlying claims — plaintiffs will still have to prove that the cigarette companies violated Maine’s consumer protection laws.

In a 2014 wrongful death lawsuit against RJ Reynolds, a Florida jury awarded more than $23 billion in punitive damages to the widow of a former smoker, but in 2015 a Florida appeals court shrank that award way down to just under $17 million.

Any type of tobacco litigation involves complex legal theories, detailed and intricate scientific analyses, and often aggressive defendants. If you want to explore whether you or a loved one can bring a claim against a cigarette manufacturer, talk to a lawyer that specializes in this field and knows the status of tobacco litigation in your particular state.

Tobacco, Deceit and Death.

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Crossbow Communications is a full-service advertising agency and public relations firm in Denver, Colorado and Phoenix, Arizona. The PR firm specializes in issue management and public affairs. Write to Gary Chandler to learn more how we can help build your brand, your bottom line and a better world.

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FDA Takes Steps To Regulate Nicotine

Agency Delays E-cigarette, Cigar Compliance Deadlines

The U.S. Food and Drug Administration today announced a new comprehensive plan for tobacco and nicotine regulation that will serve as a multi-year roadmap to better protect kids and significantly reduce tobacco-related disease and death. The approach places nicotine, and the issue of addiction, at the center of the agency’s tobacco regulation efforts. The goal is to ensure that the FDA has the proper scientific and regulatory foundation to efficiently and effectively implement the Family Smoking Prevention and Tobacco Control Act. To make certain that the FDA is striking an appropriate balance between regulation and encouraging development of innovative tobacco products that may be less dangerous than cigarettes, the agency is also providing targeted relief on some timelines described in the May 2016 final rule that extended the FDA’s authority to additional tobacco products. The agency will also seek input on critical public health issues such as the role of flavors in tobacco products.

lung cancer and smoking tobacco

Tobacco use remains the leading cause of preventable disease and death in the United States, causing more than 480,000 deaths every single year.

In addition to the devastating human toll caused mainly by cigarette smoking, tobacco also causes substantial financial costs to society, with direct health care and lost productivity costs totaling nearly $300 billion a year. A key piece of the FDA’s approach is demonstrating a greater awareness that nicotine – while highly addictive – is delivered through products that represent a continuum of risk and is most harmful when delivered through smoke particles in combustible cigarettes.

“The overwhelming amount of death and disease attributable to tobacco is caused by addiction to cigarettes –  the only legal consumer product that, when used as intended, will kill half of all long-term users,” said FDA Commissioner Scott Gottlieb, M.D. “Unless we change course, 5.6 million young people alive today will die prematurely later in life from tobacco use. Envisioning a world where cigarettes would no longer create or sustain addiction, and where adults who still need or want nicotine could get it from alternative and less harmful sources, needs to be the cornerstone of our efforts – and we believe it’s vital that we pursue this common ground.”

The FDA plans to begin a public dialogue about lowering nicotine levels in combustible cigarettes to non-addictive levels through achievable product standards. The agency intends to issue an Advance Notice of Proposed Rulemaking (ANPRM) to seek input on the potential public health benefits and any possible adverse effects of lowering nicotine in cigarettes. Because almost 90 percent of adult smokers started smoking before the age of 18 and nearly 2,500 youth smoke their first cigarette every day in the U.S., lowering nicotine levels could decrease the likelihood that future generations become addicted to cigarettes and allow more currently addicted smokers to quit.

“Because nicotine lives at the core of both the problem and the solution to the question of addiction, addressing the addictive levels of nicotine in combustible cigarettes must be part of the FDA’s strategy for addressing the devastating, addiction crisis that is threatening American families,” said Commissioner Gottlieb. “Our approach to nicotine must be accompanied by a firm foundation of rules and standards for newly-regulated products. To be successful all of these steps must be done in concert and not in isolation.”

quit smoking information

The FDA is committed to encouraging innovations that have the potential to make a notable public health difference and inform policies and efforts that will best protect kids and help smokers quit cigarettes. To make this effort successful, the agency intends to extend timelines to submit tobacco product review applications for newly regulated tobacco products that were on the market as of Aug. 8, 2016. This action will afford the agency time to explore clear and meaningful measures to make tobacco products less toxic, appealing and addictive. For example, the FDA intends to develop product standards to protect against known public health risks such as electronic nicotine delivery systems (ENDS) battery issues and concerns about children’s exposure to liquid nicotine. It also will provide manufacturers additional time to develop higher quality, more complete applications informed by additional guidance from the agency.

The agency plans to issue this guidance describing a new enforcement policy shortly. Under expected revised timelines, applications for newly-regulated combustible products, such as cigars, pipe tobacco and hookah tobacco, would be submitted by Aug. 8, 2021, and applications for non-combustible products such as ENDS or e-cigarettes would be submitted by Aug. 8, 2022. Additionally, the FDA expects that manufacturers would continue to market products while the agency reviews product applications.

Importantly, the anticipated new enforcement policy will not affect any current requirements for cigarettes and smokeless tobacco, only the newly-regulated tobacco products such as cigars and e-cigarettes. This approach also will not apply to provisions of the final rule for which compliance deadlines already have passed, such as mandatory age and photo-ID checks to prevent illegal sales to minors. It also will not affect future deadlines for other provisions of the rule, including, but not limited to, required warning statements, ingredient listing, health document submissions, harmful and potentially harmful constituent reports, and the removal of modified risk claims, i.e., “light,” “low,” or “mild,” or similar descriptors.

“This comprehensive plan and sweeping approach to tobacco and nicotine allows the FDA to apply the powerful tools given by Congress to achieve the most significant public health impact,” said Mitch Zeller, J.D., director of the FDA’s Center for Tobacco Products. “Public input on these complex issues will help ensure the agency has the proper science-based policies in place to meaningfully reduce the harms caused by tobacco use.”

American Heart Association CEO Nancy Brown issued the following comments on the U.S. Food and Drug Administration’s new plan for tobacco and nicotine regulation, announced today:

“FDA’s move today to lower nicotine levels and take a harder look at how flavored tobacco products attract the young is to be commended. However, the Association is disappointed with the agency’s decision to delay certain e-cigarette and cigar compliance deadlines. Altering the deadline for FDA review of e-cigarettes and cigars is a troubling step and one that we will closely monitor.

We are also concerned that the FDA has raised the possibility of exempting premium cigars in the future. Tobacco in any form presents risk. That’s why we have advocated for – and will continue to insist – that FDA oversight of all tobacco products is absolutely essential. Premium cigars are no different. Cigars are a concern because high school-aged males now smoke them at a higher rate than cigarettes. As we have seen in recent Senate legislation, often the definition for “premium cigars” creates a loophole that allows the flavored and cheap cigars that attract youth to qualify as “premium.” Weakening the deeming rule in any way could lead to an increasing number of Americans at risk for heart disease, stroke or even an early death due to tobacco use.

smoke cigar and cancer

In order to further explore how best to protect public health in the evolving tobacco marketplace, the agency also will seek input from the public on a variety of significant topics, including approaches to regulating kid-appealing flavors in e-cigarettes and cigars. In particular, the FDA intends to issue ANPRMs to: 1) seek public comment on the role that flavors (including menthol) in tobacco products play in attracting youth and may play in helping some smokers switch to potentially less harmful forms of nicotine delivery; and 2) solicit additional comments and scientific data related to the patterns of use and resulting public health impacts from premium cigars, which were included in the FDA’s 2016 rule. Additionally, the agency plans to examine actions to increase access and use of FDA-approved medicinal nicotine products, and work with sponsors to consider what steps can be taken under the safety and efficacy standard for products intended to help smokers quit.

As the FDA carries out its new nicotine and tobacco plan, we urge the agency to remember that protecting public health, particularly the health of young people in this country, should be at the very top of its priority list. While we look forward to agency actions that can lower the number of Americans exposed to the harms of combustible tobacco, the FDA must advance all tobacco regulation. We must not take two steps forward and then one step back.”

Nicotine News

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Crossbow Communications is a full-service advertising agency and public relations firm in Denver, Colorado and Phoenix, Arizona. The firm specializes in issue management and public affairs.

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Teen Smoking, E-Cigarette Use Down

About 4 Million U.S. Teens Already Hooked On Nicotine

By Salynn Boyles, MedPage Today

Use of all tobacco products, including conventional and electronic cigarettes, declined among U.S. teens last year, according to the latest national survey data from the CDC.

Cigarette smoking among middle school and high school students continued a two-decade decline, falling to the lowest level ever recorded in the CDC’s 2015-2016 National Youth Tobacco Survey (NYTS). Results from the survey appear in this week’s Morbidity and Mortality Weekly Report, published online June 15.

Just 8% of high school students (6.9% female, 9.1% male) reported smoking cigarettes in the 2016 NYTS, compared to 36.4% of high school students surveyed in 1997.

teen smoking

And after dramatic increases in e-cigarette use among youth in recent years, use among middle school and high school students fell in 2016 for the first time since the products were first included in the NYTS in 2011.

“The good news is we’ve seen a decline in youth tobacco use during the past year, which was primarily driven by a decline in e-cigarette use,” said Brian King, PhD, of the CDC Office of Smoking and Health. “The bad news is that we still have 3.9 million youth in this country who are using tobacco products, and about half of them are using two or more products.”

In the 2015-2016 survey, among high school students, decreases were reported in current use of any tobacco product, any combustible product, use of two or more tobacco products, e-cigarettes, and hookahs.

Among middle school students, 4.3% reported e-cigarette use, while roughly 2% reported smoking traditional cigarettes or cigars or using smokeless tobacco.

In 2016, one in five high school students and one in 14 middle school students reported current use of a tobacco product on one or more days in the past 30 days.

E-cigarettes remained the most commonly used tobacco product among high school (11.3%) and middle school (4.3%) students. Between 2011 and 2015, use of e-cigarettes among high school students responding to the NYTS increased from 1.5% to 16%. Use of the products among high school students fell to 11.3% in the 2016 survey, but King told MedPage Today that it is too soon to say if the decline in youth e-cigarette use represents a trend.

teen smoking e-cigarette

“I think it’s clear that these products are not a fad, given the exponential increase in their use up until 2015,” he said. “They are the most commonly used tobacco products among youth in the U.S., with more than 2.2 million youths using them.”

While e-cigarettes are generally considered to be safer than cigarette smoking and are considered potential smoking cessation devices by some, King said they should not be considered safe for use by teens and younger children.

“Irrespective of any potential benefit that e-cigarettes might have for adult smokers who wish to use them to quit, youth should not be using any form of tobacco product,” he said. “We know that e-cigarettes typically contain nicotine, which is highly addictive and can also harm the developing adolescent brain. And the U.S. Surgeon General has also concluded that e-cigarette aerosol is not harmless and may contain other harmful ingredients including heavy metals, ultra-fine particulates, and volatile organic compounds.”

A separate report published in the latest MMWR adds to the evidence that e-cigarette use is associated with greater uptake of cigarette smoking among teens.

In the 2015 Oregon Healthy Teens survey of 8th and 11th graders, e-cigarette use was commonly reported as the first tobacco product used among responding teens who currently smoked cigarettes or used any tobacco product.

Alexander Prokhorov, MD, PhD, who directs the University of Texas MD Anderson Cancer Center Tobacco Outreach Education Program, said while the 2016 NYTS data show welcome declines in youth e-cigarette and hookah use, as well as conventional cigarette smoking, use of these emerging tobacco products among teens should be closely monitored.

“We seen similar declines in the past and the tobacco industry always finds a way to hook youth with new products,” he told MedPage Today. “The use of flavorings and other gimmicks are all done to get them interested.”

Teen Smoking News via

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Tobacco Trends Buried In Smoke

Disparities In Tobacco Use Among Races, Classes

Tobacco use is a major preventable cause of premature death and disease worldwide. Currently, approximately 5.4 million people die each year due to tobacco-related illnesses—a figure expected to increase to more than 8 million a year by 2030. An efficient and systematic surveillance mechanism to monitor the epidemic is one of the essential components of a comprehensive tobacco control program.

Smoking harms nearly every organ of the body, causing many diseases and affecting the health of smokers in general. Quitting smoking has immediate as well as long-term benefits for you and your loved ones.

lung cancer and smoking tobacco

Although cigarette smoking has declined significantly since 1964, disparities in tobacco use remain across groups defined by race, ethnicity, educational level, and socioeconomic status and across regions of the country.

  • Although African Americans usually smoke fewer cigarettes and start smoking cigarettes at an older age, they are more likely to die from smoking-related diseases than whites.
  • American Indians/Alaska Natives have the highest prevalence of cigarette smoking compared to all other racial/ethnic groups in the United States. Some American Indians use tobacco for ceremonial, religious, or medicinal purposes. For this reason, it is important to make the distinction between commercial and traditional tobacco use.
  • Cigarette smoking among Asian American/Pacific Islander adults is lower than other racial ethnic groups. However, prevalence varies among sub-groups within the Asian American/Pacific Islander/Native Hawaiian population.
  • Hispanic/Latino adults generally have lower prevalence of cigarette smoking and other tobacco use than other racial/ethnic groups, with the exception of Asian Americans.4,5 However, prevalence varies among sub-groups within the Hispanic population.
  • Cigarette smoking among LGB individuals in the U.S. is higher than among heterosexual/straight individuals. Nearly 1 in 4 LGB adults smoke cigarettes compared with about 1 in 6 heterosexual/straight adults.
  • People living below the poverty level and people having lower levels of educational attainment have higher rates of cigarette smoking than the general population.4,5 Among people having only a GED certificate, smoking prevalence is more than 40%, the highest of any SES group.
  • Approximately 25% of adults in the U.S. have some form of mental illness or substance use disorder, and these adults consume almost 40% of all cigarettes smoked by adults.
  • Tobacco use, including cigarettes, smokeless tobacco, and cigars, varies by geographic region within the United States. People living in certain regions and communities often suffer more from poor health because of tobacco use, especially cigarette smoking.1
  • By U.S. census region, prevalence of cigarette smoking among U.S. adults is highest among people living in the Midwest (25.4%) and the South (24.2%), and lowest among those living in the Northeast (21.3%) and West (18.0%) regions.2 People in the Midwest and South also tend to use multiple types of tobacco products, such as cigarettes and smokeless tobacco. The health of people living in rural areas is impacted by tobacco use more so than those in urban and metropolitan areas, often because of socioeconomic factors, culture, policies, and lack of proper healthcare. In general, rates of death attributable to smoking are lower in states with lower prevalence of smoking.

For support in quitting, including free quit coaching, a free quit plan, free educational materials, and referrals to local resources, call 1-800-QUIT-NOW (1-800-784-8669).

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Crossbow Communications is a full-service advertising agency and public relations firm in Denver, Colorado and Phoenix, Arizona. The PR firm specializes in issue management and public affairs. Write to Gary Chandler to learn more about our campaign to prevent teen smoking

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Cigarettes The Top Cause of Lung Cancer

Smoking Causes 80 Percent Of Lung Cancer

Cigarette smoking is the number one risk factor for lung cancer. In the United States, cigarette smoking is linked to about 80 percent to 90 percent of lung cancers. Using other tobacco products such as cigars or pipes also increases the risk for lung cancer. Tobacco smoke is a toxic mix of more than 7,000 chemicals. Many are poisons. At least 70 are known to cause cancer in people or animals.

People who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who do not smoke. Even smoking a few cigarettes a day or smoking occasionally increases the risk of lung cancer. The more years a person smokes and the more cigarettes smoked each day, the more risk goes up.

Doctors believe smoking causes lung cancer by damaging the cells that line the lungs. When you inhale cigarette smoke, which is full of cancer-causing substances (carcinogens), changes in the lung tissue begin almost immediately. Chemicals in cigarette smoke enter our blood stream and can then affect the entire body. This is why smoking causes so many diseases, including at least 14 types of cancer, heart disease and various lung diseases.

smoking and lung cancer

At first your body may be able to repair this damage. But with each repeated exposure, normal cells that line your lungs are increasingly damaged. Over time, the damage causes cells to act abnormally and eventually cancer may develop.

People who quit smoking have a lower risk of lung cancer than if they had continued to smoke, but their risk is higher than the risk for people who never smoked. Quitting smoking at any age can lower the risk of lung cancer.

Smoking causes more than 4 in 5 cases of lung cancer. Lung cancer survival is one of the lowest of all cancers, and is the most common cause of cancer death. Cigarette smoking can cause cancer almost anywhere in the body. Cigarette smoking causes cancer of the mouth and throat, esophagus, stomach, colon, rectum, liver, pancreas, voice box (larynx), trachea, bronchus, kidney and renal pelvis, urinary bladder, and cervix, and causes acute myeloid leukemia.

Smoke from other people’s cigarettes, pipes, or cigars (secondhand smoke) also causes lung cancer. When a person breathes in secondhand smoke, it is like he or she is smoking. In the United States, two out of five adults who don’t smoke and half of children are exposed to secondhand smoke, and about 7,300 people who never smoked die from lung cancer due to secondhand smoke every year.

Smokers have a much higher risk of lung cancer than non-smokers, whatever type of cigarette they smoke. There’s no such thing as a safe way to use tobacco.

Filters and low-tar cigarettes make little difference – your lung cancer risk is not lower compared to smokers of average cigarettes. This may be because smokers tend to change the way they smoke in order to satisfy their nicotine craving, for example by taking bigger puffs or smoking more cigarettes.

The more cigarettes you smoke a day, the higher your risk of cancer. If you aren’t able to quit completely, cutting down the number of cigarettes you smoke a day can be a good first step. Even light or social smoking can harm your health so keep trying to stop entirely.

Scientists have found that the number of years you spend smoking affects your cancer risk even more strongly than the number of cigarettes you smoke a day. For example, smoking one pack a day for 40 years is even more dangerous than smoking two packs a day for 20 years.

public relations and public affairs firm

Crossbow Communications is a full-service advertising agency and public relations firm in Denver, Colorado and Phoenix, Arizona. The PR firm specializes in issue management and public affairs. Write to Gary Chandler to learn more about our campaign to prevent teen smoking

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Tobacco Companies Target Blacks, Indians, Women

More Women Die Of Lung Cancer Than Breast Cancer

The best way to evaluate the issue of social and racial targeting is to analyze the facts. Smoking rates are higher among some racial subgroups than others, while smoking among people of lower socioeconomic status is much higher than those from middle and upper classes.

Black smokers are 50 percent more likely to die of lung cancer than smokers of other races. Each year, about 45,000 African Americans die from a smoking-related disease.

One possible explanation for a higher death rate among blacks is menthol cigarettes. This is a growing, minority-dominated market segment primarily consisting of blacks and Hispanics.

Menthol cigarettes deliver more tar and nicotine than other cigarettes, while numbing the throat. Because of the numbing effect, those who smoke menthol cigarettes typically inhale deeper than other smokers, which expose more of the lung to the smoke. In fact, African-American women are the most susceptible to menthol-related diseases. Although there are several varieties of menthol cigarettes, the Newport brand dominates this product category.

smoke cigar and cancer

Furthermore, studies have found a higher frequency of tobacco advertisements in publications that appeal to African Americans than in those that target general audiences. Before tobacco billboards were banned, another study found the highest density of tobacco billboards in African American communities and the lowest density in white communities. Plus, a study by the CDC and the U.S. Department of Health and Human Services found that blacks are less likely to quit their nicotine habit than white people.

The racial subgroup at greatest risk from tobacco-related diseases could be the American Indians and Alaska Natives. On one hand, tobacco is considered a sacred gift and has been used in their religious ceremonies for centuries. Complicating the issue, American Indian and Alaska Native lands are sovereign and are not subject to laws prohibiting the sale of tobacco products to minors. Therefore, Native American children have easy access to tobacco products at a very young age. As a result, 41 percent of male high school seniors from this population smoke, while 39.4 percent of female seniors smoke cigarettes.

native Americans and tobacco

The use of snuff and spit tobacco also is higher among Indian Americans and Alaska Natives than among other racial subgroups. About 4.5 percent of this population uses chewing tobacco or snuff, compared to 3.4 percent of whites, 3.0 percent of African Americans, 0.8 percent of Hispanics and 0.6 percent of Asian Americans and Pacific Islanders. Tobacco companies promote directly to these audiences by sponsoring cultural events, such as powwows and rodeos.

In addition to racial subgroups, tobacco companies are targeting women, with images of slender and attractive users who are independent, confident and popular. Tobacco companies have targeted women since the 1920s. In fact, one of the earliest tobacco pitches aimed at women said, “Reach for a Lucky instead of a sweet.” Later, women were told they deserved a Virginia Slim cigarette with the campaign, “You’ve come a long way, baby.”

teen smoking

Between 1991 and 1999 alone, smoking rates among high school girls increased by nearly 30 percent (from 27 percent to 34.9 percent). Since only 18 percent of adult women smoke, these teens will boost smoking rates among women as they age. As a consequence, lung cancer among women is increasing and has been the leading form of cancer among women since 1987. About 1.5 times more women die from lung cancer than breast cancer—68,000 each year.

All tolled, about 173,000 American women die each year from tobacco-related diseases. Women now account for about 39 percent of all tobacco-related deaths—a proportion that has doubled since 1965.

In addition, about 20 percent of pregnant women in the U.S. smoke. Many other expectant mothers are exposed to second-hand smoke. The dangers include miscarriage, mental retardation, low birth weight and a variety of other complications that can require neonatal intensive care.

In May 2001, The World Health Organization (WHO) urged governments around the world to do more to reduce smoking-related diseases among women. It pointed to aggressive tobacco marketing and exposure to second-hand smoke as the cause for increases in related diseases in a 222-page study, “Women and the Tobacco Epidemic—Challenges for the 21st Century.”

public relations and public affairs firm

Crossbow Communications is a full-service advertising agency and public relations firm in Denver, Colorado and Phoenix, Arizona. The PR firm specializes in issue management and public affairs. Write to Gary Chandler to learn more about our campaign to prevent teen smoking

Posted in Cigarettes, Health, Research, Second-Hand Smoke, Tobacco Education, Women | Tagged , , , , | Leave a comment

Tobacco Company Documents Explain Marketing Strategy

Targeting the Young, Poor, Black and Stupid

Tobacco kills approximately six million people around the globe every year, including 443,000 Americans. Unchecked, tobacco-related deaths will increase to more than eight million a year by 2030, and 80 percent of those deaths will occur in the developing world. Ironically, you won’t find many tobacco executives who smoke. They know better.

“That’s a right we reserve for the young, poor, black and stupid,” said one tobacco executive in a closed-door meeting.

teen smoking statistics

When it comes to tobacco marketing, the facts speak for themselves. About 80 to 90 percent of new smokers are teenagers. This includes almost 20 percent of all eighth graders. According to tobacco company documents, these companies actually target young people to replace the sales and profits once generated by smokers who have died or quit.

A variety of lawsuits have pressured the tobacco companies to open their files for closer public scrutiny. These documents have outlined several secrets and sensitive issues including:

  • In 1962, RJR senior researcher Alan Rodgman wrote a controversial paper where he said that the amount of evidence accumulated to indict cigarettes as a health hazard was “overwhelming;”
  • A series of Philip Morris studies called “Shock I-V” administered electric shocks to college students to see if the stress caused the study subjects to smoke more. The studies were conducted from 1969-1972;
  • A 1973 RJR memo says that to lure “younger smokers” away from Philip Morris’ Marlboros, the leading teen-age brand, “comic strip type copy might get a higher readership among younger people than any other type of copy.” The document defined “younger smokers” as ages 14 to 24. Shortly thereafter, the Joe Camel character debuted in France. He came to the U.S. in 1987, and Camel rose to become the number two brand among teen-agers;
  • A 1981 internal memo indicates that Philip Morris was concerned about the decrease in young smokers and the trend’s effect on cigarette sales. The memo was addressed to the vice president of research and development at Philip Morris and spoke of the smoking habits of children as young as 12. The memo said, “today’s teen-ager is tomorrow’s potential regular customer…Because of our high share of the market among the youngest smokers, Philip Morris will suffer more than the other companies from the decline in the number of teenage smokers;”

teen smoking

  • A scientist found a way to remove carbon monoxide, a key contributor to heart disease, from cigarette smoke in the 1970s. Tobacco lawyers suppressed his discovery.       Publishing the work “would have constituted an admission on the part of the company that carbon monoxide was in smoke,” said one lawyer, and the scientist said his bosses thought the process was too expensive;
  • In the 1950s, when RJR’s top scientist attempted to isolate one of tobacco’s worst carcinogens, then-president Edward Darr responded: “Do we really need to be doing that kind of work?”
  • In July 1963, Addison Yeaman, an attorney for Brown & Williamson, wrote a memo that said, “We are, then, in the business of selling nicotine, an addictive drug.” He added that cigarettes ease stress and prevent weight gain, but also “cause or predispose” smokers to lung cancer, contribute to heart disease and “may well be truly causative in emphysema, etc., etc.” Despite this knowledge, the company chose to hide it from the U.S. government and the public. Meanwhile, the first U.S. Surgeon General report on smoking was issued just six months later, but could not yet prove that cigarettes caused any of those problems identified by Brown & Williamson;
  • An RJR memo shows that in 1972 the company concluded that smokers pick a brand based on their nicotine dosage requirements and secondarily by a variety of other factors, including flavor. When this evidence surfaced in 1995, RJR became the third tobacco company known to refer to its products as nicotine deliverers. Similar memos from Brown & Williamson and Philip Morris already had been discovered. As a result, the Food and Drug Administration unsuccessfully proposed classifying cigarettes as medical devices so it could regulate cigarettes;
  • In 1977, B.A.T. Industries, PLC debated adding an obscure narcotic called etorphine to its cigarettes. It described the drug as “10,000 times more addictive than morphine;”
  • In 1984, RJR concluded in a secret report that it needed to pitch its cigarettes to young adults to “replace” other smokers, according to court papers filed in Minnesota’s lawsuit against the tobacco industry. The marketing report cited federal information that showed smokers begin as early as 12 and rarely begin after they turn 25 years old. Based on these facts, the report suggested the company aggressively market to younger people;
  • “Younger adult smokers are critical to RJR’s long-term performance and profitability. Therefore, RJR should make a substantial long-term commitment of manpower and money dedicated to younger adult smoker programs,” the report said. “If younger adults turn away from smoking, the industry must decline, just as a population that does not give birth will eventually dwindle,” said the report;
  • A 1987 memo stamped “RJR Confidential” discusses a project code-named “LF,” where the company created a wider circumference, non-menthol cigarette targeted at young adult smokers (primarily 13-24 year-old male Marlboro smokers). Camel Wides eventually were sold.

teen smoking and tobacco marketing

  • In 1994, Dr. Victor DeNoble, a former scientist for Philip Morris testified that the company ordered him not to publish his research on nicotine addiction when it was completed in 1984. Shortly thereafter, his lab was abruptly shut down. DeNoble’s lab was trying to develop a nicotine analogue—a substance that would mimic the effects of nicotine on the nervous system, without affecting the cardiovascular system. DeNoble said his team found that lab rats would administer nicotine into their veins when given the opportunity;
  • In 1995, an undated Philip Morris memo surfaced, which cited data from 1992, and likened nicotine to cocaine, leaving little doubt that the world’s biggest tobacco company viewed nicotine as addictive. It called nicotine a “similar organic chemical” to drugs, including cocaine and morphine and acknowledged “nicotine’s particularly broad range of influence;”      
  • Jerome Rivers, an RJR scientist, testified that ammonia is used in cigarettes to deliver more nicotine into the smokers’ lungs;
  • In 1995, two internal documents from Brown & Williamson surfaced and revealed that leading U.S. tobacco companies enhance nicotine delivery to smokers, but not by adding nicotine per se. Instead, marketers add ammonia-based compounds to cigarettes to increase the potency of the nicotine a smoker actually inhales;
  • Several RJR documents revealed that the company tried to attract underage smokers. One 1987 document—stamped “RJR Secret”—discussed the planned introduction of a new version of Camel aimed at “younger adult male smokers (primarily 13-24 year-old male Marlboro smokers);”
  • Lorillard Tobacco company documents also have been very revealing. A 1977 memo from researcher Harry J. Minnemeyer to Alexander Spears discussed the company’s “nicotine enrichment project.” Another memo from T.L. Achey to then-president Curtis Judge discussed youth marketing. Company executives said that high school students were the core of Lorillard’s business and worried about losing market share to rival brands. Achey suggested developing a menthol brand to compete with Marlboros, which was popular with young smokers;
  • In the 1970s, Philip Morris used pollsters to learn more about youngsters and their smoking habits;
  • A 1972 memo by Philip Morris scientist Al Udow said market research suggested that Kool cigarettes were considered the best “after marijuana” cigarette to smoke to maintain a “high.” Udow stated in the memo that king-size Kool had the highest nicotine “delivery” of all king-size cigarettes. He said that may explain Kool’s success and it suggested a route for us to follow to capture some of Kool’s business;”
  • In 1973, RJR concluded that Philip Morris’ Marlboros had higher free-nicotine levels than the RJR brands, thus providing a greater nicotine kick and a competitive edge over RJR’s brands;

lung cancer and smoking tobacco

  • Tobacco companies allowed candy cigarette companies to make their candy and the packages look like the real brands;
  • In 1996, Ian Uydess, a former senior scientist for Philip Morris testified that the company invented a machine to measure the brain waves of smokers. At certain levels, “nicotine appeared to mimic addictive substances like cocaine;”
  • One tobacco industry document from a lawyer for the Liggett Group claimed, “Cigarettes kill people beyond a reasonable doubt;”
  • A document from a researcher at Lorillard Company suggested that industry lawyers had “thwarted” scientists’ desire to test the safety of cigarette ingredients;
  • In 1997, RJR Nabisco Holdings’ chairman said “…I have always believed that smoking plays a role in causing lung cancer. What that role is, I don’t know, but I believe it.” In a pre-hearing deposition, he also said that the addictive properties of nicotine could deprive a smoker of free will.

public relations and public affairs firm

Crossbow Communications is a full-service advertising agency and public relations firm in Denver, Colorado and Phoenix, Arizona. The PR firm specializes in issue management and public affairs. Write to Gary Chandler to learn more about our campaign to prevent teen smoking

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Nicotine More Addictive Than Cocaine, Heroin

Chemical Additives A Deadly Cocktail In Tobacco

Contrary to statements by tobacco company spokesmen, tobacco products are extremely addictive and deadly. It’s become a science for marketing purposes.

Most smokers wish that they had never started their ugly habit. The nicotine and the additives such as ammonia make cigarettes extremely addictive and deadly. In fact, nicotine is more addictive than alcohol, cocaine and heroin.

In 1992, Barbara Reuter, a director of portfolio management for Philip Morris, wrote a memo that said, “Different people smoke for different reasons. But, the primary reason is to deliver nicotine into their bodies. Similar organic chemicals include nicotine, quinine, cocaine, atropine and morphine.”

lung cancer and smoking tobacco

One of the reasons tobacco is so addictive is that about 4,000 chemicals have been found in cigarettes including 200 known poisons and several known carcinogens. Chemicals such as  ammonia, are added because they release more nicotine from the tobacco leaf when burned. This gives the cigarette a greater “kick” and makes it more addictive. It’s the same concept as free-basing cocaine. In the United Kingdom, more than 600 additives are allowed in cigarettes and other countries are equally liberal with Big Tobacco.

“Some additives such as ammonia may make cigarettes more addictive, while sweeteners make them more palatable for children,” said Amanda Sanford, research manager with the UK’s Action on Smoking and Health. “Unless tobacco companies can prove that these additives don’t have these properties, they should be banned.”

Because of these chemicals and the natural dangers of tobacco smoke, the U.S. Environmental Protection Agency (EPA) has classified Environmental Tobacco Smoke (ETS) as a Group A carcinogen—the most deadly category of cancer-causing agents.

In addition to additives, tobacco companies have tried other tactics to boost nicotine levels to make cigarettes more addictive and more profitable. Liggett boosted its nicotine yields by 70 percent between 1955 and 1957, despite adding new filters to many brands.  Furthermore, tobacco companies conducted research projects in Brazil in attempts to engineer plants that produced more nicotine. More nicotine would lead to more addicted smokers and more profit. As a result, “crazy tobacco” and Y-1 were developed by Brown & Williamson, which admitted using these powerful tobacco blends in Viceroy, Richland, Raleigh and other tobacco brands.

The experiments and the additives have paid big dividends to the tobacco companies. As a result, most who experiment with tobacco become addicted almost immediately. Furthermore, approximately seven of 10 current American smokers have tried to quit at least once. About 23 million American smokers (half of all smokers) try to quit smoking each year, but fewer than 10 percent succeed. Meanwhile, about 70 percent of adolescent smokers would not start if they could choose again. Theses statistics confirm what a viscous circle smokers face and how effective the chemical conspiracy has been. In fact, smokers now are paying up to $20 for individual cigarettes that have been soaked in embalming fluid (a combination of formaldehyde, methanol, ethanol and other solvents) and then dried. The formula induces hallucinations, euphoria, invincibility, increased pain tolerance and other effects that can last up to three days.

It only takes nicotine seven seconds to stimulate the brain. It takes heroin 15 seconds to stimulate the brain. This instant gratification makes nicotine even more addictive. In lab tests, rats will administer nicotine into their veins when given the opportunity.

Another reason the grip of nicotine is so powerful is because it works as a stimulant and a sedative, depending on the amount of nicotine in the body and the mindset of the person consuming it. As smokers know, the first cigarette of the day often works as a stimulant. As the day progresses, cigarettes usually have more of a soothing affect. As a result, smokers have a variety of motivations to smoke their next cigarette, ranging from, “I need a cigarette,” to “I have earned one.”

“The tobacco industry is like a specialized, highly ritualized, and stylized segment of the pharmaceutical industry,” wrote Claude Teague in a 1972 RJR research-planning document. “Tobacco products uniquely contain and deliver nicotine, a potent drug with a variety of physiological effects.”

tobacco addiction

Nicotine is in a class of compounds called alkaloids, which includes cocaine, morphine, quinine, and strychnine. Plants typically produce these compounds as a toxic defense mechanism against natural predators.

Nicotine can increase alertness, improve mood, and sharpen short-term memory—making it very addictive. Nicotine speeds up the flow of glutamate, a neurotransmitter chemical in the brain. This increases the firing rate of the synaptic signals through the brain. The human body quickly can become addicted to these temporary, mind-altering changes. Dopamine also is produced when nicotine reaches the brain, which stimulates nerve activity.

“The rush of nicotine into the blood stream and nervous system is short-lived,” claims a 1976 memo at British American Tobacco. “Therefore, reducing consumption would cause withdrawal and all of its unpleasant side effects. Nicotine vacates the system in 30 minutes or so and at that time, withdrawal starts.”

Tobacco companies studied these pharmacological effects to improve their understanding and control of the smoker’s mind and wallet. Philip Morris invented a machine to monitor human brain waves and their response to nicotine. For instance, Ian Uydess, a former Philip Morris senior scientist summarized one of his studies by concluding, “At certain levels, nicotine appeared to mimic addictive substances such as cocaine.”

public relations and public affairs firm

Crossbow Communications is a full-service advertising agency and public relations firm in Denver, Colorado and Phoenix, Arizona. The firm specializes in issue management and public affairs.

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E-Cigarettes Take Hit From Surgeon General

Vaping Not A Safer Way To Consume Nicotine

The surgeon general on Thursday called the skyrocketing use of e-cigarettes among youth “a major public health concern,” saying that while more research needs to be done on its potential harms, policymakers should take strong action to keep the products out of the hands of the nation’s young people.

“We know enough right now to say that youth and young adults should not be using e-cigarettes or any other tobacco product, for that matter,” Surgeon General Vivek H. Murthy said in an interview. “The key bottom line here is that the science tells us the use of nicotine-containing products by youth, including e-cigarettes, is unsafe.”

teen smoking e-cigarette

E-cigarettes are now the most commonly used form of tobacco among young people in the United States, having surpassed conventional cigarettes in 2014. During the past five years, the number of middle school and high school students who report having used e-cigarettes has tripled. Among young adults ages 18 to 24, the number has doubled.

Public health officials say that the sharp rise is troubling, in part, because of how much researchers still don’t know about the long-term effects of vaping.

For example, while e-cigarettes are widely believed to contain fewer toxic substances than traditional cigarettes, scientists have shown that the vapor from e-cigarettes isn’t entirely harmless. In addition, while Tuesday’s report stops short of saying e-cigarettes are a gateway to smoking, it found that vaping “is strongly associated with the use of other tobacco products among youth and young adults, particularly the use of combustible tobacco products.”

“A report of the surgeon general is the gold standard,” said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids. “This doesn’t answer all the questions people have about e-cigarettes, but it provides a scientific base to guide policy decisions and future discussions. This report makes clear the importance of doing everything we can to decrease the use of e-cigarettes by young people and the need for regulation to accomplish that goal.”

teen smoking

Tobacco-control advocates and public health leaders have insisted that the rise in the popularity of ­e-cigarettes stems in part from aggressive marketing campaigns that borrow from the tobacco industry playbook of earlier generations. Thursday’s report echoes those concerns and calls for strict regulation of marketing aimed at young people.

E-cigarette firms have supported minimum age requirements for their products, and industry groups such as the Smoke-Free Alternatives Trade Association insists its members “have not and do not market to minors.” But public health officials say that not all manufacturers live up to that standard and have enticed young people with slick advertisements and an assortment of flavors, from bubble gum to piña colada.

“Companies are promoting their products through television and radio advertisements that use celebrities, sexual content, and claims of independence to glamorize these addictive products,” Tom Frieden, director of the Centers for Disease Control and Prevention, wrote in a forward to Thursday’s report.

Others suggest those concerns may be misguided. Michael Siegel, a tobacco-control researcher at Boston University’s School of Public Health, said that despite fears about e-cigarettes being a gateway to smoking, existing scientific evidence doesn’t support that conclusion.

“Although electronic cigarette uptake has skyrocketed among youth, cigarette smoking has fallen at historic rates. This would be nearly impossible to explain if electronic cigarettes were causing a substantial number of youths to start smoking,” Siegel, who had not yet seen Thursday’s report, said in an email. “While the surgeon general is rightfully concerned about the emergence of a vaping culture among young people, the truth is that this vaping culture is helping to displace a smoking culture. All in all, this is a good thing.”

Siegel said he agreed with the goal of keeping young people off e-cigarettes, as well as traditional cigarettes. “But it is important that people understand the actual public health implications of the emergence of vaping,” he said, “and it is nothing close to what the surgeon general has suggested.”

Thursday’s report focuses exclusively on youth use of e-cigarettes and steers clear of the broader, public health questions surrounding what has become a $3.5 billion industry: Will vaping prove to be a healthier alternative that helps adults quite cigarette smoking and reduce overall tobacco-related deaths? Are e-cigarettes unequivocally less harmful than tar-laden, chemical-filled cigarettes, as a growing body of research seems to suggest? Should they be regulated exactly the same way as traditional tobacco products?

Murthy said Thursday’s report didn’t aim to address those larger questions. Its primary purpose, he said, was to detail the clear risks of e-cigarettes to youth and to give parents, teachers and other adults guidance on how to prevent young people from using them.

“In order to address tobacco in America, we need a multipronged approach,” he said. “What’s at stake here is really protecting the next generation from nicotine addiction and tobacco-related disease.”

This spring, the federal government for the first time began regulating the booming e-cigarette market two years after it first said it intended to do so. The regulations include a ban on the sale of e-cigarettes to anyone under age 18. They also require manufacturers to disclose their ingredients and submit their products to the government for approval.

Teen Smoking News via

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