Surgeon General Report on E-cigarette Use – Part 1

ecig_tweetThe U.S. Surgeon General released a new report December 8, 2016, titled “E-Cigarette Use Among Youth and Young Adults” which gives the facts and the risks associated with using these devices.  One fact that cannot be ignored is e-cigarettes contain nicotine and “exposure during adolescence can cause addiction and disrupt attention and learning, as well as harm brain development, which continues to about age 25.”

Electronic cigarettes, or e-cigarettes, have evolved rapidly from disposable devices that look like cigarettes into personalized, refillable devices known as e-hookahs, vape pens, mods or tank systems.  No matter the device, they all work on the same premise: a liquid, usually containing nicotine, flavorings, and other additives, is heated by means of a rechargeable batter which turns into an aerosol to be inhaled.  Teen use has skyrocketed since 2011:  Middle school use has increased from 0.6% to 5.3% in 2015 while high school use has increased from 1.5% to 16.0% during the same time period.

Many users may not even be aware the devices contain nicotine which may affect brain development.  Teen brains are still growing and developing which causes them to become addicted to nicotine more easily.  Decision making and impulse control is not yet learned and exposure to nicotine puts them at risk for addiction to other drugs, “mood disorders and permanent lowering of impulse control.”  The use of e-cigarettes “is strongly linked to the use of other tobacco products, such as regular cigarettes, cigars, hookah, and smokeless tobacco.”  And those teens and young adults who use e-cigarettes “are more likely to to try conventional cigarettes in the future” versus those who never use e-cigarettes.

Other risks, such as the aerosol, chemicals in flavorings, and battery explosions have issues of their own.  The aerosol particles are much finer than conventional tobacco smoke and can travel deeper into the lungs, carrying with it the chemicals in the flavorings. While the devices haven’t been on the market long enough for scientists to study all the chemicals and their effects, researchers have identified benzene, “heavy metals, such as nickel, tin and lead,” and “diacetyl, a chemical linked to a serious lung disease.”  There is also concern for those in the vicinity who may be exposed to the exhaled aerosol.  And exploding e-cigarette batteries have caused serious injuries and are frequently in the news.

We live in a time of great information and choices.  Cigarettes have been available for over 100 years and doctors and scientists are still learning about new dangers caused by their use.  We don’t have years of research on the dangers of electronic cigarettes to draw from, but the findings so far should be cause for alarm.

Coming Monday:  Surgeon General Report on E-cigarette Use – part 2

Click HERE for the Surgeon General site and the report.

 

 

 

 

 

 

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“Take Back the Shelves”

Consider this: the number one preventable cause of death in the U.S. is being sold in more than 50,000 pharmacies, places where you go for “health information and services.”   “DoSomething.org, a global movement of over 5.5 million young people and truth, the most successful tobacco prevention campaign, are asking young people to let their voices be heard through a campaign called  Take Back the Shelves.  Between now and December 31, 2016, the campaign wants you to be creative, use social media, and “demand that pharmacies remove tobacco from shelves.”

By going to the DoSomething.org/shelves site, you can not only sign up for the campaign, you can learn the tactics used by the “tobacco companies to attract young consumers.”  Then download a template and create artwork with items you want to see behind the counters instead of tobacco products.  Use the tag #TakeBacktheShelves to share your drawings on social media and tag a “pharmacy to ask them to remove tobacco products from their shelves.”

In 2014 CVS Health removed tobacco products and were successful with their campaign.  Now DoSomething.org and truth are “asking pharmacies to remove tobacco products altogether because we believe this can be the generation to end smoking for good.”  Let’s hope this is the generation to end smoking for good and #FinishIt.

Click on the highlighted links above to learn more about the campaigns and sign up.
Click HERE to read the entire article.

 

 

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Tobacco plays a role in addiction

facing_addictionA new report, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health, has been released.  While tobacco is mentioned throughout the report, other Surgeon General reports cover the topic extensively.  Still, tobacco does play a part with addiction and substance abuse of other drugs.

According to the report “many individuals with a substance use disorder also have a mental disorder as well, and some have multiple substance use disorders.”  For example, tobacco smoking is much higher “among patients with schizophrenia,” while smoking and alcohol use seem to combine for those with PTSD.  Researchers are not clear why “substance use disorders and mental disorders often occur together” but give three possible explanations.

One is that using certain substances can temporarily reduce the mental disorder symptom, sort of a negative reinforcement.  Another explanation is that certain substances could trigger a mental disorder that otherwise may not have occurred.  The final reason is that both the substance use and mental disorder are caused by overlapping factors, such as genes, traumatic or stressful life experiences or neurobiological deficts.

Could some of these substance uses trigger pre-existing neurobiological factors in adolescents whose brains are still undergoing significant development? While it is true not all adolescents who experiment develop a substance use disorder, researchers will need more longitudinal studies to determine “how adolescent substance use affects brain structure and function.”  In the meantime, school-based and family-based programs of education and intervention can help delay “early use of alcohol, tobacco and other substances,” and can continue to delay use for years after the programs.

The Florida Tobacco Prevention Training for Educators online course is an educational program designed to teach students about the health dangers of tobacco.   The course allows teachers to take our 30- or 60-point course and teach tobacco prevention to their students in exchange for points to renew their FLDOE certificate.  Preventing tobacco use among our Florida students now may also prevent or decrease other substance use in the future.

Click HERE for the Surgeon General’s Report
Click HERE for the Florida Tobacco Prevention Training for Educators online course

 

 

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The latest in tobacco news – Trinkets and Trash October edition

Every month, like clockwork, we receive the latest addition of Trinkets and Trash, the “surveillance project” that “monitors the tobacco industry marketing” through many different channels.  The report is not only informative and educational, it is entertaining as well.  You learn the newest methods the tobacco industry is resorting to in order to keep their customers while hooking new smokers to this lifestyle.

Winston, once owned by Reynolds, is now a member of the Imperial Tobacco Group (ITG) winstonalong with Kool, Salem, blu e-cigs, Phillies and more.  They are getting back into magazine advertising with an image that is “evocative of freedom and chance” and clearly hopes to grab the attention of the youth market.  Not much freedom if you have to pull over and stop before smoking.  The pack now features an eagle above the brand name, reminding you this is an American cigarette, headquartered in the United Kingdom. Did you know that ITG is also slang for In The Grove?   They want you to be “all in or not at all.”  We’re sticking with “not at all.”

camoCopenhagen had a sweepstakes allowing players to use a hunting simulator and decide if they would take the shot or wait for a better opportunity.  Players who took a shot received a free gift of meat rub, which probably tastes a lot better than a lip of tobacco.  Oh, and don’t forget the camo cans are back for hunting season.  Don’t you hate it when your tobacco product fails to blend in with your surroundings?  Not to be outdone, Virginia Slims is offering a “Style Spree” where “you and a friend get an all expense paid $25,000 shopping spree in New York City with a professional stylist and a hair and makeup tutorial.”  And to get you ready you get “chic style tips” but you need to log in daily.  You may even be an instant winner of a “chic scarf.”  They may have missed the message that being chic or “elegantly and stylishly fashionable” happens without tobacco in your life.

humpWhile Joe Camel is no longer with us, he hasn’t totally disappeared as his hump is still making news. In their bid to keep in the forefront of the minds of smokers, Camel reminisces about the good times by having “Hump Day” promotions.  They are thanking users for checking out the Hump, and gifting them with a box of fireball whiskey-flavored marshmallows.  At least this will clear that taste of smoker’s mouth.

If you would like to keep up with all the tobacco news, marketing campaigns, and other information not covered in this blog, subscribe to Trinkets and Trash.

 

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The Un-American Lie – A Personal Essay

The Florida Tobacco Prevention Training for Educators on-line course is always excited to share the writing assignments of our participants with the public.  The essays may involve their own struggles with tobacco or the struggles of family members, but they are always heartfelt and deeply personal.   In the end it makes you question why anyone today would want to use tobacco knowing the information we have available on its health effects.   We thank Dr. Juan R. Céspedes from Miami-Dade County Public Schools for allowing us to share his essay.

The Un-American Lie:

Methods Through History Used to Distort Facts and Promote Tobacco Products Through Channels That Would Be Unacceptable Today

As an avowed free-marketer, the instincts of this writer as a young twenty-something was that all advertising, including cigarette advertising, should be left to the market forces of supply and demand. As Dr. Monica Barratt (2016) might ask, “What if you live on top of a bakery and you like cakes?” It follows that you should

1940s Competidora Gaditana Cuban Cigarettes

1940s Competidora Gaditana Cuban Cigarettes

eat as much cake as you like and is available. That was until Uncle Jack died a prolonged and miserable death from throat cancer. Jack started smoking a young teen in Cuba, a habit that he continued when he came to the United States (see appendix “A”: The Cuban Tobacco Connection). He found American cigarettes milder than the Cuban brands he was accustomed to. It followed that they were somehow “better” or “not as bad” (Uncle Jack’s own words). Jack was unaware of the ingredients baked into the “cake” he was inhaling. Uncle Jack had been a smoker for most of his life, and although he had quit the addictive habit when he was in his early fifties, its effects came back to kill him by the time he was in his sixties. For the purposes of this paper, the writer will focus on the cigarette merchandising during the decades of the 1930s to the 1960s. 

You can read the remainder of Dr. Céspedes’ essay in our December Tobacco Prevention Training newsletter HERE.

 

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2016 Great American Smokeout

smokeout1The third Thursday of November is here!  It is time once again for the American Cancer Society Great American Smokeout event, urging smokers to put down the cigarettes for one 24-hour period of time.  Quitting for just one day can put you one step closer to quitting for good and on the path “toward a healthier life and reducing your cancer risk.”

In 1964, the year the first Surgeon General’s Report on Smoking and Health was published, about 42% of Americans smoked. By the time of the first Smokeout in 1977, that number had been reduced to about 34%.  Since then, workplace smoking bans have been implemented and smoking in public has been reduced.  Higher cigarette taxes have helped keep teens from starting and have helped current smokers quit.   Here in Florida adult cigarette smoking has dropped from 21.0% in 2006  to 15.8% in 2015.  High school smoking rates have also dropped from 15.5% in 2006 to 5.2% in 2016, a 66.5% decrease.

Quitting may be difficult but your family and friends are there to provide support. Additional support can be found by calling the number above in the picture, searching the web for quit smoking sites, or clicking on one of the links before.  And if you have thought about quitting your smokeless tobacco habit, now is a great time too.

Click HERE for more information about The Great American Smokeout.

Smoking:  Smokefree.gov
Smoking:  Tobacco Free Florida
Smoking:  UCanQuit2.org is an education campaign for the U.S. military
Smokeless tobacco:  Kill the can
Smokeless tobacco:  Quit smokeless

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No special film rating when tobacco is shown

mpaaOn Friday, November 11, a U.S. District Court judge ruled that the Motion Picture Association of America is allowed to assign whatever rating they want — G, PG, or PG-13 — to a movie that depicts tobacco use.  His ruling rejects “an argument that the practice is a form of commercial speech that dangerously encourages kids to smoke.”

The suit was brought against the MPAA and the National Association of Theatre Owners  by Timothy Forsyth, a father who took his two kids to a PG-13 film and was angered by the “tobacco imagery” on the screen.  He felt tobacco scenes should require an “R” rating unless “the dangers and consequences” of its use is reflected in the story or it represents “a real historical figure who actually used tobacco.”  His argument was that movie ratings are “pure commercial speech,” making them subject to restrictions that protect the public interest.”

Forsyth used arguments from the 2012 Surgeon General’s report, as well as statistics from the Center for Disease Control 2014 report that stated “exposure of children to tobacco imagery in films causes children to smoke.”  A 2016 report found between 2002 and 2015 tobacco use and smoking was in 59% of PG-13 movies.

The judge didn’t buy the arguments and instead said “movie ratings are a form of protected speech.”  The films themselves “are not mere commercial produces (sic) but are expressive works…and plainly entitled to full First Amendment protection.”  MPAA’s Classification and Rating Administration (CARA) did say “it would consider tobacco imagery as a factor in assigning ratings,” but said a mandatory “R” rating is out of the question.

Click HERE for the entire article.

 

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The military is slowly winning the war on tobacco use

On Veteran’s Day we honor the men and women who have chosen to serve our country in the military.  Whether they joined during a time of war or during peacetime, they all made sacrifices to fulfill their obligations.  Some made the ultimate sacrifice during battle, while others continue to battle long after their service is over.  Many of our veterans became addicted to tobacco during their time of service from free cigarettes handled out with their rations during wartime, and reinforced by cheap tobacco prices at the commissaries.  It is just recently that this problem is being addressed.

military_smokingVA information states 57% of the US civilian population claims they have never smoked cigarettes, but only 32% of Veterans can make that same claim.  While about 17% of the adult U.S. population 18 years or older currently smoke cigarettes, according to the CDC, those numbers are much higher for VA enrollees.  Of the current VA enrollees who are current smokers, 28.8% in the 30 or younger age group are the highest smokers, followed by the 50-64 age group at 28.6%.  Those in the 31-49 age group aren’t far behind at 23.6%.  Those in the 65 or older age group make up the largest percentage of VA enrollees, but the smallest group of smokers at only 10.8%.

In 2014 the Senate Appropriations defense subcommittee approved a “spending bill that warwould eliminate the 25 percent discount that members of the armed services enjoy when buying tobacco products at commissaries and elsewhere, including cigarettes and chewing tobacco.”  The low cost of tobacco ends up meaning a higher cost of health care and productivity losses for the defense department to the tune of $1.6 billion each year.

The good news is that while tobacco numbers in the military are still higher than the civilian population, tobacco sales “have steadily declined since defense officials began taking steps to reduce smoking in the ranks about 20 years ago, through a variety of efforts.”   In fact between 2014 and 2015, a 11% decrease was noted by the Army and Air Force Exchange Service.  It is good to see measures in place to protect our service men and women from unnecessary suffering from the tobacco industry.  It is one war they shouldn’t have to fight.

Click HERE and HERE on articles regarding tobacco in the military.
Click HERE for Quit Tobacco to find support for the U.S. military, sponsored by the DOD

 

 

 

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November is American Diabetes Month 2016

diabetes1Every November the American Diabetes Association focuses on raising “awareness and to create a sense of urgency about this growing public health crisis” of diabetes.  One out of every 11 Americans, more than 29 million, has diabetes.  And another 86 million adults “are at high risk of developing type 2 diabetes” in the United States.  This year the theme of the campaign is “This is Diabetes” and they want those with diabetes to share their story.

There are three types of diabetes, Type 1, Type 2 and Gestational diabetes.  Type 1 diabetes, formally known as juvenile diabetes, usually occurs in children and young adults. It is considered an autoimmune disease because the body “attacks and destroys the beta diabetescells” in the pancreas which produce the insulin.  While heredity plays an important role in who might develop this type of diabetes, “environmental factors, such as foods, viruses, and toxins, may play a role” in the development as well.  Those diagnosed with Type 1 diabetes “will need insulin shots or an insulin pump to control their blood glucose levels.”

Type 2 diabetes is the most common form, affecting millions in the U.S.  Those affected are often “middle-age and older who are also overweight or obese.”  The body produces insulin, but it is either not enough or the body is unable to use the insulin effectively.  As with Type 1 diabetes, genetics and “environmental factors are the most likely triggers of type 2 diabetes.”

Gestational diabetes occurs during pregnancy and may be “caused by hormonal changes and metabolic demands of pregnancy together with genetic and environmental factors.” Women who are overweight or obese, or those with a family history of diabetes are at a higher risk for gestational diabetes.

What does diabetes have to do with tobacco?  “Smokers are 30-40% more likely tocomplications develop type 2 diabetes than nonsmokers.”  And those with diabetes who use tobacco are “more likely to have trouble with insulin dosing and controlling their disease.”  Not only will smoking cause issues with diabetes, it can cause other serious complications including heart and kidney disease, poor blood flow to legs and feet which could lead to other problems including amputation, retinopathy (an eye disease that can cause blindness), and peripheral neuropathy (damaged nerves to the arms and legs that causes numbness, pain, weakness, and poor coordination).

Talk to your doctor about any symptoms you may have and discuss your family history.  If you smoke or use tobacco, quitting will improve your overall health and help with insulin control.  Educate yourself about how you can manage your diabetes through diet, weight lose, and try to stay active to keep yourself as healthy as possible.

Click HERE for the article “Causes of Diabetes” and HERE for the “American Diabetes Month 2016: This is Diabetes” information and how you can share your story.

 

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Cancer Mortality Due to Smoking

“What proportion of cancer deaths are attributable to cigarette smoking in each U.S. state?”  That was the key question asked in a new study reported in JAMA Internal Medicine published on-line October 24, 2016.  According to the results, at least a third of the men in every state (except Utah) and “at least 20% of women in all states” (except Utah, California, and Hawaii) are dying from cancer due to smoking.”  Those numbers are even higher in some southern states which, not surprising, also have lower tobacco taxes.  Although smoking has been cut in half since 1964 when “the first Surgeon General’s Report on the health hazards of cigarette smoking” came out, 40 million adults still smoke despite everything we know about the dangers of tobacco.

cancer_deathsAccording to the report in 2014 28.6% of all cancer deaths in the U.S. “were attributable to cigarette smoking,” with more deaths occurring in men (62.0%) than women (38.0%).  Those living in Southern states took the biggest hit in deaths in men where “smoking accounted for nearly 40% of cancer deaths in 5 states.”  It’s “where 95% of the US tobacco crop is grown.”  Of the 21 states that spend less than 10% of the CDC-recommended amount on tobacco control, 8 are located in the South.

Florida came in at #18 for combined men and women with 12,596 smoking-attributable cancer cancer_death_chartdeaths, and 42,818 cancer deaths overall.  That puts the proportion of cancer deaths at 29.8% due to smoking.  The rank for men only was at 23 with 7,773 smoking-attributable cancer deaths out of the 23,109 cancer deaths for men.  The ranking for women was far lower at 16 with 4,823 smoking-attributable cancer deaths out of 19,709 total cancer deaths.  So what can Florida do to protect its citizens and improve public health?

The first thing would be to raise the cigarette tax and impose taxes on all tobacco products.  Florida cigarette tax is currently at $1.339 per pack, putting us at 29th place in the U.S. with the last increase in 2009.  There is currently no tax on cigars in Florida. cigars.  Florida is in a unique situation as voters in 2006 constitutionally approved  protecting the allocation of tobacco settlement dollars to its tobacco control program.  On the other hand the percentage the state spends for tobacco control programs is only at 36.2% of the CDC-recommended level.  Money spent to get people off tobacco and preventing them from starting would be less than paying for health care costs later.  While smoking is prohibited in most public places such as restaurants and workplaces, bars can allow smoking provided 10% or less of their sales comes from food.  Making Florida a smoke-free state would further reduce smoking-prevalence.  And lastly, increasing the smoking age to 21 would further reduce the teen smoking rate, and possibly prevent teens from ever starting.  You can read more about the State of Tobacco for Florida HERE.

Is it any wonder tobacco use and ultimately cancer rates are so high when the combined spending on tobacco control for all states “was less than $500 million in 2016″ while the tobacco industry is spending $10 billion on marketing?”   States can’t compete with the tobacco industry in terms of money spent for prevention, but we can provide tobacco prevention courses in schools for our children as well as pass laws and regulations that are in the best interest of public health.

Click HERE for entire article, charts and maps.
If you are a Florida educator and would like to earn FLDOE certificate points while teaching tobacco prevention lessons to your students, click on www.tobaccopreventiontraining.org

 

 

 

 

 

 

 

 

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