Kick Butts Day 2019!

Kick Butts Day, March 20, 2019, is almost here!  This national day of activism, was started by the Campaign for Tobacco-Free Kids in 1996, bringing students, teachers, public health advocates and other community leaders together to “organize events designed to get youth to stand out, speak up and seize control against Big Tobacco.”

Did you know that tobacco use is the leading cause of preventable death here in the U.S. and around the world?  It causes many forms of cancer, as well as heart disease and COPD, and damages nearly every organ in the human body.  Here in the U.S. more than 480,000 people die every year due to their tobacco use.

Did you know that almost 90% of adults start using tobacco as teens or even earlier?  Kick Butts Day draws attention to the tobacco industry and their deceptive marketing practices that encourage kids to start tobacco.   It is our youth and their voices that encourage their peers and others to be tobacco-free and to stand up to the tobacco industry.

Back in 2012, the Surgeon General’s Report called teen tobacco use a “pediatric epidemic,” but the focus has shifted from tobacco to e-cigarettes and vaping.  While current cigarette use among Florida high school students is at 3.6% (middle school use is at 1.3%), current use of vaping at the high school level is much higher at 24.8% (up 651.5% since 2012 and up 58% between 2017-2018) with middle school use at 7.8% (up 387.5% since 2012 and up 44.4% between 2017-2018).  Teens who have ever tried vaping is higher still.  Our teens are still battling an epidemic brought on by the tobacco industry.

It is so important that our youth continue to speak out against tobacco and an industry that is finding new ways to addict them to nicotine.  Support our teens as they use their voices to affect social change in their communities and throughout the United States.  Every day should be Kick Butts Day.

Click HERE for more information on Kick Butts Day.
Graphics from the site.



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FDA proposes new guidelines on flavors but will it be enough?

Fruity, minty or sweet tobacco flavors may soon be missing from e-cigarettes if FDA regulations go into effect.

Vaping has increased dramatically in the past two years in part from the flavors that have made it more appealing to teens, and the proposed FDA guidelines hope to limit access to these nicotine products.  While some flavors will be outright banned, others will need FDA approval before they can be sold.

The e-cigarette industry claims their products are marketed to adults as a cessation aid to help them quit smoking, yet it is the teens who have embraced the products and setting record sales figures.  Approximately 3.6 million teens say they are current e-cigarette users, with 1.5 million teens starting between 2017 and 2018.

One of the most popular devices used by teens is Juul, which has been called the iPhone of vaping devices.  Its slim, flat look resembles a USB flash drive that plugs into your computer when charging and is easily hidden from adults.  Juul also came under fire for their marketing which used young models who looked like teens.  But other e-cigarette companies are equally guilty of making their products attractive to teens.

In the past, the FDA said it wouldn’t review e-cigarette products until at least 2022, long after many were brought to market.  But with the surge in teen use, the FDA has changed its mind.  According to Dr. Gottlieb, FDA Commissioner who will retire at the end of March, “manufacturers and retailers may be subject to FDA enforcement for selling certain flavored (e-cig) products without authorization.”  The agency has given a deadline of August 8, 2021 for applications for approval of flavored products.  Expect to see the market flooded with new flavors.  Flavored, sweet little cigars will also have sale restrictions and new guidelines forcing these products to go under a similar approval process.

The FDA brought much needed attention to the e-cig epidemic that “is addicting a new generation of kids” to nicotine.  But while the steps taken by the FDA may slow the spread of e-cigarette use by teens, they fall short from reversing the skyrocketing teen use which would only come from prohibiting flavors popular among teens.  Our kids will still be able to purchase the flavored products that are keeping them addicted in the first place.  This should be a matter of public health because it will define the future health of our nation.


Click HERE, HERE and HERE for articles used in this blog.



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SAFE Kids Act to restrict ecig flavors

The Stopping Appealing Flavors in E-Cigarettes for Kids (SAFE Kids) Act has bipartisan as well as bicameral support as members of both the Senate and the House have come together to crack down on kid-friendly flavorings in e-cigarettes and cigars.  U.S. Senators Dick Durbin (D-IL) and Lisa Murkowski (R-AK) and U.S. Representatives Diana DeGette (D-DO-01) and Jamie Raskin (D-MD-08) are the sponsors for this bill.

Senator Dick Durbin said he was concerned that “powerful e-cigarette companies are winning the war for our children’s health and well-being” by using flavors that appeal to kids in e-cigarettes and cigars.  The high levels of nicotine in the products have effects on teens brains and could create another generation that is addicted to nicotine.  Murkowski stated that while she is “glad the FDA finally took regulatory actions last year,” they should be made into law.

One of the reasons the SAFE Kids Act is so important is that vaping products are the most common form of tobacco/nicotine used by teens.  Adolescence is an important time period of brain development and nicotine use in teens alters brain growth and maturation.  It sets the teen brain up for future addictions and also increases the risk for mental health disorders.  Studies have shown that the majority of teens use a flavored tobacco product or a candy or fruit-flavored vaping product as their first product.

The Campaign for Tobacco-Free Kids supports the SAFE Kids Act as “flavored tobacco products play a key role in causing kids to start and continue using tobacco.  Between 2000 and 2018 cigarette smoking among high school students decreased from 28% to 8%, but with the newer tobacco products, such as e-cigarettes, being marketed and sold to children, tobacco use is again increasing.  In the past year alone, high-school use of e-cigarettes has seen a 78% increase while middle school use has increased 48% and flavors are the reason for these increases.

It is important for our lawmakers to protect the health of our youth, and regulating flavors will decrease e-cigarette use in youth.


Click HERE and HERE for the articles used in this blog.


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Trinkets and Trash – February 2019

February is the month of romance, and the tobacco industry also shares their brand of love with special advertisements and coupon promotions.  This information comes to us by way of Trinkets and Trash, an online surveillance system that monitors the tobacco industry marketing in various forms of media.

If there is no one special in your life at Valentine’s Day, turn it into a day that you treat yourself with, what else… tobacco.  Cheyenne cigars had red and pink packaging for wild cherry and strawberry flavored cigars.  Djarum didn’t bother showing their product, instead they had a romantic scene of a couple walking a beach at sunset.  And Swisher Sweets promoted their sweet cream flavored cigarillos instead of roses, because everyone know that tobacco breath is so romantic.

If your “bae” doesn’t like cigars, there are other methods to get to his heart, like having cupid shoot him with a can of Stoker’s smokeless.  Do people even use “bae” anymore?  General Snus also hinted you don’t need to be with your “significant other” to enjoy their product.  So much for romance, but then again, how romantic can you be with a lip of dip?  For the e-cig users, Blu surrounded their products with white rose petals, their idea of romance.  And if you don’t want to get caught using a smoking or smokeless device or a tin of tobacco, now there are nicotine “smart” toothpicks to get you that buzz.  Having a nicotine addiction doesn’t sound very smart.

If you want to know what the tobacco industry is up to, sign up for the Trinkets and Trash newsletter than comes out at the beginning of the month with the previous month’s latest ads and messages.

Click HERE for Trinkets and Trash.  All pictures are from their newsletter.



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Ecigs and other smoking devices damage the lungs

The vaping industry promotes their products as a “safer” and “less harmful” form of smoking, but don’t be fooled by their words.   A recent study looked at how nicotine from vaping, traditional cigarettes, and heat-not-burn devices like IQOS affects the epithelial cells and smooth muscle cells of the lungs and found that the newer products were not less toxic than traditional cigarette smoking.

Epithelial cells line the respiratory passageways from the nasal cavity to the bronchi and work to moisten and protect the lungs from infection and environmental factors like dust from getting into the airways.  Smooth muscle cells maintain the structure of the airway, and help regulate the flow of air into the lungs.

Researchers exposed both types of cells to conventional cigarette smoke and e-cigarette vapor.  They also used an IQOS system, a heat-not-burn tobacco device that heats up solid tobacco.  Both lower and higher concentrations of cigarette smoke and heated tobacco vapor were highly toxic to lung cells.  E-cigarette vapor was toxic at higher concentrations.  The concentrations “represent the levels of nicotine found in chronic smokers.”  The researchers discovered that the new products “were in no way less toxic to cells than conventional cigarettes or e-cigarette vaping,” and that the new devices are “as harmful as smoking traditional cigarettes.”  The IQOS system is currently not approved by the FDA for sale in the U.S.

It has taken researchers nearly five decades to understand the dangers of cigarette smoke, but e-cigarettes have only been on the market for a decade so long-term impact will take many years to discover.  What researchers currently know is that damage to the two types of lung cells can destroy lung tissue causing fatal diseases such as COPD and lung cancer, and the development of other diseases such as asthma and pneumonia.

Never assume a new device is a safer option just because the industry tells you so.

Click HERE for the article.


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Through With Chew Week 2019

This is Through With Chew Week and it gives us an opportunity to educate people about the dangers of smokeless and encourage people to quit.  The campaign began in 1989 by the American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. as a way to educate the public.  In 1994 Oral Health American’s National Spit Tobacco Education Program (NSTEP) partnered with TWC to break the connection between baseball and smokeless tobacco.

There are many forms of smokeless tobacco, but most use chew or snuff.   Chewing tobacco comes in loose leaves, plugs or twists of dried tobacco.  A piece is taken from the pouch or cut off the twist and is placed between the cheek and gum.  And like the name implies, the user may chew it to get the flavor out of the tobacco.  The juices may or may not be spit out.  According to the CDC website, the most popular of these is loose leaf with 17.5% of the market share.

Snuff is a finely ground tobacco that can come in moist, dry or Snus.   Moist snuff is the most recognizable and widely used with a market share of 80.7%.  It comes in a can, is usually highly flavored, and is refereed to as a pinch or “dip” placed between cheek or lip and gums.  Most people spit out the juices.  Dry snuff is a powder-like tobacco that can be put in the mouth or inhaled in the nose.  Snus is a moist teabag-like pouch that is placed between the cheek or the teeth and gums and does not require spitting.

There is also flavored dissolvable tobacco forms such as lozenges, orbs, melt-away strips and toothpick-sized sticks.  Many of these products haven’t been popular, but are still available through websites.  Many smokeless users turn to a smokeless form of  tobacco because they feel it is safer than smoking, but no form of smokeless is safe.

Whether you dip or chew, you are still getting nicotine from your product.  You are also getting about 28 chemicals that are known to cause cancer.  Tobacco-specific nitrosamines (TSNAs) are the most harmful and most potent cancer-causing chemicals that you are putting directly into your mouth.  Other chemicals include formaldehyde, arsenic, cadmium and radioactive polonium-210.  Dip and chew users are increasing their risk of “oral cancer by 50% compared to those who don’t use these products.”  Cancers of the lip, tongue, cheek, roof and floor of the mouth, and cancer of the larynx are the most command cancers.  And users also have an increased risk of pancreatic cancer.  Other problems include permanent gum recession and bone loss at the site of the dip like in the picture above left.  And since dip also contains sugar, tooth decay is common.   Benign or precancerous lesions on the tongue or inside of cheeks, called leukoplakia, is common like the picture on the right.

While these oral issues are easy to see, other health issues from using smokeless tobacco aren’t as easy to spot.  “There is evidence that long-term ST product use may be associated with a greater risk of fatal myocardial infarction (heart attack) and fatal stroke.”  Ignoring health problems won’t make them go away.  Quitting smokeless products will improve your overall health and put money back into your pocket.

Click HERE for CDC information and pictures of smokeless tobacco.
Click HERE for Important Facts About Smokeless Tobacco.
Dissolvables pictures from the FDA website.
Gum damage picture from National Cancer Institute off the Smokeless Tobacco awareness in Florida article.
Leukoplakia picture from the American Academy of Oral Medicine site: Oral Changes Associated with Tobacco Use.


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Rheumatoid Arthritis and Smoking

There are many health awareness days in February that we should mention, like Rheumatoid Arthritis.  While the exact cause of this autoimmune disease is still a mystery, smoking is a risk factor, but doctors don’t even know the exact role smoking may play.  Many sufferers are no longer calling it Rheumatoid Arthritis, but rather Rheumatoid Disease since it encompasses so many different diseases, with arthritis being just one of them.

RA or RD can strike anyone, but affects women more than men.  Your immune system attacks the lining  around your joints causing it to thicken, causing pain and swelling in your joint areas.  RA is an equal opportunity pain in the joint, usually affecting the same joints on both sides of the body at the same time.

Joints typically become warm and swollen and you may experience tenderness and pain.  It could cause stiffness first thing in the morning that lasts for a short amount of time, or pain could last several weeks.  And it isn’t just pain, swelling, and tenderness in the joints; many sufferers complain of fatigue and dryness of the mouth and eyes, loss of appetite and perhaps skin nodules.  Leaving this disease untreated can lead to joint deformities as well as bone loss.  But RA doesn’t stop there as it affects the rest of your body

While the disease is thickening the lining in your joints, inflammation is causing problems in other areas of the body such as the lungs, heart and blood vessels, the same areas also affected by smoking.

Inflammation from RA can produce scarring in the lungs causing shortness of breath and a dry cough.  Rheumatoid nodules can form in the lungs as well as on the hands.  Tissue around the lungs, called the pleural, can become inflamed and a buildup of fluid may result.  And chronic inflammation caused by the RA can thicken the walls of the small airways in the lungs causing shortness of breath, a chronic dry cough, fatigue and weakness.

Cardiovascular disease is also high on the list of RA sufferers as the disease doubles the risk of heart problems, “including heart attack, stroke and atherosclerosis.   Inflammation causes damage to the blood vessel lining allowing plaque to build up on the walls.  This raises blood pressure, narrows the arteries and reduces blood flow to other organs.  Supposedly RA sufferers develop atherosclerosis at a faster rate.  Veins and arteries throughout your body are affected by this inflammation.  If you smoke, you are adding unnecessary risk to your health as smoking creates the same cardiovascular problems as RA.

While you may think it would be easy to diagnose RA, that’s not often the case, especially in its early stages.  Often times doctors will use blood and imaging tests to detect the disease, but even those may not be reliable.  The one thing you should understand with RA is that smoking will make it worse.  Even social smoking increases your inflammation factors in your body.  And continuing to smoke while treating your disease makes the therapies less effective.  There is no cure for RA, but with treatment, symptoms can become manageable.

Click the following links for more information on this disease:
What you should know about RA and Smoking
Smoking and rheumatoid arthritis:  What’s the risk?
5 Reasons Smoking Makes Arthritis Worse

Pictures of joint damage were obtained at the Arthritis Support Board site.


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How do we help our kids kick a nicotine addiction?

Cigarette smoking among our youth is at an all time low and we should be celebrating these numbers.  But as cigarette use declines, the numbers for e-cigarette and vaping use are skyrocketing.  News articles report on this epidemic and how to stop kids from getting their hands on the products, but no one seems to know how to help those already addicted to the nicotine.

The government is working to stem the tide of vaping devices getting into the hands of youth.  But the bigger problem looming on the horizon is what can we do to help the millions of youngsters already addicted to these products?  It is a topic that is not discussed much because we do not have the answers.  Nicotine replacement therapies are not approved for youth and when we looked up studies on this subject the most recent ones are at least a decade old, before e-cigarettes made it to the marketplace and became a problem.

Since most teens have not been vaping for years, their level of addiction may not be as heavy as an adult with years of smoking history and ingrained habits, therefore they should be able to quit without aid.  Withdrawal symptoms will make the quit uncomfortable, but should not last long.  But the studies say nicotine addiction is different in teen users because their brain development has not reached maturity.  The hand-to-mouth fixation, the buzz they get from a hit, the candy and fruit flavors, and the fact they are surrounded by friends still using the device are all obstacles that may make quitting more difficult.  Then there is the fact that most teens do not see much risk in vaping which also works against them and quitting.

Learning a new behavior, such as quitting your addiction, requires “discipline, patience and a willingness to follow a treatment plan,” something an immature teen brain may not be able to handle well.  According to one tobacco prevention expert, “teenagers have their own ideas of what might work for them, and they’re going to do what they do.”

Counseling is one option that could help.   Colorado has one of the highest youth vaping rate in the U.S., and recently lowered the minimum age requirement for the quit-smoking hotline from 15 to 12.   The free over-the-phone counseling and online programs can help users create a quit plan, but are limited in helping the teen population because discipline is necessary for success.  According to addiction specialists, group sessions may be the most promising, but it is still difficult to get across to teens that they are inhaling a highly addictive substance when “about two-thirds of U.S. teenagers do not realize that Juul contains nicotine.”

The old saying “an ounce of prevention is worth a pound of cure,” is never more true than discussing tobacco and vaping prevention among youth.  The Florida Tobacco Prevention Training for Educators online course provides an opportunity for administrators, educators and school counselors to receive 30- or 60-credits towards renewal of their Florida Department of Education license at no cost to them or their district.  At the end of the course, participants teach six (6) tobacco prevention lessons to their students.  Lesson plans are provided for K-12 grades and FLDOE certificate holders in public, private and charter schools are allowed to take one of our courses.  This year we added a 20-CEU course for Florida School Nurses (no teaching required) and 10-point ENDS course for Palm Beach educators.

Educating our Florida youth about tobacco and vaping will help protect them from a lifelong nicotine addiction and improve the health of our state in the long run.


Several articles were reviewed for this blog.  Click HERE, HERE, and HERE for the links.
Click HERE for more information on the Florida Tobacco Prevention Training for Educators online course, and HERE to register for it.

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Walgreens and their illegal tobacco sales to minors

Walgreens has fought ending tobacco sales in its stores, and now we know why.   The “corner of happy and healthy” has continually violated federal laws by selling tobacco products to minors and is “the top violator among pharmacies that sell tobacco products.”

The drug store chain has been “issued more than 1,500 warning letters and 240 civil money penalty actions” nationwide for its underaged tobacco sales.  One store in Miami, Florida is so bad that the FDA filed a complaint to bar it from selling tobacco products for 30 days.

The FDA Commissioner will be requesting a meeting with Walgreens corporate management regarding this issue.  Walgreens has almost 1,800 violations across the U.S. for sales to minors.  Of the Walgreen’s stores the FDA inspected 22% sold tobacco products illegally.

But Walgreens isn’t the only retailer the FDA has its sites on.  Circle K Stores Inc, a chain of convenience stores, has also had violations for selling tobacco products to minors.  One store in Charleston, South Carolina will be barred from selling tobacco products for 30 days.  Other stores inspected by the FDA and the percentage of their stores that sold tobacco products illegally included Walmart, Inc (17.5%), Dollar General Corp (14%) and Rite Aid Corp, (9.6%).

A Walgreen’s spokesman said they take this matter very seriously, requiring identification of anyone purchasing tobacco, regardless of age.  Circle K also spoke out that they will work with the FDA on this issue.

The 2018 National Youth Tobacco Survey estimates 4.9 million middle and high school students have used a tobacco product in the past 30 days.   In Florida, 29.2% of high school students are currently using (past 30 days) cigarettes, cigars, hookah, vaping, flavored cigarettes or flavored cigars, an increase of 33.9% in the past year alone.  Middle school students are at 10.0% for current use of the same tobacco list above, an increase of 35.1% in the last year.

It is clearly evident that retailers are ignoring federal tobacco age laws and allowing teens to obtain tobacco products illegally.  All tobacco retailers know the federal laws concerning tobacco sales to minors.  Perhaps it is time for the FDA to get tougher on the stance of illegal sales to minors in an effort to protect the health of our kids.

Click HERE to read the entire news article from CBS News

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Public vaping to be banned in Florida

This past November Florida voters approved Amendment 9, with 68.9%  to 31.1% margin, which prohibits using e-cigarettes and vaping devices indoors.”  Now Bill 7012 is going through the Florida Senate.

Florida has had a ban on smoking tobacco in indoor workplaces for years, but makes concessions under certain conditions. This new bill also makes allowances for vaping to take place in retail vape shops, private homes, stand-alone bars, and other areas.  One provision that is included is in designated hotel rooms; however, as with smoking, vaping leaves secondhand vape residue (nicotine and chemicals) on surfaces that could cause health issues to unsuspecting guests.

Under Florida law, only the state can regulate smoking, but local governments can “impose more-restrictive regulations on vaping.”  Anti-smoking advocates believe “defining vaping devices as tobacco products by the state would help Tobacco Free Florida’s educational efforts,” because they are “currently unable to use resources to prevent youth from smoking and to educate youth on e-cigarettes because they aren’t tobacco products.”

While Tobacco Free Florida may have restrictions on what they can promote on their site,  the Florida Tobacco Prevention Training for Educators online course has been providing education to our participants on e-cigarettes and vaping for years.  This professional development course is approved by the FLDOE Office of Healthy Schools, and allows teachers, administrators and school counselors in public, private and charter schools the opportunity to earn 30- or 60-professional development points upon completion of the course and the teaching of six (6) tobacco prevention lessons.  This past year we have designated an entire chapter to ENDS (electronic nicotine delivery systems)–the health issues, chemicals, marketing, and the hazards of use– in both the 30- and 60-point courses.  We have also developed a 20-CEU course for Florida School Nurses (no teaching required) so they also understand the problems with tobacco/vaping in their settings.  And Palm Beach educators have the opportunity to take a stand alone 10-point course on ENDS to reach more students on the hazards of vaping.

As with the smoking ban, Florida lawmakers let the voters decide if vaping in public needed to be banned and the voters spoke.

Chick HERE for the news article.


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