Princess Health and Youth injuries from e-cigarettes spike; FDA is starting to regulate them, but study authors say not enough to protect children. Princessiccia

Princess Health and Youth injuries from e-cigarettes spike; FDA is starting to regulate them, but study authors say not enough to protect children. Princessiccia

children's health e-cigarettes federal legislation research vaping

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By Melissa Patrick
Kentucky Health News

The number of young children swallowing or being exposed to the liquid nicotine used in electronic cigarettes has "skyrocketed," jumping 1,500 percent from 2012 to 2015, one co-author of a recent study says.

"E-cigarettes and liquid nicotine can cause serious poisoning, and even death, among young children," Dr. Gary Smith, co-author of the study, told Randy Dotinga for HealthDay. "Like other dangerous poisons, they should be kept out of sight and reach of children, preferably in a locked location."

The research, published online May 9 in the journal Pediatrics, follows an announcement that the U.S. Food and Drug Administration will now regulate e-cigarettes. The rule bans the sale of e-cigarettes to minors, requires health warnings on all packaging and advertisements and requires manufacturers to get federal approval on all products introduced to the market after Feb. 15, 2007. It does not address marketing or advertising. The measure goes into effect Aug. 8, and gives affected industries two years to comply.

E-cigarettes, which are battery-powered devices that heat up fluid that includes nicotine and other ingredients such as flavors and chemicals, have become increasingly popular. They are now the most common form of nicotine use among teenagers. Researchers found that it is the liquid nicotine that poses the greatest danger to children.

The study looked at calls to the National Poison Data System about nicotine and tobacco products from January 2012 to April 2015, and focused on calls about children under the age of 6. The NPDS received 29,141 calls for nicotine and tobacco product exposure during this time, averaging 729 child exposures per month.

It found about 14 percent, or 4,128 of the calls were about exposure to e-cigarettes and involved children aged 2 or younger. Most of the exposures were due to ingestion.

"Children exposed to e-cigarettes had five times higher odds of a health care facility admission and almost 3 times higher odds of having a severe outcome than children exposed to cigarettes," says the report. "One death occurred in association with a nicotine liquid exposure."

"These are not trivial exposures. There were comas, seizures, and even one death in the 40-month period we studied, and these exposures were predictable and preventable," Smith told MedPage Today. "E-cigarettes and vaping liquids are products that should never have entered the market without adequate consideration of the harms they could cause to young children."

Smith, also the director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Ohio, told HealthDay that more needs to be done.

"Other prevention steps include prohibiting the use of flavors, as was done for cigarettes since 2009, restricting the use of packaging and labeling attractive to children, ensuring that liquid nicotine compartments on e-cigarettes are child-resistant, and limiting the concentration and/or quantity of nicotine in refill products," he said.

Gregory Conley, president of the American Vaping Association, a nonprofit group dedicated to education about e-cigarettes and vapor products, told HealthDay that the concern about e-cigarettes is "overblown."

He told HealthDay that the child who died "consumed a homemade nicotine liquid concoction that's much stronger than retail versions." He also pointed out that the number of cases have declined since this study was conducted, saying that this is likely due to increased publicity about the risk.

Co-author Henry Spiller, director of the Central Ohio Poison Center at Nationwide Children's Hospital, encouraged parents of young children who vape to treat liquid nicotine like a poison, suggesting that they keep refill containers "up, away and out of sight, preferably in a locked location" and to not leave vaping devices laying around.

Study authors encourage parents to call the Poison Help Line immediately, at 1-800-222-1222, if their child has been exposed to e-cigarettes.

Princess Health and Study finds most smokers are not satisfied with e-cigarettes and don't make the switch; study author wishes they would. Princessiccia

Princess Health and Study finds most smokers are not satisfied with e-cigarettes and don't make the switch; study author wishes they would. Princessiccia

e-cigarettes smoking tobacco tobacco prevention vaping

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image www.mirror.co.uk

Although e-cigarettes did help a small group of smokers quit smoking traditional cigarettes, most smokers who tried them didn't find them to be an acceptable alternative, says a recent study.

Study author Terry Pechacek told HealthDay News that smokers ideally would find e-cigarettes more appealing and less dangerous than traditional cigarettes, and suggested that traditional cigarettes should be "degraded" to encourage a switch.

"Even if they're only half as risky, there would be a huge public health benefit if we could switch 40 million smokers to them," said Pechacek, also a professor and interim division director of Health Management and Policy at Georgia State University in Atlanta.

The study, published in the journal Nicotine and Tobacco Research, is one of the first to look at whether smokers find e-cigarettes to be a satisfying alternative to regular cigarettes.It surveyed more than 5,700 Americans in 2014, and focused on the 729 current and former smokers who had tried e-cigarettes. Of the 585 current smokers who had tried e-cigarettes, 58 percent (337 people) self-reported that they didn't use them anymore and 42 percent (248 people), said they smoked both. Among the 144 former smokers, 101 had quit smoking altogether and 43 had switched exclusively to e-cigarettes.

"Greater than fivefold more current smokers did not find them satisfying and stopped using them," says the report, making it unlikely that e-cigarettes "will replace regular cigarettes unless they improve."

Pechacek told HealthDay that follow-up research to be released later suggest the problem is related to nicotine delivery, smell and flavor. In the big picture, "E-cigarettes may help a few people to quit, but mostly they don't. And the suspicion from these data is that they help keep people smoking. That is not something that the e-cigarette advocates want to hear," Thomas Wills, professor and interim director of the Cancer Prevention and Control Program at the University of Hawaii Cancer Center, told HealthDay.

The U.S. Food and Drug Administration acted to regulate e-cigarettes in early May. The rules ban the sale of e-cigarettes to minors, require health warnings on all packaging and advertisements and require manufacturers to get federal approval on all products introduced to the market after Feb. 15, 2007. It did not address advertising and marketing. The measure goes into effect Aug. 8, and gives affected industries two years to comply.

Gregory Conley, president of the American Vaping Association, told HealthDay that the rules will weaken the innovation of e-cigarettes.

He pointed out that the study did not establish if participants used an old model of e-cigarettes or a new one, which have become more appealing. He also noted that most smokers in the study who switched to e-cigarettes were more likely to use a "tank-style" device, which can deliver more nicotine and last longer than devices that look more like cigarettes.

Princess Health and FDA to regulate e-cigs: ban sales to minors, require warning signs, require federal approval; did not address advertising issues. Princessiccia

Princess Health and FDA to regulate e-cigs: ban sales to minors, require warning signs, require federal approval; did not address advertising issues. Princessiccia

e-cigarettes federal regulation food and drug administration smoking ban teens tobacco tobacco prevention youth

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In a long-anticipated move, the U.S. Food and Drug Administration announced May 5 that it is assuming regulatory authority over all tobacco products, including electronic cigarettes, cigars, hookah, tobacco and pipe tobacco that include banning sales to anyone under 18.

�Today�s announcement is an important step in the fight for a tobacco-free generation � it will help us catch up with changes in the marketplace, put into place rules that protect our kids and give adults information they need to make informed decisions," Health and Human Services Secretary Sylvia Burwell said in a news release.

FDA's new tobacco regulations will prohibit sales of e-cigarettes and all tobacco products to anyone under 18, both in person and online, and buyers must now show photo ID.

Health warnings will also be placed on packages and in advertisements, saying, �WARNING: This product contains nicotine. Nicotine is an addictive chemical.� It also bans free samples and the sale of covered products in vending machines not located in adult-only facilities.

The regulation also requires manufacturers of all newly-regulated products introduced to the market after Feb. 15, 2007, a date that is set by the Tobacco Control Act of 2009, to require federal approval. An amendment to the legislation has been submitted to change the date so more e-cigarettes would be grandfathered in, Jayne O'Donnell and Laura Ungar report for USA Today.

The e-cigarette industry is pushing back on these regulations.

"Industry experts say treating e-cigarettes, which don't contain tobacco, the same as cigarettes could lead to such onerous and costly approval that all but the largest tobacco companies would be forced out of the market � and possibly those companies, too," USA Today writes. Jeff Stier, an e-cigarette advocate with the National Center for Public Policy Research and industry officials, told USA Today that it could cost $1 million or more per application.

Vapers also argue that e-cigs help people quit, but studies on that conflict.

Ellen Hahn, a professor at the University of Kentucky College of Nursing and co-chair of the UK Tobacco-free Task Force, told USA Today that the new rule is a good first step toward controlling e-cigarettes, noting "vaping" can get youth addicted to nicotine and threatens to prolong "the tobacco epidemic."

"From a health perspective, to reduce the social acceptance of them is good because frankly, it's the wild, wild West out there," she told the newspaper. "Vape stores are everywhere."

The Robert Wood Johnson Foundation commended the FDA for these regulations, noting the use among high school students has "rocketed from 1.5 percent in 2011 to 16 percent in 2015, an increase of more than 900 percent." But it also said the regulation did not go far enough.

"Studies have proven that tobacco advertising directly influences youth, and that such sweet e-cigarette flavors as gummy bear and cotton candy play a role in children trying these products," Dr. Risa Lavizzo-Mourey, CEO of the RWJF, said in the statement "Today's final rule did not address these issues, and we strongly urge the FDA to take aggressive regulatory and enforcement actions to prevent and reduce youth tobacco use, in any form it takes."

The regulation goes into effect Aug. 8, and gives affected industries two years to comply. The original proposal was introduced in 2014.

Princess Health and UK study finds e-cigarettes aren't replacing traditional cigarettes, but their sales rise as unregulated TV ads for them increase. Princessiccia

Princess Health and UK study finds e-cigarettes aren't replacing traditional cigarettes, but their sales rise as unregulated TV ads for them increase. Princessiccia

cigars e-cigarettes research smokeless tobacco tobacco

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A study led by a University of Kentucky researcher found that electronic cigarettes have not become a substitute for traditional cigarettes, but their use is increasing, especially as television commercials for the products increase, Carol Lea Spence reports for UK AgNews.

�Cigarette purchases have dropped a bit, from about 90 percent to 80 percent of all tobacco products during the past 15 years, but it�s still a big player. Other tobacco product sales are growing, though�particularly e-cigarettes,� Yuqing Zheng, lead researcher and an agricultural economist in UK's College of Agriculture, Food and Environment, told Spence.

The study, published in The American Journal of Agricultural Economics, looked at the habit formation of non-cigarette products and studied usage in five categories, including: cigarettes, e-cigarettes, smokeless tobacco, cigarillos and cigars, Spence reports.

The study collected data from convenience stores in 30 U.S. markets, looking for evidence to support that e-cigarettes had become a substitute for traditional cigarettes. It also investigated whether consumers purchased products based on cost and advertising.

They found that when the price of e-cigarettes went up, it did not increase the demand for traditional cigarettes. And not surprisingly, it also found that the purchase of e-cigarettes increased with increased TV advertising, but not with increased magazine advertisements.

�This adds to the policy discussion,� Zheng told Spence. �While cigarettes are strictly regulated in terms of advertising, there are no advertising restrictions on e-cigarettes.�

The study also found that based on consumption patterns, all five tobacco products in the study were habit forming, and e-cigarettes had the "highest degree of habit formation," Zheng told Spence.

Zheng attributed that to three things: Most e-cigarettes contain nicotine, which is addictive; they can be used in places where traditional cigarettes are banned; and because they don't burn out, people use them for longer periods of time, Spence reports.

Zheng told Spence that there is no scientific evidence to prove e-cigarettes are less harmful than cigarettes, and noted that the study found that people will generally buy traditional cigarettes regardless of the price, but in general are "more responsive to price increases" of non-cigarette tobacco.

Princess Health and Teens now more likely to use e-cigs than tobacco; health officials call for regulations and better education about the products. Princessiccia

Princess Health and Teens now more likely to use e-cigs than tobacco; health officials call for regulations and better education about the products. Princessiccia

e-cigarettes federal regulation research smoking teenagers teens tobacco

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By Melissa Patrick
Kentucky Health News

The number of adolescents using electronic cigarettes has risen so much that more of them use e-cigs than tobacco products, says the federal Centers for Disease Control and Prevention.

The findings come from the National Youth Tobacco Survey, which collected data from about 20,000 middle- and high-school students across the country from 2011 to 2015.

Only 1.5 percent of high schoolers used e-cigarettes in 2011, but that zoomed to 16 percent in 2015, with most of the increase seen between 2013 and 2014. The number of middle-school students using e-cigarettes increased from less than 1 percent in 2011 to 5.3 percent in 2015.

Tobacco smoking with hookahs, or water pipes, showed a lesser but significant increase, rising to 7.2 percent from 4.1 percent among high-school students and to 2 percent from 1 percent among middle-school students.

During this same time frame, children's use of cigarettes, cigars and other tobacco products decreased. The share of high-school and middle-school students who reported smoking a cigarette in the last month dropped, respectively, to 9.3 percent from 15.8 percent; and to 2.3 percent from 4.3 percent.

The rise in e-cigarette and hookah use offset the decrease in traditional tobacco use, meaning there was no overall change in use of nicotine or tobacco products among middle and high school students between 2011 and 2015.

An estimated 25.3 percent of high school students and 7.4 percent of middle school students say they have used a tobacco or nicotine product in the past 30 days. That amounts to 3.82 million high school students and 880,000 middle school students.

The study did not give state-by-state figures, but Kentucky has long ranked high in youth tobacco use.

One of the reasons for the rise in popularity of e-cigarettes is that there are no restrictions on buying them on the internet, Carina Storrs reports for CNN after interviewing Brian A. King, deputy director of research translation in the CDC Office on Smoking and Health, who led the current research.

"The fact that we have a flavored product that is easier to access and possibly cheaper has created a perfect storm to lead to increased use," King said.

Also, King said, e-cigarette companies appeal to youth by advertising heavily on social media, selling trendy accessories and employing celebrities to market the products. King said older peers and family members could also be providing e-cigs, just as they have provided conventional cigarettes to.

Pediatricians have called for raising the smoking age to 21 and for the regulation of e-cigarettes.

As of April, 2016, 141 cities in 10 states and the state of Hawaii have raised the legal age to buy tobacco or vaping products to 21, according to the tobacco21.org website.

In Kentucky, Democratic Rep. David Watkins, a retired physician from Henderson, filed a bill this year to raise the legal age for buying tobacco or vaping products to 21, which made it out the the House Health and Welfare Committee, but was not called up for a vote on the House floor. Kentucky banned the sale of e-cigarettes to minors in 2014.

The Food and Drug Administration introduced a proposal in 2014 to oversee and regulate electronic cigarettes, but it has still not been finalized.

Dr. M. Brad Drummond, associate professor of pulmonary and critical care medicine at Johns Hopkins University School of Medicine, told Storrs that tighter restrictions are needed around purchasing, taxation, flavoring and advertising of e-cigarettes, noting that this would have an effect on "denormalizing their use." He also said teens need to be better educated about the harms associated with e-cigs.

Princess Health and Another Kentucky school district goes tobacco-free and e-cigarette free; efforts largely led by students in Webster County.Princessiccia

Princess Health and Another Kentucky school district goes tobacco-free and e-cigarette free; efforts largely led by students in Webster County.Princessiccia

cigarettes e-cigarettes schools smoking ban

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The Webster County school board voted unanimously May 26 to make all district property, vehicles and buildings officially tobacco-free, Matt Hughes reports for the Webster County Journal-Enterprise. As in some other school districts, efforts for the ban were largely led by students.

�This is something the Youth Experiencing Success Youth Council has been working on for years,� said board member Mickey Dunbar, who has worked closely with Youth Empowerment Services. �I think it is very important that we educate our students' minds and educate them about their bodies.�

The ban will go into effect July 1 and includes all tobacco products, including vapor devices, commonly known as e-cigarettes. It also extends to school-sponsored trips, all sporting events and all school functions.

�I will enjoy being able to walk out of a basketball game without having to navigate a gauntlet of cigarette smoke,� Dunbar told Hughes. �I think this will set a good precedence for the other schools in our area.� Webster County is in the West Kentucky Coalfield.

The YES Youth Council and its adult sponsor first approached the board last fall, and said that while supportive, the board voiced concerns that the community would not be supportive, especially during ballgames. But since then, Hughes said, board members "have gotten a lot of positive feedback from the community."

As of May 2015, Kentucky reported 40 tobacco-free school districts, which include 500 individual schools, according to the Tobacco Free Schools Kentucky website. This amounts to 40 percent of Kentucky's students.

Princess Health and Bourbon Co. teen named South's top youth anti-tobacco advocate for his efforts in pushing for county smoking ban.Princessiccia

Princess Health and Bourbon Co. teen named South's top youth anti-tobacco advocate for his efforts in pushing for county smoking ban.Princessiccia

awards e-cigarettes schools smoking smoking ban smoking bans smoking ordinances tobacco youth

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Tyler Boyle (Photo from
Lexington Herald-Leader)

Tyler Boyle, a Bourbon County High School senior and president of Students Making A Change in the Community, was named the South Region Youth Advocate of the Year by the Campaign for Tobacco Free Kids for his efforts to push a smoking ban in Bourbon County, Lashana Harney reports for the Lexington Herald-Leader.

Boyle has been a part of SMACC since it was re-established in 2013. The club is a place for youth voices to be heard on smoking issues, with the ultimate goal of a countywide smoking ban -- but in the meantime, working for a school regulation that would ban electronic cigarettes.

The smoking ban has yet to pass, but the schools have added e-cigarettes to their comprehensive tobacco policy, which banned tobacco products of any kind on school grounds.

Boyle told the Herald-Leader that he applied for the award in hopes of bringing more attention to the anti-tobacco cause in his county, which has a long history of tobacco production and sales.

"I applied for this award because of all of the work that I've done in my home community and state for tobacco control," he told Harney. "I thought that if I could make national attention, maybe, it would make the officials in my community take this issue more seriously."

Boyle said that he was honored to receive the award, which was presented at a gala in Washington, D.C., in mid-May. He plans to attend a symposium sponsored by the Campaign for Tobacco Free Kids in Washington in July and the Philip Morris Cos. international shareholder meeting next May.

Boyle told Harney that sometimes he gets frustrated because change is slow to take place, but the will to keep pushing forward always comes back.

"After attending the award gala, I was revitalized and I'm ready for the next step in tobacco control," he said.

Boyle will attend Vassar College in the fall to study political science with a focus on advocacy work and said he would continue his work with the Campaign for Tobacco Free Kids.

"Tobacco advocacy is something near to my heart," Boyle said. "Vassar is actually going smoke free in July 2015. So, I plan to work hard to implement and support their new policy."