Category Archives: Smoking

Teen prescription opioid abuse, cigarette, and alcohol use down, but e-cigarette use up

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Two white tabletsFrom the US Department of Health and Human Services

Use of cigarettes, alcohol, and abuse of prescription pain relievers among teens has declined since 2013 while marijuana use rates were stable, according to the 2014 Monitoring the Future (MTF) survey, released today by the National Institute on Drug Abuse (NIDA). However, use of e-cigarettes, measured in the report for the first time, is high.

These 2014 results are part of an overall two-decade trend among the nation’s youth. The MTF survey measures drug use and attitudes among eighth, 10th, and 12th graders, is funded by NIDA, and is conducted by researchers at the University of Michigan at Ann Arbor. NIDA is part of the National Institutes of Health.

“With the rates of many drugs decreasing, and the rates of marijuana use appearing to level off, it is possible that prevention efforts are having an effect,” said NIDA Director Nora D. Volkow, M.D.

Continue reading

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The great e-cig debate

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Fred Hutch and SCCA experts weigh in on the good, bad and ugly of the electronic cigarette quandary

By Diane Mapes / Fred Hutch News Service

Jenny McCarthy

TV personality Jenny McCarthy is a paid spokesperson for Blu eCigs. Photo by Blu eCigs

Since electronic cigarettes were introduced to the world a decade ago, they have grabbed headlines, frustrated physicians and thoroughly confused consumers.

“Our patients are highly motivated to quit, but they’re confused about the mixed messages of e-cigarettes,” said Donna Manders, a certified tobacco treatment specialist at Seattle Cancer Care Alliance. “A lot of them believe the hype that is out there, that these must be safe because they’re being sold everywhere.”

Unfortunately, there are far more advertisements, celebrity spokesmodels (like anti-vaccine advocate Jenny McCarthy) and new brands of e-cigs than strong, evidence-based studies.

“There’s a lot of excitement but very little data,” said Jonathan Bricker, psychologist and smoking cessation researcher in the Public Health Sciences division of Fred Hutchinson Cancer Research Center. “The FDA has to regulate the device before a researcher can conduct a trial on its efficacy for smoking cessation and the devices aren’t regulated yet. We’re in a Catch-22.” Continue reading

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How to protect your children from cancer – CDC

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Cancer Prevention Starts in Childhood

Tips from the US Centers for Disease Control and Prevention

Photo of two parents and three children sitting outside

You can reduce your children’s risk of getting cancer later in life.

Start by helping them adopt a healthy lifestyle with good eating habits and plenty of exercise to keep a healthy weight.

Then follow the tips below to help prevent specific kinds of cancer. Continue reading

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Women’s Health – Week 41: Quitting Smoking

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tacuin womenFrom the Office of Research on Women’s Health

Quitting smoking If you stop using tobacco, you could greatly improve your health. Tobacco use is the leading preventable cause of disease, disability, and death in the United States.

Smoking causes most cancers of the larynx (voice box), oral cavity (mouth) and pharynxesophagusbladderkidney, stomach, and cervix.

Tobacco smoke contains chemicals that are harmful. Health care providers know that at least 250 of the 4,000 chemicals in tobacco smoke are harmful.

If you smoke, your risk of developing smoking-related diseases, such as lung and other cancers, heart disease, stroke, and respiratory illnesses, increase with each additional year you smoke. Continue reading

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Qs: Who is responsible for an adult child’s coverage? Must insurers notify smokers of ways to lower premiums?

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Question markBy Michelle Andrews

Q. Do we have to carry our 24-year-old daughter on our health insurance policy? She is employed and has two degrees. We informed her that we would be dropping her at the end of the year because it’s costing us a fortune, and she told us today that we are required by law to cover her. We do not claim her on our taxes. Continue reading

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Tobacco use among Asian and Pacific Islanders varies widely

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Cigarette SmokeBy Stephanie Stephens
Contributing Writer
Health Behavior News

While past research has shown that, as a whole, Asian Americans and Native Hawaiian/Pacific Islanders living in the U.S. smoke at a lower rate than the national average, a new study in American Journal of Health Behaviorfinds significant differences in tobacco use when analyzed by specific Asian or Pacific Islander ethnicity.

Dramatic social, demographic and behavioral differences exist between Asian American (AA) and Native Hawaiian/Pacific Islander (NHPI) groups, said lead study author Arnab Mukherjea, Dr.P.H., M.P.H., who was a postdoctoral scholar at the Center for Tobacco Control Research & Education at the University of California, San Francisco at the time of the study. Continue reading

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Smoking Mad: Tobacco users caught up in Obamacare “glitch”

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Cigarette Smokeby Charles Ornstein
ProPublica, March 24, 2014

Retired New Hampshire nurse Terry Wetherby doesn’t hide the fact that she smokes.

She checked the box on HealthCare.gov saying she uses tobacco and fully expected to pay more for her insurance policy under the Affordable Care Act. “It’s not a secret at all,” she said. 

Wetherby dutifully paid the premium Anthem Blue Cross and Blue Shield charged her for January and again for February — and believed she had coverage effective on Jan. 1.

Then when Wetherby went to pay her March premium, she was told she couldn’t. A check arrived in the mail refunding her February premium with a two-word explanation: “Contract cancelled.” Continue reading

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Something odd about your cigarette? FDA wants to hear about it

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Consumer Update from the FDA

Cigarette SmokeAre you using a tobacco product that you believe is defective or is causing an unexpected health problem?

Are you using a tobacco product that has a strange taste or smell?

The Food and Drug Administration (FDA) wants to hear from you and has a new online tool you can use to report your problem. Continue reading

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lesson one

Oregon schools use ‘behavioral vaccine’ to reduce smoking

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Blackboard with "Lesson one" written on it.

Photo: Krzysztof “Kriss” Szkurlatowski

By Kristian Foden-Vencil
Oregon Public Broadcasting

Behaving well in elementary school could reduce smoking in later life. At least, that’s what Trillium Community Health Plan hopes, and it’s putting money behind the idea.

Danebo Elementary in Eugene, Ore., is one of 50 schools receiving money to teach classes while integrating something called the “Good Behavior Game.”

Teacher Cami Railey sits at a small table, surrounded by four kids. She’s about to teach them the “s” sound and the “a” sound. But first, as she does every day, she goes over the rules.

“You’re going to earn your stars today by sitting in the learning position,” she says. “That means your bottom is on your seat, backs on the back of your seat. Excellent job, just like that.”

For good learning behavior, like sitting quietly, keeping their eyes on the teacher and working hard, kids get a star and some stickers.

Railey says the game keeps the kids plugged in and therefore learning more. That in turn makes them better educated teens and adults who’re less likely to pick up a dangerous habit, like smoking.

The Washington, D.C., nonprofit Coalition for Evidence Based Policy says it works. It did a study that found that by age 13, the game had reduced the number of kids who had started to smoke by 26 percent — and reduced the number of kids who had started to take hard drugs by more than half.

The fact that a teacher is playing the Good Behavior Game isn’t unusual. What is unusual is that Trillium is paying for it. Part of the Affordable Care Act involves the federal government giving money to states to figure out new ways to prevent people from getting sick in the first place.

So Trillium is setting aside nearly $900,000 a year for disease prevention strategies, like this one. Jennifer Webster is the disease prevention coordinator for Trillium Community Health, and she thinks it’s a good investment.

“The Good Behavior Game is more than just a game that you play in the classroom. It’s actually been called a behavioral vaccine,” she says. “This is really what needs to be done. What we really need to focus on is prevention.”

Trillium is paying the poorer schools of Eugene’s Bethel School District to adopt the strategy in 50 classrooms.

Trillium CEO Terry Coplin says changes to Oregon and federal law mean that instead of paying for each Medicaid recipient to get treatment, Trillium gets a fixed amount of money for each of its 56,000 Medicaid recipients. That way Trillium can pay for disease prevention efforts that benefit the whole Medicaid population, not just person by person as they need it.

“I think the return on investment for the Good Behavior Game is going to be somewhere in the neighborhood of 10 to one,” Coplin says.

So, for each dollar spent on playing the game, the health agency expects to save $10 by not having to pay to treat these kids later in life for lung cancer because they took up smoking.

Coplin concedes that some of Trillium’s Medicaid recipients will leave the system each year. But he says prevention still makes medical and financial sense.

“All the incentives are really aligned in the right direction. The healthier that we can make the population, the bigger the financial reward,” he says.

The Oregon Health Authority estimates that each pack of cigarettes smoked costs Oregonians about $13 in medical expenses and productivity losses.

Not all the money Trillium is spending goes for the Good Behavior Game. Some of it is earmarked to pay pregnant smokers cold, hard cash to give up the habit. There’s also a plan to have kids try to buy cigarettes at local stores, then give money to store owners who refuse to sell.

This story is part of a reporting partnership that includes NPROregon Public Broadcasting and Kaiser Health News

Photo courtesy of Krzysztof “Kriss” Szkurlatowski

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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As Washington delays, states move on e-cigarettes

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eBy Jake Grovum
Stateline Staff Writer

Money grab, health concerns, or both? Absent guidance from Washington, states are pressing ahead with their own agendas on electronic cigarettes.

Heading into legislative sessions next year, policymakers, industry representatives, health advocates and tax wonks expect electronic cigarettes — or e-cigarettes for short — to be among the top issues at state capitols.

Legislatures are expected to tackle how to classify, regulate and, perhaps most importantly, tax the relatively new products.

The debates in states come as the federal government considers its own answers to similar questions. The Food and Drug Administration is considering classifying e-cigarettes as “tobacco products,” which would extend its reach and potentially subject e-cigarettes to a host of rules and regulations that apply to tobacco cigarettes.

“States are scrambling to figure out how to deal with this,” Ohio Attorney General Mike DeWine said in an interview. “It’s going to be fought out in 50 states; it’s going to be fought out in one jurisdiction after another.”

DeWine was a lead author of an Oct. 23 letter sent by 40 attorneys general to the FDA pushing for federal rules and for e-cigarettes to be treated as “tobacco products” for regulatory purposes.

So far, Washington hasn’t decided how to proceed with e-cigarettes. A proposed rule, expected to be released for public comment in November, was delayed by the government shutdown and is still pending.

That has left a patchwork of rules, regulations and product definitions across the nation, often at the urging of anti-tobacco advocates. “We think it’s really important that states act,” said Danny McGoldrick, vice president of research at the Campaign for Tobacco-Free Kids.

More than half the states, for example, have banned the sale of e-cigarettes to minors, but others have no restrictions. Currently four states — Utah, North Dakota, Arkansas and New Jersey — have lumped the products in with tobacco under indoor smoking bans, even as research about possible ill-effects from second-hand vapor smoke, if there even are any, remains limited.

Some local governments have taken similar steps on their own, enacting rules for e-cigarettes that sometimes go beyond those in place at the state level.

The intensity of the debate illustrates both the lack of good research on e-cigarettes as well as the money at stake. Often, those considering limits don’t even agree on whether applying tobacco regulations is appropriate, given how different the products are. Like tobacco cigarettes, nicotine levels in the “cartridges” that are loaded into the e-cigarette device can vary widely, complicating efforts to agree on a standard approach to regulation and taxation.

E-cigarettes first appeared about a decade ago, and sales have grown exponentially in recent years. The number of American adults who said they have tried them doubled to one in five in just one year (from 2010 to 2011), according to a Centers for Disease Control survey.

Use among middle and high school students also doubled from 2011 to 2012, according to the CDC, with nearly 1.8 million students saying they’ve used them.

E-Cig Revenue

In an era of revenue-hungry state governments — some still dealing with declining revenue from traditional tobacco taxes and recovering from the Great Recession — taxing e-cigarettes seems likely to get the most attention from state lawmakers in 2014. Questions of advertising limits, health claims and ingredient disclosure will likely remain federal issues.

So far, only Minnesota has put in place a specific state tax policy for e-cigarettes, a decision reached in 2012. The products are subject to a 95 percent tax that functions like a sales tax, tacked onto the wholesale cost of the product.

That generally means they are taxed at a higher rate than traditional cigarettes, which are subject to a $1.29-per-pack levy. The state expects to collect $1.16 billion from all tobacco taxes in the 2014-2015 fiscal year.

For now, most other states apply only a sales tax – if they have one – to e-cigarettes. But at least 30 others are considering e-cigarette taxes of some kind next year.

“I will be watching to see if more proposals like Minnesota are replicated in the states,” said Scott Drenkard of the Tax Foundation, an anti-tax research group, “But I hope they are not.”

What this is is a money grab.

As tax experts see it, there’s little rationale aside from simply raising revenue for taxing e-cigarettes as traditional cigarettes. Tobacco, they say, is taxed because it produces negative health consequences that cost the public. For now, there’s little research that shows similar effects from e-cigarettes.

“There is zero, emphasis on zero, justification for taxing e-cigarettes right now,” said David Brunori of the group Tax Analysts, a nonprofit tax analysis group that provides insight to private firms and government agencies. “What this is is a money grab. It’s a way of trying to find revenue to replace lost tobacco taxes.”

According to the nonpartisan Tax Policy Center, state and local tax revenues have somewhat leveled off in recent years as smoking has declined. Collections grew from $7.7 billion in 1997 to $15.8 billion in 2007, but reached just $17.6 billion in 2011, the most recent year available.

Tobacco companies that don’t produce e-cigarettes have often pushed tax parity so their own products are not at a disadvantage. In Minnesota’s case, the state simply said that under its laws, the tax must apply.

But the most popular argument is deterrence—higher taxes might make the product less attractive and less affordable to young people looking for nicotine.

“It has nothing to do with revenue,” Ohio’s DeWine said. “It has everything to do with discouraging use.”

An Alternative to Tobacco

Discouraging use, however, is exactly the opposite goal lawmakers should have, said Ray Story of the Tobacco Vapor Electronic Cigarette Association. It’s an opinion shared by some outside of the industry as well, especially with regard to those already smoking.

“Cigarettes are sold everywhere in the world, and we want to make sure that the e-cigarette is sold as a less-harmful alternative right there next to it,” Story said.

“We should expand the use, not restrict it,” he added, saying that if e-cigarettes can greatly reduce cigarette use the industry “will have made the greatest impact on humanity ever.”

The contrasting approach reflects two key differences in thinking about e-cigarettes: as a new recreational product similar to tobacco cigarettes, or as a potentially less-unhealthy alternative that could even help smokers quit entirely.

E-cigarette producers themselves are divided. Some welcome traditional cigarette-style regulations to a degree, content to play by similar rules as tobacco producers, especially if it saves them from more onerous limits applied to drug manufacturers, for example. Others argue that even thinking about e-cigarettes through the same frame of reference as tobacco is a flawed approach.

Federal officials in Washington will likely be the ones to eventually settle the dispute, and that decision could still be months away. Meanwhile, debates in the states over two key issues within their control – taxes and sales to minors – are likely to rage in 2014.

But the eventual decision from the FDA is sure to affect those debates. “If the FDA says these are essentially tobacco products,” said Brunori of Tax Analysts, “that will give all kinds of cover to state politicians.”

Stateline logo

Stateline is a nonpartisan, nonprofit news service of the Pew Center on the States that provides daily reporting and analysis on trends in state policy.

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Seattle hookah bars violating laws banning public smoking, King County health officials say

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Public Health – Seattle & King County has found that six Seattle hookah bars are violating the state’s law banning public smoking and ordered them to stop allowing smoking on their premises.

Here’s the announcement from Public Health – Seattle & King County

Six Seattle hookah bars receive order for violating public smoking law

Six hookah bars in Seattle are on notice for violating Washington’s Smoking in Public Places law. Public Health – Seattle & King County sent each of the establishments a Notice and Order on Tuesday, October 1, requiring them to stop allowing smoking.

To protect public health, state law requires that all places of employment and public places are smoke-free.

Health inspectors visited the hookah bars multiple times. They found patrons smoking and each of the bars operating as a public place and/or place of employment.

“Our investigation shows that these hookah bars are violating the law, and endangering the health of their workers and patrons. We are forced to take this enforcement action because they haven’t been responsive to our previous warnings,” said Dr. David Fleming, Director and Health Officer for Public Health – Seattle & King County. “Secondhand smoke is a proven killer, and state law works to protect everyone from this health threat.”

Hookah bars have claimed that they are exempt from the indoor smoking law because they are private clubs. However, smoking is prohibited by law if a club has employees and/or the club is open to the public.

The investigation found that these six bars are all open to the public, operating similarly to night clubs that charge a cover for admission.

Each of the establishments received multiple warnings from inspectors, but they have not complied with Washington law. The Notice and Orders require immediate compliance plus payment of fines and fees.

The fine for each violation is $100, in addition to escalating re-inspection fees after the first warning. Subsequent violations will result in additional steps to ensure that state law is followed, including possible court action.

Hookah is a water pipe commonly used to smoke tobacco. Research shows that hookah smoking is at least as harmful as cigarette smoke, even when mixed with sweet fruit and candy flavors.

The establishments have ten days from receipt of the Notice and Order if they wish to appeal or 30 days to pay the fines and re-inspection fees.

Hookah bars receiving a Notice and Order this week include:

 

Lounge Address
Casablanca Shisha Lounge 1221 S Main St

Da Spot Hookah Lounge

1914 Minor Ave
Medina Hookah Lounge 700 S Dearborn St
The Night Owl 4745 University Way NE
Sahara Hookah Lounge 7523 Lake City Way NE
Seattle Hookah Lounge 4701 Roosevelt Way NE

 

Hookah health threat

Tobacco use remains the number one cause of preventable death and disease in King County, costing nearly 2,000 lives and $343 million dollars in health costs and lost wages locally every year.

  • Tobacco is placed inside the bowl at the top of the hookah.

    Tobacco is placed inside the bowl at the top of the hookah.

    Hookah is a water-pipe commonly used to smoke tobacco, often mixed with sweet fruit and candy flavors.

  • Research shows that hookah smoking is not a safe alternative to cigarettes and that hookah smoke is at least as harmful as cigarette smoke.
  • During a typical 45-minute session of hookah use, a person may inhale as much smoke as smoking 100 cigarettes or more.
  • Hookah smoke contains the addictive drug nicotine, along with tar, carcinogens, and heavy metals.
  • Hookah smoking has been associated with lung cancer, oral cancer, heart disease, respiratory illness, periodontal disease, and low birthweight.
  • Sharing a hookah mouthpiece can transmit infectious diseases, including tuberculosis.

Hookah and youth

Hookah use has seen a rise in popularity, especially among youth. According to the 2012 Healthy Youth Survey, hookah use among King County high school seniors is higher than cigarette use (15% and 12%, respectively).

‘We are very concerned about the high hookah use rates among youth,” said Scott Neal, Tobacco Prevention Program Manager for Public Health – Seattle & King County. “Sweet fruit and candy flavors lure youth and help fuel the misperception that hookah smoking is safer than cigarettes.”

Report smoking law violations

To report violations, visit the Tobacco Prevention Program page for an online form; or text the establishment’s name, date of violation, and brief description of the violation to  206-745-2548.

 

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Schools Are Getting Healthier, says CDC

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school-busBy Marissa Evans

Nowadays, the hub for developing healthy habits isn’t just the gym or home. For kids, at least, it’s increasingly their schools, according to a study released this week by the Centers for Disease Control and Prevention.

School districts across the country are demonstrating a range of improvements in terms of nutrition, exercise and tobacco policies.

For instance, after years of efforts to phase out junk food like candy and chips, the percentage of school districts that prohibited such food in vending machines increased from 29.8 percent in 2006 to 43.4 percent in 2012, according to the CDC’s 2012 School Health Policies and Practices Study.

Also, slightly more than half of school districts – up from about 35 percent in 2000 — made information available to families on the nutrition and caloric content of foods available to students.

“Schools play a critical role in the health and well-being of our youth,” said CDC Director Tom Frieden, in the news release. “Good news for students and parents — more students have access to healthy food, better physical fitness activities through initiatives such as ‘Let’s Move,’ and campuses that are completely tobacco free.”

Since 2000, the number of school districts that require elementary schools to teach physical education increased. In addition, the number of districts entering into agreements with local YMCAs, Boys & Girls Clubs or local parks and recreation departments went up, according to the study.

Meanwhile, the percentage of districts with policies that prohibited all tobacco use during any school-related activity increased from 46.7 percent in 2000 to 67.5 percent in 2012.

The CDC study is a periodic, national survey that examines key components of school health at the state, district, school, and classroom level, including health education; physical education and activity; health services; mental health and social services; nutrition services; healthy and safe school environment; faculty and staff health promotion; and family and community involvement.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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