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Monday, April 6, 2015

Enormous Numbers of Children Smoking In Scioto County: "How About E-Cigarettes?"

I would like to preface this entry with a couple of reasons for my opinions about electronic cigarettes. I realize my voice as a nonsmoker has bias; however, in a county with tremendous health concerns, I think it is important to consider both pros and cons of consuming e-cigarettes.

First of all, according to the "Monitoring the Future" Pride Surveys, part of Ohio's 2015 Conference on Opiates and Other Drugs compiled by the Ohio Association of County Behavioral Health Authorities and Mission Possible 2015, Scioto County has these extremely important concerns:

* In the past 30 days, 19.2% of teens in Scioto County compared to an average of 7% of teens in the United States used cigarettes.

* In the past 30 Days, Scioto County teens smoked cigarettes at a rate 93% higher than the national average.

With these figures, I realize the importance of e-cigarettes in the fight against combustible cigarette smoking. It is estimated that more than 20 million people -- about one in 10 adults -- have tried e-cigarettes, and plenty of those people have become vaping devotees. The e-cigarette can be a very effective weapon to those who wish to quit consuming nicotine.

So, what is the problem with the current state of smoking cessation?

E-cigarettes were introduced in the United States less than ten years ago, and since then, e-cigarettes have gone relatively unregulated by health agencies. Companies marketing the products have been free to make their own rules.

Of particular concern is the fact that e-cigarette companies have been advertising their products to adults and children alike, claiming to help smokers quit while simultaneously promoting the candy-flavored liquids to all consumers. The companies have advertised their products, unhindered by the FDA’s ad regulations for tobacco products. It is evident many ads seem "shockingly child-centric."

For example, in this commercial, Jenny McCarthy flirts with the camera while rejoicing that she can now smoke without scaring guys away with her smell:

“It’s totally out of control,” says Stanton Glantz , director of the Center for Tobacco Control Research and Education at the University of California San Francisco . “For the first time since 1972, we have recreational nicotine being advertised on television and radio... The youth use is exploding in parallel to the marketing.” 

Health organizations, including the Centers for Disease Control and Prevention and even city-based public health departments are starting to fight back with their own media campaigns.

On March 30, the CDC began its first anti-smoking campaign featuring e-cigarette users. Last week, the California Department of Public Health launched a anti-vaping campaign called Still Blowing Smoke . And in January, the San Francisco Department of Health launched #CurbIt , pointing out the dangers of e-cigs and their brazen plays to hook kids while warning residents that vaping is only allowed in the same places as smoking.

(Danielle Venton. "The war over vaping's health risks is getting dirty."
MSN News. April 06, 2015)

The Good, the Bad, and the Ugly

Having products available to help people quit smoking is both necessary and beneficial. With a huge population of users, many already credit e-cigarettes with helping them to quit smoking. Of course, they loudly defend the choice to vape. E-cigarettes are almost certainly less toxic and carcinogenic than regular cigarettes.

Yet ...

That doesn’t mean that they’re not a health hazard.

Plenty of evidence currently exists in studies that link e-cigarettes to asthma, lung inflammation, MRSA infection risk, and exposure to harmful chemicals. But with little data on the long-term health effects of e-cigarettes and their usefulness as a quitting tool, ads for the products use a number of classic psychological strategies to back pro-vapers. In a couple of years, researchers will begin to do association studies to pull out long-term health effects.

Here are conclusions from one current study of electronic cigarettes:

"Current state of knowledge about chemistry of liquids and aerosols associated with electronic cigarettes indicates that there is no evidence that vaping produces inhalable exposures to contaminants of the aerosol that would warrant health concerns by the standards that are used to ensure safety of workplaces. However, the aerosol generated during vaping as a whole (contaminants plus declared ingredients) creates personal exposures that would justify surveillance of health among exposed persons in conjunction with investigation of means to keep any adverse health effects as low as reasonably achievable. Exposures of bystanders are likely to be orders of magnitude less, and thus pose no apparent concern."

(Igor Burstyn. "Peering through the mist: systematic review of what the chemistry of contaminants in electronic cigarettes tells us about health risks."
 BMC Public Health 2014, 14:18. January 09, 2014)

It seems to me that marketers of e-cigarettes should follow the same established requirements about advertising and promoting cigarettes. In 2010, FDA finalized a historic set of federal requirements as part of the Tobacco Control Act designed to curb access to -- and the appeal of -- cigarettes and smokeless tobacco products to children and adolescents in the United States.

Children are a potentially deadly target population for anti-smoking efforts because studies cited by the American Lung Association and the Centers for Disease Control show that 90 percent of smokers began the habit when they were younger than 18. Health officials say that each day, 4,000 children younger than 18 try cigarettes for the first time and 1,000 of them become lifelong smokers.

About 450,000 people in the United States die from smoking-related illnesses each year, according to the Centers for Disease Control and Prevention. On average, smokers die 14 years earlier than nonsmokers.

Then, we have Scioto County, where teen smoking is much more of a major health concern than in the rest of the country. Messages that smoking is cool, edgy, and mature appeal to many teens. E-liquids usually contain a mixture of propylene glycol, glycerin, nicotine, and flavorings. Smoking e-cigarettes for the wrong reasons can lead to the habit of combustible cigarette smoking.

Electronic cigarettes may carry a risk of addiction for those who do not already smoke. Teens should  not just consider smoking e-cigarettes for consequential social reasons of dating combustible smoking "dragons" and being around "smoky, smelly" friends, but they should also consider never smoking e-cigarettes primarily for reasons dangerous to their health.

("Questions and answers on electronic cigarettes or electronic nicotine delivery systems -- ENDS." Statement from the World Health Organization. July 09, 2013)

I contend that electronic cigarettes can be a useful tool for a person attempting to quit smoking; however, I also contend that promoting smoking of any kind, especially to youth, is detrimental to good health concerns. Children must be protected.

Given the high risk potential of teens, glamorous and stylish consumption advertising of e-cigarettes invites the potential of continued high health risks and the obvious gateway to smoking combustible cigarettes. These electronic cessation devices are not guaranteed to deliver the smoker from a costly vice -- a vice that robs the pocketbook and the life from the organs of the human body.
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