[BoulderCouncilHotline] Articles and Academic Papers on E-cigs, Cigarettes, Nicotine and Tobacco

[Young, Mary]

Dear Colleagues and Community,

At last week's testimony I found Dr. Reema Wahdan-Alaswad<https://profiles.ucdenver.edu/display/227480> testimony intriguing. In her testimony, she warned that we were not looking at the big picture. I spoke with her yesterday and she sent me the following information that I am now sharing with you.

These articles are from my own informational search:
https://www.washingtonpost.com/local/dc-politics/how-dc-smokers-and-stores-are-responding-to-2-a-pack-cigarette-tax-hike/2018/11/22/441c4d8c-ece4-11e8-8679-934a2b33be52_story.html?noredirect=on

https://www.sciencedirect.com/science/article/pii/S2211335518302195

https://www.cdc.gov/statesystem/excisetax.html

Information from Dr. Wahdan-Alaswad:
Smokers increasingly use e-cigarettes for many reasons, including attempts to quit combustible cigarettes and to use nicotine where smoking is prohibited. Researchers have aimed to assess the association between e-cigarette use and cigarette smoking cessation among adult cigarette smokers, irrespective of their motivation for using e-cigarettes.

Over 270,000 journals link cigarette use with multiple forms of cancers. Only 3,000 journals discuss e-cigarettes and the results are still being collected.
While no one argues that e-cigarettes are “healthier” than use of cigarettes, many physicians and researchers do agree that e-cigarettes help patients transition of smoking cigarettes.
*Use of e-cigs helps smokers abandon cigarettes by 28%. (https://www.ncbi.nlm.nih.gov/pubmed/26776875<https://protect-us.mimecast.com/s/hCtxCpYLWVizjOrXIYp31p?domain=ncbi.nlm.nih.gov>)
Do They Lead Kids to Smoke?
Critics of e-cigarettes fear that vaping will get kids hooked on nicotine and that they'll "graduate" to cigarettes when they want a bigger kick, Warner says.
A 2016 study in the journal Pediatrics found that teens that never smoked but used e-cigs were six times more likely to try cigarettes compared to kids who don't vape.
But, CDC stats on teen smoking show that while use of e-cigs went up to 24% in 2015, cigarette smoking dropped to an historic low -- to just under 11%.
The trend is reassuring, Benowitz says.

Regulations
The FDA is regulating e-cigarettes and tobacco products such as hookah tobacco and cigars in the same way as cigarettes and smokeless tobacco. Key rules include:
• No one under age 18 can purchase them -- in stores or online.
• Sellers will need to check ID of anyone under 27 years of age.
• The products can't be sold in vending machines, except for in adult-only facilities.
• Free samples are banned.

While the ordinance post strict rules and regulations many business in Boulder are unable to adhere to the 21 and over amendment. Additionally, blocking smokers form getting access to e-cigarettes does more harm than help. Researchers and Physicians are open to improving their smoking cessation counselling and to integrating new patient educational materials that addressed e-cigarettes. Patient educational materials that provide tailored information about e-cigarettes could potentially be used initiate e-cigarette discussions and inform smokers about what is known vs unknown about e-cigarettes. (Adapted from this paper-- https://www.ncbi.nlm.nih.gov/pubmed/30784164<https://protect-us.mimecast.com/s/GYcOCqxLW8iOpkAmFE_qIa?domain=ncbi.nlm.nih.gov>)


E-Cigs Safer than Combustible Cigarettes

A review of e-cigarettes commissioned by Public Health England (an executive agency in the United Kingdom’s Department of Health) published its review in 2015 declaring vaping is at least 95% safer than smoking.10<https://protect-us.mimecast.com/s/HozACQWgrLc653pWcxptPT?domain=ncbi.nlm.nih.gov>

10. Public Health England. E-cigarettes around 95% less harmful than tobacco estimates landmark review, August 2015: Accessed October 21, 2016 at www.gov.uk/government/news/e-cigarettes-around-95-less-harmful-than-tobacco-estimates-landmark-review<https://protect-us.mimecast.com/s/2AzJCVOnzZIlD56ACyNYtu?domain=gov.uk>.





Tobacco Companies wining on E-Cig BAN

This little-known tobacco stock is a big winner from e-cigarette bans

https://www.marketwatch.com/story/this-little-known-tobacco-stock-is-a-big-winner-from-e-cigarette-bans-2019-07-12<https://protect-us.mimecast.com/s/qJW1CW6oABijAPKBFnnN5e?domain=marketwatch.com>



A Flurry of States Have Raised Their Smoking Ages. But Big Tobacco's Involvement Has Some Health Groups Uneasy

https://time.com/5593618/vaping-tobacco-21-laws/<https://protect-us.mimecast.com/s/4jX8CXDpBVtnxqRYimKYNV?domain=time.com>



San Francisco vape ban could hinder war on tobacco, say UK experts

https://www.theguardian.com/society/2019/jun/29/san-francisco-vape-ban-could-hinder-war-on-tobacco-say-uk-experts<https://protect-us.mimecast.com/s/umySCYEqDXF3zNqxHZGIqO?domain=theguardian.com>



E-cigarettes: Good news, bad news<https://protect-us.mimecast.com/s/ZtmWCZ6rEXiM3DLNCXikYY?domain=health.harvard.edu>

https://www.health.harvard.edu/blog/electronic-cigarettes-good-news-bad-news-2016072510010<https://protect-us.mimecast.com/s/ZtmWCZ6rEXiM3DLNCXikYY?domain=health.harvard.edu>



·         One review concluded that real-world use of e-cigarettes is associated with lower quit rates<https://protect-us.mimecast.com/s/nvxTC1w3k7ip7koYuOzPfw?domain=thelancet.com>.



More Info

The E-Cigarette Debate: What counts as evidence

https://www.nyu.edu/about/news-publications/news/2019/july/will-an-e-cigarette-ban-do-more-harm-than-good-.html<https://protect-us.mimecast.com/s/DidUC2kDlJukNRXwULypIG?domain=nyu.edu>

·         In  recent years, their focus has turned to e-cigarettes: a 2017 study in the journal <https://protect-us.mimecast.com/s/kAtYC31VmJim5GlQUpA85q?domain=tobaccocontrol.bmj.com> Tobacco Control<https://protect-us.mimecast.com/s/kAtYC31VmJim5GlQUpA85q?domain=tobaccocontrol.bmj.com> co-authored by Abrams and Niaura found that if most American smokers switched from cigarettes to vaping over the next 10 years, it could save as many as 6.6 million lives.

https://www.nbcnews.com/news/us-news/banning-e-cigarettes-not-tobacco-products-ludicrous-some-public-health-n1022176<https://protect-us.mimecast.com/s/FVHeC4xGnKiJpmO1H5J0WU?domain=nbcnews.com>

·         Dr. Michael Siegel, a professor at Boston University School of Public Health whose research focuses on tobacco reduction, called the ban an "insane public policy."

·         The worst part of this, beyond the fact that it makes no sense from a public health perspective, is I think it's actually going to do public health harm," he continued. "By taking e-cigarettes off the shelves, you're basically going to force a lot of ex-smokers to go back to smoking."



·         But the plans to ban flavored cigars and menthol cigarettes “will have a greater impact in reducing tobacco use by youth and the African-American community than any regulatory measure ever undertaken by the federal government,” the Campaign for Tobacco-Free Kids said in a statement.

·         In November, vaping groups said the e-cigarette<https://protect-us.mimecast.com/s/LVxHC5yKo0T0Vx7GTVBuqO?domain=consumerreports.org> restrictions would be harmful to smokers trying to quit.

·         “This reported move by Commissioner Gottlieb will only make it harder for adult smokers to switch to a far less harmful alternative,” said Gregory Conley, president of the e-cigarette group American Vaping Association.

·         Efforts to curb teen vaping have also fared poorly. Those calling for more regulation of the vaping industry seem to forget that the FDA first passed regulations<https://protect-us.mimecast.com/s/PJnjC68KpVion1vKtQUKPL?domain=fda.gov> banning e-cigarette sales to minors in 2016<https://protect-us.mimecast.com/s/18PGC73VqJhmOQKkU1-D7D?domain=cbsnews.com>. However, teen vaping rates have substantially increased<https://protect-us.mimecast.com/s/XQ4CC82KrYij7z0RFltIqa?domain=cnn.com> since 2016.



·         Since previous efforts to promote health or deter vice have persistently failed, why should we expect anything different this time? If anything, we should expect vapers to switch to alternative nicotine products.

·         And the alternatives might be more harmful. Regulations limiting physicians’ ability to prescribe opioids frequently motivate patients to seek out heroin<https://protect-us.mimecast.com/s/4xKGCn56WJFGJK2oSLEgkI?domain=cnn.com> to cope with their addiction. Taxing soda<https://protect-us.mimecast.com/s/HdWzC0RDj3H2RM53f8BUDn?domain=jech.bmj.com> entices more consumption of alcoholic beverages or sugary fruit drinks.



·         Vaping is harmful<https://protect-us.mimecast.com/s/Da_6CgJMWXClLmR2C5McgL?domain=hopkinsmedicine.org>. But since vaping restriction might lead millions<https://protect-us.mimecast.com/s/bI0bCjR6WJHj73XqFqk7Nu?domain=atr.org> to switch to the number<https://protect-us.mimecast.com/s/z1hiCkRXWMHnMrjQijKbhw?domain=cdc.gov> one<https://protect-us.mimecast.com/s/z1hiCkRXWMHnMrjQijKbhw?domain=cdc.gov> cause of preventable death in the country, we must exercise caution so as not to make an epidemic exponentially worse.

·         San Francisco and Livermore may be the first cities to ban e-cigarette sales, but they would not be the first to cause considerable harm by enacting overzealous policies. Both should seriously reconsider before their plans to curb teen vaping go wildly up in smoke.



Mary Dolores Young
Boulder City Council
303-501-2439

"All ethics . . . rest upon a single premise: that the individual is a member of a community of interdependent parts . . ." - Aldo Leopold

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