“The time is now to end the youth e-cigarette epidemic, and Gov. Inslee’s call for prohibiting flavored e-cigarettes is exactly what we need,” Myers said in a written statement.
“The evidence is clear that flavored e-cigarettes have fueled this epidemic — 97% of youth e-cigarette users report using a flavored product in the past month and 70% cite flavors as the reason for their use. The recent spate of serious lung illnesses associated with e-cigarette use has added to the urgency of acting now to protect our kids and, indeed, the health of all Americans,” he said in the statement. “We look forward to working with Gov. Inslee and state lawmakers to pass this legislation and end the youth e-cigarette epidemic.”
Massachusetts may be next.
The state Senate of Massachusetts approved a ban on all flavoured e-cig products and a 75 percent excise tax on e-cigs. The state house earlier approved a similar bill.
The bill will be sent to a joint committee before being sent to Gov. Charlie Baker, a Republican. Baker has not stated if he will approve it, but he did impose a temporary ban on e-cig sales after the rash of illnesses broke out earlier this year.
The state of Michigan and the city of San Francisco have already banned the sale of e-cig flavours. San Francisco’s ban is a ban on all e-cig sales, period.
Washington is the latest state that will be raising its smoking and vaping age to 21. The Washington State Senate just passed a bill and Gov. Jay Inslee quickly signed it earlier this month.
This is a push going on nationwide in cities and states. Washington is the ninth state in the nation to raise the smoking/vaping age to 21.
This is something I’ve long had slightly mixed feelings about. I think there’s a valid argument that if you’re old enough to vote, join the military and go to adult jail, you’re old enough to smoke and vape.
During debate over the measure, Sen. Mike Padden, R-Spokane Valley, pointed out that 18-year-olds can make major life decisions such as joining the military, and called it hypocritical to stop them from smoking if they wanted.
“The nanny state is alive and well, and this is another example,” said Padden.
However, I also hear the argument that this is a tool to stop the rapid increase in teen vaping. If you have to be 21 to buy vaping products it makes it that much harder for some 15-year-old kid to do it in a convenience store.
There are bills in other states, such as Virginia and Texas, to raise the smoking age, but I have no idea if there is any chance of passage in these states.
It’s been such a mixed week for e-cigs, with one study showing e-cigs are more successful than nicotine patches and gum for helping people quit, yet the American Lung Association ripping the FDA as a “failure” for doing nothing to stem the tide of teen vaping.
Well, this week another study came out that e-cigarettes, while perhaps safer than cigarettes, are still not completely harmless.
In what is admittadly a pretty limited study, a new survey by the American Stroke Association shows that e-cig use is associated with a higher risk of strokes and heart attacks.
“There’s a certain notion that e-cigarettes are harmless,” says Dr. Paul Ndunda, the study’s author and an assistant professor at the School of Medicine at the University of Kansas in Wichita. “But this study and previous other studies show that while they’re less harmful than normal cigarettes, their use still comes with risks.”
This study relied on a behavioral factor survey from the CDC and looked at 66,000 e-cig users. It found a 71 percent higher risk of stroke, 59 percent higher risk of heart attack and 40 percent higher risk of heart disease.
(OK, I’m going to be honest here … while I’m sure these figures are accurate, my first question is how many of these e-cig users are smokers and former smokers … the increased risk of stroke and heart disease could be from the smoking more than the e-cigs.)
The study does get into this to a degree, to be fair.
Ndunda found e-cigarette users are twice as likely to also smoke conventional cigarettes, compared with people who don’t use e-cigarettes.
To see the health effects of e-cigarette use alone, Ndunda and his colleague Dr. Tabitha Muutu compared people who had only used e-cigarettes — not conventional cigarettes — to nonsmokers.
“Even in that group there was a 29 percent higher risk of stroke and a 25 percent higher risk of heart attack,” Ndunda says. Taken together, these two analyses point to an additive effect of e-cigarette and conventional cigarette use.
So, Ndunda admits in the aritlce that the study has its limitations because there’s so many factors at play here — e-cigs, mixing e-cigs and cigarettes, and my point, the pre-existing damage experienced by former smokers from their decades of cigarette use.
Anyway, this survey strongly suggests it’s probably a really, really bad idea to mix e-cigs and cigarettes together. That if you’re going to use e-cigs, you really have to quit cigarettes to actually have any health benefit.
Three studies came out in one day about e-cigarettes, two very, very negative and the third one with positive news.
It sort of sums up the mixed bag that are e-cigs, and sums up the quandary about them.
First, the good news. A recent study by Queen Mary University in London, published by the New England Journal of Medicine shows that e-cigarettes are far more effective than nicotine gum or patches in getting people to quit cigarettes.
The study involved 886 smokers, half were given the option to quit using e-cigs and the other half were given the option to quit through patches, gum or other nicotine replacement therapies.
After one full year, 18 percent of the e-cig group was able to quit smoking, while just 9.9 percent of the patches and gum group quit.
Those percentages may not sound good, but it’s widely known that nicotine replacement treatments have a pretty high failure rate. Most smokers, it takes four or five tries or more to actually quit.
Doctors have been wary of recommending people use e-cigarettes as a way to wean themselves off conventional cigarettes, citing both the lack of evidence showing they work and lack of data on the long-term health effects of using the products. The new study may quell some of those concerns. However, the study is also likely to receive some pushback because it was conducted in the United Kingdom, which has embraced and even encouraged e-cigarettes as an alternative for adult smokers.
Here’s another flaw with the study, I think. The point of patches and gum is to eventually wean people off of addictive nicotine. However, that’s not how very many people really use e-cigs. They remain addicted to the nicotine, and in my opinion, as long as they remain addicted, they remain at risk at falling back onto cigarettes.
From the same article:
“While e-cigarettes are ‘safer’ than traditional cigarettes, they are not without risks,” Boston University professors Belinda Borrelli and George O’Connor said in a statement.
They also pointed to the finding that at the one-year mark, 80 percent of people in the e-cigarette group were still using the devices. So while people stopped smoking cigarettes, they were still using e-cigarettes. The study’s authors also noted this finding, saying it “can be seen as problematic if e-cigarette use for a year signals ongoing long-term use, which may pose as-yet unknown health risks.”
Huge numbers of teens using the products — particularly one brand, Juul — have soured perceptions about e-cigarettes in the U.S. Even Food and Drug Administration Commissioner Scott Gottlieb, who has championed the devices as a way to help adult smokers, says the industry is at a tipping point.
That final paragraph about Juuls explains the condundrum about e-cigarettes. While they appear to have a very valid and genuine value in helping some people quit smoking, the down side is their use among teens has exploded in the past five years … and these are kids who have never smoked a cigarette in their lives. They’re not using e-cigs to get off cigarettes, they’re using them to get addicted to nicotine to begin with.
The FDA has started talking tough about e-cigs the past couple of months, even going so far as saying it might just outright ban e-cigs. If 18 percent of the people who try e-cigs to get off cigarettes are successful, I think that’d be a terrible step in the wrong direction.
But, they gotta stop the teen epidemic of vaping. If that means banning fruity e-cig flavours, so be it. I personally would like to see e-cig marketing more strictly regulated. I liked the idea the FDA came up with a few weeks ago (and quickly dropped, unfortunately), of only allowing e-cig sales in tobacco shops, where you have to show an ID just to walk into the door. The FDA came up with some odd idea of only allowing e-cig sales in adult areas … but still allowing them to be sold in convenience stores. How could that even work?
Anyway, an interesting study showing the other side of the e-cig debate and showing that it’s not a black and white issue.
The war between FDA chief Scott Gottlieb and the e-cig industry continues to escalate with Gottlieb last week threatening to just say “Fuck it” and completely take e-cigs off the market.
To wit, the Food and Drug Administration has come out harshly against the e-cig industry beginning about six months ago because of the skyrocketing increase in teen vaping rates.
So, the FDA came out with a series of rules regarding e-cigs, including some restrictions on fruity flavours and the requirement that e-cig products only be sold in areas open to adults. The FDA didn’t get into marketing of e-cig products.
These rules weren’t as strong as what *I* had hoped for, at the very least, I liked an idea that was floated to restrict e-cig sales strictly to tobacco shops, but that got dropped, likely because of pressure from the industry.
Anyway, Gottlieb said he has met with industry representatives and he remains unimpressed with their response so far.
This is a quote from a Gottlieb tweet:
I still believe e-cigarettes present an opportunity for adult smokers to transition off cigarettes and onto nicotine delivery products that may not have the same level of risks. However, if the youth use continues to rise, the entire category will face an existential threat
“I’ll tell you this. If the youth use continues to rise, and we see significant increases in use in 2019, on top of the dramatic rise in 2018, the entire category will face an existential threat,” Gottlieb told a meeting. “It will be game over for these products until they can successfully traverse the regulatory process.”
Gottlieb said he has met repeatedly with the vape industry. “I find myself debating with tobacco makers and retailers the merits of selling fruity flavors in ways that remain easily accessible to kids,” he said.
Last November, Gottlieb said he was starting the process to limit sales of flavored e-cigarettes, as well as to ban menthol in combustible cigarettes.
“I have questions about whether they are living up to the very modest promises that they made,” he said. “It matters if the e-cig makers can’t honor even modest, voluntary commitments that they made to the FDA.”
I’m curious if the industry is taking these threats seriously? Juul very quickly shut down its social media presence, but it might be too little, too late to slow down teen vaping use … or to satisfy the FDA.
Gottlieb said the dramatic rise in e-cigs is sabotaging the success public health advocates have had in cutting the teen smoking rate.
“This progress is being undercut — even eclipsed — by the recent, dramatic rise in youth vaping. A few years ago, it would have been incredible to me that we’d be here, discussing the potential for drug therapy to help addicted youth vapers quit nicotine,” he said Friday.
Gottlieb cited statistics about the large use of e-cigarettes by young people, saying that between 2017 and 2018 there was a 78 percent increase in e-cigarette use in high school students, and a 48 percent increase among middle schoolers. That means the total number of middle- and high-school students using e-cigarettes rose to 3.6 million — 1.5 million more than used the product the previous year. He added that more than a quarter (27.7 percent) of high-school-age e-cigarette users use the product regularly, and more than two-thirds (67.8 percent) are using flavored e-cigarettes.
“Youth use of e-cigarettes has become an epidemic,” Gottlieb said, adding, “It could be ‘game over’ for some [of] these products until they can successfully traverse the regulatory process. I think the stakes are that high.” Gottlieb also noted that e-cigarettes can be a helpful tool for adults trying to quit smoking traditional cigarettes, and said he hopes to avoid removing e-cigarettes from the market because of the good they can serve in that regard.
Stay tuned. Gonna be a rocky year on this issue likely.
The tobacco industry will sell you the disease and now will sell you the cure.
This came out a couple of weeks ago and apparently this week it became official. Juul, those cutesey little e-cigs that plug into laptop computer and look just like a flash drive, came to completely dominate the e-cig industry incredibly quickly, eating up 75 percent of the market in less than two years.
Altria just invested $13.5 BILLION into Juul, taking ownership of 35 percent of the company.
Juuls sort of advertised themselves as an indie company against the tide of Big Tobacco. No more. Juul IS BIG TOBACCO now, baby. Altria, formerly known as Philip Morris, makers of Marlboro cigarettes.
Here’s the shit that actually pisses me off. From an AP story:
Juul will remain an independent company, but it gains access to Altria’s massive infrastructure and reach. Namely, Altria will help Juul secure space on store shelves beside traditional cigarettes. It will also help Juul reach smokers via cigarette pack inserts and mailings.
Yeah, fuck you, Juul. You’ve been one of the biggest guilty parties, if not THE biggest guilty party, in marketing e-cigs to kids. Now that you’ve got these teenagers hooked on nicotine, you get Altria’s [quote] “massive infrastructure and reach.”
“I am officially declaring e-cigarette use among youth an epidemic in the United States,” Adams said at a news conference. “Now is the time to take action. We need to protect our young people from all tobacco products, including e-cigarettes.”
“We have never seen use of any substance by America’s young people rise this rapidly,” Health and Human Services Secretary Alex Azar said at the briefing. “This is an unprecedented challenge.”
Officials at this press conference largely blamed Juul for the epidemic, though to be fair, the increase in teen vaping was already happening before Juuls hit the market about two years ago.
Less than 2 percent of teens were vaping in 2011. In 2018, that figure has increased to 21 percent.
At the same time, there’s been a big decrease in teens smoking, which is great.
Teens getting addicted to nicotine, not so great.
I debated with a few vaping advocates on this story. They keep harping on two really false and lame narratives.
One: Who cares if teens are vaping … would you rather they be doing crack or meth?
Well, no, of course, that’s just stupid. I’d rather they not do ANY addicting substances. It’s not an either/or situation. It’s not either they vape or they do meth. I’d rather they do NEITHER.
And the second lame point: “Well, e-cigs don’t have the toxins of cigarettes, and they’re much safer than cigarettes.”
Yes, probably. And I emphasize “probably,” big time. Because the jury is still out about that. No one is totally sure everything that is in e-cig vapour. Yes, e-cigs don’t contain the Polunium-210 and carbon monoxide and benzene that cigarette smoke does, but it still contains formaldehyde and most of all … nicotine, which is incredibly addictive. And studies have shown that a higher percentage of teens who vape eventually take up smoking to get their nicotine fixed filled, than teens who never vaped to begin with.
Anyway, I’m going to get into these weak-ass arguments in a little more in-depth in a later post about libertarian fake journalist and tobacco industry apologist stooge John Stossel (again … this isn’t my first go-around with Stossel, who seems to really have a thing about tobacco issues.).
Anyway, to try and combat the increase in teen vaping, the FDA has proposed putting limits on where e-cigarettes can be sold, ruling that they must be sold in an area closed off to minors. The FDA pulled up just short of flat out banning e-cigarette sales in minimarts and convenience stores, which was being proposed.
Strong language, for sure from the surgeon general. It’s going to be really interesting what will happen with the e-cigarette industry in the next two or three years.
Here’s a good article from the Verge about what Adams’ proclamation actually means. It means e-cigarettes are squarely in regulators’ sites:
The Surgeon General’s power is more about influence, and less about enforcement: the real regulatory power over vaping comes from the Food and Drug Administration. So this advisory doesn’t have any legal force, Micah Berman, a professor of health services management and policy at The Ohio State University, tells The Verge in an email. “They are a tool used by the Surgeon General to call attention to an issue and to provide guidance to the public,” Berman says. “They are only issued rarely, when immediate action is called for — which is what makes them so noteworthy.”
That’s why it’s particularly significant that the Surgeon General is using the word “epidemic,” says Kathleen Hoke, a professor specializing in public health law at the University of Maryland: “Using the e-word, epidemic, takes it to a higher level. From a public health perspective, we try not to use that word unless it’s warranted — otherwise you have the boy cried wolf,” she says. But she says, according to these health officials, youth vaping has reached that level: “It’s broad, vast in its impacts, and of deep concern about its lasting effects.”
The headline to this article is slightly misleading. They aren’t talking about just a ban on flavoured tobacco in California, they’re talking about a ban on flavoured tobacco and flavoured e-cigarette products. I still think it’s important to differentiate between the two.
This is all part of a recent crackdown on e-cigarettes and their fruity, sugary flavours. The e-cigarette industry isn’t really fooling anyone when they claim they aren’t marketing to kids when they make flavours like “Smurf grape” and bubble gum.
Juul has apparently agreed to stop sales of some of its sweet flavours. Candy-flavoured cigarettes were banned some time ago, but Swisher sweet cigars, a long-established product and menthol cigarettes were still allowed.
Now, the FDA is moving to ban all flavoured tobacco products and menthol cigarettes. That move could be tied up in courts for a while, because menthol cigarettes are BIG business (roughly about 10 percent of cigarette sales) and the tobacco industry simply isn’t going to go down without a fight.
The City of San Francisco banned the sale of flavoured e-cig products and several state legislators in California are proposing a similar statewide ban.
Here’s my attitude about the sweet flavours. If e-cigs are really designed to help get smokers off cigarettes, then the draw should be the nicotine, not the flavour of the steam. By having strawberry and lemon-lime and what have you flavours, this to me is pretty clearly just part of the e-cig’s craven tactic of making their products appealing to kids — who are not using e-cigs to get off cigarettes, they’re using e-cigs to get addicted to nicotine to begin with.
Anyway, I hope the bill passes and in California, it probably has a good chance to pass. The day of reckoning for the e-cig industry has arrived, I think.
I wrote a few days ago about how Altria is expanding its business to marijuana. Altria, which already owns the e-cigarette brand MarkTen, is now making a move to buy into the biggest e-cigarette brand out there, Juul.
It’s interesting. A lot of people think e-cigarettes and cigarettes are somehow in competition. Nothing could be further from the truth. They’re really two sides of the same coin, doing a cutesy little dance around each other.
At one time, Big Tobacco controlled about 80 percent of the e-cigarette market. Altria had MarkTen, RJ Reynolds controlled Blu for a while, then Blu was sold to and controlled by Imperial Brands, a subsidiary of Philip Morris. Meanwhile, RJ Reynolds kept control of Vuse. Those three brands constituted about 80 percent of the e-cigarette market.
So, no, e-cigarettes were not competing with Big Tobacco. E-cigarettes WERE Big Tobacco. All those people usuing e-cigarettes to get off cigarettes. All those people using e-cig to say “F U” to the tobacco industry. Hey, you were giving your money to the same CEOs. Big Tobacco was selling you both the disease and the cure.
Then, along came Juul to overturn the apple cart. Juul is a relatively new player in the e-cigarette market and sometime around 2017, this company started dominating the e-cig industry, pushing down Big Tobacco’s share in the market. Juul’s share got up to 75 percent. They did this in about two years.
Now, Altria is following the Big Tobacco playbook. When you can’t beat them in the marketplace, simply buy them out.
Juuls are incredibly convenient. They look exactly like a computer flash drive. They can charge up by plugging them into a laptop. And the flavour viles are little and easy to use.
Juuls are controversial with a lot of people in the tobacco control industry because the company, much like Blu, was pretty fucking brazen about marketing to teens. Juul relied heavily on social media to market itself and they got themselve in the crosshairs big time not only of the tobacco control community, but of the FDA. After the FDA started suggesting that it was cracking down on e-cigs because of the explosion of e-cig use by teenagers, Juul very quickly abandoned all of its social media accounts and announced that it would no longer sell many of its fruity and surgary flavours.
Along comes Altria to save the day. Altria, the parent company behind what used to be known as Philip Morris, is abandoning its failed MarkTen product.
According to this CNBC article, Altria is looking at buying a “significant” share of Juul. And again, we follow the same pattern as Blu and MarkTen and Vuse.
Now, this news came out around the same time as the FDA announced that it was cracking down on e-cigs, mostly by requiring that e-cigs be sold in areas closed off to minors, and Juul shut down its social media accounts. We all know Altria has a long, long history of playing cutesy with the “Marketing to teens? Moi? Never!” game that Juul and every other e-cig brand has copied from.
I see this as Altria evolving and trying to stay an active player in the nicotine addiction game, via e-cigs and international marekts. (And my concern about Altria getting involved in marijuana is over the company cooking up schemes to add nicotine to marijuana to make it more addictive). This is a multi-billion dollar corporation that has no plans of simply slinking off into the sunset.
Big update today because there’s a LOT to talk about.
Well, the FDA did it, they came down fairly hard on e-cigs. And not just e-cigs, but finally came down on menthol cigarettes and flavoured cigars like Swisher sweets.
I keep scratching my head and asking myself … wait, this is the Trump Administration? The incredibly anti-regulatory and pro-business Trump Administration imposing a whole bunch of new regulations on e-cigs and cigaretttes.
The FDA is making its move as new figures from the Centers for Disease Control show a 78 percent increase in the use of vaping among teenagers since 2011.
E-cig use by teens went up from 1.5 percent of teens in 2011 to 20.8 percent of teens in 2018, according the CDC. The industry has played coy and cutesy about
“These data shock my conscience: From 2017 to 2018, there was a 78 percent increase in current e-cigarette use among high school students and a 48 percent increase among middle school students,” said FDA administrator Scott Gottlieb.
We’re not telling the retail stores you can’t sell them,” Gottlieb said. “If the establishments want to continue to sell these fruity flavored products, they’re going to have to put into place measures that will make sure they are not going to get into the hands of kids,” Gottlieb told NBC News.
OK, this is a big story that kept getting bigger, so let’s start with e-cigs.
Restrictions on sales of e-cigs and e-cig flavours
The new e-cig policy is confusing and I’m still trying to parse it.
Tthe FDA’s proposal would limit the sale of these products in retail stores to closed-off areas that are inaccessible to minors.”
I’m not positive what these means, because I don’t think I’ve ever seen an “adults only” area in a minimart. So, I guess that means no more e-cig sales or fruity flavours on display on the counters of minimarts and convenience stores. This seems slightly watered down from the proposed rules that were leaked last week, which flat out said a ban on sales in minimarts and convenience stores.
The Campaign for Tobacco-Free Children also wonders what “adults only” actually means.
From NBC News:
Anti-smoking advocates praised the moves, while questioning how easy it would be to enforce them. For one thing, vape products are sold in a variety of outlets, said Matthew Myers, president of the Campaign for Tobacco-Free Kids. “It’s a loophole big enough for a truck to go through,” Myers told NBC News.
“(Gottlieb) doesn’t define age-restricted, in-person locations. For this to have any effect, that has got to be a very vigorous definition.”
Gottlieb told NBC that measures might include a curtained-off section where vapes are sold. Online sales will need age verification protocols, he said.
The FDA is also imposing new rules on online sales of e-cig products, requiring better age verification measures from companies (Right now, literally all a kid has to do is click on “Are you 21?” Seriously, that’s all they have to do.)
Maybe this ultimately accomplishes the same thing as a flat-out ban, but it remains to be seen. The FDA might have totally wimped out here.
Juul feels the heat
Juuls have quickly grabbed up 70 percent of the e-cigarette market and this company came to realize it was seriouly in the crosshairs because its products are very popular with teens.
Juul announced a number of steps this week to try and restrict sales to minors, I’m sure realizing that if it didn’t take actions, the FDA might do worse.
Juul said it is voluntarily restricting the sales of some fruity flavours only to businesses that invest in technology to verify the age of customers, such as scanning IDs.
Juul also completely shut down all of its social media accounts — Instagram, Facebook and others. Though, now that Juul has 70 percent of the market, some people would argue that this is too little, too late.
Caroline Renzulli, a spokeswoman for the Campaign for Tobacco-Free Kids, called Juul’s announcement too little too late. “Juul’s social media marketing fueled its popularity with kids,” she said. “Now that it has captured 75 percent of the e-cigarette market, Juul no longer needs to do social media marketing because its young customers are doing it for them.”
Maura Healey, the attorney general for Massachusetts, echoed that sentiment. “Unfortunately, much of the damage has already been done,” she said. “Our investigation into Juul’s practices, including if it was knowingly selling and marketing its products to young people, will continue.”
“Juul is smart enough to try to use FDA actions to falsely create an impression of it as a caring, responsible company,” he said.
Juul now dominates the e-cigarette market with its small, sleek, pod-based product that delivers a far heftier dose of addictive nicotine than other vape devices.
“Having used social media to gain market dominance among young people, Juul can step back now because it no longer needs to pay for social media. Its young, addicted customers are doing it for them. It’s stunning to me,” Myers said.
“It is so completely out of the Big Tobacco playbook it is unbelievable,” he added.
Its products are meant to help adult smokers quit regular cigarettes, CEO Kevin Burns said in a statement.
“We don’t want anyone who doesn’t smoke, or already use nicotine, to use Juul products,” Burns said. “We certainly don’t want youth using the product. It is bad for public health and it is bad for our mission.”
Menthol cigarettes, flavoured cigars BANNED
No if ands or but(t)s. Unlike some of the slightly milquetoast measures taken toward Juuls and e-cigs, menthol cigarettes will be simply BANNED. Sugary or candy-flavoured cigarettes were banned by the FDA a few years ago, but the agency allowed menthols to continue.
Well, no more, the FDA announced it will ban all sales of menthol cigarettes and sugary cigars like Swisher Sweets.
(As an aside, my parents smoked menthols, mostly Kool brand. Most menthol smokers are black.)
However, don’t expect menthols to disappear any time soon. The tobacco industry has vowed to fight the ban and it could be tied up in the courts for years.
From the NBC story:
Tobacco companies signaled they would fight efforts to ban menthol.
“We continue to believe that a total ban on menthol cigarettes or flavored cigars would be an extreme measure not supported by the science and evidence,” Altria, which makes a range of tobacco products, said in a statement. “We expect that establishing product standards on menthol cigarettes and flavored cigars will be a multi-year, deliberative process, and we will be fully engaged throughout.”