On Sept. 22nd, the U.S. Food and Drug Administration authorized a new tobacco law that made the sale but not possession of all “cigarettes with flavors characterizing fruit, candy, or clove” illegal (FDA News Release). The public rationale for this comprehensive ban is that “flavored cigarettes attract and allure kids into lifetime addiction” and that “marketing campaigns for products with sweet candy and fruit flavors can mislead young people into thinking that these products are less addictive and less harmful.” In short, once again the government is becoming more and more Simpsons-esque.

Unfortunately, the cartoonish elements of this most recent FDA episode are still continuing to unfold. First, the FDA is woefully unprepared and uneducated on the sheer amount of tobacco products that are actually banned under the new law (FDA officials have failed to provide a list detailing exactly which products are banned and have been repeatedly silent when met with consumer questions and comments.). Second, several other government agencies including the Center for Disease Control have indicated that 80% of underage smokers use the same non-flavored brands as their adult counterparts. This means that the ban will only potentially prevent 20% of targeted underage smokers from actually smoking. However, in reality, it seems clear that underage students who already possess a fake ID or the wherewithal to try to illegally purchase flavored cigarettes will simply redirect towards buying non-flavored brands. Moreover, the new laws do not currently target cigars or “little cigarettes” and therefore provide yet another avenue for underage smokers to smoke flavored tobacco. In essence, the laws simply shift teenagers from smoking one type of cigarette towards smoking a different but equally “dangerous” type.

Ultimately, the new laws are riddled with inefficiency and are only making it illegal for retailers to sell flavored, fruit or clove cigarettes to legal and well-informed buyers. A card system has already been in place to prevent underage teenagers from purchasing tobacco products. Perhaps the FDA should first focus on strengthening the fines for noncompliance before infringing upon the legal rights of those who do obey the age laws.

Walk into any restaurant in Michigan nowadays and you’ll find yourself in an environment free of secondhand smoke thanks to the Dr. Ron Davis Smoke Free Air Law that took effect May 1, 2010. And because of this law, we are all enjoying a whopping 93 percent reduction in the level of secondhand smoke air pollutants after the law took effect.

According to an air monitoring study conducted in 77 restaurants before the law went into effect, 85 percent of them had poor to dangerous air quality. After the law went into effect, the levels of secondhand smoke pollutants at the same 77 restaurants dropped by a median of 93 percent.

Olga Dazzo, Director of the Michigan Department of Community Health said, “We’re thrilled to report that the air quality has dramatically improved. This study clearly demonstrates the health benefit of Michigan’s smoke-free air law.”

The study was conducted in 13 cities representing six major regions of the state that included Ann Arbor, Detroit, Flint, Grand Rapids, Kalamazoo, Lansing, Marquette, Midland, Novi, Saginaw, Sault Ste. Marie, Traverse City, and West Branch. The state’s department of community health, with assistance from other agencies, recruited field investigators to measure the air quality in restaurants.

E cigarettes seemed to have saved a landlord’s day. Ted Sherman was under a lot of stress as he was in the midst of an ongoing feud amongst two tenants, one of whom smoked cigarettes while the other, a non-smoker, resisted his moves. They both apparently lived in the same apartment complex. Nonetheless, a new California law has finally come to the aid of the landlord and has helped him resolve this long pending dispute amicably.

The dispute started when in the multilevel housing complex, one couple was habitual of smoking cigarettes daily while the other, who lived directly above the smoking individual’s apartment, was a non smoker and had a child. Tobacco smoke has the ability to penetrate the walls of the apartment, which in turn irritated the tenants staying right above the smoking individual. Apparently, the toxic gasses as well as the smells emitted by the smoke irritated the tenant’s baby as well. In the past, there was no law that could permit the landlord to stop the tenant from smoking a cigarette.

Nonetheless in a recent development, Governor Jerry Brown passed a bill which permitted landlords to stop tenants from smoking within the building premises, if the landlord felt it was necessary to do so. This probably helped in leading to a resolution amongst the warring tenants.

Nonetheless, a better way to have resolved the issue could have been the smoking individual opting for smoke free cigarettes. Also known as electric cigarettes, these devices do not emit smoke and are legally permitted to be smoked just about anyplace. Not only do electronic cigarettes avoid the use of tobacco in their devices, they also permit the concerned smoker to choose the nicotine levels in the e cigs. This is what makes e cigs a suitable alternative to smoking tobacco.

The Oklahoma State Department of Health is paying restaurants to go smoke free. The “Restaurant Smoking Room Rebate Program” hopes to boost Oklahoma health and reduce the number of restaurants that have smoking rooms. The rebate program’s goal is to reduce exposure of restaurant employees and customers to secondhand smoke.

“Studies show even brief exposures to secondhand smoke, less than the time spent by diners in restaurant smoking rooms, can be harmful to health, OSDH said in a news release.

“We are pleased to offer this rebate program because we recognize many restaurant owners wanted to do the right thing to improve the health of their employees and customers, but needed assistance in making the conversion to be completely smoke free,” said State Health Commissioner Dr. Terry Cline.

“It’s a win-win for everyone and a tremendous boost in helping improve the health of all Oklahomans.”

Restaurant owners can apply for a rebate of 50 percent of the capitalized expenditures for some smoking room construction costs, minus any depreciation taken from the expenditures.

To be eligible for a rebate, the smoking room must have been built after June 6, 2003, and before November 1, 2010. The restaurant must be smoke free prior to the time of receiving the rebate, but no later than January 1, 2013.

Amanda Fall never really considered herself an anti-smoking advocate. Sitting before a statistic-filled binder in a conference room plastered with advertising campaign posters, the new executive director of Tobacco Free Allen County said her personal views quickly evolved during the past five years. It was during that half-decade stretch that Fall, 36, was the Transitions program director at the Fort Wayne Women’s Bureau, where she assisted recovering women and children in reintegrating with everyday life.

“In the addiction community, even when you give up your non-tobacco addiction, your life is still surrounded by tobacco,” she said, noting that post-program participants always bombarded her with the same questions in support groups.

“When’s my smoke break?”

“How much should I budget for cigarette purchases this week?”

“Just to watch the personal struggles – a lot of them wanted to stop but just couldn’t stop,” Fall recalled.

And it was that pivotal experience that motivated her to accept the new position at Tobacco Free Allen County and replace former Executive Director Dick Conklin, who recently retired after six years with the organization.

In her third day on the job this month, Fall echoed local health officials’ pleas for state legislation banning smoking not just within businesses but also on their outdoor properties.

She also cited a historically low smoking rate for all of Indiana – 21.2 percent – that was announced last week by the state health department as a promising but unfinished step forward.

“There’s still a lot of work to be done, absolutely,” she said. “It’s great news that it’s dropped, but we still don’t have a statewide smoking policy.”

The inherent challenges Hoosiers face in motivating tobacco-free lawmaking are numerous, she added.

For one, Fall said, “enforcement is always difficult” because Fort Wayne residents must independently report ordinance violations of the city’s smoking law they witness to the appropriate agency.

In a state where tobacco usage is a nostalgic pastime, such enforcement methods may be unreliable, she said.

Fall said that’s why targeting youth and uprooting smoking tendencies early on is her No. 1 priority.

That overarching goal will continue this school year as Tobacco Free Allen County collaborates with the Indiana High School Athletic Association to combat smoking among adolescents.

The IHSAA will select two student-athletes – one from Woodlan High School and one from North Side High School – to deliver anti-tobacco presentations at area schools. The schools were chosen because they had not participated previously during the program’s five-year run.

Fall described those on-the-ground efforts as far more effective than any lecture with which she would bore teen audiences.

“Peer education always works best with youth,” she said. “If I were to go to speak with them, I’d just be the crazy tobacco lady.”

Yet Fall admitted there remain serious obstacles.

A lifetime Fort Wayne resident who received her bachelor’s degree in social work from the University of Saint Francis and an MBA from Indiana Tech, Fall offered a general outline for cutting through Indiana’s smoke-clouded history.

She said tobacco consumption must continue to decline as a social norm with increased public education. Then comes the harder part: amplifying that anti-smoking message for state lawmakers.

“With business, you can always hit the economic aspect, saying you’ll save more money if you ban smoking here,” Fall said. “But with legislators, I don’t know how you can incentivize them beyond their constituents being behind it.”

The bright purple package behind the convenience store counter looked as if it held some kind of sugary treat. But the familiar Surgeon General warning at the bottom of the wrapper indicated the product inside could cause much more than cavities. The five “honey berry” cigars were among a growing array of flavored tobacco products that critics say are luring underage teens into smoking.

“Most adults are not interested in the candy (flavors). But students are,” said Rakinya Hinson, tobacco program specialist for the Volusia County Health Department. “And they’re getting them from somewhere.” Port Orange is expected to pass a resolution Tuesday night requesting convenience store owners to stop selling flavored tobacco products altogether, a move that several managers of those businesses declined to discuss.

If passed, Port Orange will be the first city to make such a request of stores in Volusia or Flagler counties. In Florida, it’s illegal to sell any tobacco product to someone younger than 18.

“They are meant to be starter products with the sweet flavoring and colorful packages,” Hinson said of the candy-flavored cigars, cigarillos and chew. “Students are attracted to the ads … The (marketing) process is to dumb down the product and young people will think it’s less harmful. And once they try it, they’ll continue.”

In 2009, the Food and Drug Administration banned the candy-like flavorings from being added to cigarettes, but didn’t do the same with other tobacco products.

“I have no idea why,” Hinson said. “Definitely among students, flavored tobacco products are more of an issue. Adults rarely use them.”

Kevin Morrin, 54, of Port Orange, prefers Marlboro cigarettes. He said he started smoking at age 34, after leaving the Navy.

“No way. I don’t smoke it,” he said of flavored cigars or smokeless tobacco products, after stepping out of a convenience store with a fresh carton of Marlboros. “And I have no intention to try it.”

But Amanda Wiles, 19, of Port Orange, prefers single peach cigarillos.

“It’s for my boyfriend. But I like the peach a lot,” she said. “I don’t smoke cigarettes at all.”

And she is not alone when it comes to the young and tobacco products, even decades after TV ads for them were banned.

A recent Volusia County survey indicated 12 percent of middle-school students and 26 percent of those in high school used some form of tobacco one or more times in a month. In addition, they said a 2005 national survey showed youngsters ages 12 to 17 were twice as likely as adults to remember advertisements for candy-flavored tobacco products.

“Ninety percent of smokers start before age 18,” Hinson said. “The influence comes from somewhere. Peer pressure has something to do with it. But also there’s parents and guardians.”

In an effort to dissuade youngsters, the Port Orange City Council earlier this month was unanimous in support of adopting a resolution requesting store owners to voluntarily ban flavored tobacco products.

“The intent behind these products is absolutely outrageous. That these companies would do that to the youth of this country in the name of profit,” Councilman Bob Pohlmann said. “And I know many people who think our country is over-regulated. But this is certainly the kind of product that needs to be regulated very closely. I support any ordinance to eliminate these products to our youth.”

The council asked the city attorney to research what legally could be mandated, but the sentiment of the board was overwhelming to do something.

Dr. Bonnie Sorensen, director of the Volusia County Health Department, said Port Orange also was on the front lines of an anti-tobacco campaign in 2003, when it became the first local city to designate specific areas in stores where tobacco products could be placed — behind counters.

“We hope other cities will follow suit,” she said of the new resolution. “It’s already illegal, but these products end up in the hands of younger people, probably through older friends. So we urge local retailers to cease the sale altogether.”

When apartment tenants light up a cigarette, it’s not just their smoking-averse neighbors who suffer. Landlords are also sucking it up — in increased cleaning costs. But by implementing complete smoke-free rules throughout their properties, owners of California multi-unit rental buildings could save up to $18 million a year statewide on the cost of cleaning apartments vacated by tenants who smoke, according to a new UCLA study. These policies can also protect their other tenants from the secondhand smoke that seeps between units.

The study was published online Aug. 18 in the American Journal of Public Health and will appear in the journal’s October print issue.
Secondhand smoke results in about 4,000 deaths each year from ischemic heart disease and lung cancer, and it is the cause of approximately 31,000 childhood asthma episodes and 4,700 pre-term infant deliveries annually, the UCLA researchers said.
Smoke wafts between units through shared airspaces and ventilation, hallways, cracks in walls and floors, electrical outlets, and plumbing fixtures, or from outside.
“Secondhand smoke is an important cause of morbidity and mortality, and many current policy efforts are focused on encouraging owners and managers of multi-unit housing to implement smoking restrictions,” said lead study author Dr. Michael Ong, an assistant professor-in-residence in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA. “California has minimized exposure to secondhand smoke by restricting smoking in multiple public venues, including workplaces, public entryways, public parks and beaches, and vehicles carrying youths.
“However, secondhand exposure in multi-unit housing is a significant contributor to overall secondhand smoke exposure, since Californians spend an average 68 percent of their time at home and over 10 million Californians live in multi-unit housing.”
This is the first study to take a systematic measure of smoking-related costs in multi-unit housing, as well as the first study of smoking and multi-unit housing to take into account small-scale multi-unit buildings — those with 15 or fewer units, according to Ong. About 66 percent of California Apartment Association (CAA) members own or manage small-scale buildings.
For the study, the researchers conducted computer-assisted telephone surveys of 343 CAA members to determine landlords’ smoking-related costs, the costs they have avoided as a result of having smoke-free policies, and the economic benefits of having completely smoke-free policies.
If a building did not allow smoking anywhere on the property, including within units, it was listed as having a complete smoke-free policy; if smoking was prohibited in only some parts of the property — in common areas, for example — it was said to have a partial smoke-free policy. Smoking-related costs for recently vacated units included cleaning, repairs and maintenance; painting and decorating; trash collection and fire damage; property and fire insurance; and legal, administrative and other operating costs.
The researchers found that nearly half of the multi-unit housing properties owned or managed by CAA members had no smoke-free policies, but the smaller properties had a threefold higher rate of smoke-free policies than the larger ones.
They also found that:
More than 25 percent of multi-unit housing properties had smoking-related costs in the past year.
One-third of multi-unit housing properties are currently completely smoke-free.
For a single multi-unit housing property, the mean smoking-related cost was nearly $5,000 in the past year and the median cost was $2,000.
The likelihood of incurring smoking-related costs was reduced by half with the presence of a complete smoke-free policy.
Implementing complete smoke-free policies in California multi-unit housing could result in an estimated property savings of $18 million overall in the short-term.
The researchers caution that the survey response rate — 22.4 percent — was low, though it was similar to other CAA survey response rates. Also, the study was suspended for approximately six months due to the state budget crisis, which may have affected the response rate. In addition, responses to detailed financial questions may have been affected by recall bias, though potential respondents were notified in advance that they would be asked about these costs.
Co-authors of the study included Allison Diamant, Qiong Zhou and Robert Kaplan of UCLA, and Hye-Youn Park of the California Department of Public Health
A contract with the California Department of Public Health’s California Tobacco Control Program supported this study. Dr. Ong is chairman of the State of California Tobacco Education and Research Oversight Committee (TEROC), which oversees programs funded through the increased tobacco taxes mandated by 1988′s Proposition 99.
General Internal Medicine and Health Services Research is a division within the department of medicine at the David Geffen School of Medicine at UCLA. It provides a unique interactive environment for collaborative efforts between health services researchers and clinical experts with experience in evidence-based work. The division’s 100-plus clinicians and researchers are engaged in a wide variety of projects that examine issues related to access to care, quality of care, health measurement, physician education, clinical ethics and doctor–patient communication. The division’s researchers have close working relationships with economists, statisticians, social scientists and other specialists throughout UCLA and frequently collaborate with their counterparts at the RAND Corp. and Charles Drew University.

An anti-tobacco group has targeted again the advertising of a Reynolds American Inc. subsidiary that makes organic-tobacco cigarettes. The Campaign for Tobacco-Free Kids typically targets cigarette advertising it considers as overly appealing to youths. In this case, however, the group is criticizing the environmentally friendly message of the ads for Natural American Spirit cigarettes by Santa Fe Natural Tobacco Co. The ads began in March in magazines such as Field and Stream, Esquire, Mother Jones, Wired, Elle and Marie Claire.

The ads tout cigarettes “free of additives” and made in “earth-friendly growing programs” that have a lower impact on farmland and water. The ads also mention the company’s use of recycled resources and attempts to lower its carbon footprint.

“After almost 30 years, we continue to push ourselves to being the most environmentally responsible tobacco company on the planet,” the company concluded in the ad.

The advocacy group said Reynolds and Santa Fe are “once again deceiving consumers,” particularly female smokers, with the environmentally friendly ads. It has asked Reynolds and Santa Fe to immediately pull the campaign.

“This is yet another attempt by a tobacco company to downplay how deadly and addictive cigarettes truly are, this time by marketing a cigarette brand as environmentally friendly,” the group said in a statement. “There is nothing healthy or environmentally responsible about Natural American Spirit cigarettes or any cigarettes.”

Seth Moskowitz, a spokesman for Santa Fe, said the ads “are clear and accurate characterizations of our products’ attributes, and our company’s long-standing commitment to reducing our environmental footprint.”

“Our ads run in a wide variety of publications that are directed toward and read by adult men and women alike.”

It is not the first time ads for the cigarettes have been disputed.

In March 2010, Santa Fe agreed to alter its marketing to specify organic tobacco does not provide safer tobacco or cigarettes for smokers. The settlement agreement involved the attorneys general of 33 states.

John Sweeney, the director of the sports-communication program at the University of North Carolina at Chapel Hill, said the anti-tobacco criticism of Natural American Spirit had validity before the settlement agreement.

“It is easy to see that consumers could confuse the natural tobacco product as somehow a new and kinder style of tobacco,” Sweeney said. “Any criticisms making sure consumers were utterly clear that natural tobacco was just like traditional, addictive tobacco are entirely appropriate. In fact, they’re a public service.”

However, Sweeney said he does not have a problem with Santa Fe advertising the company “as a kind of earth-sensitive way to smoke.”

“A marketer has a perfect right to sell cigarettes in a politically-correct, love-mother-Earth-manner, particularly when there is support for that in the way the product is grown,” he said. “I don’t particularly think it will be a huge success in the marketplace.”

According to the Centers for Disease Control and Prevention, cigarette smoking results in more than 443,000 premature deaths in the United States each year. For African American men, tobacco related disease is a primary source of death. Recent studies show that “alternative” tobacco products may have replaced cigarettes as the most common products used by young African Americans.

Even though tobacco-related disease is higher in African American adults, tobacco use among young African American teenagers is lower than those reported for whites. However, the statistic changes in early adulthood. According to the National Survey on Drug Use and Health, a study conducted between 2002 and 2005 showed that 29.7 percent of white males 18 years of age and older reported smoking cigarettes in the past 30 days, as compared to 33.6 percent of African American men.

Cigarettes were the most common product ever used, at 54 percent, and currently used, at 39.9 percent. The study found that those who attended school for 12 years or attended religious services were less likely to use cigarettes. Next most commonly used was marijuana, blunts, and mini-cigars. Only 8.9 percent of the participants currently used mini-cigars. Rarely used were products like, bidis/kreteks, smokeless tobacco, and pipes.

“Tobacco-related disease disparities are magnified in the rural counties of the Black Belt region in rural Alabama. The Black Belt counties are named for the rich dark soil that supported the agricultural industry of an earlier era. These counties are predominantly African American, among the poorest counties in the U.S., and are characterized by striking health disparities when compared to the remainder of the state and the nation as a whole,” William Carroll, M.D., the study’s author, was quoted saying.

The authors note that the use of cigarettes in rural Alabama far exceeds the measure statewide for African American men of the same age. They stress that effective community based intervention must target cigarette initiation, and ultimately end in this vulnerable population.