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A Note From Robin
Summer is officially here! The days are getting longer, the flowers are in bloom and the thermostat sure has been rising. It's heating up here at Legacy too.
This month Legacy released a new report entitled Vaporized: E-Cigarettes, Advertising and Youth which examines the recent  rise of e-cigarette use among youth, and the entry of the major tobacco companies in the e-cigarette market. The FDA has just exerted its jurisdiction over these products, and this report underscores the need for the FDA to move quickly to finalize the rule restricting their sale to youth, as well as providing key evidence for the need to restrict marketing to youth.
Additionally the Human Rights Watch (HRW) released a chilling report which again illustrates the critical need for protecting young people from the harms of tobacco. Children under the age of 18 cannot buy cigarettes, yet they work in hazardous conditions to grow and harvest the tobacco that is used in cigarettes. Many of them report nicotine sickness, with symptoms ranging from headaches, nausea and difficulty breathing while working in tobacco fields using no protective equipment to help support their families. Legacy distributed a statement on the report and you can read the entire report here.
We are also excited to head out on the road with the
truth® tour in the upcoming weeks. As Mark Twain said, "The secret to getting ahead is getting started" and I'd say that we have certainly hit the ground running!
Robin Koval
President and CEO, Legacy
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Legacy Welcomes Indiana Attorney General Greg Zoeller and Youth Liaison Mauro Medrano to Board of Directors
At the Legacy Board of Directors Meeting earlier this month, Legacy confirmed two new members -- Indiana Attorney General Greg Zoeller and Tobacco Free Kansas Coalition's RESIST member, Mauro Medrano as Youth Board Liaison.
General Zoeller is serving his second term as Indiana's chief law enforcer. With a focus on consumer protection, General Zoeller has expanded the Do-Not-Call law to include cell phones and has protected homeowners facing foreclosures. Prior to that, he served under his predecessor, Indiana Attorney General Steve Carter, making him the first Indiana attorney general to have served in the AG's Office prior to being elected. General Zoeller serves as one of two Attorneys General on Legacy's Board.
Mauro Medrano has been involved with tobacco control since his sophomore year of high school where he volunteered with the Tobacco Free Kansas Coalition's youth prevention program, RESIST. Medrano is also a former graduate of the Legacy 2013 Youth Leadership Institute, which develops, trains and empowers young people with the skills to advocate in tobacco control in their local communities.
Click here to learn more about General Zoeller, and here for more on Mauro Medrano.
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The Bitter Effect of Candy Flavored Tobacco Products
A new study published in the May 7, 2014 edition of theNew England Journal of Medicine reveals that candy flavored tobacco products are not only being marketed under flavor names that appeal to youth, but they also contain the same chemicals that provide fruit flavors in popular candy and drinks like Kool-Aid, Jolly Ranchers and Life Savers. In 2009, the landmark Family Smoking Prevention and Tobacco Control Act banned flavorings in cigarettes, with the exception of menthol, because of their appeal to youth. However, as of late, the tobacco industry has adapted by offering other flavored tobacco products like cigars, little cigars and cigarillos, which are not included in the ban.
A recent report from the Centers for Disease Control and Prevention (CDC) found that flavored smoking products are used by 42 percent of middle and high school students who smoke. Those percentages are extremely disturbing, leaving a bad taste in the mouth of public health leaders working to solve the tobacco epidemic. Additionally, alternate combusted tobacco products are not classified as cigarettes under tax regulations, making them cheaper and more accessible to youth. The "unsweet" truth is that they are just as harmful as cigarettes, cause tobacco-related disease, are smoked and inhaled as if they were cigarettes, and they're just as addictive.
Research studies such as this one reinforce the need for further regulations surrounding the removal of flavors from all tobacco products, especially cigars. Just last month, the Food and Drug Administration (FDA) released their proposed regulations for emerging products such as electronic cigarettes. While a step in the right direction, these regulations failed to include candy-flavored e-cigarettes and little cigars which are highly appealing to youth. The FDA should move quickly to widen the scope of and act on their proposed regulations so that young people and smokers alike can see the sweet end to candy flavored tobacco because for our nation's youth, this reality is anything but sweet. Read Legacy's statement on the study to learn more.
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Disproportionate Tobacco Use Among Mental Health Populations: May is National Mental Health Month
May is National Mental Health Month, and is a reminder that tobacco is not an equal-opportunity killer. Smoking rates among individuals with any diagnosable mental, behavioral or emotional disorders are disproportionately high (approximately 36 percent) compared to smoking rates among those without any diagnosable disorders (approximately 21 percent). Additionally, individuals with no mental health disorders have higher successful quit rates compared to those with one or more disorders. A dissemination report from Legacy, entitled "A Hidden Epidemic: Tobacco Use and Mental Illness" takes a closer look at the effects of tobacco use among individuals with mental health disorders, and highlights the barriers to effective cessation programs. The report features case studies from California, Maine, Massachusetts and New Jersey and offers lessons learned for community and health care providers. Additionally, in 2012, Legacy hosted a Warner Series event entitled "A Hidden Epidemic: Tobacco Use and Mental Illness," which is still archived for viewing, where panelists discussed how public health experts can work with the mental health system to address the disparate tobacco use among mental health consumers.
The dissemination report and the Warner Series event illustrate the important connection between smoking and mental health.
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Nicotine-Addicted Parents Likely Beget Heavily Smoking Children
A study in the May 12th issue of Pediatrics reports that the children of parents who are addicted to smoking are likely to become heavy smokers themselves. The study is one of the first to look at an intergenerational view of the effects of tobacco, and how the behavior of a smoking parent might influence their children's future smoking risk. The research was conducted by a team at Georgetown's Lombardi Comprehensive Cancer Center, and led by Ray Niaura, Associate Director for Science at the Schroeder Institute for Tobacco Research and Policy Studies at Legacy.
The study concludes that the greater the number of years that a child is exposed to the smoking behavior of their parent, the greater the risk of them smoking themselves or experimenting with cigarettes in their adolescence. It also finds that social learning plays a key role in intergenerational smoking. This is why the researchers call for collective action from pediatric clinics to observe the smoking habits of their patients' parents, and offer them the help they need to quit. Additionally, Darren Mays, an Assistant Professor of Oncology at Georgetown Lombardi and Lead Investigator on this report remarks that going by the social learning principle, if a child can learn to smoke by observing their parents, they can also learn how beneficial quitting is by watching their parents quit.
To learn more about the study, read the press release here.
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Quit Programs More Accessible Thanks to Obama Administration Mandate
In an effort to help smokers quit, the Obama Administration is now requiring health insurers to provide evidence-based smoking cessation programs under the Affordable Care Act (ACA). The Administration recently noted on a FAQ page on the Department of Labor website that cessation coverage includes:
- Four tobacco cessation counseling sessions of at least 10 minutes each (including telephone counseling, group counseling and individual counseling) without prior authorization
- All Food and Drug Administration (FDA)-approved tobacco cessation medications (including both prescription and over-the-counter medications) for a 90-day treatment regimen when prescribed by a health care provider without prior authorization.
This is a critical step made by the Administration to empower the ACA with the ability to help smokers quit. Yet, despite its efforts to increase cessation, the ACA has also stigmatized smokers by charging them premiums that are 50 percent higher than non-smokers. These higher premiums have proven to be barriers to low dose computer tomography (CT) screening which can help smokers detect lung cancer earlier, and improve their chance of survival.
The 2014 Surgeon General's Report noted that tobacco exerts a heavier toll today on the nation's health than it ever has before. Smoking kills approximately 480,000 people annually and is responsible for about one in five deaths in the United States each year. Interventions like those set forth in the ACA may help make our country healthier by addressing crucial public health issues like tobacco use. Moving forward, ACA implementation should cover all bases with strategic interventions, such as offering screenings for free or at reduced prices to smokers, so that the policy can be as effective in serving people as intended.
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CDC Study Finds that Majority of Smokers Think Workplaces Should Be Smoke-Free
A recently released study from the Centers for Disease Control and Prevention (CDC) examined beliefs and attitudes towards smoke-free workplaces around the country, and also noted exposure to second-hand smoke in the workplace. The study, titled "Exposure to Secondhand Smoke and Attitudes Toward Smoke-Free Workplaces Among Employed U.S. Adults: Findings From the National Adult Tobacco Survey" was published in the May edition of Nicotine and Tobacco Research.
Key findings from the study include:
- Approximately 84 percent of all employed adults in the United States believe smoking should not be allowed in indoor areas of workplaces, and about 64 percent of cigarette smokers who are employed hold the same belief
- Despite the strong favorability toward smoke-free workplaces, one in five workers reported that they'd been exposed to secondhand smoke at work within the past seven days
- Nationally, prevalence of exposure was higher among males, those aged 18-44 years, non-Hispanic Blacks, Hispanics, and non-Hispanic American Indians/Alaska natives compared to non-Hispanic Whites, those with less education and income, those in the western United States, and those with no smoke-free workplace policy.
The study concludes that disparities exist in second-hand smoke exposure across states, income groups and sub-populations. Second-hand smoke has been known to cause heart disease and lung cancer in adults, and employees must be protected from the dangers of second-hand smoke. Efforts to increase smoke-free workplaces will greatly benefit the health of both smokers and non-smokers in the workplace. The full study is available here.
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Working on Tobacco Fields a Sick Truth for Poor, Young Children
A Human Rights Watch (HRW) released report titled
Tobacco's Hidden Children: Hazardous Child Labor in US Tobacco Farming, documents the hazardous conditions and toxic environments of U.S. child tobacco farm workers. The report found that children working on tobacco farms in the U.S. often work 50 or 60 hours a week in extreme heat, use dangerous tools and machinery and are exposed to nicotine and toxic pesticides. Nearly three-quarters of the children interviewed by HRW reported the sudden onset of serious but common symptoms due to nicotine exposure-including nausea, vomiting, loss of appetite, headaches, dizziness, skin rashes, difficulty breathing, and irritation to their eyes and mouths-while working in fields of tobacco plants and in barns with dried tobacco leaves and tobacco dust. Many of these children work on tobacco farms with no health and safety training and most often without protective gear.
It is illegal for children under 18 to buy cigarettes and other tobacco products. Astonishingly however, our current laws do not acknowledge the risks to children working in tobacco farming or provide the same protections to children working in agriculture as they do in all other sectors. It is our hope that the release of this report, which details the fact that so many children have reported acute illnesses and dangerous working conditions, will signal regulators to take the necessary steps to remove children from tobacco farming.
To learn more, read the full report and also Legacy's statement on the report.
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From the Lungs to the Liver - Increased Health Consequences Call for Action Towards a Smoke-Free Generation
The 2014 Surgeon General's Report noted that the toll tobacco takes on our nation's collective health today is far heavier than ever before. The report linked new diseases such as ectopic pregnancy, colorectal cancer, and macular degeneration to tobacco use. The report also outlined how pervasively secondhand smoke can affect health, from the lungs to the liver. The following is an infographic that shows just how imperative it is to create a new smoke-free generation.
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