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July 31, 2017 - People Smoke Where Cigarettes Are Cheap
Annual age-adjusted rate* of tobacco-related cancer† cases (2009–2013) and trends§ in rates (2004–2013), by state — National Program of Cancer Registries, and Surveillance, Epidemiology, and End Results Program, United States
"The Department is proposing in this NPRM to explicitly ban the use of electronic cigarettes on aircraft as there has been some confusion over whether the Department's ban on smoking of tobacco products includes a ban on use of electronic cigarettes. We see no reason to treat electronic cigarettes any differently than traditional cigarettes. The purpose behind the statutory ban on smoking aboard aircraft and the regulatory ban in part 252 on smoking tobacco products was to improve air quality within the aircraft, reduce the risk of adverse health effects on passengers and crewmembers, and enhance aviation safety and passenger comfort. Electronic cigarettes are generally designed to look like and to be used in the same manner as conventional cigarettes. Although a vapor, rather than smoke, is produced, the products require an inhalation and exhalation similar to smoking cigarettes. We are unaware of sufficient studies on the health impact on third parties from these vapors to conclude that they would not negatively impact the air quality within the aircraft and/or increase the risk of adverse health effects on passengers and crewmembers.
Each e-cigarette consists of three parts: The replaceable cartridge, which most often contains liquid nicotine but may contain other chemicals, the atomizer or heating element, and the battery and electronics. See Sottera Inc. v. Food & Drug Administration, 627 F.3d 891, 893 (D.C. Cir 2010). Theatomizer or heating element vaporizes the liquid inside the cartridge, and the battery and electronics power the atomizer and monitor air flow. Id. When the user inhales, the electronics detect the air flow and activate the atomizer, the liquid nicotine is vaporized, and the user inhales the vapor. Id.
Some electronic cigarette companies have claimed that their products are safe because they reportedly do not contain carcinogens or tar or produce second-hand smoke, as there is no combustion in their use. According to these arguments, while the vapor looks and feels, and may taste, like smoke produced by burning traditional tobacco products, its chemistry differs from the smoke produced from burning conventional tobacco products. The principal liquid ingredient is propylene glycol, which is widely used as a moistening food additive and an aid to vaporization. However, some research, conducted on non-asthmatic people, has shown that exposure to propylene glycol mist from artificial smoke generators may cause acute ocular and upper airway irritation, and in a few cases people reacted with cough and slight airway obstruction. See G Wieslander, D Norbäck, and T Lindgren, “Experimental exposure to propylene glycol mist in aviation emergency training: Acute ocular and respiratory effects,”Occupational and Environmental Medicine 2001; 58:649-655. Further, in a recent New England Journal of Medicine article, “E-Cigarette or Drug-Delivery Device? Regulating Novel Nicotine Products,” it was noted that the safety of inhaling propylene glycol has not been studied in humans. 365;3: 193-95.
July 17, 2017 - Cigarette Smoking Status* Among Current Adult E-cigarette Users,† by Age Group — National Health Interview Survey,§ United States, 2015
* Adults were asked if they had smoked at least 100 cigarettes in their lifetime and, if yes, whether they currently smoked cigarettes every day, some days, or not at all. Those who smoked every day or some days were classified as current cigarette smokers. Adults who had not smoked 100 cigarettes were classified as never cigarette smokers. Adults who had smoked 100 cigarettes but were not smoking at the time of interview were classified as former cigarette smokers. Percentages are shown with 95% confidence intervals.
† Current e-cigarette use was based on responses of“every day”or“some days”to the question,“Do you currently use electronic cigarettes every day, some days, or not at all?”asked of adults who had ever tried an e-cigarette, even one time.
§ Estimates are based on household interviews of a sample of the noninstitutionalized U.S. civilian population aged ≥18 years and are derived from the National Health Interview Survey sample adult component.
In 2015, 3.5% of U.S. adults were current e-cigarette users. Among adult e-cigarette users overall, 58.8% also were current cigarette smokers, 29.8% were former cigarette smokers, and 11.4% had never been cigarette smokers. Among current e-cigarette users aged ≥45 years, 98.7% were either current or former cigarette smokers, and 1.3% had never been cigarette smokers. In contrast, among current e-cigarette users aged 18–24 years, 40.0% had never been cigarette smokers.
Among adults who had never smoked cigarettes, the percentage who had ever tried an e-cigarette, even one time, was highest for those aged 18–24 (9.7%) and declined as age increased Among adults aged 45 and over who had never smoked cigarettes, 1% or less had ever tried an e-cigarette even once.
Current cigarette smokers who had tried to quit smoking in the past year were more likely than smokers who had not tried to quit to have ever tried an e-cigarette (Figure 4).
Current cigarette smokers who had tried to quit in the past year (20.3%) were almost twice as likely as cigarette smokers who had not tried to quit (11.8%) to currently use e-cigarettes.
Almost one-half of current cigarette smokers (47.6%) and more than one-half of recent former cigarette smokers (55.4%) had ever tried an e-cigarette, compared with 8.9% of long-term former smokers and 3.2% of adults who had never smoked cigarettes (Figure 3).
About one in six current cigarette smokers (15.9%) and nearly one in four recent former cigarette smokers (22.0%) currently used e-cigarettes, compared with 2.3% of long-term former cigarette smokers and 0.4% of adults who had never smoked cigarettes.
Current use of e-cigarettes was about the same for men and women. Current e-cigarette use was higher among non-Hispanic AIAN adults (10.7%) and non-Hispanic white adults (4.6%) than among Hispanic (2.1%), non-Hispanic black (1.8%), and non-Hispanic Asian (1.5%) adults.
Men were more likely than women to have ever tried an e-cigarette. More than 20% of adults aged 18–24 had ever tried an e-cigarette, with use declining steadily as age increased.
Non-Hispanic American Indian or Alaska Native (AIAN) adults (20.2%) and non-Hispanic white adults (14.8%) were more likely than Hispanic (8.6%), non-Hispanic black (7.1 %), and non-Hispanic Asian (6.2%) adults to have ever tried an e-cigarette.
According to the April 4, 2014 MMWR Report, "Calls to Poison Centers for Exposures to Electronic Cigarettes — United States, September 2010–February 2014"
"E-cigarettes accounted for an increasing proportion of combined monthly e-cigarette and cigarette exposure calls, increasing from 0.3% in September 2010 to 41.7% in February 2014. A greater proportion of e-cigarette exposure calls came from health-care facilities than cigarette exposure calls (12.8% versus 5.9%) (p<0.001). Cigarette exposures were primarily among persons aged 0–5 years (94.9%), whereas e-cigarette exposures were mostly among persons aged 0–5 years (51.1%) and >20 years (42.0%). E-cigarette exposures were more likely to be reported as inhalations (16.8% versus 2.0%), eye exposures (8.5% versus 0.1%), and skin exposures (5.9% versus 0.1%), and less likely to be reported as ingestions (68.9% versus 97.8%) compared with cigarette exposures (p<0.001).
Calls about exposures to e-cigarettes, which were first marketed in the United States in 2007, now account for 41.7% of combined monthly e-cigarette and cigarette exposure calls to PCs. The proportion of calls from health-care facilities, age distribution, exposure routes, and report of adverse health effects differed significantly between the two types of cigarette."
According to 4/16/2015's "Use of E-Cigarettes Rises Sharply Among Teenagers,"
"High-School Tobacco Use
Among high school students, e-cigarette use is growing rapidly, while the use of more traditional forms of tobacco, like cigarettes and cigars, is declining.
Use of the devices among middle- and high school students tripled from 2013 to 2014, according to federal data released on Thursday, bringing the share of high school students who use them to 13 percent — more than smoke traditional cigarettes. The sharp rise, together with a substantial increase in the use of hookah pipes, led to 400,000 additional young people using a tobacco product in 2014, the first increase in years, though researchers pointed out it fell within the margin of error. About a quarter of all high school students and 8 percent of middle school students — 4.6 million young people altogether — used tobacco in some form last year.
In interviews, teenagers said that e-cigarettes had become almost as common at school as laptops, a change from several years ago, when few had seen the gadgets. But opinions were mixed on why they had caught on. A significant share said they were using the devices to quit smoking cigarettes or marijuana, while others said they had never smoked but liked being part of the trend and enjoyed the taste — two favorite flavors were Sweet Tart and Unicorn Puke, which one student described as every flavor Skittle compressed into one.”
The rise of e-cigarettes, which was captured in the Centers for Disease Control and Prevention’s annual youth tobacco survey of about 20,000 schoolchildren, prompted an outcry from anti-tobacco advocates. They warned that e-cigarettes were undoing years of progress among the country’s most vulnerable citizens by making the act of puffing on a tobacco product normal again, and by introducing nicotine, an addictive substance, to a broad population of teenagers.
“This is a really bad thing,” said Dr. Thomas R. Frieden, the director of the C.D.C., who noted that research had found that nicotine harms the developing brain. “This is another generation being hooked by the tobacco industry. It makes me angry.”
But the change had a bright side.. The decline in cigarette use among teenagers accelerated substantially from 2013 to 2014, dropping by 25 percent, the fastest pace in years. The pattern seemed to go against the dire predictions of anti-tobacco advocates that e-cigarettes would become a gateway to cigarettes among youth, and suggested that the devices might actually be helping, not hurting. The pattern resembled those in Sweden and Norway, where a rise in the use of snus, a smokeless tobacco product, was followed by a sharp decline in cigarette use."
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