Electronic Cigarettes: What They Are, How They re Marketed, & How We Can Protect Our Youth Amy Barkley Coalition for a Tobacco- Free West Virginia Charleston, WV February 26, 2014
Big Picture Points Tobacco still takes a terrible toll on West Virginia s health and economy. We know what to do to reduce tobacco use in West Virginia, and we need to do more of it. We want to encourage new interventions, but: They must be based on science/evidence They must not undercut our progress in reducing tobacco use Focus on what works; regulate to ensure progress is not undermined by things that do not work. 2
Tobacco Industry E-Cigarette Strategies Tobacco companies have been approaching states and trying to convince them to: Promote e-cigarettes and other products as less harmful than smoking Tax e-cigarettes and other products at a lower rate Create special category for e-cigarettes with less regulation None of these strategies is evidence-based 3
E-Cigarettes What they are
Electronic Cigarettes
E-WHAT?? E-Pipes 6
E-WHAT?? E-Cigars 7
E-WHAT?? E-Hookah E-Hookah Pens 8
E-OMG????? E-Pot E-Anything 9
Tobacco Product? Currently, most, if not all, nicotine in e-cigarettes is derived from tobacco. Synthetic nicotine is possible, but extraordinarily expensive, and we are aware of no e-cigarettes or similar products that use it. 10
What else is in E-Cigarettes? Basic ingredients (as listed by most e-cigarette manufacturers): propylene glycol or glycerin, nicotine, flavor chemicals Additional chemicals found through product testing: Diethylene glycol TSNAs (low levels) Formaldehyde Acetaldehyde Acrolein Carcinogens
Potential Health Risks Not enough data on health effects (short and long-term) available Toxic substances Pulmonary problems from frequent inhalation of glycerin and/or propylene glycol Toxic levels of nicotine in refills Airborne chemicals, such as volatile organic compounds and nicotine, released by e-cigarette No safety standards for e-cigarette components Cartridges can leak out nicotine solution Battery issues leading to explosions, fire Variability in performance Mislabeled or inaccurate labeling leading to overdoses Wide variability both within and among companies, of which there are hundreds Long term health effects are UNKNOWN
E-Cigarettes Companies Who they are
BEFORE NOW Cigarettes Smokeless E-Cigarettes (UK) 14
Words of a Transformed Tobacco Company? RAI and its operating companies are committed to significantly reducing the death and disease caused by smoking. By embracing tobacco harm reduction principles and working with manufacturers, policy makers could herald a new era that fundamentally changes the impact of tobacco use on society. Today, public policy leaders and companies like RAI have a unique opportunity to lead that change. Source: Reynolds American Inc. Website, Tobacco Harm Reduction, accessed August 2, 2013, from http://www.reynoldsamerican.com/harm-reduction.cfm?plank=harmreduction1 15
Words of a Transformed Tobacco Company? We have a little mantra inside of the company that we use, which we call the 80-90-90 We spend about 80 percent of our resources in the combustible space. The combustible space is still 80 percent, 80-plus percent of our operating income. We spend the majority of our resources still in the combustible space. 90 percent of the organizational focus, the human resources inside the company, are actually focused on the combustible space. And despite a lot of these new innovations that you see coming out, 90 percent of our R&D budgets are actually directed at the combustible category. That is the category that's still going to deliver a lot of growth into the future. Daniel Delen, President and CEO of Reynolds November 2012 16
E-Cigarettes Can they help smokers quit???
Cessation??? E-cigarettes are unproven as cessation aids
Cessation??? There is currently no conclusive scientific evidence that e- cigarettes promote long-term cessation (CDC Researchers in peer-reviewed journal, Nicotine & Tobacco Research, 2013) Limited data on e-cigarettes and cessation. Some show e-cigarette users no more likely to quit than non-users Some show e-cigarette users less likely to quit Some show e-cigarettes have comparable quit rates to NRT patch but patch is approved as both safe and effective by FDA
Cessation??? Important to remember: E-cigarettes companies cannot currently make cessation claims Sottera Inc. v. Food & Drug Administration, 10-5032, U.S. Court of Appeals, District of Columbia Circuit (Washington). Industry uses citizens and retailers to make claims they can t legally make Most of those arguments are anecdotal, not science-based and are made with many caveats
Health Harms from Individual Electronic Tobacco Use Not a safe alternative but likely much less harmful than cigarettes Nicotine addiction possibly graduate to smoking Majority of e-cigarette users still use cigarettes. This dual-use undermines or eliminates potential health benefits. Can serve as a gateway product for youth
E-Cigarette Usage Among Youth National trends, 2011-2012: 6 th -12 th grades: ever use of e-cigarettes increased 3.3% to 6.8% (more than doubled) Estimated 1.78 million youth who had used e- cigarettes in 2012 High school students: ever-use increased 4.7% to 10% Dual use: 76% of middle and high school students who had used an e-cigarette in the past 30 days had also smoked conventional cigarettes in the same time period
E-Cigarette Usage Among Adults, 2010-2011 6.2% of general population used e-cigarettes in 2011 (doubled from 2010) 21.2% of smokers used e-cigarettes in 2011 (doubled from 2010)
Key Questions for E-cigarettes Are e-cigarettes less harmful to the individual than cigarettes? Likely the answer is yes, but - Even if less harmful, is this offset by: Keeping smokers smoking (bridging and/or using unproven method) Attracting youth users who progress to conventional cigarettes Luring former smokers back into smoking
Key Questions for E-cigarettes (continued) Do people actually switch to e-cigarettes from smoking combustible cigarettes? What are the impacts of long-term use? Do e-cigarettes and their marketing (which reglamorize and re-normalize smoking) encourage initiation, discourage quitting, or lead former smokers to relapse? What is the net impact on public health?
E-Cigarettes How are e-cigarettes being marketed???
E-Cigarettes Just like cigarettes!
E-Cigarettes Marketing Mimics the Worst of Cigarette Marketing TV Ads Kid-Friendly Flavors Music Sponsorships NASCAR Car Sponsorships Celebrity Endorsements Branded Items Cartoons Cigarette Girls Countertop Displays
Kid Friendly Flavors
Kid Friendly Flavors
Kid Friendly Flavors Resemblance to liquid candy products:
Celebrity Endorsements Just like cigarettes (used to be) Jenny McCarthy, Steven Dorff, Bruno Mars, Katherine Heigl, Courtney Love and more Re-glamorizing smoking
Celebrity Endorsements
Celebrity Endorsements + Youth Publications = More Hooked Kids 34
Playing to Public Health
Playing to Public Health
Youth, Rebellion and (E)-Cigarettes
Youth, Rebellion and (E)-Cigarettes
Youth, Rebellion and (E)-Cigarettes What is the message? - Keep smoking - Take back your right to smoke - It s not about quitting
E-cigarettes and smokefree laws Safety Enforcement Undermining Smoking Reduction
E-cigarettes and smokefree laws Safety
Safety of E-Cigarettes Studies show that e-cigarettes produce more than just nicotine vapor and water. Toxins in vapor include formaldehyde, acetaldehyde, acrolein, volatile organic compounds like benzene and toluene, tobaccospecific nitrosamines, and metals like cadmium, nickel, and lead. Though levels of these compounds are generally lower than those found in mainstream cigarette smoke, they still are among those identified as harmful or potentially harmful substances by the FDA. Several of the products themselves include warnings that inhaled nicotine is very toxic by inhalation.
Safety of E-Cigarettes E-cigarettes release chemicals and ultrafine/fine particles, including volatile organic compounds and nicotine, into the air. raising concerns about the effects of passive vaping. One study notes, while not polluting as a conventional cigarette, the e-cigarettes are putting detectable levels of several significant carcinogens and toxins in the air [emphasis in original]. Furthermore, using e-cigarettes in enclosed spaces could concentrate the released vapor (and therefore the airborne chemicals), which could pose additional health risks to nonusers.
E-cigarettes and smokefree laws Enforcement
Enforcement of Smokefree Laws Smokefree laws are easy to implement and are popular in part because they are easy to enforce and understand. Allowing e-cigarettes to be used in workplaces causes needless confusion and increases potential risks to other employees and patrons. E-cigarettes are designed to mimic smoking on many levels, exacerbating confusion for owners and employees and complicating enforcement efforts.
E-cigarettes and smokefree laws Undermining Smoking Reduction
Undermining Public Health Effects of Smokefree Laws Smoke-free laws protect everyone s right to breathe clean air AND create an environment in which smokers are more likely to try to quit and succeed in doing so and in which kids are less likely to start smoking. Allowing e-cigarettes in workplaces and public places could reverse this progress. By encouraging smokers to use e-cigarettes in places where they cannot smoke, e-cigarette marketing discourages quitting by offering smokers a way to get nicotine when they otherwise cannot.
Undermining Public Health Effects of Smokefree Laws Allowing e-cigarette smoking in workplaces and public places will add to the re-glamorization of smoking that e-cigarette companies are attempting to achieve through their marketing efforts, which include many of the same tactics and themes that have addicted kids for decades.
E-cigarettes and Clean Indoor Air In summary: Many states and cities across the country have already acted to include e-cigarettes in their smokefree laws. None have been struck down by courts. Opposition is strong when being debated, but is often from outside the jurisdiction and always quickly abates.
E-cigarettes and Clean Indoor Air In summary: Smoke-free laws protect everyone s right to breathe clean air. Given the uncertainties about the harm of e- cigarette vapor, it makes no sense for non-users to be exposed to it. While e-cigarette users are free to choose to take the risk of using these products themselves, the rights of non-smokers not to breathe potentially toxic substances must continue to be protected.
E-Cigarette Solutions Responsible State Actions to Protect Public Health Regarding E-Cigarettes
Best Options Act to keep e-cigarettes out of the hands of minors Add e-cigarettes to the definition of tobacco products within youth access laws and related enforcement statutes Treat e-cigarettes the same as all other tobacco products when it comes to youth access and enforcement In terms of youth access, there is NO DIFFERENCE in the way these products should be treated under the law
Best Options Act to keep workplaces and public places safe from e- cigarettes and cigarettes The vapor from e-cigs has been found to contain nicotine, chemicals, and toxins. Workers and the public should remain protected. E-cigarette use undermines enforcement of the law and promotes confusion among smokers, e-smokers, and the non-smoking public. E-cigarette use in the workplace discourages quitting among current smokers and re-glamorizes tobacco use among youth and adults, undermining the impact of smokefree laws on smoking reduction
AG s on e-cigs
THE STATE TRIFECTA Program Funding
Thank You! For more info: abarkley@tobaccofreekids.org 502-777-8148 56