Electronic Cigarettes: An Overview October 7, 2013 How to Use - - PowerPoint PPT Presentation

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Electronic Cigarettes: An Overview October 7, 2013 How to Use - - PowerPoint PPT Presentation

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Electronic Cigarettes: An Overview October 7, 2013 How to Use WebEx If you can hear us through your computer, you do not need to dial into the call. Just adjust your computer speakers as needed. If you need technical assistance, call WebEx

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Electronic Cigarettes:

An Overview

October 7, 2013

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How to Use WebEx

If you need technical assistance, call WebEx Technical Support at 1-866-863-3904. All participants are muted. Type a question into the Q & A panel for our panelists to answer. Send your questions in at any time. If you can hear us through your computer, you do not need to dial into the call. Just adjust your computer speakers as needed. This webinar is being recorded. If you arrive late, miss details or would like to share it, we will send you a link to this recording after the session has ended.

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Acknowledgments

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Presenters

Cassandra Stepan

Tobacco Prevention & Control Planner Minnesota Department of Health

Pat McKone

Director of Mission Programs American Lung Association in Minnesota

Betsy Brock

Director of Research Association for Nonsmokers - MN

Scott Kelly

Staff Attorney Public Health Law Center

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Webinar Objectives

  • Electronic Cigarettes
  • Product descriptions
  • Marketing strategies
  • Health impact
  • Regulation
  • Minnesota Tobacco Modernization

and Compliance Act

  • Minnesota Clean Indoor Air Act
  • Local Regulations
  • Questions
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Electronic Cigarettes: Background

Betsy Brock, MPH Director of Research Association for Nonsmokers-MN www.ansrmn.org

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History

 Electronic cigarettes, also called e-cigarettes, were

invented in 2003 by a Chinese pharmacist.

 Today, there are hundreds of brands.

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E-Juice, Smoke Juice

 The liquid used in e-cigarettes

is a mixture of nicotine, flavors, and propylene glycol

 Propylene glycol is a food

preservative and humectant

 Flavors include: gummy bears,

fruit punch, peach, licorice, Swedish Fish, etc.

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Brands

NJOY: 40% market share blu: 40% market share,

  • wned by Lorillard

maker of Newport

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FDA Regulation

 The FDA has the authority to regulates e-

cigarettes as tobacco products; they have not acted

 From 2008-2010, the FDA regulated e-cigarettes

as drug delivery devices

 This was challenged in court; the court

determined that e-cigs should be regulated as tobacco products

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Prevalence

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E-Cigarette: Prevalence

 Sales are increasingly rapidly: expected to reach

$1B in 2013 (cigarettes=$80B)

 Some think that EC sales could overtake

traditional cigarette sales in the next decade… or three.

Source: Wells Fargo Securities, Forbes

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E-Cigarettes: MN Adult Prevalence

 Around 1% of MN adults report that they

currently use EC

 4% of current cigarette smokers report also

using EC

 6% of 18-24 year old current cigarette smokers

also report using EC

Source: Minnesota Adult Tobacco Survey, 2010

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E-Cigarettes: Youth Prevalence

In 2012, 10% of high school students reported ever using e-cigarettes, up from 4.7% in 2011.

 More than 75% of these students also report

using cigarettes

Source: National Youth Tobacco Survey, 2012

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Dual Use

 Nationally, 20% of smokers report that they have

used an e-cigarette (2011)

 E-cigarette use was significantly higher among

current smokers than former or never smokers

 We need to think about this on a population

level!

Source: Centers for Disease Control and Prevention

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Health Impact

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Electronic Cigarettes: Health Effects

 These products are poorly regulated and highly

  • variable. One study found that:

 Nicotine content labeling was not always

accurate; some cartridges that were labeled “no nicotine” actually contained high doses of nicotine

 Secondhand EC vapor contains nicotine

Source: Trehy, M., WeiYe, Hadwiger M.E., Moore T.W., Allgire J.F., Woodruff, J.T., Ahadi, S.S., Black, J.C., & Westenberger, B.J. (2011). Analysis of electronic cigarette cartridges, refill solutions, and smoke for nicotine and nicotine related impurities. Journal of Liquid Chromatography & Related Technologies, 34(14): 1442-1458.

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NJOY: Nicotine content: ???? blu: Nicotine content: ??? Fin: 1.6% nicotine by volume EZ Cig: 2.1% nicotine Swisher e-cigar: 18 mg nicotine

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Electronic Cigarette: Health Effects

 EC vapor has been found to contain heavy

metals, silicate, and nanoparticles (which can go deep into the lungs)

 Many of the ingredients found in EC vapor

are known to be dangerous to human health. These ingredients can cause: lung and cardiac inflammation, cancer, and cell damage.

Source: Williams, M., Villarreal A., Bozhilov K., Lin S., &Talbot, P. (2013). Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol. PLoS ONE, 8(3): e57987.

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Marketing

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Vuse E-Cigarette commercial, 2013: “Tomorrow. It’s where great things

  • happen. Dreams.
  • Opportunities. The

promise of new things to come….Welcome to tomorrow.”

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blu Facebook page: September, 2013

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NJOY Facebook Page: September, 2013

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Source: Trinkets & Trash Print ad for Fin: August, 2013

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FREE SAMPLE! Received September, 2013

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NJOY Website: October, 2013

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E-Cigarettes: What’s Happening

Pat McKone, Director Tobacco Control Programs and Policy

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Vaping Shops in MN

Vaping locations in Minnesota

  • Sept. 2013
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Active on the Internet

  • Guiding members on how to get their voices

heard

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  • Awareness of the Clean Indoor Air Act
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Advocacy tips

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Advocacy via Incentives

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Tracking current news …..

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Talking Points

  • FDA Regulation is needed

– Agreement on no sales to minors – License needed (some disagreement with being a tobacco license

  • Harm Reduction this is a tobacco industry term
  • Tobacco use is the most harmful product on the market
  • Best practice is to support cessation
  • The science is not there – lots we don’t know
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Cessation “stories”… not science

  • What we know about e cigarettes and

cessation (nicotine is addictive)

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Cessation

  • There are 7 products approved by the FDA for

cessation..these products have gone through clinical trials and have shown that when used in combination with cessation counseling double the chances for cessation

  • E cigarettes derail true cessation attempts
  • FDA has sent warning letters to e cigarette

manufacturers regarding false cessation claims

  • E cigarettes are commonly used along with

cigarettes ..dual users (undermining true cessation attempts)

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Use among youth doubles!

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Youth and e-cigarettes

  • Dozens of flavors appealing to youth e.g.

cotton candy

  • Mall kiosks as sales outlets
  • Positioning as not so harmful
  • Vaping lounges
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14 Agencies Sent Letter to FDA Urging Regulation and 40 Attorneys General

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Electronic Cigarettes: Regulations

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Federalism

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Presumption

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Reality

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Evolution

“We ask the FDA to move quickly to ensure that all tobacco products are tested and regulated to ensure that companies do not continue to sell or advertise to our nation’s youth.”

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Tobacco Modernization and Compliance Act

  • Expanded state laws

related to the sale and use

  • f tobacco products and

related devices

  • Prohibits the sale to

minors of any:

  • Nicotine delivery devices
  • Lobelia delivery devices
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Distinctions (tobacco vs. e-cigarettes)

Tobacco regulations don’t specifically apply to electronic cigarettes:

  • License to sell
  • Self-service
  • Compliance checks
  • Administrative penalties
  • Suspensions
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Freedom to Breathe Act

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“Smoking”

144.413 DEFINITIONS.

  • Subd. 4.Smoking.

"Smoking" means inhaling or exhaling smoke from any lighted cigar, cigarette, pipe, or any other lighted tobacco or plant product. Smoking also includes carrying a lighted cigar, cigarette, pipe, or any

  • ther lighted tobacco or plant

product intended for inhalation.

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Local Opportunities

“All public health is local: It’s got to start and be sustained at the local level.”

  • Dr. Howard Koh, Assistant Secretary,
  • Dept. of Health & Human Services, 2009
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Local Authority – Licensing

461.19 EFFECT ON LOCAL ORDINANCE; NOTICE. Sections 461.12 to 461.18 do not preempt a local ordinance that provides for more restrictive regulation of tobacco sales. A governing body shall give notice of its intention to consider adoption or substantial amendment of any local ordinance required under section 461.12 or permitted under this section. The governing body shall take reasonable steps to send notice by mail at least 30 days prior to the meeting to the last known address of each licensee or person required to hold a license under section 461.12. The notice shall state the time, place, and date of the meeting and the subject matter of the proposed ordinance.

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Local Authority - Use

144.417 COMMISSIONER OF HEALTH, ENFORCEMENT, PENALTIES.

  • Subd. 4.Local government ordinances.

(a) Nothing in sections 144.414 to 144.417 prohibits a statutory or home rule charter city or county from enacting and enforcing more stringent measures to protect individuals from secondhand smoke. (b) Except as provided in sections 144.411 to 144.417, smoking is permitted outside of restaurants, bars, and bingo halls unless limited or prohibited by restrictions adopted in accordance with paragraph (a).

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“Policy”

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Ordinances

  • Regulate people and property
  • Provide penalties for violations
  • Comply with procedural

requirements

  • Need to be consistent with state

and federal laws

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Retail Licensing

Incorporate Electronic Cigarettes

  • Definitions
  • Licensing requirements
  • Background checks
  • Fees
  • Prohibited sales
  • Self-Service
  • Other illegal acts
  • Sampling
  • Compliance checks
  • Violations and penalties
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Clean Air

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Examples

City Council votes to restrict e-cigarette use in Duluth New restrictions soon will confront users of electronic cigarettes in Duluth.

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Examples

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Questions

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Technical Assistance Providers

Betsy Brock – Betsy@ansrmn.org

(651) 646-3005

Pat McKone - Pat.McKone@lungum.org

(218) 726-4721

Scott M. Kelly – scott.kelly@wmitchell.edu

(651) 695- 7611

The legal information and assistance provided in this webinar does not constitute legal advice or legal representation.