Friday, December 30, 2011

2011 Butt Head of the Year Awards

Nicknamed the "Cassie," the annual CASAA "Butt-Head of the Year" awards are given to public health professionals and legislators "in recognition of the most creative truth-telling, incredible inaccuracy and exceptional fact-twisting in tobacco harm reduction." 

Here are the nominees for 2011! (Be sure to cast your vote at the end before January 1st!)

Dr. Zorba Pastor
The Twist: "The real gunslingers to watch in this shootout are the tobacco makers who want you to think that "smokeless" tobacco is much safer. They're now being joined by new snake oil salesmen, the battery-powered "no smoke" cigarette lobby that claims these gadgets safely satisfy the craving. They don't and users often find themselves back on tobacco. These guys are the real pushers."
The Truth:Dr. Pastor's comments completely ignore the scientific fact that smokeless tobacco does not cause lung cancer, which would be just one thing that deems them "safer" than smoking. Scientific evidence supports smokeless tobacco has at least 98%  less health risks than smoking. In reference to e-cigarettes, he also ignores the known fact that smokers rarely find nicotine gum "satisfy the craving" and "find themselves back on tobacco," most of the time, with an established 93% failure rate. On the other hand, approximately 2.5 million e-cigarette users have significantly reduced and often completely eliminated smoking traditional cigarettes, finding them much more appealing and satisfying than the nicotine gum most had tried before.

Dr. Barbara Ferrer - Boston Public Health Commission
The Twist: "Tobacco exposure continues to be a significant factor that contributes to preventable sickness and death," said Dr. Barbara Ferrer, executive director of the Boston Public Health Commission. "The steps the board has taken today will help reduce young people's exposure to tobacco and unregulated nicotine products, and eliminate exposure to e-cigarette vapors containing nicotine and other known toxins in the workplace." 
The Truth:
"Tobacco exposure" is not the same as "smoke exposure," and she is falsely implying that e-cigarette vapor has been shown to contain toxins. The Boston Public Health Commission banned the use of e-cigarettes in places where smoking is prohibited, absent any scientific evidence of harm to bystanders, effectively removing a huge incentive for smokers to make the switch.

The White House
The Twist: "E-cigarettes may contain ingredients that are known to be toxic to humans or otherwise harm public health -- for example, if they are attractive to young people and lead kids to try other tobacco products, including conventional cigarettes, which are known to cause disease and lead to premature death. Because clinical studies of these products have not been submitted to the Food and Drug Administration (FDA), consumers currently have no way of knowing what types or concentrations of potentially harmful chemicals are found in these products, or how much nicotine people inhale when they use these products.

FDA is taking steps, as authorized by the Family Smoking Prevention and Tobacco Control Act, to include electronic cigarettes under the agency's regulatory authority.

However, in light of the lack of validated scientific data, including a lack of reliable indicators of nicotine and harmful chemical content, FDA cannot at this time conclude that electronic cigarettes are an effective alternative to smoking."

The Truth:

The White House apparently failed to even read one of the heart-felt testimonials of over 5,000 e-cigarette users and had the highly mistrusted FDA answer a submitted petition.  FDA representative Dr. Lawrence R. Deyton, in this carefully worded statement, strongly implied that e-cigarettes contain toxic chemicals, would cause youth to start smoking and that there is still not evidence "that electronic cigarettes are an effective alternative to smoking." 

Adding further insult to injury, the FDA recommended petitioners read about the Great American Smokeout, an event run by the American Cancer Society - an organization known to be actively trying to ban e-cigarettes in favor of the NRT products sold by the companies that provide the ACS with a great amount of funding.

There is absolutely no evidence youth are using e-cigarettes in great numbers or ever will. E-cigarette users largely report that tobacco smoke does not taste pleasant after using e-cigarettes. Because of this effect, e-cigarettes could actually prove to be a barrier to smoking. Additionally, numerous tests have shown no evidence of harmful levels of any chemical in e-cigarettes and an estimated 2.5 million current e-cigarette users are clearly a testament to their efficacy.

Linda Rosenthal - New York Assemblywoman 
The Twist: "...until the FDA approves e-cigarettes for smoking cessation or other medical purposes, it should be banned outright."

“The FDA has already said (e-cigarettes) contain carcinogens and chemicals found in antifreeze. But we don’t know exactly what’s in these products,” said Rosenthal, adding that she kicked her own smoking habit after using nicotine patches."

"Assemblywoman Linda Rosenthal, says most of the "e-cigs" are made in China and might not be safe."

The Truth:
For sponsoring a bill to ban all e-cigarette sales in the state. Rosenthal pulled out every argument in the Anti Nicotine and Tobacco Zealot arsenal, including the misleading FDA statement about "anti-freeze" and "carcinogens;" claiming "we don't know" what is in them (but they are still dangerous); insisting they need to be regulated the same as NRT and approved by the FDA (even though cigarettes are not regulated or approved in that same manner) and playing on the mistrust of Chinese products. Her bill died in the Senate, but she has vowed to try again in 2012. We can expect Ms. Rosenthal may find herself in the running for our 2012 Butt Head award!

The real kicker was when she perpetuated the ultimate insult used by rabid ex-smokers:

"If I can quit without e-cigarettes, then anybody can do it."

Great job insulting just about every smoker who has tried to quit and failed, Ms. Rosenthal!

Amy Sands - Tobacco Prevention and Control Program for the Utah Department of Health
The Twist:
“There’s mountains of research to show that cigarette smoking will cause lung cancer, cancer in almost every organ of your body, and kill you. The same is true of these products. These are cancer-causing, toxic products. There’s no doubt – all sorts of scientific research to prove that smokeless tobacco products like these addict and they kill.” 

The Truth:
This is an outright lie. There is absolutely no scientific research supporting her claim about the new smokeless, dissolving tobacco products, snus and electronic cigarettes. "Smokeless tobacco causes neither lung cancer nor other diseases of the lung, and users have no excess risk for heart attacks. In fact, the only consequential — but infrequent — adverse health effect of smokeless tobacco use is oral cancer. In 1981, writing in The New England Journal of Medicine, Dr. Deborah Winn and colleagues established that smokeless tobacco users are four times more likely to develop oral cancer than are nonusers of tobacco. However, this relative risk is only about one half the relative risk of oral cancer from smoking." (Rodu and Cole, 1995) In the case of snus use, there has been 30 years of research showing that there is no evidence of any increased health risks. Experts believe that the new dissolving products and electronic cigarettes would be similarly low risk.

Cast your vote for the 2011 Butt Head of the Year!


Tuesday, December 27, 2011

State of Wisconsin Call to Action!

Call to Action for Wisconsin RESIDENTS!

LRB 1287/1 and 3573/1:AN ACT to renumber 101.123 (1) (h); and to create 101.123 (1) (h) 2m. of the statutes.
This bill specifies that the term "smoking," for purposes of the general prohibition against smoking in indoor locations, does not include holding, or inhaling or exhaling vapor or a vaporized solution from, an electronic device that does not contain tobacco.
This bill would:
Specifically exempt electronic cigarettes from the statewide indoor smoking ban.

The bill's sponsor, Senator Grothman (WI-R) is currently seeking co-sponsorship. There is an identical bill introduced in the House. Groups such as the American Lung Association and the American Cancer Society are already contacting legislators in opposition of this bill. They also have issued a call to action to their members, who are already writing and calling their district legislators, asking them to oppose this bill. We need Wisconsin e-cigarette users to contact their legislators, both in the House and the Senate, to urge them to support this bill.

Please call or write the members of Wisconsin State Legislature listed below. Specifically target your district representatives. Phone calls and letters sent via mail or fax have a greater impact.
What to say:
1. You support Senator Grothman's bill to specifically exempt electronic cigarettes from the state indoor smoking ban.
2. Tell your story on how switching to an e-cigarette or smokeless tobacco has changed your life.
3. Explain how smoking bans are enacted to protect the public from the harm of second-hand smoke, but electronic cigarettes have not been shown to cause harm to bystanders. In fact, all scientific evidence to date shows that the low health risks associated with electronic cigarettes is comparable to other smokeless nicotine products. Include a link to or a copy of CASAA's report: "E‐cigarettes and Smoke‐free Policies." This comprehensive report includes all of the crucial supporting evidence to counter what the opposing groups are telling the legislators.
4. Let them know that vapor does not behave in the same manner as smoke. There is no "side stream" vapor like the side stream smoke coming from the lit end of a cigarette and unlike cigarette smoke. The vapor is virtually odorless and dissipates quickly. There is also no ash or litter. With so little evidence of use, enforcing indoor use bans on electronic cigarettes would be nearly impossible.
5. Inform them that the ability to use electronic cigarettes in public spaces will actually improve public health by inspiring other smokers to switch. Surveys of thousands of users indicate that the majority of those who switch very quickly completely replace tobacco cigarettes with the electronic cigarettes, reducing their health risks by 98-99%.
So even if smokers think they are using electronic cigarettes just for indoor use, the chances are high that they will stop using tobacco cigarettes altogether .
6. Tell them that by switching to a smokeless product, you have greatly reduced your health risks.
7. Direct them to the website and the CASAA report: "E‐cigarettes and Smoke‐free Policies" for more information.
Link to CASAA's letter to Wisconsin legislators:

To find your representative, click this link and enter your address:

Send an email supporting this bill to all representatives:Semi-colon Separated;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;;

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Thursday, December 22, 2011

Successful smoking cessation with electronic cigarettes in smokers with a documented history of recurring relapses: a case series

Introduction: Smoking cessation programs are useful in helping smokers to quit, but smoking is a
very difficult addiction to break and the need for novel and effective approaches to smoking cessation
interventions is unquestionable. The E-cigarette is a battery-powered electronic nicotine delivery
device that may help smokers to remain abstinent during their quit attempt. We report for the first time
objective measures of smoking cessation in smokers who experimented with the E-cigarette.

Case presentation: Three Caucasian smokers (two men aged 47 and 65 years and one woman aged
38 years) with a documented history of recurring relapses were able to quit and to remain abstinent for
at least six months after taking up a cigarette.

[Read full report]

Monday, December 19, 2011

Institute recommendations will block development/approval of reduced risk tobacco products

This commentary appears today on Dr. Siegel's tobacco policy blog, at:

IOM Report on Modified Risk Tobacco Products Interprets Tobacco Act as Putting Insurmountable Barriers in the Way of Reduced Risk Tobacco Products

The Institute of Medicine last week released its long-awaited report on the scientific evidence required to support designation of tobacco products as modified risk products under the Family Smoking Prevention and Tobacco Control Act [the Tobacco Act].

The report recommends that extensive scientific evidence, including findings from randomized controlled trials and longitudinal cohort studies, be required to show that potential reduced risk products will reduce individual health risks and improve the public's health on a population basis.

The report summarizes the rigorous nature of the scientific evidence required as follows: "The evaluation of the effect of MRTPs on public health will require a wide range of evidence and therefore will require many different types of study designs, including studies of the composition of MRTPs and studies of human exposure, human health effects, the likelihood of addiction and abuse, and the perception and understanding of the product by the public. Furthermore, the evidence must be able to reliably support predictions about the effect of marketing the product on public health, and therefore these studies must be properly designed and rigorously conducted. Study designs will need to include all relevant populations including populations at a high risk for tobacco use. Study designs must be able to not only support inferences about the mechanisms of the products effects, but they must also be able to support predictions about the products’ effects in the real world."

The report makes it clear that demonstration of reduced risk cannot be made based simply on laboratory or pre-clinical studies, but requires the conduct of clinical trials and long-term longitudinal cohort studies.

As the report states: "there is no proof that any individual constituent or group of constituents is responsible for a given disease. For a biomarker of exposure to be accepted as a biomarker of risk or a surrogate endpoint of disease, there should be a strong biological rational as well as compelling data from clinical and epidemiologic studies. Experimental designs, in particular randomized controlled trials (RCTs), provide data that can support the strong inferences about the effect of an MRTP on human health relative to conventional tobacco products. The use of appropriately designed clinical trials will be important to establish whether the use of the MRTP reduces exposure to toxicants or induces positive changes in surrogate markers as claimed by the manufacturer. An RCT is an effective means of examining acceptability and use of the MRTP, the ability of the MRTP to increase cessation in users of conventional tobacco products, and the likelihood that availability of the MRTP will lead to dual use. RCT methods can also produce evidence on whether and how much individuals use an MRTP after they have used it to help them quit conventional products, changes in perception of the MRTP with its continued use, and the MRTP’s ability to suppress tobacco withdrawal symptoms. It is important to recognize that no single RCT can address all of these areas, and each study should have a focused objective with a primary endpoint."

"Long, intensive, and robust observational studies of actual health outcomes may be required to fully evaluate the net effects of MRTPs relative to conventional tobacco products. Prospective cohort studies are obvious candidates for the evaluation of MRTPs, and will also be an essential tool to validating anticipated or claimed effects of marketed MRTPs on both individuals and on the public’s health."

"It is clear that no single class of evidence (e.g., preclinical, RCTs, consumer perception, epidemiologic) in itself will be sufficient to support an MRTP application."

Thus, not only must the applicant demonstrate an improvement in individual and population health through randomized controlled trials and long-term longitudinal studies, but multiple clinical trials are required.

Moreover, the report recommends that tobacco companies not be allowed to submit their own research findings: "the committee concluded that the tobacco industry currently lacks not only the trustworthiness, but also lacks the expertise, infrastructure, and other resources needed to independently produce the scientific evidence necessary to meet the public health standards set by the law."

Instead, the report insists that tobacco companies must contract with independent third parties to conduct the required research.

The Rest of the Story

The scientific requirements recommended by the IOM report are so rigorous that I believe the implementation of such standards would place an insurmountable, or virtually insurmountable, obstacle in the way of the development and marketing of truly reduced risk tobacco products. I believe that these standards would be a de facto death knell for the strategy of harm reduction as a tool for controlling tobacco-related disease in the United States.

The requirements for conducting long-term epidemiologic studies and randomized clinical trials to demonstrate reduced individual and population risk are so burdensome that they remove most of the incentive to develop such products, especially since there is no guarantee that long-term studies will support the approval of such products. In addition, the length of time required to conduct these studies is prohibitive in most cases.

Consider the need to demonstrate a reduction in cancer risk. Cancer takes many years to develop so one cannot simply conduct a two-year cohort study to determine whether a new type of cigarette will reduce cancer risk. It would take a minimum of perhaps ten years to know whether the product reduces cancer risk. Very few companies are going to want to expend the amount of money required to carry out such long-term studies, with no guarantee of success.

Moreover, the requirements for randomized clinical trials that include a control group of regular cigarette users cannot be followed while still conducting ethical research. You cannot ethically randomize human subjects to smoke regular cigarettes. I will write more about this in a separate post tomorrow.

The Two Pathways for Modified Risk Products

There are two possible pathways for modified risk tobacco products: the reduced risk pathway and the reduced exposure pathway. Reduced risk products are those for which the manufacturer wishes to claim that the product is safer than other products on the market. Reduced exposure products are those for which the manufacturer will not make any explicit health claim, but will merely inform consumers that it contains less of a certain constituent, or is free of a particular constituent.

For the reduced risk pathway, the IOM report makes it clear that the manufacturer must show that the product will reduce health risks to individual users and to the population as a whole. This is a very high scientific standard, one that can only be met through long-term epidemiologic studies with thousands of product users in order to establish the long-term relative risks of using these products.

However, this produces a catch-22 situation: A manufacturer cannot market a product until it demonstrates that it reduces individual risk. But a manufacturer cannot demonstrate that the product reduces individual risk unless it first markets the product. Receiving special FDA permission to test market the product in a small population will not allow the large sample size necessary to examine the effects of these products on cancer risk. Such studies require perhaps hundreds of thousands of users in order to have enough power to detect differences in cancer risk.

Thus, it is virtually, if not literally impossible for any reduced risk product ever to be approved by the FDA under these scientific standards.

For the reduced exposure pathway, the manufacturer need only show that the product does indeed decrease exposure to a particular constituent or constituents and that a corresponding reduction in health risk is "reasonably likely." This is possible to do with laboratory studies, so it is feasible to make the necessary demonstrations to the Agency.

However, there is a third requirement: the manufacturer must show that as it plans to package and market the product, consumers will not believe that the product reduces their risk. In other words, even though consumers know that the product reduces exposure, they must not believe that it reduces risk.

This, again, creates a nearly impossible task. If consumers are aware that a product reduces exposure to one or more harmful substances, they are naturally going to believe that it reduces their risk of disease. The only way to avoid this perception would be not to tell consumers that the product reduces exposure. But in that case, the new product is no longer a reduced exposure product and so it cannot be approved for marketing in the United States.

Thus, the FDA Tobacco Act creates another catch-22: A manufacturer cannot market a product as reduced exposure unless it can show that consumers will not perceive it to be less harmful. But consumers will only perceive that the product is not any less harmful if it is not marketed as reduced exposure.

This provision, in other words, makes it virtually, if not literally impossible to market a reduced exposure product. One would have to make very limited claims that do not result in consumers believing the product is any safer. But if consumers don't believe the product is any safer, then why would they want to switch to that product? It would not be cost-effective to market the product, because it surely would not compete with existing products on the market in the absence of any consumer belief that the new product is safer.

Consistency of the IOM Report Recommendations with the Tobacco Act

I need to make it clear that I am not criticizing the IOM report for an overly stringent interpretation of the Tobacco Act. It is my opinion, which I expressed before the Tobacco Act was even enacted, that the above implications of the modified risk tobacco product provisions of the Tobacco Act were exactly what Congress and the anti-smoking groups which supported the legislation desired.

So I believe that the IOM report is accurately outlining the rigorous scientific evidence that the statute requires. I believe that a major purpose of the FDA Tobacco Act was specifically to put a huge barrier in the way of modified risk products, which have long been despised by the anti-smoking groups (and usually with good reason). But the climate has changed (e.g., consider the development of electronic cigarettes, which contain no tobacco) and the law needs to change with the climate. Unfortunately, the Tobacco Act employs an old picture of the tobacco product space and inhibits a true harm reduction approach in favor of preventing deceptive marketing that characterized the previous century, when there was no federal regulation of tobacco products. The times have changed, but the Act's view of the times has not. As a result, the Act essentially nixes harm reduction as a viable tobacco control strategy in favor of protecting the existing high-risk cigarette market. Even the tobacco companies recognize that this is an antiquated view; they desire to bring reduced risk products into their portfolios.

The rest of the story, then, is that the Tobacco Act's modified risk provisions simply make no sense. It is essentially a hoax, designed to make it look like the policy makers and health groups are interested in protecting the health of smokers, but instead, if you actually read the fine print, you'll find that the law sacrifices the health of smokers by making it impossible for tobacco companies or public health groups to pursue a harm reduction strategy. The Act preserves the existing market of the highest risk tobacco products and stifles competition from alternative products that might truly reduce health risks. The IOM report's interpretation of the Act is perfectly consistent with the statute.

This is not science-based policy. It is protectionism. Protection of the status quo. Protection of the existing tobacco market. The anti-smoking groups are not interested in actually protecting the health of smokers by encouraging them to use potentially less harmful alternatives. Instead, they are protecting the highest risk products and making sure that smokers continue smoking these high-risk products and that they do not switch to products that could potentially save their lives, or at least greatly reduce their risk of disease.

Michael Siegel, MD, MPH
Department of Community Health Sciences
Boston University School of Public Health
801 Massachusetts Avenue, 3rd Floor
Boston, MA 02118

Disclaimer: The opinions expressed in this communication are my own personal views and do not necessarily represent the opinions of Boston University or the Boston University School of Public Health.

Saturday, December 17, 2011

CASAA Member Meeting Sunday 12-17-11

Title: CASAA member Meeting
Date: Sunday, December 18, 2011
Time: 7:30 PM - 9:00 PM EST

After registering you will receive a confirmation email containing information about joining the Webinar.

System Requirements:
PC-based attendees
Required: Windows® 7, Vista, XP or 2003 Server
Macintosh®-based attendees
Required: Mac OS® X 10.5 or newer

Space is limited.
Reserve your Webinar seat now at:

Sunday, December 11, 2011

CASAA welcomes new directors

In the past few weeks, the CASAA Board of Directors has gratefully expanded with the addition of two new directors, welcoming Karen Carey (MA) and Michael Cozzi (IL). Along with determination and passion,  Mrs. Carey brings a background in accounting and experience running the New England Vapers group and Mr. Cozzi, brings extensive IT experience to CASAA as well as being a well-known figure in the e-cigarette review and tutorial video world.

The newest board members join the other 2011 additions: Secretary Jacinda Ross (UT), who is a local e-cigarette activist and has also taken on the demanding role as "the face of CASAA" on several vaping-related online shows joined the Board in July and Treasurer Gregory Conley (NJ), a law student (often referred to as CASAA's new "rock star") who joined the Board in February and tirelessly follows tobacco harm reduction legislation for the organization and has already contributed invaluable media contacts, FOIA documents, public testimony and legal support for CASAA. Dorothy Taylor, who is an LPN and active e-cigarette advocate who contributes her medical expertise to the cause, also joined the board back in February.

The current Board of Directors also consists of Ron Ward (MD), informally acting as CASAA legal director, who joined the board in August 2010 and founding directors President Elaine Keller (VA); Vice President Kristin Noll-Marsh; Thad Marney (OR); Drew Gliem (NJ) and medical director Theresa Witt (TX).

Saturday, December 10, 2011

Boston Globe publishes CASAA letter

The Boston Globe published CASAA President Elaine Keller's Letter to the Editor, which is responding to the editorial that chided e-cigarette manufacturers for "resisiting FDA regulation".

E-cigarette makers have devised smoking substitute that works

THE DEC. 3 editorial “Banned in Boston, for now’’ blames manufacturers of e-cigarettes for resisting “efforts at regulation by the federal Food and Drug Administration by labeling e-cigarettes as devices for smoking pleasure, not therapeutic devices for nicotine replacement.’’ Why would the Globe want manufacturers to misrepresent the intended purpose of the products? Technically speaking, there is no such thing as a therapeutic product for nicotine replacement.

Nicotine patches, gum, lozenges, and prescription inhalers should more properly be referred to as “nicotine weaning therapy’’ products. Directions instruct consumers to use the products for a specified length of time, reduce the dosage of nicotine, and then discontinue use. Unfortunately, they don’t work well. By the time treatment is completed, most consumers have already relapsed, and a year after treatment, 95 percent have resumed smoking.

The idea behind e-cigarettes is to provide the nicotine that a smoker craves while eliminating nearly all of the smoking-related hazards. Medicinal drugs and devices must undergo years of testing, costing as much as $800 million, and receive FDA approval before they can be sold for therapeutic purposes. E-cigarettes are intended to serve as a replacement for smoking, and they appear to work extremely well for this purpose.

More than 90 percent of consumers who switch to e-cigarettes report better lung health, better markers of cardiovascular health, and improved stamina. In view of the fact that those who directly inhale the nicotine vapor are enjoying better health, how could the vapor they exhale, having been filtered through their lungs, be harmful to bystanders?

The Consumer Advocates for Smokefree Alternatives Association
Springfield, Va.

Friday, December 9, 2011

New Yorkers don't support e-cigarette bans, support smokeless tax increase

While the New York City Council is seeking to pass a law to ban the use of e-cigarettes where smoking is also prohibited, a summary of a survey posted by the NYC Department of Health shows that New Yorkers do not "favor a proposal that would prohibit smoking electronic cigarettes or e-cigarettes in indoor public places."

The New York Tobacco Behavior and Public Opinion Survey was developed to "evaluate the Communities Putting Prevention to Work (CPPW) grant activities, assess smoking behaviors of current smokers, and assess awareness, attitudes, and social norms about tobacco control policy strategies."  According to the summary,  New Yorkers were largely favorable towards increased prohibitions, restrictions and taxes on tobacco products, but not to banning e-cigarette use in public places.

Between 55%- 60% support prohibiting smoking in all outdoor areas on college and university campuses or facilities; all public parks; recreational areas, such as basketball courts and baseball fields; outdoor markets or street fairs; public beaches; in front of the entrances to buildings; with 51% of non-smokers even wanting to prohibit smoking on all sidewalks. Yet even with the popular opinion that smoking traditional cigarettes must be restricted, over two-thirds (68%) of those surveyed did not see a need for e-cigarettes to be banned along with them.

While this information is highly encouraging and proves that the City Council is seemingly creating legislation for which there is only minor public support, the fact that more than two thirds of New Yorkers do favor increasing state or city taxes on smokeless tobacco products is still troubling. Modern smokeless tobacco products, such as snus and tobacco lozenges, sticks and strips have similar low-health risks as e-cigarettes and should not be subjected to punitive "sin taxes" created for reducing use of high-risk products.

It seems although savvy New Yorkers are smarter than their own legislators when it comes to e-cigarettes, CASAA and other tobacco harm reduction advocates still have a lot of work to do to get the truth out to them about other safer smokeless tobacco alternatives.

URGENT! Cattaraugus County, NY Call to Action


The purpose of this law is "to prohibit the smoking of e-cigarettes, herbal cigarettes, and like products in public places where traditional forms of smoking are already disallowed and to ban the sale of such products to persons under the age of eighteen (18)."

Link: (begins on page 26)

This law would:
Ban the use of electronic cigarettes in any public place where smoking is disallowed. Ban the sale of e-cigarettes to minors.

There will be a public hearing held on the proposed local law by this County Legislature on the December 14th, at 3:01 p.m. at the Legislature's Chambers, County Office Building, 303 Court Street, Little Valley, New York

[Read More]

Saturday, December 3, 2011

EU accused of hiding support for snus

Dagens Nyheter
30 November 2011 

[Translation from original] Sweden´s hopes of lifting the export ban on snus appeared to be crushed in the summer. The European Commission announced that most member countries are saying a firm no. But DN's review shows that there is in fact strong support for making snus freely available on the market.

A majority of Member States support prohibiting all forms of oral tobacco, including snus, the European Commission categorically announced in a press release in July. The basis for the statement came from a "public consultation" on tobacco laws. There were a total 85,000 responses to questions surrounding snus, tobacco advertising and the look of cigarette packages.

EU Health Commissioner, John Dalli, shortly thereafter made it clear to ministers Göran Hägglund and Maria Larsson, that the Commission had already decided to continue its export ban on snus.

But all the responses to this major survey were only published in the autumn, and a review of these gives a very different result.

Of the citizens who submitted their opinions, more than eight out of ten, 84 percent, support lifting the export ban on snus. 86 percent of government representatives and 74 percent of industry representatives wish to lift the ban. Only among lobbyists and NGOs is there a slim majority, 56 percent, who want to keep the ban on snus.

The EU Commission, however, dismisses a significant portion of the responses from the 82,000 citizens on the grounds that two-thirds are from Italy and Poland, where tobacco merchants organised petitions.

But even if we exclude these two countries, the majority is still for lifting the export ban on snus, 10-6, when respondents are broken down by country.

Commissioner Dalli's spokesperson, Frederic Vincent, defends the Commission's contrary statement, saying that it only took account of the government representatives who responded:

“The report is based on a qualitative analysis based on responses from Member States, i.e. governments and ministries.”

DN's review of the 400 responses in this group shows that even among the responses from parliamentarians, municipalities, government agencies and ministries a large majority, 71 percent, support lifting the export ban. Even when only EU governments and ministries are included, there is still no majority against snus, but rather 3-3.

The European Commission's health directorate claims to have received responses from governments who in other ways support the ban on snus, but refuses to show them.

Snus manufacturer Swedish Match, who brought this contradictory data to the attention of DN, is accusing the European Commission of trying to sweep the snus issue under the rug.

“These are very strange conclusions that the Commission's health directorate has drawn from the results, which instead clearly shows strong support for lifting the ban,” said Public Affairs Director Patrick Hildingsson.

In Sweden all the parliamentary parties are in support of lifting the export ban on snus, and Minister for Trade, Ewa Björling (M), has raised the issue as a breach of EU internal market rules. But the EU ban on snus has been introduced for health reasons, and it is therefore Minister of Children and the Elderly, Maria Larsson (KD), that will present Sweden's case in the forthcoming negotiations on tobacco legislation.

But Maria Larsson's political advisor Ulrik Lindgren says that the matter is low on the minister`s agenda thus far:

“We are not working actively on this issue,” he says.

[Read Original Article]

CASAA Member Meeting Sunday 12-4-11

Time: Sunday, December 4th 7:30pm EST

Please join us for the bi-weekly CASAA Member Meeting! If you cannot access the AnyMeeting program for some reason, email your 10-digit phone number to and you will still be able to participate (audio only). We will call your phone when the meeting starts.

All others click the location link and then click "Join Meeting" button under "Upcoming Webinars" enter your name and email and you will be able to access the meeting.

Hope to see you there!

Friday, December 2, 2011

Boise gets it but Boston nips it

The Consumer Advocates for Smoke-free Alternatives Association, in conjunction with Jim Longden, the owner of Vapoligy (a Boise e-cigarette store) and several Boise e-cigarette users, successfully campaigned to get truthful and accurate information about e-cigarettes to the Boise City Council members, which resulted in the exclusion of e-cigarettes from ordinances which ban "smoking in bars and private clubs, near bus stops or other transit areas, on outdoor commercial patios accessible to children or on public property, at the Grove Plaza, on 8th Street from Bannock to Main streets, within 20 feet of a City of Boise-owned building and in other public locations" and "within 20 feet of the Boise Greenbelt, except in designated areas within Ann Morrison and Julia Davis parks and the Warm Springs Golf Course."

Mr. Longden was one of several who attended the Boise City Council  meeting on Novemeber 1st and his experience supports CASAA's belief that e-cigarette users who show up to these meetings can make a significant impact.

"After the meeting we were able to talk with Councilman Thomson and Adam Park, who is the Communications Director for the Mayor and City Council," said Longden. "They were both very responsive and seemed genuinely interested in seeing an eCigarette perform even to the point where Mr. Park asked me to blow vapor in his face. They both seemed truly amazed at the lack of smell and the vapor dissipating almost instantly."

"This a significant victory.  With a population of over 200,000 people, Boise is now the largest city in America to remove e-cigarettes from what was purported to be 'smoking' ban," said CASAA Director Gregory Conley.  Other locales that have recently considered, and then rejected, bans on e-cigarette use, include Delaware County, Indiana and Alexandria, Louisiana," said CASAA Director Greg Conley.

Meanwhile, the news isn't as positive for Boston's local vapers. CASAA issued a Call to Action alert September 21st that the Boston Public Health Commission had proposed the Clean Air Works Workplace Smoking and E-Cigarette Use Restrictions Regulationa prohibition on the use of e-cigarettes in the workplace, which was passed by the Commission on Wednesday. Although many members headed the call, it simply wasn't enough.

"Seeking to close a loophole on unregulated products like electronic cigarettes that deliver nicotine, the Boston Public Health Commission’s Board of Health today approved a proposal to treat e-cigarettes like tobacco products, including requiring retail establishments to obtain a permit to sell them,  prohibiting their use in the workplace, and restricting their sale to adults only," the BPHC website stated.

The Commission's statement is confusing, because the public use of many smokeless "tobacco products," such as snus, dissolvables and chew, is not prohibited. Therefore, the inclusion of e-cigarettes in the smoking ban is, in effect, treating e-cigarettes like tobacco cigarettes, not just as a tobacco product

The prohibition on smoking in the workplace is argued by public health officials as necessary to protect bystanders from the "known hazards" of second-hand smoke. However, there has been no such evidence that vapor exhaled by e-cigarette users poses any risk to bystanders. In fact, researchers and even the FDA have failed to find dangerous levels of any toxins or carcinogens in e-cigarettes tested, so there is no science-based reason to suspect e-cigarettes pose a significant health risk to the user, let alone to bystanders. Absent any scientific evidence of health risks, CASAA suspects e-cigarettes are being treated like tobacco cigarettes by the BPHC based solely on how they may "look" to bystanders.

"E-cigarettes are currently in use by approximately 2.5 million adults to eliminate or significantly reduce their exposure to tobacco smoke and there have been no reports of significant adverse health effects since their introduction to the U.S. over 4 years ago," said Kristin Noll-Marsh, CASAA's vice president. "The ability to use e-cigarettes [where smoking is prohibited] is a powerful incentive to get smokers to consider switching to these reduced harm alternatives. By approving this ordinance, the Boston Health Department is sending the message to smokers that they may as well keep smoking. How is that remotely in the best interest of public health? At least Boise [City Council] got it right."

Monday, November 28, 2011

Chew/snus alternatives free from scrutiny given to e-cigarettes

by Kristin Noll-Marsh
Wisconsin Tobacco Harm Reduction Blog

The FDA has gone after e-cigarettes because it decided that the claims that e-cigarettes were safer than smoking were unproven and that the products were actually unapproved drug delivery systems designed for smoking cessation. Arguments that e-cigarettes are actually safer alternatives to smoking (rather than a treatment) have fallen on deaf ears.

Ironically, another "alternative" to tobacco - tobacco and nicotine-free chew/snus products - have seemingly been free to make similar claims about their products without any clinical trials or FDA scrutiny. Compare the claims made on the web site for a product called "Nip the Grip":

[Read More]

Sunday, November 20, 2011

CASAA successfully stops e-cigarette use ban in Alameda, CA

As reported by CASAA's Call to Action from November 1st, the Alameda City Council was considering a comprehensive smoking ban; which included electronic cigarettes in the definition of "smoking." This would have prohibited the use of e-cigarettes everywhere smoking was not allowed - including condominiums, outdoor bar patios and beaches.

CASAA called for members to urge the City Council to remove e-cigarettes from the proposed ordinance and arranged for locals to make public comments at the Council's first reading. Due to these efforts and those of local e-cigarette merchants, e-cigarettes were removed from the ordinance until more information could be provided to the Council.

On November 15, Alameda City Council voted 5-0 to approve the new smokefree ordinance, with e-cigarettes excluded. The city prominently touts the removal of e-cigarettes from the proposed ordinance. [The City of Alameda - Secondhand Smoke Ordinance]

News story and minutes of the Nov. 15 council meeting may be read at [Big Night at Alameda City Council: Smoking Law Passes, City to Explore Alternatives to Cowan Land Swap - Alameda, CA Patch]

"Alameda City Council's decision to remove e-cigarettes is really important," CASAA Advisor Bill Godshall posted at, "as Alameda is within five miles of UCSF (where Stan Glantz is located); Berkeley (where Americans for Nonsmokers Rights is headquartered); ALA's regional office where lobbyist Serena Chen works; and the Public Health Law and Policy office in Oakland (which drafted model ordanances to ban e-cig use at Electronic Cigarettes: How They Are - and Could Be - Regulated | PHLP and"

"Hopefully, what happened in Alameda will make these e-cigarette prohibitionists reassess their strategy and tactics to inaccurately define "smoking" as including e-cigarette usage in future smokefree ordinance campaigns, and [discontinue making] f
alse claims about e-cigarettes," Godshall wrote.

Wednesday, November 16, 2011

Fat people - welcome to our world

by Kristin Noll-Marsh
Wisconsin Tobacco Harm Reduction Blog

In a recent Time magazine online article, "Let’s Stop Being Passive About Fighting Obesity: It's time to embrace the same tactics that worked against smoking," public health writer Shannon Brownlee drew comparisons between smoking and obesity, calling for public health (and the public) to start treating fat people like smokers. I responded in the comments, but felt it was worth posting here, as well:

The author says, "The war on smoking worked because it made smoking shameful and the public health measures needed to fight it permissible."
In fact, the war on smoking was most successful from 1950 (when the link to lung cancer was found) through the 1980's - when public health focused on education and information, not the "shaming" of smokers. The smoking rate dropped dramatically from 44% to 26% (from 1950 to 1990.) The greatest advances in the mid to late 1980's - nicotine gum approved by the FDA, first city bans smoking in restaurants in 1987, nicotine compared to heroin (without any actual studies to support it), had very little impact in the following decade. The research on second-hand smoke came out in the 1990's, which was gleefully used to change a war against the negative health effects of smoking (to HELP smokers improve their health) into a war AGAINST smokers. 

Tuesday, November 15, 2011

CASAA submits comments to the DOT

If you have been following this blog, you already know that the Department of Transportation (DOT) is proposing to amend its existing airline smoking rule to explicitly ban the use of electronic cigarettes on all aircraft in scheduled passenger interstate, intrastate and foreign air transportation. This Regulation would impose fines of up to $3,300 for "smoking" an e-cigarette on an airplane. Those who use an e-cigarette would be treated exactly as if they were smoking a combusted tobacco product.

The Consumer Advocates for Smoke-free Alternatives Association, along with The Competitive Enterprise Institute, has submitted a comment to the Department of Transportation. The CEI is a non-profit organization that focuses on regulatory issues, especially on raising public understanding of the often-hidden costs of over-regulation and was instrumental in helping CASAA craft this comprehensive and informative comment to the DOT!

You may read the full text here.

How health groups fight against healthy laws

A funny (yet true) The Daily Show with Jon Stewart "report" on the hypocrisy of groups like the American Heart Association and the American Cancer Society. Proves what groups like CASAA are up against. Please give your support to CASAA!

The Daily Show With Jon StewartMon - Thurs 11p / 10c
How a Bill Doesn't Become a Law
Daily Show Full EpisodesPolitical Humor & Satire BlogThe Daily Show on Facebook

Monday, November 14, 2011

DOT Plans to Ban Use of E-cigarettes on Aircraft

Today is the last day to get in comments! CASAA has made this VERY EASY to do! You can write your own, short testimonial (just a couple of sentences) on how e-cigarettes have worked for you (without adverse effects) and then just copy & paste the other facts that can be found on CASAA's Call to Action page by clicking HERE. You will also find the link to the DOT comments page on the Call to Action page.

You may not care about vaping on airplanes, but this is just another step for them to ban e-cigarettes someplace else. The ANTZ frequently cite other bans to support their proposed bans in restaurants, bars, hotels and even apartments and condos (the DOT is citing bans below decks on Navy submarines and Amtrak to support THIS airplane ban) - so we cannot sit back let ANY get passed just because they don't directly affect us, because eventually it will!

It only takes 5-10 minutes. Don't let them overstep their authority and include SMOKELESS e-cigarettes in a SMOKING policy!!! 

Tuesday, November 8, 2011

Best e-cigarette article EVER in New York Times

A Tool to Quit Smoking Has Some Unlikely Critics
New York Times

If you want a truly frustrating job in public health, try getting people to stop smoking. Even when researchers combine counseling and encouragement with nicotine patches and gum, few smokers quit.

Recently, though, experimenters in Italy had more success by doing less. A team led by Riccardo Polosa of the University of Catania recruited 40 hard-core smokers — ones who had turned down a free spot in a smoking-cessation program — and simply gave them a gadget already available in stores for $50. This electronic cigarette, or e-cigarette, contains a small reservoir of liquid nicotine solution that is vaporized to form an aerosol mist.

The user “vapes,” or puffs on the vapor, to get a hit of the addictive nicotine (and the familiar sensation of bringing a cigarette to one’s mouth) without the noxious substances found in cigarette smoke.

After six months, more than half the subjects in Dr. Polosa’s experiment had cut their regular cigarette consumption by at least 50 percent. Nearly a quarter had stopped altogether. Though this was just a small pilot study, the results fit with other encouraging evidence and bolster hopes that these e-cigarettes could be the most effective tool yet for reducing the global death toll from smoking.

But there’s a powerful group working against this innovation — and it’s not Big Tobacco. It’s a coalition of government officials and antismoking groups who have been warning about the dangers of e-cigarettes and trying to ban their sale.

The controversy is part of a long-running philosophical debate about public health policy, but with an odd role reversal. In the past, conservatives have leaned toward “abstinence only” policies for dealing with problems like teenage pregnancy and heroin addiction, while liberals have been open to “harm reduction” strategies like encouraging birth control and dispensing methadone.

When it comes to nicotine, though, the abstinence forces tend to be more liberal, including Democratic officials at the state and national level who have been trying to stop the sale of e-cigarettes and ban their use in smoke-free places....  [Read More]

Tuesday, November 1, 2011

Seattle Housing Authority Backs Down From E-cigarette Use Ban

The chance for public comments closed back in September for a proposed change in policy by the Seattle Housing Authority, which would have banned e-cigarette use "in individual apartment homes or the common spaces of a SHA community or facility of any type, unless otherwise specified."

CASAA Director Greg Conley discovered and posted about this outrageous proposal October 29, 2011, noting that the next Board of Commissioners meeting is November 8th. Director Conley encouraged members to "Please send civil e-mails requesting that the Board of Commissioners remove smoke-free e-cigarettes from the smoking ban proposal."

Members heeded CASAA's impromptu Call to Action and according to the office of Tom Tierney, SHA's Executive Director, the flood of emails and calls from "individuals who contacted our office about electronic cigarettes" has influenced the SHA to "recommend that we allow the use of electronic cigarettes in the proposed policy for all housing developments."

Another victory against the irrational and knee-jerk legislation of less hazardous, smoke-free alternatives! This is just more proof that your calls and emails DO make a difference - so please help whenever you are able - there are many other fronts on which we are currently fighting!

Emergency Message for Northern California E-cigarette Users

We only just became aware last night that tonight (Tuesday, Nov. 1) the Alameda, California City Council will be voting on an ordinance that would prohibit "smoking," including the use of electronic cigarettes, in all indoor workplace, all outdoor public places, multi-unit rental housing (including balconies and porches), and all new common interest properties.

This is a new low.  If this passes, it will be the first successful ban on the use of e-cigarettes in one's own home ever passed.  We would greatly appreciate that our California members write a public comment in opposition or attend tonight's meeting.  To see previous CASAA recommendations for writing public comments, see here.

Public comment can be sent to  If you'd like to call the City Council members at their offices tomorrow, that info can be foundhere.  The proposed ordinance can be found here.  

The council will meet at 7 p.m tonight in the third floor council chambers at City Hall, 2263 Santa Clara Ave in Almaeda.  Public comments of 3 minutes long will be accepted.  All you need to do is show up a few minutes early and sign up.

Even if you are from 8 hours away from Almaeda, a public comment would still be greatly appreciated.  Feel free to e-mail it to us at, or post it in this thread on ECF. 

Friday, October 21, 2011

New Bedford, MA Call to Action (Indoor Use / Sales Restrictions)


Comments will be accepted on this legislation until November 1, 2011.

Indoor Use Ban:
Sales Restrictions:

These Ordinances would:
Ban the use of electronic cigarettes, regardless of whether or not they contain nicotine, in places where tobacco cigarette smoking is prohibited

Rightfully ban e-cigarette sales to minors, but enact vague regulations on the sale of 'nicotine delivery products' out of their original packaging.  

Read More: