Friday, September 21, 2012

Omaha, NE increasing tax by 7% on e-cigarettes and smoke-free

Below is a copy of a letter from The Consumer Advocates for Smoke-free Alternatives Association (CASAA) to city officials and council members regarding the proposed new tobacco tax. We are urging our members that live or work in the Omaha area to attend the 2 pm public hearing at City Hall on September 25 to speak out against the proposed ordinance.

September 21, 2012

City of Omaha officials:
Mayor Jim Suttle (FAX: 402-444-6059)
Paul D. Krantz, City Attorney (FAX: 402-444-5125)
Thomas O. Mumgaard, Deputy City Attorney (FAX: 402-444-5125)
Buster Brown, City Clerk (FAX: 402-444-5263)
City Council Members:
District 1: Pete Festersen
District 2: Ben Gray
District 3: Chris Jerram
District 4: Garry Gernandt
District 5: Jean Stothert
District 6: Franklin Thompson
District 7: Thomas Mulligan

Dear Omaha City Council Members and Officials:

The Consumer Advocates for Smoke-free Alternatives Association (CASAA) encourages the City Council of Omaha to correct scientifically inaccurate information in the proposed ordinance to amend Chapter 12, Article VII of the Omaha Municipal Code pertaining to the sale of tobacco products. Once this has been accomplished, it will become evident that, as currently structured, the proposed ordinance will endanger the physical health of citizens and damage the economic health of the city.

Section 12-135(a), Findings and Intent, fails to acknowledge the scientific evidence that cigarettes are by far the most hazardous type of tobacco product. Cigarettes are burned and inhaled, which makes them far more harmful than tobacco and nicotine products that do not produce lung-damaging, carcinogenic smoke. 

A 2007 report by the Royal College of Physicians noted that a large percentage of smokers may never be able to give up all use of nicotine.(1) The practice of substituting a low-risk nicotine product for smoking is called Tobacco Harm Reduction (THR). Such low risk products include smokeless tobacco products, electronic cigarettes, and long-term use of Nicotine Replacement Therapy (NRT) products.(2) Rather than treat all tobacco products as equally dangerous, politicians and health care advocates should embrace THR. For those who are unable or unwilling to completely quit tobacco and/or nicotine use, switching to a smokeless alternative can achieve substantial health benefits, with many such products carrying less than 1 to 2% of the risk posed by smoking.

During the past several decades, millions of Swedish smokers switched to snus, a type of spit-free moist snuff. As a result, adult daily smoking (age 15 and older) has dropped to 12% for men and 17% for women, which represent reductions of 44% and 29%, respectively, between 1995 and 2008.(3) Not coincidentally, Sweden has the lowest lung cancer mortality rate in the European Union.(4) 

In a 2010 FDA workshop, Dr. Neal Benowitz reviewed the scientific evidence on the health benefits of switching to smokeless tobacco (ST) products as proof that NRT would be safe for long-term use. His presentation noted, “The lack of increase in common cancers in lifelong ST users indicates that nicotine is not a general cancer promoter,” and “studies indicate minimal if any increased CV risks (i.e., heart attacks and strokes) with ST.”(5)

The Omaha City Council needs to revise the description of health risks and economic impacts in Section 12-135(b), Findings and Intent, to reflect the fact that there are no increased costs to the City or to Omaha’s private employers related to the use of smoke-free alternatives. Furthermore, the proposed ordinance may actually result in unintended consequences: reducing the City’s revenue and increasing the health risks of its citizens. 

Higher prices on all tobacco products may result in closure of Omaha’s tobacco specialty stores, e-cigarette vendors, and other small businesses as consumers seek lower prices outside the city. It may also result in continued smoking among those who might have switched to a lower-risk product if those products had remained conveniently available and affordable on a local level.

CASAA urges the Omaha City Council to revise the proposed ordinance so as to achieve the stated purpose of just, proper, and equitable distribution of tax burdens within the city. If this cannot be accomplished, the ordinance should be tabled altogether because, as structured, it stands to do more harm than good.

CASAA is a non-profit organization that works to ensure the availability of low-risk alternatives to smoking and to provide the public with truthful information about such alternatives. Please feel free to contact us if you require any additional scientific information on relative risks of various tobacco and nicotine products.

Elaine Keller, President
The Consumer Advocates for Smoke-free Alternatives Association
CASAA - The Consumer Advocates for Smoke-free Alternatives Association 
(202) 241-9117

1. Royal College of Physicians. Harm reduction in nicotine addiction: helping people who can’t quit. A report by the Tobacco Advisory Group of the Royal College of Physicians. London: RCP, 2007.
2. Rodu B. The scientific foundation for tobacco harm reduction, 2006-2011. Harm Reduct J. 2011 Jul 29;8:19. The scientific foundation for tobacco harm reduction, 2006-2011
3. OECD/European Union (2010), “Tobacco Consumption among Adults”, in Health at a Glance: Europe 2010, OECD Publishing. Tobacco Consumption among Adults - Health at a Glance: Europe 2010 - OECD iLibrary
4. OECD/European Union (2010), “Mortality from Cancer”, in Health at a Glance: Europe 2010, OECD Publishing.Mortality from Cancer - Health at a Glance: Europe 2010 - OECD iLibrary
5. Benowitz N. Smokeless Tobacco and Disease: Evidence Related to Long-term Safety of Nicotine.

Friday, September 7, 2012

CASAA responds to untruthful e-cigarette propaganda

CASAA recently filed a complaint against Ellen Hahn, director of the Tobacco Policy Research Program and the Clean Indoor Air Partnership including the Kentucky Center for Smoke-free Policy in the College of Nursing, for attempting to influence a hotel to cancel an e-cigarette meet in Lexington, KY. (Hahn also is the Project Director for a Robert Wood Johnson Foundation (NRT manufacturer Johnson & Johnson)-funded project, "Northern Kentucky Clean Indoor Air Collaborative for Healthy Communities.")

Around the same time, under the guise of an organization called "Tobacco-Free UK," which appears to be a University of Kentucky Tobacco-Free Task Force also headed by Ellen Hahn, a poster began springing up around campus as students were returning to start classes. The poster (shown right) was titled "E-Cigarettes - 3 strikes. You're out." and ridiculously attempted to portray e-cigarettes as having no supporting evidence that they help people quit smoking, will cause cancer and are as harmful as breathing in the fumes of nail polish remover, paint thinner and fluid for "embalming dead bodies."

CASAA took some time to research the story behind these claims because, unlike Tobacco-free UK, we pride ourselves in disseminating truthful accurate, scientific and sourceable facts. The resulting flyer (shown left) was first conceptualized and then designed to reveal the falsehoods put forth on the TFUK poster. Because CASAA membership is made up completely of volunteers, the flyer was designed on a white background with very little graphics to keep costs down when printing.

The TFUK poster cited one source for its claims: "E-Cigarettes: Promise or Peril?" co-authored by none other than...Ellen Hahn. So we found the sources listed in her paper and posted them (with actual links) on the corresponding web page for our flyer at Now you can actually see for yourself how twisted and innacurate the "facts" listed on the TFUK poster really are. If you are in the University of Kentucky area, please help get these counter-flyers out on and around the campus!

Sunday, September 2, 2012

Study of e-cigarette use finds no short-term effect for some measures of heart function

Electronic cigarettes may have no acute adverse effects on cardiac function, according to research presented at an ESC Congress 2012 press conference by Dr. Konstantinos Farsalinos from Greece.

Electronic cigarettes simulate the effect of smoking by producing an inhaled vapor. The device consists of a battery, a cartridge containing liquid and a heating element which gets warm and evaporates the liquid. Laboratory analyses of the liquids show that they are less toxic than regular cigarettes. Most studies have found no nitrosamines, but even in studies where nitrosamines were found, the levels detected were 500-1400 times less than the amount present in one tobacco cigarette. This means that electronic cigarettes must be used daily for 4-12 months to get the amount of nitrosamines present in a single tobacco cigarette.

A Greek research team decided to perform the first clinical study of the acute effects of electronic 
cigarettes on cardiac function. They decided to compare their results with the acute effects of regular cigarettes on cardiac function since electronic cigarettes are marketed to smokers only, as an alternative habit.

The small study measured myocardial function in 20 healthy young daily smokers aged 25-45 years 
before and after smoking one tobacco cigarette and 22 daily electronic cigarette users of similar age before and after using the device for 7 minutes.

Experienced users of electronic cigarettes were studied because they use the device more 
intensively than first-time users. Although both groups were of equal age, users of electronic cigarettes had a 44% higher lifetime tobacco smoking exposure compared to current smokers.

For the electronic cigarettes, a commercially available liquid with a nicotine concentration of 11mg/ml 
was used (NOBACCO USA Mix). This was tested by an independent toxicology laboratory and found to contain no nitrosamines or polycyclic aromatic hydrocarbons.

Myocardial function was examined using cardiac ultrasound (echocardiography) and hemodynamic measurements (blood pressure and heart rate).

The researchers found that electronic cigarettes produced only a slight elevation in diastolic blood 
pressure. Dr Farsalinos said: “This is an indication that although nicotine was present in the liquid used (11mg/ml), it is absorbed at a lower rate compared to regular cigarette smoking.”

He added: “It is too early to say whether the electronic cigarette is a revolution in tobacco harm 
reduction but the potential is there. It is the only available product that deals with both the chemical (nicotine delivery) and psychological (inhaling and exhaling ‘smoke’, holding it, etc) addiction to smoking, laboratory analyses indicate that it is significantly less toxic and our study has shown no significant defects in cardiac function after acute use.”

Dr Farsalinos continued: “More clinical studies need to be done before suggesting that this is a 
revolutionary product. However, considering the extreme hazards associated with cigarette smoking, currently available data suggest that electronic cigarettes are far less harmful and substituting tobacco with electronic cigarettes may be beneficial to health.”

Dr Farsalinos will also present his results during an ESC Congress 2012 scientific session tomorrow.

Contributors: Konstantinos Farsalinos, MD1, Dimitris Tsiapras, MD1, Stamatis Kyrzopoulos, MD1, 
and Vassilis Voudris, MD1 
1 Onassis Cardiac Surgery Center, Athens, Greece

Authors: Dr Konstantinos Farsalinos (Greece), Onassis Cardiac Surgery CenterRefers to session: Tobacco: from early damage to late impact 

Refers to press conference:  First-hand smoke, second-hand smoke or electronic cigarettes