TIME Addiction

A New Government Anti-Smoking Campaign Includes E-Cigs

Past campaigns have increased calls to quitlines by 80%

A new federal ad campaign against smoking features e-cigarettes for the first time.

The U.S. Centers for Disease Control and Prevention (CDC) released its latest ad in its ongoing “Tips From Former Smokers” campaign. The campaign features real Americans who have experienced serious health or social consequences from smoking. Often the ads are explicit. On March 30, the first ad about e-cigarettes, as opposed to traditional tobacco, will air.

The ad features a 35-year-old woman named Kristy who picked up e-cigarettes as a way to quit smoking. She ended up using both products. Eventually she had a collapsed lung and was diagnosed with lung disease. She’s a married mother of three who works as a truck driver.

Kristy's Tip Print Full Page Ad
CDC

“Nationally, about 3 in 4 adult e-cigarette users also smoke cigarettes,” the CDC says in a statement. “If you only cut down the number of cigarettes you smoke by adding another tobacco product, like e-cigarettes, you still face serious health risks.”

Other ads focus on side effects like vision loss and colorectal cancer.

In 2014, the CDC says the national quit line received 80% more calls when the ads were on the air, and since 2012 the ads have generated more than 500,000 additional calls. The ads will run for 20 weeks on TV, radio, online, billboards, in theaters and in magazines and newspapers. Kristy’s ads will be on the radio and in print.

The ads encourage smokers to call 1-800-QUIT-NOW or visit www.cdc.gov/tips.

Read next: These 4D Ultrasound Photos Show How Fetuses Respond to Their Mothers’ Smoking

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TIME Addiction

This Is Not a Good Reason to Smoke Cigarettes

Cigarettes
Getty Images

But smoking causes weight loss, a new study says

Anyone who’s considered lighting up knows smoking’s skinny-making reputation, and a new study of 80,000 people shows there’s truth to the claim. Researchers found that smokers weighed about 5 pounds less than people who had never smoked, according to new research in the International Journal of Epidemiology. The cause of that lighter weight, the researchers say, is tobacco.

Those findings are a direct contradiction to several observational studies that have linked smoking to just the opposite: higher body weight and BMI. But researchers at Copenhagen University Hospital wanted to look at the link genetically, in a way that wouldn’t be plagued by confounding lifestyle factors that often go along with smoking. They took weight and BMI measurements of 80,342 people, along with blood samples that they analyzed for DNA.

They looked at a genetic variant associated with higher tobacco consumption, close to a gene called CHRNA3—”the smoking craving gene,” says study author Børge G. Nordestgaard, MD, professor at the University of Copenhagen in the department of clinical biochemistry. Smokers with this genotype weighed almost three pounds less than smokers who didn’t inherit this genetic variant. But in people who had never smoked or formerly smoked, there was no link between CHRNA3 and a lower body weight.

“That’s really the proof that smoking causes it,” Nordestgaard says.

That doesn’t mean that smoking will give you a better figure. In the study, smoking only affected total body weight, not body shape or fat distribution.

The weight loss effect may be due to a laundry list of chemicals in cigarettes, the authors say—some studies have found nicotine to suppress appetite and increase resting metabolic rate. “There’s a possibility that many of these chemicals may influence weight in some pathway we don’t know about yet,” Nordestgaard says.

That’s obviously no reason to start—or continue—smoking, the researchers caution. “From what we know so far, the hazards of smoking much overweigh the slight benefit of having a lower body weight,” Nordestgaard says. “But when smokers tell you they won’t stop smoking because they’re afraid of gaining weight, I think it’s important to know that this is real—so we can try at the same time to help them quit smoking and keep a lower body weight.”

Read next: What Diet Soda Does to Belly Fat

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TIME Addiction

Watching E-Cig Ads May Increase the Urge to Smoke, Study Says

TIME.com stock photos E-Cig Electronic Cigarette Smoke
Elizabeth Renstrom for TIME

A new study shows possible consequences of vaping in commercials

Seeing commercials for electronic cigarettes can increase the urge to smoke traditional cigarettes, a new study suggests.

Researchers at the Annenberg School for Communication at the University of Pennsylvania discovered that watching advertisements that showing vaping can increase the desire of current and former smokers to pick up a conventional cigarette.

In the new study, published in the journal Health Communication, the researchers assessed the urge to smoke among 301 daily smokers, 272 intermittent smokers and 311 former smokers. They then had the participants watch three e-cigarette commercials. Some of the commercials showed vaping, and others did not.

After they viewed the advertisements, the men and women were once again asked about their urge to smoke. Their responses showed that the daily smokers who saw vaping ads had a greater desire to smoke a regular cigarette, and a higher likelihood of actually doing so during the experiment.

The former smokers who watched the advertisements with vaping were more likely to report decreased intention to abstain from smoking. Intermittent smokers showed no significant changes.

The researchers say the data suggests that watching the commercials with vaping could lead to actual smoking behaviors or interfere the ability of former smokers to refrain from picking up the habit again.

“The jury is still out on the efficacy of e-cigarettes to reduce tobacco use and tobacco smoking,” says study author and communication professor Joseph N. Cappella in a video about his study. “If it turns out to be the case that e-cigarettes are a good vehicle for reducing tobacco addiction, then we not want to stand in the way of advertising…but it doesn’t mean we couldn’t carry out that advertising without the vaping cues in order to not have these deleterious consequences.”

MORE: The Future of Smoking

TIME Addiction

WHO Global Tobacco-Use Reduction Target Likely Up in Smoke, Says Study

Man lights up a cigarette with another cigarette outside an office building in Beijing
Jason Lee—Reuters A man lights up a cigarette with another cigarette outside an office building in Beijing, Nov. 25, 2014

China remains the world's largest market for tobacco products

Even as the number of smokers in many countries declines, increasing numbers in Africa and the Mediterranean are taking up the habit, meaning global tobacco-use figures will likely increase slightly over the next decade, according to a new study.

Member states of the World Health Organization (WHO) are aiming to cut worldwide tobacco consumption by 30% from 2010 levels by 2025, but the target may be missed because of smoking’s enduring popularity in low and middle-income nations, reports Agence France-Presse.

The study, published in The Lancet medical journal, projected “an estimated 1.1 billion current tobacco smokers” by 2025, higher than the current number of one billion smokers worldwide.

In time, as many as half of today’s smokers will die as a result of their tobacco use. Currently, there is a tobacco-related death every six seconds, according to the WHO.

TIME States

Indiana Moves to Regulate E-Cig Liquids

Man demonstrates an e-cigarette at Vape store in Chicago in 2014.
Nam Y. Huh—AP Man demonstrates an e-cigarette at Vape store in Chicago in 2014.

States are moving on electronic cigarettes where the feds aren't

Indiana moved closer this week to regulating the liquids that are used in electronic cigarettes, a regulatory focus that goes beyond the measures states and municipalities have been enacting for months.

The bill advanced by a state Senate committee and already passed by the state House would establish requirements for manufacturing safety standards, a ban on the sale of e-cig liquid to minors, and child-proof safety caps, the Associated Press reports. The movement comes as local governments increasingly look to regulate a cigarette alternative that is growing in popularity in the absence of federal rules.

The bill in Indiana would not extend a smoking ban to so-called vaping, something health advocates and the state attorney general had sought. But electronic cigarette business owners told lawmaers that the regulations could force businesses to close.

MORE: The Future of Smoking

The Food and Drug Administration has proposed a regulatory blueprint for regulation that would subject electronic cigarettes to the same regulations that apply to new tobacco products, and require disclosure of ingredients in the liquids used, among other things. But it could be many months, or even years, before these rules are enacted.

[AP]

TIME Addiction

It’s Really Easy for Teens to Buy E-Cigs Online

TIME.com stock photos E-Cig Electronic Cigarette Smoke
Elizabeth Renstrom for TIME

Most popular e-cigarette sites fail to verify the age of their clients, finds a new study

Young people under age 18 can buy e-cigarettes online, even in states where it’s illegal, a new study shows.

North Carolina researchers asked 11 teens between ages 14 to 17 who didn’t smoke to try to buy e-cigarettes online from 98 of the most popular Internet vendors. The sale of e-cigarettes to minors in North Carolina is illegal—but of the 98 orders, only five were rejected based on a failed age verification. Eighteen orders failed for problems unrelated to age, like website issues. Overall, the minors made 75 successful orders.

The teens were also asked to answer the door when deliveries were made. None of the companies attempted to confirm age at delivery, and 95% of the time, the orders were just left at the teens’ doors.

The findings are concerning for any state trying to regulate youth access, the authors say. Currently, there’s no federal law forbidding the sale of e-cigarettes to minors, despite the fact that they contain nicotine, which is addictive. In 2014, the U.S. Food and Drug Administration (FDA) proposed that e-cigarettes fall under their regular tobacco regulation jurisdiction, but the proposal is still not a codified law. “It may be several years before federal regulations are implemented,” the study authors write.

Some states have stepped in and banned the sale to minors within their borders. So far 41 states and the U.S. Virgin Islands forbid such transactions, or have pending legislation to do so.

But as the new study suggests, young people can easily get e-cigarettes online if they want them. “Without strictly enforced federal regulations, online e-cigarette vendors have little motivation to decrease profits by spending the time and money it takes to properly verify customers’ age and reject underage buyers,” says study author Rebecca S. Williams, public health researcher at the University of North Carolina at Chapel Hill.

None of the vendors complied with North Carolina’s e-cigarette age-verification law. The majority of U.S. carriers, including USPS, UPS, FedEx, and DHL, ban the delivery of cigarettes, only allowing the delivery of tobacco products from a licensed dealer or distributor to another licensed dealer or distributor. If these rules were extended to e-cigarettes, the study authors argue it would essentially shut down a major loophole in access.

Getting proposed rules like the FDA’s passed takes time, but when it comes to the safety of children, the researchers argue there needs to be more urgency. Prior data has shown that from 2011 to 2013, the number of young Americans who used e-cigarettes but not conventional cigarettes more than tripled, from 79,000 to over 263,000. The study authors conclude that the ease with which teens can get e-cigarettes online—in a state that forbids the practice—stresses the need for more regulation, and fast.

TIME Cancer

Taking Medication May Make It Easier to Quit Smoking

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Getty Images

A Pfizer-funded study suggests the anti-smoking drug Chantix could be used to slowly help smokers quit

According to the results of a new trial published in JAMA, an anti-smoking medication may make it easier for smokers who aren’t yet ready to quit to do so later on.

Nearly seven out of every 10 current U.S. adult cigarette smokers want to quit completely, according to data from the Centers for Disease Control and Prevention. But some smokers who aren’t yet ready to quit for good want to lower their consumption and increase their chances for success at kicking the habit down the line. That’s possible with the help of a drug called varenicline, which is sold under the trade name Chantix and is manufactured by Pfizer, finds the new study, which was also funded by Pfizer.

The researchers conducted a two-year trial with 1,510 cigarette smokers who weren’t willing to quit within the next month, but who were willing to try to quit within the following three months. The men and women were split into two groups: some received Chantix, and others received a placebo for 24 weeks. The goal for all the volunteers was to reduce smoking by at least 50% by week four, and then continue to ease up on the habit until a quit attempt at week 12.

The volunteers who were taking Chantix were significantly more successful at quitting by the end of the study compared to the people on the placebo, and the effect stuck at one year.

Developing smoking cessation strategies that allow smokers to quit gradually could attract many more smokers to the method, a Pfizer spokesperson said in an e-mail.

Chantix is not without side effects and controversy. Some data has suggested the drug is linked to serious psychiatric side effects and heart problems.

The authors disclose several conflicts of interest, including the fact that Chantix manufacturer Pfizer was involved in the design, data collection and analysis of the study, and many of the study authors received fees or grants from Pfizer. However, the findings highlight a new potential strategy for curbing smoking and possibly allowing more people to be successful. According to the American Cancer Society, only around 4% to 7% of people are able to quit smoking without medication or other means, and about 25% are able to quit smoking for over six months with the help of medicine.

TIME Television

Watch John Oliver Burn Big Tobacco

The HBO late night host sets his sights on the tobacco industry's big business in overseas markets

Last week on Last Week Tonight John Oliver called the pharmaceutical industry to task for marketing to doctors and hard-hitting advertising and then controversially announced that we are all like Radio Shack.

This week, Oliver took on an equally controversial topic: Big Tobacco. To kick off his take-down, Oliver rolled out a vintage ’70s video clip of a Philip Morris CEO saying (with a straight face) that while it’s true that women who smoke have smaller babies, “some women prefer to have smaller babies.”

Since then the U.S. government has restricted tobacco advertising and sales, which according to Oliver, has resulted in falling adult smoking rates, going from about 43% in 1965 to about 18% today. Yet despite the decline in smokers in the U.S., a 2008 report found that tobacco is more profitable than ever — a phenomenon that Oliver compares to the continuing popularity of the band U2.

According to Oliver, the tobacco industry has managed such a feat by targeting developing nations and using the legal system to block restrictions on advertising and health warnings. He illustrates his point through a jaw-dropping array of clips from around the world (a Marlboro sponsored smoking kiosk outside a school!) and the mind-boggling attempts by Big Tobacco to stop an Australian law that slapped gruesome and graphic health warnings on cigarette packages.

According to Oliver, Philip Morris International itself is suing the country of Uruguay, a battle so expensive that Uruguay has had to seek help paying their legal fees from such unlikely sources as former New York City Mayor Michael Bloomberg. The tobacco industry has sent legal letters to countries like Togo, Namibia, and even the Solomon Islands, which Oliver points out has a population of 600,000.

To help the fight, Oliver has offered a new advertising campaign free of charge to Big Tobacco: Jeff the diseased lung. He even paid for ads in Uruguay and sent t-shirts emblazoned with Jeff to Togo. If Big Tobacco wants to remain profitable, they may want to take him up on the free advertising.

Watch the full clip below.

 

TIME States

Kentucky Mulls Statewide Smoking Ban

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Shui Ta Shan—Flickr RF/Getty Images

But measure unlikely to become law

Kentucky lawmakers voted Friday to ban smoking in all public buildings and workplaces, but the measure faces a steep uphill battle to become law.

The vote was seen as a landmark move in Kentucky, which ranks among the states with highest tobacco yield. The sponsor of the bill, state Rep. Susan Westrom, said secondhand smoke kills about 950 Kentuckians each year.

The bill passed 51-46 in the Democratic-controlled state House of Representatives, WLWT reports, but will face harsher odds in the Republican-controlled state Senate.

[WLWT]

TIME Research

What to Know About the Science of E-Cigarettes

TIME.com stock photos E-Cig Electronic Cigarette Smoke
Elizabeth Renstrom for TIME

A guide to understanding conflicting and ongoing research

Two Columbia University professors warned in a new study Thursday that the health fears over electronic cigarettes are hindering research. The very same day, another new study showed that smoking e-cigs, or “vaping,” can produce cancer-causing formaldehyde.

Clearly there’s some disagreement among scientists about the risks and benefits of a product that’s growing in popularity. Here’s what you need to know about the latest science.

What’s with the latest disagreement?

Columbia public health professors Amy Fairchild and Ronald Bayer argue in Science magazine that the staunchest opponents of electronic cigarettes are so concerned about the potential downsides that they advocate for an anti-e-cigarette regulatory and research approach that may be bad for public health. This approach of “deep precaution,” they argue, “has served as a kind of trump argument, hostile to the notion of trade-offs, seeing in them perilous compromise. Such a posture does not serve either science or policy well.”

MORE The Future of Smoking

It “may be years before the disagreements over the evidence” about the effects of electronic cigarettes can be resolved, Fairchild and Bayer wrote. On the one hand, electronic cigarettes may serve as gateway drugs for young people to start smoking cigarettes, and “dual” use of electronic cigarettes with tobacco cigarettes may stop some smokers from quitting. Electronic cigarettes may also carry unknown health consequences of their own. On the other hand, they may provide harm reduction for people who have been unable to quit any other way.

Given these two competing possibilities, the authors argued that the best formula for public health is to acknowledge the possibility for costs and benefits and to push for a regulatory scheme that is flexible enough to account for both outcomes. It is better to make public policy and execute scientific research under the assumption that e-cigarettes could bring good as well as bad.

But also on Thursday, the New England Journal of Medicine published a new study reporting that chemicals inside e-cigarettes—like propylene glycol and glycerol—can produce a type of the cancer-causing chemical called formaldehyde when heated during the vaping process. The researchers report that when testing samples of the aerosol from vaped e-cigs, they found that the e-cigs can contain formaldehyde-releasing agents slightly different from regular formaldehyde, and that the levels are especially high when a user vapes at high voltages. Scientists don’t yet know if formaldehyde-releasing agents carry the same risk as pure formaldehyde, but the researchers said in their report that if they assume the substances do carry the same risks, then long-term vaping could be associated with a significantly higher risk for cancer compared to long-term smoking. The researchers said formaldehyde-releasing agents may actually burrow into the respiratory tract more efficiently than regular formaldehyde, though the observation wasn’t confirmed.

Are there other reasons experts are concerned?

There’s also debate over the safety of the liquid nicotine inside e-cigarettes. In April 2014, the Centers for Disease Control and Prevention (CDC) released a report showing what they called a “dramatic” rise in e-cigarette-related calls to U.S. poison centers. Calls went from one a month in September 2010 to 215 calls a month in February 2014, and more than half of the calls involved children age five and under. Forty-two percent involved people age 20 and older. Symptoms of liquid nicotine ingestion are known to be vomiting, nausea and eye irritation.

Researchers are also wary of the long term effects of inhaling propylene glycol, one of the main ingredients in e-cigarettes. The jury is still out, but some physicians are concerned. “As for long-term effects, we don’t know what happens when you breathe the vapor into the lungs regularly,” Thomas Glynn, the director of science and trends at the American Cancer Society, told ABC News. “No one knows the answer to that.”

Are they really attracting young people?

Several recent—but fairly small—studies say yes. A December 2o14 study in the journal Pediatrics surveyed 1,941 Hawaii high school students and found that about 17% of the high schoolers smoked e-cigarettes only, 12% smoked both e-cigarettes and conventional cigarettes, and only 3% smoked conventional cigarettes. The findings suggested that kids who smoked e-cigarettes scored lower on outside risk factors to pick up a conventional smoking habit. “The fact that e-cigarette only users were intermediate in risk status between nonusers and dual users raises the possibility that e-cigarettes are recruiting medium-risk adolescents, who otherwise would be less susceptible to tobacco product use,” the authors wrote. Numbers released in 2013 from the National Youth Tobacco Survey showed that the percentage of middle school and high school students who have tried e-cigarettes doubled from 3.3% in 2011 to 6.8% in 2012.

What’s the argument in favor of e-cigarettes?

Some smokers use e-cigarettes to help them curb their traditional cigarette habit, or even quit. An August 2014 study that surveyed over 20,000 Americans showed that among adults who used a product to help them quit smoking, 57% chose e-cigarettes. That’s compared to the 39% who used prescription drugs like Chantix and the 39% who used other over-the-counter methods like patches or nicotine gum. Another study from July 2014, which reviewed 80 studies on e-cigarettes’ safety and their effects on users, revealed that not only can e-cigarettes help smokers quit, but they are less harmful to smokers and bystanders’ health compared to regular cigarettes.

What’s the FDA doing about it?

The U.S. Food and Drug Administration (FDA) only regulates e-cigarettes that are marketed for therapeutic purposes, though the agency has proposed a rule that would give it more regulatory power over e-cigarettes but that has not yet been implemented. The FDA has suggested a ban on sale of e-cigarettes to minors, and admits that there is a lot consumers don’t know about the product like whether they attract kids and teens or just how much nicotine is inhaled when a person vapes.

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