Wednesday, September 24, 2014

Report Details How Tobacco Companies Have Made Cigarettes More Addictive, More Attractive to Kids and More Deadly



First released:        June 23, 2014
CONTACT:    Peter Hamm, 202-296-5469

New Report Details How Tobacco Companies Have Made Cigarettes
More Addictive, More Attractive to Kids and More Deadly

FDA Urged to Stop Harmful Changes Made by Tobacco Industry

WASHINGTON, DC – Design changes and chemical additives introduced by tobacco companies in recent decades have made cigarettes more addictive, more attractive to kids and even more deadly, according to a report issued today by the Campaign for Tobacco-Free Kids.

The report, titled Designed for Addiction, details how tobacco companies purposely design cigarettes to make tobacco smoke smoother, less harsh and more appealing to new users, especially kids, and to create and sustain addiction to nicotine.  Tobacco companies have made these changes without regard for the health impact and actually have increased smokers’ risk of developing lung cancer.

The report is being released on the fifth anniversary of the landmark law, signed by President Obama on June 22, 2009, that gave the Food and Drug Administration the power to regulate tobacco products.  It calls on the FDA to require tobacco companies, at a minimum, to reverse the harmful changes they have made by issuing the first-ever product standards governing the design and content of tobacco products.

The report shows how tobacco companies have:

·         Made cigarettes more addictive by controlling and increasing nicotine levels and enhancing the impact of nicotine.

·         Made cigarettes more attractive to kids by adding flavorings such as licorice and chocolate that mask the harshness of the smoke, menthol that makes the smoke feel smoother and other chemicals that expand the lungs’ airways and make it easier to inhale.

·         Made cigarettes more deadly, as disclosed in the new Surgeon General’s report on tobacco and health, released in January.  The report found that smokers today have a much higher risk of lung cancer than smokers in 1964, when the first Surgeon General’s report alerted Americans to the deadly consequences of smoking. The new Surgeon General’s report attributed smokers’ increased risk of lung cancer to “changes in the design and composition of cigarettes since the 1950s.”

“For decades, the tobacco industry had complete control over how cigarettes were made, and they responded by making a deadly and addictive product even worse,” said Matthew L. Myers, President of the Campaign for Tobacco-Free Kids.  “Now that it has the authority to regulate tobacco products, the FDA must require changes in these products to reduce the death and disease they cause.  Decisions about how tobacco products are made and what is in them must now be based on protecting public health, not tobacco industry profits.”

The Campaign for Tobacco-Free Kids and other public health organizations have called on the FDA to issue the first-ever product standard to reduce the toxicity, addictiveness and/or appeal of cigarettes and other tobacco products.  Among its key recommendations for accelerating progress in reducing tobacco use, the latest Surgeon General’s report called for “[e]ffective implementation of FDA’s authority for tobacco product regulation in order to reduce tobacco product addictiveness and harmfulness.”

While the United States has made enormous progress in reducing smoking, tobacco use is still the nation’s number on cause of preventable death.  Smoking annually kills 480,000 Americans and costs the nation at least $289 billion in health care bills and economic losses.

Key Findings: 9 Ways the Tobacco Industry Has Made Cigarettes
More Addictive, More Attractive to Kids and More Deadly

The Campaign for Tobacco-Free Kids report is based on an extensive review of scientific studies and tobacco industry documents made public as a result of litigation against the industry.  It also draws on the conclusions of Surgeon General’s reports and the 2006 Final Opinion of U.S. District Judge Gladys Kessler in her racketeering verdict against the major cigarette manufacturers.

The report highlights nine key ways in which tobacco companies have made cigarettes more addictive, more attractive to kids and more deadly:

Making Cigarettes More Addictive

Increased Nicotine: Tobacco companies precisely control the delivery and amount of nicotine to create and sustain addiction.

Ammonia: Added ammonia compounds produce higher levels of “freebase” nicotine and increase the speed with which nicotine hits the brain.

Sugars and Acetaldehyde: Added sugars make tobacco smoke easier to inhale and, when burned in cigarettes, form acetaldehyde, a cancer-causing chemical that enhances nicotine’s addictive effects.

Making Cigarettes More Attractive

Tobacco companies know that 90 percent of adult smokers start at or before age 18 and that smoking is unpleasant for new smokers, so they use chemical additives to make tobacco smoke smoother, less harsh and more appealing to the young, novice smoker. These additives include:

Levulinic Acid: Added organic acid salts, like levulinic acid, reduce the harshness of nicotine and make the smoke smoother and less irritating.

Flavorings: Added flavors like licorice and chocolate mask the harshness of the smoke and make tobacco products more appealing to young people (the 2009 tobacco regulation law prohibited cigarettes with “characterizing flavors” other than menthol, but did not prohibit the use of flavorings at levels not considered to be characterizing).

Bronchodilators: These added chemicals expand the lungs’ airways, making it easier for tobacco smoke to pass into the lungs.

Menthol: Menthol cools and numbs the throat to reduce irritation and make the smoke feel smoother.

Making Cigarettes More Harmful

The new Surgeon General’s report concluded that smokers’ increased risk of lung cancer was most likely the result of two design changes in cigarettes:

Tobacco-Specific Nitrosamines: Levels of tobacco-specific nitrosamines, a potent carcinogen, have increased substantially in American cigarettes in recent decades and are much higher than in cigarettes from Australia and Canada.  Factors affecting levels of nitrosamines include the tobacco blends and curing process used.

Ventilated Filters: Ventilation holes in cigarette filters cause smokers to inhale more vigorously, drawing carcinogens deeper into the lungs.  (Cigarettes with ventilated filters were introduced by tobacco companies because they produced lower levels of tar and nicotine in machine tests and were marketed as less hazardous. However, the evidence now shows that these cigarettes did not reduce health risks and likely increased smokers’ risk of lung cancer.)


Tuesday, September 23, 2014

Tobacco in a Surgical Setting



Q:

I am working on a presentation to our surgical staff about communicating the importance of remaining tobacco free (specifically chewing tobacco) while in the hospital for surgery.
Has anyone recently done a presentation or in-service with staff around this issue?
Any suggestions?
I have materials and plan to do some role playing with staff around how to address this with patients before they come to the hospital and again once they are admitted for surgery.

Does anyone offer NRT the morning of surgery to assist with withdrawal?

Thank you in advance for any responses.

Kathy

A: Here are a couple of free online trainings which have tailored information for the surgical setting:

·         Rx for Change (http://rxforchange.ucsf.edu/) – includes a version for surgical providers
·         Managing Nicotine Withdrawal (http://www.cecentral.com/activity/6760) -- See the “Cigarette Smoking, Nicotine, and the Surgical Patient” module

Also, the American Society of Anesthesiologists as a resource page providing tools, including brochures, video, and PowerPoint presentation about stopping smoking before surgery.

National Tobacco Education Campaign Seeks Storytellers




About 480,000 people die from tobacco-related diseases annually in the United States, yet many Americans do not understand the full extent of the health damage that smoking can cause. The Centers for Disease Control and Prevention’s (CDC's) groundbreaking national tobacco education campaign, Tips From Former Smokers (Tips), aims to tell real stories about tobacco by featuring Americans who have undergone devastating life changes caused by years of smoking. Since the launch in 2012, the campaign has motivated 1.6 million smokers to make a quit attempt. Moreover, more than 100,000 U.S. smokers will remain quit as a result of the 2012 campaign. Call volume to the 1-800-QUIT-NOW quitline increases dramatically during each campaign. In 2013, the average weekly number of calls increased by 75%.

Evidence-based research strongly supports how hard-hitting ads can reduce smoking and save lives. The Tips campaign uses this technique to reach as many smokers as possible with a profound impact. For the 2016Tips campaign,CDC is looking for stories from former smokers who:

  • Have or have had anxiety OR depression (not both) and a serious health condition due to smoking (ages 30–60)
  • Have been diagnosed with COPD (chronic obstructive pulmonary disease) due to smoking (ages 40–55)
  • Currently serve or have served in the military and have been diagnosed with a serious health condition due to smoking (i.e.,coronary artery disease/heart attack, COPD, peripheral artery disease, cancer, or stroke) (ages 30–60)
  • Have been diagnosed with rheumatoid arthritis while smoking (ages 25–60)
  • Have used electronic cigarettes along with tobacco cigarettes instead of quitting because they thought it was better for their health than smoking cigarettes alone and yet they experienced a severe health problem (ages 20–60)
  • Have been diagnosed with a serious health condition caused by smoking and now have a compelling positive story about the benefits experienced since quitting (ages 18–54)

For more information or to participate, visit www.joinCDCtips.com or contact Mimi Webb Miller Castingby e-mail(contact@joinCDCtips.com) or by phone (toll free) (844) 274-9816. Travel expenses and a stipend will be provided.

“Where's the Justice? Tobacco Use and the Incarcerated” Webinar



The Smoking Cessation Leadership Center (SCLC) is pleased to invite you to its next free webinar, “Where's the Justice? Tobacco Use and the Incarcerated”, on Wednesday, October 8, 2014, at 2:00pm Eastern Time/ 11:00am Pacific Time (90 minutes).
We are honored to have the following expert speakers presenting on this topic for us:

  • Chad D. Morris, PhD, Associate Professor and Director, Behavioral Health & Wellness Program, University of Colorado, Anschutz Medical Campus, Department of Psychiatry
  • Brenda K. Howard, MS, CADC, CCS, Public Health Section Chief, Tobacco Prevention and Cessation, Arkansas Department of Health
  • Ben Udochi, CCS, Assistant Director Parole/Probation Treatment Services, Arkansas Community Correction

Webinar Objectives
·         Identify socio-cultural, political, and environmental factors that contribute to the high prevalence of smoking among justice involved individuals. 
·         Describe a tobacco cessation continuity-of-care program for justice involved individuals that has been implemented in several states.
·         Examine processes for integrating tobacco cessation in Arkansas within justice involved incarcerated settings and field based supervised populations.


Accreditation:
The University of California, San Francisco (UCSF) School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

UCSF designates this live activity for a maximum of 1.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the webinar activity.

Nurse Practitioners and Registered Nurses: For the purpose of recertification, the American Nurses Credentialing Center accepts AMA PRA Category 1 CreditTM issued by organizations accredited by the ACCME.

Physician Assistants: The National Commission on Certification of Physician Assistants (NCCPA) states that the AMA PRA Category 1 CreditsTM are acceptable for continuing medical education requirements for recertification.

California Pharmacists: The California Board of Pharmacy accepts as continuing professional education those courses that meet the standard of relevance to pharmacy practice and have been approved for AMA PRA category 1 creditTM. If you are a pharmacist in another state, you should check with your state board for approval of this credit.

Social Workers: This course meets the qualifications for 1.5 hours of continuing education credit for MFTs and/or LCSWs as required by the California Board of Behavioral Sciences. If you a social worker in another state, you should check with your state board for approval of this credit.

CME/CEUs will be available for participants who join the LIVE session, on October 8, 2014. You will receive instructions on how to claim credit via the post webinar email.

Don’t need to claim CME/CEUs?  SCLC issues free certificates of attendance for those who want contact hours only.

Please feel free to forward this announcement to your colleagues.  For questions, contact Jennifer Matekuare, SCLC Operations Manager, at jmatekuare@medicine.ucsf.edu, or call toll-free (877) 509-3786.  This webinar will be recorded and may be viewed online on the Smoking Cessation Leadership Center’s website after the presentation.