San Francisco Passes One-Size-Fits-All Flavor Ban, Condemns Smokers to Status Quo

The ink is barely dry on amendments accepted during San Francisco’s Public Safety and Neighborhoods Committee hearing and the full Board of Supervisors has passed the ordinance that bans the sale of flavored vapor products, tobacco products, and menthol cigarettes. The new law takes effect in April 2018.

To say that San Francisco’s decision to ban flavored vapor products is disappointing would be an understatement and minimizes the real impact of this horrible miscalculation. Whereas at least some study has gone into prohibiting the sale of menthol cigarettes, there is no evidence to suggest that banning low-risk nicotine products will benefit anyone. In fact, it is reasonable to infer from emerging data that banning flavored vapor and smoke-free tobacco products will send some people back to smoking while discouraging others from quitting. At the very least, banning flavored vapor products will delay quit-attempts resulting in an unnecessary harm to San Francisco’s smoking population.

Rather than consider innovative new ways to address the disease and early death attributed to smoking, San Francisco’s Board of Supervisors has, instead, opted to experiment on their constituents with an untested policy. We need to emphasize that banning low-risk, smoke-free products is NOT based on evidence. This was purely an emotional decision.

The pace at which this ordinance was driven through San Francisco’s legislative process also indicates that very little deliberation took place. Zero consideration was given to city vape shop owners, who likely have thousands of quit-smoking stories to their credit. Even less consideration was given to individual consumers who shared their testimonials with the Public Safety Committee.

San Francisco has done a shameful thing, but there is still time to fix it. In the months leading up to implementing the flavor ban, there is still an opportunity to pass an exemption for low-risk tobacco and nicotine products. Considering the rate at which studies about tobacco harm reduction are emerging, it is possible we will have more evidence to support an exemption. Unfortunately, while we wait for the Board of Supervisors to come to their senses, hundreds of San Francisco residents will continue to smoke past a point where switching to a low-risk alternative could have saved their lives.

You can find the contact information for the SF Board of Supervisors here.

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American Lung Association in Wisconsin is Lying About Health Effects of Smoking

It used to be that the tobacco industry lied to the public in order to downplay the severe health effects of cigarette smoking. Today, it is the Wisconsin branch of the American Lung Association (ALA) that is lying about the risks of smoking.

According to the director of tobacco control and public policy for the ALA in Wisconsin: “there’s still a perception that e-cigarettes are less harmful than regular cigarettes and so for some kids who never would have tried smoking cigarettes they get the idea this might be a safer alternative.”

Clearly, the ALA is telling the public that kids are actually mistaken and that e-cigarettes are no less harmful than regular cigarettes. Of course, this also means that cigarettes are no more dangerous than e-cigarettes.

The Rest of the Story

The truth is that e-cigarettes are much safer than regular cigarettes. Dr. Stan Glantz – a highly respected, long-time scientist in the anti-tobacco movement – has stated unequivocally that e-cigarettes are safer than regular cigarettes and that if a smoker switches to e-cigarettes exclusively, they will experience an improvement in their health. Dr. Glantz may quibble with some of us who support harm reduction in terms of the exact magnitude of the risk differential, but there is no credible scientific doubt that vaping is safer than smoking.

Even the cigarette companies are not lying to the public about this point. In fact, they readily admit that their cigarettes are much more dangerous than regular cigarettes and they are even making efforts to market e-cigarettes as a less hazardous alternative.

So why is the American Lung Association picking up where the historical fraud and deception of the tobacco industry ended?

Like the ALA, I do not want youth to be taking up vaping. However, unlike the ALA, I don’t condone lying to our nation’s youth in order to try to deter them from vaping. Especially since the ultimate effect of downplaying the health hazards of smoking is that it will produce less deterrence to youth smoking. If kids think that smoking is only as bad as inhaling cherry vapes and blowing a few vape rings, then their appreciation of the serious health hazards of smoking will be undermined, which of course will lead to more kids smoking.

As Alan Selk said eloquently in his comment to the article in which the ALA was quoted:

“Donna Wininsky’s statement that there is still a perception that e-cigarettes are less harmful than regular statements is a pretty bizarre statement, considering that e-cigarettes are in fact significantly less harmful then regular cigarettes. All the real evidence points to that fact. It has also been shown that about 80% of kids who are using e-cigs are not using nicotine. They are simply playing with the vapor. A great majority of the youth who are using nicotine are using it as a substitute (and a much less harmful one) for smoking. … “


“As far as health goes there is only one number that matters, and that is how many people are inhaling smoke from cigarettes. Those numbers are at historic lows among youth and adults. There is good evidence that the reason for the drop is because people are switching to low risk alternatives. That is a very positive news. (in the UK, where e-cigs are endorsed by the health establishment as a viable harm reduction tool, and people are generally better informed as to the relative risk of smoking verses vaping, 50% of people who take up vaping end up completely quitting cigarettes).”

“I would like to know why, instead of encouraging people to switch to a far less harmful alternative to cigarettes, the American Lung Association of Wisconsin is misinforming the people of Wisconsin on the relative risk of vaping verses smoking. They are in fact killing people with there misinformation campaign.”

The ALA is not only wrong in its assessment of the relative health effects of vaping compared to smoking, but it is also wrong in suggesting that e-cigarette use among youth in Wisconsin is a problem because it leads to cigarette use. The evidence from Wisconsin suggests exactly the opposite. According to the state’s Youth Tobacco Survey, while e-cigarette use among high school students in Wisconsin continued to increase substantially from 7.9% in 2014 to 13.3% in 2016, smoking prevalence declined by 24%, from 10.7% to 8.1%. These data are not consistent with the assertion that e-cigarettes are serving as a gateway to smoking among Wisconsin youth. In fact, they suggest the opposite. As Alan Selk correctly argues, e-cigarettes appear to be serving as a deterrent to smoking as a culture of vaping replaces, rather than reinforces, a culture of smoking.

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New CDC Data Should Put to Rest the Contention that E-Cigarettes are a Gateway to Youth Smoking

New data released moments ago by the Centers for Disease Control and Prevention (CDC) should put to rest the contention that electronic cigarettes are a gateway to smoking among youth. These new data show that the prevalence of smoking among high school students was cut in half in just five years – from 2011 to 2016 – at the same time as the use of e-cigarettes among these very same students increased dramatically from 1.5% to a peak of 16.0% in 2015.

There is more good news from the CDC. Not only has youth smoking declined at an unprecedented pace in the last five years, but for the first time, the prevalence of youth use of e-cigarettes has also declined, dropping from 16.0% in 2015 to 11.3% in 2016 (among high school students). Use of cigarettes among high school students continued to fall between 2015 and 2016, dropping from 9.3% to 8.0%.

The Rest of the Story

This is great news because it reveals that smoking is truly becoming unpopular among youth. The rate of decline in youth smoking is unprecedented. This despite the rapid rise in e-cigarette experimentation. These data are simply not consistent with the hypothesis that vaping is going to re-normalize smoking and that e-cigarettes are a gateway to youth smoking.

The drop in e-cigarette use is also reassuring because it suggests that vaping is largely a social phenomenon that involves experimentation and that the addictive potential of these products is quite low. It also suggests that the popularity of youth vaping has peaked and that concerns about vaping taking over and leading to nicotine addiction among a huge proportion of youth are not warranted.

If anything, the real concern at this point is whether the decline in e-cigarette use might actually slow the unprecedented declines we have seen in youth smoking.

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CASAA Newsletter – May 2017

05.08.17 – E-Cigarette Summit – Washington, D.C.

The E-Cigarette Summit, an influential tobacco harm (THR) conference held annually in London, expanded its horizons to host a conference in Washington, D.C. (For our European friends, look for the E-Cigarette Summit in London this November.) CASAA was invited to attend as a delegation, and Brian Carter, Ph.D. and Jennifer Berger-Coleman served on two panel sessions. CASAA was also given a table next to the event registration to present written materials and a timeline of devices.

By way of background, E-Cigarette Summit is an annual conference that brings together harm reduction advocates, public health professionals, scientists, and policymakers to present and discuss the state of THR science and policy. Past events have seen a range of debate, from emotional to empirical. Ideally, the intent is to reach some sort of consensus on the efficacy of THR, if and how it should be promoted to the public, and how THR products should be appropriately regulated to maximize benefits to public health.

Oliver Kershaw (ECF Founder & Director) provides an early review of the event and its content here. More importantly, Kershaw takes a deeper look into content that was missing.

When recordings of the even become available, CASAA will provide more substantive comment. For now, we are happy to have had the opportunity to attend the event in D.C. and look forward to a second year.

Additional coverage of the event:

05.09.17 – Phil Busardo Announces Auction to Benefit CASAA!

Longtime friend and supporter of CASAA, Phil Busardo announced this week that he will be auctioning off a very large collection of vapor product. The proceeds from the auction will be donated to CASAA. The announcement is here and the details are here.

Thank you, Phil!

05.11.17 – Austin, TX City Council Passes Resolution to Ban Vaping Like Smoking

On Thursday, the Austin City Council passed a resolution directing the city manager to draft an ordinance that would add vaping to the existing ban on smoking. The city manager has 90 days to draft the language and present it to the council.

05.13.17 – Indiana Smoke-Free Alliance (ISFA) Releases Guidance on Senate Enrolled Act 1

In April, the Indiana legislature passed SB 1 which would undo monopolistic regulations imposed on the vapor industry in the state. Even though it may seem like the doors have been flung open and vapor businesses can come rushing back into Indiana, there are some guidelines that everyone needs to understand and follow.

The ISFA has published their guidance here.

As many Indiana businesses and consumers are painfully aware, In 2015, the Indiana legislature passed HEA 1432, which imposed burdensome and some impossible-to-comply-with requirements on e-liquid product manufacturing and sales. (See the Indiana Call to Action CASAA issued regarding this legislation for background information.)

#FDAdeeming – Compliance Deadlines Delayed by Three Months

In response to a lawsuit filed by the Cigar Association of America, the Food and Drug Administration has decided to delay all future compliance deadlines for products deemed to be tobacco under the 2016 rule by three months. The official announcement of the delay will be published in the Federal Register on Monday, May 15th, 2017.

While some may see this as an indication that the agency intends to implement further delays for compliance deadlines, this is no time to rest. CASAA is asking its members to continue contacting HHS Secretary Tom Price and urging him to delay implementation of the deeming regulations for another two years.

  • Shop owners can find details about providing CASAA’s engagement to their customers here.
  • Consumers can print out our pre-written letter with space provided for your personal story here.
  • Address information for Secretary Price is available here.

Recent State Alerts

Local Alerts

    • Los Gatos, CA – On May 16th, the flavor ban ordinance was passed as part of the consent agenda with no opposition. While Los Gatos’ ordinance does allow for specialty retailers (those with 60% of their gross sales coming from “tobacco products”) to continue selling flavored vapor products, the most common retail environments where smokers would become aware of vaping can now only sell tobacco flavored products.
    • Contra Costa Co., CA – A hearing for a flavor ban ordinance (item D.2., Ordinance 2017-01 on the agenda) will be held on Tuesday, June 13th. The live broadcast will be available here.
    • San Francisco, CA – A flavor ban is moving to a hearing in the Public Safety Committee on Wednesday, June 14th. Click here for our Call to Action!
    • Yellowstone County, MT – The county’s department of health, Riverstone Health, will hold a public hearing about a proposed indoor vaping ban (Rule #7). This ban covers all public indoor spaces and workplaces including vapor shops. Click here for our Alert.

CASAA Podcast Updates – May

The topics above and more are available in our weekly podcast update.

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There was a snus convention in St. Louis!

A remarkable thing happened this past weekend. The first-ever snus convention in the United States was held in St. Louis, Missouri. Down a rather nondescript hallway on the third floor of a hotel, there was a small conference room with a speaker’s dais, projection screen, and about 40 chairs. Despite its modest appearance, one couldn’t escape the feeling you were witnessing something of great importance, perhaps historical. Kudos to Chad Jones (snubie.com) for his leadership in organizing this event.

This was no snus equivalent of a vape expo. There was no grand hall with flashy vendor booths where snus users could sample and discuss the latest products. There was no swag, blaring music, or snus girls on hoverboards flitting about. Not that the snus community would roll this way if they could. Snus is decidedly low tech, which makes snusers (as they sometimes call themselves) decidedly low key. There are no ohms, coils, mods, or cloud trick equivalents. Just a tin of finely ground tobacco, a small portion of which is placed between the gum and lip. Done. Enjoy. What snusers and vapers have most in common is they talk a great deal about flavor and nicotine level. When they talk about flavor, I’m reminded of people talking about wine (“solid tobacco base with notes of bergamot”). In snus, like in vaping, nicotine comes with a peppery sensation. The higher it is, the more it tends to sting. But, just like vapers, snusers all seem to have their preferred nicotine level and list of favorite flavors.

Unfortunately, the organizers and snus makers were too scared of running afoul of FDA regulations if they set up booths and allowed tasting, even if one had to pay. I find this a tad bit galling. FDA regulations have fostered a climate that actively discourages a group of adults (IDs checked at the door) from sampling a perfectly legal product. A product that could save smokers from the early death and disease if only they could find a snus they liked. But what the FDA could not discourage was the attendees’ passion for snus, how it had changed their lives for the better, and their sense of community.

People talked about how they came to be snusers, how they were trying desperately to get off cigarettes, and found relief and satisfaction in snus. Some talked about how they were able to quit smoking with vaping, but were still missing something: a genuine tobacco flavor experience. People talked about their favorite snus brands and types of flavors. There was a tasting panel that discussed not only their experience as it was happening, but also their personal methods for conducting an honest tasting. And then there was science. Serious science.

Doctors Brad Rodu, DDS, (Professor, University of Louisville School of Medicine) and Lars Eric Rutqvist, MD, Ph.D. (Senior Vice President of Scientific Affairs, Swedish Match) each spoke of their “road to Damascus” moment about how they discovered the truth about the very low risk of snus. Both medical professionals, they were steeped in the long-held belief that using smokeless tobacco came with significant dangers. But, independently, they went through nearly identical realizations when confronted with evidence before their very eyes. Brad, an oral pathologist, had viewed hundreds of oral cancer biopsy slides from smokers, heavy drinkers, and users of a rare niche form of smokeless tobacco called dry snuff. But he couldn’t recall seeing a single cancer slide from a user of only moist snus. Likewise, Lars, making his rounds as a head and neck oncologist, couldn’t recall a single case of oral cancer in an exclusive snus user. When he asked his colleagues, none of them could remember a single case either. Being good scientists, Rodu and Rutqvist followed up their observations with several large-scale epidemiological studies. The verdict was clear: Oral cancer in exclusive snus users is extraordinarily rare. (For a more complete picture of health effects and smokeless tobacco visit Brad Rodu’s website.)

One would think this would be a groundbreaking discovery in public health. That the clarion call would go out for smokers to switch to snus. But then, one needs to understand the motives of those with the largest megaphones in charge of protecting public health. Their goal is nothing short of a “tobacco-free world.” Snus being so low risk subverts this goal. So, it is drowned out by a fierce program of propaganda about carcinogens, gum disease, and a litany of other emotionally laden distractions designed to hide the unassailable truth that snus is low risk. There’s no telling how many smokers have come to harm from this decades-long misinformation campaign.

In his presentation, Lars also made a couple of key observations. Many countries, when joining the EU, are granted exemptions from EU rules, but the exemptions are time limited and phased out over several years. Sweden is the only EU country to have a permanent exemption. Against EU rules, they will be allowed to sell snus indefinitely. For the Swedish people, giving up their snus was a deal-breaker. Snus had been banned in the EU for years when e-cigarettes and a legion of passionate vapers snuck up on the European Parliament. The EU would have been happy to simply ban e-cigarettes just like they had snus, but too many people were already praising and using these products. So, they could not. They had to allow them. Lars made a rather obvious point that bears repeating: politicians can treat convincing science like gnats, bat them away, and just do what they want. But they can’t bat away the passion of a large number of people. Politicians can swamp science, but the people can swamp politicians.   

Many vapers don’t give snus a second thought. They should start. The fight for snus is the fight for vaping. Snus is low risk for much the same reason e-cigarettes are low risk: No combustion. Winning the public’s hearts and minds for one is a win for both. Vapers may grumble about the powerful forces that lie about and seek to destroy the products we credit with saving our lives, but the snus world has been dealing with this for the past several decades. Make no mistake, the playbook that’s been used in an attempt to destroy smokeless tobacco is the very same one being used on e-cigarettes today. This is why vapers should respect and seek alliance with our snus using brothers and sisters. Together, we just might form an unstoppable force that politicians will be forced to yield to.

History is replete with small events involving just a few people getting together and triggering massive changes in culture and politics. Something is brewing, something big, among the lovers of the most popular low-risk tobacco product. Mark well this past weekend. There was a snus convention in St. Louis.

Dr. Brian Carter
CASAA Director of Scientific Communications

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Delay the FDA – Comment on the Citizen Petition Today!

A Citizen Petition has been submitted to the Food and Drug Administration (FDA) requesting that the agency issue “final guidance or regulations describing the recommended or required contents of premarket submissions…” In addition to requesting this final guidance, petitioners (NJOY et. al.) are requesting that the compliance period be extended by 24 months from the time the guidance is published. Such a delay is necessary in order for manufacturers to complete the required premarket tobacco application (PMTA) process. You can read the petition here.

(If you are writing on behalf of a business, please use the industry engagement here)

Currently, there is no clear-cut path through the PMTA process; it is an expensive hit-or-miss process. Manufacturers submitting PMTA’s must rely on the successes or failures of previous applications for guidance and make assumptions about what the agency will consider as supporting evidence. As it stands, less than 1% of the vapor industry can afford to try and the overwhelming majority of the industry will not even make an attempt.

THIS IS NOT YOUR AVERAGE PETITION!!!

21 CFR §10.30 establishes the Citizen Petition as a legitimate pathway to affect changes in regulations after the official public comment period has closed. CASAA is asking our members to post comments in support of this petition on the official docket at Regulations.gov. Comments must be submitted by November 8th, 2017, 11:59 PM (EST).

Take Action – Post Your Comment!

(If you are writing on behalf of a business, please use the industry engagement here)

Choose some of the points below to discuss in your comment:

(See our writing tips if you need help personalizing your message)
  • Share your experience with vaping.
  • How long did you smoke?
    • How many times did you try to quit smoking?
    • Were you able to quit or significantly reduce your smoking?
    • How long have you been smoke-free?
  • What is your preferred flavor of e-liquid?
    • Do you use a variety of flavored e-liquid and why is access to this variety important to you?
  • Have you noticed changes in your ability to purchase vapor products as a result of the FDA deeming rule?
    • Are shops and/or manufacturers that you purchase from shutting down?

Take Action – Post Your Comment!

(If you are writing on behalf of a business, please use the industry engagement here)

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(Writing Tip #1) If you have a lot to say, please craft your message in a separate word doc and then copy/paste it into the field provided.  If you take too long, the system will time out and you will lose your work.
(Writing Tip #2) Although we’ve provided a prewritten message with compelling talking points, we would strongly encourage you to edit the email because personalized communications to legislators are far more persuasive than form letters.  At a minimum, PLEASE INCLUDE YOUR PERSONAL STORY (just a few sentences) in the text of your message.

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