Healthy Choices - Healthy Lifestyle
Medical Innovations LLC today announced the launch of MiHealth Monitoring, a Medicare-covered daily at-home remote asynchronous monitoring service for patients with chronic health problems. It’s designed to help medical professionals keep a close eye on their patients at home, while also keeping vulnerable patients out of waiting rooms filled with sick people.
The project is spearheaded by QuitDoc Co-founder Dr. Kirk Voelker—critical care pulmonologist and director of clinical research for Sarasota Memorial Hospital—the platform leverages the technology of activity trackers, which record activity and heart rate every minute of the day and provide tracking of a patient’s normal activity patterns, as well as their heart rate response to those activities. MiHealth Monitoring also combines artificial intelligence with real human medical intelligence to see when there are deviations from normal patterns, which may indicate that there is an early problem that the patient may not even be aware of. In addition, by directly interfacing with a simple finger oxygen meter, MiHealth Monitoring allows for the detection of early physiologic changes that may indicate an exacerbation of a heart or lung problem.
Developing technologies are filling many gaps and opening new realms of possibilities in health care, especially in populations that are at risk like rural communities or the elderly. The QuitDoc Foundation is at the forefront of investigating these emerging technologies in hopes to encourage greater independence and healthier communities.
During the 2020 Florida Legislative Session, the House and Senate passed a compromise bill (SB 810) that would significantly alter the regulation of tobacco and recreational nicotine sales in the state. The bill is currently awaiting the signature of Governor Ron DeSantis before it takes effect.
In recent years Florida laws regarding the regulation of tobacco and nicotine has not kept up with changes by the U.S. Food and Drug Administration (FDA). For example, in 2016 The FDA added e-cigarettes and vaping products to the list of products to be regulated by the rules established by the Tobacco Control Act of 2009. In addition, the Federal Government raised the age for the sale and purchase of all tobacco and recreational nicotine products to 21 at the end of 2019, and banned the sale of flavored e-cigarette pods that have contributed to increased use of these products by underage minors. The goal of SB 810 is to make the regulation of tobacco and nicotine products in Florida consistent with these Federal rules.
While SB 810 is overall beneficial in the fight to reduce youth access and exposure to all tobacco products in Florida, the legislation did create some loopholes that may decrease its overall effectiveness.
SB 810 eliminates language in Florida Statute that created a separate category for “nicotine products and nicotine dispensing devices” tucked away in Chapter 877 – Miscellaneous Crimes, moving these products into Chapter 569 – Tobacco Products. Doing this accomplished two things: first, it would require all vape shops in Florida that do not sell traditional tobacco to obtain a dealer permit through the Division of Business and Professional Regulation, and 2) it would allow the Division of Alcoholic Beverages and Tobacco to conduct compliance checks in these retail outlets to make sure that these businesses are not selling their products to underage minors.
SB 810 also raises the age for the sale of all tobacco products, including the newly established categories, to 21. While this age has been established at the Federal level, the change is necessary at the state level to allow for local compliance checks. This will increase the number of compliance checks in Florida, which will contribute to a reduction in access to these products by Florida youth.
Finally, SB 810 includes language that would make the regulation of flavored tobacco products and vaping products identical to the FDA rules. If a flavored product has been approved by the FDA, then it is approved for sale in Florida; however, if a flavored product has been banned by the FDA, then it is also banned for sale in Florida.
Raising the age, enforcing that new rule, and eliminating flavored products that are appealing to children and teenagers will all help reduce the rates of tobacco use in our middle and high school populations ins Florida.
While electronic cigarettes and liquid nicotine were added to the definition of tobacco products in Florida, the legislature opted to create a separate category for these products in SB 810. This was done intentionally for one reason: by creating this separate category, free-standing vape shops will not have to pay the $50.00 Dealer Permit Fee that is required of traditional tobacco retailers.
Why, you ask? Because Florida recently changed the rules to require a super-majority in both the Florida House and Florida Senate to pass a new tax or fee. Requiring vape shops to obtain such a fee as a result of the product reclassification was viewed as “new” fee, and sponsor of SB 810 did not want to jeopardize the passage of the bill as a result of this issue surrounding the cost of the permit.
However, the secondary category will have other long-term consequences. Florida currently does not have an excise tax on vaping products and liquid nicotine, which keeps the cost of these products lower compared to other forms of recreational nicotine. Cheaper products are preferred by teenagers, who generally do not have a large disposable income, and increasing excise taxes on tobacco products has been a very successful strategy in reducing youth access and use. SB 810 does not prevent excise taxes on vaping devices and liquid nicotine; it just creates an additional hurdle to passing these user fees.
Lobbyists for the vaping industry worked hard to create the carve-out for their products. As a result of their efforts, the biggest champions for public health in Florida with respect to tobacco prevention (American Cancer Society, American Lung Association, American Heart Association) ultimately pulled their support for SB 810. In the final legislation, everybody got something that they wanted, nobody got everything that they wanted, and nobody was happy with the final product… the signs of a compromise.
However, in the aftermath of the passage of SB 810, lobbyists for the vaping industry have started a campaign to have Governor DeSantis veto the bill. In particular, the vaping industry is not happy with the provisions that would ban the sale of flavored products in Florida that are already banned by the FDA.
The industry continues to claim that the use of flavored products by youth is not their problem. In fact, it is their problem. The industry does not do enough to police itself, and middle and high school kids are the collateral damage. These flavored products are designed to be appealing to kids, because the industry knows that it cannot survive without targeting impulsive teenagers with a product that leads to long-term addiction. It is an ugly strategy by an ugly industry, and that is why regulations are necessary.
Our hope is that Governor DeSantis will sign SB 810 into law. It is not a perfect piece of legislation, but it will help reduce youth access to these addictive products in Florida while still allowing cities and counties to pass stronger licensing rules and regulations.
Chris Krikham; Reuters
After a year-long investigation, the Massachusetts attorney general’s office has enough evidence to conclude E-cigarette maker Juul Labs Inc bought online advertisements on teen-focused websites for Nickelodeon, Cartoon Network and Seventeen magazine after it launched its product in 2015. This contradicts repeated claims by Juul executives that the company never intentionally targeted teenagers, even as its products became enormously popular among high-school and middle-school students in recent years.
Read the full article here.
On Dec. 20, 2019, the President signed legislation amending the Federal Food, Drug, and Cosmetic Act, and raising the federal minimum age of sale of tobacco products from 18 to 21 years. It is now illegal for a retailer to sell any tobacco product—including cigarettes, cigars and e-cigarettes—to anyone under 21.
This is a HUGE victory for tobacco prevention efforts. At 18, most high school students had access to tobacco products, either through their older friends or by being able to purchase products directly and share them among their friends.
To assist retail stores in this monumental change the FDA website has released a series of webinars with back up signage, documentation, and tips for complying with the new federal law. You can view all their resources here.
CDC has identified vitamin E acetate as a chemical of concern among people with e-cigarette, or vaping, product use associated lung injury (EVALI). Recent CDC laboratory testing of bronchoalveolar lavage (BAL) fluid samples (fluid samples collected from the lungs) from 29 patients with EVALI submitted to CDC from 10 states found vitamin E acetate in all of the samples. Vitamin E acetate is used as an additive, most notably as a thickening agent in THC-containing e-cigarette, or vaping, products.
CDC recommends that people should not addd any substance to e-cigarette or vaping products that are not intended by the manufacturer, including products purchased through retail establishments. CDC will continue to update guidance, as appropriate, as new data become available from this outbreak investigation.
For a running update of all E-Cigarette related concerns from the CDC visit the official website here.
By Erika Edwards, health and medical news writer/reporter for NBC News and Today.
Another person has died from a severe respiratory illness linked to vaping, bringing the national death toll to nine.
The patient, a Kansas resident, was a man over age 50 who had underlying health conditions, according to a statement from the Kansas governor's office announcing the death.
This is the second such death in that state. Other states that have reported vaping-related lung illness deaths are California, Illinois, Indiana, Minnesota, Missouri and Oregon.
The Centers for Disease Control and Prevention has reported 530 cases nationwide, and state health departments are investigating hundreds more.
The Food and Drug Administration's Office of Criminal Investigations previously launched an investigation into the products behind the illnesses, but has come up with no single device or ingredient that links all of the cases.
Read more about the case here.
Chance Ammirata was never a smoker, he was just a JUULer. What started as a hit off a friend's device became a severe habit. "I was like, 'Oh, this is why you have it,'" the now 18-year-old told BuzzFeed News. "I felt this buzz and it was like all of the anxiety and stress that I had [went away]."
His experience has changed Chance and has motivated the teen to speak out about these products. As of September 18, the CDC has confirmed over 500 cases of lung disorders that have one common link: vaping. Listen to Chance's story and his new inspiration for promoting awareness about the safety of these products.
Via the Washington Post
As e-cigarettes have skyrocketed in popularity among teenagers in the past two years, pediatricians report seeing teens who behave less like tobacco users and more like patients with substance-abuse disorders.
Some young people have resorted to stealing from their parents or selling e-cigarette paraphernalia to support their habits, addiction treatment specialists said. And even though many teens assume e-cigarettes are safe, some turn up with signs of nicotine toxicity, a condition previously seen in young children who accidentally ingested nicotine gum. Others are reporting respiratory problems.
“We were thinking about vapes just like we thought about cigarettes. Over time we realized no, no. This is something really different,” said Sharon Levy, director of the Adolescent Substance Use and Addiction Program at Boston Children’s Hospital. She and other doctors said they believe they are witnessing for the first time the damage that repeated exposure to high levels of nicotine wreaks on young bodies.
Although the phenomenon has yet to be described in medical literature, anecdotal evidence from leading addiction specialists in Boston and New York and from families grappling with adolescent e-cigarette addiction points to previously unseen consequences of use among teens. Several families have sued Juul, accusing it of causing nicotine addiction in their children and describing extreme addiction symptoms.
Read the full article here.
By Jonah Hinebaugh, Staff Writer Sarasota Herald-Tribune
Sarasota county has seen a dramatic increase in the amount of students using vaporizers and e-cigarettes. Attorney General Ashley Moody visited Riverview high school to meet with educators in the area to discuss the issue as part of a statewide fact-gathering initiative.
Across the Sarasota County School District, the number of incidents involving ninth-grade students with vaporizers and e-cigarettes rose to 138 during the 2018-19 school year.
Florida Attorney General Ashley Moody said vaping seems to be the most prevalent source of an addictive substance found in schools statewide.
During her visit to Riverview High School Thursday, as part of her statewide fact-gathering mission on the issue, Moody said a proactive approach is required before statistics rise higher.
“What I’m hearing is that we have done a poor job of educating people, kids and parents, before kids take their first hit of a vape,” Moody said.
Prevention, she said, “will make it a lot easier to battle against this addictive substance.
Read more about the meeting with the Attorney General here.