Healthy Choices - Healthy Lifestyle
By Dr. Barry Hummel, SPECIAL TO THE SUN SENTINEL.
On Sept. 9, those of us who are working to reduce youth nicotine addiction in our community learned that Gov. DeSantis had vetoed SB 810, Florida legislation designed to reduce youth access and exposure to all tobacco products, including e-cigarettes and other vaping devices.
You may be wondering what was so controversial in this bipartisan legislation the governor felt compelled to stop the law from being implemented?
As passed by both houses of the Florida Legislature, the legislation would have done the following:
To be fair, it might seem redundant for Florida to pass law to simply restate current federal law. For example, if the age to buy and sell tobacco is 21 nationally, it is 21 in Florida by default.
The answer lies in the enforcement of the rules.
Poor enforcement of our current state rules, including the marketing of kid-friendly flavors targeting youth, has led to an epidemic of vaping and nicotine addiction among Florida’s teens.
In his comments regarding his veto, DeSantis did not address this youth epidemic. Instead, he seemed more concerned that “this legislation would almost assuredly lead more people to resume smoking cigarettes and it would drive others to the hazardous black market." That is a cop-out. That is the same argument as “we shouldn’t have speed limits because people are going to speed.”
There is a silver lining in this veto. The Tobacco Control Act of 2009 allows local communities to regulate the time, place and manner of tobacco sales and marketing. Every municipality in Broward County can pass their own Tobacco Retail License, raise the age to 21, ban the sale of any-and-all flavored tobacco products including vaping devices and e-liquids, and enforce those rules locally. Alachua County did all those things, charging a fee for the local license that offsets the cost of enforcement.
Our kids deserved better from our governor. Since the state has abdicated its responsibility with regards to protecting our youth from the vaping industry, it is time for local governments to step up and hold these retailers responsible.
Dr. Barry Hummel is the Vice Chair of Tobacco Free Partnership of Broward County.
This is a excerpt, you can find the complete Op Ed piece here: Click Here .
Kalia Richardson, The Independant Alligator
“Let's all be realistic. We all know [smoking and vaping] damages your lungs; it doesn't do you any good,” said UF philosophy major Bryan Berlioz, who used to smoke disposable vape. “So, I wanted to limit my chance of my body failing.”
As reported by the Independant Alligator, The Journal of Adolescent Health conducted a study with college-aged individuals and analyzed their susceptibility to COVID-19. Smokers, including e-cigarette users, are twice as likely to be vulnerable to complications from the virus, according to the findings.
“Not a lot of college students have heart disease, for example, or have had a heart attack. So, smoking either cigarettes or e-cigarettes is going to be the biggest issue for them in terms of making them susceptible to pneumonia, viral infections, things like that,” said UF assistant professor of medicine Dr. Eric Papierniak.
“In general, people who smoke have more heart disease and more lung disease. So, they tend to do worse. Those things can start relatively early on, especially if you start smoking at an early age,” Papierniak said.
Dr. Judy Lew, a former UF clinical associate professor in the department of pediatrics with a subspecialty in pediatric infectious disease, said that the correlation between COVID-19 and vaping was unsurprising because both are tied to lung damage.
“Not surprising since using cigarettes and e-cigarettes are known to potentially damage the lungs and so can Covid,” Lew wrote in an email to the Alligator.
In a similar study conducted by the European Respiratory Journal, nicotine in vaping products increases the angiotensin-converting enzyme 2 (ACE-2) in cells. The ACE-2 receptor acts as a “binding site” for the coronavirus to enter and infect human cells. This puts e-cigarette users at greater risk of contracting the virus.
“As a pulmonologist, it’s my mission in life to get people to not smoke. I think that even if we weren’t in a pandemic, I would strongly encourage people not to smoke,” Papierniak said. “In the situation we are in now, I think that anything that you could do or not do in order to make yourself less risky to get really, really sick from serious disease is something you should very strongly consider doing.”
Read the Full Article Study finds college e-cigarette users more susceptible to COVID-19 here.
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 Updates on EVALI
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.