Two vaping shops have opened at a West Midlands healthcare Trust offering staff, patients and visitors an alternative to smoking following a site-wide ban on the habit.

Ecigwizard shops are based at Sandwell and City Hospitals, which are run by Sandwell and West Birmingham NHS Trust (SWBH).

Smoking is not allowed anywhere on the grounds of the organisation, including in cars parked on site.

Anyone ignoring the ban and lighting up on site will receive a £50 fine. Smoking enforcement officers have been on site from 5 July and work alongside staff, including security staff, to challenge people smoking on site. Cameras to support the policy are also in place.

Joe Lucas, Head of Retail for Ecigwizard said: “We’re incredibly happy to announce the opening of our two shops at Sandwell and City Hospital, supporting the Trust’s smoke-free status. We are keen to offer vaping as an alternative to smoking, as a means to help people cut down or quit.

“Sandwell and West Birmingham NHS Trust chose to partner with Ecigwizard because of our attention to detail on quality and safety, from testing eliquids in a purpose built laboratory and state of the art cleanroom.”

Ecigwizard director Ben Potter revealed his delight with their new partnership with the NHS and the UK’s stance on e-cigarettes: “We are thrilled that Sandwell and West Birmingham NHS Trust has taken positive steps forward in combating tobacco smoking. The UK continues to show the world that vaping products are a valuable tool in the long-term goal of creating a smoke-free world.”

Dr David Carruthers, Medical Director of the Trust, added: “The Trust’s Board, and our clinical leaders, are united in the view that smoking kills. Given that simple truth, we can no longer support smoking on our sites, even in shelters or cars. Every alternative is available and we ask visitors and patients to work with us to enforce these changes. Giving up smoking saves you money and saves your health.

“No more passive smoking on our sites is a public health necessity.”

Ecigwizard, are celebrating their eight-year anniversary as one of the leading retailers in the e-cigarette industry and have been working with stop smoking services for the past 5 years.

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By:  Elizabeth Chuck

San Francisco’s ban on electronic cigarettes is an “insane public policy,” some public health experts say, arguing that the city should ban all tobacco products instead.

The criticism came after San Francisco on Tuesday became the first major city in the United States to ban e-cigarettes. The ban, which will go into effect 30 days after the mayor signs the ordinance, was approved by city supervisors who cited the “growing health epidemic of youth vaping” in their decision.

E-cigarette use has undeniably soared among youth, alarming public health officials: 20.8 percent of high school students reported in 2018 that they had used the vaping devices within the past 30 days, compared to 1.5 percent in 2011, according to the Centers for Disease Control and Prevention.

The CDC says e-cigarettes are not safe for children and teens, but adds that they have “potential to benefit adult smokers who are not pregnant if used as a complete substitute for regular cigarettes and other smoked tobacco products.”

Still, the long-term effects of vaping devices are unknown, particularly on youth who smoke them. They contain the addictive substance nicotine but far fewer of the toxins that combustible cigarettes have.

While e-cigarettes are generally understood to be less harmful than cigarettes or cigars, many parents, school administrators and pediatricians have expressed concern that the way e-cigarettes deliver nicotine is negatively affecting the development of teens’ brains, particularly because they can deliver a higher dose more quickly than traditional cigarettes can.

But some public health experts feel banning them altogether like San Francisco alienates an entire population of adult cigarette smokers who are trying to quit and need an alternative.

“We’re taking the risk of addiction among kids,” said Kenneth Warner, a professor emeritus at the University of Michigan of Public Health, “and comparing that with the immediate danger of smoking-related illness and death in smokers who have not been able to quit otherwise and who might be able to quit with vaping.”

Warner cited a New England Journal of Medicine study from January 2019 that found among smokers in a smoking cessation clinic trying to quit traditional cigarettes, nearly double the number of people — 18 percent versus 9.9 percent — who used vaping over nicotine-replacement products such as gum or patches were able to quit. Other studies have concluded there isn’t enough evidence yet to say whether e-cigarettes are an effective long-term aid to quit smoking.

“If the board of supervisors were interested in public health, they would prohibit the sale of cigarettes in San Francisco.”

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By: Editorial Board

Anyone over 21, and with an ID to prove it, can purchase cigarettes, booze and even marijuana in retail establishments across San Francisco. But as soon as next month, one age-restricted product won’t be available for purchase, not even online. That’s because San Francisco officials, in a misguided attempt to curb teen vaping, are moving to ban sales of all electronic tobacco products to anyone within the city until the federal government adopts regulations on them.

The San Francisco Board of Supervisors gave a tentative thumbs-up to the ban last week, and the supervisors are expected to reaffirm their support in a final vote Tuesday. We hope the supervisors will see the light before then. Not only is it bad public policy to outlaw a legal product that’s widely available just outside the city’s borders, but it’s bad public health policy to come down harder on the lesser of two tobacco evils.

Electronic cigarettes are new enough that we don’t fully understand the health effects from vaping, which involves inhaling the fumes produced by heated liquid nicotine. Nicotine in any form comes with health risks. But it’s well established that smoke from conventional combustible cigarettes can kill both smokers and bystanders, and that some longtime smokers have been able to quit that deadly habit by switching to vaping.

Granted, teen vaping is a serious concern. While smoking rates have dropped significantly among U.S. middle school and high school students — they’re down to just about 8% — electronic cigarettes are gaining popularity rapidly. In less than a decade, e-cigarette use among U.S. teens has soared from less than 2% to more than 20%. In just one year, from 2017 to 2018, teen use increased by 36%. The Centers for Disease Control and Prevention reports that, as of 2018, about one-fifth of all U.S. high school students reported using an electronic cigarette in the last 30 days. By comparison, San Francisco’s Youth Risk Behavior Study determined that as of 2017, just 7% of the city’s high schoolers had reported vaping in the last 30 days.

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By: Sally Satel and Erica Sanberg

San Francisco is a city of mind-bending contrasts.

Park your car for more than two hours on a residential street and you’ll face a steep ticket or a tow. But set up camp on a sidewalk with a collection of tents, shopping carts, and stolen bicycles and the city gives you days or more to move.

Sip from an open container of alcohol in a city park and you may be cited. Inject yourself with heroin in public, and you’re unlikely to face official response.

Enjoy your boba tea through a single-use, plastic straw – but only until July 1. After that, municipal policy aimed at keeping plastic from ending up in the ocean forbids vendors from offering them to the non-disabled.

Speaking of plastic, about 2 million of the 5.8 million syringes distributed last year by the city littered the streets or washed into the bay.

To be fair, the city is trying to rein in homelessness, drug use, and errant syringes, but the latest policy has its full-throated support: A ban on the sale of electronic cigarettes.

Yesterday, the San Francisco Board of Supervisors decreed that vaping products — from the widely popular cartridge models, of which JUUL is the best known, to tanks, vape pens, and e-liquids — can no longer be sold in brick and mortar stores or purchased online and delivered to local addresses.

The ban is intended to “protect youth from e-cigarettes,” according to a press release from City Attorney Dennis Herrera.

Doubtless, non-smoking teens shouldn’t vape. But what about smoking adults, the target audience for e-cigarettes?

If they can’t quit or don’t want to, they must have access to nicotine in a safer form. This is the principle of harm reduction.

E-cigarettes are estimated to be at least 95% less hazardousthan conventional cigarettes. This is because they do not burn tobacco, which release carcinogens and carbon monoxide. Vapers inhale nicotine via a propylene glycol-based and/or glycerin-based aerosol.

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– Daren Bakst, 6/5/19

Sometimes, it feels like we live in Bizarro World, where everything is the opposite of what we would expect.

Consider, for example, the regulation of e-cigarettes and other alternatives to traditional cigarettes. Those who advocate policies that would help maintain existing levels of cigarette smoking are somehow viewed as the “righteous.”

The Tobacco Control Act, which gave the Food and Drug Administration the power to regulate tobacco products, is creating major obstacles for the sale of e-cigarettes and other alternative products, thereby doing more to block cigarette smokers from quitting than allowing them to stop.

This all needs to change.

One of the leading tobacco researchers, the late Michael Russell, famously said, “People smoke for nicotine but they die from the tar.”

It’s the burning of tobacco that releases thousands of harmful chemicals. New products like e-cigarettes reflect this understanding, delivering nicotine without burning tobacco.

That doesn’t necessarily mean they are safe, but the research shows that they are less harmful than combustible cigarettes.

The liberal Left continue to push their radical agenda against American values. The good news is there is a solution. Find out more >>

In the most comprehensive government report of its kind, Public Health England described e-cigarettes in 2015 as “95% less harmful that tobacco cigarettes.”   The FDA also recognizes that these new products are less harmful than combustible cigarettes.

Yet, the FDA, through its implementation of the Tobacco Control Act, has issued regulations that will effectively put an end to many alternative products that are currently available to smokers.  Specifically, the FDA is requiring these products to go through the costly and burdensome pre-market tobacco-application process. That’s a barrier that, once enforced, will jeopardize the continued existence of many of these products.

Ironically, some e-cigarette opponents irrationally justify their dislike for the products based on a dislike of big tobacco companies.  Yet, the big tobacco companies and other big businesses are the ones that will be able to afford the costly approval process, while the many small businesses in the field will likely cease to exist.

The entire narrative and policy debate around e-cigarettes ignores the critical benefits of these products.  Instead of shouting from the mountaintops that private innovations are now available that can help reduce cigarette smoking, the FDA is using concern over youth usage of e-cigarettes as a way to demonize the products.

To be clear, the FDA should be concerned about youth usage of nicotine delivery products; nicotine is addictive and the safety of these new products still needs to be monitored.  The FDA, however, shouldn’t be using this concern as a reason to promote policies that would help maintain current levels of smoking or prevent Americans from having access to products that could save their lives. Nor should they be diverting attention from the critical importance of these alternative products.

Underlying this entire narrative is an unfortunate and arguably dangerous conflating of two very different issues: the harmful and cancer-causing effects of smoking cigarettes and the harmful effects of nicotine.  Smokers get cancer from the combustion of cigarettes, not the nicotine.

In fact, data show that about half of American adults incorrectly think nicotine is the main substance in cigarettes that causes cancer.  Further, American adults increasingly think that using e-cigarettes is as harmful or more harmful than smoking cigarettes (as high as two-thirds of adults).

This is a true crisis, arguably caused in large part by government messaging.  If cigarette smokers don’t even know that e-cigarettes are less harmful than cigarettes, then they don’t have much reason to switch.

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While both Public Health England and the National Academies of Sciences, Engineering and Medicine acknowledge that completely switching from combustible cigarettes to non-combustible products, such as e-cigarettes, exposes users to substantially less toxicants and dangerous chemicals, there remains lacking support for their use as a quitting tool. For example, NASEM’s report concludes that: “Overall, there is limited evidence that e-cigarettes may be effective aids to promote smoking cessation.” On the contrary, however, there is evidence to suggest that e-cigarettes are growing in popularity as a quit tool.

Accordingly, in an effort to further probe the role of e-cigarettes in initiating cessation and/or maintaining abstinence, Peter Hajek and colleagues developed a randomized trial to compare smoking cessation and abstinence among populations that use traditional nicotine replacement therapies (NRT) versus those who use e-cigarettes (EC).

In terms of participant selection, subjects were accepted into the study if they were currently not using any products and had no strong preference for use of either nicotine replacement therapies or electronic cigarettes as a quit method. After being accepted, participants were randomized to receive either an e-cigarette or an NRT of their choice (the nicotine patch was used by 84 percent of participants generally along with a fast-acting oral product) and asked simply to adhere to their treatment group (EC or NRT). Participants were then asked about smoking status at 4, 26 and between 26-52 weeks—52-week abstinence was biochemically verified at the final visit.

With respect to findings, overall, the e-cigarette group had significantly higher abstinence rates at all time points than those in the nicotine replacement therapy group. For example, at the conclusion of the study (52 weeks), the abstinence rate was 18 percent for those in the EC group and only 9.9 percent for those in the NRT group. At the 4-, 26- and between 26-52-week points, it was approximately 44, 35 and 21 percent for the EC group and 30, 25 and 12 percent for NRT.

Moreover, even participants in the EC group who were unable to achieve abstinence had higher rates of reduction in cigarettes smoked (biochemically verified as a 50 percent reduction or more) than those in the NRT group (12.8 vs. 7.4 percent respectively). At the conclusion of the study, participants in the EC group also had a much higher rate of treatment adherence than those in the NRT group at 39.5 and 4.3 percent respectively.

While these numbers overwhelmingly suggest that ECs have the potential to be more effective quitting tools than NRTs, some limitations in the study’s methodology suggest that their full potential as a cessation tool may not even yet be realized. For example, at four weeks, 56 percent of participants in the EC group were not abstinent and although statistically significant, the urge to smoke in the first four weeks was only marginally lower for those in the EC group versus those in the NRT group. However, this may have been an unintentional result of the study’s design. Those in the EC group, were given an initial supply that consisted of a 30 ml bottle at 18mg/ml and were then encouraged to experiment with nicotine concentrations in subsequent refills. While supplementary data indicated that most participants moved to lower and not higher concentrations as the study progressed, it stands to reason that if a higher concentration had been delivered initially, it may have prevented drop out early on.

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When Gov. Larry Hogan and the Maryland legislature took a firm stance against selling Electronic Nicotine Delivery Systems, or “ENDS,” to minors, I applauded their efforts to keep these products out of the hands of children. Minors should not vape, plain and simple.

However, vaping products are designed specifically as a healthier and safer alternative for adult smokers. Vapor provides a pathway away from cigarette addiction. These products were never intended to encourage teenagers to smoke and therefore should never be marketed towards children.

Unfortunately, regulators are also taking steps to limit access to these important smoking cessation tools for adults that need them. As an active member of the Asian-American business community in Maryland, I am deeply concerned that pending regulations will not only harm adult Marylanders attempting to quit smoking, but also cause potentially devastating effects on Maryland small businesses.

Recently, the Trump administration announced plans to restrict the sales of most flavored e-cigarettes in convenience stores, a measure that baselessly attacks law-abiding business. In addition, there is state level legislation under consideration that would cripple access to vapor products for adults throughout Maryland.

The Maryland General Assembly also passed measures further restricting access to vaping products and the city of Baltimore is considering a ban on flavored e-liquid – a tool that many former smokers credit with helping them quit smoking.

The industry is in full support of denouncing the issue of teen vaping. It’s now illegal to sell vaping products to anyone under the age of 21 in the state of Maryland and businesses that sell vaping products go to great lengths to adhere to the law. Just as identification is required to purchase tobacco products, purchasers of e-cigarette products must provide state-issued identification. Duplicating regulations that restrict adult access to these products do not bring us any closer to solving this problem.

Furthermore, sales of e-cigarette products play a vital role in the Maryland economy and enable retailers to employ more Marylanders. Reducing access to these products in stores would make them only available online, therefore hurting Maryland businesses, impacting the number of jobs available, and ultimately reducing the tax revenue brought in by our state. With regulations coming down on the industry at the federal, state and local level, we need to critically evaluate where the line is for safety and health and a knee-jerk regulatory reaction.

I urge the city of Baltimore, the state of Maryland and the Trump administration to consider these facts before advancing additional unnecessary regulatory burdens on the industry. It’s not too late for our elected officials to change course and take a stand against these misguided proposals.

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From 2017 to 2018, the use of electronic cigarettes among high school youth nearly doubled. In response to this uptick in teen vaping, Massachusetts lawmakers have introduced legislation (S1279) to ban the sale of e-cigarettes in the Commonwealth (with the exception of tobacco-flavored products) except in adult-only smoking bars. This bill would also ban the sale of menthol cigarettes. At first blush, it may appear this is strong public health legislation, guided by the principle that we want to limit youth access to an addictive product. But upon closer inspection, it’s clear this bill is about politics, not public health.

Supporters of this proposed bill purport to deem any tobacco product that is addicting large numbers of youth to be off-limits when it comes to sale in convenience stores, gas stations, pharmacies, and other retail outlets. There is one gaping exemption in the legislation, however, that undermines its entire purpose.

Legislators have carved out a huge exception for Marlboro cigarettes – the #1 brand of cigarettes used by youth smokers in Massachusetts. While most Newports, Kools, and Salems could not be sold in the state because nearly all of their sub-brands are menthol-flavored, virtually every sub-brand of Marlboro would be able to remain on store shelves that are easily accessible by minors.

If this legislation goes into effect, it will actually be easier for both youth and adults to get access to a traditional Marlboro cigarette than to a strawberry vape. Youth will quickly figure out that it is much easier for them to smoke than to track down a healthier alternative in an e-cigarette.

The last thing in the world that we should be doing is to give tobacco cigarettes a competitive advantage over fake (electronic) cigarettes, which contain nicotine but do not involve combustion and the release of toxins that are the driver of smoking-related illnesses. There is no justification for targeting e-cigarettes, a less harmful product, while leaving combustible cigarettes on the shelves.

What’s more, by choosing to ban menthol cigarettes, while leaving all other cigarettes untouched, Massachusetts lawmakers are arbitrarily picking one tobacco company over another. There is no public health rationale for singling out certain cigarette brands for a sales ban but not others – these brands are equally deadly.

In fact, the majority of youth smokers prefer non-menthol cigarettes; and the most popular brand among youth smokers is Marlboro, with Newport being a distant third. And the data on cigarette brand preferences among youth do not provide a justification for banning menthol cigarettes and giving non-menthol cigarettes a huge competitive market advantage. If lawmakers are sincere about wanting to protect kids from nicotine addiction, banning Newport sales but allowing Marlboro sales makes no sense.

Why, then, are policy makers targeting e-cigarettes, but not real ones? Why are they ignoring the fact that in 2017, there were 19,000 Massachusetts high schoolers who were current cigarette smokers and an additional 38,000 who had experimented with tobacco cigarettes? Why are they doing nothing to address the 10.3% of high school seniors who are cigarette smokers, according to the most recent data from the Massachusetts Youth Risk Behavior Survey?

Politics. Our elected officials appear not to have the political courage to take on the cigarette industry, with its powerful lobbying, but find it easy to go after a product being sold overwhelmingly by small businesses with little, if any, political influence. They appear to care about our kids only enough to take the politically expedient step of banning e-cigarettes, but not enough to take the principled step of removing from the youth market a product that we know has the potential to kill half of those kids who become addicted to it.

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The Food and Drug Administration (FDA) is actually doing too much to regulate e-cigarettes. While concern over youth use is indeed warranted, the agency’s overall strategy threatens access to e-cigarettes for adult smokers.

E-cigarettes are a great public health advance, intended for smokers who cannot or will not give up nicotine. Vapers inhale nicotine via a propylene glycol-based and/or glycerin-based aerosol estimated to be at least 95 percent less hazardous than conventional cigarettes, which burn tobacco and release carcinogens and carbon monoxide. A recent, rigorous study reported that “vaping” was twice as effective as FDA-approved nicotine replacements (patches, gum, lozenges) in helping smokers quit cigarettes for one year.

Unfortunately however, the FDA’s premarket regulations are needlessly burdensome. They require every electronic cigarette product on the market (the devices and the liquids that give them taste and vapor) to be accompanied by a separate application to the FDA showing that the product is beneficial to the public’s health.

To do this successfully, a company must show that its e-cigarette product is safer than regular cigarettes; that it helps smokers to quit; and that the above benefits won’t be outweighed by the adoption of the product by nonsmokers, including young people. To satisfy this last requirement alone — the so-called population effects — long-term clinical and epidemiological studies are likely to be required.

According to the FDA itself, the cost of processing these applications — dozens to hundreds from each company — will take more than 5,000 hours to complete and cost a minimum of $330,000 per product. This extremely high cost will almost surely limit applicants and thereby protect actual cigarettes upon which the agency, per congressional mandate, can impose no approval requirements.

A far better approach would entail product quality standards, reminiscent of the United Kingdom’s approach. A compendium of agency-issued rules should establish prudent vapor battery and electrical standards that prevent overheating of the charger, explosion, etc., along with restrictions that ban potentially harmful ingredients.

Recently, the FDA has devoted enormous attention to the rise in youth use of Juul, a vaping device. Doubtless, teen use is an unwanted development, but the agency has fomented alarm, absent meaningful evidence of harm to date (including convincing data on a net “gateway-to-smoking” effect or compromised cognitive functioning), regarding the impact of vaping on teens.

There is wide agreement that e-cigarettes should not be available to minors who do not smoke and that the government should restrict marketing to them. But the intense focus on teen use has diverted almost all attention from the importance of adult access.

Availability and product innovation for adult smokers should be encouraged. The FDA has lost perspective when it comes to the adult side of this policy challenge.

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Some lawmakers at the statehouse want to increase taxes on cigarettes to nearly $3 a pack, but a group of convenience store owners said the plan might not work as intended.

Illinois adds a $1.98-tax to each pack of cigarettes. Senate President John Cullerton said he’ll file legislation to increase the tax by a dollar, making it $2.98 a pack.

“The governor’s proposal in cigarette taxes is pretty modest,” Cullerton said.

Gov. J.B. Pritzker proposed increasing cigarette taxes by 32 cents. His administration has said that would provide $55 million in new revenue.

“We have tripled his initial request because we know from this research that we can actually affect behavior,” Cullerton said.

Bill Fleischli with the Illinois Association of Convenience Stores said behavior will be changed if the tax is increased. He said it will encourage people to shop for cigarettes and other things outside of Illinois.

“They’ll buy everything they need, they’ll make a one-stop-shop,” Fleischli said of shoppers going to other states for goods. “They’ll buy their groceries, they’ll maybe take their dry cleaning. All of those things people do on a Saturday, they will do it, and you’ll find volumes drop in the state of Illinois.”

Cullerton said he wants Illinois to be a leader and to have other states follow suit by raising their taxes.

Supporters of increasing the tax have said it will bring in more revenue for the state while encouraging people to quit smoking. To those who question that logic, Cullerton said the state will save much more than it loses in the long run by not having to cover the cost of smoking-related health problems.

There’s also an effort to hike the tax on e-cigarettes.

Smoke-Free Alternative Coalition of Illinois President Victoria Vasconcellos said it’s not fair to lump e-cigarettes, which she called harm-reduction products, in with other legacy tobacco products.

“So cigarettes kill you, vaping products help you quit smoking,” Vasconcellos said. “It doesn’t make any sense to tax someone looking for a healthier alternative.”

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