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HomeMy WebLinkAbout06-20-2018 HandoutsThe Truth About Flavored Tobacco The use of flavored tobacco products such as cigars, cigarillos, smokeless tobacco, hookah tobacco, and e -liquids (used in e -cigarettes) has increased in recent years.' These products use enticing flavors, colorful packaging and lower prices to hook a new generation of tobacco users. A Public Health Threat Enticing Fruit and Candy Flavors Sweet flavors like watermelon, cherry, chocolate, mint, and gummy bear appeal to kids and teens.' Flavorings mask the harsh taste of tobacco which make it easier for youth to initiate tobacco use.' Marketed to Young People Flavored tobacco products often use the same flavoring chemicals as popular brands like Jolly Rancher, Kool-Aid, and Life Savers.3 Little cigars are often sold in small packages for less than a dollar and promoted as a low-cost alternative to cigarettes.4,5 Colorful packaging and placement near the register makes them highly visible and attractive to kids.4 3=890 • Growing Teen Use A majority of youth report flavoring as a leading reason for using tobacco products.6 This includes: 82% of e -cigarette users 79% of hookah users 74% of cigar users 80% of young people who have ever used tobacco started with a flavored tobacco product.6 7out of10 teens who use tobacco have used a flavored product in the past 30 days' Consequences for Our Youth Long term addiction The U.S. Surgeon General has warned that flavored tobacco products help new users establish habits that can lead to long-term addiction.' Flavors like menthol in tobacco products make it harder for users to quit.8 All nicotine products are addictive and increase the risk of developing serious health problems.9 Cancer Heart Disease Emphysema r dik Deadly Addiction Smokers who start at a younger age, are more likely to develop a severe nicotine addiction.' Serious health risks The chemical Diacetyl, found in 75% of flavored e -liquids, is linked to bronchiolitis obliterans ("popcorn lung") which causes irreversible lung damage?0,11 Protecting Our Communities The FDA has banned the sale of flavored cigarettes (other than menthol) because they appeal to youth. But flavored e -cigarettes, e -liquid, cigars, hookah, and chewing tobacco continue to be sold. Prohibiting the sale of all flavored tobacco products is a critical step to preventing another generation of young people from living with a lifetime of addiction. • CDPH California Dcparrmcnr of PublicHealth References 1. Corey, C.G., et al., Flavored tobacco product use among middle and high school students—United States, 2014. MMWR Morbitity and Mortality Weekly Report, 2015. 64(38): p. 1066-1070. 2. King, B.A., S.R. Dube, and M.A. Tynan, Flavored cigar smoking among US adults: findings from the 2009-2010 National Adult Tobacco Survey. Nicotine & Tobacco Research, 2013. 15(2): p.608-614. 3. Brown, J.E., et al., Candy flavorings in tobacco. New England Journal of Medicine, 2014. 370(23): p. 2250-2252. 4. Oregon Public Health Division, Flavored Tobacco: Sweet, Cheap, and Within Kids' Reach, in CD Summary. 2014, Oregon Health Authority: Oregon. 5. Delnevo, C.D. and M. Hrywna, "A whole 'nother smoke" or a cigarette in disguise: How RJ Reynolds reframed the image of littlecigars. American Journal of Public Health, 2007. 97(8): p. 1368. 6. Ambrose, B.K., et al., Flavored Tobacco Product Use Among US Youth Aged 12-17 Years, 2013-2014. JAMA, 2015: p. 1-3. 7. U.S. Department of Health and Human Services, Preventing tobacco use among youth and young adults: a report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2012. 3. 8. Delnevo, C.D., et al., Smoking -cessation prevalence among US smokers of menthol versus non -menthol cigarettes. American Journal of Preventive Medicine, 2011. 41(4): p. 357-365. 9. U.S. Food and Drug Administration, Flavored Tobacco Product Fact Sheet. 2011, U.S. Food and Drug Administration. 10.Joseph G. Allen, et al., Flavoring Chemicals in E -Cigarettes: Diacetyl, 2,3-Pentanedione, and Acetoin in a Sample of 51 Products, Including Fruit-, Candy-, and Cocktail -Flavored E -Cigarettes. Environmental Health Perspectives, 2015. 11.Farsalinos, K.E., et al., Evaluation of electronic cigarette liquids and aerosol for the presence of selected inhalation toxins. Nicotine & Tobacco Research, 2015. 17(2): p. 168-174. ©2017 California Department of Public Health. 01/18 The Truth About Menthol Cigarettes Menthol is a flavoring that can be derived naturally from mint plants or synthetically produced.' This cool, minty and fresh flavor is often used in products like lip balm, cough medicine, mouth wash, and candy.2 Menthol is also used in cigarettes and makes smoking more appealing to young and beginning smokers.' A Public Health Threat Easier to Inhale The menthol flavor in cigarettes masks the harsh taste of tobacco and makes the smoke feel smoother and easier to inhale.' 0 This makes it easier for new smokers to start.' Menthol also allows smokers to inhale more deeply, which causes harmful particles to settle deeper inside the Iungs.2 Harder to Quit Scientific studies show that the sensory effects and flavor of menthol can make cigarettes more addictive.3 Menthol smokers show greater signs of nicotine dependence and are Tess likely to successfully quit smoking than other smokers.4 5 • Increasing Menthol Use Although cigarette use is declining in the U.S., use of menthol cigarettes has increased in recent years, especially among young people and new smokers.6 Approximately 19 million Americans smoke menthol cigarettes, including over 1 million adolescents.6 While only 25% of all cigarettes sold in the U.S. are labeled as menthol, 90% of all tobacco cigarettes actually contain some menthol.7.8 Young smokers often Q start with menthol cigarettes.' Disproportionate Marketing and Use African American Communities Tobacco industry documents reveal aggressive menthol tobacco product marketing and higher rates of discounts and promotions on menthol cigarette brands in African American neighborhoods.° In California, 70% of African American adult cigarette smokers smoke menthol cigarettes, compared to only 18% of white adult cigarette smokers'° LGBTQ Communities* The tobacco industry has also targeted the lesbian, gay and bisexual (LGB) community. Nearly 50% of all LGB adult cigarette smokers in California smoke menthol cigarettes, compared to only 28% of straight adult cigarette smokers.10 Data were not available for people identifying as transgender or queer. Protecting our Communities A National study found that 44.5% of African Americans and 44% of women would quit smoking if menthol cigarettes were banned 12 Prohibiting the sale of menthol cigarettes is a critical step to preventing a new generation of Californians from becoming addicted to tobacco. Youth 57% of smokers in the U.S. age 12-17 smoke menthol cigarettes?' 4.10 • California DcpCDPH artmcnt of PublicHealth References 1. Kreslake, J.M., et al., Tobacco industry control of menthol in cigarettes and targeting of adolescents and young adults. American Journal of Public Health, 2008. 98(9): p. 1685. 2. Kreslake, J.M. and V.B. Yerger, Tobacco industry knowledge of the role of menthol in chemosensory perception of tobacco smoke. Nicotine & Tobacco Research, 2010. 12: p. 98-101. 3. Henningfield, J.E., et al., Does menthol enhance the addictiveness of cigarettes? An agenda for research. Nicotine & Tobacco Research, 2003. 4. Levy, D.T., et al., Quit attempts and quit rates among menthol and nonmenthol smokers in the United States. 2011. 5. U.S. Food and Drug Administration, Preliminary scientific evaluation of the possible public health effects of menthol versus nonmenthol cigarettes. July 2013. 6. Substance Abuse and Mental Health Services Administration, The NSDU Report: Use of Menthol Cigarettes. 2009: Rockville, MD. 7. Giovino, G.A., et al., Epidemiology of menthol cigarette use. Nicotine & Tobacco Research, 2004. 6: p. 67-81. 8. Wickham, R., Focus: Addiction: How Menthol Alters Tobacco- Smoking Behavior: A Biological Perspective. The Yale Journal of Biology and Medicine, 2015. 88(3): p. 279. 9. Cruz, T.B., L.T. Wright, and G. Crawford, The menthol marketing mix: targeted promotions for focus communities in the United States. Nicotine & Tobacco Research, 2010. 12(suppl 2): p. S147 -S153. 10. Behavioral Risk Factor Surveillance System 2013-2015. Sacramento, CA: California Department of Public Health. 11. Giovino, G.A., et al., Differential trends in cigarette smoking in the USA: is menthol slowing progress? Tobacco Control, 2013. 12. Tobacco Control Legal Consortium et al., Citizen Petition to Food and Drug Administration, Prohibiting Menthol As A Characterizing Flavor in Cigarettes (April 12, 2013). ©2017 California Department of Public Health, California Tobacco Control Program