Posts Tagged ‘smoking’

FDA Bites the E-cigarette Regulation Bullet

April 24th, 2014

E-CigIt’s no public health secret that tobacco use continues to be a dominant cause of preventable disease and death in the US.  While the trend has been encouraging (Arizona’s smoking rate is down to 17%), there’s still much work to be done- and continued efforts to provide creative and effective ways to help adult smokers kick the habit are a key public health intervention strategy.

The flurry of electronic cigarettes that have come on the market recently have thrown us a tobacco cessation curve ball.  Over the last couple of years the public health community has been asking itself “… do the risks of electronic cigarettes outweigh their potential benefit as a smoking cessation tool?”.   The answer to that question depends on whether and how electronic cigarettes are regulated by the FDA.  Today, we got some information to help answer this key question.

Today the FDA released proposed new regulations that (when finalized) would: 1) ban selling of e-cigarettes to minors (it’s already illegal in AZ); 2) prohibit the distribution of free samples to anyone; 3) ban selling e-cigarettes in vending machines unless they’re in places where kids can’t come; 4) require e-cigarettes to have labels stating that they contain addictive nicotine; 5) require e-cigarette manufacturers to disclose the ingredients in their products; 6) require current e-cigarettes to provide  justification for remaining on the market…  and require new e-cigarettes to get FDA approval before being sold; and 7) only let e-cigarette claim that their product reduces risk if the FDA confirms that scientific evidence supports the claim and that marketing the product will benefit public health.

The  proposed new regulations wouldn’t restrict or ban the sale of fruit and chocolate flavored e-cigarettes that some believe are designed to attract and hook young people.  They also wouldn’t restrict TV advertising or online sales.

The FDA will begin accepting public comment on the proposed new regulations tomorrow.

Heroin: The Sleepy Killer

February 4th, 2014

I’ve written several posts about how prescription painkillers kill more Arizonans than heroin and cocaine combined- but heroin is still the No. 1 killer among the illegal drugs.   One hundred people died from a heroin overdose in AZ in 2013 (vs. about 1,000 from prescription drugs). 

Heroin is very addictive.  According to NIDA, about 23% of people that try heroin will become addicts.   Most addicts and new users mix the heroin with water and inject it into the bloodstream directly.  Injecting it basically eliminates any lag time- and the euphoric effects are almost immediate.  Heroin is sometimes smoked, snorted or eaten, but smoking or eating it mutes its effects. 

Once it’s in a person’s blood- the heroin turns into morphine.  Morphine is similar to endorphins…  which are chemicals that your body makes to halt pain and create a good feeling by inhibiting your neurons from firing.  The morphine binds to the opioid receptors in your brain.  The blocking of those opioid receptors creates a “high”.  Most people that die from a heroin overdose expire because their brain forgets to tell their body to breathe…  and they basically suffocate.

Smoking & Stillbirth

December 23rd, 2013

It’s been almost 50 years since the 1st Surgeon General’s report on the health dangers of smoking and we’re still fighting the battle.  About 43 million Americans smoke despite decades of warnings.  Science continues to uncover dangerous aspects of tobacco use.  A new report highlights the threat to unborn children.  

The study published in Obstetrics and Gynecology used blood samples from stillborn babies to find the impact of smoking, secondhand smoke, marijuana and other prescription drugs.  The results showed double the risk of stillbirth for mom’s who smoked tobacco or marijuana or other stimulant or prescription drugs.  

We know that getting healthcare while you’re pregnant is important – but it’s also important to be healthy before a woman even gets pregnant.  First stop smoking – whether you’re the mom to be or her family.   The ASHLine (our highly successful quit line) has free support and provides tools to help you make and keep the promise to stop using tobacco. Stop using drugs unless your doctor tells you to – there are great resources available in Arizona if you need help. And take care of your body – Power Me A2Z and Every Woman Arizona are geared toward helping women be healthy.

Arizonans Continue to Kick the Habit

December 6th, 2013

We continue to make strides to get Arizonans to Kick the Habit.  We got the good news this week that Arizona’s adult smoking rate dropped 2 more percentage points in the last year…  going from 19% 2011 to 17% today.  The data come from this year’s CDC Behavioral Risk Factor Surveillance System…  and it translates into 72,000 fewer AZ smokers and $432M less in total lifetime health-care costs. 

Even more dramatic is the youth rate, which fell from 17% to 14%. We’ve had a 30% drop in our AZ youth smoking rate over the last 4 years meaning that there are 110,000 fewer kids smokers today than four years ago.  A 2009 U of A report on the value of prevention found that preventing one kid from starting to smoke saves the state on average $6,000 over that smoker’s lifetime.  

It’s no coincidence that the historic drop began in 2009.  After years of stagnant youth prevention rates our Tobacco & Chronic Disease prevention team rebooted their tobacco control efforts in 2008. On the adult side, we developed a new strategic plan to improve the effectiveness of our smoking cessation resources via the Arizona Smokers’ Helpline.  A simple cost-effective campaign was created in 2010 that utilized ADHS staff as extras in their “Call Center” campaign, and it  has been very successful. The ASHLine also launched Project Quit…  which is our initiative designed to showcase the quit process. 

On the kids side, we launched our anti-tobacco youth coalition effort, Students Taking a New Direction. Better known as STAND, it empowers teens to make positive changes in their community. With assistance from Tucson based Pima Prevention Partnership, STAND has grown into over twenty collations spread throughout Arizona working on initiatives such as ordinances for smoke-free parks, smoke-free multi-unit housing and expanding smoke-free zones.

E-cigarettes and Teens

September 27th, 2013

E-cigarettes have been a huge topic of discussion in the tobacco control industry and in public health over the past few years. While containing no actual tobacco, they do contain nicotine, are flavored and require the user to emulate the act of smoking.   The CDC recently released a study showing that e-cigarette use has doubled among middle and high school students across the country over the past two years.  Up until last week it was legal for minors to buy an e-cigarette in Arizona….  but new legislation went into effect last week making it illegal for anyone under the age of 18 to purchase e-cigarettes. 

Our Bureau of Tobacco and Chronic Disease partners with the Attorney General’s Office on a program called Counter Strike. The Counter Strike program recruits youth ages 15 to 17 that have a valid ID to attempt undercover buys of tobacco products. The teens are accompanied by an undercover agent from the Attorney General’s office.  If they successfully buy tobacco products the store and clerk receive a citation. We’re also working with our partners at county health departments to make sure that local school districts have this new statutory language in their school policy to reprimand students for using e-cigarettes on campus in the same manner it would for regular tobacco users.

CDC’s Smoking Cessation Campaign

September 24th, 2013

The CDC just released a report for their national smoking cessation campaign launched in March 2012 called “Tips from former smokers.” Nationally, the ‘Tips’ campaign led to an estimated 1.6 million smokers attempting to quit with 100,000 likely quitting for good.  The campaign directed callers to 1-800-QUIT-NOW. If you call from an Arizona zip code you are routed to the Arizona Smokers’ Helpline (ASHLine). 

Locally the ‘Tips’ campaign increased calls to the ASHLine by 15%.  The additional attention the national campaign brings to quitting highlights the successfulness of the ASHLine. The CDC estimates that the ‘Tips’ campaign spent approximately $200 on each quitter and had a quit rate of approximately six percent. Compare that to the ASHLine where approximately $100 per quitter is spent resulting in a more than 30% quit rate. It’s estimated that every person who quits saves the public about $136,000 over the rest of his lifetime – that’s counting healthcare costs and lost productivity caused by illness and disease. 

We continue to help people in Arizona quit using tobacco by using innovative campaigns like Project Quit, and launching new resources like The CIGnal, which is a quitline designed for teen and young adult tobacco users.

Leveraging Medicaid to Help Arizonans “Kick the Habit”

September 19th, 2013

Many of the health disparities in the US are linked to income.  In general… the lower a family’s income the greater the prevalence of health disparities.  Health impacts from smoking cigarettes are no exception.  Arizonans below the poverty line (100% of FPL) are 40% more likely to smoke than those with more money… and about 34% of Arizona folks who receive their health insurance through Medicaid smoke.  This higher smoking rate results in a cascade of negative health impacts over the course of a lifetime.  BTW…  less than 7% of Arizonans that make over $75K smoke. 

For the last few months our Tobacco and Chronic Disease team has been working with AHCCCS to get the Centers for Medicare and Medicaid Services (CMS) to allow us to claim the 50% federal administrative match rate for the Arizona Smokers Helpline (the ASHLine) for the smoking cessation services that we provide to AZ Medicaid beneficiaries. 

Last month we were successful!  CMS approved the reimbursement for Federal Financial Participation for our Quitline Administrative Expenditures.  The reimbursement will come from CMS to AHCCCS and then back to us and then back to the ASHLine.  Arizona is only the 10th state to receive approval to reimburse Quitline services for Medicaid folks.  A shout out to Courtney Ward for making this happen! 

Establishing this public-public partnership with Medicaid is critical to ensuring access to evidence-based cessation treatments for a population disparately impacted by tobacco’s harm. This financial match coupled with our efforts to entice new partnerships with health plans and employers will help to address and provide tobacco cessation services for this AZ Winnable Battle


Youth Smoking Cessation Campaign Launches

September 13th, 2013

Our focus groups with young tobacco users across Arizona has found that teen and young adult smokers are different from adult smokers. Young smokers may not smoke daily and don’t see themselves as smokers. They also aren’t receptive to the idea of needing help to quit. Many teen and young adult smokers believe that they can quit at any time without help and have little or no knowledge about quitting. 

Using this info (and other key info from the focus groups) we’ve crafted and launched our new comprehensive program aimed at helping adolescents and young adult smokers kick the habit.  It’s called “THE CIGNAL“ and we launched it last week.  The program includes ASHLine quit coaches that have been specifically trained to help teens recognize their addiction to tobacco and provide assistance in quitting.  Of course, since this is aimed at teens and young adults, we’re mainly using social media formats for this intervention strategy.

CDC Sortable Stats

September 2nd, 2013

There’s a new CDC Sortable Stats web application that went live a couple of weeks ago that provides an interactive tool to analyze behavioral risk factors and health indicators compiled from various published CDC and federal sources.  You can search by state for things like death rates (e.g.  infant mortality, heart disease, motor vehicle death rates, etc.); health burden (e.g. obesity, Hepatitis B & C, diabetes, teen birth rate, etc.); risk factors (e.g. smoking, physical activity, seat belt use, etc.); and preventive services (colorectal cancer screening, flu vaccine, and child vaccination coverage).

A good place to start are the individual fact sheets for individual states or territories. Here’s a link to the Arizona report.

New AZ Cancer Report

August 22nd, 2013

Surveillance is a cornerstone of public health practice because it gives us the tools we need to identify priorities and craft effective interventions to improve outcomes.  Cancer surveillance is no exception.  Our Arizona Cancer Registry tracks and monitors the number and types of cancer cases in the state and publishes reports periodically.  Our new report shows that we’re continuing to have lower cancer rates than the rest of the country overall.  Prostate cancer is the most common diagnosed among men and breast cancer is the most common diagnosed among women.  

Lung cancer continues to be the deadliest cancer for all Arizonans, with 1,479 men and 1,185 women dying from lung cancer every year.  Folks can reduce their chances of dying from lung cancer if you smoke by stopping – visit or call 800-55-66-222 to find free help.