Tobacco Use and Health Impacts

If you want to vape, that's your business.

But exposing kids to nicotine-containing e-liquids -- the liquid used in “vape” products -- is another matter completely.

E-liquids, especially those containing even small amounts of nicotine, can be dangerous to children -- causing injury and even death -- if they touch or drink it.

Figures from the Food and Drug Administration (FDA) show that from April 2022 to March 2023, 7,043 e-cigarette or e-liquid exposure cases were reported, with approximately 88% of exposures occurring among children under five years old.

Why they are dangerous

Harmful effects from drinking e-liquids can include seizure, coma, respiratory arrest and death.

Accidental exposure to e-liquids and their contents -- including nicotine – can occur through contact in the mouth, on the skin, or by inhaling the e-liquid aerosol.

Moreover, containers for storing e-liquids can seem tempting to children of all ages for many reasons. But these products are not meant for children, teens, or young adults.

Safe Storage of e-liquids

As any parent knows, small kids are curious and put all sorts of things in their mouths. If you turn away even for a few seconds, they can get into things quickly that could harm them.

Here are a few tips from the FDA for storing these products:

• Always put your e-cigarettes and/or e-liquids in a safe and elevated location, in the original containers -- and out of the reach and view of children and pets -- every time you use them.
• Ask family members, house guests, and other visitors who vape to store their bags or coats that hold e-cigarettes or e-liquids in a safe and elevated location, out of the reach and view of children and pets.
• Explain to children old enough to understand that these products can be dangerous and should not be touched. Tell them that you or another adult are the only people who should handle these products.
• Know the poison control phone number. To be prepared in case of an emergency, also add the Poison Control HELP number (800-222-1222) to your phone contacts.
• When you remove products (adult-only) from their storage locations, handle them in a way that may help to prevent kids’ exposure to e-liquids.
• Store e-liquids in their original containers and lock product caps when you’re not using them. If a bottle has a cap that turns, twist it until you cannot twist it anymore.
• Clean up any spills or splashes immediately using soap and water.

A new study conducted by researchers from the American Cancer Society pinpointed two major risk factors for consumers when it comes to developing any kind of cancer: older age and smoking status. 

“Single cancer type-specific screening recommendations are based on risk factors for that specific type of cancer,” said researcher Dr. Alpa Patel. “Our findings are encouraging as we are working to define subgroups in the general population who could benefit from enhanced cancer screening and prevention.” 

Identifying those at the highest risk of cancer

The researchers analyzed data from nearly 430,000 participants enrolled in two studies – the Cancer Prevention Study-II Nutrition Cohort and the Cancer Prevention Study-3. They followed the participants over the course of five years, and none of them had a previous history of cancer. 

While several factors were taken into consideration, two came out as the biggest risks for developing any kind of cancer: older age and smoking status. The risk of developing cancer of any kind was higher for any current or former smokers (within 30 years of quitting) and participants over the age of 50; the risk was 25% higher for women and nearly 30% higher for men. 

The researchers also noted some risk factors that were specific to gender. For women, having a hysterectomy or tubal ligation, a high body mass index (BMI), high blood pressure, and type 2 diabetes all increase the risk of cancer. For men, red meat consumption and alcohol intake proved to be dangerous to long-term health outcomes. A family history of cancer and a lack of physical activity were likely to increase the risk of cancer among both men and women. 

The researchers hope their findings will help health care providers better identify those who may need preventative cancer care. 

“As we consider the possibility that future tests may be able to identify several types of cancer, we need to begin understanding who is most at risk for developing any type of cancer,” Dr. Patel said. “These types of data are not widely available, but necessary to inform future screening options, such as blood-based multi-cancer early detection tests that could help save lives.” 

While recent studies have explored consumers’ habits related to substance use during the COVID-19 pandemic, a new study conducted by researchers from the American Cancer Society looked closely at smokers. Their report showed that rates of consumers quitting smoking dropped over the course of the pandemic and remained low for over a year. 

“Smoking cessation is an urgent public health priority given that smoking is associated with an increased risk of severe COVID-19 outcomes and at least 12 cancers,” said researcher Dr. Priti Bandi. “It is essential to re-engage persons who smoke in serious attempts to quit smoking, considering a typical smoker tries to quit on average six times before being successful.” 

Consumers’ health is at stake

For the study, the researchers analyzed data from nearly 800,000 people enrolled in the Behavioral Risk Factor Surveillance System study from 2011 through 2020. They also looked at retail records from 2017 through 2020 that tracked purchases of nicotine replacement therapy (NRT) from over 30 states across the country. 

While the research spanned nearly a decade, 2020 marked the first year that attempts to quit smoking dropped. In 2011, 65.2% of American smokers attempted to quit; by 2020, that number dropped to 63.2%. These decreases remained steady throughout the pandemic. 

Similarly, NRT sales dropped over the course of the study. Experts found that purchases were as much as 13% lower in 31 states across the country when compared to national sales projections. 

The researchers also found that certain factors made it less likely for consumers to quit smoking. Consumers with lower education levels, those with comorbidities, middle-aged people, and Black consumers were all found to be the least likely to attempt to stop smoking over the course of the pandemic. The researchers believe the stressors related to COVID-19 may have come into play here. 

“These results remind us how critical it is for clinicians and health care systems to support persons who smoke with evidence-based quitting strategies,” said researcher Dr. William Dahut. 

Moving forward, the team hopes more work is done to encourage consumers across the country to quit smoking to promote the best health outcomes. 

“Tobacco is the number one, preventable cause of cancer and is responsible for up to one-third of all cancer deaths,” said researcher Lisa Lacasse. “We know quitting tobacco isn’t easy, so we must do everything in our power to ensure individuals trying to quit have access to the cessation services they need.” 

A new study conducted by researchers from the Johns Hopkins University Bloomberg School of Public Health explored the heart health risks associated with smoking cigarettes. According to their findings, consumers who currently smoke or have smoked cigarettes may be twice as likely to develop heart failure. 

“This reinforces the view that smoking casts a long shadow over heart health,” said researcher Dr. Kunihiro Matsushita. 

Long-term heart health risks

For the study, the researchers analyzed data from over 9,300 people enrolled in the Atherosclerosis Risk in Communities (ARIC) study. The participants were between the ages of 61 and 81, and none of them had a history of heart failure when the study began. The team tracked the participants’ health outcomes over the course of 13 years to better understand the link between heart health and cigarette smoking. 

The study showed that smoking cigarettes was linked with a higher risk of heart failure – even for those who had quit smoking. The researchers explained that there are two main types of heart failure – reduced ejection refraction and preserved ejection refraction. Compared to participants who never smoked, smokers were 2.16 times as likely to develop the former and 2.28 times as likely to develop the latter. 

There was also a link between the amount that the participants smoked and their heart health risks. The more cigarettes the participants smoked on a daily basis, and the more years that they smoked, the higher their risk of heart failure. 

Former smokers also weren’t exempt from heart failure risks. Only those who had stopped smoking for at least three decades had a lower risk of heart failure; all other former smokers remained at an elevated risk of heart failure. 

The team hopes these findings encourage stronger efforts to prevent smoking, particularly for younger consumers. 

“These findings underline the importance of preventing smoking in the first place, especially among children and young adults,” said Dr. Matsushita. “We hope our results encourage current smokers to quit sooner rather than later, since the harm of smoking can last for as many as three decades.”

A new study conducted by researchers from Cleveland Clinic explored how consumers’ weight may affect their cancer risk. According to their findings, losing weight following bariatric surgery may lower the risk of developing cancer. 

“According to the American Cancer Society, obesity is second only to tobacco as a preventable cause of cancer in the United States,” said researcher Dr. Steven Nissen. “This study provides the best possible evidence on the value of intentional weight loss to reduce cancer risk and mortality.” 

Long-term health benefits

For the study, the researchers analyzed data from participants enrolled in the Surgical Procedures and Long-term Effectiveness in Neoplastic Disease Incidence and Death (SPLENDID) study. There were over 5,000 adults with obesity who underwent bariatric surgery between 2004 and 2017. The researchers compared those participants' results to outcomes from 25,000 adults with obesity who didn't have the procedure.

The study showed that weight loss as a result of bariatric surgery was associated with a lower risk of cancer and cancer-related death. Under 3% of the participants who had the procedure and lost weight developed cancer, and less than 1% of the group died as a result of cancer. On the other hand, roughly 5% of the participants who didn’t have the surgery developed cancer, and 1.4% of that group died from cancer. 

“Patients can lose 20 to 40% of their body weight after surgery, and weight loss can be sustained over decades,” said researcher Dr. Ali Aminian. “The striking findings of this study indicate that the greater the weight loss, the lower the risk of cancer.” 

Overall, the study identified a nearly 50% lower risk of dying from cancer for participants who underwent bariatric surgery. The team hopes these findings highlight the importance of consumers following a healthy lifestyle in an effort to potentially lower their risk of cancer. 

“Based on the magnitude of benefit shown in our study, weight loss surgery can be considered in addition to other interventions that can help prevent cancer and reduce mortality,” said researcher Dr. Jame Abraham. “Further research needs to be done to understand the underlying mechanisms responsible for reduced cancer risk following bariatric surgery.” 

The U.S. government’s effort to curb cigarette consumption picked up speed on Thursday when the U.S. Food and Drug Administration (FDA) proposed rules prohibiting menthol cigarettes and flavored cigars.

The agency said its goals are to prevent youth initiation, significantly reduce tobacco-related disease and death, and increase the number of smokers who quit smoking altogether.

If enacted, the new standards the FDA is proposing will prohibit menthol as a “characterizing flavor” in cigarettes and prohibit all characterizing flavors (other than tobacco) in cigars. The move comes almost a year from an earlier move by the Biden administration to consider rules that would lower nicotine levels in cigarettes.

“The proposed rules would help prevent children from becoming the next generation of smokers and help adult smokers quit,” said Health and Human Services Secretary Xavier Becerra. “Additionally, the proposed rules represent an important step to advance health equity by significantly reducing tobacco-related health disparities.” 

According to Statista, the share of cigarettes in the U.S. that include menthol has been climbing steadily for years. In 2001, menthol cigarettes accounted for 26% of cigarette sales and grew to a 37% share in 2019. The company that will likely take the biggest hit from the FDA’s move is Reynolds American, which, with Newport leading the way, counts on menthol cigarettes for nearly 50% of its sales.

Reducing smoking rates

The FDA says its studies show that there would be a 15% reduction in smoking within 40 years if menthol cigarettes were no longer available. Those studies also estimate that 324,000 to 654,000 smoking-attributable deaths overall (92,000 to 238,000 among African Americans) would be avoided over the course of 40 years. The agency paid great attention to the youth market in its research.

“Characterizing flavors in cigars, such as strawberry, grape, cocoa and fruit punch, increase appeal and make cigars easier to use, particularly among youth and young adults,” the FDA said. “More than a half million youth in the U.S. use flavored cigars, and in recent years more young people tried a cigar every day than tried a cigarette.”

The agency said its proposal does not prohibit an individual consumer from possessing or using a menthol tobacco product. However, it said its enforcement would address any company that manufactures, distributes, or sells such products within the U.S. that are not in compliance with applicable requirements. 

Beginning May 4, 2022, the American public can comment on the proposed rules that the FDA will consider for future action.

Recent studies have shown how consumers’ harmful drinking habits have escalated during the COVID-19 pandemic, and now a new study conducted by researchers from Florida Atlantic University has explored how it has affected smoking habits.

According to the findings, many people who were trying to quit smoking during the COVID-19 pandemic actually ended up smoking more. 

“These data may aid health care providers to identify and provide counsel to cigarette smokers at greater risk for tobacco consumption during current and future stresses such as the COVID-19 pandemic,” said researcher Dr. Charles H. Hennekens. “All of these efforts have the potential to reduce many premature deaths from cigarette smoking, which remain alarmingly and unnecessarily high in the U.S. and are increasing worldwide.” 

Stress may increase smoking

For the study, the researchers analyzed survey responses from 150 people who were enrolled in a tobacco cessation and lung cancer screening program. The group answered questions about changes in their tobacco use, the impact the pandemic had on them, their exposure to COVID-19, and the protective measures they were taking. 

The researchers learned that while former smokers didn’t return to the habit during the COVID-19 pandemic, many smokers who were trying to quit were unable to do so. Of the current smokers involved in the study, over 28% increased their tobacco use between June 2020, and October 2020; that compares to just over 17% of respondents who decreased their tobacco use. Nearly 55% reported no change in their tobacco use throughout the pandemic. 

The team pinpointed stress as one of the biggest factors that influenced consumers’ smoking habits during the pandemic. Many of the mental health stressors associated with the pandemic -- including feeling hopeless and fearful about securing groceries and other necessities, uncertainty about the future, boredom because of the disruption to daily life, and anger with the changes to daily routines -- were all found to contribute to the participants’ tobacco use. 

The researchers also learned that there was a link between smoking habits and COVID-19 safety measures. The study showed that those who smoked less were more likely to be more cautious about health and safety during the pandemic. 

Because of the significant long-term health risks associated with smoking, the researchers hope more work is done to help smokers get the right kind of therapy and guidance moving forward. 

“Smoking cessation therapy also should include long-term counseling and at least 90 days of a prescription drug, in particular, varenicline, whose mechanisms include blocking the pleasurable sensations of nicotine on the brain,” said Dr. Hennekens. 

Tobacco users in California, Florida, Arkansas, and New Mexico will have to shop at someplace other than Walmart for their tobacco products starting soon. According to a new Wall Street Journal report, the retailer has made a decision to remove cigarettes and cigarette products from select stores in these states in the near future.

The report states that the move comes as part of Walmart’s push toward self-checkout. With no store employees stationed at the scan-and-go stations, it makes it difficult to check IDs of tobacco purchasers. The move away from cigarettes will presumably allow the company to fill up checkout areas with more reasonably priced impulse purchase items like candy. 

This decision has been a long time coming. In 2019, Walmart made its first move in this direction by raising the tobacco purchase age to 21 and discontinuing the sale of some flavored nicotine products. That move was made in response to pressure from the U.S. Food and Drug Administration about the policies Walmart had in place to prevent the sale of tobacco and electronic nicotine delivery systems to anyone who was underage. 

“We are always looking at ways to meet our customers’ needs while still operating an efficient business. As a result of our ongoing focus on the tobacco category, we have made the business decision to discontinue the sale of tobacco in select stores," a Walmart spokesperson told ConsumerAffairs.

While the company may be the largest retail outlet to remove cigarettes from stores, it’s not alone. Amazon took down vape paraphernalia from its site several years ago, and CVS stopped selling cigarettes and tobacco products when CVS rebranded itself as “CVS Health” in 2014.

Tobacco manufacturers face broad restrictions

In addition to companies like Walmart and CVS tamping down on cigarette sales, some states are also tightening their regulations regarding tobacco products.

More than a dozen states have legislation on the books or in the works regarding the regulation and taxation of tobacco, according to CSPDailyNews, which covers news about convenience stores. Some – like Hawaii and Colorado – are banning the sale of flavored tobacco products. In Mississippi, House bill 892 calls for taxing all tobacco products except cigarettes at the rate of 22.5% of the manufacturer’s list price.

In Maryland, retailers in Prince George's County are facing a tall order if they want to sell tobacco products. A proposed bill would require that any retailer who wants a license to sell tobacco products has to guarantee that they do not have an alcoholic beverage license and that the establishment is at least a mile away from another licensed establishment that sells tobacco products.

Recent studies have found that everything from air pollution to tobacco may speed up the aging process. Now, a new study conducted by researchers from Yale University found that stress may be another factor that does the same thing. 

However, their work also found that consumers can work to counteract some of these effects by lowering their stress levels through self-control and emotional regulation. 

“These results support the popular notion that stress makes us age faster, but they also suggest a promising way to possibly minimize these adverse consequences of stress through strengthening emotional regulation and self-control,” said researcher Zachary Harvanek. 

Working on stress levels can improve aging

For the study, the researchers utilized GrimAge – an epigenetic clock that measures biological age. The team collected blood samples from 444 participants between the ages of 19 and 50 and analyzed their biological ages. The participants also answered questions about their stress levels and emotional wellness. 

Ultimately, the researchers learned that stress played a large role in the participants’ biological age. Those who struggled with chronic stress were found to be biologically older than those with fewer biological markers for long-term stress. This was true regardless of factors such as race, smoking, income, and body mass index (BMI). 

However, the study showed that there is still hope for stressed-out consumers. Two factors stood out as being important in terms of stress management: self-control and emotional regulation. When participants were able to master these two things, they were more likely to cope with their stress and slow down the aging process. 

The researchers hope these findings encourage consumers to reconsider their mental health and get serious about managing their stress levels in healthy ways. 

“We all like to feel like we have some agency over our fate,” said Rajita Sinha. “So it is a cool thing to reinforce in people’s minds that we should make an investment in our psychological health.”

A new study conducted by researchers from the Barcelona Institute for Global Health (ISGlobal) explored the long-term health risks associated with early exposure to tobacco smoke.

According to their findings, secondhand smoke exposure during childhood or while in utero may speed up consumers’ biological aging process. 

“The epigenetic clock allows us to assess whether someone’s biological age is older or younger than his or her chronological age,” said researcher Mariona Bustamante. “The positive association between epigenetic age acceleration and exposure to tobacco smoke during pregnancy and early childhood go in line with previous results obtained in the adult population.” 

How smoke affects aging

For the study, the researchers assessed the epigenetic age of more than 1,100 children involved in the Human Early Life Exposome (HELIX) project. They looked closely at those who were exposed to tobacco smoke in the womb and during childhood, and then they compared the results to those with no such exposure. 

Ultimately, the researchers learned that tobacco smoke exposure at these two important developmental junctures in life was associated with more rapid biological aging. Though the participants weren’t older than 11 during the study, the team still found that their bodies were aging at a faster rate. 

These findings are concerning because a faster aging process at this age can have consequences for health in later life. The researchers explained that smoke exposure from such a young age can impact long-term cell function, increase inflammation throughout the body, and affect several other body processes. 

“As aging is considered a public health issue worldwide, new evidence in childhood populations might drive new policies to reduce environmental exposures and promote a “healthy aging” from early stages of life,” the researchers wrote.

A new study conducted by researchers from the Wake Forest School of Medicine and Children’s Hospital Colorado explored the health risks associated with children’s exposure to marijuana. According to their findings, kids exposed to secondhand marijuana smoke may have an increased risk for respiratory infections. 

“The negative impact that exposure to secondhand tobacco smoke can have on children’s health has been extensively studied but the impact of secondhand marijuana smoke on young children is unclear,” said researcher Adam Johnson. 

“Our findings identify the potential for increased respiratory infections in children exposed to secondhand marijuana smoke. This could have significant health care implications as more states in the U.S.A. move towards legalizing recreational marijuana use.”  

Health risks of marijuana exposure

For the study, the researchers analyzed survey responses from nearly 1,500 parents and caregivers living in Colorado -- a state where marijuana is legal for both medical and recreational purposes. All of the parents involved in the study had a child under 12 years old visit the emergency room between 2015 and 2017. They answered questions about their children’s medical histories and their marijuana and tobacco use, including where they typically use the drugs and their children’s level of exposure. 

Roughly 10% of the caregivers involved in the study reported using marijuana on a regular basis, compared to more than 19% of parents who reported regularly smoking tobacco. Ultimately, this impacted their children’s health. Parents who smoked marijuana reported that their children experienced viral respiratory infections more frequently than parents who didn’t smoke. 

However, the researchers also found that side effects that are typically tied to primary marijuana use, including asthma flare-ups or ear infections, weren’t impacted by secondhand exposure to marijuana. Additionally, none of the parents reported an uptick in trips to the emergency room as a result of exposure to marijuana smoke. 

While the researchers plan to do more work in this area, especially in areas where marijuana isn’t legal, they hope that these initial findings highlight some of the risks associated with exposing children to secondhand marijuana smoke. 

“Our findings highlight the prevalence of marijuana use among parents and caregivers and indicate which children may be more likely to be exposed to secondhand marijuana smoke in a U.S. state where recreational and medical marijuana use is legal,” said Johnson. “These findings could be used to help target and shape public health messaging aimed at parents and caregivers in order to raise awareness of the potential negative impacts that secondhand marijuana smoke exposure can have on children’s health.” 

It’s been talked about for years, and now the government may be ready to ban menthol-flavored cigarettes.

A citizen’s group has filed a petition in federal court to require the U.S. Food and Drug Administration (FDA) to institute such a ban, and the FDA has to reply by today. Citing “people familiar with the matter, The Wall Street Journal reports that the FDA will announce a ban.

Anti-smoking groups have long targeted menthol cigarettes over claims that they promote smoking, especially among young people. The menthol flavoring is said to mask the harshness of tobacco smoke. These groups also contend that menthol cigarette smokers have a harder time quitting.

If the FDA does seek a ban, it won’t happen overnight. Tobacco companies have said they would go to court to block a ban, so it could take years for the fight to play out. 

Should the FDA go in the expected direction, it would first publish the proposed rule so that citizens and stakeholders have the opportunity to comment.

A year ago, the FDA moved to restrict flavored e-cigarette products -- notably fruit and mint flavors. However, it stopped short of placing restrictions on menthol e-cigarettes, which anti-smoking groups oppose for the same reason they want to outlaw menthol cigarettes.

Black smokers

Surveys have shown that the overwhelming majority of Black smokers prefer menthol cigarettes, and organizations promoting Black health have led efforts to get menthol cigarettes off the market. Black men have the highest death rate from lung cancer in the country, according to the Centers for Disease Control and Prevention (CDC).

"When you combine high rates of smoking with systematic racism in health care systems, you have a tremendous health disparity," Erika Sward, national assistant vice president for advocacy at the American Lung Association, told NBC News.

The Journal notes that tobacco companies will contest any menthol ban or restriction because so much of their business rests on that flavoring. Smokers who purchase menthol cigarettes tend to be younger and can be expected to be smokers for years.

More harmful?

The American Cancer Society has suggested that menthol cigarettes could be more harmful to smokers because they’re “easier” to smoke, noting that the smoke can be held in the lungs longer than unflavored tobacco.

“This helps to explain why people who smoke menthol cigarettes and get lung cancer often have their cancers located in certain parts of the lung,” the group said in a recent statement. “It also might be a reason why it is harder for people who smoke menthol cigarettes to quit.”