In a newspaper article last week, I read the disturbing news that a new study in the New England Journal of Medicine shows that cigarette smoking is even more deadly than we already know it to be. In addition to the nearly half million Americans who die annually from the 21 diseases, including 12 types of cancer, listed by the surgeon general, another 60,000 die from at least five additional diseases, including kidney and hypertensive heart diseases. According to the Centers for Disease Control and Prevention, smokers die more than a decade before non-smokers and are more than 20 times more likely to die of lung cancer. These are chilling statistics.
What is even more frightening is the proliferation of a new technology used to deliver the addictive drug of nicotine, e-cigarettes. The Food and Drug Administration defines e-cigarettes as battery-operated products that turn nicotine and other chemicals into an aerosol that is inhaled by the consumer. Many e-cigarettes, like those manufactured by Philip Morris, give users the same level of nicotine as cigarettes by heating rather than burning. Not surprisingly, the three major tobacco corporations have been purchasing independent e-cigarette companies and are estimated by Wells Fargo to share 75 percent of the profit pool within 10 years.
Astoundingly, e-cigarettes are not regulated by the state of California, beyond a restriction on the sale to minors. In 2014, the FDA issued proposed regulations that would expand the definition of "tobacco products" to include e-cigarettes. A 2015 report on e-cigarettes by the California Department of Public Health states that mainstream and secondhand e-cigarette aerosol contains at least 10 chemicals that are on our state's Prop. 65 list of chemicals known to cause cancer, birth defects, and other reproductive harm. According to a UCSF study, these devices deliver high levels of nanoparticles, which can trigger inflammation and have been linked to asthma, stroke, heart disease, and diabetes.
Despite industry claims that e-cigarettes do not present secondhand smoke concerns, studies have found formaldehyde, benzene and tobacco-specific nitrosamines (a carcinogen) coming from secondhand emissions of e-cigarettes.
CDPH recommends that "existing laws that currently protect minors and the general public from traditional tobacco products should be extended to cover e-cigarettes."
Of course, the industry also claims that e-cigarettes are a healthy cessation device to kick the smoking habit. Yet public health experts inform us that e-cigarette users are no more likely to quit than regular smokers, with one study finding 89 percent of e-cigarette users still using them one year later. The fact remains that by switching from cigarettes to e-cigarettes, a person is simply trading one dangerous nicotine habit for another.
This year I am authoring Senate Bill 140, which would ensure that users and non-users of e-cigarettes are better protected from the potential health risks associated with these products. The bill aligns state law with the FDA's proposed ruling by defining e-cigarettes as "tobacco products" and also ensures that they fall under the restrictions of the California Smoke Free Act and the Stop Tobacco Access to Kids Enforcement (STAKE) Act.
The Smoke Free Act prohibits smoking at places of work, schools, daycare centers, restaurants, bars, hospitals, and on public transportation. These laws protect non-users from exposure to secondhand smoke and reduce the acceptability of smoking.
The STAKE Act prohibits a person from selling tobacco products to minors. The act requires retailers to post warning signs, which include a toll-free number for the public to report violations, ensures that clerks check the identification of youthful-appearing persons prior to sale and authorizes law enforcement to conduct sting operations using 15- and 16-year-olds. These stings have reduced illegal sales of cigarettes from 52.1 percent to 5.6 percent since the enactment of the STAKE Act.
Unfortunately, use of e-cigarettes in California is on the rise, especially among young people. Adults using e-cigarettes in our state doubled from 1.8 to 3.5 percent in 2013, and for younger adults aged 18 to 29, e-cigarette use tripled in that same year from 2.3 to 7.6 percent.
Last year the CDPH found that teen use of e-cigarettes surpassed the use of traditional cigarettes for the first time, with more than twice as many eighth and 10th graders reporting using e-cigarettes over regular cigarettes. Among 12th graders, 17 percent reported using e-cigarettes while 14 percent smoked traditional cigarettes.
Just as alarming are the rates of e-cigarette smoking among the LGBT community. The CDC states that less than 2 percent of Americans use e-cigarettes, but that percentage rises to 4.5 percent in the queer community. This percentage is higher than any other population group tested by the federal agency.
Big Tobacco began openly targeting the LGBT community in 1992 when Philip Morris started running ads in Genre magazine. According to the American Lung Association, 43.4 percent of California's LGBT young adults between 18 and 24 smoke, as compared to 10.7 percent of their straight peers. Lesbians smoke at a rate three times higher than that of women in the general population.
This is not Big Tobacco's first attempt to fool the public, nor will it be its last. It is critical that California act now, as San Francisco and scores of other cities already have, to prevent a new generation of youth from becoming nicotine addicts. By doing so, we will protect the health and well-being of Californians, as well as the $2 billion, 25-year investment this state has made in ridding our society of tobacco and nicotine use.
Join me, cessation groups including The Last Drag, and many in the LGBT community in saying enough already to Big Tobacco.
State Senator Mark Leno represents the 11th District, which includes San Francisco and portions of northern San Mateo County.