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Local ER doctor supports Heart Association's recommendations on E-cigarettes

The American Heart Association's new policy recommendations on the use of E-cigarettes are out and a Central Texas doctor is in full agreement with the guidance. (from the AHA) Echoing its recent comment letter on the Food and Drug Administration’s proposed tobacco oversight rule, the association recommends strict laws that curb the intense marketing and advertising of e-cigarettes, and ban flavorings in these products. Ads using celebrities and alluring flavors make the products more appealing to children and adolescents. A recent Pediatrics study cited youth exposure to e-cigarettes advertising skyrocketed over 250 percent from 2011 to 2013, effectively reaching 24 million young people. “In the years since the FDA first announced it would assert its authority over e-cigarettes the market for these products has grown dramatically,” Brown said. “We fear that any additional delay of these new regulations will have real, continuing public health consequences. Hence, we urge the agency to release the tobacco deeming rule by the end of this year.” In addition to federal oversight of e-cigarettes, the association guidance also examines state smoke-free laws in relation to these products. While the toxic substances in e-cigarettes are lower than those in cigarette smoke, non-smokers could be involuntarily exposed to nicotine in any confined space where e-cigarettes are used. Unregulated e-cigarettes could potentially turn back the clock to the days when smoking in public was normal behavior, undoing years of work on smoke-free laws and hampering current enforcement. Given these concerns, the association supports including e-cigarettes in these state laws, if the change can be made without weakening existing laws. Another key recommendation examines e-cigarettes in tobacco-cessation counseling. The statement points to the lack of evidence establishing e-cigarettes as a primary smoking-cessation aid. Some studies suggest that the use of e-cigarettes to help smokers quit may be equal or be slightly better than nicotine patches. The association will continue to encourage clinicians to use proven smoking-cessation strategies as the first line of treatment for any patient. But it reiterates in the statement that when repeated efforts with conventional treatment fails, is intolerant, or rejected by a patient who wants to utilize e-cigarettes to help them quit, clinicians should not discourage their use by the patient. However, the statement stresses that clinicians be educated so they can inform patients that e-cigarettes are unregulated, may contain low levels of toxic chemicals, and have not been FDA-approved as cessation devices. The association also proposes that given the lack of long-term research studies on e-cigarette safety that it’s appropriate for a health care professional to suggest that a patient set a quit date for their e-cigarette use. Finally in the new statement, the association calls for comprehensive and continuous research on e-cigarettes’ use, their characteristics, their marketing, and their long-term health effects on individual users, the environment, and public health. “Nicotine is a dangerous and highly addictive chemical no matter what form it takes – conventional cigarettes or some other tobacco product,” said association President Elliott Antman, M.D. “Every life that has been lost to tobacco addiction could have been prevented. We must protect future generations from any potential smokescreens in the tobacco product landscape that will cause us to lose precious ground in the fight to make our nation 100 percent tobacco-free.”

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