SEND thank you letter to Utah ligislatures

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SEND thank you letter to Utah ligislatures

Postby taz3cat » Mon Feb 28, 2011 3:14 pm

Feel free to copy or use any part of this letter, it is always best to sort of get it in your own words (if not well sign your name and send it anyway), so they know for sure we are real people. real people can make a few mistakes, well, I am one of those that make them sometimes, but that just makes me a average person. A great writer I will never be, but yours and my opinions count, and we best make them known.

Use the same addressee as you used to send the other mail. We need to keep up the pressure, until this session of the legislature is over. They could sneak back and try to pass the bill again. Thank goodness their session is short.

Dear Representative:

The Consumer Advocates for Smoke-free Alternatives Association (CASAA) sincerely thanks you for voting AGAINST H.B. 170 - Tobacco and Nicotine Product Amendments. We request that the members who voted FOR the proposal reconsider their opinion about smoke-free products, based on correcting the confusion introduced during the February 25 public testimony.

Many of those who testified about health risks were referring to the effects of cigarettes and smoking. However, H.B. 170 concerned smoke-free products that many smokers have been able to use as a replacement for smoking. If smokers who cannot or will not quit were provided with truthful information—that switching to a smoke-free product could reduce their risks of smoking-related disease by up to 99%--many, many lives could be saved.

The 2009 Family Smoking Prevention and Tobacco Control Act directed the FDA to establish requirements for identifying “reduced exposure” and “modified risk” tobacco products. Any tobacco product that is not combusted reduces exposure to the tar, carbon monoxide, particulates, and thousands of chemicals found in smoke. “Modified risk” products will need to demonstrate that they reduce harm or the risk of tobacco-related disease.

Amy Sands testified: “These are cancer-causing, toxic products. There’s no doubt – all sorts of scientific research to prove that smokeless tobacco products like these addict and they kill.”

Ms. Sands may be confused by older epidemiological studies on products that delivered higher quantities of harmful substances than current versions of these products. Nevertheless, even those earlier products eliminated the lung disease that is triggered by inhaling smoke. They also carried lower risks of cardiovascular disease and cancer than smoking.

While there is zero scientific evidence that modern smokeless tobacco products cause cancer or kill the user in any other manner, there is plenty of evidence to the contrary. Snus, a moist powder tobacco product, was developed in Sweden for the express purpose of reducing the health risks faced by smokers. Snus is processed to deliver lower concentrations of Tobacco-specific Nitrosamines (TSNAs) than traditional smokeless tobacco products.

Foulds, Ranstrom, Burke, and Fagerstrom reviewed the evidence on the effects of snus on smoking and health in Sweden. They concluded, “It is dependence forming, but does not appear to cause cancer or respiratory diseases.”

Foulds, et al. Effect of smokeless tobacco (snus) on smoking and public health in Sweden. Tobacco Control 2003;12:349–359.

Lee and Hamling reviewed 89 studies on cancer risk of smokeless tobacco and concluded, “Risk from modern products is much less than for smoking.”

Lee, et al. Systematic review of the relation between smokeless tobacco and cancer in Europe and North America. BMC Medicine 2009, 7:36.

Peter Lee’s most recent review of the evidence concludes: “Using snus is clearly much safer than smoking. While smoking substantially increases the risk of cancer and cardiovascular diseases, any increase from snus use is undemonstrated, and if it exists is probably about 1% of that from smoking.”

Lee, PN. Summary of the epidemiological evidence relating snus to health. Regul Toxicol Pharmacol. 2010 Dec 14.

Electronic cigarettes are relatively new products; however, they have been available since 2003. There have been no deaths and no reports of any serious adverse events associated with electronic cigarettes anywhere in the world. Surveys show that over 90% of users report that their health has improved.

Heavner, et al. Electronic cigarettes (e-cigarettes) as potential tobacco harm reduction products: Results of an online survey of ecigarette users. Tobacco Harm Reduction 2010 Yearbook.

The dissolvable tobacco products are even newer, so there is no published research on product safety. However, given the fact that the products are not smoked and that they contain levels of carcinogens on par with pharmaceutical nicotine products, it is most likely that their safety profile will be similar that of snus and electronic cigarettes.

Representative Ray stated, “We know that one third of kids who start using these are going to die at some point in their life from the use of tobacco.” This statistic refers to smoking, not to the use of modern smokeless tobacco products. Source: CDC, “Projected Smoking-Related Deaths Among Youth – United States,” MMWR, 45(44), November 8, 1996.

Utah PTA Health Commissioner Liz Zentner commented about electronic cigarettes, “The problem is that a lethal dose of nicotine for children is 10 mg and one of those cartridges contains 500 to over 1000 mg.”

This is false. Cartridges may contain nicotine that has been purified (pharmaceutical grade), but the content is not “pure nicotine.” A cartridge contains no more than one gram (1000 mg) of a liquid solution of water, propylene glycol and/or vegetable glycerin, flavoring, and (optionally) nicotine. The “high dose” cartridges typically contain less than 2% of actual nicotine (20 mg) and the solution is soaked into an absorbent material, which would make it nearly impossible for a child to “drink” from the cartridge.

More than one speaker mentioned accidental poisoning of children by tobacco products. Given the fact that over 70% of tobacco product poisonings are caused by eating cigarettes, butts, and cigars, it does not appear that banning flavored smokeless tobaccos would have solved the already existing issue of accidental ingestion. Not only would HB 170 have NOT solved that problem, it would have practically ensured that many children would remain exposed to second-hand smoke as well as to cigarettes, butts, and cigars, because smoking relatives would have been denied access to a variety of acceptable smoke-free alternative.

Additionally, 1,307 poisonings were caused by pharmaceutical nicotine products, yet there is no effort to ban the sale of the Mint, Fresh Mint, Cinnamon Surge, Cherry, White Ice, and Fruit Chill flavors of Nicorette products. The Nicorette lozenges look, smell, and taste much more like candy than the flavored dissolvable tobacco orbs. ... report.pdf

CASAA shares the concern for the safety of children. Parents should always keep any product that contains nicotine—including FDA-approved products such as patches, lozenges, and gum—out of the reach of pets and children. CASAA strongly supports prohibiting the sale of these adult products to underage youth and encourages regulating packaging and advertising to reduce potential accidents.

There is no evidence that adding flavorings to tobacco products induces children to start smoking. Conrad, Flay, and Hill reviewed 27 studies regarding onset of cigarette smoking. Major factors that govern initiation of smoking include low socioeconomic states, peer and school bonding, parental example, and peer smoking approval.

Conrad, et al. “Why children start smoking cigarettes: predictors of onset. “ Br J Addict. 1992 Dec;87(12):1711-24.

There is also no evidence that kids tend to start with smokeless tobacco products and “graduate” to smoking. If smoke-free products are a gateway, the gate swings away from smoking. Ranstrom and Foulds found, “Among men who used snus as a single aid, 66% succeeded in quitting completely, as compared with 47% of those using nicotine gum (OR 2.2, 95% CI 1.3 to 3.7) or 32% for those using the nicotine patch (OR 4.2, 95% CI 2.1 to 8.6). Women using snus as an aid were also significantly more likely to quit smoking successfully than those using nicotine patches or gum.”

Ramstrцm, et al. “Role of snus in initiation and cessation of tobacco smoking in Sweden.” Tobacco Control 15:210-214.

The same thing is true of electronic cigarettes. Smokers are switching to electronic cigarettes, not vice versa. Success rates for achieving complete abstinence from smoking range as high as 80%. Those users who enjoy pleasant flavors soon lose their taste for smoking and have no urges to smoke. Claims that adult smokers would not want these flavors are based on mistaken assumption and not actual research. Surveys have shown that thousands of middle-aged users find the non-tobacco flavors to be a key factor for successfully substituting electronic cigarettes for smoking.

Recent studies show that smoking quit rates have stalled and start rates are again increasing in youth. Many of these tobacco users may choose smokeless products over smoking if given accurate information about the relative risks. If HB 170 had succeeded in removing or banning low-risk smokeless tobacco products, it would have forced new and existing users to purchase only the most hazardous products available on the market. Given the enormous health risks of smoking, is it ethical to create barriers to products that carry very low disease risks and are highly acceptable replacements for smoking?

If you have any questions or concerns about smokeless alternatives please do not hesitate to contact us. We would be happy to provide you with additional scientific research reports which support the urgent need to not only keep these smokeless products available to adult tobacco users, but to also design tobacco regulation to educate and encourage smokers to switch to reduced harm alternatives.


Yolanda Villa, Esq., CASAA Legal Director,

Theresa A. Whitt, MD, CASAA Medical Director
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