Black markets for cigarettes in Gaza

 The WSJ has the story:

At $25 Each, Cigarettes Are Turning Gaza Aid Trucks Into Targets  By Stephen Kalin, Dov Lieber and Fatima AbdulKarim

"A group of Palestinian men approached a United Nations warehouse in central Gaza last week and demanded access to aid stored inside. The gang wasn’t interested in food, fuel or medicine. It wanted something it considered far more valuable: contraband cigarettes hidden in the humanitarian cargo.

"The incident, described by a U.N. official, is emblematic of a significant new impediment to aid deliveries in the enclave. Rampant cigarette smuggling—fueled by high prices for tobacco—has become the latest manifestation of a breakdown in law and order that is slowing the delivery of lifesaving assistance.

"Aid trucks and storage depots have become targets for Palestinian smugglers seeking to retrieve illicit smokes stashed inside shipments by their accomplices, say U.N. and Israeli officials. Other local criminals are also attacking vehicles they suspect have cigarettes hidden somewhere on board, they say.

"Cigarettes sell for as much as $25 apiece in isolated Gaza, so getting hold of even a pack can be enormously profitable.

...

"A second U.N. official said that on Tuesday, three armed men arrived at another U.N. warehouse in central Gaza, demanding to search through the aid. They found the cigarettes they were looking for in a box of aid. The Wall Street Journal viewed a picture of the box with a U.N. logo ripped open, exposing cartons of Karelia cigarettes inside.

“Cigarettes have become like the new gold in Gaza,” the official said."

Do e-cigarettes lead to combustables? (Two NBER papers).

 Two NBER working papers on flavor bans for e-cigarettes, and possible migration to combustables:

The Effect of E-Cigarette Flavor Bans on Tobacco Use. by Chad D. Cotti, Charles J. Courtemanche, Yang Liang, Johanna Catherine Maclean, Erik T. Nesson & Joseph J. Sabia  NBER working paper 32535, DOI 10.3386/w32535,  June 2024

Abstract: Advocates for sales restrictions on flavored e-cigarettes argue that flavors appeal to young people and lead them down a path to nicotine addiction. This study is among the first to examine the effect of state and local restrictions on the sale of flavored electronic nicotine delivery system (ENDS) products on youth and young adult tobacco use. Using data from the State and National Youth Risk Behavior Surveys, we find that the adoption of an ENDS flavor restriction reduces frequent and everyday youth ENDS use by 1.2 to 2.5 percentage points. Auxiliary analyses of the Behavioral Risk Factor Surveillance System show similar effects on ENDS use for young adults ages 18-20. However, we also detect evidence of an unintended effect of ENDS flavor restrictions that is especially clear among 18-20-year-olds: inducing substitution to combustible cigarette smoking. Finally, there is no evidence that ENDS flavor restrictions affect ENDS use among adults aged 21 and older or non-tobacco-related health behaviors such as binge drinking and illicit drug use.

########

Comprehensive E-cigarette Flavor Bans and Tobacco Use among Youth and Adults by Henry Saffer, Selen Ozdogan, Michael Grossman, Daniel L. Dench & Dhaval M. Dave NBER working paper 32534, DOI 10.3386/w32534,  June 2024

Abstract: The vast majority of youth e-cigarette users consume flavored e-cigarettes, raising concerns from public health advocates that flavors may drive youth initiation into and continued use of e-cigarettes. Flavors drew further notice from the public health community following the sudden outbreak of lung injury among vapers in 2019, prompting several states to enact sweeping bans on flavored e-cigarettes. In this study, we examine the effects of these comprehensive bans on e-cigarette use and potential spillovers into other tobacco use by youth, young adults, and adults. We utilize both standard difference-in-differences (DID) and synthetic DID methods, in conjunction with four national data sets. We find evidence that young adults decrease their use of the banned flavored e-cigarettes as well as their overall e-cigarette use, by about two percentage points, while increasing cigarette use. For youth, there is some suggestive evidence of increasing cigarette use, though these results are contaminated by pre-trend differences between treatment and control units. The bans have no effect on e-cigarette and smoking participation among older adults (ages 25+). Our findings suggest that statewide comprehensive flavor bans may have generated an unintended consequence by encouraging substitution towards traditional smoking in some populations.

Nicotine is hard to ban: Juul wins a reprieve from the FDA, and illegal vapes flood the market

 Here are two stories by Jennifer Maloney at the WSJ:

FDA Rescinds Juul Ban, Opening Door for Federal Clearance. E-cigarette maker’s products have stayed on market pending appeal of 2022 ban.. By  Jennifer Maloney

"The Food and Drug Administration rescinded its 2022 ban on Juul Labs’s e-cigarettes. The agency hasn’t yet reached a final determination on whether they can stay on the U.S. market, but the move opened the possibility for federal clearance.

The FDA in 2022 ordered Juul to halt its sales, then stayed the order pending the vaping company’s appeal. The agency said Thursday that it was placing Juul’s products back under scientific review, essentially moving them back to their regulatory status before the ban. 

...

"Juul’s products remain on the market. The FDA didn’t give a timeline for a final decision on whether they can stay there. Juul is the No. 2 e-cigarette maker in the U.S.

Juul and other e-cigarette manufacturers in 2020 were required to submit scientific research to demonstrate that their vaping products exposed users to fewer carcinogens than cigarettes and that the benefit of helping adult smokers switch to a safer alternative outweighed the potential harm of hooking young people on nicotine.

...

"The FDA ban, though it was quickly put on hold, sent Juul into a financial tailspin. The company narrowly averted bankruptcy. Juul has since submitted next-generation vaping products for FDA review. They aren’t yet for sale in the U.S."

###########

U.S. Pledges Crackdown on Illegal E-Cigarettes. FDA and DOJ form task force to go after fruity, disposable vapes flooding the market.  By Jennifer Maloney

"Big tobacco companies and their critics agree on at least one thing: The illegal, fruit-flavored, disposable vapes that are popular among teenagers have flooded the U.S. market and federal regulators haven’t done enough to stop it.

"The Food and Drug Administration and Justice Department said Monday they are stepping up enforcement by forming a multiagency task force to go after the illegal distribution and sale of e-cigarettes.

"Disposable vaping devices, almost none of which are authorized for sale by the FDA, represent more than 30% of U.S. e-cigarette sales in stores tracked by Nielsen, according to an analysis by Goldman Sachs. Many of them are imported from China. Breeze Pro and Elfbar, both of which were ordered off the market last year by the FDA, remain the top two disposable e-cigarette brands in the U.S.

"Njoy is the only disposable vaping brand authorized for sale by the FDA." 

Marijuana policy and use in the U.S., 1979-2022, by Jonathan Caulkins, in Addiction

 Here's a paper forthcoming in the journal Addiction:

Changes in self-reported cannabis use in the United States from 1979 to 2022, by Jonathan P. Caulkins, published online 22 May 2024, https://doi.org/10.1111/add.16519 

"Abstract

Background and aims: Multiple countries are considering revising cannabis policies. This study aimed to measure long-term trends in cannabis use in the United States and compare them with alcohol use.

Design and setting: Secondary analysis of United States general population survey data.

Participants: The national surveys had a total of 1 641 041 participants across 27 surveys from 1979 to 2022.

Measurements: Rates of use reported to the US National Survey on Drug Use and Health and its predecessors are described, as are trends in days of use reported. Four milepost years are contrasted: 1979 (first available data and end of relatively liberal policies of the 1970s), 1992 (end of 12 years of conservative Reagan-Bush era policies), 2008 (last year before the Justice Department signaled explicit federal non-interference with state-level legalizations) and 2022 (most recent data available).

Findings: Reported cannabis use declined to a nadir in 1992, with partial recovery through 2008, and substantial increases since then, particularly for measures of more intensive use. Between 2008 and 2022, the per capita rate of reporting past-year use increased by 120%, and days of use reported per capita increased by 218% (in absolute terms from the annual equivalent of 2.3 to 8.1 billion days per year). From 1992 to 2022, there was a 15-fold increase in the per capita rate of reporting daily or near daily use. Whereas the 1992 survey recorded 10 times as many daily or near daily alcohol as cannabis users (8.9 vs. 0.9 M), the 2022 survey, for the first time, recorded more daily and near daily users of cannabis than alcohol (17.7 vs. 14.7 M). Far more people drink, but high-frequency drinking is less common. In 2022, the median drinker reported drinking on 4–5 days in the past month, versus 15–16 days in the past month for cannabis. In 2022, past-month cannabis consumers were almost four times as likely to report daily or near daily use (42.3% vs. 10.9%) and 7.4 times more likely to report daily use (28.2% vs. 3.8%).

Conclusions: Long-term trends in cannabis use in the United States parallel corresponding changes in cannabis policy, with declines during periods of greater restriction and growth during periods of policy liberalization. A growing share of cannabis consumers report daily or near daily use, and their numbers now exceed the number of daily and near daily drinkers."

Daily and Near Daily (DND) use

...

"That is still not as high as for cigarettes. The 2022 NSDUH survey finds that 58.7% of PM ["Past Month"] cigarette smokers smoked ‘daily’—defined as ‘smoked one or more packs of cigarettes per day’ [8]. Therefore, there are more daily cigarette smokers than DND PM marijuana users (24.1 vs 17.7 million). 3 Still, patterns of marijuana consumption have shifted from being like alcohol to being closer to cigarette use. It is also no longer a young person's drug. In 2022, people 35 and older accounted for (slightly) more days of use than did those under the age of 35."

Menthol cigarettes get a reprieve

 The WSJ has the story:

Biden Administration Shelves Plan to Ban Menthol Cigarettes. White House had been weighing health benefit of ban against angering some Black voters   By Jennifer Maloney, Liz Essley Whyte, and Andrew Restuccia

"The Biden administration is reversing course on its plan to ban menthol cigarettes, after the White House weighed the potential public-health benefits of banning minty smokes against the political risk of angering some Black voters in an election year. 

...

Menthols account for more than a third of all cigarettes sold in the U.S. each year and are predominantly used by Black and Hispanic smokers. Some 81% of Black smokers used menthols in 2020, compared with 30% of white smokers and 51% of Hispanic smokers, according to a Wall Street Journal analysis of data from the National Survey on Drug Use and Health.

Some Black community leaders had fought the measure, saying a ban would expand the illicit market for cigarettes and lead police to racially profile Black smokers. The American Civil Liberties Union and some members of the Congressional Black Caucus expressed similar concerns.

...

"By contrast, Rep. Robin Kelly (D., Ill.), chair of the Congressional Black Caucus Health Braintrust, said she was “deeply disappointed that the FDA has chosen to abandon its established plan to ban menthol cigarettes… This is a common-sense plan which could have saved hundreds of thousands of lives.”

"Political considerations have swayed the Biden administration’s thinking on this public-health issue, said Mitch Zeller, who served as director of the FDA’s Center for Tobacco Products until 2022. “The science is clear that there will be a massive health benefit from removing menthol cigarettes,” he said."

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All my posts on menthol here.

Proposed age-adjusted smoking ban in the U.K.

 The BBC has the story, about a proposal to ban smoking for everyone currently under the age of 18. (What could go wrong?)

What is the UK smoking ban, how will it work and when will it start? By Aurelia Foster, BBC News

"Prime Minister Rishi Sunak effectively wants to ban smoking in the UK.

MPs have voted to back the government's plans to create a "smoke-free generation", and reduce the number of smoking-related deaths.

What is the smoking ban?

The restrictions will apply to the sale of cigarettes in the UK rather than the act of smoking itself.

Under the new law, each year the legal age for cigarette sales - currently 18 - will increase by one year.

It means that people born in or after 2009 will never be able to legally buy cigarettes, leading to an effective ban.

The law will not affect those who are allowed to buy cigarettes now.

To crack down on under-age sales, the government says it will introduce £100 on-the-spot fines for shops in England and Wales which sell tobacco and vapes to under-age people.

Local authorities will retain the proceeds to reinvest into enforcement of the law.

This would be on top of £2,500 fines that courts can already impose.

The government says it will spend £30m on enforcement, which will include tackling the availability of cigarettes on the black market.

The new rules will apply in all duty free shops in the UK, but anyone buying cigarettes abroad would be able to bring them back to the UK as long as they were legally acquired elsewhere.

The government aims to have the new system in force by 2027.

Mr Sunak wants to work with the governments of Wales, Scotland and Northern Ireland to introduce the legislation across the UK."

HT: Oğuzhan Çelebi

#######

Earlier: 

Thursday, March 14, 2024

New Zealand repeals anti-smoking law that would have prevented tobacco sales to anyone born after 2008

New Zealand repeals anti-smoking law that would have prevented tobacco sales to anyone born after 2008

 In an earlier blog post, I wrote about a New Zealand anti-smoking law, saying "And now there's a law that cuts nicotine content of cigarettes, and (get this) "bans the next generation of New Zealanders — anyone born after 2008 or currently 14 years old or younger — from ever buying cigarettes in the country. " (That's going to be a complicated age restriction to administer in, say, 10 years from now...)  

Well, people born in 2008 are turning 16 this year, and New Zealand just repealed that law, for reasons that New Zealand's prime minister Christopher Luxon says include concerns about black markets.

Here's an article from Medpage today, reporting on the change in the law. However the article takes the point of view that black markets are just a smokescreen thrown up by tobacco companies.

Up in Smoke: What Happened to New Zealand's Tobacco Ban Plan?— It appears the new government is making an embarrassing attempt to fend off a budget shortfall. by Eric Trump, March 6, 2024

"As part of the newly elected coalition government's rush to tick 49 "actions"  off its 100-day list by March 8, it has repealed  the Smokefree Environments and Regulated Products Amendment Act of 2022. This act, passed by the previous Labour government, would have banned selling tobacco products to those born on or after January 1, 2009, reduced the nicotine in tobacco products to non-addictive levels, and slashed the number of outlets allowed to sell tobacco by 90%, from 6,000 to 600. Overall tobacco use was predicted to drop from the current 8% to lower than 5% by 2025, and the act was expected to create a tobacco-free generation.

...

"Why would New Zealand's new coalition government, an alliance opens in a new tab or window

of the conservative National Party along with the libertarian ACT and populist New Zealand First parties, repeal data-driven and life- and money-saving legislation? Without a shred of evidence, Prime Minister Christopher Luxon and his coalition partners have repeatedly claimed restricting tobacco and reducing nicotine levels is experimental (as though that were a bad thing), leading to black marketsopens in a new tab or window and a proliferation of crimeopens in a new tab or window. ACT's health spokesperson Todd Stephenson, for example, said thatopens in a new tab or window the "radical prohibitionism" of creating a smoke-free generation would "push smokers into the arms of gang members."

"This rhetoric uncannily echoes the tobacco lobby. Public health experts at the University of Otago recently released a damning reportopens in a new tab or window showing that the coalition government's arguments in favor of a repeal closely mirror the tobacco industry's own narratives on this subject.

"So suspicious are the similarities between the flimsy remarks of coalition partners and tobacco companies' talking points that the report's authors are calling on all members of parliament to declare any past associations with tobacco companies.

######

 

Here's the story about the Prime Minister's concerns, from Radio New Zealand (RNZ):

Smokefree legislation would have driven cigarette black market - Christopher Luxon

Nicotine in New Zealand, banned for the future generation.

 In New Zealand, the incidence of smoking is down, but not so much among the Maori. And now there's a law that cuts nicotine content of cigarettes, and (get this) "bans the next generation of New Zealanders — anyone born after 2008 or currently 14 years old or younger — from ever buying cigarettes in the country. " (That's going to be a complicated age restriction to administer in, say, 10 years from now...)

NPR has the story:

It's one of the world's toughest anti-smoking laws. The Māori see a major flaw  by Simar Bajaj

"In 2011, New Zealand set one of the most audacious public health targets in the world: to slash its cigarette smoking rate to 5% by 2025.

"The rate was 18% at the time. Fast forwarding over a decade later, the country seems on track to reach this goal ahead of the 2025 target — but only for its European and Asian populations. Māori, on the other hand, had the country's highest smoking rate at 20% in 2021, and they are expected to reach the 5% goal only 40 years later in 2061 per government modeling.

...

"Every year, 4,000 Māori die in New Zealand, and cigarettes are responsible for nearly a quarter of these deaths, according to an estimate in The New Zealand Medical Journal. The study also found that smoking explains a third of the seven-year life expectancy gap between Māori and other New Zealanders.

...

"Last December, in an all-hands-on-deck effort to get Māori across the 2025 finish line, New Zealand passed one of the strongest anti-tobacco laws in global history.

"Specifically, the legislation limits the amount of nicotine in cigarettes to non-addictive levels and reduces the number of retailers allowed to sell cigarettes from 600 currently to 60 by July 2024.

"Most remarkably, the law bans the next generation of New Zealanders — anyone born after 2008 or currently 14 years old or younger — from ever buying cigarettes in the country. "The denicotinization and retail reduction are important for us to get to the lower than 5% smoking rate," says New Zealand's Health Minister Ayesha Verrall, "and then the smoke-free generation policy is to keep us there."

...

"Fears that the crackdown on smoking will backfire

"Tobacco regulation is like a game of whack-a-mole: Knock a product out of one market, and it'll usually pop up in another possibly illegal transaction. In 2019, illicit tobacco represented almost 12% of New Zealand's consumption, and this new legislation may further relegate tobacco to the black market, according to Māori physician and Parliament member Shane Reti, who has tribal affiliations to Ngā Puhi, Ngāti Wai, Ngāti Hine and Ngāti Kura. What he's particularly concerned about is that, given high rates of tobacco addiction in his community, this expanded black market will disproportionately impact Māori via more dangerous cigarettes and police crackdowns.

...

"The risk of such smuggled tobacco, Reti points out, is that it would exist wholly outside New Zealand's safety regulations. As such, he posits that these cigarettes would be more addictive and toxic for Māori who continue to smoke, with higher levels of nicotine and heavy metals like lead. (It is presently illegal to import tobacco into New Zealand without a permit.)

"On the supplier side, organized crime syndicates, which are responsible for large-scale cigarette smuggling, may also surge. "We have some of the highest cost of living and the highest inflation we've had in decades in New Zealand," Reti says, "and what we know is that vulnerable groups who are desperate turn to crime." Given New Zealand's incarceration rates — over half of prisoners are Māori despite representing only 17% of the country — Reti worries that an invigorated black market will lead to a disproportionate crackdown in his community and an even higher percentage of Māori prisoners.

...

"Reti is also concerned about the economic impact on New Zealand's dairies because the anti-tobacco legislation reduces the number allowed to sell cigarettes by 90%. (Dairy is the term New Zealanders use for neighborhood convenience stores.) That might be problematic because tobacco makes up a substantial proportion of dairies' revenue, with estimates ranging from 14% to 47%. If dairies can't find other ways to increase sales, this policy "will almost decimate the small retailers, those small corner dairies," says Reti.

...

"But just as he isn't concerned about the black market, Waa thinks these economic arguments are similarly overblown. "This is my conspiracy hat on, but we suspect that a lot of these arguments are put up by the tobacco industry" to keep their product in stores. Waa points to how dairy owners submitted some 1,000 complaints to the government, all of them following a single template. In any case, Waa has little sympathy for retailers insisting on selling tobacco "because they're making money out of my people dying."

#######

Related earlier post:

Friday, March 24, 2023

Alcohol and race in Australia

Innovations in addiction technology--illicitly manufactured fentanyl (IMF) combined with xylazine

 The fight against addictions is complicated by the fact that those who sell addictive goods can be innovative on many levels. (In the case of legal addictive substances such as nicotine, we are becoming accustomed to that competition, e.g. in connection with the growth of non-combustible vaping.)

Here's an article about innovation involving illegal opioids.

The emerging fentanyl–xylazine syndemic in the USA: challenges and future directions, by David T Zhu, Joseph Friedman, Philippe Bourgois, Fernando Montero, Suzanne Tamang, Lancet, August 24, 2023 DOI:https://doi.org/10.1016/S0140-6736(23)01686-0

"Xylazine, a non-opioid analgesic and sedative approved only for non-chronic veterinary use, is spreading across unregulated North American drug markets and becoming increasingly implicated in opioid overdoses. Between 2018 and 2021 in the USA, estimated fatal drug poisonings involving xylazine, often co-occurring with synthetic opioids such as fentanyl, increased from 260 to 3480 cases.1 This use of xylazine takes place in the context of the ongoing US opioid overdose crisis, which is expected to claim an estimated 1·2 million additional lives by 2029, barring urgent substantial policy reforms.2 The White House Office of National Drug Control Policy identified fentanyl adulterated or associated with xylazine (FAAX) as an emerging threat and in July, 2023, issued a response plan leveraging the Emerging Threats Committee and other vital stakeholders.3 Although this is a welcome strategy that sets out the federal government's plan to address xylazine, further non-punitive efforts and public health interventions are needed from health-care systems, policy makers, and community leaders to address the longer-term structural factors driving this crisis.

...

"Although more evidence is needed about why xylazine is combined with fentanyl, some reports suggest that by adding xylazine as an adulterant for synthetic opioids such as IMF, manufacturers can potentially maximise profits and distinguish their brand in the market, attracting a wider customer base.6,  7 This has most notably been observed in Philadelphia, PA, USA—regarded as an epicentre of the emerging xylazine crisis in mainland USA—where over 90% of the city's street opioid supply has shifted to FAAX.8 Further, xylazine has been described by people who use drugs as lengthening the sedative effects of IMF—solving the disadvantage of fentanyl's short duration of effect—thereby postponing craving and physical withdrawal symptoms"

Canada to require health warnings on individual cigarettes

 The Washington Post has the story:

Canada to require health warnings on individual cigarettes  By Sarah Dadouch

"Beginning next year, cigarettes sold in Canada will bear one of six messages in English and French. They include “TOBACCO HARMS CHILDREN,” “POISON IN EVERY PUFF” and “SMOKING CAUSES IMPOTENCE.” Health Canada announced the regulation Wednesday for World No Tobacco Day.

“This bold step will make health warning messages virtually unavoidable,” mental health and addictions minister Carolyn Bennett said. With updated graphic images on cigarette packages, she said in a statement, the labels “will provide a real and startling reminder of the health consequences of smoking.”

...

"Around 48,000 people in Canada die as a result of tobacco use each year, according to Health Canada. That’s more than those who die as a result of alcohol, opioids, suicides, murders and traffic collisions combined."

New York doesn't ban Menthol cigarettes, amid controversy

 The NYT has the stories, first about the proposed ban, and then about the budget compromise that defeated it:

Black Smokers at Center of New York Fight to Ban Menthol Cigarettes. A proposal to make New York the third state to ban menthol cigarettes has created a furious and expensive lobbying war, and has divided Black leaders. By Luis Ferré-Sadurní

"A push by Gov. Kathy Hochul to ban menthol-flavored cigarettes in New York has become the focal point of a fierce and expensive lobbying fight, pitting Big Tobacco against the medical community.

"Caught in the middle are Black smokers, who smoke menthol cigarettes at higher rates than white smokers, and are the main group the ban is meant to help. Decades of aggressive marketing by tobacco companies have caused Black smokers to consume menthol cigarettes, whose cooling sensation on the throat makes them more appealing and addictive.

...

 "Well intentioned as the ban may be, it has angered some Black leaders, including a group of ministers who have rallied against Ms. Hochul’s proposal because they worry it could increase encounters between Black people and the police if menthol cigarettes were to go underground and authorities crack down on sellers.

"Other Black opponents of the ban suggest it may be discriminatory, a heavy-handed crackdown on the preferred nicotine fix of Black smokers, even if African American men have the highest rates of lung cancer, according to the Centers for Disease Control and Prevention. 

...

"Although lawmakers have signaled their support for the tax increase, the menthol ban’s prospects are far less certain, according to four officials familiar with the negotiations.

The issue has divided Black lawmakers, leaving the measure hanging by a thread in the State Capitol "and potentially forcing Ms. Hochul to weigh how much political capital she should expend on the ban, as opposed to other policy priorities."

********

And here's a story saying that the governor abandoned the proposed ban in a set of budget compromises:

New York Would Change Minimum Wage and Bail in $229 Billion Budget Deal. After weeks of dissension, leaders in Albany reached a handshake agreement on a budget that saw Gov. Kathy Hochul fall short on some of her key objectives. By Luis Ferré-Sadurní and Grace Ashford

"Lawmakers managed to knock down other divisive ideas, including ... a ban on the sale of menthol cigarettes that was opposed by Big Tobacco and had divided Black leaders. Lawmakers did agree, however, to raise taxes on cigarettes to $5.35 a pack, up from $4.35."

**********

All posts so far on menthol

Selling flavored cigarettes after California's ban

 It's hard to regulate tobacco. The NY Times brings us up to date on California's ban on flavored tobacco products.

R.J. Reynolds Pivots to New Cigarette Pitches as Flavor Ban Takes Effect. Now that California’s tobacco prohibitions are in place, some Camel and Newport items are billed as newly “fresh” or “crisp” non-menthol versions. By Christina Jewett and Emily Baumgaertner

"R.J. Reynolds has wasted no time since California’s ban on flavored tobacco went into effect in late December. “California, We’ve Got You Covered,” the company declared in bold letters on a flier mailed to its cigarette customers.

"The law prohibits flavors, odors or “tastes” in tobacco products, including menthol cigarettes. But antismoking experts argue that R.J. Reynolds, the maker of Camel and Newport brands, is trying to circumvent the ban by luring smokers with a suite of what it says are new non-menthol versions offering “a taste that satisfies the senses” and “a new fresh twist.”

"The campaign is viewed by critics as a provocation of California authorities who are supposed to enforce the ban, which includes a provision outlawing packaging or claims that suggest a product has a flavor. The Food and Drug Administration also is moving forward with a national plan to take menthol cigarettes off the market.

...

"Dr. Robert Jackler, a professor at Stanford Medicine who provided the ads to The New York Times, called the new marketing “outrageous.”

“The thing that surprises me is there’s no camouflage,” said Dr. Jackler, who received the mailers along with staff members of Stanford’s program on tobacco advertising. “They’re saying, ‘This is our menthol replacement. And by the way — wink, wink — it is not really menthol.’”

...

"Worldwide, tobacco companies have discovered loopholes to bans on menthol or flavored tobacco, studies show. In Canada, flavor cards and additive drops have been used to supplement unflavored products. In Denmark, smokers now have access to menthol sprays, capsules and tubes."

***********

Earlier:

Tuesday, December 27, 2022

Suppressing vaping is hard

Nicotine will be with us for a long time--survey of middle school use

 Sales of tobacco products to minors are generally illegal in the U.S., but a survey shows that doesn't stop children from smoking and vaping.  Here's a report from the Centers for Disease Control and Prevention, in JAMA

Tobacco Use Remains High in Middle and High Schools by Bridget M. Kuehn, MSJ

JAMA. 2022;328(24):2389-2390. doi:10.1001/jama.2022.20058

"Nearly 1 in 9 US middle and high school students reported tobacco product use in the past 30 days—most commonly e-cigarettes—according to a CDC and US Food and Drug Administration analysis of data from the 2022 National Youth Tobacco Survey (NYTS). The researchers estimated that approximately 3.08 million students in 6th to 12th grade currently use tobacco products.

...

"The data show that 16.5% of high school students and 4.5% of middle school students reported using a tobacco product in the past 30 days. About 14% of high school students and about 3% of middle school students used electronic cigarettes. Nearly 4% of all those surveyed reported using any combustible tobacco product.

"Several subgroups of students reported even higher rates of tobacco product use. About 16% of students who identified as lesbian, gay, bisexual, or transgender reported current use of these products. The 2022 NYTS survey was the first to provide data on tobacco product use among American Indian or Alaska Native, Asian, multiracial, or Native Hawaiian or other Pacific Islander youths. It found that American Indian or Alaska Native youth reported the highest rate of a tobacco product use of any racial or ethnic group, at 13.5%.

"The report also found a link between social determinants of health and tobacco product use. For example, students who had experienced severe psychological distress or were from less affluent households were more likely to report current tobacco product use. More than a quarter of students with low academic achievement reported current use. "

Suppressing vaping is hard

 The WSJ has the story:

Major effort needed to remove illegal vaping products, review finds. Group says FDA regulators are overwhelmed and reactive  By Laurie McGinley

"An independent review of the Food and Drug Administration’s tobacco regulators described them as overwhelmed, reactive and fatigued by an oppressive workload involving e-cigarettes and called for a major effort, by several parts of the Biden administration, to remove millions of illegal vaping products from the market.

"The report, by the Reagan-Udall Foundation for the FDA, also said the agency’s Center for Tobacco Products, created by federal law in 2009, has fallen short in laying out clear priorities and has been besieged by lawsuits brought by tobacco and vaping companies, on the one hand, and public health groups on the other.

"The review said there are millions of illegal vaping products on the market — involving companies that should have applied for FDA authorization and never did, or others that had their applications rejected — and that a major effort is needed to remove them."

Lobbying for sports gambling, with cigars and whisky

 Do addictions go together?  The NY Times has the story of how legalized (online, sports) gambling lobbyists wooed state legislators with whisky and cigars (and campaign contributions, which I guess can be addictive too...). Maybe Thanksgiving football can draw in more of the gathering if there's betting involved? (Not to mention whisky...)

Gambling has long been a repugnant transaction because the consequences of gambling addiction can be destructive for individuals and families. And betting on sports has been repugnant because of the danger that athletes will be drawn into fixing matches (even in once genteel sports like tennis).  Lobbying is a competitive sport too:

Cigars, Booze, Money: How a Lobbying Blitz Made Sports Betting Ubiquitous By Eric Lipton and Kenneth P. Vogel

"Less than five years ago, betting on sports in the United States was prohibited under federal law except in Nevada casinos and a smattering of venues in other states. Sports leagues argued that the ban safeguarded the integrity of American sports, while consumer watchdogs warned that legal gambling could turn fans into addicts. In countries like Britain, sports gambling free-for-alls had left trails of addiction.

"But in 2018, the Supreme Court ruled that the federal prohibition was unconstitutional.

"DraftKings and FanDuel, giants in the fast-growing field of fantasy sports, had already mobilized an army of former regulators and politicians to press for sports betting in state capitals. Soon, in a crucial reversal, sports leagues overcame their antipathy toward gambling, which they came to see as a way to keep increasingly distracted audiences tuned in. Casino companies also hopped on board.

...

"The results of the lobbying campaign have been stunning: 31 states and Washington, D.C., permit sports gambling either online or in person, and five more have passed laws that will allow such betting in the future.

...

"In May 2018, the Supreme Court struck down the federal ban on sports gambling, ruling it infringed on states’ rights."

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Here's a map:

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The NYT has these related stories:

Key Findings From The Times’ Investigation of Sports Betting. By David Enrich

"Four years ago, it was illegal to gamble on sports in most of the United States. Today, anyone who turns on the television or visits a sports website or shows up at a stadium is likely to be inundated with ads to bet, bet, bet."

How Colleges and Sports-Betting Companies ‘Caesarized’ Campus Life. by  Anna Betts, Andrew Little, Elizabeth Sander, Alexandra Tremayne-Pengelly and Walt Bogdanich

"Ever since the Supreme Court’s decision in 2018 to let states legalize such betting, gambling companies have been racing to convert traditional casino customers, fantasy sports aficionados and players of online games into a new generation of digital gamblers. Major universities, with their tens of thousands of alumni and a captive audience of easy-to-reach students, have emerged as an especially enticing target.

"So far, at least eight universities have become partners with online sports-betting companies, or sportsbooks, many in the last year, with more expected."

Desperate for Growth, Aging Casino Company Embraced ‘Degenerate Gambler’

Image By Emily Steel

"Mr. Portnoy rarely if ever mentions the bankruptcy. Yet he and his company, Barstool Sports, are urging their tens of millions of followers to dive into the fast-growing and lightly regulated world of online sports betting."

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And here's a story about gambling addiction from The Times of London, which points to online, in-game gambling as a particularly addiction-prone activity (especially during the current World Cup):

Big rise in gambling addictions putting suicidal young men in hospital. NHS lambasts ‘predatory’ betting firms amid 42% increase in demand for specialist clinics by Eleanor Hayward (Ungated summary here).

"The NHS is “picking up the tab” of the online betting industry, with a surge in suicidal gambling addicts turning up to A&E, doctors have warned."

...

"“People start gambling as soon as they wake up in the morning; they’re gambling in the shower, gambling while they’re driving to work.

...

"Gaskell suggested that doctors' surgeries should routinely ask new patients whether they gambled--in the same way they asked how much alcohol people drank in a week.

...

"Figures from the Gambling Commission show the majority of online betters place bets in play...Customers are able to wager lare sums of money multiple times in a matter of seconds on unfolding events.

...

"There are 400 suicides a year in England lnked to gambling."

California referendum bans flavored tobacco

More midterm election news on controversial markets and repugnant transactions:

California bans flavored tobacco products, including vapes, by Nicholas Florko at Statnews

 "On Tuesday, Californians overwhelmingly voted to ban all flavored tobacco products in the state.

"The move makes California by far the largest state to ban such products, which are already illegal in a smattering of smaller states, including Rhode Island, New Jersey, and Massachusetts.

"Regulators have targeted flavored products in particular because they are overwhelmingly preferred by young people. More than 84% of young people who vape reported using flavored products, according to recently released survey data by the Centers for Disease Control and Prevention.

"California’s ban would also outlaw menthol cigarettes, which federal regulators have proposed banning nationwide because they argue such products are easier to start and harder to quit. Survey data also show that menthol cigarettes are overwhelmingly preferred by Black smokers."

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Here's a recent (massive) report on the marketing efforts that went into making menthol flavoring popular (suggesting that we can soon expect to see menthol substitutes):

Advertising Created & Continues to Drive the Menthol Tobacco Market: Methods Used by the Industry to Target Youth, Women, & Black Americans. Jackler RK, Ramamurthi D, Willett J, Chau C, Muoneke M, Zeng A, Chang M, Chang E, Bahk JR, Ramakrishnan A. SRITA Research Paper 

Full Report: high-resolution PDF link (1.62Gb) / low-resolution PDF link (46.4Mb)
Executive Summary: high-resolution PDF link (6.2Mb)