Kentucky tobacco-free advocates win Campaign for Tobacco-Free Kids' national Group Youth Advocates of the Year award

The Campaign for Tobacco-Free Kids named the #iCANendthetrend Youth Advisory Board Group Youth Advocates of the Year. Front, from left: Saumya Sikhwal, Jasmin Hernandez, Sarah Larkin and Philena Ash. Back: Jordan Joslin, Chloe Brady, Ksenia Miller, Relena Aispuro and Olivia Hardigree.

By Melissa Patrick

Kentucky Health News

The University of Kentucky's #iCANendthetrend Youth Advisory Board has been named the Campaign for Tobacco-Free Kids' 2024 Group Youth Advocates of the Year.

The Campaign for Tobacco-Free Kids says it is the leading advocacy organization working to reduce tobacco use in the United States and around the world. 

The group was recognized for its advocacy summit at the state Capitol, where over 100 youth came together to push for stronger enforcement of Kentucky’s law prohibiting the sale of tobacco products to anyone under the age of 21. This event was held Feb. 15, following its second Kentucky Youth Tobacco Control Conference the day before. 

The #iCANendthetrend Youth Advisory Board is made up of high school students from across the state who applied to join the group, which works on empowering young people to prevent tobacco and e-cigarette use.

The board is part of UK's #iCANendthetrend program, which utilizes college-student facilitators who offer presentations in schools across the state about the dangers of tobacco and electronic-cigarette use.

The program was started in 2019 and the students found such passion from the high-school students that they created a program for them in 2021, said Griffin Nemeth, the group's coordinator and a student  at UK's College of Pharmacy.

Board member Saumya Sikhwal, a senior at South Warren High School, said one of the board's biggest projects this year was to advocate for compliance checks and enforcement of the law barring sales to those under 21. 

"So my main thing was to advocate for having stricter policies and compliance checks . . . holding retailers accountable for selling nicotine products to underage youth," Sikhwal said. 

She said that for most of the students, including herself, it was the first time they had talked directly to the legislators and that they got both positive and negative feedback to their requests. 

Board member Ksenia Miller, a freshman at Villa Madonna Academy in Kenton County, said students at the conference were educated about the tobacco laws in Kentucky and how they are enforced and were then able to talk with legislators the next day "about putting in more laws to further enforce the laws."

"It was a really, really big project to work on," she said. "But it was definitely a fun one."

The students who attended the awards ceremony in Washington, D.C. and accepted the award on behalf of the group, spoke about their work in a video. Sikhwal and Miller were joined by board member Jasmin Hernandez, a junior from Casey County High School.

Asked about their experience, Miller said she enjoyed sharing the hard work that the Youth Advisory Board did and meeting fellow advocates. "It was a really great experience," she said. 

Sikhwal agreed. "It was definitely not just an award, it was more of an experience where you get to learn from others," she said. " I did not know how big Campaign for Tobacco Free Kids was. Just seeing people from across the world being there and advocating for tobacco prevention was really eye opening for me, and more inspiring. And it motivated me to do more advocacy work as I go into my next college years. " 

Sikhwal added that she was moved by Campaign for Tobacco-Free Kids' President and CEO Derrick Johnson's words, when he said we should put "people above the profits."

She said, "I will remember that for a long time."

Nemeth said, "It really just goes to show the amazing work of all the young advocates."

Kentucky Center for Smoke-Free Policy honors communities, groups and individuals who help create smoke-free communities

The Kentucky Center for Smoke-Free Policy at the University of Kentucky and the Kentucky Department for Public Health’s Tobacco Prevention & Cessation Program honored communities, groups and individuals from across the state who are leading the way to enact smoke- and tobacco-free policies at the 2024 Kentucky Tobacco Control Conference held April 23-24 in Lexington. 

“While tobacco use has decreased across the general population, disparities persist by geographic location, socioeconomic status, race, ethnicity, sexual orientation, gender identity, disability status, and mental health status,” Amanda Bucher, director of tobacco policy research and outreach in the College of Nursing at UK, said in a news release. “This is in part due to the tobacco industry’s targeted marketing of these populations. Our vision for a tobacco-free Kentucky must promote health equity and eliminate these disparities.”

Sydney Shaffer, the 2024 Smoke-free Youth
Advocate of the Year, poses with Lexington
Mayor Linda Gorton. (Photo by Tim Webb)

Sydney Shaffer, a high-school student from Scott County, received the Smoke-free Youth Advocate Award for excellence in promoting smoke-free policy and education about secondhand smoke. Shaffer has advocated for lung-health policies and youth-vaping prevention since losing her grandfather to lung cancer. She has spoken to policymakers about the importance of tobacco control policies at the local, state and national levels.

The Northern Kentucky towns of Corinth and Highland Heights received the Everette Varney Smoke-free Indoor Air Excellence Award for their "exceptional leadership" and collaborative efforts in promoting the health of their citizens by enacting comprehensive smoke-free workplace ordinances.

Dr. Timothy W. Mullett, medical director of UK's Markey Cancer Center Network, received the Lee T. Todd Jr., Smoke-free Hero Award for his courage, leadership, perseverance, and continuous commitment to smoke- and tobacco-free environments in the face of adversity.

Centre College received the Tobacco Free Campus Award for its exceptional leadership and collaborative efforts in promoting healthy campus environments by implementing a tobacco-free campus last year.

Jelaine Harlow, health-education coordinator for the Lake Cumberland District Health Department, received the Ellen J. Hahn Lifetime Achievement in Tobacco Control Award for an exceptional life devoted to leadership in advocacy and public service contributions in tobacco control.

Jessica L. Burris, UK Department of Psychology and Markey Cancer Center received the Timothy W. Mullett M.D. Lung Cancer Prevention Award for her leadership, devotion, and passion toward preventing lung cancer through policy change in tobacco control.

Dr. Michael Gieske, diredctor of lung-cancer screening at St. Elizabeth Healthcare in Northern Kentucky, received the David B. Stevens M.D. Smoke-free Advocate of the Year Award for excellence in promoting secondhand smoke education and smoke-free policy.

The event was also sponsored by UK Healthcare, the Kentucky Health Collaborative, the Kentucky Asthma Management Program, Aetna Better Health of Kentucky, the Kentucky Office of Community Health Workers, Appalachian Regional Healthcare, the Kentucky COPD Program, CHI Saint Joseph Health and Kentucky Voices for Health, a coalition of health-advocacy organizations.

Community pharmacies can help smokers quit, study finds

Photo illustration from QuitSmokingPharmacies.com

Kentucky Health News

Community pharmacies may play a key role in helping smokers quit, according to a study done in California and published in the peer-reviewed journal Pharmacy.

Kentucky' adult smoking rate, 17.4%, is tied for fourth in the nation with MIssissippi. For a partial list of pharmacies that advertise their help with smoking cessation, go to QuitSmokingPharmacies.com.

"Although two-thirds of people who smoke would like to quit, many individuals trying to quit on their own are not successful," notes a news release from the University of California, Davis, where the study was done in cooperation with  other academic institutions across the country and the Community Pharmacy Enhanced Services Network, involving 22 California pharmacists and 26 pharmacy technicians who underwent tobacco cessation training.

"Pharmacists have shown to be effective in helping patients quit," the release said. "They can reach uninsured and under-resourced patients as well as patients living in rural areas who might experience barriers to accessing primary care. However, the study showed certain barriers exist to making pharmacy cessation programs effective," such as billing complexities, software limitations and training gaps for handling complicated patient cases.

“Compatibility with existing workflows, staff buy-in and the crucial role of pharmacy technicians significantly helped” pharmacy custiomers quit smoking, said the study's senior author, Karen Hudmon of the Purdue University College of Pharmacy.

Top senators, one of whom lost both parents to smoking, say no advocates spoke to them about increasing anti-tobacco spending

By Al Cross
Kentucky Health News

Kentucky's top two state senators said Tuesday that none of the advocates for more funding of tobacco prevention spoke to them about it during the legislative session that ended Monday night.

"I never heard from those advocates. They never came to meet with me, and they probably should've. . . . I was in the room where it happened, and nobody ever spoke to me," Majority Floor Leader Damon Thayer of Georgetown said in response to a question from Kentucky Health News.

Thayer spoke at a Capitol rotunda press conference where leading Senate Republicans discussed what they considered to be the session's accomplishments. Senate President Robert Stivers told Kentucky Health News afterward that no one ever spoke to him about the proposal to increase tobacco-prevention spending to $10 million a year from $2 million.

Letter to senators (For a larger version, click on it.)

The proposal came from the American Cancer Society and several other groups interested in better health, including the Kentucky Chamber of Commerce. In a letter to senators, they said smoking is the No. 1 cause of preventable death in Kentucky and causes $2.23 billion in health-care costs, including $634 million in the federal-state Medicaid progam that covers more than one in three Kentuckians.

"A well-funded, fact-based tobacco control program is needed to counteract the $251 million per year that tobacco companies are spending to market their deadly and addictive products in Kentucky," the letter concluded. "As Big Tobacco has been working hard to addict future generations with e-cigarettes and other tobacco products, the need for more funding for tobacco-prevention programs has never been greater."

Thayer said after the press conference, "I get stacks and stacks of budget requests, and if they say, "I sent him a letter or an email,' that's not effective."

Kentucky Health News asked Doug Hogan, the Kentucky lobbyist for the cancer society, what legislators the advocates spoke with and why Stivers and Thayer were not included. He replied with this email:

“The American Cancer Society Cancer Action Network (ACS CAN) is proud to have advocated for the health of Kentuckians during this General Assembly session by asking for an increase in funding for the state’s tobacco prevention and cessation program. ACS CAN staff and volunteers were able to contact Senate and House offices to share the importance of this funding. ACS CAN is disappointed that our message was not heard, and a significant investment was not made in programs to help prevent kids from starting to use tobacco products, including e-cigarettes, and help those already addicted to quit.”

Neither side noted that the administration of Gov. Andy Beshear didn't ask for more money, either. Asked why, Cabinet for Health and Family Services spokeswoman Stephanie French said in an email that the legislature "reduced the tobacco prevention and cessation budget by more than $2.6 million" in the previous state budget, and "after flat-funding at $2 million" a year in the current budget, "The legislature has further reduced the tobacco prevention and cessation budget by another $130,700 in the recently enacted ... biennial budget. Both of these reductions were significantly lower than what Governor Beshear proposed in his Executive Branch budget."

French said Beshear put nearly $1 million extra into tobacco control due to increased receipts from the Master Settlement Agreement with cigarette manufacturers. "This was a doubling of the budget for tobacco cessation and prevention investment for this year and that money is being deployed now."

At the press conference, Stivers was asked if tobacco-control spending would be a good investment in the long term, by reducing health-care costs. He gave Thayer the microphone.

Asked if he thinks the current $2 million tobacco-control budget doesn't work, Thayer said, "I honestly don't know that it does. Honestly. I mean, how much money can you spend trying to dissuade people from doing something that everybody knows is unhealthy?"

Earlier, he said, "Everybody knows that smoking cigarettes is bad for you. . . . My dad knew the health risk his whole life and he never quit." Earlier, he said, "Both my parents died of cancer from the fact that my father was a multi-pack-a-day smoker, so this is an issue that's a little sensitive to me."

Thayer told Kentucky Health News after the press conference he believes that smoking killed his father, who died of esophageal cancer, and that secondhand smoke in their home killed his mother, who died first, of multiple myeloma: "I never saw her smoke a cigarette in my life." He acknowledged that more education on the risks of seocndhand smoke is needed.

When the final budget was released, Kentucky Health News asked Senate budget committee Chair Chris McDaniel of Northern Kentucky why there was no increase in tobacco-control spending. He said, "We kind of distributed it more broadly, with increases in funding for cancer research."

Stivers said likewise at the press conference, adding that health departments also got more funding. "What we are trying to do in all areas is to encourage people to have better and healthier lifestyles," he said.

Whether or not you smoke can be influenced by heredity; new research may help identify specific risks, and ways to quit

Photo illustration by Gerd Altmann, Pixabay, via Newswise

Kentucky Health News

If your parents or grandparents smoke, you are more likely to smoke. Perhaps that's one reason smoking persists in Kentucky, which has had a higher rate of adult smoking than any state but West Virginia. 

“Smoking is highly heritable, with genetic differences accounting for 40% to 75% of the differences in people’s smoking behaviors,” says Pamela Romero Villela, a doctoral student at the University of Colorado and main author of a new study of the phenomenon.

The university's Lisa Marshall writes, "Scientists have identified thousands of genetic variants believed to influence everything from when people first try smoking to how good that first cigarette feels to how often they light up and how hard it is to quit. Some variants influence how quickly we metabolize nicotine, while others underlie how sensitive we are to it. But little is known about how they interact with each other and with other genetic differences."

The new study "sheds unprecedented light on these interactions and provides new insight on the most well-known smoking-related variant to date," Marshall reports.

Romero Villela told Marshall, “The more we can understand what those genes do and how they interact, the better equipped we will be to develop personalized approaches to helping people quit.”

She and physiology Professor Marissa Ehringer, a longtime substance-use researcher, focused on the most widely replicated genetic variant associated with smoking behaviors, so important that researchers call it "Mr. Big."

"Mr. Big . . . influences how well nicotine binds to receptors in the brain," Marshall explains. "People with a certain version of Mr. Big, known as the AA version, are less sensitive to nicotine and have been shown to smoke more."

Romero Villela rold her, “It kind of numbs your response so in order for you to feel the same effect as someone who smoked one cigarette you might have to smoke almost one and a half cigarettes.”

The researchers found something new "when analyzing genetic information from about 165,000 current or former smokers of European, South Asian and Finnish descent," Marshall reports. "They discovered genes and variants in a completely different region of the genome that appear to interact with Mr. Big in a way that influences smoking habits. Notably, when people had the risk-boosting version of Mr. Big but also had a genetic variant called rs73586411, they smoked significantly less than expected."

Marshall writes, "More research is needed to understand just what the genes highlighted in the study do. Interestingly, one . . . has previously been associated with Parkinson’s disease. Nicotine is known to blunt some symptoms of the disease.

"The study authors imagine a day when people could be given a 'polygenic risk score' that would consider their gene variants and interactions to provide personalized recommendations for quitting. . . . Eventually, if researchers could determine what a variant does to dull the craving to smoke, they might be able to develop medications that mimic that action."

Vaping bill stripped of licensing requirements and stiffer penalties passes House; sponsor says alternate bill on retailing is expected

By Melissa Patrick
Kentucky Health News

The House passed a watered-down bill to address youth vaping Thursday, Feb. 22, after a committee removed provisions to require vape shops be licensed and raise penalties for their violations. 

Rep. Mark Hart, R-Falmouth

The bill's sponsor, Rep. Mark Hart, R-Falmouth, told Kentucky Health News that he took out the licensing and penalty provisions because Rep. Rebecca Raymer, R-Morgantown, was expected to file a bill to address those issues without the education components of his bill. The deadline for new House bills is Monday, Feb. 26, but new legislation can also be added by amendments.

"So I pulled all the education stuff out of the vaping bill and I carried just that portion," he said. "So my bill only addresses how to  deal with vaping for kids in the  school system."

Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, said it is unnecessary to put youth penalties in law because schools already have that authority, but licensing vape shops is critical. 

"I don't think there's any question about this, you need to license the people who sell the vapes. We don't even know who's selling the vapes. That's the first thing," he said. " And then the second thing is, you need to do something about these flavors. It's well established that the kids are attracted to the flavors. And why the legislature won't do something about the flavors is a mystery to me." 

Chandler said it is time to solve this problem, and Hart's bill will not do that. "I would think you'd want to try to find the solution, and this is not it." 

Griffin Nemeth, coordinator of the University of Kentucky's #iCANendthetrend Youth Advisory Board, said in an email that tobacco retail licensing should be a priority because it has helped reduce youth nicotine use in the approximately 40 of 50 states that have some form of licensing.

Tobacco retail licensing "faces particularly strong opposition in Kentucky despite its success in other states," Nemeth said. "The removal of the vapor retail licensing component of HB 142 is not surprising and will likely improve its chances of being passed."

The current version of House Bill 142 would require school districts to adopt specific policies that penalize students for possessing "alternative nicotine products, tobacco products, or vapor products." 

The policy would require the school to confiscate nicotine products from students and, if it's a first incident, to give the student and family evidence-based, age-appropriate information about nicotine cessation. A second incident would require the student to receive disciplinary action established by the school's policies. 

Any incident beyond a second offense would require the student to receive an in-school or out-of-school suspension. Upon suspension, the school must also provide the opportunity for the student to complete an evidence-based, age-appropriate nicotine education program during an in-school suspension. 

Asked why such policies need to be legislated, Hart said it is important to put these requirements into law because it gives school administrators something to "hang their hat on" when they confiscate products and penalize students. 

"They could write their policies and stuff, but now that we're making this a law, it's going to give the administrators some teeth . . . this will give them some protection because this says in law now, you've got to do this." 

One of the challenges administrators are facing, he said, is that parents don't want their kids punished for vaping and want their vaping devices returned to them because they are buying these products for their kids. 

"We've got parents out there that think it's perfectly safe and all right for their kids to vape," he said.  

The 2021 Youth Risk Behavior Survey found that 4.9% of Kentucky high-school students said they smoked cigarettes and 21.9% said they used electronic vapor products. Among middle schoolers, 1.7% said they currently smoked cigarettes and 11.3% used a vapor product. “Current use” is considered having used a product at least once during the 30 days before the survey.

Among other things, the bill requires school boards to report the number of nicotine-related behavior incidents in schools and the number that required medical intervention by Aug. 1 of each year to the state Department of Education, which would have to compile the data and submit it to the legislature before Sept. 1.

Hart said the reporting requirements will allow legislators to track this issue: "In a couple of years, if things aren't getting any better or it is still as big a problem as it is, then we can take steps to change the law or do whatever we have to at that time."

American Cancer Society wants state to spend $10 million a year on smoking cessation and prevention; current budget is $2 million

Graph from Broken Promises to Our Children: A State-by-State Look
at the 1998 Tobacco Settlement 24 Years Later; click on it to enlarge.

By Melissa Patrick
Kentucky Health News

The American Cancer Society Cancer Action Network will ask legislators in the upcoming General Assembly session to spend a lot more on tobacco prevention and cessation, with a focus on how decreasing smoking and vaping rates would improve Kentucky's economy and its workforce.  

Doug Hogan, the group's government-relations director for Kentucky and West Virginia, told Kentucky Health News that Kentucky's high smoking rates come with great cost to people's health, health-care systems and the economy. 

"From a business perspective, businesses are losing thousands of dollars each month because of lost productivity and also on increased health-care costs for their employees who smoke," Hogan said. "This is a huge cost factor for our businesses and it's also a healthy-workforce issue." 

In a news release, Hogan said "Smoking is estimated to cost Kentucky $2.23 billion in direct health-care costs, including $634 million in Medicaid costs annually. Additionally, smoking costs the state an estimated $6.3 billion in productivity costs annually." 

Doug Hogan (LinkedIn photo)

Hogan praised state officials for creating in the last several years environments that are conducive to expanding businesses and creating more jobs, but he told KHN, "If there's not a healthy workforce to fill in those jobs, then a lot of that is for naught. And so we want to take a look at the economics of this and say, we need to focus on a healthy workforce." 

The cancer society's ask of $10 million a year for tobacco cessation and prevention is $8 million more than the state is spending now. 

This increase would prevent 2,400 Kentucky teenagers from growing into adults addicted to deadly nicotine products, Hogan said in an email. 

"We want to use the additional funding for prevention so that our next generation of young people don't grow into adults who are addicted to deadly nicotine products," he said. "And then the other part of that is to provide the tools and the resources that adults need, who want to quit, to be able to be successful and move toward a smoke-free lifestyle." 

In Kentucky, the release said, “22.5% of high school students currently use tobacco products, including e-cigarettes, and 17.4% of adults in Kentucky smoke, which is over 40% higher than the national average.”

Hogan said in the release, "Kentucky has the opportunity to turn these numbers around with the 2024 budget. For every $1 spent on comprehensive prevention and cessation programs, states receive up to $55 in savings from averted tobacco-related health-care costs. So, a $10 million investment would be a great step toward a healthier workforce and could save up to $550 million." 

The University of Kentucky's Markey Cancer Center will evaluate the program to ensure the state is getting the maximum return on its investment, Hogan said.

He added, "We know that kids who experiment with electronic cigarettes are much more likely to experiment with other tobacco products and more likely to become addicted to deadly nicotine products."

A document presented to the legislature's Tobacco Settlement Agreement Fund Oversight Committee in September showed the estimated monthly and annual costs to employers from cigarette smoking, by county. In Adair County, where 26% of the adult population smokes, the annual cost to the workforce for the estimated 1,138 adults in the workforfce who smoke is $7.9 million. 

The 2024 legislative session convenes Jan. 2 and must adjourn by April 15. The deadline for filing for legislative seats and other partisan offices in the 2024 primary elections is Jan. 5. 

Lawmaker on key committees supports an increase in funding

Sen. Amanda Mays Bledsoe

Sen. Amanda Mays Bledsoe, R-Lexington, vice-chair of the Senate Appropriations & Revenue Committee and co-chair of the House-Senate tobacco committee, said she agrees with the cancer society's argument that reducing the number of people who smoke will save money in the long run and would create a healthier workforce. 

"I think their plan is on the right track," she said. 

However, she added, that she'll have to wait and see what is in the House budget before before she can react to this request. The budget must start in the House. 

"I'm not really sure where that's gonna land," Mays Bledsoe said, "but I am supportive of their ask."

She added that it's important to recognize that the tobacco-settlement money touches several pieces of the budget, with half of it allocated for agriculture diversification. 

"I was really surprised over the years of where they've used program money," she said. "And my biggest surprise was how much of it was not used on specifically tobacco cessation." That was one of the big arguments for the states' 1998 settlement with cigarette manufacturers, but states have spent relatively little on it.

Kentucky 43rd in smoking cessation and prevention funding

While $10 million would be a huge jump from the current $2 million in tobacco prevention and cessation spending, it would still fall far short of the $56.4 million advised by the federal Centers for Disease Control and Prevention.

According to a report titled Broken Promises to Our Children: A State-by-State Look at the 1998 Tobacco Settlement 24 Years Later,  Kentucky ranks 43rd among states in funding tobacco prevention and cessation programs, down five slots from 2020, when it spent $3.3 million.

Meanwhile, the tobacco industry spends $251 million for tobacco marketing in the state, says the report, issued by the cencer society, the Campaign for Tobacco-Free Kids, the American Heart Association, the American Lung Association, the Truth Initiative and Americans for Nonsmokers’ Rights.

Quit help for Kentucky smokers

Kentucky smokers have several tools to help them quit.

The state runs a 1-800-QUIT-NOW hotline that offers free tobacco-cessation services 24 hours a day, seven days a week. Coaching is available by phone or online chats. .

And while Quit Now Kentucky provides free services to people of all ages, middle- and high-school students may want to try "My Life, My Quit," a free, confidential quitline for Kentuckians 17 and younger to help them stop smoking or vaping. Teens can text "Start My Quit" to 36072, or click on the live chat button on the My Life, My Quit website to chat with a coach.

A 2017 law requires insurers, including Medicaid, to cover all seven tobacco-cessation medications approved by the U.S. Food and Drug Administration, and counseling services recommended by the U.S. Preventive Services Task Force. It also eliminated co-payments for medication and counseling, requirements tying medication coverage to counseling, and limits on the length of treatment.

The cancer society also offers a list of resources to help you quit using tobacco products.

Hogan said many Kentucky smokers still don't know what quitting resources are available to them, even though research shows that more than two-thirds of smokers say they want to quit.  

"But it's very difficult," he said. "If we increase the tobacco prevention, cessation programming, and the investment that we're making there, we can have more of an impact on the folks to get them the resources they need to quit."

Studies show that comprehensive smoke-free laws and tobacco taxes are associated with lower rates of youth smoking

Kentucky Health News

Tobacco-control policies such as taxes and comprehensive smoke-free laws are associated with lower rates of youth smoking, according to recent studies. 

The purpose of the first study, published in Sage Journals, was to determine whether the presence and strength of local smoke-free ordinances was associated with cigarette and smokeless tobacco use among high school students in Kentucky, and whether use varied by urban/rural location.

The researchers used data from more than 353,000 10th and 12th graders in the 2004-2018 biennial Kentucky Incentives for Prevention Survey. The smoke-free ordinance data came from the Kentucky Center for Smoke-Free Policy at the University of Kentucky.

The center said in a news release that UK researchers "found that high-school students living in Kentucky counties with a comprehensive smoke-free law are 23% less likely to smoke cigarettes and 16% less likely to use smokeless tobacco compared to those living in counties with a partial smoke-free law or no law." 

Also, "Students in counties with moderate/weak laws did not differ in likelihood of use for either product, compared to those in counties without a law." 

Comprehensive smoke-free laws prohibit smoking inside all workplaces and public places.

The study also found that rural youth may be more likely to smoke. 

"Students in urban counties were 14% less likely to smoke, but there was no difference in likelihood of smokeless use by urban/rural location," says the report.

In conclusion, the researchers write, "Given that nearly half of U.S. youth are not protected by smoke-free laws, advocacy for comprehensive smoke-free workplace laws in all states and municipalities may be an important component in reducing the prospect of youth cigarette and smokeless tobacco use." 

In Kentucky, nearly 5% of high-school students smoke cigarettes and nearly 22% of them use electronic cigarettes, according to data from the Campaign for Tobacco-Free Kids. 

A separate study, published in the American Journal of Preventive Medicine, that looked at how changes in state tobacco-control policies impacted youth e-cigarette use in 2013-19. It found that adolescents were 55% less likely to use e-cigarettes following the enactment of a statewide comprehensive smoke-free law than before the state had a law.

 

The researchers then compared this to the impact of age-of-purchase laws and e-cigarette excise taxes and found that comprehensive smoke-free laws had the biggest impact on youth vaping. 

"Youth were 21% less likely to use e-cigarettes when their state had a minimum age-of-purchase law than when they did not," says the release. 

In addition, the study found that "while changes in tobacco excise taxes did not have a statistically significant impact, adolescents who lived in states with higher average cigarette excise taxes were more likely to use e-cigarettes." 

"This suggests that states need to consider parity and tax all tobacco products including e-cigarettes at the same rate," says the release. "These findings indicate that comprehensive smoke-free laws, tightening restrictions on youth access, and enforcing existing age-of-purchase laws can reduce the likelihood of e-cigarette use among youth."

Going smoke-free in 2023? Medications double odds of success

Photo by Daria Kulkova, iStock/Getty Images Plus

By Audrey Darville
University of Kentucky

Most people who smoke attempt to quit at least once a year, so it’s no surprise that quitting smoking is one of the most popular New Year’s resolutions year after year.

If you plan to quit in 2023, there are support tools available that can set you up for success, including medications that can help minimize uncomfortable withdrawal symptoms and cravings when trying to quit.

Studies show that using cessation medicines can double your chances of successfully quitting.

There are three different types of medications approved by the Food and Drug Administration to help you quit smoking.

The first is nicotine replacement therapy, which includes gum, lozenges, patches, inhaler and nasal spray. The other two, bupropion and varenicline, do not contain nicotine and also help people stop smoking and reduce cravings.

If you have tried using NRT to quit before but it didn’t seem to help, you may want to talk to your health care provider about other forms of NRT, varenicline or bupropion.

Varenicline works differently than other quit-smoking medicines by attaching to the same parts of your brain that are stimulated by nicotine, reducing the urge to smoke. It also makes smoking less pleasurable by blocking some of nicotine’s effects.

Bupropion helps people quit smoking by decreasing craving and other nicotine withdrawal symptoms. We now know that combining NRT patches and gum or lozenges is more effective than using one form alone.

Most people need NRT or take varenicline or bupropion for 12 weeks. Your health-care provider might prescribe it for longer, if needed.

Talk to a health-care provider to get a prescription for varenicline, bupropion or an NRT inhaler. Your doctor will review your medical history to help determine the right prescription for you, and discuss how to use it safely.

Cessation medications are affordable for most Kentuckians. Medicaid and many health insurance plans cover FDA-approved quit-smoking medicines, including varenicline and bupropion.

In addition to medications, counseling is another accessible treatment strategy that increases your likelihood of success. In Kentucky, the free quitline 1-800-QUIT-NOW provides personalized coaching to help you quit tobacco for good.

If you’ve tried quitting before, don’t be discouraged and don’t give up! It can take around 10 attempts to quit for good. Quitting is the most important thing you can do to improve your health and quality of life.

Nov. 17 is American Cancer Society's Great American Smokeout

CDC graphic

By Melissa Patrick

Kentucky Health News

The American Cancer Society's annual Great American Smokeout, a day when smokers are encouraged to quit for the day and make a plan to quit for good, will be observed Thursday, Nov. 17. 

"The Great American Smokeout is more than a reminder of the dangers smoking poses to your health," says the Centers for Disease Control and Prevention. "It’s a call to act. No matter your age, or how long you’ve been smoking, quitting improves health both immediately and over the long term." 

Cigarette smoking continues to be the leading cause of preventable death in the United States and Kentucky, killing 8,900 Kentuckians a year. Nationwide, it kills more than 480,000 people, which is nearly one in every five deaths, says the CDC. 

Kentucky's smoking rates have steadily decreased for years, but the bad news is that nearly one in five Kentucky adults, or 19.6%, still smoke; 41% of Kentucky smokers said they had tried to quit in the last year, according to the 2021 Behavioral Risk Factor Surveillance System survey, a national CDC poll. 

The CDC says quitting smoking is one of the most important actions people can take to improve their health and offers a detailed list of the health benefits, including longer life, lowers risk of 12 types of cancer, lowers risk of heart and lung disease, and lower risk of poor pregnancy outcomes.  

Kentucky smokers have a number of tools to help them quit. 

The state runs a 1-800-QUIT-NOW hotline that offers free tobacco-cessation services. 

"The coaches at Quit Now Kentucky can help you make a plan to quit, manage nicotine cravings and get back on track if you have setbacks. Some people even are eligible for free nicotine-replacement therapy like nicotine patches, gum or lozenges," according to the state Cabinet for Health and Family Services webpage. 

And while Quit Now Kentucky provides free services to people of all ages, middle- and high-school students may want to try "My Life, My Quit," a free, confidential quitline for Kentuckians 17 and younger to help them stop smoking or vaping. Teens can text "Start My Quit" to 36072, or click on the live chat button on the My Life, My Quit website to chat with a coach.    

A 2017 law requires insurers, including Medicaid, to cover all seven tobacco-cessation medications approved by the U.S. Food and Drug Administration, and counseling services recommended by the U.S. Preventive Services Task Force. It also eliminated co-payments for medication and counseling, requirements tying medication coverage to counseling, and limits on length of treatment.

The American Cancer Society also offers a list of resources to help you quit using tobacco products.

Study: Smoking increases risk of viral and respiratory infections, including a coronavirus; supports tobacco control to curb Covid-19

A new study shows that smoking increases the risk of viral infections and respiratory illnesses, including one type of the coronavirus, this supporting efforts to curb tobacco use as a way to thwart Covid-19.  

The University of California, Davis Comprehensive Cancer Center study, published in the Nicotine and Tobacco Research journal, found that current smokers have a 12% increased risk of a laboratory-confirmed viral infection and a 48% increased risk of being diagnosed with respiratory illnesses. These results did not vary by type of virus, including a coronavirus.

“Past research has shown that smoking increases the risk of Covid-19 disease severity, but the risk of infection had been less clear,” UC Davis tobacco researcher and lead author of the study Melanie Dove said in a news release. “Our study findings show smokers have an increased risk of viral infection, including a coronavirus and respiratory illness.”

In combination with past findings, the researchers note that findings from this study support "urgent recommendations to increase tobacco control efforts for countering Covid-19," says the release. 

These findings are especially important to Kentucky, where 23.4% of adults smoke and the state continues to have some of the highest rates of new Covid-19 cases. For help to quit smoking, the state runs a  1-800-QUIT-NOW hotline that offers free tobacco cessation services. 

Data for the study came from a re-analysis of the British Cold Study, a 1986-1989 study that exposed 399 healthy adults to one of five "common cold" viruses, including a strain of the coronavirus that existed prior to the novel coronavirus that causes Covid-19. 

The data showed that current smokers had an increased risk of respiratory viral infection and illness, with no significant difference across the types of viruses. It also showed that the increased association for the mild, common coronavirus that they tested did not reach statistical significance, which the researchers  said was likely due to the small sample size.

"These findings are consistent with known harms caused by smoking to immune and respiratory defenses and some observational evidence of increased Covid-19 infection and disease progression in current smokers. . . . The relative risks from this study can provide an estimate of the strength of associations that can be used to guide tobacco control decisions," says the release. 

The researchers note that one of the  main limitations of this study is that the mild common coronavirus that they tested may have different biological and health effects than other coronaviruses, including the one that causes Covid-19, which means the the findings may not be generalizable to other coronaviruses.

“These findings may have implications for addressing tobacco use at the population level as a strategy for preventing Covid-19 infection,” Elisa Tong, senior author and UC Davis internal medicine professor, says in the release.

FDA proposes ban on menthol cigarettes and cigars, popular among Blacks, whose leaders are divided on the matter

Photo from ash.org

Last week the U.S. Food and Drug Administration announced its long-anticipated plan to ban menthol cigarettes and all flavors in cigars. 

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

When added to cigarettes and cigars, menthol's minty taste and cooling effect limits throat irritation, thereby making the products more appealing to smokers -- especially new and young smokers. The  release adds that menthol also interacts with nicotine in the brain to enhance nicotine's addictive effects and makes it more difficult to quit smoking. 

One study estimates that banning menthol in cigarettes and cigars in the U.S. would lead to a 15% reduction in smoking as early as 2026 and prevent upwards of 650,000 deaths by 2060.

The Washington Post reports on another study published in the peer-reviewed journal Tobacco Control that "found that if a menthol-cigarette ban in the United States were to have the same effect as a Canadian menthol ban, more than 1.3 million additional smokers would quit, including more than 381,000 African Americans." Nearly 85% of Black smokers smoke menthol cigarettes, compared to 30% of white smokers who smoke menthols, says the FDA. 

The proposed menthol ban has divided Black leaders. Ben Crump, a Black civil-rights attorney, told Politico, “There’s a difference between theory and reality. The reality is, we know once you make laws and such then you have local and state actors who use those as weapons to marginalize Black people.”

FDA says it "cannot and will not enforce against individual consumers for possession or use of menthol cigarettes or flavored cigars" and enforcement will only address the industry, but some Black leaders, including Rev. Al Sharpton and others, disagree that this will be the reality. 

The African American Tobacco Control Leadership Council supports the proposed rule. "This is a major step forward in saving Black lives." Dr. Phillip Gardiner, co-chair of the council, said in a statement.   

Gardiner went on to encourage tobacco control activist to continue to fight to ban the sale of menthol tobacco products at the local, state and federal level, noting that the rule-making process and court challenges by the tobacco industry could mean it will be years before this ban could becomes effective.

Stanton Glantz, who continues to conduct tobacco research even after retiring from the University of California San Francisco in 2020, writes on his blog that "FDA has built a strong foundation to justify prohibiting menthol as a characterizing flavor in cigarettes," but its justification for granting exceptions for heated tobacco products and low nicotine-cigarettes "is very weak" and "should be dropped."  

The New York Times published an essay written by Keith Wailoo, a professor of history and public affairs at Princeton University, that provides a detailed walk through the history of how the tobacco industry hooked black smokers on menthols. He is the author of "Pushing Cool: Big Tobacco, Racial Marketing, and the Untold Story of the Menthol Cigarette." 

"After decades of outcries from communities and public health experts about the health inequities and dangers posed by menthol marketing (with the NAACP now urging a ban), the FDA’s proposed rule that would impose the ban, announced April 28, is a long-awaited step that will save hundreds of thousands of lives in the decades to come," Wailoo writes. "We should not be distracted by those who work on behalf of the tobacco industry while claiming to speak for Black health and well-being. They are part of the web that has maintained the stranglehold, enticing consumers with deceptive promises."

The FDA says that in 2019 there were more than 18.5 million menthol cigarette smokers aged 12 and older in the U.S. which included high rates of youth, young adults, African Americans and other racial and ethnic minorities. In 2020 menthol made up 37% of the cigarette market in in the U.S., up from 26% in 2000, according to The Truth Initiative menthol fact sheet. 

The FDA is accepting public comments on its proposed rules for menthol cigarettes and flavored cigars through July 5. 

America's Health Rankings provide a snapshot of Kentucky's health challenges, but also of its recent progress

Kentucky page of report from United Health Foundation; to enlarge or download, click on it.

By Ben Chandler
Foundation for a Healthy Kentucky

As we move into another year, the discussion of New Year’s resolutions and the noble quest for doing some things differently and better comes to the forefront. More than half of all such resolutions are health-related – namely losing weight, better diet, and regular exercise.

Each of us will decide individually what, if anything, we would like to improve during 2022. And perhaps collectively, as a commonwealth, we should consider areas for “self-improvement.” A review of the recently released 2021 America’s Health Rankings might be a good thought-starter. The rankings, released by the United Health Foundation, provide a snapshot of Kentucky’s overall health relative to other states. It does not merely “rank” states against one another; it evaluates each state through a set of health, environmental and socioeconomic categories to help shed light on our health challenges and successes.

The rankings are created to help states determine health benchmarks and establish goals moving forward.

This year’s report reinforces the Foundation for a Healthy Kentucky’s priorities regarding how we can collectively create a healthier commonwealth in 2022 and beyond. The foundation’s priorities include combating obesity, reducing diabetes by improving nutrition, and physical exercise.

Indeed, the report validates these priorities. It indicates 36.6 percent of Kentucky adults are obese (compared to 31.9% nationally), a higher percentage than all but five states. Kentucky ranks 50th in two other categories of concern – the amount of vegetables and fruit consumed, and physical activity and exercise.

It is my hope that individual Kentuckians, their communities, their local and state government representatives, and health-care advocates – among others – can have open, candid dialogue about increasing opportunities for physical activity and ensuring more access to healthy food. For Kentucky school children, stronger nutritional standards, increased participation in school nutrition programs, and quality physical education are needed.

As an organization whose mission is to address unmet health needs of Kentuckians by developing and influencing policy, improving access to care, reducing health disparities, and promoting health equity, we view these rankings as a call to action for leaders in government, health care, education and social services … as well as for individual Kentuckians.

Though Kentucky has the second highest percentage of adults who smoke tobacco products, there is a ray of good news: Smoking among adults has declined 26 percent during recent years – from 29% in 2011 to 21.4% in 2021.

While that is a positive trend, there is much more work to be done. Every Kentuckian who smokes should strongly consider quitting as a 2022 resolution. Tobacco-use prevention and cessation programs are available, though more funding is critically needed.

It is encouraging to see we are ranked 14th for percentage of residents (93.6%) covered by private or public health insurance. But barriers to health-care access remain. Consider that Kentucky ranks 42nd for percentage of homes lacking reliable internet. Kentuckians need this access to tap into telehealth services. Though telehealth was less common pre-pandemic, it is here to stay and a necessity for residents with limited access to transportation or who live an hour or more from the nearest health-care provider.

Another noteworthy but negative item from the report: Kentucky ranks 45th for non-medical drug use among adults and 42nd for drug deaths. Kentucky’s substance-use epidemic is spiraling in a dangerous direction. There is a crisis-level need for funding and support for expanded prevention, treatment and mitigation services.

While some may view the rankings as daunting, it’s important we view them as points of reference for Kentuckians’ health. Now is the time to challenge one another – to push for new and better ways to make our entire commonwealth healthier.

Ben Chandler is president and CEO of the Foundation for a Healthy Kentucky.

Baptist Health offers a free, one-hour, online class to help smokers quit; the next one is scheduled for Wednesday, Jan. 12

"Quitting tobacco is one the most common New Year’s resolutions made each year, but often proves to be one of the most difficult to keep," Baptist Health says in a news release about its free, online class in how to quit.

Quitting is tough for most people. The Centers for Disease Control and Prevention says more than half of adult smokers try to stop smoking but only one in 10 succeed. The pandemic is making it even tougher for many to quit, says Crystal Labbato, a certified tobacco-treatment specialist with Baptist Health.

“The pandemic has been so hard and isolating, and smoking is a common way to cope with stress,” Labbato says in the news release. “If you don't have alternative coping techniques, then you tend to fall back on the thing you know best. Unfortunately, smoking happens to be that for a lot of people.”

Labbato is the leader of "Plan to be Tobacco Free," the free one-hour class offered by Baptist Health and the Kentucky Cancer Program. The one-time online class, next scheduled Jan. 12, helps viewers learn about tobacco and nicotine addiction, over-the-counter replacement products and how to develop a personal plan to quit.

Labbato offers these tips for those in the class, and to anyone trying to quit:

If at first you don’t succeed, try, try again: In Labbato’s experience, it can take many attempts before someone is able to quit tobacco for good, because nicotine is so addictive and behavior is hard to change. She urges her patients not to get discouraged if their first try doesn’t work out.

“I always like to remind people that quitting smoking is probably the hardest thing they will ever do,” Labbato says. “It took you a while to learn how to smoke, it’s going to take you a while to learn how to live as a nonsmoker. The only thing that matters is that you keep showing up and you keep trying, because you will get there.”

Smokers who want to quit should review their past attempts, she says, to find a new strategy that will work. “I think you learn something new about yourself at each quit attempt, so with each try you bring along new skills that you've learned from the last try,” she says.

Don’t be afraid to ask for help: Quitting tobacco for good takes more than willpower, and health-care providers can be important partners to get you the resources you need.

“We've moved away from talking about smoking and continuing smoking as a moral failure,” Labbato says. “Nicotine addiction is a physiologic process is happening in your brain. our doctor can help you get real treatment, so always be honest about tobacco use.”

Labbato says medicine and counseling can double the chances of quitting. The Food and Drug Administration has approved seven medications to help smokers quit, which are reviewed in the "Plan to be Tobacco Free" class.

“The idea behind using medications is to calm down the mind and the withdrawal symptoms that cause anxiety . . . so you can work on the behavioral changes and new coping skills that you need to develop to walk away from cigarettes,” Labbato says.

A personalized plan can increase chances of success: In her one-on-one counseling sessions, Labbato works with patients to create a customized stop-smoking plan. To find new coping skills, for example, she asks them to think about where they find relaxation, which might be talking to a trusted friend.

Other recommendations can include increasing the amount of water you’re drinking, reducing alcohol and caffeine, or increasing physical activity.

“Personalizing it for the individual is important,” Labbato said. “What their sources of strength are, what are the sort of healthy coping patterns that they've used in the past, and we've also worked to explore new coping pattern, so that's an essential part of any quit plan.”

Register for "Plan to be Tobacco Free": The next free, one-hour, online class is scheduled for Wednesday, Jan. 12. More information and registration are at www.BaptistHealth.com/event/plan-to-be-tobacco-free-louisville.

Legislature will again be asked to let local governments pass tobacco-regulation ordinances, aimed at preventing youth use

By Melissa Patrick
Kentucky Health News

Kentucky lawmakers can expect another bill to be filed in January to give local governments the ability to regulate tobacco products, touted as a another tool in the box to limit young people's use of the products, advocates said on a training webinar Wednesday. 

The Foundation for a Healthy Kentucky "Health for a Change" webinar provided education on the potential impacts of local tobacco control in anticipation of 2022 legislation that would restore local control over the marketing, sale and distribution of tobacco products. 

Sen. Paul Hornback

Republican Sen. Paul Hornback of Shelbyville said on a recorded video that he supports repealing the law, adopted in 1996 after lobbying by tobacco-product manufacturers, that stripped local communities of the power to regulate the sale, marketing and distribution of such products. 

"As a father, grandfather, lawmaker, tobacco farmer, I'm outraged at the the marketing tactics that have been used to attract our youth, leading to more than one in four Kentucky high schoolers using e- cigarettes. . . . Please join me today in support of repealing the old law and restoring local control to our communities and protecting our youth," Hornback said. 

He added, "Restoring these options does not create a mandate to pass laws, it only gives communities that are ready the opportunity to enact their own protections." Hornback announced in June that he will not run for reelection in 2022. 

Mahak Kalra, chief policy and advocacy officer for Kentucky Youth Advocates, applauded the General Assembly for its efforts to curb youth use of tobacco products: passing a statewide tobacco-free school policy, increasing tobacco taxes and raising the legal minimum age to buy tobacco products to 21.

"The commonwealth is trying to continue to build off this legislative momentum," Kalra said. "Everyone from policymakers to advocates to educators to parents need to be involved in this effort from keeping tobacco products away from our children and we hope that you alongside of your alongside your network of advocates will join us in this effort." 

Sen. Julie Raque Adams, R-Louisville, who sponsored a local-control bill in the 2021 session, said at the Kentucky Voices for Health annual meeting that it will be hard for such a bill to gain traction during a session in which the legislature must pass a state budget. "We're going to have to fight to get some airtime on that issue," she said. "We only have so much bandwidth."

Kalra said that while tobacco products are evolving, the tobacco industry's tactics to get products into the hands of youth have remained the same since the 1960s and that every effort should be made to minimize youth exposure to these products. 

"The reality is that nearly 90% of tobacco users first try a tobacco product by age 18. But if they did not start using nicotine by age 26, they are unlikely to never start," she said. 

Allison Adams, vice president for policy at the health foundation, painted a picture of youth use of tobacco in Kentucky. She said nearly 30% of high schoolers report using any tobacco product and 19.7% of middle schoolers are using some sort of tobacco product, the highest rate among the 11 states surveyed. 

Adams said that among current high school users of electronic cigarettes, 43.6% use vapes frequently (20 or more days in past 30 days) and 27.6% use them daily, indicating a strong dependence on nicotine among our youth that will ultimately result in 119,000 Kentuckians to die prematurely from tobacco use. 

Foundation for Healthy Kentucky graphic

"Time is of the essence to add more tools to our toolbox," Adams said. "We can't express enough the urgency of the issue to stop the nicotine addiction that we are experiencing and seeing in Kentucky amongst our youth."

Katherine Morrison, a youth advocate from McCracken County, said vaping is a real problem in her school and that many youth who would never consider smoking traditional cigarettes will use electronic cigarettes because of their flavors and lack of an offensive smell. 

If the 1996 law is repealed, local communities would have the option to enact ordinances to keep children from being exposed to the products, such as buffer zones for sales of vaping products near schools, requiring products to be under a counter rather than point-of-sale locations, and restricting advertising on marquees or store windows, said Shannon Smith of the American Heart Association. She said local communities would still not be able to raise taxes on tobacco or vape products. 

Prestonsburg Mayor Les Stapleton said he supports legislation that allows local control because communities know what works best for them. He said some will be more willing to enforce stricter measures than others.

Smith promoted the Nix the Next campaign, which seeks support for repealing the 1996 law. The Kentucky Youth Advocates webpage for the campaign includes information on ways to contact legislators about the issue.

Study: E-cigarettes don't help smokers stay off combustible cigs

truthinitiative.org photo

By Melissa Patrick

Kentucky Health News

Switching to electronic cigarettes don't help smokers stay off traditional cigarettes, according to a recent study. 

“Our findings suggest that individuals who quit smoking and switched to e-cigarettes or other tobacco products actually increased their risk of a relapse back to smoking over the next year by 8.5 percentage points compared to those who quit using all tobacco products,” John P. Pierce, distinguished professor at the University of California San Diego and first-named author of the study, said in a news release. 

“Quitting is the most important thing a smoker can do to improve their health, but the evidence indicates that switching to e-cigarettes made it less likely, not more likely, to stay off of cigarettes,” Pierce said.

The study, published in the medical journal JAMA Network Open, used data from the nationally representative Population Assessment of Tobacco and Health longitudinal study. It identified 13,604 smokers who were surveyed from 2013 to 2015 to explore changes in use of 12 tobacco products.

At the first annual follow-up, 9.4% of the established smokers had quit. Among the quitters, 62.9% remained tobacco-free and 37.1% switched to another tobacco product. Among the switchers, 22.8% used electronic cigarettes, and 17.6% of them used e-cigarettes daily.

At the second annual follow-up, the authors compared the former smokers who were tobacco free to those who had switched to e-cigarettes or other tobacco products. They found that the switchers were more likely to relapse than former smokers who had quit all tobacco, by 8.5 percentage points.

“This is the first study to take a deep look at whether switching to a less harmful nicotine source can be maintained over time without relapsing to cigarette smoking,” said Pierce. “If switching to e-cigarettes was a viable way to quit cigarette smoking, then those who switched to e-cigarettes should have much lower relapse rates to cigarette smoking. We found no evidence of this.”

This study was released soon after the U.S. Food and Drug Administration authorized three electronic cigarette products, saying they met the federal standard of protecting public health because study participants who used the products were exposed to fewer harmful chemicals, and the aerosols in those products were significantly less toxic than combusted products. 

However, the FDA emphasized in a news release that the products were not "FDA approved" because "All tobacco products are harmful and addictive, and those who do not use tobacco products should not start."

Audrey Darville, a certified tobacco-treatment specialist and an associate nursing professor at the University of Kentucky, cautioned that it's important to remember that the FDA's marketing approval was related to harm reduction, and not as a smoking-cessation device. 

"I think that's a big indicator that, you know, even the tobacco industry is not finding that the evidence is there, or is clear that these are actually effective for," she said. "So, is switching going to be better for health? Yes, probably. But is it going to keep people off of combustibles? Again, what this study shows is that it is not."

Darville also said electronic cigarettes are not entirely harmless because of the impact they can have on the cardiovascular system, and noted that the long-term impacts of them are still not known.  

She said more research is needed to find out what works to help people quit vaping, noting that e-cigarettes are a different delivery system for nicotine than combustibles, often at higher concentrations.

Also, vapers use the products in a "more continuous" manner, "especially when they're highly addicted; they'll be vaping during the night, they wake up and take a hit off of a vape."

All of this adds up to strong addictions because of the increased exposure to nicotine, she said. 

"All tobacco products are harmful, and addictive," Darville said. "That JAMA study acknowledges the strength and the power of that addiction, and that switching to e-cigarettes, as nice as it would be to have a magic bullet, is not going to be the panacea that the tobacco-cessation community is hoping for." 

According to the Centers for Disease Control and Prevention, in 2018 14.9% of U.S. adults had ever used an electronic cigarette, and 3.2% were current users. A 2018 Kentucky Health Issues Poll found that 24% of Kentucky adults had ever used an e-cigarette and 8% of that group used them regularly. In Kentucky, 23.4% of adults are smokers, more than any state but West Virginia.

The state health department offers a service called Quit Now Kentucky to help Kentuckians of all ages quit smoking. To learn more go to QuitNowKentucky.org, text QUITKY to 797979 or call 1-800-QUIT-NOW.

Ky. Center for Smoke-Free Policy honors communities, groups and individuals who work to create smoke-free communities

McCracken County Family, Career and Community Leaders of America got the Smoke-free Youth Advocate Award for pushing secondhand-smoke education and smoke-free policy. (Univ. of Ky. photo)

By Melissa Patrick

Kentucky Health News

The Kentucky Center for Smoke-free Policy at the University of Kentucky honored communities, groups and individuals from across the state who are making progress in creating healthier, smoke-free communities Aug. 3 at a virtual awards ceremony.

“The actions taken by these remarkable government, health, and youth leaders to protect the public health is truly inspiring,” Ellen Hahn, professor of nursing and KCSP director, said in a news release. “Despite challenges, all sectors of the community are coming together to attack the massive health and economic threat from tobacco use in the commonwealth.”

The event was also hosted by the Kentucky Tobacco Prevention Program, the state Department for Public Health and the UK College of Nursing. 

State Health Commissioner Steven Stack opened the meeting with praise for the advocates who work to promote smoke-free policies across the state, while acknowledging that there is more work to be done.

"You have saved lives and improved health and well-being in the Commonwealth of Kentucky through your efforts and your actions," he said. 

This year's awards include: 

The McCracken County chapter of Family, Career and Community Leaders of America earned the Smoke-free Youth Advocate Award for excellence in promoting secondhand-smoke education and smoke-free policy.

The Lee T. Todd Jr. Smoke-free Hero Award was presented to Anthany Beatty, retired assistant vice president for public safety at UK, for his courage, leadership, perseverance, and continuous commitment to smoke- and tobacco-free environments in the face of adversity.

Felicia Troutman of Owensboro Health, received the Timothy W. Mullett, M.D., Lung Cancer Prevention Award for her leadership, devotion, and passion toward preventing the disease.

The Lifetime Achievement in Tobacco Control Award was presented to Donna Teegarden, retired health promotion manager with the Bracken County Health Department, for her exceptional leadership in tobacco control.

Rebecca Horn of the Green River District
Health Department was named the David B. 
Stevens Smoke-free Advocate of the Year.

Madison County Schools received the Tobacco-free Campus Award for their leadership and collaborative efforts in promoting a healthy campus environment by implementing a 100% tobacco-free campus policy.

Knott County received the Everette Varney Smoke-free Indoor Air Excellence Award for enacting a comprehensive smoke-free workplace ordinance.

Rebecca Horn, public health services manager at the Green River District Health Department, was named the David B. Stevens, M.D., Smoke-free Advocate of the Year for excellence in promoting secondhand smoke education and smoke-free policy. 

Three additional advocates were nominated by their peers for this award: Shirley Roberson Daulton (Lake Cumberland District Health Department), Sherrie Stidham (Kentucky River District Health Department), and Breanna Williams (Northern Kentucky District Health Department).