Monthly Archives: September 2013

Michael McFadden’s questions re. Dr. Loomis’ study: “Smoking ban would not hurt state’s bars and restaurants”

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The article by reporter Blythe Bernhard, “Smoking ban would not hurt state’s bars and restaurants,” appeared in the August 8th, 2013, St. Louis Post-Dispatch, the study making something of an impression. It was also reproduced on this blog.

One pro-smoking critic of the study was Michael McFadden, who wrote to the study’s primary author, Dr. Brett Loomis, with a list of questions. He followed up with reminders but never received a reply.

Although I don’t necessarily agree with Michael McFadden, or have reason to doubt the validity of Dr. Loomis’s study, I offered to post Michael’s abbreviated list of questions on this blog to give them a public airing, as below:

Michael McFadden caption

Michael McFadden

MoGASP has allowed me to respond to the August blog entry on the CDC study by sharing a condensation of the email I sent, and re-sent, to Dr. Loomis, the study author. Although my questions about his work were simple, straightforward, and clearly deserving of a response, none was made. I feel that such non-response is both poor form and also speaks to the overall judgment of the validity of the original research.
         I thank MoGASP for helping to “balance the books” on the blog that he presented in good faith on the basis of the initial press release and publicity, although it’s unlikely this “balance” will achieve anywhere near the amount of internet and media coverage of the original.

Dear Dr. Loomis,

Can you help me with some specific quick questions to help me understand your CDC study better so I can represent it fairly? Thank you!

Mike McFadden

(1) Your WVA analysis showing restaurant improvement used NAICS coding separating bars and restaurants but the separation was unclear in the other seven states:
         “We found no significant association between smoke-free laws and economic outcomes in restaurants and bars in 7 of the 8 states.”
         Clearly you are saying that neither restaurants nor bars were hurt, but the word “and” rather than “or” opens the possibility you were speaking only overall.
         Did you actually find no significant losses in restaurants OR bars anywhere?

(2) If there were no significant changes in any state’s bar OR restaurant revenue other than WVA, it is informative but what about non-significant changes? If 12 of the remaining 13 sectors all had non-significant gains or all had non-significant losses, that result would carry some meaning.
         What was the actual breakdown?

(3) Since bar losses would ordinarily be expected, did you test for significance with a one-tailed 90% test?
         If not, why not?

(4) You say, “we combined data from all counties for which data were available, whether smoke-free or not, and compared the average effect of smoke-free laws in counties that contain smoke-free communities with counties that have no smoke-free communities.”
         Am I correct in understanding you compared changes in bar employment between 2000-2010 in counties that banned smoking as compared to bar employment in that period for the ten counties that continued to permit smoking?
         Is that what you compared and found no differences?

And, related to that:

(5) Did you examine changes in bar employment in counties where smoking had become banned only in restaurants?
         If so, did you run separate analyses then for (A) no ban counties, (B) partial ban counties, and (C) full ban counties?

(6) Is the grant proposal for this research publicly available?

2013-09-26 P-D: “Booming sales of e-cigarettes attract big-time marketing and more calls for regulation”

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Today’s St. Louis Post-Dispatch had an in-depth report by Tim O’Neil into how e-cigarettes, which remain unregulated, are catching on locally, and simultaneously causing increasing concern among health and tobacco control groups. It’s hard to know why the FDA is dragging its feet on this issue.

The article was front page above the fold on page B1 of the Health section and continued on page B4. The printed newspaper’s headline was E-cgarette sales boom draws praise, concern, with the subhead: Users tout healthier effects; anti-smoking groups call for regulations.

As of 8:00 pm Thursday, September 26, there were 49 comments, but a quick search did not turn up any of those commonly railing against smoke-free air regulations.

Booming sales of e-cigarettes attract big-time marketing and more calls for regulation
By Tim O’Neil toneil@post-dispatch.com 314-340-813246

Harry Kholer vaping in his store - substitute wording

Harry Kholer, who is opening a new store, Move2Vapor, with his wife, Donna, in south St. Louis County. What appear to be cigarette smoke is actually water vapor from Kholer’s electronic cigarette. Photo by Erik M. Lunsford, St. Louis Post-Dispatch

It smells vaguely like cooling steam.
         Kholer, 67, is a “vaper,” a true-believing practitioner of electronic cigarettes, or e-cigarettes. He said he took up cigarette smoking at age 8, burned through three packs a day for decades and developed emphysema. He didn’t quit until he took his first hit of an e-cigarette three years ago.
         “I still have the habit, but I’m not inhaling all the bad stuff,” he said at his home in Mehlville. “I get all the nicotine I need.”
         His nonsmoking wife, Donna, chimed in: “Had he not switched to these, he’d be dead by now.”
         That’s what they tell all their customers. Harry and Donna Kholer sell e-cigarette kits with devices they import from China and liquids they mix for the faux-smoke sensation. Their Move2Vapor is a mom-and-pop business in a wide-open, burgeoning and unregulated market that is attracting the big tobacco companies, which are launching advertising campaigns and pushing slick display cases in convenience stores.
         Anti-smoking organizations are pressing the federal government to at least regulate the devices, if not restrict them pending lengthy studies. Last week, 16 organizations, including the American Lung Association and the American Academy of Family Physicians, urged President Barack Obama to press the Food and Drug Administration to quickly approve regulations.
         “This delay is having very real public-health consequences,” the letter said.
         On Tuesday, 40 attorneys general, including Missouri’s Chris Koster and Illinois’ Lisa Madigan, followed up with a similar pitch to the FDA. The agency has said it will produce something by Oct. 31, but previous such dates have come and gone.
         Erika Sward, national spokeswoman for the Lung Association, said there has been too little research into the claims of e-cigarette sellers and too much marketing that looks disturbingly like the bad old days. Cigarette ads were banned from TV in 1971.
         “These are classic tobacco-industry tactics, using flavors and glamorizing smoking,” Sward said. “There has been very little research on the contents of these things, and we don’t want to take the industry’s word for it.”
         On Sept. 5, the federal Centers for Disease Control and Prevention said the number of youths who have tried e-cigarettes more than doubled from 2011 to 2012. That report helped inspire the latest calls by anti-smoking groups.
         The FDA once banned the importation of e-cigarettes, but a federal appeals court overruled the agency in 2010. The court said the agency could regulate them, and anti-smoking groups are impatient for action.
         It all has happened quickly. Invented in China, e-cigarettes were oddities in the United States even only a few years ago. Users were likely to draw stares and ridicule. Industry watchers say that at least 250 companies sell them in this country, many over the Internet. Nobody’s sure.
         Meanwhile, annual sales growth has been about 30 percent, says Wells Fargo Securities analyst Bonnie Herzog in New York, who monitors the tobacco business. She estimated that e-cigarettes could churn $1.8 billion in sales this year and surpass cigarette use by 2023.
         Lorillard Inc. of Greensboro, N.C., seller of Newport and Kent cigarettes, is marketing an e-cigarette called Blu, with ads featuring actor Stephen Dorff and actress-model Jenny McCarthy, who speak of guilt-free puffing. They confidently exhale their drags, just like Humphrey Bogart and Lauren Bacall did in the movies 60 years ago.
         E-cigarettes come in different styles but in two parts — a battery, often hidden in what looks like the tobacco part of a cigarette, and a cartridge that holds the liquid. The cartridge often resembles a filter. The liquid usually is propylene glycol — stage smoke — and is mixed with nicotine and one or more of many flavors, including standard tobacco.
         When a “vaper” sucks on the device, the battery powers a coil that heats enough liquid to create the inhaled vapor. The user then exhales as with a cigarette.
         Kholer said inhaling and exhaling are psychologically important to many former smokers, making e-cigarettes more attractive than nicotine gum or patches. Sward, of the Lung Association, said it would be better for smokers to use FDA-approved cessation methods.
         E-cigarettes have some support in the medical world as a workable lesser evil. Dr. Walt Sumner, associate professor of medicine at the Washington University School of Medicine, has studied the issue and interviewed vapers and believes e-cigarettes are a safer way for people addicted to nicotine to get that drug, if they must have it.
         Sumner said the vapors probably aren’t dangerous and certainly are much better than tobacco smoke — for smokers or people around them.
         “I have been to vaper meetings and people have exhaled toward me all day, and I’ve had no reaction at all,” Sumner said. “Anecdotally, people who use them say they feel better and believe it a better way to manage their nicotine problem.”
         He opposes any use by young people. “Early exposure to nicotine causes changes in the brain that makes addiction more likely,” he said.
         Banning sales to teens also seems to be popular among many fledgling e-cigarette advocacy groups, such as the Tobacco Vapor Electronic Cigarette Association and Consumer Advocates for Smoke-free Alternatives. But no single group has arisen as the authoritative voice.
         In all but a few cities across the country, no-smoking ordinances governing public places don’t apply to e-cigarettes. Craig LeFebvre, spokesman for the St. Louis County Health Department, said vapers can puff away at local restaurants. He said the department has received few complaints, and not many more calls from people asking if they are legal.
         In St. Charles County, where smoking is allowed, local vapers hold periodic gatherings at Side Pockets, a sports bar and restaurant in St. Louis. Chantel Davis, the manager there, is glad to have them.
         “The vapers are 1,000 times better to be around than regular smoke,” said Davis, a former smoker. “I can’t really smell it. It doesn’t stick to my hair.”
         The early vapers were brave people, she said, because of the kidding they received. “But now a lot of people are doing it,” she said.
         Martin Pion of Ferguson, a longtime anti-smoking activist in the St. Louis area, said he generally concedes their value to addicted smokers, but doesn’t like the trend toward glamorous advertisement. Pion said he wants the FDA to regulate e-cigarettes — and wants local ordinances amended to keep them out of public places.
         “If they are allowed in restaurants, there will be never-ending confusion,” he said.

2013-09-09 P-D: “St. Charles County discusses new proposal for smoking ban”

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Council Joe Cronin’s latest proposal for a smoke-free air bill in St. Charles County got mixed reactions at the county council meeting on Monday, despite his best efforts to assuage critics, while hoping supporters of secondhand smoke legislation will remain on board.
from everything that’s going to hurt them
It remains to be seen where this will go, given the inability of opponents to view this issue as they do other public nuisances or issues affecting the public health and welfare.

Below is the story by reporter Mark Schlinkmann, followed by letters from both Councilman Joe Cronin, clarifying some points in his bill, and Bill Hannegan, lauding Councilman Cronin’s initiative while describing more comprehensive local smoke-free air regulations as “Draconian.”

St. Charles County discusses new proposal for smoking ban

September 09, 2013 11:05 pm • By Mark Schlinkmann mschlinkmann@post-dispatch.com 636-255-723330

ST. CHARLES COUNTY • Almost a year after a judge blocked its last plan for a countywide smoking ban, the St. Charles County Council began discussing a new version on Monday night. But it wasn’t immediately clear what the outcome would be.

Councilman Joe Cronin, St. Paul

Councilman Joe Cronin, St. Paul

“I want to make the county a healthier place while preserving business rights,” said the sponsor, Councilman Joe Cronin, R-St. Paul.
         An opponent, Councilman Joe Brazil, R-Defiance, called the bill “another way of whittling away that stick of freedom … that gets smaller and smaller and smaller.”
         The proposal would ban smoking in all businesses and other enclosed public places except those off limits to people under age 21 as customers or employees.
         That would exempt gambling areas at the Ameristar Casino in St. Charles and bars in most parts of the county. Cronin also emphasizes that other businesses also could choose to be exempt by imposing the age restriction. An example, he said, might be an auto parts store where most of the customers are adults.
         Harold Ellis, the acting county counselor, said the bill also would allow a restaurant or other business to go smoke-free but operate an adjoining 21-and-older bar if separated by walls and doors.
         Unlike past council-endorsed bans, Cronin’s new bill wouldn’t go before voters at an election. Instead, it would become law if it wins approval of the council and County Executive Steve Ehlmann. Ehlmann and the county health director, Julie Eckstein, didn’t take a position on the bill Monday.
         Besides Cronin, two councilmen indicated they might support it. However, each said they still wanted to put whatever the council devised on the issue before voters.
         Brazil was joined by another councilman in opposing the bill. Two others said they were undecided, although one of them, Mike Elam, R-Dardenne Prairie, said he was wary of a tendency of government to try “to protect everybody from everything that’s going to hurt them.”

Sharon Lee

Sharon Lee

Sharon Lee, who directs the Siteman Cancer Center at Barnes-Jewish St. Peters Hospital, spoke in favor.
         “Some may say (the bill) doesn’t go far enough, but we have to start somewhere,” she said.
         Carol Gold, owner of the South 94 Bistro in St. Peters, complained that the bill would pick “winners and losers” among businesses. “It should be our choice to decide” on smoking, she said. Also opposed was Dave Beckering, president of the St. Charles City Council, who said there wasn’t any consensus countywide on the issue.
         The new bill would apply both to unincorporated areas and municipalities. However, cities could enact stricter laws, and current ones in place in O’Fallon and Lake Saint Louis would remain. Those two cities have no exceptions for bars.
         Last year, the County Council approved putting two propositions before voters. One was a countywide ban with no exceptions and the other an exemption bill with the 21-and-older limit. Each was kept off the November ballot by a judge who ruled that the council didn’t comply with proper procedures.

Letters, St. Louis Post-Dispatch, September 11, 2013:

St. Charles County bill gives businesses a choice on smoking

Regarding “New smoking ban effort is under way in St. Charles County” (Sept. 7):

         As the author of the bill noted in your article, I would like to make several clarifications that were not expressed by your writer. The most important being that under this proposed law, all businesses have a choice as to whether they become a smoking establishment or a smoke-free establishment. They need only post a readily available sign to let the public know their smoking status. But, if they allow smoking on their premises, they would have to ban admittance to those under age 21 as secondhand smoke is a known public health threat.
         Additionally, if a business chose to have an indoor area for smokers and nonsmokers, this law allows it as long as the areas are separated by walls and doors, have separate outside entrances, and separate ventilation systems.
         Also, administration, interpretation and implementation of this law is not handled by elected officials, but placed in the hands of the Department of Community Health and the Environment. And the benefit of having this law implemented by ordinance, instead of a vote of the people with a county charter amendment, is that this law can be changed by future elected councils to serve the residents at that time.
         The bill was crafted to address secondhand smoke, a known public health threat that kills 1,100 Missourians per year, while allowing businesses a choice and the smallest possible impact on property rights.
         Hopefully, it is a compromise that most St. Charles County residents and businesses can literally live with.

County Councilman Joe Cronin • St. Charles County

Letters, St. Louis Post-Dispatch, Saturday, September 21, 2013:

Consider smoking regulations, not a ban, in St. Charles County

Bill Hannegan

Bill Hannegan

The St. Charles County Council should take a hard look at Councilman Joe Cronin’s new public smoking ordinance (“St. Charles County discusses new proposal for smoking ban,” Sept. 10). Unlike his previous proposals, this ordinance is really not a true smoking ban. Rather it is public smoking regulation that attempts to keep kids away from smoke while respecting the free choice of business owners.
         Under this ordinance, any business owner can still allow indoor smoking as long as specified measures are taken to keep minors separate from smoke. Cronin rightly points out that if enacted such comparatively mild regulation might forestall the Draconian smoking ban St. Charles County bar and casino owners so strongly fear.

Bill Hannegan • St. Louis

2013-09-07 P-D: “New smoking ban effort underway at St. Charles County Council”

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County Councilman Joe Cronin is trying again to make progress on the secondhand smoke issue in St. Charles County. His proposal contains loopholes which may gain support from the likes of Bill Hannegan but at the possible expense of losing support from those wanting more effective smoke-free air legislation.

New smoking ban effort underway at St. Charles County Council

September 06, 2013 10:30 pm • By Mark Schlinkmann mschlinkmann@post-dispatch.com 636-255-723339

Councilman Joe Cronin, St. Paul

Councilman Joe Cronin, St. Paul

ST. CHARLES COUNTY • After two near-misses since 2011, County Councilman Joe Cronin is launching another effort to pass a countywide smoking ban.

Cronin’s new version, to be introduced Monday, would apply to all businesses and other enclosed public places except those off limits to people under age 21 as customers and employees.
         That mainly would exempt gambling areas at the Ameristar Casino in St. Charles and bars in most parts of the county.
         Cronin, R-St. Paul, called it a compromise. “This isn’t 100 percent of what any one group wants” but something everyone can support, he said.
         Whether that will happen is unclear, based on the mixed reaction Friday from council members and others.
         Unlike previous council efforts on this subject, the bill wouldn’t require approval by voters at a countywide election. Instead, it need be passed by only the council and signed by County Executive Steve Ehlmann.
         “I think it has a chance,” Council Chairman Terry Hollander, R-St. Charles, said Friday. He said he was “somewhat in agreement” with the bill but hadn’t decided how he’d vote.
         Pat Lindsey, acting executive director of Tobacco-Free St. Louis, called the bill “a very small step forward” limited by the over-21 exemptions.
         “We would probably not be in favor because it’s not inclusive enough,” she said. However, “at least people could go out to eat” in restaurants without being exposed to smoke.
         Carl Bearden, a former state legislator and county councilman who led last year a business group opposed to strict bans, said the new bill had some merit because of the exemptions.
         However, he said it would still hurt other businesses such as restaurants and bowling lanes. “It’s better than what’s been proposed” in the past, he said.
         As with the previous council smoking ban proposals, Cronin’s new measure would apply both to unincorporated areas and to municipalities.
         But cities could enact stricter laws, and existing ones in place in O’Fallon and Lake Saint Louis would remain. Those two cities have no exemptions for bars.
         Cronin said Ehlmann, who in June 2011 vetoed a council-endorsed ban, had yet to weigh in on his new bill.
         Ehlmann objected to the 2011 bill because it applied to bars and restaurants but exempted the casino, cigar bars and parts of hotels. He said a health ordinance shouldn’t have such exceptions.
         A different approach approved by the council last summer was kept off the ballot by a judge who cited procedural reasons.
         In that plan, voters would have decided two propositions — one a countywide smoking ban with no exceptions and the other an exemption bill with the 21-and-older limit.
         Councilman Joe Brazil, R-Defiance, opposed that plan and is against Cronin’s new bill as well. “Government doesn’t need to be involved” in decisions that should be made by business owners and customers, he said.
         Councilman John White, R-St. Charles County, said the new measure is “pretty weak” but a step in the right direction. However, he said he will insist that the bill be put before voters.
         He also wants to require businesses getting an age-related exemption to provide separately-ventilated areas for non-smoking customers.

2013-07-12 P-D: New health concern about e-cigarettes?

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Dave Coverly recently raised a new health concern about e-cigarettes which I hadn’t seen before. It appeared in the July 12, 2013, Everyday section of the St. Louis Post-Dispatch and Mr. Coverly kindly agreed to its reproduction on this blog:

Speed bump by Dave Coverly bmp130712dAPC

Reproduced with permission from Dave Coverly, creator of the Speed Bump cartoon at www.speedbump.com

Funnily enough, e-cigarettes were actually making the news both in Friday’s St. Louis Post-Dispatch and also on Saturday’s national TV. Here’s the link to the Post-Dispatch story:

STUDY: CHILDREN’S USE OF E-CIGARETTES INCREASING

"Blue" cigarette ad

“Blu” cigarette ad featuring Jenny McCarthy

Originally, it seemed that e-cigarettes were being promoted mainly as a way for smokers to quit or at least reduce the risks from smoking regular cigarettes. However, increasingly they’re being glamorized in ads just as regular cigarettes were in the past, as in this example promoting Blu e-cigarettes, featuring actress & model Jenny McCarthy, with the tag line “freedom to have a cigarette without the guilt.”