Bullitt County, KY (E-Cigarette FOIA Request Result)

8/4/2019 Bullitt County, KY (E-Cigarette FOIA Request Result)

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Jett, Swannie (LHD - Bullitt Co)From:Sent:To:Cc:Subject:Attachmehts:

Flag Status:

Riker, Carol A [riker@email,uky.eduJTuesday, December 14, 20108:58 AMJett, Swannie (LHD - Bullitt Co); Brown, Cynthia G (LHD-Bullitt Co); Taylor, Brittany P (LHD-Bullitt Co)Hahn, Ellen J; Mundy, Monica E; Johnson, John DBG Institute article and info re BOH regulationsBOH Regulations suggested updates 112910 EH.pdf; ecig_onepager.pdf; tobcont KCSPHookah Indoor AQ One Pager.pdfCompleted

Hi Swannie, Cynthia, and Brittany,Hope you all are surviving this arctic blast!Amanda Fallin on our team found this article on the Bluegrass Institute's website and we wanted to make sure you allhad seen it. It sounds like Jim Waters came to your forum in Hiilview. (Someone was at the last forum spouting the samethings about working smoke-free to support the health depar tment's payroll .. they're really reaching!)Also wanted to send you some new information on BOH regulations. With Scott Lockard's blessing we have developedSuggested Updates for BOH regulations in KY; it's based on the Clark Co regulation. As you know, Madison County BOHhas had first reading on some amendments to their regulation to eliminate the tobacco retailer exemptions and includee-cigarettes in the definit ion of smoking. Madison is updating because they had several requests for waiver of theirregulation for Hookahs, so I'm attaching in fo on Hookahs.At first reading in Madison several people spoke against including e-cigarettes, saying they were using them to "quitsmoking." After first reading the BOH received numerous written comments to the same effect, with copies to the localnewspaper. Several came from "health" entities, primarily those in the "harm reduction" camp. I hope you will find thee-cigarette one-pager helpful to refute comments that they are "safe" and can help people quit. Research to date showsthat nicotine levels in e-cigs vary widely regardless of labeling. At the very least users will send nicotine and othercomponents back into the indoor air through exhalation, where the whole third hand smoke dangers begin.Let us know how we can be helpful as you go forward.Thanks,Carol RikerCarol Riker, RN, MSNAssociate ProfessorProvost's Distinguished Service ProfessorCommunity Advisor, Rural Smoke-free Communities555 College of NursingUniversity of Kentucky751 Rose StreetLexington, KY 40536-0232Phone: 859-323-6615Fax: 859-323-1057Cell: 859-619-3776www.mc.uky.edu/tobaccopolicywww.kcsp.uky.edu

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Find kysmokefree on Twitter and FacebookSmoke-free Communities:Good for People, Good for Business

COLLEGE OF NURSINGOur Go::!! i ~ 3 {o H:..::lIJ Yu:..) Pcak::o \burG

From: Fallin, Amanda TSent: Monday, December 13, 2010 1:49 PMTo: Hahn, Ellen J; Riker, Carol ASubject: Bullitt County-Jim WatersDid we see this? It was on the Bluegrass Institute's Website, up on November 5 th

Simon says: Our rights are 'slip slid n' away'By Jim WatersLike school kids atop a snow-covered hill during a driving storm - oblivious to conditions around them - sohealth nannies stand, gleefully ready to push us and our freedoms down a slippery slope leading to a ride thatmight not offer so much fun.I don't question the motives behind a smoking-ban proposal now under consideration by the Bullill CountyHealth Department and its Board of Health. They and many - including me - have grave concerns about thehealth of Kentuckians.Kentucky ranks as one of the unhealthiest states in the union. If the University of Kentucky football team did aswell in polls as Kentucky does in poor health rankings, Big Blue fans would forget about basketball.But I run into problems with how bureaucrats act on such a crisis.C.S. Lewis once said, "Of all tyrannies, a tyranny exercised for the good of its victim may be the mostoppressive."Appointed (not elected) health-department bureaucrats see nothing wrong with pushing that sled down the hill,no mailer where it may end up. Those riding the sled have a different view. At a minimum, they would like tohave some notion of where it's going to end up.If a public health department can bypass elected officials and engineer policies that trump other important

liberties - such as constitutionally endorsed private-property rights - while using claims that "we'reresponsible for the public's health," that sled won't stop in a good place.I'm sure that when New York City banned smoking in 2003, many folks who like dining in smoke-freesurroundings welcomed that decision. But I also suspect that many of them never dreamed the city would inonly three years ban those same restaurants from using trans fats in their food.What?! No margarine on my dinner roll?Now the health nannies and their unsalted nuts in the New York General Assembly have filed a bill that wouldfine restaurants $1,000 if chefs use salt in recipes. That sled ride turned into the equivalent of skiing downMount Everest.

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Yes. the health police want to send us careening down a slippery slope toward more nanny-ism, less libertyand even less personal responsibility. They will never be satisfied until they can stand in homes throwing outcigarettes and forcing inhabitants to eat unseasoned Brussel sprouts.Coming next: The Sugar Free Candy Halloween Ordinance.It's hard to stop a sled careening down a snow-covered slope.At a forum I attended in Hillview, near Shepherdsville, some who support the proposed smoking banrepeatedly stated that they want to go to restaurants in which they breathe smoke-free air. Me, too.But that's a very shortsighted view - one that health-department bureaucrats count on to attack propertyrights in the future.Keep in mind: Local health boards could apply their "public nuisance" arguments to private residences, too."If a person has rats running out of their house, the health department can move in because that's a publicnuisance," said Harlen Compton, a local businessman and spokesman for Bullitt County Choice. "What's tokeep them from using that same argument to ban smoking in a private residence as well?"Or if the department gets its way on smoking bans, what will it have to attack next to justify keeping so manybureaucrats on taxpayer-backed payrolls?I bet those folks who want to use government force to ensure a more enjoyable dining experience might notsmile as widely when denied margarine on their baked potatoes, salt on their Happy Meal fries or Halloweencandy that tastes like wax.If the health bureaucrats can get by with claiming that smoking bans address a "public nuisance," who's to saythat more, much more, won't follow - and soon?- Jim Waters is vice president ofpolicy and communications for the Bluegrass Institute, Kentucky's freemarket think tank. Reach him at [email protected]. Read previously published columns atwww.bipps.org.Amanda Fallin, MSN, RNCommunity AdvisorClean Indoor Air PartnershipUniversity of Kentucky College of Nursing509 CON BuildingLexington, KY [email protected]

Smoke-free Communities:Good for People, Good for BusinessFind kysmokefree on Twitter and Facebook

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Jett, Swannie (LHD - Bullitt Co)From:Sent:To:

Brown, Cynthia G (LHD-Bullitt Co)Monday, December 06,201010:44 AMJett, Swannie (LHD - Bullitt Co)Subject: FW: KCSP November Community Partner NewsletterAttachments: One-pager e-cigarettes and Secondhand Smoke EH 112110.pdf; One pager Green Circle111610.pdf

Swannie, Here is some information about e-cigarettes and the "Green Circle" issue that may be useful.~ / t - 7 f ; t t O P. EUUINIHealth Education CoordinatorPublic Information OfficerBullitt County Health Department183 Lees Valley RoadP.O. Box 278Shepherdsville, KY 40165ph: 502-955-5355fx: 502-543-2449www.bullittcountyhealthdept.com

"Bulliff COllllty Parlllers il l Pre)'i!Jltiolt f l f l ! Cflril1g im'oll'ell citizens working to creale a safe ami healtlty elH'irollmeJll through comprelteJlSi),1! p , e ~ ' e l l f i o l l sefl'icesmul reduc illg substallce ubf/se amoJlg Bullill COllllt)'youth fllldfamUies." www.hcPartllelsiIlPrt!l'el11ioll.coJ1l

Notice ojC01!fidenlialily:Tllis e-mail ineluding all)' attachmellfs, is illtel/dedDII(rjin'lhe lise qfthe illdil'idllal nr the elltity (a which it is addressedan d ma)' con(ail1 cOI!fidl.'lIffal ill/ormotinn thatis legally privilege am i exemptfrolll disclosure u1Ider applicable 1m I', If he reader oflhis message is noillie ill/em/ed recipient, you are 1Iotified llro! (111.1' rel'icll', lise.disclo.HtI'C, distriblltion 01' copying o/Ihis COllllllllllicaioll is slricl(v prohibited {(YOIl haw rect:i\'

From: Johnson, John D [mailto:[email protected])Sent: Thursday, December 02, 2010 10:05 AMTo: A. Weddle; [email protected]; Alyce Graves; Fallin, Amanda T; Lancaster, Amanda (LHD-Woodford Co.); AmyBarkley; Thomas, April S (LHD - Anderson Co); [email protected]; Horn, Rebecca (GRDHD); Salyer, Bertie K (LHDMagoffin Co); Lewis, Beverly J (DOC); Gilley, Brandi N (LHD- Laurel Co); Hurley, Brandon (LHD - Anderson Co); Douglas,Carol F (LHD-Barren River Dist); Carol Jo May [email protected] ; Burtner, Carolyn M (LHD-Clark Co);[email protected]; Chrissy Booth; Meek, Connie (LHD - Johnson Co); Brown, Cynthia G (LHD-Bullitt Co);Steele, Cynthia E (LHD-Bourbon Co); Dave Baxter; Fleming, Deborah H (LHD-Franklin Co); Deborah Shortt; Donita; Livy,Dori D (LHD-Oldham Co); Dr. Todd Bohannon; Dudley Conner; Edwina Smarr; Napier, Ellen J; Feltner, Frances J; FriedaGlantz; Wallen, Geneva S (LHD-Martin Co); Tincher, Geri G (LHD-Woodford Co); Heather Owens; Sidney, Hilarie E;Centers, Irene (CHFS HPB-Health Promotions); J. Lee; Jaclyne Hodges; Thaxton, James T (LHD - Three Rivers Dist);Jamie Browning ([email protected]); Bradshaw, Jamie L (LHD- Boyle Co); Janna Smith; Bennett, Jean; JeanRosenberg; Tolley, James M (LHD-Pennyrile Dist); Cain, John H; Adkins, Joyce N (LHD-Barren River Dist); Julie Brackett;Lay, Katharine L (LHD-Whitley Co); Kelly Harl ; Kerry Cork; Flood, Kimberli N (LHD-Breckinridge Co); Dozier, Kyle (LHD -Clark Co HD); Martin, Larry D (LHD - Powell Co); Taylor, Lee Ann (LHD-Lincoln Co); Leslie Newman; Justice, Lindsay M(LHD- PikeCo); Houchin, Lisa J (LHD-Barren River Dist); Liz Burrows; Crigler-McGuire, Elizabeth R. (Bullitt Co.); LizWilliams; Perkins, Lora S (LHD - Gateway Dist); Sizemore, Mark (CHFS HPB-Health Promotions); Mary Jo Dike; Ritchie,Maxine (LHD- Ky River Dist); Melissa Brown; Helton, Michael; Shoemaker, Michael E (LHD - Martin Co); Michelle Webb;Mona Ollis McClain; Paul Kiser ([email protected]); Petty Gregory; Phil Marinaro; Rachael King; RachelWilloughby; Nading, Richard L (GRDHD); Richard Wilson; Trent, Roger D (LHD-Boyle Co); [email protected]; ; RuthDavis; Sam Castle; Sandy Bailey; England, Sandy; Good, Sandra B; Dunlap, Sara (LHD - Ash-Boyd Co); Savannah Knopp;Lockard, Anthony S (LHD - Clark Co); Scott Walker; Peterson, Shana M (LHD-Jessamine Co); Shannon Pratt; ShannonRoss; Faul, Sharon; Shawn Jones; Sheldon Kozee; Shirley A. Roberson; Crase, Stacy L (LHD - Powell Co); Stephanie1


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Vogel; Sueticia Sutton; Teresa Collins; Ferguson, Teresa 0; Terry Tipton; Sloan, Thursa C (LHD-Floyd Co); Tiffany Potter;Todd Warnick; Tonya; Tonya Chang; Aaron, Tracy S (LHD-Lake Cumberland Dist); Trina Winter; Brewer, Vanessa C (LHD- Franklin Co); Ent, Veronica; Hudson, Vickie A; Poore, Vickie L (LHD-Barren River Dist); 'Virginia Oldham'Subject: KCSP November Community Partner Newsletter

KENTUCKY CENTER FOR SMOKE-FREE POLICY

Community Partner NewsletterNovember 2010Smoke-free Communities: Good/orPeople, Good/or Business

Find us on Face Book: kysmokefi'ee

Welcome to the Kentucky Center for Smoke-Free Policy (KCSP) Community Partners' Newsletter!This Newsletter contains:

1. Smoke-free Policy Updates@ University of Kentucky's Tobacco-free Campus Anniversary@ News from the American Public Health Association Annual Meeting,

Denver, CO Adult education as a vehicle fo r health communication Norm spreading or behavioral compensating- Do clean indoor air laws increase

voluntary home smoke-free rules? Critical appraisal training to expand health literacy and reduce health

disparities Messages that motivate rural communities to support smoke-free policy

change Justice is what love looks like: Quote from Cornel West

2. Smoke-free Research Update@ State-specific Prevalence of Cigarette Smoking and Smokeless Tobacco Use Among Adults-

20093. Opposition Watch

@ The Growing Popularity of E-cigarettes@ Northern Kentucky Tea Party

Please scroll down fo r more information on each topic!2


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Smoke-free Policy Updates1. University of Kentucky's Tobacco-free Anniversary

November marked the first anniversary of the University of Kentucky's tobacco-free campus policy. Thiswas celebrated the week of November 15 with activities including distribution of policy reminder cards(with free drink coupon), display tables around campus with cold turkey sandwiches, s-mores ("cold turkeyis not the way to go-ask for s'more information about how to quit"), and hot chocolate, and a campuswide cigarette butt clean-up.Check out Kysmokefree on Facebook for tobacco-free anniversary pictureshttp://www.facebook.com/album.php?aid=25739&id=121589417877279

2. News from the American Public Health Association meeting in Denver, ColoradoSeveral members of the KCSP team attended the 2010 American Public Health Association conference inNovember. Below are selected highlights from some of the sessions we enjoyed the most IAdult education as a vehicle for health communicationAriela M. Freedman, MPH, MAT - Rollins School of Public Healthy, Emory University, Atlanta, GAAccording to the Institute on Medicine, "nearly half of all Americans - 90 million people - have difficul tyunderstanding and acting upon health information." So much of what we do in tobacco control is based onprint media and we may be missing a large audience who possess low literacy and low health literacy skills.During Ms. Freedman's session at APHA, she suggested reaching out to adult education to reach those whoare often disproportionately affected by smoking and/or secondhand smoke. Adult educators are experiencedin translating information to meet the literacy skills of their participants. Adult education is also a known andsafe location where participants often have existing relationships and participants frequently report learningfrom each other.Questions to consider:

Are you aware of the adult education programs in your county? Have you ever talked with the adult education program about your smoke-free activities? Have you reviewed the materials you use in your tobacco control program to make sure they are

readable for low literacy audiences?For more information on clearly communicating health information, visit:http://www.health.gov/communication/literacy/plainlanguage/PlainLanguage.htmFor a "how to" on writing easy-to-read health information: http: //www.nlm.nih.gov/medlineplus/etr.html

Norm spreading or behavioral compensating- Do clean indoor air laws increase voluntary home smoke-freerules?Dr. Kai-Wen Cheng, Center for Tobacco Control Research and Education, University of California, San

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This session examined whether smoke-free laws increase the adoption of voluntary home smoke-free rulesamong smoking households. The study found that smoke-free laws increase the likelihood that familyhouseholds voluntarily implement smoke-free home rules. For more information on smoke-free homes andmulti unit housing, please visit Americans for Non-smokers Rights at http://www.no-smoke org/goingsmokefree.php ?id=101

Critical appraisal training to expand health literacy and reduce health disparitiesDonna Odierna, DrPH, University ofCalifornia, San FranciscoThe goal of this project was to implement and evaluate health literacy workshops for consumer advocates,journalists, and healthcare providers. The ability to evaluate evidence for credibility and quality, and toanalyze risks and benefits is important for healthcare decision-making. It is also crucial for effectivecommunication with others, including policy makers. As a result of taking part in the workshops, participants'confidence in critical appraisal skills increased by about 30%. Attendees reported that they were more likely touse critical appraisal skills to identify valid sources of information, recognize financial conflicts of interest,effectively communicate health information, and critique tobacco advertising.

Additional information on health literacy training may be found at:http://www.hsph.harvard.edu/healthliteracy/practice/training/index.htmlMessages that motivate rural communities to support smoke-free policy changeAnna Kostygina, PhD, Postdoctoral Scholar, University of KentuckyFocus groups were conducted with 82 residents of three rural communities to study the perceivedeffectiveness of print advertisements used in rural communiti es to promote smoke-free policies in regard tomessage framing and emotional tone. Based on the results, tips are included below for successful mediacampaigns in rural communities:

Use bright colors, such as red or yellow. Include a clear phone number or website where people can take action. Be concise with the wording. Messages with a serious tone tend to be more effective than lighthearted messages (such as jokes or

cartoons). Messages stressing the risks of secondhand smoke exposure were more effective than those focusing

on the benefits of smoke-free air. Messages that appear to blame smokers (i.e.: "Smokers kill non-smokers") were offensive to some

participants. Messages appealing to social norms and religious beliefs received strong support from the participants.

Visit American's for Nonsmokers' Rights for examples of smoke-free ads used in other communities:http://www.no-smoke org/goingsmokefree.ph p ?id=115.Justice is what love looks like, Cornel West, PhD, Professor, Princeton UniversityQuote:..."allow suffering to speak ... have the courage to question things that obstruct justice ...unregulated marketsdon't work to provide justice for all."

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Questions to consider: Is it fair or just that some people have to breathe smoky air at work? Would workers exposed to secondhand smoke at work in your community be willing to get involved in

your smoke-free efforts? Could you use their quotes (anonymous) in a 'worker quote' document? How can you frame smoke-free as a justice issue in your community?

See Robert Wood Johnson's summary of th e APHA meeting: http://rwjfapha.com/Smoke-free Research Updates"State-Specific Prevalence of Cigarette Smoking an d Smokeless Tobacco Use Among Adults --- United States,2009." Morbidity an d Mortality Weekly Report, November 5, 2010/59(43); 1400-1406Cigarette smoking and smokeless tobacco use cause or increase th e risk for lung, throat, oral, and other typesof cancers. In the article, th e CDC analyzed data from the 2009 Behavioral Risk Factor Surveillance System(BRFSS). Smoking prevalence was highest in Kentucky & West Virginia (25.6%). The prevalence of smokelesstobacco use was higher among men than women in all states and territories. These data suggest thatsmokeless tobacco use is predominantly a public health problem among men, young adults, and persons withlower education, and in certain states:

Smokeless tobacco use among men was significantly higher than among women in all 50 states Among th e 50 states and DC, smokeless tobacco use was most common among persons aged 18--24

years Smokeless tobacco use tended to decrease with increasing education Percent of smokeless tobacco use among adults in Kentucky: 6.7% Percent of cigarette smokers who also use smokeless tobacco in Kentucky: 7.7%

As smoke-free laws become more widespread and th e tobacco industry continues to market their products for'dual use: th e percent of cigarette smokers who also use smokeless is expected to rise.http://www.cdc.gov/mmwr/preview/mmwrhtml/mmS943a2.htm?s cid=mm5943a2 wopposition WatchThe Growing Popularity of E-cigarettesElectronic cigarettes, or e-cigarettes, have continued to become more popular and widelyaccepted as evidenced by th e article in th e link below. The e-cigarette industry has launched an organizedcampaign to convince th e public that e-cigare ttes help smokers quit. There is no research evidence that this isth e case. In fact, there is evidence that e-cigarettes actually help smokers remain addicted to nicotine. TheU.S. Food and Drug Administration (FDA) sent letters to five tobacco companies in September indicating thatthey were marketing their products illegally as unapproved drugs and that th e products would need to beregulated by th e FDA.http://new-smoke.com/e-cigarette-news/david-Ietterman-smokes-the-electronic-cigarette/http://www.fda.gov/ICECI/EnforcementActions/Warningletters/2010/default.htm?fragment25 NextRow=51

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See the attached fact sheet on E-cigarettes andSmoke-free Policies. Several local smoke-freeordinances/regulations in Kentucky prohibit the use of e-cigarettes (Bardstown, Glasgow, Madison CountyBOH regulation, amended 12/1/10).Northern Kentucky Tea Par tyThe Northern Kentucky Tea Party is doing the bidding of the tobacco industry and other anti-health groups(i.e., Bluegrass Institute, Kentucky Libertarian Party, NKY Choice) to vigorously oppose the proposed smokefree ordinances in Campbell and Kenton Counties. Check their website: http://www.nkyteaparty.org/ and read'Smoking Ban Supporters Hypocritical: The Lexington Herald-Leader called out the Tea Party and urgedCampbell and Kenton Fiscal Courts to make the healthy decision in an opinion editorial this week.http://www.kentucky.com/2010/11/30/1545933/go-smoke-free-northern-ky.html

FeedbackIf you have any comments or suggestions regarding the KCSP Communi ty Partners' Newsletter, or would liketo suggest future content for the newsletter, please let us know! We would love to hear your [email protected] or contact John Johnson [email protected], 859-323-4587.Voluntary ParticipationThe KCSP Community Partners' distribution list is intended to provide pertinent information to local tobaccocontrol community advocates in Kentucky. If you have received this newsletter in error or wish to be removedfrom the list, please reply to this email with REMOVE in the subject headline.

John D. Johnson, MACommunity liaisonKentucky Center for Smoke-free PolicyUniversity of Kentucky College of Nursing751 Rose Street, College of Nursing 509Lexington, Kentucky 40536-0232859-323-4587859-323-1057 (FAX)[email protected]

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Brown, Cynthia G (LHD-Bullitt Co)From:Sent: Brown, Cynthia G (LHD-Bullitt Co)Monday, January 24, 2011 11 :42 AMTo: Brown, Cynthia G (LHD-Bullitt Co); Crigler, Elizabeth R. ; Crum, Daniel E (LHD - Bullitt Co);Taylor, Brittany P (LHD - Bullitt Co)Subject: FW: The CDC Public Health Law News, Thursday, January 20, 2011Tracking: Recipient

Brown, Cynthia G (LHD-Bullitt Co)Crigler. Elizabeth RCrum. Daniel E (LHD - BulllU Co)Taylor. Brittany P (LHD - Bullitt Co)

From: Jett, Swannie (LHD - Bullitt Co)Sent: Friday, January 21, 2011 8:51 AM

Read

Read: 1/24/201112:01 PMRead: 1/24/2011 1 02 PMRead: 1/24/201112:17 PM

To: Blanton, Mary A (LHD-Bullitt Co); Brown, Cynthia G (LHD-Bullitt Co); Butterworth, Ida M (LHD-Bullitt Co.); Haner, Joe(LHD- Bullitt Co); Loy, Marilyn S (CHFS LHD Bullitt Co); Renfrow, Andrea (LHD-Bullitt Co); Trevino, Vickie M (LHD-BullittCo)Cc: Foster, Frances C (LHD-Bullitt Co)Subject: FW: The CDC Public Health Law News, Thursday, January 20, 2011Please distribute to staff.

Swannie Jett, DrPHc. MSPublic Health DirectorBullitt County Health Department181 Lees Valley RoadShepherdsville, KY 40165Phone: (502) 955-6680 Fax: (502) 543-2998HDedkale)'Olll'llle to (/ lJIifJiOIJ or /'(//{Je that J}Jillof(tkut),oll"NOTICE OF CONFIDENTIAliTY: This e-mail.includinganyattachments.isintendedonly for the use a/the individual or entity to which it is addressed and may contaIn confidentialinformation tllat Is legally privileged and exempt f10m disclosure under applicable low. lithe reader a/this message is not the intended recipient, you ore notified that anyreview, use, disclosure, distribution Of copying of this communication Is strictly prohibited. If you have received this communication in error, please contoct the sender by reply e-mail and destroy alf copies of the original message.

From: Centers for Disease Control & Prevention [mailto:[email protected]]Sent: Thursday, January 20, 2011 3:01 PMTo: Jett, Swannie (LHD - Bullitt Co)Subject: The CDC Public Health Law News, Thursday, January 20, 2011

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Thursday, January 20, 2011From the Public Heallh Law Program, Office for State, Tribal, Local, and Territorial Support, CDChttp://www2a.cdc.gov/phlp/

Announcements***USDA National School Lunch and Breakfast Nutrition Standards. On January 13, 2011, the U.S.Department of Agriculture (USDA) released a plan to revise the meal pattems and nutrition requirements for theNational School Lunch Program and the School Breakfast Program. The proposed rule would increase theavailability of fruits, vegetables, whole grains, and fat-free and low-fat milk in school meals. The rule wouldalso reduce the levels of sodium and saturated fat in meals and help meet the nutritional needs of childrenwithin their calorie requirements. For more information, including infolmation on the public comment period,please visit http://www.regulations.gov/#!home.

*** Tobacco Control Legal Update. The Tobacco Control Legal Consortium has released The ConsortiumBulletin, a new monthly electronic news feature. The January 2011 edition features a series of short referenceguides on regulating tobacco use, a white paper on regulating smoking in cars carrying children, andinformation on recent tobacco litigation. To read the Bulletin, visithttp://campaign.r20.constantcontact.com/render?l1r=kgavj6dab&v=00 1 7pdtfONbx025e035S I jMi Ouxu 53nePIYBOm6Hl GK6wzKmBFS6JHHGG-p3GJKC8RU5l HODKPogKcAg7G6cpWLccB8DNSPr2.***Traffic Safety State Legislative Action. The National Conference of State Legislatures has published areport summarizing bills regarding traffic safety issues that were considered by state legislatures during the2010 legislative sessions. To access the report, visit http://www.ncsl.orgldefault.aspx?Tabld=21947.*** APHA Call for Abstracts. Please submit your abstract for the 139th American Public Health AssociationAnnual Meeting, October 29- November 2,2011. The Health Law Special Interest Group (SPIG) will beaccepting abstracts on a variety ofpublic health related topics until February 8, 2011. Please see the full call athttp://apha.confex.comlaphal139am1blf.htm. You may contact Heather A. McCabe at hamccabe@iupuLedu orKern Lowrey at [email protected] with questions.***ASLME Call for Papers. The American Society of Law, Medicine & Ethics' Journal ofLaw, Medicine &Ethics is seeking scholarly commentary on the public health impact of federal health reform for an issue entitled"Public Health Reform: Patient Protection and Affordable Care Act Implications for the Public's Health." Formore information, visit http://llewsmanager.commpartners.com/ashne/issues/2011-01-1117.html.*** Public Health Emergency Legal Preparedness Workshop (0212212011). The National Association ofCounty and City Health Officials (NACCHO), the Association of State and TelTitorial Health Officials(ASTHO), and the CDC Public Health Law Program are co-sponsoring the workshop "High-PriOlity Tools forPublic Health Emergency Legal Preparedness," on February 22, 2011, as part of the 2011 Public HealthPreparedness Summit in Atlanta. This interactive workshop will feature tools that local, state, and Tribal public

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health practitioners can use to improve preparedness using their public health laws. Several new tools will behighlighted, including "Legal Tools for Tuberculosis Contro\." To register, visit http://www.phprep.org/201 II.*** Free 2-hour CLE at the ABA Midyear Meeting (02/12/2011). The American Bar Association's (ABA's)Special Committee on Disaster Response and Preparedness and the CDC Public Health Law Program are cosponsoring a special program, "The Role of Law and Courts in Public Health Emergency Response," at theABA Midyear Meeting on FeblUary 12, 2011, from 2-4 PM at the Marriott Marquis in Atlanta. Legal expertsrepresenting emergency preparedness in both public health and the judiciary will discuss a number of topicsincluding balancing federal, state, and local power and responsibilities. The program is free and open to allABA attendees and any interested attomeys and COUlt administrators. Two hours of CLE credit is offered toattomey participants. Please contact Jin Kim, ABA, at [email protected] or Stacie Kershner, CDC, [email protected] for more infOimation.

Top StoryI. Califomia: State's first report on hospital infections seen as incomplete

States and Localities2. New York: Judge rejects city law on antismoking posters

National3. Firms told to divulge all changes to tobacco4. New law calls for govemment, public attention to Alzheimer's crisis5. The implants loophole

International

6. United Kingdom: "Great swapathon" voucher bid to boost healthy livingBriefly Noted

Arizona school recess' Arkansas school bus signage . California menu labeling Fast food ban' Floridachocolate milk ban' Montana DUI on a horse' National Ground Zero volunteers' Cocaine smugglingBone marrow donation' Recalled diet supplement PTSD . Hospital acquired infections' Toning shoes'Workplace breastfeeding . Food safety bill End oflife planning ' Child Supper Program Meal nutritionlabels' Japan dlUg shortage' United Kingdom organ donation

Journal ArticlesDlUgjaii sanctions' Ireland anti-smoking laws' Motorcycle helmet use' Antitrust laws' Pre-exposure HIVprophylaxis China and Big Tobacco' ACOs

Court Opinions

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Illinois underinsured motorist coverage' Michigan privacy of patient documents' Minnesota "light"cigarettes' New York municipal water contamination ' Ohio mosquito abatement district enlargementPennsylvania mold in prison' Federal point of purchase warnings Landfill toxicity

Quotation of the MonthClaude Arnold, Special Agent in Charge, U.S. Immigration and Customs Enforcement, Homeland SecurityInvestigations, Los Angeles, California

______________________1______________________

"State's first report on hospital infections seen as incomplete"Ventura County Star (01104/2011) Tom Kiskenhttp://www.vcstar.comlnews/20 I l / j anl03/states- first-report -on -hospital-infections-seenl

In 2008 Califomia passed Nile's Law, requiring hospital-acquired infection data to be publicly released byJanuary 1, 2011. The Califomia Department of Public Health hopes the release of individual hospital data onseveral infections, including antibiotic-resistant Methicillin-resistant Staphylococclis AIII'eIlS (MRSA), will helpprotect patients and increase hospital safety."The goal is not necessarily to scare people but to make them more aware and to make hospitals more awarethat they might be having more infections than another hospital. The goal should be zero infections. The furtheraway (hospitals) are from zero infections, the more concems you should have," said director ofthe ConsumersUnion's Safe Patient Project, Lisa McGiffert.According to Califomia officials, one in 20 patients is affected by hospital-acquired infections each year - about20,000 infections annually with roughly 12,000 of these resulting in the patient's death. Bloodstream infectionsaccount for about 3,680 deaths a year and are the primary focus ofthe state' s new report.Some officials, however, contend the data is flawed because there was no uniform method for data collection,possibly not indicating which hospitals pose greater risks of infections. Some gaps in data, such as hospitalsreporting no MRSA infections, are implausible to those in the field such as Cindy DeMotte, vice president ofquality at Community Memorial Hospital in Ventura. "This wide variation has to be due either to reporting orsurveillance issues: how vigilant you are out there looking at patient records and lab results. I don't think we'reon the same page," she said.According to the report, less than 70 percent of hospitals provided all required information, but many hospitalsmaintain their data were not recorded by the state. Kevin Reilly, chiefdeputy director of policy and programsfor the state Public Health Department, said in the future all Califomia hospitals will report their infection datato a web-based system which will be operated by the CDC, standardizing and minimizing currentinconsistencies.[Editor's Note: To read the California law, visithttp://www.cdph.ca.gov/services/boardslDocuments/SB I 058chaptered09 25 08.pdf.]

_______________________2_______________________"Judge rejects city law on antismoking posters"

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New York Times (12/2912010) Anahad O'Connorhttp://www.nytimes.coml2010/12/30/nyregion/30smoking.htmlFederal Judge Jed S. Rackoffof the United States District Comi, Southern District ofNew York, struck down aNew York City law requiring all convenience stores and bodegas to display images of diseased lungs, teeth, andbrains in a bid to discourage customers from purchasing cigarettes. The ruling halts the city's plan to have thegraphic placards displayed beside cash registers in more than 11,000 businesses citywide.In his 13-page ruling, Judge Rackoff said the city had violated federal law because only the federal governmenthas the authority to regulate cigarette adveliisements and warnings. "Even merchants ofmorbidity are entitledto the full protection ofthe law, for our sake as well as theirs," he wrote.The judge noted that health officials were justified in viewing smoking as a "public health threat" becausesmoking is the leading cause of preventable death in New York City and the U.S. at large. "Within New YorkCity, roughly 7,500 people die from smoking annually- more than from AIDS, homicide and suicidecombined," he wrote.Advocates for the convenience stores are "very pleased" with the ruling, said Floyd Abrams, counsel for theconvenience store association. He said the decision "will allow retail stores in New York to be freed of theobligation to put signs up urging customers not to buy their lawful products."The New York City Department ofHealth, however, is disappointed in the decision. In a public statement theDepaliment defended the signs saying, "The city's warning signs pOliray completely factual messages about thedangers of smoking. They do so at the exact moment when smokers are making decisions about purchasingtobacco. We believe it is the city's responsibility to help smokers quit and to protect children from the harmfuleffects of tobacco smoke."[Editor's Note: To read the decision, visit http://www.courthollsenews.com/2010/12/30Itobacco.pdfl.

______________________ _______________________"Firms told to divulge all changes to tobacco"New York Times (01/0612011) DuffWilsonhttp://www.nytimes.com/2011/01/06lhealthl06tobacco.htmlFor the first time the tobacco industry will be required to disclose any changes to their products, according tonew rules promulgated by the Food and Drug Administration (FDA). The rules, part of extensive changes underthe tobacco control law signed by President Obama in June 2009, also enumerate how tobacco firms must seekpermission to market new products.Dr. Lawrence R. Deyton, director of the Center for Tobacco Products of the FDA, said, "up to now, tobaccoproducts have been the only mass-consumed products for which users do not know what they are consuming."Under the new lUles, any tobacco product modified after FeblUary 15, 2007, when the legislation wasintroduced to Congress, must be reviewed by the FDA. While companies may apply for fast track review ofnew products that are "substantially equivalent" to earlier products, the disclosures by companies are expectedby March 22, 2011. Fmthermore, products changed after March 22, 2011, cannot be sold without FDApelmission and the agency may remove some products from the market which were introduced betweenFeblUary 15,2007 and March 22,2011.

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"As a result of the blight spotlight ofFDA scrutiny, tobacco companies will no longer be able to secretlymanipulate their products in ways that make them more addictive and appealing," said Mathew L. Myers,president of a Washington advocacy group, Campaign for Tobacco-Free Kids.The maker ofMarlboro cigarettes, Altria, had expected the changes and is reviewing them. David Howard, aspokesman for R.J. Reynolds, the second largest tobacco firm, said the company's products are all identical orsubstantially similar to other products and the company is applying for fast track designations.[Editor's Note: To read the rules, visithttp://www.fda.gov/TobaccoProducts/GuidanceComplianceRegulatoryInformationlucmI91982.htm J

_____________________4_____________________''New law calls for govemment, public attention to Alzheimer's clisis"Intemal Medicine News (01106/2011) Michele G. Sullivanhttp://www.intemalmedicinenews.com/news/neurology/single-article/new-law-calls-for-government -publicattention-to-alzheimer-s-crisis17ff8d49f12.htmlOn January 4, 2011, President Obama signed the National Alzheimer's Project Act into law.The law, passed by unanimous vote in the House and Senate, creates the Office of the National Alzheimer'sProject, a new depatiment within the Depaliment ofHealth and Human Services (HHS). The presidentiallyappointed director will work with an advisory council "to promote research efforts into mechanisms to slow andstop the development ofAlzheimer's for those at risk of developing the disease."The new advisory council, complised of eight federal appointees, including the Surgeon General, will assesshow to address Alzheimer's in several different areas, such as patient care, research, advocacy, and caregiversupport. Unlike similar laws, however, the Alzheimer's council will be required to provide an annually updatedAlzheimer's response plan."Some [laws such as this J have mattered very little and some have made very large impacts," said Robert Egge,vice president ofpublic policy and advocacy for the Alzheimer's Association. "We think all the elements arehere to make this a meaningful piece of legislation. One very important element is the requirement of annualreporting to Congress. This will create an ongoing dialogue we have never had about Alzheimer's disease, whatwe are doing about it, and how we are progressing.""I applaud Congress for passing the National Alzheimer's Project Act with bipartisan support. We . . . recognizethe devastating impact Alzheimer's has on Amelica's seniors, families and our health care system. The passageof this act will help to ensure we confront this challenge with an aggressive and coordinated national strategy,"said HHS Secretary Kathleen Sebelius.

[Editor's Note: To read the law, visit http://thomas.loc.gov/cgi-binlquerylz?clll:H.R.4689:.J______________________ ________________________

"The implants loophole"New York Times (12/16/2010) Barry Meierhttp://www.nytimes.coml2010/12/17/business/17hip.html

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While new dmgs must undergo rigorous clinical trials before receiving Food and Dmg Administration (FDA)marketing approval, new implants that are substantially similar to devices already approved may be soldwithout such testing. The process allows manufacturers to make small improvements rapidly. Many experts sayit also creates a loophole by allowing producers to include aspects of unapproved devices into existing designs."You are basically testing these devices in an uncontrolled way on a large number of people," said Dr. SidneyM. Wolfe, director of Public Citizen's Health Research Group.For patients receiving untested augmented devices, the consequences of device failure can be grave. Betty JaneHaak, 74, received a hip with a redesigned hip cup that had been approved because of the similar design, theA.S.R. cup designed by DePuy Orthopaedics, a division of Johnson and Johnson, but the hip is faulty and manyrecipients need replacements. Though her hip cup is painful and has highly elevated her blood colbalt levels,Ms. Haak is medically unable to receive a replacement due to a healt attack she suffered after the initialimplant. Ms. Haak summarized her situation, "Do I risk a heart attack, or do I risk poisoning myselfl"Cunent rules do not require FDA notification when producers bundle together components from approved andunapproved devices, said Mark Melkerson, an agency official. An internal agency review recently released,however, found problems with the process and the FDA is proposing changes.

_______________________6_______________________" 'Great swapathon' voucher bid to boost healthy living"BBC News (0110112011)http://www.bbc.co.uklnews/health-12099867The United Kingdom is implementing a new program to encourage healthy living by offering 250 million($396.85 million) in vouchers for food, nutritional advice and discounted activities. The vouchers are part of thegovernment's health-promoting initiative Changes 4 Life's "Great Swapathon," and are being paid for by thefood and fitness industries as part of the govemment 's plan to involve business in healthy living promotion.Paliicipants can receive 50 ($79.37) vouchers by filling out a questionnaire on the Great Swapathon website, agovernment website encouraging visitors to swap unhealthy habits for healthier choices.While some food policy experts have voiced concerns about involving large corporations in public healthcampaigns, four million 50 voucher booklets will be offered through the News of he World and Asada storesand an additional one million will be available from local businesses participating in Change 4 Life."I'm nervous ifbig companies are put in charge of public health- that's not to say they can't be good for publichealth- but if they are centrally involved in delivering it. I think that history suggests we need to setframeworks, level playing fields in which they then operate. I don't like them controlling it," said Tim Lang,professor of food policy at City University.U.K. Health Secretary Andrew Lansley remains hopeful for program success saying, "It's a great example ofhow government, the media, industry and retailers can work together to help families to be helpful. The healthyoption isn't always the cheapest option so it's a really important step to be able to offer 50 of f healthier foods,drinks and activities."

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Arizona: Law required evaluation of recess policies, most schools maintain status quo"Arizona schools ' recess policies examined"Arizona Central (01102/2011) Hayley Ringlehttp://www.azcentral.comlnews/articles/2011/01l02120110102arizona-school-recess-policy.htmlArkansas: New signs required on school busses too wordy, drivers unable to read"School bus safety law needs tweaking, education officials say"Arkansas News (01/0112011) John Lyonhttp://arkansasnews.comI20 11/0 110 I/schoo I-bus-safety-Iaw-needs-tweaking-education-officials-saylCalifornia: State law requires calorie counts displayed at restaurants, federal law may supersede"Calorie counts appearing on fast-food menus in California"Los Angeles Times (12/30/2010) Sharon Bernsteinhttp://miicles.latimes.comI20 I 0/dec/30/business/la-fi-1230-calorie-count-menus-20 I 0 1230California: Radical food policy bans new fast-food restaurants in South Los Angeles"In South Los Angeles, new fast-food spots get a 'No, Thanks'"New York Times (0111512011) Jennifer Medinahtlp:llwww.nytimes.com/201110 III 6/usll 6fastfood.html?src=twrhpFlorida: Board ofEd.'s chocolate milk ban may sour under new Agriculture Commissioner"Incoming state agriculture chief seeks to table chocolate-milk ban in schools"Miami Herald (1213012010) Denise-Marie Balonahttp://www.mianliherald.coml20 I 01l2/30/1993418/incoming-state-agriculture-chief.htmlMontana: Not illegal to ride a horse while intoxicated in Montana"Montana ad raises issue: can you be charged with DUI on a horse?"USA Today (0111712011) Douglas Stanglinhttp://content. usatoday comlcommunitieslondeadl ne/postl20 1110 I/montana-ad-raises-key-issue-can-you -becharged-with-dui-on-a-horse/lNational: Ground Zero volunteers covered under new health bill"Congress passes Ground Zero health bill"The Journal News (12/32/2010) Jorge Fitx-Gibbon and Candice Ferrettehttp://www.lohud.comlmiicle/20 I 0 I 223INEWSO1/12230400lCongress-passes-Ground-Zero-health-billNational: Christmas holiday not all it was cracked up to be for Easter egg cocaine smuggler''Feds: Smuggler caught hiding cocaine in Easter eggs before Christmas"CNN (12/2712010) Michael Martinezhttp://articles.cnn.com/2010-12-27/justice/california.easter.egg.smuggle 1 easter-eggs-cocaine-drugtraffickers? s=PM:CRIMENational: Company uses models to induce public into giving DNA samples, no informed consent"Flil iy models were hired in bid to find bone marrow"New York Times (1211612010) Abby Goodnoughhttp://www.nytimes.comI2010112/17/usIl7models.htmlNational: Recalled diet supplement linked to several heart attacks and one death"Fruta Planta diet product recalled after FDA warning"Orlando Sentinel (01/0312011) Linda Shrieves

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http://m1icles.orlandosentinel.coml20 11-0 1-03lhealthlos-fda-warning-fruta-planta-20110 103 I fda-warningsibutramine-weight-Ioss-productNational: Veterans Affairs implements new program to help aging veterans suffering from PTSD"Helping the brave fight their final battle"Chicago Tribune (12/2812010) Judith Grahamhttp://articles.chicagotribune.comI20 I0-1 2-28/healthlsc-fam-1 228-senior-health-veteran-201 0 1228 I vamedical-centers-honor-veterans-veterans-projectNational: Hospitals must track and report bloodstream infections under Affordable Care Act"Hospitals will have to report infections"United Press International (12/2712010)http://www.upi.comlHeal h News/20 I0/12/271H0spitals-will-have-to-report -infectionslUPI -5 340 12935025401National: Suit claims these shoes ain't made for walkin', despite ads' claims"New Balance sued over toning-shoe ads"Boston Globe (01/05/2011) Jenn Abelsonhttp://www.boston.com/lifestyle/health/m1icles/2011/01l05/ new balance sued over toning shoe adslNational: 'Appropriate workplace accommodations' for federal employees who are nursing"Obama orders breastfeeding policy for federal workplace"Washington Post (12122/2010) Ed O'Keefehttp://www.washingtonpost.comlwp-dynicontentiarticleI2010/12/2I1AR2010122105385.htmlNational: FDA has more regulatory power under new food safety bill"Obmna signs food safety bill"CNN (01104/2011)http://articles.clll.coml20 11-0 1-04/politics/obama.food.safety I food-safety-fda-power-commissionermargaret-hamburg? s=PM:POLITICSNational: Elderly Black patients much less likely to have end oflife planning"Study: Blacks less likely to have living wills, DNR ordersUSA Today (0110712011) Janice Lloydhttp://www.usatoday.comlyourlife/healthimedicaIl2011-01-07-livingwills07STN.htmNational: Federal law to provide more than 140,000 children with dinner"USDA announces expanded child supper program"Reuters (01114/2011) Wendell Marsh and Jerry Nortonhttp://www.reuters.com/al1icle/idUSTRE70D4Z92011 0 114National: Major cuts of meat required to advertise nutrition information on packaging"USDA requires nutrition labels for 40 cuts ofmeat"Los Angeles Times (12/30/2010) P.J. Huffstutterhttp://articles.latimes.comI201 0/dec/30/business/la-fi-1230-usda-meat -label-20 I 0 1230Japan: Government raises tax on cigarettes, Pfizer misses chance to supply quitters' drug"In Japan, Pfizer is Sh011 of drugs to help smokers"New York Times (01/03/2011) Hiroko Tabuchihttp://www.nytimes.coml2011/01/04/business/globaIl04smoke.htmlUnited Kingdom: Drivers will be asked about organ donation, hope to raise donor numbers

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"Organ donation bid to target new drivers"BBCNews (12/3112010)http://www.bbc.co.uklnews/health-12097225

_____________ JOURNALARTICLES,______________"Impact of ail sanctions during dlUg court participation upon substance abuse treatment completion"Addiction 0112011 Randall T. Brown, Paul A. Allison, and F. Javier Nietohttp://onlinclibrary.wiley.com/doilI0.IIII/LI360-0443.20 1O.03102.x/abstract"The road to smoke-free legislation in Ireland"Addiction 01/2011 Laura M. Currie and Luke Clancyhttp://onl inelibrary.wiley.com/doiIl0.IIII/LI360-0443.20 I 0.03 I57.x/abstract"Findings on youth injuries bolster case for helmet use by all motorcycle riders"Joumal of the American Medical Association 12/22/2010 Mike Mitkahttp://jama.ama-assn.org/content!304/2412683. full"AntitlUSt laws"Joumal ofthe American Medical Association 111212011 Mike Mitkahttp://jama.ama-assn.org/content/30 5/21139.3 .fhll"Ethical allocation of pre-exposure HIV prophylaxis"Joumal of the American Medical Association 1112/2011 Lawrence O. Gostin and Susan C. Kimhttp://jama.ama-assn.org/content!305/21191.full"China's unhealthy relations with big tobacco"The Lancet 01115/2011http://www.thelancet.com/journals/lancet/atticle/PIISO l40-6736( II )60028-7/fhlltext"ACOs and the enforcement of fraud, abuse, and antitlUst laws"New England Joumal ofMedicine 01/1312011 Robert F. Leibenlufthttp://www.nejm.org/doi/pdf/lO.l056/NEJMpI011464

_____________COURTopmIONS,______________Illinois: Municipality exempt from providing underinsured motorist insurance coveragePritza v. Village of LansingAppellate Court ofIllinois , First District, Fifth DivisionCase No. 1-10-0100Decided November 24,2010Opinion by Justice Toominhttp://www.state.il.us/couttlopinions/ AppellateCouttl20 IOil stDistrictINovember/l1 00 1OO.pdfMichigan: Motion to compel discovery ofpeer review and patient documents deniedJohnson v. Detroit Medical Center, et al.COutt ofAppeals ofMichiganCase No. 293304Filed December 21,2010

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Opinion per curiamhttp://coa.courts.mi.gov/documents/OPINIONS/FINALICOAl20101221 C293304 94 293304.0PN.PDFMinnesota: Action over false advertising, fraud, and deception over "light" cigarettes remandedCurtis v. Altria Group, et al.Court ofAppeals ofMinnesotaCase No. AlO-215Filed December 28, 2010Opinion by Judge Stoneburnerht!p:llscholar.google.com/scholar case?case=200371 002971151 0704&g=CUllis+v.+A1tria+Group&hl=en&assdt=2,11New York: Summary judgment denied in county tort action over PCE contamination in waterSuffolk County Water Authority v. Dow Chemical Company, et al.Supreme Court, Suffolk CountyCase No. 24852-2010Decided December 17, 20 I 0Opinion by Judge Pineshttp://www.COUlls.state.ny.uslRepOller/3dseries/2010/201052243.htmOhio: Enlargement of existing sanitary district denied without showing benefit to public healthIn re: the Barberton-Norton Mosquito Abatement DistrictCOUll ofAppeals ofOhio, Ninth District, Summit CountyC.A. No. 25126Dated December 30, 2010Opinion by Presiding Judge Can'http://www.sconet.state.oh.us/rod/docs/pdf/91201 0/2010-ohio-6494.pdfPennsylvania: Appeal by corrections officers alleging "toxic mold" within prison dismissedFerraro, et al. v. County ofNorthampton, et al.Commonwealth Court ofPennsylvaniaCase No. 1496 C.D. 2010Filed January 5, 2011Memorandum opinion by Judge Pellegrinihttp://www.aopc.orglOpPostinglCwealth/outlI496CDlO 1-5-II.pdfFederal: Regulation requiring point ofpurchase smoking cessation signage invalid23-34 94th St. Grocery Corp, et al. v. New York City Board of Health, et al.U.S. District Court for the Southern District ofNew YorkCase No. 10 Civ. 4392 (JSR)Decided December 29, 2010Opinion by Judge Rakoffhttp://www.nysd.uscourts.gov/ecf.phpFederal: Summary judgment in case over TCEIPCE contamination from landfill deniedNational Resources Defense Council, Inc. v. County ofDickson, TennesseeU.S. District Court for the Middle District ofTennessee, Nashville DivisionCase No. 3:08-0229Decided January 3, 20 IIOpinion by Judge Campbellhttps:llecf.tnmd.uscoUlls.gov/cgi-biniShowIndex.pl

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____ .RL NEWS QUOTATION OF THE MONTH,___"Obviously two days before Christmas, this defendant didn't expect his trip would end with federal officersconducting an Easter egg hunt."-- Claude Arnold, Special Agent in Charge, U.S. Immigration and Customs Enforcement, Homeland SecurityInvestigations, Los Angeles, Califomia, on a drug smuggler who camouflaged cocaine as Easter candy.

The CDC Public Health LawNews is published the third Thursday of each month except holidays, plus special issues when warranted.It is distributed only in electronic form and is free of charge. News content Is selected solely on the basis of newsworthiness andpotential interest to readers. CDC and DHHS assume no responsibility for the factual accuracy of the items presented. The selection,omission, or content of items does not Imply any endorsement or other position taken by CDC or DHHS. Opinions expressed by theoriginal authors of Items included In the News, or persons quoted therein, are strictly their own and are in no way meant to representthe opinion or views of CDC or DHHS. References to products, trade names, publications, news sources, and non-CDC Websltes areprovided solely for Informational purposes and do not imply endorsement by CDC or DHHS. Legal cases are presented for educationalpurposes only, and are not meant to represent the current state of the law. The findings and conclusions reported In this document arethose of the author(s) and do not necessarily represent the views of CDC. The News Is In the public domain and may be freelyforwarded and reproduced without permission. The original news sources and the CDC Public Health LawNews should be cited assources. Readers should contact the cited news sources for the full text of the articles.For past issues or to subscribe to the CDC Public Health Law News, visit htlp:11www2a.cdc.gov/phlp/cphln.asp. For help withsubscriptions or to make comments or suggestions, send an email to Lindsay Culp at [email protected] News is published by the Public Health Law Program, Office for State, Tribal, Local, and Territorial Support, Centers for DiseaseControl and Prevention (CDC), U.S. Department of Health and Human Services (DHHS). Lindsay Culp, J.D., M.P.H., Editor.

Modify/Update Subscriber Preferences I Unsubscribe I Send Feedback I Learn more about CDC Email UpdatesTo receive the latest news for your region, please update your profile with your country, state and zip code.Questions or problems? Please contact [email protected].

Centers for Discase Control and Prevention (CDC) . 1600 Clifton Rd . Atlanta GA 30333 aOO-COC-INFO ( ~ O O - 2 3 2 - 4 6 3 6 1

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Brown, Cynthia G (LHD-Bulli tt Co)From:Sent:To:

Johnson, John D [email protected]]Friday, February 25,2011 10:41 AMJohnson, John DSubject: KCSP Community Partner NewsletterSmokefreeAdvocateoftheYear.docttachments:

KENTUCKY CENTER FOR SMOKE-FREE POLICYCommunity Partner NewsletterFebruary 2011

Smoke-free Communities: Good/or People, Good/or BusinessFind k J ' s l l l o k ~ f i ' e e o n ~ " lIIld11

This Newsletter contains:1. Smoke-free Policy Updates

6) Campbell County Repeals Smoke-free Ordinance6) Oak Grove Implements Partial Smoke-free Ordinance6) Bullitt County Board of Health schedules second reading of smoke-free regulation, March 22, 20116) SlIIoke-free Kentucky-Join the coalition!

2. Voices of Smoke-free Communities3. Smoke-free Research Updates

6) Summary of the Article, Electronic Cigarettes as a Harm Reduction Strategy for Tobacco Control:A Step Forward or a Repeat ofPast Mistakes?

4. Tobacco in the News6) Nebraska Judge says 'No' to Smoking in Cigar Bars and Hotels

S. Advocacy at Work6) 57th Annual Grammy Awards did not include E-Cigarettes in Celebrity Gift Bags

6. Opposition Watch6) Smoke-free Ordinances: Infringement on Your Rights?

7. Save the Date6) February 25,2011: Last day to nominate Smoke-free Advocate of the Year!6) March 24, 2011 : Smoke-free Spring Conference 2011

Please scroll down for more information on each topic!1


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Smoke-free Policy Updatese Campbell County Repeals Smoke-free Ordinance

On February 16, in a 3-1 vote, the Campbell County Fiscal COUIt ovelturned the comprehensivesmoke-fiee ordinance that was enacted in December 2010 by the previous Fiscal Court. This wasnot an unexpected move by Campbell County given the newly elected commissioners' vehementcampaign promises that they would overturn the smoke-free ordinance. The Northern KentuckyTea Party and the Campbell County Tea Party helped elect two commissioners who were opposedto smoke-free laws. The repeal decision is a step back for Campbell County and for Kentucky.Given that workers should not have to choose between their health and a paycheck, CampbellCounty has turned its back on the science behind secondhand smoke, under the guise of liberty vs.health.For fiuther reading, click on the link below:http://uews.cincinnati.com/alticle/20110216INEWSO I08/302160081INKY-smoking-bandies?odyssey=tab% 7Cmostpopular%7Ctext%7CFRONTP AGE

e Oak Grove Implements Partial Smoke-free OrdinanceOn JanualY 4,2011, the city of Oak Grove (Christian County) joined the ranks of smoke-freeKentucky communities. The ordinance offers partial protection to workers and citizens by coveringonly some restaurants. Smoking is prohibited in any restaurant that serves prepared food andbeverages on the premises and which derives 50% or more of gross annual income fiom food sales.Meanwhile, bars, workplaces and other enclosed public places continue to permit smoking.For more information about exemptions and smoke-free laws, go to:htlp:llwww.mc.uky.edu/tobaccopolicy/KCSP/OnePagers/OnepagerExemptionsaugust08FINAL.pdf

e Bullitt County Board ofHealth Schedules Second Reading of Smoke-free Ordinance, March 22,2011On February 17, 2011 Bullitt County Board ofHealth had a first reading of a proposedcomprehensive smoke-free regulation that would prohibit smoking in enclosed public places,places of employment, and certain outdoor areas such as service lines alld sports arenas. Thesecond reading of the ordinance is scheduled for March 22, 2011.

e Smoke-Fee Kentucky-Join the Coalition!Stay informed about the state smoke-free campaign! Please sign up for the Smoke-free KentuckyCoalition at www.smokefreekentucky.org. HB 193 is scheduled for an education hearing in HouseHealth & Welfare on March 3, 2011, at noon. For more infonnation, visitwww.smokefreekentucky.org.

Voices of Smoke-free Communities2


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6) Voices ofSmoke-Fee Communities vignettes feature narrative accounts from Kentuckians whoenjoy clean air living in smoke-free communities, from advocates and elected officials who havebeen involved in creating smoke-free communities. Voices highlight the importance of havingcomprehensive smoke-free laws and debunk the common anti-health arguments.You might consider using these vignettes during public forums or educational events in yourcommunity. If appropriate, you might ask to show one during a public hearing, fiscal court, or citycommission meeting. Would your local cable TV be willing to show it? Your online newspapermight be willing to link to it as well!Click on the link below to access all of the vignettes in the series.http://www.mc.uky.edu/tobaccopolicy/KCSP/VoicesofSF.HTM

Smoke-free Research Updates6) Calm, z., & Siegel, M. (20l0). Electronic Cigarettes as a Harm Reduction Strategy for Tobacco

Control: A Step Forward or a Repeat ofPast Mistakes? Journal ofPublic Health Policy 02} 1-16.The authors conclude that e-cigarettes may be a harm reduction product that helps smokers quit(although further testing is needed). The authors claim that the contents of e-cigarettes do notcontain the multitude of cancer causing agents found in traditional cigarettes; e-cigarettes do notcombust unlike a traditional cigarette; and they may curb nicotine cravings. The reader should usecaution in interpreting the findings due to a small sample size.One thing that the authors fail to acknowledge is that e-cigarettes contain carcinogenic chemicals;among them, propylene glycol (and formaldehyde), which is used in theatre production to makesmoke. Side effects of e-cigarettes include: sore throats, dizziness, running pulse, mouth ulcers andslurred speech. The replaceable cartridges are often poorly labeled; the contents can often leak out;and the level ofnicotine within the cartridges is not standardized.Although the smoker may get their nicotine fix, there is no evidence that what they are inhaling orexhaling is safe for them or for those around them. E-cigarettes are not approved by the FDA as anicotine delivery device or a tobacco product; nor are they endorsed by the World HealthOrganization, American Cancer Society, American Heart Association or the American LungAssociation. Some call for e-cigarettes to be removed from the market until there is adequatetesting for safety and efficacy.For further reading, please click on the links below:http://www.prlog.org/l 0942504-cigarettes-ballned-on-domestic-flights-repolis-ash.htmlhttp://tobaccocontrol.bmj.com/colltelltlearly/2010/l 0/22/tc.20 10.037259 .full

Tobacco in the News6) Nebraska Judge Says 'No' to Smoking in Cigar Bars and Hotels

A Nebraska judge ruled that cigar bars, tobacco shops, and all hotel and motel rooms are coveredunder the statewide smoke-free law because they are not substantially different enough from otherworkplaces to be excluded. Proponents of this decision argue that smoke-free air is for everyoneregardless ofthe nature of the business. There is no reason why cigar bar employees and customersas well as hotel room patrons, should not enjoy smoke-free air. An appeal is likely; however, this isgreat precedent for other cities and states to challenge exemptions to their smoke-free ordinances.Everyone deserves to breathe smoke-free air.

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Click on the below to read the full article:http://journalstal'.com/news/locallgovt-and-politics/article8blll928-b80d-5d4d-9446-c7f357166cba.htmlAdvocacy at Work

e Grammys did not include E-Cigarettes in Celebrity Gift BagsNeil Portnow, President of the Recording Academy, announced that the celebrity gift bags for the57 th Annual Grammy A wards would not contain e-cigarettes or related merchandise. Members ofthe American Smoke-free Movies group, as well as their national affiliates, addressed a letter toMr. POltnow requesting that the Recording Academy reconsider the inclusion of e-cigarettes incelebrity gift bags. We commend the Recording Academy for promoting good health.

Opposition Watche Smoke-free Ordinances: Infringement on Your Rights?

On the Smoker's Club website, the pervasive battle cry is that the rights of smokers are violated by a wellfunded, pharmaceutical company-backed, group of anti-smoking bullies. The website alleges that antismoking groups are too focused on trampling personal rights in their zeal to eradicate smoking for the goodthe people.They are not the only group who has adopted the personal rights argument when it comes to smoke-freeordinances. Take Back Kentucky, a website dedicated to protecting state's rights, argues that some laws, forexample, smoke-free ordinances, have iguored proper legal procedures. As a result, smoke-free ordinanceshave been enacted with disregard to people's wishes and their personal rights.Northern Kentucky Choice propagates a similar argument on the principles of free market and free choice.'To smoke or not to smoke is a personal decision, and consumers should be free to choose if they wish toattend an establishment that allows smoking.Smoke-free laws and regulations respect personal rights, while giving everyone a chance to breathe smokefree air at work and when visiting places open to the public. Smoke-free ordinances are about the right tobreathe clean air. There is no constitutional right to smoke. Individuals retain the right to continue to smoke,if they so wish, but only in places where others are not harmed. The arguments mounted against smoke-freelaws by the Smoker's Club, Take Back Kentucky and Northern Kentucky Choice aim to preserve the statusquo, where an individual must choose between their health and a paycheck.Click on the links below to view the opposition arguments.The Smoker's Club: http://www.smokersclub.coml

Northern Kentucky Choice: http://www.nkychoice.comlTake Back Kentucky: http ://www.takebackkentucky.com/

Save the Date:e 2011 Smoke-free Advocate of the Year Nominations

We invite you to submit nominations for the 2011 Smoke-liee Advocate of the Year Award! Pleasenominate a colleague or coalition member who has made a difference in smoke-free policy in yourarea or in other communities. We will recognize one dedicated community member who iscommitted to advocacy to reduce secondhand smoke exposure. The award will be presented at ourannual statewide Smoke-free Conference in Lexington on March 24, 2011.

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Please see attached nomination fonn for more details. The application deadline is February 25,2011 by 5PM, You may submit your nomination fonn to Amanda Fallin. If you have anyquestions, please contact Amanda Fallin, at [email protected], or 859-323-3550.


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Brown. Cynthia G (LHD-Bull itt Co)From:Sent:To:Cc:Subject:Attachments:

Follow Up Flag:Flag Status:

tobacco_coordinators [[email protected]]Tuesday, March 22, 2011 9:42 [email protected]; [email protected] MemoCC-facilitator letter_2.docx; Cooper Clayton Evaluation.docx; Cooper_Clayton_March10.pdf;Tobacco Program Save the Date.pdfFollow upCompleted

We are working on cleaning up the listserv contact list. You may get this email twice (you only need to read itonce). Sorry for the duplication.CPPW MeetingThe Tobacco Program staff will be attending the CPPW conference next week in Atlanta (3/27 - 3/30). Therewill be no Monday Memo. If you need assistance while we are away, email your concerns [email protected]. Irene will forward the message to the appropriate staff. We will contact you as soon awe can. Please make sure you provide a phone number where we can contact you.May ConferenceAttached is the save the date for our May conference. Attendance at this conference is required; it wasincluded in your annual work plan.Community GrantsWe have received many applications for the 2012 Community Grants. Due to the volume of grants and ourout of the office schedule, it will be MID-APRIL at the earliest before we will know final results.Apri l Conference CallThe April Conference call will be Tuesday, April 5 at 9:30 EST, 8:30 CST. Our subject this month will be theCatalyst reporting system. Dennis Peyton wil l make this presentation. Prior to the call, we will place thepresentation on our web site at http://chfs.ky.gov/dph/info/dpqi/hp/cotools.htm. The phone number fo r thecall is: 1-866-889-3903, participant code is 515701#.

Cooper/Clayton Data CollectionSee the three attached documents regarding Cooper/Clayton Facilitator and Evaluation. We are trying tocollect data on Cooper/Clayton Method to quit smoking classes held in 2009 and 2010. If you conducted CCclasses during this two year period, we would greatly appreciate any data you can provide. Please follow theinstructions on these two documents or contact Jessica Jones at Phone: 859-219-0772 x246 Email:[email protected]

FDA Advisors Recommend Ban on Menthol CigarettesMarch 21, 2011News Summary

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An expert panel advising the Food and Drug Administration (FDA) has recommended in a draft report that menthol cigarettes beoutlawed to protect Americans' health, The Washington Post reported March 19.The advisory panel - made up of scientists, physicians, and public health experts -- found that putting menthol in cigarettes did notincrease the individual risk of smoking-related health problems, such as strokes and lung cancer. About 400,000 people die oftobacco-related disease every year In the United States.However, in its draft report (PDF), the panel found that menthol cigarettes Increased "the likelihood of addiction and the degree ofaddiction in youth smokers," and menthol In cigarettes made It harder for African American smokers to quit. Additionally, mentholcigarettes could make groups more likely to experiment with smoking and become regular smokers.The panel found that advertising appeared to make youth, African Americans, and Hispanics more likely to smoke, although the samewas not true for Asian Americans, HawaiianslPacific Islanders, or women. Tobacco companies, the Post said, "have advertised menthobrands heavily in black communities and media." Although African Americans smoke less than whites, they are more likely to sufferfrom tobacco-related disease.Members of the panel have been reviewing the research on menthol cigarettes over the past year. They said that taking mentholCigarettes off the market could save thousands of American lives. Their fin at report is due to the FDA on March 23. The agency is notbound to follow its recommendations.In a statement about the adVisory panel's report, the FDA said that panel members who are representatives of tobaccocompanies will submit a separate "industry perspective document" to the agency on March 23. Menthol cigarettes make up about onethird of the $70 billion American cigarette market.According to Lawrence R. Deyton, M.D., who directs the FDA's Center for Tobacco Products, the agency's own experts willreview the panel's recommendations. He wrote In published remarks that although the agency was not required to act within a specifictimeline, the "FDA intends to provide Its first progress report on the review of the science in approximately 90 days."Heavy Smoking Declines in u.S.Biggest drops in California because of tobacco control programs, researchers sayBy Steven ReinbergHealthDay ReporterTUESDAY, March 15 (HealthDay News) -- The number of people who smoke a pack or more a day has droppedsignificantly in the United States, and perhaps nowhere more than in California, a new study finds.The number of people smoking less than a pack but at least 10 cigarettes a day has also dropped Significantly, addedthe researchers, who examined national data on smoking rates from 1965 to 2007 to come to their conclusion."Public health advocacy can have a major impact on social norms and lead to major changes in population behavior,"said lead researcher John P. Pierce, a professor of family and preventive medicine at the University of California SanDiego.In addition, there has been a significant decline In lung cancer rates in California, and those rates will continue to dropfaster than In the rest of the country over the next 15 years, he noted."The Tobacco Control Program in California has aimed to change social norms in the population, and this has had amajor impact," Pierce said. "Such programs need to be disseminated more widely. The change in social norms inCalifornia impacted both initiation and cessation."The report is published in the March 16 issue of the Journal of the American Medical Association.For the study, Pierce's team collected data on 1,801,529 people who took part in the National Health InterviewSurveys, 1965-1994 and the Current Population Survey Tobacco Supplements, 1992-2007.A total of 139,176 responders were in California, and 1,662,353 were located throughout the rest of the UnitedStates.

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In 1965, 56 percent of all smokers in the United States smoked a pack (20 cigarettes) a day or more. In California,this represented 23.2 percent of smokers while in the rest of the country the prevalence of heavy smokers was 22.9percent, the researchers found.By 2007, this prevalence of heavy smokers was 2.6 percent in California and 7.2 percent in other states, they added.For those who smoked 10 to 19 cigarettes a day, the prevalence in 1965 was 11.1 percent in California and 10.5percent in the rest of the country. By 2007, the prevalence in California was 3.4 percent while it was 5.4 percent Inthe rest of the United States, the researchers noted."This decline has not been accompanied by higher rates of lower-intensity smoking," Pierce said. "This decline inintensity of smoking has come about by a major change In the number of young people who have taken up even ahalf-pack per day habit."There has also been a major cessation effect, Pierce added.Danny McGoldrick, vice president for research at the Campaign for Tobacco-Free Kids, noted that "California hasreduced overall smoking and high-Intensity smoking much faster than the rest of the country, and this has led todeclines in lung cancer rates that are larger than the rest of the country -- saving lives and health-care dollars."California has achieved these lifesaving gains because it has put in place those policies and programs proven toreduce tobacco use, Including the nation's longest running prevention and cessation program, the nation's firststatewide smoke-free law and, in earlier years, higher tobacco taxes, McGoldrick said. "Every state should followCalifornia's example," he said.However, these gains are in jeopardy, as California has fallen behind its funding of tobacco control programs,McGoldrick said."To continue its progress, California must raise its tobacco tax, which has fallen well below the national average, anduse some of the new revenue to increase funding for its model prevention and cessation program, which has declinedsignificantly in recent years," McGoldrick said.Dr. Norman H. Edelman, scientific consultant for the American Lung Association, said that "this is validation of all ofour efforts,lI

These findings show that both prevention programs and programs to help people quit are essential, he said. Inaddition, laws passed that prevent public smoking have also played an important role in the decline in smoking,Edelman noted."The ban on public smoking seems to help people quit," he said. "But, the job Is not over -- 20 percent of Americansstill smoke, so there Is still a long way to go. But we have begun to turn the tide in lung cancer and it looks like it'shappening in chronic obstructive pulmonary disease (COPD)."More information

For more information on quitting smoking, visit Smokefree.gov.SOURCES: John P. Pierce, Ph.D., professor, family and preventive medicine, University of California San Diego, LaJolla; Danny McGoldrick, vice president, research, Campaign for Tobacco-Free Kids; Norman H. Edelman, M.D.,scientific consultant, American Lung Association; March 16, 2011, Journal of the American Medical AssociationCopyright 2011 HealthDay. All rights reserved.

U.K. Will Require Stores to Hide Tobacco ProductsMarch 15. 2011News Summary

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Displays of tobacco products will not be allowed in any British stores as of 2015, Reuters reported March 9.Britain's Department of Health has instituted a ban that will be phased In gradually. Supermarkets and large stores will need to complyby 2012; small shops will follow In 2015.The move is part of a larger campaign to reduce adult smoking rates in the country from over 20 percent to 18.5 percent by 2015. Othetactics include raising tobacco prices and providing assistance to smokers who want to quit. Later this year, the government will belooking into whether to force tobacco manufacturers to use plain packaging.

"Smoking Is undeniably one of the biggest and most stubbom challenges in public health," said Health Secretary Andrew Lansley."Over eight million people in England still smoke and it causes more than 80,000 deaths each year."Tobacco companies are fighting the new ban in court, and a judicial review is expected in April.

Electronic Cigarettes As a Smoking-Cessation Tool: Results from an Online SurveyMichael B. Siegel, Kerry L. Tanwar, Kathleen S. Wood

Tracking the Rise in Popularity of Electronic Nicotine Delivery Systems (Electronic Cigarettes) Using Search Query SurveillanceJohn W. Ayers, Kurt M. Ribisl, John S. Brownstein

Menthols Not Worse, But Could Be More Addictive: FDA Tobacco Panel DraftMarch 8, 2011News SummaryA panel advising the Food and Drug Administration (FDA) has concluded that menthol Cigarettes are not worse for smokers' health thanregular cigarettes -- but they may be more addictive, Bloomberg reported Feb. 28.To reach its conclusions -- which the FDA does not have to act upon -- the Tobacco Products Scientific Advisory Committee looked atmarketing data from the three largest U.S. tobacco companies, Altria (a unit of Philip Morris USA), ReynoldsAmerican, and Lorillard, as well as decades of research.The advisory panel posted two chapters from its draft report on the FDA website In advance of a March 23 deadline. The report isrequired as part of the 2009 law that granted the FDA the authority to regulate tobacco and prohibited all cigarette flavoringsexcept menthol. If the FDA rules that menthol presents an elevated health risk, It could ban it as a tobacco flavoring.With regard to whether menthol cigarettes pose a greater health risk to smokers than regular cigarettes, the panel concluded, "Theevidence Is insufficient," In a draft chapter titled, "Effects Of Menthol on the Disease Risks of Smoking" (PDF),However, in a draft chapter titled, "The Physiological Effects of Menthol Cigarettes" (PDF), the panelists said it was"biotogically plausible" for menthol cigarettes to be more addictive than regular cigarettes."Menthol provides an unmistakable sensory experience -- the minty taste, cooling sensation and throat irritation or impact," they wrote."The taste and odor are pteasurable for menthol cigarette smokers and may reinforce smoking behavior."In the first chapter of its report, the panel said that menthol could also present other risks to public health besides disease."The availability of menthol cigarettes could have no significant effect on risk for disease outcomes, yet have a significant effect onincreasing initiation or reducing the success of cessation," panelists wrote. "The resultant increase In the prevalence of smoking wouldrepresent a negative public health Impact."Two companies, Lorillard and Reynolds, have sued the FDA to prevent it from "receiving or relying on" the panel's conclusions, thoughthe panel's report is non-binding. According to Bloomberg, the companies alleged that three of the panel's eight members had conflictsof Interest because they have "served as paid witnesses in tawsuits against the tobacco industry and take money from drug companiesthat make smoking-cessation aids,"

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Menthol cigarettes make up 30 percent of the $85 billion U.S. tobacco market, with Lorillard's Newport brand leading Marlboro Menthol,Camel Menthol, Kool, and Salem.

Study Suggests Minorities Smoke Less, But Find Quitting HarderMarch 10, 2011Research SummaryNew research suggests that smoking is less prevalent in communities of color, and, among those who smoke, racial and ethnic"minorities" are more likely to be "light" smokers -- but may find it harder to quit, UPI reported Mar. 9.The study relied on census data from adults age 20 to 64. Among other things, the results showed that fewer African Americans, AsianAmericans/Pacific Islanders, and Latinos had ever taken up smoking compared with non-Hispanic Whites. Racial and ethnic"minorities" were more likely than Whites to be light smokers.The study also found that light smokers may have just as hard a time as heavy smokers quitting.Although racial and ethnic minorities were just as likely as Whites to be told to quit smoking by health professionals, they were lesslikely to use nicotine replacement therapy. According to the study abstract, "significantly fewer African Americans reported long-termquitting.""Our understanding of how to get people to quit smoking has been based on those who were the heaviest smokers, that is, those whosmoked a pack a day or more," said Dennis T rinidad, of Claremont Graduate University's School of Community and Global Health."Now, as the smoking population shifts to include more light smokers, we may need to look for better ways to help them stop."The study, "A Nationwide Analysis of US Racial/Ethnic Disparities In Smoking Behaviors, Smoking Cessation, and Cessation-RelatedFactors," was published online on Feb. 17, 2011, in the American Journal of Public Health.

This article summarizes an external report or press release on research published in a scientific journal. When available, links to thesources are provided above.

Menthols Not Worse, But Could Be More Addictive: FDA Tobacco Panel DraftMarch 8, 2011News SummaryA panel advising the Food and Drug Administration (FDA) has concluded that menthol cigarettes are not worse for smokers' health thanregular cigarettes -- but they may be more addictive, Bloomberg reported Feb. 28.To reach its conclusions -- which the FDA does not have to act upon -- the Tobacco Products Scientific Advisory Committee looked atmarketing data from the three largest U.S. tobacco companies, Altria (a unit of Philip Morris USA), ReynoldsAmerican, and Lorillard, as well as decades of research.The advisory panel posted two chapters from its draft report on the FDA website In advance of a March 23 deadline. The report isrequired as part of the 2009 law that granted the FDA the authority to regulate tobacco and prohibited all cigarette flavoringsexcept menthol. If the FDA rules that menthol presents an elevated health risk, it could ban it as a tobacco flavoring.With regard to whether menthol cigarettes pose a greater health risk to smokers than regular cigarettes, the panel concluded, "Theevidence is insufficient," in a draft chapter titled, "Effects Of Menthol on the Disease Risks of Smoking" (PDF).However, in a draft chapter titled, "The Physiological Effects of Menthol Cigarettes" (PDF), the panelists said it was"biologically plausible" for menthol cigarettes to be more addictive than regular cigarettes.

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"Menthol provides an unmistakable sensory experience -- the minty taste, cooling sensation and throat irritation or impact," they wrote."The taste and odor are pleasurable for menthol cigarette smokers and may reinforce smoking behavior."In the first chapter of its report, the panel said that menthol could also present other risks to public health besides disease."The availability of menthol cigarettes could have no significant effect on risk for disease outcomes, yet have a significant effect onincreasing initiation or reducing the success of cessation," panelists wrote. "The resultant increase in the prevalence of smoking wouldrepresent a negative public health impact."

Two companies, Lorillard and Reynolds, have sued the FDA to prevent it from "receiving or relying on" the panel's conclusions, thoughthe panel's report is non-binding. According to Bloomberg, the companies alleged that three of the panel's eight members had conflictsof interest because they have "served as paid witnesses In lawsuits against the tobacco Industry and take money from drug companiesthat make smoking-cessation aids."Menthol cigarettes make up 30 percent of the $85 billion U.S. tobacco market, with Lorillard's Newport brand leading Marlboro Menthol,Camel Menthol, Kool, and Salem

Secondhand Smoke Risk Penetrates WombBy Crystal Phend. Senior Staff Writer, MedPage TodayPublished: March 07. 2011Reviewed by Robert Jasmer, MD: Associate Clinical Professor of Medicine, University of California,San Francisco andDorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

Nonsmoking women who breathe secondhand tobacco smoke during pregnancy increase their risk of stillbirth, major birth defecother harms to their babies, according to a meta-analysis.The analysis of 19 observational studies found a 23% increased risk of stillbirth with tobacco smoke exposure during pregnancyratio 1.23, 95% confidence interval 1.09 to 1.38) in four of the studies, reported Jo Leonardi-Bee, PhD, MSc, of the University ofNottingham, England, and colleagues.

And seven of the studies found that pregnant women exposed to second hand smoke were also 13% more likely give birth to a cwith congenital malformations (OR 1.13, 95% CI 1.01 to 1.26), Leonardi-Bee and co-authors wrote in the April issue of Pediatrics"Because the timing and mechanism of this effect is not clear, it is important to prevent secondhand smoke exposure in women and during pregnancy," the group urged in their paper.Previous data have shown that smoking during pregnancy boosts the risk of birth defects by 10% to 34% and stillbirth risk by 2034%, so a modest impact of environmental exposure involving lower levels of the same tobacco smoke toxins wasn't surprising,group noted.A prior meta-analysis by Leonardi-Bee's group found that maternal exposure to secondhand smoke decreased infant birth weigh33 g (1.16 oz) and increased the risk of having a low birthweight baby (defined as


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used self-reported exposure.The group claimed that theirs was the first systematic review and meta-analysis of all world evidence available to quantify the effectmaternal secondhand smoke exposure during pregnancy on a range of adverse fetal outcomes.Spontaneous abortion -- defined as miscarriage of the pregnancy before 20 weeks' gestation -- wasn't significantly more common wsecondhand smoke exposure in utero (OR 1.17, 95% CI 0.88 to 1.54).Death of the baby after 20 weeks' gestation to within the first 28 days after birth also showed no significant Impact of secondhandsmoke (OR 1.07, 95% CI 0.48 to 2.38) but was only evaluated in two studies.Wilh regard to individual congenital malformations, again, relatively few studies reported on outcomes but with elevated point estimafor some risks, despite small numbers and statistical non-significance. These included:

Conotruncal heart defects (OR 1.30, 95% CI 0.85 to 2.10) Clubfoot and other similar deformities of the feet (OR 1.80, 95% CI 0.97 to 3.30) Cryptorchidism (OR 1.55, 95% CI 0.95 to 2.54) Neural tube defects (OR 1.20, 95% CI 0.83 to 1.73) Anencephaly (OR 2.10, 95% CI 0.90 to 4.90) Spina bifida (OR 1.90, 95% CI 0.70 to 9.40) Orofacial clefts (OR 1.09, 95% CI 0.93 to 1.27) Craniosynostosis (OR 1.30, 95% CI 0.89 to 1.90)

Leonardi-Bee's group suggested that their results should be generalizable, but cautioned about the likelihood of residual confoundinsince they were limited by reliance on confounding factors adjusted for in the original studies. "Therefore, w

Bullitt County, KY (E-Cigarette FOIA Request Result)

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Transcript of Bullitt County, KY (E-Cigarette FOIA Request Result)