I just started vaping 1 week ago. I am looking to quit nicotene all together, but I must pass a continine test which is about 7 weeks away. Does anyone know how long I need to be nicotene free for, to pass the test? I'm thinking it's around 10-14 days.
Cotinine tests. How long do I need to be nicotene free to pass?
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Wikipedia says several days, up to one week. Also says level of cotinine is proportional to amount of exposure, so I'd think that if you work yourself down to a very low level of nic the week before (like 5-6 mg/ml), then switch to 0 maybe 3-4 days before the test, you'd probably be okay. Might want to give it a full week just to be 100% sure.
Good luck! Is this for a job or for insurance? If that's too personal, just ignore.
Good luck! Is this for a job or for insurance? If that's too personal, just ignore.
WTF, Will you get penalized for not having stellar levels in each category besides cotinine?
it doesn't have to be stellar, jut not horrible really. It can change our insurance to anywhere between 8% to 20%.
These is what we have to meet:
Mens waist size has to be 40" or less. (womens 35")
BMI- less then 30%
cholesterol- total of less then 240 mg/dl; and HDL of 40 mg/dl or more
blood glucose- less then 140 mg/dl
Blood pressure- lower then 140/90 mmHg
no tobacco use
These is what we have to meet:
Mens waist size has to be 40" or less. (womens 35")
BMI- less then 30%
cholesterol- total of less then 240 mg/dl; and HDL of 40 mg/dl or more
blood glucose- less then 140 mg/dl
Blood pressure- lower then 140/90 mmHg
no tobacco use
Depends on the level that they consider to be a tobacco user. The Cotinine tests can detect levels created by being exposed to second hand smoke! I'd want to be at zero nic levels for a week before and drink lots of water besides just to make sure.
If the 8% to 20% price increase for failing parts of the testing is an increase to your individual rate, then it's worth it to pass with flying colors. If it's a collective rate for all employees, not so much other than being classed as a smoker. It used to cost me the loss of a $200 discount off my annual rate to check the smoker box. I started vaping after retirement.
If the 8% to 20% price increase for failing parts of the testing is an increase to your individual rate, then it's worth it to pass with flying colors. If it's a collective rate for all employees, not so much other than being classed as a smoker. It used to cost me the loss of a $200 discount off my annual rate to check the smoker box. I started vaping after retirement.
Last edited:
Yes the increase would be to my personal rate I pay for health insurance, so I am trying to pass with flying colors.
I guess I will go to 0 nic juice for about 7-10 days before test and drink a ton of water.
It is pure ignorance (and years of propaganda) that lead employers to believe that all tobacco is equally harmful so that they feel justified in penalizing employees for tobacco use, not just smoking. You might be interested in the content of CASAA's letter to South Carolina's House of Representatives
Dear Representative:
The Consumer Advocates for Smoke-free Alternatives Association (CASAA) urges you to amend S. 418, Proviso Codification Act of 2011, so that it does not penalize former smokers who quit by switching to a reduced-risk smoke-free alternative.
Cigarette smoking causes a high risk for numerous health problems. By contrast, smoke-free tobacco products (smokeless tobacco and the clean nicotine inhalers known as "electronic cigarettes", which are legally classified as a tobacco product) cause risks so small that they cannot be measured. They are estimated to be about 1% of the risk from smoking.
Because of this, switching to smoke-free products has become a common way for smokers to stop smoking, and thus eliminate the health hazards of smoking. A law that treats this choice -- switching to low-risk alternative tobacco products -- the same as cigarette smoking -- imposes a financial penalty on former smokers who have taking the healthy (and cost-saving) step of switching sends the wrong message: “You might as well smoke.” It would be one less reason for cigarette smokers to take advantage of the opportunity to switch. Moreover, to the extent that the purpose of the law would be to make smokers pay for the extra cost they are imposing, this would be unfair: Users of smoke-free tobacco products do not impose extra costs.
This change in the proposal would also be more practical than the current version. We assume that you did not intend to include users of "nicotine replacement therapy" (NRT) pharmaceuticals like nicotine gum among those subject to the extra charge. If an insurer is trying to enforce this rule using testing for the presence of nicotine, rather than just taking people's word for it, it is not possible to distinguish a smokeless tobacco or electronic cigarette user from a user of nicotine gum. However, it is possible to smokers from non-smokers by testing for exhaled carbon monoxide. If the rule were rewritten to refer specifically to smokers, it would be more fair and better for public health.
CASAA recommends changing Section 2, Item J of S. 418 to substitute the phrase “cigarette smokers” for “tobacco users” and changing the two instances of “tobacco use” to “cigarette smoking.” In the References section below, we have listed citations to scientific journal articles that discuss the reduced risks of using smokeless tobacco products and the effectiveness of switching to a smoke-free alternative as a method of smoking cessation.
REFERENCES
Tobacco Harm Reduction
American Council on Science and Health. Helping Smokers Quit: The Science Behind Tobacco Harm Reduction. December 2011. http://www.acsh.org/docLib/20120214_HelpingSmokersQuitFINAL.pdf
Bates C, Fagerstom K, Jarvis M, Kinze M, McNeil A, Ramstrom L, European Union Policy on Smokeless Tobacco: A statement in Favor of Evidence-Based Regulation for Public Health, Feb 2003, http://ash.org.uk/html/regulation/html/eusmokeless.htm l
Kozlowski L. First Tell The Truth, A Dialogue on Human Rights, Deception, and the Use of
Smokeless Tobacco as a Substitute for Cigarettes Tobacco Control,12:34-36, 2003.
First, tell the truth: a dialogue on human rights, deception, and the use of smokeless tobacco as a substitute for cigarettes -- Kozlowski 12 (1): 34 -- Tobacco Control
Kozlowski L, Edwards BQ, “Not safe” is not enough: smokers have a right to know more than there is no safe tobacco product, Tobacco Control, Vol. 14, 3-7, 2005. âNot safeâ is not enough: smokers have a right to know more than there is no safe tobacco product -- Kozlowski and Edwards 14 (suppl 2): ii3 -- Tobacco Control
Phillips C, Wang C, Guenzel B, You might as well smoke; the misleading and harmful public message about smokeless tobacco, BMC Public Health, 2005, 5:31, doi:10.1186/1471-2458-5-31. http://www.biomedcentral.com/147.../1471-2458/5/31
Protecting Smokers, Saving Lives: The case for a Tobacco and Nicotine Authority, Royal College of Physicians, London, 2002. http://www.starscientific.com/404/royal college of physicians.pdf
Rodu B. The scientific foundation for tobacco harm reduction, 2006-2011. Harm Reduct J. 2011 Jul 29;8:19. The scientific foundation for tobacco harm reduction, 2006-2011
Rodu B, Godshall W. Tobacco harm reduction: an alternative cessation strategy for inveterate smokers. Harm Reduction Journal 2006, 3:37 doi:10.1186/1477-7517-3-37. http://www.harmreductionjournal.com/content/pdf/1477-7517-3-37.pdf
Waterbor J, Adams R, Robinson J, et al, Disparities between Public Health Educational Materials and the Scientific Evidence that Smokeless Tobacco Use Causes Cancer, J Cancer Educ. Vol. 19, 17-28, 2004. BMC Public Health | Full text | Meta-analysis of the relation between European and American smokeless tobacco and oral cancer
Wikmans T, Ramström L. Harm perception among Swedish daily smokers regarding nicotine, NRT-products and Swedish Snus. Tob Induc Dis. 2010 Aug 13;8:9. Harm perception among Swedish daily smokers regarding nicotine, NRT-products and Swedish Snus
Health Effects of Smokeless Tobacco
Accortt NA, Waterbor JW, Beall C, Howard G. Cancer incidence among a cohort of smokeless tobacco users (United States), Cancer Causes and Control, 2005, Vol. 16, 1107-1115. Cancer incidence among a cohort of smo... [Cancer Causes Control. 2005] - PubMed - NCBI
Boffetta P, Aagnes B, Weiderpass E, Andersen A, Smokeless tobacco use and risk of cancer of the pancreas and other organs, Int. J. Cancer Vol. 114, 992-995, 2005. Smokeless tobacco use and risk of cancer of the... [Int J Cancer. 2005] - PubMed - NCBI
Bouquot JE, Meckstroth RL. Oral cancer in a tobacco-chewing US population - no apparent increased incidence or mortality, Oral Surgery Oral and Maxillofacial Pathology, 1998, Vol. 86, No. 6. 697-706. Oral cancer... [Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998] - PubMed - NCBI
Colilla SA. An epidemiologic review of smokeless tobacco health effects and harm reduction potential. Regul Toxicol Pharmacol. 2010 Mar;56(2):197-211. Epub 2009 Sep 29. Review. An epidemiologic review of smokeless... [Regul Toxicol Pharmacol. 2010] - PubMed - NCBI
Foulds J, Ramstrom L, Burke M, Ragerstom K, Effect of smokeless tobacco (snus) on public health in Sweden, Tobacco Control, 2003, Vol 12, 349-359. Effect of smokeless tobacco (snus) on smoking and public health in Sweden -- Foulds et al. 12 (4): 349 -- Tobacco Control
Gupta R, Hitinder G, Bartholomew J. Smokeless Tobacco and Cardiovascular Risk. Arch Intern Med, Vol. 164, 1845-1849, Sep. 27, 2004. JAMA Network | Error
Henley SJ, Thun MJ, Connell C. Calle EE, Two large prospective studies of mortality among men who use snuff or chewing tobacco (United States), Cancer Causes and Control, Vol. 16, 347-358, 2005. Two large prospective studies of morta... [Cancer Causes Control. 2005] - PubMed - NCBI
Henley SJ, Connell C, Calle EE, Thun MJ. Tobacco‐related disease mortality among men who switched from cigarettes to spit tobacco. Tob Control. 2007; 16(1): 22–28. Tobacco
Lee PN. Circulatory disease and smokeless tobacco in Western populations: a review of the evidence. Int J Epidemiol. 2007 Aug;36(4):789-804. Epub 2007 Jun 25. Circulatory disease and smokeless tobacco in Western populations: a review of the evidence
Lee PN. Summary of the epidemiological evidence relating snus to health. Regul Toxicol Pharmacol. 2011 Mar;59(2):197-214. Epub 2010 Dec 14. Review. Summary of the epidemiological evide... [Regul Toxicol Pharmacol. 2011] - PubMed - NCBI
Levy DT, Mumford EA, Cummings KM, et al, The Relative Risks of a Low-Nitrosamine Smokeless Tobacco Product Compared with Smoking Cigarettes: Estimates of a Panel of Experts, 2004, Cancer Epidemiol Biomarkers Prev, Vol. 13, No. 12, 2035-2042. http://cebp.aacrjournals.org/content/13/12/2035.full.pdf+html
Levy D, Mumford E, Cummings KM, et al. The potential impact of a low-nitrosamine smokeless tobacco product on cigarette smoking in the United States: Estimates of a panel of experts, Addictive Behaviors, Nov. 2005. http://www.ihra.net/files/2011/07/13/Levy_-_Impact_of_Low-Nitrosamine_Smokeless_Tobacco.pdf
Lewin F, Norell SE, Johansson H, et al, Smoking tobacco, oral snuff and alcohol in the etiology of squamous cell carcinoma of the head and neck. A population based case-referent study in Sweden. 1998, Cancer, Vol. 82, 1367-1375. Smoking tobacco, oral snuff, and alcohol in the etiol... [Cancer. 1998] - PubMed - NCBI
Phillips CV, Heavner KK. Smokeless tobacco: the epidemiology and politics of harm. Biomarkers. 2009 Jul;14 Suppl 1:79-84. Smokeless tobacco: the epidemiology and politics ... [Biomarkers. 2009] - PubMed - NCBI
Rodu B, Cole P. Smokeless tobacco use and cancer of the upper respiratory tract. Oral Surgery Oral Medicine Oral Pathology, 2002, Vol. 93, No. 5, 511-515. Smokeless t... [Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002] - PubMed - NCBI
Rodu B. Lung cancer mortality: Comparing Sweden with other countries in the European Union. Scand J Public Health July 2009 vol. 37 no. 5 481-486. Lung cancer mortality: comparing Swede... [Scand J Public Health. 2009] - PubMed - NCBI
Schildt E-B, Eriksson M, Hardell L, Magnusson A. Oral snuff, smoking habits and alcohol consumption in relation to oral cancer evaluated in a Swedish case-control study, 1998, International Journal of Cancer, Vol. 77, 341-346. Oral snuff, smoking habits and alcohol consumpt... [Int J Cancer. 1998] - PubMed - NCBI
Sponsiello-Wang Z, Weitkunat R, Lee PN. Systematic review of the relation between smokeless tobacco and cancer of the pancreas in Europe and North America. BMC Cancer. 2008 Dec 1;8:356. Systematic review of the relation between smokeless tobacco and cancer of the pancreas in Europe and North America
Smokeless Tobacco for Smoking Cessation
Barrett SP, Campbell ML, Temporale K, Good KB. The acute effect of Swedish-style snus on cigarette craving and self-administration in male and female smokers. Hum Psychopharmacol. 2011 Feb 9. The acute effect of Swedish-style snus o... [Hum Psychopharmacol. 2011] - PubMed - NCBI
Fagerstrom K, Rutqvist LE, Hughes JR. Snus as a smoking cessation aid: a randomized placebo-controlled trial. Nicotine Tob Res. 2012 Mar;14(3):306-12. Epub 2011 Oct 12. Snus as a smoking cessation aid: a randomiz... [Nicotine Tob Res. 2012] - PubMed - NCBI
Gorini G. [Harm reduction strategy in tobacco control]. Epidemiol Prev. 2011 May-Aug;35(3-4 Suppl 1):19-32. [Harm reduction strategy in tobacco c... [Epidemiol Prev. 2011 May-Aug] - PubMed - NCBI
Hatsukami DK, Jensen J, Anderson A, Broadbent B, Allen S, Zhang Y, Severson H. Oral tobacco products: preference and effects among smokers. Drug Alcohol Depend. 2011 Nov 1;118(2-3):230-6. Epub 2011 Apr 23. Oral tobacco products: preference and ef... [Drug Alcohol Depend. 2011] - PubMed - NCBI
Kotlyar M, Hertsgaard LA, Lindgren BR, Jensen JA, Carmella SG, Stepanov I, Murphy SE, Hecht SS, Hatsukami DK. Effect of oral snus and medicinal nicotine in smokers on toxicant exposure and withdrawal symptoms: a feasibility study. Cancer Epidemiol Biomarkers Prev. 2011 Jan;20(1):91-100. Effect of oral snus and med... [Cancer Epidemiol Biomarkers Prev. 2011] - PubMed - NCBI
Joksić G, Spasojević-Tišma V, Antić R, Nilsson R, Rutqvist LE.Randomized, placebo-controlled, double-blind trial of Swedish snus for smoking reduction and cessation. Harm Reduct J. 2011 Sep 13;8(1):25. HRJ | Full text | Randomized, placebo-controlled, double-blind trial of Swedish snus for smoking reduction and cessation
Le Houezec J, McNeill A, Britton J. Tobacco, nicotine and harm reduction. Drug Alcohol Rev. 2011 Mar;30(2):119-23. Tobacco, nicotine and harm reduction. [Drug Alcohol Rev. 2011] - PubMed - NCBI
Lund KE, McNeill A, Scheffels J. The use of snus for quitting smoking compared with medicinal products. Nicotine Tob Res. 2010 Aug;12(8):817-22. The use of snus for quitting smoking compared with medicinal products
Lund I, Scheffels J. Perceptions of the relative harmfulness of snus among Norwegian general practitioners and their effect on the tendency to recommend snus in smoking cessation. Nicotine Tob Res. 2012 Feb;14(2):169-75. Epub 2011 Oct 24. Perceptions of the relative harmfulness of ... [Nicotine Tob Res. 2012] - PubMed - NCBI
Lund KE, Scheffels J, McNeill A.The association between use of snus and quit rates for smoking: results from seven Norwegian cross-sectional studies. Addiction. 2011 Jan;106(1):162-7. The association between use of snus and quit rates... [Addiction. 2011] - PubMed - NCBI
Lunell E, Curvall M. Nicotine delivery and subjective effects of Swedish portion snus compared with 4 mg nicotine polacrilex chewing gum. Nicotine Tob Res. 2011 Jul;13(7):573-8. Epub 2011 Mar 31. Nicotine delivery and subjective effects of... [Nicotine Tob Res. 2011] - PubMed - NCBI
Norberg M, Lundqvist G, Nilsson M, Gilljam H, Weinehall L. Changing patterns of tobacco use in a middle-aged population: the role of snus, gender, age, and education. Glob Health Action. 2011;4. doi: 10.3402/gha.v4i0.5613. Epub 2011 Jun 3. Changing patterns of tobacco use in a middle-aged population
Ramström L, Foulds J: Role of snus in initiation and cessation of tobacco smoking in Sweden. Tobacco Cont 2006, 15:210-214. http://www.tobaccoprogram.org/pdf/ramstr%F6m_foulds_tc_june06.pdf
Rodu B, Phillips CV: Switching to smokeless tobacco as a smoking cessation method: evidence from the 2000 National Health Interview Survey. Harm Red J 2008, 5:18 HRJ | Full text | Switching to smokeless tobacco as a smoking cessation method: evidence from the 2000 National Health Interview Survey
Stenbeck M, Hagquist C, Rosén M.The association of snus and smoking behaviour: a cohort analysis of Swedish males in the 1990s. Addiction. 2009 Sep;104(9) The association of snus and smoking behaviour: a c... [Addiction. 2009] - PubMed - NCBI
Wiium N, Overland S, Aarø LE. Smoking cessation among Norwegian adolescents and young adults: preferred cessation methods. Scand J Psychol. 2011 Apr;52(2):154-60. Smoking cessation among Norwegian adolescent... [Scand J Psychol. 2011] - PubMed - NCBI
Electronic Cigarettes for Smoking Cessation
Dockrell M, Indu SD, Lashkari HG, McNeill A. "It sounds like the replacement I need to help me stop smoking": Use and acceptability of "e-cigarettes” among UK smokers. 12th annual meeting of the Society for Research on Nicotine and Tobacco Europe. Bath, UK, 2010. https://secure2.symphonyem.co.uk/CMS/UserDocuments/899/Cathy Book1-121 .pdf
Etter JF. Electronic cigarettes: a survey of users. BMC Public Health. 2010; 10: 231. Electronic cigarettes: a survey of users
Etter JF, Bullen C. Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy. Addiction, 106: 2017–2028. Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy - Etter - 2011 - Addiction - Wiley Online Library (accessed June 2011) Full Text: Electronic Cigarettes
Siegel MB, Tanwar KL, Wood KS. Electronic cigarettes as smoking cessation tool: Results from an Online Survey. American Journal of Preventive Medicine 2011 Apr; 40(4):472-5. http://www.stop-tabac.ch/fra/images...op_tabac/seigel e cigs am j prev med 2011.pdf
Cahn Z, Siegel M. Electronic cigarettes as a harm reduction strategy for tobacco control: A step forward or a repeat of past mistakes? Journal of Public Health Policy advance online publication 9 December 2010; doi: 10.1057/jphp.2010.41. http://www.hsph.harvard.edu/centers-institutes/population-development/files/article.jphp.pdf
Bullen C, C, McRobbie H, Thornley S, Glover M, Lin R, Laugesen M. Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial. Tob Control. 2010 Apr;19(2):98-103. http://www.healthnz.co.nz/2010 Bullen ECig.pdf
Caponnetto P, Cibella F, Mancuso S, Campagna D, Arcidiacono G, Polosa R. Effect of a nicotine free inhalator as part of a smoking cessation program. Eur Respir J. 2011 May 12. Effect of a nicotine-free inhalator as part of ... [Eur Respir J. 2011] - PubMed - NCBI
Caponnetto P, Polosa R, Auditore R, Russo C, Campagna D. Smoking Cessation with E-Cigarettes in Smokers with a Documented History of Depression and Recurring Relapses. International Journal of Clinical Medicine, 2011, 2, 281-284. http://www.casaa.org/files/Polosa-E-Cig-Smoking-Cessation-Depression.pdf
Polosa R, Caponnetto P, Morjaria J B, Papale G, Campagna D, Russo C: Effect of an Electronic Nicotine Delivery Device (e-Cigarette) on Smoking Reduction and Cessation: A Prospective 6-Month Pilot Study. BMC Public Health 2011, 11:786. http://www.biomedcentral.com/content/pdf/1471-2458-11-786.pdf
Rose JE, Turner JE, Murugesan T, Behm FM. Pulmonary delivery of nicotine pyruvate: sensory and pharmacokinetic characteristics. Poster, Society for Research on Nicotine and Tobacco 16th annual conference, Baltimore, 27 February 2010. http://www.srnt.org/conferences/2010/pdf/2010_Program.pdf
Vansickel AR, Cobb CO, Weaver MF, Eissenberg TE. A clinical laboratory model for evaluating the acute effects of electronic "cigarettes": nicotine delivery profile and cardiovascular and subjective effects. Cancer Epidemiol Biomarkers Prev. 2010 Aug;19(8):1945-53. Epub 2010 Jul 20. http://www.casaa.org/files/Virgiania Commonwealth University Study.pdf
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I hope someone finds the above information useful.
Dear Representative:
The Consumer Advocates for Smoke-free Alternatives Association (CASAA) urges you to amend S. 418, Proviso Codification Act of 2011, so that it does not penalize former smokers who quit by switching to a reduced-risk smoke-free alternative.
Cigarette smoking causes a high risk for numerous health problems. By contrast, smoke-free tobacco products (smokeless tobacco and the clean nicotine inhalers known as "electronic cigarettes", which are legally classified as a tobacco product) cause risks so small that they cannot be measured. They are estimated to be about 1% of the risk from smoking.
Because of this, switching to smoke-free products has become a common way for smokers to stop smoking, and thus eliminate the health hazards of smoking. A law that treats this choice -- switching to low-risk alternative tobacco products -- the same as cigarette smoking -- imposes a financial penalty on former smokers who have taking the healthy (and cost-saving) step of switching sends the wrong message: “You might as well smoke.” It would be one less reason for cigarette smokers to take advantage of the opportunity to switch. Moreover, to the extent that the purpose of the law would be to make smokers pay for the extra cost they are imposing, this would be unfair: Users of smoke-free tobacco products do not impose extra costs.
This change in the proposal would also be more practical than the current version. We assume that you did not intend to include users of "nicotine replacement therapy" (NRT) pharmaceuticals like nicotine gum among those subject to the extra charge. If an insurer is trying to enforce this rule using testing for the presence of nicotine, rather than just taking people's word for it, it is not possible to distinguish a smokeless tobacco or electronic cigarette user from a user of nicotine gum. However, it is possible to smokers from non-smokers by testing for exhaled carbon monoxide. If the rule were rewritten to refer specifically to smokers, it would be more fair and better for public health.
CASAA recommends changing Section 2, Item J of S. 418 to substitute the phrase “cigarette smokers” for “tobacco users” and changing the two instances of “tobacco use” to “cigarette smoking.” In the References section below, we have listed citations to scientific journal articles that discuss the reduced risks of using smokeless tobacco products and the effectiveness of switching to a smoke-free alternative as a method of smoking cessation.
REFERENCES
Tobacco Harm Reduction
American Council on Science and Health. Helping Smokers Quit: The Science Behind Tobacco Harm Reduction. December 2011. http://www.acsh.org/docLib/20120214_HelpingSmokersQuitFINAL.pdf
Bates C, Fagerstom K, Jarvis M, Kinze M, McNeil A, Ramstrom L, European Union Policy on Smokeless Tobacco: A statement in Favor of Evidence-Based Regulation for Public Health, Feb 2003, http://ash.org.uk/html/regulation/html/eusmokeless.htm l
Kozlowski L. First Tell The Truth, A Dialogue on Human Rights, Deception, and the Use of
Smokeless Tobacco as a Substitute for Cigarettes Tobacco Control,12:34-36, 2003.
First, tell the truth: a dialogue on human rights, deception, and the use of smokeless tobacco as a substitute for cigarettes -- Kozlowski 12 (1): 34 -- Tobacco Control
Kozlowski L, Edwards BQ, “Not safe” is not enough: smokers have a right to know more than there is no safe tobacco product, Tobacco Control, Vol. 14, 3-7, 2005. âNot safeâ is not enough: smokers have a right to know more than there is no safe tobacco product -- Kozlowski and Edwards 14 (suppl 2): ii3 -- Tobacco Control
Phillips C, Wang C, Guenzel B, You might as well smoke; the misleading and harmful public message about smokeless tobacco, BMC Public Health, 2005, 5:31, doi:10.1186/1471-2458-5-31. http://www.biomedcentral.com/147.../1471-2458/5/31
Protecting Smokers, Saving Lives: The case for a Tobacco and Nicotine Authority, Royal College of Physicians, London, 2002. http://www.starscientific.com/404/royal college of physicians.pdf
Rodu B. The scientific foundation for tobacco harm reduction, 2006-2011. Harm Reduct J. 2011 Jul 29;8:19. The scientific foundation for tobacco harm reduction, 2006-2011
Rodu B, Godshall W. Tobacco harm reduction: an alternative cessation strategy for inveterate smokers. Harm Reduction Journal 2006, 3:37 doi:10.1186/1477-7517-3-37. http://www.harmreductionjournal.com/content/pdf/1477-7517-3-37.pdf
Waterbor J, Adams R, Robinson J, et al, Disparities between Public Health Educational Materials and the Scientific Evidence that Smokeless Tobacco Use Causes Cancer, J Cancer Educ. Vol. 19, 17-28, 2004. BMC Public Health | Full text | Meta-analysis of the relation between European and American smokeless tobacco and oral cancer
Wikmans T, Ramström L. Harm perception among Swedish daily smokers regarding nicotine, NRT-products and Swedish Snus. Tob Induc Dis. 2010 Aug 13;8:9. Harm perception among Swedish daily smokers regarding nicotine, NRT-products and Swedish Snus
Health Effects of Smokeless Tobacco
Accortt NA, Waterbor JW, Beall C, Howard G. Cancer incidence among a cohort of smokeless tobacco users (United States), Cancer Causes and Control, 2005, Vol. 16, 1107-1115. Cancer incidence among a cohort of smo... [Cancer Causes Control. 2005] - PubMed - NCBI
Boffetta P, Aagnes B, Weiderpass E, Andersen A, Smokeless tobacco use and risk of cancer of the pancreas and other organs, Int. J. Cancer Vol. 114, 992-995, 2005. Smokeless tobacco use and risk of cancer of the... [Int J Cancer. 2005] - PubMed - NCBI
Bouquot JE, Meckstroth RL. Oral cancer in a tobacco-chewing US population - no apparent increased incidence or mortality, Oral Surgery Oral and Maxillofacial Pathology, 1998, Vol. 86, No. 6. 697-706. Oral cancer... [Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998] - PubMed - NCBI
Colilla SA. An epidemiologic review of smokeless tobacco health effects and harm reduction potential. Regul Toxicol Pharmacol. 2010 Mar;56(2):197-211. Epub 2009 Sep 29. Review. An epidemiologic review of smokeless... [Regul Toxicol Pharmacol. 2010] - PubMed - NCBI
Foulds J, Ramstrom L, Burke M, Ragerstom K, Effect of smokeless tobacco (snus) on public health in Sweden, Tobacco Control, 2003, Vol 12, 349-359. Effect of smokeless tobacco (snus) on smoking and public health in Sweden -- Foulds et al. 12 (4): 349 -- Tobacco Control
Gupta R, Hitinder G, Bartholomew J. Smokeless Tobacco and Cardiovascular Risk. Arch Intern Med, Vol. 164, 1845-1849, Sep. 27, 2004. JAMA Network | Error
Henley SJ, Thun MJ, Connell C. Calle EE, Two large prospective studies of mortality among men who use snuff or chewing tobacco (United States), Cancer Causes and Control, Vol. 16, 347-358, 2005. Two large prospective studies of morta... [Cancer Causes Control. 2005] - PubMed - NCBI
Henley SJ, Connell C, Calle EE, Thun MJ. Tobacco‐related disease mortality among men who switched from cigarettes to spit tobacco. Tob Control. 2007; 16(1): 22–28. Tobacco
Lee PN. Circulatory disease and smokeless tobacco in Western populations: a review of the evidence. Int J Epidemiol. 2007 Aug;36(4):789-804. Epub 2007 Jun 25. Circulatory disease and smokeless tobacco in Western populations: a review of the evidence
Lee PN. Summary of the epidemiological evidence relating snus to health. Regul Toxicol Pharmacol. 2011 Mar;59(2):197-214. Epub 2010 Dec 14. Review. Summary of the epidemiological evide... [Regul Toxicol Pharmacol. 2011] - PubMed - NCBI
Levy DT, Mumford EA, Cummings KM, et al, The Relative Risks of a Low-Nitrosamine Smokeless Tobacco Product Compared with Smoking Cigarettes: Estimates of a Panel of Experts, 2004, Cancer Epidemiol Biomarkers Prev, Vol. 13, No. 12, 2035-2042. http://cebp.aacrjournals.org/content/13/12/2035.full.pdf+html
Levy D, Mumford E, Cummings KM, et al. The potential impact of a low-nitrosamine smokeless tobacco product on cigarette smoking in the United States: Estimates of a panel of experts, Addictive Behaviors, Nov. 2005. http://www.ihra.net/files/2011/07/13/Levy_-_Impact_of_Low-Nitrosamine_Smokeless_Tobacco.pdf
Lewin F, Norell SE, Johansson H, et al, Smoking tobacco, oral snuff and alcohol in the etiology of squamous cell carcinoma of the head and neck. A population based case-referent study in Sweden. 1998, Cancer, Vol. 82, 1367-1375. Smoking tobacco, oral snuff, and alcohol in the etiol... [Cancer. 1998] - PubMed - NCBI
Phillips CV, Heavner KK. Smokeless tobacco: the epidemiology and politics of harm. Biomarkers. 2009 Jul;14 Suppl 1:79-84. Smokeless tobacco: the epidemiology and politics ... [Biomarkers. 2009] - PubMed - NCBI
Rodu B, Cole P. Smokeless tobacco use and cancer of the upper respiratory tract. Oral Surgery Oral Medicine Oral Pathology, 2002, Vol. 93, No. 5, 511-515. Smokeless t... [Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002] - PubMed - NCBI
Rodu B. Lung cancer mortality: Comparing Sweden with other countries in the European Union. Scand J Public Health July 2009 vol. 37 no. 5 481-486. Lung cancer mortality: comparing Swede... [Scand J Public Health. 2009] - PubMed - NCBI
Schildt E-B, Eriksson M, Hardell L, Magnusson A. Oral snuff, smoking habits and alcohol consumption in relation to oral cancer evaluated in a Swedish case-control study, 1998, International Journal of Cancer, Vol. 77, 341-346. Oral snuff, smoking habits and alcohol consumpt... [Int J Cancer. 1998] - PubMed - NCBI
Sponsiello-Wang Z, Weitkunat R, Lee PN. Systematic review of the relation between smokeless tobacco and cancer of the pancreas in Europe and North America. BMC Cancer. 2008 Dec 1;8:356. Systematic review of the relation between smokeless tobacco and cancer of the pancreas in Europe and North America
Smokeless Tobacco for Smoking Cessation
Barrett SP, Campbell ML, Temporale K, Good KB. The acute effect of Swedish-style snus on cigarette craving and self-administration in male and female smokers. Hum Psychopharmacol. 2011 Feb 9. The acute effect of Swedish-style snus o... [Hum Psychopharmacol. 2011] - PubMed - NCBI
Fagerstrom K, Rutqvist LE, Hughes JR. Snus as a smoking cessation aid: a randomized placebo-controlled trial. Nicotine Tob Res. 2012 Mar;14(3):306-12. Epub 2011 Oct 12. Snus as a smoking cessation aid: a randomiz... [Nicotine Tob Res. 2012] - PubMed - NCBI
Gorini G. [Harm reduction strategy in tobacco control]. Epidemiol Prev. 2011 May-Aug;35(3-4 Suppl 1):19-32. [Harm reduction strategy in tobacco c... [Epidemiol Prev. 2011 May-Aug] - PubMed - NCBI
Hatsukami DK, Jensen J, Anderson A, Broadbent B, Allen S, Zhang Y, Severson H. Oral tobacco products: preference and effects among smokers. Drug Alcohol Depend. 2011 Nov 1;118(2-3):230-6. Epub 2011 Apr 23. Oral tobacco products: preference and ef... [Drug Alcohol Depend. 2011] - PubMed - NCBI
Kotlyar M, Hertsgaard LA, Lindgren BR, Jensen JA, Carmella SG, Stepanov I, Murphy SE, Hecht SS, Hatsukami DK. Effect of oral snus and medicinal nicotine in smokers on toxicant exposure and withdrawal symptoms: a feasibility study. Cancer Epidemiol Biomarkers Prev. 2011 Jan;20(1):91-100. Effect of oral snus and med... [Cancer Epidemiol Biomarkers Prev. 2011] - PubMed - NCBI
Joksić G, Spasojević-Tišma V, Antić R, Nilsson R, Rutqvist LE.Randomized, placebo-controlled, double-blind trial of Swedish snus for smoking reduction and cessation. Harm Reduct J. 2011 Sep 13;8(1):25. HRJ | Full text | Randomized, placebo-controlled, double-blind trial of Swedish snus for smoking reduction and cessation
Le Houezec J, McNeill A, Britton J. Tobacco, nicotine and harm reduction. Drug Alcohol Rev. 2011 Mar;30(2):119-23. Tobacco, nicotine and harm reduction. [Drug Alcohol Rev. 2011] - PubMed - NCBI
Lund KE, McNeill A, Scheffels J. The use of snus for quitting smoking compared with medicinal products. Nicotine Tob Res. 2010 Aug;12(8):817-22. The use of snus for quitting smoking compared with medicinal products
Lund I, Scheffels J. Perceptions of the relative harmfulness of snus among Norwegian general practitioners and their effect on the tendency to recommend snus in smoking cessation. Nicotine Tob Res. 2012 Feb;14(2):169-75. Epub 2011 Oct 24. Perceptions of the relative harmfulness of ... [Nicotine Tob Res. 2012] - PubMed - NCBI
Lund KE, Scheffels J, McNeill A.The association between use of snus and quit rates for smoking: results from seven Norwegian cross-sectional studies. Addiction. 2011 Jan;106(1):162-7. The association between use of snus and quit rates... [Addiction. 2011] - PubMed - NCBI
Lunell E, Curvall M. Nicotine delivery and subjective effects of Swedish portion snus compared with 4 mg nicotine polacrilex chewing gum. Nicotine Tob Res. 2011 Jul;13(7):573-8. Epub 2011 Mar 31. Nicotine delivery and subjective effects of... [Nicotine Tob Res. 2011] - PubMed - NCBI
Norberg M, Lundqvist G, Nilsson M, Gilljam H, Weinehall L. Changing patterns of tobacco use in a middle-aged population: the role of snus, gender, age, and education. Glob Health Action. 2011;4. doi: 10.3402/gha.v4i0.5613. Epub 2011 Jun 3. Changing patterns of tobacco use in a middle-aged population
Ramström L, Foulds J: Role of snus in initiation and cessation of tobacco smoking in Sweden. Tobacco Cont 2006, 15:210-214. http://www.tobaccoprogram.org/pdf/ramstr%F6m_foulds_tc_june06.pdf
Rodu B, Phillips CV: Switching to smokeless tobacco as a smoking cessation method: evidence from the 2000 National Health Interview Survey. Harm Red J 2008, 5:18 HRJ | Full text | Switching to smokeless tobacco as a smoking cessation method: evidence from the 2000 National Health Interview Survey
Stenbeck M, Hagquist C, Rosén M.The association of snus and smoking behaviour: a cohort analysis of Swedish males in the 1990s. Addiction. 2009 Sep;104(9) The association of snus and smoking behaviour: a c... [Addiction. 2009] - PubMed - NCBI
Wiium N, Overland S, Aarø LE. Smoking cessation among Norwegian adolescents and young adults: preferred cessation methods. Scand J Psychol. 2011 Apr;52(2):154-60. Smoking cessation among Norwegian adolescent... [Scand J Psychol. 2011] - PubMed - NCBI
Electronic Cigarettes for Smoking Cessation
Dockrell M, Indu SD, Lashkari HG, McNeill A. "It sounds like the replacement I need to help me stop smoking": Use and acceptability of "e-cigarettes” among UK smokers. 12th annual meeting of the Society for Research on Nicotine and Tobacco Europe. Bath, UK, 2010. https://secure2.symphonyem.co.uk/CMS/UserDocuments/899/Cathy Book1-121 .pdf
Etter JF. Electronic cigarettes: a survey of users. BMC Public Health. 2010; 10: 231. Electronic cigarettes: a survey of users
Etter JF, Bullen C. Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy. Addiction, 106: 2017–2028. Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy - Etter - 2011 - Addiction - Wiley Online Library (accessed June 2011) Full Text: Electronic Cigarettes
Siegel MB, Tanwar KL, Wood KS. Electronic cigarettes as smoking cessation tool: Results from an Online Survey. American Journal of Preventive Medicine 2011 Apr; 40(4):472-5. http://www.stop-tabac.ch/fra/images...op_tabac/seigel e cigs am j prev med 2011.pdf
Cahn Z, Siegel M. Electronic cigarettes as a harm reduction strategy for tobacco control: A step forward or a repeat of past mistakes? Journal of Public Health Policy advance online publication 9 December 2010; doi: 10.1057/jphp.2010.41. http://www.hsph.harvard.edu/centers-institutes/population-development/files/article.jphp.pdf
Bullen C, C, McRobbie H, Thornley S, Glover M, Lin R, Laugesen M. Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial. Tob Control. 2010 Apr;19(2):98-103. http://www.healthnz.co.nz/2010 Bullen ECig.pdf
Caponnetto P, Cibella F, Mancuso S, Campagna D, Arcidiacono G, Polosa R. Effect of a nicotine free inhalator as part of a smoking cessation program. Eur Respir J. 2011 May 12. Effect of a nicotine-free inhalator as part of ... [Eur Respir J. 2011] - PubMed - NCBI
Caponnetto P, Polosa R, Auditore R, Russo C, Campagna D. Smoking Cessation with E-Cigarettes in Smokers with a Documented History of Depression and Recurring Relapses. International Journal of Clinical Medicine, 2011, 2, 281-284. http://www.casaa.org/files/Polosa-E-Cig-Smoking-Cessation-Depression.pdf
Polosa R, Caponnetto P, Morjaria J B, Papale G, Campagna D, Russo C: Effect of an Electronic Nicotine Delivery Device (e-Cigarette) on Smoking Reduction and Cessation: A Prospective 6-Month Pilot Study. BMC Public Health 2011, 11:786. http://www.biomedcentral.com/content/pdf/1471-2458-11-786.pdf
Rose JE, Turner JE, Murugesan T, Behm FM. Pulmonary delivery of nicotine pyruvate: sensory and pharmacokinetic characteristics. Poster, Society for Research on Nicotine and Tobacco 16th annual conference, Baltimore, 27 February 2010. http://www.srnt.org/conferences/2010/pdf/2010_Program.pdf
Vansickel AR, Cobb CO, Weaver MF, Eissenberg TE. A clinical laboratory model for evaluating the acute effects of electronic "cigarettes": nicotine delivery profile and cardiovascular and subjective effects. Cancer Epidemiol Biomarkers Prev. 2010 Aug;19(8):1945-53. Epub 2010 Jul 20. http://www.casaa.org/files/Virgiania Commonwealth University Study.pdf
Vansickel AR, Weaver MF, Eissenberg T. Clinical laboratory assessment of the abuse liability of an electronic cigarette. Addiction. 2012 Jan 9. Clinical laboratory assessment of the abuse liabil... [Addiction. 2012] - PubMed - NCBI
I hope someone finds the above information useful.
It is pure ignorance (and years of propaganda) that lead employers to believe that all tobacco is equally harmful so that they feel justified in penalizing employees for tobacco use, not just smoking. You might be interested in the content of CASAA's letter to South Carolina's House of Representatives
Dear Representative:
The Consumer Advocates for Smoke-free Alternatives Association (CASAA) urges you to amend S. 418, Proviso Codification Act of 2011, so that it does not penalize former smokers who quit by switching to a reduced-risk smoke-free alternative.
Cigarette smoking causes a high risk for numerous health problems. By contrast, smoke-free tobacco products (smokeless tobacco and the clean nicotine inhalers known as "electronic cigarettes", which are legally classified as a tobacco product) cause risks so small that they cannot be measured. They are estimated to be about 1% of the risk from smoking.
Because of this, switching to smoke-free products has become a common way for smokers to stop smoking, and thus eliminate the health hazards of smoking. A law that treats this choice -- switching to low-risk alternative tobacco products -- the same as cigarette smoking -- imposes a financial penalty on former smokers who have taking the healthy (and cost-saving) step of switching sends the wrong message: You might as well smoke. It would be one less reason for cigarette smokers to take advantage of the opportunity to switch. Moreover, to the extent that the purpose of the law would be to make smokers pay for the extra cost they are imposing, this would be unfair: Users of smoke-free tobacco products do not impose extra costs.
This change in the proposal would also be more practical than the current version. We assume that you did not intend to include users of "nicotine replacement therapy" (NRT) pharmaceuticals like nicotine gum among those subject to the extra charge. If an insurer is trying to enforce this rule using testing for the presence of nicotine, rather than just taking people's word for it, it is not possible to distinguish a smokeless tobacco or electronic cigarette user from a user of nicotine gum. However, it is possible to smokers from non-smokers by testing for exhaled carbon monoxide. If the rule were rewritten to refer specifically to smokers, it would be more fair and better for public health.
CASAA recommends changing Section 2, Item J of S. 418 to substitute the phrase cigarette smokers for tobacco users and changing the two instances of tobacco use to cigarette smoking. In the References section below, we have listed citations to scientific journal articles that discuss the reduced risks of using smokeless tobacco products and the effectiveness of switching to a smoke-free alternative as a method of smoking cessation.
REFERENCES
Tobacco Harm Reduction
American Council on Science and Health. Helping Smokers Quit: The Science Behind Tobacco Harm Reduction. December 2011. http://www.acsh.org/docLib/20120214_HelpingSmokersQuitFINAL.pdf
Bates C, Fagerstom K, Jarvis M, Kinze M, McNeil A, Ramstrom L, European Union Policy on Smokeless Tobacco: A statement in Favor of Evidence-Based Regulation for Public Health, Feb 2003, http://ash.org.uk/html/regulation/html/eusmokeless.htm l
Kozlowski L. First Tell The Truth, A Dialogue on Human Rights, Deception, and the Use of
Smokeless Tobacco as a Substitute for Cigarettes Tobacco Control,12:34-36, 2003.
First, tell the truth: a dialogue on human rights, deception, and the use of smokeless tobacco as a substitute for cigarettes -- Kozlowski 12 (1): 34 -- Tobacco Control
Kozlowski L, Edwards BQ, Not safe is not enough: smokers have a right to know more than there is no safe tobacco product, Tobacco Control, Vol. 14, 3-7, 2005. âNot safeâ is not enough: smokers have a right to know more than there is no safe tobacco product -- Kozlowski and Edwards 14 (suppl 2): ii3 -- Tobacco Control
Phillips C, Wang C, Guenzel B, You might as well smoke; the misleading and harmful public message about smokeless tobacco, BMC Public Health, 2005, 5:31, doi:10.1186/1471-2458-5-31. http://www.biomedcentral.com/147.../1471-2458/5/31
Protecting Smokers, Saving Lives: The case for a Tobacco and Nicotine Authority, Royal College of Physicians, London, 2002. http://www.starscientific.com/404/royal college of physicians.pdf
Rodu B. The scientific foundation for tobacco harm reduction, 2006-2011. Harm Reduct J. 2011 Jul 29;8:19. The scientific foundation for tobacco harm reduction, 2006-2011
Rodu B, Godshall W. Tobacco harm reduction: an alternative cessation strategy for inveterate smokers. Harm Reduction Journal 2006, 3:37 doi:10.1186/1477-7517-3-37. http://www.harmreductionjournal.com/content/pdf/1477-7517-3-37.pdf
Waterbor J, Adams R, Robinson J, et al, Disparities between Public Health Educational Materials and the Scientific Evidence that Smokeless Tobacco Use Causes Cancer, J Cancer Educ. Vol. 19, 17-28, 2004. BMC Public Health | Full text | Meta-analysis of the relation between European and American smokeless tobacco and oral cancer
Wikmans T, Ramström L. Harm perception among Swedish daily smokers regarding nicotine, NRT-products and Swedish Snus. Tob Induc Dis. 2010 Aug 13;8:9. Harm perception among Swedish daily smokers regarding nicotine, NRT-products and Swedish Snus
Health Effects of Smokeless Tobacco
Accortt NA, Waterbor JW, Beall C, Howard G. Cancer incidence among a cohort of smokeless tobacco users (United States), Cancer Causes and Control, 2005, Vol. 16, 1107-1115. Cancer incidence among a cohort of smo... [Cancer Causes Control. 2005] - PubMed - NCBI
Boffetta P, Aagnes B, Weiderpass E, Andersen A, Smokeless tobacco use and risk of cancer of the pancreas and other organs, Int. J. Cancer Vol. 114, 992-995, 2005. Smokeless tobacco use and risk of cancer of the... [Int J Cancer. 2005] - PubMed - NCBI
Bouquot JE, Meckstroth RL. Oral cancer in a tobacco-chewing US population - no apparent increased incidence or mortality, Oral Surgery Oral and Maxillofacial Pathology, 1998, Vol. 86, No. 6. 697-706. Oral cancer... [Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998] - PubMed - NCBI
Colilla SA. An epidemiologic review of smokeless tobacco health effects and harm reduction potential. Regul Toxicol Pharmacol. 2010 Mar;56(2):197-211. Epub 2009 Sep 29. Review. An epidemiologic review of smokeless... [Regul Toxicol Pharmacol. 2010] - PubMed - NCBI
Foulds J, Ramstrom L, Burke M, Ragerstom K, Effect of smokeless tobacco (snus) on public health in Sweden, Tobacco Control, 2003, Vol 12, 349-359. Effect of smokeless tobacco (snus) on smoking and public health in Sweden -- Foulds et al. 12 (4): 349 -- Tobacco Control
Gupta R, Hitinder G, Bartholomew J. Smokeless Tobacco and Cardiovascular Risk. Arch Intern Med, Vol. 164, 1845-1849, Sep. 27, 2004. JAMA Network | Error
Henley SJ, Thun MJ, Connell C. Calle EE, Two large prospective studies of mortality among men who use snuff or chewing tobacco (United States), Cancer Causes and Control, Vol. 16, 347-358, 2005. Two large prospective studies of morta... [Cancer Causes Control. 2005] - PubMed - NCBI
Henley SJ, Connell C, Calle EE, Thun MJ. Tobacco‐related disease mortality among men who switched from cigarettes to spit tobacco. Tob Control. 2007; 16(1): 2228. Tobacco
Lee PN. Circulatory disease and smokeless tobacco in Western populations: a review of the evidence. Int J Epidemiol. 2007 Aug;36(4):789-804. Epub 2007 Jun 25. Circulatory disease and smokeless tobacco in Western populations: a review of the evidence
Lee PN. Summary of the epidemiological evidence relating snus to health. Regul Toxicol Pharmacol. 2011 Mar;59(2):197-214. Epub 2010 Dec 14. Review. Summary of the epidemiological evide... [Regul Toxicol Pharmacol. 2011] - PubMed - NCBI
Levy DT, Mumford EA, Cummings KM, et al, The Relative Risks of a Low-Nitrosamine Smokeless Tobacco Product Compared with Smoking Cigarettes: Estimates of a Panel of Experts, 2004, Cancer Epidemiol Biomarkers Prev, Vol. 13, No. 12, 2035-2042. The Relative Risks of a Low-Nitrosamine Smokeless Tobacco Product Compared with Smoking Cigarettes: Estimates of a Panel of Experts
Levy D, Mumford E, Cummings KM, et al. The potential impact of a low-nitrosamine smokeless tobacco product on cigarette smoking in the United States: Estimates of a panel of experts, Addictive Behaviors, Nov. 2005. http://www.ihra.net/files/2011/07/13/Levy_-_Impact_of_Low-Nitrosamine_Smokeless_Tobacco.pdf
Lewin F, Norell SE, Johansson H, et al, Smoking tobacco, oral snuff and alcohol in the etiology of squamous cell carcinoma of the head and neck. A population based case-referent study in Sweden. 1998, Cancer, Vol. 82, 1367-1375. Smoking tobacco, oral snuff, and alcohol in the etiol... [Cancer. 1998] - PubMed - NCBI
Phillips CV, Heavner KK. Smokeless tobacco: the epidemiology and politics of harm. Biomarkers. 2009 Jul;14 Suppl 1:79-84. Smokeless tobacco: the epidemiology and politics ... [Biomarkers. 2009] - PubMed - NCBI
Rodu B, Cole P. Smokeless tobacco use and cancer of the upper respiratory tract. Oral Surgery Oral Medicine Oral Pathology, 2002, Vol. 93, No. 5, 511-515. Smokeless t... [Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002] - PubMed - NCBI
Rodu B. Lung cancer mortality: Comparing Sweden with other countries in the European Union. Scand J Public Health July 2009 vol. 37 no. 5 481-486. Lung cancer mortality: comparing Swede... [Scand J Public Health. 2009] - PubMed - NCBI
Schildt E-B, Eriksson M, Hardell L, Magnusson A. Oral snuff, smoking habits and alcohol consumption in relation to oral cancer evaluated in a Swedish case-control study, 1998, International Journal of Cancer, Vol. 77, 341-346. Oral snuff, smoking habits and alcohol consumpt... [Int J Cancer. 1998] - PubMed - NCBI
Sponsiello-Wang Z, Weitkunat R, Lee PN. Systematic review of the relation between smokeless tobacco and cancer of the pancreas in Europe and North America. BMC Cancer. 2008 Dec 1;8:356. Systematic review of the relation between smokeless tobacco and cancer of the pancreas in Europe and North America
Smokeless Tobacco for Smoking Cessation
Barrett SP, Campbell ML, Temporale K, Good KB. The acute effect of Swedish-style snus on cigarette craving and self-administration in male and female smokers. Hum Psychopharmacol. 2011 Feb 9. The acute effect of Swedish-style snus o... [Hum Psychopharmacol. 2011] - PubMed - NCBI
Fagerstrom K, Rutqvist LE, Hughes JR. Snus as a smoking cessation aid: a randomized placebo-controlled trial. Nicotine Tob Res. 2012 Mar;14(3):306-12. Epub 2011 Oct 12. Snus as a smoking cessation aid: a randomiz... [Nicotine Tob Res. 2012] - PubMed - NCBI
Gorini G. [Harm reduction strategy in tobacco control]. Epidemiol Prev. 2011 May-Aug;35(3-4 Suppl 1):19-32. [Harm reduction strategy in tobacco c... [Epidemiol Prev. 2011 May-Aug] - PubMed - NCBI
Hatsukami DK, Jensen J, Anderson A, Broadbent B, Allen S, Zhang Y, Severson H. Oral tobacco products: preference and effects among smokers. Drug Alcohol Depend. 2011 Nov 1;118(2-3):230-6. Epub 2011 Apr 23. Oral tobacco products: preference and ef... [Drug Alcohol Depend. 2011] - PubMed - NCBI
Kotlyar M, Hertsgaard LA, Lindgren BR, Jensen JA, Carmella SG, Stepanov I, Murphy SE, Hecht SS, Hatsukami DK. Effect of oral snus and medicinal nicotine in smokers on toxicant exposure and withdrawal symptoms: a feasibility study. Cancer Epidemiol Biomarkers Prev. 2011 Jan;20(1):91-100. Effect of oral snus and med... [Cancer Epidemiol Biomarkers Prev. 2011] - PubMed - NCBI
Joksić G, Spasojević-Tima V, Antić R, Nilsson R, Rutqvist LE.Randomized, placebo-controlled, double-blind trial of Swedish snus for smoking reduction and cessation. Harm Reduct J. 2011 Sep 13;8(1):25. HRJ | Full text | Randomized, placebo-controlled, double-blind trial of Swedish snus for smoking reduction and cessation
Le Houezec J, McNeill A, Britton J. Tobacco, nicotine and harm reduction. Drug Alcohol Rev. 2011 Mar;30(2):119-23. Tobacco, nicotine and harm reduction. [Drug Alcohol Rev. 2011] - PubMed - NCBI
Lund KE, McNeill A, Scheffels J. The use of snus for quitting smoking compared with medicinal products. Nicotine Tob Res. 2010 Aug;12(8):817-22. The use of snus for quitting smoking compared with medicinal products
Lund I, Scheffels J. Perceptions of the relative harmfulness of snus among Norwegian general practitioners and their effect on the tendency to recommend snus in smoking cessation. Nicotine Tob Res. 2012 Feb;14(2):169-75. Epub 2011 Oct 24. Perceptions of the relative harmfulness of ... [Nicotine Tob Res. 2012] - PubMed - NCBI
Lund KE, Scheffels J, McNeill A.The association between use of snus and quit rates for smoking: results from seven Norwegian cross-sectional studies. Addiction. 2011 Jan;106(1):162-7. The association between use of snus and quit rates... [Addiction. 2011] - PubMed - NCBI
Lunell E, Curvall M. Nicotine delivery and subjective effects of Swedish portion snus compared with 4 mg nicotine polacrilex chewing gum. Nicotine Tob Res. 2011 Jul;13(7):573-8. Epub 2011 Mar 31. Nicotine delivery and subjective effects of... [Nicotine Tob Res. 2011] - PubMed - NCBI
Norberg M, Lundqvist G, Nilsson M, Gilljam H, Weinehall L. Changing patterns of tobacco use in a middle-aged population: the role of snus, gender, age, and education. Glob Health Action. 2011;4. doi: 10.3402/gha.v4i0.5613. Epub 2011 Jun 3. Changing patterns of tobacco use in a middle-aged population
Ramström L, Foulds J: Role of snus in initiation and cessation of tobacco smoking in Sweden. Tobacco Cont 2006, 15:210-214. http://www.tobaccoprogram.org/pdf/ramstr%F6m_foulds_tc_june06.pdf
Rodu B, Phillips CV: Switching to smokeless tobacco as a smoking cessation method: evidence from the 2000 National Health Interview Survey. Harm Red J 2008, 5:18 HRJ | Full text | Switching to smokeless tobacco as a smoking cessation method: evidence from the 2000 National Health Interview Survey
Stenbeck M, Hagquist C, Rosén M.The association of snus and smoking behaviour: a cohort analysis of Swedish males in the 1990s. Addiction. 2009 Sep;104(9) The association of snus and smoking behaviour: a c... [Addiction. 2009] - PubMed - NCBI
Wiium N, Overland S, Aarø LE. Smoking cessation among Norwegian adolescents and young adults: preferred cessation methods. Scand J Psychol. 2011 Apr;52(2):154-60. Smoking cessation among Norwegian adolescent... [Scand J Psychol. 2011] - PubMed - NCBI
Electronic Cigarettes for Smoking Cessation
Dockrell M, Indu SD, Lashkari HG, McNeill A. "It sounds like the replacement I need to help me stop smoking": Use and acceptability of "e-cigarettes” among UK smokers. 12th annual meeting of the Society for Research on Nicotine and Tobacco Europe. Bath, UK, 2010. https://secure2.symphonyem.co.uk/CMS/UserDocuments/899/Cathy Book1-121 .pdf
Etter JF. Electronic cigarettes: a survey of users. BMC Public Health. 2010; 10: 231. Electronic cigarettes: a survey of users
Etter JF, Bullen C. Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy. Addiction, 106: 20172028. Electronic cigarette: users profile, utilization, satisfaction and perceived efficacy - Etter - 2011 - Addiction - Wiley Online Library (accessed June 2011) Full Text: Electronic Cigarettes
Siegel MB, Tanwar KL, Wood KS. Electronic cigarettes as smoking cessation tool: Results from an Online Survey. American Journal of Preventive Medicine 2011 Apr; 40(4):472-5. http://www.stop-tabac.ch/fra/images...op_tabac/seigel e cigs am j prev med 2011.pdf
Cahn Z, Siegel M. Electronic cigarettes as a harm reduction strategy for tobacco control: A step forward or a repeat of past mistakes? Journal of Public Health Policy advance online publication 9 December 2010; doi: 10.1057/jphp.2010.41. http://www.hsph.harvard.edu/centers-institutes/population-development/files/article.jphp.pdf
Bullen C, C, McRobbie H, Thornley S, Glover M, Lin R, Laugesen M. Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial. Tob Control. 2010 Apr;19(2):98-103. http://www.healthnz.co.nz/2010 Bullen ECig.pdf
Caponnetto P, Cibella F, Mancuso S, Campagna D, Arcidiacono G, Polosa R. Effect of a nicotine free inhalator as part of a smoking cessation program. Eur Respir J. 2011 May 12. Effect of a nicotine-free inhalator as part of ... [Eur Respir J. 2011] - PubMed - NCBI
Caponnetto P, Polosa R, Auditore R, Russo C, Campagna D. Smoking Cessation with E-Cigarettes in Smokers with a Documented History of Depression and Recurring Relapses. International Journal of Clinical Medicine, 2011, 2, 281-284. http://www.casaa.org/files/Polosa-E-Cig-Smoking-Cessation-Depression.pdf
Polosa R, Caponnetto P, Morjaria J B, Papale G, Campagna D, Russo C: Effect of an Electronic Nicotine Delivery Device (e-Cigarette) on Smoking Reduction and Cessation: A Prospective 6-Month Pilot Study. BMC Public Health 2011, 11:786. http://www.biomedcentral.com/content/pdf/1471-2458-11-786.pdf
Rose JE, Turner JE, Murugesan T, Behm FM. Pulmonary delivery of nicotine pyruvate: sensory and pharmacokinetic characteristics. Poster, Society for Research on Nicotine and Tobacco 16th annual conference, Baltimore, 27 February 2010. http://www.srnt.org/conferences/2010/pdf/2010_Program.pdf
Vansickel AR, Cobb CO, Weaver MF, Eissenberg TE. A clinical laboratory model for evaluating the acute effects of electronic "cigarettes": nicotine delivery profile and cardiovascular and subjective effects. Cancer Epidemiol Biomarkers Prev. 2010 Aug;19(8):1945-53. Epub 2010 Jul 20. http://www.casaa.org/files/Virgiania Commonwealth University Study.pdf
Vansickel AR, Weaver MF, Eissenberg T. Clinical laboratory assessment of the abuse liability of an electronic cigarette. Addiction. 2012 Jan 9. Clinical laboratory assessment of the abuse liabil... [Addiction. 2012] - PubMed - NCBI
I hope someone finds the above information useful.
Dear Representative:
The Consumer Advocates for Smoke-free Alternatives Association (CASAA) urges you to amend S. 418, Proviso Codification Act of 2011, so that it does not penalize former smokers who quit by switching to a reduced-risk smoke-free alternative.
Cigarette smoking causes a high risk for numerous health problems. By contrast, smoke-free tobacco products (smokeless tobacco and the clean nicotine inhalers known as "electronic cigarettes", which are legally classified as a tobacco product) cause risks so small that they cannot be measured. They are estimated to be about 1% of the risk from smoking.
Because of this, switching to smoke-free products has become a common way for smokers to stop smoking, and thus eliminate the health hazards of smoking. A law that treats this choice -- switching to low-risk alternative tobacco products -- the same as cigarette smoking -- imposes a financial penalty on former smokers who have taking the healthy (and cost-saving) step of switching sends the wrong message: You might as well smoke. It would be one less reason for cigarette smokers to take advantage of the opportunity to switch. Moreover, to the extent that the purpose of the law would be to make smokers pay for the extra cost they are imposing, this would be unfair: Users of smoke-free tobacco products do not impose extra costs.
This change in the proposal would also be more practical than the current version. We assume that you did not intend to include users of "nicotine replacement therapy" (NRT) pharmaceuticals like nicotine gum among those subject to the extra charge. If an insurer is trying to enforce this rule using testing for the presence of nicotine, rather than just taking people's word for it, it is not possible to distinguish a smokeless tobacco or electronic cigarette user from a user of nicotine gum. However, it is possible to smokers from non-smokers by testing for exhaled carbon monoxide. If the rule were rewritten to refer specifically to smokers, it would be more fair and better for public health.
CASAA recommends changing Section 2, Item J of S. 418 to substitute the phrase cigarette smokers for tobacco users and changing the two instances of tobacco use to cigarette smoking. In the References section below, we have listed citations to scientific journal articles that discuss the reduced risks of using smokeless tobacco products and the effectiveness of switching to a smoke-free alternative as a method of smoking cessation.
REFERENCES
Tobacco Harm Reduction
American Council on Science and Health. Helping Smokers Quit: The Science Behind Tobacco Harm Reduction. December 2011. http://www.acsh.org/docLib/20120214_HelpingSmokersQuitFINAL.pdf
Bates C, Fagerstom K, Jarvis M, Kinze M, McNeil A, Ramstrom L, European Union Policy on Smokeless Tobacco: A statement in Favor of Evidence-Based Regulation for Public Health, Feb 2003, http://ash.org.uk/html/regulation/html/eusmokeless.htm l
Kozlowski L. First Tell The Truth, A Dialogue on Human Rights, Deception, and the Use of
Smokeless Tobacco as a Substitute for Cigarettes Tobacco Control,12:34-36, 2003.
First, tell the truth: a dialogue on human rights, deception, and the use of smokeless tobacco as a substitute for cigarettes -- Kozlowski 12 (1): 34 -- Tobacco Control
Kozlowski L, Edwards BQ, Not safe is not enough: smokers have a right to know more than there is no safe tobacco product, Tobacco Control, Vol. 14, 3-7, 2005. âNot safeâ is not enough: smokers have a right to know more than there is no safe tobacco product -- Kozlowski and Edwards 14 (suppl 2): ii3 -- Tobacco Control
Phillips C, Wang C, Guenzel B, You might as well smoke; the misleading and harmful public message about smokeless tobacco, BMC Public Health, 2005, 5:31, doi:10.1186/1471-2458-5-31. http://www.biomedcentral.com/147.../1471-2458/5/31
Protecting Smokers, Saving Lives: The case for a Tobacco and Nicotine Authority, Royal College of Physicians, London, 2002. http://www.starscientific.com/404/royal college of physicians.pdf
Rodu B. The scientific foundation for tobacco harm reduction, 2006-2011. Harm Reduct J. 2011 Jul 29;8:19. The scientific foundation for tobacco harm reduction, 2006-2011
Rodu B, Godshall W. Tobacco harm reduction: an alternative cessation strategy for inveterate smokers. Harm Reduction Journal 2006, 3:37 doi:10.1186/1477-7517-3-37. http://www.harmreductionjournal.com/content/pdf/1477-7517-3-37.pdf
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I hope someone finds the above information useful.
Yep. It makes me angry that they test for cotinine. Even using patches or gum would raise levels. Wish they could do a CO2 test or something to test for actual smoking rather than nicotine use.
Btw- you had a double post Elaine. Seems to be happening a lot on the forums lately.
Btw- you had a double post Elaine. Seems to be happening a lot on the forums lately.
That's bull s***, even when I'm thin and trim I'm over a 40 waste wonder if they take height and build into account? I'm glad my insurance company isn't run by Nazis.
Part of the reason I've dropped out and retired early. Well, that, and having been laid off. ;-)- Status
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