Chicago Medical Society Backs Alderman’s Tax on E-cigarettes and Smokeless Tobacco

The Chicago Medical Society is giving its strong support for Ald. Proco Joe Moreno’s proposal to extend the current tax on cigarettes to smokeless tobacco and electronic cigarettes. “Clearly, these products should be taxed out of our children’s reach,” said Adrienne Fregia, MD, president-elect of the Chicago Medical Society. Speaking before a press conference at City Hall on Sept. 10, Dr. Fregia said that a steep tax, roughly equivalent to the amount slapped on to a pack of cigarettes, at $7.00, will price these products out of the range of many adolescents.

Dr. Fregia pointed out that unfortunately, as smoking rates decline, e-cigarette use among middle and high school students tripled from 2013 to 2014, according to the CDC and the FDA’s Center for Tobacco Products.

Quoting from findings of the 2014 National Youth Tobacco Survey, Dr. Fregia said that current e-cigarette use (use on at least 1 day in the past 30 days) among high school students increased from 4.5% in 2013 to 13.4% in 2014, rising from approximately 660,000 to 2 million students. Furthermore, among middle school students, e-cigarette use more than tripled from 1.1% in 2013 to 3.9% in 2014—an increase from approximately 120,000 to 450,000 students.

“Sadly, this is the first time since the survey started collecting data on e-cigarettes in 2011 that current e-cigarette use has surpassed current use of every other tobacco product overall, including conventional cigarettes,” Dr. Fregia said.

She commented that while promoters argue that Electronic Nicotine Delivery Systems (ENDS) could be the disruptive technology that phases out tobacco products, with a safer replacement, one study in 2014 showed wide-ranging nicotine levels in e-cigarettes and substantial variability between listed and actual nicotine levels in ENDS products, according to the American Lung Association.

In addition, she said, the FDA conducted lab tests and found detectable levels of toxic cancer-causing chemicals, including an ingredient used in antifreeze, in two leading brands of e-cigarettes and 18 various cartridges. “A 2014 study found that e-cigarettes with a higher voltage level have higher amounts of formaldehyde, a carcinogen,” Dr. Fregia said.

“Also unknown is what the potential harm may be to people exposed to secondhand emissions from e-cigarettes. Two initial studies have found formaldehyde, benzene and tobacco-specific nitrosamines (all carcinogens) coming from those secondhand emissions,” she said. “Other studies have shown that chemicals exhaled by users also contain formaldehyde, acetaldehyde and other potential irritants.”

Dr. Fregia cautioned that whatever “good” might accrue from use of this technology as a “weaning” device, it clearly comes at the expense of hooking a new generation of teenagers on nicotine. “Middle school and high school students are not part of the real consumer market for weaning devices,” she said.

“To combat e-cigarettes, we must employ the same strategies used against combustible tobacco products,” Dr. Fregia urged. She pointed out that the Chicago Medical Society works for comprehensive action at the local, state and national levels within both the medical community and local legislatures. “We recently adopted a policy position calling for excise taxes on all smokeless tobacco products and ENDS, including e-cigarettes. Our platform supports a combination of price increases, media outreach, cessation treatment, patient education, laws, and strong enforcement to prevent the marketing and sales of ENDS to youth,” she said.

Dr. Fregia recalled that the Chicago Medical Society’s policy platform builds on the Society’s previous success in local and state legislatures.

“In 2014, for example, our organization was the point of origin for a ban on e-cigarettes in public indoor places. This came several years after our medical societies worked for a stringent statewide smoking ban in public venues. The Chicago Medical Society reinforces its legislative proposals with testimony to lawmakers. We also participate in press conferences, as we did a few years ago, when our leaders publicly endorsed Cook County Board President Toni Preckwinkle’s proposal to hike the ‘sin tax’ on alcohol.”

Dr. Fregia said she is proud of the Chicago Medical Society’s legacy of promoting public health and wellness, which goes back 165 years, since the organization’s founding. “For decades, the Chicago Medical Society has been a local leader in the war on smoking and tobacco use. That campaign has brought success, with the enactment of laws at the city, county and state levels, and overall decline in smoking rates. We know that a combination of strategies is working.”

Summing up, Dr. Fregia said, “Today, we carry the torch forward, working with the Chicago Department of Public Health, to reinforce our shared mission of protecting the citizens of this city. We know that nicotine is deadly. We must protect our children with a steep tax on e-cigarettes.”