More than 75 percent of youth users smoke conventional cigarettes too

The percentage of U.S. middle and high school students who use electronic cigarettes, or e cigarettes, more than doubled from 2011 to 2012, according to data published by the Centers for Disease Control and Prevention.

The findings from the National Youth Tobacco Survey, in today s Morbidity and Mortality Weekly Report, show that the percentage of high school students who reported ever using an e cigarette rose from 4.7 percent in 2011 to 10.0 percent in 2012. In the same time period, high school students using e cigarettes within the past 30 days rose from 1.5 percent to 2.8 percent. Use also doubled among middle school students. Altogether, in 2012 more than 1.78 million middle and high school students nationwide had tried e cigarettes.

“The increased use of e cigarettes by teens is deeply troubling,” said CDC Director Tom Frieden, M.D., M.P.H. “Nicotine is a highly addictive drug. Many teens who start with e cigarettes may be condemned to struggling with a lifelong addiction to nicotine and conventional cigarettes.”

The study also found that 76.3 percent of middle and high school students who used e cigarettes within the past 30 days also smoked conventional cigarettes in the same period. In addition, 1 in 5 middle school students who reported ever using e cigarettes say they have never tried conventional cigarettes. This raises concern that there may be young people for whom e cigarettes could be an entry point to use of conventional tobacco products, including cigarettes.

“About 90 percent of all smokers begin smoking as teenagers,” said Tim McAfee, M.D., M.P.H., director of the CDC Office on Smoking and Health. “We must keep our youth from experimenting or using any tobacco product. These dramatic increases suggest that developing strategies to prevent marketing, sales, and use of e cigarettes among youth is critical.”

Electronic cigarettes, or e cigarettes, are battery powered devices that provide doses of nicotine and other additives to the user in an aerosol. E cigarettes not marketed for therapeutic purposes are currently unregulated by the Food and Drug Administration. The FDA Center for Tobacco Products has announced that it intends to expand its jurisdiction over tobacco products to include e cigarettes, but has not yet issued regulatory rules. Because e cigarettes are largely unregulated, the agency does not have good information about them, such as the amounts and types of components and potentially harmful constituents.

“These data show a dramatic rise in usage of e cigarettes by youth, and this is cause for great concern as we don t yet understand the long term effects of these novel tobacco products,” said Mitch Zeller, director of FDA s Center for Tobacco Products. “These findings reinforce why the FDA intends to expand its authority over all tobacco products and establish a comprehensive and appropriate regulatory framework to reduce disease and death from tobacco use.”

Although some e cigarettes have been marketed as smoking cessation aids, there is no conclusive scientific evidence that e cigarettes promote successful long term quitting. However, there are proven cessation strategies and treatments, including counseling and FDA approved cessation medications.

Cigarette smoking remains the leading preventable cause of dis ease, dis ability, and death in the United States, responsible for an estimated 443,000 deaths each year. And for every one death, there are 20 people living with a smoking related disease. To quit smoking, free help is available at 1 800 QUIT NOW or

Under the Affordable Care Act, more Americans than ever will qualify to get health care coverage that fits their needs and budget, including important preventive services such as services to quit smoking that are covered with no additional costs. Get ready today for the new Health Insurance Marketplace. Visit or call 1 800 318 2596 (TTY/TDD 1 855 889 4325) to learn more. Open enrollment in the Marketplace begins October 1 for coverage starting as early as January 1, 2014.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Cvs to become first major us drugstore to drop cigarettes

Switching from traditional cigarettes to v2 electronic cigarettes

On Wednesday, CVS Caremark Corp announced that its 7,600 stores would stop selling all tobacco products by October making the company the first U.S. drugstore chain to remove cigarettes from its shelves.

Public health experts called the decision by the No. 2 U.S. drugstore chain a precedent setting step that could pressure other stores to follow suit.

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CVS, whose Caremark unit is a major pharmacy benefits manager for corporations and the government Medicare program, believes the decision will strengthen its position as a healthcare provider.

“I think it will put pressure on other retailers who want to be in healthcare,” said CVS Caremark Chief Medical Officer Dr. Troyen Brennan.

Although some U.S. cities, including Boston and San Francisco, already ban the sale of tobacco products in pharmacies, advocates hope CVS’ voluntary decision will have a ripple effect among other pharmacy chains.

Some retailers stopped selling cigarettes years ago Target Corp decided to drop them in 1996, while East Coast supermarket chain Wegmans Food Markets did so in 2008.

Matthew Myers, president of the Campaign for Tobacco Free Kids, which advocates for tobacco control, said that CVS’s announcement could drive momentum for declining tobacco use.

Dr. Risa Lavizzo Mourey, chief executive officer of the Robert Wood Johnson Foundation, which focuses on public health, called CVS’ decision “a bold, precedent setting move because it acknowledges that pharmacies have become healthcare settings.”

The move was also applauded by President Obama, who said CVS could set a powerful example for other drugstores.

‘ T oday s decision will help advance my Administration s efforts to reduce tobacco related deaths, cancer, and heart disease, as well as bring down health care costs ultimately saving lives and protecting untold numbers of families from pain and heartbreak for years to come,” the president said in a statement.

While headline grabbing, CVS said the move will not make a big dent in its profits.

CVS said it will lose about $2 billion in annual sales and between 6 and 9 cents of profit per share this year. Analysts expect the company to report 2014 revenue of $132.9 billion and a profit of $4.47 per share, according to Thomson Reuters.

U.S. cigarette sales have fallen 31.3 percent between 2003 and 2013, according to Euromonitor International.

The falling smoking rates, along with new competition in the last two years from the low cost Family Dollar Stores Inc and Dollar General Corp chains, suggest shrinking prospects for tobacco product sales at CVS. Dollar stores have far more locations and offer goods at lower prices.

Although adult smoking rates have fallen from 43 percent of Americans in 1965 to the current 18 percent, smoking remains the leading cause of preventable death in the United States, killing more than 480,000 people each year.

Last month, the American Lung Association and other advocacy organizations called on political leaders to commit to cutting smoking rates to less than 10 percent of the population in a decade and to protect all Americans from secondhand smoke within five years.

Focus on health care

The CVS decision comes on the heels of several recent deals bolstering CVS Caremark’s position in the health care market.

CVS in December said it expected its pharmacy benefit manager revenues to rise between 7.25 percent and 8.5 percent in 2014, easily outpacing growth of 2 percent to 3.25 percent in its retail business.

In December, CVS and pharmaceutical distributor Cardinal Health Inc announced a 10 year agreement to form the largest generic drug sourcing operation in the United States. A month earlier it said it was buying Coram LLC, Apria Healthcare Group Inc’s specialty infusion services business unit.

CVS executives said the company will replace some of lost cigarette sales through smoking cessation programs at its pharmacies and will offer more programs to Caremark members. CVS said the programs will be also be a key selling point as it tries to land more corporate contracts this year.

Reuters contributed to this report.