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Letter to the Editor: Response to Tobacco 21 bills in legislature

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If Missouri legislators truly wish to reduce youth tobacco use and enhance public health, they should disregard e-cigarette activist A. J. Moll’s call for passage of HB 517 and instead listen to long-established health groups such as Missouri State Medical Association, Missouri Academy of Family Physicians, and American Academy of Pediatrics in support of SB 124.

When it became apparent in late 2019 that President Donald Trump would sign the bill that included a provision for raising the minimum age to purchase tobacco to 21, the industry placed a high priority to get local preemption bills passed in state legislatures. Why? Because they know local authorities are much more effective in conducting compliance checks and enforcement than state agencies.

Comparison of FDA retailer compliance data showed Missouri communities with Tobacco 21 ordinances had notably better rates for retailers not selling tobacco to youth than communities without such ordinances.

Mr. Moll stated e-cigarettes are a method to quit smoking and are 95 percent less harmful than combustible cigarettes. However, not a single e-cigarette maker has applied to the FDA to be approved to market their products as smoking cessation devices.

The 95 percent safer myth is based on a subjective report released by Public Health England a number of years ago. The report was not based on actual scientific evidence but on opinions of harm-reduction and e-cigarette enthusiasts (some of which were funded by the industry) that ranked perceived harms of nicotine-containing products. Even so, they admitted a “lack of hard evidence for the harms of most products on most of the criteria.”

Since then, more evidence has been established showing e-cigarettes are not a safe alternative. But rather, e-cigarette use leads to an increase in heart rate and blood pressure, obstruction of airways, and arterial stiffness. Animal models found long-term e-cigarette use leads to DNA damage and inhibition of DNA repair.

SB 124 sponsored by Sen. Lincoln Hough will help reduce youth tobacco initiation and use, as well as reduce the burden that tobacco products, including e-cigarettes, place on public health. Its Senate Committee hearing received supporting testimonies from physicians and health care organizations and opposing testimonies from tobacco retailer trade associations. Shouldn’t that be a big clue as to its value for the welfare of our young people?

Stan Cowan is a retired public health official. He previously worked with the state health department where he led its tobacco prevention program. Stan also worked at the School of Medicine at the University of Missouri in Columbia providing assistance to tobacco control coalitions and organizations.


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