Right now we all hear a lot of “Hillary Clinton this,” “Donald Trump that.” Love or hate Donald and Hillary, the 2016 presidential election has dominated our newsfeeds and happy hour conversations. And don’t get me wrong–the presidential election is incredibly important. But many of the laws that affect us on a day-to-day basis are made at the state level, often by our state legislators, but also by us, the American people. States give voters the opportunity to weigh in on important questions, and in some cases directly impact our state’s laws through ballot measures. And there’s a bunch up for grabs this year that millennials should be paying attention to. Learn more about ballot measures, and Law Street’s picks for the top five types of ballot measures we should all be paying attention to below. 

What is a Ballot Measure?

Generally speaking, a ballot measure is a public vote on a proposed issue or question that voters get to weigh in on. Rules about ballot measures vary from state to state and there are a few different ways that ballot measures end up on the ballot. One type, a ballot initiative, requires signatures from citizens who want to see the question weighed by voters. Another option is legislative referral, in which the legislature puts up a law it’s considering to be voted on. In some states, this process is required to pass an amendment to the state constitution.

Why Should I Care About Ballot Measures?

They give you a chance to weigh in directly on issues. America’s government is, at its core, a representative democracy. We elect people to make decisions for us, and we have to accept that sometimes we don’t like those decisions. We, as millennials, routinely answer in polls that we don’t trust the government, the path our country is on, or our elected officials.

But ballot initiatives are different–they’re a real, legitimate way to vote on issues we care about. There’s not really political middlemen to deal with. They’re direct democracy. Regardless of how you feel about the politicians you’ll be asked to vote for in November, it’s important that you make your voice heard on these issues, many of which can and likely will affect millennials.

Gun Control

Image courtesy of Peretz Partensky; License: (CC BY-SA 2.0)

What States are Looking at Gun Control Measures?

California’s Proposition 63: Proposition 63, which is also called the “Safety for All Initiative,” would prohibit Californians from owning high-capacity magazines, make any gun theft a felony, and tighten a variety of loopholes regarding felons owning guns. The especially contentious part of the proposal, however, is that it would require a background check and a four-year permit to obtain ammunition. Here’s the full text.

Maine’s Question 3: Question 3 would require a background check when an individual who is not a licensed firearm dealer sells or transfers a gun to another individual. They would have to meet at a licensed firearm dealer in order to conduct the background check, although there are exceptions, such as for family members. Here’s the full text.

Nevada’s Question 1: Nevada will be asking voters to vote on whether firearm transfers have to go through licensed gun dealers, and therefore be required to have a background check. Like Maine, there would be some exceptions to these provisions, like temporary transfers or transfers to family members would not require a gun dealer. Here’s the full text.

Washington’s Initiative 1491: Formally named the “Individual Gun Access Prevention by Court Order” a “yes” vote on this initiative would allow the use of courts to issue “extreme risk protection orders,” that would prevent someone from having a firearm. This would be used for people who pose a serious threat to themselves or others. Here’s the full text.

Image copyright Law Street Media

Why should we be paying attention to gun control measures?

From Columbine, to Virginia Tech, to Sandy Hook, our lives have been marked by high profile gun violence. We learned what to do if there was an armed shooter in our schools–a drill that probably would have been unthinkable to our parents. We grew up watching violent movies and playing first person shooter video games–a phenomenon that had some worried about the relationship between young people and violence. And guns affect many of our daily lives too–54 percent of Americans killed by gun violence in 2010 were under the age of 30. But exactly how to deal with this violence hasn’t necessarily manifested itself in strong support for one side or the other: do we need more control or less?

Millennials remain split on gun control measures as a whole. A 2015 Gallup poll found that 50 percent of millennials support more gun control, which stands in contrast to 57 percent of the 30-49 age bracket. A 2015 Pew poll also saw millennials almost perfectly split on whether or not to ban assault weapons.

These measures give us the chance to weigh in more directly depending on how we feel about the prospect of more restrictions and the Second Amendment.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

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The Food and Drug Administration (FDA) is making a big push to regulate e-cigarettes, cigars, and other non-cigarette smoking devices for the first time. The FDA has been working on these rules for a while, but finalized them on Wednesday. Most of the regulations pertain to smoking via means that aren’t traditional cigarettes, cigarette-related products, or smokeless tobacco–such as hookah, e-cigarettes, and cigars.

One of the most noteworthy new policies is that the FDA will ban the sale of e-cigarettes to individuals under the age of 18. Additionally, the way that e-cigarette manufacturers are allowed to market the e-cigarettes already on sale will require federal permission. The other regulations that will be placed on e-cigarettes include:

A prohibition on distribution of free samples; a ban on selling e-cigarettes in vending machines unless they are in secure places that never admit young people; and a requirement that e-cigarettes carry warnings that they contain nicotine, which is addictive.

Additionally, the regulations will ban the sale of cigars, pipe tobacco, and hookah tobacco to minors under 18.

The FDA put out a statement about its new regulations, stating:

This action is a milestone in consumer protection — going forward, the FDA will be able to review new tobacco products not yet on the market, help prevent misleading claims by tobacco product manufacturers, evaluate the ingredients of tobacco products and how they are made, and communicate the potential risks of tobacco products.

The FDA has been attempting to regulate e-cigarettes for some time. In 2009, the FDA tried to regulate e-cigarettes as drug-delivery products, but a court ruling struck those provisions down in 2010. The newly announced regulations have been two years in the making, as the FDA has sought to deal with the new influx of e-cigarettes on the market and in popular culture.

The federal government isn’t the only one cracking down on e-cigarettes (or vaping–the act of using e-cigarettes or other electronic smoking devices). California’s governor Jerry Brown just signed a law that, in addition to changing the legal smoking age to 21, will restrict the use of e-cigarettes in some public places. According to the Los Angeles Times:

Electronic cigarettes are considered to be tobacco products and cannot be used in restaurants, theaters, bars and other places where smoking has long been banned. They also cannot be marketed to minors.

E-cigarettes are certainly more popular than ever, but as various federal and state regulations crack down, that popularity may not be permanent.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

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President Obama signed a bill this week that closes a nearly 85-year-old trade loophole allowing the import of slave-produced goods into the United States. The new regulations, which will affect a long list of goods known to be created by child or forced labor, will go into effect in about two weeks.

The loophole allowing goods made by child or forced labor into the United States is found in the Tariff Act of 1930. While these types of goods are traditionally prohibited under U.S. law, there’s an exception in the tariff–“consumptive demand.” Essentially what that means is that if it’s impossible to supply the domestic demand without importing products made via child or forced labor, those products are allowed to be imported.

The list of products that these new regulations will affect most heavily are cotton, sugarcane, tobacco, coffee, cattle, and fish. The Department of Labor’s list of goods produced by child labor or forced labor also includes things like gold, diamonds, electronics, and pornography–depending of course on the producing country.

There’s been a particular focus on the use of forced labor in the Thai fishing industry, after a number of exposes written over the last year have exposed the use of trafficked Rohingya migrants as slave workers on Thai fishing boats. According to the Guardian:

Hundreds of people are thought to have been traded as slaves to support Thailand’s $7.3bn seafood industry. Costco and CP Foods are facing a lawsuit, filed in California, to prevent the sale of Thai prawns/shrimp tainted by slavery. In January, European Union investigators visited Thailand to see whether it had made enough progress on the issue of slavery to avoid an EU-wide ban on seafood imports from the country.

Senator Sherrod Brown (D-Ohio) proposed the amendment that closed the loophole, and now his office is asking the U.S. Customs and Border Protection agency to begin enforcing the new roles as soon as they go into effect in 15 days. Brown stated:

It’s embarrassing that for 85 years, the United States let products made with forced labor into this country, and closing this loophole gives the U.S. an important tool to fight global slavery.

Brown is right–while this may mean less choices for consumers in the U.S., it will be a comfort to know that we no longer lend such support to forced labor.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

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The idea of child labor in the United States sounds absurd. It’s 2015, after all. But the truth is that it’s more common than you may think, especially in the agriculture industry. The U.S. government currently has exemptions in place for the minimum age and maximum work hour requirements for child farmworkers. Hazardous work is prohibited until 18 in other industries, but notable exemptions exist for agricultural companies. Child farmworkers have high rates of injury, are exposed to serious health risks, and often receive few protections, particularly on tobacco farms. Read on to learn more about dangerous, but legal, child labor in the United States.

What is the Current Federal Law?

Loopholes in child labor laws for the agriculture industry stem from the 1938 Fair Labor Standards Act (FLSA), last revised in 2007. For all nonagricultural sectors, the FLSA restricts the hours children under 16 can work and prohibits children under 18 from work that is considered dangerous. In those industries, for example, children cannot work more than three hours on school days or more than eight hours on nonschool days.

However, the rules are far more lenient for the agriculture industry. Children under 16 cannot work during school hours, but there are no maximum hour limits beyond that. There is also no limit for working after school or on weekends, and there is essentially no limit for child workers during the summer. Some states place additional hour restrictions on child employment in agriculture.

At age 16, children can perform hazardous work, like operating chainsaws, forklifts, forage harvesters, or power post hole diggers. They can work from a ladder or scaffolding at over 20 feet from the ground and may drive a tractor over 20 PTO horsepower. They can also handle or apply toxic agricultural chemicals and may also handle or use a blasting agent (i.e. dynamite, black powder).

With parental consent, children under 12 can work on farms where workers are exempt from federal minimum wage requirements. Children aged 12 and 13 can be employed with parental consent or on a farm where a parent or guardian is also working. At 14, children can work any agricultural occupation not deemed hazardous by the Secretary of Labor and 16-year-olds can engage in any agricultural occupation, even during school hours. Children of any age may be employed on a farm in any occupation at any time if a parent or guardian owns the business.

Minors do not need working paper or work-permits. Farm workers under 20 years old can be paid $4.25 an hour during the first consecutive 90 calendar days of employment. Lastly, farmworkers of all ages are not subject to the overtime provisions in the FLSA.

Tobacco Farms

In 2014, Human Rights Watch (HRW) conducted a survey, which found that child laborers on tobacco farms face harsh conditions and receive little protections. According to HRW, 90 percent of American tobacco is cultivated in Kentucky, Virginia, North Carolina, and Tennessee. Although exact numbers remain unknown, thousands of child laborers work on these fields every year. Ohio Rep. Mary Kaptur and several British Members of Parliament toured a North Carolina tobacco farm last year. An article from The Hill summarized the report from their visit noting the “squalid conditions, lack of sanitation, hot water, flushing toilets and basic health services” that tobacco farm workers face. According to the HRW report, child laborers often work 50 to 60 hours a week in bad conditions and extreme heat.

Injury Risks

Machinery poses a real risk to child farmworkers. According to a 2013 study from the National Institute for Occupational Safety and Health (NIOSH), the agriculture industry accounts for the largest number of work-related deaths. NIOSH reported that the fatality rate for child farm workers is four times greater than that of any other industry and that two-thirds of farm deaths occurred among children 16 years old and under. According to the study:

Young worker deaths in agriculture are noteworthy. In addition to accounting for the largest number of deaths of any industry, previous research has suggested that the fatality rate is about four times greater than for youth working in other industries [Barkume et. al. 2000, Hard and Myers 2006] and comparable to the risk for young and middle-aged workers in agriculture. Nearly 2/3rds of the deaths in agriculture occurred among youth less than 16 years of age [Windau and Meyer 2005]. Nearly 60% of the deaths of youth in agriculture occurred on family farms. Farm family workers accounted for nearly 25% of all young worker deaths from 1998 to 2002.

Human Rights Watch also reported that more than 1,800 children working on farms in 2012 received non-fatal injuries from  sharp tools and machines. In 2010, two teenagers died trapped in a grain bin. One 16-year-old Tennessee worker, interviewed by Human Rights Watch, remembered an incident saying, “I cut myself with the hatchet.… I probably hit a vein or something because it wouldn’t stop bleeding and I had to go to the hospital…. My foot was all covered in blood.” Another 16-year-old said that he lost two fingers in an accident involving a mower.

Health Risks

Another alarming aspect is the health risks that workers on tobacco fields may encounter. Child laborers under 16 may be free from operating the most dangerous machinery, but they are exposed to toxic pesticides and risk nicotine poisoning. You have to be at least 18 to buy cigarettes, but not to cultivate tobacco. According to Margaret Wurth from Human Rights Watch, “as the school year ends, children are heading into the tobacco fields, where they can’t avoid being exposed to dangerous nicotine, without smoking a single cigarette.”

Child laborers interviewed by Human Rights Watch also reported working while nearby field were sprayed with chemicals. These pesticides can cause cancer, damage to the nervous system, and issues with reproductive health. Public health experts  have linked nicotine exposure in adolescents with mood disorders and permanent cognitive deficits.

A number of the children interviewed by HRW exhibited signs of acute nicotine poisoning, also known as Green Tobacco Sickness. Side effects include nausea, vomiting, dizziness, headaches, loss of appetite, and sleeplessness. Others also reported difficulty breathing, skin rashes, and irritations to the mouth and eyes.

What is being done?

Recent attempts at reform have been futile. Although countries across the globe, like Brazil and India, prohibit children under the age of 18 to work on tobacco fields, the United States does not.

In 2011, during President Obama’s first term, former Secretary of Labor Hilda Solis proposed banning workers under the age of 16 in the tobacco fields–ridding the FLAS of many of its exemptions. Her plan included stricter regulations for “agricultural work with animals, pesticides, timber, manure pits, and storage bins.” It also proposed safety measures for young farmworkers.

However, powerful opposition from farm conglomerates emerged. Montana Representative Denny Rehberg lamented the consequences when “big-city bureaucrats try to craft policies for rural America.” Farmers also complained that it would prevent their children from contributing to chores, even though Solis suggested an exception regarding farmers’ children. State legislators responded by drafting bills asking respective Congressional delegates to oppose the proposed changes to child labor exemptions. The successful lobbying campaign resulted in all the proposals being dropped and the Obama administration promising to abandon the issue indefinitely.

Another legislative attempt to help child laborers is Representative Lucille Roybal-Allard’s Children’s Act for Responsible Employment (CARE Act). Initially introduced in 2001, the CARE Act has been reintroduced in several sessions of Congress over the past decade, most recently in June. The CARE Act standardizes child labor protection in agriculture with every other industry.

Not only would the CARE Act revise current child labor law exemptions, it would increase and establish criminal penalties for child labor violations. The bill currently sits in the House Committee on Education and the Workforce.

The Children Don’t Belong on Tobacco Farms Act, co-authored by Illinois Sen. Dick Durbin and Rhode Island Rep. David Cicilline, is the most recent attempt to alter the current laws. Although the bill doesn’t prohibit children from tobacco fields, it limits the type of work that can be performed. Children under eighteen would be banned from direct contact with tobacco plants or dried tobacco leaves. Like other legislation attempting to reform these laws, the bill has not moved past its assigned committee.

Conclusion

The evidence shows that dangerous child labor conditions are not exclusively third world problem– it is prevalent here in the United States. Although multiple attempts at reform have been made, they have either failed or stalled in Congress. Significant progress could also be made without major changes to existing laws. Removing exemptions for the agriculture industry could create uniform standards for the employment of children in all industries. However, such efforts seem unlikely to succeed as powerful interests have managed to block recent efforts.

Resources

Primary

Human Rights Watch: Child Workers in Danger on Tobacco Farms

U.S. Department of Labor: Child Labor Requirements In Agricultural Occupations Under the Fair Labor Standards Act

Trade Union Group: A Smokescreen for Slavery

Additional

The Atlantic: How Common Is Child Labor in the U.S.?

CNS News: Farm State Outrage Intensifies Over Labor Dept. Proposal to Ban Children From Doing Some Chores on Farms 

Congress.gov: CARE Act of 2013

The Hill: Back to School – Or Back to the Fields? 

The Hill: Democrats Want Children Off Tobacco Farms

The Nation: Child Labor in the USA

NCBI: Short- and Long-Term Consequences of Nicotine Exposure during Adolescence for Prefrontal Cortex Neuronal Network Function

NIOSH: Health and Safety of Young Workers

The United States Department of Labor: US Labor Department Proposes Updates to Child Labor Regulations

Editor’s Note: This post has been updated to clarify the history of the CARE Act.

Jessica McLaughlin

Jessica McLaughlin is a graduate of the University of Maryland with a degree in English Literature and Spanish. She works in the publishing industry and recently moved back to the DC area after living in NYC. Contact Jessica at staff@LawStreetMedia.com.

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You just sunk every penny you have into opening a restaurant. After spending years perfecting every detail from menus to music, you forgot one major element: an advertising budget. How will you make sure people experience your culinary genius? Fueled by passion, you do something you know you probably shouldn’t. You write a glowing review of your restaurant on Yelp.

Is the review a lie just because it came from the owner? Not necessarily. Just because a biased party tells you something is good doesn’t necessarily mean it’s not; their recommendation just holds less value than one from a disinterested party.

But, bias fueled by passion and economic interest happens in medical research all the time. Like you and your restaurant review, medical study funders often promote the information best for their cause. They finesse study designs and findings to make results seem more favorable for their product or service. A manufacturer of a new blood pressure drug might play up one specific benefit of their product in a way that makes you believe the drug beats others overall. It’s not fraud or misconduct, it’s just spinning results in a positive way–something any human with a vested interest in an outcome tends to do. Furthermore, data from a study means nothing by itself to most people, so invested parties can play with it as much as they want to tell a good story.

In discussing the interpretation of statistics in Made to Stick, authors Chip and Dan Heath put it this way:

Ethically challenged people with lots of analytical smarts can, with enough contortions, make almost any case from a given set of statistics.

Keep reading for more on funding bias and what you can do about it.

How is scientific research funded?

When you read a juicy new bit of research about something that might kill you or change the world as we know it, the study’s funding probably escapes your interest. But any study you read, whether it’s about drugs, medical treatments, nutrition, or even sleep, costs money. Where does the money come from? It can come from government grants, nonprofits, independent companies, and even you. When you buy dish soap, some of that profit might go to funding a Procter & Gamble study on a new cleaning chemical. Some portion of your taxes might trickle down to a government grant and end up in a laboratory. And of course, if you donate to a charity, that money might fund studies supporting that cause.

Money Talks

Since money fuels science, science itself can be shackled by economic interests, and interests of any kind can lead to bias. Even without fabricating results, funders have tools they can use to sway study results.

In a paper titled “Tobacco industry manipulation of research,” Dr. Lisa A. Bero calls out some reasons why research findings might not be as concrete as they seem:

• Any study has a context that can be skewed by framing the study, defining the problem, and sculpting that language of study questions and results.
• Data doesn’t present itself. It’s up to the funders and researchers to deliver it to the world, and this delivery can be nuanced to serve a given purpose.

That covers underlying reasons why bias happens, but how does it happen? The World Health Organization analyzed thousands of books, articles, and other materials to see how bias can occur in drug studies and promotions. Its paper, “Drug Promotion – What We Know, What We Have Yet to Learn,” outlined several ways researchers can skew results:

• Publishing results in multiple journals and with multiple authors. Different researchers can write papers on the same exact study. The multiplication of evidence revealing the same findings makes the results look more credible and can lead to a general overestimation of the studied drug’s treatment power.
• Leaving out unfavorable conclusions. Industry-funded studies left out negative results more often than their nonprofit counterparts.
• Using retrospective design, which looks backward to prove a determined outcome. With a known outcome, it’s easier to manipulate study designs to show X might cause Y.
• Putting focus on some features and leaving out others. Industry-funded studies tend to focus on acute benefits of drugs and stray away from ranking the drug’s benefits overall.
• Publishing only favorable results. If a study doesn’t achieve the desired outcomes, the industry funder can simply choose not to publish it, like a lie of omission.

Now let’s look at some real-world examples. In practice, a common method of skewing public scientific opinion involves funding counter blows to combat damaging research.

Bias in Practice

So we know bias happens, we know how it happens in theory, and in the real world the skewing attempts get even scrappier. In these examples, the industries used their funding prowess to spin the science of others.

Sugar

This NPR article relays the story of Dr. Christin Kearns, a dentist who was shocked when a handout of government advice about diabetes didn’t mention sugar. Detecting the scent of industry involvement, she began digging for evidence of similar foul play in the dental community.

After months of research and scouring through internal beet and cane sugar documents dating back to the 1950s, Kearns found that the industry does in fact push policy, especially when it concerns potentially damaging research. When the sugar industry caught wind of dental professionals’ intentions to tackle sugar consumption, they launched a counterattack to help people combat tooth decay while eating as much sugar as they wanted. They looked into enzymes that busted up plaque and other ways to fight tooth decay.

Tobacco

No surprise here: the tobacco industry’s efforts to combat damaging research have been fodder for many public health case studies. Tobacco companies specialized in contending with the findings of detrimental studies. Their philosophy read something like this: The longer you argue, the longer it takes to make decisions. And the longer it takes to make decisions, the more time we have to continue business as usual before we’re hampered with new policies. The tobacco industry used this philosophy to fight regulations for decades.

The 1950s and 60s saw tobacco companies fighting claims that smoking was bad for you. After that, they gracefully transitioned to denying the harms of secondhand smoke.

Here’s a commercial for Camel cigarettes showing doctors smoking and enjoying cigarettes and even recommending the Camel brand. Their decision to use a doctor as the main character sends a strong message to the public: If smoking was so bad, would a doctor do it?

In the 1990s, tobacco companies moved to using PR campaigns focusing on “junk science” to criticize reports on the risks of tobacco smoke, even from the government.

In 1998, big tobacco and the United States reached an agreement about how tobacco could be marketed and advertised. This Master Settlement Agreement surfaced documents outlining tobacco’s science-fighting strategy that confirmed what many had already suspected. When it came to steering science dialogue, tobacco’s policy was to:

• Pay for, publish, and promote research supporting their goals; and ,
• Suppress and criticize research going against their goals.

Tobacco’s efforts mark some of the first concerted and funded campaigns against science in history. Their efforts demonstrate the power of manipulating public opinion. Luckily, physician opinion is much harder to shape.

Does funding bias influence practice?

Good news: doctors know how to evaluate medical studies.

In a randomized study of physicians’ interpretations of funding disclosures published in the New England Journal of Medicine, researchers found a majority of physicians were fully capable of evaluating research based on academic rigor and were not fooled by common manipulations. In fact, the knowledge that a study was funded by industry caused their evaluation of the study’s rigor and likelihood of prescribing the studied drug to decrease.

What You Can Do

We can’t ignore oodles of research just because it might be biased. Luckily, there are safeguards in place. Title VIII of the Food and Drug Administration (FDA) Amendments Act of 2007 (FDAAA) made researchers start registering and submitting results to clinicaltrials.gov where you can check them out at any time. Individual journals also have publishing regulations protecting us from misleading science. For example, the New England Journal of Medicine publishes information on funding, protocols, and the funding organization’s involvement in the study with all of their articles.

But if you’re feeling less than trusting, you can develop your own methods of evaluating the research you read. When you see something new, check for other studies on the same subject to see if they coincide and take an extra careful look at the study’s design.

This graphic from Compound Interest ranks study methods on a descending scale. Keep this in mind when you’re evaluating research.

Even if it’s just something you see in a magazine, you can look up the original study to investigate the design for yourself and form your own opinion. We have access to more science than ever before. With that comes great power, but also great responsibility. Science can be biased but it’s still up to you whether or not to buy into the bias.

Resources

Primary

World Health Organization: Drug Promotion: What We Know, What We Have Yet to Learn

Additional

Washington Post: As Drug Industry’s Influence Over Research Grows, So Does the Potential For Bias

NPR: Documents Detail Sugar Industry Efforts to Direct Medical Research

Heath, Chip and Dan: Made to Stick

Plos Medicine: Sugar Industry Influence on the Scientific Agenda of the National Institute of Dental Research’s 1971 National Caries Program: A Historical Analysis of Internal Documents

Journal of the American Medical Association: Association of Funding and Conclusions in Randomized Drug Trials: A Reflection of Treatment Effect or Adverse Events?

University of California Museum of Paleontology: Who Pays For Science?

Public Health Chronicles: Tobacco Industry Manipulation of Research

Scientific American: Can the Source of Funding For Medical Research Affect the Results?

New England Journal of Medicine: A Randomized Study of How Physicians Interpret Research Funding Disclosures

New England Journal of Medicine: The Proposed Rule For U.S. Clinical Trial Registration and Results Submission

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

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When it comes to smoking cigarettes, public support for the known cancer-causers has consistently dwindled in recent decades thanks mainly to national “quit smoking” campaigns. In an attempt to help further curtail tobacco consumption, one state is poised to take further action by changing its minimum legal smoking age.

Last Friday, the Hawaii legislature passed a bill, that if signed into law by Governor David Ige, will make it the first state in the nation to raise its minimum legal smoking age from 18 to 21. The bill would ban individuals under the age of 21 from buying tobacco products, including e-cigarettes.

Some communities, counties, and cities, including New York City, have already approved initiatives to raise the smoking age. But if this bill is signed into law, it will make Hawaii the first state to entirely do so.

However, when it comes to enforcing the new legal smoking age, the punishment for underage violators is almost laughable. According to the Associated Press, first-time offenders will be fined a measly $10, which is roughly 50 cents more than the cost of a pack of cigarettes in the state. Any later violations would lead to a $50 fine or mandatory community service.

In a statement from the Campaign for Tobacco-Free Kids commending the bill’s passage, the nonprofit asserts that currently more than 10 percent of Hawaii’s high school students smoke, and tobacco use overall in the state claims 1,400 lives and costs $526 million in health care bills each year. Therefore supporters of the measure say that raising the legal smoking age will help reduce smoking among young people who will probably use tobacco products as adults.

Democratic state Senator Rosalyn Baker who introduced the bill told the AP:

Today we have the opportunity to change the paradigm…

While the industry is not allowed to directly market to children, it is still developing packaging and advertising products in ways that appeal to children,

Some of the advertising she’s referring to are candy flavored e-cigarettes that are increasingly gaining popularity with youths. According to Baker, the favorite flavors among teens who use electronic cigarettes are sweet tart and “unicorn puke”, which has been described by some as a combination of every flavor of Skittle in one.

Interestingly enough, the AP also reports that projections for raising the minimum smoking age to 21, from a report conducted by the Institute of Medicine, predict smoking prevalence would fall an estimated 12 percent.

If signed into law, the new minimum age probably won’t be welcomed by all. Critics may use the old argument that “if you’re old enough to enlist you should be old enough to smoke.” But given that lung cancer is the leading cause of cancer deaths in America, laws like this may become more common.

The post Hawaii May Raise the Legal Smoking Age to 21 appeared first on Law Street.

There is a new danger posing a massive threat to the health and longevity of young people. It holds the potential to be more lethal than MDMA, Heroin, tobacco, and every other street drug combined. The name of this new terror? Electronic cigarettes, designed to help the smokers of the real thing quit. DUN, DUN, DUN! Everybody start homeschooling your kids lest they pick up this atrocious habit and head down a lifelong path of recklessness. The scents of fruits and baked goods that encompass the flavors of electronic cigarette juice will surround the nation’s youth like an ominous black thunder cloud. Inhale vapor, exhale Satan’s breath.

The above paragraph is what is called hyperbole, a dramatic exaggeration for added emphasis. Recently, New York state passed a ban on electronic cigarettes in Central Park. I understand banning them indoors, where it makes complete sense that someone in a place like a restaurant would not want to eat his entree in a cloud of someone else’s electronic cigarette vapor. But in an enormous, unenclosed space? If it is between someone vaping e-cigarettes and smoking traditional ones, what would you choose?

Nicotine: Save our Children from this Toxic, Relentless Horror

A 2011 federal court case gives the Food and Drug Administration the authority to regulate electronic cigarettes under existing tobacco laws presumably because they deliver nicotine, which is derived from tobacco. This broad generalization that all electronic cigarettes “deliver nicotine” is not even true, since the flavored juices that turn to vapor via the use of devices often contain less nicotine than cigarettes and sometimes none whatsoever. Most articles stressing the health risks associated with nicotine delivered via e-cigarettes conveniently leave out this fact. Thankfully, an article on HowStuffWorks correctly points out that “there are also cartridges available that contain flavored liquid without nicotine, for users who want the sensory experience of smoking a cigarette without the harmful effects.”

According to an article bashing electronic cigarettes as a horrific danger to us all, the juice “poses a significant poisoning risk.” The article cites that, according to the CDC, “The number of calls to poison centers involving e-cigarette liquids containing nicotine rose from one per month in September 2010 to 215 per month in February 2014.” More than half of those calls involved children under age five.” How does this differ in any way from children getting into their parents’ medicine cabinets and overdosing on some candy-flavored medication? Here’s how you solve the issue of children getting a hold of electronic cigarette juice — put it on a higher shelf. There. I just solved one of the greatest concerns associated with e-cigs. Additionally, now that the good ol’ FDA is involved, they will probably make the juices childproof.

But of course, the concerns don’t stop there. The FDA claims that e-cigarette use can “increase nicotine addiction among young people and may lead kids to try other tobacco products.” First of all, please see my above comment about the nicotine-free juices. Additionally, in most states, minors are not allowed to purchase e-cigarettes or their accessories. Louisiana, one of the few exceptions previously, now prohibits the sale of e-cigarettes to minors. That law I get, because minors have underdeveloped brains that make rash decisions just to piss off their parents and the authorities. They are not trying to stop blackening their lungs and potentially giving themselves cancer by switching to a healthier method of getting their nicotine fix. Huge difference.Third, in response to leading kids to try other tobacco products, who wants to go from inhaling a smooth vapor flavored like delicious baked goods or refreshing fruits to choking down repulsive, chemical-laden and bitter tobacco smoke? No one, that’s who.

Toxic Vapor

Those adamantly calling for the banning of e-cigarettes argue that their juice has a high chemical content; however, the substance that is inhaled when vaping typically has four ingredients: propylene glycol, vegetable glycerin, nicotine, and food-grade flavors, whereas cigarette smoke contains substances such as carbon monoxide, tar, arsenic, ammonia, cyanide and acetone among many others. The Boston University School of Public Health has gone on record saying that “few, if any, chemicals at levels detected in electronic cigarettes raise serious health concerns.”

The FDA is more anxious than a preteen girl at a high school dance to regulate the heck out of e-cigarettes. Mitchell Zeller, director of the FDA’s Center for Tobacco Products, said the agency is exploring potential product standards in the areas of addiction, toxicity, and product appeal as it prepares to gain regulatory authority over electronic cigarettes and other nicotine-delivery devices. One of the positive aspects that would go hand in hand with these regulations would be the increased public education by the FDA.

It’s not the nicotine that kills half of all long-term smokers, its the delivery mechanism.
-Mitchell Zeller

Well said Zeller, well said.

Exploding E-Cigs

Another oft-cited criticism of e-cigarettes is that they have exploded in the mouths of their users. I’m not sure which punch I want to throw at this absurdity first. Let’s start with all of the explosions our beloved friends cigarettes have caused in their long reign. The fact that there are signs at gas stations warning smokers to smother their cancer-causers prior to fueling clearly started as a result of an explosion caused by the proximity of a cigarette to the flammable substance gasoline. Search “cigarette gas station explosion” on any search engine and the page will instantly bombard you with a string of news stories. Electronic cigarettes that explode generally have been tampered with in some way or another by their owner. Before you decide to label all e-cigarettes as potentially causing your face to burn off, remember that quality electronic cigarettes come with safeguards like automatic battery shutoffs or smart chargers that prevent overheating, and are properly tested prior to sale. According to manufacturers, regular e-cigarette batteries can’t do much damage even in the extremely unlikely event of their explosion.

My Lungs Hurt!

Let me cite and mercilessly rip apart another anti-electronic-cigarette argument. According to a scholarly article, “despite the marketing claims that e-cigarettes are safer than smoking tobacco, researchers are finding e-cig users experience diminished lung function, airway resistance and cellular changes, regardless of whether or not they currently (or ever) smoke cigarettes. Users who vape nicotine-free e-cigs can’t escape the effects, either; they also experience airway resistance and other signs of inflammation as side effects of e-cigarette use.” However, all tests done with e-cigarettes are short term studies, as in what happens ten minutes after you inhale their vapor. Additionally, nicotine isn’t the culprit of airway resistance and inflammation. Tobacco has thousands of carcinogens and causes 90 percent of lung cancer, while short term studies indicate some minor inflammation after vaping on an electronic cigarette. Which would you choose? A painful, lingering and potentially lethal disease or about ten minutes of smaller airwaves?

While one study performed by Greek researchers at The European Respiratory Center found that “E-cigarettes, electronic tubes that simulate the effect of smoking by producing nicotine vapor, caused an immediate increase in airway resistance, lasting for ten minutes, making it harder for participants to breathe,” another study by Greek researchers published in February 2013 found that e-cig use did not affect short term lung function in comparison to both mainstream and sidestream tobacco smoke. The important aspect to note in the first study’s findings is that it increased airway resistance for “ten minutes.” Oh Heaven forbid, TEN whole minutes! I guess in this ADD era of short attention spans, that is basically a lifetime…

E-Cigarettes Already Making a Difference

Yet there is success story following success story of musicians, athletes, and other individuals who push their lungs to the physical limits as part of their jobs switching from traditional cigarettes to electronic ones.

Playing a wind instrument requires an incredible amount of lung capacity and physical endurance. I used to smoke analog cigarettes and my lungs hurt every day, and playing upwards of 8 hours a day in college with painful lungs was absolutely miserable. As soon as my friend brought the earliest version of the now much more advanced electronic cigarette to rehearsal, I knew there was hope and I had to make the switch. I vape almost constantly every single day and ever since I switched from cigarettes to electronic cigarettes my lungs haven’t hurt once. I can’t remember the last cigarette I smoked, and I have no plans to start again.

-Alex Cazet, freelance saxophone musician

Switching from traditional to electronic cigarettes also makes a huge difference for athletes. Online forum after online forum feature athletes relaying statements about the huge difference e-cigs made in their athletic performance, health, and lives overall. With the potential of e-cigarettes providing extreme health benefits for previous cigarette smokers, it only makes sense to make their use completely legal. Yet state after state is imposing ridiculous bans on the devices. At the moment, North Carolina is considering adding a tax to e-cigarettes. Okay, let’s take a long, hard look at what this will cause. One of the reasons cigarette smokers want to quit: it costs a ton, especially with the jacked-up tax rates on each pack they buy. So, if saving money by switching to electronic cigarettes is no longer a draw, then a good number of smokers destroying their health will just shrug their shoulders and stick with their nasty habit. There are also a vast amount of laws banning the use of electronic cigarettes which are, rightfully so, pissing off their dedicated users. In New York, electronic cigarette users took part in a “vape-in” to protest the New York City ban on the devices. New Jersey, Utah, and North Dakota already have similar bans and more states are considering following suit.

These over-the-top laws, regulations and the seemingly sudden backlash against electronic cigarettes are completely befuddling to me. I admit that, due to their relatively recent popularity and invention, the effects of electronic cigarette use ought to continue being studied. Although the e-cig juices found to contain toxins are often poorly made, cheap options while there are myriad options on the market that are comprised of organic materials. Tobacco cigarettes, on the other hand, contain thousands of toxins including arsenic, a deadly poison.

So, aside from “grossing out” Rachael Ray and giving kids a new device to covet and try to obtain from their older friends, e-cigarettes hardly pose a more pertinent threat than that of their toxin-laden tobacco predecessors. Well, now that I feel I have educated the public, I’m off to go vape. Peace.

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Marisa Mostek (@MarisaJ44) loves globetrotting and writing, so she is living the dream by writing while living abroad in Japan and working as an English teacher. Marisa received her undergraduate degree from the University of Colorado in Boulder and a certificate in journalism from UCLA. Contact Marisa at staff@LawStreetMedia.com.

Featured image courtesy of [Joseph Morris via Flickr]

Marisa Mostek

Marisa Mostek loves globetrotting and writing, so she is living the dream by writing while living abroad in Japan and working as an English teacher. Marisa received her undergraduate degree from the University of Colorado in Boulder and a certificate in journalism from UCLA. Contact Marisa at staff@LawStreetMedia.com.

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