Answers About Tobacco

TFN E-News Update / March 2023

ARTICLE: What happens in Vegas, stays in your lungs: an assessment of fine particulate matter in casinos that prohibit and allow smoking in Las Vegas, Nevada, USA

The Centers for Disease Control and Prevention (CDC) and the University of Washington released the following tobacco-related article in the journal Tobacco Control.

Despite progress in the adoption of smoke-free policies, smoking in casinos is allowed in some U.S. states, including Nevada. In 2020, for the first time, a resort-style casino in Las Vegas prohibited smoking voluntarily.

This is the first study to assess PM2.5 levels in a smoke-free casino in Las Vegas. Despite robust evidence about the harms of secondhand smoke, tens of thousands of casino employees and tens of millions of tourists are exposed to high levels of secondhand smoke in Las Vegas casinos annually, with PM2.5 levels 5.4 times higher in gaming areas when compared with a smoke-free casino. Nearly all casinos in Las Vegas continue to allow smoking indoors. The only way to protect people from secondhand smoke exposure is to prohibit smoking in all indoor areas.


CDC Foundation Posts National and State Data on Trends in E-Cigarette Sales

The CDC Foundation has posted its most recent National and State Data Briefs highlighting national and state trends in e-cigarette sales from January 2018 through December 25, 2022.

These data briefs provide an update on trends in unit sales of e-cigarettes in the United States by product and flavor type. The briefs do not include online sales or vape store sales and cannot be used to make conclusions about subgroup (e.g., youth) purchasing or behaviors. These estimates are based on the information available at the time of publication and may be subject to updates as more information becomes available.


U.S. Food and Drug Administration (FDA) Announcements

The FDA authorized U.S. Smokeless Tobacco Company’s Copenhagen Classic Snuff, a loose moist snuff smokeless tobacco product, to be marketed as a modified risk tobacco product (MRTP). Copenhagen’s moist snuff smokeless tobacco product is a pre-existing tobacco product that has been marketed in the U.S. for years without modified risk information. This action now allows the product to be marketed as a modified risk product with the claim: “IF YOU SMOKE, CONSIDER THIS: Switching completely to this product from cigarettes reduces risk of lung cancer.”
The FDA has filed civil money penalty (CMP) complaints against four tobacco product manufacturers for manufacturing and selling e-liquids without marketing authorization. This is the first time the FDA has filed CMP complaints against tobacco product manufacturers to enforce the Federal Food, Drug, and Cosmetic (FD&C) Act’s premarket review requirements for new tobacco products.
The FDA issued marketing denial orders (MDOs) for two menthol e-cigarette products currently marketed by R.J. Reynolds Vapor Company under the Vuse Solo brand. The currently marketed products include the Vuse Replacement Cartridge Menthol 4.8% G1 and the Vuse Replacement Cartridge Menthol 4.8% G2.
In response to the increase of non-tobacco nicotine in popular tobacco products, Congress passed a federal law that went into effect on April 14, 2022, granting the FDA authority to regulate tobacco products containing nicotine from any source, including synthetic nicotine. This new law extended the tobacco product requirements in the Federal Food, Drug, & Cosmetic Act to manufacturers, importers, retailers, and distributors of non-tobacco nicotine products. Previously, the FDA’s tobacco product authority only extended to tobacco products that contain nicotine made or derived from tobacco. Under this legislation, the definition of “tobacco product” in FDA’s regulations and guidances has been considered to be amended since April 14, 2022. On March 17, 2023, the FDA issued two notices in the Federal Register updating the definition of “tobacco product” in its existing regulations and guidances, and has also posted nine revised guidances to FDA’s website.


ARTICLE: Racial Disparities in Flavored Tobacco Product Use, Curiosity, Susceptibility, and Harm Perception, National Youth Tobacco Survey 2019–2020

The CDC released the following tobacco-related article in the journal, Health Equity.
Studies characterizing differences in youth flavored tobacco product use prevalence, curiosity/susceptibility, and harm perceptions by race and ethnicity are limited. This study comprehensively examines flavored tobacco product use and harm perceptions among U.S. middle and high school students, by race and ethnicity.
Among youth who currently used tobacco, use of flavored tobacco products increased across all racial and ethnic groups; the largest increase was observed among Hispanic youth using other flavored tobacco products (30.3%). The group with the highest susceptibility to future electronic cigarette (e-cigarette) use was Hispanic students (42.3%). Hispanic students also had the highest curiosity about the future use of cigarettes and cigars.

Communications Tool: Plain Language for Public Health

The Public Health Communications Collaborative has created a new Plain Language for Public Health guide to support public health communicators in creating messaging to advance health literacy, build trust in your organization as a source of information, and promote overall community health. In this guide, you’ll find plain language principles, simple techniques that can make your communications more accessible, and resources to learn more about plain language to help build your communications skills.
Help your audience to:
  • Find what they need
  • Understand the information the first time they read or hear it
  • Use the information to meet their needs

Download the Plain Language for Public Health guide


Nebraska Tobacco Quitline Order Form Has Been Updated

Tobacco Free Nebraska has updated the Nebraska Tobacco Quitline order form! This resource provides the option to preview, order, download and print free and updated resources such as brochures, window clings, magnets, information sheets and more with information about the Quitline. Most materials are available in both Spanish and English. Please feel free to order or use these free materials as needed. 



Monthly Health Awareness Observances


  • Colorectal Cancer Awareness Month
  • National Kidney Month
  • Save Your Vision Month
  • Women’s History Month
  • American Diabetes Alert Day, March 23, 2023
  • National Puppy Day, March 23, 2023
  • World Tuberculosis Day, March 23, 2023
  • National Doctor’s Day, March 30, 2023
  • Take Down Tobacco National Day of Action, March 31, 2023
  • Limb Loss Awareness Month
  • National Cancer Control Month, National Minority Cancer Awareness Month, National Oral, Head and Neck Cancer Awareness Month
  • National Minority Health and Health Disparities Month
  • Oral Health Awareness Month
  • National Stress Awareness Month
  • National Public Health Week, April 3-9, 2023
  • World Health Day, April 7, 2023
  • Earth Day, April 22, 2023
  • National Infertility Awareness Week, April 23-29, 2023
  • Every Kid Healthy Week, April 24, 2023
  • National Sense of Smell Day, April 29, 2023



Nathan, a Native American and member of the Oglala Sioux tribe, never smoked cigarettes. For 11 years, he worked at a casino that allowed smoking. Secondhand smoke contains dangerous chemicals. The exposure to secondhand smoke caused him to develop allergies and serious infections that triggered asthma attacks, eventually causing permanent lung damage.
Nathan used to be active and athletic. He served in the Marines. He loved to participate in tribal dances. After getting sick, dancing just a few steps wore him out.
Nathan hoped that sharing his story would help others understand how dangerous exposure to secondhand smoke really is. Nathan’s lung damage led to his death on October 17, 2013. He was 54.

MCRC 101 Orientation
March 23, 2023 | 12:00-1:00 p.m. CST
CDC OSH’s Media Campaign Resource Center (MCRC) will hold its next MCRC 101 training webinar on March 23, 2023, from 12:00-1:00 p.m. CST. This orientation, only offered a few times a year, will familiarize you with all things MCRC and give you an opportunity to speak directly with MCRC administrators. 


2023 Nebraska Public Health Conference
April 4-5, 2023 | Lincoln, NE or Virtual
Nebraska Association of Local Health Directors (NALHD) is again partnering with UNMC College of Public Health and the Public Health Association of Nebraska (PHAN) to bring you the 2023 Nebraska Public Health Conference.
Tobacco Free Nebraska (TFN) Quarterly Coalition Meeting
April 12, 2023 | 9:30-11:00 a.m. CST
TFN is hosting a virtual State Coalition Meeting on Wednesday, April 12, 2023, from 9:30-11:00 a.m. CST/8:30-10:00 a.m. MST.
No Menthol Sunday
May 21, 2023
The Center for Black Health & Equity’s No Menthol Sunday is an annual opportunity for faith communities to address the detrimental impact tobacco is having on African American communities. Each year, faith leaders are encouraged to dedicate this day to educating congregants about smoking, vaping and the role of menthol and other flavors. 
Tobacco Disparities Reframing Project
OPEN NOW | Virtual
The CDC Office on Smoking and Health’s (OSH) training resource to help the tobacco control community use new evidence-based framing and messaging.



Nebraska Tobacco Quitline Adds Continuing Education Opportunity for Healthcare Providers

Accredited courses are now available online, through the Nebraska Tobacco Quitline, for providers looking to receive CME, CNE, or CPE credits.

Every year providers in Nebraska support their patients quitting tobacco by referring them to the Quitline. The courses offered help providers discuss how cessation can increase quit success and reduce the risks associated with tobacco use, including vaping.

Several courses are offered and cover a variety of topics, such as Tobacco Use Disparities for People with Behavioral Health Conditions, Myths About Quitting, Vaping and E-Cigarette Devices, and more. Additionally, providers can refer patients using the new online web referral option or the updated fax referral form. Go online to access tools, resources, and education modules, plus the web and fax referrals for providers ready to help patients quit, at

Call 1-800-QUIT-NOW or visit to reach a trained quit coach, get access to free quit-smoking medication, and make a plan to quit tobacco for good.