Category Archives: Infectious disease
United States, Mexico to Enhance Safety of Certain Agricultural Products
The U.S. Food and Drug Administration (FDA) and Mexico’s National Service for Agro-Alimentary Public Health, Safety and Quality and Federal Commission for the Protection from Sanitary Risks have entered an agreement to form a partnership to improve and promote the safety of fresh and minimally processed agricultural products. Each year, Mexico exports approximately $4.6 billion in fresh vegetables; $3.1 billion in fresh fruit, excluding bananas; $1.9 billion in wine and beer; and $1.5 billion in snacks to the United States.
The preventive practices and verification measures will include:
- Exchanging information to better understand each other’s produce safety systems
- Developing effective culturally-specific education and outreach materials that support industry compliance with produce safety standards
- Identifying common approaches for training auditors who will verify compliance with such standards
- Enhancing collaboration on laboratory activities as well as outbreak response and traceback activities
“To be successful as regulators, the FDA must continue developing new strategies and partnerships that allow us to more comprehensively and collectively respond to the challenges that come with globalization,” said FDA Commissioner Margaret A. Hamburg, MD, in a release. “The FDA is working with our Mexican government counterparts as well as stakeholders from industry, commerce, agriculture, and academia to ensure the safety of products for American and Mexican consumers.” Read more on food safety.
JAMA: Health Experts Call for End on Blood Donation Ban for Gay and Bisexual MenEx
perts writing in the Journal of the American Medical Association have called for the repeal of a 30-year ban on blood donations from gay and bisexual men. The U.S. Food and Drug Administration (FDA) instituted the ban for any man who had sex with another man in 1983, near the beginning of the AIDS crisis. Now, however, the experts said that technological and societal advances mean the ban should be lifted. "We think it's time for the FDA to take a serious look at its policy, because it's out of step with peer countries, it's out of step with modern medicine, it's out of step with public opinion, and we feel it may be legally problematic," said Glenn Cohen, who directs Harvard Law School's Petrie-Flom Center for Health Law Policy, Biotechnology & Bioethics, who co-wrote the article with Jeremy Feigenbaum of Harvard Law School and Eli Adashi, MD, of Brown University's medical school. They also noted that the ban is not in line with other FDA policies regarding people considered high-risk donors due to their sexual behavior. Read more on HIV/AIDS.
CDC Re-Opens Clinical TB Lab; Safety Reviews of Other Labs Continues
Less than two weeks after closing laboratories due to two serious lapses with anthrax and avian flu virus and an intensive review by its CDC’s internal Laboratory Safety Improvement Working Group, the U.S. Centers for Disease Control and Prevention (CDC) has resumed the transfer of inactivated materials out of its high-containment Clinical Tuberculosis Laboratory. The moratorium on material transfers remains in effect for BSL-3 and BSL-4 laboratories, with those supporting direct patient care receiving priority review. The working group’s ongoing lab assessments focus on two main areas:
- Each lab must demonstrate that its protocols for key control points—such as inactivation of a pathogen—are not only being used but that they are being used by appropriately trained and supervised individuals.
- Each lab is expected to establish redundant controls, similar to the two-key system used in other contexts for critical control points. For example, in the TB lab when heat is used to kill a pathogen, a second trained lab technician will witness the process to make sure the right temperature is used for the right amount of time. Both individuals then sign off on the process.
Strokes Fall Among Older Americans
Fewer older Americans are having strokes and those who do have a lower risk of dying from them, according to researchers at the Johns Hopkins Bloomberg School of Public Health. The study, published in JAMA, followed close to 15,000 stroke-free patients ages 45 to 64, beginning in the 1980s and ending in 2011. It found a 24 percent overall decline in first-time strokes in each of the last two decades and a 20 percent overall drop per decade in deaths after stroke. However, the decline was found mainly in people over age 65, with little progress in reducing the risk of strokes among younger people. The researchers say the decrease in stroke incidence and mortality is partly due to more successful control of risk factors such as blood pressure, smoking cessation and use of statin medications for controlling cholesterol, but that more efforts are needed to reduce strokes in younger people, including reducing obesity and diabetes and increasing physical activity. Read more on mortality.
Study: Insufficient Sleep Can Harm Memory
Lack of sleep, currently considered a public health epidemic in the United States, can also lead to errors in memory, according to a new study in Psychological Science. The study found that participants who didn’t get a full night’s sleep were more likely to make mistakes on the details of a simulated burglary they were shown in a series of images. “We found memory distortion is greater after sleep deprivation,” said Kimberly Fenn, an associate professor of psychology at Michigan State University and a co-investigator of the study. “And people are getting less sleep each night than they ever have.” The U.S. Centers for Disease Control and Prevention has linked the insufficient sleep epidemic to car crashes, industrial disasters and chronic diseases such as hypertension and diabetes. Read more on mental health.
The U.S. Environmental Protection Agency (EPA) has recently released a new graphic design available for use by insect repellent makers to more easily show how long the product is effective. “We are working to create a system that does for bug repellents what SPF labeling did for sunscreens,” said Jim Jones, Assistant Administrator of the Office of Chemical Safety and Pollution Prevention. “By providing vital information to consumers, this new graphic will help parents, hikers and the general public better protect themselves and their families from serious health threats caused by mosquitoes and ticks.” The release of the graphic design was accompanied by a joint statement from the EPA and the U.S. Centers for Disease Control and Prevention (CDC) urging the public to use insect repellents and take other precautions to avoid biting insects that carry serious diseases, including Lyme and West Nile virus. Incidence of insect-borne diseases is on the rise, according to the CDC. In order to place the new graphic on their labels, manufacturers must submit a label amendment, including test results on effectiveness. The public could see the graphic on repellent products early next year. Read more on infectious disease.
Ukraine Crash Kills Scores of AIDS Researchers
Malaysian Flight 17, believed to have been shot down by a missile over Ukraine yesterday, included dozens of AIDs researchers headed to Melbourne for AIDS 2014, the annual international gathering of AIDS researchers. Global Health Now, a daily newsletter produced by the Johns Hopkins Bloomberg School of Public Health, interviewed Prof. Richard Boyd, director of the Monash Immunology and Stem Cell Laboratories in Melbourne, who said, "There were some serious HIV leaders on that plane. This will have ramifications globally because whenever you lose a leader in any field, it has an impact. That knowledge is irreplaceable.” Read more on HIV.
First Chikungunya Case Acquired in the United States reported in Florida
The first locally acquired case of Chikungunya was reported in Florida this week in a man who had not recently traveled outside the United States. The U.S. Centers for Disease Control and Prevention (CDC) is working with the Florida Department of Health to investigate how the patient contracted the virus and will also monitor for additional locally acquired U.S. cases of the virus.
“The arrival of chikungunya virus, first in the tropical Americas and now in the United States, underscores the risks posed by this and other exotic pathogens,” said Roger Nasci, PhD, chief of CDC’s Arboviral Diseases Branch. Chikungunya virus is transmitted to people by two species of mosquitoes, Aedes aegypti and Aedes albopictus. Both species are found in the southeastern United States and limited parts of the southwest; Aedes albopictus is also found further north up the East Coast, through the Mid-Atlantic States and is also found in the lower Midwest.
The CDC has asked state health departments to report cases of chikungunya to help track the virus in the United States. Local transmission occurs when a mosquito bites someone who is infected with the virus and then bites another person. People infected with chikungunya virus typically develop fever and joint pain. Other symptoms can include muscle aches, headaches, joint swelling or rash. Read more on infectious diseases.
HHS Releases Health Insurance Information for Immigrant Families
The U.S. Department of Health and Human Services (HHS) recently released information clarifying health insurance coverage options for immigrant families, including:
- In order to buy private health insurance through the Marketplace, individuals must be U.S. citizens or be lawfully present in the United States.
- People who recently gained U.S. citizenship or had a change in their immigration status may qualify for a Special Enrollment Period.
- Many immigrant families are of “mixed status,” with members having different immigration and citizenship statuses. Mixed status families can apply for a tax credit or lower out-of-pocket costs for private insurance for their dependent family members who are eligible for coverage in the Marketplace or for Medicaid and CHIP coverage. Family members who aren't applying for health coverage for themselves won't be asked if they have eligible immigration status.
- Federal and state Marketplaces and state Medicaid and CHIP agencies can’t require people to provide information about the citizenship or immigration status of any family or household members who aren’t applying for coverage.
- States can’t deny benefits because a family or household member who isn't applying hasn’t provided his or her citizenship or immigration status.
- Information provided to the Marketplace won’t be used for immigration enforcement purposes.
- If a person is not eligible for Marketplace coverage or can't afford a health plan, they can get low-cost health care at a nearby community health center. Community health centers provide primary health care services to all residents, including immigrant families, in the health center’s service area.
Read more on the Affordable Care Act.
CDC Closes Flu and Anthrax Labs After Serious Lapses
After two serious lapses with anthrax and avian flu virus, the U.S. Centers for Disease Control and Prevention (CDC) announced it was temporarily closing its anthrax and flu laboratories and stopping shipments of all infectious agents. Last month at least 63 CDC employees may have been exposed to live anthrax bacteria after samples were sent to laboratories that were not prepared to handle the infectious agents. Anyone possibly exposed has been offered a vaccine and antibiotics; the CDC says no one was in danger.
In the second incident, technicians in a CDC lab accidentally contaminated a largely benign flu virus with a much more dangerous H5N1 bird flu strain. A lab worker who received a shipment of the strain and realized it was more dangerous than the sample expected contacted the CDC. And, in a third incident, the CDC also announced on Friday that two of six vials of smallpox vaccine recently found stored at the National Institutes of Health since 1954 contained live virus that could have infected people.
CDC has convened an investigation with finding expected later this week, as well as:
- Established a high-level working group, reporting to the CDC Director, to help accelerate improvements in laboratory safety; review and approve—on a laboratory-by-laboratory basis—resuming transfer of biological materials; and serve as the transition group for accountability on laboratory safety.
- Established a review group, under the direction of CDC’s Associate Director for Science, to look at the systems, procedures and personnel issues that led to the events, as well as how to prevent similar events in the future.
- Plans to take personnel action regarding individuals who contributed to or were in a position to prevent this incident.
Read more on infectious disease.
Military Servicemembers at Increased Risk of Financial Abuse
Members of the military are at increased risk of financial abuse, according to a new survey from the National Foundation for Credit Counseling (NFCC), and more must be done to help servicemembers protect themselves. An NFCC survey of active duty military personnel found that:
- 77 percent of respondents have financial worries
- 55 percent feel not at all or only somewhat prepared to meet a financial emergency
- 60 percent say they had to look outside of traditional institutions and utilized alternative, non-traditional lenders to meet their financial needs
In order to answer this need, the NFCC is working to give servicemembers a deeper understanding of personal finance through its Sharpen Your Financial Focus program, which includes materials that address their particular financial literacy challenges. The program presents 10 individual lesson topics, ranging from banking to planning for retirement. “No one should be victimized by financial abuse, particularly the military,” said Gail Cunningham, spokesperson for the National Foundation for Credit Counseling (NFCC). “One way to avoid financial abuse is through financial education, as an educated consumer is always a better consumer, one more equipped to identify fraud or deception and make wise financial decisions.” Read more on the military.
Study: Confusion Over Spoon Sizes Can Lead to Incorrect Medication Doses for Kids
Confusion over and differences in spoon sizes can lead to frequent medication dosing errors for children, according to a new study in the journal Pediatrics. Researchers observed 287 parents provide medicine to their children using teaspoons and tablespoons, finding that 39 percent incorrectly measured the dose they intended and 41 percent made an error in measuring what their doctor had prescribed. The findings indicate a growing need to change how doctors prescribe medicine for children. "A move to a milliliter preference for dosing instructions for liquid medications could reduce parent confusion and decrease medication errors, especially for groups at risk for making errors, such as those with low health literacy and non-English speakers," said the study's lead author Shonna Yin, MD, an assistant professor of pediatrics at NYU School of Medicine in New York City. Poison control centers receive approximately 10,000 calls each year related to incorrect dosages of oral liquid medications. Read more on pediatrics.
CDC: 60 Percent of Diners Will Use Menu Calorie Counts When Available
Approximately 6 in 10 U.S. adults will choose their restaurant meals in part because of menu label information when it’s available, according to the U.S. Centers for Disease Control and Prevention’s (CDC) latest Morbidity and Mortality Report. Researchers analyzed the self-reported usage of 118,013 adults in 17 states in 2012 to determine that about 57 percent will look to the provided calorie information. New York had the highest rate, with 61.3 percent, while Montana had the lowest, at 48.7 percent. Federal law requires calorie information be provided by any restaurant with 20 or more locations; while the regulations are not yet final, many establishments already voluntarily provide menu labeling, according to the CDC. Read more on nutrition.
Depression, Stress, Hostility Tied to Higher Stroke Risk
Depression, stress and hostility may be linked to a higher risk for stroke, according to a new study in the journal Stroke. Using information provided by approximately 7,000 adults who did not have heart disease or a history of stroke at the beginning of the study, researchers followed up nearly nine years later and determined that depression was associated with an 86 percent increased chance of a stroke or a transient ischemic attack, stress was associated with a 59 percent increase and hostility doubled the risk. “[C]hronic stress and negative emotions are important psychological factors that affect one's health, and findings from this study link these factors to brain health in particular," said the study's lead author, Susan Everson-Rose, an associate professor of medicine at the University of Minnesota, according to HealthDay. "Patients and their health care providers should be aware that experiences of chronic stress and negative emotional states can increase risk for stroke.” Read more on heart health.
Washington State Sees Most Measles Cases Since 1996
A slight decline in Washington State’s mumps and rubella vaccination rate has coincided with the state’s highest number of measles case in 18 years, according to officials. Washington has reported 27 cases so far this year and is currently in the midst of its third outbreak. While homegrown measles was declared officially eliminated from the United States in 2000, infections from people who have travelled overseas remain a threat. There were 554 total cases of measles and 17 outbreaks reported in the United States between Jan. 1 and July 3 of this year. Read more on infectious diseases.
Study: Global Child TB Rates 25 Percent Higher than Previously Realized
The true number of children who develop tuberculosis (TB) each year in the 22 countries with the worst TB rates is nearly 25 percent higher than the World Health Organization (WHO) estimated as recently as 2012, according to a new study in The Lancet Global Health. Researchers used mathematical modeling to determine that approximately 650,000 children in these countries develop TB each year; the WHO estimate was 530,000. The study also determined that approximately 15 million children are exposed to TB every year and 53 million are living with latent TB infections which can become infectious active TB. While the findings are troubling, they also indicate promising ways to reduce the risk. "Our findings highlight an enormous opportunity for preventive antibiotic treatment among the 15 million children younger than 15 years of age who are living in the same household as an adult with infectious TB,” said lead author Peter Dodd, MD, from the University of Sheffield in the United Kingdom, in a release. "Wider use of isoniazid therapy for these children as a preventative measure would probably substantially reduce the numbers of children who go on to develop the disease." Read more on global health.
Severe Obesity Can Cut a Person’s Lifespan by Nearly 14 Years
Severe obesity can take nearly 14 years off a person’s life, according to a new study in the journal PLOS Medicine. Using data from 20 previous studies, researchers determined that severe obesity—defined as a body mass index (BMI) greater than 40—can cut lives short by anywhere from 6.5 to 13.7 years, due to increased risk of health problems such as heart disease, cancer and diabetes. "We found that the death rates in severely obese adults were about 2.5 times higher than in adults in the normal weight range," said lead investigator Cari Kitahara, a research fellow at the U.S. National Cancer Institute, according to HealthDay. Approximately 6 percent of U.S. adults are severely obese; severe obesity accounts for approximately 509 deaths per 100,000 men annually and 382 deaths per 100,000 women annually. Read more on obesity.
HHS: $100M for 150 New Community Health Centers
The U.S. Department of Health and Human Services (HHS) has announced approximately $100 million in available funds for communities to expand access to affordable, high-quality primary care through an estimated 150 new community health centers in 2015. Currently there are approximately 1,300 health centers with more than 9,200 service sites providing care to more than 21 million people in the United States and its territories. The centers, made possible under the Affordable Care Act (ACA), have also helped approximately 4.7 million people enroll for ACA coverage. Read more on community health.
Study: Indoor Cooking Can Lead to Exposure to Dangerous Pollutants
Routine cooking also routinely exposes many Americans to dangerously high levels of pollutants such as carbon monoxide (CO), nitrogen dioxide (NO2) and particulate matter (PM), according to a new study in the journal Environmental Health Perspectives. While the World Health Organization is currently establishing guidelines for indoor air quality, neither the U.S. Environmental Protection Agency (EPA) nor any other U.S. agency regulate indoor air quality in non-industrial buildings. Researchers determined that during the average winter week approximately 1.7 million Californians could be exposed to excessively high CO levels simply because of cooking on gas stoves without range hoods; 12 million could be exposed to excessive NO2 levels. “That’s a lot of people in California, and those results ballpark-apply across the country,” said Brett Singer, study author and a staff scientist at Lawrence Berkeley National Laboratory (LBNL). “The EPA would say we don’t have a carbon monoxide or nitrogen dioxide problem in this country...In reality, we absolutely do have that problem; it’s just happening indoors.” The researchers listed improved ventilation; improved filtration; and improved building codes and standards as ways to combat the public health danger. Read more on air and water quality.
Multiple Errors Behind CDC’s Anthrax Exposure Incident
Multiple protocol breaches at a U.S. Centers for Disease Control and Prevention (CDC) laboratory led to 84 workers being exposed to live anthrax, including the fact that CDC researchers allowed only 24 hours to kill the pathogens—half the recommended time—according to Reuters. So far no one has died or become ill from the unprecedented U.S. exposure incident, but they are being treated with a vaccine and antibiotics. The errors at the biosafety level 3 facility raise new concerns over lax laboratory oversight. "If the protocol was already there, then there is really no excuse for it," said Amesh Adalja, MD, an infectious disease expert at the University of Pittsburgh Medical Center. "The question goes down to personnel and why wasn't protocol followed.” Read more on infectious disease.
Study: Autism Risk Higher in Children Whose Mothers Lived Near Commercial Pesticides
Pregnant women who live within a mile of places where commercial pesticides area used—including farms, golf courses and other public places—are more likely to have children with an autism spectrum disorder, according to a new study in the journal Environmental Health Perspectives. In a study of approximately 1,000 families, researchers determined that depending on the kinds of chemicals used, proximity to the treated area and when during the pregnancy the mother was exposed, their children were 60 to 200 percent more likely to develop autism; exposure during the third trimester brought the highest risk. Approximately one in every 68 children has autism, according to the U.S. Centers for Disease Control and Prevention. Read more on maternal and infant health.
CDC: Two U.S. MERS-CoV Cases Did Not Spread Any Further
In May of this year the U.S. Centers for Disease Control and Prevention (CDC) announced two cases of imported Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in the United States, with one in Florida and the other in Indiana. Both patients were health care providers who lived and worked in Saudi Arabia. The CDC has now confirmed that in neither case did the disease spread to either members of the patients’ households or health care workers who treated the patients. “The negative results among the contacts that CDC considered at highest risk for MERS-CoV infection are reassuring.” said David Swerdlow, MD, who is leading CDC’s MERS-CoV response. “Today, the risk of MERS-CoV infection in the United States remains low, but it is important that we remain vigilant and quickly identify and respond to any additional importations.” Read more on infectious disease.
FDA Approves the Manufacture of Cell-based Influenza Vaccine
Yesterday the U.S. Food and Drug Administration (FDA) announced approval to manufacture the first cell-based seasonal influenza vaccine in a U.S. facility. The Holly Springs, N.C., facility, which is owned by the Swiss company Novartis, will also be capable of manufacturing vaccines against pandemic influenza viruses. The technology was created in partnership with the Biomedical Advanced Research and Development Authority, part of the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response. According to a statement from Robin Robinson, PhD, ASPR Director and Deputy Assistant Secretary for Preparedness and Response, the cell-based vaccines will be part of multi-use approach that “strengthens everyday systems and increases our resilience in emergencies.” Read more on influenza.
Study Links Air Pollution, Cognitive Decline in Older Adults
One way to help reduce age-related cognitive decline may be to reduce air pollution, according to a new study in The Journals of Gerontology: Series B. Researchers determined that older adults who live in areas with low concentrations of fine particulate matter air pollution—from sources such as vehicle exhaust—made fewer cognitive errors on math and memory tests than did older adults who lived in areas with high pollution levels. “Although finding a link between the air we breathe on a daily basis and our long-term brain health is alarming, the good news is that we have made remarkable progress in the last decade in reducing levels of air pollution across the country, and there are efforts underway to further reduce air pollution,” said study co-author Jennifer Ailshire, of the Center for Biodemography and Population Health and the Andrus Gerontology Center at the University of Southern California in Los Angeles. Read more on aging.
CDC: Man Previously Reported Having MERS Does Not Harbor the Virus
After completing additional and more definitive laboratory tests, the U.S. Centers for Disease Control and Prevention (CDC) has retracted a report made last week that an Illinois man contracted the potentially deadly MERS virus from a patient who was diagnosed with MERS in the United States after spending time as a health care worker in Saudi Arabia. The confusion over the diagnosis came from earlier tests that indicated antibodies to a coronavirus, the class of virus MERS belongs to. However, more definitive tests found that he did not harbor the MERS virus. There are six known versions of the coronavirus; four cause mild illness and two cause the much more serious MERS and SARS viruses. Read more on infectious disease.
Study: 30 Percent of the World’s Population is Obese
A new analysis of global obesity trends finds that approximately 2.1 billion people—or nearly 30 percent of the world population—are obese, according to a new study in The Lancet. Researchers found that rates of being obese or overweight climbed 20 percent in adults and 47 percent in children during the 33 years analyzed. The study, which was funded by the Bill & Melinda Gates Foundation, determined that while obesity was once more common in wealthier nations, approximately two-thirds of the world’s obese population lives in developing countries. In addition, the statistics for the United States were especially troubling; while only 5 percent of the world’s population lives in the United States, the country is home to approximately 13 percent of the world’s obese population. Read more on obesity.
Study: Lung Cancer Screening Can Scare People into Quitting Smoking
In addition to early detection and treatment of lung cancer, early screening can also scare people into quitting smoking before they even develop the disease, according to a new study in the JNCI: Journal of the National Cancer Institute. Researchers based their findings on an analysis of 14,621 current smokers, 55-70 years old, with a 30 or more pack-year smoking history and who had smoked during the last 15 years. The data was taken from the Lung Screening Study component of the U.S. National Lung Screening Trial. The study found that "...abnormal screening results may present a 'teachable moment'" and that "[f]uture lung cancer screening programs should take advantage of this opportunity to apply effective smoking cessation programs." Read more on tobacco.
Study: Family Stress Can Impact Mortality Risk
Stressful family situations can significantly increase the risk of death, according to a new study in the Journal of Epidemiology and Community Health. Using health data on 9,875 men and women aged 36-52 years from The Danish Longitudinal Study on Work, Unemployment and Health, researchers determined that frequent worries and/or demands from a partner or children were linked to a 50-100 percent increase in mortality risk, and that frequent conflicts with any type of social relation were linked to a 2-3 times increase in mortality risk. Researchers also concluded that people outside the labor force were at higher risk of exposure to stress family situations. Read more on mortality.
National Task Force Recommends Regular Hep B Screening for People at Highest Risk
The U.S. Preventive Services Task Force is recommending regular screening for all people at high risk for contracting hepatitis B virus. If left untreated, the chronic illness can lead to liver cancer. Among the groups that the national panel says should be screened are:
- People born in countries with a high rate of infection, mainly in Asia, sub-Saharan Africa, the Pacific Islands, the Middle East and Eastern Europe.
- Those who share risk factors similar to those for HIV, including injection drug users, men who have sex with men, and people living with or having sex with someone with a hepatitis B infection.
- Patients with a weakened immune system or who are undergoing treatment for kidney failure.
"We have treatments that are effective at suppressing the virus and at improving abnormalities in the liver, so we can prevent some of the damage that occurs due to chronic hepatitis B," said Roger Chou, MD, an assistant professor at Oregon Health & Science University in Portland and director of the Pacific Northwest Evidence-based Practice Center, as well as lead author for the evidence review that formed the basis of the task force's recommendation. Read more on infectious disease.
Fewer Smokers See E-cigarettes as a Safer Smoking Alternative
While the national profile of e-cigarettes continues to increase, smokers are also increasingly less likely to view them as safer than traditional cigarettes, according to a new study in the American Journal of Preventive Medicine. Using data collected from the Health Information National Trends Survey (HINTS), researchers determined that awareness of e-cigarettes rose to 77.1 percent in 2013 from 16.4 percent in 2009. However, while 84.7 percent of smokers in 2010 viewed e-cigarettes as less harmful than traditional cigarettes, that number was down to 65 percent in 2013. Current estimates are that c-cigarette sales will soon reach $1.7 billion annually, or approximately 1 percent of all U.S. cigarette sales. Read more on tobacco.