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ByMarilynnMarchione APChiefMedicalWriter TheAmericanHeartAs- sociation's first policy state- ment on electronic ciga- rettes backs them as a last resort to help smokers quit. The American Cancer So- ciety has no formal policy but quietly took a similar stance in May. Both groups express great concern about these popular nicotine-vapor products and urge more regulation, especially to keep them away from youth. They also stress that proven smoking cessation methods should always be tried first. But if those fail, "it is rea- sonable to have a conversa- tion" about e-cigarettes, said the Heart Associa- tion's president, Dr. Elliott Antman. The Cancer Soci- ety said e-cigarettes "may be a reasonable option" for people who could not quit after trying counseling and approved methods, such as nicotine patches. Neither group recom- mends e-cigarettes for smoking cessation, and makers of the devices do not market them that way. E-cigarettes are battery- powered devices that vapor- ize nicotine. They've been sold in the U.S. since 2007 and now have millions of users worldwide and nearly $2 billion in annual sales. They contain less toxic sub- stances than traditional cigarettes do, but little is known about their health effects. Whether they help or hurt anti-smoking efforts is hotly debated. Some say they encourage smoking by letting people maintain their habit in places where cigarettes are banned. Others say they are a less risky way to satisfy a nico- tine craving for people who want to quit, similar to how methadone is used to curb heroin abuse. This concept, called harm reduction, "is proba- bly the most important and the most contentious issue that the tobacco commu- nity is dealing with right now," said Tom Glynn, who recently retired as the Can- cer Society's top scientist on the e-cigarette issue. No solid evidence shows that e-cigarettes aid smok- ing cessation unlike the nic- otine patches, gums and medications approved now. "We need hard-nosed regulation for e-cigarettes and we need more re- search," Glynn said, but mostly, "we need to have people stop smoking com- bustible cigarettes."y The Heart Association stressed the toll — 20 mil- lion deaths in the U.S. alone from tobacco use over the last 50 years. "We are fiercely com- mitted to preventing the tobacco industry from ad- dicting another genera- tion of smokers," says a statement from the asso- ciation's chief executive, Nancy Brown. Besides nicotine — "a highly addictive chemi- cal no matter what form it comes in" — some e-cig- arettes form other prod- ucts such as formaldehyde, a carcinogen, Antman said. "There are many things we see as dark clouds on the horizon" about e-cigarettes' effects on blood vessels and secondhand exposure, espe- cially to pregnant women, he said. The Heart Associa- tion policy was published Monday in its journal Cir- culation. The Cancer Soci- ety statement was in a pa- tient page accompanying an article on e-cigarettes in the group's journal for doctors. In April, the federal Food and Drug Administration proposed treating e-ciga- rettes as tobacco products with rules such as a ban on sales to those under 18 and warning labels. Earlier this month, attorneys general from more than two dozen states sent a letter asking the agency to also ban fla- vors — more than 7,000 are available. The American Medical Association also has urged a ban on kid-ap- pealing flavors and other moves to keep e-cigarettes out of young hands. The Campaign for To- bacco-Free Kids has pushed for regulation and does not embrace the view that e-cig- arettes may have a role in smoking cessation. "Quitting smoking is hard," and people often try several times before they succeed, says a statement from a spokesman for the group, Vince Willmore. If they can't, doctors should work with them to come up with a plan, but the fo- cus should be on approved therapies, he wrote. Marilynn Marchione can be followed at http://twit- ter.com/MMarchioneAP . HEART ASSOCIATION Group:E-cigarettesmighthelpsmokersquit ASSOCIATEDPRESS In this April 23 file photo, an electronic cigarette is demonstrated in Chicago. In a surprising new policy statement, the American Heart Association backs electronic cigarettes as a last resort to help smokers quit. Online:Heart Asso- ciation policy: http:// tinyurl.com/lc6sw43 "We need hard-nosed regulation for e-cigarettes and we need more research."— Tom Glynn, who recently retired as the Cancer Society's top scientist on the e-cigarette issue. By Rick Callahan Associated Press INDIANAPOLIS When Niki Quasney felt a piercing pain in her ribcage in March, the oncologist treating her ad- vanced ovarian cancer told her to get to an emergency room immediately. But instead of making the short drive to a hospital near her home in Munster, Indiana, she drove alone for more than 40 minutes to one in neighboring Illi- nois. Quasney said she was "terrified" her local hospi- tal might not allow her and her partner of more than 13 years, whom she wed last year in another state, to be together if she suffered a health emergency. Quasney and her partner, Amy Sandler, are among dozens of couples challeng- ing Indiana's and Wiscon- sin's gay marriage bans in a case being heard Tuesday in the 7th U.S. Circuit Court of Appeals in Chicago. Loom- ing large in the case is the issue of medical emergen- cies faced by same-sex cou- ples. Crowds of supporters at- tended rallies in both states on Monday and boarded Chicago-bound buses to support the plaintiffs, who are suing for the right to marry or to have their out- of-state marriages recog- nized. They argue that pow- ers of attorney and domes- tic partner registries don't guarantee they'll be al- lowed to make critical end- of-life or life-saving deci- sions. No legal document, they say, can provide the same protections as a marriage certificate. Judi Trampf said that be- came clear when her part- ner of 25 years, Katy Heyn- ing, suffered a seizure in New Orleans several years ago. The Madison, Wis- consin, couple had health care powers-of-attorney al- lowing each other to make medical decisions for the other, but that paperwork was at home. Trampf told hospital workers Heyning was her domestic partner, but she said they refused to allow her to make any decisions without the documents. When Trampf tried to an- swer questions for Heyning, who was having trouble re- sponding after regaining consciousness, the hospital staff ignored her. "That's when I realized I really didn't have any rights in the situation," Trampf said in a recent telephone interview. "Heterosexual couples don't have to pull out anything." Judges have overturned numerous states' gay mar- riage bans since last sum- mer, when the U.S. Su- preme Court ordered the federal government to rec- ognize state-sanctioned gay marriages. Same-sex marriage is now legal in 19 states and the District of Columbia, and the remain- ing state bans all face legal challenges. Henry Greene, who along with his partner of 23 years, Glenn Funkhouser, and their son were among nearly 100 people at an In- dianapolis rally, said he be- lieves same-sex marriage will eventually be legal na- tionwide. "We're pretty confident in the final outcome," he said. "It's playing out pretty much like all the experts said it would." In Milwaukee, rally goers blew bubbles and held sup- portive signs as same-sex couples and their support- ers boarded a bus for Chi- cago, where they plan to lis- ten to Tuesday's arguments. Federal judges struck down the bans in Wisconsin and Indiana in June, and hundreds of couples mar- ried in the two states be- fore those rulings were put on hold following requests by the states' attorneys gen- eral. The cases were com- bined on appeal because both states' federal courts fall under the 7th Circuit. Attorneys for Wisconsin and Indiana will defend the bans Tuesday. Indiana's at- torney general argued in the state's final brief ahead of the hearing that tradi- tional marriage is in the interest of the state, while a recent brief by Wiscon- sin's attorney general con- tends there is no fundamen- tal right to gay marriage. Attorneys for both sides expect the issue to even- tually land in the U.S. Su- preme Court. The appeals court did, however, let stand a spe- cific order by the lower court that required Indiana to recognize the marriage between Quasney, 38, and Sandler, 37, because Quas- ney is dying. The women, who married in Massachu- setts and have 3-year-old and 1-year-old daughters, are currently the only same- sex couple whose marriage is recognized in Indiana. CONCERNED COUPLES Health-care fears loom large in gay marriage cases ASSOCIATED PRESS Rob MacPherson, le , listens as his husband Steven Stolen speaks at a rally for gay couples in Indianapolis on Monday who are part of a court hearing on the challenge to Indiana's same-sex marriage ban. RANDAL S. ELLOWAY DDS IMPLANTDENTISTRY 2426 SO. MAIN ST., RED BLUFF 530-527-6777 Askyourselfthefollowingquestions: Are you missing one or more of your natural teeth? Do you have a complete or partial denture that is no longer completely comfortable? Have you ever been embarrassed by a denture or a bridge? If you answered "yes" to one or more of these questions, call us today at (530) 527-6777 to schedule an evaluation appointment. We would be pleased to evaluate your oral health and discuss treatment options with you. 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