Author: Taco Tuinstra

Vapers Starting Younger: Study

Photo: eldarnurkovic
Although the prevalence of teen vaping has declined in recent years, those who do vape are starting younger and using e-cigarettes more intensely, according to a new study published in JAMA Network Open by investigators at Massachusetts General Hospital (MGH) in collaboration with Stanton A. Glantz, a retired professor from the University of California at San Francisco.
In the analysis of data from the annual National Youth Tobacco Survey, a nationally representative survey of middle school and high school students in grades 6–12, researchers found that e-cigarette prevalence among youth peaked in 2019 then declined, but e-cigarette initiation age dropped between 2014 and 2021, and intensity of use and addiction increased after the introduction of protonated nicotine products.
Protonated nicotine is created by adding acid to the e-cigarette liquid, which makes the nicotine easier to inhale. Since Juul pioneered protonated nicotine, it has been widely adopted by other e-cigarette companies.
Age at first use of e-cigarettes fell by 1.9 months per year while age at first use of cigarettes, cigars and smokeless tobacco did not change significantly. By 2017, e-cigarettes became the most common first tobacco product used.
E-cigarette nicotine addiction, measured as the odds of use within five minutes of waking, an indicator of addiction, increased over time. By 2019, more youth e-cigarette users were using their first tobacco product within five minutes of waking than for cigarettes and all other products combined. The percent of sole e-cigarette users who used e-cigarettes within five minutes of waking was around 1 percent through 2017, but then it increased every year, reaching 10.3 percent youth using their first e-cigarette within five minutes of waking by 2021.
Median e-cigarette use also increased from three days to five days per month in 2014–2018 to six days to nine days per month in 2019–2020 and 10 days to 19 days per month in 2021.
The recently released 2022 National Youth Tobacco Survey data show that 2.55 million adolescents use e-cigarettes and 27.6 percent of adolescents use e-cigarettes daily. The comparable numbers reported in this paper for 2021 were 2.1 million and 24.7 percent.
“The increasing intensity of use of modern e-cigarettes highlights the clinical need to address youth addiction to these new high-nicotine products over the course of many clinical encounters,” said senior author Jonathan P. Winickoff, a pediatrician at MGH and a professor of pediatrics at Harvard Medical School, in a press note.
“In addition, stronger regulation including state and local comprehensive bans on the sale of flavored tobacco products, such as voting YES on Proposition 31 on California’s November ballot, should be implemented,” said first author Glantz.
November 8, 2022
Advocacy Group Suggests FDA Reforms
Photo: Araki Illustrations
The U.S. Food and Drug Administration has “significantly and substantially failed” to fulfill its congressional mandate to protect the public health, Americans for Tax Reform (ATR) told the Reagan-Udall Foundation in a letter.
The Reagan-Udall Foundation is reviewing the FDA Center Tobacco Products’ (CTP’s) policies and procedures following months of criticism over its handling of e-cigarette reviews. As part of its assessment, the foundation offered stakeholders an opportunity to share their input.
In its comment, the ATR suggested seven reforms to improve the agency’s performance:
FDA should introduce cross-disciplinary expert analysis factoring input from fields like psychology and behavioral economics to increase public awareness and engagement in the decision-making process.
FDA must provide an easy, streamlined PMTA pathway as initially promised.
FDA’s PMTA process should focus on product safety and individual risk, not behavioral and population assessments that are better gathered by a singular postmarket surveillance team.
FDA should be in regular, proactive contact with all PMTA applicants as opposed to merely issuing marketing denial orders after year-long periods of silence.
FDA should consider implementing product standards to assist in the streamlining process and look also to countries such as the United Kingdom as a model for a regulatory system that works.
FDA must urgently act to combat significant public misinformation that it admits exists in the community and is a barrier to smoking cessation.
FDA must reform its approach to youth risk behavior. FDA should accept that youth can benefit from harm reduction and properly evaluate the consequences of reduced vape access for both adults and youth.
Tim Andrews, ATR’s director of consumer issues, wrote that the Reagan-Udall Foundation’s review could help the agency better the PMTA review process.
“[The PMTA] process has created impossible administrative burdens on applicants,” he said. “When processes and requirements were changed, FDA failed to notify applicants and is alleged to have applied a new and different standard to certain applicants. FDA’s failures are structural. Our submission is cognizant of that and emphasizes that these issues can’t be solved with increased funding, especially not through user fees on small vape manufacturers.”
November 8, 2022
Pakistan Leaf Exports Up Nearly 75 Percent

Photo: Taco Tuinstra
Pakistan’s leaf tobacco exports jumped 74.66 percent during the first three months of fiscal year 2022–2023 as compared to the corresponding period of last year, reports the Daily Times, citing figures from the Pakistan Bureau of Statistics (PBS).
During the quarter, the nation exported tobacco worth $13.8 million. In terms of volume, tobacco exports also rose by 93.35 percent from 3,096 metric tons to 5,986 metric tons, the data revealed.
Meanwhile, the year-on-year basis for tobacco export increased by 29.39 percent during September as compared to the same month of last year.
The tobacco exports in September 2022 were valued at $3.5 million against the export of $2.71 million in September 2021, the PBS data revealed.
On a month-on-month basis, leaf exports in September were down 34.96 percent from $5.381 million in August 2022.
November 7, 2022
Gold Leaf Tobacco’s Assets Remain Frozen

Photo: somemeans
A South African court on Nov. 7 postponed a hearing about the frozen assets of Gold Leaf Tobacco until Jan. 30. 2023, reports News24.
At the end of August, the South African Revenue Service (SARS) secured a provisional preservation order in court against Gold Leaf and its directors Simon Rudland and Ebrahim Adamjee. The tax agency suspects Gold Leaf and its directors underpaid tax and hidden assets.
The preservation order prevents the tobacco group and its directors from selling any assets while the tax agency investigates the case.
Gold Leaf and Rudland denied any wrongdoing.
According to the provisional preservation order, the initial return date for the case was Nov. 7. At this hearing, the respondents get to argue why the order should not be made permanent.
Gold Leaf holds the distribution rights for brands such as Voyager, RG, Chicago, Sahawi, Sharp and Savannah.
November 7, 2022
22nd Century Welcomes Reduced Nicotine Study

Photo: 22nd Century Group
22nd Century Group welcomed the results of a recent study that found switching to reduced-nicotine content (RNC) cigarettes “reduces toxicant exposure and increases smoking cessation without worsening mental health among smokers with mood or anxiety disorders.”
According to 22nd Century, the study conclusively dispelled a common misconception that RNC’s may exacerbate general health and mental health problems. The study also concluded that a national nicotine reduction policy for cigarettes will likely result in reduced nicotine absorption and likely result in greater smoking cessation from smokers with mood and anxiety disorders.
The study examined adult smokers with a current or lifetime anxiety or unipolar mood disorder. The participants were randomly assigned to smoke conventional cigarettes or 22nd Century’s RNC research cigarettes. Adult smokers who were assigned to smoke 22nd Century’s RNC cigarettes had significantly lower cigarette consumption, lower cigarette dependence, lower plasma cotinine (metabolite of nicotine) and lower exhaled carbon monoxide than smokers assigned to the conventional group.
At the end of the study, despite having selected only participants not intending to stop smoking, those randomized to the group using 22nd Century’s RNC cigarettes were more likely to have quit smoking.
“Study after study, reduced-nicotine cigarettes are shown to be beneficial to adult smokers. The combination of reduced-nicotine cigarettes and a proposed nicotine standard have the potential to forever change the trajectory of public health by helping adult smokers smoke less,” said James A. Mish, chief executive officer of 22nd Century Group, in a statement.
“Based on last week’s comments from FDA’s [U.S. Food and Drug Administration’s] Center for Tobacco Products Director, Dr. Brian King, we are confident the FDA will use its existing authority to advance both a reduced nicotine policy and a menthol ban. These policies and 22nd Century’s reduced-nicotine cigarettes are expected to save millions of lives and increase the chances that current smokers quit. Our VLN reduced-nicotine content cigarettes are backed by clear science and evidence, which support FDA’s proposed product standards, and are the only FDA-authorized combustible product able to meet the stringent reduced nicotine levels determined by the FDA to be ‘minimally or nonaddictive.’”
November 7, 2022
Japanese Want More Smoking Restrictions

Photo: Colleen Williams
Nearly half of respondents to a recent government survey want Japan to strengthen measures against secondhand smoke, reports Kyodo News. Approximately 60 percent of those study participants asked for a reduction in outdoor smoking locations.
In April 2020, Japan banned smoking indoors in principle at restaurants, offices, hotel lobbies and other places open to the general public.
The survey queried 3,000 adults between August and September online and via mail, with 1,556 of them giving valid responses.
Around 83 percent of respondents said they find tobacco smoke unpleasant. The latest data cannot be compared directly with the last study conducted in 2019, which showed approximately 78 percent answered similarly, due to changes in the survey method.
In a multiple choice question about which smoking locations people disliked, most respondents (70 percent) cited streets, followed by nearly 51 percent who picked restaurants.
About 40 percent said they find tobacco smoke to be unpleasant even in locations frequented by smokers, including alcohol-serving establishments such as bars and izakaya Japanese pubs, as well as designated outdoor smoking areas.
November 7, 2022
Dropping Names

Photo: oxygen_8
After rooting out ENDS flavors, regulators may turn their attention to flavor names.
By Neil McKeganey
In the world of illegal drugs, there are few substances that have become popular as quickly as 3,4-Methylenedioxymethamphetamine. If you are wondering what that awkwardly named substance is, you will almost certainly recognize it by its street name, Ecstasy. In advance of its marketing, the drug developers thought about calling it Empathy but decided on Ecstasy instead—who, after all, could turn down the opportunity of experiencing “ecstasy”? And so it proved with a drug that sold in the millions in countries around the globe. That anecdote tells you something that every marketing person worth his or her salt knows all too well: Names matter. Indeed, when it comes to driving consumers to your product, names may matter more than the substance itself.
In recent years, the vaping world has seen the heavy hand of regulatory intervention focused on limiting the range of flavors that can be legally sold. Senior health officials, sections of the media, lobbyists, parent groups and others have forcefully argued for banning “kid-appealing flavors.” Restrictions on flavors, though, have gone well beyond the flavors that are seen to be appealing to vulnerable groups.
Out of some 1.6 million products for which premarket tobacco product marketing authorizations have been sought in the U.S., not a single flavor has been approved. Recent pronouncements from Brian King, head of the Food and Drug Administration’s Center for Tobacco Products, suggest that menthol is now in the regulatory agency’s crosshairs. In the face of such expanding regulatory action, it is by no means a stretch of the imagination to ponder a world in which only a single electronic nicotine-delivery system (ENDS) flavor—tobacco—remains, bringing vaping products that much closer to combustibles and in the process almost certainly weakening their capacity to offer a route out of smoking.
In a mono-flavored ENDS world, flavor names may become the new fertile terrain—promising consumers a realm of limitless variations in taste that, like the world of expensive Hi-Fi, where differences in quality are barely discernible, nevertheless draw in consumers seeking particular sensorial and taste experience.
With the removal of flavors from the market, next in line may be flavor names, with regulators galvanized by the belief that it is the names more than the flavors that are driving consumers to these products. In that event, it will become increasingly important for manufacturers to be able to present regulators with evidence that their specific-named tobacco-flavored products are not attracting young people and that those named flavors are assisting adults in quitting smoking.
If anyone is inclined to think that this is an unlikely scenario, it is worth remembering that regulatory authorities within the U.S. already involve themselves in determining what words can and cannot be used when referring to tobacco products. Some states already ban the use of food terms when referring to tobacco products, and the Family Smoking Prevention and Tobacco Control Act bans words like mild, light and ultra-light when referring to tobacco products. In the face of such regulatory restrictions, companies replaced the names mild, light and ultra-light with terms such as gold, silver and blue. Research undertaken by Gregory Connolly and Hillel Alpert and published in Tobacco Control in 2014 showed that even in the face of such name-switching, smokers were still able to identify their preferred product.
Within the world of ENDS, some e-liquid manufacturers have already chosen to move away from taste-based flavor names. Bidi Vapor, for example, uses product names such as Winter, Summer, Dawn and Marigold in describing its product range. Years before Bidi opted to anonymize the taste experience in its product names, e-liquid manufacturer Five Pawns opted to use words derived from chess, like Gambit and Grandmaster, to name its products. These are names that convey nothing about the taste or sensorial experience.
In time, there may be a push from the anti-e-cigarette lobby to reduce the variety of tobacco flavor names even further, requiring manufacturers to differentiate their products by numbers alone. Seems unlikely? Probably not for those who remember Players No. 6, No. 10 and No. 555. Flavor names may be the next item on the regulatory hit list.
Neil McKeganey is the director of the Center for Substance Use Research in Glasgow, Scotland.

November 7, 2022
Thai Activists Detect ‘Teen Vaping Crisis’

Photo: samart boonprasongthan/EyeEm
Tobacco control activists have expressed concern about the number of young people smoking e-cigarettes in Thailand, reports The Bangkok Post. While e-cigarettes are illegal in Thailand, they remain readily available across the country.
According to a health survey conducted in 2019 and 2020, 5.3 percent of Thais aged 10 to 19 have tried vaping, and 2.9 percent do so regularly. Around 30 percent of people in this age bracket who smoke e-cigarettes are women, the study showed.
Patcharapan Prajuablap, secretary-general of the Thailand Youth Institute, attributed the popularity of vaping in part to the fact that it is considered safer and more trendy than smoking cigarettes, especially among high school students.
Over the past year, Thai lawmakers have mulled legalizing e-cigarettes to offer smokers a less harmful method of nicotine consumption and to tap a new source of tax revenue.
Alarmed by the underage vaping numbers, Roengrudee Patanavanich, a lecturer at the Faculty of Medicine at Ramathibodi Hospital, urged the government to keep e-cigarettes illegal.
November 7, 2022
Philip Morris Clinches Swedish Match

Photo: Swedish Match
Philip Morris International is moving forward with its $16 billion takeover of Swedish Match despite securing less than the 90 percent stake it sought, reports Reuters.
In a press note dated Nov. 7, PMI said it had secured 82.59 percent of the Swedish company, short of the 90 percent level at which it can start a compulsory purchase of the remaining shares.
This suggests that Elliott Management Corp., which had built a 10.5 percent stake in Swedish Match and opposed PMI’s offer, has tendered its shares.
PMI also announced it would further extend the acceptance period for remaining shareholders until Nov. 25, 2022, adding that the price in the offer for shares tendered during the further extended acceptance period will be reduced to SEK115.07 in cash per share.
“We are pleased that 82.59 percent of Swedish Match shareholders, including—we believe—the top 10 shareholders, have tendered their shares at the best and final price of SEK116 per share. This achievement of a high controlling stake should allow us to harness the strategic potential of the transaction, including anticipated revenue synergies,” said PMI CEO Jacek Olczak.

“We look forward to welcoming Swedish Match’s employees and leading oral nicotine portfolio into the PMI family to create a global smoke-free champion.”
Jacek Olczak, CEO, PMI
“We are today extending the acceptance period until Nov. 25 to allow those shareholders who have not tendered—including outstanding index funds—additional time to accept the offer while waiving the 90 percent acceptance condition to provide certainty to those shareholders who have already tendered. Our objective is to delist the shares of Swedish Match from the stock market after reaching an ownership of more than 90 percent. We, therefore, encourage the remaining retail and other institutional shareholders to tender in the extended time.
“We look forward to welcoming Swedish Match’s employees and leading oral nicotine portfolio into the PMI family to create a global smoke-free champion, notably bringing IQOS and ZYN together in both the U.S. and international markets. We will be working together to create value as we accelerate toward our shared vision of a smoke-free future.”
Mark Kelly, managing director of Cowen’s Event Driven Group, welcomed the acquisition.
“History will likely prove this as a successful transaction all around,” he said. “Swedish Match shareholders engineered a material improvement to the already healthy premium that Philip Morris had offered, and Philip Morris has now secured ownership of a world-class smokeless operation. Swedish Match will help PMI accelerate its goal of going 50 percent smokeless by 2025 and also brings it a U.S.-wide distribution network to facilitate its own rollout of IQOS heat-not-burn products going forward.”
November 7, 2022
‘Jordanians Spend More on Tobacco Than Food’

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Jordanians spend more on tobacco than on food, reports The Jordan Times, citing the World Health Organization.
According to the global health body, Jordanian households spend JOD73.6 ($103.80) per month on tobacco-related products compared with JOD27 on fruits, JOD38 on dairy products and eggs, JOD50 on meat and poultry, and JOD42 on vegetables and legumes.
With 82 percent of men aged between 18 and 69 lighting up, Jordan’s smoking prevalence is the world’s highest. Some 66 percent of men smoke cigarettes and shisha, according to local media agencies. Another 15 percent vape e-cigarettes.
November 7, 2022