Category: Harm Reduction

  • New take on old problem

    New take on old problem

    Italy is mulling a ban on tobacco smoking in private automobiles, according to a Xinhua News Agency story.

    The country already bans smoking in vehicles for hire, such as taxis, and in private vehicles when a pregnant woman or a person under the age of 12 is present.

    But people are divided on the latest measure to be proposed.

    Advocates of the ban claim it would help avoid health problems related to smoking, while also decreasing traffic risks associated with drivers being distracted while smoking.

    Fabio Galli, a road- and traffic-issues analyst with the consumer organization Codacons, was said to have told Xinhua that the issue presented a new take on a very old problem, which is how to balance the rights of an individual’s freedom to make personal choices and the desire to make changes that benefit the public at large.

    Galli said the proposal was in the “earliest stages” of passage, and that it had several apparent flaws. “The first question I have is how it would be enforced,” Galli said. “There’s also the question of whether this is the kind of issue where the government should be involved.”

    Oliviero Fiorini, a political affairs consultant with ABS Securities, said a law limiting smoking in vehicles would probably be treated as government overreach if questioned by courts. “We see a few examples of the government trying to incentivize a kind of moral code,” he said in an interview.

    Fiorini said that if the goal was to reduce smoking, it would be more efficient to raise taxes on cigarettes or to outlaw them altogether. If the goal was to remove distractions from drivers, then rules should be introduced also in respect of mobile-phone use in vehicles.

  • E-cig ban to be lifted

    E-cig ban to be lifted

    A ban on the sale of electronic cigarettes and heat-not-burn (HNB) devices is due to be lifted in the UAE by mid-April, according to a story in The Khaleej Times.

    The lifting of the ban had been expected following an announcement on February 16 that the Emirates Authority for Standardization and Metrology (ESMA) had approved new standards for electronic cigarettes and HNB devices.

    And the intention to lift the ban was confirmed the next day by Abdullah Al Maeeni, director general of the ESMA. “We issued the regulation to legalize it, and it will be enforced by mid of April 2019, as the Authority is working hard through the development of technical standards and regulations,” he said.

    UAE residents readily smoke electronic cigarettes in public though their sale has been illegal.

    The new standards set by ESMA will reportedly regulate a range of matters, including nicotine components, technical specifications, packaging, and labeling.

    They will apply to e-cigarettes and HNB devices, and to their associated products such as e-liquids and tobacco sticks.

    The story said that the new ESMA standards were in line with the Government’s efforts to curb smoking and put a stop to the illegal sale of electronic cigarettes.

  • Smokeless making headway

    Smokeless making headway

    Swedish Match’s volume shipments of snus in Scandinavia during the 12 months to the end of December, at 263.4 million cans, were increased by six percent on those of the year to the end of December 2017, 247.6 million cans.

    But despite the volume increase, SM’s share of Sweden’s snus market fell by 2.3 percentage points, from 65.7 percent during 2017 to 63.4 percent during 2018. And it’s share of Norway’s snus market fell by 0.8 of a percentage point to 51.3 percent.

    Meanwhile, SM’s volume shipments of moist snuff on the US market during 2018, at 126.3 million cans were down by one percent on those of 2017, 127.4 million cans.

    Also in the US, the company’s volume shipments of cigars in 2018, at 1,703 million, were increased by five percent on those of 2017, 1,629 million.

    But, during the same period, volume shipments of chewing tobacco, excluding contract manufacturing volumes, at 6,093,000 pounds, were down by four percent from 6,341,000 lb.

    SM’s worldwide shipments of matches during 2018, at 64.5 billion sticks, were down by one percent on those of 2017, 65.0 billion sticks.

    During the same period, worldwide shipments of lighters fell by nine percent from 368.1 million to 333.9 million.

    In announcing its results, SM said that, in local currencies, sales had increased by seven percent for the fourth quarter and by nine percent for the full year. Reported sales had increased by 12 percent to SEK3,301 million for the fourth quarter and by 10 percent to SEK12,966 million for the full year.

    In local currencies, operating profit from product segments (excluding larger one-off items and other operations) increased by eight percent for the fourth quarter and by 12 percent for the full year. Reported operating profit from product segments increased by 14 percent to SEK1,246 million for the fourth quarter and by 14 percent to SEK4,936 million for the full year.

    Operating profit amounted to SEK1,196 million for the fourth quarter and to SEK4,812 million for the full year.

    Profit after tax amounted to SEK925 million for the fourth quarter and to SEK3,578 million for the full year.

    Earnings per share increased by six percent to SEK5.41 for the fourth quarter and by nine percent to SEK20.63 for the full year. Adjusted earnings per share increased by 28 percent to SEK5.41 for the fourth quarter and by 26 percent to SEK20.63 for the full year.

    In commenting on the results, CEO Lars Dahlgren (pictured) said 2018 had been a successful year for Swedish Match with very healthy growth in sales and operating profit from product segments. “While our base businesses in our two largest product segments performed well, our growth initiatives continued to demonstrate very promising developments, with exceptional momentum for ZYN in the US,” he said.

    “More and more, we see evidence of a trend where the global consumption of nicotine products is shifting away from traditional combustible cigarettes, and the best alternatives to cigarettes lie in smokeless products.

    “While we continue to believe that the global regulatory stance towards smokeless products is disproportionate given the role that such products can play in harm reduction, we are encouraged to see positive regulatory developments in the smokeless arena and our strategy and focus position us well to compete in pursuit of our vision.”

  • Dynamic change foretold

    Dynamic change foretold

    Gemma Webb, British American Tobacco UK’s GM, said yesterday that the tobacco industry was entering the most dynamic period of change it had ever encountered.

    “We are experiencing an extraordinary, once-in-a-generation coming-together of societal change, public health awareness and, crucially, access to technological innovation in the nicotine category,” she said.

    “This convergence of factors has created a unique opportunity for the industry and our business: the opportunity to make a substantial leap forward in our ambition to provide our consumers with a choice of potentially reduced risk tobacco and nicotine products.”

    Webb was speaking at a BAT launch party for the newest iterations of its Vype electronic cigarettes, Vype iSwitch and iSwitch Maxx.

    The party, which was held against the background of the London skyline as seen from the top of the ‘Gherkin’ building, attracted about 60 people from the vaping and creative industries, along with journalists and influencers.

    During the formal part of the evening, guests were addressed by Webb and Marina Trani, new categories group R&D director.

    Guests were taken through the innovative devices and technologies that BAT had introduced since 2014: innovative devices such as the ePen3 and new e-liquid technologies that brought nicotine salts into the equation.

    The iSwitch devices, meanwhile, include BAT’s Puretech blade, which replaces the coil and wick system. Trani said the Puretech system incorporated an ultra-slim, stainless steel blade that heated the e-liquid to create vapor. The blade, which was about the thickness of a human hair, had a surface area 10 times larger than a traditional coil and wick heating system. It provided a much more precise and measured way to heat the e-liquid, increasing consumer taste satisfaction by ensuring a smoother, richer and more consistent vape, with no off-notes.

    The Maxx version was said to be BAT’s most interactive and connected vapor device. Bluetooth enabled, it connects with the MyVype app through which consumers can tailor their device’s power setting; remotely lock the device to ensure that nobody else can use it; monitor puff count, battery level and device performance to track their usage; and access tips and news.

    Brief mention was made at Tuesday night’s event of the Monday announcement by BAT that it had entered into a new global partnership with McLaren that was ‘rooted in advanced technology and innovation’.

    ‘The multi-year partnership is focused on accelerating its transforming tobacco agenda, at the heart of which is its commitment to providing a portfolio of potentially reduced-risk products (PRRPs), which can deliver a “better tomorrow” for its consumers,’ BAT said in a press note.

    ‘As part of the agreement, BAT will work closely with McLaren Applied Technologies, collaborating and sharing technology expertise; including batteries, advanced materials and design. The two companies will share best practice, processes, innovation, know-how and mutual experience.’

  • General decision time

    General decision time

    Some members of a Tobacco Product Scientific Advisory Committee have argued that if a product such as snus does not qualify for the US Food and Drug Administration’s modified risk tobacco product (MRTP) status, the designation might as well not exist, according to a MedPage Today story relayed by the TMA.

    “I think the health [benefits] are really clear compared to smoking – more so than for any other smokeless tobacco product,” committee member Kenneth E. Warner, PhD, of the University of Michigan in Ann Arbor, was quoted as saying. “My sense is that if this is not approved, it might be the death knell for the [MRTP] process because we would be basically saying you can’t get anything through this process.”

    The committee was considering an MRPT application by Swedish Match North America in respect of its General snus brand. The company has been trying for years to have a health warning changed in respect of its General snus brand, but the issue has been kicked down the road.

    Most people believe that the consumption of snus is hugely less risky than is smoking and that health warnings should reflect this.

    However, some members of the Committee reportedly expressed concerns that increased popularity of General snus could lead to increased uptake among young people.

    In fact, according to the findings of an FDA-requested Swedish Match study, Swedish Match snus product users in the US are mostly male, have a median age of 35, are fairly well educated, are slightly more affluent than general smokeless tobacco users, and are largely Caucasian.

    The Committee met in Washington DC on February 6 to review the scientific evidence, health risk, claim development, testing and population impact revealed in a 10,000-person Consumer Research study requested by the FDA of Swedish Match.

    It considered the statement that consumers in the 10,000-person study found to be the most understandable the warning: ‘Using General Snus instead of cigarettes puts you at a lower risk of mouth cancer, heart disease, lung cancer, stroke, emphysema, and chronic bronchitis’.

    One Committee member was quoted as saying: “Swedish Match is a company that has never marketed to youth, it has a history I trust. Semantic issues can be fixed, but the public needs to be informed about tobacco harm reduction products”.

    And, in summarizing the proceedings, the chairman of the panel, Dr. Robin Mermelstein of the University of Illinois at Chicago, said she believed there had been a fair amount of consensus against a background of a range of opinions. There had been consensus around the importance of providing accurate information about relative harms.

    The goal of getting people who were unable to quit smoking off combustibles and on to less harmful products was certainly a laudatory one, Mermelstein said. She seemed to indicate, too, that there was a fair amount of consensus around the fact that whatever could be done to promote such switching was worthwhile, and that the Swedish Match approach was a potential path to such switching.

    The FDA did not ask the Committee for a vote because, according to its spokesperson: “We felt what would be most useful [to us] was to have the qualitative discussion to make sure we hear the points that are concerning [the panel]”.

    After listening to the proceedings, tobacco harm reduction expert David Sweanor, of the University of Ottawa’s Centre for Health Law, Policy and Ethics said the data on snus being dramatically less hazardous than smoking was overwhelming; as was the data on smokers not knowing this fact.

    “In many ways, the FDA proceedings are less a test for Swedish Match than of the FDA itself,” he said. “After a decade of the tobacco law, and literally millions of American deaths from cigarettes, can the agency simply allow people to be told the truth? This should be no more complicated than allowing the public to know that three-point seatbelts – another Swedish innovation – reduce the risks of driving.”

  • Scientific rigor plummets

    Scientific rigor plummets

    A public health expert in the US has demolished claims by some researchers that vaping causes chronic obstructive lung disease (COPD).

    One researcher was said to be claiming that the use of electronic cigarettes increases the risk of COPD ‘just like’ smoking does.

    Dr. Michael Siegel (pictured), a Professor in the Department of Community Health Sciences, Boston University School of Public Health, writing on his blog, said the paper, published in Drug and Alcohol Dependence, reported the results of a cross-sectional study based on the 2016 Behavioral Risk Factor Surveillance System (BRFSS) survey in Hawaii. ‘The outcome variable was reporting ever having been told that one has COPD,’ Siegel said. ‘The main predictor variable was ever having used an e-cigarette. ‘The key finding of the study was that: “there was a significant association of e-cigarette use with COPD among non-smokers … but the association was not significant among smokers…”.

    Siegel went on to say that it was not possible to conclude or even speculate, based on the results of this cross-sectional study, that vaping was a cause of COPD disease – emphysema and chronic bronchitis.

    Siegel looked at such factors as sample size, but explained that the worst problem with the conclusions and speculation was that they were biologically implausible.

    And he went on to say that he believed there was a strong, subconscious bias among many researchers who were so determined to find an association between vaping and chronic disease that they were forgetting basic pathology.

    ‘The reason this is all so disturbing to me is not simply that it shows how scientific rigor in tobacco control literature has deteriorated,’ he said. ‘It is disturbing because disseminating these scientifically unsupported claims is going to discourage many smokers from trying to quit using e-cigarettes and may even cause many former smokers to return to smoking.’

  • It’s the environment

    It’s the environment

    For the fifth year in a row, electronic cigarettes were the most commonly used tobacco product among young people in the US, according to a note issued yesterday by the Food and Drug Administration through its Center for Tobacco Control [e-cigarettes are ‘deemed’ by the FDA to be tobacco products].

    This was said to be one of the findings of the 2018 National Youth Tobacco Survey (NYTS) published in an MMWR [Morbidity and Mortality Weekly Report] article, Vital Signs: Tobacco Product Use Among Middle- and High-School Students – United States, 2011-2018.

    This article includes findings on current use of seven tobacco products, cigarettes, cigars, e-cigarettes, smokeless tobacco, hookah, pipe tobacco, and bidis, as well as findings on the use of multiple products and frequency of use.

    ‘The study authors found that in 2018, approximately five million middle- and high-school students currently used any tobacco product, with over 3.6 million currently using e-cigarettes and about half (2.5 million) currently using a combustible tobacco product, such as cigarettes and cigars,’ said the FDA in its note. ‘For the fifth year in a row, e-cigarettes continued to be the most commonly used tobacco product among US youth. Among current tobacco product users, 41.7 percent of high-school students and 33.3 percent of middle-school students used two or more tobacco products. E-cigarette and cigarette use was the most common combination among those using multiple products.

    ‘From 2017 to 2018, use of any tobacco product increased significantly by 38.3 percent (19.6 percent to 27.1 percent) among high-school students and by 28.6 percent (5.6 percent to 7.2 percent) among middle-school students. Current e-cigarette use increased significantly by 77.8 percent (11.7 percent to 20.8 percent) among high-school students and by 48.5 percent (3.3 percent to 4.9 percent) among middle-school students between 2017 and 2018. Furthermore, frequent e-cigarette use (more than 20 days in the past 30 days), increased significantly by 38.5 percent (20.0 percent in 2017 to 27.7 percent in 2018) among high-school students who were current e-cigarette users.

    ‘Due to the alarming nature of these findings, they were released early in a Notes from the Field article in Nov. 2018. The current study finds that e-cigarettes were the primary driver of the increase in current use of any tobacco product among both middle- and high-school students. During this same period, although there were no significant changes in current use of combustible tobacco products, such as cigarettes and cigars, there was a slight uptick in any combustible tobacco product use (12.9 percent to 13.9 percent) and current cigarette use (7.6 percent to 8.1 percent) among high-school students.

    ‘The high rates of youth tobacco use, particularly e-cigarette use, continue to be of concern to FDA. Last spring, FDA launched the Youth Tobacco Prevention Plan, which aims to prevent youth access to tobacco products; curb marketing of tobacco products aimed at youth; and educate teens about the dangers of using any tobacco product, including e-cigarettes, as well as educate retailers about their key role in protecting youth.

    ‘As part of the plan, FDA has ramped up efforts around compliance of the marketing and sales of e-cigarettes and conducted an ongoing series of enforcement actions to prevent initiation of tobacco products, including e-cigarettes, by youth. FDA continues to invest in compelling, science-based campaigns to educate youth about the dangers of all tobacco products. In Sept. 2018, FDA launched the full-scale youth e-cigarette prevention effort under “The Real Cost” brand umbrella. In Nov. 2018, the concerning findings from the 2018 NYTS youth e-cigarette use data prompted FDA to outline a policy framework on actions to reduce youth e-cigarette use, targeting the central problems – youth appeal and access to flavored tobacco products.’

    Meanwhile, in a statement posted on its website yesterday in response to the CDC National Youth Tobacco Survey, Altria Client Services senior vice president, corporate citizenship, Jennifer Hunter said young people shouldn’t use any tobacco products and Altria shared the FDA’s concerns with their use of e-vapor.

    “We remain committed to being part of the solution,” she said. “Raising the legal age of purchase for all tobacco products to 21, which we strongly support, is the single most effective way to address underage use. We continue to meet with state and federal policy makers on this effort and stand ready to work with all interested parties.”

  • Driving change

    Driving change

    New Zealand is planning to ban vaping and tobacco smoking in vehicles when people under 18 are present, according to a story in The New Zealand Herald quoting the associate health minister Jenny Salesa.

    The ban would apply to all vehicles and whether they are parked or on the move.

    “Public education and social marketing campaigns over many years have had some impact, but the rate of reduction in children exposed to smoking in vehicles is slowing,” Salesa said. “It is now time to do more by legislating.”

    Salesa said that she expected the Smoke-free Environments Act 1990 to be changed by the end of this year so that police would be able to use their discretion about whether to give warnings, refer people to stop-smoking support services, or issue infringement fees of NZ$50.

    The focus of the ban is said to be on education and changing social norms – not on issuing infringement notices; so the legislation will be backed up with what is described as a new and innovative public education and social marketing effort.

    “First and foremost, this change is about protecting children,” said Salesa. “However, it is also part of the Government’s commitment to achieving Smokefree 2025.

    “Too many New Zealand children, particularly Māori and Pacific children, are exposed to second-hand smoke in the vehicles they usually travel in.

    “Children are especially vulnerable to the harmful effects of second-hand smoke due to their smaller lungs, higher respiratory rate and immature immune systems.

    “Second-hand smoke accumulates in vehicles, even with the windows open. It reaches much higher levels than in homes.”

    The story said there was likely to be strong support for the move because several surveys had shown that about 90 percent of people support the idea of a ban on smoking in cars with children present.

  • Irresponsibility exposed

    Irresponsibility exposed

    A public health expert in the US has said that according to a study, making a serious attempt to quit smoking is associated with a significant (41 percent) increase in heart attack risk.

    Dr. Michael Siegel, a Professor in the Department of Community Health Sciences, Boston University School of Public Health, wasn’t attempting to discourage smokers from attempting to quit their habit – far from it; he was pointing out how it was possible for studies to arrive at perverse findings.

    Siegel’s focus was on a recent study that, according to news coverage, had used cross-sectional data from the 2016 Behavioral Risk Factor Surveillance Survey (BRFSS) and found that ever use of e-cigarettes increased the risk of reporting ever having had a heart attack, while controlling for age, gender, body mass index, history of diabetes, and smoking status. The news articles had reported that the study found a 59 percent increase in heart attack risk associated with the use of e-cigarettes.

    On his blog, The Rest of the Story, Siegel points out that it is irresponsible to use the results of this cross-sectional study to conclude (or even suggest) that e-cigarette use increases heart attack or stroke risk because the study assessed only the relationship between ‘ever’ having used e-cigarettes and ‘ever’ having had a heart attack. The study had no information on whether the heart attacks or the e-cigarette use had come first.

    Referring to his own take on quit attempts being associated with a 41 percent increase in heart attack risk, Siegel said that he had used the 2016 BRFSS and modeled the risk of having had a heart attack as a function of having tried to quit smoking (and succeeding for at least one day). He had controlled for age, gender, body mass index, diabetes, and smoking status.

    ‘Obviously, what is going on here is not that quitting smoking increases your risk of having a heart attack,’ he said. ‘Instead, what is happening is that smokers who experience a heart attack are more likely to try to quit smoking.

    ‘But the same reasoning used by researchers to conclude that vaping increases heart attack risk supports the conclusion that trying to quit smoking increases heart attack risk.’

  • Smoker loses custody battle

    Smoker loses custody battle

    A Spanish father has lost custody of his children after the provincial court of Cordoba ruled that his addiction to tobacco was toxic to his children’s health, according to a Euronews story.

    The father had been sharing custody of his children, aged 10 and 13, with his ex-wife since his divorce in 2017.

    The children had complained that they had to share an ‘environment full of smoke’ in their father’s house, according to the judgement seen by Euronews.

    ‘In this situation and wanting to avoid a health risk for the minors, it is evident that the father’s way of living puts in danger the health of his children in an irresponsible way. He ignores everything else except his addiction.’

    The judgement added that it wasn’t logical for the children to be in a place that would present a risk to the public.

    In Spain, a 2011 anti-tobacco law banned smoking in enclosed public spaces and accesses to hospitals, schools, children’s playgrounds, and smoking rooms in airports.

    At the time, it was considered one of the most restrictive tobacco laws, but it stopped short of outlawing smoking in the presence of minors in private places, such as vehicles or homes.