The US public has become mostly unaware that smokeless tobacco is much less harmful than cigarettes, according to a story by David J. Hill for the University of Buffalo.
In 1986, Hill said, the US government passed legislation requiring a series of warnings for smokeless tobacco products, one of which advised “This product is not a safe alternative to cigarettes”.
That warning, however, obscured an important distinction – that cigarettes were much more harmful to health than were smokeless tobacco products.
And over the 30-plus years since, the US public had mostly been unaware that smokeless tobacco use is much less harmful than smoking cigarettes, Hill said, quoting one of the nation’s leading tobacco policy experts writing in a paper published recently in Harm Reduction Journal.
“It is important to distinguish between evidence that a product is ‘not safe’ and evidence that a product is ‘not safer’ than cigarettes or ‘just as harmful’ as cigarettes,” said the paper’s author Lynn Kozlowski, professor of community health and health behavior in the University at Buffalo’s School of Public Health and Health Professions.
“The process at the time of the establishment of official smokeless tobacco warnings in the 1980s paid no attention to this distinction,” Kozlowski adds. “The American public has become mostly unaware that smokeless tobacco is much less harmful than cigarettes.”
Kozlowski was quoted as saying that as long as cigarettes remained legal in the US, US consumers should be provided with proper information on the relative risks of tobacco/nicotine products that are ‘less lethal’ or otherwise less harmful than cigarettes. In addition, consumers should receive information on the ways in which a product causes harm, he said, adding that none should be viewed as harmless.
Category: Harm Reduction
US public misinformed
Nothing new there then
With the Australian federal and Victorian state elections in sight, this week a coalition of twenty-four public health and medical organisations have called for the virtual elimination of tobacco smoking by 2025, according to a story by Terry Barnes on spectator.com.au.
Barnes, who is a fellow of the UK Institute of Economic Affairs, with a special interest in ‘nanny state regulation’, was scathing about the strategy outlined for achieving this goal, particularly the absence of any mention of the use of modern, reduced-risk products.
He said that all that was on offer to achieve the ‘do-good’ manifesto’s aims were five ideas that amounted to more of the same of the past four decades.
‘There is no recognition in this election-motivated manifesto that there are new technological weapons capable of disrupting the traditional cigarette and tobacco market, helping smokers to reduce or quit, and of leading to the sorts of real reductions in the number of lives to smoking the Pooh-Bah bullies dream of but, because of their arrogant bone-headedness, can never achieve,’ Barnes said.Harm reduction glows anew
British American Tobacco Korea on Monday launched in South Korea its second-generation tobacco-heating device, glo, according to a story on pulsenews.co.kr.
At the launch, BAT Korea said consumers would be able to buy the new edition of glo from July 30 at the brand’s flagship store, nationwide from convenience stores and via the official web site.
The second-generation glo device, which is being launched about a year after the previous model was launched, will be priced at 90,000 won.
BAT Korea said that the upgraded version of glo came with enhanced function and design. The all-in-one device was simple to operate, the company said, because users did not need a separate charging device.
The device could be used up to 30 times on a full charge, it added.
BAT Korea has unveiled also neo, a new heated-tobacco consumable unit for the new device, which will replace Neostiks, the existing heated tobacco unit.
Pulse quoted an unnamed official of BAT Korea as saying the company would continue to provide more diverse and satisfying options to Korean smokers seeking potentially reduced-risk, alternative products.
Despite the Ministry of Food and Drug Safety’s health warning about vapor products, demand for smokeless tobacco devices has been growing.Time for urgent action
The US’ National Tobacco Reform Initiative (NTRI) is calling on the Food and Drug Administration actively and expeditiously to pursue the course of action the agency announced in July 2017 ‘with respect to its proposed tobacco and nicotine regulatory framework that would focus on nicotine and support innovations to promote tobacco harm reduction based on the continuum of risk for nicotine-containing products’.
On July 28, 2017, the NTRI said, the FDA commissioner, Scott Gottlieb, and the director of the agency’s Center for Tobacco Products, Mitch Zeller, announced new policy directions on tobacco and nicotine that called for a ‘comprehensive regulatory plan’ that would accelerate efforts in winning the war against cigarette smoking.
In a letter to the commissioner on the one-year anniversary of his announcement, the public health leaders who are part of NTRI said that while they had seen progress during the past 50 plus years in respect of declining smoking prevalence, an estimated 32 million US adults still smoked cigarettes. ‘Cigarette smoking remains this nation’s leading cause of preventable disease and death, responsible for about 480,000 deaths each year and costing this country approximately $300 billion in health care costs and lost productivity,’ the NTRI said in a press note. ‘With so many lives on the line each year, there must be an urgency to take bold, visionary actions immediately to reduce the disease burden that smoking addiction inflicts on the health of Americans.
‘While the NTRI fully supports the FDA’s announced visionary initiatives, we are concerned that the FDA is/will become mired in overly bureaucratic processes that will delay taking necessary and obvious steps to protect the public’s health. While some attention is being focused on the priority to consider reducing nicotine levels in cigarettes, the other equally important priority to establish a more workable and flexible regulatory framework to regulate all tobacco and nicotine products based on their risks and relative risks (continuum of risk) is nowhere to be seen.’
“[I]f prudent product standards and reasonable guidelines for making truthful modified risk claims are not available before introducing a product standard for reducing nicotine’s addictiveness in combustible cigarettes, the opportunity to accelerate a mass-migration away from smoked tobacco products, relegating cigarettes to the ashtray of history, will be lost,” veteran tobacco and nicotine researcher and NTRI member, David B. Abrams, PhD, was quoted as saying. Abrams is a professor at the Department of Social and Behavioral Sciences, NYU College of Global Health, New York University.A cautionary tale
The New Nicotine Alliance (UK) has welcomed ‘the bold vision’ a UK MP in highlighting the increased role that tobacco harm reduction could play in the future of tobacco control policy.
In a press note issued on Friday, the Alliance said that, in a debate on the Government’s Tobacco Control Plan in the House of Commons on July 19, Sir Kevin Barron had highlighted the gulf between the UK and Ireland, two countries with identical traditional tobacco control policies but with differing approaches to electronic cigarettes. Between 2012 and 2016, smoking had dropped by nearly a quarter in the UK, while in Ireland, where e-cigarettes were viewed with suspicion, the smoking rate had risen.
‘Sir Kevin, who has 20 years’ experience of government policy surrounding tobacco, suggested that a “proper harm reduction strategy” which further welcomed the advent of innovative nicotine delivery products could deliver significant further benefits to public health in the UK,’ the press note said.
‘The NNA applauds Sir Kevin’s bold vision of the increased role that tobacco harm reduction could play in the future of tobacco control policy and calls on Under-Parliamentary Secretary of State, Steve Brine, to be less cautious and to commit to promoting a better understanding of risk-reduced products amongst health authorities under his charge.’
“E-cigarettes are a proven safer alternative to smoking and the UK boasts 1.5 million former smokers who have converted from combustible tobacco to exclusively vaping instead,” said NNA chair Sarah Jakes (pictured). “Sir Kevin’s comments are most welcome, but it is continually disappointing that Steve Brine is reluctant to recognise the part that recreational use of these products can play. Instead of adhering to a goal of total nicotine abstinence, it would be better to install policies which would encourage long-term use of alternatives.
“As mentioned during the debate, many smokers genuinely enjoy smoking and view giving up smoking as giving up on an enjoyable part of their life. Devices that can deliver the nicotine they enjoy without the harm of combustible tobacco are a perfect solution for huge numbers of people. Government should be more understanding of the pleasure that nicotine can deliver and of the reasons that current smokers continue to smoke.
“Pleasure should not be a dirty word when it comes to nicotine, just as it isn’t when talking about a pint in the pub or a welcome coffee in the morning. It is the combustion of tobacco which causes the harm, and if smokers are more confident in trying reduced-risk products, there will be even more future public health successes, like the ones highlighted by Sir Kevin yesterday [July 19].
“The UK is regarded worldwide as a global leader in tobacco harm reduction and the results speak for themselves, therefore we hope that Mr Brine will show more leadership, and less caution, towards safer nicotine products to better enable him to achieve the ambitious targets that he has set in the government’s Tobacco Control Plan.”Looking on the bright side
Indonesia’s Ministry of Finance estimates that the Government may collect up to Rp3 trillion ($207 million) in additional revenue next year from a new excise on vaping liquids, according to a story in The Jakarta Globe.
At the beginning of this month, the Government imposed a 57 percent excise tax on e-liquids containing tobacco extracts or nicotine, a rate the Globe said was more than four times the maximum excise on ‘regular cigarettes’.
The country’s 200 domestic producers are required to start paying excise on e-liquids by October. 31.
Noegroho Wahyu, acting director of excise, said that so far three e-liquid producers were registered to pay excise, but that the government expected the remaining producers to register before the deadline.
The Government is expected to collect Rp50-70 billion in additional revenue from the new excise this year, but it estimates that will rise to about Rp3 trillion per year once all manufacturers are registered.
Aryo Andrianto, chairman of the Indonesian Personal Vaporizer Association (APVI), was quoted as saying that the excise rule meant the government had officially acknowledged the industry and provided it with legal certainty.
Vaping liquid producers were planning to increase their prices by a maximum of 20 percent to soften the blow on consumers, Aryo said, before indicating that the producers were not opposed to the excise tax.
Meanwhile, producers hope that, following the imposition of the excise tax, the government may be more willing to support the industry’s export efforts.
Deni Syarifa, chairman of the E-Liquid Micro-Entrepreneurs Association, estimates that manufacturers could export up to two million bottles of vaping liquid per month.
“There is currently demand for around 5,000 to 10,000 bottles per month from just one country,” Deni said, adding that producers planned to ship the liquid to countries in Asia, Central America and Europe.Young drawn to abstinence
During the past four decades, an increasing number of US teenagers have decided to say no to drugs and alcohol, according to a story by Alan Mozes for medicalxpress.com citing a new report.
But the million-dollar question is why.
“There has been a steady increase in the proportion of students graduating high school who report never having tried alcohol, marijuana, tobacco or any other drugs,” said study author Dr. Sharon Levy, who directs the adolescent substance use and addiction program at Boston Children’s Hospital.
For example, while about five percent of high school seniors had embraced abstinence in 1976, that figure had risen to 25 percent in 2014, according to the most recent poll of nearly 12,000 students.
Surveys conducted among 8th and 10th graders between 1991 and 2014 unearthed a similar trend, with abstinence jumping from roughly 10 percent to almost 40 percent among the former, and from 25 percent to more than 60 percent among the latter.
Levy was quoted as saying that the downward trends didn’t catch her off-guard, even if “the findings may surprise people because we constantly hear bad news about drug use and the opioid epidemic”.
Levy said that both drinking and smoking – the number one and number three most common substance use habits – had been sliding in popularity across the board for a while now, even though pot use had held steady.
But why? That remains “the million-dollar question,” said Levy, “and for sure it doesn’t have one simple answer.”
Overall, she credited public health efforts for giving rise to a new cultural climate that encourages teens to shun substance use because it’s dangerous and unhealthy, rather than because it’s immoral or forbidden.
Meanwhile, Dr. Eric Sigel, an adolescent medicine specialist at the Children’s Hospital Colorado in Aurora, who was not involved in the study, was quoted as saying that the good news was “quite precarious”.
For example, he said, “while fewer teens overall are using substances, those who do face a landscape of more dangerous substances [like opioids] compared to their parents’ generation”.Don't say a word
The UK Government has said it will take Philip Morris to court unless it stops illegally targeting UK consumers with tobacco adverts, according to a story by Katie Morley for the Electronic Telegraph.
Earlier this week the Department of Health reportedly sent a formal order to Phillip Morris telling it to remove poster adverts for ‘healthier’ tobacco products from shops around the UK.
Speaking to the Daily Telegraph, the public health minister, Steve Brine, warned that the department was prepared to take legal action against Phillip Morris to protect UK consumers from being targeted by the adverts.
Advertising tobacco can result in a financial penalty or custodial sentence of up to six months.
Phillip Morris denies the adverts are illegal and says it wants to help smokers by providing them with better tobacco alternatives.Juul launching in UK
Juul Labs is launching its vaping device in the UK this week, according to a story by Martinne Geller for Reuters.
Since launching in the US in 2015, Juul has transformed the market there, where it now accounts for nearly 70 percent of tracked electronic-cigarette sales.
The Juul device will reportedly be available in 250 vape shops across the UK by the end of this week.
A starter pack, including the device and four nicotine pods, will cost about £29.99 ($39.66).
Grant Winterton, Juul Labs’ president for Europe, the Middle East and Africa, told Reuters that the UK had been chosen as Juul’s third market after the US and Israel, partly because it had the world’s “most supportive government” when it came to encouraging smokers to vape. Also on the radar are France, Germany and Italy.Not-so-fine particles
A French member of the European Parliament has asked the European Commission whether it is of a mind to encourage member states to assess the toxicity of the air in industrial areas.
Joëlle Mélin’s question was inspired by reports of poor air quality at Étang de Berre, which is in the south of France and which comprises one of the largest industrial areas in Europe, with more than 200 factories.
‘It turns out that, in 2010, the French Institute for Public Health Surveillance highlighted an excessive number of hospitalizations for cardiovascular conditions and for multiple illnesses west of Étang de Berre,’ Mélin said in a preamble to her question.
‘In January 2017, new information emerged from the community-based participatory environmental health survey (CBPEH), which noted the high likelihood of a link “between the illnesses and industrial pollution”.
‘However, in 2011, the Eco-citizen Institute launched campaigns to measure the air quality, which resulted in it noting that the air around the industrial area “was made up of 80 percent ultra-fine particulate matter and [that] the chemical composition of the air pollutants was extremely complex”.
‘Ultra-fine particulate matter is the most dangerous for our health because it gets deep into our bodies.
‘However, if Air Paca [a non-profit association that manages the air quality survey network in south-eastern France’s Provence Alpes Côte d’Azur region] does not measure it, it is because European legislation does not require member states to measure the levels of ultra-fine particulate matter.
‘Therefore, we would like to know whether the Commission wishes to encourage member states to measure the levels of ultra-fine particulate matter in order to assess toxicity of the air in industrial areas in more detail.’
