The number of prescriptions issued for drugs aimed at helping smokers quit their habit fell by 75 percent in England during the past decade, according to a story in The Guardian published ahead of the release of a new report.
The report, based on an analysis of NHS prescribing data, was due to be published by the British Lung Foundation (BLF) under the name Less Help to Quit: What’s happening to stop-smoking prescriptions across Britain.
General Practitioners were said by the Guardian to be the most common first port of call for smokers who wanted to beat their addiction in England, with 38 percent of them choosing this route.
However, primary care prescriptions of nicotine replacement patches and gum and the smoking-cessation drugs bupropion and varenicline had fallen by three-quarters in England between 2005-06 and 2016-17.
The report is said to indicate also wide regional variations in the prescribing of such products across Great Britain.
In Scotland, there was said to have been a 40 percent drop in prescriptions for stop-smoking drugs, while in Wales prescription rates had fallen by two-thirds.
The drop in prescriptions had come about even though a combination of support and medication had been shown to be the most effective way to help smokers quit, the Guardian reported.
Such a combination, which was recommended by the National Institute for Health and Care Excellence, was said to increase the chance of a smoker’s beating her addiction threefold, when compared with going “cold turkey”.
Alternative routes to getting help, such as specialist clinics, are also declining in some areas, the report finds.
In the English county of Worcestershire, for example, where 15 percent of the population smokes, the local authority decommissioned its stop-smoking services, and local clinical commissioning groups advised GPs in April 2016 not to prescribe stop-smoking aids for new patients.
As a result of these changes, the Guardian said, 98 people last year were helped to quit smoking across the Worcestershire council area, down from 2,208 the previous year. And there were no recorded attempts to quit through GPs and only one in a hospital setting.
The BLF was quoted as saying that smokers were bearing the brunt of government budget cuts and were being discriminated against.
Category: Harm Reduction
Britain quitting quitting
Nigeria e-cig launch plan
British American Tobacco plans to launch its electronic cigarettes in Nigeria in the near future, according to a story in the Nation, relayed by the TMA.
Chris McAllister, MD of BAT Nigeria and West Africa, reportedly said the stability of the exchange rate and the revival of consumers’ purchasing power had given the company “the confidence to continue to invest in our state-of-the art factory in Ibadan and our recently commissioned West African headquarters in Lagos”.
He added that the company planned to launch “our world leading range of e-cigarettes in Nigeria in the near future”.
McAllister said the company was aware of the health risks of smoking and was investing in products that had the potential to reduce harm.
He said also that BAT Nigeria had worked with the government to reduce the illegal trade in tobacco from 80 percent to about 20 percent. This was the result of having a local manufacturing operation that stimulated a value chain of local businesses.
Commenting on an amendment to the excise tax law, under which the current ad-valorem tax rate will remain at 20 percent while an additional specific rate will be introduced over a three-year period, McAllister said there should be collaboration and consultation between relevant stakeholders for tax policies to be balanced and reasonable, reducing the potential for unintended consequences in respect of both the economy and wider government objectives.Vapor pressure building
Hong Kong’s Legislative Council has begun to debate a proposal to regulate vaping and heat-not-burn (HNB) products because of a push by pro-liberalization members including Helena Wong, according to a story by Alex Frew McMillan for Nikkei Inc.
Vaping and HNB products occupy a gray regulatory region in Hong Kong, which means that they are not readily available to people without access to overseas sources.
Despite this, they seem to have a big following.
As Council discussions began in June on the proposal, supporters presented Wong with a petition bearing 10,000 signatures. And Peter Shiu, who represents the retail and wholesale trade in the legislature, was quoted as saying that 10 percent of Hong Kong’s 600,000 smokers had switched to alternatives.
The government however is guarded about the legalization proposal. The secretary for Food and Health Sophia Chan said in June that her department was “very concerned about the existence of e-cigarettes … [because] there are many unknown constituents or components,” some of which had been shown to be harmful. There had been little to no third-party research in Asia on their health effects.
McMillan reported that in much of Asia-Pacific, the sale of vaping and/or HNB devices was either illegal or, as in Hong Kong, occupied a regulatory gray area that kept them off store shelves. Now with users on the rise, consumers were joining together to pressure the authorities for explicit legalization on what they felt were healthier alternatives to traditional cigarettes. And they were starting to have some political impact.
In the past three years, consumers had formed vape-advocacy organizations in Australia, India, Malaysia, New Zealand, the Philippines and Thailand. And the International Network of Nicotine Consumer Organisations, an umbrella group, was lobbying for change in places including Hong Kong, Indonesia, Singapore and Taiwan. Its Asian members had gathered last December in Bangkok to plan a concerted lobbying effort.
“There was an unprecedented feeling among delegates that they are no longer alone, that they are part of a regional and even global movement for change,” said Nancy Sutthoff, the president of INNCO’s board.
And help might come from an unlikely place – Australia, where laws differ from state to state but where, in effect, the sale of e-liquids containing nicotine is either banned or heavily restricted.
This is because Australian lawmakers are themselves under pressure now that New Zealand and Canada have both legalized vaping. “These are countries we compare ourselves with,” said Colin Mendelsohn, associate professor of public health and community medicine at the University of New South Wales and chairman of the Australian Tobacco Harm Reduction Association. “If Australia does make progress in this area, it will be very influential to other Asian countries. Drug policy in Australia has been very instrumental in Asia.”
Mendelsohn went on to say that allowing smoking and banning vaping was costing lives. “The government just needs to get out of the way and let people get on with leading their lives, as long as they are not harming anyone else,” he said.Missing even a no-brainer
The debate about whether to legalize electronic cigarettes in Australia is unfolding all over again, according to a story by Luke Grant for 4bc.com.au.
Grant said that a recent report suggested the push for e-cigarettes was coming from tobacco companies that were eager to lure another demographic into their market. ‘On this reasoning, vaping is presented as being a “gateway” activity,’ Grant said. ‘It supposedly leads or prompts consumers towards conventional smoking products.’
But Dr. Attila Danko, the medical director of Nicovape and the former president of the New Nicotine Alliance, Australia, was quoted as saying this was not the case.
“If it was true that e-cigarettes were a massive gateway to children becoming addicted, I wouldn’t be on the side of legalizing it,” Danko said.
“But the truth is, the use among young people is mostly experimental. They have found that teenagers who tried e-cigarettes also tried smoking. They’ve said that because they tried e-cigarettes and then they tried smoking, the e-cigarettes must have led to the smoking. But it’s just not the case.”
Danko said he could not understand the resistance around legalizing e-cigarettes, given that, comparatively, vaping was far less dangerous [than was smoking].
“The Royal College of Physicians, which has to be one of the most authoritative medical bodies in the world; they did one of the most extensive studies on the whole field, looking at all the research,” Danko said.
“They concluded that vaping almost certainly represents less than five percent of the risk of smoking.
“It’s just a no-brainer. Why would you allow the most harmful product to be freely sold everywhere and ban the far safer product?”Flavors key to switching
Restricting access to non-tobacco vaping flavors might discourage smokers from switching to e-vapor products, according to a EurekAlert story citing the results of a study involving more than 20,000 adult US vapers
The story said that peer-reviewed research published on Monday in the Harm Reduction Journal showed that flavors played a critical role in attracting smokers into and retaining them in the vaping category, directly contributing to tobacco harm reduction.
“The results show that non-tobacco flavors, especially fruit based flavors, are being increasingly preferred to tobacco flavours by adult vapers who have completely switched from combustible cigarettes to vapor products,” said Dr Christopher Russell (pictured), deputy director of the Centre for Substance Use Research (CSUR), who led the research.
The survey, one of the largest of its kind to focus on flavors, was conducted by the CSUR and funded by Fontem Ventures, a subsidiary of Imperial Tobacco.
Of the 20,836 adult, frequent users of e-vapor products who took part in the survey, nearly 16,000 were said to have completely switched from smoking to vaping, while 5,000 were dual users who were smoking and using e-vapor products.
“The data suggest that US vapers’ journeys towards quitting smoking are increasingly likely to start with, progress to, or be sustained by frequent use of vaping devices containing non-tobacco flavors”, said Russell.
Meanwhile, Dr. Grant O’Connell, corporate affairs manager at Fontem Ventures, said the declining popularity of tobacco flavors among adult vapers strongly suggested that flavor bans, such as the one recently passed in San Francisco, could see vapers return to cigarette smoking and discourage other adult smokers from switching.
The full peer-reviewed article can be downloaded for free at the Harm Reduction Journal.Getting the message across
Smokers believe that advertising that included messages about the positive public-health and financial potential of vaping would be key to them making the switch from smoking, according to a press note from the UK Vaping Industry Association (UKVIA) citing new research.
The study, which was conducted by Consumer Intelligence on behalf of the UKVIA is said to have shown that:- 68 percent of respondents felt that changing current advertising restrictions imposed by the Advertising Standards Agency to allow public health messages to be promoted by the vaping industry would help more smokers make the switch.
- 63 percent of those interviewed felt that information from their GP, pharmacist or a healthcare professional would influence their decision to make the change;
- 61 percent said that information in a healthcare environment would be beneficial;
- 48 percent called for more ‘educational advertising’ by public health organizations or the government in the media;
- 61 percent agreed with the idea that Public Health England’s recent recommendation for hospitals to allow vaping on their premises and to sell e-cigarettes and e-liquids on site would convince more of them to take up vaping.
“This highlights the critical role that accurate advertising has to play in realizing the public health prize that vaping represents,” said John Dunne (pictured), a director at UKVIA, in commenting on the findings. “This isn’t coming from the industry but from smokers who could be convinced to break their habits.
“More education all round is needed to get smokers to make the switch and to realise the full public health potential of vaping. There needs to be a strong and cohesive message from government, public health and the vaping industry to make switching from smoking to vaping an obvious choice.”
The research, which surveyed more than 1,000 smokers, revealed also that the vaping industry, despite its fast rate of growth, was in danger of not fulfilling its potential. It showed that many people considered vaping to be as harmful or more so than smoking. A significant number of people wrongly believed that vaping was more expensive than smoking and were confused by the array of vaping devices on the market.
The Consumer Intelligence study looked also at smokers’ experiences of and attitudes to using e-cigarettes to identify what was most likely to help them make the switch to vaping. It showed that:- The odor of conventional cigarettes (62 percent of respondents), vaping being cheaper (60 percent) and favourable insurance premiums for vapers (50 percent) were viewed by smokers as being key influences in making the switch from smoking to vaping;
- 46 percent of smokers said media coverage of vaping hadn’t encouraged them to consider a switch to vaping;
- Over-55s are the least likely group to have tried vaping and are proving to be the hardest group to reach with vaping communications, with 73 percent claiming not to have seen any form of information from the media and health bodies.
“The research reveals that there is an appetite for better information, including clear benefits in terms of assured health implications and the cost savings that can be made by consumers,” said Dunne. “Current advertising restrictions inevitably make it very difficult to reach smokers on the potential health benefits. This is particularly concerning when considering smokers over 55, who are most likely to suffer the ill effects of smoking. We currently have few ways to let them know that a switch to vaping could dramatically improve their health.”
Vapers; here’s your chance
People in the US who have quit smoking by using vapor products are being offered the opportunity to submit sworn statements about their quitting to help forestall bans or restrictions on flavored e-liquids – and, thereby, allow current and future smokers the chance of taking the same route to quitting.
In a blog last week, Brad Rodu, who is a professor of Medicine at the University of Louisville and who holds an endowed chair in tobacco harm reduction research, noted that a year and a half ago, he had blogged about government agencies ignoring federal survey data showing that 2.5 million former smokers were current vapers.
Rodu said that when the Food and Drug Administration’s tobacco-center director Mitch Zeller dismissed this evidence as mere “anecdotal reports”, he – Rodu – had argued that such data constituted legitimate population-level evidence.
Rodu went on to say that, in aiming to build a fresh dataset on smokers’ success in using vapor as a quitting aid, the Vapor Technology Association and Consumer Advocates for Smoke-Free Alternatives had recently launched a national campaign called I Am Not An Anecdote.
‘The groups are asking vapers to submit to the FDA detailed, sworn statements to “encourage Congress and federal regulators to reject any proposal that would ban OR limit flavored e-liquid products”, said Rodu. ‘The groups note that FDA Commissioner Scott Gottlieb has said that your “personal stories are important to me”. But, he also refers to your stories of quitting cigarettes with vapor products as “anecdotes”.’
Rodu admitted that, in scientific terminology, individual cases were anecdotal, but said that their cumulative value was considerable.
‘FDA should give weight to published studies, even when they do not conform to visions of a tobacco-free society,’ he said. ‘The agency should also recognize the scientific value of mass declarations of smoking cessation accomplished through vaping substitution.’Clearing the smoke
Philip Morris International says it has taken another step towards a smoke-free future by entering a strategic collaboration with Parallax, a Canadian-based start-up.
‘The agreement focuses on advancing the development and commercialization of an effective nicotine-delivery system that leverages the most advanced technologies in pulmonary medicine,’ PMI said in a note posted on its website.
‘The co-founders of Parallax, Drs. Noe Zamel and Arthur Slutsky, are Canadian leaders in pulmonary research and medicine, with global reputations and more than 750 peer-reviewed publications between them. For years, they have been firm believers in tobacco harm reduction: the policy of providing safer alternatives to people who smoke as a complement to measures meant to encourage quitting and discourage people from starting to smoke.
‘Since its founding, Parallax has assembled a world-class team of experts in formulation, device design, pharmaceutical quality manufacturing, product research and consumer insights.’
Prof. Manuel Peitsch, PMI’s chief scientific officer, said that science and technology would be essential to a future where all men and women who smoked switched to better alternatives. “Our collaboration with Parallax, founded by world-renowned experts in pulmonary research and technology, is another step forward and will give us access to innovative technologies and expertise.”
Meanwhile, Zamel and Slutsky were quoted as saying: “As physicians and co-founders of Parallax, we believe that to save lives requires technology, innovation, and a paradigm shift in the mainstreaming of the concept of harm reduction”.
And Steven Ellis, Parallax’s CEO, was quoted as saying: “Our team couldn’t be more excited about this next step in our journey – working with the global leader in smoke-free innovation and collaborating with its scientific team in fulfilling our joint mission of replacing what we all know is the most harmful delivery system for nicotine – the cigarette – with innovative alternatives that clearly move smokers to a better place in the harm reduction continuum”.Smoke-free simulcasting
Philip Morris International yesterday issued a call to action for the creative, media and communications communities to embrace its ongoing commitment to creating a smoke-free world.
‘As part of this initiative, PMI will offer smoke-free alternatives wherever we can, including heated tobacco products and e-cigarettes, to current smokers in the industry who would otherwise continue to smoke,’ the company said in a press note.
The initiative was announced during a keynote speech at the PMI Science Lounge at The Cannes Festival of Creativity, where senior vice president of communications Marian Salzman said: “We are asking the creative community to join us in raising awareness of the potential of science, technology and innovation for those who smoke and the people around them”.
PMI described the move as being part of its vision ‘to lead the charge towards greater innovation and technology in the tobacco industry, all of which is backed by science’.
Agencies interested in joining the movement can contact Marian Salzman at marian.salzman@pmi.com.
“People who smoke deserve information about better alternatives,” said COO Jacek Olczak (pictured). “The media industry can play an important role in making this happen, including by championing this initiative.
“Quitting tobacco and nicotine remains the best option for smokers, but for those who don’t, science-based non-combustible alternatives are a better choice than continuing to use cigarettes.”
Olczak said PMI wanted a world where all people who would otherwise continue to smoke instead switched to less harmful alternatives. “We started with a bold statement in Cannes: we are looking to create a world where all these smokers switch to better alternatives,” he said. “Now it’s time to make sure people know we are serious. And now, we are following up with concrete actions.”
The press note said that the Emakina Group, an independent group of communication agencies in Europe, had been the first agency network to declare its commitment to a smoke-free future by pledging support to the initiative across its 13 offices. “A smoke-free future for the whole company? Challenge accepted,” said Brice Le Blévennec, CEO, Emakina Group. “And you know what? Let’s start now!”
PMI says it is developing and assessing a range of smoke-free alternatives to cigarettes including heated tobacco products, e-cigarettes, and other innovative technologies. ‘The company is conducting extensive research to examine the risk reduction potential of the products compared to continued smoking,’ it said. ‘All evidence to date indicates that PMI’s smoke-free alternatives are a better choice for smokers than cigarettes.’Spreading the word
Although during its 15-year existence the electronic cigarette has been successful in encouraging millions of smokers to switch to this much less harmful alternative, there is still a pressing need to disseminate further the message about the advantages of these products.
This is according to Dustin Dahlmann (pictured), founding member of the Independent European Vape Alliance (IEVA) and the author of a sponsored-content piece published yesterday by politico.eu.
Dahlmann said that, according to a study published in 2016 by the Onassis Cardiac Surgery Center in Athens, Greece, more than six million tobacco smokers in the EU had succeeded in quitting their habit with the help of e-cigarettes, while another nine million smokers had been able to reduce their dependence on combustible cigarettes by using the electronic alternative.
A German study from 2017, meanwhile, had found that 99 percent of all e-cigarette users were current or former tobacco smokers.
The Graz-based toxicologist Professor Bernd Mayer was quoted as saying that on switching to e-cigarettes, the typical smoker’s cough disappeared within a few weeks, the susceptibility to infection decreased massively and the physical condition improved.
For him, the transition to e-cigarettes in terms of health improvements was comparable to stopping smoking. In an opinion written in 2016, as an appointed expert of the Federal Government, Mayer said the most significant difference between e-cigarettes and conventional cigarettes was that the former did not burn during use; so no combustion products were formed, and it was these products that were responsible for potentially fatal diseases such as cancer, heart attacks, strokes and COPD.
But Dahlmann pointed out that the proven lower degree of harmfulness of e-cigarettes had not penetrated sufficiently into the consciousness of European society. ‘A survey in Germany in 2017 revealed that more than half of the population believe e-cigarettes are at least as harmful as tobacco cigarettes,’ he said. ‘Comparable studies in Great Britain have come to similar conclusions. This also applies to the only relevant target group for e-cigarettes: adult smokers and their relatives, for whom a switch could provide significant relief.
‘In this regard, public health bodies are encouraged to spread the generally accepted facts about the e-cigarette to the wider public, so that smokers can correctly assess the alternatives.’
