A statement made last week by the Korean Food and Drug Administration (KFDA) could mislead millions of people into thinking that the use of heated tobacco products is as harmful as smoking cigarettes, according to Philip Morris International.
‘There is compelling scientific evidence, including KFDA’s own findings, that heated tobacco products generate an aerosol that is completely different from cigarette smoke, and that they are a better choice than cigarettes, a PMI press note said.
‘And yet, with their June 7 statement, the agency could be risking the health of millions of Koreans who use tobacco products. These are the very people they are charged with protecting.
‘Those who are still smoking may be discouraged from switching, and those who have switched may turn back to cigarette smoking.’
PMI said that everybody agreed that smoking was harmful. Now, it said, there was a much better alternative, made possible by technology and science, for the millions of Koreans who would put themselves at the greatest risk of serious health consequences if they continued to smoke cigarettes.
‘Rather than focusing on the significant reductions in harmful chemicals compared to cigarette smoke that the agency’s own science shows, KFDA points to “tar” measurements to judge the relative risk of tobacco products,’ the note said.
‘However, the World Health Organization (WHO) – an objective and respected group with the public good as its goal – has been crystal clear on this matter: “Tar need not be measured, as it is not a sound basis for regulation, and the levels can be misleading”. Exactly. The concept of “Tar” applies to cigarette smoke, which is not the same as the aerosol from heated tobacco products – a fact that has been confirmed by numerous studies.
‘Scientific evidence shows that switching to heated tobacco products, while not risk-free, is a much better choice than continuing to smoke. ‘Koreans who use tobacco products, and those around them, deserve truthful information based on 21st-century science – not political agendas. Measuring “tar” is yesterday’s approach misapplied to today’s innovative products.
‘For the benefit of the people of Korea, we believe KFDA should consider issuing a clarification.’
Category: Harm Reduction
'Clarification' sought
High nicotine levels needed
Vapers using low- rather than high-nicotine e-liquids in electronic cigarettes may be using their devices more intensely, potentially increasing the risk of exposure to toxins in the vapor, according to a medicalxpress.com story citing new research funded by Cancer Research UK and published in Addiction on June 7.
Researchers, based at London South Bank University, studied 20 e-cigarette users and found that people using low-nicotine e-liquid in their devices puffed more deeply and more often than did those using high-nicotine liquid. Those using low-nicotine liquids also increased the power of their vaping devices when possible.
Despite this ‘compensatory’ behaviour, the low nicotine vapers were unable to get as much nicotine as could the high-nicotine group. But in their quest to do so their puffing behavior may have increased their exposure to toxins such as formaldehyde, a chemical formed when the e-cigarette liquid is heated.
While there can be toxic chemicals present in vapor, they are far fewer and generally at lower concentrations than in tobacco smoke. Evidence so far still shows that the use of both high- and low-nicotine e-cigarettes is far less harmful than is smoking.
“Some vapers might believe that starting out on a low nicotine strength is a good thing, but they should be aware that reducing their nicotine concentration is likely to result in the use of more e-liquid,” said Dr. Lynne Dawkins, lead author of the study.
“This obviously comes with a financial cost but also possibly with a health cost. The results of our study suggest that smokers who want to switch to vaping may be better to start with higher, rather than lower, nicotine levels to reduce compensatory behaviour and the amount of e-liquid used.”Flavors have role in THR
The Heartland Institute has urged the US Food and Drug Administration to acknowledge tobacco harm reduction (THR) products as tools that have been shown to have a positive impact on public health.
The Institute was responding to an FDA advanced notice of proposed rulemaking aimed at obtaining information related to the role that flavors play in tobacco products.
Lindsey Stroud, the Institute’s state government relations manager said that anti-tobacco campaigns and tax increases had tried to curb the use of tobacco products, but that they offered only a strategy of “quit or die”. There was another approach: tobacco harm reduction, which explicitly included the continued use of tobacco or nicotine, and was designed to reduce the health effects of tobacco use.
There were numerous THR products currently on the market in the US – including snus, electronic cigarettes and vaping devices, and HNB products – all of which effectively delivered nicotine in a less harmful way than combustible cigarettes.
‘Flavors are an important component of THR products and vital to helping many smokers cease using combustible tobacco,’ she said.
Stroud’s response looks in depth at the role of flavors in THR products, at youth and tobacco harm reduction, at advertising and e-cigarettes; and it presents some recommended regulatory priorities.HNB not less risky
South Korea’s health authorities said yesterday that five cancer-causing substances ‘were found in heat-not-burn electronic cigarettes’ sold on the local market, according to a Yonhap News Agency story.
Presumably the tests were carried out on the vapor produced by these devices.
The five ‘group 1 carcinogens’ – benzopyrene, nitrosopyrrolidine, benzene, formaldehyde and nitrosamine ketone – were said to have been detected in all the products.
However, the level of these carcinogens was between 0.3 percent and 28.0 percent of that discovered in tests on conventional combustible products.
The Ministry of Food and Drug Safety carried out their investigation into three tobacco heating devices – Philip Morris Korea’s IQOS, British American Tobacco’s Glo, and KT&G’s lil.
“There is no reason to think that e-cigarettes [sic] are less harmful than conventional cigarettes after comprehensively considering various research, such as those carried out by WHO,” a ministry official said.
Two of the three products were said to have ‘contained’ more tar than conventional cigarettes did, though which two was not stated.
However, a graphic included with a story on koreabiomed.com indicated that the two were IQOS and Lil.
“The amount of nicotine contained in e-cigarettes was about the same level compared to conventional tobaccos, indicating that e-cigarettes are not helpful to those wanting to quit smoking,” the official said.IQOS rumored for India
Philip Morris International is planning to launch IQOS in India, according to a story by Aditya Kalra for Reuters citing ‘four sources familiar with the matter’.
A government source was quoted as saying the government would keep an open mind if PMI approached it to discuss a device that helped people quit smoking, but added that such devices, including electronic cigarettes, could be banned if found to be harmful.
A PM spokesman was quoted as saying that the company did not comment on its plans, but that it was committed to working to replace cigarettes with scientifically-substantiated smoke-free products.
But Reuters said that the company seemed to have started building a public case for IQOS in India.
On World No Tobacco Day, R. Venkatesh, PM’s top corporate affairs executive in India, wrote a column for India’s Economic Times newspaper calling for ‘effective regulations’ for alternative smoking devices.
‘With alternatives to cigarettes available and countries already delivering on their smoke-free ambitions, the incentive is there for lawmakers to support Indian smokers – who deserve a better option,’ Venkatesh wrote.PMI issues research update
Philip Morris International yesterday published its latest Scientific Update for Smoke-Free Products, a regular publication on its research efforts to develop and assess a range of smoke-free alternatives to cigarettes.
‘We are focusing this issue on the growing body of independent research on our electrically heated tobacco product (EHTP, marketed as IQOS), the most advanced smoke-free alternative in our portfolio,’ according to a press note posted on the company’s website.
‘The covered research comprises independent, peer-reviewed publications on smoke-free products that focus on EHTP, and also includes four recent government reports from the UK, the US, Germany, and the Netherlands.’
Other sections are said to include an update on the assessment of each product in PMI’s smoke-free portfolio, recent R&D milestones and a compendium of the company’s peer-reviewed publications on its smoke-free products this year.
“We are happy to see growing interest in studying our smoke-free products and that the general trend among independent results is in line with our own research,” said Prof. Manuel Peitsch, PMI’s chief scientific officer.
“Independent research on our electronically heated tobacco product, ETHP, demonstrates significant improvements relative to cigarettes, and is crucial to our efforts to change the lives of millions of smokers around the world.”
PMI said its extensive research and assessment program was inspired by the well-recognized practices of the pharmaceutical industry and in line with the draft guidance of the US Food and Drug Administration for Modified Risk Tobacco Product (MRTP) Applications.Flavors vote tomorrow
A proposed ban on the sale of flavored tobacco products in the city of San Francisco, US, has been portrayed as a fight between pro-ban David and anti-ban Goliath, but the allegory doesn’t work because David isn’t the good, little guy he’s made out to be.
In a piece for the Competitive Enterprise Institute, Michelle Minton wrote on Friday that ‘big tobacco’ was pouring millions into a campaign to maintain its ability to keep selling harmful products that target children. ‘At least, that’s the narrative most news outlets have sold about Proposition E, a measure on the city’s June 5th ballot, which would ban the sale of flavors, including menthol, for tobacco products, including e-cigarettes,’ she added as clarification.
‘The David and Goliath story is compelling, but don’t be fooled. The other side, comprised of hundreds of anti-tobacco activists, is just – if not more – powerful than big tobacco companies. These groups have an advantage by cloaking their support of Prop E under the guise of “public health” and the support of factions in government and the university system, along with the industries that compete with e-cigarettes (e.g. big pharma). They also have vast financial resources, including taxpayer money, which they can spend without reporting it as “lobbying”.’
Minton goes on to describe the amounts and types of funding behind this lobbying and ‘non-lobbying’.
And she looks at the situation as it is currently, concluding, in part, that ‘kids, it seems, are neither targeted nor very interested in vaping, despite what anti-vaping activists claim’.
‘However, adult smokers increasingly rely on these devices as a safer means of consuming nicotine.
‘While likely not risk-free, recent analyses estimate that vaping has just one percent of the cancer risk that traditional combustible cigarettes carry.
‘And flavor seems to be an essential element in keeping people from returning to cigarettes. As a 2013 study found, the number of flavors a vaper used was independently associated with smoking cessation.’E-cigs, not taxes, work
The imposition of higher excise taxes on tobacco products does not necessarily lower smoking rates, but substituting electronic cigarettes for traditional cigarettes does, according to a story in The Philippine Daily Inquirer quoting the representative of a pro-nicotine alliance.
Nancy Sutthoff, spokesperson for the International Network of Nicotine Consumer Organizations, was recently in the Philippines to address the first Summit on Harm Reduction, held at the Sulo Riviera Hotel in Quezon City.
Citing the case of her own country, New Zealand, Sutthoff said the government had increased tobacco excise by 10 percent every six months.
“Our smoking rate has yet to go down,” she said.
Sutthoff, who is also co-founder and co-director of the Aotearoa Vapers Community Advocacy (Avca) in New Zealand, said Avca had launched the Vape It Forward program in 2017 to support smokers who wanted to quit smoking by switching to vaping.
Eighteen months after its launch, the VIF program had delivered an 88-percent success rate.HNB probe results due
South Korea’s health authorities have indicated that they will announce this month the findings of their investigation into whether heat-not-burn (HNB) products deliver potentially harmful substances.
The Ministry of Food and Drug Safety said it would make its announcement before June 13.
The ministry launched its investigation in August into three HNB devices – Philip Morris Korea’s IQOS, British American Tobacco’s Glo, and KT&G’s lil.
‘The investigation is focused on the amount of harmful chemicals such as nicotine and tar released in e-cigarettes,’ the story said.A missed opportunity
The UK-based New Nicotine Alliance (NNA) has called upon the World Health Organization to show leadership in highlighting ‘the considerable public health potential of reduced risk products’.
Speaking today, designated by the WHO as World No Tobacco Day, Sarah Jakes (pictured), chair of the NNA, said that electronic cigarettes comprised a proven safer alternative to combustible cigarettes, and an alternative that many people found to be an acceptable substitute.
“They have contributed to record falls in smoking prevalence in the UK,” she said.
“There have also been big declines in smoking prevalence in France and the USA due to uptake of innovative products, while Sweden and Norway boast by far the lowest smoking rates in Europe thanks to the widespread use of snus, a tobacco product which carries a fraction of the risk of smoking lit tobacco.
“The WHO Framework Convention on Tobacco Control was founded with a commitment to encourage tobacco harm reduction. Its Ottawa Charter and Jakarta Declaration also pledge to put people at the heart of decision-making and to support and enable consumers to keep themselves, their families and friends healthy. Yet these goals appear to have been abandoned in favour of blindly attacking industry, ignoring the global success of alternative nicotine products and refusing to engage with consumers.”
Jakes went on to say that, on World No Tobacco Day, it was time for leadership from the WHO in educating governments that e-cigarettes were not tobacco products as some states wrongly categorised them. It was time to emphasize that it was the act of lighting and smoking tobacco, not the consumption of tobacco in all its forms, that led to heart and cardiovascular disease.
“In 1976, Michael Russell famously said ‘people smoke for nicotine but they die from the tar’, leading to an acceptance of the nicotine replacement therapy market we have today,” she said. “Yet increasingly the public are being misled into believing nicotine is a problem, when it can be a solution.
“World No Tobacco Day should be a great opportunity to raise awareness of far safer alternative nicotine products to maximise benefits to public health worldwide. The WHO should be empowering people to take control of their health by way of clear messages on differing risks and the relative safety of nicotine, but this year they have sadly missed the target.”
Finally, the NNA said it would like to see a greater commitment by the WHO and NGOs ‘to correcting ideological opposition to successful consumer-driven solutions to lit tobacco, and a better recognition of long-term recreational use of nicotine as a powerful incentive for smoking cessation’.
