Category: Harm Reduction

  • Spreading the word

    Spreading the word

    British American Tobacco has invested more than $1.5 billion dollars during the past six years to develop and commercialize alternative and potentially less-risky products, according to a press note issued yesterday by Imperial Tobacco Canada (ITCAN).

    ‘This has been a strategic priority for the group for many years’, the note said.

    ‘Through the creation of inspiring products, we can drive change.

    ‘At the heart of this is our commitment and desire to reduce the health impact of smoking.’

    The note was issued ahead of a press conference that is due to be held in Vancouver, Canada, on July 6, attended by BAT’s managing director of Next Generation Products, Kingsley Wheaton, who is based in London, UK.

    Wheaton will be accompanied by ITCAN’s president and CEO, Jorge Araya, and its head of external and corporate affairs, Eric Gagnon.

    According to the note, Araya and Gagnon will be ‘open to discuss Canada’s lack of a cohesive regulatory framework for next generation products and the challenges created by this regulatory environment’.

  • Ploom Tech on sale in Japan

    Ploom Tech on sale in Japan

    Japan Tobacco Inc said yesterday it hoped to catch up with Philip Morris International in respect of smokeless tobacco by expanding the number of smoke-free restaurants and public places that allowed its vaping product to be used, according to a story by Taiga Uranaka for Reuters.

    Tobacco firms see Japan as a test ground for alternative vaping products because the country’s pharmaceutical regulations ban the nicotine e-liquids used with electronic cigarettes.

    While PMI’s heated-tobacco product IQOS is already enjoying strong demand in Japan, JT’s launch of its Ploom Tech product has run into delays due to production shortages.

    But JT was due to start selling Ploom Tech at its flagship shops today and at 100 tobacco stores in Tokyo on July 10. The company says it plans to sell the product nation-wide during the first half of the next year.

    The company test-launched the product in Fukuoka in March last year and at its online shop, but it had to suspend sales after demand overwhelmed supply. It had apparently sold 250,000 Ploom Tech devices by the end of last year.

    Unlike Philip Morris’s IQOS, Ploom Tech does not directly heat tobacco leaves. Instead, the battery-powered device generates vapor that goes through a capsule packed with tobacco leaves.

    Japan Tobacco said the mechanism produced less smell than heated tobacco products produced, and the company hopes this will be a strong differentiating factor against its rivals’ products.

    The Reuters story is at: http://uk.mobile.reuters.com/article/businessNews/idUKKBN19J0EP.

  • Huge investment in HEETS

    Huge investment in HEETS

    Philip Morris International said yesterday it planned to invest about €500 million of additional funds in expanding capacity at its smoke-free product manufacturing facility at Crespellano, Bologna, Italy.

    The facility at Crespellano was PMI’s first dedicated manufacturing facility for large-scale production of HEETS, the tobacco units used with the electronic tobacco heating device IQOS.

    Completed in September 2016, the facility currently employed more than 600 people with a high level of technical expertise in areas such as mechanical engineering, electronics and chemistry, PMI said in a note posted on its website.

    The expansion, which was expected to be completed by the end of 2018, formed part of the company’s plans to have a total annual installed capacity of about 100 billion heated tobacco units by the end of next year.

    “Last week, we announced our second greenfield facility in Dresden [Germany],” Frederic de Wilde, president of PMI’s EU region, was quoted as saying. “The expansion of our first one, in Crespellano, shows the momentum of our efforts to turn PMI’s vision for a smoke-free future into a reality as soon as possible.”

    Meanwhile, Michele Cattoni, PMI’s vice president of Technology & Operations RRPs, said the opening of the Crespellano plant had represented a historic milestone in PMI’s commitment to replace cigarettes with better alternatives to the benefit of smokers, public health and society at large. “We are now rapidly expanding our capacity to manufacture smoke-free products in order to meet growing demand from adult smokers,” she said.

    ‘IQOS and HEETS were first made available for adult smokers in Milan in November 2014,’ the PMI note said. ‘IQOS is currently available nationwide in Italy, and in key cities or nationwide in more than 25 markets around the world. More than two million people have already given up smoking and switched to IQOS.

    ‘The expansion of the Bologna facility follows the announcement earlier this month that PMI will invest approximately US$320 million in a HEETS production facility in Dresden, Germany, adding to the previously announced investments in the conversion of cigarette manufacturing facilities in Greece, Romania and Russia to HEETS production.

    ‘IQOS is one of four scientifically substantiated smoke-free product platforms that PMI is developing to address adult smoker demand for better alternatives to cigarettes. Since 2008, PMI has hired more than 400 scientists and experts and invested over US$3 billion in research, product development and scientific substantiation for smoke-free products. The company openly shares its scientific methodologies and findings for independent third-party review and verification, and has published its research in over 200 articles and book chapters since 2011. Results of scientific research conducted by PMI to date indicate that switching completely to IQOS is likely to reduce the risk of harm compared to cigarette smoking, and is a better choice for those who would otherwise continue to smoke.’

  • Support sought for clinics

    Support sought for clinics

    More than 60 percent of ‘in-patients’ at a South Korean smoking cessation clinic successfully ‘quit’, double the figure for ‘out-patients’, according to a story in The Korea Herald citing the latest findings by the Korean Society for Research on Nicotine and Tobacco (KSRNT).

    The story reported that 216 of the 292 ‘patients’ [74 percent] who joined an anti-smoking program at Dankook University Hospital successfully quit smoking for four weeks.

    Meanwhile, 69.2 percent of those taking part remained smoke free for three months, and 66.7 percent quit for six months.

    At the same time, fewer than 30 percent of outpatients successfully quit smoking after attending the smoking cessation program.

    The KSRNT has called on the government to provide financial assistance to hospitals to help them establish such clinics.

    “It is very hard for even in-patients to stop smoking as nicotine is highly addictive,” Chung Yoo-seok of the research society said, while stressing the need for the government to funnel part of its increased tobacco tax revenue to anti-smoking clinics.

    The tobacco tax revenue rose to 12.3 trillion won ($10.7 billion) in 2016 from 6.9 trillion won in 2014 and 10.5 trillion won in 2015, according to figures produced by the Korea Taxpayers’ Association.

    The government increased taxes on cigarettes by 2,000 won ($1.70) per pack from January 1, 2015, taking the price of a pack from about 2,500 won toto 4,500 won.

    It cited as a reason for the tax increase the need to discourage smoking.

  • Vapor no bar to healing

    Vapor no bar to healing

    Laboratory wound-healing assays have revealed that whereas cigarette smoke completely prevents wound healing at concentrations of more than 20 percent, electronic-cigarette vapor has no such effect, even at 100 percent concentration and double the amount of nicotine relative to that in smoke.

    According to a British American Tobacco press note, the scratch tests involved growing in the laboratory a layer of endothelial cells (cells that line the inside of blood vessels), creating a wound/scratch in the layer of cells, and observing how long it took to heal.

    It was found that the wound healed normally when exposed cells were untreated or when they were exposed to e-cigarette vapor, but not when exposed to cigarette smoke.

    The results are published today in Toxicology Letters (DOI is 10.1016/j.toxlet.2017.06.001).

    “Our results suggest that chemicals in cigarette smoke that inhibit wound healing are either absent from e-cigarette vapor or present in concentrations too low for us to detect an effect,” Dr. James Murphy, head of reduced risk substantiation at BAT was quoted as saying.

    The press note went on to say that it was thought that the presence of damaged endothelial cells, which have an impaired ability to repair, might be a factor in the development of heart disease. Smoking was known to be a risk factor for the development of heart disease.

    ‘The basic steps of the test involve creating a wound in a single layer of cells grown in the lab, capturing images of the beginning and at regular intervals during the “healing” process, as the cells move together, and then comparing the images,’ the press note said.

    ‘In this way, it is possible to measure the ability of a tissue to repair an artificial injury in the presence of various substances. To repair the wound created by a scratch, cells must move into the wound and close the gap, and it’s the rate at which they do it that the test measures.

    ‘Scientists at British American Tobacco used the scratch test to compare the effects of smoke extract from a reference cigarette (3R4F) and vapor extract from two commercial e-cigarettes, Vype ePen (a closed modular device) and Vype eStick (a cig-a-like device), on the wound healing process.

    ‘When a person smokes or vapes, water-soluble chemicals pass into circulation and interact with endothelial cells lining blood vessels. So to mimic this exposure, the scientists tested aqueous extracts – the water-soluble fraction – of smoke or vapor. Aqueous extracts were obtained by bubbling puff-matched amounts of smoke or vapor through cell-growth medium to produce a stock that could be diluted into various concentrations. Smoke extract was then assessed at concentrations from 0 percent to 30 percent. To ensure that e-cigarette extracts were tested at equivalent and higher nicotine concentrations than smoke (as possibly experienced by a heavy vaper), vapor was tested at concentrations between 40 percent and 100 percent (over twice the nicotine).

    ‘Immediately after the wound was made, the cells were immersed in smoke or vapor extract for 20 hours. Smoke decreased cell migration rate in a concentration-dependent manner, completely inhibiting movement of cells towards the wound at concentrations over 20 percent. In stark contrast, vapor from both types of e-cigarette had no effect – cells could migrate into the wounded area, as normal, even at 100 percent concentration and double the amount of nicotine.’

  • Where’s the harm?

    Where’s the harm?

    A health-care policy advisor at the Heartland Institute has questioned whether the US Environmental Protection Agency (EPA) can build an argument demonstrating that vaping creates a public harm.

    And in replying to his own question, Dr. John Dale Dunn, MD, JD, said: “The answer is no, they can’t”.

    Dunn and two other vaping- and tobacco-policy experts, were responding to news that on Monday the New York State Senate had passed a measure that would treat vaping exactly like cigarette smoking is treated: banning it everywhere smoking is banned indoors, including in restaurants, bars, and offices.

    The Heartland Institute in February published a booklet titled Vaping, E-Cigarettes, and Public Policy Toward Alternatives to Smoking, which encouraged policymakers to be mindful of the extensive research that supported tobacco harm reduction and to understand that ‘bans, excessive regulations, or high taxes on e-cigarettes could encourage smokers to stay with more-harmful traditional cigarettes’.

    “Any effort to control or ban vaping is built on the claims that second-hand smoke causes harm,” said Dunn. “Bypassing the ridiculous premise, built on junk science research by the EPA, that second-hand smoke is harmful, the question is: Can the EPA or its allies build an argument that vaping, which produces water vapor after inhaling nicotine, be shown to create a public harm? The answer is no, they can’t.

    “There is no research or science that shows vaping causes second-hand harm, so the campaign is the usual effort to impose a preference by a leftist hegemon. I would suggest, instead, that vapers be left alone while we consider the benefits to them by foregoing the smoking of cigarettes.”

    Meanwhile, Matthew Glans, senior policy analyst at The Heartland Institute, said the New York Senate’s decision to treat vaping in the same way as conventional smoking was treated was both short-sighted and potentially harmful.

    “Vaping is not the same as smoking tobacco products, and many smokers use e-cigarettes to stop smoking, thereby reducing the likelihood of suffering in the future from serious tobacco-related illnesses such as lung cancer,” he said. “E-cigarettes and other vaping devices have far fewer negative consequences for both vapers and bystanders, so they should not be treated in the same way. While many supporters of this ban would argue total ‘cold turkey’ cessation is the only safe route towards quitting smoking, for many this method will simply never work and vaping may be their best option.

    “Protecting the vaping market from over-regulation is important. According to many in the public health community, e-cigarettes are far safer than combustible cigarettes, and several studies show they remain one of the most successful methods used by smokers to stop their consumption of tobacco. The American Association of Public Health Physicians concluded e-cigarettes ‘could save the lives of four million of the eight million current adult American smokers who will otherwise die of a tobacco-related illness over the next 20 years’.”

    Looking at the likely effects of the New York measure on the ground, Jeff Stier (pictured), senior fellow, National Center for Public Policy, and research policy advisor, The Heartland Institute, said that New York’s smoking ban was passed to achieve two primary goals, the first of which was to limit exposure to second-hand smoke. The second primary goal was to limit the places smokers could smoke cigarettes, with an eye towards getting them to quit.

    “Treating e-cigarettes like cigarettes can’t possibly lower exposure to second-hand smoke, because there is no second-hand smoke from e-cigarettes,” Stier said. “The law could only increase exposure, by removing an incentive to switch from smoking. And by falsely suggesting that the products are the same, by treating them equally under the law, this ban will undermine the prospects that smokers will switch, by making it more difficult to replace the harmful behavior with a far less risky one. Especially in a bar, where the temptation to smoke is higher, removing the option to vape is especially wrong-headed.

    “When you walk past a bar and see a group smoking outside, it’s likely that some of those smokers would prefer to be vaping inside with their co-quitters. Once they are forced outside, the temptation to revert back to smoking will be too hard for many to overcome, especially after a couple of drinks. This is what we mean when we talk about ‘unintended consequences.’ In this case, the consequences are deadly.

    “The bottom line is that smokers in New York are quitting smoking and using e-cigarettes instead. This law would undermine that.”

  • ‘Smoke-free’ status sought

    ‘Smoke-free’ status sought

    Malaysia is aiming to reduce the incidence of tobacco smoking in the country to 15 percent by 2025 and to five per cent by 2045, according to a story in The Borneo Post. Some people claim that a smoking incidence of below five percent is indicative of a smoke-free nation.

    There seemed to be no specific new initiatives aimed at reducing the prevalence of smoking, but Health Minister Datuk Seri Dr S. Subramaniam was quoted as saying the ministry ‘would be intensifying efforts to empower and promote overall health to assist smokers to kick the unhealthy habit’.

    Subramaniam said the government had carried out various initiatives to combat smoking, including raising the excise duty on cigarettes, requiring that health warnings were displayed on cigarette packs, and banning smoking in almost all public places.

    “We hope the people will heed the message seriously and co-operate with the government to produce a smoking-free nation,” he told reporters on Tuesday.

    The National Health and Morbidity Survey in 2015 showed that 22.8 percent or five million Malaysians aged 15 and above were smokers.

    Most of the smokers were men, and male smokers were said to make up 43 percent of the group actively contributing to national economic growth.

    Subramaniam said that, on average, Malaysians spent about RM178 a month on cigarettes, while the nation needed to spend RM2.92 billion annually in treating those with diseases linked to smoking.

    “Imagine how much Malaysians would save if they stopped smoking,” he added.

  • Prosecutions sought

    Prosecutions sought

    In a letter sent on June 20 to Israel’s Attorney General Avichai Mandelblit, members of the Knesset Yehudah Glick and Yoel Hasson called for the criminal prosecution of cigarette companies, according to a story in the Jerusalem Post relayed by the TMA.

    The politicians argued that cigarette companies were continuing to produce and market cigarettes in the country, even though they ‘have known for decades that their products have caused and cause an unthinkable number of fatalities’.

    Tobacco use in Israel had increased by 13 percent in one year, driven by low taxes on roll-your-own tobacco and vigorous marketing of smokeless and other tobacco products, the politicians said.

    Tobacco use was responsible for more than 8,000 deaths in the country every year.

    The companies’ actions were “actually an attack on Israeli residents” and “[o]ur purpose is to prevent the destructive consequences of this attack,” they said.

  • Holes under the spotlight

    Holes under the spotlight

    Questions have been raised in the EU parliament about the possible health risks associated with cigarettes whose filters have ventilation holes.

    In a preamble to their questions, which will be answered in writing by the Commission, the Dutch MEP, Gerben-Jan Gerbrandy, and the Belgian MEP, Frédérique Ries, said that, on May 29, the Dutch national newspaper ‘de Volkskrant’ had reported that ventilation holes in cigarettes contributed to an increasing risk of ‘adenocarcinoma’, the most common form of lung cancer.

    ‘Research from the National Cancer Institute in the US shows a connection between the perforated filter and an increase in this specific type of cancer,’ they said.

    ‘Based on the findings of the research institute, the ventilation holes in cigarettes could pose a new threat to public health.

    ‘Moreover, these ventilation holes mislead the measuring equipment that is developed to detect harmful substances in cigarettes.

    ‘Experts have therefore requested a strict ban on ventilation holes.’

    Gerbrandy and Ries went on to ask whether the Commission was aware of the potential health risk of ventilation holes in cigarettes and whether the Commission had taken any action or investigated the issue at an earlier stage?

    ‘Based on the research findings, does the Commission believe that the European standards for cigarette components and the measurement methods, which are developed to detect harmful substances in cigarettes, should be adapted?,’ they asked.

    ‘Has the Commission envisaged other steps to further investigate the issue and does the Commission intend to update the current Tobacco Products Directive (2014/40/EU) based on the findings of this research?’

    In May, an article in the Journal of the National Cancer Institute suggested that the US Food and Drug Administration should consider regulating cigarette filter ventilation, up to and including a ban.

    It further suggested a research agenda to support such an effort.

    A short background to the article said that filter ventilation was adopted in the mid-1960s and was initially equated with making cigarettes safer. But since then, lung adenocarcinoma rates had paradoxically increased relative to other lung cancer subtypes.

    Filter ventilation was said to alter tobacco consumption in such a way as to increase smoke toxicants. It was said to allow for elasticity of use so that smokers inhaled more smoke to maintain their nicotine intake. And it was said to cause a false perception of lower health risk from ‘lighter’ smoke.

  • Snus: safe but banned

    Snus: safe but banned

    New data analysis presented on Friday at the annual Global Forum on Nicotine (GFN) meeting demonstrates the potential of the low-risk tobacco product snus for reducing the impact of tobacco-related disease and death in Europe, according to a eurekalert.org story.

    The GFN was held at the Marriott Centrum Hotel, Warsaw, Poland, on June 15-17.

    The latest evidence, presented by Peter Lee, epidemiologist and medical statistician, indicates that the consumption of snus is at least 95 percent safer than is smoking. And analysis by Lars Ramström, a snus researcher in Sweden, showed that if snus were made available throughout the EU, where it is currently banned outside Sweden, and similar use levels to Sweden were adopted, up to 320,000 premature deaths could be avoided among men every year.

    Snus use is more popular than smoking in Sweden. Its availability has led to a reduction in smoking and smoking-related diseases with the 2017 EC EuroBarometer survey showing only five percent of Swedes being daily smokers, compared with the European average of 24 percent.

    Correspondingly, Swedish men have Europe’s lowest level of tobacco-related mortality, 152 per 100,000 compared with the European average of 373 per 100,000.

    While 46 percent of deaths due to smoking result from respiratory diseases such as lung cancer, chronic obstructive pulmonary disease and pneumonia, there is no evidence that risk of these diseases is increased by using snus. Nor does snus appear to increase the risk of other smoking related diseases including heart disease, stroke and a range of cancers.

    In addition, the role of snus in both reducing initiation of smoking and increasing cessation of smoking is a key element in defeating the actual cause of tobacco-related ill-health caused by cigarette consumption.

    Due to strong evidence behind snus’ potentially life-saving benefits, the New Nicotine Alliance (NNA), a UK consumer group supporting access to safer nicotine products, is calling for its legalization and has joined legal action case against the banning of snus, which has now been referred to the European Courts of Justice.

    The Eurekalert piece is at: https://www.eurekalert.org/pub_releases/2017-06/kac-nds061517.php