Category: Harm Reduction

US vapor bill introduced
Duncan Hunter, a member of the US House of Representatives, has introduced the Cigarette Smoking Reduction and Electronic Vapor Alternatives Act that, if passed, would amend the Food and Drug Administration’s deeming regulations by separating vapor products from tobacco products, according to a story in the San Diego Union-Tribune relayed by the TMA.
In addition, the act would formally incorporate the concept of ‘harm reduction’ into the FDA’s mission by requiring the agency to support nicotine-delivery products.
And while the FDA would still have regulatory authority over the industry, provisions such as pre-market tobacco applications, modified risk assessments and qualification systems would be replaced with the American E-Liquid Manufacturing Standards Association requirements.
Hunter was quoted as saying that by introducing these standards the bill would make vaping safer. He said that under the proposals e-liquids, atomizers and coils would all have standards.
The vapor industry has argued that the current FDA certifications would cost hundreds of thousands of dollars per individual product, putting small and medium-sized vaping companies out of business.
Gregory Conley, president of the American Vaping Association, said that though he liked the bill’s intent, the Cole-Bishop amendment, which would exempt nearly all existing vaping products from the FDA’s deeming rules, was a better option.
May 2, 2017
Plain packs persuasive
Standardized cigarette packaging could persuade 300,000 people in the UK to quit smoking, according to a story in The Guardian citing a review by scientists at the independent health research organization Cochrane.
The 300,000 estimate is based on the experience in Australia, the first country to introduce standardized packaging, being repeated in the UK.
Standardised cigarette packaging will be compulsory in the UK from May20.
The Guardian story said that the review of the impact of standardized packaging ‘around the world’ had found that it does affect the behaviour of smokers.
‘The Cochrane reviewers found 51 studies that looked at standardized packaging and its impact on smokers, but only one country had implemented the rule fully at the time,’ the Guardian story said. ‘Australia brought in plain packs in 2012.
‘Analysing the evidence from Australia, the team found a reduction in smoking of 0.5 percent up to one year after the policy was introduced. According to the Australian government, that translates to 100,000 people no longer smoking. The decline was attributable specifically to plain packaging, after taking into account the continuing drop in the numbers of smokers caused by other tobacco control measures.’
Dr Jamie Hartmann-Boyce of the Cochrane tobacco addiction group at Oxford University’s Nuffield Department of Primary Care Health Sciences said: “We are not able to say for sure what the impact would be in the UK, but if the same magnitude of decrease was seen in the UK as was observed in Australia, this would translate to roughly 300,000 fewer smokers following the implementation of standardized packaging.”
The full story is at: https://www.theguardian.com/business/2017/apr/27/plain-cigarette-packaging-could-drive-300000-britons-to-quit-smoking.
April 28, 2017
E-cig evidence mounts
A new study has found no evidence that vapor from a commercially-available electronic cigarette promotes the development of cancer in laboratory cells, whereas smoke from a reference tobacco cigarette was found to be positive for cancer-promoting activity, even at very low concentrations.
“These results add to growing weight of evidence that e-cigarettes are likely to be significantly safer than conventional cigarettes,” said Damian Breheny, lead author and adverse outcome pathway manager at British American Tobacco.
Scientists at BAT used a test called the Bhas 42 assay to compare tobacco and nicotine products. The Bhas 42 cell transformation assay assesses the carcinogenic potential of chemicals by looking for changes in a line of cells that are characteristic of tumor development.
Bhas 42 was used to compare the tumor promoter activity of vapor from a Vype ePen, one of BAT’s commercially available electronic cigarettes, and smoke from a reference cigarette (3R4F), by exposing cells to the total particulate matter collected from the vapor or smoke.
Results showed that cigarette smoke was positive for cancer-promoting activity at concentrations as low as 6μg/mL, whereas the test electronic cigarette vapor was not observed to have any in vitro cancer promoter activity at concentrations up to 120μg/mL.
The Bhas 42 assay is part of a suite of in vitro tests being developed by BAT to compare the relative biological effects of electronic cigarettes and tobacco-heating products with those of traditional cigarettes.
“This is the first study to use the Bhas assay to compare tobacco and nicotine products, and it demonstrates the potential for its future application as part of a product assessment framework,” said Breheny.
Assessment of tobacco and nicotine products has traditionally involved genotoxicity tests, which evaluate initial DNA damage that can lead to cancer. Such tests indicate that electronic cigarette vapor, in contrast to cigarette smoke, does not cause mutations and DNA damage. Using the Bhas 42 assay allows for increased understanding of potential carcinogenic risk.
Previous research conducted by BAT has shown that Vype ePen vapor contains about 95 percent less toxicants – in terms of the nine harmful components the World Health Organization recommends should be reduced in cigarette smoke (Chem. Res. Toxicol, DOI: 10.1021/acs.chemrestox.6b00188) – than does cigarette smoke from a reference cigarette.
April 27, 2017
Sacking veiled in vapor
Photo by tedeytan
The US Surgeon General Vivek Murthy has been fired by President Donald Trump’s administration, according to a story in The Hill.
In a statement, the Department of Health and Human Services said Murthy, who was appointed by President Barack Obama’s administration in 2014, had been asked to resign, and that he would be replaced temporarily by Rear Admiral Sylvia Trent-Adams, the current deputy Surgeon General.
‘Today [Friday, April 21], Dr. Murthy, the leader of the US Public Health Service Commissioned Corps, was asked to resign from his duties as Surgeon General after assisting in a smooth transition into the new Trump Administration,’ the statement said.
‘Dr. Murthy has been relieved of his duties as Surgeon General and will continue to serve as a member of the Commissioned Corps.’
The statement said that Health and Human Services Secretary Tom Price “thanks him for his dedicated service to the nation”.
Citing a New York Times story, The Hill reported that Murthy’s sudden departure had surprised employees at HHS.
The Hill pointed out, however, that Murthy had called gun violence a health threat to the US, which had won him opposition from the National Rifle Association.
Elsewhere, press reports speculated that his sacking might have been in part prompted by his support for vaccinations, and/or for his opposition to electronic cigarettes.
April 24, 2017
Smokeless – it’s not rocket science
It has been known for two decades that, by avoiding smoke, tobacco users – chewers, dippers, and snusers – eliminate about 98 percent of the health risks associated with smoking, according to two public health experts in the US.
The risks are so small, they say, that even large epidemiologic studies with hundreds of thousands of users cannot provide indisputable evidence that smokeless tobacco causes any disease.
And yet, the Food and Drug Administration – and, indeed, the EU – seems implacably opposed to allowing tobacco consumers to be informed about this lower risk.
The question is why?
In an interview published by the Huffington Post, the psychotherapist, author and TV commentator, Robi Ludwig, Psy.D, tries to get to the bottom of this and other questions by talking with Dr. Brad Rodu, who has studied the science behind tobacco harm-reduction strategies and has been appointed the first holder of the Endowed Chair in Tobacco Harm Reduction Research at the University of Louisville’s James Graham Brown Cancer Center, and Dr. Joel Nitzkin, public health physician, who is board certified in preventive medicine and has been involved in tobacco control activities since the late 1970s.
The interview is at: http://www.huffingtonpost.com/entry/two-doctors-on-a-mission-to-set-the-record-straight_us_58f96d42e4b0de26cfeae28c.
April 21, 2017
E-cigs preferred quit aid
Cigarette smokers in the US prefer electronic cigarettes to Food and Drug Administration-approved quit methods, according to a tobacco harm reduction expert citing a research brief authored by the Centers for Disease Control and Prevention’s Office on Smoking and Health, RTI International and the University of North Carolina.
Writing on the Heartland Institute website, Dr. Brad Rodu, who holds the Endowed Chair in Tobacco Harm Reduction Research at the University of Louisville’s James Graham Brown Cancer Center and who is a Senior Fellow of the Heartland Institute, said that, using a nationally representative online survey of 15,943 adult smokers who tried to quit during the past three months, the researchers found that 75 percent used one or more methods to quit, and 25 percent used only one method.
‘E-cigarettes were far more popular single quit aids for partial or complete substitution (2.2 percent), compared with nicotine patches/gum (0.8 percent) or other prescription medicines (0.4 percent),’ Rodu wrote. ‘They were also more popular when more than one aid was used.
‘Participants here were current smokers. A similar analysis performed on former smokers will show even more impressive effects from vaping.’
Rodu was disappointed by the survey authors’ response to the findings.
‘Despite the current study’s evidence of vaping’s popularity among smokers, the authors’ summation was understated: “Given that our data show that e-cigarettes are more commonly used for quit attempts than FDA-approved medications, further research is warranted on the safety and effectiveness of using e-cigarettes to quit smoking”.
‘The fact is that the CDC has documented with real-world data that e-cigarettes are preferred smoking cessation aids, negating the argument that evidence is merely “anecdotal”.
‘Our government should adopt the UK Royal College of Physicians’ position that “the hazard to health arising from long-term vapour inhalation from the e-cigarettes available today is unlikely to exceed 5 percent of the harm from smoking tobacco”.
‘In Britain e-cigs have been the leading quit-smoking aid since 2013.’
The Heartland Institute piece is at: http://blog.heartland.org/2017/04/cdc-e-cigarettes-more-popular-than-fda-approved-quitting-aids/.
It was first published at Tobacco Truth at http://rodutobaccotruth.blogspot.com.
April 19, 2017
Vapor far less toxic
New research by British American Tobacco comparing the effects of cigarette smoke and electronic cigarette vapor has shown that, at equivalent or higher doses of nicotine, acute exposure to electronic cigarette vapor has very limited impact on gene expression when compared to the impact of cigarette smoke.
A BAT press note said that the human genome had tens of thousands of genes, and that the profile of genes that were switched on and off could be used to understand whether exposure to an aerosol had had a toxic effect.
‘Scientists at British American Tobacco used nicotine as a reference point and exposed MucilAir™, a realistic in vitro 3D model of a human airway, to e-cigarette vapor and cigarette smoke to assess their comparative effect on gene expression,’ the press note said.
‘The MucilAir™ human respiratory tissue was exposed to smoke from a reference cigarette (3R4F) or vapor from an e-cigarette (Vype ePen) continuously for an hour. Two doses of vapor were tested, matching or doubling the amount of nicotine reaching the cells compared to smoke. Then, to measure the cell response, the scientists mapped the genes that were switched on and off at 24 hours and 48 hours after the one-hour exposure.
‘In the tissue exposed to smoke, the scientists found 873 and 205 genes were affected after 24 and 48 hours of recovery, respectively. However, significantly fewer genes – only 3 and 1, respectively – were affected after exposure to e-cigarette vapour.’
Further analysis was said to have revealed that the exposure to cigarette smoke had caused changes in the expression of genes involved in the development of lung cancer, inflammation and fibrosis, while the test electronic cigarette vapor had caused only minor changes in genes known to be involved in cell metabolism and oxidative stress mechanisms.
“Our results clearly show that cigarette smoke has an adverse effect on cells, triggering a robust gene expression response,’ said Dr. James Murphy, head of reduced risk substantiation at BAT. “However,” he said, “even at equivalent or higher dose of nicotine, acute exposure to the test e-cigarette vapor has very limited impact on gene expression compared to cigarette smoke exposure – it’s a striking difference.”
These results, which were published in Scientific Reports (DOI: 10.1038/s41598-017-00852-y), were said to add to an increasing weight of evidence that electronic cigarette vapor caused less damage to cells than did cigarette smoke.
‘Previous research conducted by British American Tobacco has shown that Vype ePen vapor contains around 95 percent less toxicants (Chem. Res. Toxicol, DOI: 10.1021/acs.chemrestox.6b00188) compared to cigarette smoke from a reference cigarette (in terms of the priority list of nine toxicants which the World Health Organization recommends to reduce),’ the press note said.
April 18, 2017
Tobacco-free by 2025
Photo by D-Stanley
Turkmenistan’s President Gurbanguly Berdymukhammedov is pushing ahead with his plan to make the country tobacco-free by 2025, according to a story in The Times of Central Asia quoting a Turkmen state media report.
The state-run newspaper Neitralny Turkmenistan reported that the president had signed a program ordering measures to be taken during the next five years to push his initiative.
Berdymukhammedov has been a proponent of healthy living and has made it a key aspect of his ‘autocratic rule’, the Times said.
In 2013, he banned the sale of cigarettes in state stores during the month of April each year, according to local media reports.
The country aimed to become the first ‘tobacco-free country in the European region’ by reducing its smoking rate to five percent or lower by 2025.
The actions undertaken by the government so far have included ratification in 2011 of the World Health Organization’s Framework Convention on Tobacco Control, enactment of a comprehensive tobacco control law in 2013, and the provision of free support and counselling services for individuals trying to give up smoking.
The government was said also to be implementing the WHO tobacco control project, ‘Implementation of the Ashgabat Declaration: Towards the Tobacco Free European Region for 2015-2018’.
April 18, 2017
GFN program nearly complete
The organizers of the Global Forum on Nicotine (GFN) have said that the program for the 2017 event is almost complete.
The GFN is due to be held at the Marriott Centrum Hotel, Warsaw, Poland on June 15-17.
The main GFN program, which is scheduled for June 16 and 17, will examine the rapidly developing science in relation to nicotine use and the changing landscape, including policy responses and the influence of different stakeholders in this.
The program will comprise plenary sessions, symposia, panel discussions and poster presentations – including video posters.
June 15 is scheduled to include the Michael Russell oration, and satellite and side meetings, including one for consumers organised by the International Network of Nicotine Consumer Organisations.
It will include, too, the first International Symposium on Nicotine Technology designed to showcase the latest technological advances in alternative nicotine delivery systems, next generation devices and the science behind them (http://isontech.info/).
The program is at: https://gfn.net.co/2017/programme-details
The speakers and chairpersons are at: https://gfn.net.co/home-2017/bios/
April 13, 2017
E-cigs sold to non-smokers
Photo by VapingCheap
Nearly nine out of 10 British vape shops are violating an industry code of conduct by agreeing to sell electronic cigarettes to non-smokers, according to a story by Katie Forster for the Independent, citing an undercover investigation.
About 1,700 specialist shops in England, Scotland and Wales are advised by the Independent British Vape Trade Association (IBVTA) to ‘never knowingly sell to anyone who is not a current or former smoker, or a current vaper’. The guidelines aim to stop non-smokers from becoming addicted to nicotine.
Nevertheless, staff at 87 percent of vape shops are either knowingly or unwittingly prepared to sell electronic cigarettes to people who have never smoked or vaped before, according to the Royal Society for Public Health (RSPH).
Forster said that the organisation had visited 100 vape shops in February and found 45 percent did not check whether customers smoked or used to smoke.
And in cases where the staff did check, customers were encouraged to start vaping even if they declared that they were non-smokers.
Shirley Cramer, chief executive of the RSPH, said electronic cigarettes had to be seen as “evidence-based quitting aids – rather than lifestyle products”. They should be aimed only at smokers.
April 10, 2017