Category: Science

  • Scientific rigor plummets

    Scientific rigor plummets

    A public health expert in the US has demolished claims by some researchers that vaping causes chronic obstructive lung disease (COPD).

    One researcher was said to be claiming that the use of electronic cigarettes increases the risk of COPD ‘just like’ smoking does.

    Dr. Michael Siegel (pictured), a Professor in the Department of Community Health Sciences, Boston University School of Public Health, writing on his blog, said the paper, published in Drug and Alcohol Dependence, reported the results of a cross-sectional study based on the 2016 Behavioral Risk Factor Surveillance System (BRFSS) survey in Hawaii. ‘The outcome variable was reporting ever having been told that one has COPD,’ Siegel said. ‘The main predictor variable was ever having used an e-cigarette. ‘The key finding of the study was that: “there was a significant association of e-cigarette use with COPD among non-smokers … but the association was not significant among smokers…”.

    Siegel went on to say that it was not possible to conclude or even speculate, based on the results of this cross-sectional study, that vaping was a cause of COPD disease – emphysema and chronic bronchitis.

    Siegel looked at such factors as sample size, but explained that the worst problem with the conclusions and speculation was that they were biologically implausible.

    And he went on to say that he believed there was a strong, subconscious bias among many researchers who were so determined to find an association between vaping and chronic disease that they were forgetting basic pathology.

    ‘The reason this is all so disturbing to me is not simply that it shows how scientific rigor in tobacco control literature has deteriorated,’ he said. ‘It is disturbing because disseminating these scientifically unsupported claims is going to discourage many smokers from trying to quit using e-cigarettes and may even cause many former smokers to return to smoking.’

  • Irresponsibility exposed

    Irresponsibility exposed

    A public health expert in the US has said that according to a study, making a serious attempt to quit smoking is associated with a significant (41 percent) increase in heart attack risk.

    Dr. Michael Siegel, a Professor in the Department of Community Health Sciences, Boston University School of Public Health, wasn’t attempting to discourage smokers from attempting to quit their habit – far from it; he was pointing out how it was possible for studies to arrive at perverse findings.

    Siegel’s focus was on a recent study that, according to news coverage, had used cross-sectional data from the 2016 Behavioral Risk Factor Surveillance Survey (BRFSS) and found that ever use of e-cigarettes increased the risk of reporting ever having had a heart attack, while controlling for age, gender, body mass index, history of diabetes, and smoking status. The news articles had reported that the study found a 59 percent increase in heart attack risk associated with the use of e-cigarettes.

    On his blog, The Rest of the Story, Siegel points out that it is irresponsible to use the results of this cross-sectional study to conclude (or even suggest) that e-cigarette use increases heart attack or stroke risk because the study assessed only the relationship between ‘ever’ having used e-cigarettes and ‘ever’ having had a heart attack. The study had no information on whether the heart attacks or the e-cigarette use had come first.

    Referring to his own take on quit attempts being associated with a 41 percent increase in heart attack risk, Siegel said that he had used the 2016 BRFSS and modeled the risk of having had a heart attack as a function of having tried to quit smoking (and succeeding for at least one day). He had controlled for age, gender, body mass index, diabetes, and smoking status.

    ‘Obviously, what is going on here is not that quitting smoking increases your risk of having a heart attack,’ he said. ‘Instead, what is happening is that smokers who experience a heart attack are more likely to try to quit smoking.

    ‘But the same reasoning used by researchers to conclude that vaping increases heart attack risk supports the conclusion that trying to quit smoking increases heart attack risk.’

  • Recalling nicotine’s benefits

    Recalling nicotine’s benefits

    A study funded by the US’ National Institutes of Health is testing whether nicotine patches can improve memory and functioning in people who have mild memory loss or Mild Cognitive Impairment (MCI), according to a story at globenewswire.com.

    The largest and longest-running study of its kind, the MIND (Memory Improvement through Nicotine Dosing) Study is looking for 300 volunteers at sites across the US who have mild memory loss but are otherwise healthy, non-smokers and over the age of 55.

    “The MIND Study will provide valuable information for researchers with regard to early memory loss that is associated with normal aging and early Alzheimer’s disease, but we need volunteers if we are going to succeed,” said Dr. Paul Newhouse, MD, director of the Vanderbilt Center for Cognitive Medicine and lead investigator for the MIND Study.

    The story said that, according to the Alzheimer’s Association, about one in five people aged 65 or older had mild memory loss or MCI and were more likely to develop Alzheimer’s disease or other dementias.

    Although currently there was no FDA-approved medication indicated to treat this condition, it was known that nicotine stimulated an area in the brain known to be important for thinking and memory, and scientists believed it could be an effective treatment for adults with MCI.

    “People often think nicotine is addictive and harmful because it is in tobacco products, but it’s safe when used in patch form,” Newhouse said. “Nicotine is an inexpensive, readily-available treatment that could have significant benefits for people experiencing mild memory impairment.”

    Potential study volunteers can learn more by visiting MINDStudy.org or calling 1-866-MIND-150.

  • When quitting isn’t quitting

    When quitting isn’t quitting

    A public health expert in the US has been moved to ask a pointed question of the American Lung Association.

    Writing on his blog, The Rest of the Story, Dr. Michael Siegel (pictured) asked whether the Association really hated smokers so much that it wanted to discourage them from making quit attempts using electronic cigarettes, despite new clinical trial evidence of their superiority to nicotine replacement therapy (NRT).

    On Saturday, Siegel, who is a Professor in the Department of Community Health Sciences, Boston University School of Public Health, referred to a one-year randomized, clinical trial that was published in the New England Journal of Medicine and in which e-cigarettes were compared to NRT as aids to smoking cessation.

    This, the most definitive study yet on the effectiveness of electronic cigarettes for smoking cessation, found that one-year smoking cessation rates with e-cigarettes were nearly twice those obtained using NRT, Siegel said.

    This was great news for smokers, as it suggested that switching to vaping was another smoking cessation option that could be added to those already available.

    Siegel quoted the Association as responding to the study’s results by saying that the US Food and Drug Administration had not found any e-cigarette to be safe and effective in helping smokers quit. ‘We only support methods that are FDA approved and regulated,’ it said. ‘Switching to e-cigarettes does not mean quitting. Quitting means truly ending the addiction to nicotine, which is very difficult.’

    In other words, Siegel said, the Association was saying that despite this clinical trial’s demonstrating that e-cigarettes are probably much more effective than NRT for smoking cessation, they would rather smokers continued smoking than make a quit attempt using electronic cigarettes.

  • Quitting with e-cigarettes

    Quitting with e-cigarettes

    For those wanting to quit smoking, switching to electronic cigarettes may offer better odds of success than using nicotine patches, lozenges or gum, according to a HealthDay story by Alan Mozes citing new research.

    This finding reportedly derives from a year-long study that tracked about 120 British smokers enrolled in a National Health Service smoking cessation program. Seventy-nine smokers were enrolled in an ‘e-cig group’ and given a refillable e-cigarette to use. The remaining 44 smokers were given a three-month supply of any approved nicotine replacement product they wanted.

    “In our study, smokers used e-cigarettes much like other nicotine replacement treatments,” said study author Dunja Przulj, PhD, who is a research health psychologist with the Health and Lifestyles Research Unit at Queen Mary University of London. “They were asked to set a ‘quit day,’ and advised to use their e-cigarette regularly throughout the day, and whenever they felt they needed it. Everyone was encouraged to try and avoid smoking any normal cigarettes.”

    The researchers found that while nearly 10 percent of the nicotine replacement group were not smoking traditional cigarettes a year later, that figure was 18 percent among those using e-cigarettes.

    The report was published online on January 30 in the New England Journal of Medicine.

    The study was funded by the National Institute for Health Research and Cancer Research UK.

    A Reuters story by Kate Kelland that seems to be based on the same study, or perhaps a related study, was carried out with 886 participants.

  • Smoky development

    Smoky development

    Researchers at the University of Oulu, Finland, in collaboration with scientists at Imperial College London, UK, have determined that tobacco smoking during pregnancy can irreversibly alter foetal DNA, according to a story in The Helsinki Times.

    In what is said to have been one of the most comprehensive studies ever conducted into this subject, the researchers gathered data from more than 18,000 participants in a number of countries, including the UK and the US, to explore the effects of tobacco smoking on mothers and children both before and after pregnancy.

    What was described as ground-breaking research was said to have determined that, rather than changing the genetic code of an unborn child, carcinogens found in cigarette smoke could add or remove chemical groups to her or his DNA.

    These chemical groups can permanently alter DNA, leaving the individual particularly prone to cardiovascular diseases, high blood pressure, and obesity later in life.

    It is estimated that, worldwide, about 53 percent of female smokers continue to smoke during pregnancy, presenting a significant risk to public health.

  • A message of hope

    A message of hope

    Public Health England (PHE) has released a new film showing the devastating harms that can be caused by smoking combustible cigarettes, and how those health problems can be avoided by switching to vaping electronic cigarettes or by using a quit aid.
    The film has been released as part of PHE’s Health Harms campaign, which encourages smokers to attempt to quit in January. It demonstrates the harm to health caused by every cigarette.
    The film features a leading smoking cessation academic at University College London, Dr. Lion Shahab, and a National Health Service GP, Dr. Rosemary Leonard, ‘visually demonstrating the high levels of cancer-causing chemicals and tar inhaled by an average smoker over a month, compared to not smoking or using an e-cigarette,’ according to a PHE press note on the GOV.UK website.
    ‘The results of the demonstration visually illustrate the stark contrast between the impacts of smoking and vaping. Research estimates that while not risk-free, vaping is at least 95 percent less harmful than smoking.
    ‘Around 2.5 million adults are using e-cigarettes in England, and they have helped thousands of people successfully quit – but many smokers (44 percent) either believe that vaping is as harmful as smoking (22 percent) or don’t know that vaping poses much lower risks to health (22 percent).’
    Professor John Newton, director of health improvement at PHE, was quoted as saying that it would be tragic if thousands of smokers who could quit with the help of an e-cigarette were being put off due to false fears about safety. “We need to reassure smokers that switching to an e-cigarette would be much less harmful than smoking,” he said. “This demonstration highlights the devastating harms caused by every cigarette and helps people see that vaping is likely to pose only a fraction of the risk.
    “We want to encourage more smokers to try and quit completely with the help of an e-cigarette, or by using other nicotine replacement such as patches or gum, as this will significantly improve their chances of success. If you’re trying to stop smoking, our free online personal quit plan will help you find the support that’s right for you.”
    Meanwhile, Shahab was quoted as saying that the false belief that vaping was as harmful as smoking could be preventing thousands of smokers from switching to e-cigarettes to help them quit. “I hope this illustrative experiment helps people see the huge damage caused by smoking that could be avoided by switching to an e-cigarette,” he said.
    “Research we and others have conducted shows that vaping is much less harmful than smoking and that using e-cigarettes on a long-term basis is relatively safe, similar to using licensed nicotine products, like nicotine patches or gum. Using e-cigarettes or nicotine replacement such as patches or gum will boost your chances of quitting successfully.
    “Smoking increases the risk of developing more than 50 serious health conditions, including cancer and heart disease, and doubles the risk of dying from a stroke. Of the 6.1 million smokers in England, 6 in 10 want to quit, but many try to quit using willpower alone – or going ‘cold turkey’ – despite this being the least effective method.
    “The most successful quit attempts use a combination of effective stop smoking support methods. Recent research suggests that smokers who quit with the help of an e-cigarette are less likely to start smoking again.
    “Public Health England’s personal quit plan is a quick, free and easy-to-use digital tool to help smokers find the right support to help them quit, taking into account how much they smoke, and any quitting support used previously.”
    Leonard said that she had wanted to be involved in the experiment because every day she saw the devastating impact that smoking had on people’s health, but rarely got the opportunity to show people what was happening inside their bodies when they smoked.
    “I regularly give patients advice about quitting and when I recommend e-cigarettes, I am often surprised to hear the misconceptions some people have about them, she said. “The results of this experiment clearly show that every cigarette you smoke causes tar to enter your body and spreads poison throughout your bloodstream. Vaping is much less harmful than smoking and I really hope this experiment will encourage smokers to make a quit attempt. No matter how old you are, it’s never too late to stop.”
    John Dunne MD of E-Liquid Brands and director of the UK Vaping Industry Association (UKVIA) described the contents of the PHE press note as “fantastic news going into the new year when many people in this country are looking to quit smoking and improve their health”. “This further goes to support the positive vaping narrative that this country is lucky to have and I hope it will assist smokers in making an informed decision,” he said.
    “Vaping is fast becoming the most popular quitting aid in the UK and around the world. However, according to the latest ASH research 40 percent of smokers have not tried them. There is a serious public misunderstanding of the risks and benefits of e-cigarette use.
    “Millions of smokers wrongly think that vaping is as harmful as smoking and fewer than one in ten adults know that most of the health damage caused by smoking comes from the by-products of cigarette combustion, and not from the nicotine content. In 2017 only 13 percent of adults correctly identified that e-cigarettes are much less harmful than smoking, compared to 21 percent in 2013. The proportion of adults thinking that e-cigarettes are at least as dangerous as smoking nearly quadrupled from 2013 to 2017 from seven percent to 26 percent.
    “I hope that this experiment will go some way to dispelling this false notion.”

  • Biggest study backs vaping

    Biggest study backs vaping

    The largest study on vaping safety to date has confirmed that vapers are exposed to far fewer toxic chemicals than are smokers, according to a story published on the website of the Australian Tobacco Harm Reduction Association.
    The story, by Dr. Colin Mendelsohn, conjoint associate professor at the School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia, referred to a study of 5,105 adults that was published recently in JAMA Network Open by a group of leading researchers, led by Maciej Goniewicz.
    The study measured the levels of tobacco toxins in the urine in four different groups: exclusive vapers (vaping only); exclusive smokers (smoking only); dual users (smoking and vaping); and never-smokers
    Mendelsohn said that the researchers had tested 50 of ‘the most important toxins normally found in tobacco smoke which cause most of the smoking-related disease, including TSNAs (tobacco-specific nitrosamines), PAHs (polycyclic aromatic hydrocarbons), metals and VOCs (volatile organic compounds). Many of these chemicals were carcinogens or were toxic to the cardiovascular, lung or reproductive organs.
    Mendelsohn said that the key finding of the study was that vapers had a 10-98 percent lower concentration of toxins compared to smokers for the toxins measured.
    ‘All levels were lower in vapers except for most metals and 3 VOCs (toluene, benzene and carbon disulfide),’ he said. ‘Vapers had higher exposure to passive smoking so some of the toxins may have come from second-hand smoke. Also, some chemicals such as metals stay in the body for years and may have originated from past smoking or other sources.’
    Never smokers had toxin levels that were 19-91 percent lower than those found in vapers.
    The study results were said to have been similar to other previous studies as summarised in the 2018 US National Academies of Medicine, Science and Engineering report.

  • A question of transparency

    A question of transparency

    Researchers have raised concerns about how the Brussels Declaration was developed and, in particular, the extensive involvement in it of tobacco- and alcohol-industry actors.
    A Tobacco Control paper published on the British Medical Journal website describes in its introduction the Brussels Declaration as a statement of ethics and principles for science and society policymaking.
    ‘This arose from discussions at the prestigious World Science Forum, and was designed to attract attention,’ the paper says. ‘It was launched formally at the American Association for the Advancement of Science in February 2017, accompanied by an announcement in the journal Nature.
    ‘It raises questions about the integrity of scientists and calls on them to be less ‘aloof and perhaps less arrogant’. It calls on policymakers to be more accountable and, crucially, demands that voices of interest groups are heard in the policy debate.
    ‘At a time when facts are increasingly being questioned in some political fora, it has the potential to be very influential.
    ‘Its avowed goal, evidence-based policymaking, will be widely shared. Yet while it makes much of the need for research integrity and transparency, the Declaration fails to disclose its own origins and funding, or the interests of those involved.
    ‘Moreover, on closer inspection there are many curious aspects to the organisation of what purports to be a ‘bottom up’ initiative’.
    The paper, whose lead author is Professor Jim McCambridge, of the Department of Health Sciences, at the UK’s University of York, concludes that while the Brussels Declaration argues for the need to protect science from distortion by vested interests, it appears to be a vehicle for advancing the vested interests of certain corporate sectors.
    ‘Calls for research integrity reflect core values of the research community,’ the conclusion said. ‘They should not be used as instruments to undermine science or to assist harmful industries.
    ‘It will be important to study carefully to what extent this initiative, and others like it, do form part of the global political strategies of tobacco and alcohol industry actors, and the extent to which these are successful in influencing public health and science policies, in order to counter any adverse effects on population health.’

  • HNB workshop for March

    HNB workshop for March

    A report on its 2018 Congress is included in the latest newsletter from CORESTA (Co-operation Centre for Scientific Research Relative to Tobacco).
    The 2018 Congress was hosted by the China National Tobacco Corporation and held in Kunming in October.
    The report includes details about the CORESTA Congress presentations and workshops, and a brief outline of the networking events.
    Special mention is made of the Heated Tobacco Products Open Discussion and the announcement that a workshop is due to be held on this topic in Paris, France, in March.
    The report includes, too, an outline of the CORESTA Prize presentation and medal awards ceremony, the results of the Board elections during the General Assembly, and the names of the newly-elected Scientific Commission executives.
    The newsletter includes mention of the Golden Leaf Award, which was presented to CORESTA at Tobacco Reporter’s GTNF 2018 for outstanding service to the industry.
    And, as usual, the newsletter has a list of recently published CORESTA Technical Reports, Guides and New Projects launched, and revised CRMs.
    It has an update on CORESTA external communications and the dates of upcoming CORESTA meetings.