Category: Science

  • ‘Now is the time to act’

    The National Tobacco Reform Initiative (NTRI) is urging US health care professionals to embrace the concept of relative risk.
    The NTRI said in a press note today that a recent report by the US’ National Academies of Sciences, Engineering, and Medicine (NASEM) had lessons also for public health advocates and officials outside the Food and Drug Administration.
    ‘We urge these professionals, within and outside government, to embrace the concept of relative risk,’ the press note said. ‘The science base clearly demonstrates that e-cigarettes represent less of a risk for smokers than continuing to smoke.’
    The NTRI team is said to be made up of 10 senior and independent national smoking control leaders who, collectively, have provided decades of service fighting the tobacco epidemic.
    “After fighting the tobacco epidemic for over five decades, we now have proven harm reduction methods to help us avoid a carnage in otherwise-preventable deaths,” NTRI team member, John Seffrin, PhD, was quoted as saying.
    The NTRI said the much anticipated NASEM report on e-cigarettes supported the FDA’s bold new two-part nicotine strategy for product regulation, which comprised one, reducing the addictiveness and appeal of deadly combustible cigarettes; and, two, making safer alternative nicotine products available to addicted smokers.
    ‘There is an urgency to help smokers since one in two of them will die from a smoking-caused disease,’ the NTRI said. ‘This outcome can be prevented. ‘Cigarettes and other combustible tobacco products are substantially more harmful than non-combustible tobacco and nicotine products, such as e-cigarettes. The fundamental truth, that smoking – not nicotine – is responsible for most of the harm, and that smokers should have a variety of potentially less harmful nicotine-containing products if they want or need to continue using nicotine, is the keystone of FDA’s approach.
    ‘A careful reading of the Report (…Public Health Consequences of E-Cigarettes: Health and Medicine Division) leads to the following evidence-based conclusions:

    • E-cigarettes are significantly less dangerous than lethal tobacco smoke;
    • To date, there simply is no evidence of long-term-use damage to the heart or lungs;
    • E-cigarettes use can help smokers reduce their risk of certain lethal diseases;
    • E-cigarettes use can and has helped many smokers quit tobacco smoking completely;
    • E-cigarettes can help reduce the risk of lethal disease in smokers who either can’t or won’t quit smoking tobacco completely.’

    The NTRI said that now is the time to act.
    And it presented a number of action points:
    *          Approach regulation of tobacco and nicotine products according to their relative risk;
    *          Educate smokers that nicotine delivered without smoke is a less harmful choice and that there are massive differences in risk across the products;
    *          Pursue regulations that work to enable smokers to switch completely to the much less hazardous non-combustible products such as snus, and e-cigarettes.
    ‘The NASEM Report and these evidence-based conclusions can help a consumer in making an informed choice about their use of nicotine products,’ the NTRI said.
    This Report, along with FDA’s comprehensive nicotine strategy, demonstrate that we know enough to tell smokers that the most important thing they can do to improve their health is to stop inhaling smoke from burning tobacco products (like cigarettes, cigars, roll-your-own) into their lungs. And, if they continue to want to use nicotine, it is much better for their health to use it in a form that is not lit on fire and smoked.’
    “Smokers have been horribly misled to believe e-cigarettes are as or are more harmful than smoking,” David Abrams, Professor of Global Public Health at New York University, was quoted as saying. “The truth can reassure those who want to switch”.

  • Pressing the vapor case

    Pressing the vapor case

    Philippine vapers say that the latest Public Health England (PHE) report validates their position that vaping electronic cigarettes is far less harmful than is smoking cigarettes, and that e-cigarettes should form part of the country’s tobacco control program, according to a story in The Business Mirror.
    The new e-cigarette evidence review, undertaken by leading independent tobacco experts, provides evidence that vaping poses only a fraction of the risks of smoking, and that switching completely from smoking to vaping conveys substantial health benefits. It recommends that e-cigarettes be made available to those who wish to quit smoking.
    “Listen to the experts,” said Tom Pinlac, president of The Vapers Philippines. “It is time for the Department of Health to look into this report so that they can recommend e-cigarettes and heated-tobacco products to smokers who want to quit.”
    Pinlac said it was an outrage that smokers were denied the proper information about e-cigarettes and heated tobacco products. “Educate smokers about vaping and heated-tobacco products instead of resorting to fearmongering,” he said.
    Meanwhile, Edward Gatchalian, president of Philippine E-Liquid Manufacturers Association, said that more than 17 million Filipino smokers could benefit from vaping e-cigs or heated-tobacco products because they were significantly less harmful than was smoking.
    “It is said that 87,000 deaths every year are attributed to smoking-related diseases,” Gatchalian said. “Smokers should switch to vaping or tobacco-heated products if they want to kick the habit of smoking. This is a very clear message embodied in the PHE report.”

  • Scholarships on offer

    Knowledge Action Change (KAC) and the Global Forum on Nicotine (GFN) have launched the 2018 Tobacco Harm Reduction Scholarship Programme.
    In announcing the inaugural program, the GFN organizers said they wanted people to learn from the GFN and have the opportunity to implement that learning in their home countries.
    Fifteen scholarships will be offered during the year, with funds available to support agreed projects up to the value of $7,500.
    The scholarships will start at the GFN conference on June 13. The conference is scheduled to be held at the Marriott Hotel, Warsaw, Poland, on June 14-16.
    The organizers say that the scholarships are intended to:

    • build research capacity in the field of tobacco harm reduction;
    • develop the evidence base;
    • raise awareness of research and its implications for public health policy;
    • enable consumers to make more informed personal health choices;
    • improve the implementation and understanding of tobacco harm reduction.

    Applications are invited from people with an interest in tobacco harm reduction; such as:

    • people intending to enter the field of research into tobacco harm reduction and/or public health;
    • students
    • researchers and scientists
    • medical professionals
    • writers
    • Internet and social media professionals.

    More information is at: https://gfn.net.co/scholarships

  • Vaping key to quitting

    Vaping poses only a small fraction of the risks of smoking and switching completely from smoking to vaping conveys substantial health benefits, according to a new Public Health England (PHE) electronic-cigarette evidence review.
    The report, which was undertaken by leading independent tobacco experts, provides an update on PHE’s 2015 review.
    It covers e-cigarette use among young people and adults, public attitudes, the impact on quitting smoking, an update on risks to health and the role of nicotine. It also reviews heated tobacco products.
    PHE lists the report’s key findings as:
    * E-cigarettes could be contributing to at least 20,000 successful new quits per year and possibly many more;
    * E-cigarette use is associated with improved quit success rates over the last year and an accelerated drop in smoking rates across the country;
    * Many thousands of smokers incorrectly believe that vaping is as harmful as smoking; around 40 percent of smokers have not even tried an e-cigarette;
    * There is much public misunderstanding about nicotine. Less than 10 percent of adults understand that most of the harms to health from smoking are not caused by nicotine;
    * The use of e-cigarettes in the UK has plateaued over the last few years at just under three million;
    * The evidence does not support the concern that e-cigarettes are a route into smoking among young people. Youth smoking rates in the UK continue to decline. Regular use is rare and is almost entirely confined to those who have smoked.
    PHE’s evidence review comes a few weeks after a US National Academies of Sciences, Engineering and Medicine report on e-cigarettes found that, based on the available evidence ‘e-cigarettes are likely to be far less harmful than combustible tobacco cigarettes’.
    Professor John Newton, Director for Health Improvement at PHE said that smoking led to someone being admitted to hospital every minute in England, and that there were about 79,000 smoking-related deaths a year in England alone.
    “Our new review reinforces the finding that vaping is a fraction of the risk of smoking, at least 95 percent less harmful, and of negligible risk to bystanders,” he said. “Yet over half of smokers either falsely believe that vaping is as harmful as smoking or just don’t know.
    “It would be tragic if thousands of smokers who could quit with the help of an e-cigarette are being put off due to false fears about their safety.”
    David O’Reilly, British American Tobacco’s group scientific and R&D director, welcomed the report.
    “We welcome this latest report from Public Health England which reiterates their view that e-cigarettes are less harmful than smoking; that accurate information is needed about these new products; and that the evidence does not support that e-cigarettes are a gateway to smoking, and may in fact be an important tool to help people quitting,” he said. “It’s positive to see that for the first time they’ve also referenced tobacco heating products [THPs] – and how the available information suggests that these may also be considerably less harmful than traditional cigarettes.
    “The report noted that there is significant public misunderstanding about risks associated with vaping and this has coincided with a plateauing of use of e-cigarettes in the U.K.  We believe that this lack of understanding could be holding back this important consumer category – consumers and regulators need accurate information to provide them with the facts they need on the potential safety profile of these products. We believe the industry, public health and regulators have a role to play in providing accurate and robust information to support this important category.
    “The science we’ve done on our products, across e-cigarettes and tobacco heating products, is pointing in the direction of these being a potentially safer alternative to cigarettes. We all agree that more long-term data is needed and, in line with this, at BAT, we continually assess our products, with many long-term studies currently underway across vapour and THP with our Vype and Glo brands respectively.
    “Tobacco harm reduction is a critical part of our company’s strategy. We are committed to offering consumers a choice of high quality, innovative and inspiring alternative products with reduced risk potential, from vapor to THP. With increasing evidence in support of e-cigarettes, as an option for smokers looking for potentially safer alternatives, it is crucial that there is appropriate regulation in place to give consumers the information they need. It is imperative that regulations ensure high product quality and give sensible innovation and marketing freedoms, whilst also ensuring that these products are not available to youth.
    “We’ve invested $2.5 billion in this important consumer category over the last six years and our commitment to the future is larger still as we seek to transform tobacco.  Our quest to offer more alternatives to cigarettes, with harm reduction potential, could transform tobacco for consumers, regulators and society.”
     
     
     

  • A glowing report on vapor

    A glowing report on vapor

    Scientists at British American Tobacco have reported that they observed changes in just two genes when human airway tissue was exposed to vapor from the company’s glo tobacco heating product (THP), whereas thousands of gene changes were observed in tissue exposed to cigarette smoke.
    They pointed out, however, that these results do not necessarily mean that the use of glo is less harmful than is the use of other tobacco products.
    ‘The impact on tissue exposed to glo vapor was minimal and more comparable with that of air when tested in laboratory conditions,’ according to a BAT press note.
    ‘These results add to evidence suggesting that glo has the potential to be substantially reduced risk compared to smoking conventional cigarettes.’
    As part of the press note, Dr. James Murphy, head of reduced risk substantiation at BAT was quoted as saying that products such as glo were new, and that consumers and regulators wanted as much information about them as possible. That was why testing the impact of glo vapor compared to that of smoke was so important.
    In this case, scientists were observing gene expression, which could give an indication of whether exposure to an aerosol, such as smoke or glo vapor, had had particular toxic effects.
    BAT’s results clearly showed that cigarette smoke triggered a robust gene expression response, while exposure to vapor from glo had very limited impact on gene expression.  Murphy said there was a striking difference.
    In the recent study, scientists at BAT used human cells grown in the laboratory to test the impact of glo vapor and compare it to the impact of smoke and air.
    The tissue (MucilAir™) is made up of human cells that grow in the laboratory to create a 3-dimensional structure that mimics the natural structure and characteristics of the living human airway. The resulting tissue is, for example, capable of producing mucus, as in the living airway, and it is covered in hair-like projections called cilia, which are used to expel inhaled dust from the respiratory system.
    ‘Using a robot that mimics how consumers use their products, this tissue was exposed to air, smoke from a reference cigarette (3R4F), or vapor from glo continuously for one hour,’ the BAT note said. ‘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.
    ‘This involves breaking open the cells and the cell nucleus to get at the genetic material inside it. The material is then studied to determine what genes are impacted.’
    “Our technology is state-of-the-art,” said Murphy. “We have the capability to profile the activity of tens of thousands of genes simultaneously, providing more information than ever before on the genetic profile of exposed cells.”
    ‘Results show that cigarette smoke triggered thousands (2809) of changes in the expression of genes strongly involved in the development of lung cancer, inflammation and fibrosis,’ the note said. ‘In contrast, only two genes were affected by exposure to glo vapor.
    ‘These results, which are published in the journal Scientific Reports (doi: 10.1038/s41598-018-19627-0) add to evidence that glo vapor may cause less damage to cells as compared to cigarette smoke. Future studies will look at the impact on human tissues of more intense and longer exposure to this vapor.
    ‘Previous research conducted by British American Tobacco has shown that glo vapor contains around 90-95 percent less toxicants compared to cigarette smoke from a reference cigarette, in terms of the priority list of nine toxicants that the World Health Organization recommends reducing in cigarette smoke.’

  • Study is a ‘wakeup call’

    Study is a ‘wakeup call’

    A new Tel Aviv University (TAU) study published in Addiction finds that eight out of 100 smokers who take smoking cessation medications will have benefited from taking such medications after one year’s time, according to a story in medicalxpress.com.
    The researchers conclude that this is a low rate of success that should encourage policymakers to try to find better methods to help smokers quit, and to prevent young people from taking up smoking.
    “By the end of the first year of intervention, only eight out of 100 smokers will have abstained from smoking due to the smoking medication,” said lead researcher Dr. Laura J. Rosen of the School of Public Health at TAU’s Sackler Faculty of Medicine.
    “This study is particularly important in Israel, where 22.5 percent of adults smoke and the rate of smoking is not declining. While the Israeli national healthcare system offers a strong package of aid to smokers who want to quit, there is no permanent funding for other tobacco control strategies.”
    The scientists used meta-analysis to combine the results of 61 randomized controlled trials involving some 28,000 participants who took the first-line US Food-and-Drug-Administration-approved smoking cessation medications bupropion (Zyban), nicotine replacement therapy (NRT) or varenicline (Chantix/Champix). In all of the trials, participants were randomized either to an intervention group, which received smoking cessation medications, or to a control group, which did not receive active medications. Most of the trials also featured some form of counseling in addition to the medication.
    “Less than 40 percent of those receiving the medications continued to abstain from smoking after three months, about 25 percent had still quit after six months, and about only a fifth — 20 percent — remained abstinent after a full year,” Rosen says. “Importantly, 12 percent of those who did not receive active medication continued to abstain from smoking after one year.
    “Because benefit is calculated by starting with the quit rate among those who received the medication, and subtracting from the percentage who quit in the groups which didn’t receive the medication, just eight percent of smokers who received smoking cessation medications continued to benefit from the drugs after one year.”
    According to Rosen, this study differs from previous meta-analyses in that it examines the relative success of quitting over different time periods (three, six and 12 months) and the overall decline in benefits from the medication over time.
    “This study is a wakeup call for policymakers everywhere and for physicians who treat smokers,” Rosen concludes. “Much more needs to be done to reduce tobacco use and its enormous toll on the population. We applaud current efforts by the FDA to develop more beneficial forms of medicinal nicotine for smokers who want to quit. Policymakers should use all possible means to prevent young people from starting to smoke. Prevention of entry into the cycle of addiction is the best possible medicine.”
    The full story is at: https://medicalxpress.com/news/2018-01-benefits-cessation-medications-diminish.html

  • PMI: review continuing

    PMI: review continuing

    Philip Morris International has made the point that the ‘careful review’ by the US Food and Drug Administration of the Modified Risk Tobacco Product (MRTP) applications for PMI’s heated tobacco device IQOS is continuing.
    On January 24 and 25, the Tobacco Products Scientific Advisory Committee (TPSAC) carried out, at the request of the FDA, an investigation into the scientific issues related to these MRTP applications and broadly recommended that they be rejected.
    On a note posted on its website yesterday, PMI said that experts from PMI and Philip Morris USA Inc. had presented to the TPSAC meeting.
    ‘The meeting was part of the FDA’s review of PMI’s request to commercialize IQOS in the US as a “Modified Risk Tobacco Product”,’ the note said. ‘US law and policy recognize product innovation as important to the 40 million American men and women who smoke.
    ‘To advise the agency on PMI’s applications, the committee covered a wide range of scientific, technical, and consumer-communications topics. It raised questions and probed the likelihood and magnitude of potential benefits as well as how best to address possible unintended use.
    ‘Although the Committee did not agree with some of the specific language of proposed risk and harm consumer communications, it confirmed that the evidence supported the statement that switching completely to IQOS significantly reduces exposure to harmful chemicals.’
    Meanwhile, PMI’s CEO, André Calantzopoulos (pictured), described the committee’s two-day discussion as a milestone event. “We thank the agency and the committee for their interest in our scientific dossier and our determination to enable adults who smoke to have access to and information about better alternatives,” he was quoted as saying. “I am deeply grateful to my colleagues for their exceptional work on our application to the FDA and for the presentations last week. Our science and the commitment of our people give me confidence that we will realize our vision of a smoke-free future.”
    The PMI note said that the company believed the committee’s interactions with presenters and its discussion reflected respect for PMI’s scientific data and commitment to bring IQOS to the US.
    ‘The Committee delved into such areas as inferences about long-term health outcomes, quantification and comparison of risk, the best way to formulate consumer information, and areas for post-market surveillance,’ the note said. ‘At the end of the meeting, the members of the committee discussed and voted on particular questions on which the agency requested the committee’s views. TPSAC recommendations and votes are not binding on the FDA.’
    Calantzopoulos said that as a next step, PMI looked forward to working with the FDA to clarify outstanding points so as to best assist in the agency’s ongoing decision-making process, which inherently entailed a certain degree of scientific uncertainty pre-market. “As the FDA routinely does with regard to the many products it regulates, I believe the agency will ultimately address that uncertainty in the best interest of people who smoke,” he said.
    PMI has submitted also a Pre-Market Tobacco Application (PMTA) to the FDA which, if granted, will permit the commercialization of IQOS in the US without modified risk messages. This application was not before the committee because it follows a separate regulatory pathway.
    Under agreements with PMI, PM USA is licensed to sell IQOS in the US should PMI receive a PMTA marketing order from the FDA

  • Grants-offer spurned

    Grants-offer spurned

    Seventeen public health schools in the US and Canada yesterday pledged to refuse research money from the New York-based Foundation for a Smoke-Free World (FSFW), according to a story by Collin Binkley for WHSV Online relayed by the TMA.
    Presumably they have pledged not to apply for such grants.
    FSFW was launched in September with a $1 billion grant from Philip Morris International.
    The foundation has yet to issue any funding but it has received proposals that are currently under review.
    “The idea of taking money that’s from the tobacco industry is just antithetical to everything we do,” said Karen Emmons, dean for academic affairs at Harvard’s public health school.
    A letter signed by the 17 college deans said both the tobacco industry and PMI had a long history of funding research in ways meant purposely to confuse the public and advance their own interests.
    The foundation has said it will pay for research that helps smokers quit, helps tobacco farmers find other livelihoods and develops reduced-risk alternatives to traditional cigarettes.
    Derek Yach, chief of the FSFW and a former executive of the World Health Organization (pictured), said that the foundation was “fully insulated” from industry influence.

  • iQOS due for discussion

    iQOS due for discussion

    The US Tobacco Products Scientific Advisory Committee (TPSAC) is due to meet later this month to discuss scientific issues related to the modified risk tobacco product (MRTP) applications submitted by Philip Morris Products S.A.
    According to a note issued by the Food and Drug Administration’s Center for Tobacco Products (CTP), the meeting is due to take place on January 24-25 at the FDA’s White Oak campus.
    ‘The committee will discuss scientific issues related to the modified risk tobacco product (MRTP) applications submitted by Philip Morris Products S.A. for its iQOS system and several Marlboro HeatSticks products, which are currently under scientific review by FDA,’ the CTP said.
    ‘Seating for this meeting may be limited, so the public is encouraged to watch the free webcast instead of traveling to the meeting.
    ‘The link for the webcast will be available approximately 15 minutes prior to the beginning of the meeting each day and can be accessed through the Tobacco Products Scientific Advisory Committee website.’

  • HNB products less risky

    HNB products less risky

    An independent scientific committee that advises UK government departments has said that there is likely to be a reduction in risk for cigarette smokers who switch to heat-not-burn (HNB) products, according to a story by Diane Caruana for the Vaping Post.
    The Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) is an independent scientific committee that provides advice to the Food Standards Agency, the Department of Health and other government departments and agencies on matters concerning the toxicity of chemicals.
    It reviewed the two HNB products sold in the UK, Philip Morris International’s iQOS and British American Tobacco’s iFuse.
    The evidence gathered by the committee was said to have indicated that the products posed a risk that it was unable to quantify, but that this risk was lower than that posed by smoking.
    “The evidence suggests that heat-not-burn products still pose a risk to users,” said professor Alan Boobis, chairman of the COT. “There is likely to be a reduction in risk for cigarette smokers who switch to heat-not-burn products but quitting entirely would be more beneficial.”
    The COT said there was a reduction in risk to bystanders when comparing second hand vapor to second hand smoke, but added that the risk to unborn babies from pregnant women using HNB products was difficult to quantify.
    “The committee expressed concern over the potential for non-smokers to take up these products because they are not without risk,” Boobis added.
    The CEO of Action on Smoking and Health, Deborah Arnott, while generally welcoming the COT findings, said the study was incomplete because it did not include electronic cigarettes.
    “The COT review did not examine the evidence on e-cigarettes, so was unable to compare the two,” she said.
    “This is needed to help provide reassurance to the public and Ash recommends COT be commissioned to carry out such a comparison.”