Tag: United States

  • Gateway appears blocked

    Gateway appears blocked

    A US health expert says that despite widespread claims that vaping is a gateway to smoking initiation among young people, the most definitive study to date of this issue has failed to provide any evidence to support that contention.

    Providing ‘The Rest of the Story’ on his tobacco analysis blog, Dr. Michael Siegel, Professor in the Department of Community Health Sciences, Boston University of Public Health, said: ‘If anything, it provides evidence suggesting that vaping acts as a kind of diversion that can keep some youth away from cigarette smoking’.

    Siegel was commenting on a landmark study, published on January 25 in the Journal of the National Cancer Institute. This was the largest, longitudinal study of youth smoking initiation – the PATH (Population Assessment of Tobacco and Health) study – and included two waves of observations on nearly 12,000 young people in the US.

    The main reported finding of the study was that ever use of e-cigarettes at baseline was a risk factor for ever use of cigarettes at follow-up, said Siegel. This was consistent with the findings of several other studies.

    ‘Buried deep within the article is the rather startling, but most critically relevant finding of the entire study: The investigators were unable to report a single youth out of the 12,000 in the sample who was a cigarette naive, regular vaper at baseline who progressed to become a smoker at follow-up,’ he said. ‘Why? Because the number of these youth was so small that it was impossible to accurately quantify this number.’

    Siegel said that it was necessary to await the results from future waves of the PATH study to have a clearer idea of the trajectory of youth vaping and smoking.

  • PMI to webcast presentation

    PMI to webcast presentation

    Philip Morris International is due to host at www.pmi.com/2019cagny a live audio webcast of a presentation by CEO André Calantzopoulos, COO Jacek Olczak and CFO Martin King at the Consumer Analyst Group of New York (CAGNY) Conference starting about 14.00 Eastern Time on February 20.

    The webcast, which will be in listen-only mode, will provide live audio of the entire PMI session.

    It can be accessed also on iOS or Android devices by downloading PMI’s free Investor Relations Mobile Application at www.pmi.com/irapp.

    An archived copy of the webcast will be available at www.pmi.com/2019cagny until 17.00 on March 21.

    The presentation slides and script will be available at www.pmi.com/2019cagny.

  • General decision time

    General decision time

    Some members of a Tobacco Product Scientific Advisory Committee have argued that if a product such as snus does not qualify for the US Food and Drug Administration’s modified risk tobacco product (MRTP) status, the designation might as well not exist, according to a MedPage Today story relayed by the TMA.

    “I think the health [benefits] are really clear compared to smoking – more so than for any other smokeless tobacco product,” committee member Kenneth E. Warner, PhD, of the University of Michigan in Ann Arbor, was quoted as saying. “My sense is that if this is not approved, it might be the death knell for the [MRTP] process because we would be basically saying you can’t get anything through this process.”

    The committee was considering an MRPT application by Swedish Match North America in respect of its General snus brand. The company has been trying for years to have a health warning changed in respect of its General snus brand, but the issue has been kicked down the road.

    Most people believe that the consumption of snus is hugely less risky than is smoking and that health warnings should reflect this.

    However, some members of the Committee reportedly expressed concerns that increased popularity of General snus could lead to increased uptake among young people.

    In fact, according to the findings of an FDA-requested Swedish Match study, Swedish Match snus product users in the US are mostly male, have a median age of 35, are fairly well educated, are slightly more affluent than general smokeless tobacco users, and are largely Caucasian.

    The Committee met in Washington DC on February 6 to review the scientific evidence, health risk, claim development, testing and population impact revealed in a 10,000-person Consumer Research study requested by the FDA of Swedish Match.

    It considered the statement that consumers in the 10,000-person study found to be the most understandable the warning: ‘Using General Snus instead of cigarettes puts you at a lower risk of mouth cancer, heart disease, lung cancer, stroke, emphysema, and chronic bronchitis’.

    One Committee member was quoted as saying: “Swedish Match is a company that has never marketed to youth, it has a history I trust. Semantic issues can be fixed, but the public needs to be informed about tobacco harm reduction products”.

    And, in summarizing the proceedings, the chairman of the panel, Dr. Robin Mermelstein of the University of Illinois at Chicago, said she believed there had been a fair amount of consensus against a background of a range of opinions. There had been consensus around the importance of providing accurate information about relative harms.

    The goal of getting people who were unable to quit smoking off combustibles and on to less harmful products was certainly a laudatory one, Mermelstein said. She seemed to indicate, too, that there was a fair amount of consensus around the fact that whatever could be done to promote such switching was worthwhile, and that the Swedish Match approach was a potential path to such switching.

    The FDA did not ask the Committee for a vote because, according to its spokesperson: “We felt what would be most useful [to us] was to have the qualitative discussion to make sure we hear the points that are concerning [the panel]”.

    After listening to the proceedings, tobacco harm reduction expert David Sweanor, of the University of Ottawa’s Centre for Health Law, Policy and Ethics said the data on snus being dramatically less hazardous than smoking was overwhelming; as was the data on smokers not knowing this fact.

    “In many ways, the FDA proceedings are less a test for Swedish Match than of the FDA itself,” he said. “After a decade of the tobacco law, and literally millions of American deaths from cigarettes, can the agency simply allow people to be told the truth? This should be no more complicated than allowing the public to know that three-point seatbelts – another Swedish innovation – reduce the risks of driving.”

  • 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.’

  • It’s the environment

    It’s the environment

    For the fifth year in a row, electronic cigarettes were the most commonly used tobacco product among young people in the US, according to a note issued yesterday by the Food and Drug Administration through its Center for Tobacco Control [e-cigarettes are ‘deemed’ by the FDA to be tobacco products].

    This was said to be one of the findings of the 2018 National Youth Tobacco Survey (NYTS) published in an MMWR [Morbidity and Mortality Weekly Report] article, Vital Signs: Tobacco Product Use Among Middle- and High-School Students – United States, 2011-2018.

    This article includes findings on current use of seven tobacco products, cigarettes, cigars, e-cigarettes, smokeless tobacco, hookah, pipe tobacco, and bidis, as well as findings on the use of multiple products and frequency of use.

    ‘The study authors found that in 2018, approximately five million middle- and high-school students currently used any tobacco product, with over 3.6 million currently using e-cigarettes and about half (2.5 million) currently using a combustible tobacco product, such as cigarettes and cigars,’ said the FDA in its note. ‘For the fifth year in a row, e-cigarettes continued to be the most commonly used tobacco product among US youth. Among current tobacco product users, 41.7 percent of high-school students and 33.3 percent of middle-school students used two or more tobacco products. E-cigarette and cigarette use was the most common combination among those using multiple products.

    ‘From 2017 to 2018, use of any tobacco product increased significantly by 38.3 percent (19.6 percent to 27.1 percent) among high-school students and by 28.6 percent (5.6 percent to 7.2 percent) among middle-school students. Current e-cigarette use increased significantly by 77.8 percent (11.7 percent to 20.8 percent) among high-school students and by 48.5 percent (3.3 percent to 4.9 percent) among middle-school students between 2017 and 2018. Furthermore, frequent e-cigarette use (more than 20 days in the past 30 days), increased significantly by 38.5 percent (20.0 percent in 2017 to 27.7 percent in 2018) among high-school students who were current e-cigarette users.

    ‘Due to the alarming nature of these findings, they were released early in a Notes from the Field article in Nov. 2018. The current study finds that e-cigarettes were the primary driver of the increase in current use of any tobacco product among both middle- and high-school students. During this same period, although there were no significant changes in current use of combustible tobacco products, such as cigarettes and cigars, there was a slight uptick in any combustible tobacco product use (12.9 percent to 13.9 percent) and current cigarette use (7.6 percent to 8.1 percent) among high-school students.

    ‘The high rates of youth tobacco use, particularly e-cigarette use, continue to be of concern to FDA. Last spring, FDA launched the Youth Tobacco Prevention Plan, which aims to prevent youth access to tobacco products; curb marketing of tobacco products aimed at youth; and educate teens about the dangers of using any tobacco product, including e-cigarettes, as well as educate retailers about their key role in protecting youth.

    ‘As part of the plan, FDA has ramped up efforts around compliance of the marketing and sales of e-cigarettes and conducted an ongoing series of enforcement actions to prevent initiation of tobacco products, including e-cigarettes, by youth. FDA continues to invest in compelling, science-based campaigns to educate youth about the dangers of all tobacco products. In Sept. 2018, FDA launched the full-scale youth e-cigarette prevention effort under “The Real Cost” brand umbrella. In Nov. 2018, the concerning findings from the 2018 NYTS youth e-cigarette use data prompted FDA to outline a policy framework on actions to reduce youth e-cigarette use, targeting the central problems – youth appeal and access to flavored tobacco products.’

    Meanwhile, in a statement posted on its website yesterday in response to the CDC National Youth Tobacco Survey, Altria Client Services senior vice president, corporate citizenship, Jennifer Hunter said young people shouldn’t use any tobacco products and Altria shared the FDA’s concerns with their use of e-vapor.

    “We remain committed to being part of the solution,” she said. “Raising the legal age of purchase for all tobacco products to 21, which we strongly support, is the single most effective way to address underage use. We continue to meet with state and federal policy makers on this effort and stand ready to work with all interested parties.”

  • Universal focused on leaf

    Universal focused on leaf

    In announcing Universal Corporation’s nine-months’ results to the end of December, chairman, president, and CEO George C. Freeman, III, said the company remained committed to strengthening its market share and investing for growth in its core tobacco business.

    “As we recently announced, we are expanding our leaf purchasing, processing, and grower support services in the Philippines, as part of a new leaf supply arrangement with one of our major customers [Philip Morris International Management SA], who had previously purchased and processed their own tobacco,” Freeman was quoted as saying. “This arrangement will increase the efficiency of the supply chain in that origin by providing procurement synergies and economies of scale.

    “Another aspect of improving efficiencies and reducing costs in the supply chain is ensuring that our operations and footprint support and reflect global market demand for leaf. Customer demand over recent years for tobacco sourced from Tanzania has declined. As a result, we have undertaken a review of the Tanzanian leaf tobacco market and our operations there. The review is ongoing, and we have decided to substantially reduce our permanent workforce and have incurred an impairment charge on certain assets there.

    “This move and the expansion of services in the Philippines are consistent with our continued focus on effective rationalization of global leaf procurement supply chains, appropriate with changes in our customers’ leaf tobacco requirements to maintain strong and stable markets into the future.

    “Looking forward, we expect that our fourth quarter shipments will be strong. We are, however, continuing to monitor container and vessel availability, particularly in Brazil, which may shift some shipments into the first quarter of fiscal year 2020.”

    Freeman reported net income for the nine months ended December 31 at $72.8 million, or $2.87 per diluted share, compared with $75.1 million, or $2.94 per diluted share, for the same period of the prior fiscal year.

    Operating income of $100.4 million for the nine months ended December 31, which included restructuring and impairment charges of $19.4 million in Tanzania, decreased by $10.3 million compared to operating income of $110.7 million for the nine months ended December 31, 2017.

  • 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.

  • Prohibition proposed

    Prohibition proposed

    Under a proposal before Hawaii’s state Legislature, cigarette sales would be effectively banned outright by 2024, according to a Hawaii News Now story.

    The ban would go into effect progressively, starting with raising the minimum age for buying cigarettes from 21 to 30 in 2020.

    By 2022, no one under 50 could buy cigarettes.

    And two years later, no one under 100 would be allowed to buy cigarettes.

    The story rated the measure, House Bill 1509, as a long shot. It said it had passed its first reading last week, a procedural hurdle, and had been assigned to committees. But it didn’t yet have a hearing.

    That didn’t mean it wouldn’t get one, the story went on to say, especially after news of the proposal started generating headlines nationally.

    The authors of the bill, two Democratic representatives and a Republican, said the proposed ban simply made sense.

    “The cigarette is considered the deadliest artifact in human history,” they wrote in the preamble to the measure. “The cigarette is an unreasonably dangerous and defective productive, killing half of its long-term users.”

    About 13 percent of Hawaii adults are smokers, which is lower than the national average of 17 percent.

    Hawaii also has one of the nation’s highest cigarette taxes, at $3.20 a pack. And more than a decade ago, the Hawaii Legislature significantly expanded smoke-free zones, and included e-cigarettes in those prohibitions three years ago.

    The measure before lawmakers that would ban cigarette sales would not include e-cigarettes.

  • 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.