A US public health expert has shone a new light on the results of a widely reported study claiming that vaping causes heart attacks.
On his tobacco analysis blog, Dr. Michael Siegel, a professor in the Department of Community Health Sciences, Boston University School of Public Health, said the new study, which had been presented on Saturday at the annual meeting of the Society for Research on Nicotine and Tobacco (SRNT), had concluded that vaping caused heart attacks, increasing the heart attack risk for dual users beyond that of smoking alone.
The research has not yet been published but was presented as a poster at the conference.
‘The study was a cross-sectional analysis of nearly 70,000 respondents to the combined 2014 and 2016 National Health Interview Surveys (NHIS), a nationally representative survey of health risk factors and outcomes in US adults,’ Siegel’s blog explains. ‘Respondents were asked to report their current vaping and smoking statuses and to report whether they had ever had a heart attack. The researchers found that there was a significant association (odds ratio = 1.8) between daily e-cigarette use and having experienced a heart attack. The analysis controlled for level of current cigarette use.
‘Based on this observation, the study concludes that daily e-cigarette use doubles the risk of heart attacks.’
At this point, Siegel reports ‘The Rest of the Story’.
‘Hold your horses,’ he warns.
‘Before accepting the conclusion that vaping causes heart attacks in unsuspecting smokers, remember the old adage: correlation does not equal causation. This study is a perfect demonstration of that phenomenon.
‘Because this is a cross-sectional study, and because respondents were asked whether they had ever had a heart attack, one cannot determine whether the heart attacks followed e-cigarette use or preceded it. In other words, we do not know that vaping preceded the heart attack for any of the subjects. It is entirely possible that in most of these cases, the smokers suffered a heart attack and then started vaping in an attempt to quit smoking. In fact, I believe that is the most likely explanation for the observed study findings.’
The rest of The Rest of the Story is at: http://tobaccoanalysis.blogspot.co.uk/2018/02/new-study-concludes-that-vaping-causes.html.
Tag: United States
‘Hold your horses’
Smoking record worn out
About three out of four US citizens agree that smoking cigarettes causes health problems, but public perception of the risks posed by smoking may be declining, according to a eurekalert.org story citing a Duke Health study published in the journal Drug and Alcohol Dependence.
From 2006 to 2015, the number of people in the US who said smoking a pack or more per day posed a great health risk was said to have dropped by one percent, or three million people.
So far, the change in perceived risk has not appeared to result in more smokers. During the same period, the incidence of smoking dropped from 20.8 percent to 15.1 percent, according to statistics from the Centers for Disease Control and Prevention. But, the story warned, the change could signal a potential slowing of progress.
“That’s three million people who might be more likely to start smoking, go back to smoking, or who are less likely to quit if they already smoke,” said Lauren Pacek, PhD, the study’s lead author and an assistant professor in psychiatry and behavioral sciences at Duke.
The change in risk perception changed more significantly in women than in men, the authors found.
“We were surprised by the findings,” said co-author Joe McClernon, PhD, professor in psychiatry and behavioral sciences. “Cigarettes haven’t fundamentally changed over the last 15 years. They’re no safer. And we continue to see that large numbers of Americans are dying from tobacco related disease – as many as 400,000 a year. So, it’s curious that the facts haven’t changed, but the risk perceptions have gone down.”
The number of respondents who saw smoking as posing no risk increased from 1.45 percent to 2.63 percent over the 10-year span.
Older teens and adults were more likely than teens 12 to 17 to see smoking as a great health risk. Daily smokers were less likely than former smokers and non-smokers to see cigarette use as dangerous to their health.
A number of factors could be driving the change, McClernon said, including message fatigue.
“The idea here is that Americans have heard so often, and for so long, about how harmful cigarettes are that the message is less impactful,” McClernon said. It might also be possible that fewer people know smokers or people with tobacco-related disease, and this also could decrease perceived harm, he said.
The full story is at: https://eurekalert.org/pub_releases/2018-02/dumc-fat022718.php.More support needed
The US-based Consumer Choice Center (CCC) yesterday applauded the American Cancer Society’s acknowledgement that electronic cigarettes ‘can appropriately help smokers quit’.
In a press note, the CCC said that ACS, in a clinical recommendation, had tepidly endorsed e-cigarettes in making the statement:
“Many smokers choose to quit smoking without the assistance of a clinician and some opt to use e-cigarettes to accomplish this goal. The ACS recommends that clinicians support all attempts to quit the use of combustible tobacco and work with smokers to eventually stop using any tobacco product, including e-cigarettes. Some smokers, despite firm clinician advice, will not attempt to quit smoking cigarettes and will not use FDA approved cessation medications. These individuals should be encouraged to switch to the least harmful form of tobacco product possible; switching to the exclusive use of e-cigarettes is preferable to continuing to smoke combustible products.”
CCC Senior Fellow Jeff Stier (pictured) was quoted as saying that the ACS had taken a step in the right direction by recognizing this important harm-reduction method.
‘I continue to call on the American Heart Association and other major health organizations to reverse course and support smokers who wish to quit smoking with the use of e-cigarettes, heat-not-burn tobacco, or smokeless tobacco, all of which are significantly less harmful than smoking,’ said Stier.
In a June 2016 piece for Morning Consult, Stier had called out the ACS by name for failing to support smokers – and their healthcare providers – by not only refusing to endorse the use of e-cigarettes as a way to quit smoking but for actively distorting the science to oppose it.
‘It’s no wonder that American doctors are doing a poor job helping their addicted patients make better decisions about how to get nicotine if they can’t or aren’t ready to get off of it completely,’ said Stier. ‘Public health groups in the US have been indoctrinating providers with misinformation.’
In contrast, the press note said; in the UK the government had been constantly evaluating e-cigarette use. Just this month, Public Health England had issued an update to its landmark 2015 review where it concluded: “that e-cigarettes are around 95 percent safer than smoked tobacco and they can help smokers to quit”.
‘Physician specialty groups must do a better job of educating their members and standardizing harm reduction advice,’ the press note said. ‘There’s barely a body part or function which isn’t compromised by smoking. From medical schools to credentialing organizations, the entire American medical establishment needs to kick the habit of providing politically correct quit-smoking advice and replace it with up-to-date medically validated harm reduction advice. They should do so as if their patients’ lives depend on it.’More support for e-cigs
In a position statement issued today, the American Cancer Society (ACS) says that for smokers who will not or cannot quit smoking using other methods, switching to the exclusive use of electronic cigarettes is preferable to continuing to smoke combustible products.
Although the support given to the use of e-cigarettes is much qualified; coming as it does from the ACS, it is nevertheless hugely significant.
The position statement on e-cigarettes was approved by the ACS’ board of directors and will be used to guide the society’s tobacco control and cessation efforts in relation to these products.
Under the heading, Scientific Summary, the statement said in part that, based on currently available evidence, using current-generation e-cigarettes was less harmful than was smoking cigarettes, but that the health effects of long-term use were not known.
‘The … ACS recognizes our responsibility to closely monitor and synthesize scientific knowledge about the effects of all tobacco products, including e-cigarettes and any new products derived from tobacco,’ the statement said. ‘As new evidence emerges, the ACS will promptly report these findings to policy makers, the public and clinicians.’
The statement, under the heading, Clinical Recommendations, went on to say that the ACS had always supported smokers who were considering quitting, no matter what approach they used; there was nothing more important that they could do for their health.
‘To help smokers quit, the ACS recommends that clinicians advise their patients to use FDA-approved cessation aids that have been proven to support successful quit attempts,’ the statement said. ‘Many smokers choose to quit smoking without the assistance of a clinician and some opt to use e-cigarettes to accomplish this goal. The ACS recommends that clinicians support all attempts to quit the use of combustible tobacco and work with smokers to eventually stop using any tobacco product, including e-cigarettes.
‘Some smokers, despite firm clinician advice, will not attempt to quit smoking cigarettes and will not use FDA approved cessation mediations. These individuals should be encouraged to switch to the least harmful form of tobacco product possible; switching to the exclusive use of e-cigarettes is preferable to continuing to smoke combustible products. Of course, these individuals should be regularly advised to completely quit using all tobacco products.
‘The ACS strongly discourages the concurrent (or “dual”) use of e-cigarettes and combustible cigarettes, a behavior that is far more detrimental to a person’s health compared to the substantial health benefit of quitting smoking.’
Under the heading, Policy Recommendations, the statement said that the ACS strongly recommended that every effort be made to prevent the initiation of e-cigarettes by youth. ‘The use of products containing nicotine in any form among youth is unsafe and can harm brain development,’ the statement said. ‘Furthermore, evidence indicates that young e-cigarette users are at increased risk for both starting to smoke and becoming long-term users of combustible tobacco products.
‘The ACS encourages the FDA to regulate all tobacco products, including e-cigarettes, to the full extent of its authority, and to determine the absolute and relative harms of each product. The FDA should assess whether e-cigarettes help to reduce tobacco-related morbidity and mortality, and the impact of marketing of e-cigarettes on consumer perceptions and behavior.
‘Any related regulatory regime should include post-marketing surveillance to monitor the long-term effects of these products and ensure the FDA’s actions have the intended health outcome of significantly reducing disease and death.’
The full statement is at: https://www.cancer.org/healthy/stay-away-from-tobacco/e-cigarette-position-statement.html.FDA seeking feedback
The US Food and Drug Administration says it is establishing a public docket to receive suggestions, recommendations and comments on topics or policy issues for consideration by the agency’s Nicotine Steering Committee.
In a press note issued through its Center for Tobacco Products, the agency said it would like to receive feedback from academic institutions, regulated industries, patient representatives, and other interested organizations and individuals.
It wants to use this feedback to help identify and address priorities related to the use of therapeutic nicotine for combustible tobacco product cessation.
‘The Nicotine Steering Committee was established in November 2017 and includes senior leaders from the Office of the Commissioner, Center for Drug Evaluation and Research, and Center for Tobacco Products,’ the note said.
‘The committee was formed to help develop and implement nicotine policy and regulation, especially on issues related to therapeutic nicotine for combustible tobacco product cessation.
Electronic or written comments should be submitted by April 16.
More information, including details about how to submit comments to the public docket, is at: https://www.federalregister.gov/documents/2018/02/20/2018-03341/nicotine-steering-committee-establishment-of-a-public-docket-request-for-comments.‘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”.PMI to make presentation
Philip Morris International is due to host at www.pmi.com/2018cagny 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 Conference from about 09.00 Eastern Time on February 21.
The webcast, which will be in listen-only mode, will provide live audio of the entire PMI session.
The audio webcast may 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/2018cagny until 17.00 on March 22.
The presentation slides and script will be available also at www.pmi.com/2018cagny.Seeking new alliances
Alliance One International’s volume sales during the nine months to the end of December, at 255.8 million kg, were 1.7 percent up on those of the nine months to the end of December 2016.
In announcing its nine-months and third-quarter results, the company said the higher volume was made possible by South America’s crop having been returned to a more normal level after the weather-affected, smaller crop of the previous year, and by the timing of shipments in North America, offset by volume decreases in Africa caused by unhelpful weather, primarily in Malawi.
Total sales and other operating revenues were said to have increased by $97.0 million to $1,202.1 million because of a 7.5 percent increase in the average sales price brought about by a favorable product mix, primarily in South America, North America, Asia and Europe, and because of the increase in volume sales.
Average tobacco costs per kg increased by 7.9 percent because of the product mix and the impact of European currency movements, partially offset by lower conversion costs.
‘Gross profit increased 14.7 percent to $171.5 million and gross profit as a percentage of sales improved to 14.3 percent from 13.5 percent last year,’ Alliance said. ‘The increase in gross profit was driven by revenues increasing by 8.8 percent with total costs of goods and services sold increasing by 7.9 percent. The larger South America crop size this year was the primary driver of processing and other revenues increasing 2.1 percent, with processing costs decreasing 10.1 percent from lower conversion costs.’
President and CEO Pieter Sikkel (pictured) said, fiscal year 2018 continued to progress in line with the company’s expectations. “We achieved solid sales growth during the third quarter when compared to last year,” he said. “Our volume sold has increased, as crop sizes have returned to more normal levels in many key markets despite reduced crop sizes in Africa.
“We are pleased with this quarter’s results and with the continued progress against our key initiatives and strategic objectives.”
Sikkel said he was excited to announce that Alliance One had embarked on an ambitious transformation plan called ‘One Tomorrow’. “This initiative will drive future growth opportunities and reshape our brand as the trusted provider of responsibly produced, independently verified, sustainable, and traceable agricultural products and services,” he said. “As part of our ‘One Tomorrow’ long-term business strategy, we are actively developing new business lines and building upon the strength of our core operations.
“Most of our new business lines focus on products that are value-added or require some degree of processing. These products generally have higher margin potential than our core business and play well to our strengths.
“In January, we successfully acquired majority stakes in two new joint ventures. The extension into growth segments, namely e-liquids, industrial hemp and cannabis, expands Alliance One’s presence in higher-margin, fast-growing categories.
“We intend to broaden our business portfolio over the next three to four years by focusing on consumer-driven agricultural products, with increased operating margins when compared to our historical leaf processing business.
“Consistent with our commitment to growth and incremental to our core leaf earnings, our goal is to generate a significantly increasing portion of our profit from new, higher-margin businesses by 2020.”Presentation to be webcast
The Altria Group is due to host a webcast of its business presentation at the annual Consumer Analyst Group of New York conference in Boca Raton, Florida, starting about 13.00 Eastern Time on February 21.
The webcast, which will be in listen-only mode, will feature a presentation by chairman, CEO and president, Marty Barrington, and other members of the company’s senior management team.
Directions for the necessary pre-event registration are at www.altria.com/webcasts.
An archived copy of the webcast will be available on altria.com or through the Altria Investor App.
The free app is available for download at www.altria.com /irapp or through the Apple App Store or Google Play.Universal looking forward
Universal Corporation reported yesterday that its net income for the nine months to the end of December was $75.1 million, or $2.94 per diluted share, compared with $73.4 million, or $2.63 per diluted share, during the same period of the prior fiscal year.
For the third fiscal quarter to the end of December, net income was $45.4 million, or $1.78 per diluted share, compared with net income for the prior year’s third quarter of $53.6 million, or $1.92 per diluted share.
Net income for the nine months and third quarter included a one-time reduction in income tax expense of $10.5 million, or $0.41 per diluted share, resulting from the enactment of the Tax Cuts and Jobs Act in December 2017.
Operating income for the nine months to the end of December of $111.2 million was down by $7.3 million compared to that of the nine months to the end of December 2016. Operating income for the third quarter of fiscal year 2018 fell to $59.7 million from $83.2 million.
“As expected, our earnings from operations so far in fiscal year 2018 have been impacted by lower Burley crop volumes in Africa and fewer carryover crop sales in North America, offset in part by the return to normal crop volumes in Brazil, where we continue to see the benefits of higher volumes and lower factory unit costs,” said George C. Freeman, III, Chairman, President, and CEO. The Burley crop shortfall will predominately affect our third and fourth fiscal quarters when we typically ship African crops.”
Looking ahead, Freeman said Universal expected that its volumes for the fourth quarter of fiscal year 2018 would be lower than those achieved in the fourth quarter of the prior year, given reduced crop volumes available for sale in Africa this year, which typically had strong shipment volumes during the fourth fiscal quarter. “As a result, we continue to believe our total lamina volumes for fiscal year 2018 will be modestly lower than those volumes in fiscal year 2017.
“Looking forward, the next crop cycle, which will be reflected in our fiscal year 2019 results, has begun with green tobacco purchases in Brazil. The crop season is off to a good start, and assuming the recovery of African volumes and overall market stability, we believe that our fiscal year 2019 total sales volumes will be higher.”
