October 31, 2020
Another month, another round-up of the top articles on vaping and tobacco harm reduction. It’s a long reading list for October and there are some really great reads. Learn how much nicotine is in a cigarette and how that compares to vaping in an article from Jim McDonald, or about the impact of vaping restrictions on Indians from Alex Norcia. Colin Mendelsohn discusses the situation facing Australians and Joseph Magero has written an article that addresses issues of access in low and middle-income countries. And, of course, we have news from Canada where smoking rates have gone up in Nova Scotia (the province with the most restrictive vape legislation) and the NWT looks at possible restrictions. Among the good news: studies continue to add to the evidence in support of vaping and a new trade organization has been formed in the United States to help shops with the PMTA process. Happy reading!
Access to safer nicotine products in low- and middle-income countries more vital than ever, Joseph Magero, Medium
80% of smokers live in low-and middle-income countries and have no access to safer nicotine products — resulting in greater pain and suffering, prolonged illness and preventable deaths. Health professionals and Policy makers in Africa find themselves confronted by a phenomenon of rising cigarette smoking rates. Despite some effort by African governments in achieving some of the Sustainable Development Goals, reducing tobacco smoking has proved the hardest to deliver. Although the prevalence rate of cigarette smoking in Africa today is only 14%; low, compared to North America (23%) and the Eastern Mediterranean (31%), its growth is the highest on the planet!
Democrats More At Risk for Anti-E-Cigarette Stance, Michelle Minton, CEI
Vapers may have bigger priorities when they choose which presidential candidate to vote for. But, for the many millions who quit smoking with vaping when nothing else worked, their families and friends who care about their health, and everyone whose livelihood depends on the independent vapor industry, the vaping issue may prove a deciding factor. It will be hard for vapers to forget lawmakers who actively sought to strip away freedom of choice.
Marlboro maker Altria takes $2.6 billion hit as Juul valuation crumbles, Reuters Staff, Reuters
Its stake in Juul is now worth $1.6 billion, the company said, implying that the value of the vaping products maker was a fraction of the $38 billion it was worth when the cigarette company picked up a 35% stake in December 2018.
Let Science Lead the Way in Tobacco-Harm Reduction Debate, Dr. Vivian Manyeki, Capital News
The health consequences of tobacco smoking are well documented; if current trends continue, it has been estimated that globally, a billion lives will be lost to tobacco smoking in the twenty-first century.
Vaping And COVID-19: Plausibility And Causality, David Jaroslaw, Christopher Gismondi and Naira Gorovits
To establish general causation, a plaintiff must prove that it is more probable than not that an exposure is capable of causing or contributing to the disease in question. A mere showing that the relationship is plausible is legally insufficient.
How Much Nicotine Is In A Cigarette? Jim McDonald, Vaping 360
When we use nicotine, we decide ourselves how much we take in—by smoking more or less, faster or slower, and with greater or lesser frequency. That’s called self-titration, and all nicotine consumers do it.
Yk vape sellers worry about implications of banning flavoured products, Natalie Pressman, Yellow Knifer
“It wasn’t the tobacco flavour that helped me quit,” he said, “it was peach apricot.” It’s the flavoured products that help smokers dissociate from smoking, Cooper said. Without them, “customers are saying, ‘Well, I’ll just go back to smoking.’”
Smoking rates in the UK are at an all-time low but this masks considerable inequalities; prevalence amongst adults who are homeless remains four times higher than the national average. The objective of this trial was to assess the feasibility of supplying free e-cigarette starter kits to smokers accessing homeless centres and to estimate parameters to inform a possible future larger trial.
Juul Beats Racketeering Claims in Marketing Suits, For Now, Jef Feeley and Edvard Pettersson, Bloomberg News
U.S. District Judge William Orrick in San Francisco on Friday said claims brought by consumers, local governments and school districts under the Racketeer Influenced and Corrupt Practices Act -- which could have put Juul on the hook for triple damages -- didn’t pass legal muster. But the judge said the plaintiffs can amend their court filings and try to make a RICO case.
Vaccines, vaping and the north-south divide, your Covid questions answered, Nicola Davis and Linda Geddes, The Guardian
Notley said this underlined the need to wear masks, and for people who vaped to be considerate of others. But she said there was no evidence to say whether vape clouds were more of a problem when it came to passing on an infection than normal exhalations. “It is not a good idea for anyone to be exhaling big clouds of vape or singing loudly in a crowded area and sharing their exhaled breath with other people,” she said. “Of course, we would not want to discourage people from vaping if they have successfully managed to quit smoking.”
Tobacco Harm Reduction, Muzammil Ferozi, Daily Times (Pakistan)
Unofficially, e-cigarettes and vapes of different types and quality are already available in the market through various means. However, these products are usually brought in through grey channels and due to lack of proper sales channels and regulations, are either not reliable or too expensive. If there were proper laws in place, these alternative products could go a long way in improving the overall health statistics of Pakistan.
COPD patients who switch from conventional smoking to regular vaping achieve sustained abstinence resulting in a 50% reduction in COPD exacerbations and overall improvement in exercise tolerance and quality of life.
The Unfolding Tragedy of India’s Vape Prohibition, Alex Norcia, Filter
The Indian government owns a significant stake in the nation’s largest tobacco country, ITC, and India itself is one of the biggest tobacco cultivators on the planet. So “if you want to fight Big Tobacco in India,” said Indian vaper Aryan Sharma, “you have to fight the government itself.”
Businesses: Flavored tobacco ban will harm, Cameron Evans, The Missoulian
The Chamber said it does not support the proposed ban in a letter to Council last week, saying it would punish retailers who follow the law and only sell to legal-aged customers, and would not address the passage of legally-purchased products to underage users.
How Could We Have Known: Prohibiting E-cigarettes Leads to Smuggling and Smoking, Michelle Minton, CEI
Government-funded propaganda, junk science, Michael Bloomberg-funded advocacy, and lazy journalism have fomented a moral panic over vaping in America. That panic has provided a golden opportunity for politicians to boost their reputation by appearing to “do something” about the supposed problem. And, rather than taking the time to understand the real risks, the complexities of why people use the products, its trade-offs, or the unintended consequences of bans, the “do somethings” pushed for prohibition, with cities, states, and entire nations banning flavored e-cigarettes or vaping entirely.
Study: Vaping Looks Like a Gateway Out of—Not Into—Smoking, Filter Staff, Filter
In 2020, more than half (58 percent) of UK adult vapers are ex-smokers—a proportion that’s been trending upwards since 2014. Meanwhile the proportion of adult vapers who are also current smokers has been on the decline—this year hitting 38 percent, compared with 65 percent six years ago, according to a YouGov survey commissioned by Action on Smoking and Health, a UK-based organization aiming to end global harms of tobacco. Only 2 percent of the vapers were never-smokers.
Commenting on Flavor Bans: What Should You Discuss? Jim McDonald, Vaping 360
While doing research for my own comment on the proposed Michigan flavor ban, I decided to offer some general suggestions for others making comments on the Michigan ban—or any other flavor ban. This is not by any means all the topics you could write about; it’s just the outline I used for my comments. There are many other ways you might approach the issues.
Good News: Young Adults Sustain the High School Smoking Decline! Brad Rodu, Tobacco Truth
The prevalence of smoking in 2014 -- the first year that the NHIS collected vaping information -- was 16.6%; it had fallen by over one-half by 2019, to 7.7%. That was even better than the decline in smoking among high schoolers, which fell from 9.2% in 2014, to 5.7% in 2019 (in the chart below, for easy comparison).
SACCHARIN TRANSIT TIME IN EXCLUSIVE E-CIGARETTES AND HEATED TOBACCO PRODUCTS USERS: A CROSS-SECTIONAL STUDY, Riccardo Polosa, R. Emma, F. Cibella, et al., MedRxiv
Comparison of MCCTT values showed significant difference among the five study groups (p<.00001); current smokers had a median (IQR) MCCTT of 13.15 (9.89-16.08) mi n, which was significantly longer compared to that of never smokers at 7.24 (5.73-8.73) min, former smokers at 7.26 (6.18-9.17) min, exclusive EC users at 7.00 (6.38-9.00) min, and exclusive HTP users at 8.00 (6.00-8.00) min (Figure 1). Pairwise comparisons between each study group showed that significant differences occurred only when current smokers were compared to any other study group, whereas no significant differences were observed for any other between-group comparisons.
‘Blood in the water’: Why the next 12 months is critical for vaping regulation, Doug Hendrie, News GP
As the country grapples with the question of what to do about vaping, the opposing sides agree on only one thing: The year ahead will be crucial in shaping how vaping unfolds in Australia.
CrossTalk proposal: The benefits of e‐cigarettes outweigh the harms, Rachna Begh, Paul Aveyard, The Journal of Physiology
When Sweden joined the EU, snus, a nicotine‐containing oral tobacco pouch, was used commonly by men. The EU banned snus use everywhere but exempted Sweden. In Sweden, oral tobacco use prevalence is high (20%) but Sweden has the lowest rates of daily cigarette use in the EU (5% compared to the EU 24%) (The European Commission, 2017). Swedish men have the lowest rates of tobacco‐related mortality and lung cancer in Europe (Ramström & Wikmans, 2014), while snus use poses only a fraction of the risk of smoking (Gartner et al. 2007). This example highlights the danger of over‐regulation of harm‐reduction products, which appear to be able to break the tenacious hold that smoking has on many people and substantially reduce avoidable morbidity and mortality.
Differences in Exposure to Nicotine, Tobacco-Specific Nitrosamines, and Volatile Organic Compounds among Electronic Cigarette Users, Tobacco Smokers, and Dual Users from Three Countries, Danielle M. Smith, Lion Shahab, et al., MPD
Urinary levels of most toxicant biomarkers measured in this study did not differ significantly between e-cigarette-only users and non-users, except for a small number of VOCs and TSNAs. Our findings also showed that while being exposed to high nicotine levels, long-term exclusive e-cigarette users showed significantly lower levels of toxicant biomarkers compared with cigarette smokers or dual users. These results are consistent with a number of studies examining toxicant levels in e-cigarette users in contrast to conventional tobacco users [1,3,4,16,18,19,20]. In line with prior studies, our findings confirm that while not without some low level risk of exposure, exclusive e-cigarette use results in lower VOC and TSNA exposure compared with use of tobacco cigarettes and dual use.
Consumer group eyes filing graft charges against FDA, Manila Bulletin
The troubles for the Food and Drug Administration (FDA) which admitted receiving foreign grants from vested interest groups continue to pile up as stakeholders threaten to file graft charges against the beleaguered agency before the Ombudsman.
If there’s a scientific consensus on e-cigs, it may not be quite what you think, Aidan Semmens, Ecig Intelligence
To quote Hartmann-Boyce again: “While there are still unknowns regarding possible longer-term harms of e-cigarettes, experts generally agree that e-cigarettes are considerably less harmful than smoking, even though they are not completely risk free.” If there is a scientific consensus, that seems to sum it up pretty well.
This is according to a new review undertaken by Cochrane. However, findings from charity Action on Smoking and Health (ASH) reveal e-cigarette uptake fell in 2020 when compared to 2019. Data from its annual survey with Yougov found that in March 2020 there were 3.2 million e-cigarette users in Great Britain. This is down from 3.6 million in 2019. Additionally, almost all users are smokers or ex-smokers – with low use among those who have never smoked. As a result, the charity warns that ‘unfounded concerns’ regarding e-cigarettes are discouraging thousands of smokers from seeking effective help.
Vaping nicotine facing a crisis in Australia, Colin Mendelsohn, Nicotine Science and Policy
Under proposed customs changes, vapers will no longer be able to import nicotine liquid into Australia for personal use from 1 January 2021. A fine of $220,000 will apply for attempts to do so. Further regulatory changes will ensure nicotine liquid is classified strictly as a medicine.
COVID and Vaping: A Perfect Storm of Misleading Science and Media, Annie Kleykamp and Helen Redmond, Filter
Leading medical researchers have begun sounding the alarm on the “pandemic of bad science” threatening our understanding of COVID-19 and potentially putting people at risk (case in point: hydroxychloroquine). Inevitably, this bias and bad science has found its way into the debate on tobacco harm reduction by positing a tenuous link between vaping nicotine and COVID-19.
Major Anti-Vaping Scientific Study Retracted, Wesley J. Smith, National Review
Last year, the Journal of the American Heart Association published a study finding that vaping posed as great a heart risk as smoking itself. That study fueled public policies at all levels of government to stifle the industry. A lot of small business people had their livelihoods destroyed or damaged as a result.
Now, the study has been retracted — which is a very big deal in science — because the editors are “concerned that the study conclusion is unreliable” due to what appears to have been an uncompleted peer review process.
Cigarette sales in Nova Scotia increasing: Atlantic Convenience Stores Association, Matt Brand, Halifax Today
Flavoured vaping products were banned in Nova Scotia back on April 1st. But a recent survey shows more people may be going back to regular, combustible cigarettes. The poll by Abacus Data shows about 29 percent of the vaping population in Nova Scotia is at risk of switching to cigarettes. But according to Mike Hammoud, president of the Atlantic Convenience Stores Association, the switch from e-cigarettes to original cigarettes has already begun.
Australia's anti-vaping activists and bureaucrats working together to harass citizens and protect the cigarette trade, Clive Bates, The Counterfactual
I remember back when I was Director of Action on Smoking and Health in the UK (1997-2003), we used to glance across hemispheres and admire what they were doing on tobacco in Australia. Australia’s anti-smoking coalition was engaged in a feisty battle for genuine public health, defending the little guy from predatory tobacco companies. At that time, it was the David of the story taking on the giant. No longer. What a pitiful spectacle they make now. Now they are the predatory giants, harassing and bullying the little guy.
House suspends public consultations on vape, heated tobacco, Inquirer.net (Phillipines)
Two members of the House of Representatives recently moved to suspend public consultations on e-cigarettes and heated tobacco products after the Food and Drug Administration (FDA) admitted receiving funds from foreign anti-tobacco groups — namely, The Union and Bloomberg Initiative. The issue of a potential conflict of interest came out last Oct. 8 during a virtual public consultation on the proposed General Guidelines for the Regulation of Heated Tobacco Products, according to a statement issued by the lawmakers.
In a newly updated review published in the Cochrane Library, the team looked at three studies involving 1,498 people that compared e-cigarettes with nicotine replacement therapy, such as patches or gum. The results showed that more people gave up smoking if they used e-cigarettes containing nicotine than if they used another form of nicotine replacement. In a statement, the team said: “If six people in 100 quit by using nicotine replacement therapy, 10 people in 100 would quit by using electronic cigarettes containing nicotine.
“This means an additional four people in 100 could potentially quit smoking with nicotine-containing electronic cigarettes.”
Vapes more effective to quit smoking than gum or patch, review finds, Kate Kelland, Reuters
John Britton, a respiratory medicine professor at Nottingham University, said the review was “comprehensive” and gave “definitive confirmation that electronic cigarettes offer smokers an effective means of quitting”.
Amanda Wheeler Will Lead New Small Vape Trade Group, Jim McDonald, Vaping 360
A new vaping industry trade association launched Monday, with the goal of representing small businesses trying to navigate the FDA’s complex regulatory pathway for vaping products.
Stub out misinformation to save lives, Joseph Magero, The Star
One in every three Kenyan smokers has tried to quit. Yet, only a tiny fraction succeed. Just how do we help them kick this deadly habit? And how do we persuade other smokers that it is a good idea to follow suit? A sensible start would be to put an end to the well-intentioned but misguided “quit or die” approach to tobacco control.
Vape Taxes and Cannabis on State Ballots Nov. 3rd, Jim McDonald, Vaping 360
Voters on Nov. 3 will be choosing the U.S. President and Vice President, 35 U.S. Senators, all 435 U.S. House of Representatives members, and 11 state governors—along with thousands of state and local office holders. They’ll also be deciding a huge number of state and local ballot issues, including some that affect vapers.
E-cigarette use among young people has fallen for the first time in Wales, according to research by Cardiff University. But the decline in 11 to 16-year-olds smoking has stalled, the study found. The 2019 Student Health and Wellbeing Survey asked more than 100,000 pupils from 198 secondary schools across Wales about their smoking habits. The findings show 22% of young people had tried an e-cigarette, down from 25% in 2017. Those vaping weekly or more often had also declined from 3.3% to 2.5% over the same period.
Reported patterns of vaping to support long-term abstinence from smoking: a cross-sectional survey of a convenience sample of vapers, Sarah Victoria Gentry, Emma Ward, et al., BMC Harm Reduction Journal
E-cigarettes are the most popular aid to smoking cessation attempts in England and the USA. This research examined associations between e-cigarette device characteristics and patterns of use, tobacco-smoking relapse, and smoking abstinence.
Youth Vaping Declines, But the CDC Clings to Its “Epidemic” Narrative, Michael McGrady, Filter Mag
David Sweanor, professor of law and chair of the Advisory Board of the Centre for Health Law, Policy and Ethics at the University of Ottawa, Canada, believes the CDC has misbehaved. “The CDC has become politicized in recent years, due to pressure from the administration but also by choice of CDC officials who have prioritized personal moralistic views in place of objectivity,” he told Filter.
Yale Study on Lung Disease Forecasts Dire Consequences for Flavor Bans, Elizabeth Sheld, Real Clear Policy
A new study from Yale School of Public Health should serve as a warning to e-cigarette opponents and public health officials pushing e-cigarette flavor bans and restrictions around the country.
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