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HOW TO REPORT A SMOKING OFFENSE IN HONG KONG

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The Quest for Pharmacotherapies to Treat Tobacco Use Disorder

More than Smoke and Patches: The Quest for Pharmacotherapies to Treat Tobacco Use Disorder

http://pharmrev.aspetjournals.org/content/72/2/527.long

Abstract

Tobacco use is a persistent public health issue. It kills up to half its users and is the cause of nearly 90% of all lung cancers. The main psychoactive component of tobacco is nicotine, primarily responsible for its abuse-related effects. Accordingly, most pharmacotherapies for smoking cessation target nicotinic acetylcholine receptors (nAChRs), nicotine’s major site of action in the brain. The goal of the current review is twofold: first, to provide a brief overview of the most commonly used behavioral procedures for evaluating smoking cessation pharmacotherapies and an introduction to pharmacokinetic and pharmacodynamic properties of nicotine important for consideration in the development of new pharmacotherapies; and second, to discuss current and potential future pharmacological interventions aimed at decreasing tobacco use. Attention will focus on the potential for allosteric modulators of nAChRs to offer an improvement over currently approved pharmacotherapies. Additionally, given increasing public concern for the potential health consequences of using electronic nicotine delivery systems, which allow users to inhale aerosolized solutions as an alternative to smoking tobacco, an effort will be made throughout this review to address the implications of this relatively new form of nicotine delivery, specifically as it relates to smoking cessation.

Significance Statement Despite decades of research that have vastly improved our understanding of nicotine and its effects on the body, only a handful of pharmacotherapies have been successfully developed for use in smoking cessation. Thus, investigation of alternative pharmacological strategies for treating tobacco use disorder remains active; allosteric modulators of nicotinic acetylcholine receptors represent one class of compounds currently under development for this purpose.

Retail Outlets and Point-of-Sale Marketing of Alternative Tobacco

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Third of NZ students have tried vaping, despite most being non-smokers

http://www.voxy.co.nz/health/5/361613

New research shows that more than a third of New Zealand high school students have tried vaping even though nearly two-thirds of those doing so have never smoked cigarettes.

Vapes, or electronic cigarettes, are not recommended for non-smokers, as the long-term effects are not known, and vapes containing nicotine are likely to be addictive.

“Vaping is not as harmful as smoking, but it is not harmless. Taking up vaping is not a good idea for people who are not otherwise smokers, particularly young people,” says study co-author Dr Terry Fleming from Te Herenga Waka-Victoria University of Wellington’s School of Health.

The study is the first in New Zealand to look at vaping in high school students of all ages. It found 65 percent of teenagers who had tried vaping reported they had never smoked cigarettes, as well as 48 percent of those who said they vaped regularly. Overall, 38 percent of teenagers reported they had tried vaping, 10 percent said they vaped regularly, and 6 percent vaped weekly or more often.

The research also shows vaping is relatively common for students in all school deciles, whereas smoking is now rare in higher decile schools.

“Vaping seems to appeal to a wider range of young people than smoking and unlike smoking it is more common in boys than girls,” says Dr Fleming.

Recently published data from another New Zealand study shows the long-term decline in smoking among Year 10 students that began in 2000 stalled from about 2015 and may even be reversing, particularly in MÄori and low decile schools.

“When you put these findings together, it calls into question the idea that vaping is displacing smoking. The alternative possibility, that vaping is fuelling smoking, must be taken seriously by communities and policymakers,” says study co-author Associate Professor Terryann Clark from the University of Auckland.

Researchers say measures to protect youth, particularly MÄori and disadvantaged youth, from both vaping and smoking harm are needed, such as limits on where vapes and tobacco can be sold and a ban on vaping advertising and sponsorship, including online and social media promotion.

The research is timely, as the Government is currently consulting on new vaping regulations announced earlier in the month.

“New Zealand has fewer restrictions on promoting vaping and on vape flavours than many other countries. Supporting smokers to step down to vaping and non-smokers to stay that way are both important-this is possible with good policy and leadership,” says Dr Fleming.

The research is part of the Youth19 survey, which aims to collect data on a range of issues affecting New Zealand youth. Further results from the survey will be available over the coming year. This survey is a collaboration between Te Herenga Waka-Victoria University of Wellington, the University of Auckland, the University of Otago, and AUT.

Analyzing big tobacco’s global youth marketing strategies

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Big Tobacco criticised for ‘coronavirus publicity stunt’ after donating ventilators

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Raise Hong Kong tobacco tax to protect youth against lifelong addiction

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Vaping Could Compound Health Risks Tied to Virus, FDA Says

https://www.bloomberg.com/news/articles/2020-03-27/vaping-could-increase-health-risks-tied-to-covid-19-fda-says?sref=vEQJzSks

Vaping Could Compound Health Risks Tied to Virus, FDA Says

By

Anna Edney

and

Angelica LaVito

March 28, 2020, 4:28 AM GMT+8 Updated on March 28, 2020, 7:19 AM GMT+8

  • Heart, lung problems increase risk of Covid-19 complications
  • FDA says in email that e-cigarette use can damage lung cells

Vaping may leave users with underlying health conditions at higher risk of serious complications if they contract the respiratory disease caused by the novel coronavirus, the Food and Drug Administration said.

“People with underlying health issues, such as heart or lung problems, may have increased risk for serious complications from Covid-19,” Michael Felberbaum, an FDA spokesman, said in an email Friday in response to questions from Bloomberg. “This includes people who smoke and/or vape tobacco or nicotine-containing products.”

“E-cigarettes can damage lung cells,” Felberbaum said.

Some health experts have speculated that vaping is causing younger patients in the U.S. to be hospitalized with Covid-19 at a higher rate than anticipated. Felberbaum declined to comment on whether the FDA was investigating a possible connection.

Earlier this week, Nora Volkow, director of the National Institute on Drug Abuse, wrote a blog post warning that the coronavirus “could be an especially serious threat to those who smoke tobacco or marijuana or who vape.”E-cigarettes have been touted by some as less risky than smoking. But any increased harm associated with Covid-19, and the FDA’s direct language linking the products to lung damage, could boost detractors who have raised questions about the potential that vaping can lead to health problems.

Last year, some vapers began coming down with a mysterious and sometimes deadly lung illness. Those cases have been linked to products containing THC, the active ingredient in marijuana.

The FDA under President Donald Trump originally took a largely hands-off approach to regulating e-cigarettes, but began to change course in 2018 to stem an epidemic of youth use. After multiple delays, e-cigarette makers have until May to apply to the FDA for clearance to continue marketing their products. None have received FDA approval to market themselves as less risky than smoking.

STOP the virus spread – BAN VAPING – BAN ENDs

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ENDs products no safer than cigarettes- generate dual users – designed to keep youth and adults addicted to nicotine

Dear Panel members,

the enhanced addictiveness of RECON used exclusively in iQos HEETS

iQos Heets use cast leaf technology aka RECON (reconstituted tobacco)

The veins, stalks and stems, leaf dust (named OFFAL) from the cigarette production process are mixed with chemicals in a slurry to create a Recon sheet.

https://startobacco.biz/reconstituted-tobacco/

The manufacturer can fine tune the addictiveness of the RECON product and using a smaller amount of RECON.

http://www.jeffreywigand.com/theinsider.php

see The Insider Dr Wigand’s expert report under –‘Testimonies’ – ‘Dr Wigand’s WHO Expert Report’

Search the report for ‘Recon’

The Report is eye opening and informatory.

For your ease of reference I attach some sections on RECON from the WHO Expert report:

Quote:

“The use of RECON is the one of the principal methods of introducing acid base ammonia  chemistry and other additives into the USB non-menthol cigarette blend. RECON can be  considered a chemical-additive delivery system in addition to the casing process of tobacco.  Ammonia chemistry is utilized for several reasons; 1) to scavenge nicotine from each blend  component; 2) to equalize the concentration of nicotine in the tobacco column rod; and 3) to modify pH such that nicotine becomes a free base.

Free nicotine, which is controlled by smoke pH, is a more potent form of nicotine that is in the gas phase rather than bound nicotine that is in  the particulate phase.  The extensive use of ammonia chemistry in RECON converts the salt  linked or protonated nicotine into “free” nicotine that has a higher potency than its salt/protonated form.  Free nicotine it is not detected by the smoking machine analysis of tar and  nicotine since it is in the gaseous state not in the particulate state of matter.

The primary importance of RECON is neither the utilization of manufacturing waste nor  the enhancement of economy of manufacture.  Rather, RECON is important because it  introduces a significant amount of additives into the cigarette blend. These additives accomplish  two distinct purposes: 1) they increase the addictive capacity of the cigarette and 2) they facilitate the ease of smoking by ameliorating the effects of inhaling smoke.

 RECON tobacco comprises about 20-30% of a USB cigarette’s blend formulation on a  w/w basis.  It is a chemically manipulated material using abundant additives, such as glycerol, licorice, cocoa, honey, polyethyleneglycol (PEG), simple sugars, invert sugars and ammonia based additives such as ammonium hydroxide, urea and diammonium hydrogen phosphate  (DAP). The ammonia based additives in RECON play a key role in the manipulation of nicotine.

The finished product is a highly energized chemical matrix which forms the basis of many of the  chemical reactions occurring in the tobacco rod column, such as nicotine scavenging, generation of free nicotine, smoke pH manipulation, and formation of some flavor reaction products.

  1. Raw material components and composition of RECON

RECON is produced utilizing by numerous by-products of the cigarette manufacturing process.  There are three (3) distinct RECON types; Paper I, Paper II and band cast. The raw material used to make RECON contains the following components:

1) Offal or the tobacco dust generated in either the Green Leaf Trashing (GLT) plant or in the Primary manufacturing process.  The GLT Plant strips and removes the veins of the tobacco leaf into large strips of lamina and produces a by-product called stems.  Stems can be utilized either as a cigarette blend component or as one of the sources of raw material for RECON.

 

2) The primary portion of the manufacturing plant produces the fines and winnowers when tobacco, a moisture sensitive biomaterial is moved rapidly through the

manufacturing process, either pneumatically or via high-speed conveyor belts. This aspect of the manufacturing process causes dehydration and brittleness of the tobacco material, and therewith the formation of tobacco fines and dust (offal).

3) Stems produced at the GLT Plant

4) Tobacco fines or winnowers

5) Product Reclaim.  Finished product that is collected from the distribution channel is returned to the manufacturing plant for reprocessing.  This includes the finished goods that, due to moisture content loss, are deemed unsuitable for smoking due to increased irritation, harshness and the fact that they pose a fire hazard.

 6) Unique tobacco cultivars are used either to augment nicotine content or to augment or enhance flavor attributes of the final RECON product.

 7) Cellulosic material from wood pulp added for fiber content

 3. Band cast reconstituted tobacco (Dark RECON)

Band cast uses the same starting raw materials but differs fundamentally from the paper  making RECON process. Unlike the paper process, band cast is made by adding the stock raw  tobacco materials (see list above) and prescribed chemical additives into one reaction vessel. 

The tobacco material is then pulverized with the additives forming a thermally and chemically reacted slurry mixture.  The sheet is made by pouring the slurry into a “doctor blade” which  regulates the amount of slurry that is applied to a moving S/S non-perforated belt.  The basis weight can be controlled at this point.

The slurry mixture then goes through three separate heating zones where the water content is reduced forming a solid sheet.  This solid sheet is then cut into irregular pieces and boxed in a similar manner to the paper RECON.”

 

See also

https://www.who.int/news-room/q-a-detail/q-a-on-smoking-and-covid-19

Kind regards,

James Middleton

Chairman

Clear the Air NGO

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South Korean court delivers latest blow to e-cigarette makers

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