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Health Risks

Studying the interactive effects of menthol and nicotine among youth

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Australia Classifies E-Cigarettes as Dangerous

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Vaping – E-Cigs Have Their Own Set Of Risks, Says Vascular Surgeon

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Towards a smoke-free world? Philip Morris International’s new Foundation is not credible

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Tobacco control: a Foundation too far?

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Commentary on the launch of the Foundation for a Smoke-Free World

September 2017 saw the launch of the Foundation for a Smoke-Free World, which describes itself as “an independent, non-profit organization created to accelerate global efforts to reduce health impacts and deaths from smoking, with the goal of ultimately eliminating smoking worldwide”.

http://blogs.bmj.com/tc/2017/10/13/commentary-on-the-launch-of-the-foundation-for-a-smoke-free-world/

The creation of such an organization would usually be a matter for celebration among the tobacco control community and especially for the WHO Framework Convention on Tobacco Control (WHO FCTC), the United Nations tobacco control treaty, whose Secretariat I lead.

And yet this is not good news. The Foundation is currently 100% funded by Philip Morris International (PMI). The company has already pledged around US$1 billion for the period of 12 years or around US$80 million a year. To put that in context, this is more than eight times greater than the entire WHO FCTC annual budget.

The Foundation claims that its funding source doesn’t matter, since its bylaws prohibit tobacco industry interference, and safeguard against conflicts of interest, thereby guaranteeing its independence. We are asked to believe that this industry-funded organization will simply ignore the commercial interests of its paymaster. We are asked to believe this where the organization is established to work on specific issues of interest to PMI, where that work may promote other products that contain nicotine and have the ability to sustain addiction, and where the paymaster can decide not to continue funding the organization from one year to another. How can masters of this Foundation that claim to be independent be unaware of PMI’s lobbying strategies, and ensure that their Foundation is not inadvertently supporting bad public health policy?

The establishment of the Foundation ties into a broader PMI strategy to ensure that there is little or no regulation on new tobacco products PMI is producing. It also fits into the tobacco industry’s corporate social responsibility schemes. Such projects are designed to mislead or confuse public opinion. They are the anti-truth.

How do we know? Reams of research and legal documents on tobacco industry behaviour confirm that the Foundation’s public statements fit seamlessly into the tobacco industry’s strategy, which is to sell new products while continuing to sell cigarettes. Over decades, tobacco industry dollars have funded influence buying, covert activities and scientific misrepresentation. Industry money has never advanced the cause of public health, as is made clear in excruciating detail by the millions of tobacco industry documents. These reveal, for example, that firms have “sought to influence debate by buying up scientists on a spectacular scale.”

PMI recently rejected an appeal from 120 Organisations asking it to halt the production of cigarettes. To make it plain, if the company were serious about making the world smoke-free they should immediately stop fighting, in several countries, tobacco control measures to implement the Framework Convention.

This Foundation fits within a broader strategy of PMI attempting to present itself as a “stakeholder” in tobacco control. Some examples of these initiatives include PMI Impact,which claims to counter the illicit trade in tobacco products but in fact serves to slow and disrupt the entry into force of the Protocol to Eliminate Illicit Trade in Tobacco Products. Another tobacco industry initiative, which PMI co-funds, is the Eliminating Child Labour in Tobacco Growing Foundation (ECLT). With little impact on reducing child labour on tobacco in low and middle income countries, this Foundation detracts from implementation of Article 17 of the WHO FCTC, which calls upon governments to support tobacco workers and growers to switch to alternative sustainable livelihoods.

Taken as a whole, the tobacco industry’s corporate social responsibility programmes are an abomination, which seek to give the impression of action on important issues, while boosting its own profits and hiding its own role in creating problems.

Parties to the WHO FCTC have pledged, through Article 5.3 of the treaty, to resist tobacco industry interference. In a 2016 ruling against the tobacco industry, a senior English judge accurately summarised this key Article and its Guidelines : “[T]he tobacco industry should be treated as having adopted a deliberate policy of subverting public health policy through, inter alia, the deployment of its substantial capital and organisational resources to generate evidence designed to contradict the established policy consensus… that this evidence is unreliable, i.e. false.”

WHO FCTC Parties should therefore adopt legislation or rules to implement Article 5.3 and ensure they do not promote, participate in or endorse tobacco industry involvement, directly or through these “foundations”, in initiatives related to tobacco control. No government and no reputable academic, research or public health organisation should partner with PMI’s new foundation.

It is already clear that this tobacco industry-funded Foundation fits a long-established and sinister pattern of corporate chicanery. The industry’s aim, after all, is not to help its customers but to profit from them.

The tobacco industry’s new “partnerships” with supposedly independent organizations do constitute a serious threat, but we have a response to hand.

It’s called the WHO FCTC, and it’s the true foundation for a smoke-free world.

Dr Da Costa e Silva is the Head of the WHO FCTC Secretariat.

Scientist explains how nicotine in just one e-cigarette can cause changes to the heart

Electronic cigarettes have become popular over the last couple of years as devices that help smokers quit smoking. Also called e-cigarettes, vapourisers or simply vapes, the nifty gadgets do not contain tobacco, which is known to release several carcinogenic compounds upon combustion. However, e-cigarettes do contain nicotine, which, several doctors and public health specialists fear is equally detrimental to health.

https://scroll.in/pulse/852074/video-scientist-explains-how-nicotine-in-just-one-e-cigarette-can-cause-changes-to-the-heart

Many such experts wants e-cigarettes banned or strictly regulated because they fear the devices could draw teenagers and non-smokers into smoking.

In fact, a new study from the University of California, Los Angeles has found that nicotine in e-cigarettes can produce significant physiological changes. They showed that healthy non-smokers experienced elevated adrenaline levels after using just one e-cigarette.

The researchers had previously shown that chronic e-cigarette users have increased sympathetic nerve activity, which increases adrenaline directed to the heart and are more susceptible to oxidative stress. These are risks factors for heart attack.

The new study published in the Journal of the American Heart Association aimed to find out whether these cardiac risk factors were caused by nicotine or something else associated with e-cigarette use.

Here Dr Holly R Middlekauff, senior study author and professor of cardiology and physiology at the David Geffen School of Medicine at UCLA, explains why even though e-cigarettes may help smokers quit tobacco, they can be harmful if used for prolonged periods of time.

E-Cigarettes Increase Vital Signs and Arterial Stiffness

By HospiMedica International staff writers

https://www.hospimedica.com/critical-care/articles/294770869/e-cigarettes-increase-vital-signs-and-arterial-stiffness.html

Significant increases in blood pressure (BP), heart rate, and arterial stiffness are seen in the first 30 minutes after smoking electronic-cigarettes containing nicotine, according to a new study.

Researchers at the Karolinska Institutet (KI; Solna, Sweden) recruited 15 young, healthy volunteers (average age 26, 59% female) who were seldom smokers–smoking a maximum of ten cigarettes a month–and who had not used e-cigarettes before the study. Study participants were randomized to use e-cigarettes with nicotine for 30 minutes on one of the study days, and e-cigarettes without nicotine on the other day. The researchers measured BP, heart rate, and arterial stiffness immediately after smoking the e-cigarettes, and then two and four hours later.

The results showed that in the first 30 minutes after smoking e-cigarettes containing nicotine, there was a significant increase in BP, heart rate, and arterial stiffness; no such effect was seen on heart rate and arterial stiffness in the volunteers who had smoked e-cigarettes without nicotine. Importantly, arterial stiffness increased around three-fold in those who were exposed to nicotine containing e-cigarettes. The study was presented at the European Respiratory Society International Congress, held during September 2017 in Milan (Italy).

“The immediate increase in arterial stiffness that we saw is most likely attributed to nicotine; the increase was temporary. However, the same temporary effects on arterial stiffness have also been demonstrated following use of conventional cigarettes,” said senior author and study presenter Magnus Lundbäck, MD, PhD. “Therefore, we speculate that chronic exposure to e-cigarettes with nicotine may cause permanent effects on arterial stiffness in the long term.”

“The marketing campaigns of the e-cigarette industry target current cigarette smokers and offer a product for smoking cessation. However, several studies question the e-cigarette as a means of smoking cessation, and there is a high risk of double use, where people use both e-cigarettes and conventional cigarettes,” concluded Dr. Lundbäck. “Furthermore, the e-cigarette industry also targets non-smokers with designs and flavors that appeal to a large crowd, even the very young, and that carry the risk of a lifelong nicotine addiction.”

Electronic cigarettes consist of a cartridge containing a liquid with a nicotine concentration of 11mg/ml and a battery powered heating element that evaporates the liquid, simulating the effect of smoking by producing an inhaled vapor that is less toxic than that of regular cigarettes. They were first developed by Herbert Gilbert in 1963, but the dawn of the modern e-cigarette is attributed to Chinese pharmacist Hon Lik, who introduced them as a smoking cessation device in 2004.

Nicotine is still nicotine, no matter the delivery system, and it’s still bad for you

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Nicotine is still nicotine, no matter the delivery system, and it’s still bad for you

House Call: Nicotine is still nicotine, no matter the delivery system, and it’s still bad for you

http://www.spokesman.com/stories/2017/sep/25/house-call-nicotine-is-still-nicotine-no-matter-th/

E-cigarettes have been available in the United States for just more than 10 years now. In that time, they have really taken off and are becoming increasingly popular. They are frequently marketed as a safe alternative to smoking and other tobacco products, and sometimes as a tool to help you stop smoking all together. I’d like to have a look at these claims and other issues surrounding vaping.

Because e-cigarettes are so new, we don’t have solid information about their long-term health effects, but we can make educated predictions from what we know about lung damage from other types of chemical exposure. E-cigarettes may reduce your exposure to the harmful chemicals connected to smoking tobacco, but they are exposing you to other harmful chemicals. These are connected to the breakdown of the chemicals (nicotine, propylene glycol, glycerin, and flavoring compounds) during heating. The vapor from e-cigarettes goes deep into the lungs and contains a soup of toxic compounds from the heating of the fluid to 450 degrees F or higher, breaking down and allowing the recombination of the component chemicals into an enormous variety of chemicals. These compounds are much more likely than not to damage the lungs, even in nicotine-free vaping.

As a tool to help a person stop smoking, e-cigarettes produce mixed results. There are a few reports of people successfully quitting the habit using e-cigarettes, but there are far more cases where people simply end up using them to replace tobacco use in situations where they cannot smoke. Sometimes people even end up consuming more nicotine per day than they were before they started using e-cigarettes. Another issue with e-cigarettes that I was surprised to learn about was injury due to battery faults. Every year, there are people who are injured by exploding e-cigarette batteries.

A big problem I’ve seen with e-cigarettes has to do with young people. Many of the flavors offered are enticing to young people and research has shown that young people who vape are five times more likely to try smoking cigarettes than those who do not vape.

With the invention of nicotine delivery systems such as e-cigarettes, more research is being done on the effects of nicotine exposure that does not involve tobacco. The news is not good. In 2015, a group of scientists reviewed 90 articles reporting on the effects of nicotine that excluded exposure through smoking. Even without exposure to the tar and other chemicals from tobacco smoke, exposure to nicotine is harmful to your body. That said, there is debate in the public health community about e-cigs. In England, they are being recommended alongside nicotine patches, gum, etc., as an aid for quitting smoking. While I am not ready to recommend them, I agree that it is hard to believe that they are worse than burning compost and sucking the smoke into your lungs. Cough. Gag.

As I have written in previous columns, nicotine damages your cardiovascular system and puts you at increased risk of strokes, heart attacks and arterial disease. Nicotine makes wounds heal more slowly, so if you are injured or have to have surgery, your recovery time will be longer than it ought to be. Nicotine in any form increases the risk of getting cancer.

My advice is if you don’t vape, don’t start. If you smoke cigarettes and want to stop, don’t use e-cigarettes as a way to wean yourself off of nicotine. Talk with your doctor about trying one of several proven methods of smoking cessation and give one a try.

Dr. Bob Riggs is a family medicine physician practicing at Kaiser Permanente’s Riverfront Medical Center. His column appears biweekly in The Spokesman-Review.