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Heat-Not-Burn Tobacco Cigarettes: Smoke by Any Other Name

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Revealed: Electronic cigarettes could damage sperm

Electronic cigarettes could damage men’s fertility through toxic chemicals in the flavourings, a study suggests.

Cinnamon-flavoured e-cigarettes in particular make sperm slower swimmers, according to the latest research to raise health concerns about the fashionable devices.

Bubblegum flavouring, another of the most popular, kills off cells in the testes which help to produce sperm, scientists found.

It is well known that cigarettes can damage men’s fertility through DNA damage to the sperm – while e-cigarettes are promoted as a healthier alternative to smoking.

But researchers at University College London found e-cigarette flavourings could affect men’s chances of starting a family, even when no nicotine is included.

It follows research that these flavourings, which are taken into the lungs within vapour from the aerosol, contain cancer-causing chemicals including formaldehyde.

And it comes as scientists at the University of Salford – who found e-cigarette flavourings such as butterscotch and menthol risk lung damage by killing off bronchial cells – call for better safety checks.

The danger to sperm is believed to come from chemicals in the flavourings such as coumarin, which is a cheaper version of cinnamon bark and commonly found in flavourings sold in the UK and made in China.

Lead author Dr Helen O’Neill, who presented the findings to the British Fertility Conference in Edinburgh yesterday, said the results were “shocking”.

“In terms of motility, progression and concentration of sperm, there was a detrimental effect,” she said. “E-cigarettes are promoted as the health alternative to smoking, the healthy thing to do.

“Vaping is less harmful than conventional cigarettes, but nonetheless they are not without their harmful effects.”

There are 7,000 different flavours of electronic cigarettes, but those tested were the two most popular – cinnamon and bubblegum – and ‘plain’ devices just containing propylene glycol, a tasteless liquid used in the production of the vapour. Sperm samples were taken from 30 men, tested with concentrations of the flavours similar to the average intake for casual and more habitual e-cigarette users.

Researchers found sperm exposed to the highest concentration of flavourings moved significantly more slowly, while their swimming speed was affected. The biggest impact came from the cinnamon flavour.

The men, who were undergoing IVF but had healthy sperm, were not able to use the devices directly, but the flavourings were inserted directly into the sperm in the concentrations they would be exposed to. No nicotine was included. A second experiment looked at how mice reacted to being exposed to the flavourings – it found cells in the testes were killed off by the chemicals in them.

Bubblegum had the worst effect, with the highest number of dying cells in the testes tissue.

Dr O’Neill said these chemicals may harm men’s fertility through the toxins they produce when heated in e-cigarettes.

Many flavourings are only regulated as foodstuffs, based on being consumed rather than inhaled.

Dr O’Neill said: “There is very little regulation before they are allowed onto the market.”

When the tax stamp covers the health warning label: conflicting ‘best practices’ for tobacco control policy

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E-cigarette use as a predictor of cigarette smoking

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Just ONE puff of flavoured e-cigarette vapour ‘contains dangerous levels of cancer-causing chemicals’

Flavoured liquids used in the devices exposes smokers to “unacceptably high” levels of aldehydes, produced when a compound decomposes

JUST one drag of a flavoured e-cigarette exposes a smoker to “unacceptably high” levels of cancer-causing chemicals, experts warned today.

They found aerosols – commonly called vapours – produced by the devices contain the dangerous substances.

These toxic aldehydes, including formaldehyde, are produced during the chemical breakdown of the flavoured e-liquid during the rapid heating process that happens inside e-cigs.

Dr Andrey Khylstov, of the Desert Research Institute, Las Vegas, said: “One puff of any of the flavoured e-liquids that we tested exposes the smoker to unacceptably dangerous levels of these aldehydes, most of which originates from thermal decomposition of the flavouring compounds.”

His team found the production of toxic aldehydes “is exponentially dependent on the concentration of flavouring compounds”.

E-cigarette liquids are marketed in nearly 8,000 different flavours, according to a 2014 report by the World Health Organisation.

Recent reports show many of these flavours, such as Gummy Bear, Tutti Fruity, and Bubble Gum, to name a few, are especially appealing to teens and kids – encouraging them to use the devices.

Around 2.8million adults use the devices in the UK and a 2014 study revealed more kids aged 11 to 15 experimented with e-cigs than traditional cigarettes.

In the US, 16 per cent of high school students regularly vape – making them the most commonly used tobacco product in teenagers.

To examine the dangers, Dr Khylstov and his team measured the levels of aldehydes in vapour produced by three common e-cigs.

To determine if flavourings were to blame for producing the cancer-causing chemicals, the researchers tested five flavoured liquids, as well as two control unflavoured liquids.

Researcher Dr Vera Samburov explained: “To determine the specific role of the flavouring compounds we fixed all important parameters that could affect aldehyde production and varied only the type and concentration of flavours.”

She said the devices used in the experiments were three of the most common types of e-cig.

Using a controlled system, the researchers were able to ensure the same level of “puff” each time, simulating common vaping conditions.

All tests revealed the level of cancer-causing chemicals produced by flavoured e-liquids exceeded limits set by American authorities, designed to protect against hazardous chemical exposure.

Dr Khylstov added: “These results demonstrate the need for further, thorough investigations of the effects of flavouring additives on the formation of aldehydes and other toxic compounds in e-cigarette vapours.”

The findings are published in the journal Environmental Science and Technology.

Association of e-Cigarette Vaping and Progression to Heavier Patterns of Cigarette Smoking

E-cigarette vaping is reported by 37% of US 10th-grade adolescents1 and is associated with subsequent initiation of combustible cigarette smoking.2 Whether individuals who vape and transition to combustible cigarettes are experimenting or progress to more frequent and heavy smoking is unknown. In addition, because some adolescents use e-cigarettes as a smoking cessation aid,3 adolescent smokers who vape could be more likely to reduce their smoking levels over time. Therefore, associations of vaping with subsequent smoking frequency and heaviness pattern among adolescents were examined.

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Tobacco packaging and labelling policies in countries of the Eastern Mediterranean and Western Pacific Regions

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E-cigarettes as a source of toxic and potentially carcinogenic metals

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Livestream of brain could help smokers quit

Real-time data from smokers’ brains could help them re-programme their minds and stub out cigarettes for good.

It’s one of the options being explored by researchers who are looking into the most successful ways to quit.

Neurofeedback is a brain-training technique that uses electrodes placed on a person’s head to create a live feed of their brainwaves. This information is displayed in front of the person who can then visibly reshape their thoughts.

The Issue

Smoking causes an estimated 650 000 EU citizens to die prematurely each year, but it is also the largest cause of preventable morbidity worldwide.

In 2009 the Council of the European Union called upon all Member States to protect their citizens from tobacco smoke by enhancing smoke-free laws such as encouraging efforts to quit and putting warnings on tobacco packages.

A European Commission follow-up report in 2013 found 17 EU countries have comprehensive smoke-free laws in place.

‘It allows them to control what they see,’ said Professor Panagiotis D. Bamidis from the Aristotle University of Thessaloniki in Greece, who is testing the effectiveness of the technique to help smokers give up.

‘Subjects are asked if they can do specific tasks and their reactions provide a feedback loop that lets them train their own brain.’

The ability of neurofeedback to identify negative thought processes has been used to treat mental illness and memory problems, but this is the first research looking into whether it is an effective technique for breaking an addiction.

‘With neurofeedback we can see what type of brain signals smokers are emitting when they are relaxed, then we ask them to follow specific tasks and record their reactions,’ said Prof. Bamidis.

When the subject encounters something that may trigger an urge to smoke, they will learn what the cause was and what thoughts could help them overcome the craving.

Prof. Bamidis says that smokers would need around twenty hours of treatment before feeling the effects from neurofeedback, but considering it’s a natural, drug-free treatment it could lead to high numbers of smokers willing to give it a try.

‘It’s a non-invasive, pain-free technique with no side effects so it has a lot of promise to change (smokers’) behaviour,’ he said.

Neurofeedback is just one of the quitting techniques being studied by Prof. Bamidis as part of the EU-funded SmokeFreeBrain project, to evaluate the best ways to stop smoking.

Another technique under examination is SoLoMo, which stands for social-local-mobile and focuses on using physical locations to send tailored information to a mobile device.

‘We are going to use social media techniques translated for local populations and ask them to follow healthy lifestyles with reminders and mini-games,’ said Prof. Bamidis.

SmokeFreeBrain will also assess the effectiveness of e-cigarettes, communication campaigns and more classic approaches like nicotine patches. At the end of the project in 2018, the researchers hope to have a guide outlining the best practices in smoking cessation and how these can be applied on a large scale.

‘We will figure out which approach is the most effective and economic,’ said Prof. Bamidis.

‘Our research will then help form tobacco policy at national and international levels.’

While these techniques and policies will help, any smoker knows that quitting is easier said than done. That leaves us with the bigger question – how do we motivate people to stop people smoking in the first place?

Over the last fifty years the number of smokers in Europe has been declining, but more than 20 % of the adult population still smoke.

‘Policies to ban smoking in public places and general social norms have changed and we see smoking rates have declined, but it has been quite slow,’ said Professor Anton Kunst from the University of Amsterdam, the Netherlands. ‘If it continues at this speed, smoking will persist for many decades to come.’

Ability to quit

In recent years smoking has become concentrated in lower socio-economic areas where the ability to quit is harder due to financial and employment circumstances and the subsequent emotional stress. This in turn creates a spiral where following generations are regularly exposed to those who smoke.

‘Among people in lower socio-economic circles, smoking is much more common and that could be related to factors like more emotional problems and being exposed to smoking amongst friends and parents,’ said Prof. Kunst.

Prof. Kunst is the coordinator of the EU-funded SILNE-R project which is examining how antismoking policies in seven European cities affect the smoking behaviour of 16-year-olds.

Through comparison, the project aims to use the data gathered to create better prevention programs.

‘Different countries and municipalities have different tobacco policies,’ said Prof. Kunst. ‘We want to understand why some policies are able to influence young people and why others are not.’

They have already looked at smoke-free policies in schools, which have revealed findings into youth smoking behaviour.

‘If you ban smoking from school premises it changes the way young people look at smoking and raises awareness of the health hazards,’ said Prof. Kunst.

But while these anti-smoking rules can protect some it could make matters worse for others.

‘Such policies may create peer groups that go out of school to smoke which reinforces the habit and attracts others to start smoking who just wanted to be part of the group,’ said Prof. Kunst.

Possible solutions are to ban smoking in places around schools or to discourage kids from leaving by offering more appealing activities like sports or hobby clubs.

At the end of the project in 2018, SILNE-R hopes to present policy makers with concrete suggestions on how to make anti-smoking policies more effective for young people. In the meantime, Prof. Kunst warns any young smoker not to overestimate their willpower.

‘Young people don’t see how addictive smoking can be and are very confident they will stop later in life,’ said Prof. Kunst. ‘They must be told that there is no silver bullet to quit, that they would need to try hard to stop and find help where they can.’

Introduction of plain packaging and new, enlarged graphic health warnings in the Australian state of Victoria

Change in public support for the introduction of plain packaging and new, enlarged graphic health warnings in the Australian state of Victoria, 2011–2013


Since December 2012, all Australian tobacco products have been supplied in packaging that is a standardised drab brown colour with uniform fonts. The implementation of plain packaging coincided with the introduction of refreshed graphic health warnings (GHWs) that increased in size from 30% to 75% of the pack face, with coverage of the pack rear maintained at 90%.1

A slight rise in opposition to plain packaging among Australian smokers was reported immediately prior to implementation, followed by a significant increase in support, from 28% preimplementation (late 2011 to early 2012) to 49% postimplementation (early 2013).2 No data on the views of former or never smokers have previously been published.