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Plain packaging effective in reducing misperceptions of tobacco products among Australian Indigenous

Dec 29th, 2015
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http://www.eurekalert.org/pub_releases/2015-12/smh-ppe122115.php

Following the introduction of plain packaging on tobacco products in 2012, Australian Aboriginal and Torres Strait Islander people were 12 per cent less likely to think certain tobacco brands were less harmful than others, a new study found.

Plain packaging means tobacco company colours, logos and design elements are not allowed on tobacco products, but government health warnings still appear. Australia was the first country to implement plain packaging in December 2012 in an effort to curb national smoking rates. Canada plans to implement plain packaging as part of Prime Minister Trudeau’s Safer Kids Initiative.

The research, published today in the Australian and New Zealand Journal of Public Health, studied the effects of plain packaging on Australian Aboriginal and Torres Strait Islander people’s perceptions of different brands being less harmful or more prestigious than others.

“We know that brand imagery and design elements influence perceptions of consumer risk and status,” said Dr. Raglan Maddox, a postdoctoral fellow at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, specializing in Aboriginal tobacco use, public health and evaluation. “Colours, shapes and symbols on packaging contribute to beliefs that certain brands are more high-status, while using words like mild, light or slim can give consumers the impression that some tobacco products are less harmful than others.”

The study found plain packaging not only reduced overall misperceptions that there are healthier tobacco brands, but also found that participants under the age of 35 were 16.5 per cent less likely to view some brands as more prestigious than others. Research also indicates that smokers, especially those ages 18 to 29, found the new plain packs less appealing.

“These age-specific findings provide important insight for changing perceptions of status or prestige associated with tobacco brands in the younger indigenous population,” said Dr. Maddox. “Preventing uptake and eliminating tobacco use in this demographic is central to addressing the disproportionate burden of smoking-related death and disease, while also improving overall health and life expectancy.”

In 2013, approximately 42 per cent of Aboriginal and Torres Strait Islander people were smokers – a substantially higher rate than the general population. Tobacco-related illness is the most preventable cause of disease and death in both Australian Aboriginal and non-Aboriginal people, contributing to heart disease, chronic respiratory disease and various forms of cancer.

Dr. Maddox said the study adds to growing literature indicating the world’s first plain packaging initiative is associated with increased thoughts of smoking cessation, attempts to stop smoking and calls to cessation helplines.

“The findings are consistent with recent, broader research that smokers were more likely to correctly identify that cigarette brands are equally harmful and similar in prestige after plain packaging was implemented,” said Dr. Maddox. “The findings on Australian Aboriginal and Torres Strait Islander people further support plain packaging and health warnings as an effective strategy in reducing global tobacco use.”

As Canada and Australia are both Commonwealth countries with similar health and social systems, Dr. Maddox said he believes Australia’s documented success combined with this study’s findings could haves huge potential for Canadians – especially vulnerable populations, which include First Nations, Inuit and Métis people.

Both countries observe much higher rates of smoking among Indigenous people than non-Indigenous citizens. According to Statistics Canada, First Nations, Inuit and Métis people are twice as likely to smoke or use tobacco products as non- Indigenous people. Among those who smoke, the majority started between the ages of 13 and 16 years of age.

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This study was conducted in conjunction with Winnunga Nimmityjah Aboriginal Health Service and received funding from the ACT Health Directorate and the University of Canberra.

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

E-cig users warned they are as well smoking normal fags as vaporizers can cause cancer too

Dec 29th, 2015
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NEW study shows that e-cigarettes can lead to cancer even when they are nicotine-free because of the other toxins that many of them contain.

http://www.dailyrecord.co.uk/news/health/e-cig-users-warned-well-7086704

A new study says vapers pose health risks similar to normal cigarettes

E-CIGS can cause cancer – even when they are nicotine-free, according to new research.

And a professor carrying out research says that based on the evidence so far there might be little difference health-wise between using e-cigarettes and smoking regular cigarettes .

Lab experiments on the battery-operated devices found they lead to the same kind of cell damage that triggers the disease.

The finding adds to growing evidence electronic cigarettes may cause serious health problems because of the toxins they contain.

In the study scientists tested two popular brands and showed they harmed cells in ways that could spark the development of a tumour even with no nicotine, the addictive ingredient in tobacco.

Writing in the journal Oral Oncology, they said: “Our study strongly suggests electronic cigarettes are not as safe as their marketing makes them appear to the public.”

Although some countries have banned e-cigs their use and sale in the UK, like the US, is legal .

But the US Food and Drug Administration does not regulate e-cigarettes and has warned of possible health risks, although evidence is limited as they have just been readily available for less than a decade.

Professor Jessica Wang-Rodriquez, of the University of California, San Diego, said: “There haven’t been many good lab studies on the effects of these products on actual human cells.”

The head and neck cancer specialist and colleagues at the Veterans Affairs San Diego Healthcare System created an extract from the vapour of the products and used it to treat human cells in petri dishes.

These were more likely to suffer DNA damage and die, compared with untreated cells.

Prof Wang-Rodriguez said: “There have been many studies showing nicotine can damage cells. But we found other variables can do damage as well.

“It is not that the nicotine is completely innocent in the mix, but it looks like the amount of nicotine the cells are exposed to by e-cigarettes is not sufficient by itself to cause these changes.

“There must be other components in the e-cigarettes that are doing this damage. So we may be identifying other carcinogenic components that are previously undescribed.”

Her researchers are now trying to sort out those other substances and their specific effects.

Scientists already know of some troubling chemicals in the products. One is formaldehyde, a known carcinogen.

Using the products at a low voltage setting may minimise the production of formaldehyde, research suggests.

Another possible culprit is diacetyl, a flavouring that has been linked to lung disease.

A Harvard study found it in more than three quarters of flavoured e-cigarettes and refill liquids, or ‘e-juice’.

There are nearly 500 brands of e-cigarettes on the market, in more than 7,000 flavours, so scientists have their work cut out for them identifying all the potential problems.

Prof Wang-Rodriguez said: “For now, we were able to at least identify that e-cigarettes on the whole have something to do with increased cell death. We hope to identify the individual components that are contributing to the effect.”

While accepting lab cells are not completely comparable to those within a living person and the dose did not mimic what an e-cigarette user would get, she said the overarching question is whether e-cigs are really any safer than the conventional cigarettes they are designed to replace.

Added Prof Wang-Rodriquez: “Based on the evidence to date, I believe they are no better than smoking regular cigarettes.”

Instead of burning tobacco, e-cigs generally contain cartridges filled with nicotine and other chemicals .

When it is used, the liquid chemicals in the cartridge are turned into a vapour or steam that is inhaled by the smoker.

It is estimated there are currently 2.6 million adults in Great Britain using electronic cigarettes , while regular users in the US number roughly 12.5 million.

Flavouring chemical in e-cigarettes linked to severe respiratory disease

Dec 10th, 2015
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Diacetyl among three harmful compounds found in over 75 per cent of flavoured electronic cigarettes; in other research, male hormone gives women a better sense of direction

Diacetyl, a flavouring chemical linked to cases of severe respiratory disease, was found in more than 75 per cent of flavoured electronic cigarettes and refill liquids tested by researchers at the Harvard T.H. Chan School of Public Health. Two other potentially harmful related compounds were also found in many of the tested flavours, which included varieties with potential appeal to young people such as Cotton Candy, Fruit Squirts, and Cupcake. For more than a decade, inhaling diacetyl has been linked with the debilitating respiratory disease bronchiolitis obliterans, colloquially termed “popcorn lung” because it first appeared in workers who inhaled artificial butter flavour in microwave-popcorn processing facilities. The researchers tested 51 types of flavoured e-cigarettes and liquids sold by leading brands for the presence of diacetyl, acetoin, and 2,3-pentanedione, two related flavouring compounds that may pose a respiratory hazard in the workplace. Each e-cigarette was inserted into a sealed chamber attached to a lab-built device that drew air through the e-cigarette for eight seconds at a time with a resting period of 15 or 30 seconds between each draw. The air stream was then analysed. At least one of the three chemicals was detected in 47 of the 51 flavours tested. Diacetyl was detected above the laboratory limit of detection in 39 of the flavours tested.

www.scmp.com/lifestyle/health-beauty/article/1889273/flavouring-chemical-e-cigarettes-linked-severe-respiratory?cx_tag=recommend_desktop

Boys’ fitness affected by smoking mothers – new research shows

Dec 10th, 2015
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http://www.westerndailypress.co.uk/Boys-fitness-affected-smoking-mothers-new/story-28340573-detail/story.html

Mothers who smoke during pregnancy risk making their sons unfit in later life, according to new research.

In the first study of its kind researchers discovered that the sons of women who smoked had worse aerobic fitness by the age of 19 than those whose mums didn’t smoke.

Lead author Dr Maria Hagnäs, of the University of Oulu, Finland, said: “It’s well established that smoking and breathing in second-hand smoke are harmful for both mother and baby.

“Our study adds to the existing evidence base of the negative and long-standing impacts of maternal smoking.

“Women must receive advice and support to help them stop smoking during pregnancy, as well guidance on how to maintain a healthy weight to minimise the risks to their unborn child.”

The research, published in the International Journal of Obstetrics and Gynaecology, analysed the fitness of 508 men with an average age of 19, as they began their military service.

Of those 59 had mothers who smoked more than one cigarette a day throughout their pregnancy.

Results found that maternal smoking was associated with lower aerobic fitness of their children, which was measured by ability on a running test.

Aerobic activity was also independently associated with their own smoking status, weight and physical activity.

Dr Geeta Kumar, Chair of the Royal College of Obestetricians and Gynaecologists’s Patient Information Committee, said: “Stopping smoking is one of the most important things a pregnant woman can do to improve their baby’s health, growth and development, and this study demonstrates the negative effect smoking in pregnancy can have on a child’s long-term health too.

“It is important that women understand the risks of smoking in pregnancy and are aware of the support that is available to help them stop.

“Women who are unable to quit smoking should be encouraged to abstain during their pregnancy, use nicotine replacement therapy, or to reduce smoking as much as they can.

“We encourage all healthcare professionals working with pregnant women to access the RCOG’s new patient information leaflet which contains practical and evidence-based advice and guidance to share with women about smoking during pregnancy.”

The links between smoking during pregnancy and ill health have long been established.

Mothers who smoke are at a higher risk of miscarriage, ectopic pregnancy, intrauterine growth restriction, premature birth and stillbirth.

Their babies are also more likely to suffer from birth defects, and neurological, psychological or behavioural difficulties.

As well as being smaller babies are also at greater risk of asthma, chest and ear infections and pneumonia as well as being more susceptible to infant death syndrome.

The smoke-free legislation in Hong Kong: its impact on mortality

Nov 19th, 2015
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http://tobaccocontrol.bmj.com/content/early/2015/11/19/tobaccocontrol-2015-052496.abstract

Abstract

Objectives

To examine trends in deaths for conditions associated with secondhand smoke exposure over the years prior to and following the implementation of a smoke-free policy in Hong Kong.

Design

Time-series study.

Setting

Death registration data from Hong Kong Special Administrative Region (SAR) Government Census and Statistics Department.

Participants

All deaths registered from 1 January 2001 to 31 December 2011.

Main outcome measures

Deaths for conditions associated with passive smoking include cardiovascular disease (CVD), respiratory disease and other causes.

Results

There was a decline in the annual proportional change for ischaemic heart disease (IHD), acute myocardial infarction (AMI) and CVD mortality in the year after the intervention for all ages and those aged 65 years or older. There were also clear declines in the cool season peaks for these three conditions in the first postintervention year. There was a further drop in the cool season peak for AMI among all ages in the year after the exemptions ceased. No declines in annual proportional change or changes in seasonal peaks of mortality were found for any of the control conditions.

Conclusions

The findings in this study add to the evidence base, as summarised in the Surgeon General’s report, extending the impact of effective smoke-free legislation to those aged 65 years or older and to cerebrovascular events in younger age groups. They also reinforced the need for comprehensive, enforced and effective smoke-free laws if the full extent of the health gains are to be achieved.

Try, try again: Smokers may need to quit 6 to 9 times

Nov 9th, 2015
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http://www.delawareonline.com/story/news/2015/11/08/try-try-again-smokers-may-need-quit-6-9-times/75436522/

Every year, on the third Thursday of November, smokers across the nation take part in the American Cancer Society’s Great American Smokeout.

What started back in the 1970s continues to motivate smokers to quit each year.

About 20 percent of adult Delawareans smoke. Annually, 1,400 Delawareans die from the effects of cigarettes. Smoking kills more people than alcohol, car crashes, illegal drugs, murders and suicides combined.

There are a number of reasons why smokers light up. First and foremost, nicotine is an addictive substance, making it VERY difficult to quit. Past failed attempts can also feed into the notion that quitting is futile.

The average smoker may attempt to quit six to nine times before they’re successful. The message? Try, try again. More than 46 million Americans have quit for good.

Another reason for not quitting is the fear of weight gain. Packing on the pounds is not inevitable if you approach your quit date with a plan.

Even if you do gain, having to lose weight pales in comparison to the risks associated with continuing to smoke.

The amount of weight gain depends on the individual and can range from a few pounds to more than 25 pounds.

Weight gain is caused in part by a decrease in your metabolic rate after quitting. An improved sense of smell and taste can result in increased food consumption. Using food to replace the hand-mouth motion of smoking a cigarette is also a contributing factor.

New research published in the International Journal of Obesity has identified some trends and data.

Smokers who had fewer than 15 cigarettes daily and quit smoking weighed the same as non-smokers after 10 years. Heavy smokers and obese individuals tended to gain the most weight after quitting. The heavy smokers gained 23 pounds while the obese smokers gained 16 pounds on average.

An important message for smokers is that quitting is the single most important thing they can do for their health.

To avert weight gain, make a plan to engage in healthier habits starting the same day you quit. View it as a replacement – adding healthier lifestyle choices in place of a lethal one.

Increase your activity level. Not only will activity help you manage your weight after you’ve quit, it’s also helpful in managing cravings and elevating your mood.

If you’re currently sedentary, try walking – start out with 10-15 minutes, and gradually increase your minutes in motion. A daily 30-45 minute walk will counteract changes in your metabolism.

Also come up with a plan for how you’ll handle cravings. A list of activities to keep you busy – cleaning out the closet, calling a friend, taking a walk – can help. If the urge to eat strikes, reach for healthy snack options, and be sure to drink plenty of water

Try chewing sugarless gum or sucking on a cinnamon stick. Toothpicks, plastic straws and sugar-free hard candies are also ideas.

Talk with your healthcare provider about quitting. He/she can counsel you about the use of medications or nicotine replacement therapy (patches, gum, inhaler), which greatly improve your chances for success.

Delaware residents can contact the Delaware Quitline at 1-800-QUIT-NOW for free telephonic or face-to-face cessation counseling. Dependent on income, residents may also be eligible for free nicotine replacement therapy or medication.

This year’s Smoke-Out is scheduled for Nov. 19. Smokers are encouraged to abstain from smoking or use that day to make a plan to quit.

Good luck.

Marianne Carter is a registered dietitian and certified health educator. She’s the director of the Delaware Center for Health Promotion at Delaware State University.

Why using e-cigarettes could be riskier than we thought

Oct 28th, 2015
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E-cigarette use has knock-on effects, like increased alcohol use and exposure to chemicals from aerosol, research suggests

https://www.elsevier.com/connect/why-using-e-cigarettes-could-be-riskier-than-we-thought

When e-cigarettes first hit the market around 10 years ago, smokers rejoiced at the prospect of being able to replace their cancer-causing cigarettes with a similar but less harmful electronic device to help them quit. E-cigarette use has accelerated since then, leading researchers to investigate its health effects.

But what about the knock-on effects of e-cigarette use on other risky behavior, such as drinking? A new study reveals that such secondary effects could be more serious than we thought.

According to new research published in Addictive Behaviors, using e-cigarettes is related to problematic drinking. The researchers, from Indiana University-Purdue University Indianapolisin the United States, say it’s crucial to consider the knock-on effects of e-cigarette use when evaluating their safety, not just their direct health effects.

Electronic cigarettes, or e-cigarettes, were developed to mimic real cigarettes, giving users the same look, feel and experience as smoking a cigarette. They are widely promoted as a “healthy” alternative to smoking and as support devices for smoking cessation. More than 6 percent of the general population – and 17 percent of people with addictions – use e-cigarettes.

Because of the rapid increase in their use, research has focused on their health effects. However, the new study looks at one of the secondary effects of e-cigarette use and suggests that people need to be aware of the link between e-cigarette use and problematic drinking.

“This area of research is extremely important, and I don’t want it to get pushed to the side,” said lead author Alexandra Hershberger, a PhD student in clinical psychology.

“Establishing the direct health effects of e-cigarette use is important, but it’s vital to look at the secondary effects too.”

Monitoring e-cigarette and alcohol use

Previous studies have revealed a strong link between cigarette smoking and drinking, so the researchers hypothesized that a similar connection may be found with e-cigarette use and drinking. They surveyed two groups of people who drink alcohol using a modified version of the Nicotine and Other Substance Interaction Expectancy Questionnaire (NOSIE) to find out whether people expected to use e-cigarettes and alcohol together.

In both groups, of 692 and 714 people, the survey revealed that drinking alcohol is related to e-cigarette use. E-cigarette users were significantly more likely to drink problematically than non-users in both groups. What’s more, people who expected to use e-cigarettes and alcohol together reported drinking more.

The results suggest that using e-cigarettes to quit smoking could mean people miss out on the benefits of quitting; smoking cessation generally results in people drinking less alcohol, but using e-cigarettes means this decrease may not happen.

Hershberger explained:

If you quit smoking cold turkey, it affects other behaviors associated with smoking, such as drinking. By replacing smoking with e-cigarette use, it could be that you’re at risk of continuing behaviors you don’t want to continue. This is particularly serious for people with alcohol addiction – using e-cigarettes could make it harder to stop drinking.

More women use e-cigarettes socially

The survey also revealed that more women than men use e-cigarettes socially, opposite to patterns seen in regular cigarette smoking. In general, men report more risk-taking behaviors than women, including smoking, drinking and drug use. The findings suggest that women may not perceive e-cigarette use as risky.

“We were surprised to see higher e-cigarette use in women,” Hershberger said. “Generally men tend to report more risk-taking across the board, but in our study, women outnumbered men in terms of e-cigarette use. This could be because women perceive the device differently to other risk-taking behavior; e-cigarettes tend to be viewed more positively than cigarettes. Those views could be driving more use in women than we’d expect.”

Harmful chemicals in one puff

E-cigarettes work by vaporizing a liquid to mimic smoke, which can be inhaled. Although chemical analyses have determined the content of the liquid, so far the aerosol has not been fully characterized. New research published in the Journal of Chromatography A does just that – and reveals compounds not found in the liquid.

The researchers, from Restek Corp. and Juniata College in Pennsylvania, used gas chromatography and mass spectrometry to analyze the liquids and aerosols of four commercially available e-cigarettes. The results revealed more than 115 volatile and semi-volatile organic compounds in a single 40-milliliter puff of the aerosol. In comparison, the liquid contained only 64 compounds.

Some of the compounds found in the aerosol but not the liquid include formaldehyde, acetaldehyde, acrolein and siloxanes. This suggests that the aerosolization process may result in the formation of harmful chemicals that have an implication for human health. The researchers say this stresses “the need for an emphasis on electronic cigarette aerosol testing.”

Read the study

Elsevier has has provided free access to this article until 29 January 2016:
Alexandra R. Hershberger et al: “Combined expectancies of alcohol and e-cigarette use relate to higher alcohol use,” Addictive Behaviors (January 2015).
________________________________________

The Lead Author

Alexandra Hershberger is a PhD student in Clinical Psychology at Indiana University-Purdue University Indianapolis working under the mentorship of Dr. Melissa A. Cyders, whose research focuses on how impulsivity and its neurocognitive underpinnings affect risk-taking behaviors, including alcohol abuse, sexual risk-taking and gambling. Alexandra’s research is interested in examining co-morbid substance use disorders, particularly in adolescents in outpatient care and in the juvenile justice system. Specifically, her recent work examines the relationship between alcohol use and e-cigarette use, behavioral and cognitive underpinnings of the relationship and examining how this relationship is affected by e-cigarette ban legislation, being a former smoker, and individual differences in impulsive personality.

The Journal

Addictive Behaviors is an international peer-reviewed journal publishing high quality human research on addictive behaviors and disorders since 1976. The journal accepts submissions on substance-related addictions such as the abuse of alcohol, drugs and nicotine and behavioral addictions such as compulsive gambling and internet excesses. The journal primarily publishes behavioral and psychosocial research but articles span the fields of psychology, sociology, psychiatry, epidemiology, social policy, medicine, pharmacology and neuroscience.

E-Cigarette Awareness, Perceptions and Use among Community-Recruited Smokers in Hong Kong

Oct 26th, 2015
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The advertised price of cigarette packs in retail outlets across Australia before and after the implementation of plain packaging

Oct 23rd, 2015
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Nicotine Increases Codeine Relief, Could Mean Risk of Addiction

Oct 21st, 2015
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http://www.biosciencetechnology.com/news/2015/10/nicotine-increases-codeine-relief-could-mean-risk-addiction

Nicotine increases the amount of a specific enzyme in the brain that may increase the speed codeine is converted to morphine in the brain, according to research from the University of Toronto. The findings could implicate that smokers are at a higher risk for addiction to codeine.

Nicotine increases the amount of a specific enzyme in the brain that may increase the speed codeine is converted to morphine in the brain, according to research from the University of Toronto. The findings could implicate that smokers are at a higher risk for addiction to codeine.

Researchers, led by Rachel Tyndale, Ph.D., professor of pharmacology, toxicology, and psychiatry at the University of Toronto, administered codeine to rats in four groups and measured both their pain relief and levels of codeine and morphine.

The first group received nicotine for one week before receiving codeine; the second group was given an inhibitor, propranolol, which blocks the activation of codeine; the third group received both nicotine and the inhibitor, while a fourth control group was given neither.

The rats that received only nicotine had substantially more morphine in their brain and experienced greater pain relief, than those who also received the inhibitor. The group that was given propranolol and not nicotine had the lowest levels of pain relief and brain morphine. All of the groups maintained the same level of morphine in the blood, which showed it was change in the activity of the enzyme within the brain, not the liver that determined the effect of codeine on pain relief.

The biggest take away from the study, published earlier this year in Neuropsychopharmacology, “is there is genetic and environmental influences on the effects of drugs of abuse,” Tyndale, who is also senior scientists in the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health (CAMH), told Bioscience Technology. “In this case both those with faster activation of codeine to morphine, within the brain, due to genetics or due to induction of the enzyme, likely have better pain control, but also more risk for addiction to codeine. The latter group includes smokers. More generally it suggests that metabolism of drugs within the brain may alter the abuse potential for drugs.”

In the team’s preclinical mouse model, they showed that chronic nicotine increases the level of the enzyme in the brain which activates codeine to morphine. “We know this as we observe more of the enzyme in the brain in animals treated with nicotine, and in the brains of smokers in autopsy tissues,” Tyndale told Bioscience Technology. “When there is more of the enzyme in the brain, what we have shown is that codeine gets activated to nicotine more quickly and more extensively, increasing the pain relief from codeine by creating more morphine.”

This is a new way of looking at the brain’s role, as a more active participant, with codeine not just metabolized in the liver, but also in the brain itself.

“This is opening up a whole new area of research and potentially a substantial source of variation between people in their response to drugs and toxins acting on the brain,” Tyndale said. “We’re starting to see patterns and relationships, like the nicotine and codeine connection. This is also of interest in drug development as we might be able to create drugs that are only activated once they get to the brain.”

A limitation of the study is that it is a preclinical animal model. While the researchers know that the enzyme is higher in the brains of smokers, they still need to demonstrate that the brain enzyme is important to the effects of codeine in people.

Up next, the team plans to look at other opiates such as oxycodone, and hydrocodone, Tyndale said, “which are also metabolized by the same enzyme to determine what the effect of metabolism in the brain is for these other drugs.” They are also planning translational studies to take the work into humans.

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