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Tobacco Watchdog Expands Its Reach: A Primer

http://www.nytimes.com/interactive/2016/08/31/us/politics/tobacco-primer-listy.html

What Is The FDA’s Authority?

Since 2009, the Food and Drug Administration, based on authority it gained from Congress, has regulated cigarettes, smokeless, and roll-your-own tobacco. But it has been working to enact a regulation to extend its authority over all tobacco products, including e-cigarettes, cigars and pipe and hookah tobacco. That regulation was finalized in May and went into effect on Aug. 8.

What Happens Broadly for These Products?

As of Aug. 8, it became illegal to sell e-cigarettes or cigars to minors, although most states already had adopted such a prohibition. Free samples are also now prohibited. Companies are also no longer allowed to introduce new kinds of e cigarettes or cigars unless they get so-called premarket authorization from the F.D.A. By December, manufacturers must also register with the F.D.A. and submit lists of their products, including labeling and advertisements. Any products introduced since February 2007 are considered “new products” and will have to seek some kind of F.D.A. marketing approval.

What Happens to Cigars?

Certain cigars, like e-cigarettes, may be considered “new tobacco products” and have to undergo a thorough premarket review to determine if they are “beneficial to the population as a whole.” But most other cigars have either been around since before 2007 or will be able to argue they have “substantial equivalence” to cigars on the market before 2007, meaning they also would essentially be grandfathered. The cigar companies argue that even these “substantial equivalence” reviews will be expensive and they fear they will be forced to submit different applications just because a cigar differs in size. As a result, they predict many cigar manufacturers, particularly those smaller businesses that sell hand-rolled products, will be put out of business, and consumers will have less choice. The F.D.A. acknowledges that certain cigars may be removed from the market. But it estimates applications per cigar product for the less onerous substantial equivalence reviews should cost only between $1,500 and $22,787, depending on what type of application is submitted.

What Also Happens to E-Cigarettes?

Any e-cigarette introduced since 2007 – essentially all of them –must now receive retroactive market approval by going through an application process to examine whether the “product prompts young people to become addicted to nicotine, reduces a person’s interest in quitting cigarettes, and/or leads to long-term usage with other tobacco products.” Companies have until August 2018 to file their applications that must list all ingredients, components, and additives and include an analysis of the impact their products will have on public health. The F.D.A. estimates these reports will cost in the “low- to mid-hundreds of thousands of dollars,” while industry executives predict they could cost $1 million or more, perhaps putting many companies out of business. Companies then have until 2019 to get approval for e-cigarette products, or they will need to be removed from store shelves. Thousands of vape shops that now mix their own e-liquids, at a minimum, will most likely no longer be allowed to do this, and will instead have to sell preapproved products.

Salford shisha bar boss fined £2k for allowing smoking in premises

http://salfordonline.com/30916-salford-shisha-bar-boss-fined-2k-allowing-smoking-premises.html

The owner of a shisha bar in Salford has been fined for allowing people to smoke on the premises.

Reflexion Lounge on Salford Quays was found guilty in their absence to two offences of smoking in a smoke free place at Greater Manchester Magistrates Court on Thursday 11 August 2016.

The company was fined £2,000, made to pay costs of £906 and a victim surcharge or £100.

The case began when environmental health officers visited the Reflexion Lounge after receiving a complaint. No owner or director was present so officers left a letter of advice for their attention.

After several more complaints, council officers arranged a meeting in August 2015 with two directors of the business. They were told that people should not smoke on the premises and action needed to be taken. The directors said they advised customers they should not spoke in the premises and pointed to no smoking signs on the walls of the building.

In January an unannounced visit was made, with police, and people were found to be smoking inside the building. Mr Maithm Alsalah was interviewed under caution where he admitted to being in control.

Councillor David Lancaster, Executive Lead Member for Community Safety and Environment at Salford City Council, said: “A business owner should know better than to allow paying customers to smoke in their building as the smoking ban has been in place for more than 10 years.

“Officers went out of their way to meet the directors to give advice, which was ignored, so we had no choice but to prosecute. Any other business that allows smoking will also be prosecuted – it is just not acceptable.”

It’s now illegal to sell e-cigarettes, cigars, hookah tobacco to minors

http://www.mypalmbeachpost.com/news/business/its-now-illegal-to-sell-e-cigarettes-cigars-hookah/nsCms/

Federal officials are hopeful that a new law that took effect Monday which expands the types of tobacco products it’s illegal to sell to minors will help curb tobacco use.

The new law prohibits retailers from selling e-cigarettes, hookah tobacco or cigars to people under 18, Mitch Zeller, director of the U.S. Food and Drug Administration’s Center for Tobacco Product said.

For years, it has been illegal under federal law to sell cigarettes and smokeless tobacco to minors. Now all tobacco products are covered except for accessories.

Retailers are required to check photo ID of anyone under age 27, and are not be allowed to give away free samples of newly deemed tobacco products.

In addition, retailers will not be allowed to sell cigars, hookah tobacco, and e-cigarettes in a vending machine where anyone under age 18 has access at any time.

“While there has been a significant decline in the use of traditional cigarettes among youth over the past decade, their use of other tobacco products continues to climb — putting a new generation of kids at risk of addiction. E-cigarette use, for example, skyrocketed from 1.5 percent in 2011 to 16 percent in 2015 (an over 900 percent increase) among high school students; and hookah use also increased significantly. And every day, more teenage boys try a cigar than try a cigarette,” Zeller said in a blog post.

The 2009 Family Smoking Prevention and Tobacco Control Act into law, Zeller added, gave the FDA the authority to regulate cigarettes, cigarette tobacco, roll-your-own tobacco, and smokeless tobacco.

“But cigar, hookah tobacco and e-cigarette markets remained unregulated, creating a market environment I have equated in the past to the Wild, Wild West,” Zeller wrote.

In addition to restricting youth access to tobacco products, FDA will now be able to review new tobacco products not yet on the market, prevent misleading claims and help better provide consumers with information to make informed decisions about their tobacco use. This means tobacco product manufacturers will be required to register and list their products with FDA. Manufacturers will also be required to report ingredients and harmful and identify potentially harmful ingredients in their products.

Stunning discovery: Marijuana may be harmful

http://www.morningticker.com/2016/07/stunning-discovery-marijuana-may-be-harmful/

Bad news, marijuana users: a new study claims that the drug isn’t as safe as you might think it is — and in one very key way is just as bad as tobacco smoke. The study, published in the Journal of the American Heart Association, states that second hand marijuana smoke is just as harmful as tobacco smoke on blood vessels, so you might want to think twice before you toke up.

In fact, it was actually a lot worse. Scientists exposed rats to both pot and tobacco smoke for one minute. Their blood vessels narrowed and it took 90 minutes to widen again for rats exposed to tobacco smoke — it took three times as long for rats exposed to marijuana smoke, according to the study.

The researchers decided to conduct this study because of what they felt was a lack of attention on the dangers of the actual smoking of marijuana versus just the drug itself. The study showed that, just like tobacco smoke, chronic marijuana smoking can narrow and harden your arteries which can lead to potentially deadly cardiovascular complications.

Investigating a toxic risk (self-inflicted)

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One minute of secondhand marijuana smoke impairs cardiovascular function

http://universityofcalifornia.edu/news/one-minute-secondhand-marijuana-smoke-impairs-cardiovascular-function

One minute of exposure to secondhand smoke (SHS) from marijuana diminishes blood vessel function to the same extent as tobacco, but the harmful cardiovascular effects last three times longer, according to a new study in rats led by UC San Francisco researchers.

In a healthy animal, increased blood flow prompts arteries to widen, a process known as flow-mediated dilation (FMD). When FMD is compromised, as happens during SHS exposure, blood flow is impeded, and the risks of heart attack, atherosclerosis and other heart problems increase, said UCSF’s Matthew Springer, Ph.D., professor of medicine and senior author of the new study.

“Your blood vessels can carry more blood if they sense that they need to pass more blood to the tissues,” Springer said. “They dilate to allow more blood through. But that’s inhibited by exposure to smoke.”

Previous work by Springer and others has shown that as little as one minute of exposure to tobacco SHS diminishes FMD, but the effects of marijuana SHS hadn’t been examined. In the new research, published online in the July 27, 2016, issue of the Journal of the American Heart Association, a team of scientists in Springer’s laboratory measured rats’ FMD, which works similarly to FMD in humans, before and after exposure to both tobacco SHS and marijuana SHS.

The researchers found that rats exposed to marijuana SHS experienced a more than 50 percent reduction in FMD, similar to the reduction in artery function seen in both rats and humans exposed to tobacco smoke in previous studies. As with tobacco, the reduction occurred after just one minute of exposure to SHS from marijuana.

However, while rats exposed for one minute to tobacco SHS recover within 30 minutes – an observation that was reproduced in the new study – one minute of exposure to marijuana SHS still significantly affected FMD 90 minutes after the initial exposure.

Filling a void in secondhand smoke research

The research group used equipment designed to mechanically “smoke” cigarettes and fill a reservoir with the resulting smoke. In a series of experiments using marijuana ciagarettes, when the smoke in the collecting chamber was determined to be at a level roughly comparable to those found in restaurants that allow smoking, the rats were exposed to the marijuana smoke.

Using methodology that they developed for previous tobacco studies, the researchers temporarily blocked off blood flow to rats’ legs after they were exposed to SHS. They then let the blood rush back into the arteries and used ultrasound technology to measure the resulting widening of the femoral artery, a vessel similar to the human brachial artery of the arm, where FMD is typically measured in clinical studies.

The study fills a void in SHS research, as marijuana studies are difficult to undertake because of its illicit status and the numerous agencies, such as the Drug Enforcement Agency and the Food and Drug Administration, that must approve the use of the drug in experiments.

“The biggest reason that people believe marijuana secondhand smoke is harmless is because the public health community hasn’t had direct evidence of its harmful effects like it does with tobacco,” Springer said. “We hadn’t done the experiments, so I think there is definitely an underestimation of how harmful marijuana smoke is.”

To ensure the effect on FMD wasn’t a result of smoke from the rolling paper used in marijuana cigarettes or the cannabinoid compounds like tetrahydrocannabinol (THC, the main psychoactive substance in marijuana), the researchers also tested marijuana not rolled in paper and with cannabinoid compounds removed. Arterial function was still impaired in those situations, leading the team to conclude that smoke from burning marijuana plant matter itself caused the decline in FMD.

‘Just avoid smoke’

The rats were likely exposed to less SHS than people at certain rock concerts, such as one Springer attended in 2010, where there were so many people smoking marijuana that there was a haze in the air. This experience prompted his curiosity about whether marijuana SHS was really as benign as people made it out to be.

“It was really interesting to me, and distressing, because all these people in the stands would not tolerate it if the person next to them started smoking a cigarette,” Springer said, “but they were fine with the marijuana.”

Springer’s preliminary findings, presented at the November 2014 American Heart Association Annual Scientific Sessions, helped inspire California Assembly Bill 2300, a proposed law working its way through the State Legislature that would allow landlords to prohibit marijuana smoking —even for medicinal purposes—if smoking is already banned in their building. The medicinal use of marijuana complicates such public policy questions, Springer said, but he believes the current study solidifies the evidence that exposure to marijuana SHS carries risks.

“At this point, we’re saying that inhaling any smoke is detrimental to your health,” Springer said. “I think that people should avoid inhaling smoke whether it’s from tobacco or marijuana cigarettes, forest fires, barbecues—just avoid smoke.”

Study co-authors from Springer’s UCSF lab are Xiaoyin Wang, M.D.; Ronak Derakhshandeh, MS; Jiangtao Liu, M.D.; Shilpa Narayan; Pooneh Nabavizadeh, M.D.; Stephenie Le; Olivia M. Danforth; Kranthi Pinnamaneni, M.D.; Hilda J. Rodriguez; Emmy Luu; and Richard E. Sievers. Other UCSF co-authors include Suzaynn F. Schick, Ph.D., assistant adjunct professor of medicine, and Stanton A. Glantz, Ph.D., professor of medicine.

The study was funded by the National Institutes of Health’s National Institute on Drug Abuse, and the Elfenworks Foundation.

Full ban on shisha, emerging tobacco products in S’pore from Aug 1

SINGAPORE — The ban on shisha will kick in on Monday (Aug 1) after the end of a grace period.

http://www.todayonline.com/singapore/full-ban-shisha-emerging-tobacco-products-spore-aug-1

Licensed tobacco importers and retailers who import or sell shisha tobacco will be prohibited from importing, wholesaling or selling tobacco, the Ministry of Health (MOH) and the Health Sciences Authority announced in a joint statement on Thursday (July 28).

Although it was banned since Nov 28, 2014, shisha tobacco importers and retailers were given a grace period until July 31, 2016 to allow them to restructure their businesses and deplete their existing stock.

The ban on shisha tobacco is part of a larger suite of measures to reduce tobacco consumption.

Also coming into force on Monday is the second phase of the ban on on emerging tobacco products available in Singapore, including nasal snuff, oral snuff, gutkha, kaini and zarda.

In June last year, the MOH announced the first phase of the ban on emerging tobacco products not already available in Singapore. The ban was put into effect on Dec 15, 2015, and prohibited products such as smokeless cigars, dissolvable tobacco or nicotine, topically applied tobacco, and any solution with tobacco or nicotine that could be used with e-cigarettes.

All licensed tobacco importers, wholesalers and retailers will therefore be prohibited from importing, wholesaling or retailing all forms of emerging tobacco products.

Anyone who flouts the bans on emerging smoking products and shisha could be jailed up to six months and/or fined up to S$10,000. Those with a prior conviction could be jailed up to 12 months and/or fined up to S$20,000.

As part of the Tobacco (Control of Advertisements and Sale) Act (TCASA), there will also be a ban on the point-of-sale display of tobacco products. This will take effect on Aug 1, 2017 as retailers have a one-year grace period.

The existing ban on advertisements for tobacco products will also be extended to cover advertising for e-cigarettes and similar products. The ban on advertising for tobacco products, e-cigarettes and similar products will include advertisements published electronically. This covers advertisements and sales promotions originating from Singapore and those from outside of Singapore that can be accessed by people in Singapore.

Customer loyalty programmes and promotional schemes involving tobacco products are also not allowed.

Members of the public with information on retailers and importers contravening the ban may call the authorities’ reporting line at 6684-2036 or 6884-2037 during office hours.

Mixing pot and tobacco increases dependence risk

Many people mix dagga and tobacco to save money and make inhalation more efficient. This practice, however, may increase the likelihood of users becoming dependent.

http://www.health24.com/Lifestyle/Street-drugs/Plants/mixing-pot-and-tobacco-increases-dependence-risk-20160707

People who mix marijuana with tobacco are at greater risk for dependency and less motivated to find support to quit these drugs, researchers report.

Cannabis less addictive

One billion people around the globe use tobacco and 182 million people smoke pot, making these two of the world’s most popular drugs, according to the World Health Organisation and the United Nations Office on Drugs and Crime.

Many people mix the two drugs together to save money. Tobacco also makes pot inhalation more efficient. This practice, however, may increase the likelihood that users become dependent, the researchers found.

“Cannabis dependence and tobacco dependence manifest in similar ways, so it is often difficult to separate these out in people who use both drugs,” said study lead author Chandni Hindocha.

“Cannabis is less addictive than tobacco, but we show here that mixing tobacco with cannabis lowers the motivation to quit using these drugs,” added Hindocha, a doctoral student at University College London’s clinical psychopharmacology unit.

For the study, researchers examined survey responses from nearly 34,000 marijuana users from 18 different countries in Europe, North and South America, and Australasia who participated in the anonymous online 2014 Global Drug Survey.

Marijuana vaporisers

Marijuana is consumed in different ways around the world, the study authors said. Mixing marijuana with tobacco is much more popular in Europe than in other parts of the world, the researchers reported in the journal Frontiers in Psychiatry.

Mixing pot with tobacco is popular with up to 91 percent of European marijuana users, compared to 52 percent of Australian pot users and just 21 percent of New Zealand users.

Tobacco-mixing methods are even less popular in the Americas, where they are used by only 16 percent of Canadian marijuana users, 4 percent of those in the United States, and about 7 percent of Mexican and Brazilian users, the researchers reported.

Use of marijuana vaporisers, which don’t use tobacco, was reported by 13 percent of survey respondents in Canada and 11 percent of those in the United States. This method is less popular in other parts of the world, the researchers said.

But, the study authors added, the way in which people use marijuana can affect their motivation to quit or seek professional help to do so.

Negative health effects

People who preferred non-tobacco methods of using pot were 62 percent more likely to want professional help to use less marijuana. And they were 81 percent more likely to want professional help to use less tobacco, the findings showed.

“Our results highlight the importance of routes of administration when considering the health effects of cannabis,” Michael Lynskey, an addiction specialist at King’s College London, said in a journal news release.

“Given a changing legislative environment surrounding access to cannabis in many jurisdictions, increased research focus should be given to reducing the use of routes of administration that involve the co-administration of tobacco,” Lynskey added.

The negative health effects of tobacco use are well known. The short-term effects of marijuana use include temporary loss of motor, working memory and decision-making skills. Long-term pot use also may lead to dependence, permanent reductions in brain function as well as heart and lung disease and some forms of cancer, according to the World Health Organisation.

Pot And Cigarette Smoking Have At Least One Health Consequence In Common

Both kinds of smokers are at high risk of gum disease.

http://www.huffingtonpost.com/entry/pot-and-cigarette-smoking-have-at-least-one-health-consequence-in-common_us_5751a477e4b0ed593f142ade

Middle-age people who have smoked marijuana for many years may have a higher risk of developing gum disease, according to a new study.

However, the study did not find a link between long-term marijuana use and several other health problems associated with cigarette smoking, the researchers said.

“What we’re seeing is that cannabis may be harmful in some respects, but possibly not in every way,” Avshalom Caspi, a co-author of the study and a professor of psychology and neuroscience at Duke University, said in a statement. “We need to recognize that heavy recreational cannabis use does have some adverse consequences, but overall damage to physical health is not apparent in this study.” [11 Odd Facts About Marijuana]

In the study, the researchers looked at 1,037 people who were born in New Zealand in 1972 or 1973, and followed them until the people were 38 years old. The researchers examined whether the people had used marijuana when they were between 18 and 38, and whether they had physical health problems at age 38.

The researchers found that, among the 38-year-olds who had regularly smoked pot for 15 to 20 years, 55.6 percent had gum disease, also called periodontal disease. In comparison, only 13.5 percent of the 38-year-olds who had never used marijuana had gum disease. In some cases, this disease may lead to tooth loss.

The results also showed that the people who had smoked marijuana for up to 20 years had brushed their teeth and flossed less frequently than those who had never smoked marijuana, according to the findings, published today (June 1) in the journal JAMA Psychiatry. However, the less-frequent brushing and flossing did not explain the link between marijuana use and gum disease, which suggests that marijuana use itself may lead to damage to the gums. [5 Surprising Ways to Banish Bad Breath]

Researchers have long known that cigarette smoking has been associated with a higher risk of gum disease, said Dr. Ronald P. Burakoff, chairman of dental medicine at Northwell Health in New Hyde Park, New York, who was not involved in the study. “So I am not surprised that marijuana use also is associated with periodontal disease,” Burakoff told Live Science.

In the new study, the researchers also looked at the dental and general physical health of 484 people in the study who had smoked cigarettes on a daily basis at some point in their lives. In line with previous research, they found that those people were also more likely to have gum disease than those who had never smoked.

But these people were also more likely to have problems with their lung function, higher blood sugar levels andinflammation than those who had never smoked cigarettes.

In contrast, when the researchers looked at the same aspects of lung function and cardiovascular health among the people who had smoked marijuana for up to 20 years, they did not find these aspects were worse than they were in the people who had never smoked marijuana.

One limitation of the new study was that the researchers looked only at specific aspects of the people’s health assessed at a specific age, the researchers said. This means that the use of marijuana still may be linked to other health problems, such as cancer, that tend to occur later in life, they said.

Previous research has found links between the use of marijuana and weight gain, brain changes and the worsening of sexual function, among other health problems.

The new results “should be interpreted in the context of prior research showing that cannabis use is associated withaccidents and injuries, bronchitis, acute cardiovascular events and, possibly, infectious diseases and cancer, as well as poor psychosocial and mental-health outcomes,” the researchers wrote.

Say Why To Drugs: the smoke and mirrors of tobacco cigarettes

In this series, I’ll be investigating different drugs, busting some myths and explaining potential harms and benefits. This week it’s the turn of tobacco

https://www.theguardian.com/science/sifting-the-evidence/2016/jun/02/say-why-to-drugs-the-smoke-and-mirrors-of-tobacco-cigarettes-harm

What’s the appeal?
Tobacco, the dried leaf that’s smoked in cigarettes, cigars and pipes, and taken in various other forms such as snus and chewing tobacco, has been used as a recreational drug for hundreds, if not thousands of years. Cigarettes as a method for smoking became popular during World War one, when they were included as part of soldiers’ ration packs. People who smoke report that it relives stress, and can make them feel calmer and more relaxed. But is this really the case? Two in three smokers will have started smoking before the age of 18, and smoking is illegal in this age group, in the UK and many other countries around the world. The percentage of current smokers who want to quit is similarly high (around 2 in 3 current smokers report wanting to quit).

Short term effects
While there’s no real intoxication effect of cigarettes, if a person is not used to nicotine, a cigarette can make them feel sick or dizzy. Smoking a cigarette raises your heart rate. If a person is a regular smoker and addicted to nicotine, then smoking a cigarette can bring a person out of withdrawal. Nicotine withdrawal is characterised by feelings of anxiety, irritability, headaches and difficulty concentrating. It could be that the reason smokers report that cigarettes lower their anxiety and stress is because of the alleviation of these withdrawal effects – indeed, this seems likely, as long term use of cigarettes is associated with higher levels of depression and anxiety.

Long-term effects
The health impacts of cigarettes have been known for well over half a century. Cigarettes are responsible for the premature deaths of 2 in 3 users, according to recent figures from the UK and the USA. Smoking causes lung cancer, and at least 13 other types of cancer, to a varying degree. Cancer Research UK estimate that smoking causes a quarter of all cancer deaths in the UK, and nearly 1 in 5 cancer cases. Smoking also increases the risk of heart disease and lung disease aside from cancer.

There has been some suggestion that smoking, or nicotine in particular, might be beneficial for Parkinson’s disease. Indeed, Parkinsons UK have funded research looking in to this. However, as yet the evidence is thin on the ground, and there’s some reason to believe that this seemingly positive association might be a statistical artefact. Given that smoking kills so many people who do it, the smokers who survive long enough to be at risk of Parkinson’s disease might be an unusually hardy bunch, so it could be this rather than the nicotine that’s protective against Parkinson’s. Elderly smokers represent a really interesting population to research for this reason, if we can identify why they don’t succumb to smoking related illnesses, this might be extremely useful for designing treatments for others.

Myth busting
Nicotine is extremely dangerous: No, while nicotine is the addictive substance in cigarettes, it’s not the really harmful part of them. The process of burning tobacco releases carbon monoxide, hydrogen cyanide, at least 70 known carcinogens, and a variety of other chemicals. Nicotine is addictive, but specifically in cigarettes rather than in other forms, as tobacco’s acidity in cigarettes differs from cigars and chewing tobacco, meaning that nicotine is absorbed through the lungs when smoking cigarettes, giving a much more immediate hit. Cigars, inhalators, nicotine gum and patches all have a slower effect due to the nicotine being absorbed through the mouth or skin, and therefore taking longer to reach the brain.

Shisha is less harmful than cigarettes: A lot of people assume that shisha is less harmful than smoking cigarettes, because the smoke is cooler, and because of the flavouring, some people assume that shisha doesn’t contain tobacco. However, most commonly shisha will contain tobacco, and although the smoke is cooler, very little filtering of the smoke occurs as it passes through the water, and the current evidence suggests its unlikely to be less harmful than cigarattes. However, given different smoking patterns when using shisha compared to cigarettes, direct comparisons are hard. Although shisha sessions often last a lot longer, they are undertaken much less frequently. And far less research has been conducted on the effects of shisha, as compared to cigarettes. Even so, it seems that shisha is not as safe as a lot of people seem to assume it is.

Menthol cigarettes are safer/menthol cigarettes are more harmful: There is disagreement even among the myths surrounding menthol cigarettes. Again, there’s been less research conducted on menthol cigarettes compared to regular cigarettes, but there’s no evidence to suggest they’re any more or less harmful – it seems likely that they’re just as harmful as regular tobacco.

Roll-ups and natural tobacco are less harmful: It’s a common belief that rolling tobacco contains less of the harmful chemicals and components than machine made cigarettes. This is a myth. Some studies have found that rolling tobacco actually contains more additives than factory made cigarettes, and one animal study suggested that rolling tobacco was more addictive, although this was a small study.

Light or low tar cigarettes are less harmful: You may have noticed that there’s no such thing as Marlboro lights any more. Tobacco companies are no longer allowed to market cigarettes as ‘light’, since light cigarettes were no less harmful than regular cigarettes. And this was due to the difference between humans and machines. Light cigarettes were created by altering the filter – more holes were added to it, with the idea being that smoke would escape before being inhaled, so less harmful particles would be breathed in. This was tested using machines that ‘smoked’, and lo and behold, this was the case. The machines ‘inhaled’ lower levels of smoke. But humans aren’t machines, and altered their smoking patterns, squeezing at the filters and dragging more deeply on the cigarettes, meaning any benefit of the altered filters was lost.

Cutting down smoking will reduce the levels of harm from smoking: It seems hard to believe that this isn’t the case, but cutting down the number of cigarettes you smoke doesn’t necessarily reduce the risk of smoking-related harm. This is related to the myth above – if a person is used to getting a certain amount of nicotine in a day, then if they smoke fewer cigarettes, they’re likely to draw more deeply, take more puffs, and hold the smoke in their lungs longer for the cigarettes they do smoke. Psychologically, cutting down is a great first step in the quit process, but in terms of harm reduction, quitting is really the only way.

What do we still not know?
You might think that we know all there it to know about cigarettes and tobacco. We’ve known for more than half a century that smoking causes lung cancer, and the physical effects of smoking are fairly well understood. But there is still a lot that we don’t know. For example, why do some people find it really easy to quit smoking, while others really struggle? There’s evidence that smoking behavior is partly genetic. Genotype predicts how heavily a smoker will smoke, and can affect it up to the level of a couple of cigarettes extra per day. This might go some way to explaining why it’s easier for some to give up than others, and could even represent a method to work out how to help a person to quit. If your addiction is stronger, maybe you’ll need pharmacotherapy rather than trying to quit cold turkey, for example.

The other emerging area of research that I’m really interested in is trying to understand why smoking rates are so much higher in populations with mental health difficulties. We understand the physical effects of tobacco so well, but we’re much less sure about why these associations come about.

These articles are companion pieces to my Say Why To Drugs podcast, which can be listened to here.

Previous articles in the Say Why to Drugs series can be found here: cannabis.

This piece was corrected on 2 June 2016 to clarify that the statement ‘nicotine is extremely dangerous’ is a myth.