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Local Anti Tobacco Advocate Busts E-cigarette Myths

Jan 5th, 2017
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http://www.caledonianrecord.com/features/health/local-anti-tobacco-advocate-busts-e-cigarette-myths/article_65ee5497-ed23-5131-b69d-a503312368c3.html

According to a recently released report by the US Surgeon General, research has confirmed that there has been a significant increase in electronic cigarette (e-cigarette) use in recent years. Just last year alone, in 2015, the increase of electronic cigarette use has more than doubled particularly among our youth (ages 11 – 14), adolescents (ages 15 – 17) and in our young adults (ages 18 – 25) with more than 3 million youth in middle and high school using electronic cigarettes within the past 30 days. A cash cow for the tobacco industry, these numbers are increasing daily. More than 85 percent of electronic cigarette users ages 12 – 17 use flavored e-liquids, which come in a large variety of flavors, and are especially appealing to youth. And the flavors are the leading reason for youth use, according to the Surgeon General’s report.

Tobacco companies have been ramping up their marketing strategies to attract and cause young people to start using electronic cigarettes. In the United States, $3.5 billion dollars in sales is big business for the industry. Electronic cigarette manufacturers spent $125 million dollars in advertising their products with retail stores becoming the most frequent source of youth exposure to the tobacco industry’s advertising approaches. The tobacco industry has gone back to its old tactics that are much the same as the ones used to promote the conventional tobacco products.

Unlike the marketing campaigns of yesteryear, advertising approaches and themes today have a significant advantage with the use of internet and social media creating a more effective and wider outreach to attract youth and young adults, causing them to start using tobacco products at a much earlier age. In 2014, more than 7 out of 10 middle and high school students stated that they have been exposed to tobacco advertising. Research has shown that youth who use tobacco products like electronic cigarettes or chew, are most likely to go on to use other tobacco products like the traditional tobacco cigarette. In 2015, nearly 6 out of 10 high school cigarette smokers were also using electronic cigarettes.

The tobacco industry has claimed that electronic cigarettes are safer than the traditional tobacco cigarette. The tobacco industry has also claimed that the chemicals in e-liquids are not harmful to the user. The tobacco industry has suggested that electronic cigarettes can and may be used as a cessation tool to quit smoking. On the contrary, the newly released US Surgeon General’s report has confirmed these claims to be myths. The US Surgeon General’s report has busted these myths by saying;

The use of products containing nicotine poses dangers to youth, pregnant women, and fetuses. The use of products containing nicotine in any form among youth, including electronic cigarettes, is unsafe.

The liquid usually has nicotine, which comes from tobacco, flavoring; and other additives. Many electronic cigarettes contain nicotine, which is highly addictive. The nicotine in electronic cigarettes and other tobacco products can prime young brains for addiction to other drugs, such as cocaine and methamphetamine. Electronic aerosol is not harmless. The aerosol or vapor created by electronic cigarettes can contain ingredients harmful and potentially harmful to the public’s health.

There have been no conclusive study results or evidence to confirm that electronic cigarettes are a possible cessation tool for those who want to quit smoking. On the contrary, there is sufficient evidence to substantiate that the use of electronic cigarettes promotes users to use both electronic cigarettes along with smoking the conventional tobacco cigarette and that can potentially place the user at risk for exposure to higher levels of nicotine in the body that may ultimately lead to acute toxicity and possible death from over-exposure to nicotine.

The US Surgeon General’s full report titled: E-Cigarette Use Among Youth and Young Adults, can be found on the Surgeon General’s official website: https://e-cigarettes.surgeongeneral.gov.

Nicotine’s Highly Addictive Impact on Youth Underestimated

Jan 3rd, 2017
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http://www.medscape.com/viewarticle/873955

Although smoking trends among youth have shifted in recent years from tobacco cigarettes to e-cigarettes, the highly addictive culprit nicotine remains constant, a fact that should be underscored in discussion of risk with youth and their parents.

“I think most people realize nicotine is addictive, but I don’t know if there’s an understanding of just how addictive it is – particularly for youths,” said Lorena M. Siqueira, MD, MSPH, lead author of a new report on nicotine, addiction, and youth that was released by the American Academy of Pediatrics (AAP).

“People think, for instance, only having a few cigarettes a week may be fine and they can quit any time, but they don’t realize that they are already well on their way to dependency,” Dr Siqueira, a member of the AAP Committee on Substance Use and Prevention, told Medscape Medical News.

The report was published in the January issue of Pediatrics.

Evidence shows that the earlier in life a person is exposed to nicotine, the less likely they will be able to quit using tobacco and the more likely they will consume increasingly greater quantities.

The vast majority of tobacco-dependent adults – up to 90% – started smoking before age 18 years. The authors also point out that the earlier a child starts smoking, the greater the risk of continuing to smoke in adulthood.

Approximately two thirds of children who smoke in sixth grade, for example, become regular smokers as adults. In comparison, 46% of youth who begin smoking in the eleventh grade go on to become regular smokers as adults.

In addition, compared to adult smokers, youths require more attempts to quit smoking before being successful. In addition, only about 4% of smokers aged 12 to 19 years have been shown to successfully quit each year, the authors report.

Although e-cigarettes are marketed as a tool for smoking cessation, there is no strong evidence to support these claims, the authors note.

In fact, research, including a study published in JAMA Pediatrics in 2014, indicates that e-cigarettes, which contain nicotine, encourage, rather than discourage, tobacco use in youth.

Since that study’s publication, a number of other studies have shown similar harms, the study’s coauthor, Stanton A. Glantz, PhD, of the Center for Tobacco Research and Education at the University of California, San Francisco, told Medscape Medical News.

“There are now seven published longitudinal studies showing that youths who initiate smoking with e-cigarettes are about three times more likely to be smoking conventional cigarettes a year later,” he said.

“So clearly, e-cigarettes are acting as a gateway to conventional cigarette smoking.”

Instead of making quitting easier, e-cigarettes make it harder, Dr Glantz added.

“What the evidence shows is youths who use e-cigarettes are much less likely to stop smoking than youths who don’t use e-cigarettes, so not only are they not beneficial, as promoted, or even useless, they actually [work against] cessation.”

Among key attractions to e-cigarettes – and arguments that adolescents are likely to raise with parents ― is the idea that at least they are not as harmful as tobacco, Dr Siqueira said.

“It’s not unlike the prescription drug epidemic – adolescents think, ‘If my grandmother takes it, then it must be safe,’ so this is sort of the same thing,” she said.

The report also notes that e-cigarettes are not without toxic hazards of their own. Accidental poisonings associated with e-cigarette use have increased from one per month in 2010 to 215 per month in 2014, including one death.

“The take-home message is that there’s no arguing that nicotine is highly addictive, and it’s not just in cigarettes but it’s in all of these other products that are being cleverly marketed to youths to include ingredients and flavors to increase the palatability,” she said.

A new report from the University of Michigan’s Monitoring the Future study shows some encouraging trends regarding e-cigarettes. According to the study, after gaining popularity earlier in the decade, the percentage of US teens who use e-cigarettes declined for the first time from 2015 to 2016. The percentage of adolescents who used e-cigarettes in the past 30 days declined from 16% to 13% for 12th graders, from 14% to 11% for 10th graders, and from 8% to 6% among 8th graders; each change was statistically significant.

The report had even more encouraging news for cigarette smoking. The levels of smoking among 8th-, 10th-, and 12th-grade teens are the lowest they have been since annual tracking began 42 years ago.

“Since the peak year in 1997, the proportion of students currently smoking has dropped by more than three quarters — an extremely important development for the health and longevity of this generation of Americans,” principal investigator Lloyd Johnston, PhD, University of Michigan, Ann Arbor, said in a release.

The authors have disclosed no relevant financial relationshps. Dr Glantz has received research funding from the National Institutes of Health and from the Truth Initiative, a tobacco use prevention nonprofit organization.

The Economics of Tobacco and Tobacco Control

Jan 1st, 2017
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Tobacco and its environmental impact: an overview

Jan 1st, 2017
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Monitoring tobacco use and prevention policies

Jan 1st, 2017
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Beijing public smoking ban sees significant effect

Dec 30th, 2016
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A newly released report shows Beijing has seen a significant drop in the number of smokers by 200 thousand since the city brought in a strict smoking ban less than two years ago, The Paper reports.

http://english.cctv.com/2016/12/30/ARTIdBzgQ8OF7DnrmDC0Z11L161230.shtml

According to a report on tobacco use among adults, the smoking rate this year went down to 22.3 percent, compared with 23.4 percent in 2014, even though only about 30 percent of adults were said to understand the serious risks to disease caused by smoking.

The report also indicates that 16.8 percent of adults attempted to quit smoking this year, an increase of 1.9 percent compared with 2014.

Meanwhile, the report also shows that smoking in public spaces and second-hand smoking indoors has also been declining.

An earlier report shows that Beijing has established the most transparent law-enforcement system for smoking control in the country, with over 1,400 people among every 10,000 receiving smoking-quit services.

Teens are vaping more than ever, and not just nicotine

Dec 29th, 2016
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The latest report from the CDC digs into teens’ relationship with ecigarettes

Vaping is more popular with teens than ever, with more than one-third of high school students reporting having tried e-cigarettes. And teens aren’t always using e-cigs for nicotine, according to a new US Centers for Disease Control and Prevention report that dug into teen vaping behavior.

To evaluate e-cig use, the CDC and the US Food and Drug Administration poured through surveys filled out by 17,000 middle and high school students across the US in 2015. About 38 percent of high school students and 13 percent of middle school students reported that they’ve tried e-cigarettes.

That could be an underestimate, too, since the students were reporting their own behavior, and surveys based on self-reports are known to be unreliable.

The CDC is interested in vaping is because we still don’t know exactly how using e-cigarettes could affect a teen’s development. A medical group in the UK lauded e-cigs as useful tools to help current smokers quit, but the CDC said in a statement there’s no evidence that they work. What’s more, e-cig use during adolescence could kickstart an addiction, and the US Surgeon General Vivek Murthy warns that nicotine in any form is unsafe for teenagers. Still, more than 3 million teens used e-cigs in 2015, a tenfold increase over four years that Murthy called a public health crisis. But to stop it, the CDC has to understand it better.

In today’s report, one-third of e-cigarette users reported using their devices for something other than nicotine. This was more common for male white and Hispanic students than non-Hispanic black students. The survey didn’t get into what exactly the students were using their vape pens for, if not nicotine. But other studies point to pot as the most likely substance.

More than half of the e-cig users stuck to reusable electronic cigarettes — the ones you can refill with new liquid nicotine cartridges — as opposed to the disposable kind.

Although most of the students didn’t know what brand they were using, the ones who did used blu and VUSE most frequently.

Both of these brands are owned by big tobacco companies, and are among the most heavily advertised. Millions of teens are exposed to ads for ecigarettes online and in stores. These ads take a leaf out of big-tobacco’s book, promising independence and sex appeal to manipulate people into buying. And they work: more exposure to e-cig advertisements corresponds with more e-cig use in young adults, according to previous CDC research.

The CDC has repeatedly called for restricting e-cig marketing, but they have no control over advertisements. But regulation of the devices is growing; just this year, the FDA ruled that e-cigarettes and vape pens fall under the regulatory umbrella of tobacco products, which means the agency can ban sales to people under 18. We’ll see if the numbers of teenage users drop when the CDC analyzes the data from 2016.

EU Comes Up With A Plan To Prevent Illicit Cigarette Trade

Dec 28th, 2016
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http://www.nasdaq.com/article/eu-comes-up-with-a-plan-to-prevent-illicit-cigarette-trade-cm727157

A draft report commissioned by the EU has stated a Europe-wide system should be developed to track cigarettes , which should be run by the industry together with independent third parties, according to the Financial Times. This new program should be up and running by May 2019 in order to prevent the smuggling and counterfeiting of cigarettes, which costs €10 billion a year, according to the European Commission. As per the new laws, European Union countries must ensure that all tobacco packets are “marked with a unique identifier,” as well as a security stamp, so that the packet can be tracked from the factory to the shop floor. The Commission is yet to decide whether the tracking and tracing program should be implemented by the tobacco industry itself, or if it should be given to a third party.

While the commission says that the tobacco companies must work with numerous third parties to implement this system, the tobacco industry has maintained that it should be allowed to run the system by itself, arguing that external influence would cause disruption. Meanwhile, anti-tobacco groups have asserted the need for outside help to tackle this problem, given past allegations that some tobacco groups have benefited as a result of smuggling of, and illicit trade in, cigarettes. This recommendation comes after the ending of a $1.25 billion tracing deal between the EU and Philip Morris International ( PM ) this year, which was agreed in 2004, following criticism by lawmakers.

What Are Illicit Cigarettes?

Illicit cigarettes enter or are sold in a market in violation of certain rules and regulations, such as without payment of import duties, excise tax, or VAT. Such products can be genuine products manufactured by a official tobacco company, and sold without payment of applicable taxes, or else counterfeit cigarettes, made without the consent of the trademark owner. A number of regulatory measures and actions have been taken up by the government in response to this. Such trade harms governments, consumers, and manufacturers. According to World Health Organization (WHO) estimates, the illegal, unregulated black market in cigarettes amounts to 11% of the global consumption. Tobacco manufacturers themselves have taken a series of measures to ensure their brands are protected and consumers receive genuine products.

How Bad Is The Situation?

Counterfeit and Contraband (C&C) cigarettes declined by 6% in 2015 in the EU, over the previous year. This was against a backdrop of improved economic conditions and increased measures undertaken to counter the illicit trade activities. According to the Economic Intelligence Unit, personal disposable income rose at an average of 2.6% in 2015 across all EU member states. This may have prompted consumers to increase the consumption of Legal Domestic Sales (LDS). Furthermore, after a rise in tobacco taxes to meet the minimum EU excise requirements in a number of countries in 2014, 2015 was a year of more stable prices, which contributed to the decline in the sales of C&C cigarettes; prices rose by three percentage points less in 2015 than in 2014.

eu-cig-consumption

However, C&C still accounts for close to 10% of the total consumption, with high consumption in countries such as Greece, Norway, UK, and Ireland, which have the highest prices within Europe. In Eastern EU, high levels of C&C were seen in those regions bordering non-EU countries, where average prices tended to be four times lower. France was noted to have the largest volume of C&C, though it did not have the highest level as a proportion of consumption.

eu-top-10-cc-countries

The major source of C&C are non-EU countries, with Belarus being the largest contributor, followed by Ukraine, Algeria, and Russia. The volume of counterfeit cigarettes continued to decline from EU countries, accounting for just 12.2% of the total in 2015.

eu-cc-consumption

Illicit Whites (IW), which are cigarettes manufactured legally in one country, but which are smuggled across borders, accounted for over a third of C&C, of which 5.3 billion cigarettes has Belarusian labeling. These have grown as a proportion of total C&C from 7.8 billion in 2009, to 18.8 billion in 2015. Further, counterfeit cigarettes increased 28% during 2015, but remain less than 9% of the illicit consumption in Europe.

forcast-pmi

During 2015, Philip Morris reported revenue, net of excise, from its EU segment of $8.07 billion. If we consider the rate of illicit trade in EU to be 10%, this would amount to over $800 million in lost revenue for the company. In May, the company pledged $100 million to fund projects to confront this problem. The company has come up with a new initiative – PMI IMPACT – to combat illicit trade practices. Besides expending the aforementioned sum, the initiative will also raise funds from public and non-governmental organizations. Given the large amount of lost revenue annually for Philip Morris from just the EU region, this is definitely a move that would be beneficial to the company.

eu-cig-market-volume

Notes:

1) The purpose of these analyses is to help readers focus on a few important things. We hope such lean communication sparks thinking, and encourages readers to comment and ask questions on the comment section, or email content@trefis.com

2) Figures mentioned are approximate values to help our readers remember the key concepts more intuitively. For precise figures, please refer to our complete analysis for Philip Morris International .

 

UK public health experts move to quash e-cigarette fears in wake of US report

Dec 9th, 2016
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https://www.onmedica.com/newsarticle.aspx?id=be447bf6-8e2a-430a-9ba1-7783e5078bd8

UK public health experts have moved to quash fears about the potential dangers of e-cigarettes in the wake of the US Surgeon General’s report* setting out the urgent need to curb the rising popularity of vaping among young people in the US.

Clinicians should not be put off from helping smokers to quit or cut their risk of harm by switching to vaping, they insist.

In his report,* published earlier this week, Dr Vivek Murthy pointed to the evidence on the impact of nicotine on the developing brain, and its ability to trigger lifelong addiction, as well as the potentially harmful additives found in some e-cigarettes.

Use of e-cigarettes among high school students in the US had soared by 900% in the past five years, surpassing all other forms of conventional tobacco use, he said.
“We must protect our nation’s young people from a lifetime of nicotine addiction and associated problems by immediately addressing e-cigarettes as an urgent public health problem. Now is the time to take action,” he urged.

But Professor Kevin Fenton, national director of health and wellbeing at Public Health England, said that while he understood the concern about the rapid uptake of e-cigarettes in the US, attempts to regulate these products in the US had been difficult, and the situation in the UK was very different.

“We have comprehensive regulations in place, including a ban on selling e-cigarettes to under-18s and tough restrictions on advertising, as well as minimum standards for safety, maximum nicotine levels and health warnings on packs,” he said.

“Our review of the evidence found e-cigarette use carries a fraction of the risk of smoking, a conclusion reiterated by the Royal College of Physicians earlier this year. No new evidence has been published to contradict this, however we are closely monitoring any emerging evidence,” he added.

Professor Peter Hajek, Director of the Tobacco Dependence Research Unit at Queen Mary University of London (QMUL), reiterated the findings of the Royal College of Physicians report, which identified vaping “as a great public health opportunity,” rather than a threat.

“The new US report’s conclusions do not tally with what the actual data show. It is simply not true that e-cigarettes are a tobacco product or that vaping lures children to smoking or that it creates dependence in non-smokers,” he insisted.

“The prevalence of smoking among young people is at an all-time low and regular use of nicotine containing e-cigarettes among never-smokers is extremely rare. Ongoing vigilance is needed, but so far, e-cigarettes have acted as a gateway away from smoking, for adults and adolescents alike,” he continued.

The report also ignores the huge benefits of vaping for adult smokers in helping them switch from “deadly smoking,” he added.

“The worst part of the report is its policy recommendations. They may be well meant, but no consideration is given to their likely unintended consequences. Limiting smokers’ access to the much less risky option of vaping is likely to contribute to keeping smokers smoking and smoking-related disease and death going at the current rate,” he said.

Linda Bauld, Professor of Health Policy at the University of Stirling and Co-Chair of the Smoking in Pregnancy Challenge Group, said the evidence presented in the report on the potential harms of vaping during pregnancy had been fundamentally misunderstood, and was based on studies in rats and mice, not people.

“While we need more research on e-cigarettes, pregnant women who find it difficult to stop smoking should not be discouraged from using them. This is the position and current advice in the UK endorsed by a range of organisations,” she pointed out.

The Surgeon General’s report might make clinicians more hesitant about discussing e-cigarettes with pregnant women who smoke. “That would be harmful to maternal and child health and must be avoided,” she insisted.

Surgeon General calls youth vaping a public health threat

Dec 8th, 2016
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http://www.usatoday.com/story/news/nation-now/2016/12/08/surgeon-general-calls-youth-vaping-public-health-threat/95134890/

E-cigarette use among young people is a major health concern, according to a new report from the U.S. Surgeon General on Thursday.

Surgeon General Vivek Murthy said in the report that not enough research has been conducted to prove that use of e-cigarettes among youth are harmless.

“E-cigarettes went from being rare in 2010 to being the most common tobacco product used by our nation’s youth,” Murthy said during a press conference. “This represents a staggering development in a relatively short period of time, and it threatens 50 years of hard-fought progress we have made curbing tobacco use and puts a new generation at risk for … addiction.”

According to the U.S. Centers for Disease Control and Prevention, e-cigarette use among high school students rose from 1.5% in 2011 to 16% in 2015. Federal health officials estimate that about 3 million middle and high school students use e-cigarettes.

The potential safety of e-cigarettes, devices that heat a liquid consisting of nicotine, flavorings and other chemicals to create a vapor, is hotly debated. Unlike traditional cigarettes, e-cigarettes do not contain tar or other chemicals generated by the combustion of tobacco that are responsible for harmful tobacco-related diseases. Proponents of e-cigarettes say they are a safer alternative to traditional cigarettes and can help people quit smoking.

Nicotine is harmful to the developing brain regardless of whether it’s smoked through a traditional cigarette or an e-cigarette, Benard Dreyer, President of American Academy of Pediatrics, said during the press conference.

“Nicotine… regardless of its source is highly addictive and has clear neurotoxic effects especially on the developing brains of adolescent and even into early adulthood,” Dryer said.

For years, e-cigarettes have been largely unregulated, with many consumers unaware of what chemicals are used in their e-cigarette products. In May, the Food and Drug Administration released a rule that requires electronic cigarettes to be regulated much like tobacco cigarettes. The rule requires nearly every e-cigarette on the market — and every different flavor and nicotine level — to submit a separate application for federal approval.

While many may believe that e-cigarettes emit a harmless aerosol, that’s not the case, Dreyer said.

“Aerosol from e-cigarettes is not harmless, it includes nicotine and other potentially harmful chemicals including heavy metals and carcinogens,” Dreyer said, adding that second-hand inhalation should also be avoided. “Because there is no safe level of exposure, it is extremely important to protect children from these.”

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