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Harsh words for HK regulators on e-cigs

Jun 23rd, 2016
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http://harbourtimes.com/2016/06/23/hong-kong-may-be-left-behind-in-e-cigarette-debate/

An Asian smokers’ rights advocacy group has condemned Undersecretary for Food and Health Sophia Chan Siu-chee (陳肇始) for putting smokers’ long-term welfare at risk by turning a deaf ear to e-cigarette advocates and users, who oppose the Hong Kong government’s intention to push for a local ban on the devices.

“Half of some 650,000 smokers are condemned to death by Sophia Chan for [her] refusing to talk to any of us and she should get out of the office for not doing her job,” said factasia cofounder John Boley on the sidelines of the third annual Global Forum on Nicotine (GFN), held in Warsaw on 17-18 June.

Heneage Mitchell, Boley’s partner in factasia, had no good words about Chan and the Hong Kong government’s attitude either.

“Chan was tasked by the government to look into the whole issue and bring in different views, but what she did was to shut the door … and warned media representatives not to come to our briefing event in last December,” he recalled. “Vaping is a very large part of the nicotine alternative. Consumers have chosen it, so why on earth should you stand on the way?”

According to a survey conducted by factasia in the region December 2015, about 26% of smokers in Hong Kong were already using e-cigarettes regularly or occasionally, with 66% stating that they would switch to e-cigarettes if they were “legal”, “met quality and safety standards”, and were “conveniently available”.

Repeat study proposed

The group’s statements are emblematic of the concerns of many local e-cigarette activists, who believe that Chan’s bureau, as well as the statutory Council on Smoking and Health (COSH), are cherry-picking evidence to support their case.

In February 2016, Baptist University announced the results of a COSH-commissioned study on e-cigarettes. That study found high levels of polycyclic aromatic hydrocarbons (PAH) and polybrominated diphenyl ethers (PBDE) in the devices – one is a petroleum byproduct and the other is a flame retardant. At the time, Baptist University Assistant Professor of Biology Dr Chung Shan-shan (鍾姍姍) was widely quoted (or misquoted) as saying that the level of PaHs was “at least 1 million times more than roadside air in Hong Kong”.

In response, European doctor and scientist Professor Riccardo Polosa has a repeat of Dr Chung’s study. He said that a laboratory experiment would be conducted simultaneously in Hong Kong and Italy by the end of the summer. “We hope that by conducting a repeat study we can clarify some of the findings on e-cigarettes, which may not be accurate, and Dr Chung’s response was very positive,” Polosa stated.

Chung was invited by factasia to attend the conference, but she turned it down citing personal reasons.

A packed conference

About 350 participants from 55 countries joined the Warsaw conference to discuss the latest scientific and regulatory developments in the e-cigarette industry.

“Deeming” regulations by the US Food and Drug Administration and strengthened product and advertising restrictions in the European Union were particularly hot topics. To various degrees, advocates argued that these new rules would drive smaller e-cigarette companies out of business and force vapers back to their deadly habit.

In contrast, the United Kingdom was praised by many. Professor Gerry Stimson, Director of UK-based advocacy group Knowledge-Action-Change and chair of the GFN programme committee, provided a four-point summary of that country’s favourable environment: A general acceptance for tobacco harm reduction in the UK’s public health and medicine field on top of demand and supply control; good risk communications and consensus-building by the official Public Health England; positive responses from evidence-led tobacco researchers and civil society organisations; and active lobbying in Parliament by e-cigarette consumers.

“We have 2.9 million e-cigarette users in the UK, 8 million smokers. Of the 2.9 million, a million have stopped smoking. This is a huge public health success at no cost to the government.” Stimson asserted.

However, the United Kingdom has recently endorsed strict European standards despite an attempt in Parliament to undo them.

“It’s not as bad it could have been. Nevertheless it’s a strange bit of regulation and it’s a lesson for countries not to burden themselves with legislations when you can do things in less burdening ways, such as an advertising code of practice and a standard regulatory framework just as you can for phones or washing machines and so on,” Stimson elaborated. “So my advice to governments is to avoid jumping to legislation when all the concerns about e-cigarettes can be dealt with as you would deal with other consumer products.”

Doctors call for e-cigarette ban in public places over ‘passive vaping’ fears

Jun 23rd, 2016
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Electronic cigarettes should be banned in public places to avoid the risk of “passive vaping”, doctors have warned.

http://www.standard.co.uk/news/uk/doctors-call-for-ecigarette-ban-in-public-places-over-passive-vaping-fears-a3278746.html

The British Medical Association (BMA) yesterday called for e-cigarettes to be outlawed in bars, cafes, restaurants, museums and schools.

Glasgow public health consultant Dr Iain Kennedy warned there was evidence of second-hand vaping, particularly at people’s homes.

He claimed the activity, judged to be around 95 per cent safer than smoking tobacco, still polluted the air with harmful chemicals.

Dr Kennedy told the association’s annual meeting in Belfast: “There is growing evidence that passive vaping happens, particularly based around testing nicotine levels in households.

“What we don’t know yet is what the precise mechanisms of that are, what long-term harm there is.

“This is cutting edge research, with findings being published at the moment.”

But the BMA’s position put them at odds with Public Health England, which has warned that banning e-cigarettes would damage people’s chances of quitting smoking.

The organisation’s director of drugs, alcohol and tobacco, Rosanna O’Connor, said: “Vaping is not the same as smoking.

“Second-hand smoke is harmful to health but there is no evidence that e-cigarette vapour carries the same harms.

“In fact a ban on using e-cigarettes in public places could be damaging, as it may put off smokers from using e-cigarettes to help them quit.”

State bans sale of e-cigarettes

Jun 15th, 2016
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http://www.tobaccojournal.com/E-cigarette_sales_banned.53643.0.html

The government of Karnataka has banned the sale of e-cigarettes in the state, effective immediately, newspaper The Times of India reported.

The decision announced today follows the recommendation of the state’s Minister for Health and Family Welfare, U T Khader, who said a study on e-cigarettes conducted by a committee together with an NGO found that youth were becoming addicted to the products, the newspaper reported.

“The state hereby prohibits the sale (including online sale), manufacture, distribution, trade, import and advertisement of Electronic Nicotine Delivery Systems, its parts and components in any shape or size of cartridges containing nicotine in the interest of the public,” the newspaper quoted a government notice as saying.

New E-Cigarette rules come into effect September 1st

Jun 10th, 2016
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http://www.news1130.com/2016/06/10/new-e-cigarette-rules/

VANCOUVER (NEWS 1130) – E-cigarettes will soon be treated the same as regular cigarettes when it comes to where you can smoke them. Rules promised last spring are coming into effect in B September 1st.

Under the Tobacco and Vapour Products Control Act, you won’t be able to vape inside a public place like a restaurant. No vaping on school or health authority grounds. Minors can no longer buy E-cigarettes and there can be no more retail displays kids might see.

Health Minister Terry Lake says it’s fairly simple. “If it’s not legal to smoke cigarettes or cigars in that location, E-cigarettes would fall into the same category. That’s to protect those members of the public that don’t want to inhale the vapours from the e-cigarettes. There are still a lot of unknowns in terms of what is in these products and out of an abundance of caution, we want to make sure people, particularly young people are protected.”

He says there was some push back from people who use E-cigarettes to quit smoking, but he says they may not be any better for you. “We don’t have enough data and quality control over what is in the juices that are vaporized.”

There’s one exception for vaping in public indoor spaces. Customers can sample the products inside shops, but only customers per shop at one time.

End of vaping in Hong Kong? Government plans to ban import and sale of e-cigarettes

Jun 3rd, 2016
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http://www.scmp.com/news/hong-kong/health-environment/article/1963152/end-vaping-hong-kong-government-plans-ban-import

A bill banning the import and sale of electronic cigarettes will be submitted to the Legislative Council in the next legislative session, a lawmaker revealed after meeting a top health official.

Kwok Wai-keung of the Federation of Trade Unions said the plan was confirmed during a meeting with the Undersecretary for Food and Health, Professor Sophia Chan Siu-chee, on Thursday.

Hong Kong still plans e-cigarette ban despite new UK study claiming they’re 95% less harmful than tobacco

That came after Chief Executive Leung Chun-ying announced in his January policy address that the government would consider regulating e-cigarettes through legislation.

Before a ban comes into effect, officials said they would continue to educate the public on the harm of e-cigarettes, conduct tests and studies, monitor international regulatory developments and study legislative frameworks for a ban.

Kwok said the government should announce a list of e-cigarette products which had been inspected and found to contain harmful substances.

“The regulation of e-cigarettes is now imminent. Officials should draft a direction plan and list out short, mid and long-term measures,” Kwok said.

A million times more harmful than outdoor air: Hong Kong study raises e-cigarette cancer alarm

E-cigarettes can be purchased easily by primary and secondary school students in local shopping malls. A six-year-old girl was once spotted by the local media in Sham Shui Po inhaling a fruit-flavoured e-cigarette like an experienced smoker.

A study conducted by the University of Hong Kong between October 2014 and April last year found that 2.6 per cent of primary pupils and 9 per cent of secondary students had tried e-cigarettes.

While the harm of e-cigarettes remains unclear and some argue that the products could be used to help people quit, a Baptist University study revealed that the 13 e-cigarette samples it collected contained nicotine and cancer-causing substances.

But the Asian Vape Association, a group promoting the use of e-cigarettes, urged regulation rather than a total ban, claiming that complete prohibition would create a more active black market.

IMA condemns use and sale of e-cigarettes

May 11th, 2016
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http://www.merinews.com/article/ima-condemns-use-and-sale-of-e-cigarettes/15916121.shtml

Electronic cigarettes or e-cigarettes are a type of electronic nicotine delivery system, which are much in rage today as alternatives to cigarettes. The younger generation is increasingly switching to e-cigarettes because they feel that they are safe to use, less harmful than normal cigarette smoking and satisfy their cravings.

The recent regulation on e-cigarettes by the FDA restricting its sale and promotion to the younger generation proves otherwise. Welcoming the move, the Indian Medical Association is running a mass awareness campaign educating the masses about the dangers of e-cigarettes and dispelling common myths, which state that e-cigarettes are safe and nicotine free.

E-cigarettes are battery-operated devices that heat a liquid to produce a vapour that the user inhales. Unlike conventional cigarettes, which burn tobacco and generate smoke, e-cigarettes have a cartridge containing a liquid which contains nicotine and other constituents.

In Focus

The liquid is heated to produce a vapour the user inhales. Unlike conventional cigarettes, e-cigarettes can be sold with flavorings. More than 7000 flavours are available, including candy, fruit, soda, and alcohol flavors. Flavorings may increase the attractiveness of e-cigarettes to youths, especially those who are not already smokers.

Speaking about the same, Dr SS Agarwal, National President IMA & Dr KK Aggarwal, Honorary Secretary General IMA in a statement said, “Nicotine exposure from e-cigarette use, as with cigarette smoking, increases heart rate and produces measurable levels of blood cotinine, a nicotine metabolite. Experienced e-cigarette users tend to take longer puffs and use the device more intensively compared with novice users. As a consequence, they have higher blood nicotine levels that more closely resemble the levels achieved by smoking conventional cigarettes.”

They added, “Similar to cigarette smoke, e-cigarette vapour contains particles. It is not known whether the particles in e-cigarette vapour have any toxicity. IMA, therefore, does not advocate e-cigarettes as an effective way to reduce smoking cessation and believe that they are as harmful as normal cigarettes and must not be promoted.”

Given the concerns that e-cigarette use may be a gateway to nicotine dependence in adolescents, many public health authorities have recommended restricting e-cigarette marketing and advertising to youth, much in the same way that conventional cigarette smoking advertising is restricted. The nicotine in e-cigarette fluid poses a potential for accidental ingestion, especially by children.

E-cigarettes have been banned in some countries (including Brazil, Singapore, Canada, and Uruguay). In Europe, the European Parliament approved a directive that regulates nicotine-containing e-cigarettes with concentrations up to 20mg/mL as tobacco products E-cigarettes with higher nicotine concentrations are regulated as medical devices.

As per WHO, regulations are needed to stop promotion of e-cigarettes to nonsmokers and young people, minimise potential health risks to users and nonusers, stop unproven health claims about e-cigarettes, and protect existing tobacco control efforts.

Barack Obama bans e-cigarettes for children but not child labour on tobacco farms

May 11th, 2016
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Human Rights Watch says some children working on tobacco farms reported symptoms consistent with acute nicotine poisoning

http://www.independent.co.uk/news/world/americas/barack-obama-bans-e-cigarettes-for-children-but-not-child-labour-on-tobacco-farms-a7023611.html

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‘Sofia,’ a 17-year-old, works in a tobacco field in North Carolina Benedict Evans/Human Rights Watch

Children as young as 12 will still be allowed to work on US tobacco farms despite new regulations banning the sale of e-cigarettes to under-18s, Human Rights Watch has said.

Although President Barack Obama’s administration has extended the FDA’s authority to include all tobacco products, including e-cigarettes, 12-year-olds can still work 50 to 60 hours a week outside of school on tobacco farms.

According to HRW, some children working on farms in North Carolina, Kentucky, Tennessee and Virginia have reported vomiting, nausea, headaches and dizziness while working with tobacco leaves.

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The group warned the symptoms were consistent with acute nicotine poisoning.

They also suggest some of the pesticides commonly used in tobacco farming are known neurotoxins, which can destroy nerve tissue.

Under US law, children cannot work on farms during school hours, but they can work in the field at other times.

Hours typically increase in the summer, when school is not in session and the tobacco crop season is at its peak.

“If the administration can implement a ban on e-cigarettes for children in 90 days,” a spokesperson for Human Rights Watch said, “it can ban children from working with toxic tobacco plants.”

Jury is still out on e-cigarettes

May 9th, 2016
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US bans e-cigarette, cigar sales to those under 18 years old

May 6th, 2016
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US regulators on Thursday took their first steps to crack down on e-cigarettes and cigars, increasingly popular among American youth, and banned sales to anyone under age 18 in hopes of preventing a new generation from becoming hooked on nicotine.

The Food and Drug Administration’s action brought regulation of e-cigarettes, cigars, pipe tobacco and hookah tobacco in line with existing rules for cigarettes, smokeless tobacco and roll-your-own tobacco. The new rules take effect in 90 days.

Health advocacy groups hailed the move, while industry officials said it could cripple many of the smaller companies that make e-cigarette devices they say can help traditional smokers quit. Wall Street analysts expect the regulation to herald a new wave of consolidation led by big tobacco companies.

The FDA said it will require companies to submit e-cigarettes and other newer tobacco products for regulatory review, provide it with a list of their ingredients and place health warnings on packages and in advertisements.

The FDA’s regulation had been highly anticipated after the agency issued a proposed rule two years ago on how to oversee the US$3 billion e-cigarette industry and these other products.

US Secretary of Health and Human Services Sylvia Burwell said health officials still do not have the scientific evidence showing e-cigarettes can help smokers quit and avoid the known ills of tobacco. In the interim, the quick uptake of e-cigarettes by young people has added urgency to instituting consumer protections, Burwell said.

“Nicotine does not belong in the hands of kids,” Burwell told reporters.

E-cigarettes are hand held electronic devices that vaporise a fluid typically including nicotine and a flavour component. Using them is called “vaping.”

Three million US middle and high school students reported using e-cigarettes in 2015, compared with 2.46 million in 2014, making them the most commonly used tobacco products for youngsters, according to the most recent federal data.

“This is a real epidemic and banning the sales of these products to minors, much like cigarettes, is a critical step to protecting their health now and into the future,” said Democratic US Representative Lois Capps of California.

Other groups including American Academy of Pediatrics also lauded the FDA move. However, public health advocates have also urged the agency to ban the use of flavoured nicotine liquid in e-cigarette and personal vaporisers.

They say the flavours, which can range from bacon to bubble gum, are a major draw for youngsters to take up vaping. FDA officials said they would consider future regulation on flavours based on further study of the potential risks and benefits of vaping.

In 2009, Congress allowed the FDA to extend its oversight to all tobacco products. The agency began focusing on e-cigarettes, which were quickly gaining traction in the US market.

Cigars had previously not been regulated by the FDA. Their makers had lobbied for their more expensive, typically hand-rolled products to be excluded from such oversight. The agency’s new rules ban flavours in cigars, in another effort to prevent youth use.

Erika Sward, Assistant Vice President for National Advocacy at the American Lung Association, described the regulations as “a win for public health.” She said that the association was disappointed that while the FDA relied on anecdotal information to ban flavours on cigars, it did not use the same metrics regarding e-cigarettes.

The FDA will review products introduced after February 15, 2007, but will give e-cigarette manufacturers up to two years to submit their applications. E-cigarette makers can continue to sell those products while the review is pending.

Agency officials expect that most products on the market will require its review, a costly prospect for the many smaller manufacturers of vaping devices.

“The winners are the large tobacco manufacturers, primarily Altria and Reynolds (American), which have the experience and financial wherewithal” to deal with FDA processes, said Adam Fleck, an equity analyst at Morningstar. “The net result is a very fragmented e-cigarette market is likely to be consolidated.”

Shares in Altria and Reynolds were little changed on Thursday.
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Source URL: http://www.scmp.com/lifestyle/health/article/1941593/us-bans-e-cigarette-cigar-sales-those-under-18-years-old

Australia’s prohibition of e-cigarettes is out of step with the evidence

May 2nd, 2016
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http://theconversation.com/australias-prohibition-of-e-cigarettes-is-out-of-step-with-the-evidence-58725

A new report by the Royal College of Physicians in the United Kingdom says electronic cigarettes (e-cigarettes) are much safer than smoking and encourages their widespread use by smokers. It concludes that e-cigarettes have huge potential to prevent death and disease from tobacco use.

The review identifies e-cigarettes as a valuable tool to help smokers quit. For those who are unable to quit with currently available methods, e-cigarettes can substitute for smoking by providing the nicotine to which smokers are addicted without the smoke that causes almost all of the harm. This approach is supported by the scientific and public health community in the UK and is consistent with a previous review by Public Health England, the government health agency.

E-cigarettes are the most commonly used aid to quit smoking in the UK. According to the new review, evidence available so far suggests e-cigarettes are at least as effective as nicotine replacement therapy, such as patches or chewing gum. More than one million people have quit smoking in the UK using e-cigarettes. Quit rates are likely to be even higher with professional counselling and with more advanced devices.

E-cigarettes have been available in the UK since 2007 as a general consumer product – with some additional restrictions on advertising and minimum age of sale. They’re used almost exclusively in the UK by smokers who are trying to cut down or quit smoking, or who have quit smoking.

Concerns about e-cigarettes

In Australia, e-cigarettes containing nicotine are prohibited. Most Australian health organisations such as the National Heart Foundation, Cancer Council Australia and the Australian Medical Association take a very risk-averse approach based on potential harms. They say e-cigarettes could be a gateway to smoking for non-smokers; they may make the act of smoking socially acceptable again (renormalisation); there may be unknown long-term safety risks; and dual use may delay quitting.

The new review explores the evidence for these concerns and says they are mostly unfounded.

In the UK, there is no evidence e-cigarettes are a gateway to smoking. E-cigarette use is almost entirely restricted to current or past smokers. Use by children who would not otherwise have smoked appears to be minimal.

The report found no evidence to suspect the use of e-cigarettes renormalises smoking. On the contrary, smoking rates in the UK have been falling as e-cigarette use rises.

E-cigarette vapour contains some toxins and the report acknowledges some harm from long-term use cannot be dismissed. However, it supports the widely held view that the hazard to health is unlikely to exceed 5% of the risk of smoking, and may well be substantially lower. This level of harm is similar to nicotine replacement therapy and is likely to reduce with further technological advances. Similarly, the report concludes the harm to bystanders from vapour exposure is negligible.

Many e-cigarette users continue to smoke as well for a period of time (dual use) but there is no evidence this has reduced the number of smokers who quit. Indeed, dual use is often a transitional phase and many users will go on to quit completely as is the case of smokers concurrently using nicotine replacement therapy. A recent study found dual use reduces smoking intake and is less hazardous.

Implications for Australia

Australia has a comprehensive tobacco control policy including high tobacco taxes, mass media campaigns and smoke-free policies that stimulate quit attempts. However, smoking is highly addictive and most of Australia’s three million smokers try and fail repeatedly to quit, even with existing therapies

Based on the UK experience, e-cigarettes could assist many Australian smokers to quit or could replace cigarettes with a much safer source of nicotine. This could potentially save many thousands of lives each year.

As established smokers are more likely to be socioeconomically disadvantaged or to have mental health problems, the burden of disease falls disproportionately on these groups who have higher levels of addiction to nicotine and greater difficulty quitting.

The precautionary position taken by Australian health organisations and governments is not supported by the available evidence and overseas experience. The growing evidence for safety and effectiveness of e-cigarettes significantly outweighs any potential risks to public health.

A rational, evidence-based approach would be to make e-cigarettes available in Australia as consumer products and to encourage their use while minimising uptake by people who would not otherwise have used nicotine products. Ongoing monitoring and appropriate proportionate regulation would help minimise any risks.

E-cigarettes represent a massive opportunity for Australian smokers and have the potential for large-scale improvements in individual and public health, and social inequality. We cannot afford not to embrace them.

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