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February 26th, 2015:

Study: Smokers may tap into multiple sources for nicotine

The first peek at a major study of how Americans smoke suggests many use combinations of products, and often e-cigarettes are part of the mix.

It’s a preliminary finding, but it highlights some key questions as health officials assess electronic cigarettes.

“Are e-cigarettes a step toward a cigarette smoker getting off of cigarettes? Or are e-cigarettes a crutch so they can get nicotine in places and times when they wouldn’t normally be allowed to smoke cigarettes?” asked Dr. Andrew Hyland of the Roswell Park Cancer Institute, the primary investigator for a huge government study of trends in smoking and tobacco use.

Hyland’s study is one of a number of projects that scientists are watching as they explore the public health implications of e-cigarettes. Here are some things to know:


At a meeting of nicotine researchers late Thursday, Hyland presented preliminary findings from the first 20,000 people to enroll in the study, a baseline as the Food and Drug Administration and National Institutes of Health track how use of tobacco products, or alternatives like tobacco-free e-cigarettes, is evolving.

A fraction — 28 percent of adults and nearly 9 percent of youths — reported they currently use any type of tobacco product, Hyland said.

About 40 percent of those current tobacco users report using two or more products. And half say battery-powered e-cigarettes are one of the multiple products they use, Hyland found. In fact, the most common combination was cigarettes and e-cigarettes.

Mitch Zeller, director of the FDA’s Center for Tobacco Products, said the early findings showing use of more than one type of tobacco product are compelling and underscore “how popular e-cigarettes have become.”

Ultimately, the PATH study — it stands for Population Assessment of Tobacco and Health — will follow 46,000 people ages 12 and older over five years, a source of information as FDA decides how to regulate tobacco-related products.


Policymakers are debating the health effects of “vaping” as it grows in popularity. Many anti-smoking advocates consider e-cigarettes a safer alternative for smokers who can’t or don’t want to quit altogether.

E-cigarettes work by heating liquid nicotine into an inhalable vapor. They contain fewer toxic substances than burning traditional cigarettes. But health officials warn that they shouldn’t be considered harmless and say much more needs to be known about long-term effects.

Critics ask if they keep smokers addicted or even act as a gateway to hook new users who eventually try tobacco.


Concern about e-cigarettes grew after a different government study in December found some teens who’d never smoked a real cigarette were trying out the electronic kind.

“Is it a passing fancy or something that sticks with them?” Dr. Wilson Compton, deputy director of NIH’s National Institute on Drug Abuse, said in an interview with The Associated Press. He hopes that over the next few years, the new PATH study will help tell.

The FDA has proposed regulating e-cigarettes, including banning sales to minors, a step that many states already have taken.


No one knows if experimenting with e-cigarettes poses as much risk of hooking someone as experimenting with regular cigarettes, Compton said.

Nicotine levels vary widely by type of e-cigarette, from small amounts to nearly as much as a traditional cigarette, he said. Users learn to puff a bit differently as they draw in vapor, and even the voltage in the device’s wires may affect nicotine delivery, he explained. NIDA plans to fund development of what Compton calls a “standard e-cigarette” that will be a yardstick for comparison with the different e-cigarettes on the market.

US tobacco giants settle smoking lawsuits

Three major US tobacco companies – Philip Morris, RJ Reynolds and Lorillard – have agreed to pay $US100 million to settle more than 400 lawsuits claiming that smoking damaged people’s health.

A judge awarded a combined $US100 million ($A126.72 million) to the plaintiffs in the lawsuits filed in Florida by smokers or their families, seeking damages for injuries caused by smoking.

As part of the settlement, Philip Morris USA, maker of Marlboro cigarettes; RJ Reynolds Tobacco Company; and Lorillard Tobacco Company will collectively pay $US100 million to the plaintiffs, one of the law firms representing them said in a statement on Wednesday.

‘We are very pleased that after many years of litigation, the parties were able to reach agreement. This settlement will provide immediate compensation to our clients, many of whom are very elderly,’ said lawyer Robert Nelson, of Lieff Cabraser Heimann Bernstein, who helped negotiate the deal.

Under the terms of the agreement, Altria unit Philip Morris USA, the largest US tobacco company, and RJ Reynolds, the second-largest, will each pay $US42.5 million to resolve the federal cases. Lorillard will pay $US15 million.

The settlement only involves cases that are pending in federal court, the law firm noted, not cases filed in state court. The tentative agreement is subject to the approval of all the plaintiffs.

The settled cases are part of the so-called Engle cases, a Florida class-action lawsuit filed against the cigarette companies in 1994. They were also part of a 2006 Florida Supreme Court decision to decertify the class action, saying the $US145 billion in punitive damages to the entire group was ‘excessive’.

However, the top court opened the door to individual lawsuits, and allowed the findings to stand in the case, including that smoking cigarettes harmed health and the tobacco companies had knowingly concealed the health effects of cigarettes or their addictive nature.

‘Today’s agreement is in the best interest of the company,’ said Murray Garnick, senior vice president and associate general counsel at Altria, in a separate statement.

‘As for the Engle progeny cases in state court, we will continue to defend ourselves vigorously, including appealing adverse verdicts.’

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WHO: Treaty Making Inroads in Global Tobacco Epidemic

The World Health Organization said its landmark tobacco control treaty is making inroads in slowing the global tobacco epidemic. But as it observes the 10th anniversary of the entry into force of the Framework Convention on Tobacco Control, the U.N. agency warns the fight to prevent millions of tobacco-related premature deaths is far from over.

The World Health Organization said it is celebrating a number of successes in reducing tobacco use during the past 10 years.

Since the Framework Convention on Tobacco Control entered into force, the U.N. agency notes the number of countries introducing graphic pictures and health warnings on cigarette packages has increased from five to 50.

It finds more than 80 percent of the 180 countries ratifying the treaty adopted new tobacco control legislation or strengthened existing laws. Technical Officer with the Framework Convention Tibor Szilagyi told VOA countries implementing measures required under the Convention are seeing positive results.

“They have started seeing decreases of let us say 15 to 30 percent in the past 10 years in tobacco use prevalence, which means that millions of deaths have been averted by the implementation of this treaty,” stated Szilagyi.

But the World Health Organization reports about six million people a year die prematurely from causes related to tobacco, the majority in low- and middle income countries. It warns tobacco use will account for more than eight million deaths each year by 2030, if the epidemic is unchecked.

The agency accuses the tobacco industry of using its economic power to influence governments not to enact control policies. It said the industry uses slick media campaigns to entice women and young people to pick up the smoking habit.

Dr. Szilagyi said countries in Africa are targets of these ploys and many have succumbed to the economic temptations dangled before them. But he notes many do not. He said Kenya, Mauritius, and South Africa among others have resisted the tobacco industry and made strong progress in implementing the Convention.

He said another challenge is emerging tobacco products. “This includes electronic cigarettes and electronic nicotine delivery systems and non-nicotine delivery systems, but also those products, which have been traditionally used in some countries, but not in others,” he explained. “For example, water pipe tobacco, which becomes trendy and widespread among mostly young people in those countries where water pipe was not traditionally used.”

The Framework Convention continues to be strengthened through additional protocols. Parties to the Convention are in the process of promoting ratification of a new protocol dealing with illicit trade in tobacco products.

We will not be bullied on plain cigarette packets, says Reilly

Minister says Ireland close to becoming first EU country to introduce plain packaging

Ireland is on the verge of being the first EU country to pass a law paving the way for the introduction of plain packaging for cigarettes, Minister for Children and Youth Affairs Dr James Reilly has told the Dáil. He said the House should share in the sense of satisfaction.

“We do so despite legal threats from the lawyers for the tobacco industry,’’ Dr Reilly added. “We do so despite an extraordinary legal letter demanding that we stop and stop immediately.’’

Dr Reilly was speaking during the final stage debate on the Public Health (Standardised Packaging of Tobacco) Bill 2014, providing for the measure. The Bill will pass through the Oireachtas next week after the Seanad passes a number of technical amendments.

JTI Ireland, owner of the Benson & Hedges and Silk Cut brands, has strongly opposed the legislation, which was first introduced by Dr Reilly when he was Minister for Health. The Minister said the Dáil would not be “intimidated’’ by such action. “We will pass such laws as we believe to be correct,’’ he added.

Dr Reilly said he wanted to send a message to children around the country on a lesson that could be learned. “Remember if a bully tries to intimidate you with actions, you should stand firm and be true to what you believe to be right,’’ he added.

Ireland, said the Minister, had always been a leader on tobacco control. “We have ranked at the forefront in introducing measures to protect our country’s health from the scourge of smoking,’’ he added. “Standardised packaging is the latest strand in the comprehensive range of tobacco control legislation we already have in place.’’

He said he was confident the research available demonstrated that standardised packaging would have a positive impact on health and that it was a proportionate and justified measure.

It could reduce the appeal of tobacco products and increase the effectiveness of health warnings and the ability of branded tobacco packaging to mislead people about the effects of smoking. “And these are important points when we consider that almost 80 per cent of smokers start when they are children,’’ Dr Reilly added.

He said he was pleased the Irish public, including TDs and Senators, had not, and would not, allow themselves to be manipulated by the arguments of the tobacco industry against the measure.

Fianna Fáil health spokesman Billy Kelleher commended the Minister for his personal efforts in bringing the legislation to the House. The Government, parliament and people should be resolute and stay the course in the face of threats, intimidation and bullying tactics from organisations whose sole purpose was to sell a product that harmed and killed people on a daily basis, he added.