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September, 2015:

Pot and tobacco: How much damage can a lung cell take?

HSN researchers trying to pinpoint when smoke damages cells beyond repair

A new machine at Health Sciences North is lighting up to help researchers learn more about lung exposure to cigarette and marijuana smoke.

Dr. Leslie Sutherland, a researcher with the hospital’s Advanced Medical Research Institute of Canada (AMRIC), is using the machine to expose lung cells – grown in a lab setting – to small amounts of marijuana and cigarette smoke.

“With my research on tobacco smoke, I’m trying to determine the absolute earliest possible moment cigarette smoke exposure alters cells from the regular development and veers them off on a path of becoming cancerous,” Sutherland said in a press release. “I also want to determine what the trigger is for this process and if it’s universal or unique to someone’s genetic makeup. This would have profound implications, in terms of predicting, preventing, and treating lung cancer.”

The machine “smokes” the equivalent of one cigarette a week, that is then diluted down to 1/200th its regular strength.

The lung cells are then analyzed to determine at what level of exposure they are altered from their regular healthy development to mutating into cancerous cells.

For her research on marijuna smoke, the machine takes in the equivalent of three joints, and the smoke is then diluted to 1/10,000th of its regular strength.

“We tried diluting the marijuana smoke down to 1/200th of its regular strength, but the cells were completely destroyed by the smoke within 16 hours,” Sutherland said. “So while they won’t become cancerous because they’re dead, we don’t know what that’s doing to the body at the molecular level.”

She added there are no reliable studies on the effects of long-term exposure to marijuana smoke.

“We just don’t know what those effects are, and with medical marijuana for medicinal use now being permitted and regulated, we need to give physicians as much information as we can so that they can have an informed discussion with their patients about whether medical marijuana is an effective treatment option,” Sutherland said.

Sutherland plans to compare her findings on lab-grown cells to ongoing lung cancer research she has done with patients at the North East Cancer Centre.

The Northern Cancer Foundation and the Ontario Lung Association’s Ontario Thoracic Society have funded her research.

Flavored Tobacco May Entice Kids, Teens to Smoke

7 out of every 10 kids who said they used tobacco have used flavored varieties, survey shows

WebMD News from HealthDay
By Robert Preidt

HealthDay Reporter

WEDNESDAY, Sept. 30, 2015 (HealthDay News) — Bubblegum, cotton candy, chocolate: Just a few of the tempting flavors often added to tobacco being consumed by American children and teens.

Now, an analysis of the 2014 National Youth Tobacco Survey finds that seven in 10 middle and high school students who used tobacco in the previous month have used at least one flavored tobacco product.

“Flavored tobacco products are enticing a new generation of America’s youth into nicotine addiction, condemning many of them to tobacco-related disease and early death,” Dr. Tom Frieden, director of the U.S. Centers for Disease Control and Prevention, said in a CDC news release.

One expert agreed that more should be done to curb uptake of these products.

“Although flavorings in cigarettes, except for menthol, have been banned by the U.S. Family Smoking Prevention and Tobacco Control Act for the last several years, over 7,000 flavors that entice adolescents remain in many other tobacco products,” said Pat Folan, director of the Center for Tobacco Control at North Shore-LIJ Health System in Great Neck, N.Y.

Folan said that while most kids understand that smoking is a deadly habit, “the attractive flavors in products, such as e-cigarettes, hookah, cigars and smokeless tobacco, have led young people to perceive them as less harmful.”

The new study was led by Linda Neff of the CDC’s Office on Smoking and Health. Her team looked at the survey data and found that about 63 percent of the students who used tobacco products — nearly 1.6 million children and teens — had used a flavored electronic cigarette.

In addition, among the students who used tobacco, nearly 61 percent (about one million) had used flavored water pipe tobacco, about 63 percent (910,000) had smoked a flavored cigar, nearly 59 percent (690,000) had used flavored smokeless tobacco, nearly 54 percent (900,000) had puffed on menthol cigarettes, and about 42 percent (120,000) had used flavored tobacco in pipes, the findings showed.

High school students were more likely than middle school students to use flavored tobacco, the study found. About 18 percent of all high school students said they used at least one flavored tobacco product in the previous 30 days, compared with just under 6 percent who said they used only non-flavored tobacco products

Alberta ban on menthol cigarettes comes into effect Thursday

CALGARY – The Alberta government’s ban on menthol tobacco comes into effect Thursday, four months after Health Minister Sarah Hoffman announced the substance would be added to the province’s flavoured tobacco ban.

Alberta Health confirmed menthol cigarettes will be able to be sold up until midnight Wednesday, but not after.

“Although it’s illegal for minors to purchase tobacco, we know that these products are still making their way into the hands of our youth,” said the department in a statement on its website. “In fact, approximately one-third of youth smokers use menthol-flavoured tobacco. Because of this, the Alberta government announced the ban on the sale of menthol tobacco products in May 2015.”

“[Businesses] want to make sure that they can continue to be viable business and we want them to too, but the most important thing is we protect the health of Albertans and in particular of our youth and the research was very clear that this step needed to be taken to do so,” said Hoffman at a May press conference.

On June 1, the sale of other kinds of flavoured tobacco were banned in Alberta under the Tobacco Reduction Amendment Regulation. Cigars that cost more than $4 each and weigh five grams or more and pipe tobacco are exempt.

In May, the Western Convenience Stores Association spoke against adding menthol to the flavoured tobacco ban. It said lobbyists for health organizations were trying to shame the new NDP government into making it impossible for adults to buy menthol cigarettes. Association president Andrew Klukas said a ban would cost the government tax revenue and drive the sale of menthol tobacco underground.

One Lethbridge convenience store owner said the ban would also hurt the bottom line of his stores.

“It’s going to have a lot of impact–the same as the flavour ban did,” said Brian Eakett, owner of Green’s Pop Shop in Lethbridge. “People are already making changes and turning to mild smokes. If the government thinks people are going to quit smoking, then they are not as smart as I think they are.”

Stores will receive a fine of $500 if caught selling menthol tobacco products.

Tobacco control organization Action on Smoking & Health said the new regulations will keep thousands of Alberta youth out of the hands of the tobacco industry.

“We cannot allow tobacco companies to dictate public health and health policy in Alberta,” said ASH executive director Les Hagen. “In other words, we must keep the fox out of the hen house.”

The NDP government highlight other tobacco-restricting measures put into place on its website:

November 14, 2014 – smoking in vehicles with minors present as well as selling or giving tobacco products to minors is banned.
June 1, 2015 – the sale of most flavoured tobacco products is banned and cigarettes, bidis, blunt wraps and certain cigars are required to be sold in minimum package sizes.
June 1, 2015 – retailers are notified that menthol will be banned.
September 30, 2015 – the sale of menthol flavoured tobacco products in Alberta is banned.
Watch below: Health Minister Sarah Hoffman announced the government would add menthol to the province’s flavoured tobacco ban in May. Lisa Wolansky reports.

Low-nicotine cigarettes cut use, dependence, study finds; may aid push for FDA to set limits

By MARILYNN MARCHIONE, AP Chief Medical Writer

A new study might help the push for regulations to limit nicotine in cigarettes. Smokers who switched to special low-nicotine ones wound up smoking less and were more likely to try to quit, researchers found.

The study only lasted six weeks, and researchers call the evidence preliminary. But they say it’s the first large study to show that slashing nicotine, perhaps below an addiction threshold, is safe and leads to less smoking.

The Food and Drug Administration was given the power in 2009 to mandate lower nicotine levels if it would help public health, but has not yet done so.

“This, I think, provides support” for lowering nicotine, said one study leader, Dr. Neal Benowitz of the University of California, San Francisco.

“What our study shows is that it’s feasible,” and that people won’t smoke more regular cigarettes to compensate, he said.

Results are in the New England Journal of Medicine. The FDA and the National Institute on Drug Abuse paid for the study. Two study leaders have advised companies that make smoking cessation aids, and two testified in tobacco lawsuits.

Smoking is a leading cause of heart disease and cancer. Tar and other substances inhaled through smoking make cigarettes deadly, but the nicotine in tobacco is what makes them addictive.

Some earlier work suggests they might not be if nicotine was limited to roughly 0.7 milligrams per gram of tobacco. Most cigarettes contain around 15.8 milligrams per gram of tobacco. There are no low-nicotine cigarettes on the market; the government made special ones with several lower nicotine levels to test.

“We wanted to see how much lower it would need to be to see that effect,” where dependence did not happen or was diminished, said another study leader, Dr. Eric Donny, a University of Pittsburgh psychologist.

For the study, about 800 people who smoked five or more cigarettes a day and had no interest in quitting were assigned to smoke either their usual brand or an experimental type with nicotine ranging from a low of 0.4 milligram to 15.8 milligrams, the level in most cigarettes.

The cigarettes were provided for free, and no one except people assigned to keep smoking their regular brand knew how much nicotine any of their smokes contained.

Smokers had to report daily how much they smoked and to make 10 office visits, some of which included tests to measure nicotine exposure and dependence. They were paid $20 an hour or so for the visits and extra for completing tests and daily calls, up to $835 in all.

The low-nicotine users were a little more likely to smoke some regular cigarettes in addition to the ones provided in the study, yet the overall number of cigarettes and nicotine levels were lower in those groups. During the last week of the study, those given cigarettes with low amounts of nicotine — 2.4, 1.3 or 0.4 milligrams per gram of tobacco — were averaging 15 or 16 smokes a day. That compares to 21 or 22 cigarettes for those given the 15.8-milligram cigarettes or their usual brand.

One low-nicotine level — 5.2 milligrams — did not cause any change in number of cigarettes smoked from smokers’ usual brand.

All low-nicotine cigarette users reported fewer symptoms of nicotine dependence on various standardized tests.

The study was not intended or designed to get smokers to quit. But twice as many in the low-nicotine group than those smoking standard-strength cigarettes — 35 percent versus 17 percent — said they had tried in the month after the study ended.

A longer study is under way to see whether a gradual or abrupt shift to low-nicotine cigarettes is best.

Dr. Michael Fiore and Timothy Baker, tobacco researchers from the University of Wisconsin, Madison, wrote in a commentary in the journal that the study shows the potential for a policy to cut nicotine that “could help to end the devastating health consequences” of smoking.
The FDA declined to comment on the study, but the director of its Center for Tobacco Products, Mitch Zeller, said in a statement that “though all tobacco products are potentially harmful and potentially addictive, different categories of tobacco products may have the potential for varying effects on public health.”

Two large cigarette makers — R.J. Reynolds Tobacco Co., which sells Camel and other brands, and Altria Group Inc., which owns Philip Morris USA — declined to comment.

Legislation Looks to Raise Tobacco Sale Age Nationally

Hawai’i became the first state in the country to raise its minimum tobacco age of sale to 21 earlier this year. Now, Senator Brian Schatz, along with nine additional Senators, have introduced the Tobacco to 21 Act [1]. Under the Act, the sale of tobacco products would be prohibited to anyone under the age of 21.

“We know that the earlier smokers begin their unhealthy addiction to nicotine, the more likely they are to suffer from tobacco-related diseases or die,” said Senator Schatz. “This year, Hawai‘i became the first state in the nation to raise the minimum smoking age to 21. It was an historic public health achievement that we should adopt nationwide. By raising the minimum tobacco age of sale to 21 across the country, we can cut the number of new smokers each year; build a healthier, tobacco free America, and save lives.”

Tobacco-related illness is one of the leading causes of preventable death in the United States, with over 21 million people who have died in the past 50 years due to related illnesses.

The Institute of Medicine recently reported that raising the legal age of sale of tobacco products to 21 would reduce the number of new tobacco users, decrease smoking frequency by 12 percent, and save more than 222,000 lives from tobacco-related illnesses that lead to death.

Along with Senator Schatz, the bill is co-sponsored by Senators Mazie Hirono, Hawai’i; Dick Durbin, Illinois; Sherrod Brown, Ohio; Ed Markey, Massachusetts; Richard Blumenthal, Connecticut; and Sheldon Whitehouse, Rhode Island.

Representatives Mark Takai of Hawai’i and Diana DeGette of Colorado introduced companion legislation in the House of Representatives.

Various associations and agencies support the Tobacco to 21 Act, including the American Heart Association, the American Lung Association, Campaign for Tobacco-Free Kids, American Cancer Society Cancer Action Network, American Academy of Pediatrics, Academic Pediatric Association, American PediatricSociety, American Academy of Family Physicians, American Veterans (AMVETS), American Public Health Association, American Congress of Obstetricians and Gynecologists, Trust for America’s Health, Society for Adolescent Health and Medicine, Association of Medical School Pediatric Department Chairs, First Focus Campaign for Children, Pediatric Policy Council, Society for Pediatric Research, Association of Asian Pacific Community Health Organizations, Asian Pacific Partners for Empowerment, Advocacy and Leadership (APPEAL), Hawai‘i Medical Service Association, and Coalition for a Tobacco-Free Hawai‘i.

Marked Fall in Illicit Trade Seen

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ITIC Meets with Philippines Officials

On 28-29 September, ITIC President Daniel Witt and Senior Advisor Wayne Barford held a series of meetings to present the ASEAN Excise Tax Reform Manual to key stakeholders.

On 29 September, House Committee on Ways and Means Chairman Romero Quimbo chaired a roundtable at the School of Economics at the University of the Philippines. Members of the House Committee on Ways and Means and the Senate Tax Study and Research Staff attended the roundtable (pictured below).


Witt and Barford also met with Senate Committee on Ways and Means Chairman Sonny Angara and attended a Senate Plenary session, where they presented a copy of the ASEAN Excise Tax Reform Manual to Senate President Frank Drilon, among other Senators.

Following the House and Senate meetings, Witt and Barford also attended a dinner organized by the Philippine Chamber of Commerce and Industry.


Illegal tobacco and drug syndicate run by corrupt waterfront officials smashed by police in Sydney

A TOBACCO smuggling operation with links to Middle Eastern organised crime and involving corrupt Sydney waterfront workers has been shut down after the seizure of millions of cigarettes bound for black markets.

The syndicate, which allegedly shipped large quantities of cigarettes from the United Arab Emirates, is accused of paying kickbacks worth tens of thousands of dollars to employees from customs brokerage and freight-forwarding companies.

Authorities expect to make further arrests after 12 people, including one woman, were charged after raids at 17 Sydney properties on Tuesday.

Two men faced Sutherland Local Court today on various charges related to the illegal tobacco importation as well as the alleged importation of 270g of cocaine.

A third man, who is a member of the Lone Wolf outlaw motorcycle gang, was also due to face the same court today over the cigarette syndicate and drugs charges.

The remainder of the syndicate will face court next month.

The arrests come after a joint operation involving the Australian Federal Police, NSW Police and Australian Border Force, which began just over a year ago.

Australian Border Force Deputy Commissioner Michael Outram said the “sheer size of the profits” available in the illegal tobacco trade made it attractive to organised crime.

“Elicit tobacco is a real priority for the Australian Border Force simply because of the involvement of serious and organised crime groups and transnational crime groups,” he told reporters in Sydney.

“They’ll trade in tobacco, they’ll trade in drugs, they’ll trade in human beings.”

He said the same tactics could be used to smuggle guns and drugs.

“If they can turn a quick buck with relatively low risk then they’ll do it, whether that’s drugs, whether that’s tobacco or in some cases whether that’s people smuggling.”

Police also seized $400,000 in cash during the raids on Tuesday. About $2 million worth of assets including bank accounts and properties had been frozen.

It’s alleged the syndicate imported more than 10 million cigarettes, including one shipment of nine million “Manchester” branded cigarettes, which was seized after arriving at Sydney’s Port Botany last week, and had a black market value of about $5.4 million.

More than $700,000 had been seized during the course of the investigation.

AFP acting deputy commissioner Ian McCartney said further arrests were expected.

“This is a sophisticated syndicate, obviously with tentacles here plus overseas,” he told reporters.


UN officially acknowledges tobacco makes the world poorer

The United Nations General Assembly last week formally adopted the Sustainable Development Goals (SDGs), a 17-point plan to eradicate global poverty, which also formally recognised the negative impact of tobacco consumption on health, wealth, and development around the world.

The the SDGs, the UN pledged to combat continued mainstream use of tobacco, particularly through the implementation of the World Health Organization Framework Convention on Tobacco Control (FCTC).

The FCTC is the first global health treaty; its objective “is to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke.”

“It is our hope that the SDGs will raise the profile of the FCTC and provide desperately needed resources for poor countries to fully implement it,” said Laurent Huber, executive director of Action on Smoking and Health (ASH), a DC-based health organization.

The SDGs are a 15-year plan to reduce poverty across the globe. They follow on the Millennium Development Goals (MDGs), adopted in 2000 and which are replaced at the end of 2015. But the SDGs are not simply a continuation of the MDGs.

Key differences relating to tobacco include:

· The new recognition of the growing impact of noncommunicable diseases (NCDs) on health and poverty, especially in low and middle income countries. Tobacco is the leading risk factor for NCDs.
· The SDGs apply to all UN members, including high income countries like the US. While Americans enjoy one of the highest standards of living in the world, there are still pockets of poverty among several socio-economic groups. This disparity is especially true for tobacco use, which is increasingly becoming a disease of the poor in the US.
“We have made important progress in combatting tobacco in the 50+ years since the 1964 US Surgeon General’s report made the first official connection between tobacco and disease clear,” said Dr Alfred Munzer, chair of ASH. “However, tobacco still costs over half a million lives and over three hundred billion dollars a year, just in America. The global toll of 6 million lives is staggering. This is unacceptable.”

The World Health Organization estimates that, unless urgent action is taken, tobacco will cost one billion lives this century.

The SDGs serve as a roadmap for global development, including international assistance. The SDGs will come into force on January 1, 2016. The individual targets to track its implementation and success are still in draft form but will be revealed publicly once approved.

Leadership by example: saying no to health industry board membership

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