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September 15th, 2015:

Promoting Health and Preventing Disease and Injury through Workplace Tobacco Policies

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Electronic cigarettes banned in ALL America’s national parks

Electronic cigarettes have been banned in America’s national parks, the National Park Service announced on Monday.

The policy, effective immediately, prohibits the use of electronic smoking devices in all areas where tobacco smoking is banned in the country’s 408 national parks, according to the Washington Times.

National Park Service Director Jonathan B. Jarvis said in their efforts to protect the health and safety of visitors and employees, they are extending restrictions on tobacco smoke to include vapor from electronic smoking devices.

‘Protecting the health and safety of our visitors and employees is one of the most critical duties of the National Park Service,’ Jarvis said.

‘We are therefore extending the restrictions currently in place protecting visitors and employees from exposure to tobacco smoke to include exposure to vapor from electronic smoking devices.’

Under the new policy, e-cigarettes are banned within all national mark concession facilities and all facilities and vehicles that are government-leased or owned, according to the Washington Times.

The National Park Service also noted that vapor exhaled from e-cigarettes and other electronic nicotine delivery systems (ENDS) contains about one-tenth the nicotine that is found in second-hand smoke.

‘Nicotine is highly addictive, toxic to developing fetuses and impairs fetal brain and lung development,’ the National Park Service said.

Evidence about electronic cigarettes: a foundation built on rock or sand?

Evidence about e-cigarettes: They are much safer than cigarettes and do not lure children to smoking.

McKee and Capewell recently criticised Public Health England’s position on e-cigarettes (EC) [1] and our report underlying it [2], in a Lancet letter [3], the media [4], and now again in this BMJ article [5]. Their statement ‘directors of public health and the wider community desperately need advice on EC that is evidence based and free from any suspicion of influence by vested interests’ [5] is offensive.

We have an extensive track record of research dedicated to understanding smoking behaviour and helping smokers stop smoking, published hundreds of primary research articles on smoking, nicotine, and EC and have many years of clinical experience in smoking cessation treatments. During that time we have not taken any funds from the tobacco or EC industry. In contrast, McKee and Capewell are not experts in this field – they have carried out no tobacco dependence, smoking cessation, or EC research – but they have a history of warning smokers and health professionals about EC dangers [6-10]. This may explain their interest in trying to undermine the message that vaping is much safer than smoking and that the public misperception of the relative dangers needs to be corrected.

Several responses to their earlier accusations and inaccuracies have been published [11-14] which were ignored in their latest ‘analysis’. Space constraints allow us to address only a few errors in this latest piece.

1. Defining the role of e-cigarettes.

The analysis states that EC supporters ‘focus narrowly on existing smokers, comparing the device effects with those of smoking conventional cigarettes’ while EC opponents compare vaping with non-smoking and believe that it should be discouraged because of ‘concern about the uptake of EC among people, especially children and adolescents, who would not otherwise smoke and about their long term health effects’.

Comparing vaping with smoking is not a narrow focus. The fundamental task of tobacco control is to reduce death and disease caused by smoking. Switching from smoking to vaping avoids most of the risks of smoking (notwithstanding potential long-term effects) and smokers should be encouraged to do so. The charge that EC should not be promoted because there is no clear evidence that they are more effective than current stop-smoking medications is a non-sequitur. EC currently are much more popular than other treatments and hence have much wider reach and potential for a major public health impact.

We share concerns about uptake of smoking and EC use among children (discussed below). Our report carefully examined the relevant evidence and noted the continuing decline in cigarette smoking, which is the only test of whether EC are ‘renormalising’ smoking that matters.

2. Dual use

McKee and Capewell’s statement that we rarely used this term is inaccurate. We did, additionally making this clear statement ‘As per existing NICE guidance, all smokers should be supported to stop smoking completely, including ‘dual users’ who smoke and use EC’. These ‘dual users’ should not be castigated – most of them are trying to stop smoking and need clear messages about how they can best achieve that goal. In contrast to McKee and Capewell, our report provided some advice about how best to do that.

3. Health effects and quality of evidence

The estimate of relative risk is a matter of logic. Risky chemicals in tobacco smoke are either absent from EC vapour or present at levels much below 5%, and the key chemicals present in EC only are not expected to pose serious health risks. We explained this previously [11] and the accusations about the work of Nutt and colleagues and conflict of interests have been addressed elsewhere [15]. The authors highlight the dangers of formaldehyde – our report covered this false alarm extensively.

4. Gateway effect

The danger of EC luring children to smoking seems to be the core of the authors’ opposition to EC. They present as evidence for this a study suggesting that the same young people who try vaping also try smoking [16]. The authors of this paper acknowledged that their study provided no evidence of causation. EC have not promoted smoking or vaping in children in Great Britain. Daily vaping in non-smokers is extremely rare [17].


We believe that there are much stronger grounds for criticising the stance of McKee and Capewell than for attacking the PHE position. The evidence of relative safety of EC and of the lack of any gateway effect is much stronger than any evidence to the contrary; misinforming smokers and health professionals about the relative risks of smoking and vaping is wrong; and discouraging smokers from using EC is irresponsible, however much the safe-sounding ‘precautionary principle’ is invoked.

Overall however, we agree, as stated clearly in our report, that there remain areas of uncertainty and that ongoing careful monitoring of EC safety and of its population impact is necessary. If problems emerge, regulatory solutions need to be ready.


1 Public Health England: E-cigarettes: a new foundation for evidence-based policy and practice. PHE publications gateway number: 2015260
2. McNeill A, Brose LS, Calder R, Hitchman SC, Hajek P, McRobbie H. E-cigarettes: an evidence update. A report commissioned by Public Health England 2015
3. McKee M, Capewell S. Electronic cigarettes: we need evidence, not opinions. Lancet Lond Engl Published Online First: 4 September 2015. doi:10.1016/S0140-6736(15)00146-4
4. Boseley S. Public Health England under fire for saying e-cigarettes are 95% safer. The Guardian. 2015.… (accessed 14 Sep2015).
5 McKee M, Capewell S. Evidence about electronic cigarettes: a foundation built on rock or sand? BMJ Published Online First: 2015. doi:10.1136/bmj.h4863
6 McKee M. E-cigarettes and the marketing push that surprised everyone. BMJ 2013;347:f5780. doi:10.1136/bmj.f5780
7 McKee M. Electronic cigarettes: peering through the smokescreen. Postgrad Med J 2014;90:607–9. doi:10.1136/postgradmedj-2014-133029
8 McKee M. Electronic cigarettes: proceed with great caution. Int J Public Health 2014;59:683–5. doi:10.1007/s00038-014-0589-z
9 Diethelm P, McKee M. Nicotine: not just an unregulated poison but now a potential chemical weapon. Eur J Public Health. 2011 Dec;21(6):681. doi: 10.1093/eurpub/ckr148.
10 BMJ Investigation Examines Bitter Dispute over E-cigarettes in the Public Health Community – ScienceNewsline. (accessed 14 Sep2015).
11 McNeill A, Brose LS, Calder R, et al. E-cigarettes: the need for clear communication on relative risks. Lancet Lond Engl Published Online First: 31 August 2015. doi:10.1016/S0140-6736(15)00079-3
12 O’Connor R, Fenton K. E-cigarettes: spelling out the available evidence for the public. Lancet Lond Engl Published Online First: 2 September 2015. doi:10.1016/S0140-6736(15)00107-5
13 Britton J. E-cigarettes, Public Health England, and common sense. Lancet Lond Engl Published Online First: 4 September 2015. doi:10.1016/S0140-6736(15)00145-2
14 Polosa R. E-cigarettes: Public Health England’s evidence based confusion? Lancet Lond Engl Published Online First: 4 September 2015. doi:10.1016/S0140-6736(15)00133-6
15 Nutt D, Hulbert J. Blinded by smoke? Why do e-cigarettes provoke such irrational reactions? Drug Science, independent committee on drugs. 2015.… (accessed 14 Sep2015).
16 Leventhal AM, Strong DR, Kirkpatrick MG, et al. Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence. JAMA 2015;314:700–7. doi:10.1001/jama.2015.8950
17 West R, Brown J. Smoking in England 2007-2014. 2015. (accessed 14 Sep2015).
Competing interests: HM was an investigator on a 2008 study of e-cigarettes sponsored by manufacturer Ruyan Group and conducted independently at University of Auckland. He has no links with any tobacco or e-cigarette manufacturers. The other authors declare no competing interests.

Hong Kong Customs seize contraband tobacco worth HK$12m

Cigarette-smuggling ring stubbed out as Hong Kong Customs seize contraband tobacco worth HK$12m

Smuggling syndicates used different concealment methods in an attempt to evade detection. Photo: SCMP Pictures

Smuggling syndicates used different concealment methods in an attempt to evade detection. Photo: SCMP Pictures

Hong Kong Customs believes they have struck a heavy blow against a cross-border tobacco-smuggling syndicate following the seizure of HK$12 million worth of untaxed cigarettes in two operations this month.

Investigations revealed the gang mixed boxes of illicit cigarettes with other products and used goods vehicles to smuggle the contraband from Shenzhen to Hong Kong via various border crossings, according to a senior customs official.

“Upon arrival in Hong Kong, the cigarettes would have been conveyed to tobacco traffickers who sell to buyers through telephone orders,” Wan Hing-chuen, deputy head of Customs’ revenue and general investigation bureau, said today.

He said intelligence indicated the gang was one of the major cigarette-smuggling syndicates in the city.

This was revealed today after customs officers confiscated 1.9 million cigarettes on board a truck at the Man Kam To border crossing yesterday.

The consignment was found concealed inside 76 sofas when officers intercepted the truck entering the city from Shenzhen via the control point.

Customs officers show the haul.

Customs officers show the haul.

Wan said the one-metre-long sofas, which were wrapped with plastic sheets, were hidden behind more than 900 boxes of plastic and electronic goods in the innermost part of a shipping container loaded at the back of the truck.

“After suspicious images were found in an X-ray examination, officers cut open the sofas and discovered the cigarettes,” he said.

“About 120 to 130 cigarette cartons [each with 10 packets of 20 cigarettes] were hidden in the hollow centre of each sofa,” the superintendent said.

He said the contraband worth HK$5.1 million was for local consumption and the haul would have amounted to evasion of HK$3.6 million in taxes if it went undetected.

Officers arrested the truck driver, a Hong Kong man, 47, and impounded the truck. In the afternoon, he was still being held for questioning and had not been charged.

The seizure came a fortnight after customs officers at Lok Ma Chau control point arrested a lorry driver, 40, after discovering HK$7 million worth of illicit cigarettes on board his vehicle on September 1.

Wan said intelligence indicated the same syndicate was behind the smuggling of the two consignments.

The cigarettes were concealed in the back of 76 sofas.

The cigarettes were concealed in the back of 76 sofas.

“Supply of the illicit cigarettes had dwindled after the first operation [made on September 1],” he said. “Intelligence showed the syndicate tried to smuggle the second consignment into the city to meet the demand.”

He said investigations were still continuing.

According to the Customs and Excise Department, smuggling syndicates used different concealment methods in an attempt to evade detection.

“Previously, we have found fake water heaters, bogus ovens and mattresses that were used to hide contraband cigarettes,” Wan said.

He said Customs would continue stringent enforcement actions against the trade of illegal cigarettes.

Mass. bans e-cig sales to minors, standardizes rules

BOSTON — Massachusetts officially plans to join the majority of the United States in enacting a statewide ban on the sale of e-cigarettes to minors.

Attorney General Maura Healey’s office announced Monday that it completed new rules that were proposed earlier this year to standardize regulations on the sale of e-cigarettes to minors across Massachusetts. Individual municipalities were previously left in charge of deciding their own rules on sales to minors.

Until now, minors could technically buy an e-cigarette in Massachusetts unless the city or town set regulations that stated otherwise. But according to the Boston Globe,152 municipalities in Massachusetts — including Boston — already enacted laws prohibiting sales to minors.

So for many e-cigarette vendors around the state, like David Mattuchio, owner of Vapor Station in Woburn, Mass., these new regulations will not make a difference to his business, as he said he operates in one of the many municipalities that already prohibited the sales.

The new rules simply extend previous regulations of traditional tobacco products to include e-cigarettes, which use heat to generate a vapor containing nicotine. The Attorney General’s office said the regulations also require nicotine liquid or gel be sold in “appropriate child resistant packaging that meets federal standards.”

Most of the regulations are effective in Massachusetts Sept. 25. The packaging requirement is effective March 15, 2016.

This official legislation in Massachusetts comes among increasing popularity of e-cigarettes around the USA, as well as growing concerns over their health effects. According to a survey by the Centers for Disease Control and Prevention, while the percentage of high school students smoking cigarettes has decreased from 15.7% to 9.2% from 2013 to 2014, the percentage of high school students using vaporizers tripled in the same time period.

Although some critics see e-cigarettes as a safer alternative to smoking, others argue that the devices have serious unknown health risks and are a gateway to nicotine addiction.

In a move that’s familiar to those who vape, the U.S. National Park Service is banning e-cigarettes in areas where regular cigarettes are banned. Newslook

At least 46 states prohibit sales of electronic cigarettes or vaping/alternative tobacco products to minors, according to the National Conference of State Legislators. The Food and Drug Administration is in the process of developing national regulations.

Evidence about electronic cigarettes: a foundation built on rock or sand?

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