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September 17th, 2015:

Tobacco control news: e-cigarette health risks; decline in Greek smoking rates

E-cigarettes affect airways

A new study finds that electronic cigarettes, marketed as safer alternatives for nicotine fixes than tobacco products, carry health risks of their own. Researchers from the Center for Global Tobacco Control at Harvard School of Public Health (HSPH), working with colleagues in Greece, asked healthy adult smokers to smoke an electronic cigarette for five minutes. After taking breathing tests, subjects showed signs of airway constriction and inflammation.

“This is the first evidence that just one (e-cigarette) use can have acute physiologic effects,” lead researcher Constantine Vardavas, a visiting scientist at HSPH, told Reuters Health. “More studies on the long-term effects are needed,” he said.

Higher taxes, less smoking

Tax hikes on cigarettes appear to finally be making a dent in the smoking habits of Greeks, who are among the world’s heaviest smokers. Bans on smoking in public places are widely ignored and little enforced, but HSPH’s [[Gregory N. Connolly]] is encouraged by the 16% drop in the number of those lighting up over the past year. Connolly, director of the HSPH Center for Global Tobacco Control, recently presented a report on the “Greek Tobacco Epidemic” at a conference in Athens. He believes that public awareness campaigns about the dangers of tobacco are beginning to make a mark with the Greek people.

Referring to Greek youth, Connolly told the SETimes, “[Foreign tobacco companies] are sending a message that smoking is cool, but it’s killing them.”

E-cigarettes: Mixing Research and Marketing

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Commerce ministry sacks Tobacco Board Chairman Kothati Gopal

HYDERABAD: The commerce ministry has sacked the chairman of Tobacco Board, Kothati Gopal, after reviewing the instances of suicides by some tobacco farmers in Andhra Pradesh, one of the largest tobacco producers.

India is the third-largest global producer and second largest exporter of tobacco.

The ministry has on Tuesday asked the 1992 batch Tamil Nadu cadre bureaucrat to proceed on leave with immediate effect until further orders have been given.

In a tweet on Wednesday evening, the Union Minister of State for Commerce and Industry Nirmala Sitharaman, said she reviewed “the situation arising due to death of tobacco farmers.”

A statement issued by the ministry said the minister took a detailed review of the situation “consequent upon reported instance of some tobacco farmers having committed suicide on ac count debt burden”.

“The commerce and industry minister took cognizance of the absence of chairman, Tobacco Board, and his visit to Italy in the midst of this crisis, which shows lack of sensitivity to the farmers’ issues,” said the ministry in a statement.

Apart from asking Gopal to proceed on leave, the ministry has directed a senior officer to take additional charge as the chairman of Tobacco Board. The minister, through review, found that only 142.6 million kg of tobacco was lifted by the trade in Andhra Pradesh till Monday out of the 172 million kg and directed the Board to take immediate steps to facilitate disposal of the balance quantity of 30 million kg by month-end.

Health bodies push for new law on tobacco

Six key public health organisations and allies Thursday vowed to support the new draft of Tobacco Control Act and called on the government and the National Legislative Assembly to push this law through to protect children and youth.

They also called on the lawmakers to see through the excuses and twisted facts provided by tobacco |firms and not let them interfere in the legislation procedure.

At an academic conference in Chiang Mai province, the group also said that their campaign, via, had won over 12 million signatures as of Tuesday, and their target for 15 million signatures would easily be achieved when the law is up for deliberation in six months.

The organisations behind the campaign include the Thai Public Health Club, the Mohanamai Network Foundation and the Health Professional Association of Thailand.

Did Public Health England get it right over e-cigarettes?

Public Health England’s endorsement of e-cigarettes might be premature.

Best estimates show electronic cigarettes are 95% less harmful to your health than normal cigarettes — that was the bold statement issued by Public Health England (PHE) in its recent report on the safety and effectiveness of e-cigarettes as smoking cessation aids. But was there strong enough evidence to warrant this endorsement?

The 95% figure came primarily from a 2014 paper by David Nutt, British psychiatrist and neuropsychopharmacologist specialising in the research of drugs, and colleagues published in European Addiction Research, again cited in a briefing report to the all-party parliamentary group on pharmacy in the same year. Nutt’s paper described the outcomes of a two-day workshop in which a panel of experts, convened by the Independent Scientific Committee on Drugs (now called DrugScience), which Nutt founded, considered the relative importance of the harms related to the use of nicotine-containing products. The group ranked cigarettes as the most harmful nicotine delivery system, with an overall harm score of 99.6, and e-cigarettes as having only 4% of the maximum relative harm. And so it came to pass: e-cigarettes are 95% less harmful than standard cigarettes.

But Nutt and his co-authors in the original paper point out several limitations to their results, not least that there was a “lack of hard evidence for the harms of most products on most of the criteria” the panel had used to score the different nicotine delivery systems. They also conceded that the experts had not been selected based on any pre-specified criteria in terms of expertise in tobacco control. Hardly the most solid foundation on which to base public health policy.

And since the report was published on 18 August 2015, a US public health body has issued its own, somewhat different, judgement on e-cigarettes: of 24 companies whose products were tested, 21 had at least one product that, when tested under normal-use conditions, produced high levels of one or both of the cancer-causing chemicals formaldehyde and acetaldehyde. The Center for Environmental Health is now suing e-cigarette makers in California for failing to warn consumers about the effects of the chemicals, as required under California’s strong consumer protection laws.

The Royal Pharmaceutical Society (RPS) was quick to express concern over PHE’s support for e-cigarettes. “No one can be sure of the consequences of long-term use on health and further research is needed to determine this,” said Howard Duff, RPS director for England, when PHE published its report. And experts are now beginning to unpick the recommendations made by the public health body. Writing in The BMJ on 15 September 2015, Martin McKee at the London School of Hygiene and Tropical Medicine and Simon Capewell at the University of Liverpool argue that the available evidence about e-cigarettes “suggests that the debate is far from over and questions remain about their benefits and harms”.

Questions do remain about the safety of e-cigarettes and pharmacists need high quality evidence-based information on which to base the advice they give to their customers.

Citation: The Pharmaceutical Journal, 19 September 2015, Vol 295, No 7880, online | URI: 20069361

E-cigarette truths- a gathering of 62 studies

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British Heart Foundation Policy Statement on Electronic Cigarettes

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