October, 2015:
Vaping might not help you quit
http://www.abc.net.au/triplej/hack/stories/s4336102.htm
South Australian researchers have found e-cigarettes aren’t helping people to quit smoking.
Their study is small, just 87 people were surveyed. Researchers pulled data from Quitline callers over eight months.
They said they thought vaping would help them deal with cravings, and replace the hand-to-mouth action of smoking. But it’s not working – most of those who vaped, vaped every day, and also had a nicotine addiction.
The organisation’s Lauren Maksimovic said some people thought e-cigarettes were too similar to smoking.
“They were using that hand to mouth action, but it actually enhanced their smoking and it was just the same thing, they were continuing to smoke”
She says people were also worried about the unknown impacts of vaping on their health.
“We maintain serious concerns about the safety of e-cigarettes, particularly given that it delivers chemicals directly to the lungs.”
There’s mixed opinions on vaping – a peak health body in England has said e-cigarettes are about 95 percent less harmful than tobacco cigarettes. But the Australian Cancer council has long campaigned against them, saying there’s no evidence e-cigarettes are safe or that they help with quitting attempts.
Under Victorian poisons laws, e-cigarettes are banned if they have nicotine in them. Many e-cigarettes don’t have nicotine – and the Cancer Council found some people were using them in conjunction with other pharmacotherapies to help them quit.
In NSW e-cigarettes can’t be sold to people under 18. Lauren Maksimovic says they’re currently being aggressively marketed to young people through advertising, and their fruit flavours.
“We really want to raise the awareness that there’s not evidence out there at the moment that e-cigarettes are useful in quitting.”
Nicotine Increases Codeine Relief, Could Mean Risk of Addiction
http://www.biosciencetechnology.com/news/2015/10/nicotine-increases-codeine-relief-could-mean-risk-addiction
Nicotine increases the amount of a specific enzyme in the brain that may increase the speed codeine is converted to morphine in the brain, according to research from the University of Toronto. The findings could implicate that smokers are at a higher risk for addiction to codeine.
Researchers, led by Rachel Tyndale, Ph.D., professor of pharmacology, toxicology, and psychiatry at the University of Toronto, administered codeine to rats in four groups and measured both their pain relief and levels of codeine and morphine.
The first group received nicotine for one week before receiving codeine; the second group was given an inhibitor, propranolol, which blocks the activation of codeine; the third group received both nicotine and the inhibitor, while a fourth control group was given neither.
The rats that received only nicotine had substantially more morphine in their brain and experienced greater pain relief, than those who also received the inhibitor. The group that was given propranolol and not nicotine had the lowest levels of pain relief and brain morphine. All of the groups maintained the same level of morphine in the blood, which showed it was change in the activity of the enzyme within the brain, not the liver that determined the effect of codeine on pain relief.
The biggest take away from the study, published earlier this year in Neuropsychopharmacology, “is there is genetic and environmental influences on the effects of drugs of abuse,” Tyndale, who is also senior scientists in the Campbell Family Mental Health Research Institute at the Centre for Addiction and Mental Health (CAMH), told Bioscience Technology. “In this case both those with faster activation of codeine to morphine, within the brain, due to genetics or due to induction of the enzyme, likely have better pain control, but also more risk for addiction to codeine. The latter group includes smokers. More generally it suggests that metabolism of drugs within the brain may alter the abuse potential for drugs.”
In the team’s preclinical mouse model, they showed that chronic nicotine increases the level of the enzyme in the brain which activates codeine to morphine. “We know this as we observe more of the enzyme in the brain in animals treated with nicotine, and in the brains of smokers in autopsy tissues,” Tyndale told Bioscience Technology. “When there is more of the enzyme in the brain, what we have shown is that codeine gets activated to nicotine more quickly and more extensively, increasing the pain relief from codeine by creating more morphine.”
This is a new way of looking at the brain’s role, as a more active participant, with codeine not just metabolized in the liver, but also in the brain itself.
“This is opening up a whole new area of research and potentially a substantial source of variation between people in their response to drugs and toxins acting on the brain,” Tyndale said. “We’re starting to see patterns and relationships, like the nicotine and codeine connection. This is also of interest in drug development as we might be able to create drugs that are only activated once they get to the brain.”
A limitation of the study is that it is a preclinical animal model. While the researchers know that the enzyme is higher in the brains of smokers, they still need to demonstrate that the brain enzyme is important to the effects of codeine in people.
Up next, the team plans to look at other opiates such as oxycodone, and hydrocodone, Tyndale said, “which are also metabolized by the same enzyme to determine what the effect of metabolism in the brain is for these other drugs.” They are also planning translational studies to take the work into humans.
Deeming regulations reach their final hurdle: the White House
http://ecigintelligence.com/deeming-regulations-reach-their-final-hurdle-the-white-house/
Federal control has come a step closer for the U.S. e-cigarette market this week, with the Food and Drug Administration (FDA) sending its proposed deeming regulations to the White House office responsible for their final review.
On Monday, the FDA sent the regulations – which deem e-cigs to be tobacco products, and thereby bring them under the agency’s authority – to the Office of Information and Regulatory Affairs (OIRA) within the Office of Management and Budget (OMB) in the White House.
The OMB’s main role in the deeming regulations process is to ensure that they comply with overall federal policies set by the White House.
Its approval is the final step before the deeming regulations are published and become effective. It could send the regulations back to FDA for further revisions, but will likely approve them and allow them to move forward to publication.
There is no strict timetable for the OMB to comment, although it typically responds to agencies within 60 days.
However, its review could take weeks or months. During this time, the OIRA will consult with stakeholders to assess any unintended consequences that the regulations could have on the vapour industry.
They have been labelled as “economically significant” priorities, which “will be likely to have international trade and investment effects, or otherwise be of international interest”. Several industry groups have said that they will be in contact with the OIRA, including the Smoke Free Alternatives Trade Association (SFATA) and the Consumer Advocates for Smoke-Free Alternatives Association (CASAA).
These groups’ representations to the White House are likely to focus on widely-expressed concerns over the deeming regulations, including the cost of obtaining approval from the FDA for each e-cigarette product – reportedly estimated by the regulatory consultancy SciLucent at $2m-10m per item – and the lack of a meaningful “grandfathering” exemption for existing products.
It is not certain, however, exactly what the FDA has submitted to the OMB. The latest version of the deeming regulations could well differ from the text published for public comment last April, if the agency has decided to make changes based on that feedback.
The OMB previously reviewed the proposed rule before its publication last April by the FDA.
What This Means: The mere fact that the deeming regulations have moved to the OMB provides few clues as to the FDA’s final decisions on their content, although it certainly raises the possibility that no measures on child-proofing have been included, despite being called for by many in Washington and elsewhere.
After all, the FDA omitted those from the first published version, and a public consultation period on their inclusion only finished a few weeks ago: can there have been time for the agency to digest the comments and craft a policy accordingly?
In any case, what the progress of the regulations to the OMB surely does mean is that we can now expect their final publication in a few months at the most, unless – as seems unlikely – the OMB demands substantial changes.
Meanwhile, there may now also be renewed Congressional interest in the Cole bill that would provide a workable grandfathering date for e-cigs, allowing existing products to stay on the market without going through the full FDA approval procedure. That might be a bigger victory for the sector than anything else which could be achieved with the OMB.
– Carly Souther ECigIntelligence staff
More than 1 in 4 cigarettes consumed in Hong Kong were illicit
Illicit tobacco remains a significant problem afflicting Hong Kong, with more than one in every four cigarettes consumed in 2014 being illicit. Illicit cigarettes cost the Government HK$2.5 billion in lost tax revenues.
The Asia-16: Illicit Tobacco Indicator 2014 (“Asia-16”) study, conducted by Oxford Economics, found that 28.0% of cigarettes consumed in Hong Kong in 2014 were illicit, a 5.6% point drop compared to 2013.
Intensified law enforcement efforts are believed to have led to a notable decline in Hong Kong’s illicit tobacco consumption, bringing it to the lowest level since the Illicit Trade Indicator first reported figures for 2012. However, illicit tobacco remains a serious problem in Hong Kong.
“Hong Kong still has significant problem with illicit cigarettes, driven in part by the substantial retail price gaps with neighboring countries that were exacerbated by tax hikes in 2009 and 2011”, said Adrian Cooper, Chief Executive Officer of Oxford Economics. “The consumption of illicit cigarettes has effectively wiped out tax revenues that could have covered more than two months’ rentals for 750,000 public housing tenants in Hong Kong.”
“Clearly, Hong Kong’s serious illicit tobacco problem is dominated by cross-border organized crime groups that use the proceeds to finance numerous other criminal activities”, said Jeff Herbert, former Senior Superintendent with the Hong Kong Police and Advisor of the Hong Kong United Against Illicit Trade (HKUAIT). “Hong Kong still needs to get a lot tougher with such organized crime syndicates.”
Mr. Herbert refers to the Organized and Serious Crimes Ordinance as an effective tool to seek heavier penalties, freeze the assets of organized criminals, and confiscate their crime proceeds.
In addition, Mr. Herbert believes that a robust public education campaign is also key to tackling Hong Kong’s illicit tobacco problem. “The recent anti-illicit trade TV campaign run by the Customs is a good start, and I look forward to seeing more in the coming months”, continued Mr. Herbert.
Mr. Herbert urges the Government to introduce a balanced excise policy with regular but moderate tax increases in pace with inflation, and cautions against excessive tax and regulations such as 85% health warning labels that may risk fueling the illicit trade and defeat the significant enforcement efforts.
“The elimination of illicit tobacco and of the smuggling groups and syndicates must take place first,” added Mr. Herbert.
http://www.stopit.hk/?page_id=505&lang=en
Supporting Organizations
Supporting organizations of the Hong Kong United Against Illicit Trade:
Mega Hospitality International (MHI)
Infinitum Technology Co., Ltd.
Millennium Wells Ltd.
Coalition of Hong Kong Newspaper and Magazine Merchants
Hong Kong Newspaper Hawker Association
Kampo Employment Agency
Coalition on Tobacco Affairs (CTA)
Philip Morris Asia Limited
The Office of Wong Tai Sin District Councillor Lai Wing-Ho
The Office of Legislative Councillor Paul Tse Wai-chun
The Office of Tsuen Wan District Councillor Kot Siu-Yuen
The Office of Tsuen Wan District Councillor Man Yu-Ming
The Office of Tsuen Wan District Councillor Timmy Chow
The Office of Eastern District Councillor Marcus Tse
The Office of Kwun Tong District Councillor Poon Chun-yuen
Tsuen Wan Kwai Ching District Women’s Association
Hong Kong Shippers’ Council
King Fu District Residents’ Advancement Association
Choi Wan Estate Residents’ Affairs Advancement Association
Keng Leng Neighborhood Association
National smoke-free law needed: WHO
http://www.ecns.cn/2015/10-20/184913.shtml
Some 740 million people in China, including 182 million children, are exposed to second-hand smoke at least once a day in a week, leading to 100,000 Chinese deaths every year, said the latest report of the World Health Organization (WHO) on Monday.
According to the report released at a press conference in Beijing, more than 1 million people die each year in China from tobacco-related illnesses, and the number is expected to triple by 2050 if the smoking habit continues.
The report, jointly released by the WHO, the International Tobacco Control Policy Evaluation Project and the Chinese Center for Disease Control and Prevention (CDC), was based on a survey conducted between 2006 and 2014 in seven cities, including Beijing, Guangzhou in Guangdong Province and Shanghai. The data were collected from 5,600 adult smokers and 1,400 non-smokers.
Liang Xiaofeng, CDC’s deputy director, said China, the world’s largest tobacco producer and consumer, has over 300 million smokers, some 53 percent of whom are male, news site thepaper.cn reported on Monday.
About 72 percent of non-smokers aged 15 and above have been suffering from second-hand smoke, he said.
A survey conducted between 2013 and 2014 showed that 72.9 percent of junior high students were exposed to second-hand tobacco smoke at home, at indoor and outdoor public spaces, or in public vehicles.
“China has the highest rate of smoking in workplaces and homes, and among the highest rates in restaurants and bars. This puts the health of millions of non-smokers at risk every single day,” Dr Geoffrey T. Fong, principal investigator of the ITC Project, said at the conference.
“China’s addiction to tobacco is taking a dreadful toll on its health, its society, and its economy. A national smoke-free law is the only way to effectively protect all of China’s population from the harms of tobacco smoke – and the report we are releasing today demonstrates the urgent importance of this,” said Dr Bernhard Schwartländer, WHO Representative in China.
Beijing has implemented what WHO called “the strongest smoking ban” from June 1, requiring all indoor public places to be 100 percent smoke-free.
“Beijing’s comprehensive law sets an example for the whole country. Although there have been some smoke-free policies in other Chinese cities, they have been poorly enforced. We need more stringent laws, effective enforcement and mass education campaigns to enlighten people about the dangers of inhaling second-hand smoke,” said Liang.
The report also shows relatively high levels of support for smoke-free policies in China. According to a survey conducted between September 2011 and November 2012 in seven major Chinese cities, including Beijing, over half or close to half of smokers in each city supported a complete ban on smoking indoors.
Second-hand Smoke Kills Over 100,000 in China Annually: WHO
http://www.womenofchina.cn/womenofchina/html1/news/international/1510/1185-1.htm
Editor: Eileen Cheng
The World Health Organization (WHO) has called on China to enact a national tobacco control law in a report on Monday that said second-hand smoke causes more than 100,000 deaths in the country annually.
According to the report, jointly released by the WTO, International Tobacco Control (ITC) Policy Evaluation Project and Chinese Center for Disease Control and Prevention (CCDCP), around 1 million people die from tobacco-related illnesses in China annually and if uncurbed the number could rise to some 3 million by 2050.
It said Chinese citizens’ exposure to second-hand smoke is extraordinarily high, with 740 million non-smokers in China — 182 million children included — being exposed to second-hand smoke at least once a day in a typical week.
“China is unfortunately a world leader in second-hand smoke exposure: among the countries we work in, China has the highest rate of smoking in workplaces and homes, and among the highest rates in restaurants and bars,” said Dr. Geoffrey T. Fong, principal investigator of the ITC project.
When comprehensive smoking bans are effectively implemented and supported, indoor smoking virtually disappears Dr. Fong said, underlining China’s need to enact a law.
Dr. Bernhard Schwartlander, WHO representative in China, said the report demonstrated the urgent importance of a national smoke-free law.
The report recognized Beijing’s efforts after they adopted the strongest smoke-free law in China, which requires all indoor places to be 100 percent smoke-free. The law sets an excellent precedent for other Chinese cities, it said.
But Liang Xiaofeng, deputy director of CCDCP, said although there have been some smoke-free policies in other Chinese cities, they have been partial and poorly enforced. “We need stronger laws, effective enforcement and mass education campaigns to tell people about the dangers of inhaling second-hand smoke.”
The report also found high levels of public support in China for stronger smoke-free policies, even among smokers. Evidence from other countries shows that support will continue to grow after implementation of strong national smoke-free law, it said.
China is the world’s largest tobacco-producing and -consuming country, with more than 350 million smokers. Yet only a few provinces and cities have enacted local legislation on public smoking bans, and no special law has been adopted at the national level.
Smoking ‘too easy’ in China, says WHO, and even smokers agree
Jessie Lau jessie.lau@scmp.com
Even smokers themselves agree – the mainland doesn’t go far enough in stamping out tobacco use in public places, especially at work, according to a World Health Organisation report.
The findings were a clear indication the government lagged behind society in dealing with the health threats posed by smoking, the organisation said.
A comprehensive ban on smoking was introduced in Beijing in June, but many mainland cities have yet to follow suit. A national draft law banning smoking in public places was released for public consultation by the State Council in November last year, but has yet to be adopted.
“We see no reason to delay,” said Angela Pratt, who leads the WHO’s Tobacco Free Initiative in Beijing. “The existing laws aren’t working partly because many have loopholes. They’re not well enforced. They don’t protect people from exposure.”
More than a million people die annually from tobacco-related illnesses on the mainland, and an additional 100,000 die from diseases arising from exposure to second-hand smoke.
About 70 per cent of Chinese smokers and ex-smokers said they had witnessed smoking in indoor workplaces in 2011 and 2012 – the highest percentage among the countries surveyed. About 82 and 89 per cent of respondents had observed smoking in restaurants and bars in the past six months, respectively.
About half wanted a complete ban on lighting up in indoor workplaces. “The level of support right now among smokers in China for smoke-free zones is higher than it was in any of the countries we’ve studied,” said Geoffrey Fong, founder and chief principal investigator at the International Tobacco Control Policy Evaluation Project – which examines the effects of the WHO’s anti-smoking efforts. “There should be no barrier to implementing smoke-free laws.”
Extending the ban to bars was also viewed more favourably on the mainland than in other countries before the adoption of a nationwide law. On average, 35 per cent of Chinese supported smoke-free bars. In Ireland, the first country to ban smoking in bars, only 12 per cent supported the law before it was introduced.
The survey was conducted in six mainland cities, including Beijing, Shanghai and Guangzhou, and the report was prepared in conjunction with the Chinese Centre for Disease Control and Prevention and the international policy evaluation project.
Critics say policies – no matter how broadly aimed – will not be well enforced on the mainland, and that tobacco companies generate significant income for the government in the form of taxes. The industry accounts for about 10 per cent of the national fiscal revenue, and contributed 911 billion yuan (HK$1.11 trillion) last year, Beijing Business Today has reported.
The existing laws aren’t working partly because many have loopholes
Angela Pratt, WHO
Yet Pratt said stronger laws were easier to enforce, and the cost of tobacco use to public health far outweighed the tax dollars the industry contributed.
Wu Yiqun, deputy director of the ThinkTank Research Centre for Health Development, also supports the idea of a nationwide law and stressed the need to separate the business of tobacco companies from the government. “It’s getting better. The people living in Beijing … they support this regulation. Their behaviour is changing,” Wu said. “Compared to other countries, we’re very slow.”