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November 1st, 2015:

CDC Office on Smoking and Health E-cigarette Information

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Health Bureau defends proposed ban on e-cigarette sales

The local health authority said it did not agree with a survey suggesting that smokers would like to be able to choose to switch to less harmful alternatives to traditional tobacco products such as e-cigarettes

The city’s Health Bureau has defended its proposed ban on local sales of electronic cigarettes as part of the amendment of the tobacco control regime, saying that it does not agree with a survey suggesting that most smokers want to be able to choose to switch to ‘less harmful’ alternatives such as e-cigarettes.

In a statement released on Thursday night, the Bureau stated that e-cigarettes are not less harmful than traditional cigarettes, and that e-cigarettes should not be considered as an alternative to conventional tobacco products.

“To ensure public health, the MSAR Government has clearly suggested regulating e-cigarettes as a tobacco product as written in the delivered bill on the amendment of the tobacco control regime, and this has already gone through the first reading in the Legislative Assembly,” the Bureau stated.

The bill, which is now being reviewed by the second permanent committee of the Assembly, suggests a blanket ban on e-cigarette sales. The same bill also proposed a universal smoking ban in the city’s casinos.

The Health Bureau’s statement followed the Thursday briefing of two Hong Kong-based consumer advocacy groups calling for the government and legislature to give an opportunity to adults to choose e-cigarettes as a safer alternative to smoking.

The two groups are Fact Asia and Asian Vape Association, and the former’s supporters include Axiom Select, the Tobacco Vapour Electronic Cigarette Association, and Philip Morris International.

In the briefing, Fact Asia has presented a survey conducted by Ipsos of 404 local adult smokers in late August to mid-September, in which 54 per cent agreed that e-cigarettes represent a positive alternative to smoking. Some 55 per cent of respondents agreed that the government should not prevent or delay legalising less harmful products.

The Health Bureau said they disagreed with the conclusion of the survey.

Citing a World Health Organisation (WHO) report of 2014 on electronic nicotine delivery systems (ENDS), the Bureau stressed the possible health risks to ENDS users and non-users and that the efficacy of e-cigarettes helping smokers to quit smoking has not been systemically evaluated. Electronic cigarettes are the most common prototype of ENDS.

The WHO report, which recommends strict regulation of e-cigarettes and bans sales to minors, noted that the aerosol to ENDS users usually contains some carcinogenic compounds and other toxicants.

‘The fact that ENDS exhaled aerosol contains on average lower levels of toxicants than the emissions from combusted tobacco does not mean that these levels are acceptable to involuntarily exposed bystanders,’ the WHO report reads. ‘In fact, exhaled aerosol is likely to increase above background levels the risk of disease to bystanders, especially in the case of some ENDS that produce toxicant levels in the range of that produced by some cigarettes.’

Banning the trade

In Macau’s neighbouring city Hong Kong, the health authority is considering a ban on the sale of e-cigarettes despite a recent British Study suggesting their vapours are around 95 per cent less harmful than tobacco. Currently, e-cigarettes can be sold legally in Hong Kong, and they are regulated as pharmaceutical products by the Pharmacy and Poisons Ordinance.

The study, conducted by Public Health England, concluded that most of the chemicals causing smoking-related diseases were absent in e-cigarettes. The study also suggests e-cigarettes should be promoted as a means to help smokers quit.

Macau’s legislature will soon be considering whether it goes along with the government’s proposed ban on e-cigarette sales, as legislator Chan Chak Mo noted last week that he was still hopeful the bill could be approved before the legislative year ends in August, 2016.

“We recommend that the Legislative Assembly take note of regulations that have been introduced in other countries, and look at the body of evidence. They should introduce evidence-based regulation of e-cigarettes in Hong Kong instead of banning them without any in-depth understanding of the reasons why harm-reduction experts are calling for their legalisation,” co-founder of Heneage Mitchell commented in a note to the survey.

Progression to Traditional Cigarette Smoking After Electronic Cigarette Use Among US Adolescents and Young Adults


Electronic cigarettes (e-cigarettes) may help smokers reduce the use of traditional combustible cigarettes. However, adolescents and young adults who have never smoked traditional cigarettes are now using e-cigarettes, and these individuals may be at risk for subsequent progression to traditional cigarette smoking.


To determine whether baseline use of e-cigarettes among nonsmoking and nonsusceptible adolescents and young adults is associated with subsequent progression along an established trajectory to traditional cigarette smoking.

Design, Setting, and Participants

In this longitudinal cohort study, a national US sample of 694 participants aged 16 to 26 years who were never cigarette smokers and were attitudinally nonsusceptible to smoking cigarettes completed baseline surveys from October 1, 2012, to May 1, 2014, regarding smoking in 2012-2013. They were reassessed 1 year later. Analysis was conducted from July 1, 2014, to March 1, 2015. Multinomial logistic regression was used to assess the independent association between baseline e-cigarette use and cigarette smoking, controlling for sex, age, race/ethnicity, maternal educational level, sensation-seeking tendency, parental cigarette smoking, and cigarette smoking among friends. Sensitivity analyses were performed, with varying approaches to missing data and recanting.


Use of e-cigarettes at baseline.

Main Outcomes and Measures

Progression to cigarette smoking, defined using 3 specific states along a trajectory: nonsusceptible nonsmokers, susceptible nonsmokers, and smokers. Individuals who could not rule out smoking in the future were defined as susceptible.


Among the 694 respondents, 374 (53.9%) were female and 531 (76.5%) were non-Hispanic white. At baseline, 16 participants (2.3%) used e-cigarettes. Over the 1-year follow-up, 11 of 16 e-cigarette users and 128 of 678 of those who had not used e-cigarettes (18.9%) progressed toward cigarette smoking. In the primary fully adjusted models, baseline e-cigarette use was independently associated with progression to smoking (adjusted odds ratio [AOR], 8.3; 95% CI, 1.2-58.6) and to susceptibility among nonsmokers (AOR, 8.5; 95% CI, 1.3-57.2). Sensitivity analyses showed consistent results in the level of significance and slightly larger magnitude of AORs.

Conclusions and Relevance

In this national sample of US adolescents and young adults, use of e-cigarettes at baseline was associated with progression to traditional cigarette smoking. These findings support regulations to limit sales and decrease the appeal of e-cigarettes to adolescents and young adults.

NVAP urges authorities to implement no-smoking law

MANILA – The New Vois Association of the Philippines (NVAP) has urged authorities to implement the no smoking law as millions of Filipinos flock to cemeteries and transport terminals in observance of All Saints’ Day.

NVAP President Emer Rojas said while Republic Act 9211 prohibits smoking in public areas it is loosely implemented because of lack of law enforcement and awareness.

“As we remember our departed loved ones let us also show respect to those who are still with us by considering their wellbeing. We don’t want to expose them to cigarette smoke which we all know kills,” Rojas, a cancer survivor and member of the CANCER coalition. CANCER stands for Cancer Alleviation Network on Care Education and Rehabilitation.

Around 24 million Filipinos are exposed to tobacco smoke everyday. An estimated 67% inhale second-hand smoke in the workplace while 76% are exposed in areas that do not implement an anti-tobacco policy.

Data from the Philippine Cancer Society reveals that around 3,000 Filipinos die of lung cancer each year due to second-hand smoke.

“There is no safe level when it comes to inhaling tobacco smoke. Whether you consume cigarette yourself or you are exposed to its smoke, it is equally dangerous and fatal. We must protect public health from the dangers of tobacco by enforcing the law on non-smoking in areas where there are huge crowds of people including children,” he said.

According to the Philippines 2011 Global Youth Tobacco Survey, more than two in five 13-15 year old children are exposed to second-hand smoke in their homes.

The World Health Organization’s Tobacco Atlas reveals that second-hand smoke increases the risks of contracting lung cancer by 30 percent and coronary heart disease by 25 percent.

“Despite increased information dissemination including involvement of social media, the fact remains that many Filipinos are still not fully aware of the harmful effects of smoking and second-hand smoke,” said Rojas.

The NVAP head and Global Cancer ambassador noted that the implementation of the graphic health warnings law would surely help address this issue as pictures emit powerful messages that can be understood by anyone including children.

Signed last year by President Benigno Aquino III, the graphic health warnings law mandates the placement of actual pictures of the dangers of smoking on cigarette packs that must be implemented starting November 5 this year or one year after the first publication of the GHW templates.

Workers harmed in Florence restaurants that allow smoking

FLORENCE, Ala. (AP) – A new air quality study says workers in a Florence restaurant that allow smoking are exposed to a greater amount harmful air particles than those working in non-smoking environments.

The TimesDaily reports ( ) that the study says workers in smoking-allowed restaurants are exposed to a 66 percent higher rate than the opposite. It was released this week by the Partnership for a Tobacco-Free Shoals and Smoke-Free Shoals. The results were performed by Roswell Park Cancer Institute this year.

The air in six smoke-free restaurants and six restaurants that allow smoking was tested.

An official from the Partnership for a Tobacco-Free Shoals says the level of harmful air particles measured in bars and restaurants that allow smoking was higher than the level found in forest fires.

Your E-Cig Has Just Been Banned From Your Checked Luggage

The world has just become a little sadder for people who enjoy their cigarettes in electronic form. The devices have just been banned from checked luggage, which means that those people wanting to smoke once they arrive at their destination will either just have to purchase a disposable cig they can toss, go back to getting their nicotine fix manually, or carry their vapes onto the plane so they can keep a close eyes on them. But that’s not because the Department of Transportation is trying to be a buzzkill; they just want to make sure that no one’s cool-as-hell smoking machine will set the entire plane on fire.

Forbes reports that the ban doesn’t come without precedent. In 2014, an electronic cigarette set someone’s luggage on fire while in the cargo hold (the plane had to be evacuated), and, just this year, a piece of luggage caught on fire while chilling in the baggage area at LAX. The cause? An overheated e-cig.

“We know from recent incidents that e-cigarettes in checked bags can catch fire during transport,” U.S. Department of Transportation Secretary Anthony Foxx said in a statement. “Fire hazards in flight are particularly dangerous. Banning e-cigarettes from checked bags is a prudent safety measure.”

The interim final rule, issued on Monday by the Pipeline and Hazardous Materials Safety Administration (PHMSA) in coordination with the Federal Aviation Administration, applies to e-cigarettes, battery-powered devices that simulate tobacco smoking by producing heated vapors, which resembles smoke, as well as similar items like e-cigs, e-cigars, e-hookahs, e-pipes, personal vaporizers, and electronic nicotine delivery systems.
It goes without saying that passengers won’t be allowed to charge their electronic cigarettes aboard commercial aircrafts, either. But if that’s what it takes to keep you safe while you’re hurtling through the sky at hundreds of miles an hour, it sounds pretty reasonable.