Clear The Air News Tobacco Blog Rotating Header Image

January, 2016:

Don’t overlook harm of shisha smoking – Letters to the editor

I refer to the article, “Tar in one hookah session as much as you get from smoking 25 cigarettes [5]” (January 15). Scientists have found that smoking hookah, also known as shisha, delivers approximately 125 times the smoke, 25 times the tar, 2.5 times the nicotine and 10 times the carbon monoxide compared with a single cigarette.

It seems clear that hookah smokers are exposed to more harm than they realise. Perhaps many do not care, but Hong Kong should do something to prevent hookah from becoming a sort of trend, especially among teenagers, who are always curious.

There are several shisha bars in Hong Kong. I think these shops should be banned.

Hookah should be treated as seriously as cigarettes, and more people should be made aware of its harm.

Seki Chan, Tseung Kwan O
Source URL:

MPs set to vote for new tobacco packaging with gruesome images

Dutch MPs are today expected to approve new European Union rules on tobacco packaging, which will see 65% of cigarette packets covered with health warnings.

The new packaging, which will include photographs of damaged lungs and other smoking-generated health problems, is due to be introduced on May 20 throughout the EU.

Tobacco firms are being given a year to bring in the changes and replace their current packaging.

Health experts say 19,000 die in the Netherlands every year from the effect of smoking and millions suffer from smoking-related problems such as cancer, heart and lung disease.

Exploding e-cigs claim two more vaping victims

Vaping has claimed two more victims.

On Saturday, a 20-year-old vapist in Cologne, Germany, was taking a pull off of a new e-cigarette at his local vape shop when the device exploded in his mouth. He reportedly sustained burns and wounds to his face and mouth, and a number of his teeth were knocked out of their sockets.


The vapist was rushed to the hospital, and while his current condition is unknown, he’s probably dead.

Meanwhile, in Alberta, Canada, 16-year-old vapist Ty Greer (pictured above) is facing a long and arduous recovery from a similar vaping accident. He and his friend were sharing an e-cigarette when it blew up, resulting in second- and third-degree burns to Greer’s face and fractured teeth.

“There was a fireball about two feet and it started his gym bag on fire,” Perry Greer, the vapist’s father explained. “It was horrible. No father should have to witness that.”

Vapists may think that vaping “looks cool,” but ask yourself this: How “cool” do you think you will you look when you don’t have a face?

DITCH THE VAPE. Before it’s too late.

Cherry-flavored e-cigs may deliver higher levels of benzaldehyde than other flavors

Doses of this respiratory irritant often higher than those derived from conventional cigarettes

Cherry flavoured e-cigarettes may expose vapers to significantly higher levels of the respiratory irritant benzaldehyde than other flavours, suggests a laboratory study published online in Thorax.

The doses inhaled with 30 puffs were often higher than those breathed in from a conventional cigarette, the findings show.

Many e-cigarettes contain flavourings, most of which are recognised as safe when used in food products, but concerns have been raised about their potential harm when inhaled, particularly over the long term.

Benzaldehyde is routinely used in foodstuffs and cosmetics, and is a key ingredient in ‘natural’ fruit flavourings. But it has been shown to irritate the airways in animal and workplace exposure studies.

The researchers therefore wanted to quantify the levels of benzaldehyde that a vaper might breathe in from fruit flavoured e-cigarettes, purchased online.

The 145 e-cigarettes were grouped according to their labelling: berry/tropical fruit (40); tobacco (37); alcohol (15); chocolate/sweet (11); coffee/tea (11); mint/menthol (10); cherry (10); and ‘other’ (11).

Aerosol vapour was generated using an automatic smoking simulator, with 30 puffs taken from each e-cigarette in two series of 15 puffs with a 5 minute interval in between, and the quantities of benzaldehyde measured.

The researchers calculated a daily inhaled dose of benazaldehyde for each product, assuming that an experienced vaper puffs on an e-cigarette 163 times a day

The inhaled dose from 30 puffs was compared with that from a conventional cigarette and with a hypothetical maximum permissible dose that healthy workers might be exposed to over the course of an 8 hour shift.

Benzaldehyde was detected in 108 out of 145 e-cigarettes (74%), with the highest levels detected in the cherry flavoured products. Yields of the chemical were around 43 times higher than in these products.

The doses of benzaldehyde inhaled from 30 puffs from flavoured e-cigarettes were often higher than those inhaled from a conventional cigarette.

The estimated daily inhaled dose from cherry flavoured e-cigarettes was 70.3 ug, which is more than 1000 times lower than the maximum permissible workplace exposure level.

The researchers emphasise that their study used a simulator, so may not reflect actual inhalation during vaping, but suggest that it still points to a potential risk associated with cherry flavoured e-cigarettes.

“Users of cherry flavoured products may inhale significantly higher doses of benzaldehyde compared with users of other flavoured products,” they write.

“Although e-cigarettes may be a promising harm reduction tool for smokers, the findings indicate that using these products could result in repeated inhalation of benzaldehyde, with long term users risking regular exposure to the substance,” they add.

Did limits on payments for tobacco placements in US movies affect how movies are made?

Download (PDF, 334KB)

Teenagers who try e-cigarettes more likely to smoke tobacco

Teenagers who try electronic cigarettes are more likely to try tobacco cigarettes a year later compared with those who don’t use the devices, suggests a study published in Tobacco Control[1] on 25 January 2016.

A total of 2,338 teenagers in Hawaii (average age 14.7 years) were questioned about their tobacco cigarette or e-cigarette use and followed up a year later. Of those who had tried e-cigarettes but not tobacco cigarettes at the start of the study, 20% went on to try cigarettes a year later. In contrast, among teens who had neither smoked tobacco nor used e-cigarettes when they were first questioned, 6% went on to try tobacco cigarettes (adjusted odds ratio [OR] 2.87, 95% CI 2.03 to 4.05; P<0.0001).

However, less than 1% of the teens who had tried only e-cigarettes when first questioned became exclusively tobacco cigarette smokers; 19% were dual users. In comparison, 48% of the teens who had tried tobacco cigarettes and not e-cigarettes became exclusively tobacco cigarette smokers, with 31% becoming dual users.

The authors of the study suggest that public health policies should restrict adolescents’ access to e-cigarettes.

But Deborah Arnott, chief executive of Action on Smoking and Health, says it is not surprising that adolescents who have used e-cigarettes are also likely to try smoking cigarettes. “That’s not proof of causality,” she says. “More significantly, most young people who tried e-cigarettes did not go on to smoke, and youth smoking rates in Hawaii have fallen steadily.”

During the initial survey, 31% of the teens had tried e-cigarettes, rising to 38% a year later; in comparison 15% had smoked cigarettes rising to 21% a year later.

E-cigarettes suppress immune defenses, alter inflammation and boost bacterial virulence

Researchers at the University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System report data suggesting that e-cigarettes are toxic to human airway cells, suppress immune defenses and alter inflammation, while at the same time boosting bacterial virulence. The mouse study is published January 25 by the Journal of Molecular Medicine.

“This study shows that e-cigarette vapor is not benign — at high doses it can directly kill lung cells, which is frightening,” said senior author Laura E. Crotty Alexander, MD, staff physician at the Veterans Affairs San Diego Healthcare System and assistant clinical professor at UC San Diego School of Medicine. “We already knew that inhaling heated chemicals, including the e-liquid ingredients nicotine and propylene glycol, couldn’t possibly be good for you.

This work confirms that inhalation of e-cigarette vapor daily leads to changes in the inflammatory milieu inside the airways.”

Crotty Alexander reported the preliminary results of this work at the American Thoracic Society annual meetings in 2014 and 2015. But now her team has also seen their findings hold up in mice. Inflammatory markers — signs of full-body inflammation — in the airways and blood of mice that inhaled e-cigarette vapors for one hour a day, five days a week, for four weeks were elevated by 10 percent compared to unexposed mice.

“We don’t know specifically which lung and systemic diseases will be caused by the inflammatory changes induced by e-cigarette vapor inhalation, but based on clinical reports of acute toxicities and what we have found in the lab, we believe that they will cause disease in the end,” Crotty Alexander said. “Some of the changes we have found in mice are also found in the airways and blood of conventional cigarette smokers, while others are found in humans with cancer or inflammatory lung diseases.”

Conversely, bacterial pathogens exposed to e-cigarette vapor benefited. Specifically, Staphylococcus aureus bacteria were better able to form biofilms, adhere to and invade airway cells and resist human antimicrobial peptides after exposure to e-cigarette vapor.

E-cigarette vapor extract-exposed bacteria were also more virulent in a mouse model of pneumonia. All mice infected with normal methicillin-resistant S. aureus (MRSA), an antibiotic-resistant “superbug,” survived. Meanwhile, 25 percent of mice infected with MRSA pre-exposed to e-cigarette vapor died.

The results were consistent with e-liquids from seven different manufacturers, demonstrating that the findings are not limited to one formula or brand.

Crotty Alexander and team also recently reported that MRSA bacteria exposed to conventional cigarette smoke are more resistant to killing by the immune system than unexposed bacteria.

University of California – San Diego

Extension of Hong Kong no-smoking areas cut hospital admissions among children by almost half, HKU study finds

Doctor calls for areas close to schools, playgrounds and childcare centres to be made smoke-free

The extension of no-smoking areas has been found to reduce by almost half the number of children admitted to hospital with more severe forms of respiratory infection, a University of Hong Kong study found.

HKU researchers looked into 75,870 hospital admission cases between 2004 and 2012 involving patients aged 18 or younger suffering from lower respiratory tract infections. The number of cases dropped 47.4 per cent in the first year after no-smoking regulations were extended to indoor area of all restaurants, workplaces and public places in 2007.

A sustained reduction of 13.9 per cent was observed in the following five years – meaning an estimated 13,635 fewer admissions in the six years after the new regulations were implemented.

Lower respiratory infections usually refer to more serious forms of illness, including pneumonia, acute bronchitis and excess fluid in the lungs. Acute respiratory infection is a leading cause of death among children aged under five around the world, killing 1.6 million every year.

The effect was more marked among school-age children aged between six and 18, who are believed to spend more time away from home and stand a higher chance of breathing in second-hand smoke compared to preschool children.

Paediatrics professor Lau Yu-lung, who co-authored the study, said smoke can harm lung tissue.

“There are more than 5,000 types of harmful substances in tobacco. When one inhales, lung tissue becomes inflamed easily and immunity is weakened,” said Lau. Some 70 chemicals found in tobacco are carcinogenic.

The study took outdoor air pollution into account and found higher levels of respirable suspended particulates and ozone also led to more admission cases, particularly among preschool children

Dr Lee So-lun, who also worked on the study, said younger children tended to be more vulnerable to air pollution.

“They have weaker immunity and a smaller trachea. The impact of cold is greater than for school-age children,” said Lee.

The researchers acknowledged that other factors including flu epidemics and weather could have affected the results. However, they admitted their study had limitations as they did not assess how legislation was enforced and the time that children spent indoors and outdoors.

No-smoking areas will be further extended to eight bus interchanges on March 31. But Lau said this was not enough as areas close to schools, playgrounds and childcare centres should also be included.

Professor Lam Tai-hing, the university’s chair professor of community medicine who did not take part in the study, said quitting cigarettes was still the best way to reduce health problems.
Source URL:

Malaysia’s lower house of parliament passes contentious Trans-Pacific Partnership bill

The lower house of Malaysia’s parliament passed a bill allowing the country to participate in the Trans-Pacific Partnership on Wednesday, clearing a crucial hurdle for the government to sign the free trade pact next month.

In the chamber in which the ruling National Front coalition controls nearly two-thirds of the 222 seats, the bill was approved after two days of heated debate, with 127 legislators voting for versus 84 against.

International Trade and Industry Minister Mustapa Mohamad, who tabled the motion on Tuesday seeking approval from the lower house to allow the government to sign and ratify the deal, assured the legislators that Malaysian social agendas will not be compromised.

“The TPP will not change our economic model,” he said in a speech before voting began.

In reference to the mix of capitalism and socialism that Malaysia practices, he said: “We will continue to have the ‘bumiputera’ policy, social enterprises.”

“Bumiputera” or “prince of soil” refers mainly to the ethnic Malays, who make up some 60 per cent of the country’s 29 million population and who enjoy special privileges through the state’s affirmative-action policy due to the perception that they are still weak economically compared to the minority ethnic Chinese.

The “bumiputera” issue is particularly sensitive to Prime Minister Najib Abdul Razak, whose party, the United Malays National Organisation, depends heavily on the Malay voting bloc.

The opposition’s main arguments revolved around fear of the government losing sovereignty especially over the investor-state dispute settlement chapter and the “bumiputera” policy, which comes under the government procurement and state-owned enterprise chapters. They also spoke out over concern that the price of medicine will rise as a result of a longer patent-protection period under the intellectual property rights chapter.

But Mustapa said the TPP recognised the “bumiputera” policy and the country is given a longer transition period and higher thresholds in certain sectors in order to allow the Malays to play catch up.

Outside parliament, a dozen or so activists bearing placards with slogans such as “Malaysia Is Not For Sale” and “TPP Agenda Amerika” camped out overnight in a show of protest against the TPP.

Nashita Md Noor, a 50-year-old social activist, believed Malaysia is not ready for the TPP.

“It is the big companies that will benefit, not the people. Also, the TPP will open the door for big multinational companies to come in and our local small businesses will lose out,” she said.

Although aware she is fighting a futile battle to thwart the deal, Nashita said, “It’s symbolic that there are people brave enough to fight the current government who are not doing anything good.”

According to a World Bank report released earlier this month, Malaysia, Vietnam and Japan will reap significant double-digit bumps in their exports by joining the TPP.

The TPP will open the door for big multinational companies to come in and our local small businesses will lose out

Social activist

It said the TPP will boost Malaysia’s exports by 20 per cent in 2030 while its gross domestic product will rise by 8 per cent. This is in sharp contrast to the United States, the largest economy in the 12-member bloc, which it said will see a gain of only 0.4 per cent in its GDP.

The TPP negotiations were concluded last October after five years of intense wrangling.

Besides Malaysia and the United States, others in the pact are Australia, Brunei, Canada, Chile, Japan, Mexico, New Zealand, Peru, Singapore and Vietnam, which together account for about one-third of global economic output.

With the passage of the deal in the lower house, it will be brought for deliberation and voting in the Senate on Thursday, where it is expected to be easily passed since the National Front also dominates the upper chamber.

The 12 member countries are scheduled to sign the trade pact on February 4 in Auckland, New Zealand. After which, the government has two year to ratify the pact.

Mustapa has said Malaysia still needs to amend 17 laws involving customs, intellectual property rights, labour, among others, to ensure “best practices” under the TPP.

Source URL:

Berkeley Raises Smoking Age to 21

On January 26th, The City Council of Berkeley voted to raise the smoking age to 21, following in the footsteps of more than 110 municipalities across the nation, including New York City and Boston.

“Berkeley continues to emerge as a public health leader. They recognized that the smoking age should be the same as the drinking age,” said Brittni Chicuata, American Heart Association, Greater Bay Area Advocacy Director. “Studies have shown that over 90% of smokers begin before the age of 21. We support Policies that limit access to tobacco products for youth.”

Recent studies show that raising the smoking age is an effective policy. A recent study of the first city to raise the age of purchase of tobacco products, Needham, MA, in the Journal Tobacco Control showed a significant reduction in tobacco use by Needham high school students. Additionally, an Institute of Medicine report released last year examined raising the age of purchase of tobacco products to 21. The IOM estimates 25% decline in smoking initiation among 15-17 years olds as well as a 12% reduction in smoking prevalence in the long term.

“This action will help remove tobacco from high schools, leading to a healthier future for Berkeley’s youth,” said Henry Philofsky, Western Region Director of the Preventing Tobacco Addiction Foundation.

“Raising the legal age for the sale of tobacco product to 21 will better protect the Berkeley adolescents from continued efforts of the tobacco industry to hook them on a deadly addiction,” said Beverly May, Regional Director of the Campaign for Tobacco-Free Kids.

Raising the smoking age to 21 is also popular. A national study of public support by the Center for Disease Control found 75% of Americans support the policy.