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February, 2016:

Talking with … An anti-tobacco crusader

Feb 11th, 2016
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http://www.jweekly.com/article/full/76864/talking-with-an-anti-tobacco-crusader/

Name: Stanton Glantz

Age: 69

City: San Francisco

Position: Professor of medicine at UCSF, director of Center for Tobacco Control, Research and Education

Stanton Glantz

J.: It’s been a few years since the fight against big tobacco was a big news item. Where does that fight stand now?

Stanton Glantz: We haven’t solved the problem but we’ve made dramatic progress. Here in California, for example, we’ve dramatically cut the smoking rate down to 11 or 12 percent, and most smokers are relatively light smokers. But there are still millions of smokers. And the tobacco companies have become more active in the state Legislature. California has the 33rd lowest cigarette tax rate in the country. Jerry Brown is the first governor in decades to take tobacco campaign money.

I was surprised to find that you’re not an M.D. Your education was in engineering, including your undergrad, master’s and Ph.D. studies. How did you first get into anti-tobacco work?

I started out as a rocket scientist. I worked in several different areas at NASA, but I spent the largest amount of my time working in the mission planning and analysis divisions where we actually design the missions. I got interested in a project to use the same kind of methods that are used to control spacecraft to control anesthesia, which turns out to be a harder problem. That led to a dissertation on how the heart muscle works. Then I spent the first chunk of my career as an academic doing bioengineering, applying engineering concepts to how the heart and cardiovascular system work. And then the tobacco stuff was sort of a hobby that I got interested in in the late ’70s. It’s become a big part of my life, but I still do cardiovascular research and publish in those journals.

One of your projects is called SmokeFreeMovies, which has a website where people can see which current movies include smoking. What’s the goal of that campaign and what kind of success have you had with it?

Smoking in the movies is the major reason kids start smoking. I realized that we weren’t going to solve this talking with studios in the backrooms because tobacco has been putting money into Hollywood going back a long time. So we started this public campaign to get smoking out of movies. The six major studios now have policies discouraging smoking in their youth-rated movies. The amount of smoking in movies in 2015 was about half what it once was. The big goal for the next year is to get rid of the remaining half.

There’s a lot of new research on e-cigarettes. What is their impact and what do people need to know?

It’s true that heating up a [nicotine] solution does not create as many cancer-causing chemicals — but most people who are using e-cigarettes are not abandoning regular cigarettes, but using the two together. The odds of quitting smoking are 28 percent lower in smokers who use e-cigarettes compared to smokers who don’t. More kids are starting nicotine addictions through e-cigarettes, and those who do are more likely to go on to smoke regular cigarettes. San Francisco has integrated e-cigarettes into its indoor clean air law, but Alameda County just refused to.

The tobacco industry has twice sued the University of California over your work. What can you tell me about that?

On May 12, 1994, I got a box of purloined industry documents sent to me anonymously. The tobacco companies sued the university, trying to prevent us from releasing them, and we beat them. The second time, the tobacco industry claimed indoor smoking laws would destroy restaurant revenue, but our research found that to be false. So they sued the university on that, and it was dismissed because they didn’t have a case. But the tobacco companies are bullies with infinite money so they appealed it all the way up the Supreme Court. They lost.

Do Jewish ethics play a role in your work?

They play a big role. Historically, Jews have been on the edge, and we’re willing to take some risks that some others might not. Underlying attitudes built into Jewish culture have certainly been an element in why I am who I am and why I do what I do. My wife and I are members of Congregation Beth Sholom in San Francisco, and my wife is very active. We do Shabbos every week and always have, but I’m more into the ethical and prophetic part of the Jewish tradition, rather than ritualistic stuff.

E-Cigarettes’ Effect On The Immune System Could Make Them No Better Than Regular Cigarettes

Feb 11th, 2016
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http://www.medicaldaily.com/vaping-cinnamon-smoking-cigarettes-immune-system-373316

Electronic cigarettes, or e-cigs, have been marketed in the United States since 2007. Many people believe vaping is not very harmful, perhaps because of the fanciful flavors — everything from cotton candy to tangerine. New research from UNC School of Medicine suggests the opposite may be true with evidence that cinnamon-flavored e-liquids not only harm epithelial cells, but also change immune responses in our airways.

In previous work, Dr. Ilona Jaspers, a professor and director of the curriculum in toxicology, demonstrated how smoking regular cigarettes impaired the immune responses of mucosal cells within the respiratory system. She wondered if vaping did similar damage.

For her current study, Jaspers and her colleagues obtained tissue samples of the epithelial layer inside the nasal cavities of smokers, non-smokers, and users of e-cigarettes. Examining the samples, the team analyzed expression of nearly 600 genes involved in immunity. The researchers also obtained nasal fluid, urine, and blood samples from the participants to study inflammation, immunity, and possible changes occurring as a result of tobacco and nicotine exposure.

“Our data indicate that cinnamaldehyde-containing e-liquids have a significant negative effect on epithelial cell physiology and barrier function,” Jaspers wrote in her presentation to the American Association for the Advancement of Science, while also noting the cinnamon-flavored liquids, when inhaled, compromise respiratory immune cell function.

Smoking Vs. Vaping

While smoking cigarettes caused suppression of several key immune genes in the nasal mucosa, the data showed e-cig vapers were even worse. Along with suppressing the same key immune genes in the nasal mucosa, e-cigarette vapers also dampened the positive actions of additional immune genes.

This possibly broad effect on the respiratory immune response system, Jaspers theorized, might have something to do with the flavoring. Though the Food and Drug Administration rates the liquid flavorings as “safe” for oral consumption, they’ve never been tested for inhalation.

In separate experiments using cell cultures, Jaspers’ lab examined the effects of cinnamaldehyde — the chemical flavoring that makes an e-cigarette taste like cinnamon. Cinnamaldehyde e-liquids had a “significant” negative effect on epithelial cell physiology, the results showed. The chemicals hindered key immune cells, including macrophages, natural killer cells, and neutrophils.

This compromised immune function could begin a whole cascade of cellular mechanisms that ultimately lead to impaired immune responses in the lung, Jaspers says.

Going forward, she and her colleagues will experiment to understand the health effects of long-term exposure to e-cigarettes, especially cinnamon-flavored e-cigs. Because they are increasingly popular among teens and young adults — because so many people don’t believe they are harmful — the question of potential needs to be answered.

Secondhand smoke exposure at home among one billion children in 21 countries

Feb 11th, 2016
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Tobacco companies ‘operating in shadows’

Feb 10th, 2016
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http://www.irishexaminer.com/ireland/tobacco-companies-operating-in-shadows-381018.html

Tobacco companies are working through the courts and lobbying the European Commission to roll back rules on smoking that have taken years to bring into force, Children and Youth Affairs Minister James Reilly has warned.

He has written to the senior vice-president of the commission, Frans Timmermans, accusing it of “operating in the shadows” in its dealing with the tobacco industry.

Mr Reilly, who pushed through tough new EU legislation during Ireland’s presidency of the union three years ago, reminded Mr Timmermans that 700,000 people a year die from the effects of tobacco, 5,200 in Ireland.

He has urged the commission to comply with recommendations issued by the EU ombudsman, Emily O’Reilly, to publish all its dealings with tobacco lobbyists.

The former health minister has harshly criticised the commission’s claim that it doesn’t have to abide by the World Health Organisation’s guidelines on tobacco lobbying because they “are not legally binding”.

He accused it of hiding behind legalese saying it signed up to the WHO framework convention on tobacco control that includes protecting public health policies from the tobacco industry vested interests.

“And yet when it comes to the Framework Convention on Tobacco Control guidelines which seeks to ‘establish measures to limit interactions with the tobacco industry and ensure the transparency of those interactions that occur” the commission hides behind the position that the guidelines are not legally binding.

“The industry, with its multibillion euro resources has a major lobbying programme at work with the clear intention of hindering or rolling back progressive public health measures aimed at reducing the prevalence of smoking.

“They leave no stone unturned in efforts to influence decision-making,” he said.

The Government has passed the Regulation of Lobbying Act 2015 because citizens have the right to know what lobbyists are trying to influence government policy, he said.

“It is unacceptable that lobbyists, working on the EU Commission to further the interests of the tobacco industry can do so under the cover of regulations not being “legally binding”.

“It is not against the law for them to be transparent, but clearly it is against their culture. This needs to change,” he said.

Ireland will introduce plain cigarette packaging and he hoped the new graphic health warnings on packets will stop children taking up what he called “this killer addiction”.

“But look at the tobacco industry fighting this development in courts in Ireland, the UK and in Europe every step of the way. Their lobbyists must not be able to work on the EU commission while hidden in the shadows,” he said.

In his letter to Mr Timmermans he said the tobacco industry had a long and shameful record of concealing the truth to protect its profits.

The minister admitted that when he was working on the EU tobacco directive during Ireland’s EU presidency in 2013 that he was “deeply conscious of the lobbying of big tobacco, the meetings being sought and the influence being brought to bear on police being made in the best interests of public health”.

There were revelations at the time that Taoiseach Enda Kenny and Finance Minister Michael Noonan met tobacco lobbyists, despite Ireland signing up to the WHO tobacco convention.

“Lets have a high level of transparency when it comes to meetings with an industry which creates a product which prematurely kills up to one in two of its habitual users”, his letter to vice-president Timmermans concluded.

James Reilly criticises EU lack of detail on tobacco industry

Feb 10th, 2016
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http://www.irishtimes.com/news/politics/james-reilly-criticises-eu-lack-of-detail-on-tobacco-industry-1.2528767

Commission rejects calls from European ombudsman Emily O’Reilly for transparency

Minister for Children James Reilly has criticised the European Commission for failing to detail their dealings with the tobacco industry.

The commission has rejected calls from European ombudsman Emily O’Reilly for transparency on its discussions with the industry.

Dr Reilly said the position was “extremely disappointing”, considering the high death rate from tobacco-related illnesses.

“It is not acceptable that the European Parliament works hard to progress a tobacco directive which seeks to protect public health and yet the commission is not proactively transparent in all its dealings with the tobacco industry.

“The industry, with its multibillion-euro resources, has a major lobbying programme at work with the clear intention of hindering or rolling back progressive public health measures aimed at reducing the prevalence of smoking.”

A report by the European Ombudsman in October sharply criticised the European Commission’s transparency policy regarding contacts with the tobacco industry, accusing the commission of breaching World Health Organisation (WHO) disclosure rules.

While the health directorate general of the European Commission publicises its dealings with the tobacco industry, Ms O’Reilly said this policy should be extended to all sections of the commission.

However, it has rejected the findings of the investigation, arguing that its current policy is in line with WHO rules.

Govt should raise tobacco taxes by up to 50 per cent: smoking opponents

Feb 10th, 2016
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There is very “strong scientific ground” for the government to increase taxes on tobacco to cut smoking rates, according to a public health expert.

Increasing tobacco taxes by as much as 50 per cent a year could form the “backbone” of efforts to make New Zealand smoke-free, politicians have been told.

Tobacco taxes increased by 10 per cent at the start of the year, and academics and anti-smoking groups have encouraged Parliament’s finance and expenditure select committee to support a bigger price hike.

Otago University public health professor Nick Wilson, who has studied the best-value methods for reducing the impact of smoking, said politicians were “on extremely strong scientific ground” when raising taxes on tobacco.

“It’s one of the most powerful things that can be done to improve the health of the population … tax can be the backbone of the strategy.”

Wilson said raising taxes would save money in the health sector within a year, due to a reduction in heart attacks and strokes, while it would also reduce the gap in smoking rates between Maori and non-Maori.

“This is in some way a no-brainer public health intervention if you’re actually gaining healthy years of lives and saving health costs.”

Wilson said the issue of e-cigarettes, which are not currently approved for smoking cessation in New Zealand, was “a very complex area” due to the amount of new studies coming out every week.

It would be best to control their use through pharmacies until their benefits and dangers were fully known, he said.

National Maori Tobacco Control Leadership Service kaiwhakahaere Zoe Hawke said tax increases were a “foundation policy” that anti-tobacco organisations could use to improve quitting rates.

“It gets people thinking about quitting, it moves people into accessing services more.”

Hawke said she was keen to see more progress on plain packaging rules for tobacco products, as well as the de-nicotinisation of cigarettes and consideration of e-cigarettes.

“We need to remove nicotine from the products out there and do some transitional moves to help people move away from it, and e-cigarettes could potentially be something that will help with that too.”

The health benefits of tax increases would outweigh the economic costs to smokers, but they would need to be backed up by support services “so they’re not just left out there stranded”, she said.

T&T Consulting director Sue Taylor said the smoking health programmes already in place were not doing enough to help people quit, and a significant price increase would make a big difference.

“Our people out there in the community … a lot of them are saying, ‘That’s the only thing that will encourage me to give up smoking’.

“My own father, when he smoked … he gave up because of the price increase: it was more important for him to be able to provide better things for us as children, than to continue smoking.”

Taylor said tobacco taxes should be increased by 50 per cent this year, followed by 25 per cent each year until 2020.

She did not support e-cigarettes as they “normalised” smoking, and was also concerned that the majority of e-cigarettes were produced by tobacco manufacturers.

“They’re still trying to double-dip everywhere, they’re still trying to introduce other ways of continuing to have the population addicted to nicotine, so we seriously need to think about how we’re going to tax those as well.”

Health New Zealand smoking policy researcher Murray Laugesen supported a tax increase, and said the Government should look at legalising the use of e-cigarettes.

“They’ve killed nobody so far, against 4000 deaths [a year] from ordinary cigarettes.”

Laugesen also said there was “sound” evidence for low-nicotine cigarettes from trials in New Zealand and the United States.

“They show clearly that this reduces the appetite for nicotine, and if we lose the appetite for nicotine, we smoke less.”

Teen data find vapers often become smokers

Feb 10th, 2016
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New study shows teens who might not normally smoke begin doing so after using e-cigarettes

https://student.societyforscience.org/article/teen-data-find-vapers-often-become-smokers

Many people see vaping as being less harmful than smoking cigarettes. After all, unlike tobacco, e-cigarettes don’t deliver dozens of lung-cancer-causing chemicals, called carcinogens, with each puff. So the fact that more teens are vaping than smoking might be viewed as a good thing.

Except — that more and more studies are showing e-cigarettes can cause harm. They irritate lungs and make asthma worse. They also raise the risk a teen will take up smoking. A new study not only confirms this risk but also suggests that vaping may encourage smoking by even those teens who would have seemed the least likely to have taken up the habit.

E-cigarettes have been widely available for less than a decade. So there’s not yet much long-term data on how they affect health. But vaping liquids do contain nicotine, a chemical known to cause harm. Indeed, this chemical is what makes smoking so addictive. And it now may explain why many young people who vape move on to try smoking.

Two studies published last year (see Related Readings below) showed that vaping can act as a gateway habit for teens. That means it can lead to more harmful addictions. Those may include smoking tobacco or a hookah. (A hookah delivers cooled tobacco smoke through a pipe.) The new study found worrisome support for that.

“All the information that’s come out in the past few months suggests that there is a risk associated with e-cigarette use,” says Thomas Wills. He studies alcohol and smoking in teenagers at the University of Hawaii Cancer Center in Honolulu.

For their new study, Wills and his colleagues surveyed more than 2,200 9th and 10th graders in Hawaii. They asked whether, and how often, a student had vaped or had smoked cigarettes. They also asked about the students’ relationships with their parents. And some questions probed how much the kids liked to take risks and whether they liked to do things they’re not supposed to do.

One year later, the scientists surveyed these students again. The researchers then compared the teens’ answers. And those who said in the first survey that they had vaped were nearly three times as likely as the nonvapers were to have begun smoking over the next year.

Teasing out the role of vaping

Some people might think that those teens who moved from vaping to smoking were likely to have done so anyway. To test this idea, the researchers looked at one big factor that predicts whether teens will start smoking: personality.

Studies have shown that rebellious teens, those who are more likely to take risks and who don’t have a close relationship with their parents are all more likely to take up cigarettes. Those same traits aren’t as strongly linked to vaping. Why? Vaping isn’t seen as dangerous. So even students who are not rebellious or risk takers often try vaping. And many of these teens — who would otherwise have been at low risk of smoking — later moved on to real cigarettes.

In other words, vapers who moved on to cigarettes probably wouldn’t have done so if they hadn’t first used e-cigs, Wills says: “The effect we detected is truly an effect of e-cigarette use.”

His team reported its findings January 26 in Tobacco Control.

“What this shows is that, as much as people might think that it’s safer to vape, that’s not necessarily true,” says William Shadel. He is a behavioral scientist at the RAND Corporation in Pittsburgh, Penn. “Vaping could make you more dependent on nicotine, and cause you to later want to take up cigarette smoking.” And, he adds, “That may not be something you have control over.”

The U.S. Food and Drug Administration (FDA) has proposed a rule that would prevent the sale of e-cigarettes and associated products to minors, just as they do for tobacco cigarettes. But it hasn’t yet gone into effect. This new study and those that came before may help push that along.

“The question of whether e-cigarette use will prevent or promote smoking is the number one public health question of our time,” Wills says. “I think we need as much data as possible so as to provide the FDA with a scientific basis for making decisions about whether or not to regulate e-cigarettes — and, if so, how.”

Immediate effect on tobacco excise tax hike

Feb 10th, 2016
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http://www.nationmultimedia.com/breakingnews/Immediate-effect-on-tobacco-excise-tax-hike-30278966.html

Thailand’s excise tax on tobacco products is raised from 87 per cent to 90 per cent with immediate effect.

The Cabinet approved the Finance Ministry’s move yesterday, aimed at raising tax revenue by about Bt15 billion per annum from Bt60 billion.

The tax hike is expected to raise retail cigarette prices by Bt5-Bt10 per pack.

The higher tax rate is also expected to reduce the number of smokers. According to Thai Health Promotion Foundation, there are about 12 million smokers in Thailand.

Chicago Finance Committee Approves Amended Tobacco Ordinance

Feb 10th, 2016
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http://www.cspnet.com/category-news/tobacco/articles/chicago-finance-committee-approves-amended-tobacco-ordinance

CHICAGO – On Feb. 10, the Chicago City Council’s Finance Committee voted 22-9 to approve an amended tobacco ordinance that increases the legal age to purchase tobacco to 21, sets minimum prices for certain tobacco products, mandates minimum package sizes for various tobacco products, prohibits the redemption of tobacco product coupons, outlaws multipack discount pricing, and assesses new taxes on other tobacco products.

In addition, the amended ordinance says if a lawsuit is brought against the city of Chicago that results in a court overturning the new tax on other tobacco products (OTPs), then the minimum price and minimum package size requirements would take effect. However, the substitute ordinance also says that if a lawsuit is not brought to overturn the new OTP tax, then the minimum price and minimum package size requirements would not take effect.

Mayor Rahm Emanuel, the original sponsor of the ordinance, also agreed in the amended ordinance to double the fine for the sale of loose cigarettes to $5,000 for the first violation and $10,000 for repeat offenses, while also using some of the revenue from the new tax on tobacco products to fund smoking cessation programs in addition to funding incoming high school orientation programs. The mayor also agreed to increase city and police enforcement against the sale of single cigarettes and report back to the city council annually on the progress of the stepped up enforcement.

The amended ordinance as approved by the Finance Committee will go before the full Chicago City Council for a vote, which may occur sometime Feb. 10.

On Feb. 8, the Finance Committee held a hearing on the proposed tobacco ordinance and a number of the Chicago Finance Committee members raised questions about the lack of legal authority for the city council to adopt a new OTP tax, the effect of such a tax on lower income residents, the expansion of the current black market in Chicago, the loss of retail jobs, the likelihood of retail store closings, and the fact that 18-, 19- and 20-year-olds are adults and should be allowed to decide whether to buy and use tobacco products.

Turnout by retailers at the hearing was very high, with about 50 7-Eleven franchisee owners attending and the president of the Illinois 7-Eleven franchisee association testifying against the ordinance. NATO Board Member Mike Gold, the owner of Arango Cigar Co., testified about the lack of regulation of premium cigar sales over the Internet, the fact that the proposed minimum prices on premium cigars will drive more consumers to buy cigars over the Internet—resulting in lost retail sales and lost excise tax and sales tax revenue for the city, and that four tobacco stores have already closed in the past several years.

I testified about the Illinois state law that prohibits Chicago from enacting an OTP tax while also responding to misinformation from ordinance advocates, opposing the age 21 provision, and explaining how the minimum pricing would expand the current black market in Chicago.

The amended ordinance as approved by the Finance Committee creates a dilemma for retailers who will be forced to decide whether to pursue their legal rights to overturn the new OTP tax and face minimum price and package size mandates, or give up their legal rights and involuntarily agree to an unlawful tax on tobacco products in order to avoid minimum price and package size regulations.

A study on liability and the health costs of smoking

Feb 9th, 2016
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Smoking can not only ruin your health, but it can also burn a nasty hole through your wallet. Tobacco use accounts for nearly half a million premature deaths in the U.S. each year and is the leading cause of lung cancer, according to the American Lung Association. Even those around tobacco smokers aren’t safe from its harmful effects. Since 1964, smoking-related illnesses have claimed 20 million lives in the U.S., 2.5 million of which belonged to nonsmokers who developed diseases merely from secondhand-smoke exposure.

However, the economic and societal costs of smoking-related issues are just as staggering. Every year, Americans collectively spend a total of $326 billion, including nearly $170 billion in direct health-care costs and more than $156 billion in lost productivity due to premature death and exposure to secondhand smoke. Unfortunately, some people will have to pay more depending on the state in which they live.

In light of Tobacco-Free Awareness Week and to encourage the more than 66 million tobacco users in the U.S. to kick the dangerous habit, WalletHub’s analysts gauged the true per-person cost of smoking in each of the 50 states and the District of Columbia. We did so by calculating the potential monetary losses — including the cumulative cost of a cigarette pack per day over several decades, health care expenditures, income losses and other costs — brought on by smoking and exposure to secondhand smoke.

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