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July 27th, 2016:

More cancer-causing chemicals found in electronic cigarettes

The vapor from electronic cigarettes contains two previously unidentified chemicals that can cause cancer, according to a new study. The new research, published in Environmental Science & Technology, also shows that levels of harmful chemicals vary between e-cigs.

Researchers in the Lawrence Berkeley National Laboratory used two different electronic cigarettes and simulated vaping at different battery power settings. Then they analyzed the e-cigs’ vapor. They found that the vaporizers released 31 harmful chemicals, including two possibly cancer-causing compounds that had never been previously found in e-cig vapor. The amount of chemicals produced varied, based on the temperature at which liquids are “vaporized” by the device’s “heating coil.” The higher the temperature inside the coil, the higher the amount of chemicals emitted. E-cigs with one heating coil instead of two also released higher chemical levels, probably because two coils better distribute the heat between them, which means their temperatures don’t climb quite as high.

E-cigs released 31 harmful chemicals

Previous studies had already shown that e-cigarettes contain toxic chemicals. In 2009, the FDA warned that some e-cigs contain diethylene glycol, an ingredient used in antifreeze. And in 2015, a study showed that aerosols from e-cigs contain formaldehyde, another carcinogen. Some of these chemicals are also found in cigarette smoke.

An e-cig with only one heating coil operated at 3.8 volts was found to emit 0.46 micrograms of acrolein — a severe eye and respiratory irritant — per puff in the first five puffs, while the coil was heating up. But when the heat got steady, the e-cig emitted much more: 8.7 micrograms per puff. The amount of acrolein released is still much less than a regular cigarette, which delivers 400 to 650 micrograms. About 20 puffs on an e-cigarette release 90 to 100 micrograms in comparison.

“Advocates of e-cigarettes say emissions are much lower than from conventional cigarettes, so you’re better off using e-cigarettes,” Berkeley Lab researcher and study co-author Hugo Destaillats said in a statement. “I would say, that may be true for certain users — for example, long time smokers that cannot quit — but the problem is, it doesn’t mean that they’re healthy. Regular cigarettes are super unhealthy. E-cigarettes are just unhealthy.”

“Regular cigarettes are super unhealthy. E-cigarettes are just unhealthy.”

Chemical emissions also changed based on the e-cig’s battery voltage. The higher the voltage, the higher the temperature in the coil — and the heat meant higher chemical amounts were released. Emissions also varied based on how long the e-cig had been used. The longer it was used, the higher the level of chemicals it released, including formaldehyde, acetaldehyde, and acrolein — which are all carcinogens or respiratory irritants. That’s because chemical residue was accumulated on or near the heating coil. As this residue was heated up, it released even more chemicals.

The researchers also analyzed two chemicals often used as solvents in e-cigs: propylene glycol and glycerin. Both are used to make artificial smoke, though little is known about whether it’s safe to heat and inhale them. The researchers found that the solvents created 31 harmful chemicals, including propylene oxide and glycidol, both of which are probable carcinogens. These two chemicals has never been reported in e-cigs before. This is possibly because e-cigarettes are relatively new compared to traditional cigarettes, which have been studied for more than 50 years.

The use of e-cigarettes has spiked: the percentage of US adults who smoke e-cigs rose to 8.5 percent in 2013 from 3.3 percent in 2010. And in 2014, nearly 13 percent of adults said they tried electronic cigarettes, according to the CDC.

Though some experts think e-cigs are a good alternative for regular cigarette smokers, health officials are particularly concerned about how popular vapes are among teenagers. Many e-cigs contain nicotine and could expose children to the addictive chemical. In 2015, three million American teens used e-cigs. (In May, the FDA finally banned e-cig sales to minors.) But much more research is needed to actually understand how harmful they are.

The paper’s goal was to learn more about the risks of e-cigarettes, so that manufacturers, users, and regulators can try to minimize the harm the electronic cigarettes pose. “Understanding how these compounds are formed is very important,” Destaillats said. “One reason is for regulatory purposes, and the second is, if you want to manufacture a less harmful e-cigarette, you have to understand what the main sources of these carcinogens are.”

Exclusive: E-cigarettes should not be available on prescription, say GPs

The vast majority of GPs do not believe that e-cigarettes should be prescribed for patients trying to stop smoking, a GPonline survey has found.

Almost 70% of GPs rejected the idea that NHS e-cigarette prescriptions should be made be available for patients wanting to quit smoking.

A small proportion (17%) of GPs backed the idea of prescribing e-cigarettes, while 14% of the 448 doctors who responded said they weren’t sure.

A report from the Royal College of Physicians, published earlier this year, advised GPs to promote e-cigarettes ‘as widely as possible as a substitute for smoking’.

The report said the use of e-cigarettes was a viable harm reduction strategy. After its publication, the RCGP called on NICE to investigate whether e-cigarettes should be prescribed to patients.

E-cigarette safety

Many GPs felt there was not enough long-term data on the safety of e-cigarettes to justify prescribing them. One GP said: ‘To my mind it is still smoking and we do not know the harm these vapours are doing.’

Another said: ‘If people can afford to smoke they can afford to buy the e-cigarette to quit. The NHS should not bear the burden of everything. We have to prioritise.’

A GP who backed prescribing e-cigarettes said: ‘Yes they should be available on prescription, but it is difficult to evidence what strength or prescription would be beneficial across a standard population.’

Another said: ‘These certainly have a role in encouraging smoking cessation, but I feel that making them available on prescription serves to medicalise this issue rather than better promoting patient self-management and responsibility.’

However, 37% of GPs said that they were likely or very likely to recommend e-cigarettes to patients who are trying to give up smoking, compared with just 28% who said they were either unlikely or very unlikely to recommend them. The remaining 35% said they were ‘neutral’ on whether to recommend e-cigarettes.

Smoking cessation

One GP said: ‘I don’t have any information on long-term consequences so feel unable to recommend them, but if a patient asked, I would agree that evidence based on short-term use suggests that they are less harmful than cigarettes, with the qualification that this does not mean they are safe.’

Another said: ‘I am not convinced that they are safe, but I know that a cigarette isn’t.’

A spokeswoman for NICE said its public health guidance on reducing harm from smoking recommends licensed nicotine-containing products, and e-cigarettes licensed by the Medicines and Healthcare products Regulatory Agency would come under this category.

‘We haven’t produced guidance that looks at e-cigarettes specifically,’ she said.

‘As is usual process, the DH or Public Health England would have to officially refer the products to us before we can appraise them.’

Toxins in e-cig vapor increase with heat and device use

Electronic cigarettes, or e-cigs, have grown in popularity as an alternative to traditional cigarette smoking. But health experts and consumer advocates have raised concerns over their safety. Now scientists report in ACS’ journal Environmental Science & Technology new measurements of potentially toxic compounds in e-cigarette vapor and factors that affect these levels.

Hugo Destaillats and colleagues analyzed vapor from two different kinds of e-cig vaporizers filled with three different refill e-liquids. They identified several vapor components including glycidol — which hadn’t previously been identified in e-cig vapor — formaldehyde and acrolein.

The World Health Organization categorizes glycidol as a probable carcinogen, and acrolein is a powerful irritant. Testing also showed that increasing the voltage and heat in a single-coil vaporizer (as opposed to one with a double-coil) triples the aldehyde emissions per puff and bumped up the acrolein levels by a factor of 10.

Additionally, the release of potentially toxic compounds increased with use. These compounds originate from thermal decomposition of propylene glycol and glycerin, two solvents used to formulate most e-liquids.

Vaping’s toxic vapors come mainly from e-liquid solvents

With age, heat, e-cigs emit more toxicants

Over the last three years, growing evidence has shown that electronic cigarettes are not the harmless alternative to smoking that many proponents have argued. Now, a new study traces a large share of e-cigs’ toxic gases to a heat-triggered breakdown of the liquids used to create the vapors. And the hotter an e-cig gets — and the more it’s used — the more toxic compounds it emits, the study shows.

“There is this image that e-cigarettes are a lot better than regular cigarettes, if not harmless,” says Hugo Destaillats, a chemist at Lawrence Berkeley National Laboratory in California. But after his team’s new analyses, published July 27 in Environmental Science & Technology, “we are now definitely convinced that they are far from harmless.”

Electronic cigarettes draw liquids over one or more hot metal coils to transform them into vapors. Those liquids — propylene glycol, glycerin or a mix of the two — are food-grade solvents laced with flavorings and usually nicotine.

The Berkeley team used two current models of e-cigs and three different commercially available e-liquids. The experimental setup mechanically drew air through the devices to create the vapors that a user would normally inhale.

Heating up

The higher an e-cigarette’s voltage, the more toxic aldehydes it produces in each puff of vapor. Once a certain threshold is hit, each voltage increase produces a disproportionate increase (see last bar) in acrolein, acetaldehyde and formaldehyde, three of the most harmful compounds in the vapor.

Adapted from M. Sleiman et al/Environmental Science & Technology 2016

Adapted from M. Sleiman et al/Environmental Science & Technology 2016

Toxic aldehydes (such as formaldehyde, acetaldehyde and acrolein) were at negligible levels in the starting e-liquids, Destaillats notes. But the chemistry of the vapors varied as the e-cig device heated up: The first puffs contained somewhat less of the aldehydes than later puffs.

The new data show that “through the process of vaping, you are generating almost 1,000-fold higher emissions of those same compounds. And that is from the thermal degradation of the solvents,” Destaillats says.

Some devices can vary the voltage used to heat their coils. Higher voltages produced hotter conditions and more of the toxic aldehydes, which are probable or suspected carcinogens. Acrolein is also a potent irritant of the eyes and airways.

With a rise from 4.3 to 4.8 volts, the jump in emissions “goes exponential,” Destaillats adds, particularly “for the three aldehydes that are among the most harmful compounds present in the vapor.” Users could inhale up to 165 micrograms of these aldehydes per puff, the study found.

In their first tests, the chemists used a new e-cigarette for each puffing session. But in a second set of tests, they used one device over and over at its high-voltage setting.

After the ninth 50-puff cycle, the toxic aldehyde emission rate had climbed by another 60 percent. This was consistent with a buildup on or near the heating element of what has come to be known colloquially as “coil gunk,” the researchers say. “Heating these residues would provide a secondary source of the volatile aldehydes.”

The data on changes in the vapor composition of “aged” e-cigarettes “is something new,” notes toxicologist Maciej Goniewicz of the Roswell Park Cancer Institute in Buffalo, N.Y. And using a better analytical technique than others have employed, he says, the Berkeley team turned up new toxicants — such as propylene oxide and glycidol — which neither his group nor others had detected in e-cig vapors.

Price increase hurts British American Tobacco’s results

British American Tobacco (M) Bhd’s (BAT) second-quarter financial performance was hurt by the continued impact of the November 2015 excise-led price increase, as well as the reduced consumption during the fasting month.

The company remains concerned with legal volumes continuing to be impacted by the current rampant illegal cigarette trade after the unprecedented excise increase in November last year that saw consumers down-trading within the legal market.

It cited a market research done by the Confederation of Malaysian Tobacco Manufacturers last December that discovered close to one out of two packs of cigarettes sold in the country was illegal.

The company said in a press release that the total legal domestic market experienced a volume decline of 26.3% in the first half of 2016, and pursuant to that, it saw a contraction in its domestic and duty-free volumes by 28.9% versus the first half of last year.

“The overall volume reduction and its consequent escalating cost pressures resulted in a total revenue decline of 16% and gross profit of 21.5%, both when compared to the first half of 2015.

“This fall in volumes is principally driven by the steep excise increase in November 2015 and the industry has yet to see any signs of recovery,” said BAT managing director Erik Stoel in the press release accompanying the results.

The company saw its second-quarter to end June net profit declining 78.2% year-on-year (y-o-y) to RM47.72mil, while revenue also saw a y-o-y drop of 11.5% to RM962.58mil.

The company has declared a dividend of 45 sen per share, which was a decline from the 78 sen per share dividend in the same period a year ago.

EU has chance to stop illegal tobacco trade

The trade in illicit tobacco is a massive problem, but the European Commission has been presented with a golden opportunity to strike a blow against the smugglers. But it must look long-term, writes Eric Lequenne.

Eric Lequenne is International Business Development Manager at Worldline.

According to KPMG, illicit tobacco accounts for up to 12% of all cigarettes and more than 58 billion cigarettes in the EU alone. Aside from the obvious public health risk of illicit cigarettes flooding the EU, there’s a huge impact on tax revenues: as much as €12.5 billion a year. Those billions could go towards schools, infrastructure or tax cuts. That hurts us all, slowing growth, reducing competitiveness and costing jobs.

Cigarettes are among the top five illegally-traded products alongside drugs, arms, fuel and diamonds. By market share, smugglers run the third-largest tobacco business in the world.

So it’s understandable why the European Commission is focused on tackling the issue through the revised EU legislation on Tobacco Products (EUTPD), adopted in 2014. It is a good example of product-specific legislation, as it aims to protect public health, while improving the internal market for tobacco and related products. In this context, the EUTPD introduces new requirements to combat illicit trade that will be made operational through implementing acts on tracking, tracing and security features, expected to be finalised in late 2017.

The tobacco industry, its suppliers, law enforcement authorities, member states, and the EU should work together to eliminate this illicit trade. Everyone agrees that Europe needs a solution that can be implemented quickly, and meets the objectives of the Tobacco Products Directive. We need a system that encourages competition – flexible and effective solutions based on common standards. This will strengthen cooperation between enforcement, manufacturers, and others in the supply chain. We also need adequate control in place, and penalties for those who fail to comply, or simply cheat.

The department leading efforts on tobacco is DG SANTE. To help reach a decision, an independent consultancy was asked to conduct a feasibility study into different possible solutions that would meet the conditions of EU legislation.

The result? A report that correctly identified the need for universal standards, but failed to properly consider the emerging Track&Trace technologies being tested in the real world. The report also failed to encourage technological progress through competition.

We thus welcome the news that DG SANTE has commissioned a further study into the options available. It’s an opportunity to get it right and come up with a future-proof solution to the problem – a solution with a fighting chance of getting ahead of the criminals who feed off the trade.

Imposing a single solution across the EU rather than defining open standards may seem superficially attractive. But the real-world implications are significant – and highly negative, if the chosen approach stifles innovation and competition among service providers. The key to fighting this battle – and winning it – is to supercharge the power of innovation. This means working with third parties to ensure the solutions compete with each other, continue to improve, and respond to changing threats – while meeting basic technical standards.

The World Health Organisation’s (WHO) Framework Convention on Tobacco Control (FCTC) and its Protocol to Eliminate the Illicit Trade in Tobacco Products provided a good model. The Protocol requires the implementation of T&T systems for tobacco products throughout the entire supply chain. But it rightly does not establish any specific global standards for implementation, since these would be impossible to apply. Instead, it requires governments to implement their own systems and work together to maximise effectiveness.

In the GSM telecoms sector, too, open standards have been effective in driving innovation, ensuring a competitive environment that hugely benefits businesses and consumers.

Many industries, including pharmaceuticals, alcohol, and luxury goods, face similar issues. They are responding with digital solutions that can effectively track, trace and authenticate products throughout the supply chain. Many of the most advanced solutions proposed by the technology and security industries today are embedded into the packs themselves, rather than being merely glued on with a physical stamp containing the security feature.

We have worked with many of the industries facing similar challenges. Worldline has seen the benefits of collaboration – essentially, taking advantage of the industries’ own expertise in fighting counterfeiting and illicit trade. We do recognise that the tobacco industry is different; some argue this industry should be excluded from participating in implementing any regulation. But we believe that leveraging their expertise can help fight the scourge of illicit trade. This should be part of a clear framework, based on independent auditing and effective controls – ensuring consistent best practice.

The directive’s acts may not be implemented until 2019. Who knows what new technology will be market-ready by this point? That’s why EU work must look beyond the prescriptive and restrictive, and take the more complex but ultimately more effective route of developing interoperable standards. The Commission now has a unique opportunity to deal a real blow to the criminals who trade in illicit tobacco.

Tobacco products entering Macau decrease 82 percent

From January to May this year, 3.48 million packs of cigarettes have entered Macau, an 82 percent decrease compared to the same period last year, when the number was around 19 million packs, according to a report by Jornal Va Kio.

Cheong Iok Ieng, Chief of the Office of the Secretary for Security, pointed out that the significant decrease occurred after the Macau government raised cigarette taxes last July. Cheong claims that raising taxes is an effective measure to control tobacco consumption.

Between July 14 last year and June 20 of 2016, the Macao Customs Service inspected a total of 1,690 cases related to tobacco products, seizing 1.68 million cigarettes, 392 cigars, and 10.82 kilograms of tobacco.

Last year, the MSAR raised the tax per cigarette from MOP0.5 to MOP1.5. Additionally, each kilogram of tobacco carried MOP600 in taxes, while each kilogram of cigars brought MOP4,326 in taxes. The price adjustment means that 70 percent of the value paid for cigarettes is a tax. Another implemented change concerns individuals who are allowed to bring only 19 cigarettes into Macau per day (a decrease from 100 cigarettes). Instead of 19 cigarettes, individuals may bring in only one cigar, or other tobacco products weighing at most 25 grams.

During the first three days after the law amendment came into effect last year, customs apprehended 3,500 cigarettes per day at the border gate, mainly from mainland tourists.

Cheong revealed that Macau Customs Service required Gongbei customs to broadcast related information about Macau’s tobacco control regulations on the mainland side.

She further informed that the customs officers increased inspections of tourists and vehicles at several border gates in order to combat tobacco smuggling.

In 2012, the local government approved a restriction that meant only 100 cigarettes would be allowed to be brought to the city, half the number allowed before the change.