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November, 2016:

National view: Lung cancer battle raises concerns about e-cigs, other ‘nicotine-delivery devices’

November has been Lung Cancer Awareness Month and a good time to recall an old saying in the lung cancer community: “If you’ve got lungs, you can get lung cancer.” Lung cancer is everybody’s fight.

It’s the deadliest cancer in America, accounting for 25 percent of all cancer deaths. Lung cancer is also the leading cause of cancer deaths among women. The National Cancer Institute estimates that 71,600 women will die of lung cancer this year. And you may be surprised to learn that of the women who get lung cancer, approximately 1 in 5 are nonsmokers.

Unfortunately, the false stigma that automatically ties smoking to lung cancer has severely hindered life-saving lung cancer research. In fact, of the $5.3 billion the National Cancer Institute receives every year from the federal government, only 6.5 percent is devoted to lung cancer.

That’s a big part of the reason my husband, U.S. Rep. Rick Nolan, is a founder and co-chairman of the bipartisan Congressional Lung Cancer Caucus. For us, and for millions of other families, lung cancer and the need for more federal support for prevention, treatment and, ultimately, a cure, is personal. Our youngest daughter, Katherine, is battling nonsmoking stage 4 small cell lung cancer. And Rick’s father and aunt both had lung cancer.

Of course, the battle against lung cancer is being waged on many fronts, including efforts to discourage young people from smoking. In that regard, experts increasingly are concerned that hard-won progress against lung cancer could be curbed by the growing popularity of “nicotine-delivery devices,” particularly electronic cigarettes, or e-cigarettes, that turn nicotine into an inhalable liquid vapor, and hookah, which are water pipes used to smoke flavored tobacco.

Simply stated, we don’t really know how dangerous these products are or what chemicals and components users are taking into their bodies. For example, we know little about the safety of propylene glycol, a substance contained in many e-cigarettes. And tests have found that some e-cigarettes contain small amounts of nitrosamines and formaldehyde, both cancer-causing agents.

Thankfully, after years of public review and comment, new Food and Drug Administration regulations are being rolled out to address these concerns. Over the next two years, the FDA will be given more authority to require manufacturers to report the content of their products to the public.

Until then, though, the chemicals — and the potential health effects — will remain largely unknown.

Young people are particularly attracted to the exotic and fruity flavors available in e-cigarettes and specialty tobaccos. In fact, a 2014 Minnesota Department of Health survey of more than 70 schools revealed that 13 percent of high school students and 3 percent of middle school students had used e-cigarettes. Those figures are even higher nationwide as these nicotine-delivery devices have become big business. By some estimates, U.S. sales of e-cigarettes and other more-specialized e-smoking products reached $5.5 billion in 2015.

The new FDA regulations will make it harder for children and teenagers to obtain e-cigarettes, hookah tobacco and cigars. Even now, it’s illegal to sell these products to anyone younger than 18 or in vending machines accessible to minors. The FDA also no longer allows stores to give away samples of new tobacco products.

These measures will help in the battle against lung cancer, but we all need to take our own steps to promote tobacco-free families, homes and communities.

Remember, if you’ve got lungs, you can get lung cancer. We’ve all got lungs, so we all have a stake in this fight.

Mary Nolan of Crosby, Minn., is a member of the Congressional Families Cancer Prevention Program of the Prevent Cancer Foundation and is the wife of U.S. Rep. Rick Nolan. She wrote this for the News Tribune

FTC Releases 2014 Cigarette and Smokeless Tobacco Sales and Marketing Expenditures Reports

The number of cigarettes sold by the largest cigarette companies in the United States to wholesalers and retailers in the U.S. declined from 256.7 billion in 2013 to 253.8 billion in 2014, according to the most recent Federal Trade Commission Cigarette Report.

The amount spent on cigarette advertising and promotion decreased from $8.95 billion in 2013 to $8.49 billion in 2014, due mainly to a decrease in spending on price discounts (discounts paid to cigarette retailers or wholesalers in order to reduce the price of cigarettes to consumers).

Spending on price discounts decreased from $7.64 billion in 2013 to $6.76 billion in 2014. The price discount categories (retail and wholesale) were the two largest expenditure categories in 2014, accounting for 79.7 percent of industry spending in 2014. For the first time, this year’s report breaks out the retail ($5.56 billion) from wholesale ($1.20 billion) price discounts. Price discounts had been the single largest expenditure category every year since 2002.

According to the 2014 Smokeless Tobacco Report, smokeless tobacco sales declined slightly from 128.0 million pounds in 2013 to 127.8 million pounds in 2014. The revenue from those sales increased, however, from $3.26 billion in 2013 to $3.42 billion in 2014.

Spending on advertising and promotion by the major manufacturers of smokeless tobacco products in the U.S., which had increased from $435.9 million in 2012 to $503.2 million in 2013, further increased to $600.8 million in 2014. As with cigarettes, price discounts made up the two largest spending categories, totaling $357.2 million – or 59.4 percent of all spending in 2014, up from the $287.7 million spent in 2013. As with the cigarette report, this year’s smokeless tobacco report breaks down price discounts provided to retailers ($257.3 million) and to wholesalers ($99.8 million).

The Commission has issued the Cigarette Report periodically since 1967 and the Smokeless Tobacco Report periodically since 1987.

The Commission vote to issue the reports was 3-0. (FTC File No. P114508, the staff contact is Michael Ostheimer, 202-326-2699)

COP7 decisions: an overview

FCA identified three interlinked implementation-related priorities for COP7 of the Framework Convention on Tobacco Control (FCTC):

  • Follow-up on the 30-percent prevalence reduction target agreed at COP6;
  • Establishment of an implementation review mechanism (IRM: i.e. a system to review Parties’ reports);
  • Action on fundraising for national-level implementation, building on the work of the sustainable measures working group.

At the meeting there was action on all three, though with a somewhat surprising twist with respect to IRM. Rather than immediately establishing an implementation review committee, Parties instead set up a working group to draft a “strategic framework” for the FCTC – which should deal with a range of implementation issues, including a possible IRM. The working group will also review and prioritize Parties’ needs for implementation assistance and will reflect them in the strategic framework.

It is quite common for treaty bodies to draw up strategic plans, and these have proven to be helpful both to keep a tight focus on priority issues and to raise funds.

30-percent target

On the 30-percent target, Parties requested that the Secretariat and WHO hold a technical consultation between COP7 and COP8 to identify necessary actions that the COP could take to ensure that the global voluntary target is achieved. The decision also requests that the Secretariat collect information regarding national targets.

There were other notable debates at COP7. On the Illicit Trade Protocol, unlike during previous COP sessions, there was widespread recognition that people shouldn’t wait until the ITP is in force before thinking about some of the implementation issues that are likely to arise.

On e-cigarettes, Parties spent a considerable amount of time re-hashing the issue, and butted heads for quite a while on the exact wording of a decision. The COP7 decision is quite similar to what was decided at COP6.

Finally, there were a host of other decisions. (COP7 had the longest list of official documents of any COP session to date.) These included:

Art 5.3 Knowledge Hub

  • On Article 5.3, a decision to establish a Knowledge Hub, and to ask the Secretariat to continue promoting measures to address tobacco industry interference among UN agencies.
  • On Article 9/10, additions to the existing guidelines were adopted. These included provisions to regulate design features that increase attractiveness (e.g. slims), and disclosure to governments of the contents of tobacco products.
  • Continuing work on Article 17&18, including a request to WHO to develop guidelines for surveillance, prevention and early diagnosis of occupational harms and risks specific to tobacco cultivation and manufacture.
  • Endorsement of a toolkit on Article 19 developed by an expert group, as well as some follow-up by the Secretariat.
  • On the FCTC impact assessment submitted to COP7, the COP welcomed the findings but did not commit to repeating the exercise immediately, instead encouraging Parties to consider evaluating on a regular basis the impact of the Convention at country level.

Cross-border advertising

  • On cross-border advertising, establishment of a new expert group to provide recommendations on operationalizing the implementation of Article 13 and its Guidelines on cross-border advertising and TAPS in entertainment media.
  • On Waterpipe: a request for a report to COP8 including a situation analysis and an overview of challenges and recommendations for improving the prevention and control of water pipe tobacco use.
  • On Gender: the Secretariat and WHO were requested to prepare a paper for COP8 on opportunities and challenges in implementing gender-specific tobacco control policies.
  • On trade and investment agreements, the COP called on Parties to increase coordination and cooperation between health and trade/investment departments, including in the context of negotiations of trade and investment agreements. It also requested a report for COP8 on a number of topics, including on practices in promoting and safeguarding public health measures under trade and investment agreements.
  • Moving to institutional matters, COP7 decided the following:

‘Voluntary’ no more

  • Parties’ mandatory payments to the FCTC budget will now be called Assessed Contributions (not Voluntary Assessed Contributions). The COP also agreed on a scheme of penalties should a Party fail to provide these payments.
  • The Convention Secretariat should consider holding a financing dialogue to raise extra-budgetary funding for the FCTC budget and to alert funders to the implementation needs of Parties. It was also agreed that when raising funds from stakeholders other than Parties, the Secretariat should follow the practices agreed on in WHO’s Framework for Engagement with Non-State Actors (FENSA).
  • The Secretariat was tasked to undertake a review of accreditation of intergovernmental organizations (IGOs) with the status of observer to the Conference of the Parties, as proposed by the COP7 report. At COP8, results of this review will be discussed and further decisions, such as whether this review should take place on a regular basis or whether observer status may be discontinued for some IGOs, might be taken.

New Observers

  • The observer status of non-governmental organizations (NGOs) was extended for most of the current observers. In addition, the following three NGOs were granted an observer status: American Cancer Society, Inter-American Heart Foundation, Vision mondiale de la santé / World Vision Health. A number of organizations were denied observer status per the recommendation of the Bureau.
  • The Secretariat was encouraged to apply for observer status to a number of UN bodies and other relevant entities, including UNDP, World Bank, ILO, FAO, and WTO. The Secretariat’s participation at governing body meetings of these organizations could raise the profile of the treaty and its provisions, including the Article 5.3 principles.
  • Synergies between the WHO and FCTC governing bodies – the Conference of the Parties (COP) and the World Health Assembly (WHA) – were strengthened by agreeing that reports on decisions from COP will be presented to WHA and vice versa.

WHO and FCTC agreement

  • The Bureau was requested to oversee and guide the preparation of the draft hosting terms between the Convention Secretariat and WHO. Once finalized, the hosting agreement should clarify the exact WHO contributions to support the work of the Convention Secretariat.
  • A dedicated methodology to review performance of the Head of the Secretariat was agreed upon. The review of performance for the current Head is set to take place in 2017, as her mandate expires in mid-2018.
  • The COP took no decision on transparency of Party delegations (i.e. whether Party delegates should make a declaration on any links with the tobacco industry, and what possible follow-up steps should take place). This point will be reviewed again at COP8.

Finally, on the issue of the FCTC budget, it was decided that the budget for 2018-2019 covered by Parties’ mandatory payments will be lowered by nearly US$300,000 compared to the budget for the current biennium. As a result, virtually all activities included in the workplan for 2018-2019 will need to be funded by extra-budgetary contributions.

Please note that the above summary is not an exhaustive list of all the decisions taken at COP7, and there may be surprises in the final version of the decisions when they are published (in part because many decisions were not finalized till very late in the session.)

– See more at:

E-cigarette use as a predictor of cigarette smoking

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Quebec’s new tobacco laws come into full effect Saturday

Smoking outside, within a 9 metre-radius of a window or door that opens, is now prohibited in Quebec, under the Tobacco Control Act.Formerly known as the Tobacco Act, several amendments were made to the law with the first changes coming into effect one year ago today.According to a government website, the Tobacco Control Act was enacted to protect the public from the dangers of second-hand smoke, to encourage smokers to quit smoking and to prevent youth from taking up smoking to begin with.

Changes to the act targeted several areas, including but not limited to, the use of tobacco in certain places, the promotion and advertising of tobacco products, a framework for electronic cigarettes and increased fines for offences.The last amendments to the law came into effect Saturday.The nine-metre radius rule is also applicable to air intakes connected to an enclosed place where smoking is not allowed. The exception is when the radius extends beyond property limits, meaning that if a door or window leads to a municipal sidewalk the smoke ban doesn’t apply.As of Saturday, it is also illegal for adults to buy tobacco products for minors.Anyone caught contravening the act can be fined anywhere from $250 to $3,000 depending on the offence and whether or not it’s a repeat offence. Prior penalties ranged from $50 to $3,000.For a full list of regulations, fines and offences, you can consult the Quebec government’s online health portal.

Civil society report unveils tactics of tobacco industry

Shops place cigarettes with candies and snacks, 14pc give free gifts on purchase of cigarettes, 89pc shops do not display ‘No sale to Minors’ signage

Islamabad: Fifty percent of the 500 shops surveyed in six major cities of Pakistan including Islamabad and Rawalpindi place cigarettes for sale together with candies and snacks, 14% give ‘limited time offers’ or free gifts on purchase of cigarettes, and 89% shops do not display ‘No sale to Minors’ signage.

This is how multinational cigarette manufacturing companies are systematically targeting enticing children as young as six years old to tobacco addiction as current customers die or quit smoking, reveals a national survey conducted by TheNetwork for Consumer Protection.

The findings of the survey, which is the first of its kind conducted in Pakistan to expose the marketing techniques of tobacco companies, were released at the launching of a report on ‘Monitoring of Tobacco Advertising, Promotion, Sponsorships (TAPS) and Point of Sales (POS) Advertising’ here at a local hotel. Tobacco manufacturers are exposed as employing aggressive marketing techniques including placement of cigarette advertisements on shops selling candies and chocolates, and directly outside the gates of primary and secondary schools throughout Pakistan. The survey was conducted in schools around six major cities namely, Islamabad, Rawalpindi, Peshawar, Lahore, Karachi, and Quetta, where 500 Point of Sales (shops) of cigarettes were monitored.

The event offered a platform that called for adoption of a five-point ‘Charter of Action’ to safeguard Pakistan’s vulnerable school children from the malicious motives of the cigarette manufacturing companies. The charter calls upon the federal government to amend the Prohibition of Smoking and Protection of Non-Smokers Health Act 2002 to comprehensively ban TAPS as per Article 13 of the World Health Organisation Framework Convention on Tobacco Control (FCTC), which the government ratified in 2005. Secondly, it calls for the development of a strict official mechanism to ensure enforcement of the 2002 law for completely banning sale of cigarettes around schools and holding the multinationals accountable for its gross violations. Thirdly, it urges the government to ensure that shopkeepers selling cigarettes to minors are mandatorily booked and strictly penalized under the law. Fourthly, it calls upon local authorities to ensure that cigarettes are sold in packs of 20 and must not in lose or single sticks.

Finally, the charter calls for enforcement of Tobacco Vendors Act 1958 (that was legislated as part of the West Pakistan and was later adopted by provincial setups) by making licenses mandatory for retail sale of manufactured tobacco.

Supporting the initiative, Senator Nasreen Jalil called for a ban on tobacco advertisements in view of its serious implications on youth. “There should be a strict enforcement of existing tobacco laws to regulate the industry. It is unfortunate that laws are present but are not being enforced. It is an uphill task to control tobacco use and take action against multinational cigarette manufacturers, but we have to do it at every cost,” she said. Nasreen requested the courts to ensure enforcement of tobacco-related laws, and assured that the parliamentarians are ready for necessary legislation to control tobacco use and advertising.

I R Rehman of the Human Rights Commission of Pakistan suggested that a national movement against acts of tobacco manufacturers should be launched with the participation of teachers, social workers, and other stakeholders.

The CEO of TheNetwork, Nadeem Iqbal, rejected the industry’s claim that it sells cigarettes to persons above 18 years of age only. Referred to a previous survey, he said, not a single shopkeeper produced the relevant license required for selling cigarettes at shops. “We have already filed a petition in the IHC for implementation of 85 per cent graphic health warnings on cigarette packs which is not being implemented by manufacturers,” he added. Nadeem also regretted non-compliance of prohibition of smoking in the premises of the Supreme Court and Parliament.

Earlier, Dr. Maria from The Network termed the egregious marketing tactics of multinational cigarette manufacturing companies as a clear violation of the law.

The ceremony also featured small children sharing their personal experiences about sale of tobacco products along side sweets and candies, etc. Bakar Raza claimed being attracted to cigarettes at a shop, which had prominently displayed tobacco products. Five year-old Alina Iqbal said many children are attracted to cigarettes in shops where red and blue boxes of cigarettes are placed with chocolate packs. Muhammad Rabi and Iman Javed objected why shopkeepers are displaying cigarette packs along side chocolates and candies. Laiba Akhtar recollected how a shopkeeper handed over a cigarette pack to her when she demanded one, without inquiring about her age or asking any other question. Mahir Ali and Ayyan displayed banners and chanted slogans against the tactics of multinational tobacco manufacturers. Mian Osama questioned why the government wants to generate revenue at the cost of the health of young people. Nayyab Shakir also shared his experience about sale of tobacco products to youngsters by shopkeepers.

The event was attended by senior officials of the Competition Commission of Pakistan, parliamentarians, and representatives of NGOs and civil society, all of who endorsed the need to stop multinational cigarette manufacturing giants from deceptive marketing practices and selling techniques which attract small children towards tobacco products at retail shops near schools.

Ban on flavoured tobacco products will hurt business: Retailers

Retailers have strongly objected to a proposal to ban the sale of flavoured tobacco products such as menthol cigarettes, as it could hit their businesses hard.

A survey of 1,475 independent general trade retailers by a group of trade associations — such as the Foochow Coffee Restaurant & Bar Merchants Association and Singapore Mini Mart Association — found that 99 per cent of the respondents stated that such a prohibition would negatively affect their business, while 97 per cent were concerned that the move could lead adult smokers to turn to illegal sources.

The proposed ban was among a suite of tobacco-control measures — which also included raising the minimum legal age for smoking and enhancing graphic health warnings — put up for public consultation early this year by the Health Promotion Board, the Ministry of Health, and the Health Sciences Authority.

Pointing to how some stores had closed after they were badly affected by the new liquor laws, which started last year, Mr Hong Poh Hin, who chairs the Foochow Coffee Restaurant & Bar Merchants Association, said: “It is important to ensure any proposed tobacco-control measures are supported by evidence of effectiveness in reducing smoking incidence in Singapore, while addressing the impact on the affected retailers.”

“Our members, many of which are small- and medium-enterprises, have been bearing the brunt of escalating operating costs, manpower constraints and a flurry of increasing regulations that directly impacted their biggest sources of income,” he added.

Among other things, the new laws bar supermarkets and convenience stalls from selling takeaway alcohol from 10.30pm to 7am.

“We fear that such recurrent regulations will lead many more to shut down their businesses. This prompted our associations to launch this (survey),” Mr Hong added.

Other associations involved in the survey were Kheng Keow Coffee Merchants Restaurant and Bar-Owners Association, and Singapore Provision Shop Friendly Association.

Ninety-eight per cent of those surveyed said almost half of their customers who buy tobacco products only request the flavoured variants. The survey, which was conducted between July and September, also uncovered concerns that adult smokers would turn to illegal sources to have a puff.

Noting that the illicit cigarette trade is “substantial” here, Singapore Mini Mart Association chair Alan Tay said: “These illegal activities have a huge adverse impact on legitimate traders like us, that operate within the parameters of the law.”

The trade associations are also in the midst of another study on the efficacy and impact on trade of the proposed ban on flavoured tobacco products, and plan to share its results with the Government. KELLY NG

Secret report shows Big Tobacco targeted city politicians in Sudbury and Sault

Algoma municipalities are being asked to stub out all motions proposed by tobacco companies or front groups that slip demands for a freeze on excise taxes into campaigns against contraband tobacco.

Leaked map shows 10 Ontario 'strategic municipalities' whose local politicians were targeted in 2012 by Imperial Tobacco Canada. Reasons for selecting these targets included their 'proximity to illicit tobacco' and 'likelihood of buy-in.'

Leaked map shows 10 Ontario ‘strategic municipalities’ whose local politicians were targeted in 2012 by Imperial Tobacco Canada. Reasons for selecting these targets included their ‘proximity to illicit tobacco’ and ‘likelihood of buy-in.’

Greater Sudbury has the dubious distinction of being named in a secret Big Tobacco document aimed, ostensibly, at fighting contraband smokes, but at the same time quietly lobbying to freeze the excise tax on legitimate tobacco products.

Algoma Board of Health, the governing body of Algoma Public Health, is warning area politicians about new evidence linking Imperial Tobacco Canada Ltd. to lobbying campaigns against contraband tobacco.

The health board voted this week to ask Algoma municipalities to reject all motions received from tobacco companies or front groups that spike campaigns against illicit smokes with demands for a tobacco excise tax freeze or limits on regulation of tobacco products.

Imperial Tobacco Canada Ltd. is a wholly-owned subsidiary of British American Tobacco Plc., one of the world’s five biggest tobacco companies with 55,000 employees in 44 factories in 41 countries.

In a recently leaked internal report prepared for its London-based parent, Imperial Tobacco Canada reveals that it’s been quietly involved for years in lobbying campaigns by convenience-store and anti-contraband groups.

The secret report describes Project M&M, a 2012 campaign intended to “mobilize local governments to pressure for big government action” against illicit tobacco, with demands for an excise tax freeze piggybacked on the main message.

Listed as partners in Project M&M are the Canadian Convenience Store Association, the National Coalition Against Contraband Tobacco, the Ontario Chamber of Commerce, Fédération des Chambres de Commerce du Québec and the Canadian Taxpayers Federation.

The leaked 32-page document includes a map identifying 10 “strategic municipalities” to be targeted in Ontario: Sault Ste. Marie, Sudbury, Windsor, Brantford, London, Mississauga, Niagara Falls, Whitby, Cornwall and Toronto.

These municipalities were selected, the report says, because of their:

  • proximity to illicit tobacco
  • seizure activity
  • internal sales data
  • political weight
  • likelihood of buy-in

The document also identifies 10 targeted municipalities in Quebec: Montreal, Gatineau, Chateauguay, Laval, St. Georges, Sherbrooke, Quebec City, Drummondville, Trois Rivieres and Saguenay.

An article published one month ago by the National Post pointed to other close ties between convenience-store organizations and the tobacco industry.

“In fact, there is other evidence of their close links to the industry, including at least three former tobacco-company executives who are now leaders in the Ontario, Quebec and national convenience-store associations,” the Post’s Tom Blackwell reported.

The leaked Imperial Tobacco report suggests that the “2012 lobbying campaign was no grassroots movement, and that the retail and contraband organizations have for years been used as surrogates by the cigarette giant to promote its own interests,” Blackwell wrote.

Sales of illicit cigarettes are considered a major problem in Ontario, where a bag of 200 illegal “rollies” sells for as little as $10 to $15, compared to more than $80 for legally taxed smokes bought at a corner store.

A 2013 study of collected cigarette butts conducted by NIRIC Group for the Ontario Convenience Store Association found that 17.7 per cent of butts picked up in Sault Ste. Marie were contraband, compared to 30.1 per cent in Kitchener, 28.5 per cent in Barrie, 24.5 per cent in Sudbury, 20.9 percent in Thunder Bay, 18.7 per cent in Toronto, 18.1 per cent in Guelph and 11 per cent in North Bay.

Trends in E-Cigarette Awareness and Perceived Harmfulness in the U.S.

Electronic cigarettes (e-cigarettes) are gaining in popularity as an alternative to regular cigarettes, as they are viewed as potentially less harmful. However, it remains unclear how awareness about e-cigarettes is permeating through the general U.S. population. This study seeks to extend previous research and examine trends in e-cigarette awareness and perceived harmfulness, and their association with smoking-cessation efforts.

Data from three cycles (2012, 2013, and 2014) of the Health Information National Trends Survey were combined into a single data set. Controlling for survey year, multivariate logit models were used to determine the association between demographic characteristics and e-cigarette awareness, perceived harmfulness, quit attempts, and quit intentions. Data were analyzed in 2015.

Awareness of e-cigarettes increased from 77.1% in 2012 to 94.3% in 2014. Controlling for demographic characteristics, e-cigarette awareness significantly increased in both 2013 and 2014, relative to 2012. Perception that e-cigarettes were less harmful than regular cigarettes declined from 50.7% in 2012 to 43.1% in 2014. Among smokers, no relationship was observed between e-cigarette awareness and past-year quit attempts or quit intentions, but those that viewed e-cigarettes as less harmful were less likely to have a past-year quit attempt.

These analyses reveal a continued increase in overall public awareness of e-cigarettes and shifting harm perceptions relative to regular cigarettes. New regulatory oversight by the U.S. Food and Drug Administration may have major effects on both dimensions, which are worth continued monitoring.

e-cigarettes carry several health risks: expert

There are several health risks associated with e-cigarettes and portraying them as safe is ‘extremely irresponsible and potentially dangerous,’ a Weill Cornell Medicine-Qatar (WCM-Q) official has warned.

“Studies into the health risks posed by using electronic cigarettes, which are illegal in Qatar, are now beginning to be published,” said Dr Ziyad Mahfoud, associate professor, Healthcare Policy and Research at WCM-Q at the latest instalment of WCM-Q’s ‘Ask the Expert Series.’

“E-cigarettes are quite new and until recently there had not been much research into them, but now there have been few good quality studies and we are gaining some understanding of the health risks they carry,” he pointed out.

“Firstly, the production of the devices and the liquid that is vaporised and inhaled is poorly regulated. A user cannot be sure of what chemicals they are actually inhaling, and it is never recommended to introduce unknown, potentially harmful substances into the body.

“Secondly, e-cigarettes deliver nicotine, which is highly addictive, and research indicates that young people who use e-cigarettes are more likely to start smoking normal cigarettes, which we know can have catastrophic negative effects on health, including increased risk of respiratory disease, heart disease and many forms of cancer.

Portraying e-cigarettes as safe is therefore extremely irresponsible and potentially dangerous.”

Dr Mahfoud said that a few studies have shown that smoking e-cigarettes can reduce the normal consumption of regular cigarettes among smokers, but on the other hand marketing them as a safe alternative has led to some ex-smokers picking up the habit again.

“Until there are more regulations on the manufacturing of e-cigarettes and more studies about its health hazards, nicotine gum, nicotine patches, medications and cognitive behavioural therapy provide safer ways to reduce nicotine dependency and give up smoking.”

“A common misperception of shisha is that because the tobacco is fruit-flavoured, it is somehow healthier than normal tobacco. This is wrong: it is just normal tobacco that is mixed with molasses and other additives. It is harmful to health. Smoking shisha has been linked to respiratory, cardiovascular and periodontal diseases and many forms of cancer. It is addictive and also harmful to pregnant women and their foetuses.

“It is also completely untrue that the water in the shisha pipe filters out toxins. Scientific studies have proven that shisha smoke contains similar levels of tar and other hazardous chemicals as cigarette smoke does, and in some cases much higher levels.”