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E-cig studies provide more conflicting outcomes on potential harm

http://www.journalnow.com/news/local/e-cig-studies-provide-more-conflicting-outcomes-on-potential-harm/article_f1bf6e4b-90e8-5c52-86c5-f845e4808150.html

Another week, another release of studies that have conflicting outcomes on the attractiveness and potential risk of electronic cigarettes, particularly to young adults.

One report, from researchers at Georgia State University’s School of Public Health, determined that government agencies and public-health advocates may be providing an incomplete assessment of smoking e-cigs and vaporizers.

“The proportion of American adults who perceive e-cigarettes to be equally or more harmful than traditional cigarettes has tripled over the last few years (from 12 percent to 35 percent), highlighting the need for more accurate public-health messaging,” according to the researchers. Their study was published in the American Journal of Preventive Medicine.

The other report, from the federal Centers for Disease Control and Prevention, found that 40 percent of current e-cigs smokers ages 18 to 24 had never tried traditional cigarettes before consuming e-cigs and vaporizers, while 43 percent were current traditional cigarette smokers.

By comparison, nearly all adults at least 45 years old were listed as a current or former traditional cigarette consumer.

The CDC report determined that 3.5 percent of adult Americans, or about 8.7 million, were current e-cig users in 2015. The report did not provide how many young adults were current e-cig users.

E-cigs, such as the top-selling Vuse brand by R.J. Reynolds Vapor Co., typically are battery-powered devices that heat a liquid nicotine solution in a disposable cartridge and create a vapor that is inhaled. Vaporizers can be supplied and reused through the insertion of a liquid capsule.

Neither report broke new ground per se.

But until a universally accepted definitive study is released, the two reports add more evidence to support either anti-tobacco advocates, who promote a “quit or die” approach to tobacco products, or anti-smoking advocates, who believe reduced-risk tobacco and nicotine products can play a pivotal role in decreasing the number of traditional cigarette consumers.

For example, anti-smoking advocates have explained the increase in young adults consuming e-cigs as experimentation typical of individuals their age, and a better alternative than traditional cigarettes.

The Georgia State researchers based their report on data from the Tobacco Products and Risk Perception surveys from 2012 through 2015. Nearly 16,000 adults completed the surveys.

Researchers said the proportion of adult smokers who thought e-cigs were addictive more than doubled from 25 percent in 2012 to nearly 57 percent in 2015. Similar trends were seen in non-smoking adults.

“Although the impact of long-term use of e-cigarettes on health is still unknown, the available scientific evidence indicates that e-cigarettes are less harmful than combustible cigarettes,” the researchers said.

Some studies, including from the Royal College of Physicians, have claimed that e-cigs and vaporizers are up to 95 percent less harmful than traditional cigarettes.

However, a pivotal component of the Food and Drug Administration’s tighter e-cig and vaporizer regulations was that they were necessary to limit or thwart the use of nicotine and tobacco products by youth. The regulations, which went into effect Aug. 8, ban the sale nationwide of those products to anyone under age 18.

Mitch Zeller, director of the FDA’s Center for Tobacco Products, said May 5 that “there are still many open questions about are e-cigarettes a gateway to smoking more harmful products.”

However, most recent federal reports have shown a significant decline in youth smoking of traditional cigarettes in the past 10 years.

Interestingly, among the sponsors of the Georgia State study is the FDA’s Center for Tobacco Products.

“Our public health messages should accurately convey to cigarette smokers that switching completely to e-cigarettes would reduce their risks even if e-cigarettes are addictive and not risk-free,” said Dr. Michael Eriksen, dean of Georgia State’s School of Public Health.

Matt Myers, president of the Campaign for Tobacco-Free Kids, responded to the CDC data by saying it “raises fresh concerns that a large majority of adult e-cigarette users are using e-cigarettes in addition to regular cigarettes rather than in place of them.”

“If there is a public health benefit to the emergence of e-cigarettes, it will come only if they are effective at helping smokers stop using cigarettes completely, responsibly marketed to adult smokers and properly regulated to achieve these goals.”

In August, a national study on youth vaporizer use determined that up to 65 percent of students consume the products for flavor, compared with 20 percent for nicotine.

University of Michigan researchers said the results “challenge the common assumption that all vaporizer users inhale nicotine.” The results were published in the publication Tobacco Control.

Patrick Miech, the lead Michigan researcher, said in an email to the Journal that “vaping is a case where the science has yet to catch up with policy, which seems to be guided more by emotion and anecdote than hard facts.”

Scott Ballin, past chairman of the Coalition on Smoking or Health, has called for “all stakeholders to curtail their public relations efforts and call for scientific cooperation, monitoring and surveillance.”

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