E-cigarettes
Survey stresses role of vaping in tobacco control
https://manilastandard.net/business/biz-plus/321405/survey-stresses-role-of-vaping-in-tobacco-control.html
Results of a first-of-its-kind survey in India highlight the potential of e-cigarettes as an additional option for tobacco control and how vaping can have a substantial impact on public health.
Peter Paul Dator, president of The Vapers Philippines, said the groundbreaking survey in India clearly shows that vaping helps smokers quit or reduce smoking.
“Its results are particularly relevant to the Philippines because like India, our country has a large number of smokers and a low smoking cessation rate. The Department of Health and other local policymakers should look at the evidence for e-cigarettes with an open mind and start making science-based decisions to help reduce smoking in the country,” said Dator.
Dator was referring to the interview-based survey involving 3,000 vapers aged 18 and older from eight of the largest metropolitan cities in India. The vast majority of respondents (71.3 percent) used e-cigarettes to quit (30 percent) or reduce (41.3 percent) smoking.
Similar results were observed in smokeless tobacco users. Most (79 percent) believe that e-cigarettes are less harmful than combustible cigarettes. Survey participants reported minimal side effects (cough, headache, dry mouth/throat) and some health benefits (improved general health, breathing, smell and taste) after they started vaping.
Around 81 percent of survey respondents were men and 19 percent women, with average age of 29 years. The majority (80 percent) were first exposed to nicotine through combustible cigarette smoking, SLT use or both.
Leading tobacco harm reduction expert Dr. Konstantinos Farsalinos and Indian researchers conducted the survey whose results were published on March 30, 2020 in Harm Reduction Journal.
Dator said that India and the Philippines face similar smoking-related public health challenges. The World Health Organization estimates that there are over 120 million smokers in India, accounting for almost 12 percent of the 1.1 billion smokers globally.
The 2016-2017 Global Adult Tobacco Survey revealed that India has the second-lowest quit rate among GATS countries surveyed at the end of 2017. It also showed that India has the second-largest tobacco consuming population in the world, estimated to be over 267 million, which includes at least 100 million tobacco smokers and over 199 million SLT users.
Dr. Farsalinos and his co-authors said that tobacco-related deaths in India are estimated to be over 1 million a year and are projected to rise to 1.5 million by 2020. They also pointed to the prevalence of smoking-related illnesses such as heart disease, lung cancer and chronic pulmonary obstructive disease in India.
Dator cited DOH data, which show that almost 88,000 Filipinos die from smoking-related diseases every year. Healthcare expenditures and lost income due to smoking-related sickness and premature death cost the country P188 billion ($4 billion) yearly.
These figures only cover four of more than 40 smoking-related diseases namely lung cancer, chronic obstructive pulmonary disease, heart disease and stroke.
GATS found that there are currently 16 million Filipino adult smokers. “Like India, the Philippines has a very low smoking cessation rate of 4 percent. This dismal quit rate indicates the ineffectiveness of currently approved smoking cessation strategies in the country such as ‘quitting cold turkey’, counseling, and nicotine replacement therapy,” Dator said.
“We all know that the combustion in cigarettes is what is harmful to the health of smokers. The harm from smoking is caused primarily through the toxins produced by the burning or combustion of tobacco. By contrast, non-tobacco, non-smoked nicotine products such as e-cigarettes are considerably less harmful,” Dator said.
He cited the widespread agreement among organizations such as Action on Smoking and Health, Public Health England, Cancer Research UK, the Royal College of Physicians and the Royal College of General Practitioners that, on the basis of current evidence, e-cigarettes or vapes represent a significantly less harmful alternative to tobacco cigarettes for smokers who are unable or unwilling to stop using nicotine.
“The DOH should pay particular attention to how the study authors described India’s e-cigarette ban as a ‘missed opportunity’ and urged the Indian government to promote additional research and consider revising the regulatory framework if the evidence warrants it,” Dator said.
The Indian government banned the import, manufacture, sale, advertisement, storage and distribution of e-cigarettes in September 2019. According to Dator, India’s vaping ban is a tobacco control approach that other governments should not adopt.
“Such a retrogressive policy will be a major blow to smokers who have switched to vaping. It will likely push them to go back to smoking combustible cigarettes,” he said.
Severe E-Cigarette, or Vaping, Product Use Associated Lung Injury Requiring Venovenous Extracorporeal Membrane Oxygenation
https://journals.lww.com/pccmjournal/Citation/2020/04000/Severe_E_Cigarette,_or_Vaping,_Product_Use.11.aspx
Abstract
Objectives:
To report a severe case of e-cigarette or vaping product use-associated lung injury with complex course requiring venovenous extracorporeal membrane oxygenation.
Design:
Case report.
Setting:
PICU in an academic medical center.
Patients:
A 16-year-old girl presenting with gastrointestinal and respiratory symptoms was admitted to our PICU after having progressive respiratory failure and bilateral pulmonary ground-glass opacities on chest CT.
Interventions:
Venovenous extracorporeal membrane oxygenation
Measurements and Main Results:
After extensive infectious workup was unrevealing, she reported a history of vaping e-cigarette containing either nicotine or delta-9-tetrahydrocannabinol oil prior to symptom onset. She was given a presumptive diagnosis of e-cigarette or vaping product use-associated lung injury. The PICU team in consultation with pulmonology and medical toxicology started high-dose IV methylprednisolone 1 mg/kg bid. Despite initial improvements, she continued to require positive pressure ventilation and developed pneumomediastinum with progression to tension pneumothoraces and a persistent air leak. Unable to maintain her oxygenation, she was placed on venovenous extracorporeal membrane oxygenation for a prolonged course and had a tracheostomy placement. The clinical course, severity, and range of interventions in affected patients around the country have varied widely. Respiratory symptoms have been the most severe, but the constellation of symptoms in e-cigarette or vaping product use-associated lung injury include constitutional symptoms (fevers, weight-loss) and gastrointestinal symptoms (nausea, vomiting, diarrhea). In many cases, steroid use led to rapid clinical improvements. However, other cases with severe illness, like our patient, necessitated high-dose IV steroids, intubation, and venovenous extracorporeal membrane oxygenation. The underlying etiology and pathophysiology of e-cigarette or vaping product use-associated lung injury remains unknown. The Centers for Disease Control and Prevention in conjunction with state/local health departments and the Food and Drug Administration is actively investigating the outbreak.
Conclusions:
Clinicians need to be aware of the current outbreak of e-cigarette or vaping product use-associated lung injury and ask about vaping in patients presenting with gastrointestinal and respiratory symptoms. Treatment options are anecdotal and necessitate a multidisciplinary approach.
Third of NZ students have tried vaping, despite most being non-smokers
http://www.voxy.co.nz/health/5/361613
New research shows that more than a third of New Zealand high school students have tried vaping even though nearly two-thirds of those doing so have never smoked cigarettes.
Vapes, or electronic cigarettes, are not recommended for non-smokers, as the long-term effects are not known, and vapes containing nicotine are likely to be addictive.
“Vaping is not as harmful as smoking, but it is not harmless. Taking up vaping is not a good idea for people who are not otherwise smokers, particularly young people,” says study co-author Dr Terry Fleming from Te Herenga Waka-Victoria University of Wellington’s School of Health.
The study is the first in New Zealand to look at vaping in high school students of all ages. It found 65 percent of teenagers who had tried vaping reported they had never smoked cigarettes, as well as 48 percent of those who said they vaped regularly. Overall, 38 percent of teenagers reported they had tried vaping, 10 percent said they vaped regularly, and 6 percent vaped weekly or more often.
The research also shows vaping is relatively common for students in all school deciles, whereas smoking is now rare in higher decile schools.
“Vaping seems to appeal to a wider range of young people than smoking and unlike smoking it is more common in boys than girls,” says Dr Fleming.
Recently published data from another New Zealand study shows the long-term decline in smoking among Year 10 students that began in 2000 stalled from about 2015 and may even be reversing, particularly in MÄori and low decile schools.
“When you put these findings together, it calls into question the idea that vaping is displacing smoking. The alternative possibility, that vaping is fuelling smoking, must be taken seriously by communities and policymakers,” says study co-author Associate Professor Terryann Clark from the University of Auckland.
Researchers say measures to protect youth, particularly MÄori and disadvantaged youth, from both vaping and smoking harm are needed, such as limits on where vapes and tobacco can be sold and a ban on vaping advertising and sponsorship, including online and social media promotion.
The research is timely, as the Government is currently consulting on new vaping regulations announced earlier in the month.
“New Zealand has fewer restrictions on promoting vaping and on vape flavours than many other countries. Supporting smokers to step down to vaping and non-smokers to stay that way are both important-this is possible with good policy and leadership,” says Dr Fleming.
The research is part of the Youth19 survey, which aims to collect data on a range of issues affecting New Zealand youth. Further results from the survey will be available over the coming year. This survey is a collaboration between Te Herenga Waka-Victoria University of Wellington, the University of Auckland, the University of Otago, and AUT.
Quit smoking immediately to reduce the risks of COVID-19
https://www.smokefree.hk/en/content/web.do?page=news20200331
In view of the latest epidemic development of Coronavirus Disease 2019 (COVID-19) across the globe, Hong Kong Council on Smoking and health (COSH) advised the general public to stop using any kinds of tobacco products including conventional cigarettes, electronic cigarettes, heat-not-burn tobacco products and waterpipe tobacco immediately. Mr Antonio KWONG, COSH Chairman said, “Study of COVID-19 cases revealed that smokers are associated with higher risk of getting severe symptoms than non-smokers. Also, smoking at home increases the risk of secondhand smoke (SHS) exposure among family members, especially young children. COSH reminded the public not to initiate smoking and smokers must quit smoking now to safeguard their health.”
There is a misleading claim that “smoking could help prevent COVID-19”. The World Health Organization had already clarified that the statement is false, and scientific evidence has also emerged to show that smoking may increase the risk of the infection. According to a review study on COVID-19 cases in China, smokers were 1.4 times more likely to have severe symptoms of COVID-19 and approximately 2.4 times more likely to be admitted to an Intensive Care Unit, need mechanical ventilation or die compared to non-smokers. Since smokers are unable to wear a surgical mask or avoid contact with the mouth and nose while smoking, it might increase the risk of spreading COVID-19 and viral infection.
According to COSH’s Tobacco Control Policy-related Survey conducted from February to June 2018, among all respondents, 15.1% lived with at least one smoker and 13.8% reported SHS exposures at home in the past seven days. Evaluation Study on “School Interactive Education Theatre Programme 2018-2019” reflected that 34.6% of children exposed to SHS at home in the past seven days. Members of the public are urged not to smoke at home to protect family from SHS exposure, as well as to minimize the risk of smoking-related fire accidents while staying home for prevention of COVID-19.
Some of the recent confirmed COVID-19 cases in Hong Kong traced to visits to bars, expert in communicable diseases warned that the use of waterpipe tobacco in bars might increase the risk of infection transmission among users. Smoke of waterpipe tobacco contains numerous toxicants including tar, carbon monoxide, heavy metals and carcinogens. A research found that one-hour waterpipe smoking session exposes the user to 100 to 200 times the volume of smoke inhaled from a single cigarette. COSH emphasized that there is no safe and harmless tobacco product. All people should reduce social activities, maintain good personal hygiene and develop healthy habits for reduction of disease risk. COSH highly recommended smokers to stop smoking as soon as possible to maintain a healthy lifestyle. Smokers can call the Integrated Smoking Cessation Hotline (Department of Health) 1833 183 for professional assistance if necessary.