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December, 2014:

First Child’s Death From Liquid Nicotine Reported as ‘Vaping’ Gains Popularity

A toddler from upstate New York could be the first child to die from liquid nicotine, the substance used in e-cigarettes, poisoning in the U.S., concerning health officials as e-cigarettes continue to rise in popularity.

Police reported that the 1-year-old child died after ingesting liquid nicotine at a home in Fort Plain, New York, on Tuesday. The child was found unresponsive and rushed to a hospital where he was later pronounced dead.

Fort Plain police released a statement saying the death is believed to be a “tragic accident.” They declined to say whether the liquid nicotine was associated with an e-cigarette.

But health officials are concerned if steps aren’t taken to protect children, they could see more fatal accidents similar to this one.

The rise of e-cigarettes and “vaping” in recent years has also meant a rise in the purchase of liquid nicotine. Coming in flavors like cotton candy or gummy bear, health officials say that the brightly colored liquid could appeal to young children.

“One teaspoon of liquid nicotine could be lethal to a child, and smaller amounts can cause severe illness, often requiring trips to the emergency department,” the American Association of Poison Control centers in a statement today. “Despite the dangers these products pose to children, there are currently no standards set in place that require child-proof packaging.”

In November the American Association of Poison Control Centers announced that the number of dangerous “exposures” to liquid nicotine has skyrocketed in recent years with 3,638 exposures as of Nov. 30. An exposure means coming into contact with liquid nicotine through ingestion, inhalation or by absorbing the substance through the skin.

The number is more than double the 1,543 exposures reported in 2013 and exponentially higher than in 2011 when 271 exposures were reported.

Before this week, the only confirmed death related to liquid nicotine happened in 2012 when a man injected himself with the substance, according to the American Association of Poison Control Centers.

Dr. Donna Seger, director of the poison control center at Vanderbilt University Medical Center, said her center has started to get more calls about exposure to e-cigarettes or liquid nicotine.

“They’re not that difficult to get into,” Seger said of the vials that contain the nicotine. “The issue is once the exposure occurs, it could be bad.”

Seger said just a small amount of nicotine can cause dangerous symptoms in children, including seizures.

Phil Daman, president of the Smoke-Free Alternatives Trade Association, said he was “saddened to hear the terrible news.”

“[We] want to always be mindful to put safe products on the market,” said Daman, who said the trade association recommends childproofing products to “err on the side of caution.”

Daman questioned if the child could have gotten a hold of a high-grade liquid nicotine that could be a much higher concentration than what is in many common e-cigarette products. Because e-cigarettes are not federally regulated there is a wide-range of liquid that could be purchased to use in e-cigarette products, ranging from potent high grade liquid nicotine to material that has an extremely small amount of nicotine.

In April the U.S. Centers of Disease Control and Prevention warned they were seeing an increase of calls to poison control centers for liquid nicotine exposure and children were becoming sick after ingesting, inhaling or absorbing the chemical through their skin. The most common symptoms were vomiting, nausea or eye irritation.

“Use of these products is skyrocketing and these poisonings will continue,” U.S. Centers for Disease Control and Prevention Director Dr. Tom Frieden said in April. “E-cigarette liquids as currently sold are a threat to small children because they are not required to be childproof, and they come in candy and fruit flavors that are appealing to children.”

To combat these cases of increased exposure some state lawmakers have introduced bills that would require e-cigarette companies to put child-resistant caps on bottles of liquid nicotine.

In New York State, a bill passed earlier in the year that would require child resistant containers for liquid nicotine. Gov. Andrew Cuomo is set to sign the bill in the next few weeks, according to ABC News affiliate WABC-TV.

At least one e-cigarette, Vapor World, changed their packaging this year so that bottles of liquid nicotine are more child resistant.

Temporal framing and consideration of future consequences: effects on smokers’ and at-risk nonsmokers’ responses to cigarette health warnings


This research examines the influence of temporal framing (long-term vs. short-term) and individual difference in consideration of future consequences (CFC) on the effectiveness of cigarette health warnings among smokers and at-risk nonsmokers in a college population. An online experiment (N = 395) revealed a three-way interaction among temporal framing, CFC, and smoking status. The results among at-risk nonsmokers supported the temporal fit hypothesis–those high in CFC responded more favorably to long-term framing, whereas those low in CFC responded more positively to short-term framing. The findings among smokers revealed a different pattern in which short-term framing was more effective among high-CFC smokers, whereas among low-CFC smokers the framing effect was not distinct. Theoretical and practical implications of the findings are discussed.

Awareness of FDA-mandated cigarette packaging changes among smokers of ‘light’ cigarettes


Previous research has clearly demonstrated that smokers associate cigarette descriptors such as ‘light’, ‘ultra-light’ and ‘low tar’ with reduced health risks, despite evidence showing that cigarettes with these descriptor terms do not present lower health risk. In June 2010, regulations implemented by the US Food and Drug Administration went into effect to ban the use of ‘light’, ‘mild’ and ‘low’ on cigarette packaging. We surveyed smokers participating in human laboratory studies at our Center in Philadelphia, PA, USA shortly after the ban went into effect to determine the extent of awareness of recent cigarette packaging changes among smokers of light cigarettes. In our sample of 266 smokers, 76 reported smoking light cigarettes, but fewer than half of these smokers reported noticing changes to their cigarette packaging. Simple removal of a few misleading terms may be too subtle of a change to register with consumers of so-called ‘low tar’ cigarettes; more comprehensive regulation of cigarette packaging design may be necessary to gain smokers’ attention and minimize misperceptions associated with tobacco pack design characteristics and color.

Australian Smokers’ and Nonsmokers’ Exposure to Antismoking Warnings in Day-to-Day Life



Smokers and nonsmokers can encounter a variety of antismoking messages in their everyday life. Antismoking warnings often involve fear appeals to which particularly smokers may react in a defensive manner by avoiding or derogating the messages, or downplaying their personal risk. However, previous studies testing the effects of antismoking warnings have either been retrospective or lab-based, thus introducing potential recall biases and yielding limited ecological validity. We used ecological momentary assessment (EMA) to give an overview on the number, type, and locations where individuals encounter such messages and to examine their immediate reactions.


In an EMA study, 33 smokers and 37 never-smokers logged every encounter with antismoking warnings during 2.5 weeks (1,237 participant days of monitoring). After randomly selected encounters, several markers of defensiveness were assessed.


On average, nonsmokers reported noticing significantly fewer warnings than smokers (M = 0.49/day vs. M = 2.14/day). Both groups saw the majority of warnings on cigarette packages. Smokers reported a significantly higher level of message derogation and a significantly lower level of message acceptance than nonsmokers. There were no differences in feelings of vulnerability between smokers and nonsmokers upon encountering the warnings.


The overall number of encounters with antismoking warnings in people’s everyday life is relatively low, particularly among smokers. Smokers are likely to avoid messages and respond defensively, thus limiting their potential effectiveness.

A front group for Big Tobacco

October 20, 2014

Sir, In James C Miller III’s letter (October 16), the International Tax and Investment Center (ITIC) attempts to cast itself as a key stakeholder in setting tobacco taxation policy at last week’s meetings for the Framework Convention on Tobacco Control. But the Russian government and Secretariat for the treaty were right to renounce ITIC as an arm of the tobacco industry. For all ITIC’s bluster about offering “fact-based taxation advice” and “transparency” in its dealings with governments, the reality is the organisation acts as a front group for big tobacco. Its main financial sponsors includes four of the largest tobacco corporations, including Philip Morris International and British American Tobacco.

Margaret Chan, the World Health Organisation director-general, has many times noted that allowing these bad actors to participate in their own regulation is akin to foxes guarding the hen house. And to this end the treaty has prohibited as much. The strong guidelines on tobacco taxation adopted last week by the 178 countries party to the treaty is tribute to this prohibition.

John Stewart

Corporate Accountability International

Director, Challenge Big Tobacco Campaign



Ireland to vote on introducing plain cigarette packets to cut smoking rates

02 December, 2014

Agence France-Presse in Dublin

Ten years since setting a trend with its workplace smoking ban, Ireland is pushing ahead to be the first EU state with plain packaging for cigarettes despite fierce opposition from tobacco companies.

As part of Dublin’s plan to make Ireland a smoke-free society by 2025 – meaning a prevalence rate of under 5 per cent – lawmakers will vote to introduce plain packaging in the new year.

Under the draft legislation before parliament, all forms of branding, including logos and colours, would be banned and all products would have a uniform packaging with graphic health warnings.

“The cigarette box is the last form of advertising that the industry has,” said James Reilly, Ireland’s minister for children who is spearheading the drive.

“Children are influenced by advertising. I believe this will prevent many children from taking up cigarette smoking.” In March 2004, Ireland became the first country in the world to adopt a total workplace smoking ban. A decade on, Ireland is at the forefront for Europe, following Australia’s introduction of similar plain packaging legislation in 2012.

Canberra’s move was met with fierce opposition by tobacco companies and other nations, particularly tobacco-producing economies.

Five World Trade Organisation members have initiated dispute proceedings against Australia’s measures at the WTO, arguing the laws are an illegal restriction on trade.

As was the case in Australia, the tobacco companies are fighting Dublin’s plans. They say plain packaging infringes their intellectual property rights. Philip Morris International said imposing an “arbitrary ban on trademarks ignores the hard data showing that ‘plain packaging’ is misguided and unjustifiable”.

Japan Tobacco International’s general manager in Ireland, Igor Dzaja, said: “No evidence has emerged from Australia, where plain packaging has been in place for almost two years, showing that plain packaging has changed the rate of decline in smoking or has had any actual positive behavioural impact.”

Canberra says daily smoking rates are down from 15.1 per cent to 12.8 per cent in three years.

Pat Doorley, head of the Royal College of Physicians of Ireland Policy Group on Tobacco, said 50 studies show the measure will work. “The thrust of all these studies is that people prefer packages with the logos and the embossing and the colours to the plain packs,” he said.

“The kids think they’re cooler. The other thing is people are less likely to take notice of health warnings on coloured packets.”

Dublin is also looking to ban smoking in cars with children and to continue increasing the price of tobacco. In last month’s budget, the price of 20 cigarettes was increased to €10 (HK$96).

Male smokers at risk of losing their Y chromosome

Steve Connor

04 December 2014

Men who smoke are more likely than non-smokers to lose the male sex chromosome – which could explain why male smokers are more prone to certain cancers than women who smoke, scientists have said.

Researchers found that male smokers had significantly fewer blood cells with a Y chromosome compared to non-smokers, and that the trend increased with heavy smoking – and disappeared when a man gave up cigarettes.

“We have previously demonstrated an association between loss of the Y chromosome in blood and greater risk for cancer. We now tested if there were any lifestyle or clinical factors that could be linked to loss of the Y chromosome,” said Lars Forsberg of Uppsala University in Sweden, who led the study published in the journal Science.

“Out of a large number of factors that were studied, such as age, blood pressure, diabetes, alcohol intake and smoking, we found that loss of the Y chromosome in a fraction of the blood cells was more common in smokers than in non-smokers,” Dr Forsberg said.

The risk was dose dependent, indicating that the more cigarettes a man smoked, the greater the proportion of blood cells with missing Y chromosomes. Giving up cigarettes led to a reversal of the mutation, Dr Forsberg said.

“These results indicate that smoking can cause loss of the Y chromosome, and that this process might be reversible. We found that the frequency of cells with loss of the Y chromosome was not different among ex-smokers compared to men who had never smoked. This discovery could be very persuasive for motivating smokers to quit,” he said.

The Use of Cigarette Package Inserts to Supplement Pictorial Health Warnings



Canada is the first country in the world to require cigarette manufacturers to enclose package inserts to supplement the exterior pictorial health warning label (HWL). In June 2012, Canada implemented new HWL package inserts that include cessation tips accompanied by a pictorial image. This study aims to assess the extent to which adult smokers report reading the newly mandated HWL inserts and to see whether reading them is associated with making a quit attempt.


Data were analyzed from an online consumer panel of Canadian adult smokers, aged 18-64 years. Five waves of data were collected between September 2012 and January 2014, separated by 4-months intervals (n = 1,000 at each wave). Logistic generalized estimating equation (GEE) models were estimated to assess correlates of reading inserts and whether doing so is associated with making a quit attempt by the subsequent wave.


At each wave, between 26% and 31% of the sample reported having read HWL package inserts at least once in the prior month. Smokers who read them were more likely to be younger, female, have higher income, intend to quit, have recently tried to quit, and thought more frequently about health risks because of warning labels. In models that adjusted for these and other potential confounders, smokers who read the inserts a few times or more in the past month were more likely to make a quit attempt at the subsequent wave compared to smokers who did not read the inserts.


HWL package inserts with cessation-related tips and messages appear to increase quit attempts made by smokers.

Responses of Australian cigar and cigarillo smokers to plain packaging

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‘It will harm business and increase illicit trade’

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