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March 7th, 2016:

FDA Reveals First Wave of E-Cig, Tobacco Study

Results show little evidence of consistent electronic cigarette use

CHICAGO — Last week’s Society for Research on Nicotine and Tobacco Conference included numerous tobacco and nicotine-related presentations, most notably select data from the first wave of the U.S. Food and Drug Administration (FDA) and National Institute of Health’s Population Assessment of Tobacco and Health (PATH) study.

“E-cigs were a big topic in the PATH study, along with many other presentations, as the regulatory and scientific communities try to get a better grasp of the implications from this innovation, Vivien Azer, a tobacco analyst at the New York-based Cowen Group, wrote in a research note.

PATH is a longitudinal study, first mandated in 2011, in order for the FDA to gain a better understanding of tobacco use. About 46,000 U.S. tobacco and nontobacco users participate, all above the age of 12. The first wave of the study began in 2013 and was presented at the conference.

The data suggested regular use of electronic cigarettes is still very low, with just 5.5% of adults and 3.1% of 12- to 17-year-olds having used e-cigs in the past month. Azer added that daily e-cig users make up a very small percentage of these 30-day e-cig users.

“In fact, among current adult e-cig users, more than 40% had only used an e-cig less than three times in the past 30 days,” she said. “We believe [this] points to the continued lack of consumer adoption of the products.”

The data also seemed to dispute claims that e-cigs act as a gateway to other tobacco products, as the majority of e-cig users in the study were already consumers of other tobacco products.

“Overall, 15.9% of adult current e-cig users were nicotine naive,” Azer said. “While a smaller 8.5% of daily e-cig users had not previously used tobacco.”

In terms of flavors in e-cigs and other tobacco products, PATH researchers found the use of flavors was most prominent in e-cig users across the board. For e-cig consumers 25 years and older, 63% reported using flavors, while 85% of e-cig users ages 12 to 17 reported using flavors (though Azer noted this youth group exhibited a strong flavor preference across all tobacco categories).

Azer said the Wave 1 database is currently only available for restricted use, but full dataset will be available later this year. The second wave of data is currently being reviewed, and Wave 3 is 40% complete. PATH researchers announced last week that the study will be extended four years and will now include seven waves, with the final wave set to be completed in 2022.

“We view the extension of the study as a positive (given the agency will take time to evaluate findings from the study and could potentially push back any incremental regulations),” Azer said.

In the interests of public health, it’s time to ban e-cigarettes

Given the continuing terrible toll of smoking and second-hand smoking, much of which might have been avoided by more decisive action early on, authorities should now shoot first and ask questions later

It took years of campaigning and government consultation with vested interests before Hong Kong introduced a law banning smoking in indoor public places in 2009. Six years later, a battle continues to push back the boundaries against smoking in public open spaces where people gather, especially children. These laws apply equally to electronic cigarettes. But if it is in the interests of public health, there is still time to ban them outright before they gain a foothold. That is the goal of the Hong Kong Council on Smoking and Public Health, an advocacy group that commissioned a study aimed at bolstering its case.

Researchers at Baptist University said a study of 13 types of e-cigarettes found they contained one million times more cancer-causing substances than outdoor air, and also discovered a type of flame retardant that affected the reproductive system and , they said, could lead to cancer.

As e-cigarettes become popular with more people – either new smokers or addicts seeking a “safer” alternative – more countries have banned them, indicating the case for regulation should be delayed no longer. According to council chairman Antonio Kwong Cho-shing, 16 countries have banned the sales, advertising, import, distribution and manufacturing of e-cigarettes. Although the World Health Organisation has pushed for better health protection measures, many governments are dragging their feet, citing inconclusive medical research. The Food and Health Bureau says it is discussing legislation to ban e-cigarettes with other departments and hoped to submit a proposal to lawmakers as soon as possible.

A distributors association has asked the government to consider regulating the ingredients of the e-cigarette vapour rather than banning their products outright. But given the continuing terrible health toll of smoking and second-hand smoking, much of which might have been avoided by more decisive action against the practice early on, the authorities should shoot first and ask questions later when it comes to claims that e-cigarettes are less harmful.
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Scotland Votes Regulation for E-cigarettes

Recent years have brought a rapid rise in popularity to e-cigarettes, so much so that researchers and regulators haven’t had the time to decide on their benefits and health side effects.

Consequently, e-cigs are now the subject of heated debate: do they indeed provide helpful a cessation treatment for smokers? Or do they actually make smoking more attractive to young people?

At the same time, some group advocates claim that e-cigarettes are Big Tobacco’s way of protecting its profits in markets, seeing that smoking is declining in some markets.

While their benefits continue to be debated, and the potential risks to non-smokers remain under-explored, politicians across the world and regulators must still decide what to do.

Scotland is among the latest countries confronted with this question, where parliament has just banned people under 18 years old from using e-cigarettes. This decision – which imposes the same age limit as for traditional cigarettes – brings Scotland into line with England and Wales.

Countries across the globe take different approaches to vaping – the broadly used term for using e-cigarettes. In Canada, sales have technically been made illegal, although regulation is still largely unenforced.

In the US, regulation is mixed, but San Francisco has just raised the minimum buying age to 21 years. Across Europe, countries like Ireland, Poland, and Bulgaria have yet to regulate sales and advertising, while Wales takes a more restrictive approach, looking to introduce a ban on e-cigarettes in public places.

But which approach is the most sensible? While voting on the new Scottish Health Bill, opponents of e-cigarette regulations argued that vaping is significantly less harmful than traditional cigarettes and help smokers to quit.

According to this group, restrictions will only prevent smokers from trying safer alternatives, and reduce the chances of lowering tobacco consumption.

On the other side of the debate, supporters of regulation say claim that children and young people need to be protected from developing a nicotine addiction.

They advocate a precautionary approach until researchers offer evidence that e-cigarettes do not undermine the country’s recent successes at curbing smoking.

More than just banning sales of e-cigs to under-18s, the new Scottish laws requires retailers to ask customers who look under 25 to offer proof of age. They also ban selling e-cigarettes from vending machines, make it illegal to buy on behalf of someone under 18.

Even though there might be some years before we have any clear evidence about the risks of e-cigarettes, the Scottish Parliament can, at least, say it has done what the country wants. Back in 2014, a large majority of respondents supported the regulation.