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March 9th, 2017:

When Public Health and Big Tobacco Align

Nobody trusts the tobacco industry, and it’s easy to understand why. For decades, industry executives knew that smoking caused cancer and heart disease yet publicly denied the dangers of cigarettes. It relentlessly attacked its critics. Documents that emerged in the 1990s showed that the industry targeted teenagers, knowing that the earlier someone became addicted to cigarettes, the more likely they would be lifelong smokers. And so on.

https://www.bloomberg.com/view/articles/2017-03-09/when-public-health-and-big-tobacco-align

In the 1980s and 1990s, the public health community went to war with the tobacco industry. Though the war largely ended in 1998 with Big Tobacco agreeing to a multi-billion-dollar settlement with the states, it remains a powerful memory for public health.

To this day, most tobacco-control advocates view the cigarette companies as being every bit as duplicitous and evil as they were in the bad old days. Some years ago, I asked Stanton Glantz, perhaps the leading anti-tobacco scientist in the U.S., what his ultimate goal was. He didn’t say it was to eliminate the scourge of smoking. He said: “To destroy the tobacco industry.”

What brings this to mind is an excellent cover story in the upcoming issue of Bloomberg Businessweek about the efforts of the tobacco industry to devise and market so-called reduced risk products like electronic cigarettes — products that give users their nicotine fix without most of the attendant carcinogens that come with combustible tobacco.

Although the tobacco companies have done decades of R&D on smokeless products, the business was dominated early on by startups like NJOY, which is today the largest independent e-cigarette company in America. From the start NJOY has said that a big part of its mission was “to end smoking-related death and disease.” And from the start, messages like that have been scorned by the public health community.

Ingesting nicotine in some smokeless fashion is vastly safer than smoking a combustible cigarette. (In the words of the late South African tobacco scientist Michael Russell, “People smoke for the nicotine but die from the tar.”) Last year, the Royal College of Medicine issued a report saying that e-cigarettes were some 95 percent safer than cigarettes.

Even so, the public health community in the U.S., led by the Centers for Disease Control and Prevention, has done everything it can to demonize smokeless products. Some of this has been with good reason: to try to keep kids from picking up an addictive habit. But this effort has also helped to create the impression that smokeless products are as dangerous as cigarettes. One result, sadly, is that many long time smokers have refused to try them, even though they could save their lives.

My sense in talking to tobacco-control officials over the years is that too many of them simply don’t believe in a reduced-harm approach. We give heroin addicts methadone not because methadone is good but because it is better than heroin. With cigarettes, however, the public health mindset appears to be all or nothing — that the only “right” thing for smokers to do is to go cold turkey.

But the lingering distrust of the tobacco industry has also had a lot to do with public health’s unwillingness to acknowledge the potential benefits of alternative products. Matt Myers, the president of the Campaign for Tobacco Free Kids, has often complained, for instance, about the marketing of e-cigarettes, saying that companies are using the same tactics to hook teenagers that Big Tobacco once used.

With the e-cigarette market clearly established, the four big tobacco companies — BAT, Reynolds American, Altria (formerly Philip Morris) and Philip Morris International (spun off from Altria) — have proclaimed themselves all in.

Philip Morris International is an especially interesting case: Not only does it have an array of e-cigarettes and other smokeless products, but as the Bloomberg Businessweek story points out, it has publicly proclaimed that its goal is to lead the world into “a smoke-free future.” The home page of its website asks, “How long will the world’s leading cigarette company be in the cigarette business?”

As astonishing as it is that a company with $26 billion in tobacco revenue last year would be calling for the end of cigarettes, I believe Philip Morris is sincere. It has spent around $3 billion in research. Its new flagship product, called IQOS, heats tobacco but doesn’t burn it — which the company believes will be more satisfying to smokers than vaping. IQOS already has 7 percent of the tobacco market in Japan, and is being rolled out in other countries.

Philip Morris recently asked the British government that tobacco products “be taxed according to their risk profile.” In other words, it wants the government to impose higher taxes on cigarettes to encourage smokers to move to reduced-risk products. What tobacco company has ever done that before?

In the U.S., Philip Morris has done something extraordinary: It has made a submission to the Food and Drug Administration to get the right to market IQOS as a reduced risk product. The expensive submission consumed 2.3 million pages and is backed by a great deal of research, including several clinical trials. So far, none of the U.S. e-cigarette companies have attempted to get such a designation, and it is a big problem. How do you sell a reduced risk product when you can’t tell anybody it reduces risk?

The business case for diving into this market is that it’s a product category that’s growing, while the cigarette market is shrinking. Philip Morris doesn’t want to be left behind. But there is no particular need for the company to set out such a transformative agenda, at least not yet. The small smokeless companies are not much of a threat. NJOY filed for bankruptcy last fall. And under a 2009 law, every company in the e-cigarette industry will have to file something called a premarket tobacco application with the FDA by August 2018. The submissions will cost, on average, over $450,000, and the companies will have to show that their products have some public health benefit. There is a legitimate chance that some small companies won’t be able to clear the hurdle.

No, Philip Morris is pushing as hard as it is, I believe, because it wants to get on the right side of the issue, finally — to be viewed as a good corporate citizen. When I spoke to Glantz the other day about the company’s new anti-smoking agenda, he said, “I don’t believe them.” (He added, “If they were serious, they would stop marketing cigarettes right now.”)

No doubt many others in the tobacco-control community feel the same way. They still loathe Big Tobacco, and view Philip Morris’s new strategy as just another deception. But the truth is, if there is ever going to be a serious move from cigarettes to less dangerous products, it will have to come from Big Tobacco. They have the R&D resources, they have the marketing apparatus — and, it appears, they have the will.

Public-health advocates don’t have to trust Philip Morris, or any other tobacco company. They don’t have to believe what I believe in order to arrive at the same conclusion: that the advocates should be rooting for the companies’ innovations — pushing them, double-checking their data, making sure regulations are in place to prevent their products from being marketed to kids. The advocates should also be spreading the word that there is an alternative to cigarettes. Who really cares whether it’s Big Tobacco or some other entity that reduces smoking deaths? What matters is that it happens.

The tobacco wars are long over. Continuing to fight the cigarette companies may bring a certain satisfaction to the veterans on the public-health side. But joining forces is the way to save lives.

This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.

To contact the author of this story:
Joe Nocera at jnocera3@bloomberg.net

To contact the editor responsible for this story:
Philip Gray at philipgray@bloomberg.net

Legal age for smoking to be raised to 21

http://www.channelnewsasia.com/news/singapore/minimum-legal-age-for-sale-of-tobacco-products-to-be-raised-to/3580594.html

The legal age for smoking and buying tobacco products in Singapore will be raised from 18 to 21, Senior Minister of State for Health Amy Khor announced in Parliament on Thursday (Mar 9).

“We want to protect our young from the harms of tobacco, and lay the foundation for good health,” she said.

The restrictions, which will be phased in over the next few years, will cover the retail and social supply to minors; and the purchase, use and possession of tobacco products by minors, the Ministry of Health said.

Dr Khor said that in Singapore, 45 per cent of smokers become regular ones between the ages of 18 and 21. Research has also shown that adolescent brains have a heightened sensitivity to the effects of nicotine, with a World Health Organization (WHO) report stating that people who do not start smoking before the age of 21 “are unlikely to ever begin”, she added.

She also noted the Health Promotion Board conducted public consultation on further tobacco control measures between December 2015 and March 2016, and feedback showed “considerable support” for raising the minimum legal age for smoking in Singapore.

As such, to further de-normalise tobacco use and reduce the number of youths from picking up the habit, the ministry will propose legislative changes to Parliament within a year to raise the minimum legal age to sell tobacco products to minors from the ages of 18 to 21, Dr Khor said.

Dr Khor also gave an update on standardising tobacco packaging, saying the ministry had studied closely the experience of Australia, France and the United Kingdom as countries that had implemented this.

“(We) see significant value in moving in this direction, so as to reduce the appeal of tobacco products, particularly to youths, and raise the visibility and effectiveness of health warnings,” she said.

“We will conduct a further public consultation on standardised packaging this year to seek additional and more detailed views on possible standardised packaging measures,” Dr Khor added.

Responding to the decision, the Tobacco Association of Singapore highlighted various concerns on how this would be implemented by licensed tobacco retailers “in a practical manner” and whether the regulation would be enforced for non-Singaporean visitors.

It also raised the issue of whether retailers facing manpower issues would face restrictions in hiring workers between the ages of 18 and 20 as a result.

The association added that it welcomed the opportunity to provide further input in the second round of public consultation on the proposal for standardised packaging.

Vapors Of High-Powered E-Cigarettes May Cause Cancer

http://www.sciencetimes.com/articles/10054/20170309/vapors-of-high-powered-e-cigarettes-may-cause-cancer.htm

People might have to stop powering their e-cigarettes to the highest level as scientists have found out that its vapors can cause cancer. There are significant levels of cancer-causing benzene in the vapors of those e-cigarettes in the highest power, stated Portland State University scientists.

The result of the study was published on March 8 in the online journal “PLOS ONE”. The chemistry professor James F. Pankow led the research team, reported EurekAlert. The level of benzene they found from the high powered e-cigarettes was thousand times higher than in the surrounding air. It also depends greatly on the device itself. If it is not at its highest level, the benzene levels are not that high.

When the e-cigarette fluid additive chemicals benzoic acid or benzaldehyde is present it added so much to the benzene levels. However, of course, the level of this is nothing compared to the level of a conventional smoke from a cigarette. Benzene is one component of gasoline. It is very bad for people.

It has been linked to a number of illnesses that are very grave and can cause death. Diseases like leukemia and bone marrow failure are few of the examples of diseases a person can acquire with benzene. Benzene is usually found in the urban areas where industrial emissions are very rampant plus fuel tank leaks. This chemical has been deemed as the largest single cancer-risk air component in the U.S.

Meanwhile, according to Science Daily, the smoke that conventional cigarettes release is affecting the natural healing process of lungs. The blocking then leads to chronic obstructive pulmonary disease or COPD. Cough, bronchitis and breathing difficulties are the major signs of COPD. The findings were published in “American Journal of Respiratory and Critical Care Medicine”. It was from the researchers at the Helmholtz Zentrum München, a partner in the German Center for Lung Research (DZL), and their international colleagues.

An individual with COPD does not heal its own lungs anymore. Researchers are now trying to find out why.

‘War of Innovation’ Rages in Tobacco Industry

A recent Bloomberg report titled “Big Tobacco Has Caught Startup Fever” sheds light on traditional tobacco and cigarette industry leaders’ accelerated race to offer innovative products in light of anti-smoking regulation and campaigns, along with changing consumer preferences. As a byproduct of this shift, market giants such as Philip Morris International Inc. (PM), Reynolds American Inc. (RAI) and Japan Tobacco Inc. have invested heavily in product development, funding tech incubators, launching venture funds and creating apps after the style of Silicon Valley in efforts to develop next-gen reduced-risk tobacco platforms. (See also: Business Groups Increasingly Turn Against Tobacco.)

http://www.investopedia.com/news/war-innovation-rages-tobacco-industry/

‘Next-Gen Nicotine Delivery’

Philip Morris, the world’s largest publicly traded tobacco company, demonstrated its commitment to offer “next-gen nicotine delivery” through a new $111 million environmentally progressive research center called the Cube.

As a testament to the Lausanne, Switzerland-based firm’s new greeting on its re-launched homepage, “Designing a smoke-free future,” the high-tech center has three wings named Earth, Wind and Air. The absence of Fire signifies the company’s push for “heat not burn” tobacco products, including its popular IQOS heat stick. Philip Morris has poured more than $3 billion into new tobacco-based inventions as an alternative to the fragmented e-cigarette market. The decision makes sense given that the largest companies already have a competitive edge in the tobacco space.

A Cigarette-Free Future

A wave of tobacco companies shadowing Philip Morris have shown their willingness to deliver tobacco through any means consumers will adopt, whether it be heat-not-burn products, gum, lozenges, dip, e-cigarettes etc.

In January 2016, America’s second-largest tobacco company, Reynolds, announced the formation of RAI Innovations Co., following the nationwide release of its e-cigarette brand Vuse. Later, British American Tobacco Inc. (BTI) announced plans to acquire Reynolds for $49.4 billion. The London-based company’s CEO, Nicandro Durante, told sources that the deal was more about the future of smokeless nicotine than of scale.

“It’s going to be an arms race,” said analyst Nik Modi of RBC Capital Markets. “Who has the best technology, the best science? Who can get their applications through the FDA the quickest? We’re not in a pricing war. We’re in an innovation war.” (See also: Tobacco Giants Push New ‘Alternative Products’.)