ASH Daily News 14 December 2017



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UK

  • Researcher expresses concern about evidence base for using electronic cigarettes

International

  • USA: Study finds that monetary incentives improve cessation in smokers with mental health issues
  • USA: FDA limitations on e-cigarette marketing may be harmful and unconstitutional
  • USA: Study raises concern about effectiveness of anti-smoking images on packaging
  • USA: New study finds that more US teens are vaping than smoking cigarettes
  • USA: County offers support for Washington plans to raise tobacco age limit to 21

 

UK

Researcher expresses concern about evidence base for using electronic cigarettes

A researcher at Leeds Beckett University has called for further research into the efficacy and health effects of e-cigarettes. In a letter published in The Lancet Respiratory Medicine, titled ‘The irresponsible promotion of e-cigarettes and Swaptober’, Dr. Stuart Flint urged for further study of the potential health benefits of e-cigarettes to be undertaken before they are used as an alternative to cigarettes to help people stop smoking.

Source: The Daily Mail, 13 December 2017

Editorial Note:
The article also states that “NICE, the drug’s rationing watchdog, has told GPs not to recommend e-cigarettes because there is limited evidence over their safety”.

NICE has previously issued a corrective statement concerning its position on e-cigarettes.

NICE stated: “These are new products and naturally results of long term studies are only now emerging – strongly reinforcing the view that e-cigarettes carry a fraction of the risk of smoking.

“We promote e-cigarettes as aids to stop smoking and when used in conjunction with other support, smokers have some of the highest success rates. Our recommendation is that people should receive advice on e-cigarettes so that they can make informed decisions on how to stop smoking

“E-cigarettes are now the most popular quitting aid in England with growing evidence of their effectiveness, with similar or better results than nicotine replacement therapies such as patches. A recent BMJ study estimated that, in England, e-cigarettes lead to 16,000 – 22,000 additional smokers quitting a year.

“Our guidance is draft and we are keen to get feedback on the use of e-cigarettes during the consultation.”

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International

USA: Study finds that monetary incentives improve cessation in smokers with mental health issues

A study published in Psychiatric Services in Advance found that monetary incentives based on smoking abstinence improved cessation outcomes amongst 661 poorer smokers with mental health issues.

The study explored the benefits of three different types of intervention and found that those who received monetary incentives were more likely to abstain from smoking.

While the authors of the study pointed out the promising nature of their results, they also drew attention to the limitations of the study itself. These included the short period of time that the abstinence incentives were delivered for and difficulties posed by the mental instability of the participants.

Source: Psychiatry Advisor, 8 December 2017
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USA: FDA limitations on e-cigarette marketing may be unhelpful and unconstitutional

Earlier this year, the Food and Drug Administration (FDA) announced that it would reevaluate its own tobacco policies. As such, it recognised that the primary health threat from tobacco products comes from combustion rather than nicotine itself and noted the role that “less harmful tobacco products” could play in reducing the death toll from cigarettes.

However, federal regulations and governmental suggestions that e-cigarettes are just as harmful as tobacco cigarettes may be hampering the harm-reducing potential of e-cigarettes. In fact, these restrictions may be preventing makers and retailers of e-cigarettes from making factually true statements about their products.

In May 2016, the FDA deemed that e-cigarettes must be regulated as “tobacco products” under the Tobacco Act of 2009. This subsequently placed restrictions on the “commercial speech” rights of makers and retailers of e-cigarettes, rights which are enshrined in the First Amendment and only recoverable after a “lengthy and costly approval process”.

Source: The Washington Post, 12 December 2017
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USA: Study raises concern about effectiveness of anti-smoking images on packaging

A study from the US-based RAND Corporation has suggested that graphic images aimed at discouraging people from smoking may not be effective in this goal.

The study made use of health warnings in an enlarged poster style at a replica corner store and surveyed 441 young people about their habits before and after visiting the replica store. These young people were categorised as smokers, at-risk and non-smokers. The researchers found that the images had no effect on the habits of those who had never smoked, but suggested that the 20% of smokers in the ‘at risk’ category could be more likely to take up smoking after visiting the store with the posters. It was posited that this may have been a “defensive reaction” against firms trying to influence their decisions

Source: The Daily Mail, 13 December 2017

Editorial note:
Cochrane Tobacco Addiction Group, a research group that conduct systematic and comprehensive reviews of available evidence surrounding tobacco, has commissioned a review of the data from 700,000 people before and after the introduction of standardised packaging in Australia.

This review indicated a reduction in the number of people who used tobacco after the introduction and also found that people consistently found standardised packaging less appealing than branded packaging.

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USA: New study finds that more US teens are vaping than smoking cigarettes

A new, nationally representative survey from Monitoring the Future, a government funded group looking into the behaviour of American youth, has found that 35.8% of students entering their final year of high school had tried vaping, whereas 26.6% had ever smoked a tobacco cigarette.

The survey nonetheless shows encouraging figures about the continuing decline of students who are smoking; in 1997, 65.4% of final year high school students had ever smoked, with the percentage dropping to 26.6% in the space of two decades.

The lead member on the survey team urged caution on the usage of e-cigarettes, stating that young people should not consume nicotine “in any way, shape or form”.

Source: The Guardian, 14 December 2017

Editorial note:
This survey concerns the experimentation with e-cigarettes, as opposed to regular usage of devices. In the UK, while there is evidence of experimentation amongst teens, very few teenagers are regularly using the devices. There is no evidence that the use of e-cigarettes is leading to an increase in teen smoking. Smoking rates among UK teenagers continue to fall.

For further information please see: ‘Young People’s Use of E-Cigarettes across the United Kingdom: Findings from Five Surveys 2015–2017‘, a joint piece of research from PHE, Cardiff University and ASH, and ASH’s factsheet: Use of electronic cigarettes among children in Great Britain.

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USA: County offers support for Washington plans to raise tobacco age limit to 21

Spokane County has offered its support to legislative efforts to raise the legal tobacco purchasing age to 21 across the state of Washington.

The board of the Regional Health District offered unanimous and bipartisan support of the measure, which health officials and supporters claim would restrict youth access to tobacco products and bring tobacco into line with the minimum age limits on alcohol and cannabis use in the state.

Measures to raise the tobacco age limit have failed to pass for the previous three years running; Washington state law means that cities and counties cannot set their own rules on smoking and as such the county must press for legislative change at the state level.

Source: The Spokesman, 14 December 2017
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