ASH Daily News 21 December 2017


  • Derbyshire and Dorset: NHS figures show variations in rates of smoking during pregnancy
  • West Sussex: Store loses alcohol license as a result of illicit tobacco seizure


  • USA: Reuters special report raises questions about Philip Morris International’s research into ‘heat not burn’ products and their interaction with governments
  • Canada: Study published about potential health risks surrounding varenicline



Derbyshire and Dorset: NHS figures show variations in rates of smoking during pregnancy

NHS figures have shown a rise in rates of smoking during pregnancy in south Derbyshire, a trend that runs counter to the overall national decline.

Published figures show that during the second quarter of 2017, there were 1,447 pregnancies and that 233 of the mothers smoked throughout. This results in a rate of 16.1%, an increase on the figure of 15.1% four years ago and also a higher figure than the overall national average of 11% across England.

In contrast, smoking during pregnancy has declined in Dorset, reaching a low of 10.5%, which is a further decrease on the same period last year, when 11.9% of mother smoked throughout pregnancy.

Reducing rates of smoking during pregnancy is a key platform of the government’s tobacco strategy, with an ambition of reducing the national figure to 6% by 2022.

Sources: Derby Telegraph and Bournemouth Echo, 20 and 21 December 2017
Derby Telegraph
Bournemouth Echo


West Sussex: Store loses alcohol license as a result of illicit tobacco seizure

A store in Worthing has lost its license to sell alcohol as a result of a seizure of illicit tobacco in July.

A search from Trading Standards officers revealed illicit cigarettes and hand-rolling tobacco; a sample showed that this illicit tobacco would not self-extinguish and thus failed to pass safety regulations. The store was also found to have supplied e-cigarette liquid to an underage customer.

A spokesman for West Sussex County Council said: “For a shop to be licensed to sell alcohol, responsibilities include ensuring no crime and disorder is taking place. The shop lost its alcohol licence because illicit tobacco was found there and an under-age sale took place.”

Trading standards officers and council officials also condemned the shop for undermining public safety and for failing to protect children from harm as a result of its actions.

Source: More Radio, 20 December 2017
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USA: Reuters special reports raise questions about the quality of Philip Morris International’s research into ‘heat not burn’ products and their interaction with governments

Part 3:
Philip Morris International has applied to the U.S. Food and Drug Administration (FDA) to market iQOS, a ‘heat not burn’ product that heats tobacco without causing combustion, as less harmful than cigarettes.

A successful application to the FDA would allow PMI to sell the iQOS product on the American market and crucially allow it to be labelled as a “modified-risk tobacco product”. Such a designation could mean that Philip Morris is allowed to market iQOS as presenting less harm or risk of disease to users than traditional tobacco.

However, the Reuters report details the concerns of scientists and researchers who worked on the iQOS project about whether using the device has a lower risk of disease than regular cigarettes. Former employees and contractors have also described a number of irregularities involving the clinical trials that underpin the company’s application to the agency.

Concerns have been raised over the quality, competence and suitability of the lead researchers in these particular clinical trials. David Kessler, the former commissioner of the FDA between 1990 and 1997, has said that although he does not claim that there is “malicious intent”, it was clear to him that PMI lacked the “sophistication to carry out adequate and well-controlled clinical trials”. Philip Morris International said in a statement that “all studies were conducted by suitably qualified and trained Principal Investigators”.

Part 4:
Interviews with government officials and trade groups reveal how PMI is seeking to convince national authorities of the benefits of iQOS. A key objective of this lobbying campaign is to convince governments of the benefits of iQOS so that they do not impose the same taxes and restrictions on the device as they do on cigarettes.

Philip Morris International is thus employing a novel argument. It claims that the tobacco sticks that are inserted into the iQOS device should not be classified as cigarettes because they do not burn or produce smoke. The device itself, the company says, is an electronic product and so should not be regulated like tobacco.

The report details how intense launch campaigns in Japan, Israel and Colombia show that the company is extremely serious about the future of ‘heat not burn’ products. It also notes how this was made explicit in September 2016 when PMI Chief Executive Andre Calantzopoulos told investors that it was the company’s aim to “become the undisputed leader” of a new tobacco category it calls “reduced-risk products.”

The goal is to have these products ultimately replace regular cigarettes and the Reuters report details the exceptional legal lengths to which PMI are going in order to ensure favourable conditions within this new terrain of the tobacco industry.

Source: Reuters, 20 and 21 December 2017
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Canada: Study published about potential health risks surrounding varenicline

Researchers from the University of Toronto have studied 56,851 new varenicline users, measuring their rates of cardiovascular and neuropsychiatric events.

The findings were published in the American Journal of Respiratory and Critical Care Medicine and suggested that varenicline might play a role in emergency room admissions, specifically noting that there were 3.95 cardiovasular events per 1,000 varenicline users during the 12-week administration period that could be attributed to the drug.

The findings also noted that of the 56,581 users, 4,720 individuals experienced neuropsychiatric events during the course. This was especially prevalent among those aged 65 and above; the study raised several potential explanations for this increased prevalence amongst the older population but researchers specifically stated that they “cannot be sure of causality” as a result of the observational study design that was used.

Source: The Daily Mail, 20 December 2017

Editorial note:
The researchers noted the limitations that their methodology presented. They asserted that the evidence of neuropsychiatric outcomes was of “questionable clinical significance” and consistent with other, previous studies that found no association between such events and varenicline.

The study was also limited by the fact that researchers could not accurately report whether people were taking varenicline in the prescribed manner or what the individual smoking habits of the participants were.

The study’s lead author Dr. Andrea Gershon said: “Quitting smoking greatly reduces a person’s chances of developing heart disease and cancer and has many other health benefits. Our findings should not be used to suggest people not take varenicline. The findings should be used to help people make an informed decision about whether they should take varenicline based on accurate information about its risks as well as its benefits.”

See also: American Journal of Respiratory and Critical Care Medicine: Cardiovascular and neuropsychiatric events following varenicline use for smoking cessation

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