ASH Daily News for 17 September 2019



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UK

  • Public Health England shares vaping advice amid ban calls

International

  • Ireland: Health minister Simon Harris to ban cigarette machines and under-18 vaping
  • USA: Study examines risk of ‘pulegone’ additive in menthol-flavoured e-cigarettes and smokeless tobacco products
  • USA: California to spend $20 million on anti-vaping campaign

UK

Public Health England shares vaping advice amid ban calls

Public Health England (PHE) has spoken out amid calls for vaping to be banned following six deaths in the US. Reports of the vaping-related deaths prompted some calls for e-cigarettes to be banned. But PHE responded on Twitter by saying despite the risks, vaping is safer than tobacco and more effective in helping people quit than willpower alone.

PHE said: “Our advice on e-cigarettes remains unchanged – vaping isn’t completely risk-free but is far less harmful than smoking tobacco […] There is no situation where it would be better for your health to continue smoking rather than switching completely to vaping. All UK e-cigarette products are tightly regulated for quality and safety by @MHRAgovuk […] It’s important to use UK-regulated e-liquids and never risk vaping home-made or illicit e-liquids or adding substances, any of which could be harmful.”

“Smoking kills thousands every year and creating a smoke-free generation is one of our top priorities. Vaping is a fraction of the risk of smoking and makes it much more likely you’ll quit successfully than relying on willpower alone […] The sooner you stop smoking completely the better.”

Source: Evening Standard, 17 September 2019

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International

Ireland: Health minister Simon Harris to ban cigarette machines and under-18 vaping

The health minister of Ireland has announced that he intends to ban cigarette vending machines across the country. Speaking on Monday, Simon Harris said he was in favour of the move because of children under 18 being able to buy cigarettes from vending machines so easily, and the impact of smoking on public health.

“It’s my intention to ban cigarette vending machines, and e-cigarettes to under-18s,” Mr Harris said. “I don’t think it’s that controversial at all, tobacco kills you, it’s really bad for you, it causes cancer. We have a policy called Tobacco-Free Ireland, the leader of the opposition [Micheál Martin] did really good work when he was minister for health in that regard and I want to continue to build on that work as successive health ministers have.”

When asked how he would tackle the tobacco lobbyists who are likely to have major objections to the move, Mr Harris said he was prepared and felt that public opinion would be on his side.

He said: “I’ve shown an appetite to take on vested interests in the interest of public health. People told me I wouldn’t pass the Public Health Alcohol Act, it may have taken 1,000 days but we did, so I’m absolutely determined. Tobacco is killing people, it is causing misery to many families saying goodbye to loved ones early, and it’s also having a huge impact on our economy, so I don’t think moves to make cigarettes less available and less visible are controversial. I would hope there is as big a lobby in favour of banning this.”

Source: The Times, 17 September 2019

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USA: Study examines risk of ‘pulegone’ additive in menthol-flavoured e-cigarettes and smokeless tobacco products

A new study by researchers at Duke University School of Medicine has examined the cancer risk of pulegone as an ingredient in menthol-flavoured e-cigarettes and smokeless tobacco products. The study found that “although pulegone is toxic in humans, it is unknown if users of combustible tobacco products, smokeless tobacco, or e-cigarettes absorb and metabolise the quantities associated with production of a carcinogenic effect”. In spite of this, the researchers said that the findings “appear to establish health risks associated with pulegone intake and concerns that the FDA should address before suggesting mint and menthol-flavoured e-cigarettes and smokeless tobacco products as alternatives for people who use combustible tobacco products.”

Scientists from the UK pointed out limitations in the study. Paul Aveyard, Professor of Behavioural Medicine at the University of Oxford, said: “It is not possible from this [study] to assess whether people who vape menthol flavours have excess exposure to pulegone. A study to examine whether there is a concern would measure pulegone concentrations in people who vaped, but the authors have not done this. The study seems to have reported on the pulegone concentration in e-liquids, making the unjustified assumption that all the pulegone in the e-liquid is absorbed. We know, for example, that nearly all the nicotine in e-liquid is not absorbed either from cigarettes or from e-liquids and it is likely that most pulegone is not absorbed, as most of the vapour from e-cigarettes is exhaled.”

Dr Lion Shahab, Senior Lecturer in Epidemiology & Public Health at University College London, said: “There are no studies which have linked the constituent considered here, pulegone, to cancer in humans. By contrast, based on numerous studies of e-liquids, aerosols and actual exposure in humans we know that the level of exposure to constituents known to cause cancer in humans is orders of magnitude lower in e-cigarette users than in smokers. The results reported in this study need to be considered in this context.”

In the UK menthol cigarettes are in a four-year phase-out before they are banned in May 2020, to deter younger people from smoking.

Source: i newspaper, 16 September 2019

JAMA. Risk Analysis for the Carcinogen Pulegone in Mint- and Menthol-Flavored e-Cigarettes and Smokeless Tobacco Products. September 2019

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USA: California to spend $20 million on anti-vaping campaign

Democratic Governor Gavin Newsom has announced that California will spend $20 million on a public awareness campaign about the dangers of vaping nicotine and cannabis products and step up efforts to halt the sale of illicit products. California has seen at least 63 cases of vaping-related illnesses and one of the six deaths reported around the USA.

Newsom announced the actions on Monday as part of an executive order. The public awareness campaign will aim to tackle all forms of vaping. While President Donald Trump and New York Governor Andrew Cuomo have announced plans to ban the sale of flavoured e-cigarettes, Newsom has said he doesn’t have similar executive authority, but wants lawmakers to send him legislation to do so next year.

Beyond the public awareness campaign, Newsom has also asked officials to consider changing how e-cigarettes are taxed, because they typically face lower taxes than traditional cigarettes. He argued that making the products more expensive to buy could make them harder for teenagers to purchase.

Source: Medical XPress, 16 September 2019

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