ASH Daily News for 4 October 2019



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UK

  • Opinion: The vaping deaths backlash is in danger of doing more harm than good
  • Warnings should be printed on every cigarette, charity says

International

  • New York court halts state ban on flavoured e-cigarettes
  • USA: Vaping-related deaths rise to 18
  • USA: Altria launches IQOS tobacco device
  • USA: Report says that flavoured e-cigarette use among young people has increased, while use of flavoured hookah and smokeless tobacco has decreased

Links of the week

  • ASH Health Inequalities Toolkit
  • Smoking reduction interventions for smoking cessation

UK
Opinion: The vaping deaths backlash is in danger of doing more harm than good

In an opinion piece for Wired, Matt Reynolds argues that introducing bans on the sale of e-cigarettes might end up causing more harm than good. Critics of the recent vaping backlash say that it may squander the opportunity for more useful long term tobacco regulation or make smokers less likely to quit cigarettes altogether.

Most of the restrictions on e-cigarettes in the US so far have either concentrated on flavoured e-cigarette pods or lumped all e-cigarettes together. Neither approach seems to address the suspected cause behind the recent cases of lung illness. Of the vaping-related patients that the CDC currently has data on, 77% reported using THC-containing products in the month before the onset of their symptoms. And these percentages might be underestimates says Eric Lindblom, a former FDA tobacco control official now at Georgetown Law’s O’Neill Institute. Of the four states with the highest number of reported cases – California, Texas, Wisconsin and Illinois – only one (California) has currently legalised recreational cannabis use. Patients in states where cannabis is illegal might be less willing to admit that they had been vaping THC. Despite the evidence strongly hinting that vapes containing THC are at least partly responsible for this outbreak of lung illness, no state has brought out specific regulation targeting THC vapes. “It seems kind of backwards given that the problem is clearly much more closely linked to vaping cannabis THC products,” says Lindblom. “It totally doesn’t address the mystery illness in any way.”

Concerns about the number of young e-cigarette users could explain why so much of the vaping backlash has centred on flavoured e-cigarette products. But Deborah Arnott, chief executive of Action on Smoking and Health (ASH), has warned that banning flavoured pods altogether might put people off quitting smoking. “What we don’t want it for people to be scared back to smoking or for smokers – who are often looking for a reason not to quit – to think ‘oh well, I might as well carry on with smoking’ […] the relative risk compared to smoking is the initial thing to be concerned about, but if people are going to carry on vaping for the long term then you need to worry about what the long term impacts might be and whether it would be better for them to quit vaping as well,” she says.

But if it’s approached in the right way, the rash of vaping illness could be an opportunity for useful regulation to be passed, says Lindblom. As well as only allowing e-cigarettes that had been proven to have a net benefit to public health, it could provide an opportunity to re-examine regulation of menthol cigarettes, which are often a gateway into smoking for young people.

Whatever happens, Lindblom and Arnott agree that regulators should be looking for ways to reduce the total number of smokers. That might mean encouraging people to switch to e-cigarettes, but it also shouldn’t preclude tighter regulation of conventional cigarettes, Lindblom says.

Source: Wired, 4 October 2019

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Warnings should be printed on every cigarette, charity says

Campaigners have expressed enthusiasm at the suggestion of health warnings being printed on every cigarette to help motivate smokers to quit. It comes as researchers in Australia found that pictures of black lungs, rotten teeth and cancerous mouths on packaging had lost their shock value.

Deborah Arnott, chief executive of Action on Smoking and Health (ASH), told The Sun Online: “Cigarettes are widely known as cancer sticks –why not put ‘smoking causes cancer’ on every cigarette to remind smokers every time they pull out a cigarette. The government admits it needs to do more if it is to achieve its ambition of a smoke-free England by 2030. Warnings on cigarettes is an obvious next step, it’s already under consideration not just in Australia but also in Canada and Scotland. Smokers themselves say it could help them quit, and it would also be the clearest warning possible to children not to start.”

Source: Metro, 3 October 2019

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International

USA: New York court halts state ban on flavoured e-cigarettes

On Thursday 3rd October, New York’s appellate court put a hold on the ban on the sale of flavoured e-cigarettes that was announced by New York state’s Democratic Governor Andrew Cuomo last month. The ban was a response to widespread growing concern about the rising use of e-cigarettes among teens and a nationwide spate of lung illnesses.

The ban, which was due to start on Friday 4th October, will be paused until at least 18th October when the Supreme Court in Albany is scheduled to hear the case brought by industry trade group Vapor Technology Association arguing for a preliminary injunction on the ban. New York Health Commissioner Howard Zucker said he remained confident that the ban would eventually be enforced.

Source: Reuters, 4 October 2019

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USA: Vaping-related deaths rise to 18

The Centers for Disease Control and Prevention (CDC) announced on Thursday that the number of people who have died from a vaping-related illness has increased to 18. The CDC and Food and Drug Administration (FDA) have not yet announced a link to one particular product, but said they have information on products used by 578 patients so far. Of them, about 78% used products that contained THC. As the investigation continues, they said those percentages might change.

Source: Evening Standard, 4 October 2019

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USA: Altria launches IQOS tobacco device

Marlboro maker Altria will be formally launching IQOS, a ‘heat-not-burn’ tobacco device, for the first time in the US in Atlanta today (Friday 4th October). Altria started developing its new tobacco device more than a decade ago — as smoking rates declined but long before vaping became popular in the US. The Food and Drug Administration (FDA) authorised its sale in the US in April.

In Japan and Russia, IQOS has proven popular, while adoption has been slower in Canada and the United Kingdom. It is unknown how US consumers will respond to IQOS.

Source: CNBC, 4 October 2019

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USA: Report says that flavoured e-cigarette use among young people has increased, while use of flavoured hookah and smokeless tobacco has decreased

Flavoured e-cigarette use among young people in the United States increased from 2014 to 2018, according to a new report from the US Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration (FDA). The report, released on Thursday 4th October, said current use of flavoured e-cigarettes — defined as use in the past 30 days — had increased among high school students since 2014 and among middle school students since 2015.

The analysis, based on data from the National Youth Tobacco Survey, found that use of flavoured hookah pipe tobacco among middle and high school students declined from 2014 to 2018. The use of flavoured smokeless tobacco, cigars, pipe tobacco and menthol cigarettes decreased among high school students during that time, the report said.

Source: CNN, 3 October 2019

CDC. Flavored Tobacco Product Use Among Middle and High School Students — United States, 2014–2018. October 2019

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Links of the week

ASH Health Inequalities Toolkit

ASH has produced a set of materials to help reduce smoking-related health inequalities. The pack is designed as a set of pragmatic tools, setting out the problems and solutions, to support the case for targeted tobacco control work with groups with high smoking prevalence.

This includes the Ready Reckoner, an easy-to-use cost calculator, which allows you to see the costs of smoking to society at national, regional, local authority and ward levels.

Access Toolkit

Study: Smoking reduction interventions for smoking cessation

A new Cochrane review looks at whether cutting down smoking before quitting helps people to stop smoking, and the best ways that people can cut down to help them stop completely. The review found moderate-certainty evidence that cutting down before quitting may result in similar quit rates to quitting all at once, which suggests that cutting down to quit may be a helpful approach. There is also moderate-certainty evidence that using varenicline or fast-acting NRT (e.g. gum) helps people cut down to quit.

Read Review