Pharmaceutical companies have worked hard to protect their reputation by shifting blame for the opioid crisis away from themselves and onto individual patients. In the new article, “The Rise of Clinical Decision Support Algorithms in Pain Management, 2009–2024,” published in the Journal of General Internal Medicine, CTCRE Fellow Dan Kabella, PhD looks at how digital tools like NarxCare play a key role in this.
NarxCare is a tool used in healthcare to predict the risks of opioid misuse, addiction, and overdose and to guide doctors’ decisions. These tools often put the focus on patients’ behavior instead of problems like aggressive marketing with the pharmaceutical companies. Using internal documents and public information, their research shows how these companies have pushed tools like NarxCare as proof they are managing the crisis. Instead of making real changes, these tools allow the opioid industry to define “legitimate” opioid use through careful prescribing and monitoring, while leaving the system that protects industry interests intact.
This article was co-aithored by CTCRE Fellowship Co-Director Dorie Apollonio, PhD, MPP, UCSF Professor Kelly Knight, PhD, and doctoral student Halle Young.
A recent publication by CTCRE fellow Allison Temourian, PhD, has been selected as the cover story for the March 2025 issue of Urban Science. Her paper, Citizen Science to Collect Tobacco Waste: Exploring the Usability of Two Protocols, evaluates the feasibility of two tobacco product waste protocols using a community-based approach. The study highlights the impact of adaptable methodologies that not only engage the public in meaningful scientific participation, but also empower local communities. This collaborative approach also serves as a model for integrating public participation.
Explore the full publication here.
2024 Surgeon General's Report- Eliminating Tobacco-Related Disease and Death: Addressing Disparities
On November 19th 2024, the Surgeon General released a new report titled Eliminating Tobacco-Related Disease and Death: Addressing Disparities, the 35th tobacco-related Surgeon General’s Report published since 1964. Pamela Ling, MD, MPH, Director of the UCSF Center for Tobacco Control Research and Education, and Maya Vijayaraghavan, MD, MAS, Fellowship Co-Director of the UCSF Center for Tobacco Control Research and Education, were contributing authors on this report.
Eliminating Tobacco-Related Disease and Death: Addressing Disparities assesses health disparities related to tobacco use. While the US has made progress in reducing tobacco use in the overall population, advancements have not been equally distributed across all US population groups.
Disparities in commercial tobacco product use, exposure to secondhand tobacco smoke, exposure to marketing of tobacco products and smoking-related health outcomes persist by race and ethnicity, level of income, level of education, sexual orientation, gender identity, type of occupation, geography, and behavioral health status.
The full report can be read online here.
Greetings and Happy New Year everyone!
We are very happy to announce a partnership between the University of North Carolina at Chapel Hill University Libraries and the University of California, San Francisco (UCSF) resulting in a new acquisition of roughly 4 million internal documents from the State of North Carolina’s $40 million settlement with electronic cigarette maker JUUL Labs:
https://www.industrydocuments.ucsf.edu/tobacco/collections/juul-labs-collection/
The first 280,000 documents are now available online as part of the UCSF Truth Tobacco Industry Documents and we plan to publish the remaining documents monthly, concluding the project in 2025.
See the UNC announcement for more information on the partnership: https://uncnews.unc.edu/2024/01/31/university-collaboration-to-create-public-depository-of-nearly-4-million-documents-associated-with-north-carolina-vaping-settlement/
https://www.industrydocuments.ucsf.edu/
African Americans face a higher stroke risk than other racial groups in the U.S., which is not fully accounted for by traditional risk factors or socioeconomic differences. Tobacco smoking, a well-established independent risk factor for stroke and responsible for one-fifth of all strokes in the US, has only recently been evaluated in this population. The 2.5 times higher risk for African American smokers compared to non-smokers, is even greater when contrasted with non-Hispanic Whites, highlighting the need to investigate the underlying reasons for this disparity.
In the cross-sectional study, Mustra Rakic and colleagues investigated the role of two clinically important genetic variants of apolipoprotein L1 (APOL1) in tobacco-related stroke. These variants are common among the African American population and very rare in people of other races. They studied 500 self-identified African American adults recruited through the UCSF Lipid Clinic, and discovered that participants who were current or past smokers and carry the APOL1 risk variants have higher odds of having a history of stroke. Tobacco smoking is suggested to act as a 'second hit,' alongside the genetic predisposition conferred by APOL1 risk variants. They also observed that carriers of two APOL1 risk alleles who have ever smoked tend to have highest odds for stroke, followed by those carrying one APOL1 risk allele who have ever smoked. The smallest odds are among those who have ever smoked but do not carry any APOL1 risk alleles. Given the high frequency of APOL1 risk variants in the African American population, (roughly 50% of African American people carry at least one risk allele), this study may offer an…
The UCSF TCORS submitted the following public comment to the FDA on April 13, 2023. The Comment Tracking Number is lgf-ds2n-iuvb. Click here to download the PDF.
FDA’s proposed regulation establishes reasonable tobacco product manufacturing practice requirements that could help minimize the risks of products, especially to youth and young adults
Docket No. FDA-2013-N-0227
Requirements for Tobacco Product Manufacturing Practice
Lauren Kass Lempert, JD, MPH; Bonnie Halpern-Felsher, PhD; Stanton A. Glantz, PhD;
Neal L. Benowitz, MD; Carolyn S. Calfee, MD MAS; Benjamin W. Chaffee, DDS MPH PhD; Jennifer Fung, PhD; Stuart Gansky, DrPH; Wendy Max, PhD;
Vira Pravosud, PhD, MPH, MS; Matthew L. Springer, PhD;
Pamela M. Ling, MD, MPH
UCSF TCORS
April 13, 2023
FDA’s proposed regulation[1] establishing tobacco product manufacturing practice requirements for manufacturers of finished and bulk tobacco products is designed to establish controls to prevent or minimize some risks inherent in tobacco products, ensure that products are manufactured in conformance with established specifications, minimize the likelihood that nonconforming tobacco products are manufactured and distributed, require investigating and addressing nonconforming products, prevent contamination of tobacco products, and establish…
The use of vape products (e-cigarettes) to consume nicotine and cannabis (marijuana) has become a significant public health concern, especially use by adolescents. A new study conducted by Benjamin Chaffee and colleagues at UCSF and the California Tobacco Control Program gives further evidence to suggest that having flavors in those vapes may increase adolescents’ willingness to try them, regardless of whether the vape contains nicotine or cannabis.
The study was part of the 2021-2022 California Teens Nicotine and Tobacco Project and was based on a statewide online survey of 2,342 adolescents aged 12-17. As part of a discrete choice experiment within the survey, teens were shown two hypothetical vape products and asked to select which one they would be willing to use (or neither) if offered by a best friend. The hypothetical products differed in their flavor, what they contained (nicotine, cannabis, or “just vapor”), and other characteristics.
The study found that flavors, notably candy/dessert, fruit, and fruit-ice combination flavors, were associated with greater willingness to try vape products, regardless of what the vape contained. Candy/dessert flavors, in particular, enhanced willingness to try among exclusive nicotine e-cigarette users, exclusive cannabis users, co-users of both, and non-users.
This study provides additional evidence that flavors…
In 2017, California passed a $2 cigarette tax increase, and between 2014-2020, local Bay Area cities passed local flavored tobacco bans. Dr. Vira Pravosud led a new study that showed that between 2014 and 2020, cigarette prices increased even more than the $2 tax, and prices were higher in San Francisco and in cities in Alameda County with local flavor bans. San Francisco was more expensive than any other city in Alameda County. The study also found that the menthol flavored tobacco policy in San Francisco was well implemented. The retail stores in San Francisco had completely stopped selling Newport menthol cigarettes and Blu brand menthol e-cigarettes in 2019. This study suggests that local flavor bans affected menthol product availability and might also have indirect effects to increase tobacco prices. Higher prices and elimination of flavored tobacco products should help reduce youth tobacco use.
Study link: https://pubmed.ncbi.nlm.nih.gov/36943027/