Tobacco Center Faculty Blog

November 25, 2019

Stanton A. Glantz, PhD

My colleagues at UCSF (and Stanford) just submitted this public comment to FDA on the material FDA specifies that tobacco companies need to submit as part of the premarket tobacco marketing applications.  Our comment highlights some items that need further clarification or other tweaking.  We also provide a redlined version of the propsed rule that implements the changes we suggested.  The tracking number is 1k3-9dik-7qka.  A PDF of the comment is available here.


November 23, 2019

Stanton A. Glantz, PhD

Jacob George and colleagues recently published “Cardiovascular Effects of Switching From Tobacco Cigarettes to Electronic Cigarettes” in Journal of the American College of Cardiology.  This nicely-done study measured changes in blood vessel function in cigarette smokers before and a month after they switched from cigarettes to e-cigarettes and found that vascular function improved after switching.

A particularly interesting result is that the improvement was seen in women but not men.  There are gender differences in heart disease mechanisms and risks (especially before menopause).  This paper highlights the importance of considering gender effects when assessing effects of e-cigarettes on the cardiovascular system.

Like other studies of the effects of e-cigs on vascular function, the effect was independent of nicotine.

This paper does differ from most of the literature, which shows that e-cigs have similar effects on blood vessels as cigarettes (some recent examples are here), but, as noted above, this study is well done and the results contribute to the overall evidence base on ecigs and cardiovascular function.

Here is the abstract:

November 22, 2019

Stanton A. Glantz, PhD

Earlier this week the State of California sued Juul, alleging a wide range of efforts to addict kids and violate a range of California laws.

Every one of these law suits adds more details to our understanding of how Juul made its billions.  The thing that struck me in the California case is the detailed explanation about how Juul's "state of the art" online agre verification system let a ton of kids buy Juul and collected informationn that could be used to email marketing materials to kids.

Beginning on page 41, the case explains the purposeful holes in the online verification system and how Juul gamed the system to allow kids to get through.  In addition to incomplete verifications, the system allowed -- indeed, encouraged -- multiple attempts for kids who did not get through.

November 19, 2019

Stanton A. Glantz, PhD

I am just catching up on my reading after being on the road for a while and want to highly reccomend Chris Kirkham's extensive story, published by Reuters on November 5, 2019, "Juul disregarded early evidence it was hooking teens."  Kirkham meticulously follows the development of Juul's nicotine salt system and highlights how and why the company's leaders not only ignored intenal warnings that Juul would be hightly addictive to teens, but used this fact to line up retailers.

The stody also has an excellent discussion about nicotine delivery and how that relates to addiction.  They also report the fact that I had met with the two Juul inventors,  Monsees and Bowen . years ago and warned them that getting kids addicted would be a big problem with their product.  As Krikham reports that " Juul declined to comment on whether Glantz and other researchers warned the company about the danger of addicting teenagers."

This story is a must read.

November 19, 2019

Stanton A. Glantz, PhD

LA Times reporter Emily Baumgaertner dug through documents that the FDA obtained from Juul as part of its investigation of the company to write an excellent article, "Juul wanted to revolutionize vaping. It took a page from Big Tobacco’s chemical formulas."  She shows how James Monsees and Adam Bowen, the two guys who came up with Juul, used the UCSF Truth Tobacco Industry Documents Library, RJR patents and other materials to come up with the idea of using nicotine salts to develop their highly addictive product.

Lauren Lempert and I put in a FOIA for the material that the FDA obtained from Juul.  While the FDA only released a tiny fraction of the material they have -- citing the need to protect Juul's trade secrets for witholding the rest -- Baumgaertner found a lot of important material in what was released.