September 3, 2015
On September 2, 2015, the Center for Environmental Health released a the largest study of the toxicity of e-cigarettes done to date. As they have done with several other consumer products, they went in to stores and bought the same e-cigarettes that consumers bought, then did laboratory testing on them.
They found high levels of the cancer-causing chemicals formaldehyde and acetaldehyde, in violation of California safety standards.
The full report, A Smoking Gun: Cancer Causing Chemicals in E-cigarettes, is available here.
They have also filed a notice to sue the e-cigarette companies under California Proposition 65. Filing that action gives California Attorney General Kamala Harris (who is running for US Senate) 60 days to take up the case on behalf of the people of California. Given Harris’ flaccid record on tobacco, I am concerned that she would not purse the case as vigorously as CEH.
Here is the CEH press release:
September 1, 2015
In collaboration with colleagues at the CDC Office on Smoking and Health and at UCSF, we just published “Protobacco Media Exposure and Youth Susceptibility to Smoking Cigarettes, Cigarette Experimentation, and Current Tobacco Use among US Youth,” in PLoS ONE. This paper uses data from the 2012 National Youth Tobacco Survey to concurrently examine the effects of a wide range of media influences, including movies and TV, on youth smoking.
We founds that youth susceptibility to smoking, experimentation, and current use varies by type of protobacco media channel exposure. Susceptibility and experimentation are associated with exposure to static tobacco advertising, with experimentation being mediated by perceptions of peer tobacco use. Current tobacco use is also associated with static advertising through increasing perceptions of peer tobacco use. In addition, current tobacco use is associated with both exposure to static advertisements through perception of peer tobacco use of tobacco products, and by exposure to tobacco use in TV and movies, both directly and through perception of peer tobacco use.
September 1, 2015
Clayton Velicer, Stella Bialous, and I just published “Tobacco companies’ efforts to undermine ingredient
disclosure: the Massachusetts benchmark study” in Tobacco Control. When the State of Massachusetts passed strong ingredient disclosure legislation, in addition to suing, the cigarette companies offered to do a “benchmark” study in which they provided regression equations that they claimed could be used to reliably estimate the key constituents in cigarette smoke from published tar, nicotine, and carbon monoxide measurements.
At the same time, they knew that this approach was not reliable.
This bit of history is important because the companies have used similar strategies around the world and are likely to continue to do so as countries move to implement the ingredient disclosure provisions of the FCTC.
Here is the abstract:
Objectives To assess the ‘Massachusetts Benchmark Study’ (MBS) that the tobacco companies presented to the Massachusetts Department of Public Health (MDPH) in 1999 in response to ingredient disclosure regulations in the state. This case study can inform future ingredient disclosure regulations, including implementation of Articles 9 and 10 of the WHO Framework Convention on Tobacco Control (FCTC).
August 31, 2015
On August 18, 2015, Adam Leventhal and his colleagues at USC published first longitudinal study of the relationship between e-cigarette use and starting to smoke cigarettes, “Association of Electronic Cigarette Use With Initiation of Combustible Tobacco Product Smoking in Early Adolescence” in JAMA. This large, carefully done study followed 2530 9th graders for a year. Never smoking youth who used e-cigarettes at baseline were 3-4 times more likely to be smoking cigarettes or other combustible tobacco products a year later.
This is a huge effect that is consistent with the earlier cross-sectional studies that suggested a “gateway effect” of e-cigarettes in promoting smoking of conventional cigarettes.
In addition, as the authors point out (and also consistent with earlier cross-sectional studies), there is also a reverse effect, with kids who start smoking more likely to use e-cigarettes. But this paper demonstrates quite unequivocally that never smoking kids who use e-cigarettes are a lot more likely to become smokers.
August 31, 2015
Today Sara Kalkhoran and I published “Modeling the Health Effects of Expanding e-Cigarette Sales in the United States and United Kingdom” in JAMA Internal Medicine.
There have been many commentaries and opinion pieces on the potential health effects of e-cigarettes that describe some of the various scenarios that could play out. This paper applies numbers to these potential scenarios to compare them in a more quantitative manner.
Specifically, in the debate over the desirability or effects of e-cigarettes entering the market, particularly among e-cigarette optimists, people have tended to focus on very simple models of how things would change, often assuming that the only effect e-cigarettes have on population health would be established smokers switching partly or entirely from combustible cigarettes to e-cigarettes or using them to quit entirely. The assumption was always that e-cigarettes were “harmless water vapor” or, at least, minimally risky.
The real situation is more complicated.
The entry of e-cigarettes is having several interacting effects: