Tobacco Center Faculty Blog

February 16, 2019

Stanton A. Glantz, PhD

Pawan Sharma and colleagues recently published “IQOS exposure impairs human airway cell homeostasis: direct comparison with traditional cigarette and e-cigarette” in which they measured a wide range of effects of cigarette smoke extract (from Philip Morris’ Marlboro cigarettes, Philip Morris International’s heated tobacco product IQOS, and an e-cig using Blu liquid) on human lung cells.  All three products adversely affected lung cells with a dose-response (i.e., bigger effects at higher doses).

In this study they exposed lung from the lining of the bronchi (big air pipes) and airway smooth muscle cells in vitro (i.e., cells in “test tubes”) to solutions made from the aerosols from all three products.

Here is my simplified version of their summary:

February 11, 2019

Stanton A. Glantz, PhD

It’s no secret that I was initially skeptical of Tobacco 21; I saw it as another supply-side effort that wouldn’t work.  What changed my mind was research that Dorie Apollonio and I did using the tobacco industry documents that revealed that many states had age limits for selling tobacco older than 18 and the tobacco companies worked hard to reduce the age in order to make it easier to market cigarettes to kids.  Even since then, I have supported Tobacco 21. 

My view that Tobacco 21 was important was reinforced when I saw how hard the cigarette companies fought the issue here in California.

There is now clearly momentum behind this idea and so, now, Altria and Juul are taking a page from their playbook on smokefree policies and starting to sponsor their own weak and unenforceable laws. 

They got a lot of these bad (nominally) smoking restriction laws passed with the assistance of well-meaning but naïve health groups who, tired of getting nothing, decided to support flawed laws as a “first step” toward high-quality legislation (beginning with Florida in 1985).  The problem is that it takes a median of 17 years to get these weak laws fixed.

February 11, 2019

Stanton A. Glantz, PhD

The full release of the 2018 National Youth Tobacco Survey by the CDC in its paper, “Vital Signs: Tobacco Product Use Among Middle and High School Students — United States, 2011–2018” (summarized in non-technical terms here) in the Morbidity and Mortality Weekly Report (MMWR) has generated a lot of concern.

E-cigarette use, driven primarily by Juul, by youth continues to accelerate (see figure provided by Tom Eissenberg), as does multi-product use, led by dual use of e-cigarettes and cigarettes. In addition to the rapid growth in e-cig use, the historic decline in cigarette smoking has stopped.  This is exactly what one would expect if e-cigarettes were bringing new low-risk kids into the market and acting as a gateway for cigarette smoking. 

Of course, even if the kids did not go on to smoke cigarettes, addicting a new generation of kids to nicotine e-cigs is a bad thing.

February 11, 2019

Stanton A. Glantz, PhD

CDC requested public comments on what steps they can take to better fight the tobacco epidemic.  Here is what we suggested.  The tracking number on is 1k3-9875-2kpn and a PDF of the comment is available here.

CDC should promote strategies proven effective at the local and state levels including banning all flavored tobacco products, improving community education, and engaging vulnerable populations to prevent youth initiation to tobacco, ensure smokefree air, and eliminate tobacco-related disparities


Bonnie Halpern-Felsher, PhD; Maya Vijayarghavan, MD, MAS; Jonathan Polansky, BA;

Anabel Razo, BA; Aditi Venkatesh; Maria Fernanda Bernal;

Lauren Kass Lempert, JD, MPH; Stanton Glantz, PhD


UCSF Tobacco Centers of Regulatory Science



February 11, 2019


February 10, 2019

Stanton A. Glantz, PhD

Lauren Lempert and I published a paper showing that the cigarette companies use colors in the packaging to affect how smokers perceive  the strength and taste of products even when the companies don’t change the physical cigarette.  We argued that the FDA should treat pack colors as an “ingredient” and consider packaging changes when evaluation substantial equivalence claims made by cigarette companies to get their new products approved.  Other investigators (cited in our paper) had shown that the companies use colors to get around the legal prohibitions of using words like “light” and “mild” to make misleading health claims.

Now Karma McKelvey,  Bonnie Halpern-Felsher and their colleagues at Stanford have shown the same thing for kids. 

Their paper,  “A cigarette pack by any other color: Youth perceptions mostly align with tobacco industry-ascribed meanings “ published in Preventive Medicine Reports shows that youth do perceive specific and industry-meaning messages from the colors of cigarette packs.