Tobacco Center Faculty Blog

February 3, 2020

Stanton A. Glantz, PhD

Rebecca Evans-Polce and colleagues just published “Trends in E-Cigarette, Cigarette, Cigar, and Smokeless Tobacco Use Among US Adolescent Cohorts, 2014-2018” in American Journal of Public Health.  They used data from the National Youth Tobacco Survey fro 2014-2018, the years in which e-cigarette use really took off, to assess the age at which kids started using e-cigarettes, cigarettes, smokeless tobacco, and cigars.  They found that the age of initiation for cigarettes, smokeless, and cigars did not change over these 5 years, but that the age initiation for e-cigarettes dropped. 

In 2014, 8.8% of lifetime e-cigarette users had started by age 14; in 2018 this fraction had increased to 28.6%.

This result adds to the overwhelming case that e-cigarette use is an epidemic with kids and highlights the need to continue to press for bans on the sale of all flavored tobacco products, including e-cigarettes, and also stopping the sale of all e-cigarettes that have not been approved as “appropriate for the protection of public health” by the FDA.

This is also more evidence that the FDA’s “enforcement policy” that exempts popular new disposable and refillable e-cigarettes is likely to fail to have much impact on youth use.  It needs to be comprehensive.

Here is the abstract:

February 3, 2020

Stanton A. Glantz, PhD

The public health debate and FDA frame for evaluating e-cigs, heated tobacco products, and other new products has been over whether they were an “off ramp from cigarettes” or whether they were a less dangerous alterative to cigarettes.

That’s not how the tobacco companies think about these products.  The see them as alternatives to quitting entirely.

At the UCSF Tobacco Center’s annual “It’s About a Billion Lives” symposium last week, Professor Dorie Apollonio gave a brilliant history of the industry’s alternative products going back over 100 years, to the invention of the Bonsack cigarette manufacturing machine.

The tobacco companies have known for over 100 years that people were concerned about the health dangers of smoking and working to quit smoking.  All these new products have been developed as an alternative to quitting so that the companies could hold on to customers.

“Harm reduction” and “continuum of risk” ideas were developed as marketing and policy messages to promote these alternatives to quitting completely. 

January 26, 2020

Stanton A. Glantz, PhD

Kim Nguyen, Casey Palmer, Laura Schmidt and I recently published “Transferring Racial/Ethnic Marketing Strategies From Tobacco to Food Corporations: Philip Morris and Kraft General Foods” in American Journal of Public Health.  This paper, based on the tobacco industry documents, shows how Philip Morris transferred the knowledge of how to target racial and ethnic minorities it developed to sell them cigarettes to sell them junk food.

This paper is a companion to our earlier paper, “Tobacco industry involvement in children's sugary drinks market” that showed how RJR did a similar technology transfer from tobacco to sugary beverages in order to increase youth use of sugar sweetened beverages.

Both these papers show the value of cross-industry analysis of industry documents to understand how these major multinational corporations trade public health for profits.

Here is the abstract for the new paper:

Objectives. To investigate the transfer of marketing knowledge and infrastructure for targeting racial/ethnic minorities from the tobacco to the food and beverage industry in the United States.

January 17, 2020

Stanton A. Glantz, PhD

Jim Lightwood and I have published a series of papers on the short-term (one year) medical care cost savings associated with drops in smoking.  The most recent of these showed an elasticity between changes in smoking and changes in medical care costs of 0.11.  What this means is that a 10% relative drop in smoking (about 1.5% drop in absolute prevalence) would lead to a 1% drop in aggregate health care costs the following year.  This has powerful policy implications because this is a big effect in terms of dollars, policy makers are looking for ways to lower medical costs, and this change is fast.

For example, I used this elasticity to estimate the immediate (one year) savings on state-by-state Medicaid expenditures of a 1% absolute drop in smoking prevalence; the total savings for all states totaled $2.6 billion (in 2017 dollars). Each state saved a median (interquartile range) of $25 million ($8 million to $35 million).

January 10, 2020

Stanton A. Glantz, PhD

Amit Yadav, Pam Ling and I just published “Smokeless tobacco industry’s brand stretching in India“ in Tobacco Control.  This paper, published in the journal’s Industry Watch section, shows how the smokeless tobacco companies introduced look-alike non-tobacco products that they then promoted as a way to get around India’s ban on tobacco advertising and promotion.  It points to the need for a clear and uniform policy against brand stretching of tobacco products that harmonizes different laws and regulations to mitigate the problem permanently.