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:
August 15, 2015
I just submitted this public comment to the FDA on its request for public comment on Swedish Match's amendments to its application to make reduced risk claims for 10 brands of snus.
Comment on
Modified Risk Tobacco Product Applications:
Applications for 10 Products Submitted by Swedish Match...
FDA-2014-N-1051-0843
August 15, 2015
The FDA has posted amendment for a modified risk tobacco product (MRTP) application submitted on June 10, 2014, by Swedish Match North America Inc. for 10 snus smokeless tobacco products specifically to seek comments on the amendments to the originally filed applications. The FDA stated in its press release that “After filing the applications for scientific review—the first MRTP applications to reach this milestone—FDA requested clarifying and other information from the company and received several amendments in response” and is requesting public comment on these amendments.
The FDA has, however, redacted the amendments so extensively for “trade secrets and confidential commercial information” that there is nothing of substance remaining upon which for the public to make an informed comment.
August 14, 2015
After years of the tobacco companies bullying governments in court, it is nice to see health advoacte pushing back when government caves to Big Tobacco. Here is a press release that the International Union against Turbulosis and Lung Disease just put out:
Civil society groups in Pakistan have issued a high court petition to prevent the Ministry of National Health Services Regulation and Coordination from withdrawing life-saving legislation to reduce tobacco use. The new law – which was due to come into force on 31 July – required 85 per cent of the surface area of all tobacco packaging to be covered with harrowing photos of the health consequences of smoking. Now, after months of delay, the warnings could be diminished in size to just 50 per cent.
The legal intervention from the Coalition for Tobacco Control Pakistan (CTC-Pak) blocks the immediate watering-down of the law and calls health and finance ministers to account for reneging on a policy proven to protect public health. Tobacco industry pressure to weaken and delay the measure has been intense since the law was announced by Health Minister Saira Afzal Tarar in February 2015, because graphic health warnings encourage smokers to quit and discourage non-smokers from starting.