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.
August 12, 2015
We just submitted a 29 page comment responding to the questions that FDA posed regarding packaging and warning labels for liquid nicotine and related products.
Feel free to use this information in preparing your comments. (The deadline for submitting them is the end of the month.)
The full comment is available here.
The tracking number is 1jz-8kin-qyu8.
July 27, 2015
Pru Talbot and her colleages at UC Riverside just published an important paper, "Unexpected nicotine in do-it-yourself electronic cigarette flavourings" in Tobacco Control. The title says it all.
The bottom line of the paper is:
The current finding of nicotine in DIY flavouring products that are expected to be nicotine free and our prior finding that a DIY bottle of nicotine (134.7 mg/mL) was unlabelled, are important public health problems. These products, which are presented to the consumer as ‘nicotine free’ (http://www.tastypuff.com/product/joosy-froot/), could lead to unwanted addiction, poisoning, or even death.
They go on to recommend