January 8, 2020
The evidence of substantial health risks for e-cigarettes just continues to grow. Tarang Parekh and colleagues’ paper “Risk of Stroke With E-Cigarette and Combustible Cigarette Use in Young Adults” in American Journal of Preventive Medicine reports elevated risk of stroke in dual cigarette smokers and e-cigarette users beyond the risks of smoking. Significantly, they also show no benefit of “complete switching.”
They do find that people who just use e-cigarettes (and never smoked cigarettes) have a lower risk of stroke than people who just smoke, but most adult e-cigarette users are dual users or switchers.
Here is the abstract:
Introduction. Rising trends in stroke incidence and hospitalizations because of combustible cigarette smoking have been noted among younger adults. However, the association between e-cigarette use and stroke in this population remains largely unknown. This study examines the association between e-cigarette use with or without a history of previous or concurrent combustible cigarette use and stroke among young adults.
January 6, 2020
I just published "Net Effect of Young Adult Dual Combusted Cigarette and E-Cigarette Users’ Anticipated Responses to Hypothetical E-Cigarette Marketing Restrictions" in Substance Use and Abuse. This paper is an additional analysis of a previously reported experimental study on how getting rid of flavored e-cigs would affect e-cig and cigarette use, considering both changes in consumption and quitting. The earlier analysis considered separate effects, but did not look at the net effect of quitting or reducing vs. incraeses in consumption of both products.
The net analysis I did showed positive effects (in terms of health) on both outcomes.
Here is the abstract:
Stan Glantz will step down as UCSF Tobacco Center director June 30, 2020 and continue as a professor
January 6, 2020
I have notified Dean Talmadge King that I will be stepping down as Director of the Center for Tobacco Control Research and Education effective June 30, 2020.
I will be continuing as an active member of the faculty, including as Principal Investigator of the UCSF Tobacco Center of Regulatory Science (TCORS) and my other research grants, working with the UCSF Library to continue to build the tobacco and other industry documents collections, posting to the Tobacco Center blog, and will be continuing efforts to expand the UCSF Smokefree Movies campaign to a Smokefree media campaign. I will also be continuing my mentoring work and teaching.
We have built an amazing program in the nearly 20 years since we started building the Tobacco Center. We are probably the leading center for tobacco control research and education in the world and have recently added a group of faculty members working on cannabis. We have trained nearly 100 postdocs who have moved into leadership positions in academia, as well as government and nongovernmental organizations around the world.
January 4, 2020
My colleagues Poonam Rao, Jiangtao Liu, and Matt Springer just published “JUUL and Combusted Cigarettes Comparably Impair Endothelial Function” in Tobacco Regulatory Science. They compared to Juul, a third generation tank system e-cigarette (the kind FDA is giving a pass in its enforcement against some e-cig flavors), and a Marlboro Red cigarette against clean air affect arteries’ ability to dilate (get larger) in the face of increased demands for blood flow. Impairment of this so-called flow mediated dilation (FMD) makes impaired functioning of the cardiovascular system and predicts future heart attack risk.
The graph below (taken from Figure 3 of the paper) shows the similarities in how these three tobacco products reduce FMD:
January 2, 2020
The FDA has released its detailed “guidance” document that outlines what enforcement action it plans to take against flavored e-cigarettes. It is important to understand that this is not a law or even a regulation, but rather a non-binding statement of how FDA plans to enforce the law.
This plan is based on the fact, stated several times (pages 3, 11, and 12) that all e-cigarettes currently on the market are there illegally. The FDA is simply going to stop giving all of them passes and is going to start enforcing the law against some e-cigarettes. As FDA says on page 3, “This guidance does not in any way alter the fact that it is illegal to market any new tobacco product without premarket authorization.”
What the FDA says it is going to do is "prioritize enforcement" to stop the sale of: