May 26, 2014
On May 21, 2014 Andrea King and colleagues published a nice experimental study, "Passive exposure to electronic cigarette (e-cigarette) use increases desire for combustible and e-cigarettes in young adult smokers," in Tobacco Control, showing that when young adult smokers saw someone using an e-cigarette it made them want to smoke as much as if they saw someone smoking a cigarette. (The "passive exposure" is watching someone use an ecig during a conversation.)
Seeing an ecigarette being used did not make smokers who did not already use ecigarettes want to use an ecigarette, but did stimulate desire for an ecigarette among ecigarette users. Exposure to to a neutral stimulus (seeing someone drink a bottle of water) did not affect desire for either a cigarette or ecigarette.
May 24, 2014
Wendy Max and Yingning Wang, two economists at UCSF have submitted a public comment on the FDA's regulatory impact (cost-benefit) analysis. Here is a summary from the beginning of their comment:
May 20, 2014
Several people have asked me how to submit comments. It is easy.
1. Go to www.regulations.gov.
2. Type (or cut and paste) FDA-2014-N-0189 into the search box and press "search."
3. This will open the page for the deeming rule docket.
4. Type your comment into the text box or upload any files that you want the FDA to consider (or do both).
5. Fill in your name and the other identifying information that is requested and click the button to submit the comment.
May 20, 2014
Robert West and colleagues just published a large population-based cross-sectional study of the relationship between e-cigarette use and having stopped using cigarettes in England that shows that, among smokers who made at least one quit attempt in the last year, smokers who used ecigs as part of their quit attempt were statistically significantly more likely to no longer be smoking cigarettes than smokers who used unassisted NRT or no aids.
Subject to all the usual caveats about cross-sectional studies, this is a reasonably done study for what it claims to compare. The use of statistical methods to adjust for differences between the groups is the standard way to analyze such real world studies. Like others, they found that the adjustments did not change the results very much.
I agree with West that, for mass-marketed products like e-cigarettes, this kind of real-world study is more meaningful than randomized clinical trials.
It is important, when interpreting their findings, to remember what they studied: They limited themselves to people who were using ecigs as part of quit attempts.
May 20, 2014
We just submitted the following public comment to the FDA (comment number 1jy-8c7f-bqh8):
E-cigarette and cigar companies and trade associations have petitioned the FDA to extend the comment period by up to an additional 105 days, bringing the total comment period to 180 days. There is a real health cost to granting such a delay. Based on 2012 use patterns of e-cigarettes alone, we estimate that during the requested 105 day extension we estimate that an additional 26,000 youth will start experimenting with e-cigarettes and 8,000 youth will become established e-cigarette users.
These estimates are probably low because they do not account for the fact that e-cigarette market penetration continues to accelerate. These estimates do not include new experimenters and established users for cigars and other products covered by the proposed deeming rule.
The FDA needs to include these health costs when evaluating the industry’s request and deny it. This rule has been years in the making and 75 days is enough time for industry to respond.
DETAILS OF CALCULATIONS: