December 12, 2013
As part of the process of issuing regulations, the FDA (or any other agency) conducts a cost-benefit analysis of the proposed regulation to make sure it is worth doing. The FDA's ill-fated regulation on graphic warning labels was no exception. The Agency's cost-benefit analysis did find a very small net benefit, but that small showing was not enough to convince the courts that the warning label rule was legal in the face of a constitutional challenge.
Last month Jidong Huang, Frank Chaloupka, and Geoff Fong published an excellent paper showing that the FDA gross underestimated the benefits that graphic warning labels would have on cigarette consumption and made the point that this severe underestimation undermined the FDA's ability to defend the warning labels in court as necessary.
Today we published a paper in American Journal of Public Health that shows how the FDA grossly overestimated the costs of reducing smoking by counting, as a substantial cost, the lost pleasure people would experience if they were not smoking.
December 10, 2013
Here are the Union's recommendations. The full document is available here.
• The International Union Against Tuberculosis and Lung Disease (The Union) has issued this position statement based on a careful review of the scientific evidence; the position statement will be reviewed by mid-2015.
• The safety of electronic cigarettes (ECs) or electronic nicotine delivery systems (ENDS) has not been scientifically demonstrated.
• Adverse health effects for third parties exposed (second-hand exposure) cannot be excluded because the use of electronic cigarettes leads to emission
of fi ne and ultrafine inhalable liquid particles, nicotine and cancer-causing substances into indoor air.
• The benefits of e-cigarettes have not been scientifically proven. To date, very few studies have assessed ECs/ENDS as a harm reduction and cessation aid, with conflicting findings.
• The Union is concerned that the marketing, awareness and use of ECs or ENDS is growing rapidly.
• A range of current and proposed legislative and regulatory options exists; some countries (such as Brazil, Norway, and Singapore) have banned ECs/
ENDS completely.
December 10, 2013
The Kentucky Regional Poison Control Center of Kosair Children’s Hospital has received 39 calls about e-cigarettes so far this year, a 333-percent increase from nine calls received in 2012. Nationally, poison control centers have seen a 161 percent increase in calls from people with concerns about these devices. With sales of e-cigarettes doubling to $1.5 billion in the past year, the calls are likely to increase.
Details here.
December 10, 2013
Our paper on the tobacco industry's role, going back to the 1980s, in building what is now called the Tea Party was the most downloaded paper in Tobacco Control for the month of November, the 10th month in a row since it was published in February.
December 5, 2013
We (and others) have shown that as little as 30 minutes of breathing secondhand smoke impairs the ability of arteries to dilate (get bigger) in response to increased demands for blood flow. This effect occurs because secondhand smoke exposure turns off an enzyme called nittric oxide synthase in the artery walls that releases nitric oxide which, in turn causes the artery to relax and dilate. (Stimulating nitric oxide synthase is how Viagra works to increase blood flow to the penis to cause an erection; secondhand smoke is like anti-Viagra..) This impairment of arterial function plays in important role in development of heart disease and in mediating the response to a heart attack.
The question has repeatedly come up of just how fast this effect can happen.
My colleague Matt Springer has developed an exposure chamber in which rats can be exposed to secondhand smoke in a controlled way to measure its effects on arteries. His group (which incldes me) just published a paper in Nicotine and Tobacco Research showing that as little as 1 minute of secondhand smoke exposure at about the level of a smoky restaurant or bar measurably reduces the ability of arteries to dilate.
This information adds to the case that the cardiovascular system is exquisitely sensitive to something in tobacco smoke.