Tobacco Center Faculty Blog

August 5, 2013

Stanton A. Glantz, PhD

Casinos throughout the country are often exempt from smoke-free workplace laws. Now a new study led by UC San Francisco has found that when smoking is banned in casinos, it results in considerably fewer emergency calls for ambulances.
The study is the first to examine the health impact of smoking bans in casinos.
The authors conclude that if smoke-free laws were to apply to casinos as well as other businesses, it would prevent many medical emergencies and reduce public health costs.
“Our study suggests that exempting casinos from smoke-free laws means that more people will suffer medical emergencies as a result,” said lead author Stanton A. Glantz, PhD, UCSF professor of medicine and director of the Center for Tobacco Control Research and Education at UCSF.
“The research shows strong evidence of a significant drop in ambulance calls due to less secondhand smoke exposure,” Glantz said. “Inhaling secondhand smoke increases the likelihood of dangers with blood clots and makes it more difficult for arteries to expand properly – changes that can trigger heart attacks. Legislative and tribal exemptions for casinos, which are all too common, are potentially putting employees and customers at risk of secondhand smoke exposure.”   

August 3, 2013

Stanton A. Glantz, PhD

The Mayo Clinic just published an excellent answer in the Chicago Tribune in response to question by smoker who is considering using nicotine inhaler or e-cigs to help quit smoking.  The Mayo Clinic explained that e-cigs contain toxic substances, do not deliver a controlled amount of nicotine, are not regulated, are not effective in helping people quit smoking, and not enough is known about safety of e-cigs.  They recommend nicotine inhaler and not e-cigs.  The full question and response is here.

July 29, 2013

Stanton A. Glantz, PhD

E-cigarette supporters are fond of quoting a risk assessment, "Comparison of the effects of e-cigarette vapor and cigarette smoke on indoor air quality," by McAultey et al (Inhalation Toxicology 2012; 24(12): 850-857) as evidence that e-cigarettes are safe.  Indeed, the last sentence of the abstract states, "This study indicates no apparent risk to human health from e-cigarette emissions based on the compounds analyzed."

I've gone back and re-read the paper again together with the online supplemental material and found lots of problems, including the fact that they did not detect any benzo(a)pyrene in the conventional cigarette smoke despite the fact that it has been established for over half a century that benzo(a)pyrene is an important carcinogen in cigarette smoke and that they way they did their "risk assessment" is not described in any detail.

The most amazing conclusion in the paper (on page 855, second column, 11 lines from the top), however, is that “neither vapor from e-liquids or cigarette smoke  analytes posed a condition of ‘Significant Risk’ of harm to human health via the inhalation route of exposure."

July 28, 2013

Stanton A. Glantz, PhD

Based on Mike Daube's rule that "you can measure the effectiveness of your program by the response it provokes," Philip Morris International's exceptionally comprehensive and aggressive political campaign against plain packing in the UK shows that plain packaging is a very important thing to do.

On Saturday July 27, The Guardian used leaked PMI documents to "reveal how the world's largest tobacco company sought to kill the [UK] government's plans to introduce standard packs for cigarettes, using a sophisticated lobbying campaign that targeted key politicians and civil servants who it believed were supportive of its views."

Steps included:

July 22, 2013

Stanton A. Glantz, PhD

The FDA has finally released its long-awaited menthol report and invited public comment and submission of additional information during the next 60 days.
Based on a quick reading it seems to essentially be agreeing with TPSAC's conclusions over two years ago.  Based on these conclusions, if the FDA proceeds based on  the science and the standard in the law, they need to ban menthol and its analogs.

A consequence of the FDA's conclusion that menthol -- and not just menthol as a "characterizing flavor" -- encourages initiation and deters cessation is that every month of delay means thousands of new smokers and thousands few quitters.
Here are the key conclusions (with some nonsubstantive bureaucratic language deleted):
From a nonclinical toxicity standpoint, menthol in cigarettes is not associated with increased or decreased smoke toxicity.

Menthol in cigarettes is likely associated with altered physiological responses to tobacco smoke.

Menthol in cigarettes is likely not associated with increased or decreased levels of biomarkers of exposure [CO, COHb and TSNAs].