Tobacco Center Faculty Blog

June 13, 2019

Stanton A. Glantz, PhD

Candice Bowling and I just published “Civic Engagement in California Cannabis Policy Development” in the Journal of Psychoactive Drugs.   This paper tells the tale of how the California Bureau of Cannabis Control proposed a rule that would have allowed the same law enforcement officials charged with enforcing cannabis laws to go into the cannabis business themselves, an obvious conflict of interest.

This was the first time any state proposed such an exemption.  After public comment, including from us, the provision was withdrawn.  This paper highlights the need for clear conflict of interest laws in cannabis regulation and enforcement.  It also shows the value of participating in the public comment process.

This detailed case study is a companion paper to our earlier publication on cannabis and conflict of interest laws, “Conflict of Interest Provisions in State Laws Governing Medical and Adult Use Cannabis” published a few months ago in American Journal of Public Health.

Here is the abstract:

June 8, 2019

Stanton A. Glantz, PhD

On June 7, the Public Safety and Neighborhood Services Committee voted 3-0 to endorse two bills on e-cigs to the full Board, which will consider them on June 18.  One states that the City will no longer allow the sale, distribution, or manufacturing of any tobacco product, including e-cigarettes, on city property.  (Juul’s main office is on rented city property, but would not be affected until its current lease runs out.)  The other, more important, one makes it illegal to see e-cigarettes in San Francisco until they have a marketing order from the FDA.

Neither Juul nor any other e-cigarette company has even applied for such an order even though they could have done so for the last three years, since the FDA issued its “deeming rule” in August 2016.

Under the original rule, e-cig companies would have 2 years (until 2018) to submit their applications; the products could stay on the market for up to another year while the FDA considered their applications.

June 6, 2019

Stanton A. Glantz, PhD

Dharma Bhatta and I just published “Electronic Cigarette Use and Myocardial Infarction Among Adults in the US Population Assessment of Tobacco and Health” in Journal of the American Heart Association.  Like earlier analyses, we found an independent effect of e-cigarette use on risk of having had a heart attack (myocardial infarction) when controlling for smoking and other clinical and demographic factors.

The odds of having had a heart attack among daily e-cigarette users were more than doubled compared to people who neither used e-cigs not smoked cigarettes.  We also found a statistically significant dose-response, with people who used e-cigs daily having higher risks than nondaily, former, or never users.

While the point estimates of the risks of former, nondaily, and daily e-cigarette use are lower than the comparable numbers for smoking cigarettes, the “margins of error” (95% confidence intervals) for e-cigarettes and cigarettes overlap, suggesting that for heart attacks, the risks of e-cigs and cigarettes are comparable.  

This finding is what one would expect based on what is known about the biological effects of e‐cigarette use.

June 3, 2019

Stanton A. Glantz, PhD

The core principle that undermines the tobacco industry, the FDA, and our friends in England ‘s idea that there is a “hard core” of smokers who “can not or will not quit”  and that the existence of this group should drive policy.

Under this logic, e-cigarettes, IQOS, and smokeless tobacco all continue to be promoted as the better alternative than “abandoning all the smokers to die.”

Now there is yet another study showing that, in response to tried and true tobacco control policies (smokefree laws, strong media, taxes, warning labels and plain packaging) the remaining smokers are smoking less and quitting more.

That’s just the opposite of what the hardening hypothesis predicts.

It is particularly important to reject these new “less risky” products because their net effect is to reduce quitting, increase initiation, promote relapse and generally prolong the tobacco epidemic.

It is time for the FDA, England, and everyone else to abandon this outdated idea and stop promoting these product.

June 3, 2019

Stanton A. Glantz, PhD

While Mitch McConnell's bill raising the federal age for selling tobacco products did not include state preemption as I was worried it would, it still contains a very dangeous provision requiring states to raise their legal ages to 21 by amending the Synar Ammendment to raise the age from 18 to 21.

The Synar Amendment, passed in 1992 by Congress, requires states to reduce sales of tobacco to youth under 18 or risk losing some of their Substance Abuse and Mental Health funding from the federal government. Unfortunately, the tobacco companies used Synar to get a lot of bad state laws passed that ended up blocking effective tobacco control measures.  (You can read the details for 33 of the states here.)  The McConnell bill could start that process all over again by creating a rush to pass state legislation raising the age to 21 together with a lot of bad technical details that will actually make it easier for Juul, Philip Morris, and RJ Reynolds to continue preying ok kids by simply overwhelming the health groups in state legislatures.