April 16, 2018
My UCSF colleagues and I submitted this public comment to the FDA Nicotine Steering Committee. The tracking number is 1k2-92ml-1zcp . A PDF of the comment (which includes the footnote referencing which is lost in this blog post) is available here and and the two attachments are here and here.
April 12, 2018
Big Tobacco usually brags about all their civic activities as part of their “corporate social responsibility” campaigns designed to convince the public and public policymakers what great citizens they are.
But that’s not the case for RJ Reynolds Tobacco, who so far has single-handedly financed the referendum – Proposition E on the June ballot -- to overturn San Francisco’s prohibition on flavored tobacco products (to the tune of $3.5 million so far). They certainly don’t brag about it on their internet ads like the ones below.
April 12, 2018
My colleagues and I just submitted this public comment to the FDA Nicotine Steering Committee. The tracking number is 1k2-92jz-nsej; a PDF is available here.
FDA Should Facilitate Investigational New Drug Applications (IND) for Commercially Available Electronic Nicotine Delivery Devices
Comment for Nicotine Steering Committee
Docket No. FDA–2018–N–0128
Neal Benowitz MD, Michael Matthay MD, Gideon St. Helen, PhD,
Pooneh Nabavizadeh Rafsanjani MD, Stanton A. Glantz, PhD
Tobacco Center for Regulatory Science
University of California San Francisco
April 12, 2018
Policy issue
April 9, 2018
There have been several studies published recently (the latest is here) showing that daily users of high nicotine delivery e-cigarette systems quit more than people who don’t use e-cigarettes. These studies also show depressed quitting or no effect of non-daily users of high delivery systems as well as cig-alikes. Because only a small minority of e-cigarette users (10-20%) are daily users of high delivery systems, the overall population health effect of e-cigarettes on smoking cessation remains negative, i.e., on average smokers who use e-cigarettes are less likely to quit than smokers who do not use e-cigarettes.
In 2016 Sara Kalkhoran and I published a meta-analysis that considered all the available evidence at the time, which found an overall negative effect of e-cigarette use on smoking cessation. (In that paper we also suggested that there was some evidence that heavy users of high delivery systems quit more; as noted above, the evidence to support this view had grown stronger.)
Since then I have been updating the meta-analysis every time a new study comes out. The conclusion that, overall, e-cigarettes depress quitting has been remarkably stable.
April 7, 2018
Kaitlyn Berry and colleagues just published “E-cigarette initiation and associated changes in smoking cessation and reduction: the Population Assessment of Tobacco and Health Study, 2013–2015,” a well-done analysis of the FDA/NIH path dataset that concludes that “daily e-cigarette initiators were more likely to have quit smoking or reduced use compared to non-users. However, less frequent e-cigarette use was not associated with cigarette cessation/reduction.”
This paper adds to the growing body of evidence that the kind of e-cigarette is important as well as how intensely it is used matters. As they stated in the abstract (quoted above), they only found significantly more quitting among daily e-cigarette users. An important point in considering how to interpret this result is that only 19% of e-cigarette users are daily users.