March 8, 2018
In 2014 Lauren Dutra and I published “Electronic cigarettes and conventional cigarette use among U.S. adolescents: a cross-sectional study,” showing that e-cigarette use was associated with progression from experimenting with cigarettes (kids who had “smoked a puff” of a cigarette) and established smoking (smoked 100 cigarettes). We got beat up by a lot of e-cigarette enthusiasts because the UCSF press release used the word “gateway,” which they said could only be demonstrated with a longitudinal study that followed kids forward in time. (The criticisms are at Youth experimentation with e-cigarettes: another interpretation of the data [JAMA. 2014]; Youth tobacco use and electronic cigarettes [JAMA Pediatr. 2014]; Tobacco control policy and electronic cigarettes [JAMA Pediatr. 2014]; Youth tobacco use and electronic cigarettes [JAMA Pediatr. 2014]. Our response is at Youth tobacco use and electronic cigarettes—reply [JAMA Pediatr. 2014])
March 7, 2018
Strong evidence for a huge gateway effect for e-cigs in England
Recently researchers from England, led by Ann McNeill and including prominent e-cigarette advocates, published a well-done study showing a huge gateway effect for e-cigarettes leading to cigarette smoking among youth in Great Britain.
The paper, “Association between smoking and electronic cigarette use in a cohort of young people,” published in Journal of Adolescent Health, showed that youth who initiated product use with e-cigarettes had 12 times the odds of smoking cigarettes 4 months later than kids who did not use e-cigarettes.
Two strengths of the study are that it is longitudinal (follows the kids forward in time) and controls for a wide range of other risk factors for smoking, including susceptibility to smoking. The fact that, controlling for susceptibility e-cigarettes have such a huge effect, indicates that (like other studies) e-cigarettes are attracting kids at low risk of initiating nicotine use with conventional cigarettes.
February 24, 2018
Here is the UCSF press release on a new study I am presenting at the Society for Research on Nicotine and Tobacco today (24 Feb 2018):
Smoking E-Cigarettes Daily Doubles Risk of Heart Attacks
When Combined with Daily Cigarette Use, Heart Attack Risk Rises Five-Fold, Study Finds
Daily use of electronic cigarettes is associated with nearly a doubling of the odds of a heart attack, according to a new study led by UC San Francisco. This is the first evidence of a substantial, human health impact of the popular devices that were first introduced about a decade ago, indicating that e-cigarettes may be more dangerous than previously thought.
February 15, 2018
My colleagues and I have submitted this public comment to FDA in response to its request for information about its comprehensive nicotine policy and alternative forms of nicotine delivery. The tracking number is 1k2-91ii-k7sy . A PDF of the comment is here.
The FDA should not adopt the nicotine “harm reduction” paradigm because doing so is likely to increase the amount of smoking-caused disease and death
Docket No. FDA-2017-N-6529
Dorie Apollonio, PhD, Stanton A. Glantz, PhD, Sharon Hall, PhD, Lauren Lempert, JD, MPH, Gideon St.Helen, PhD, and Janice Tsoh, PhD
University of California, San Francisco
February 13, 2018
Dan Orenstein and I just published “Regulating Cannabis Manufacturing: Applying Public Health Best Practices from Tobacco Control” in Journal of Psychoactive Drugs. Here is the UCSF press release summarizing the paper:
Marijuana Should Be Packaged, Regulated Following Tobacco Control Best Practices
UCSF Study Finds Current Cannabis Regulations Inadequate to Protect Public Health
California already has the nation's largest medical marijuana market, and this year is expected to have the world's largest recreational market. With enormous potential to influence policy, the state should take an assertive approach to cannabis labeling, packaging and product formulation, according to a new UC San Francisco study.
The analysis found that requiring plain packaging and large warning labels, reducing visual appeal to minors, and putting strict limits on the potency of cannabis products would better protect public health over business interests.
The research, which draws upon the best practices of tobacco control, serves as a roadmap to improve new marijuana regulations in California.