January 25, 2018
The FDA Tobacco Products Scientific Advisory Committee (TPSAC) just voted not to accept Philip Morris' claims that its new heat-not-burn product, IQOS, is less dangeous than cigarettes. As the press coverage (summarized below courtesy of Stan Shatenstein:), this is an important development.
As followers of this blog know, UCSF has submitted 10 public comments supporting the scientific conclusion that IQOS is not safer than conventional cigarettes and that even allowing "reduced exposure" claims would be misinterpreted as reduced harm claims. (You can see my plain English language summary of why Philip Morris' own data does not support the claim that IQOS is safer than cigarettes.) For the same reasons, FDA should not approve PMI's premarket application to to sell IQOS in the US because doing so would not be "good for public health," which is the standard in the law.
Other countries should not be tricked by PMI's claims.
Here is the press coverage:
January 20, 2018
On January 18, 2018, Goldman Sachs reported that the FDA is expected to approve Philip Morris International's "Premarket Tobacco Product Application" (PMTA) for IQOS as early as February. This application is different from the "Modified Risk Tobacco Product" (MRTP) that has been open for public comment and that is scheduled to be discussed at the TPSAC meeting on January 24-25 (assuming that the government is open then). The difference between a PMTA and an MRTP is that the PMTA is an application to sell IQOS in the United States whereas the MRTP application is a request to make health claims about the IQOS.
In both cases the law requires the FDA to determine that approving the application is “appropriate for the protection of the public health” with respect to the risks and benefits to the population as a whole, considering both users and nonusers. Lacking this essential finding, FDA is required to deny the PMTA under section 910(c)(2)(A) of the Family Smoking Prevention and Tobacco Control Act.
January 11, 2018
David Bareham and I just published “E-Cigarettes: Use, Effects on Smoking, Risks, and Policy Implications” in Annual Review of Public Health. The review, which includes 151 references, is a comprehensive overview of all aspects of e-cigarettes, including an updated meta-analysis on the association between e-cigarette use and smoking cessation (still shows depressed quitting overall).
Here is the abstract:
Since e-cigarettes appeared in the mid-2000s, some practitioners, researchers, and policy makers have embraced them as a safer alternative to conventional cigarettes and an effective way to stop smoking. While e-cigarettes deliver lower levels of carcinogens than do conventional cigarettes, they still expose users to high levels of ultrafine particles and other toxins that may substantially increase cardiovascular and noncancer lung disease risks, which account for more than half of all smoking-caused deaths, at rates similar to conventional cigarettes. Moreover, rather than stimulating smokers to switch from conventional cigarettes to less dangerous e-cigarettes or quitting altogether, e-cigarettes are reducing smoking cessation rates and expanding the nicotine market by attracting youth.
January 3, 2018
The California Office of Traffic Safety is running an ad campaign produced by Prosio Communications that makes the important point that “DUI doesn’t just mean booze.” That’s a good idea.
And one of the ads, which compares marijuana to tobacco, is quite good. People need to make the connection that smoke (including secondhand smoke) is smoke, whether it is from a tobacco cigarette or a joint. (I know that is not the point of the ad, but it is part of the implicit message, which is a good thing.)
Another of the Office of Traffic Safety ads shows several mellow marijuana users extolling the virtues of getting high (just don’t drive). The implicit message of this one is “marijuana is great stuff.”
While marijuana is legal in California now, the State shouldn’t be out there promoting it. After all, the same State of California has identified marijuana smoke as “known to cause cancer.”
January 2, 2018
Janice Tsoh and our colleagues at UCSF just submitted this public comment to the CDC on improving their smoking cessation efforts. The tracking number is 1k2-90p6-pbgp and a PDF of the comment is available here.
CDC should employ evidence-based strategies to help people quit using tobacco that support the initiation of quit attempts and maintaining long-term abstinence, including: social media interventions, clinician-extender or point-of-care technology tools, interactive voice response systems, market segmentation, insurance coverage for cessation treatment, tobacco-free policies in substance abuse treatment, mental health and other institutional settings including prisons and military settings.
Janice Tsoh PhD, Dorie Apollonio PhD, Noah Gubner PhD, Joseph Guydish PhD, Sharon Hall PhD, Gary Humfleet PhD, Pam Ling MD, Danielle Ramo PhD, Jason Satterfield PhD, Maya Vijayraghavan MD, Lauren Lempert JD, MPH, and Stanton Glantz PhD
Center for Tobacco Control Research and Education, University of California San Francisco
Docket control number CDC-2017-0103
January 2, 2018