Rassegna Stampa Scientifica Marzo 2023

 

“Most experts agree that vaping carries far lower health risks than smoking, says Ann McNeill, professor of tobacco addiction at King’s College London. “Nicotine is an addictive substance but not the one that kills,” she says. But nuance is important: “If you’ve got something very dangerous and something much less dangerous, it doesn’t mean it’s harmless.”… The rise of the disposable vape has been meteoric. In 2021, just 7.7% of teenage vapers used them; by 2022, this figure had jumped to 52%... McNeill acknowledges that “disposables seem to be more attractive to the younger audience”. “I think that is something we need to look at – if we are seeing ‘never smokers’ taking up disposables, we need to make sure we’re enforcing the law so that these products can’t be sold quite so readily as they clearly are at the moment.”” [Clea Skopeliti. ‘Beside himself with craving’: the teenagers hooked on vaping, The Guardian]

 

“Sydney councils are looking at updating their “no smoking” signs to explicitly mention e-cigarettes after concerns that vapers do not know that the prohibitions apply to them too. A legislative amendment in 2018 expanded all NSW [New South Wales] non-smoking legislation – such as rules banning the use of cigarettes in indoor public areas, cars and outdoor dining areas – to include the smoking of e-cigarettes… The number of people who smoke cigarettes in NSW has dropped to record levels, although vaping is increasingly popular. The latest NSW Population Health Survey showed the number of people aged 16 to 24 who were current vape users more than doubled to 11 per cent in 2021.” [Mary Ward. Why vapers don’t know they are also banned from non-smoking areas, Sydney Morning Herald]

 

“This Black History Month [in February], I have a simple message for nonprofit organizations in the United States: If you have accepted money from the tobacco industry, send it back. For hundreds of years, from enslaved people working on tobacco plantations to today’s menthol smokers, Black people have died for the tobacco industry’s profit. Today, the makers of Marlboro, Camel and Newport are using cash donations to polish their images and influence policy while approximately 45,000 Black Americans die of smoking-related illness every year… Tobacco’s shameful chapter in that story [through the lens of African American history and culture] is forever connected to the slave trade and tobacco plantations, where forced labor formed part of the foundations of the United States — and what is now a global tobacco industry.” [Phillip Gardiner. Black history has taught us that Big Tobacco is not an ally, Washington Post]

 

“In their articles critiquing the US Food and Drugs Administration’s (FDA) first marketing order to allow the legal marketing of any e-cigarette, for Vuse Solo tobacco-flavoured e-cigarettes, Glantz and Lempert and Meshnick et al discuss a range of serious procedural, technical and substantive problems with FDA’s publicly released explanation of how its evaluation of the Vuse application supports that order as appropriate for the protection of the public health. …Glantz and Lempert and Meshnick et al reasonably conclude that FDA should withdraw its order allowing the marketing of the Vuse Solo e-cigarettes because the agency did not adequately evaluate the Vuse Solo application, did not establish that allowing its marketing was ‘appropriate for the protection of the public health’, and did not structure its final pre-market tobacco product application (PMTA) order to avoid increases in youth product use or unnecessary new health harms and risks.”

 

Commentary

How might FDA fix this e-cigarette PMTA mess? Commentary on Glantz and Lempert and Meshnick et al

Tobacco Control Published Online First: 09 February 2023.

Eric N Lindblom

https://tobaccocontrol.bmj.com/content/early/2023/02/09/tc-2022-057872

 

Note: Open Access.

 

Referenced Tob Control studies:

 

Vuse Solo e-cigarettes do not provide net benefits to public health: a scientific analysis of FDA’s marketing authorisation

https://tobaccocontrol.bmj.com/content/early/2023/02/09/tc-2022-057296

Analysis of FDA’s Vuse market authorisation: limitations and opportunities

https://tobaccocontrol.bmj.com/content/early/2023/02/15/tc-2022-057540

 

Also:

 

Rapid-response surveillance of the first US test market for VLN cigarettes

https://tobaccocontrol.bmj.com/content/early/2023/03/15/tc-2022-057888

Industry marketing of tobacco products on social media: case study of Philip Morris International’s IQOS

https://tobaccocontrol.bmj.com/content/early/2023/03/15/tc-2022-057833

JUUL and its ‘Action Network’ attempt to prevent a local flavour ban

https://tobaccocontrol.bmj.com/content/early/2023/02/22/tc-2022-057869

Multistate transition modelling of e-cigarette use and cigarette smoking among youth in the UK

https://tobaccocontrol.bmj.com/content/early/2023/03/09/tc-2022-057777

 

Note: UK Multistate paper Open Access.

 

“In this study comprising 2 surveys conducted among 2469 youths (aged 11-18 years) and 12 046 adults (aged ≥18 years) from Great Britain, youths had higher odds of reporting no interest in trying e-cigarettes in standardized green packaging than e-cigarettes in branded packaging, but adults had lower odds of reporting no interest in trying e-cigarettes in standardized green packaging than e-cigarettes in branded packaging.”

 

Association of Fully Branded and Standardized e-Cigarette Packaging With Interest in Trying Products Among Youths and Adults in Great Britain

JAMA Netw Open. 2023;6(3):e231799.

March 14, 2023

Eve Taylor, Deborah Arnott, Hazel Cheeseman, David Hammond, Jessica L. Reid, Ann McNeill, Pete Driezen, Katherine East

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802391

 

Note: Open Access.

 

Related coverage:

 

Putting vapes in plain packaging ‘reduces their appeal to children’

https://www.independent.co.uk/news/uk/research-chris-whitty-tiktok-ash-government-b2300708.html

 

"Vaping of most newer-generation e-cigarettes results in the delivery of nicotine to the lungs in a manner similar to that of cigarettes. These e-cigarettes pose a risk of nicotine addiction for some young people, but for adults already addicted to cigarettes — the single deadliest consumer product ever invented — they also serve as an important, less-hazardous alternative to continued smoking. Considerable evidence indicates that e-cigarettes help some adults to quit smoking."

 

Nicotine e-cigarettes as a tool for smoking cessation

Nature Medicine (2023)

Published: 13 February 2023

Kenneth E. Warner, Neal L. Benowitz, Ann McNeill & Nancy A. Rigotti

https://www.nature.com/articles/s41591-022-02201-7

 

Ed. Note: No footnote provided to support the claim of "Considerable evidence".

 

“The Statement [by Australia's National Health and Medical Research Council (NHMRC) on e-cigarettes] exaggerates the risks of vaping and fails to compare them to smoking; incorrectly claims that the association between adolescent vaping and subsequent smoking is causal and discounts evidence of the benefits of e-cigarettes in assisting smokers to quit. The Statement dismisses the evidence that vaping is probably already having a positive net public health effect, and misapplies the precautionary principle.”

 

A critique of the Australian National Health and Medical Research Council CEO statement on electronic cigarettes

Addiction

First published: 20 February 2023

Colin P. Mendelsohn, Wayne Hall, Ron Borland, Alex Wodak, Robert Beaglehole, Neal L. Benowitz, John Britton, Chris Bullen, Jean-François Etter, Ann McNeill, Nancy A. Rigotti

DECLARATION OF INTERESTS

C.P.M. was an unpaid board member of the Australian Tobacco Harm Reduction Association (ATHRA), a registered health promotion charity, from October 2017 to January 2021. ATHRA accepted unconditional seed funding from the vape retail industry to become established. Funding ceased in March 2019. C.P.M. was a Director of ATHRA in March 2018 when it received a donation from KAC Communications. The donation was sourced from a surplus arising from the Global Forum on Nicotine conference in May 2017... A.W. has been an unpaid board member of the Australian Tobacco Harm Reduction Association (ATHRA), a health promotion charity, since October 2017. ATHRA received unconditional funding for establishment costs from small Australian vape businesses. Vape industry funding has not been accepted since March 2019. A.W. was a Director of ATHRA in March 2018 when it received a donation from KAC Communications. The donation was sourced from a surplus arising from the Global Forum on Nicotine conference in May 2017…

https://onlinelibrary.wiley.com/doi/10.1111/add.16143

 

Note: Open Access.

 

“An overall mean of 22.7% of the samples (n = 13,804; males: n = 11,099; females: n = 2705) showed nicotine intake, with male samples also displaying higher positivity rates than female (24.1% vs 18.5%). Sample positivity was higher during 2012–2014 (25–33%) than 2015–2020 (15–20%). Samples from team sports displayed a higher positivity rate than those from individual sports (31.4 vs 14.1%)… WADA [World Anti-Doping Agency], international and national sports federations should consider these findings with concern, proactively investigate this phenomenon and act in order to protect the health and welfare of its athletes.”

 

Should We be Concerned with Nicotine in Sport? Analysis from 60,802 Doping Control Tests in Italy

Sports Medicine (2023)

Published: 24 February 2023

Thomas Zandonai, Francesco Botrè, Maria Gabriella Abate, Ana María Peiró & Toby Mündel

https://link.springer.com/article/10.1007/s40279-023-01819-y

 

Note: Open Access.

 

Related PR & coverage:

Study finds ‘alarming’ rates of nicotine in sport, says Brock researcher

https://brocku.ca/brock-news/2023/03/study-finds-alarming-rates-of-nicotine-in-sport-says-brock-researcher/   

Les sportifs, consommateurs insoupçonnés de nicotine [Athletes, unsuspecting consumers of nicotine]

https://www.ledevoir.com/societe/sante/785524/les-sportifs-consommateurs-insoupconnes-de-nicotine

 

 

“Earlier this week, the man who runs the vape shop took me through the new flavours he’d just got in, like I am a connoisseur of fine whisky. I’m not that. I am a silly little girl who likes her dummy [pacifier]. I have had my brain well and truly fried over the past nine months or so by vapes. Not the old-style vapes: unflavoured, nerdy-looking objects that were for a long time the preserve of morose ex-smokers… Until recently I liked to kid myself that at least vaping, unlike smoking, wasn’t damaging my health… Vapes might be better for you than smoking but this isn’t a great starting point. Anything that is addictive enough to have you shelling out hundreds of pounds a month against your better judgment can’t be good for society… Making these things pricier, or more difficult to get hold of, would make it easier [to quit]. Or maybe uglier, like cigarette packets are now, and not presented at eye-level in all their rainbow appeal in every corner shop and at every supermarket checkout.” [Imogen West-Knights. My vaping addiction came out of nowhere – and I’m finding it impossible to quit, The Guardian]

 

“America's vaping epidemic is being fueled by people who never smoked before — in more evidence the devices are not simply a cessation aid. The number of US adults who use the devices increased 16 percent from 2019 to 2021, according to a report by the American Cancer Society (ACS), from 8.8 to 10.2 percent of the population. But the rates among people who have never smoked traditional cigarettes are rising twice as fast. Over that three-year period, those numbers jumped 31 percent.” [, Daily Mail]

 

“E-cigarette use prevalence increased among younger adults between 2019 and 2021 (8.8%−10.2%, adjusted prevalence difference=1.7% points, 95% CI=0.1, 3.3), primarily owing to an increase among those who never smoked cigarettes (4.9%−6.4%, adjusted prevalence difference=1.7% points, 95% CI=0.3, 3.1). People who never smoked cigarettes constituted 53% (2.68 million) of younger adults who used E-cigarettes in 2021, increasing by 0.71 million from 2019… Conclusions: Efforts must address the rise in E-cigarette use among younger adults who never smoked cigarettes. At the same time, assistance is needed to help those who switched to E-cigarettes to stop smoking to transition to non-use of all products.”

 

Changes in E-Cigarette Use Among U.S. Adults, 2019–2021

American Journal of Preventive Medicine

Published: April 18, 2023

Priti Bandi, Jessica Star, Adair K. Minihan, Minal Patel, Nigar Nargis, Ahmedin Jemal

https://www.ajpmonline.org/article/S0749-3797(23)00122-8/fulltext

https://www.ajpmonline.org/action/showPdf?pii=S0749-3797%2823%2900122-8

 

Note: Open Access.

 

“Teenagers who smoke and vape are up to twice as likely to be heavy smokers by the time they leave school than those who only use tobacco, research suggests. Experts said using the devices to supplement cigarettes was more likely to 'entrench' tobacco use amongst adolescents… Researchers said it showed the devices, billed as quitting-aids for adult smokers, could be especially damaging among the young, adding that 'comprehensive steps must be taken to reduce adolescent access to e-cigarettes'… The findings come after the [UK] government announced free vape kits will be offered on the NHS [National Health Service] to help smokers to give up tobacco, in a world first.” [Kate Pickles. Vapes 'do NOT help young smokers ditch habit': Gadgets might actually 'entrench' cigarette use among kids, study claims, Daily Mail]

 

“Youth who smoked tobacco cigarettes by early adolescence (before age 15) were selected from the ongoing UK Millennium Cohort Study (n=1090) and the US Population Assessment of Tobacco and Health (n=803) study… Among youth who were early cigarette smokers, 57% of UK and 58% of US youth also used e-cigarettes. The odds of later adolescent smoking among early smoking youth were significantly higher among e-cigarette users relative to those who had not used e-cigarettes (adjusted OR (AOR UK)=1.45; AOR USA=2.19)… Conclusions: Despite national differences in e-cigarette regulation and marketing, there is evidence e-cigarette use among early adolescent smokers in the UK and USA leads to higher odds of any smoking and more frequent tobacco cigarette use later in adolescence.”

 

E-cigarette use among early adolescent tobacco cigarette smokers: testing the disruption and entrenchment hypotheses in two longitudinal cohorts

Tobacco Control Published Online First: 18 April 2023.

Brian C Kelly, Mike Vuolo, Jennifer Maggs, Jeremy Staff

https://tobaccocontrol.bmj.com/content/early/2023/03/20/tc-2022-057717

https://tobaccocontrol.bmj.com/content/tobaccocontrol/early/2023/03/20/tc-2022-057717.full.pdf

 

Note: Open Access.

 

Related coverage:

 

Research examines whether vaping can ‘entrench’ smoking habits in teenagers

https://www.independent.co.uk/news/uk/teenagers-research-experts-university-of-nottingham-university-of-east-anglia-b2322246.html

E-Cigs in Early Adolescence Tied to Heavier Smoking Later On

https://www.medpagetoday.com/primarycare/smoking/104086

 

Rassegna Stampa Scientifica Maggio 2023

 

“The Australian government said it wanted to crack down on the use of e-cigarettes in an effort to “reduce smoking and stamp out vaping” in one of the most sweeping tobacco regulatory moves in the country in years. The proposal, announced on Tuesday, would ban all single-use, disposable vapes; stop the importation of nonprescription vapes; require “pharmaceutical-like packaging”; reduce nicotine concentrations and amounts; and restrict certain flavors, colors and ingredients. The federal government would also work with states and territories to end the sale of vapes in convenience stores and other retail settings “while also making it easier to get a prescription for legitimate therapeutic use,” the Department of Health and Aged Care said in a statement…

 

“Mark Butler, the health minister, said [the federal government’s] long-term intentions were clear. “I want vaping to return to the purpose that we were told it was invented for, that is a therapeutic product to help long-term smokers quit… We were promised this was a pathway out of smoking, not a pathway into smoking. That is what it has become.”” [Remy Tumin. Australia Aims to ‘Stamp Out’ Vaping With Sweeping Regulations, New York Times. See also: Federal government to unveil $234 million crackdown on vaping, Sydney Morning Herald; National Tobacco Strategy 2023–2030, Australian Government, Department of Health and Aged Care]

 

“Australians already pay some of the highest tobacco tax in the world but a pack of cigarettes will become even dearer as the government aims to reduce the number of daily smokers to below 10% of the population by 2025 and below 5% by 2030. According to data collected by the Cancer Council of Victoria, the cost of a pack of 25 or 30 cigarettes has increased from a few dollars in the early 1990s to well over $40. Taxes on tobacco are already pegged to rises in the average wage but there will be a further 5% rise a year over the next three years.” [Josh Nicholas, Cait Kelly. Australia’s tobacco tax is among the highest in the world – and it’s about to get higher, The Guardian]

 

“Health Canada is "missing in action" on the regulation of e-cigarette flavours in Canada as youth vaping rates rise, health advocates say, and at a time when the vaping industry is expanding into highly addictive new devices that experts warn appeal directly to kids… Vaping has been marketed as an effective way to quit smoking, but e-cigarettes have never been approved as smoking cessation aids in Canada… David Hammond, a public health professor at the University of Waterloo and a leading Canadian youth vaping researcher, said the federal government implied they were either going to, or were considering, banning flavours, but "they've not done anything."…

 

“Meanwhile, the vaping industry has dramatically expanded its availability of flavours and recently shifted to new discrete, disposable e-cigarettes that hold thousands of pre-loaded puffs, don't require refilling or cartridges and are linked to a surge in youth vaping… "Over the last 15 years, there's been a growing divide [on regulating flavours] and Health Canada is not in the middle and is definitely on the pro-vaping side," said Cynthia Callard, the executive director of Physicians for a Smoke-Free Canada. "And the provincial governments, by and large, are on the more cautious side."” [Adam Miller. Health Canada 'missing in action' on youth vaping crisis, experts say, CBC News]

 

“There was no clue on the packaging of the vape about how to properly dispose of it. A tiny white symbol of a crossed-out bin is the only indication that the device shouldn’t just be placed with the rest of your rubbish… Currently 1.3m single-use vapes are thrown away every week in the UK, according to recycling group Material Focus. When littered, they can leach dangerous metals, battery acid, and nicotine into the environment. Plus, each vape contains on average 0.15g of lithium, which equates to 10 tonnes thrown away over a year in the UK – enough to make around 1,200 electric car batteries. Producing this metal is an environmentally costly process that uses huge amounts of energy and water.” [Emma Snaith. I tried to properly recycle a disposable vape. It did not go well, The Guardian]

 

“Although the full spectrum of cardiovascular and cardiometabolic consequences of e-cig use is not fully appreciated, data is beginning to show that e-cigs can cause both short- and long-term issues on cardiac function, vascular integrity and cardiometabolic issues… A cross-sectional analysis has shown that daily e-cig use was independently associated with higher odds of myocardial infarction (odds ratio, 1.79 [95% CI, 1.20–2.66]), as was daily conventional cigarette smoking (odds ratio, 2.29 [95% CI, 2.29–3.24])… Acute exposures (2 weeks) to e-cigs showed cardiac function changes via echocardiography… [E]-cig effects on the cardiovascular and metabolic outcomes of individuals with comorbidities are of paramount concern when considering the relative and absolute risks of e-cig use in these individuals.”

 

Electronic Nicotine Delivery Systems and Cardiovascular/Cardiometabolic Health

Circ Res. 2023 Apr 28;132(9):1168-1180. Epub 2023 Apr 27.

Matthew J Mears, Harrison L Hookfin, Priya Bandaru, Pablo Vidal, Kristin I Stanford, Loren E Wold

https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.123.321565

https://www.ahajournals.org/doi/epub/10.1161/CIRCRESAHA.123.321565

 

Note: Open Access.

 

“Our results demonstrate that smoking EC [electronic cigarettes] is associated with a significant increase in cardiovascular hemodynamic measures and biomarkers. Our findings can aid policymakers in making informed decisions regarding the regulation of EC to ensure public safety.”

 

Association of Electronic Cigarette Exposure on Cardiovascular Health: A Systematic Review and Meta-Analysis

Current Problems in Cardiology

Available online 22 April 2023, 101748

Tariq Jamal Siddiqi, Ahmed Mustafa Rashid, Ahmed Kamal Siddiqi, Anusha Anwer, Muhammad Shariq Usman, Hifza Sakhi, Aruni Bhatnagar, Naomi M. Hamburg, Glenn A. Hirsch, Carlos J. Rodriguez, Michael J. Blaha, Andrew P DeFilippis, Emelia J. Benjamin, Michael E. Hall

https://www.sciencedirect.com/science/article/abs/pii/S0146280623001652

 

“Overall, 38.8% of the sample reported intent to discontinue using their e-cigarette if tobacco and menthol-flavored e-liquid were the only options available, whereas 70.8% would discontinue under a tobacco-only product standard… Conclusions: Results indicate potential for flavor restrictions to reduce use of e-cigarettes among AYAs [adolescents and young adults] and suggest that a tobacco flavor product standard may result in the greatest discontinuation of use.”

 

Adolescent and Young Adult Response to Hypothetical E-Liquid Flavor Restrictions

Journal of Studies on Alcohol and Drugs, 84(2), 303–308 (2023).

Published Online: May 03, 2023

Natasha K. Sidhu, William V. Lechner, Sam N. Cwalina, Lauren Whitted, Sabrina L. Smiley, Jessica L. Barrington-Trimis, Junhan Cho, Theodore L. Wagener, Adam M. Leventhal, & Alayna P. Tackett

https://www.jsad.com/doi/full/10.15288/jsad.21-00466

https://www.jsad.com/doi/epdf/10.15288/jsad.21-00466?role=tab

 

Note: Open Access.

 

Canada will soon require health warnings to be printed directly on individual cigarettes, making it the first country to implement this kind of measure aimed at reducing tobacco usage. Details of the new regulations were announced on Wednesday, which was World No Tobacco Day. The regulations take effect on Aug. 1 and will be implemented through a phased approach over the next year… King size cigarettes are set to be the first to feature the warnings and will be sold by Canadian retailers by the end of July 2024, followed by regular size cigarettes and little cigars with tipping paper and tubes by the end of April 2025. The government said the new regulations are part of its strategy to reach a target of less than five per cent tobacco use in the country by 2035…

 

“Other measures the government is taking include strengthening and updating health-related messages on tobacco product packages, extending the requirement for health-related messaging to all tobacco product packages, and implementing the periodic rotation of messages.” [Noushin Ziafati. Video: Canada is first to require health warnings printed on individual cigarettes, CTV News. See also: Every Canadian cigarette will soon carry a health warning, BBC News; Canada becomes first country to require health warnings on individual cigarettes, Toronto Star; Cigarette warning labels are about to get even harder to ignore in Canada, CBC News; Des avertissements liés au tabagisme bientôt imprimés sur chaque cigarette, Radio-Canada; Canada to become first country in the world to require health warnings on individual cigarettes, Health Canada]

 

 

Rassegna Stampa Scientifica Giugno 2023

 

“The children’s commissioner for England has urged ministers to crack down on the “insidious” marketing of vapes to young people, which is leaving them so addicted to nicotine they can’t concentrate on lessons. Rachel de Souza said the government would be “failing a generation” if these “highly addictive and sometimes dangerous products” were allowed to become mainstream. Her comments are underpinned by research into the experiences of 3,500 young people across the UK, which found “deeply worrying” evidence that children feel pressured to vape, with addictions preventing some from concentrating for whole lessons, while others are avoiding school toilets for fear of peer pressure to vape.” [Rachel Hall. Ministers urged to restrict marketing of vapes to children in England, The Guardian]

 

“There is no reason to produce flavoured vapes with bright packaging designs, unless it is to appeal to children. Highly addictive, nicotine-based products should not be marketed to anyone, let alone the young. In 2020, menthol cigarettes were banned in legislation focused on discouraging young people from smoking. But at that time, it was perfectly legal for companies to offer children free samples of flavoured, single-use vapes to entice them. That these “starter packs” are nicotine-free is little consolation — they can act as a gateway to long-term nicotine use… E-cigarettes must have proper health warnings. Vaping is not risk free. At the very least, we know nicotine is highly addictive. It has been shown to impair attention, learning, mood and impulse control in children and young adults. Many of the flavourings, while safe for oral consumption, have an unknown impact when inhaled deep into the lungs. Some legal products contain nickel, tin and lead at very small doses: long term, when inhaled, this may be associated with lung disease.” [David Strain. Vaping as a cure for smoking has brought its own ills, Financial Times]

 

“Ministers looking to refresh Scotland’s policies on tobacco are being urged by campaigners to add warnings to individual cigarettes. The country has set a bold aim to create a tobacco-free generation by 2034. Sheila Duffy, chief executive of charity Action on Smoking and Health (Ash) Scotland, said the action plan, which will be updated later this year, could “re-establish” the country as a “world-leading public health nation”. Campaigners from Ash are now urging the Scottish Government to follow countries including Canada and New Zealand in reforming its anti-smoking plans.” [Lucy Skoulding. Calls for health warning labels to be put on individual cigarettes, Metro]

 

“Scottish Government ministers are being told it is time to tackle the “true scandal” of products such as elf bars to help protect both children’s health and the environment. The Royal College of Paediatrics and Child Health (RCPCH) wants to see an outright ban on single use e-cigarettes, which come in bright colours and a range of “exotic flavours”. First Minister Humza Yousaf has already said a complete ban is not off the table, with an expert group looking at the issue. But the RCPCH said paediatricians were “increasingly concerned” about the growing popularity of vapes.” [No author. Scots paediatricians join calls for total ban on single use vapes, PA Media/STV News; See also: Children's doctors call for single-use vape ban in Scotland, BBC News; Scottish children’s doctors call for an outright ban on disposable e-cigarettes, RCPCH]

 

“The government has been criticised for its “completely inappropriate” endorsement of an e-cigarette manufacturer blamed for fuelling an “epidemic” of underage vaping in the US. Juul Labs was promoted in an official briefing circulated by the Department of Health and Social Care about the prime minister’s plan to close a loophole allowing free samples to be given to children… It also included a quote from Joe Murillo, a former tobacco executive and chief regulatory officer at Juul Labs, in which he praised the UK government’s policy and called for more to be done “to combat underage use of these products”… But it failed to mention that the company has been blamed more than any other for fuelling an “epidemic” of youth vaping in the US, and in recent months has agreed to pay out more than $1bn to settle claims it unlawfully promoted its products to children.” [Shanti Das. UK government endorsed e-cigarette firm accused of fuelling underage vaping, The Observer]

 

“Plans to introduce a ban on selling e-cigarettes to under-18 has secured approval from the Republic of Ireland's cabinet. New laws, due to be enacted this summer, will limit which retailers can sell nicotine-inhaling products in the Republic of Ireland. Earlier, the tánaiste (Irish deputy PM) described vaping as "very dangerous, particularly for young people", according to Irish broadcaster RTÉ. Micheál Martin said… "In many ways, I see vaping as the revenge of the tobacco industry in terms of getting people hooked on nicotine again."” [No author. Vaping 'the revenge of tobacco industry' – Martin, BBC News]

 

“It’s now mandatory for over-the-top (OTT) streaming platforms to display anti-tobacco warnings as seen in movies screened in theatres and TV, as per a Union Health Ministry notification on May 31 amending the rules under the Cigarettes and Other Tobacco Products Act, 2004… Meanwhile, as per the notification, released on World No Tobacco Day, publishers of online curated content displaying tobacco products, or their use will be required to display anti-tobacco health spots at the beginning and middle of the programme.” [Bindu Shajan Perappadan, Aroon Deep. OTT platforms mandated to show anti-tobacco warnings, The Hindu; See also: Netflix, Disney, Amazon to challenge India's tobacco rules for streaming, Reuters; India first country to address tobacco promotions in streaming content, Stanton Glantz Blog]

 

“The chief executive of Philip Morris International says the maker of Marlboro cigarettes is charting a path to becoming an ESG [environmental, social, and governance] stock as part of a push to win back investors that have shunned the stock because of tobacco exclusion policies. PMI’s pivot away from cigarettes towards less harmful vapour-based nicotine alternatives, which accounted for about a third of its revenues last year, placed the tobacco group’s new product line “on the podium” when it came to environmental, social and governance impact, argued Jacek Olczak.” [Oliver Barnes, Harriet Agnew. Philip Morris on path to becoming an ESG stock, says chief executive, Financial Times]

"Before the advent of e-cigarettes, there was less interest in finding an answer to this question [of nicotine's harm to the human brain] — there are already more than enough good reasons to not take up smoking. The growing popularity of vaping has provided fresh impetus, but also represents an opportunity for scientists. Research into the impact of nicotine on people’s health has long been held back by difficulties in isolating the effects of this one molecule from all the other components of cigarette smoke. “We never had a clean nicotine delivery product that would be used recreationally for long periods,” [Roswell Park nicotine pharmacologist Maciej] Goniewicz says. Now, thanks to e-cigarettes, researchers do."

Outlook

Is nicotine bad for long-term health? Scientists aren’t sure yet

Nature 07 June 2023

Anthony King
https://www.nature.com/articles/d41586-023-01840-1

 

Note: Open Access.

 

“Marked similarities between FSFW’s [Foundation for a Smoke-Free World’s] practices and previous corporate attempts to influence science were observed, including: producing tobacco industry-friendly research and opinion; obscuring industry involvement in science; funding third parties which denigrate science and scientists that may threaten industry profitability; and promoting tobacco industry credibility.”

 

Document analysis of the Foundation for a Smoke-Free World’s scientific outputs and activities: a case study in contemporary tobacco industry agnogenesis

Tobacco Control Published Online First: 03 May 2023

Tess Legg, Bryan Clift, Anna B Gilmore

https://tobaccocontrol.bmj.com/content/early/2023/05/02/tc-2022-057667

 

Note: Open Access.

 

“The study demonstrates a significant association between psychosocial stressors and adolescent e-cigarette use, highlighting the potential importance of interventions, such as targeted school-based programs that address stressors and promote stress management, as possible means of reducing adolescent e-cigarette use.”

 

Psychosocial stressors and current e-cigarette use in the youth risk behavior survey

BMC Public Health volume 23, Article number: 1080 (2023)

Published: 06 June 2023

John Erhabor, Ellen Boakye, Ngozi Osuji, Olufunmilayo Obisesan, Albert D. Osei, Hassan Mirbolouk, Andrew C. Stokes, Omar Dzaye, Omar El-Shahawy, Carlos J. Rodriguez, Glenn A. Hirsch, Emelia J. Benjamin, Andrew P. DeFilippis, Rose Marie Robertson, Aruni Bhatnagar & Michael J. Blaha

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-16031-w

 

Note: Open Access.

 

“Compared with never e-cigarette users, current and former e-cigarette users were 30% (95% CI: 1.13, 1.50) and 15% (95% CI: 1.03, 1.28) more likely to have MetS [metabolic syndrome]. Current e-cigarette use was also associated with elevated triglycerides and reduced high-density lipoprotein (HDL) cholesterol and former e-cigarette use was associated with elevated triglycerides, elevated fasting glucose, and elevated blood pressure (AOR ranged from 1.15 to 1.42, all P<0.05). The prevalence of MetS for dual users were 1.35-fold (95% CI: 1.15, 1.58) higher than that for never smokers and 1.21-fold (95% CI: 1.00, 1.46) higher than that for combustible cigarette-only users.”

 

Associations between e-cigarette use or dual use of e-cigarette and combustible cigarette and metabolic syndrome: Results from the National Health and Nutrition Examination Survey (NHANES)

Ann Epidemiol. 2023 May 16;S1047-2797(23)00094-7. Online ahead of print.

Jiahui Cai, Aurelian Bidulescu

https://www.sciencedirect.com/science/article/abs/pii/S1047279723000947

 

 

“A total of 7,043 reports [of calls to poison centres gathered by the National Poison Data System] were fielded due to potential poisonings by e-cigarettes, with nearly 9 in 10 cases concerning children under 5 years old. Most had either inhaled or ingested vape liquid. The number of total reports is around double the 2,901 that were reported during 2018, when around two-thirds involved children under 5 years old.” [Alexander Tin. E-cigarette sales surge — and so do calls to poison control, health officials say, CBS News. See also: MMWR reports highlighted below.]

 

"While e-cigarette use rose a bit, from 4.9% in 2021 to 6% in 2022, visually, it may lack the star power of cigarettes. “I’m not sure if it ever looked cool to vape, but it definitely doesn’t look cool now,” [Brock] Colyar [a New York magazine writer who covers nightlife] said. Culturally, “vaping has entered its death phase. There’s just something about cigarettes.”... Tyler McCall, a writer and the former editor-in-chief of Fashionista, blames the boon in celebrities lighting up on the Ozempic craze. While the obesity drug reportedly curbs addictions like smoking and drinking, it has become most synonymous with weight loss, and fashion media has cited it as a reason for the return of “thin is in”. Since cigarettes have long been used to curb appetite and reduce hunger, McCall sees a connection." [Alaina Demopoulos. Celebrities are smoking again: ‘Things are grungier, edgier, sleazier’, The Guardian]

 

“A series of “grassroots” campaigns telling UK e-cigarette users they are under attack and urging them to “stand up for their rights” by opposing new vaping regulations are being run by secretive lobby groups with links to Big Tobacco. The campaigns – pushed to millions of Facebook and Twitter users in the past few weeks – have names such as #BackVapingSaveLives and Save My Vape, and are styled to look like they are coordinated by members of the public. But in reality they are run and promoted by rightwing thinktanks and lobbyists that oppose stricter regulation and want to influence government policy. They include a movement called We Vape UK, which claims to be run by an “independent” organisation “for vapers by vapers”, but was set up by a fellow at the Adam Smith Institute, a free market lobby group that does not disclose its funders and has long-running ties to the tobacco industry.” [Shanti Das, Jon Ungoed-Thomas. Lobbyists with links to Big Tobacco fund pro-vaping Facebook campaigns, The Guardian]

 

“E-cigarette unit sales increased by 46.6% during January 2020–December 2022. After January 2020, sales of mint and other flavored prefilled cartridges ceased, and disposable e-cigarettes in fruit, sweet, and other flavors increased. Disposable e-cigarettes in youth-appealing flavors are now more commonly sold than prefilled units… Comprehensive restrictions on the sale of all flavored tobacco products that include e-cigarettes, menthol cigarettes, and flavored cigars are warranted in all jurisdictions. These strategies, when coupled with longstanding evidence-based strategies to prevent youth tobacco use such as price increases, comprehensive smokefree policies that include e-cigarettes, and counter-marketing campaigns, are expected to reduce youth initiation and use as well as reduce disparities in tobacco product use.”

 

E-cigarette Unit Sales by Product and Flavor Type, and Top-Selling Brands, United States, 2020–2022

MMWR Weekly / June 23, 2023 / 72(25);672–677

Fatma Romeh M. Ali, Andrew B. Seidenberg, Elisha Crane, Elizabeth Seaman, Michael A. Tynan, Kristy Marynak

https://www.cdc.gov/mmwr/volumes/72/wr/mm7225a1.htm

https://www.cdc.gov/mmwr/volumes/72/wr/pdfs/mm7225a1-H.pdf

 

Also:

 

Notes from the Field: E-Cigarette–Associated Cases Reported to Poison Centers — United States, April 1, 2022–March 31, 2023

https://www.cdc.gov/mmwr/volumes/72/wr/mm7225a5.htm

https://www.cdc.gov/mmwr/volumes/72/wr/pdfs/mm7225a5-H.pdf

 

Note: Open Access.

 

Related coverage:

 

E-cigarette sales surge — and so do calls to poison control, health officials say

https://www.cbsnews.com/news/e-cigarette-sales-vapes-poison-control-cdc-fda/

Number of children under-5 being poisoned by vaping has TRIPLED since 2018

https://www.dailymail.co.uk/health/article-12223573/Number-children-5-poisoned-vaping-TRIPLED-2018.html

 

“Susceptibility to e-cigarette use was apparent among 54% of respondents from Australia, 61% from India, 62% from the UK, and 82% from China. Factors positively associated with susceptibility were tobacco use, exposure to advertising, higher income, and having friends and family members who vape. Factors negatively associated with susceptibility were perceptions of harmfulness and education.”

 

Short communication

Short report: Factors contributing to young people’s susceptibility to e-cigarettes in four countries

Drug and Alcohol Dependence

Available online 13 June 2023, 109944

In Press, Corrected Proof

Simone Pettigrew, Joseph Alvin Santos, Yuan Li, Min Jun, Craig Anderson, Alexandra Jones

https://www.sciencedirect.com/science/article/pii/S0376871623001825

 

Note: Open Access.

 

Related PR:

 

Many young people who have never vaped may be susceptible to starting, study suggests

https://medicalxpress.com/news/2023-06-young-people-vaped-susceptible.html

 

“We used the cross-sectional 2019 European School Survey Project on Alcohol and Other Drugs data from 32 countries with 98 758 students aged 15-16 years and the 2020 WHO's assessment of the e-cigarette regulations… Of the respondents, 13.3% had ever used cigarettes, 10.6% e-cigarettes and 27.3% both; 13.0% currently used cigarettes, 6.0% e-cigarettes and 6.4% both… Conclusions: More comprehensive e-cigarette regulations and enforcement of age-of-sale laws may be protective of e-cigarette and dual use among adolescents.”

 

Exclusive and dual use of electronic cigarettes among European youth in 32 countries with different regulatory landscapes

Tob Control. 2023 Apr 25;tc-2022-057749. Online ahead of print.

Hanna Ollila, Yelena Tarasenko, Angela Ciobanu, Elizaveta Lebedeva, Kirsimarja Raitasalo

https://tobaccocontrol.bmj.com/content/early/2023/04/24/tc-2022-057749.long

https://tobaccocontrol.bmj.com/content/tobaccocontrol/early/2023/04/24/tc-2022-057749.full.pdf

 

Note: Open Access.

 

“Approximately 22% of Californians were subject to a partial or comprehensive FTSR [flavored tobacco sales restriction] by December 31, 2020. Accounting for potential confounders, residents of jurisdictions with a comprehensive FTSR (vs. no ban) had 30% lower odds of using any flavored tobacco… Conclusion: Recent passage of a statewide ban in California will close gaps from the patchwork of local policies and eliminate most partial FTSR exemptions.”

 

Variation in adults' use of flavored tobacco products by sales restrictions in California jurisdictionsInt J Drug Policy. 2023 Jun;116:104041. Epub 2023 Apr 27.

David S Timberlake, Julian Aviles, Denise Diaz Payán

https://www.sciencedirect.com/science/article/abs/pii/S0955395923000890

 

 

Rassegna Stampa Scientifica Luglio 2023

 

 

"Councils are joining paediatricians in calling for a ban on disposable vapes owing to the environmental damage they cause and the soaring number of young people taking up the addictive products. The Local Government Association (LGA), which represents councils in England and Wales, said urgent action was needed to save taxpayers’ money – as single-use e-cigarettes are costly to recycle without going through special treatment – protect the planet and keep children safe. With the EU proposing a ban from 2026 and France due to introduce one this December, there are concerns that more vapes could flood into the UK." [Sarah Marsh, Councils in England and Wales join calls for ban on disposable vapes, The Guardian]

 

“The British Medical Association (BMA) will review the potential dangers of vaping in a bid to tackle the “growing epidemic” of e-cigarette usage. At its annual representative meeting in Liverpool on Wednesday, [July 5], the BMA was urged to explore the dangers of vaping, as well as calling for plain packaging on e-cigarettes in line with tobacco and cigarettes. The motion, which was approved by members, also urged a ban on flavoured vapes and said more should be done about products being sold to under 18s illegally… Last month, NHS [National Health Service] figures revealed 40 children and young people were admitted to hospital in England last year for “vaping related disorders”, up from 11 two years earlier.” [Storm Newton. Review to tackle ‘growing epidemic’ of vaping, The Independent]

 

"The number of women diagnosed with lung cancer in the UK is expected to overtake men this year for the first time... Cancer experts said the “very stark” figures reflected historical differences in smoking prevalence, specifically that smoking rates peaked much earlier in men than women. Women should now be as alert to potential lung cancer signs as they were about checking for lumps in their breasts, they said... Ministers must do more to help smokers to quit, [Cancer Research UK’s prevention policy manager Alizée] Froguel said. “Lung cancer causes more deaths in the UK than any other cancer type, and smoking is by far the biggest cause of the disease. But funding cuts have meant that there aren’t enough public health campaigns to encourage people to quit smoking, and many people don’t have access to the services that will support them to do so.”" [Andrew Gregory. Lung cancer diagnoses of UK women to outnumber men’s for first time, The Guardian]

 

“German Health Minister Karl Lauterbach is pushing for a ban to prevent smoking in cars where minors and pregnant women are passengers, German media group RedaktionsNetzwerk Deutschland (RND) reported on Friday [July 7]… Smoking in cars is not currently illegal in Germany. The plan, which is part of Lauterbach's draft proposal to legalize cannabis, aims to expand the existing Non-Smokers Protection Act… The expansion of the smoking ban, which already applies in public transport, is intended to "ensure the necessary protection from passive smoking for this particularly vulnerable group of people," according to the draft cited by RND. Smoking in cars has been proven to pose higher risks due to the small space volume.” [No author. Germany: Minister plans ban on smoking in cars with children, DW]

 

“The papers in this issue provide further insight into e-cigarettes and can inform what might be done to maximise their benefits and reduce their harms. Clearly, the heterogeneity of the e-cigarette—for example, the range of design features of the devices and liquids that influence their appeal, the variation in use patterns and the extent to which they deliver nicotine and other chemicals to users—poses many challenges for research as well as for regulation. The continued rapid change in the products that are available and how they are marketed does not help. From a policy perspective, we need to remain open-minded about the interventions that could achieve our policy goals, evaluate their impacts and unintended consequences and remember that policies that address a very circumscribed target may result in a ‘whack-a-mole’ state where our ‘solution’ yields another problem popping up elsewhere.”

 

Editorial

Broad range of research on e-cigarettes

Tobacco Control 2023;32:e137-e138.

Online issue publication July 19, 2023

Joanna E Cohen

https://tobaccocontrol.bmj.com/content/32/e2/e137

 

Ed. Note: Virtually all papers in this new e-issue of Tobacco Control (August 2023 - Volume 32 - e2) appeared Online First in 2021-2022 and were highlighted in earlier editions of this bulletin. All papers are now Open Access.

 

"In 2021, 4.5% of adults aged 18 and over were current e-cigarette users, with people aged 18–24 having the highest levels (11.0%) compared with those aged 25–44 (6.5%) and 45 and over (2.0%). Men had higher percentages of e-cigarette use overall and among adults aged 25–44. E-cigarette use among those aged 18 and over was highest among White adults and those living in families with the lowest level of family income... Dual use of tobacco products is a health concern because it may result in greater exposure to toxins and worse respiratory outcomes than using either product alone. In 2021, most e-cigarette users aged 18–24 had never smoked cigarettes."

 

Current Electronic Cigarette Use Among Adults Aged 18 and Over: United States, 2021

NCHS Data Brief No. 475, July 2023

Ellen A. Kramarow and Nazik Elgaddal

https://www.cdc.gov/nchs/products/databriefs/db475.htm  

https://www.cdc.gov/nchs/data/databriefs/db475.pdf

 

Note: Open Access.

 

“Maternally nicotine vaped embryos exhibited histological and transcriptional changes consistent with impaired distal lung development. Embryonic lung gene expression changes mimicked transcriptional changes observed in adult mouse lungs exposed to cigarette smoke, suggesting that the developmental defects may be due to direct nicotine exposure… Nicotine directly binds and inhibits the Kcnj2 potassium channel which is important for bone development… These data indicate that intrauterine nicotine exposure disrupts fetal lung and skeletal development likely through inhibition of Kcnj2.”

 

Intrauterine exposure to nicotine through maternal vaping disrupts embryonic lung and skeletal development via the Kcnj2 potassium channel

Dev Biol. 2023 Sep;501:111-123. Epub 2023 Jun 22.

Yunus H Ozekin, Maxwell L Saal, Ricardo H Pineda, Kayla Moehn, Madison A Ordonez-Erives, Maria F Delgado Figueroa, Caleb Frazier, Kamryn M Korth, Melanie Königshoff, Emily A Bates, Eszter K Vladar

https://www.sciencedirect.com/science/article/pii/S001216062300101X

https://pdf.sciencedirectassets.com/272543/1-s2.0-S0012160623X00074/1-s2.0-S001216062300101X/main.pdf

 

Note: Open Access.

 

“All animals exposed to CC [conventional cigarettes] and EC [e-cigarettes] showed an increase in lipid peroxidation and protein oxidation. There was an increase of IL-6 [Interleukin-6] in males and females exposed to EC. The IL-13 levels were higher in the females exposed to EC and CC. Both sexes exposed to EC and CC presented tissue damage characterized by septal destruction and increased alveolar spaces compared to control. Our results demonstrated that exposure to CC and EC induced pulmonary emphysema in both sexes, and females seem to be more susceptible to EC.”

 

Long-term e-cigarette aerosol exposure causes pulmonary emphysema in adult female and male mice

Regulatory Toxicology and Pharmacology

Volume 142, August 2023, 105412

Available online 27 May 2023

Andrea Jazel Rodriguez-Herrera, Ana Beatriz Farias de Souza, Thalles de Freitas Castro, Pedro Alves Machado-Junior, Elena Cecilia Marcano-Gomez, Tatiana Prata Menezes, Maria Laura da Cruz Castro, André Talvani, Daniela Caldeira Costa, Sílvia Dantas Cangussú, Frank Silva Bezerra

https://www.sciencedirect.com/science/article/abs/pii/S0273230023000806

 

“Twelve months after purchasing JUUL, almost all smokers reported either switching or reducing their smoking by 50%+, including those who had recently failed to quit smoking with approved pharmacotherapies. E-cigarettes provide an alternative route to abstinence from smoking for smokers with a history of cessation and cessation treatment failure.”

 

Switching away from smoking at 12 months among adult JUUL users varying in recent history of quit attempts made with and without smoking cessation medication

Drug Testing and Analysis

First published: 25 July 2023

Saul Shiffman, Michael J. Hannon

Funding Information: Funding for this study was provided by Juul Labs Inc. The sponsor approved the research plan and provided comment on a near-final draft of the paper.

CONFLICT OF INTEREST STATEMENT

Through Pinney Associates, SS and MJH provide consulting services on tobacco harm reduction on an exclusive basis to Juul Labs Inc. The funding for this study was provided by Juul Labs Inc. The sponsor approved the research plan and provided comment on a near-final draft of the paper.

https://analyticalsciencejournals.onlinelibrary.wiley.com/doi/10.1002/dta.3551