Listing Details
| ID: | 127 |
| Title: | Tobacco News Analysis And Commentary |
| URL: | http://tobaccoanalysis.blogspot.com/ |
| Category: | News & Media: Analysis & Opinion |
| Description: | Physician Michael Siegel who specialised in preventive medicine and public health writes about the stories behind tobacco-related news. |
| Further Analysis of FDA Warning on Electronic Cigarettes: What is the Agency Saying to Smokers Who Have Quit Using E-Cigs and Tried NRT Unscuccessfully in the Past? - Thu, 17 May 2012 10:52:00 +0000 |
| One of the hallmarks of a national recommendation by a public health agency is that it applies to all persons unless qualified as to relate only to a sub-group of the population. Thus, the FDA'srecommendationsregarding the use of electronic cigarettes, which Ihighlightedyesterday, can be inferred as being meant to apply to the whole population, not only to smokers who have not yet tried electronic cigarettes. Today, let's consider what the FDA is saying specifically to this sub-group of the population, which consists of thousands: ex-smokers who have quit successfully with the help of electronic cigarettes and who have tried NRT unsuccessfully in the past. In fact, the failure of NRT was the reason why most of these smokers decided to try electronic cigarettes in an attempt to quit smoking. To remind readers, the FDA warns the public against the use of electronic cigarettes because their risk profile and chemical constituents have not been definitively characterized, because they may interest some kids in smoking, and because they may not deliver nicotine at precisely defined quantities. The Rest of the Story To the specific subgroup of ex-smokers who have quit by using electronic cigarettes and who are successfully maintaining themselves smoke-free with the help of electronic cigarettes, the FDA is saying: stop using your electronic cigarettes because we do not know how unsafe they are. Instead, throw away your e-cigs and switch to a known entity -- FDA-approved NRT products. However, the truth is that these are a population of people who have already tried NRT products and found them to be unhelpful in aiding their quit attempts. Many of these ex-smokers have tried NRT multiple times and failed every time. Clearly, if everyone in this population took the FDA's advice, threw away their electronic cigarettes, and switched to NRT, the majority of them would be smoking regular cigarettes by week's end. And by month's end, most of the rest would also be smoking. By year's end, the overwhelming majority of these smokers would have returned to cigarette smoking. Some recommendation. Why can't the FDA make a recommendation that makes more sense from both a scientific and a public health perspective? Something like: "If you have successfully quit smoking using electronic cigarettes, congratulations! You have succeeded in the most important action you can take to improve your health. Because the long-term risks of electronic cigarettes are not completely understood, you may want to consider efforts to wean yourself off electronic cigarettes, or if that is not possible, to wean yourself from a high to a low nicotine cartridge and then down to a zero nicotine cartridge if possible. But in no case should you return to regular cigarettes. You are an ex-smoker and we want you to stay that way for the sake of your health. The FDA has made it an urgent priority to study the safety and efficacy of electronic cigarettes and should we gain any new information which alters the above advice, we will share it promptly. We will be issuing regulations this summer to make sure that the quality control processes used by electronic cigarette distributors are as solid as they can and should be." No. Instead, the message being sent to these ex-smokers is: "e-Cigarettes may contain ingredients that are known to be toxic to humans, and may contain other ingredients that may not be safe. Additionally, these products may be attractive to young people and may lead kids to try other tobacco products, including conventional cigarettes, which are known to cause disease and lead to premature death." "Because clinical studies about the safety and efficacy of these products have not been submitted to FDA, consumers currently have no way of knowing
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| FDA Warns Smokers Against Using Electronic Cigarettes Because Unlike Tobacco Cigarettes, Their Risks are Not Precisely Known - Tue, 15 May 2012 11:00:00 +0000 |
| On itsweb site, the FDA is warning smokers against the use of electronic cigarettes because - in contrast to the known hazards of tobacco cigarettes - the risks of electronic cigarettes are not precisely known. The FDA's electronic cigarette warning reads as follows: "e-Cigarettes may contain ingredients that are known to be toxic to humans, and may contain other ingredients that may not be safe. Additionally, these products may be attractive to young people and may lead kids to try other tobacco products, including conventional cigarettes, which are known to cause disease and lead to premature death." "Because clinical studies about the safety and efficacy of these products have not been submitted to FDA, consumers currently have no way of knowing
The web page closes by urging smokers to use FDA-approved smoking cessation methods, such as nicotine replacement drugs. The Rest of the Story As a service to my readers, I will now provide a translation of what the FDA is really saying to U.S. smokers, using Google's convenient "lay person translation" application. Here is the translation: "We urge smokers not to use electronic cigarettes because unlike regular cigarettes, it is not known whether e-cigarettes are safe for their intended use, it is not known what types of potentially harmful chemicals are found in these products, and it is not known how much nicotine they are inhaling when using these products. Thus, with electronic cigarettes, you get a bunch of unknowns. But with regular cigarettes, you get a sure thing. We know exactly how unsafe these products are for their intended use. We also know thousands of the harmful chemicals that are found in cigarettes. And to boot, the consumer knows exactly how much nicotine he or she is getting because those levels are tightly controlled by the tobacco industry. We urge smokers not to take risks with their health. Don't substitute electronic cigarettes - with their many question marks - for the well-known and well-characterized risks you get with your normal cigarettes. Do you really want to be inhaling a vapor that could potentially contain some harmful chemicals, when instead, you could be inhaling smoke whose harmful constituents have already been neatly categorized and classified? We also urge smokers not to take risks with the amount of nicotine they may be getting from electronic cigarettes. Why take a chance that you may be getting a lower amount of nicotine than you get with your usual Marlboros, Camels, Newports, Winstons, and Kools? With these tobacco cigarettes, you can count on the tobacco companies to provide you with a carefully regulated dose of nicotine in each puff. They have spent years perfecting the carefully titrated and consistent delivery of nicotine. But with electronic cigarettes, you're dealing with amateurs. They really don't know what they're doing and there's no way to be sure that you're getting the precise amount of nicotine that they say you're getting. Why take a chance when you can get a known amount of nicotine? Additionally, there is the risk that electronic cigarettes may be attractive to young people and might lead kids to try smoking. With your regular cigarettes, it is a known fact that your using the product will attract kids to smoking. Why take a risk on an unknown when you can be sure that your smoking has known effects on the youth population? While a preliminary clinical trial demonstrated a 22.5% six-month cessation rate among unmotivated smokers who used electronic cigarettes to try to quit, why take a risk that the true quit rate among highly motivated smokers is lower than that? Why not stick with the reliable and well-documented 8% long-term quit rate that has been demonstrated with the use of approved nicotine replacement therapy? And if you are one of the many electronic cigarette users who tried those products specifically because you failed with NRT, all we can say is: try and try again. Why take a risk on an unknown when you can use a product that has a very high known failure rate?"  |
| Cohasset May Ban Vaping in Public Places to Protect Kids from Seeing People Trying to Quit Smoking - Mon, 14 May 2012 11:36:00 +0000 |
| The Cohasset (MA) Board of Health isconsideringregulations to ban vaping (use of electronic cigarettes) in public places that are subject to no-smoking rules. According to anarticlein theBoston Globe: "In an interview, Dr. Michael Siegel, a tobacco control specialist at Boston University School of Public Health, ...had concerns about lumping electronic cigarettes with other tobacco products when regulating public smoking because “there’s no scientific evidence that the exhaled vapor poses any health hazard to bystanders.” The battery-operated devices, which were introduced in China in 2003, look like cigarettes but produce nicotine-laced vapors that are usually far less potent than the real thing. Studies have shown the e-cigarettes are effective in helping smokers kick the habit, Siegel said. While Lawrence [a Board of Health member] acknowledged that the health effect of e-cigarettes was unclear, he said their similarity to cigarettes was unsettling. 'From my perspective, using [them] models a child to a smoking behavior that can be easily turned into the real deal,' he said. 'I may be out on the fringe, but my responsibility is to look out for the health of the citizens in the town where I live.'" The Rest of the Story It appears that the Cohasset Board of Health wants to outlaw vaping in public places because they don't want children to see people using electronic cigarettes. In other words, they don't want children to see people trying to quit smoking. Apparently, the Board of Health seems to misunderstand the most basic fact about electronic cigarettes: these products are being used primarily by smokers who want to quit smoking or cut down substantially in order to protect their health. Why would this be something that we wouldn't want children to see? In fact, it might be that if children were to see how many smokers want to quit, it would actually decrease their perceptions of the glamor of smoking. While opponents of vaping in public argue that it may lead children to start smoking, I think the opposite may be true. Such a view is, I believe, very short-sighted. While it may be true that if a child sees, for the first time, someone use an electronic cigarette, the child may be confused and think it is a real cigarette. But surely, over time, children will come to recognize electronic cigarettes and to understand that they are being used by smokers who are trying to quit because they are concerned about the health effects of smoking. This will help to de-glamorize smoking by teaching children that many smokers are unhappy that they started smoking and now want to quit. This could actually serve as an anti-smoking, rather than a pro-smoking phenomenon. The second major argument against banning vaping in public places is that there is no evidence that exhaled electronic cigarette vapor is hazardous to bystanders. I believe that it undermines the justification for banning smoking in public places if health boards and city councils ban a behavior for which there is no evidence of harm. The reason why I believe workplace smoking bans are justified is that there is solid scientific evidence that secondhand smoke exposure is a significant health hazard for nonsmoking employees. If health boards start to ban behaviors without evidence of health hazards, then it undermines the seriousness of their responsibility to regulate behaviors for which there is evidence of health harm to others. The article also noted that the Cohasset Board of Health is considering banning the sale of tobacco products in pharmacies because it "would do anything to reduce the amount of tobacco products being used." The problem is that banning the sale of tobacco in pharmacies will not reduce tobacco use. It will simply shift the sale of tobacco away from pharmacies and towards other types of stores, such as gas stations and convenience stores.  |