Author: Taco Tuinstra

  • Solons Must Seize Potential of Safer Nicotine Products

    Solons Must Seize Potential of Safer Nicotine Products

    Knowledge-Action-Change (KAC) has published The Global State of Tobacco Harm Reduction 2022: The Right Side of History. The Global State of Tobacco Harm Reduction (GSTHR) publication charts the history of tobacco harm reduction and considers the future of a strategy that can hasten the end of smoking and drastically reduce smoking-related death and disease worldwide.

    According to the report’s authors, the emergence of new safer nicotine products has caused substantial disruption to nicotine use, public health and tobacco control institutions and the traditional tobacco industry. However, mistrust and ideological opposition is hampering widespread adoption of a strategy that could help 1.1 billion adult smokers failed by existing tobacco control interventions.

    “Technology helped smoking become one of the world’s biggest health problems,” said Harry Shapiro, author of The Right Side of History, in a statement. “Now, technological innovations from beyond both the tobacco industry and public health have combined to produce safer nicotine products, and millions of people who smoked have already chosen to switch. Yet progress is being hampered. Although disruption is not always comfortable, the genie is out of the bottle—these new technologies demand the development of new policies and new thinking.”

    “A failure to recognize and exploit the potential of tobacco harm reduction will mean millions more avoidable deaths each year.”

    Gerry Stimson, project lead, GSTHR

    “A failure to recognize and exploit the potential of tobacco harm reduction will mean millions more avoidable deaths each year and contribute to an ever-growing burden of disease that disproportionately affects the most vulnerable countries and communities,” said Gerry Stimson, GSTHR project lead and emeritus professor at Imperial College London.  

    “Tobacco control’s lack of evolution, despite its very limited gains, means that many aspirational targets to achieve smoke-free status by 2030 or within the next generation are no more likely to be met than former aspirations for a drug-free world. Tobacco harm reduction offers us an historic opportunity. We must not let it slip away.”

    The Right Side of History is the third in the biennial series of GSTHR reports, following No Fire, No Smoke in 2018 and Burning Issues in 2020. The GSTHR project is produced with the help of a grant from the Foundation for a Smoke-Free World.

  • Chowdhury: Implementation of Tobacco Control Act Flawed

    Chowdhury: Implementation of Tobacco Control Act Flawed

    Azim Chowdhury

    The U.S. Food and Drug Administration’s implementation of the 2009 Tobacco Control Act, which gave the agency authority to regulate tobacco products, has been fundamentally flawed from the beginning, according to Azim Chowdhury, a partner in the Keller and Heckman law firm.

    Writing in Filter, Chowdhury explains that the premarket authorization requirements for “new” products subjects potentially reduced-harm products to nearly insurmountable hurdles while allowing preexisting products, including combustible cigarettes, to mostly escape FDA scrutiny.

    In his article, Chowdhury suggests several ways in which the FDA can more effectively implement the Tobacco Control Act.

    For example, rather than conducting reviews in a silo, the FDA should consider the totality of evidence in a premarket tobacco product application, according to Chowdhury.    

    “It is also critical that the FDA hamper the spread of counterfeit products, which may be riskier for consumers and are drowning out the small businesses and vape shops that continue to bear the brunt of FDA enforcement,” he writes.

    “Finally, the FDA should shift more resources to developing reasonable safety, quality and marketing product standards.”

  • Judge Denies LG Chem Exploding Battery Lawsuit

    Judge Denies LG Chem Exploding Battery Lawsuit

    Photo: gangster9686

    LG Chem has defeated a lawsuit in Ohio over an exploding e-cigarette battery after a federal judge ruled he has no jurisdiction to oversee the case, reports Law360.

    Paul Straight sued the South Korean chemicals company after an e-cigarette purchased at a Vapor Station store in Ohio exploded and burned through his jeans and left thigh. He sustained second and third-degree burns to his thighs and left wrist and now limps as a result of his injuries, according to his lawsuit.

    LG Chem maintained it did not authorize Vapor Station to sell single batteries. Rather, they were meant to be used in battery packs for power tools and other products. The company also argued it did not make, sell or distribute the batteries in Ohio.

    The judge did not buy Straight’s assertion that the company’s other business in the state was enough for the judge to exercise specific jurisdiction.

    “LG Chem in fact has established that it neither earned revenue from the sale or distribution of 18650 cells in Ohio nor advertised or solicited business in Ohio with respect to 18650 cells,” Judge James L. Graham of the Southern District of Ohio wrote.

    The case is Paul Straight v. LG Chem Ltd. et al., case number 2:20-cv-06551.

  • Study: Evidence on Heat-not-Burn Products Lacking

    Study: Evidence on Heat-not-Burn Products Lacking

    Photo: librakv

    The quality of evidence available about heated tobacco products (HTPs) is substandard and policymakers should be wary of claims made about their role in harm reduction, say the authors of a new study published in Tobacco Control.

    HTPs have gained popularity in recent years, with proponents insisting they are less harmful to health than conventional cigarettes. However, researchers at the University of Bath argue that the evidence underpinning these claims is largely unrepresentative of real-world use and at high-risk of bias.

    In their analyses of 40 publicly available clinical trials for HTPs—29 of which were tobacco industry affiliated or funded—the researchers judged most of the available clinical trials “at high risk of bias” given their methodology and choice of study design.

    The most common reason for studies being at high risk of bias was performance bias, whereby the interventions allocated were known to participants and those conducting tests. There was also failure to report all results data for all trial measurements, a shortcoming known as selective reporting bias.

    The authors argue that presence of these biases compromises the validity of trials and can lead to overestimation of the effects of HTPs. They also identified further limitations within trials, including short durations, restrictive conditions unreflective of real-world circumstances, and a lack of relevant comparators, like e-cigarettes.

    Bath’s Tobacco Control Research Group says much more detailed, independent research is needed to assess the short- and long-term health effects of HTPs.

    In the meantime, they argue that consumers should be wary of harm reduction claims and that policymakers and regulators should carefully consider the usefulness of these trials when making decisions surrounding HTPs.

    “Over recent years we have seen great expansion in the heated tobacco market in the U.K. and around the world. This growth has been predicated on a marketing claim that these products are better for health, in comparison with traditional cigarettes,” said lead researcher Sophie Braznell from Bath’s Department for Health.

    “Our analysis suggests that the picture is far less clear-cut. The clinical trials available, which are used by the tobacco industry to substantiate these claims, were often substandard in terms of how studies were conducted and reported, and most were industry-affiliated in some way.

    “As more consumers move away from cigarettes towards these new generation products, we need much better evidence to assess their health impacts now and into the future. In the meantime, the jury is very much still out on their benefits.”

    “These findings in relation to clinical trials for heated tobacco products are significant and we need to be wary of health claims made,” added study co-author Gemma Taylor from the Addiction & Mental Health Group and Deparmtent of Psychology at the University of Bath.

    “At the same time though, it is important to note the clear distinction between ‘heated tobacco products’ and ‘e-cigarettes.’ Consumers and health policymakers must not equate the potential benefits of e-cigarettes in helping people to quit smoking with heated tobacco products.”

     

  • HK Health Minister Open to Generational Tobacco Ban

    HK Health Minister Open to Generational Tobacco Ban

    Photo: Dmitry Rukhlenko

    Hong Kong Health Minister Lo Chung-mau confirmed that banning tobacco sales for future generations will be on the table as a tool to further reduce youth smoking, according to the South China Morning Post.

    Earlier news reports suggested authorities were considering a lifetime ban on anyone born in or after 2009 buying smoking products.

    With a smoking prevalence of 9.5 percent in 2021, Hong Kong already has one of the world’s lowest smoking rates, but health authorities are keen to bring it down further still.

    Lo said the government would look at the experience of other places in stopping young people from taking up the habit and move toward a “smoke-free Hong Kong.” New Zealand plans to phase out smoking through a generational tobacco ban and Malaysia is pondering similar measures.

    Henry Tong Sau-chai, chairman of Hong Kong’s Council on Smoking and Health also suggested doubling the tobacco tax to encourage users to quit. This would mean a pack of cigarettes currently priced at HKD60 would rise to around HKD100.

    Lo on Tuesday also said the government had also been pushing towards raising the tobacco tax, and tightening regulations on tobacco product advertisements.

    Stepping up tobacco control was stipulated in Chief Executive John Lee Ka-chiu’s maiden policy address last month. He set a target to further reduce the smoking rate to 7.8 percent by 2025, and a public consultation will be launched next year on its steps.

    Last year, the legislature also passed amendments to prohibit the import, promotion, manufacture, sale or the possession of alternative smoking products, including e-cigarettes, herbal cigarettes, or heated tobacco products.

  • Study: Evidence on Heating Products is Substandard

    Study: Evidence on Heating Products is Substandard

    Photo: librakv

    The quality of evidence available about heated tobacco products (HTPs) is substandard and policymakers should be wary of claims made about their role in harm reduction, say the authors of a new study published in Tobacco Control.

    HTPs have gained popularity in recent years, with proponents insisting they are less harmful to health than conventional cigarettes. However, researchers at the University of Bath argue that the evidence underpinning these claims is largely unrepresentative of real-world use and at high-risk of bias.

    In their analyses of 40 publicly available clinical trials for HTPs—29 of which were tobacco industry affiliated or funded—the researchers judged most of the available clinical trials “at high risk of bias” given their methodology and choice of study design.

    The most common reason for studies being at high risk of bias was performance bias, whereby the interventions allocated were known to participants and those conducting tests. There was also failure to report all results data for all trial measurements, a shortcoming known as selective reporting bias.

    The authors argue that presence of these biases compromises the validity of trials and can lead to overestimation of the effects of HTPs. They also identified further limitations within trials, including short durations, restrictive conditions unreflective of real-world circumstances, and a lack of relevant comparators, like e-cigarettes.

    Bath’s Tobacco Control Research Group says much more detailed, independent research is needed to assess the short- and long-term health effects of HTPs.

    In the meantime, they argue that consumers should be wary of harm reduction claims and that policymakers and regulators should carefully consider the usefulness of these trials when making decisions surrounding HTPs.

    “Over recent years we have seen great expansion in the heated tobacco market in the U.K. and around the world. This growth has been predicated on a marketing claim that these products are better for health, in comparison with traditional cigarettes,” said lead researcher Sophie Braznell from Bath’s Department for Health.

    “Our analysis suggests that the picture is far less clear-cut. The clinical trials available, which are used by the tobacco industry to substantiate these claims, were often substandard in terms of how studies were conducted and reported, and most were industry-affiliated in some way.

    “As more consumers move away from cigarettes towards these new generation products, we need much better evidence to assess their health impacts now and into the future. In the meantime, the jury is very much still out on their benefits.”

    “These findings in relation to clinical trials for heated tobacco products are significant and we need to be wary of health claims made,” added study co-author Gemma Taylor from the Addiction & Mental Health Group and Deparmtent of Psychology at the University of Bath.

    “At the same time though, it is important to note the clear distinction between ‘heated tobacco products’ and ‘e-cigarettes.’ Consumers and health policymakers must not equate the potential benefits of e-cigarettes in helping people to quit smoking with heated tobacco products.”

     

  • KT&G Set to Release New HnB Products in Korea 

    KT&G Set to Release New HnB Products in Korea 

    Photo: Tobacco Reporter archive

    KT&G Corp. will launch new heat-not-burn products in South Korea to strengthen its electronic nicotine devices lineup, reports the Yonhap News Agency.

    The South Korean cigarette manufacturer will release Lil Able and its premium version, Lil Able Premium, on Nov. 16.

    KT&G’s third-quarter net profit jumped 29 percent from a year earlier on increased exports and a strong U.S. dollar. Currently, the company earns 90 percent of its sales from the cigarette business division and 10 percent from the heat-not-burn division. 

    The company has been stepping up efforts to increase sales in the noncigarette business division. 

    From January to September, net income climbed 21 percent to KRW1.06 trillion from KRW878.58 billion in the same period of last year. 

    On Nov. 4, the company announced a KRW350 billion share buyback to boost shareholder returns.

  • Study Finds Teen Vaping Down, Some Start Younger

    Study Finds Teen Vaping Down, Some Start Younger

    Photo: eldarnurkovic

    Although the prevalence of teen vaping has declined in recent years, those who do vape are starting younger and using e-cigarettes more intensely, according to a new study published in JAMA Network Open by investigators at Massachusetts General Hospital (MGH) in collaboration with Stanton A. Glantz, a retired professor from the University of California at San Francisco.

    In the analysis of data from the annual National Youth Tobacco Survey, a nationally-representative survey of middle and high school students in grades 6–12, researchers found that e-cigarette prevalence among youth peaked in 2019 then declined, but e-cigarette initiation age dropped between 2014 and 2021, and intensity of use and addiction increased after the introduction of protonated nicotine products

    Protonated nicotine is created by adding acid to the e-cigarette liquid, which makes the nicotine easier to inhale. Since Juul pioneered protonated nicotine, it has been widely adopted by other e-cigarette companies.

    Age at first use of e-cigarettes fell by 1.9 months per year, while age at first use of cigarettes, cigars, and smokeless tobacco did not change significantly. By 2017, e-cigarettes became the most common first tobacco product used.

    E-cigarette nicotine addiction, measured as the odds of use within 5 minutes of waking, an indicator of addiction, increased over time. By 2019 more youth e-cigarette users were using their first tobacco product within five minutes of waking than for cigarettes and all other products combined. The percent of sole e-cigarette users who used e-cigarettes within five minutes of waking was around 1 percent through 2017, but then it increased every year, reaching 10.3 percent youth using their first e-cigarette within five minutes of waking by 2021.

    Median e-cigarette use also increased from three to five days per month in 2014–2018 to six to nine days per month in 2019–2020 and 10 to 19 days per month in 2021.

    The recently released 2022 National Youth Tobacco Survey data show that 2.55 million adolescents use e-cigarettes and 27.6 percent of adolescents use e-cigarettes daily. The comparable numbers reported in this paper for 2021 were 2.1 million and 24.7 percent.

    “The increasing intensity of use of modern e-cigarettes highlights the clinical need to address youth addiction to these new high nicotine products over the course of many clinical encounters,” said senior author Jonathan P. Winickoff, a pediatrician at MGH and a professor of pediatrics at Harvard Medical School, in a press note.

    “In addition, stronger regulation including state and local comprehensive bans on the sale of flavored tobacco products such as voting YES on Proposition 31 on California’s November ballot, should be implemented,” said first author Stanton A. Glantz, a retired UCSF professor of medicine

  • FDA Expected to Attack Names of E-liquids Next

    FDA Expected to Attack Names of E-liquids Next

    Photo: oxygen_8

    After rooting out ENDS flavors, regulators may turn their attention to flavor names.

    By Neil McKeganey

    In the world of illegal drugs, there are few substances that have become popular as quickly as 3,4-Methylenedioxymethamphetamine. If you are wondering what that awkwardly named substance is, you will almost certainly recognize it by its street name, Ecstasy. In advance of its marketing, the drug developers thought about calling it Empathy but decided on Ecstasy instead—who, after all, could turn down the opportunity of experiencing “ecstasy”? And so it proved with a drug that sold in the millions in countries around the globe. That anecdote tells you something that every marketing person worth his or her salt knows all too well: names matter. Indeed, when it comes to driving consumers to your product, names may matter more than the substance itself.

    In recent years, the vaping world has seen the heavy hand of regulatory intervention focused on limiting the range of flavors that can be legally sold. Senior health officials, sections of the media, lobbyists, parent groups and others have forcefully argued for banning “kid-appealing flavors.” Restrictions on flavors, though, have gone well beyond the flavors that are seen to be appealing to vulnerable groups.

    Out of some 1.6 million products for which premarket tobacco product marketing authorizations have been sought in the U.S., not a single flavor has been approved. Recent pronouncements from Brian King, head of the Food and Drug Administration’s Center for Tobacco Products, suggest that menthol is now in the regulatory agency’s crosshairs. In the face of such expanding regulatory action, it is by no means a stretch of the imagination to ponder a world in which only a single electronic nicotine-delivery system (ENDS) flavor—tobacco—remains, bringing vaping products that much closer to combustibles and in the process almost certainly weakening their capacity to offer a route out of smoking.

    In a mono-flavored ENDS world, flavor names may become the new fertile terrain—promising consumers a realm of limitless variations in taste that, like the world of expensive Hi-Fi, where differences in quality are barely discernible, nevertheless draw in consumers seeking particular sensorial and taste experience.

    With the removal of flavors from the market, next in line may be flavor names, with regulators galvanized by the belief that it is the names more than the flavors that are driving consumers to these products. In that event, it will become increasingly important for manufacturers to be able to present regulators with evidence that their specific-named tobacco-flavored products are not attracting young people and that those named flavors are assisting adults in quitting smoking.

    If anyone is inclined to think that this is an unlikely scenario, it is worth remembering that regulatory authorities within the U.S. already involve themselves in determining what words can and cannot be used when referring to tobacco products. Some states already ban the use of food terms when referring to tobacco products, and the Family Smoking Prevention and Tobacco Control Act bans words like mild, light and ultra-light when referring to tobacco products. In the face of such regulatory restrictions, companies replaced the names mild, light and ultra-light with terms such as gold, silver and blue. Research undertaken by Gregory Connolly and Hillel Alpert and published in Tobacco Control in 2014 showed that even in the face of such name-switching, smokers were still able to identify their preferred product.

    Within the world of ENDS, some e-liquid manufacturers have already chosen to move away from taste-based flavor names. Bidi Vapor, for example, uses product names such as Winter, Summer, Dawn and Marigold in describing its product range. Years before Bidi opted to anonymize the taste experience in its product names, e-liquid manufacturer Five Pawns opted to use words derived from chess, like Gambit and Grandmaster, to name its products. These are names that convey nothing about the taste or sensorial experience.

    In time, there may be a push from the anti-e-cigarette lobby to reduce the variety of tobacco flavor names even further, requiring manufacturers to differentiate their products by numbers alone. Seems unlikely? Probably not for those who remember Players No. 6, No. 10 and No. 555. Flavor names may be the next item on the regulatory hit list.

    Neil McKeganey is the director of the Center for Substance Use Research in Glasgow, Scotland.
  • Thailand: Activists Detect New ‘Teen Vaping Crisis’

    Thailand: Activists Detect New ‘Teen Vaping Crisis’

    Photo: samart boonprasongthan/EyeEm

    Tobacco control activists have expressed concern about the number of young people smoking e-cigarettes in Thailand, reports The Bangkok Post. While e-cigarettes are illegal in Thailand, they remain readily available across the country.

    According to a health survey conducted in 2019 and 2020, 5.3 percent of Thais aged 10 to 19 years have tried vaping and 2.9 percent do so regularly. Around 30 percent of people in this age bracket who smoke e-cigarettes are women, the study showed.

    Patcharapan Prajuablap, secretary-general of the Thailand Youth Institute, attributed the popularity of vaping in part to the fact that it is considered safer and more trendy than smoking cigarettes, especially among high school students.

    Over the past year, Thai lawmakers have mulled legalizing e-cigarettes to offer smokers a less harmful method of nicotine consumption and to tap a new source of tax revenue.

    Alarmed by the underage vaping numbers, Roengrudee Patanavanich, a lecturer at the Faculty of Medicine at Ramathibodi Hospital, urged the government to keep e-cigarettes illegal.