The organizers of the Global Forum on Nicotine (GFN) have announced an outline program for the 2016 conference, which can be viewed here: https://gfn.net.co/programme-2016/program.

The working sessions of the GFN are due to be held in Warsaw, Poland, on June 17-18, under the theme Evidence, Accountability, Transparency.

This year’s event will include a special showing of the landmark documentary, You Are Being Lied To – A Billion Lives, which is due to be screened on June 16, before the conference’s social event.

The documentary will be introduced by Aaron Biebert, the director, who will take part also in a short Q&A session after the screening. All GFN delegates will receive a ticket for the screening and an invitation to the conference social event immediately afterwards. More information is at: https://gfn.net.co.

The US-based Tax Foundation yesterday published a new summary and analysis of vapor product taxes in the US, a subject that it says has received little attention in the past.

‘Many states are grappling with the questions of if and how to tax the new market of vapor products, also known as “e-cigarettes”,’ the foundation said in a news release.

‘Although there is a substantial amount of ongoing research about the health costs of vapor products, there has not been much in the way of guidance on how best to tax them.

‘Currently, only a small handful of states tax the products, but do so in dramatically different ways.’

The study summarizes the basics of what the products are and how they compare to cigarettes in terms of production and health risks, and it provides a detailed overview of enacted and proposed taxes in each state.

The key findings include:

• As of January 1, 2016, four states, the District of Columbia, and three local jurisdictions had enacted taxes on vapor products (electronic cigarettes), but their methods and levels of taxation vary dramatically.
• In 2015, at least an additional 23 states considered excise taxes on vapor products.
• Vapor products are generally found to have a much lower risk profile than traditional incinerated cigarettes.
• Public Health England, housed in the British Department of Health, issued findings that vapor products are 95 percent less harmful than are cigarettes and can serve as an effective tobacco-cessation method.
• Vapor products are likely have much lower externalities than are traditional cigarettes, and it follows that the excise taxes on the products should be lower or non-existent.

Policymakers should avoid extending punitive tax rates from traditional cigarettes to vapor products because this would limit the consumer’s ability to use vapor products to quit cigarettes, said the foundation’s economist and director of state projects Scott Drenkar.

“Our first reaction should not be to impose cigarette taxes on what is fundamentally a different product.”

The report goes on to discuss why vapor taxes should be based on the volume of nicotine liquid in the product, rather than on the wholesale price, and how pending federal regulation would impact state tax policies.

The full report, Vapor Products and Tax Policy, is at: http://taxfoundation.org/article/vapor-products-and-tax-policy.

What’s next for vapor

By Dmitry Churakov

A significant part of my time goes into attending trade shows all over the world, and each one has something unique to contribute. I view the Tobacco Plus Expo (TPE), which took place Mach 16-18 in Las Vegas, Nevada, USA, as a small microcosm of what’s in store for the industry, as it steadily evolves along with it, and is always one of the first to point to emerging trends. The shift to electronic devices has been steady, as the morphing of products themselves.

Three years ago the show was dominated by cigalikes, open systems such as eGo, and basic liquids. The following year cigalikes where replaced by an avalanche of mods, and premium liquids began to appear. This year was all about premium liquids, which in of itself begs the question—what is a premium liquid these days? When everyone is pandering luxury experience, what makes a brand truly unique?

A major part boils down to branding. The companies are going all out in development of sophisticated packaging and unique brand identification that aims to appeal to various market segments. MYLK is one great example of just that. With its milkshake flavors and clever positioning, Brewell has hit a great niche. The product is all of the latest rave in China even though the Chinese are not major milk consumers nor milkshake aficionados. Cosmic Fog is steadily paving the way with its clear and consistent brand story, and is a great case study of a vape shop-focused company that now made it into a tobacco-centric distribution arena of TPE.

Another important development in the race for a slice of the premium sector is adaptation to simple and crisp flavors. As opposed to offering a 35 options with stereo effects in each liquid, the brands are opting for a flavor lineup that clearly defines their identity, providing a powerful differentiator. From what I see, this is one of the baldest steps towards true premium status, more in line with the accepted lineups of classic high end scotch.

A special mention should go out to SQN, which showcased NKTR—a new line of e-juice based on Tobacco-Free Nicotine developed in partnership with the Next Generation Labs. To me it truly set the tone for the next step in luxury liquids in terms of packaging, flavors, and most importantly the science behind the e-juice. This was definitely the product that exceeded expectations on all parameters and should lead the next wave of innovation.

Dmitry Churakov is CEO of Wingle Group, a China-based research and development consulting service geared toward the e-cigarette and adjacent technologies and manufacturing processes. He is also a co-founder of Calumet Advisors, an international strategic consulting company dedicated to the e-cigarette segment.

A series of cell-based tests developed to compare the biological impact of cigarette smoke with e-cigarette vapor revealed no activity in cells exposed to vapor from Vype ePen, a commercially available e-cigarette.  In contrast, when the cell culture systems were exposed to cigarette smoke, they exhibited a series of responses including stress responses, DNA damage and cellular transformation, depending on the assay used.

The use of these tests to assess the biological impact of e-cigarettes was reported by scientists from British American Tobacco (BAT) at the annual meeting of the Society of Toxicology in New Orleans, Louisiana, USA, today.

“The results of these tests show that toxicity and biological activity is unaffected by the vapor from the e-cigarette tested, Vype ePen,’ said Kevin McAdam, head of next-generation product (NGP) research at BAT.  “These tests are part of a suite of tests  being developed to test novel tobacco and nicotine products and could be used to help develop standards for these products in the future,” he said.

E-cigarette vapor can contain nicotine, humectants, flavorings and thermal degradation products, so it is important to understand the potential impact on biological systems.

A number of tests were used to compare the biological impact of cigarette smoke and e-cigarette vapor: cell stress tests, looking at the production of intracellular antioxidants, free radicals and inflammatory markers; assessment of DNA damage, which can set the scene for cancer; and a transformation assay, which measures the transformation or conversion of normal cells into a cancerous cell phenotype.

Cells respond to stress in a number of ways. They can produce compounds that protect the cellular structures or they can recruit compounds from the immune system to help protect the cell or commit suicide.

By measuring the levels of the various compounds produced and the level of cell apoptosis/death, it is possible to determine the levels of cellular stress.

The cell culture systems tested conventional 3R4F reference cigarette and Vype ePen, a commercially available e-cigarette.  When cells were exposed to the cigarette smoke, all cell stress responses were activated. These same cell stress responses were not activated on exposure to e-cigarette vapor.

Cellular DNA can become damaged by exposure to toxicants, especially when stressed. DNA double-strand breaks (DSB) in which both strands of the double helix are broken, is the most serious type of DNA damage. This is a possible precursor to cancer and potentially lethal to the cell.  The cell attempts to repair the DNA damage by modifying the histone or protein around which the DNA is wrapped.  The changes observed in this histone can be used as an indicator of the level of DSB.

When this test was used to compare the impact of conventional 3R4F reference cigarette and Vype ePen on DSBs, the results showed that cigarette smoke induced significant DNA damage in human lung cells. This was dose dependent, that is, the higher the dose, the more DNA damage was induced.  E-cigarette vapor produced no affect, even when the dose used was 15 times higher than the equivalent smoke exposure.

Damaged cells often go on to become cancerous. The cells are transformed from normal cells to abnormal cells that clump together and grow uncontrollably, eventually becoming tumor-like.  This process can be mimicked in the lab by using cells that are already damaged and testing the tumor-promoting activities of different compounds.

In this case, the cell culture system was used to test the ability of conventional 3R4F reference cigarette and Vype ePen to promote tumor formation in a specialized cell type called Bhas 42.

After exposure to reference cigarettes, the layers of cells were seen to become transformed, clumping together to create colonies, suggesting that the smoke is a tumor promoter. By contrast, the e-cigarette produced no activity.

In each test, the e-cigarette produced the same results as an untreated control – there was no activity.

Many in the public health community believe that e-cigarettes are substantially reduced risk compared to cigarettes.  Public Health England, an executive body of the UK Department of Health, recently published a report saying that e-cigarettes are 95% safer than cigarettes.  But there are still no internationally agreed testing protocols to establish this.

The stringency of Internet age-verification measures varies across e-cigarette brands, according to a new study published March 7 in JAMA Pedriatics.

A team of researchers, led by Samir Soneji of Dartmouth College’s Geisel School of Medicine in Lebanon, New Hampshire, USA, reviewed the websites of 12 e-cigarette companies that held 98 percent of the retail market share in 2014 and 19 of their e-cigarette brands.

Of the site reviewed, two had no age-verification gates, five posting warnings, 10 required users to click/check that they were old enough to use the site, one required users to enter their birth date, and one required a detailed registration

 Following reports that the EU is planning to tax electronic cigarettes under the same regime as applies to tobacco cigarettes, the UK Labour peer and medical professional Lord Turnberg told the House of Lords that such a move would have a detrimental impact on public health, according to a story by Shaun Connolly for the Press Association News.

Lord Hung of Kings Heath questioned why the EU was trying to “make it much more difficult for e-cigarettes to be promoted” despite e-cigs’ “clear benefit to the public health”.

And the Conservative, Viscount Ridley, suggested that EU regulations on electronic cigarette promotions could be a result of pressure from the pharmaceutical industry that is worried about the nicotine replacement therapy market losing market share to electronic cigarettes.

Lord Forsyth of Drumlean said the British government was powerless to stop the EU when “these e-cigarettes cost less … [and] enable people to save their health”.

However, Lord Prior of Brampton, minister for NHS Productivity, was quoted as saying: “Any proposal on an excise duty is not part of the directive as I understand it. We should be promoting this product, not discouraging it.”

A new study shows that the daily exposure to formaldehyde from three different types of e-cigarettes is well below the levels considered safe by the World Health Organization (WHO), at less than a sixth of the indoor air quality standard.

“In cigarette smoke, most formaldehyde is produced as the result of burning sugars naturally present in tobacco as well as added sugars and glycerol,” explains Sandra Costigan, principal toxicologist for e-cigarettes at British American Tobacco, “whereas in vaping products, it is generally produced as a thermal breakdown product of glycerol and propylene glycol (PG).

Glycerol and PG are used to make the e-liquid and dilute the nicotine and flavoring.  There has been a lot of material published recently on the amount of formaldehyde released from e-cigarettes.

Formaldehyde is classified as a carcinogen by the International Agency for Research of Cancer and is thought to contribute to the development of tobacco-related disease.  For this reason, there has been some concern over the possible health effects of inhaling formaldehyde released into the aerosol of e-cigarettes.

“In this study, we measured the formaldehyde produced in the aerosol of three different e-cigarettes formats,” Costigan said.

Three types of vaping products were studied: a rechargeable “cigalike” device; a refillable open-tank system, also called a clearomiser, and a closed modular system with variable voltage. Where there was a choice, the products were tested under worst-case, high-voltage conditions, under which the most formaldehyde would be produced.

Consumer use of the products was surveyed to establish real world use patterns. A total of 350 puffs per day represents a realistic estimate of the intense use for these products.

Lab-based vaping robots were programmed so that they produced vapor in a realistic way and the formaldehyde levels in this vapor were measured.

The results showed that even the worst case amount of formaldehyde per 10 puffs of the e-cigarettes tested, was over 10 times less than the formaldehyde from a 3R4F reference cigarette smoked under standard ISO conditions.

Using 350 puffs per day, and assuming a standard breathing volume of 20m³ over 24 hours, average daily formaldehyde concentrations were calculated for the different products. For all products, these were well below a variety of formaldehyde safety benchmarks such as the threshold for throat and respiratory tract irritation, the European REACh Derived No Effect Level, occupational exposure guidelines, and the WHO guidelines for indoor air quality for selected pollutants which includes a guideline on formaldehyde levels.

“We believe e-cigarettes hold great potential for reducing tobacco-related disease. For this reason, we continue to strive to better define and further reduce any residual risks that there may be, to as low a level as possible,” said Costigan.

“The results from this study show that even heavy use of these products still only results in daily formaldehyde exposure that is less than one sixth of the exposure from breathing indoor air that complies with WHO air quality standards,” she said.

The results will be presented today at the annual conference of the Society for Research on Nicotine and Tobacco in Chicago.

Researchers from University College London (UCL) estimate that the use of electronic cigarettes produced 16,000-22,000 additional long-term quitters in England in 2014, according to an Eurekalert story. A long-term quitter is someone who has not smoked for at least a year.

The UCL team, whose study was published in the journal Addiction, has been tracking the rise in the use of electronic cigarettes using monthly national surveys, and estimates that in 2014 about 891,000 smokers used one of these products to try to quit.

Professor Robert West, who led the research team, was quoted as saying that electronic cigarettes appeared to be helping a significant number of smokers to stop who would not have done otherwise – not as many as some electronic cigarette enthusiasts claimed, but a substantial number nonetheless.

“There have been claims by some public health researchers that e-cigarettes undermine quitting if smokers use them just to cut down, and that they act as a gateway into smoking,” said West.

“These claims stem from a misunderstanding of what the evidence can tell us at this stage, but this is clearly something we need to watch carefully.”

Meanwhile, a story by the ITV Network reported that the research had been welcomed by the director of the Tobacco Dependence Research Unit at Queen Mary University of London, Professor Peter Hajek, who had said he hoped it might help develop new ways of supporting people through quitting.

“E-cigarettes have a potential to reduce smoking related morbidity and many smokers are successful in making the switch from smoking to vaping,” he said.

“Specialist smoking cessation services are currently not offering e-cigarettes and are seeing a marked decline in interest. This is unfortunate, as it is likely that even more smokers would switch to vaping successfully if e-cigarettes were combined with behavioral support that the services provide.

“Hopefully, findings like this will encourage the services to start offering e-cigarettes as a part of their overall toolkit.”