A new study from Canadian researchers shows banning e-cigarette advertising reduces teen vaping. The study compared teen vaping rates in Quebec and Manitoba where there are strict laws against e-cigarette ads, to other provinces that do not restrict these ads.
Researchers at University of Waterloo in Ontario found that exposure to vaping ads was more prevalent in areas without restrictions, and teens who noticed the ads were more likely to vape. The study was published in ‘Pediatrics.’
Study author David Hammond, a professor of public health at the University of Waterloo, said this situation set up a “unique natural experiment” for researchers as Canada went from ban to a more open market, in an article from US News and World Report.
“It allowed us to answer the hypothetical question: Would lifting the restrictions make a difference in teen e-cigarette use?” he said.
The answer? “E-cigarette marketing does make a difference,” Hammond said. “It does reach minors. What our study says is that regulating marketing limited the amount of vaping.”
Scenes like this are rare in Thailand. This vaper in Koh Samui, Thailand could face fines or even jail. (Timothy S. Donahue)
A consumer advocacy group wants the government of Thailand to consider science as basis for ending e-cigarette ban. The group cites Hong Kong’s use of scientific studies as the basis for ending the ban on smoke-free nicotine, including vapor, heat-not-burn tobacco products (HnB) and snus.
Asa Ace Saligupta, who runs consumer group ENDS Cigarette Smoke Thailand, said the Hong Kong Legislative Council (Legco) decided to suspend the discussions on the proposed ban on vaping products, after some members of Legco’s Bills Committee on Smoking cited scientific studies showing that e-cigarettes, HnB and the likes have much lower levels of toxicants compared to combustible cigarettes, according to a release on pressat.co.uk.
He noted that after nine meetings, including three public hearings, the committee which was established in March 2019 decided to end the discussions on the vaping ban on June 2, 2020. The members of the committee also expressed concern that an outright ban would create more illegal channels and that the products could end up in the hands of underage users.
“The Hong Kong experience sets forward a good example of listening to opinions and engaging all parties involved, including the public sector—something that the policymakers in Thailand have avoided so far,” Saligupta said.
Saligupta said his group will petition the Thai government to also set up a committee to study e-cigarettes and find suitable control channels that will enable adult Thai cigarette smokers to find safer alternatives.
“Instead of using electronic cigarettes as a tool to create fear by creating a discourse on children and youth or Covid-19, we want to call on the Thai government to set up an independent committee to seriously study the science, commercial aspects, and regulatory framework for electronic cigarettes like Hong Kong and many other countries,” he said.
An Asia-Pacific coalition of tobacco harm reduction advocates has protested the ban imposed by the Australian Therapeutic Goods Administration (TGA) on the importation of nicotine liquids, saying this will deprive millions of Australian vapers and existing smokers of their rights to access better alternatives to combustible cigarettes.
CAPHRA says the ban will only exacerbate the smoking problem which kills 21,000 Australians a year, according to a press release.
The Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA) said the ban on importation of vaping products for personal use into Australia effective 1 July means that cigarette smokers looking for safer alternatives will no longer be able to import these products for their own personal use.
The ban will cover e-cigarettes containing vaporizer nicotine (nicotine liquids and salts) and nicotine-containing refills. Only doctors or medical suppliers will be allowed to import these products as long as they have a permit from the Health Department.
CAPHRA says the ban will only exacerbate the smoking problem which kills 21,000 Australians a year.
According to the new regulatory framework, vapers will have to visit a general practitioner, get a prescription, and then obtain their vaping liquids from an approved medical dispensary.
“Smokers in Australia have been denied access to a proven harm reduction tool and vapers in Australia have yet again been dealt a potentially fatal blow which will see many of the 300,000 strong vaping community go back to smoking cigarettes,” CAPHRA Executive Director Nancy Loucas said in a statement.
The share of people who believe e-cigarettes are equally harmful or more harmful than traditional cigarettes depends on how the question is asked, according to new research published in Tobacco Control.
Tobacco companies often claim that a large proportion of the population perceives potential modified risk tobacco products as equally or more harmful than cigarettes, and argue misperceptions need to be corrected using modified risk claims.
However, the studies they cite predominantly use one specific measurement of comparative risk, according to the researchers.
Image: Tobacco Control
The authors studied the way questions were posed in the 2017 Tobacco Products and Risk Perceptions Survey. When asked directly to compare harms of e-cigarettes and cigarettes, 33.9 percent of participants identified e-cigarettes as less harmful than cigarettes, 36.4 percent reported equal harm, 4.3 percent said e-cigarettes were more harmful and 25.3 percent said, “I don’t know.”
When asked indirectly, however, 42.1 percent identified e-cigarettes as less harmful than cigarettes, 23.8 percent said they were of equal harm, 7.1 percent perceived e-cigarettes to be more harmful and 27.1 percent did not know.
The authors say researchers should use both direct and indirect risk questions when assessing the public’s perceptions of harms associated with novel tobacco products.
Respira Technologies plans to submit an inhaler device to the U.S. Food and Drug Administration by late 2021 for authorization as nicotine-replacement therapy.
The company aims to disrupt a $618 billion market dominated by decades-old gums and patches from pharmaceutical companies as well as tobacco companies’ electronic nicotine-delivery devices with a nebulizer that converts nicotine to an aerosol.
Based in West Hollywood, California, USA, Respira Technologies says that the Covid-19 pandemic has sparked new interest in quitting, and today’s users of vapor devices and e-cigarettes need updated cessation products.
“The reality is we have folks who are addicted to nicotine who never tried combustible products before,” Respira CEO Mario Danek told Bloomberg Technology, referring to tobacco products that are burned like cigarettes and cigars.
“They’re used to sleeker products, and we have that design.”
Vaping is a safer alternative to smoking, according to a Hong Kong health advisory group. The Hong Kong Legislative Council (Legco) has suspended all discussions on a proposed ban on vaping products. Legco says the products provide smokers with safer smoke-free alternatives.
Legco’s Bills Committee on Smoking announced it had ceased discussions over the proposed ban on electronic cigarettes, heat-not-burn tobacco products (HTPs) and other electronic nicotine delivery systems on June 2, according to a press release.
The committee ended its work after nine meetings, including three public hearings, since it was established in March 2019 to tackle the bill that aimed to amend the Smoking Ordinance and impose a blanket ban on vaping or the use of e-cigarettes, HTPs and the likes.
Hong Kong’s vaping ban was strongly opposed by some members of the committee who cited scientific studies showing that e-cigarettes, HTPs and the likes have much lower levels of toxicants compared to combustible cigarettes.IQOSER, a heated tobacco concern group in Hong Kong, said the end of discussions on the proposed ban on HTPs could hopefully bring lawmakers’ attention to the more important task of addressing the smoking problem. “Smoking incidence remains at more than 10 percent in Hong Kong, which means a tenth of our population is exposed to the health risks brought about by toxicants found in tar, the by-product of tobacco smoke,” said Joe Lo of IQOSER, which is also a member of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA).
“As we have been saying all along, nicotine is not the problem, but the smoke, which is responsible for thousands of deaths globally each day. Unlike combustible tobacco, e-cigarettes and HTPs do not involve combustion or burning, because they only heat tobacco to a certain degree that is not harmful to humans,” said Lo.
Nancy Loucas, Executive Coordinator of CAPHRA, noted that Hong Kong, like Japan and Korea, has a high number of former smokers who have switched to reduced-harm products, such as heat-not-burn (HnB) devices.“It was pleasing to see that some of the officials involved in the process to decide the fate of the products strongly opposed the ban based on science that proves that [HnB devices] have a lower level of toxicants compared to cigarettes, whilst addressing the concerns of creating black market in illicit trade in the products,” Loucas said.
In Hong Kong, many heated tobacco users were forced back to combustible tobacco because of the inability to access the product in the past year, according to Loucas. “Others, with the means, have risked being caught buying through illicit channels. Legislators such as Peter Shui, Raymond Chan and Cheng Chunt-tai, have repeatedly argued that a ban was neither logical nor feasible. More importantly, all three pointed out that adult smokers should not be deprived of the right to choose tobacco harm reduction,” she said.
Asa Ace Saligupta, who runs consumer group ENDS Cigarette Smoke Thailand, said the country should follow the lead of Hong Kong in putting to rest the discussions on vaping ban. “Lifting the ban on e-cigarettes, HTPs and the likes will provide Thai smokers representing more than 20 percent of our population an opportunity to switch to reduced-risk alternatives. At present, nearly 40 percent of Thai males are at risk of suffering from illnesses caused by the smoking epidemic,” he said.
Photo Credits: Timothy S. Donahue
Stephanie Thuesen, director of stakeholder engagement at The Progressive Public Health Alliance, said any restrictive policy on e-cigarettes and HTPs will exacerbate the smoking problem as this will discourage smokers from switching to reduced-risk alternatives. “Tobacco harm reduction should be viewed as a progressive health policy by all countries to put an end to the smoking problem,” she said.
Kulthida Maneechote of SmokeFree4Life campaign asked tobacco harm reduction advocates and vapers to unite against bans and restrictive policies imposed by countries based on alleged lies fed by the World Health Organization to deprive smokers of less harmful alternatives.
“Let us challenge the fallacies and unscientific guidelines being spread by the World Health Organization on electronic cigarettes especially with the upcoming WHO Framework Convention of Tobacco Control (WHO FCTC) in November this year [the convention has since been cancelled for 2020]. If left unchallenged, e-cigarettes might be banned by governments altogether. This will put many smokers at risk of not being able to choose a better alternative,” she said.
Thirty-nine percent of smokers cut down on smoking during the Covid-19 ‘StayHome’ period and 83 percent of the people put on face masks and gloves when going out, a poll has revealed.
The survey was carried out by the Health Promotion Department (HPD) at the Supreme Council for Family Affairs Sharjah, in cooperation with the University of Sharjah. It aimed at investigating the impact of lockdown on dietary behaviour, lifestyle and health practices.
Enhanced awareness
The findings reflected people’s enhanced awareness during the pandemic, thanks to the precautionary and preventive measures adopted by the UAE government. The preliminary results showed that 98 percent of those surveyed believed that home isolation was a good way to protect their families and stop the spread of infectious disease outbreaks.
The poll found that 79 percent of respondents were keen to sterilise the purchased food items and 84 percent of those who have children at home encouraged them to carry out physical activity.
Lifestyle, dietary changes
Among the 2,060 participants who were surveyed, 66.7 percent were obese or overweight, 56.6 percent engaged in physical activity before home isolation and out of them, 30 percent reduced their activity after the lockdown. The percentage of people sleeping over seven hours increased from 63 to 70 percent since the lockdown, the survey disclosed.
As far as eating habits were concerned, 29.4 percent reported weight increase while 32 percent of the people increased their food intake during the Covid-19 ‘StayHome’ period. Besides, 62 percent increased their citrus intake and 50.2 percent their water consumption. Around 38.4 per cent started taking herbal teas, and 94 percent contended that extra intake of vitamins and minerals could strengthen the body against Covid-19, the study revealed.
It also demonstrated that 67.2 percent felt more stressed during the home isolation amid the lockdown, 42 percent of the respondents felt more irritated and angry than before, even as the majority believed that after lockdown, their lifestyle will improve.
Supporting national efforts
Iman Rashid Saif, HPD Director, said: “This study aims primarily to support the national efforts to fight Covid-19 pandemic by gauging the community awareness and developing solutions and recommendations to enhance people’s health awareness and the behaviours they have to adopt during the crisis.”
“It also aims to investigate to what extent the people are committed to healthy lifestyle, such as physical activity and diet, so that further steps could be taken in the future to improve their quality of life.”
Dr. Hadia Radwan, assistant professor, University of Sharjah, College of Health Sciences, pointed out: “The comprehensiveness of the data collected, as well as the timing of the study, clearly reflect the lifestyle practices of people during the pandemic which will have key implications on the health of community members.”
She added that adjusting lifestyles and dietary habits would help boost immunity system to combat viruses. “The findings of this study will be compared with the global data of nutrition and health to be used as a base for indepth future studies,” she said.
The number of people quitting combustible cigarettes seems to be growing in the UK during the coronavirus lockdown, new research reveals.
The study by smoking cessation advocates Vape Club shows that the average annual Google searches increasing from 37,200 to 100,440 since restrictions began, according to a story in Talking Retail.
‘How to quit smoking’ is Googled an average of 37,200 times per year in the UK, but since 26 April the number of average monthly searches has pushed the yearly average to 100,440, an increase of 62,800.
The similar phrase ‘how to stop smoking’ has seen a comparably sharp increase of 40 percent in the past month in the UK. There are 31,200 searches on average per year, which has increased to an average of 43,680 with last month’s search figures.
In addition, searches for ‘NHS stop smoking service’ have increased by 120 percent in the same period.
Dan Marchant, director at Vape Club and member of the UK Vaping Industry Association, said: “The volume of people turning to Google searches for advice suggests that greater support and clearer information should be made available. I’d like to see stop smoking services reaching out to the most vulnerable and hard-to-reach in society, as there’s clearly a desire to quit with the right support. With vaping being the most effective form of smoking cessation, it’s important that it is presented as an effective quitting tool.”
Pod-style vapor products have an efficient delivery of nicotine. A new study by Harvard T.H. Chan School of Public Health finds that the nicotine salts used by the devices may foster greater dependence than other types of e-cigarettes.
According to the study, the design of pod-based e-cigarettes ensures the delivery of high doses of nicotine in a low pH form, which is less harsh compared to the higher pH nicotine found in most other e-cigarette brands, thus encouraging deeper inhalation.
This is the first paper to synthesize research findings on Juul and similar pod-based devices, said first author Stella Lee, formerly a National Cancer Institute Cancer Prevention postdoctoral fellow in the Department of Social and Behavioral Sciences and currently an assistant professor at Konkuk University in South Korea, according to the Harvard Gazette.
“We found that pod-based e-cigarettes have a higher potential to get youth and young adults addicted than other devices,” she said. “To prevent this from happening, we need stronger health communication messages that alert people to these findings.”
The study will be published online June 1 in JAMA Pediatrics.
The authors of a recent editorial published by a prestigious medical journal write, “most patients with EVALI had inhaled vapor from e-cigarette liquids containing THC.” [emphasis added] In this piece, I will explain why I used to consider the term ‘THC e-cigarettes’ a logical fallacy, and how I have come to believe this original conclusion was wrong.
First, let’s review some basic terminology. The word ‘vape’ is a verb; those who vape are ‘vapers’; their devices are ‘vaporizers’. Some vape nicotine, others tetrahydrocannabinol (THC), according to an opinion piece from Foundation for a Smoke-Free World.
‘Vaping’ involves heating a liquid to release a liquid aerosol called ‘vapor’. Unlike smoke inhaled from burning plant leaves, vapor contains fewer – and lower levels of – harmful toxins, no solid particulates and no carbon monoxide.
Products, people, and purposes
THC and nicotine vaping involve different devices, liquids, supply chains, people, and purposes. The former gets you high (and may relieve pain). The latter may help smokers quit. Evidence suggests that nicotine vaping is safer than tobacco smoking, and this constitutes the central tenet of tobacco harm reduction.
Because nicotine is not soluble in oil, nicotine vaporizers are designed to produce vapor from aqueous ‘e-liquids.’ In contrast, THC dissolves readily in oil, so THC vaporizers are designed to produce vapor from oils. They use different heating coils and operate at different temperatures than nicotine vaporizers.
The problem with e-cigarettes
The term ‘e-cigarette’ was originally chosen to encourage adult cigarette smokers to switch to what many believe are vastly safer alternatives. Advocates for THC vaping and cannabis legalization deliberately avoid the term ‘e-cigarette’ to prevent confusion.
Over time, however, the perception of ‘e-cigarettes’ has changed, perhaps in part because of negative associations with the deadly products that they were invented to replace. Recently, researchers at the University of California, Davis, made a similar argument.
Terminological confusion
During the fall of 2019, health officials in the United States observed a sudden cluster of vaping-related lung injuries. The cause of those injuries was ultimately found to be an adulterant in the bootleg (illicit) THC vape oil supply chain: vitamin E acetate (VEA).
VEA is soluble in oils, but not soluble in nicotine vape liquids, which are aqueous. So, the US Centers for Disease Control and Prevention (CDC’s) disease terminology — e-cigarette, or vaping, product-use associated lung injuries (EVALI) — seemed problematic for several reasons.
First, multiple lines of evidence pointed to illicit THC vaping as the cause of EVALI. Second, omitting ‘illicit THC’ from the name could cause real harm if THC consumers continued to vape bootleg products. Third, highlighting ‘e-cigarettes’ in that scary acronym runs the risk of simultaneously encouraging legal nicotine vapers to relapse to smoking, and discouraging adult smokers from quitting.
The ‘E’ in EVALI still makes many nicotine vapers bristle. “No one calls joints cigarettes,” they say, so “why is the CDC claiming that THC vapes are e-cigarettes?” I used to agree. But there is a problem with that argument.
‘Cannabis cigarettes’ are a thing
Merriam–Webster’s dictionary defines a ‘joint’ as a ‘marijuana cigarette’. Just Google ‘cannabis cigarettes’. They are a thing. They are especially a thing in countries and American states where recreational cannabis is legal, and companies use modern manufacturing methods to produce them.
The authors above, who referred to “e-cigarette liquids containing THC,” were not deliberately trying to confuse their colleagues by conflating bootleg THC vape oil harms with legal nicotine vaping products. Yet confusion remains. Most people who hear the word ‘e-cigarette’ will think nicotine, not THC.
Finding a solution
In my view, there is only one way out of this terminological muddle. In this post, the only way that I could clearly distinguish ‘nicotine vaping’ from ‘THC vaping’ was to use exactly those terms. I now see the term ‘e-cigarette’ itself as a potentially deadly source of confusion. In the COVID-19 era, avoiding terminological confusion could be a matter of life and death.
IQOSER, a heated tobacco concern group in Hong Kong, said the end of discussions on the proposed ban on HTPs could hopefully bring lawmakers’ attention to the more important task of addressing the smoking problem. “Smoking incidence remains at more than 10 percent in Hong Kong, which means a tenth of our population is exposed to the health risks brought about by toxicants found in tar, the by-product of tobacco smoke,” said Joe Lo of IQOSER, which is also a member of the Coalition of Asia Pacific Tobacco Harm Reduction Advocates (CAPHRA).
“It was pleasing to see that some of the officials involved in the process to decide the fate of the products strongly opposed the ban based on science that proves that [HnB devices] have a lower level of toxicants compared to cigarettes, whilst addressing the concerns of creating black market in illicit trade in the products,” Loucas said.
