A study led by the University of California – Los Angeles (UCLA) has found that women who use electronic cigarettes during pregnancy are 33 percent more likely than those who don’t to give birth to low-birthweight infants, according to a press release. Low-birthweight babies — those weighing less than 5.5 pounds — often require specialized medical care and are at greater risk of early-life complications and long-lasting health issues, said Annette Regan, the study’s corresponding author and an adjunct assistant professor of epidemiology at the UCLA Fielding School of Public Health.
Credit: Duster 112
Findings from the study, which also involved researchers from the University of San Francisco, Texas A&M University and the U.S. Centers for Disease Control and Prevention, are published online in the journal Obstetrics & Gynecology.
The researchers analyzed data on approximately 80,000 mothers from the 2016–18 Pregnancy Risk Assessment Monitoring System, or PRAMS, a CDC-coordinated project that collects information nationwide on maternal experiences before, during and shortly after pregnancy. Among that cohort, 1.1 percent (800) reported having used e-cigarettes during the final three months of their pregnancy, and nearly two-thirds (533) of those e-cigarette users said they had also combustible cigarettes during that period.
“Although only a small percentage of people used e-cigarettes, we were surprised with how many used both e-cigarettes and combustible cigarettes during pregnancy,” said Regan, who also teaches at the University of San Francisco’s nursing school. “We found increased rates of low birthweight for e-cigarette users, and this occurred even for those who didn’t also smoke cigarettes.”
Juul Labs paid $51,000 to buy out an entire issue of the American Journal of Health Behavior (AJHB) and make it publicly available, the New York Times reported.
The AJHB’s May/June issue published 11 company-funded studies that promote the health benefits of Juul devices in helping smokers quit traditional tobacco products.
“Electronic nicotine delivery systems (ENDS) represent a significant opportunity to realize tobacco harm reduction at the population level around the world,” the authors write in an introduction to the journal.
Juul Lab’s five-figure buyout of the journal issue is part of a public influence campaign that the Center for Responsive Politics tallied at more than $3.9 million in 2020 alone.
Juul Labs recently reached a legal settlement with the state of North Carolina in which it will pay $40 million to avoid a jury trial over the question of whether it illegally marketed nicotine products to teens.
A large study conducted by the TPA shows e-cigarettes control youth smoking.
By Maria Verven
An extensive, state-by-state analysis conducted by the Taxpayers Protection Alliance (TPA) proves e-cigarettes are more effective in controlling youth smoking than tobacco control programs started after the Master Settlement Agreement (MSA).
“Tobacco & Vaping 101: 50 State Analysis,” authored by Lindsey Stroud, uses data from the Centers for Disease Control and Prevention (CDC) to argue the benefits of vaping, especially when it comes to teen usage. Ironically, this same data had been used to create public hysteria over vaping rates, especially among youth.
“As lawmakers across the country seek to reduce youth tobacco and vapor product use, many have introduced and passed legislation that regulates, taxes and in some cases prohibits the sale of products that actually help reduce tobacco use,” Stroud said.
Stroud said she’s been using the findings in state legislative testimony this year. “I’ve received positive feedback from pro-vaping and tobacco groups but have not heard much back from the anti-groups,” she said. “They may be surprised to see that I used the same data they do to argue the benefits of vaping,” she said, adding that she’s determined to make this information publicly available and accessible.
Stroud said she hopes other researchers and industry followers will use the report’s state-by-state information on adult and youth use of tobacco and vapor products in future articles and reports.
Of particular interest is the effectiveness—or lack thereof—of tobacco settlement payments, taxes and vapor products on reducing combustible cigarette use.
While all 50 states and Washington, D.C. saw a decrease in the percent of smokers, some states actually saw an increase in the number of smokers, due to an overall increase in the state’s population. Stroud’s analysis took into account both the percent difference and population change in examining adult and youth vapor and tobacco rates.
The analysis of cigarette tax revenues between 2000 and 2019 found that while cigarette tax hikes helped increase revenues in the short-term, these increases didn’t contribute to the decline in smoking rates.
It also shows that most states drastically underfunded programs for tobacco cessation services, education and prevention after collecting cigarette tax revenue and tobacco settlement monies over the past 19 years.
Vapor products tied to decrease in youth smoking
Of greatest importance is the analysis on the reduction in youth use of combustible cigarettes—which is at an all-time low. The report also examines youth vapor rates, specifying whether they ever tried an e-cigarette or are truly current or daily users.
Here’s where the data got really interesting. Stroud compared the smoking rates among 18-year-olds to 24-year-olds in the 10 years after the MSA with the smoking rates in the 10 years after e-cigarettes appeared on the market.
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Lo and behold, there were greater decreases in smoking rates in the 10 years after the emergence of e-cigarettes when compared to the 10 years after tobacco settlement lawsuits.
And in the four states where smoking rates actually increased after e-cigarettes came on the market, policymakers had increased scrutiny and restrictions on e-cigarettes due to the perceived youth vaping “epidemic.” Coincidence? Stroud doesn’t think so.
“Addressing youth use of any age-restricted product is laudable, but it should not come at the expense of adult users of such products,” Stroud wrote in Politics, adding that bans, arduous regulations and/or unfair taxation threaten adult access to e-cigarettes and other tobacco harm reduction products.
“Completely disregarding that youth smoking rates are at all-time lows, officials often propose ‘solutions’ that fail to address the real reason why youth use e-cigarettes,” Stroud said.
States with higher rates of youth smoking have higher rates of youth vaping. Stroud said that the data clearly indicate that youth use e-cigarettes because friends and family members use them.
When asked about the “primary reason” for using e-cigarette products (among current users, only 10 percent of respondents from many states answered it was due to “flavors” while 17 percent cited “friends and family” and 51 percent cited “other.”
Vapor Voice caught up with Lindsey Stroud to learn more about this groundbreaking report and how this plethora of tobacco and vaping data can be used to inform future policymaking.
Vapor Voice: How was all this data collected? How long did it take?
Stroud: The idea was to provide policymakers with a plethora of tobacco-related data in a simplified manner.
We compiled the data manually by inputting data from the Centers for Disease Control and Prevention’s Behavior Risk Factor Surveillance System (BRFSS) between 1995 and 2019.
While state-specific BRFSS data included detailed demographic information such as age, gender, race, education level, income and smoking status, it wasn’t easy finding that data for the U.S. as a whole. So I started going through individual state data and putting together state-specific spreadsheets on cigarette use.
In addition, I examined annual state cigarette tax receipts, annual state tobacco control funding, cigarette tax increases and youth tobacco and vapor product use, which came from the CDC’s Youth Risk Behavior Survey.
It’s important to note that the Campaign for Tobacco-Free Kids also uses this same BRFSS data. However, while Tobacco-Free Kids only shows smoking rates and the cost of smoking in each state, we pulled various data items to tell a more complete, insightful picture.
What surprised you the most about this project?
I was amazed that my hypothesis—that e-cigarettes were more effective than the MSA in reducing smoking rates among young adults—actually held true. It was really eye-opening.
It’s still pretty amazing that 45 states and D.C. saw greater decreases in smoking rates among 18[-year-old] to 24-year-old adults in the 10 years after e-cigarettes emerged on the market than in the 10 years after the tobacco companies started shelling out millions that states were supposed to use on smoking cessation programs.
In the outlier states, smoking rates were at their lowest levels ever until 2018—the same year the surgeon general declared a “youth vaping epidemic.” Tragically, that’s when smoking rates began to increase.
Why did you feel this data was needed?
I really wanted to show policymakers data that compared youth vaping to youth smoking rates, which were way higher in the 1990s, especially compared to today’s youth vaping rates.
In all states, cigarette tax increases led to immediate increases in revenue in the short term, but these have all fallen as less adults smoke cigarettes.
I also wanted to call attention to the lack of state funding for tobacco control programs, despite the fact that states receive millions if not billions of dollars annually from tobacco monies such as excise taxes and tobacco settlement payments.
As far as I know, this is one if not the first analysis of the BRFSS data to include graphs—which clearly show the reduction in smoking rates among young adults as well as how little funding is spent on tobacco control.
Finally, I wanted to prove my hypothesis that vaping can take much of the credit for the reduction in both adult and youth smoking rates.
A new study being conducted in the U.K. will offer homeless people free e-cigarette starter packs. The trial is aimed at helping them quit smoking. An estimated 70 percent of homeless people smoke combustible cigarettes, according to research from University of East Anglia (UEA).
Credit: Mat Hayward
Homeless centers in five parts of the UK including London, Scotland and Wales will provide 480 contributors with starter kits or care group sessions, according to the BBC. The study will assess if e-cigarettes help participants quit smoking and whether it offers them value for money.
Half of the contributors will be offered the e-cigarettes, while the other 240 people will be allocated to a care group. The project is being led by London South Bank University (LSBU) and University College London. Lynne Dawkins, a professor with LSBU, said that in an earlier trial the kits “worked well” and staff at homeless centers were able to support the study.
The £1.7m project has been funded by the National Institute for Health Research (NIHR) and is in collaboration with UEA, Kings College London, Queen Mary University of London, the University of York, Cardiff University, the University of Stirling and the University of Edinburgh. Caitlin Notley, a professor with UEA, said studies suggested e-cigarettes were “more helpful” than nicotine gum or patches when people tried to stop smoking.
“If we find that providing free e-cigarette starter kits helps people to quit, homeless centers could decide to adopt this approach in future, to help reduce the impact of smoking-related diseases on the homeless,” she said.
Policies that restrict the sale of flavored e-cigarettes, e-liquids and other tobacco products including menthol cigarettes impact health disparities among vulnerable populations is the subject for a new study to be conducted by the University of Kentucky College of Medicine. The five-year, $2.8 million grant from the National Cancer Institute (NCI) will support the study on how local policies impact at-risk groups — including communities of color, low-income populations and youth — that are more likely to use flavored tobacco products.
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The results could help lawmakers create policies that are more equitable, says the study’s principal investigator Shyanika Rose, Ph.D., a faculty member of the Center for Health Equity Transformation (CHET), assistant professor in the Department of Behavioral Science and member of the Markey Cancer Center Cancer Prevention and Control Program. “We already know that stopping the sale of these products can reduce their availability and use in these communities,” said Rose. “But understanding the impact of policies across race and socioeconomic status will give guidance about what kinds of policies work and have the most equitable benefits.”
Rose says flavored tobacco (including vaporizers and e-cigarettes) products, which are more appealing, easier to use and more addictive, have a long history of being disproportionately marketed toward vulnerable communities, particularly African Americans. Currently, federal laws only prohibit the sale of certain flavored tobacco products.
The sale of menthol cigarettes and all flavors of smokeless tobacco, cigars and hookah is still permitted. While the Food and Drug Administration recently announced new steps to implement a ban on the sale of menthol cigarettes and flavored cigars, the proposal will not eliminate all flavored tobacco products from the market, specifically flavored e-cigarettes and e-liquids.
“While the FDA is moving federal policy in the right direction, comprehensive policies that restrict the sale of all flavored tobacco products may be more likely to protect the health of the most vulnerable populations and this is something this project will investigate,” Rose said.
A new study has concluded that teens who use e-cigarettes would have likely become combustible cigarette smokers if vaping products did not exist. Published in Nicotine & Tobacco Research, researchers found that “vaping is largely concentrated among non-smoking youth who would likely have smoked prior to the introduction of e-cigarettes, and the introduction of e-cigarettes has coincided with an acceleration in the decline in youth smoking rates.”
Credit: Krystian Graba
Dr. Natasha Sokol, a fellow at Brown University’s Center for Alcohol and Addiction Studies, and Dr. Justin Feldman, a fellow at Harvard’s François-Xavier Bagnoud Center for Health and Human Rights, wanted to find whether there was any truth to the so-called “gateway” theory: the idea that vaping, for teenagers, is a path toward smoking. The results they found is that e-cigarettes may be an important tool for population-level harm reduction, even considering their impact on youth.
Sokol and Feldman ran a regression analysis of 12th-graders with data culled from the “Monitoring the Future” report, a survey conducted by the National Institute on Drug Abuse (NIDA) that measures different forms of drug use by adolescents nationwide. The researcher’s modeling examined variables including age, race and ethnicity, geographic region of residency, grade point average, alcohol consumption and parents’ educational attainment, among several others. The end goal was to determine whether youth who used vaping products between 2014 and 2018 would have become smokers.
“Our model predicted smoking prevalence quite accurately prior to the availability of e-cigarettes,” Sokol told Filter. “But once e-cigarettes became available in a widespread way, it increasingly overestimated the prevalence [of smoking]. So the prevalence was decreasing, but our model based on a pre-e-cigarette era was predicting a decrease but not as steep. [The youth] who had a low propensity to smoke after e-cigarettes were available were exceedingly unlikely to use e-cigarettes.”
The researchers concluded that the youth who do vape are generally those who would have been smoking were vapes unavailable. “The decline in youth smoking,” Sokol continued, “really accelerated after the availability of e-cigarettes.”
“There are two bits of good news in this,” Clive Bates, a tobacco control expert and former director of Action on Smoking and Health (UK), told Filter. “The first is that young smokers will be diverted into vaping and probably spared a life of smoking. The second is that most of the vaping among kids who never would have been smokers will be pretty transient and likely not persist after a period of experimentation.”
The latest version of Juul pods are superior to there predecessors, according to new research. Juul Labs began marketing in the European Union “new technology” Juul pods that incorporated a new wick that the company claimed provided “more satisfaction.” The wick system, Juul stated, would deliver more consistent voltage and provide a better experience to users.
Credit: Juul Labs
In new study, published in BMJ, the researchers compared design and materials of construction, electrical characteristics, liquid composition and nicotine and carbonyl emissions of new technology Juul pods to their predecessors. The study concluded that the pods were “consistent with manufacturer’s claims, we found that the new pods incorporated a different wicking material. However, we also found that the new pod design resulted in 50 percent greater nicotine emissions per puff than its predecessor, despite exhibiting unchanged liquid composition, device geometry and heating coil resistance.”
The study also found that when connected to the new technology pods, the Juul power unit delivered a more consistent voltage to the heating coil. This suggests that the new coil-wick system resulted in better surface contact between the liquid and the temperature-regulated heating coil. “Total carbonyl emissions did not differ across pod generations,” the report states. “That nicotine yields can be greatly altered with a simple substitution of wick material underscores the fragility of regulatory approaches that center on product design rather than product performance specifications.”
The Taxpayers Protection Alliance (TPA) has released new data on the vaping industry for all 50 U.S. states. TPA analyst Lindsey Stroud says that the analysis includes state specific information on tobacco and vapor product use among adults and youth in all 50 states, as well as Washington D.C. Each state paper examines smoking rates among adults in the respective, youth use of tobacco and vapor products, and the effectiveness of tobacco settlement payments, taxes, and vapor products on reducing combustible cigarette use, according to the report.
Credit: Andy M
One section, Youth Tobacco and Vapor Rates, examines most state level youth vapor and tobacco rates, including identifying ever, current, and daily use. “It also provides an analysis on the reduction of youth combustible cigarette use among the years, which, as identified by this series, is at all time lows,” Stroud states in the report.
In another section, Vapor Product Emergence and Young Adult Smoking Rates, Stroud examines the efficacy of e-cigarettes as a smoking cessation tool and analyzed smoking rates among 18- to 24-year-old adults in the 10 years after suing tobacco companies and compares it to smoking rates in the 10 years after e-cigarettes’ market emergence, which is identified in the period between 2009 and 2012.
“In this 50-state analysis, as well as D.C., 46 states and the District of Columbia, saw greater decreases in smoking rates among young adults in the 10 years after e-cigarette market emergence, compared to the 10 years after tobacco settlement lawsuits,” Stroud states. “In the four outliers, smoking rates only increased among 18- to 24-year-old adults after policymakers increased scrutiny over e-cigarettes due to youth use.”
The TPA is a non-profit non-partisan organization dedicated to educating the public through the research, analysis and dissemination of information on the government’s effects on the economy, according to its website. The analysis concludes with a section on policy implications, graphs of young adult smoking rates and tobacco monies, and a list of references.
The WS-23 cooling agent has limited impact on the experiment animals at the tested dose, according to a study performed by RLX Technology and published in the Journal of Applied Toxicology.
The RLX Technology study showed that there were no deaths in any of WS-23 treated groups in the acute and subacute inhalation studies, with no remarkable changes occurred in body weight, organ weight, hematology and serum biochemistry and no toxic effects in the histopathologic analysis.
It was the first study published on the Science Citation Index (SCI) indexed journal conducted by the Chinese e-cigarette industry.
WS-23 is a well-known artificial synthesis cooling agent widely used in foods, medicines and tobaccos. As a common cooling agent in e-cigarette liquids, WS-23 has led to concerns about the inhalation toxicity with the proliferation of e-cigarettes in recent years. The study shows that at the tested dose level, inhalation of WS-23 will not bring toxic side effect to test animals.
“Product safety has always been RLX’s top concern, and it is also the direction and commitment in our research and development,” said Xingtao Jiang, head of RELX Lab, which is part of RLX Technology, in a statement. Before the study was published, RELX Lab conducted vitro tests to prove the aerosol containing WS-23 is safe to use in the products.
A large majority of Malaysians want the government to regulate the vaping industry more heavily, according to a recent survey. The Malaysian Insights & Perspectives on Vape survey, commissioned by the Malaysian Vape Industry Advocacy (MVIA), showed that 87 percent Malaysians agree that a tax should be imposed on vaping products and 74 percent think that the revenue collected from vape products could be spent by the government on important sectors such as education.
Credit: Peter Nguyen
The survey also revealed that 76 percent of those polled think the country’s economy will benefit from such regulations, according to an article in the Malay Mail. A sample size of 1,025 Malaysian adults were polled and “is reflective of the perception of all Malaysian adults nationwide.” Conducted by Green Zebras, a market research company, the survey was commissioned to get a better understanding of Malaysians’ perception on vaping and its use as a method of tobacco harm reduction, according to the MVIA.
“The opinion poll shows most Malaysians want regulations on vape products. Official reports from the Ministry of Health indicate that there are over one million vapers in Malaysia and yet there are no regulations in place, leaving consumers no choice but to use unregulated products,” said Rizani Zakaria, president of MVIA. “Recent reports from local industry groups have already confirmed that the vape industry has significant potential to contribute to the Malaysian economy with capabilities to create jobs, develop existing businesses and SMEs within the industry, and attract investments. This is a fact that cannot be ignored, and the government must act quickly to introduce regulations on vape products.”
