After an average follow-up of 13 years and five months, the risk of lung cancer among quitters fell 42%, with smaller falls of 27%, 20% and 14% recorded for liver, colorectal and stomach cancers respectively, compared with those who continued smoking. Details were published in Jama Network Open [Note: See below]... According to the study, smokers who quit before the age of 50 had their risk of lung cancer fall 57% over the follow-up period compared with those who continued to puff. Those who quit at 50 or older experienced a 40% reduction in lung cancer risk over that time." [Ian Sample. Quitting smoking reduces cancer risk at any age, says study, The Guardian]

 

“A top Biden administration health official is urging allies outside the government to lobby the White House to ban menthol cigarettes nationwide, fearing that President Joe Biden may abandon the proposal to avoid backlash from Black voters. Robert Califf, the commissioner of the Food and Drug Administration, has privately asked friends and public health experts to press their White House contacts over the status of the long delayed policy… He has voiced concerns that White House support for the ban is waning amid warnings that outlawing a product popular with Black smokers could dent enthusiasm for Biden’s reelection in the minority communities that are core to the president’s base. Califf’s behind-the-scenes encouragement… illustrates the extraordinary lengths that the FDA chief has gone in pursuit of a landmark tobacco policy he considers a top agency priority.” [Adam Cancryn, David Lim. A top official fears Biden might let politics interfere with public health, Politico]

 

“[Senate Majority Leader Chuck Schumer (D-NY) has] called on the Federal Trade Commission to investigate [nicotine pouch Zyn's] marketing, and for the Food and Drug Administration to look into ZYN’s health effects. He described the product as a “pouch packed with problems.” “I am delivering a warning to parents because these pouches seem to lock their sights on young kids, teenagers and even lower—and then use the social media to hook ’em"... Instead of encouraging people to quit tobacco products, critics worry that ZYN is a gateway to harmful cigarettes and vapes. A 2023 study found that 1.5 percent of middle high school students had used nicotine pouches in the past 30 days...

 

“As for the “ZYNsurrection,” anti-tobacco leader Sen. Richard Blumenthal (D-CT) told The Daily Beast he just doesn’t get it. “I’m not sure of the motivation,” Blumenthal said. “I sued the big tobacco companies. I’ve had to take action against vaping. Nicotine is a really powerfully addictive drug, and once kids are addicted, the door is open to other even more harmful products.” [Riley Rogerson. ‘Come and Take It’: Congress’ War Over ZYN Nicotine Pouches, Daily Beast]

 

Ten million fewer cigarettes will be smoked each day by 2040 under the government’s new generational smoking ban, new analysis shows. Historic legislation will be put before MPs this week, making it illegal to ever sell tobacco to those born after January 1, 2009, who are presently aged 15 and under. The ban will mean that by 2040, nobody under the age of 31 will have ever been able to smoke legally in the UK. Modelling by Cancer Research UK has examined the impact of banning this generation of young adults from ever taking up smoking.” [Eleanor Hayward. Smoking ban: 10 million fewer cigarettes will be smoked each day by 2040, The Times]

 

"Of course, the [UK] legislation could go further – reducing affordability is another form of regulation that we have seen work with other harmful products… However, what is important is that we recognise the opportunity the legislation proposal is giving us: a unique chance to change the nation’s health by preventing thousands of deaths and cases of disease. But over the coming weeks and months, there will be significant pressure from the tobacco industry on MPs to vote against the legislation. After all, their business relies on encouraging children to buy an addictive product so that they continue to make a profit… [thus] we must keep the facts at the forefront of the conversation so that when MPs are called to vote, they can do so with all the information to hand and make a balanced decision on behalf of their constituents." [Greg Fell. Big Tobacco will try its hardest to prevent the ban on disposable vapes and the reduction of the legal smoking age, New Statesman; See below: New tobacco and vaping legislation will go a long way to protect children’s health, BMJ; See also: How bad is vaping for your health? We’re finally getting answers, New Scientist]

 

"In this population-based cohort study of more than 2 million participants, the cancer risk showed a slightly higher value for 10 years after quitting compared with continued smoking, and then gradually decreased, reaching 50% of the risk associated with continued smoking after 15 years or more. Lung cancer risk decreased 3 years earlier than that of other cancer types, with a larger relative reduction. Meaning  These findings suggest that sustained smoking cessation is associated with reduced risk of cancer, especially lung cancer, after 10 years since quitting smoking."

 

Cancer Risk Following Smoking Cessation in Korea

JAMA Netw Open. 2024;7(2):e2354958.

February 6, 2024

Eunjung Park, Hee-Yeon Kang, Min Kyung Lim, Byungmi Kim, Jin-Kyoung Oh

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2814567

 

Note: Open Access.

 

Related Coverage:

 

Ian Sample. Quitting smoking reduces cancer risk at any age, says study

https://www.theguardian.com/society/2024/feb/06/quitting-smoking-reduces-cancer-risk-at-any-age-says-study

 

“Tobacco companies created separate divisions to develop and roll out these products, and the majority developed medical research programmes to steer these [pharmaceutical-like] products through regulatory agencies, seeking certification as reduced-harm or pharmaceutical products. These products were regarded as key to the survival of the tobacco industry in an unfriendly political and social climate. Conclusions: Pharmaceuticalisation was pursued to perpetuate the profitability of tobacco and nicotine for tobacco companies, not as a sincere search to mitigate the harms of smoking in society.”

 

Pharmaceuticalisation as the tobacco industry's endgame

BMJ Glob Health. 2024 Feb 5;9(2):e013866.

Yogi Hale Hendlin, Elieen Le Han, Pamela M Ling

https://gh.bmj.com/content/9/2/e013866.long

https://gh.bmj.com/content/bmjgh/9/2/e013866.full.pdf

 

Note: Open Access.

 

"Ultimately, informed public health policies and regulations should be grounded in evidence-based research, striking a delicate balance between supporting adult smokers in reducing harm and protecting non-smokers and youth from potential risks... In conclusion, the safety of e-cigarettes is a complex and multifaceted issue that requires ongoing investigation and careful consideration of various factors. By addressing the limitations identified and continuing to conduct rigorous research, we can advance our understanding of e-cigarettes' safety profile and make more informed decisions to protect public health."

 

Comparative systematic review on the safety of e-cigarettes and conventional cigarettes

Food and Chemical Toxicology

Volume 185, March 2024, 114507

Available online 6 February 2024, Version of Record 9 February 2024.

Josef Yayan, Karl-Josef Franke Christian Biancosino, Kurt Rasche

https://www.sciencedirect.com/science/article/pii/S0278691524000735

 

Note: Open Access.

 

Related coverage:

 

How dangerous IS vaping compared with smoking? New review analyzes the dangers of both.... and finds former is linked to EIGHT lung diseases

https://www.dailymail.co.uk/health/article-13057345/vaping-dangerous-cigarettes-report-dangers-lung-disease.html

 

“The UK government recently announced proposed legislation intended to prevent millions of children ever starting to smoke, while applying new restrictions on the availability and appeal of vapes to limit their use by young people and people who do not smoke… These measures are not intended to be a “silver bullet” that eliminates tobacco use altogether or entirely stops young people from vaping, but they will make UK tobacco control much stronger. There are obstacles to overcome before legislation can be passed and implemented. The biggest of these is attempts from tobacco industry lobbyists to stop, delay, and dilute legislation… The proposed legislation is ambitious and the most important in a generation for UK tobacco control. If successful, it will go a very long way to improving the health of our children for decades to come.”

 

Opinion

New tobacco and vaping legislation will go a long way to protect children’s health

BMJ 2024;384:q381 (Published 14 February 2024)

Sanjay Agrawal

https://www.bmj.com/content/384/bmj.q381

https://www.bmj.com/content/bmj/384/bmj.q381.full.pdf

 

Note: Open Access.

 

“Stricter regulations, including enforcing sales restrictions, and appropriate health-promoting campaigns are needed to prevent vaping by young people, but these measures must be balanced with the health needs of older adults who smoke and require support to quit. There is understandable scepticism about the motives of the tobacco industry in selling smoke-free products while continuing to expand tobacco markets in low-income and middle-income countries. To remain profitable, the tobacco industry will eventually need to migrate its global business to less harmful alternatives since cigarettes will no longer monopolise the delivery of nicotine.”

 

Harnessing tobacco harm reduction

The Lancet

COMMENT| VOLUME 403, ISSUE 10426, P512-514, FEBRUARY 10, 2024

Published: February 01, 2024

Robert Beaglehole, Ruth Bonita

 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)00140-5/fulltext

 

 

People who vape suffer similar changes to their DNA as smokers who develop cancer, researchers have revealed.

Scientists at University College London analysed samples of cheek cells from vape users and compared these with those from cigarette smokers. Both groups had similar changes to the DNA of cells in their mouth.

These changes were, in turn, linked to the future development of lung cancer in smokers.

• Health minister begs husband to stop vaping during live interview

The authors of the study, published in the journal Cancer Research, said the findings did not prove e-cigarettes cause cancer but show that “the devices might not be as harmless as originally thought”.

It is the first major study to draw a link between e-cigarettes and an increased risk of cancer.

Little is known about the long-term effects of e-cigarettes, and debates over their harm have so far mainly focused on concerns about nicotine addiction among the young. On Wednesday MPs will be presented with world-leading legislation restricting the flavours and promotions of vapes, as well as banning smoking for younger generations altogether.

Rishi Sunak said that the bill would “save thousands of lives and billions of pounds for our NHS” and that he was confident of staving off a party rebellion. Some MPs on the Tory right, led by Liz Truss, have criticised the smoking ban for those born after January 1, 2009, as curtailing individual freedom, but all of the UK’s present and former chief medical officers, including Professor Sir Chris Whitty, have taken issue with this argument.

Little is known about long-term side eff­ects of vaping, which is a relatively new phenomenon

TIMES PHOTOGRAPHER RICHARD POHLE

Writing for The Times, they said: “To be pro-individual choice should mean being against the deliberate addiction of children, young people and young adults to something that will harm them, potentially fatally.”

They urged MPs to back the legislation to help end the “flagrant marketing of vapes to children using colours, flavours and packaging”. They added: “Vapes can help smokers quit. But if you don’t smoke, our advice is don’t vape.”

A recent investigation by The Times revealed how the promotion of e-cigarettes by the government and NHS as a tool to stop smoking led to an epidemic of youth vaping, as organisations linked to the tobacco industry played down e-cigarettes’ health risks.

Because vaping is relatively new, ­little is known about long-term side eff­ects. UCL’s study is the first to examine how smoking and vaping can modify the DNA in cells, in a process known as epigenetics. These changes are thought to allow cells to divide more quickly, potentially growing into tumours.

The study involved data from 4,000 people, and looked at cell samples from hundreds of smokers, as well as vapers who don’t regularly use tobacco. This showed that cells in the mouth, which are exposed to tobacco and vape smoke, were “substantially” altered. The changes were also seen in the lung cancer tissue of smokers who developed cancer.

The study’s author, Dr Chiara Herzog, said: “While the scientific consensus is that e-cigarettes are safer than smoking tobacco, we cannot assume they are completely safe to use and it is important to explore their potential long-term risks and links to cancer. We hope this study may help form part of a wider discussion into e-cigarette usage, ­especially in people who have never previously smoked tobacco.”

Her co-author, Professor Martin Widschwendter, said: “Changes that are observed in lung cancer tissue can also be measured in cheek cells from smokers who have not [yet] developed a cancer. Importantly, our research points to the fact that e-cigarette users exhibit the same changes, and these ­devices might not be as harmless as originally thought. Long-term studies of e-cigarettes are needed.”

The study examined the effects on cells by studying a type of epigenetic change in cells called DNA methylation. Epigenetics is the term for factors, such as our environment and lifestyle, that can modify and determine how our DNA is expressed, such as by suppressing genes that stop cells dividing into tumours.

Dr Ian Walker, executive director of policy at Cancer Research UK, said: “This study contributes to our understanding of e-cigarettes, but it does not show that e-cigarettes cause cancer.

“Decades of research has proven the link between smoking and cancer, and studies have so far shown that e-cigarettes are far less harmful than smoking and can help people quit.

“This paper does, however, highlight that e-cigarettes are not risk-free, and so we need additional studies to uncover their potential longer-term impacts on human health.

“Smoking tobacco causes 150 cases of cancer every single day in the UK, which is why we look forward to seeing the government’s age of sale legislation being presented in parliament. Nothing would have a bigger impact on reducing the number of preventable deaths in the UK than ending smoking, and this policy will take us one step closer to a smoke-free future.”

Andrew Beggs, a professor of cancer genetics and surgery at the University of Birmingham, said: “Although it doesn’t show a direct causal effect, this study shows that further research must be done to understand the effects of e-cigarettes on human health and ­whether they could be linked to an increased risk of cancer.”

Behind the story

Few countries have embraced vaping as enthusiastically as Britain, where e-cigarettes have become ubiquitous in high streets, parks and schools across the country (Billy Kenber, Senior Investigations Reporter, writes).

While other nations adopted a precautionary approach in the absence of long-term health data, public health bodies in the UK were early and vocal supporters of the use of e-cigarettes by smokers, declaring them 95 per cent safer than smoking.

The stance, which extended to handing out free vapes to smokers and allowing vape shops to open in hospitals, was spearheaded by academics specialising in addiction who viewed e-cigarettes as a potentially invaluable tool in the battle to persuade smokers to quit the habit.

They saw it as a continuation of the UK’s ‘harm reduction’ approach of offering safer alternatives like nicotine replacement therapy to people unable to give up.

But critics claim this narrow focus on existing smokers meant insufficient consideration was given to the risks to the wider public from non-smokers, including children, taking up vaping.

E-cigarettes were invented by a Chinese pharmacist in 2003 and were initially of niche interest to small numbers of smokers.

But as they grew in popularity, tobacco giants began to buy up existing brands and launch their own e-cigarettes as they sought to take over the market.

The UK’s pro-vaping stance has made it something of a global outlier, with many other countries choosing to restrict vapes to prescription-only, prohibit certain flavours or ban e-cigarette sales altogether.

It retained this approach for years even as public health experts and paediatricians warned that the promotion of vapes was normalising e-cigarettes for non-smokers and risked creating a generation of nicotine-addicted youth vapers, a Times investigation has previously revealed.

An academic article published in 2018 accused Public Health England of “complacency” as “thousands of children become nicotine addicted through vaping” amid the rising popularity of cheap, brightly coloured vapes pioneered in the United States by Juul. It warned of the unknown health consequences of e-cigarettes and the possibility of an “epidemic of devastating lung disease for today’s children”.

Meanwhile, international organisations such as the World Health Organisation continued to question the scientific evidence around e-cigarettes and warned that they were harmful to health.

 

By 2023, more than one in five children under 18 in the UK had tried an e-cigarette, a 30 per cent increase in a year.

The UK’s pro-vaping approach made it a target for those wishing to promote the use of e-cigarettes around the world.

A Times investigation in December exposed ties between tobacco companies and a secretive lobbying campaign to boost e-cigarette sales and block health measures aimed at protecting children.

Cigarette manufacturers fostered links to doctors, scientists and activists who have promoted the use of e-cigarettes and lobbied against efforts to impose tighter regulations on vapes.

This has included funding scientific papers which have played down the risks of children vaping and helping to run a supposedly ‘grassroots’ campaign which presented itself as the voice of ordinary vapers and tried to influence policy decisions.

Hundreds of British doctors attended smoking cessation training sessions which included advice on the use of e-cigarettes and nicotine replacement therapies by smokers looking to quit. They were run by an NHS doctor who has received millions in funding from a foundation which was solely-funded by a tobacco giant.

Lobbying efforts continued amid a government consultation on how to tackle youth vaping.

In January, Rishi Sunak made his decision, electing to bring in new restrictions on flavours and packaging and pledging to ban disposable vapes.

“We’ve got a generation of nicotine addicted kids,” Martin McKee, a professor of European public health at the London School of Hygiene and Tropical Medicine, has said. “Hopefully, many of them will come off it but it won’t be all.”

 

 

COMMENT

Why MPs must back vape controls

Professor Sir Chris Whitty and all other chief, deputy and former chief medical officers

Millions of smokers want to quit but cannot due to an addiction to nicotine. It is an addiction they know could well kill them but is now trapping them. More than 80 per cent of smokers start before the age of 20, many as children, after persistent marketing.

To be pro-individual choice should mean being against deliberate addiction of children, young people and young adults to something that will harm them, potentially fatally.

Over the life course, addiction to smoking damages individuals, families and society. From stillbirth in pregnant women through asthma in children due to passive smoking, heart disease, stroke, lung disease, diabetes and 15 different types of cancer to dementia, smoking blights lives.

Smoking remains Britain’s biggest preventable killer, resulting in about 80,000 deaths a year, and is a major driver of socioeconomic and geographic inequalities. Passive smoking of second-hand smoke, including by children, damages health for life. The NHS carries the burden of trying to undo some of the damage smoking causes.

Parliament is about to debate a bill which will, if passed, produce enormous public health benefit and, we hope, lead to a smoke-free generation.

At the same time, it will help to ensure the flagrant marketing of vapes to children using colours, flavours and packaging is reduced. The overwhelming majority of doctors, nurses and other healthcare workers, who have seen the misery nicotine addiction causes, will support this bill.

Vapes can help smokers quit. But if you don’t smoke, our advice is don’t vape — and marketing of vapes to children is utterly unacceptable.

We strongly encourage MPs and peers from all four nations and all political parties to support a smoke-free generation and restrictions of marketing of vapes to children.

Signed:
Current Chief Medical Officers
Professor Sir Chris Whitty, Chief Medical Officer for England
Professor Sir Michael McBride, Chief Medical Officer for Northern Ireland
Professor Sir Gregor Smith, Chief Medical Officer for Scotland
Professor Sir Frank Atherton, Chief Medical Officer for Wales

Former Chief Medical Officers
Professor Dame Sally Davies, Former Chief Medical Officer for England
Professor Sir Liam Donaldson, Former Chief Medical Officer for England
Professor Sir Kenneth Calman, Former Chief Medical Officer for England and Scotland.
Dr Henrietta Campbell, Former Chief Medical Officer for Northern Ireland
Dr James McKenna, Former Chief Medical Officer for Northern Ireland
Professor Catherine Calderwood, Former Chief Medical Officer for Scotland
Professor Aileen Keel, Former Chief Medical Officer for Scotland
Professor Sir Harry Burns, Former Chief Medical Officer for Scotland
Dr Ernest Macalpine Armstrong, Former Chief Medical Officer for Scotland
Sir David Carter, Former Chief Medical Officer for Scotland
Dr Ruth Hussey, Former Chief Medical Officer for Wales
Dr Tony Jewell, Former Chief Medical Officer for Wales
Dr Ruth Hall, Former Chief Medical Officer for Wales
Dame Deirdre Hine, Former Chief Medical Officer for Wales
Current Deputy Chief Medical Officers
Professor Thomas Waite, Deputy Chief Medical Officer for England
Dr Jeanelle DeGruchy, Deputy Chief Medical Officer for England
Dr Aidan Fowler, Deputy Chief Medical Officer for England
Professor Lourda Geoghegan, Deputy Chief Medical Officer for Northern Ireland
Dr Naresh Chada, Deputy Chief Medical Officer for Northern Ireland
Professor Marion Bain, Deputy Chief Medical Officer for Scotland
Professor Nicola Steedman, Deputy Chief Medical Officer for Scotland
Professor Graham Ellis, Deputy Chief Medical Officer for Scotland
Professor Chris Jones, Deputy Chief Medical Officer for Wales.

https://www.thetimes.co.uk/article/vaping-cancer-smoking-damage-study-xwtv32fl9

 

Cigarette smoking and e-cigarette use induce shared DNA methylation changes linked to carcinogenesis

Cancer Res. 2024 Mar 19. Online ahead of print.

Chiara Herzog, Allison Jones, Iona Evans, Janhavi R Raut, Michal Zikan, David Cibula, Andrew Wong, Hermann Brenner, Rebecca C Richmond, Martin Widschwendter

 

Abstract

 

Tobacco use is a major modifiable risk factor for adverse health outcomes, including cancer, and elicits profound epigenetic changes thought to be associated with long-term cancer risk. While electronic cigarettes (e-cigarettes) have been advocated as harm reduction alternatives to tobacco products, recent studies have revealed potential detrimental effects, highlighting the urgent need for further research into the molecular and health impacts of e-cigarettes. Here, we applied computational deconvolution methods to dissect the cell- and tissue-specific epigenetic effects of tobacco or e-cigarette use on DNA methylation (DNAme) in over 3,500 buccal/saliva, cervical, or blood samples, spanning epithelial and immune cells at directly and indirectly exposed sites. The 535 identified smoking-related DNAme loci (CpGs) clustered into four functional groups, including detoxification or growth signaling, based on cell type and anatomical site. Loci hypermethylated in buccal epithelial cells of smokers associated with NOTCH1/RUNX3/growth factor receptor signaling also exhibited elevated methylation in cancer tissue and progressing lung carcinoma in situ lesions, and hypermethylation of these sites predicted lung cancer development in buccal samples collected from smokers up to 22 years prior to diagnosis, suggesting a potential role in driving carcinogenesis. Alarmingly, these CpGs were also hypermethylated in e-cigarette users with a limited smoking history. This study sheds light on the cell type-specific changes to the epigenetic landscape induced by smoking-related products.

 

https://aacrjournals.org/cancerres/article/doi/10.1158/0008-5472.CAN-23-2957/741851/Cigarette-smoking-and-e-cigarette-use-induce

 

Note: Open Access. A PDF of the Times article with graphics and current poll results is available upon request.

 

 

 

“Atlantic City casino workers have tried unsuccessfully for years to persuade New Jersey lawmakers to outlaw smoking on gambling floors. [Last] Friday morning, they took their efforts to court. In a lawsuit filed in State Superior Court in Mercer County, groups representing thousands of casino employees accused state legislators of giving special treatment to casino owners by allowing them to let people smoke inside their facilities. The state has allowed casinos to “knowingly force employees to work in toxic conditions,” the workers argued in court documents, and as a result, casino workers have experienced “life-threatening illness and death.”” [Erin Nolan. You Can Still Smoke in Atlantic City Casinos. Workers Want to Ban It, New York Times. Ed. Note: See below for two SHS papers by James Repace.]

 

“The American College of Cardiology has some bad news for e-cigarette users after a new study found that those who vape are 19% more likely to develop heart failure compared to their non-vaping counterparts. Researchers used data from a National Institutes of Health (NIH) study, including surveys and electronic health records, to assess potential correlations between heart failure diagnoses and e-cigarette use in over 175,000 patients… Marketing campaigns for vaping have appealed to younger audiences in recent years, touting flavors like cotton candy, marshmallow and bubble gum to entice potential buyers, similar to decades-long advertisements. Over the years, though, advertisements for traditional cigarettes have dwindled as experts have increasingly sounded the alarm over their potential side effects.” [Taylor Penley. Smoking cigarettes can destroy lungs, but shocking new study reveals why vaping can harm the heart, Fox News. See also: Study Links E-Cigarette Use with Higher Risk of Heart Failure, American College of Cardiology]

 

“A Go Smoke Free spokesman said: …“The new disposable vape ban should help to discourage children from taking up vaping, while encouraging adults to shift to more sustainable alternatives, such as refillable vapes.”… Ministers are seeking to draw up measures which will stop children from taking up the habit, while ensuring that they do not deter the use of e-cigarettes as a route to quit smoking… A Cancer Research UK study found that between January 2021 to August 2023, the prevalence of disposable e-cigarette use grew from 0.1 per cent to 4.9 per cent of the adult population. The proportion of those aged 18 to 24 using disposable vapes was significantly higher at 14.4 per cent, including 7.1 per cent who did not have a history of smoking tobacco.” [Alex Barton. The town named the vape shop capital of the UK, The Telegraph]

 

“A leading medical information company has been urged to cancel a series of new education courses on smoking cessation funded by the tobacco industry giant Philip Morris International (PMI). Physicians and academics have rounded on Medscape for partnering with PMI on five courses launched in the past few months, and they have called for stricter oversight by certification bodies. Anna Gilmore, professor of public health and director of the Tobacco Control Research Group at the University of Bath, UK, said that Medscape had “now lost all credibility and has some serious questions to answer. PMI lost all credibility decades ago, despite its ceaseless and highly misleading attempts to rehabilitate its image. It has now sunk to a new low.” Medscape has temporarily taken down some of the courses while it carries out a review, but it told The BMJ that it had so far “found no evidence of deviation from Medscape’s strict quality and integrity standards.”…

 

““The support for the use of smokeless tobacco products and e-cigarettes in the content aligns with the corporate objectives of Philip Morris International,” [Pamela Ling, director of the Center for Tobacco Control Research and Education at the University of California San Francisco] said. “The tobacco industry has an exceedingly well documented history of denying and distorting scientific evidence, and it has no place in medical education… Robert Jackler, Sewall professor emeritus at the Stanford University School of Medicine in California, said, “I’ve been a physician for over 40 years. I don’t ever remember the tobacco industry sponsoring . . . certified physician education.”… He highlighted a slide of the courses that stated, “The health goal for all smokers should be smoke free, not tobacco/nicotine abstinent.” Jackler commented, “Only purveyors of tobacco products would make such a ridiculous assertion. The health goal is not switching to another PMI product line but rather to break nicotine addiction and thus halt all use of tobacco products.””

 

BMJ Investigation

Exclusive: Outcry as Philip Morris International funds smoking cessation courses on Medscape

BMJ 2024;385:q830 (Published 09 April 2024)

Hristio Boytchev

https://www.bmj.com/content/385/bmj.q830

https://www.bmj.com/content/bmj/385/bmj.q830.full.pdf

 

Note: Open Access.

 

“To date, 66 countries have implemented what are considered best-practice TAPS [tobacco advertising, promotion and sponsorship] bans, protecting almost 2 billion people and, according to Andrew Black, team leader for development assistance at the WHO FCTC Secretariat, they have significantly decreased smoking uptake and prevalence, particularly among young people. Unfortunately, as digital media content and the platforms designed to support their dissemination have continued to evolve, tobacco companies and other nicotine purveyors have found ways to get round the bans, notably by using social media platforms.

 

““Many of the bigger social media platforms and search engines have banned direct promotion, but tobacco companies have just slipped below the surface,” says [University of Sydney Professor Becky] Freeman. “For example, they might use Facebook web pages featuring ‘lifestyle’ content that seeks to normalize tobacco and nicotine consumption by depicting young people smoking or vaping.”… For Freeman, regulatory tightening cannot come too soon. “There has been this narrative that nothing can be done,” she says. “But there is a lot that government can do, as we have shown in Australia.””

 

Editorial

Countering the influence of tobacco

Bull World Health Organ. 2024 Apr 1; 102(4): 230–231.

Published online 2024 Apr 1.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976864/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10976864/pdf/BLT.24.020424.pdf

 

Note: Open Access.

 

“The study was a cross-sectional descriptive analysis of tobacco expenditure from the Smoking Toolkit Study (STS) matched to income and smoking prevalence data for English local authorities… The total dividend in England is estimated to be £10.9 billion each year, which equates to £1776 per person who smokes or £246 per adult regardless of smoking status… Conclusions This study has estimated that local economies could gain a substantial dividend if everybody stopped smoking, which is larger in lower income areas, meaning that geographical economic inequalities could be reduced… Conclusions: This study has estimated that local economies could gain a substantial dividend if everybody stopped smoking, which is larger in lower income areas, meaning that geographical economic inequalities could be reduced.”

 

Potential smoke-free dividend across local areas in England: a cross-sectional analysis

Tobacco Control Published Online First: 20 March 2024.

Damon Morris, Duncan Gillespie, Martin J Dockrell, Mark Cook, Marie Horton, Jamie Brown, Tessa Elisabeth Langley

https://tobaccocontrol.bmj.com/content/early/2024/02/05/tc-2023-058264

https://tobaccocontrol.bmj.com/content/tobaccocontrol/early/2024/02/05/tc-2023-058264.full.pdf

 

Also:

 

Industry Watch: Marlboro Man goes artisanal?

https://tobaccocontrol.bmj.com/content/early/2024/04/02/tc-2024-058645

https://tobaccocontrol.bmj.com/content/tobaccocontrol/early/2024/04/02/tc-2024-058645.full.pdf

Across the world availability of flavour accessories for tobacco products

https://tobaccocontrol.bmj.com/content/early/2024/04/05/tc-2023-058255

https://tobaccocontrol.bmj.com/content/tobaccocontrol/early/2024/04/05/tc-2023-058255.full.pdf

 

Note: Open Access.

 

Related coverage:

 

Quitting smoking could redirect £11bn a year into local economies, study says

https://www.theguardian.com/society/2024/apr/08/quitting-smoking-could-redirect-11bn-a-year-into-local-economies-study-says

 

“This study investigates the health problems reported by 162 nonsmoking residents residing in 104 multiunit apartments in 71 municipalities in 19 U.S. States and the District of Columbia, plus 2 Canadian Provinces… Nonsmokers complained of eye, nose, throat, and lung irritation, headache, dizziness, nausea, difficulty in breathing, tachycardia, and asthmatic attacks as well as malodors. Many sought medical care and some were hospitalized. Some regarded their apartments as uninhabitable. About 12% resorted to litigation… Conclusions: Secondhand smoke infiltration from smokers’ apartments into nonsmokers’ apartment units in multiunit housing can provoke major morbidity for nonsmoking residents. Nonsmokers’ efforts to eliminate infiltration by sealing of cracks, air cleaning, or increased ventilation proved futile. Building owners and managers need to be educated about protecting nonsmoking residents’ health and welfare from secondhand smoke infiltration. Smoking of tobacco and marijuana products in multiunit housing should be banned.”

 

Secondhand smoke Infiltration in multiunit housing: Health effects and nicotine levels

Indoor Environments

Volume 1, Issue 2, June 2024, 100013

Available online 26 March 2024, Version of Record 3 April 2024.

James L. Repace

https://www.sciencedirect.com/science/article/pii/S2950362024000109

 

Note: Open Access.

 

“Ms. PJM’s modeled exposure to fine particulate matter from secondhand smoke ranged from the Hazardous to Significant Harm Levels of the EPA Air Quality Index for fine particles (PM2.5). Her modeled dose of serum cotinine ranged from the 90th to beyond the 95th percentile of nonsmokers’ dose, measured in a statistical sample of the U.S. nonsmoking population. Her estimated risk exceeds OSHA’s Significant Risk of Material Impairment of Health Level by a factor of three. She is estimated to have been exposed to the thirdhand smoke of at least 1.4 million cigarettes outgassing from room surfaces during her 20 years of labor… Conclusions: As a result of her occupational exposure to secondhand and thirdhand smoke, Ms. PJM [who had been employed as a motel maid cleaning rooms for 20 years] lost an estimated 33 years of life expectancy. The State of California has been remiss in failing to extend its workplace smoking ban to hotels and motels, leaving their workstaff at grave risk of the manifold diseases of passive smoking.”

 

Case Report

Forensic Analysis of Lung Cancer from Secondhand Smoke Exposure of a Motel Worker

European Society of Medicine

Vol 12 No 3 (2024): March issue, Vol.12, Issue 3

Published Mar 26, 2024

James L. Repace

https://esmed.org/MRA/mra/article/view/5120

https://esmed.org/MRA/mra/article/view/5120/99193547825

 

Note: Open Access.

 

“The study subjects were patients aged ≥20 years undergoing surgery from December 2021 to September 2022 who completed spirometry and reported tobacco (cigarette and HTP [heated tobacco product]) use status during the preoperative assessment… Conclusion: Current HTP use was associated with airway obstruction among patients with cancer who had completely switched from cigarettes even after quitting smoking for a long period. Patients should be routinely screened for HTP use and advised to quit any tobacco.”

 

Association between heated tobacco product use and airway obstruction: a single-centre observational study, Japan

BMJ Open Respir Res. 2024 Mar 9;11(1):e001793.

Satomi Odani, Shihoko Koyama, Isao Miyashiro, Hironobu Tanigami, Yoshifumi Ohashi, Takahiro Tabuchi

https://bmjopenrespres.bmj.com/content/11/1/e001793.long

https://bmjopenrespres.bmj.com/content/bmjresp/11/1/e001793.full.pdf

 

Note: Open Access.