Rassegna Stampa Scientifica Marzo 2023
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“Most experts agree that vaping carries far lower health risks than smoking, says Ann McNeill, professor of tobacco addiction at King’s College London. “Nicotine is an addictive substance but not the one that kills,” she says. But nuance is important: “If you’ve got something very dangerous and something much less dangerous, it doesn’t mean it’s harmless.”… The rise of the disposable vape has been meteoric. In 2021, just 7.7% of teenage vapers used them; by 2022, this figure had jumped to 52%... McNeill acknowledges that “disposables seem to be more attractive to the younger audience”. “I think that is something we need to look at – if we are seeing ‘never smokers’ taking up disposables, we need to make sure we’re enforcing the law so that these products can’t be sold quite so readily as they clearly are at the moment.”” [Clea Skopeliti. ‘Beside himself with craving’: the teenagers hooked on vaping, The Guardian]
“Sydney councils are looking at updating their “no smoking” signs to explicitly mention e-cigarettes after concerns that vapers do not know that the prohibitions apply to them too. A legislative amendment in 2018 expanded all NSW [New South Wales] non-smoking legislation – such as rules banning the use of cigarettes in indoor public areas, cars and outdoor dining areas – to include the smoking of e-cigarettes… The number of people who smoke cigarettes in NSW has dropped to record levels, although vaping is increasingly popular. The latest NSW Population Health Survey showed the number of people aged 16 to 24 who were current vape users more than doubled to 11 per cent in 2021.” [Mary Ward. Why vapers don’t know they are also banned from non-smoking areas, Sydney Morning Herald]
“This Black History Month [in February], I have a simple message for nonprofit organizations in the United States: If you have accepted money from the tobacco industry, send it back. For hundreds of years, from enslaved people working on tobacco plantations to today’s menthol smokers, Black people have died for the tobacco industry’s profit. Today, the makers of Marlboro, Camel and Newport are using cash donations to polish their images and influence policy while approximately 45,000 Black Americans die of smoking-related illness every year… Tobacco’s shameful chapter in that story [through the lens of African American history and culture] is forever connected to the slave trade and tobacco plantations, where forced labor formed part of the foundations of the United States — and what is now a global tobacco industry.” [Phillip Gardiner. Black history has taught us that Big Tobacco is not an ally, Washington Post]
“In their articles critiquing the US Food and Drugs Administration’s (FDA) first marketing order to allow the legal marketing of any e-cigarette, for Vuse Solo tobacco-flavoured e-cigarettes, Glantz and Lempert and Meshnick et al discuss a range of serious procedural, technical and substantive problems with FDA’s publicly released explanation of how its evaluation of the Vuse application supports that order as appropriate for the protection of the public health. …Glantz and Lempert and Meshnick et al reasonably conclude that FDA should withdraw its order allowing the marketing of the Vuse Solo e-cigarettes because the agency did not adequately evaluate the Vuse Solo application, did not establish that allowing its marketing was ‘appropriate for the protection of the public health’, and did not structure its final pre-market tobacco product application (PMTA) order to avoid increases in youth product use or unnecessary new health harms and risks.”
Commentary
How might FDA fix this e-cigarette PMTA mess? Commentary on Glantz and Lempert and Meshnick et al
Tobacco Control Published Online First: 09 February 2023.
Eric N Lindblom
https://tobaccocontrol.bmj.com/content/early/2023/02/09/tc-2022-057872
Note: Open Access.
Referenced Tob Control studies:
Vuse Solo e-cigarettes do not provide net benefits to public health: a scientific analysis of FDA’s marketing authorisation
https://tobaccocontrol.bmj.com/content/early/2023/02/09/tc-2022-057296
Analysis of FDA’s Vuse market authorisation: limitations and opportunities
https://tobaccocontrol.bmj.com/content/early/2023/02/15/tc-2022-057540
Also:
Rapid-response surveillance of the first US test market for VLN cigarettes
https://tobaccocontrol.bmj.com/content/early/2023/03/15/tc-2022-057888
Industry marketing of tobacco products on social media: case study of Philip Morris International’s IQOS
https://tobaccocontrol.bmj.com/content/early/2023/03/15/tc-2022-057833
JUUL and its ‘Action Network’ attempt to prevent a local flavour ban
https://tobaccocontrol.bmj.com/content/early/2023/02/22/tc-2022-057869
Multistate transition modelling of e-cigarette use and cigarette smoking among youth in the UK
https://tobaccocontrol.bmj.com/content/early/2023/03/09/tc-2022-057777
Note: UK Multistate paper Open Access.
“In this study comprising 2 surveys conducted among 2469 youths (aged 11-18 years) and 12 046 adults (aged ≥18 years) from Great Britain, youths had higher odds of reporting no interest in trying e-cigarettes in standardized green packaging than e-cigarettes in branded packaging, but adults had lower odds of reporting no interest in trying e-cigarettes in standardized green packaging than e-cigarettes in branded packaging.”
Association of Fully Branded and Standardized e-Cigarette Packaging With Interest in Trying Products Among Youths and Adults in Great Britain
JAMA Netw Open. 2023;6(3):e231799.
March 14, 2023
Eve Taylor, Deborah Arnott, Hazel Cheeseman, David Hammond, Jessica L. Reid, Ann McNeill, Pete Driezen, Katherine East
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2802391
Note: Open Access.
Related coverage:
Putting vapes in plain packaging ‘reduces their appeal to children’
https://www.independent.co.uk/news/uk/research-chris-whitty-tiktok-ash-government-b2300708.html
"Vaping of most newer-generation e-cigarettes results in the delivery of nicotine to the lungs in a manner similar to that of cigarettes. These e-cigarettes pose a risk of nicotine addiction for some young people, but for adults already addicted to cigarettes — the single deadliest consumer product ever invented — they also serve as an important, less-hazardous alternative to continued smoking. Considerable evidence indicates that e-cigarettes help some adults to quit smoking."
Nicotine e-cigarettes as a tool for smoking cessation
Nature Medicine (2023)
Published: 13 February 2023
Kenneth E. Warner, Neal L. Benowitz, Ann McNeill & Nancy A. Rigotti
https://www.nature.com/articles/s41591-022-02201-7
Ed. Note: No footnote provided to support the claim of "Considerable evidence".
“The Statement [by Australia's National Health and Medical Research Council (NHMRC) on e-cigarettes] exaggerates the risks of vaping and fails to compare them to smoking; incorrectly claims that the association between adolescent vaping and subsequent smoking is causal and discounts evidence of the benefits of e-cigarettes in assisting smokers to quit. The Statement dismisses the evidence that vaping is probably already having a positive net public health effect, and misapplies the precautionary principle.”
A critique of the Australian National Health and Medical Research Council CEO statement on electronic cigarettes
Addiction
First published: 20 February 2023
Colin P. Mendelsohn, Wayne Hall, Ron Borland, Alex Wodak, Robert Beaglehole, Neal L. Benowitz, John Britton, Chris Bullen, Jean-François Etter, Ann McNeill, Nancy A. Rigotti
DECLARATION OF INTERESTS
C.P.M. was an unpaid board member of the Australian Tobacco Harm Reduction Association (ATHRA), a registered health promotion charity, from October 2017 to January 2021. ATHRA accepted unconditional seed funding from the vape retail industry to become established. Funding ceased in March 2019. C.P.M. was a Director of ATHRA in March 2018 when it received a donation from KAC Communications. The donation was sourced from a surplus arising from the Global Forum on Nicotine conference in May 2017... A.W. has been an unpaid board member of the Australian Tobacco Harm Reduction Association (ATHRA), a health promotion charity, since October 2017. ATHRA received unconditional funding for establishment costs from small Australian vape businesses. Vape industry funding has not been accepted since March 2019. A.W. was a Director of ATHRA in March 2018 when it received a donation from KAC Communications. The donation was sourced from a surplus arising from the Global Forum on Nicotine conference in May 2017…
https://onlinelibrary.wiley.com/doi/10.1111/add.16143
Note: Open Access.
“An overall mean of 22.7% of the samples (n = 13,804; males: n = 11,099; females: n = 2705) showed nicotine intake, with male samples also displaying higher positivity rates than female (24.1% vs 18.5%). Sample positivity was higher during 2012–2014 (25–33%) than 2015–2020 (15–20%). Samples from team sports displayed a higher positivity rate than those from individual sports (31.4 vs 14.1%)… WADA [World Anti-Doping Agency], international and national sports federations should consider these findings with concern, proactively investigate this phenomenon and act in order to protect the health and welfare of its athletes.”
Should We be Concerned with Nicotine in Sport? Analysis from 60,802 Doping Control Tests in Italy
Sports Medicine (2023)
Published: 24 February 2023
Thomas Zandonai, Francesco Botrè, Maria Gabriella Abate, Ana María Peiró & Toby Mündel
https://link.springer.com/article/10.1007/s40279-023-01819-y
Note: Open Access.
Related PR & coverage:
Study finds ‘alarming’ rates of nicotine in sport, says Brock researcher
Les sportifs, consommateurs insoupçonnés de nicotine [Athletes, unsuspecting consumers of nicotine]
https://www.ledevoir.com/societe/sante/785524/les-sportifs-consommateurs-insoupconnes-de-nicotine
“Earlier this week, the man who runs the vape shop took me through the new flavours he’d just got in, like I am a connoisseur of fine whisky. I’m not that. I am a silly little girl who likes her dummy [pacifier]. I have had my brain well and truly fried over the past nine months or so by vapes. Not the old-style vapes: unflavoured, nerdy-looking objects that were for a long time the preserve of morose ex-smokers… Until recently I liked to kid myself that at least vaping, unlike smoking, wasn’t damaging my health… Vapes might be better for you than smoking but this isn’t a great starting point. Anything that is addictive enough to have you shelling out hundreds of pounds a month against your better judgment can’t be good for society… Making these things pricier, or more difficult to get hold of, would make it easier [to quit]. Or maybe uglier, like cigarette packets are now, and not presented at eye-level in all their rainbow appeal in every corner shop and at every supermarket checkout.” [Imogen West-Knights. My vaping addiction came out of nowhere – and I’m finding it impossible to quit, The Guardian]
“America's vaping epidemic is being fueled by people who never smoked before — in more evidence the devices are not simply a cessation aid. The number of US adults who use the devices increased 16 percent from 2019 to 2021, according to a report by the American Cancer Society (ACS), from 8.8 to 10.2 percent of the population. But the rates among people who have never smoked traditional cigarettes are rising twice as fast. Over that three-year period, those numbers jumped 31 percent.” [, Daily Mail]
“E-cigarette use prevalence increased among younger adults between 2019 and 2021 (8.8%−10.2%, adjusted prevalence difference=1.7% points, 95% CI=0.1, 3.3), primarily owing to an increase among those who never smoked cigarettes (4.9%−6.4%, adjusted prevalence difference=1.7% points, 95% CI=0.3, 3.1). People who never smoked cigarettes constituted 53% (2.68 million) of younger adults who used E-cigarettes in 2021, increasing by 0.71 million from 2019… Conclusions: Efforts must address the rise in E-cigarette use among younger adults who never smoked cigarettes. At the same time, assistance is needed to help those who switched to E-cigarettes to stop smoking to transition to non-use of all products.”
Changes in E-Cigarette Use Among U.S. Adults, 2019–2021
American Journal of Preventive Medicine
Published: April 18, 2023
Priti Bandi, Jessica Star, Adair K. Minihan, Minal Patel, Nigar Nargis, Ahmedin Jemal
https://www.ajpmonline.org/article/S0749-3797(23)00122-8/fulltext
https://www.ajpmonline.org/action/showPdf?pii=S0749-3797%2823%2900122-8
Note: Open Access.
“Teenagers who smoke and vape are up to twice as likely to be heavy smokers by the time they leave school than those who only use tobacco, research suggests. Experts said using the devices to supplement cigarettes was more likely to 'entrench' tobacco use amongst adolescents… Researchers said it showed the devices, billed as quitting-aids for adult smokers, could be especially damaging among the young, adding that 'comprehensive steps must be taken to reduce adolescent access to e-cigarettes'… The findings come after the [UK] government announced free vape kits will be offered on the NHS [National Health Service] to help smokers to give up tobacco, in a world first.” [Kate Pickles. Vapes 'do NOT help young smokers ditch habit': Gadgets might actually 'entrench' cigarette use among kids, study claims, Daily Mail]
“Youth who smoked tobacco cigarettes by early adolescence (before age 15) were selected from the ongoing UK Millennium Cohort Study (n=1090) and the US Population Assessment of Tobacco and Health (n=803) study… Among youth who were early cigarette smokers, 57% of UK and 58% of US youth also used e-cigarettes. The odds of later adolescent smoking among early smoking youth were significantly higher among e-cigarette users relative to those who had not used e-cigarettes (adjusted OR (AOR UK)=1.45; AOR USA=2.19)… Conclusions: Despite national differences in e-cigarette regulation and marketing, there is evidence e-cigarette use among early adolescent smokers in the UK and USA leads to higher odds of any smoking and more frequent tobacco cigarette use later in adolescence.”
E-cigarette use among early adolescent tobacco cigarette smokers: testing the disruption and entrenchment hypotheses in two longitudinal cohorts
Tobacco Control Published Online First: 18 April 2023.
Brian C Kelly, Mike Vuolo, Jennifer Maggs, Jeremy Staff
https://tobaccocontrol.bmj.com/content/early/2023/03/20/tc-2022-057717
https://tobaccocontrol.bmj.com/content/tobaccocontrol/early/2023/03/20/tc-2022-057717.full.pdf
Note: Open Access.
Related coverage:
Research examines whether vaping can ‘entrench’ smoking habits in teenagers
E-Cigs in Early Adolescence Tied to Heavier Smoking Later On