Tobacco.org

Debate on public health - Our opinion: E-cigarettes pose risks  

All the public has to go on now is the word of the product's marketers. Before consumers inhale something that gives them "vapes" of highly addictive nicotine, they might want an independent authority testing the product to see what's in it.

But soon after the Food and Drug Administration tried to assert its authority over e-cigarettes by detaining some shipments at the border, two distributors sued, claiming that the FDA has no power to regulate the product as a drug-delivery device.

While both sides await a federal judge's ruling, e-cigarettes are on the market (kits with the e-cigarette and nicotine cartridges generally sell for $70 to $150). And contrary to the old adage, what you don't know can hurt you. Among the reasons to be wary:

— Most e-cigarettes are made in China . . .

— Despite protests from the Electronic Cigarette Association that its members don't make claims about helping smokers quit, plenty of sellers make far more outrageous health claims. In recent weeks, one marketer claimed e-cigarettes reduce the risk of heart disease and touted an endorsement by a physician-and-nurses group. Another website, which says it reviews e-cigarettes, went them one better: It claims, based on a 1942 study, that an ingredient in e-cigarettes could prevent flu and other respiratory diseases.

It is conceivable e-cigarettes might be a valuable tool for weaning some smokers away from a deadly habit. But without the testing and clinical trials opposed by marketers and their allies, no one will ever know.

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NRT Smoking Cessation Aids in the US - Chantix Sales Declined by 30% in the US in 2008  

Research and Markets (http://www.researchandmarkets.com/research/dbf721/nrt_smoking_cessat) has announced the addition of the "NRT Smoking Cessation Aids in the US" report to their offering.

NRT smoking cessation value declined for the second year in a row in 2008, although the drop was less dramatic than that of 2007. Declines in 2007 were driven by the huge popularity of Chantix, an Rx remedy launched by Pfizer in 2006, and the growing strength of private label smoking cessation products, most notably private label NRT lozenges, which were approved in 2006. Private label products continued to hamper value growth in 2008, as consumers looking to quit smoking opted for cheaper alternatives. However, the impact of Chantix on the OTC NRT sector was negligible, as Chantix sales actually declined by 30% in the US in 2008.

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Abstract: A Randomized Placebo-Controlled Clinical Trial of 5 Smoking Cessation Pharmacotherapies 

Results All pharmacotherapies differed from placebo when examined without protection for multiple comparisons (odds ratios, 1.63-2.34). With such protection, only the nicotine patch plus nicotine lozenge (odds ratio, 2.34, P < .001) produced significantly higher abstinence rates at 6-month postquit than did placebo.

Conclusion While the nicotine lozenge, bupropion, and bupropion plus lozenge produced effects that were comparable with those reported in previous research, the nicotine patch plus lozenge produced the greatest benefit relative to placebo for smoking cessation.

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Want to quit smoking? Switching to mild cigarettes will NOT improve your chances 

Smokers who swapped to low-tar cigarettes were less likely to successfully quit the habit

Smokers who hope to kick the habit by first switching to a low-tar or mild brand of cigarette may actually find it harder to quit, researchers said today.

They found that smokers who traded to light cigarettes were 50 per cent less likely to kick the habit.

'It may be that smokers think that a lighter brand is better for their health and is therefore an acceptable alternative to giving up completely,' said study author Dr Hilary Tindle from the University of Pittsburgh.

Her study of 31,000 smokers found that 12,000, or 38 per cent, had switched to a lighter brand.

Nearly half of these said they had switched brands because they wanted to smoke a less harmful cigarette and hoped to give up smoking completely.

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• Switching cigarettes may hinder smokers' attempts to quit  

What does this mean for me?

We don't know why people who switched cigarette types were less likely to succeed in quitting. The researchers suggest some possibilities:

* People who switched may have been more addicted to nicotine, so tried to cut down by switching first rather than simply trying to quit

* They may have used up their initial motivation by switching brands, and run out of enthusiasm to quit altogether

* They may have felt that quitting was less important, because they wrongly thought they were doing less damage to their health with the low-tar brand.

Overall, the study suggests that swapping types of cigarette doesn't help you give up smoking. The message seems to be that it's better to concentrate your energies on giving up, rather than worrying about the type of cigarette you smoke.

What should I do now?

If you want to give up smoking, contact your GP surgery. They can help you to quit. Alternatively, call the NHS Smoking Helpline on 0800 022 4332 to find out about stop smoking services in your area.

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MOHEN: Renewing an old addiction 

Envision five years from now teachers telling students not to vaporize tobacco.

However unlikely this scenario may seem now, vaporized cigarettes will become a well-known and warned-against product in the near future. . . .

Hardly any tests or evidence have been conducted on the smokeless cigarettes, establishing a strong caution amongst health officials of the product, but no regulation from the FDA.

With its increasing popularity, the FDA holds a responsibility to the American people to conduct greater research into the E-Cigarette and the true effects it has on users.

Strict regulations must be imposed on the device to prevent its trendy appeal from influencing the young and old alike who do not need to become hooked on such an equally, if not more, addictive version of the common cigarette.

According to a representative from ECigarettesChoice.com, Electronic Cigarettes are unavailable to minors across the country as they contain nicotine.

However, this does not mean kids and teens are unable to get their hands on the tobacco gadget.

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• New Study Reveals Quitting Smoking is Good but Switching to Low-risk Nicotine Products is Usually Better 

Prof. Carl V. Phillips, just published in Harm Reduction Journal, shows that for most smokers, immediately switching to a low-risk alternative will lower their risk of dying from their habit more than quitting eventually, even if they use the smoke-free product for the rest of their lives. . . .

Professor Phillips is an epidemiologist and health policy researcher, journal editor, popular educator, and consultant. He and his work group are leading advocates of tobacco harm reduction, and he advises and works with many other organizations who are trying to promote it, some of which are companies that hope to profit from selling low-risk nicotine products. The www.TobaccoHarmReduction.org research group at the University of Alberta School of Public Health is partially supported by an unrestricted (completely hands-off) grant from U.S. Smokeless Tobacco Company. No funder, company, or other organization played any role in initiating, designing, or conducting this research.

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• Switch to lights goes up in smoke  

SMOKERS who switch to low-tar cigarettes have half the chance of successfully quitting the habit.

A study of the smoking history of almost 31,000 US adults found that the odds of smokers managing to leave the habit behind them were 46 per cent lower if they had previously tried to switch to a "lighter" cigarette for any reason.

About 38 per cent of the sample, or 12,000 people, had switched in this way and 43 per cent of those said their reasons had included a wish to quit smoking altogether.

The study, published in the journal Tobacco Control, said although low-tar cigarettes made up about 84 per cent of the US market, the amount of harmful chemicals they delivered into the lungs was comparable to that from regular strength cigarettes. . . .

Simon Chapman, a professor of public health at the University of Sydney and a senior editor with the journal, said the popular belief that "mild" or "light" cigarettes were less harmful than other variants was "a complete myth".

"Smokers adjust the way in which they smoke the cigarette, in order to give them the dose of nicotine that their brain says they want," Professor Chapman said. "The tobacco industry would not put any product on the market that actually contributed towards a cessation of smoking."

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Patch Plus Lozenge Beats Other Stop Smoking Regimens  

Action Points

* Explain that after controlling for tighter P-values, the patch-plus-lozenge modality was the one of five treatments with significantly higher smoke-free abstinence rates after six months compared with placebo.

Out of five different smoking cessation modalities, the nicotine patch plus lozenges proved to be the most efficacious, researchers said.

After controlling for tighter P-values, the combination was the only modality with significantly higher smoke-free abstinence rates after six months compared with placebo, Megan E. Piper, PhD, of the University of Wisconsin School of Medicine and Public Health, Madison, and colleagues reported in the November issue of Archives of General Psychiatry.

The findings suggest that a "combination pharmacotherapy comprising the nicotine patch and an ad libitum nicotine replacement therapy should be routinely considered for use as a smoking cessation treatment," the researchers said.

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Nicotine patch plus lozenge appears best for smoking cessation 

In a comparison of five different smoking cessation medications, a nicotine patch plus a nicotine lozenge appears most effective at helping smokers quit, according to a report in the November issue of Archives of General Psychiatry, one of the JAMA/Archives journals.

"Many smokers have successfully quit using a variety of smoking cessation pharmacotherapies, yet there is little direct evidence on the relative efficacies of these different pharmacotherapies," the authors write as background information in the article. "Without such evidence clinicians and smokers lack a strong empirical basis for recommending or selecting among them."

Megan E. Piper, Ph.D., of the University of Wisconsin Center for Tobacco Research and Intervention, Madison, and colleagues conducted a randomized clinical trial of smoking cessation therapies involving 1,504 adults. All had smoked at least 10 cigarettes a day during the previous six months and were motivated to quit. Participants were randomly assigned to one of six treatment groups: nicotine lozenge alone, nicotine patch alone, bupropion alone, patch plus nicotine lozenge, bupropion plus nicotine lozenge or placebo. Bupropion treatment began one week before a designated quit date and continued for eight weeks; all other treatments were taken for eight to 12 weeks after the quit date. All participants also received six individual counseling sessions.

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• Nicotine Patch Plus Lozenge Best for Quitting Smoking  

first head-to-head comparison of different quit-smoking products finds that a nicotine patch combined with a nicotine lozenge had the most success.

More than other methods, including antidepressants, this combination best mimics the actual highs and lows of smoking to help smokers kick their habit, experts said.

"The study shows that, yes, one therapy came out on top, the patch and the lozenge [together]," said Dr. Jonathan H. Whiteson, co-director of the Joan and Joel Smilow Cardiopulmonary Rehabilitation and Prevention Center at NYU Langone Medical Center in New York City.

"The reasoning behind it is that the patch supplies a steady supply of nicotine replacement and the lozenges give a boost of nicotine which you can use when you have an extra craving. It gives people control," said Whiteson, who was not involved in the research.

"If you combine these different types of nicotine replacement you're going to get the best bang for your buck," added Megan E. Piper, lead author of the new study and an assistant professor at the Center for Tobacco Research and Intervention at the University of Wisconsin, Madison. "But also remember that in this study people got a lot of counseling. It was that combination that resulted in a 40 percent quit rate [at six months out]."

In fact, coupling the patch with the lozenge was the only intervention that performed better than a placebo, reported the study, which appears in the November issue of the Archives of General Psychiatry.

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What's the best way to quit smoking?  

Giving up cigarettes is no easy task, but smokers motivated to quit can make it easier by using a nicotine patch combined with a nicotine lozenge, gum or nasal spray, according to a new study.

Smoking cessation aides are known to be helpful, but there’s very little data on which products are most effective. Researchers from the University of Wisconsin School of Medicine and Public Health in Madison have filled in that gap with a head-to-head comparison of five different strategies. . . .

Their results, published in the November issue of Archives of General Psychiatry, found that all five treatments increased the odds of being a nonsmoker after six months. The benefits ranged from a 63% greater chance of staying smoke-free with bupropion (as compared with taking the placebo) all the way up to a 234% boost from the patch-plus-lozenge combination (compared with placebo).

When the treatments were compared directly with each other, only the patch-plus-lozenge regimen proved to be significantly better than any of the other approaches at helping users abstain from smoking for six months.

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A Developmental Twin Study of Church Attendance and Alcohol and Nicotine Consumption: A Model for Analyzing the Changing Impact of Genes and Environment  

Conclusions: As individuals mature, they increasingly shape their own social environment in large part as a result of their genetically influenced temperament. When individuals are younger and living at home, frequent church attendance reflects a range of familial and social-environmental influences that reduce levels of substance use. In adulthood, by contrast, high levels of church attendance largely index genetically influenced temperamental factors that are protective against substance use. Using genetically informative designs such as twin studies, it is possible to show that the causes of the relationship between social risk factors and substance use can change dramatically over development.

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22nd Century Continuing Development of its Smoking Cessation Aid; Independent Review of Clinical Trials Involving Very Low Nicotine Cigarettes is Encouraging  

22nd Century Limited, LLC ("22nd Century") is pleased to announce that it is continuing development of a very low nicotine cigarette for use in smoking cessation. Clinical trial results demonstrate that these cigarettes, also referred to as 'nicotine-free' and 'denicotinized,' may be more effective for quitting than FDA-approved therapies.

22nd Century's vice-president of research and development, Michael R. Moynihan, Ph.D. recently presented an overview of clinical investigations using very low nicotine (VLN) cigarettes in promoting smoking cessation in a presentation entitled, "Smoking with Reduced Reward as an Aid to Cessation" at the Visiongain 3rd Annual Smoking Cessation Conference in Philadelphia.

Separately, an independent review of using reduced-nicotine cigarettes as a smoking cessation aid will appear in the journal Nicotine & Tobacco Research. "Further investigation of RNCs as a cessation aid is warranted," concludes the authors, Drs. Natalie Walker and Chris Bullen of the Clinical Trials Research Unit, University of Auckland and Dr. Hayden McRobbie, Barts & The London School of Medicine and Dentistry, Queen Mary University of London.

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Ash Claims E Cigarettes Are "Relatively Harmless" 

It is another bizarre twist in the electronic cigarette battle over the safety of this new product that has hundreds of thousands of followers across the United States and a growing number of supporters around the world.

ASH UK has all but put their name on the dotted line in endorsement of the e cigarette as a safe and plausible substitute to the traditional tobacco cigarette with their new report and also agrees with the e cigarette industry that they may be an acceptable alternative to tobacco. . . .

While ASH does believe that e cigarettes may be a good alternative to tobacco, they have some concerns about the e cigarette and states "most deliver a low dose of nicotine which may not give a typical smoker a sufficient 'hit' to satisfy cravings, discouraging smokers from continuing to use them."

ASH UK does not seem to be worried about high doses of nicotine, but rather that the e cigarette does not deliver enough nicotine which is a direct contradiction of the American based ASH, which has been openly caught in a conflict of interest in its attack on e cigarettes in the United States by accepting funds from major pharmaceutical companies who may compete in an open market someday concerning cessation products.

http://www.ecigarettesnational.com is a full service retailer of the e cigarette.

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