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Nicotine In the News - Nicotine Science and Policy

Nicotine In the News

Nicotine in the News

Nicotine in the News is a new NSP column authored by Harry Shapiro.

Harry is Director of DrugWise an online drug information service and managing editor of DS Daily - an online news service on drugs, alcohol and tobacco. He is an author, journalist and lecturer who has written widely on the subject of drugs. He is the author of several books relating to drugs and popular music including Waiting for the Man: the story of drugs and popular music; Shooting Stars: drugs, Hollywood and the movies; Jimi Hendrix, Electric Gypsy; Eric Clapton: Lost in the Blues and Jack Bruce: Composing Himself : the Authorised Biography.

Harry’s blog 39: A future without fags?

An economic forecasting company has estimated that if smoking in the UK declines at the current rate, nobody will be smoking by around 2050. Frontier Economics predicts that:

1. Our central forecast is for the Government to meet its smoke-free target – to reduce smoking prevalence to 5% or below of England’s adult population – around 2040. This forecast is based on a continuation of current above-inflation excise increases and known regulatory interventions.

2.  If smoking then continued to decline at the same rate after 2040, it would reach 0% in around 2051.

3. Smoking is in long-run decline, but since 2012 it has declined at more than twice the rate seen between 1993 and 2011. Smokers switching to e-cigarettes appear to have made a material contribution to that recent trend.

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Harry’s blog 38: Another Brick in the Wall

My friend Ethan Nadelmann once told of a conversation he had with an officer from the US Drug Enforcement Administration. Ethan asked him if there was anything they could agree upon, any common ground across which a bridge could be built. The officer replied that the wall between their views was just too high for him to want to climb over and engage in meaningful dialogue.

On the strength of the latest example hot from the desk of the WHO, I fear that is where we are with this agency too. It almost seems pointless to continue berating the WHO over its intransigent opposition to safer nicotine products (SNP). At one level it is a bit like continually criticising the DEA for not supporting drug law reform. Except the DEA is a law enforcement agency; they have a remit to enforce the drug laws whatever they might be. They don’t have a mission to be concerned about the welfare of drug users – and they aren’t. But the WHO is supposed to be an agency with a ‘health for all’ remit, so the deliberate undermining of efforts to increase the availability of SNP is something that should be highlighted at every turn.

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Harry’s blog 37: Where is the right Mann/WoMann for the job?

Insightful read of the week award goes to a review of a new book on the AIDS pandemic in which the authors reveal how the leadership of the WHO failed miserably to save thousands of lives until redeemed by an administrator, Dr Jonathan Mann who did everything right from inaugurating World AIDS day to involving NGOs and fighting stigma and discrimination. Yet he felt he had to resign from WHO, frustrated that his boss was just putting every obstacle in his path. Mann tragically died in an air crash in 1998.

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Harry’s blog 36: WHO’s afraid of the Big Bad Wolf?

In May, the Icelandic pro-vaping coalition Veipum Lifum (VL) held a conference in Reykjavik. On their website, they included a link to the WHO FCTC as well as links to the Icelandic Parliament and an article in Icelandic media both of which also carried the WHO logo. On 18th August VL  received a letter from the legal unit of the WHO Regional Office for Europe threatening legal action stating that they had not given permission for the logo to be used especially as placing it on the VL website suggested that the WHO endorsed the use of e-cigarettes. The WHO demanded that the logo be removed not only from the VL website, but also from the other locations over which of course, VL had no control. The letter also said that examples of ‘misuse’ of the logo were attached which they were not.

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Harry’s blog 35 – Land of the Rising Sum

Cigarette smoking continues its rapid decline in Japan while the upward trajectory of smokers seeking alternative nicotine products shows no signs of slowing down. According to PMI a small percentage (calculated variously at between 5—15%) of their IQOS customers are dual users, but the rest have fully converted. The access to the market for companies like PMI afforded by the Japanese government plays a big part in this; advertising is seemingly allowed in any ways the imagination can conceive and is just as ubiquitous as the most aggressive cigarette advertising. Tobacco regulators around the world may choke on the vapour here, but the experience in Japan strongly suggests that putting obstacles in the way of e-cigarette and HNB marketing simply prolongs your cigarette problem.

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Harry`s Blog 34: WHO’s health is it anyway?

The heat and dust continues to swirl around the Foundation for a Smoke Free World https://www.smoke-freeworld.org/leadership.

Whether the negativity continues will very much depend on what it actually does, although suspicion will always dog its tracks no doubt. The WHO have weighed in with a statement urging all governments and public health bodies to steer clear and refuse any collaboration: https://www.cnbc.com/2017/09/28/who-tells-governments-to-reject-philip-morris-funded-smoking-foundation.html

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Harry`s Blog 33: Evidence and the long grass

As you can see, this is blog number 33 and so I hope I am not repeating this little anecdote, even though it does bear repeating.

There used to be a BBC TV political comedy called Yes Minister in which the senior civil servant Sir Humphrey Appleby was consistently trying to derail any initiative by his Minister Jim Hacker, which might not be in the interests of the civil service. One failsafe tactic, should the Minister suddenly announce such a move, would be for Sir Humphrey to say, ‘That’s a very brave decision, Minister’ At which point Hacker would turn pale and instantly drop the idea. Because no politician who is actually in power wants to be regarded as ‘brave’ as that invariably means a risky enterprise which could end in the sack, reshuffled to some low-level post, a loss of votes or even the loss of a parliamentary seat entirely.

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Harry`s Blog 31: Very low nicotine cigarettes or shit without the hit

Harry Shapiro Director DrugWise

There is a new Holy Grail within the world of tobacco control – the reduced nicotine cigarette which proponents claim will make cigarettes so unattractive that smoking tobacco will be eliminated. This was the thrust of a recent commentary from Scott Gottlieb and Mitch Zeller in the New England Journal of Medicine http://www.nejm.org/doi/full/10.1056/NEJMp1707409#t=article and is likely to become a major tobacco control policy goal internationally. Scientific evidence is being presented that this works; the Gottlieb commentary cited the FDA-funded study by Eric Donny which has been challenged by Dr Brad Rodhu. No doubt ‘methodologies at dawn’ will be played out in the medical press in the coming months.

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Harry`s Blog 32: Solid foundation, or castle made of sand?

Harry Shapiro Director DrugWise

No guesses as to the big story of the moment – the announcement that PMI are funding a Foundation for a Smoke-Free World to the tune of $80 million annually over the next twelve years. The interim president is Dr Derek Yach, former WHO director for noncommunicable diseases and mental health where he led the development of the Framework Convention on Tobacco Control. Eyebrows have shot skywards at this appointment leading to inevitable claims that Dr Yach has been won over to the Dark Side.

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Nicotine in the News - 28 August

Harry Shapiro Director DrugWise

Two contrasting items this week about the idea that celebrities who are either seen to be endorsing drug use or actively campaigning against it, have any influence on decision-making among young people.

The first is an opinion piece by Guy Bentley in the Washington Examiner about the continuing controversy over movie stars smoking on-screen. It was prompted by this report, which showed the use or implied use of tobacco in top-grossing movies rose 72 percent from 2010 to 2016. In PG-13 movies these "tobacco incidents" rose 43 percent, and there was a 90 percent increase for R-rated movies. The researchers included e-cigarettes in their category of tobacco incidents, despite the total lack of tobacco in an e-cigarette. It will therefore come as no shock that one of the authors of this report was one S. Glantz and Bentley goes on to describe why this kind of causal relationship research is deeply flawed.

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Nicotine in the News - 15 August

Harry Shapiro Director DrugWise

The Washington Post has published a letter from the vice chair of the American Thoracic Society’s Tobacco Action Committee attacking the FDA for its more neutral position on new nicotine technologies, accusing the agency of promoting a switch from one addiction to another, underlining an ideological trope that lies at the heart of much of the response from many national and international so-called ‘health’ agencies.

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Nicotine in the News - 7 August

Harry Shapiro Director DrugWise

There has been much hum on the wires about the FDA seeming to put reduced nicotine cigarettes (or Very Low Nicotine Content -  VLNC) front and centre of its revised tobacco control strategy. Invariably there are arguments for and against. So here is my brief take on the debate.

VLNC advocates argue that a VLNC will stimulate quitting because the cigarette will not be delivering its essential ingredient – nicotine. There is a hope too that if young people take up VLNC cigarettes, they are less likely to become lifetime smokers again because the product will not be satisfying. And VLNC may be a pathway to quitting perhaps in the same way that moving heroin users onto methadone and then gradually reducing the dose of methadone does help some people become free of drug use altogether.

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Nicotine in the News - 31 July

Harry Shapiro Director DrugWise

Tobacco harm reduction is on a roll right now – and I don’t mean a roll-up. Let me count the ways.

The big one of course is the announcement by Scott Gottlieb on the FDA’s revised approach to THR. Here is the full FDA news release

https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm568923.htm

The FDA has shifted to a more neutral position on e-cigarettes and similar products through a recognition of the role that THR plays in reducing the harms of using nicotine via cigarettes. It is saying that adults who want or need nicotine can get it from much lower risk products; that there will be rules and standards for e-cigarettes; that the Center for Tobacco Products will reconsider aspects of deeming of reduced risk products while pushing back the compliance period for e-cigarettes from 2018 to 2022.

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Nicotine in the News - 24 July

Harry Shapiro Director DrugWise

Since attending the 2016 GFN Conference in Warsaw, I have heard all sorts of dark tales about the Framework Convention on Tobacco Control (FCTC), the Framework Convention Alliance (FCA) and the Conference of the Parties (COP). The FCTC adopted by the 56th World Health Assembly held in Geneva, Switzerland on 21 May 2003 came into force in 2005 and seeks "to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke”. The FCA is an international civil society consortium of around 500 organisations, mainly NGOs who act to support the maintenance and development of the FCTC. The COP is an annual gathering of FCTC signatories, the FCA and other observers.

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Nicotine in the News - 17 July

Harry Shapiro Director DrugWise

This week some further reflections on the links between drug and tobacco harm reduction.

There are many interventions from a public health or health and safety perspective that could be called harm reduction – seat belts, crash helmets, speed limits, safer drinking levels, smoking bans. But as Ethan Nadelmann was at pains to point out at the GFN conference, harm reduction is not just another name for public health or health and safety. It sits at the intersection between public health on the one hand – and human rights and civil liberties on the other.

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Nicotine in the News - 11 July

Harry Shapiro Director DrugWise

GFN 2017 – report of the rapporteur Harry Shapiro

Being a conference rapporteur is not like taking minutes; it is more impressionistic, trying to pick up threads and themes, getting a feel for the event - and of course, listening in to private conversations. 

It would be hard not to start with Ethan Nadelmann’s impassioned Michael Russell Oration. I’m not going to try and summarise what he said, because you can visit the GFN site to view all the marvellous videos shot and edited by one of the unsung heroes of GFN conferences, Jon Derricott.

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Nicotine in the News - 3 July

Harry Shapiro Director DrugWise

A meta-analysis published in the Journal of the American Medical Association received widespread publicity as it purported to demonstrate an ‘association’ between teen vaping and later smoking. http://jamanetwork.com/journals/jamapediatrics/fullarticle/2634377

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Nicotine in the News - 26 June

Harry Shapiro Director DrugWise

For those of you fortunate enough to be there, I hope you enjoyed the Warsaw GFN conference as much as I did. There was a very rich and diverse mix of science, technology, law, public policy, health and advocacy. Something for everyone in an excellent venue where all the logistics ran with quiet efficiency.

My contribution as conference rapporteur will be published later, but here are just a few headline thoughts.

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Nicotine in the News - 12 June

Harry Shapiro Director DrugWise

Well, not quite ‘in the News’ more my news – or rather vignettes from an ordinary life that have wider implications.
I was sitting outside a café with my wife and the guy on the next table was ‘enthusiastically’ vaping. ‘I hope that’s not toxic’ said my wife as the vapour wafted our way.’ So I put her right on that one and then she said ‘Mind you, it smells quite nice’.

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Nicotine in the News - 6 June

Harry Shapiro Director DrugWise

As I’m writing this, more news is emerging about the terrorist attack in London Bridge, an area I know well having worked round there for many years, often shopped in Borough Market and frequented the cafes and restaurants in the area. So my mood is not what you would call bright, but even so I thought I’d start this week’s missive with an amusing slot about the vagaries (or should that be vaparies?) of Australia’s e-cig laws.

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Nicotine Science and Policy posts news items on a wide range of issues related to the use of nicotine and posting of a news item does not imply endorsement of the views expressed in any item.